{"_id":"000debd9-d4ae-ad42-ed5c-da98ebf1dffd","text":"Physiotherapy rehabilitation following posterior cervical spine decompression and fusion surgery for cervical disc disease has been proven to be beneficial in restoring ROM, muscular strength of bilateral upper limbs, reducing pain, and helping the patient get back to performing ADLs independently. In our report, the cervical ROM of the patient was improved by performing a range of motion and stabilization exercises for the cervical joint. Adhesions and scar tissue began to relax without any pain at the suture site, and the soft tissue around his cervical and thoracic spine became more mobile. We believe this effect is brought on by the smaller stabilizing muscles because of their ability to directly stabilize the vertebral segments and reduce undue strain or stress on the intervertebral disc, which is important for stability in the cervical spine.","title":"Effectiveness of Multicentric Therapy Post Posterior Cervical Decompression and Fusion for Cervical Disc Disease: A Case Report"}
{"_id":"000df439-5a04-d698-69b5-cc8dfb90ff56","text":"Another factor to be considered is the possibility of anatomical variants in dogs. Recognition of anatomical variants and detailed knowledge of the areas in which entrapment is most likely to occur enhances the accuracy of imaging evaluation. To the best of our knowledge, there are no studies in dogs investigating the anatomical variants within the sciatic nerve. Ultrasound examination was performed under the assumption that there were no such variants in the dog. No anatomical variants were found in the canine patients of this study.","title":"Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis"}
{"_id":"001c352a-16ca-7dbb-e5d7-4d1e1102db1b","text":"The diagnosis of NLD obstruction was confirmed by the ophthalmologist by probing and irrigation and the exclusion of the other eye disease that may result in similar symptoms. After removal of the DCR tube, success was defined as the achievement of patency of the NLD throughout the period of follow up as confirmed by probing and irrigation. Furthermore, the patient reporting the disappearance of epiphora. The recurrence of NLD obstruction was documented when the patient reported epiphora again with the ophthalmologist verifying obstruction of the NLD by probing and irrigation. Endoscopic DCR was performed in all patients with the collaboration between an ENT surgeon and an ophthalmologist at the hospital.","title":"Endoscopic dacryocystorhinostomy: A comparison of double-flap and single-flap techniques"}
{"_id":"00234478-aee4-8875-8711-2c91c34e06d7","text":"The aim of this study was to develop a technology for the in vitro evolution of allergens with a native-like structure for a maintained immunogenicity and treatment efficacy, but with reduced IgE-binding and T cell activation for reduction of immediate and late phase side effects during allergen-specific immunotherapy. Numerous studies have demonstrated sensitization to allergens as a risk factor for the development of allergy and asthma. In more severe cases, asthma is a chronic condition without curative therapeutic options. An alternative rarely considered for this group of patients is alleviation of allergic and asthmatic symptoms by SIT. One of the reasons for the restricted use of SIT in the treatment of extrinsic allergic asthma is the risk of adverse reactions which even may have a fatal outcome [37].","title":"In Vitro Evolution of Allergy Vaccine Candidates, with Maintained Structure, but Reduced B Cell and T Cell Activation Capacity"}
{"_id":"0023a54c-504c-4605-9f8b-ba63896333b3","text":"Routine clinical care included patient education with all patients instructed to contact the center in case of signs or symptoms of recurrence. After the diagnosis of acute DVT, annual controls were scheduled and patients contacted on the same day if they missed the visit. Routine ultrasound examination of the whole leg was performed at the time of DVT diagnosis, upon anticoagulant discontinuation as a baseline reference allowing future comparisons in case of suspected recurrent events, during follow-up visits, and on suspicion of recurrence.","title":"Recurrence Risk after First Symptomatic Distal versus Proximal Deep Vein Thrombosis According to Baseline Risk Factors"}
{"_id":"0024eebf-2519-8ef9-3fdd-18e5b546d726","text":"Skin tumors are on the rise in the Nepalese community. The different morphological pattern of skin tumors requires its meticulous categorization for understanding its effect on prognosis and treatment. Our study aimed at studying the prevalence of skin tumors among the skin biopsies performed in the dermatology outpatient department in a tertiary care hospital of Nepal.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"00263913-8657-fa08-18a1-b8dcfec5080d","text":"A Cohort study was done by Sreedharan Namboothiri in 2012 where a prospective evaluation of 121 patients who underwent major spine surgeries was conducted to find the incidence of only clinically identifiable Deep Venous Thrombosis. The incidence of Deep Venous Thrombosis was only 0.78% and did not show statistically significant correlation between incidence of Deep Venous Thrombosis and spine surgery.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"0026e7a6-b9a6-4e70-edbd-e281e0b90542","text":"In conclusion, teriparatide appears to be useful for treating tumoral calcinosis in the presence of adynamic bone disease. Hypocalcemia can occur in the initial months of therapy. More studies are needed regarding the effectiveness and safety of this drug in treating tumoral calcinosis.","title":"Treatment of Severe Tumoral Calcinosis with Teriparatide in a Dialysis Patient after Total Parathyroidectomy"}
{"_id":"002afd69-93e3-e42a-e097-d0a0d744570e","text":"Local perforator flaps should be considered as one of the primary treatment options for post burn reconstruction.","title":"Use of Local Perforator Flaps for Post Burn Reconstruction"}
{"_id":"00315c6c-8fe9-b52d-7afa-3c21bdf09a1c","text":"We evaluated the clinical outcomes of free flaps created with large-to-small venous anastomosis using the MPETS technique in soft tissue defects of the extremities. Because of the limited availability of reliable and suitably sized veins for free flap surgery for the repair of soft tissue defects caused by severe trauma or infection, it is important to deal properly with vessel size discrepancy between the recipient and flap veins. The MPETS technique is simple, reliable, and useful for performing various types of venous anastomoses, regardless of vessel size discrepancy and the presence of a venous valve. This technique may be a good option for venous anastomosis with vessel size discrepancy between a small recipient vein and a large flap vein.","title":"Efficacy of the microscopic parachute end-to-side technique for creating large-to-small venous anastomoses in free flaps in the extremities"}
{"_id":"003987e0-62fd-9d8b-66dc-f2e40dd0efdb","text":"All patients had already taken and tolerated the culprit drug before their clinical symptoms manifested.","title":"The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults"}
{"_id":"0040108e-a48c-3d45-ec72-70194989770f","text":"The patient is a 60-year-old man with a history of T4 paraplegia for 21 years from a boating accident. He had not undergone any previous flap surgeries for coverage of his pressure sores. He had exposure of his right posterior iliac wing and the posterior portion of his right hip along with small pressure sores on the left ischium. Three weeks after a colostomy, the patient underwent debridement of all of his wounds, resulting in a defect that measured about 650 cm2, requiring a right total leg fillet flap for coverage. He lost an estimated 1 L of blood and got transfused with 2 units of packed red blood cells. The flap healed well without complication with follow-up lasting 6 years.","title":"Pedicled Fillet of Leg Flap for Extensive Pressure Sore Coverage"}
{"_id":"0041dbd0-dae2-8fc1-67c1-c8bba2892625","text":"Seven patients were positive for circulating tumour cells both prior to and after surgery, 4 patients were positive prior to but not after surgery, 3 patients were positive after but not prior to surgery and 2 patients were negative. Two patients tested positive for circulating cells but there was no other evidence of tumor spread. Given this patient cohort had mostly advanced disease, as expected the detection of circulating tumour cells was not associated with significant differences in overall or disease free survival.","title":"Long term survival following the detection of circulating tumour cells in head and neck squamous cell carcinoma"}
{"_id":"004aca01-8464-5056-0df3-7664229b18d4","text":"SWTC are also critically needed to participate in efforts for sustainable development and systems strengthening. There is an opportunity for surgeons to apply for and administer grants focused on development and capacity building; to create enduring programs and partnerships that enable SWTC to leverage their collective abilities and energies to address critical priorities; and to otherwise offer their own time, knowledge, and skills to enhance capacity in areas of great need. These efforts should focus on collaborative approaches to addressing needs as perceived by all relevant stakeholders, while minimizing waste and disruption and maximizing sustained benefit. The pitfalls of short-term volunteerism and of projects or programs implemented without adequate stakeholder input should be considered and avoided. Multiple examples exist of bilateral or multilateral international partnerships and programs that have had enduring effect; where these have achieved success and contributed sustained benefit, there is an opportunity for SWTC to emulate and expand. Within these efforts, it must be recognized that there is tremendous diversity and heterogeneity in epidemiology and resource allocation not only among countries but sometimes within countries such as India where incidence rates and treatment options vary between regions; strengthening initiatives will need to be context-specific but informed by unified guiding principles.","title":"A Review of the Current State of Global Surgical Oncology and the Role of Surgeons Who Treat Cancer: Our Profession’s Imperative to Act Upon a Worldwide Crisis in Evolution"}
{"_id":"004b3b5c-c2d5-129d-0766-f4d089e69d99","text":"What do you think is most important for the team to work well together?","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"00559506-a0da-5c5d-817f-847f285f158b","text":"Effective treatment with imiquimod is dependent upon tissue penetration. sBCC may be more amenable to topical treatments as a result of their minimal depth of invasion. The increased depth of nodular tumours results in incomplete tumour penetration with the drug and hence lower clearance rates.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"005af640-1b44-e3a6-0612-294f7ea0c9cf","text":"Although diversification of academic medical leadership has been proposed as a potential solution to the lack of minority and female representation in medicine, there have been limited studies exploring this topic. Results of our cross-sectional analysis suggest that when compared with faculty in 2019, only program directors in family medicine had greater minority representation than their faculty counterpart, which was primarily caused by the greater proportion of Asian Americans. However, the majority of chairperson and program director analyses of minority and female representation for each specialty showed decreased diversity when compared with faculty in 2019, specifically in the categories of Asian American and other. Although some specialties demonstrated significant increases in minority or female chairperson representation from 2007 to 2019, all specialties displayed significantly lower racial, ethnic, and gender diversity among chairpersons in 2019 when compared with faculty in 2019, with the exception of ENT. These data suggest that, although there have been some gains across various specialties in terms of leadership diversification, there is still a decrease in minority and gender diversity when advancing from faculty to leadership positions in academic medicine.","title":"Racial, Ethnic, and Sex Diversity in Academic Medical Leadership Racial, Ethnic, and Sex Diversity in Academic Medical Leadership"}
{"_id":"005d1168-c083-c6db-e155-c5eb4c148d02","text":"In the rivaroxaban group there were 44 patients who took the drug for up to 90 days of observation period. There was an incidence of DVT in the rivaroxaban group on the 27th day of observation. The study drug with a prophylactic dose of thrombosis was then changed to a therapeutic dose, so that in the rivaroxaban group there were 43 study subjects without DVT events.","title":"The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy"}
{"_id":"00660532-cb96-f855-17e6-9663051a856a","text":"Biopsy site infection in the setting of osteosarcoma is a challenging problem with limited treatment recommendations examined in the literature. In our case, a 16-year-old patient with a biopsy site infection was successfully treated with a combination of local excision of the infected area and antibiotic therapy throughout the duration of her chemotherapy course. This resulted in eradication of the infection and a relatively uncomplicated course. We think that for osteosarcoma, continuing antibiotics for the duration of chemotherapy may represent an approach to biopsy site infections that may minimize the risk of deep periprosthetic infection. Additional investigation into this protocol and antibiotic choice is warranted.","title":"The Management of an Open Biopsy Tract Site Infection and Ulceration in the Setting of Osteosarcoma"}
{"_id":"00666928-27ed-10a7-71d7-084f05525a8f","text":"The fillers are silanized FAS fillers and silanized nonreactive fillers that are able to bond with the resin matrix and play a role in the wear resistance and esthetics of the material.","title":"Commercially Available Fluoride-Releasing Restorative Materials: A Review and a Proposal for Classification"}
{"_id":"006fb2e7-f553-ceab-0291-42a964c26730","text":"The review explores the use of LIBS as a potential technique for the depth profiling of tumors during Mohs micrographic surgery. The potential of real-time diagnosis of tumor margins and defining the extent of tumors could be a time-saving approach when used with the conventional Mohs micrographic surgery. However, it is not limitations free. The major limitation is the requirement of a LIBS probe which could go deep inside, as it would be difficult to assess samples with thickness more than 20 mm. There will also be the requirement for a probe which could collect spectral data in the horizontal plane, as these tumors don’t strictly go deep inside but also have side branches in the horizontal plane.","title":"Exploring Laser-Induced Breakdown Spectroscopy as a Potential Tool in Mohs Micrography: A Mini Review"}
{"_id":"0071062c-4059-d2aa-6d02-dd58b9f50972","text":"With little or no formal training in medical school or residency, physicians today are often unprepared for their leadership roles within large interdisciplinary healthcare teams., These leadership roles range from leading individual patients to larger interdisciplinary organizations. Physicians are expected to lead effectively based on the assumption that the skills that made them successful as a physician will naturally transfer into success as a leader. Although this may be true for some physicians, it may not always be the case. Recognizing that many physicians lack the necessary leadership skills, healthcare organizations continue to fill many core leadership positions with skilled non-physician leaders.","title":"Improving medical leadership education through the Feagin leadership program"}
{"_id":"00841950-276f-3122-5170-c3c83d42ffa3","text":"Our estimates of seasonality in VTE occurrence are contingent on the validity of diagnoses in the DNPR. Of note, a validation study found positive predictive values of 86 and 90% for diagnoses of first-time deep vein thrombosis and pulmonary embolism. 34 The diagnosis of retinal vein thrombosis in the DNPR is assumed to have high validity because almost all patients are diagnosed at ophthalmologic departments. 35 While the splanchnic vein thrombosis and cerebral vein thrombosis diagnoses in the DNPR have not yet been validated, most splanchnic vein thrombosis diagnoses are based on an ultrasound examination or a computed tomography scan, 36 and it is unlikely that the validity of the cerebral vein thrombosis diagnosis diverges greatly from that of other VTE diagnoses.","title":"Venous Thromboembolism in Denmark: Seasonality in Occurrence and Mortality"}
{"_id":"00877e6e-9c2f-0799-69e1-bc820ab14f1d","text":"We found that the HATLFF has a high reliability in a study of infants with tongue-tie and control infants","title":"Reliability of the Hazelbaker Assessment Tool for Lingual Frenulum Function"}
{"_id":"008d4ede-d475-fa87-442a-9ec4bd6614fb","text":"Histopathological examination is the gold standard for accurate diagnosis and prognostic assessment of the patient. Staging of the malignant tumors in excision biopsy specimen needs to be emphasized since it is a predictor of prognosis.","title":"Histomorphologic Profile of Skin Tumors"}
{"_id":"0098ede2-27de-1139-a262-7e4abeb39b05","text":"The postoperative ICG lymphographic images and lymphangiograms of the live dogs in our study showed that lymphatic vessels in the obstructed territory connected to the lymph nodes in adjacent territories and spontaneous lymphaticovenous shunt. These collaterals are thought to act as bypasses to prevent manifestation of lymphedema and new metastatic pathways of residual cancer. The timing of the collateral formation in our study was uncertain, but the reduction of limb size suggests that this process occurred within 3 weeks after the surgical obstruction of the vessels. The capillary-like network played a key role to form the collaterals and this may develop together with scar formation.","title":"Lymphatic Territories (Lymphosomes) in a Canine: An Animal Model for Investigation of Postoperative Lymphatic Alterations"}
{"_id":"0099fa1e-0800-5507-2893-1cdcb339cea2","text":"All patients included in this study underwent serological testing for total IgE and serum tryptase levels as well as Api m1, Api m3 and Api m10 bee venom allergens and showed IgE-mediated sensitization to bee venom.","title":"Anaphylactic reactions in the build-up phase of rush immunotherapy for bee venom allergy in pediatric patients: a single-center experience"}
{"_id":"009a52a9-27bb-307c-68f4-d48014eb5c01","text":"The phenomenon means movements between expectations from oneself and others in being and in becoming a “fulfilled” mother, thus managing both the new role and the feelings of failure and despair when not being capable of nursing\/feeding or satisfying the child. This is given expressions like wavering between powerlessness and joy. The close ties envisioned during pregnancy are put at stake regarding expectations of the managing role of being a nourishing mother and the challenges related to nursing and feeding the child in the complex breastfeeding situations described because expectations are both fulfilled and come to naught. Complications arise when the infant refuses to take the breast, when it hurts too much because of functional difficulties, or when the child cannot retain the milk because of anatomic disabilities.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"009d78d4-ea15-afcc-e319-627f83243cae","text":"Additionally, we expect a degree of reporting bias (through both non-publication of studies and selective reporting of outcomes) which may affect this systematic review. There is clearly a potential conflict of interest in terms of reporting one’s own incidence of incomplete excision which may affect funding from national bodies or cause patients to seek a different specialist in a private system. Authors will likely have less drive to publish data on a ‘bad’ audit cycle or may not report specific outcomes of interest like the incomplete excision rate which could bias the results. We hope to minimise this through contact authors for missing details and identifying publication bias using a funnel plot.","title":"Global incidence of incomplete surgical excision in adult patients with non-melanoma skin cancer: study protocol for a systematic review and meta-analysis of observational studies"}
{"_id":"00a8e71b-7c23-12fc-e901-f5f4d8269fb2","text":"The action of a correct photodynamic therapy is based on a maximum diffusion of the photosensitizing agent within the micro-anatomies of the endodontic system, but a certain amount of oxygen is required, as well as a light source with a certain wavelength and intensity, that must arrive in the areas where the photosensitizer is present.","title":"5-Aminolevulinic Acid and Red Led in Endodontics: A Narrative Review and Case Report"}
{"_id":"00ac152d-3937-041b-7dc9-91a663206eec","text":"Ultrasound contrast is based on the conventional color Doppler ultrasound, which has more advantages in revealing the blood perfusion information of tumors.18 It is different from color Doppler examination as it is not affected by breathing, movement and angle and can display small vessels with diameter less than 200 μm. Therefore, it can display the blood supply around and inside lesions, especially the small vessels with low velocity and also show the intensity of perfusion in different areas of the lesion and the sequence of perfusion and regression.19 Contrast agent can effectively enhance two-dimensional ultrasound image and Doppler flow signal through its strong scattering effect in blood flow to fully display the blood flow signal in lesions, including small blood vessels in tumors, low velocity blood flow or blood flow distribution in the deep part of the tumor and accurately evaluate the blood vessels in the tumor. It overcomes the influence of the size and depth of tumors on the blood flow display rate, achieves the purpose of differential diagnosis, abd improves the accuracy of tumor diagnosis.20","title":"Application Value of Color Doppler Ultrasound and Ultrasound Contrast in the Differential Diagnosis of Ovarian tumor"}
{"_id":"00bc836a-c65a-36b1-4939-8d03e5f8dc94","text":"We report a case of an oesophageal carcinoma with an azygos vein continuation of the IVC. In this case, the azygos vein required protection, and the surgical procedure necessitated a veno-venous bypass between the left femoral vein and the jugular vein to guarantee an adequate venous return in the event that the azygos vein was injured.","title":"Oesophagectomy in a patient with azygos vein continuation of the inferior vena cava: report of a case"}
{"_id":"00c0f127-0f30-e319-deb1-085119feb374","text":"The initial interviews were no more than one hour in length. Participants were provided the opportunity to review the questions before the scheduled interview session.","title":"Women’s Perspective of Breast Self-examination"}
{"_id":"00c1ad5f-f391-d581-86a4-fd066c8ade45","text":"Table 5 Multivariate analysis using demographics, comorbidities and surgical factors found to be significant on univariate analysis","title":"Chemoprophylaxis in addition to mechanical prophylaxis after total knee arthroplasty surgery does not reduce the incidence of venous thromboembolism"}
{"_id":"00c2a99d-2eaf-8199-ded6-aaea95fb3537","text":"A third of new cases of breast cancer could be detected early, which would prevent more serious consequences, such as mastectomy and death. Access to the subjectivity of mastectomized patients becomes relevant to elucidate failures in early detection of breast cancer and thus improve the cancer care network. Given that, the present study aimed to identify mastectomized women’s perception of the quality of care provided by the cancer care network for the early detection and diagnosis of breast cancer.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"00c49a00-d9d8-6dfb-1335-10bfeede1662","text":"This study suggests an increased risk for breast cancer recurrence in women receiving a delayed DIEP flap reconstruction. However, the results should be interpreted carefully due to potential selection bias and the limitations inherent to its retrospective design. Further research with a larger sample size is needed to elaborate on the findings of this study and to provide recommendations for clinical practice.","title":"The difference in local, regional and distant breast cancer recurrence between the immediate and delayed DIEP flap procedure; a retrospective cohort study"}
{"_id":"00c9ebf7-8d71-97cf-266d-c7b2ff6fabb2","text":"Malignant melanoma of the vagina is very rare tumor so it is necessary to requires the integration of further cases.","title":"Concomitant sentinel lymph node biopsy leading to abbreviated systematic lymphadenectomy in a patient with primary malignant melanoma of the vagina"}
{"_id":"00ce640e-6456-7eb5-125b-edc3ea56a586","text":"There is currently no gold standard for the type of analgesia or preferred circumcision technique in infants requiring circumcision after 1 month of age. Our study presents a modified Plastibell circumcision technique, which offers excellent surgical outcomes, and can be performed under local anesthesia until 6 months of age, thereby avoiding the risks of general anesthesia in delayed circumcision.","title":"Avoidance of general anesthesia for circumcision in infants under 6 months of age using a modified Plastibell technique"}
{"_id":"00d12387-ea12-da7b-9631-4c65dd501bee","text":"In a patient suffering from a heminasal defect, the paramedian forehead flap is considered the gold standard of treatment.2 There is no other flap that can precisely match both color and texture and simulate what we perceive to be normal. This is a reliable and versatile flap that possesses a robust vascular supply, rich in collaterals based primarily on the supratrochlear artery and supraorbital plexus.3 The flap is generally designed contralateral to the defect to allow minimal kinking at the pivot point.4 The surgeon must be prepared to deal with complications such as poor donor site healing, flap necrosis, hematoma formation, impaired nasal function, as well as a poor aesthetic outcome.1 In this case, performing an ipsilateral paramedian forehead flap reconstruction would have allowed us to perform a contralateral flap reconstruction after the initial reconstruction flap was divided. Performing a contralateral flap reconstruction damaged critical blood vessels necessary for a subsequent ipsilateral flap.","title":"Reconstruction of a Nasal Defect With a Radial Forearm Flap Following Trauma of a Paramedian Forehead Flap"}
{"_id":"00d21061-cb37-2607-e467-5ee136ce31f5","text":"Lymphadenectomy of the lymphatic draining field beyond positive-IN testify has proved to be a safe procedure that may improve prognosis in melanoma patients with tumor-positive INs. The better prognosis of patients with tumor-positive INs undergoing lymphadenectomy may be justified by the earlier treatment of lymphatic metastases. Further multicentric comparative studies are needed to evaluate possible impact of this procedure on prognosis of melanoma patients.","title":"Surgical management of tumor-positive interval node in melanoma patients An observational study"}
{"_id":"00e38106-d9b2-ea98-c9a3-2a93bc7825c0","text":"The changes in the gingival height after each one of the retraction methods.","title":"A Comparative Analysis of Post-Retraction Changes in Gingival Height after Conventional and Surgical Gingival Displacement: Rotary Curettage, Diode and Er:YAG Laser Troughing"}
{"_id":"00e5f0e9-306b-b4e0-70a9-17dc6c9ab336","text":"Even though internal fixation has expanded the indications for cervical spine surgery, it carries the risks of fracture or migration, with associated potential life threatening complications. Removal of metal work from the cervical spine is required in case of failure of internal fixation, but it can become challenging, especially when a great amount of scar tissue is present because of previous surgery and radiotherapy.","title":"Screw migration and oesophageal perforation after surgery for osteosarcoma of the cervical spine"}
{"_id":"00e969ed-98e1-70ee-0a5e-49e57a3da20e","text":"The purpose of this systematic review is to determine the optimal methods of disinfection of musculoskeletal tissue following recovery to minimize the risk of disease transmission while maintaining the structure and function of the tissue for its intended use.","title":"Disinfection of human musculoskeletal allografts in tissue banking: a systematic review"}
{"_id":"00f84047-2309-d156-9fd2-c04cb174e606","text":"Ensure the patient receives an epinephrine auto-injector and is instructed on its use","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"00f85174-c7ef-d92b-a05e-4ddc6c2073b9","text":"When there were several articles with similar contents and data, we choosed the article with most detailed information for our analysis. No limitation of minimum sample sizes were set for exclusion criteria in this analysis. The debate were resolved by discussion of authors.","title":"Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis"}
{"_id":"00fd106f-a561-9967-0896-91f61531ccc4","text":"This study retrospectively analyzed the application of the no-touch technique in off-pump bypass surgery with sequential vein grafts. The results indicate that this method is safe and effective. We compared the patency rate and MACCEs for sequential vein grafts harvested by the NT technique and conventional technique 1 year after the operation. The results showed that there was no significant difference between the two groups, suggesting that the use of sequential vein grafts harvested by the NT method in off-pump bypass is reasonable.","title":"No-Touch Sequential Saphenous Venous Harvesting Technique in Off-Pump Bypass Surgery: A Retrospective Study"}
{"_id":"010495da-fff1-87a2-6692-92d9e1d9295e","text":"We consider that the peculiarities of our case are as follows:","title":"The Benefits and Challenges of the Multimodal Treatment in Advanced\/Metastatic Malignant Melanoma"}
{"_id":"0104aa94-1330-c164-2025-3c65e0f63ac5","text":"Electronic reporting of PROs is feasible in a fragile and comorbid population of patients during routine active cancer treatment. Despite clear implementation strategies the physician compliance remained low throughout the study proving the need for further implementation strategies.","title":"Electronic reporting of patient-reported outcomes in a fragile and comorbid population during cancer therapy – a feasibility study"}
{"_id":"01098d88-265f-9746-9f85-e0085da8d9b2","text":"The parents were advised at the time of the examination not to feed the babies for at least two hours before the evaluation.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"010b5498-efdc-8fd1-ec08-5adb58fd2a05","text":"Our review of the literature shows a clear association between UV radiation exposure and increased risk of melanoma and other skin cancers. However, there is no clear evidence of any relationship between skin cancer and IR or laser radiations.","title":"The Role of Optical Radiations in Skin Cancer"}
{"_id":"010ce458-7a3c-46ed-ccfd-23de249977c6","text":"Approval of the Trust Ethical Committee was obtained together with written informed consent from patients. Twenty-seven consecutive patients who had undergone chin bone harvesting to augment intra-oral sites prior to implant placement between March 2000 to March 2002 at the Department of Oral and Maxillofacial Surgery, University Dental Hospital of Manchester were requested to participate in the study. Post-operative morbidity was examined by completion of the assessment form as outlined in Table 2. The patients had been operated on by three surgeons.","title":"An investigation of post-operative morbidity following chin graft surgery"}
{"_id":"010e07c5-da42-2076-450f-03d5e24e9d38","text":"The venous drainage follows the artery so a dermal bridge is not required. However one must be very careful about shear injuries to the pedicle at its base on the pectoral muscles.","title":"Reduction mammoplasty"}
{"_id":"010e81fc-c786-4b06-aa4a-d9020554a62c","text":"The minor complications included donor site wound dehiscence. The major complication was flap failure. Flap failure was encountered in three cases, two of them occurred in the early part of the series. These two cases had arterial insufficiency secondary to the anastomosis in the zone of injury. One flap failed due to infection on the fourth postoperative day in the later part of the series. All donor sites were closed primarily, but one patient encountered dehiscence secondary to necrosis at the wound edges because of closure under tension.","title":"Lateral Arm Flap: Its Usage as Pedicle and Free Flap"}
{"_id":"0112afe3-aa49-5182-f3ef-2d700f457b9c","text":"Directed efforts by individuals, institutions, and leaders of the field will be required to improve diversity among shoulder and elbow surgeons and specifically among fellowship directors. Such efforts have begun with the creation of the ASES Committee on Diversity, Equity, and Inclusion in 2020 to expand leadership opportunities and promote diversity within the shoulder and elbow surgery community. Additional positive measures could include a focus on increasing diversity across all committees in the ASES. Fellowship programs can also focus on developing pathways for female and underrepresented minority orthopaedic surgeons to take on more leadership responsibilities within their programs.","title":"Leadership Trends in Shoulder and Elbow Surgery Fellowship Directors: A Cross-sectional Study"}
{"_id":"011534b7-1e3f-6951-e75d-fab68455a1f3","text":"The risk of recurrence in the nodal basin previously determined to be SLNB tumour-negative has been shown to be related to increasing Breslow thickness and ulceration of the primary tumour and advanced age. Some propose that age-related traits of the lymphatic system influence metastasising patterns, whereby ageing may cause subclinical stasis contributing to a higher probability of entrapment of melanoma within small lymphatic vessels and\/or lymphatic insufficiency. This might explain the observed lower rates of SLNB positivity among older patients. Some authors suggest that this age-related lymphatic dysfunction may account for a higher rate of SLNB false negativity in older patients.","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"0116864d-2ee9-9bfe-68e2-28f6699d2395","text":"We previously reported the development of an osteogenic bone filler scaffold consisting of degradable polyurethane, hydroxyapatite, and decellularized bovine bone particles. The current study was aimed at evaluating the use of this scaffold as a means of local antibiotic delivery to prevent infection in a bone defect contaminated with Staphylococcus aureus. We evaluated two scaffold formulations with the same component ratios but differing overall porosity and surface area. Studies with vancomycin, daptomycin, and gentamicin confirmed that antibiotic uptake was concentration dependent and that increased porosity correlated with increased uptake and prolonged antibiotic release. We also demonstrate that vancomycin can be passively loaded into either formulation in sufficient concentration to prevent infection in a rabbit model of a contaminated segmental bone defect. Moreover, even in those few cases in which complete eradication was not achieved, the number of viable bacteria in the bone was significantly reduced by treatment and there was no radiographic evidence of osteomyelitis. Radiographs and microcomputed tomography (µCT) analysis from the in vivo studies also suggested that the addition of vancomycin did not have any significant effect on the scaffold itself. These results demonstrate the potential utility of our bone regeneration scaffold for local antibiotic delivery to prevent infection in contaminated bone defects.","title":"Evaluation of a bone filler scaffold for local antibiotic delivery to prevent Staphylococcus aureus infection in a contaminated bone defect"}
{"_id":"0116a71b-8a19-3894-0c0e-8d5b8e7e3e35","text":"We have examined the effectiveness of photodynamic therapy against R3230AC rat mammary adenocarcinoma and human mesothelioma as xenografts in the same host. The results demonstrate that the xenografted human tumour is significantly more responsive to photodynamic treatment than the rodent mammary tumour. Studies also showed that the mesothelioma xenograft was fluence rate- and fluence-dependent while the rat tumour exposed to the same conditions demonstrated neither of these dependencies. This disparity in response was not attributable to a difference in either whole-tumour uptake or subcellular distribution of the porphyrin photosensitiser. Analysis of the effects of visible irradiation on cytochrome c oxidase activity, measured in mitochondria prepared from tumours borne on hosts injected with photosensitiser, demonstrated that photoradiation-induced enzyme inhibition was significantly greater in mesothelioma than in R3230AC mammary tumour preparations. However, in parallel studies conducted in vitro, when photosensitiser and light were delivered to previously unperturbed mitochondria, rates of enzyme inhibition were not significantly different. Both tumours were established in long-term cell culture. While the uptake of porphyrin photosensitiser was equivalent in both cell lines, the R3230AC cells displayed a significantly greater photosensitivity than the mesothelioma cells. The data presented here demonstrate that the mechanisms that govern response to photodynamic therapy are complex, but in the case of these two xenografted tumours host response to therapy is not likely to play a significant role.","title":"Effects of photodynamic therapy on xenografts of human mesothelioma and rat mammary carcinoma in nude mice."}
{"_id":"011d3877-a065-a779-1b8c-35bfd7c0e3e4","text":"Currently, the use of preoperative antibiotic prophylaxis has significantly decreased the incidence of surgical site infections. The Center for Disease Control and Prevention released guidelines for preventing SSIs in 2017 which discussed the use of parenteral antimicrobial prophylaxis prior to incision. The current timing guidelines for antibiotic administration are defined as within 60 minutes prior to incision. However, these guidelines fail to provide further details on the timing of antibiotic administration given the duration of therapy for the selected prophylactic antibiotic [3]. While it is widely accepted that the use of antibiotic prophylaxis preoperatively decreases the frequency of SSIs, the best time to administer the antibiotics is still under debate. One systematic review and meta-analysis covering over 54,000 patients found that the risk of SSI almost doubled when antibiotics were administered after the first incision compared to over two hours prior to incision but found no significant difference in the rate of infections when antibiotics were administered within one hour or two hours prior to incision [4].","title":"The Ideal Time to Administer Pre-operative Antibiotics: Current and Future Practices"}
{"_id":"012094fa-03ad-6095-ce16-79858cb8339e","text":"A 28-year-old male presented at Day General Hospital following traumatic complete nasal tip amputation after a personal altercation. The amputated tissue was detached about three hours previously at the scene of the conflict and was brought to the emergency department. It was preserved in frozen saline until the time of surgery, which occurred approximately five hours after the occurrence of the altercation.","title":"Use of Forehead Flap for Nasal Tip Reconstruction after Traumatic Nasal Amputation"}
{"_id":"01298af4-f4d8-a09c-addc-4222c9b8c382","text":"More intriguing was that high expression of BTLA on switched memory B cells, the main subset that responds to vaccination against influenza virus to which adult humans in general have immunological memory was linked to better preservation of VNA responses to the two influenza A virus strains of TIV and to higher recall responses upon the next dose of TIV given one year later. This in turn suggests that BTLA may promote rather than suppress the induction of long-lived plasma cells and memory B cells, a hypothesis that remains to be investigated further.","title":"BTLA expression declines on B cells of the aged and is associated with low responsiveness to the trivalent influenza vaccine"}
{"_id":"012a7072-b955-d946-c051-981ed59cbc6f","text":"The objective of the present investigation is to conduct a comprehensive search and meta-analysis of all relevant studies that have evaluated the diagnostic precision of PET\/CT in the context of periprosthetic joint infection.","title":"Diagnostic accuracy of positron emission tomography\/computerized tomography for periprosthetic joint infection of hip: systematic review and meta-analysis"}
{"_id":"01368767-5424-6a40-4c03-ab9ab21cf3d6","text":"Performance comparison of SiFo vs DLMRI for noisy brain images for radial sampling are shown in Figure 6 and Table 3.","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"014acfa9-c2bc-8b40-0f3e-e2cd649b2df9","text":"Several breakthroughs have occurred as a result of the partnership between the Missouri Orthopaedic Institute and the Comparative Orthopaedics Laboratory at the University of Missouri. We have determined that at least 70% of the chondrocytes in a transplanted specimen must be viable in order to achieve success. We have also analyzed the ideal size and shape for grafts that are being transplanted and determined that a thickness of only 6–7 mm is ideal to balance strength with diffusion characteristics. We have also determined that soaking the donor graft in the recipients bone marrow aspirate concentrate exponentially speeds the process of boney incorporation of the graft. Finally, we have determined that storage in a special media at room temperature yields grafts with better chondrocyte survival at 60 days than chondrocyte survival with conventional storage methods at 28 days.","title":"A One Health overview, facilitating advances in comparative medicine and translational research"}
{"_id":"014de408-389b-1e65-3526-a062b65c83e6","text":"Accurate liver resection is very significant for a better outcome in curing patients with liver cancer. Three-dimensional visual reconstruction technology combined with virtual surgical planning is used in this work. The 2D CTA images of liver cancer are preprocessed at first. Then, the images are reconstructed into a 3D image using ENURBS for efficient visualization and diagnosis of liver cancer. Finally, planning of the surgical methods based on the 3D reconstructed liver model for precise liver resection is performed using VSP. The flow of the proposed work is shown in Figure 1 and explained in this section.","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"014e233e-cfd3-92a6-5729-047f118cfb65","text":"A rare complication of intravenous calcium gluconate infusion is extravasation, which may result in calcinosis cutis, necrosis, and a bullous reaction in its most severe form. Although a bullous reaction after an intravenous calcium gluconate infusion is extremely rare, clinicians should be aware of this potential adverse effect. Proper administration of calcium gluconate and other risk reduction strategies can reduce the potential for such events, preventing prolonged and complicated hospital courses for patients. More thorough reporting of this complication and understanding of the pathophysiology are needed to improve patient management when such events occur.","title":"Calcinosis Cutis as an Unsuspecting Complication of Hyperkalemia Treatment"}
{"_id":"0155baf9-45ed-4783-7e82-15d84afd0be0","text":"A retrospective analysis and chart review was performed for 11 out of 284 consecutive spondylodiscitis patients who underwent EVAR\/TEVAR procedure and developed destructive per continuitatem spondylodiscitis.","title":"Destructive per continuitatem spondylodiscitis after endovascular abdominal or thoracic aneurysm repair (EVAR\/TEVAR): rare and untreatable?"}
{"_id":"01563c0c-a308-79a2-75b3-45b7f2272808","text":"Retrospective review of patients who underwent primary surgery for head and neck cancer followed by ALT flap reconstruction at our institution from 2014 to 2018. All patients underwent CDS prior to surgical excision of the flap.","title":"Colour Doppler sonography in the preoperative assessment of the vascular pedicle from the anterolateral thigh flap: proposal for a mathematical formula to predict pedicle length"}
{"_id":"015fc017-4543-323f-d13e-5f77711cee64","text":"Although more studies are required, this adjunct appears to be relatively safe. Many cases of retained antibiotic spacers have resulted in satisfactory patient outcomes, such as in the case of periprosthetic joint infections or postarthroscopy shoulder destructive osteomyelitis. Bone resorption is another concern associated with retained spacers and has been reported in the setting of infected hip replacements; however, this may not be the case in long bones because of the spacer being immobile. We did not notice any notable resorption.","title":"Antibiotic Impregnated Cement Dowel in a Tibial Stump to Salvage Infected Below-Knee Amputation in a Diabetic"}
{"_id":"01773f45-6554-1394-c1e4-8d4b446a3af3","text":"Hematoxylin and eosin staining has been performed for each sample and reviewed by the pathologist.","title":"Human microRNA expression in sporadic and FAP-associated desmoid tumors and correlation with beta-catenin mutations"}
{"_id":"0179a660-f334-d8fd-e6a8-05b0089318f6","text":"In a previous visit to another clinic food allergy was considered as a diagnosis, a full-blood count and total IgE level were normal, and allergy tests for food panel came negative. In view of the mild asymmetry of the cheek an ultrasound of the soft tissue was performed which showed normal facial structures including the salivary glands and slight asymmetry of the subcutaneous fat which was more prominent on the right side. No underlying focal soft tissue lesion or abnormal vascularity was seen.","title":"Recurring Facial Erythema in an Infant"}
{"_id":"017ad385-6f4e-3267-4b28-69cf3403b0ca","text":"Fellows are all practicing clinicians from diverse backgrounds, specialties, and geographic locations. Clinical practice provides fellows unique expertise while working with their federal and NGO partners. In addition, they learn how to integrate climate and health education into their individual specialties and careers and are empowered to influence organized medicine and their respective academic medical departments to engage with this burgeoning field.","title":"Creating climate-informed physician leaders: The evolution of a physician fellowship in climate and health science policy"}
{"_id":"0181aaa4-c941-6d55-3217-05926d5741d8","text":"As an opportunistic pathogen it should be considered when unclear skin and soft tissue infections occur on immunosuppressed patients like patients on corticosteroid therapy, after organ transplantation and with immunodeficiency or autoimmune disorders.","title":"Atypical Osteomyelitis Caused by Mycobacterium chelonae—A Multimodal Imaging Approach"}
{"_id":"0185bfea-132d-c280-73a5-9920a785ef19","text":"There are some limitations to this retrospective study. Although a prospective study would provide more consistent data and be powered for generalizability of predictive factors, we do not believe that a prospective study would change the likelihood of epinephrine administration. This study was also limited to patients on SCIT for aeroallergens and did not consider the incidence or risk factors for patients on venom immunotherapy, limiting the generalizability of these findings to other SCIT populations. Furthermore, the narrow geographic and demographic patient profile from this single-center study may limit the generalizability of our results. Similar studies in larger multicenter settings are needed to confirm these observations.","title":"A single centre retrospective study of systemic reactions to subcutaneous immunotherapy"}
{"_id":"01927de0-cebc-71eb-98f0-7c3c5363004a","text":"The classic treatment for a PAA consists of exclusion of the aneurysm with a bypass using an autologous or synthetic graft.19 The technique most often used is via a medial access with exclusion achieved by ligature of the popliteal artery upstream and downstream of the aneurysm, followed by popliteal -popliteal bypass with the great saphenous vein either reversed or devalved or with Dacron or PTFE grafts.","title":"Treatment of bilateral popliteal artery aneurysms"}
{"_id":"0199d3fc-ee77-bb14-2681-5a3e89ea3795","text":"The authors developed an algorithm to provide surgical options for optimal recipient vessels and an ALTP flap type for free tissue transfer to osteomyelitis-related soft-tissue defects around the knee. We then performed individualized microsurgical reconstructions based on a selected option according to the defect size and location in each patient and achieved sufficient successful coverage of the knee defect to enhance eradication of infection and protection from it. We believe that our algorithm could help surgeons devise a strategic reconstructive plan for peri-knee soft tissue defects and obtain successful surgical outcomes in patients with chronic post-traumatic osteomyelitis of the knee.","title":"An algorithmic approach to soft-tissue reconstruction around the knee using anterolateral thigh perforator flap in patients with post-traumatic knee osteomyelitis"}
{"_id":"019c5d8c-797b-a72e-2234-1f666ef8da74","text":"The disease most commonly involves young children. Mandible is rarely involved due to the less amount of cancellous bone. The chief routes of spread are from infected sputum, surrounding soft tissue and haematogenous route. Wound following extraction of a tooth is also a possible conduit. The angle and the ramus of mandible are commonly involved. Destruction and erosion of the cortex occurs which is replaced by soft granulation tissue. Caseation occurs resulting in softening, liquefaction and formation of a subperiosteal abscess which can either burst intraorally or extraorally. Sinuses which continue to discharge despite repeated course of antibiotics could also be the presenting symptom.","title":"Primary tuberculous osteomyelitis of the mandible mimicking a parotid fistula"}
{"_id":"019f5ab9-d441-2328-49f7-84619e02fb0f","text":"We identified 12 patients and the senior surgeon determined that all these patients needed additional mechanical stabilization in the form of intramedullary cortical strut in addition to locking compression plating (LCP). As the bone bank is not available and affordable in our region, the senior surgeon elected to use ipsilateral fibula as a nonvascularized cortical strut graft to provide additional mechanical stability and autologous iliac crest cancellous graft for osteoinduction at the fracture site along with LCP. Closure of the gap is performed whenever possible. All 12 patients were followed up regularly clinically and radiologically for a minimum period of two years. There was no loss of follow-up. We excluded infected nonunion, and aseptic nonunion after conservative management for this study.","title":"Autologous Nonvascularized Fibula Graft and Locking Compression Plating for Failed Fixation of Humeral Shaft With Atrophic Gap Nonunion"}
{"_id":"01a09c6c-80c0-0127-1d97-2d9b551e23dd","text":"Throughout the whole study, screening logs will be kept at each site to determine the number of patients assessed for eligibility and reasons for any exclusion. Patients who decline to continue to take part during the feasibility phase will be given the opportunity to discuss\/inform the research team of their reasoning behind their decision not to take part.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"01a1462f-15b0-8a7d-2f47-c843335aa429","text":"Introduction: Chronic nonbacterial osteomyelitis is a primary autoinflammatory bone disease that presents more frequently in children and is characterized by inflammatory bone lesions in the absence of an infectious etiology1. There is minimal data available on this condition in UAE","title":"Proceedings of the 29th European Paediatric Rheumatology Congress"}
{"_id":"01a384d9-6c28-ca66-982f-2af11b8d5bf7","text":"Aim of this review is to emphasise current diagnostic and therapeutic modalities for VTE.","title":"Venous Thromboembolism – Current Diagnostic and Treatment Modalities"}
{"_id":"01a58fb3-b85e-2fdf-03de-dace73ea98d1","text":"The data presented here for different cancers and therapies estimate the rate of progression in an overall population, but they do not predict what would happen in an individual patient. They also do not predict rate of progression in a population that differs from the patients entered on the clinical trial from which the data were derived. Clinical trials eligibility criteria typically require patients with good performance status. Since poor performance status patients may progress more rapidly than good performance status patients,28 as may patients with high tumor bulk,29 patients with poor performance status or high tumor bulk would on average be expected to have more rapid tumor progression than the patients entered on the clinical trials that formed the basis for our scan frequency calculations. Hence, it would be rational to do scans more frequently than our calculations would suggest if one is dealing with a patient with poor performance status patients, high tumor bulk, an unusually aggressive cancers, or an early indication of possible tumor progression.","title":"Optimal frequency of scans for patients on cancer therapies: A population kinetics assessment"}
{"_id":"01ba7c8b-b50c-2100-0b9d-32659e712a54","text":"Primary melanoma of the colon is a rare clinical entity. Whenever a seemingly primary melanoma is detected in an atypical location such as the colon, it is prudent to conduct a thorough clinical investigation to consider the possibility of metastatic disease. Further studies are needed to document the long term follow-up, survival advantage and safety of the management approaches employed in patients with primary colonic melanoma. Based on current data, surgical resection appears to be appropriate management for primary colonic melanomas; unless the disease has metastasized to distant sites where surgery may have a limited palliative role.","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"01bbd991-3be6-c555-f163-9f451671558a","text":"Most of us did not find that any of the systems are likely to be suitable for use by patients. Almost all agreed that the ACCP system was suitable for professionals and most considered that the USPSTF system was suitable for professionals. There was not much agreement about the suitability of any of the other systems for professionals or about the suitability of any of the systems for policy makers, although most assessed the USTFCPS system to be suitable for policy makers.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"01bbfb03-f727-8418-fc1c-1006b7099e79","text":"In three patients, delayed union was noted of which two patients belonged to the first group and one to the second group. In two patients belonging to the first group, infected nonunion was observed in the 14th week of treatment. The etiological factor was Staphylococcus aureus and Staphylococcus epidermidis. Because of this, the exchange of the nails was carried out together with reaming and irrigation of the medullary cavity with saline and gentamicin, accompanied by local intravenous antibiotic therapy according to Court Brown.7 Union was achieved in the 52nd week of treatment. In the patients belonging to the second group, no infected nonunion was noted and union occurred approximately after 42 weeks.","title":"Management of open fractures of the tibial shaft in multiple trauma"}
{"_id":"01bc1b48-cdd9-e8df-a900-1490181a9c4d","text":"None of the patients reported recurrence of infection and all of them had good spinal canal volume and complete fusion of the grafted bone without loosening of the implant nor kyphosis of the cervical spine during the last follow-up.","title":"Emergency 1-stage anterior approach for cervical spine infection complicated by epidural abscess"}
{"_id":"01bdc453-e17d-1279-1b8f-239f227b4f3c","text":"Postoperative functional and aesthetic concerns, particularly with regard to shoe-fitting, should be part of the algorithm for extremity limb salvage. Revision procedures for fasciocutaneous flaps are well documented. Fasciocutaneous flaps have been found to be particularly problematic with contour and bulk. 61 62 63 Kotsougiani et al reviewed their series of 389 patients with free flap reconstruction in the lower limb (142 muscle and 193 fasciocutaneous free flaps). 64 They reported 13.9% requiring one to three secondary refinement procedures, the majority being surgical debulking, and found that the flap type did not predict secondary refinement procedures. Nelson et al reported 21.1% of their 152 patients underwent secondary aesthetic revisions again with debulking being the most common procedure. 65 However, they did not compare fasciocutaneous versus muscle groups. In our experience, free muscle flaps with an unmeshed skin graft provide durable coverage and muscle atrophy leads to acceptable contouring if inset well at initial operation. In our experience, compression bandaging until there is no pitting edema of the muscle flap effectively reduces edema and improves contour but there is currently no published evidence to support this.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"01c2bb0c-68a4-9e27-1d99-e4cba450b246","text":"Every patient underwent the TriFlo Inspiratory Exerciser test immediately after extubation and weaning from mechanical ventilation, which was compared to the baseline test performed immediately before surgery. Data showed that patients in the parasternal block moved up a mean of one ball more than the Control group (2 and 1 balls, respectively). This result may suggest a better analgesic effect of the parasternal block during thoracic excursions and consequently a better respiratory performance in the postoperative period; this implies better blood oxygenation and oxygen saturation, better airway clearance and a lower risk of postoperative pneumonia. Moreover, earlier extubation and less mechanical ventilation time could also have improved respiratory performance in the Parasternal group.","title":"Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study"}
{"_id":"01c9d766-d212-887a-1021-28a3a3feffc6","text":"The ALT flap can be raised successfully without using laser-assisted angiography but this can be at the expense of potentially harvesting a much larger skin paddle than required. By making the anterior incision more medially, the surgeon will increase the odds of capturing the septal musculocutaneous perforators. However, this will increase the likelihood of a difficult closure. We believe ICG analysis may be especially useful for less experienced surgeons in their flap design. We contend that the analysis provides valuable data about perforator perfusion zones and should be considered when designing the skin paddle. A larger experience using this technique will determine whether flap viability is actually improved by this method.","title":"Near-Infrared Laser-Assisted Indocyanine Green Imaging for Optimizing the Design of the Anterolateral Thigh Flap"}
{"_id":"01d094e7-b8d2-2f56-9325-534d158115f2","text":"AWR in the setting of CVH with or without LD, is a challenging problem. Preoperative chemo-denervation with BTA may be a valuable adjunct for complex AWR, often limiting the need for additional myofascial release and mitigating the effect and complications associated with increased intrabdominal pressures. The safety and efficacy of these surgical adjuncts need to be validated with larger prospective studies.","title":"Preoperative botulinum A toxin as an adjunct for abdominal wall reconstruction: a single-center early experience at an Academic Center in New York Toxina botulínica A pré-operatória como adjuvante na reconstrução da parede abdominal: experiência inicial em Centro Acadêmico em Nova York"}
{"_id":"01d2f459-c6ac-f53a-720a-8650db8f634a","text":"Radiological evidence of extension of the tumour through the bone cortex and involvement of surrounding soft tissue should be noted as this provides evidence of a locally aggressive or malignant tumour. The nature of the periosteal reaction associated with a bone lesion oftens reflects the growth rate of the tumour. When the tumour grows slowly, the periosteum forms a thick layer of bone. Multiple layers of periosteal new bone are formed when there is a succession of fast and slow growth phases associated with the enlargement of the underlying lesion. The presence of tumour on both sides of the cortex (which is not yet destroyed) often indicates a very aggressive lesion.","title":"Guidelines for histopathological specimen examination and diagnostic reporting of primary bone tumours"}
{"_id":"01ea0f2d-9906-9c01-0273-94b075a98506","text":"Some surgeons immobilise the knee in extension for two to three weeks after gastrocnemius flap because they reported higher wound complication rate with early mobilisation. Reduced joint range of motion and muscle strength have also been reported by Daigeler et al in their series of patients who underwent gastrocnemius muscle flap. We did not immobilise the knee following GMCF in this series and had not found any flap-related complications. The joint contractures and limitation in the range of motions in our series occurred in patients with severe intra-articular open fractures treated with Ilizarov circular external fixation.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"01eb34c0-5876-6820-4da1-2eb11844d2f7","text":"Radiotherapy treatment plays an important role in the treatment strategy of NMSC. It can be used both in the adjuvant setting of surgically treated patients with aggressive pathological features, and in the definitive setting, usually when surgery is not performed. Even in an era when immune checkpoint inhibitors are becoming a significant part of the treatment regimen for advanced cSCC, the role of radiotherapy treatment in these cases cannot be undermined, and current and future research may aid in consolidating the role of a combination of these modalities, either concurrently or as adjuvant treatment.","title":"The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer"}
{"_id":"01ec772f-bc77-b724-ee0f-f734ce9b8491","text":"In conclusion, the marked improvement in the early detection and survival of CF patients has seen a concomitant rise in challenges faced by late childhood and early adolescence in this group of patients. We believe our case series highlights an important phenomenon that is likely to feature more prominently as the average age of CF survivors increases. Presently, there is no clear consensus as to whether to routinely screen CF patients to identify those at risk for significant thrombosis prior to the development of VT. Our recommendation that those who have a history of a previous VT and those with a significant family history of this should potentially undergo an extended thrombophilia screen is based on the best available evidence. The use of directed Doppler ultrasound prior to TIVAD insertion, and at fixed intervals thereafter, may help identify the formation of catheter-related VT prospectively. Thromboprophylaxis cannot be recommended routinely at this stage. We strongly feel this is an area that would benefit from larger and more robust studies to achieve early identification of CF patients who are at risk for serious thrombotic and thromboembolic complications arising from their indwelling central lines.","title":"Increased Vigilance Needed for the Detection of Thrombotic Complications of Central Venous Access in Adolescent Cystic Fibrosis Patients"}
{"_id":"01f13876-d2b4-4a41-6f77-159f85d4af64","text":"To investigate whether the pattern of lymphatic basin drainage influences the risk of nodal disease in patients with melanoma of the trunk and negative sentinel lymph node biopsy.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"01f1dc25-2aa3-c9d0-8b32-6b2f9fb3c5b2","text":"While rare, desmoid tumors can develop after abdominal surgery and are difficult to differentiate from recurrent tumors following cancer resection. In this report, we describe two cases of desmoid tumors that occurred following gastric cancer procedures and were successfully treated with surgical resection.","title":"Desmoid tumor occurrence following gastric cancer surgery: A report of two cases"}
{"_id":"01f2dcae-bc91-2267-c9a9-324fcb120af6","text":"After complete thrombosis of each conduit, it was resected during postoperative period and the normal side was followed-up to 6 months when the animals were sacrificed and the specimens were examined by gross inspection, light microscopy, and histopathologic assessments for chronic changes. All the specimens were placed in buffered formalin after removal. They were processed after 24 h for paraffin embedding. A fire microthick slide was prepared from each block and stained by hematoxylin and eosin and examined under a light microscope.","title":"Using inverted autogenous veins to substitute arteries in a canine model"}
{"_id":"01f4a401-9cd1-7f0f-3752-6eabf2978eb4","text":"In our study, the mean number of axillary nodes removed during ALND was 13.4 per person in the study group and 17.4 in the control group; the difference between these means was statistically significant. Although the quantity of retrieved lymph nodes in the ARM group was less than the number of resected nodes with classic axillary dissection, there was no statistically significant difference between the number of harvested nodes and the number of nodes that were positive for malignancy. Notably, the mean number of excised nodes in our ARM study group was greater than the 10 nodes previously suggested to be the minimum number resected for axillary clearance to be oncologically successful [16].","title":"Prevention of lymphedema via axillary reverse mapping for arm lymph-node preservation following breast cancer surgery: a randomized controlled trial"}
{"_id":"01fac4bc-128f-da3f-868b-53f0adb95778","text":"The eyebrow area is a clinically critical district due to the anatomical complexity and the propensity to aging-related atrophy. Hyaluronic acid fillers have been proposed to recover the dermal volume of the facial and lips regions.","title":"Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure"}
{"_id":"01fb5759-99f9-92b2-4781-f250523ab73d","text":"All patients were followed up for at least 2 years according to set guidelines, with visits every third month for the first 2 years and thereafter every 6 months.","title":"Early self-care rehabilitation of head and neck cancer patients"}
{"_id":"01fb77e9-bd8b-beaf-3b04-6798ceff29da","text":"Breast reconstruction conventionally involves a multispecialty team with the patient being operated upon simultaneously by the onco-surgeons and the plastic surgeons. A microvascular procedure would be technically more demanding has longer operating time and is definitely more expensive. The mean operative time for harvesting, and the inset of the TRAM flap in our series was 3 h. Doing this simultaneously with the onco-surgeons would further ensure that there is no significant prolongation of operative time.","title":"Assessment of the abdominal wall function after pedicled TRAM flap surgery for breast reconstruction: Use of modified mesh repair for the donor defect"}
{"_id":"0202bfb3-9db2-2d98-a76c-3869e0099c65","text":"More studies are needed to identify optimal radiotherapy use in subcutaneous melanoma therapy, either alone or in combination with other local and systemic therapies, in order to relieve symptoms and also improve local control and survival.","title":"Radiotherapy in the Treatment of Subcutaneous Melanoma"}
{"_id":"020dec4c-7249-da98-9665-ad303379a997","text":"SLNB allows us to histopathologically examine the lymph nodes with the highest risk of containing metastases more precise than routine examination of all lymph nodes in END.27 In SLNB‐negative patients, a watchful waiting strategy of the neck renders the opportunity for micrometastasis, which can easily missed by routine histopathological examination of a neck dissection specimen, to become clinical manifest.28 Therefore, SLNB can serve as a more accurate reference standard than END for the evaluation of tests predicting the presence of lymph node metastases.","title":"Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy"}
{"_id":"020e6c82-bec1-d3fb-7f3a-728c7feb53e6","text":"Skeletal fixation is often undertaken for bony stability rather than to allow early full weight bearing. This strategy is used in patients not capable of early weight bearing due to coexisting injuries of limbs, trunk and CNS. The principle of minimising the quantity of fixation implants used not only reduces the surgical insult but maximises the number of fractures that can be stabilised in a short anaesthetic period in a sick, febrile patient.","title":"Factors influencing infection in 10 years of battlefield open tibia fractures"}
{"_id":"020ff049-1ca1-a0d0-cec7-6b7079d83df8","text":"An important component of surgical planning is the design of surgical aids such as drill or osteotomy guides and the design of custom implants. One of the most crucial aspects of this design phase is the communication between designer and surgeon. It should be clear to both parties that it takes time to effectively work together, and a tight schedule usually cannot be met when working together for the first time. Inefficiencies lead to undesired results and a substantial increase in the time required to complete the design and manufacturing but may be minimized when the designer and the surgeon are the same person (33).","title":"Virtual surgical planning and 3D printing: Methodology and applications in veterinary oromaxillofacial surgery"}
{"_id":"0216f698-f2ce-baae-04e9-b34793ed5dd7","text":"Currently there is thus no accurate way of determining the presence of occult lymphatic metastasis for cancers of the head and neck. It is clear that the gold standard for detecting involved lymph nodes is accurate pathological analysis of the nodes. This is traditionally done in a retrospective manner by sending the neck dissection specimen for analysis. In the normal pathological processing there is a possibility to miss micro metastases as the specimens are not as accurately examined as with a sentinel node protocol. In such a protocol stepwise serial sectioning as well as immunohistochemistry will be able to find occult microscopic deposits that would be missed with routine pathology examinations [7].","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"0222ddbb-def5-6615-21df-36a8f67be59c","text":"Methods: A retrospective medical record review was performed on children patients diagnosed with anaphylaxis between 2009 and 2013 in 23 tertiary hospitals of South Korea.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"02255618-0d40-8bd4-34f4-3ee92feb6309","text":"Many of the alterations in the nasal anatomy found in patients undergoing revision rhinoplasty are difficult to manage, not only from a surgical point of view but also from a psychological one, when dealing with a patient previously dissatisfied with prior results and who, in most cases, has high expectations and anxieties that make it difficult for them to understand the intrinsic limitations of the procedure.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"0226e4ba-807f-83f9-2e5b-c8ff15731480","text":"Among these modalities, radiotherapy focused on PVTT seems to be reasonable as it could deliver a local therapeutic effect on PVTT in HCC patients. In this investigation, we gathered data on patients who had advanced HCC with PVTT to evaluate the therapeutic outcome and prognosis of external beam radiotherapy focused on PVTT. Meanwhile, the feasibility and outcome of radiotherapy combined with other modalities for these patients were assessed as well.","title":"Efficacy of External Beam Radiation-Based Treatment plus Locoregional Therapy for Hepatocellular Carcinoma Associated with Portal Vein Tumor Thrombosis"}
{"_id":"0235c82b-d806-02fb-51c8-52f9e51bfdb4","text":"We report an unusual case in which subcutaneous injections of botulinum toxin to treat axillary hyperhidrosis appeared to trigger AAU in a patient with BD even though he had not experienced a uveitis attack since starting periodic infliximab treatment 8 years ago. He received his regularly scheduled infliximab injection 2 days later, and the AAU resolved quickly with near-normal opacity, intraocular pressure, and LF a month later. Based on this temporal progress of uveitis, we concluded the AAU was not a simple relapse of BD but was induced by botulinum toxin injection, which was attenuated by infliximab, although the precise mechanism is still unclear. To the best of our knowledge, this is the first report of the triggering of AAU by botulinum toxin and effective attenuation of AAU by infliximab in a patient with BD.","title":"Botulinum toxin-induced acute anterior uveitis in a patient with Behçet’s disease under infliximab treatment: a case report"}
{"_id":"0246a861-2b01-d3fd-952c-e05d49c3b97d","text":"The aim of follow up should be to provide patients with the best quality of life by providing reassurance and dealing with new symptoms as they arise. Over investigation causes anxiety and we suggest appropriate investigations should be used at the discretion of the clinician when new symptoms arise. Based on the limited evidence currently available, a five year hospital based clinical follow up programme for patients undergoing curative oesophagogastric resection with transfer back into the primary care sector seems a reasonable strategy for patients who are well. However there may be some patients who would prefer annual follow up for years 3-5 under the care of their general practitioner, which may be feasible provided rapid communication links are open between primary and secondary healthcare systems. Urgent referral is required for any patient developing new or worrisome symptoms. New strategies, clinical prognostic scoring models and tumour markers may be of benefit in the future.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"02491600-f6bc-a7af-7461-a08e8a612a55","text":"Matrix metalloproteinase 9 is an essential member of the matrix metalloproteinase family and functions primarily to degrade and remodel the dynamic balance of the extracellular matrix, playing diverse roles in tumor growth, invasion and metastasis, and tissue remodeling in inflammatory diseases. Studies show that matrix metalloproteinase-9 is highly expressed within macrophages on biomaterial surfaces and is also involved in macrophage fusion, foreign-body giant cell formation, and foreign-body response. In this study, macrophages phagocytose a small portion of test sample particles can be seen after 13 weeks, a large number of foreign body giant cells engulfed with test samples can be seen after 52 weeks. Macrophages phagocytose a large number of listed control samples can be seen after 13 weeks, a small number of macrophages can be seen after 52 weeks, and the gels were surrounded by dense fibrous tissues and adipose tissues, were also further supported this notion. In this study, the positive expression of MMP 9 was mainly distributed in the cyst walls formed at the periphery of the implantation sites with fibrous encapsulation and degraded debris, and the positive cells were mainly macrophages and fibroblasts, which are the main cellular components involved in the host response and tissue repair process, so the differences in MMP 9 expression could reflect the changes in the process of tissue remodeling after implantation of materials.","title":"Mechanism of remodeling and local effects in vivo of a new injectable cosmetic filler"}
{"_id":"02527f7b-9ff9-a876-ab1d-44bd366db2b7","text":"Different areas of the face have different skin and subcutaneous thicknesses, so it is essential to inject the proper fluidity of tissue superficially without any risk of visibility and lumpiness. The clusters’ dimensions can be further reduced to obtain different degrees of fluidity; with the guided SEFFI technique, such a reduction can be achieved using an emulsification procedure by connecting two 10 mL syringes through a transfer mechanism provided in the device and performing passages of tissue from one syringe to the other (Figure 4).","title":"Guided Superficial Enhanced Fluid Fat Injection (SEFFI) Procedures for Facial Rejuvenation: An Italian Multicenter Retrospective Case Report"}
{"_id":"02575eed-e0a7-0548-9999-255861512cb1","text":"Our second result was a significant correlation between greater anosognosia for the clinical symptoms in bvFTD patients and lower synaptic density in the caudate nucleus and the frontal pole. It is well recognized that beyond behavioral symptoms, patients with bvFTD often exhibit early and severe overestimation of cognitive abilities. In previous studies, anosognosia for cognitive impairment was correlated to atrophy in the subgenual cingulate cortex. The correlation between anosognosia for behavioral symptoms in bvFTD and grey matter atrophy did not show any region surviving correction for multiple comparisons, while negative correlation was observed with glucose uptake in the superior part of the temporal pole. In studies where different patient groups were combined (including patients with bvFTD), impaired self-awareness was already correlated to medial prefrontal cortex atrophy.","title":"In vivo exploration of synaptic projections in frontotemporal dementia"}
{"_id":"025eed88-a78f-dd74-7b2c-e966e99fc7d1","text":"Previous human studies compared the exposure of different surgical approaches by measuring exposed osseous surface area via similar methodology to this study (16–18). Calibrated digital photographs were taken from the surgeon’s perspective and analysed in ImageJ software by comparing a known length to number of pixels. Measurement of acetabular area helped to establish that the DGO provides the surgeon with at least equivalent exposure of the acetabulum as DGT. Given the concave nature of the acetabular surface it may have been a limitation to measure this with a 2D image.","title":"Approach to the canine coxofemoral joint using an osteotomy of the deep gluteal muscle insertion for total hip replacements"}
{"_id":"0261a69b-6ac8-31f2-476f-e2d86677de08","text":"In cases wherein all the drainage veins from the stomach are removed, an anastomosis between the left gastric vein and splenic vein can be effectively used to prevent gastric venous congestion and bleeding after total pancreatectomy.","title":"Surgical treatment of gastric venous congestion in association with extended resection of pancreas: a case report"}
{"_id":"026739e9-687e-5d1b-75ae-f4af1d1e7fbe","text":"That point of view is the most favored by plastic surgeons, in regard to better conditions of local residual tissues, less alterations due to inflammatory process and the frequent availability of vessels in the surgical field as source for microsurgical transplant.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"02685830-a0c9-856a-137f-96624107fb2c","text":"Clinical cure is defined by the presence of any of the following:","title":"Efficacy and safety of different antimicrobial DURATions for the treatment of Infections associated with Osteosynthesis Material implanted after long bone fractures (DURATIOM): Protocol for a randomized, pragmatic trial"}
{"_id":"026ec378-4ba7-c18b-4453-67a561360f4f","text":"Rush venom immunotherapy against hymenoptera venom is safe in pediatric patients and was safe in this small retrospective cohort study. As of now there are no definitive predictive serological parameters that can help to identify patients that may be at risk for developing anaphylactic reactions during rush immunotherapy. The risk of anaphylactic reactions however seems to be elevated in the dosing interval between 40 and 80 μg—the same amount of venom that is administered by a field sting. Even patients who developed anaphylactic reactions during build-up phase could continue VIT with a modified up-dosing protocol and did not experience further side-effects.","title":"Anaphylactic reactions in the build-up phase of rush immunotherapy for bee venom allergy in pediatric patients: a single-center experience"}
{"_id":"02793d41-3e01-4c47-e6b1-267c77793f54","text":"Long-lasting longitudinal follow-up in our study shows no impact on IgG titers according to anticancer therapy. All subgroups of patients appeared to seroconvert with an adequate median of IgG titers. Most of the patients in our cohort mounted adequate IgG titers in response to vaccination after two doses. Only one patient was infected between the first and second dose. IgG titers were maintained over time in evaluable patients. For those patients receiving the 3rd dose, the rise of IgG titers suggests that repeated vaccination is crucial in maintaining IgG titers in patients with LC and would support future boosts of the vaccine. However, the adequate timeline for additional boosts remains unclear.","title":"Immune Response and Effects of COVID-19 Vaccination in Patients with Lung Cancer—COVID Lung Vaccine Study"}
{"_id":"0279745c-acce-8ac9-c394-4f148b4435eb","text":"The aim of the study is to evaluate the density of intratumoral and peritumoral lymphatic vessels in primary cutaneous melanomas and to assess their correlation with the status of sentinel lymph nodes and the VEGF expression in tumor cells and stromal cells. A total of 40 patients were enrolled in the study: the melanomas were radically excised with the extirpation of the sentinel lymph node. The study subjects were divided into two groups: 20 cases with positive and 20 cases with negative sentinel lymph node results. The density of lymphatic vessels was evaluated by the antibody D2-40 and the VEGF expression was investigated in the semiquantitative way. The VEGF expression in melanoma cells and the stromal cells was negative to variable positive at both SLN negative and SLN positive patients in all pT stages. In the group of SLN positive patients, the density of intratumoral lymphatic vessels was low up to moderate, while it was observed to be absent, somewhere on the low level in the group of SLN negative patients. On the other side, the density of peritumoral lymphatic vessels was equally numerous at both SLN negative and SLN positive patients. The lymphatic invasion was found out at 4 SLN positive patients only. The ulceration was chiefly in the group of LN positive patients. The results show that the density of lymphangiogenesis and the intensity of the VEGF expression are considered to be an unreliable predictor of melanoma metastasis to the sentinel lymph node, but the ulceration and the lymphatic invasion can predict the potential for metastasis.","title":"Lymphangiogenesis and Its Correlation with the VEGF Expression and the Sentinel Lymph Node in Cutaneous Melanomas"}
{"_id":"027d2a6c-3eb3-f4cc-d187-09131583e305","text":"The outcome measures were classified according to ICD 10 as follows:","title":"Second primary cancers in patients with skin cancer: a population-based study in Northern Ireland"}
{"_id":"0280868c-d510-4765-9879-abe4718f4ccb","text":"Trainees traditionally have mostly followed the route of dentistry first then medicine though, increasingly medical graduates are following a path through a second degree in dentistry to train in OMFS.","title":"Education of trainees, training and fellowships for head and neck oncologic and surgical training in the UK: United Kingdom National Multidisciplinary Guidelines EDUCATION OF TRAINEES, TRAINING AND FELLOWSHIPS: UK GUIDELINES"}
{"_id":"02810964-330d-2b0e-5cca-3dcaa68f9787","text":"A further procedure undertaken in secondary care was defined as a code for surgery after injection or a second injection in the same hand when calculating incidence rates, survival and regression analysis. In order to identify the ‘worst-case scenario’ of possible patients who may go on to a procedure but have missing laterality codes, a further definition of three or more procedures per person was also included when calculating an estimate of the number of people requiring a further procedure.","title":"Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis"}
{"_id":"0282c5d4-9103-5062-bbfa-4b382445f549","text":"Therefore, in the current study, we retrospectively reviewed 498 patients treated using gynecologic surgery between July 2012 and May 2014. The aim of the current study was to find out the clinical characteristics and risk factors of DVT after gynecologic surgery, to help surgeons better understand and prevent the fatal complication during perioperative periods.","title":"Analysis of deep venous thrombosis after Gynecological surgery: A clinical study of 498 cases"}
{"_id":"02832f0c-ed03-1804-d234-cd8c4518b154","text":"Nevus sebaceus is often treated by surgical excision [10, 18]. Confirmation of complete tumor removal can be established either by using Mohs micrographic surgery and examination of the margins during the procedure or by processing the excised tissue for routine pathology evaluation. The depth of the excision should be to the level of the subcutaneous fat in order to minimize the risk of recurrence.","title":"Osteoma Cutis Associated with Nevus Sebaceus: Case Report and Review of Cutaneous Osteoma-associated Skin Tumors (COASTs)"}
{"_id":"029767d8-ff07-dc4f-d3a8-e1d010003228","text":"The first and most important obstacle for a topically applied drug is the barrier formed by the layers of the epidermis and, in particular, by stratum corneum, which represents an effective obstruction against the penetration of substances from the external environment. The epidermis only allows passive passage of compounds with molecular weight below 500 Da and adequate lipophilicity. Thus, not many products designed for transdermal administration show during their development the appropriate characteristics to find their way to the people; many new-generation actives such as peptides, proteins and nucleic acids are not compatible with topical administration because of their large molecular size.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"0297d845-6c9a-f758-0431-6e55bf86d047","text":"The BTA allergic symptoms reported so far all occurred around the injection sites or primarily occurred in the injection sites before spreading to other sites. We have noticed several patients in our clinical practice who experienced inconspicuous and nonpruritic erythema on the chest after BTA injection into the upper face, but the injection sites showed no anomaly. We speculate that some of the BTA we injected may have diffused into the blood and invoked some kind of hypersensitive reaction on the chest. The symptoms could be alleviated by dexamethasone tablets, in a short time. If these symptoms do not attract timely attention, we suspect serious events may occur in further BTA treatment.","title":"Mild Allergic Reactions after Botulinum Toxin Injection: A Case Series and Literature Review"}
{"_id":"029a07ff-13b6-807c-3298-7e69254a3064","text":"CT is considered as the first level imaging technique for a prompt diagnosis of intra-abdominal DT and their possible acute complications especially in the Emergency Department.","title":"Multimodality imaging features of desmoid tumors: a head-to-toe spectrum"}
{"_id":"02a05ccf-3b76-4174-7faf-be0d085f316f","text":"Table 4 Reasons for no longer breastfeeding at 14 weeks as reported by mothers at KIBS 2","title":"Are we doing enough? Improved breastfeeding practices at 14 weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa"}
{"_id":"02a63b31-cccd-8362-e4ad-ef592413de2a","text":"The pathognomonic presentation includes recurrent preauricular fluid collection in the first week after surgery. Patients may report increased swelling or drainage when eating. Diagnosis is often clinical but can be confirmed with aspiration and testing for elevated amylase levels. Initial treatment consists of serial aspiration or closed drainage. For persistent cases, intraglandular injection of 100 units botulinum toxin has replaced transdermal scopolamine due to its improved adverse effect profile.","title":"How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications"}
{"_id":"02a9d303-3d01-35eb-7fa4-d57272bb384a","text":"Besides trying to overcome the currently existing limitations of PDT in the clinic, other research is focussed on improving certain aspects to stimulate the applicability of PDT as a treatment modality. Combining the therapeutic property of PDT with diagnostics will not only expand its application but will also improve treatments as immediate evaluation of treatment outcome is possible and follow-up can be adjusted accordingly. Theranostics are often built around nanocarriers which can also be used to implement other therapeutics to create multifunctional agents capable of diagnosing disease and simultaneously treat it with different therapeutics. The combination of PDT with other therapeutics is an exciting prospect that could lead to enhanced efficacy and better applicability in the clinic.","title":"Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions"}
{"_id":"02a9d722-ae74-c08b-1281-151c2d358702","text":"The presence of hyaline cartilage to any extent in repair tissue did not show a significant relationship with the overall MOCART score compared with repair biopsies containing only fibrocartilage. Only 2 biopsies in this subgroup (ie, with an MRI scan at a similar time point) were categorized as fibrous tissue, and these had an overall MOCART score of 80 and 25. Neither of these biopsies had poor basal integration. The overall MOCART score did not significantly correlate with either the presence or severity of ectopic calcification or vascularization, as seen histologically.","title":"Magnetic Resonance Imaging Parameters at 1 Year Correlate With Clinical Outcomes Up to 17 Years After Autologous Chondrocyte Implantation"}
{"_id":"02aa592b-8eaf-2990-2380-cd1cea442b4b","text":"All the most significant studies discussed here are summarized in Table 1.","title":"Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: The Current and Future Role of Radiation Therapy in the Era of Immunotherapy"}
{"_id":"02b8193d-16a0-2231-cd0f-9bac6628e9b0","text":"A pre-treatment plan was calculated with a prescribed dose of 150 Gy at the apex of the tumor, taking into account that a cumulated dose of not more than 1200 Gy should be delivered to the sclera, otherwise a clinical decision must be made to treat the tumor. A depth of 1 mm corresponding to the sclera thickness was added to the real depth measured. After the treatment, the applied plan was calculated and documented.","title":"106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma"}
{"_id":"02b90ae1-07ed-9508-2d13-f8c3dcccebc8","text":"New idea and finding of our work are the use of ultrasound examination for age-related changes of soft tissues of the lower third of face and neck in the vertical position of the patient. Different ptosis tissues and the degree of their participation in age-related changes are visible in different anatomical areas. It significantly help in determination of effective minimally invasive treatment methods in a number of clinical situations.","title":"Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques"}
{"_id":"02bbde74-04fc-2467-a16f-9c5a0f26cd5c","text":"SLN biopsy should be performed with the appropriate technical expertise to correctly identify the sentinel node in the context of recognizing both the likelihood of positivity in a specific patient and the prognostic relevance of a positive or negative result. NCCN guidelines recommend SLN biopsy for all cutaneous melanoma patients with a primary tumor thickness greater than 1 mm and in selected patients with a thickness between 0.8 and 1 mm. However, they acknowledge a lack of consistency in its utility for prognosis and therapeutic value in tumors 1 mm and leave the decision to be made at the discretion of the patient and the attending physician.","title":"Sentinel Lymph Node Biopsy in Cutaneous Melanoma, a Clinical Point of View"}
{"_id":"02bc3f78-d755-19d8-a55c-273898000427","text":"Our realist review identified 19 CMOCs which are the starting point for this evidence base. We used the CMOCs to develop the first programme theory to explain in which context and for whom leadership interventions in surgery work and why. The programme theory provides evidence-based guidance for those who are conducting research on leadership in surgery or who are planning or designing evidence-based leadership interventions in surgery.","title":"Advancing leadership in surgery: a realist review of interventions and strategies to promote evidence-based leadership in healthcare"}
{"_id":"02c09798-8b8b-7efb-88aa-3317389d38b8","text":"Educational environment changes analysis was performed to assess possible factors that could influence the number of surgeries undertaken per resident. During the study period, we observed an increase in the number of annual surgical procedures and in the number of attending surgeons and residents per year. Nevertheless, the steadiness of the ASE and RPS indices could explain that the increase in both total and laparoscopic abdominal surgeries performed by residents were not affected by changes in these variables, but by the introduction of the LSTP.","title":"IMPACT OF A SIMULATED LAPAROSCOPIC TRAINING PROGRAM IN A THREE-YEAR GENERAL SURGERY RESIDENCY IMPACTO DE UM PROGRAMA DE TREINAMENTO LAPAROSCÓPICO SIMULADO EM RESIDÊNCIA DE CIRURGIA GERAL DE TRÊS ANOS"}
{"_id":"02c2d53a-838a-9d68-1efe-7d47ce0ce570","text":"The indications for postoperative plaster cast immobilization in children who underwent ESIN stabilization of fractures of the lower leg are not clearly described in the literature. Vallamshetla et al and O’Brien et al placed all children after ESIN of the tibia in a plaster cast for several weeks and allowed “protected” weight bearing in the walking plaster when a callus formation was seen and the fracture site did no longer hurt. O’ Brien et al justified the cast application on the grounds of the patient's comfort and protection. However, Ligier et al did not recommend the application of a cast except for the postoperative correction of an axial deviation.","title":"Slow Recovery of Weight Bearing After Stabilization of Long-Bone Fractures Using Elastic Stable Intramedullary Nails in Children"}
{"_id":"02c481ad-9644-93cb-d6d4-66d013c9b63d","text":"SDS-PAGE analysis of gastric digestion products showed the presence of a single protein band of Mr 18,500 corresponding to that of intact native blg indicating the protein was essentially undigested blg even after 2 h gastric digestion. During subsequent duodenal digestion for 15 min the protein was broken down into a series of lower Mr polypeptides although a sizable amount of intact protein still remained (Figure 1). The 15 min time point was chosen as approximately the time it might take gastric digesta to transfer to the duodenal compartment and flow down the small intestine to around the position of the first Peyer's patch, a relevant site where immunologically relevant sampling of the luminal contents of the gut might occur.","title":"Effect of simulated gastro-duodenal digestion on the allergenic reactivity of beta-lactoglobulin"}
{"_id":"02c5367c-50f1-0fda-69ea-bc7ad21ccceb","text":"Most of the newborns with ankyloglossia were able to breastfeed and guidelines for breastfeeding are directly linked to the ease of breastfeeding. Mothers who could breastfeed exclusively and those with a lower income had fewer breastfeeding difficulties. Although our results show that ankyloglossia did not affect breastfeeding, there is a need for prospective studies with a long-term evaluation of newborns to determine possible factors associated with the interruption of breastfeeding.","title":"Does ankyloglossia interfere with breastfeeding in newborns? A cross-sectional study"}
{"_id":"02c62b3a-666a-29ab-5776-b1e39fbc1ce2","text":"This study was limited by its design as a retrospective, observational, single armed study with no comparison group. The patient cohort was operated on by a specific experienced surgical team with a subspecialist interest in sarcoma surgery. Results may vary according to surgical expertise and experience. Potential selection bias and possible shifts in clinical practice during the study period confound our ability to make definitive recommendations regarding the indications for flaps.","title":"Preoperative Radiotherapy and Wide Resection for Soft Tissue Sarcomas: Achieving a Low Rate of Major Wound Complications with the Use of Flaps. Results of a Single Surgical Team"}
{"_id":"02c9f003-ccab-c029-7e06-1ac8614a3386","text":"Adequate venom IT is very effective while ongoing but somewhat less effective after cessation, while inadequate treatment gives poor results. More of our patients should complete five years of IT and some should continue IT. The type of reaction to IT during incremental dosing may be of help in deciding who should continue beyond five years. Maintenance IT may be taken over by the general physician.","title":"Insect sting allergy. A study from 1980 to 2003 of patients who started treatment with venom immunotherapy between 1980 and 1998"}
{"_id":"02c9f1a6-e769-c578-9dc2-66eb4bb2dad0","text":"The conclusion is that the vascularization of the grafted bed decreases continuously according to the total dose and time after radiation treatment.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"02ccc92b-8bc0-906e-fcdf-9d7460c73538","text":"Wide resection and reconstruction with a rectus abdominis musculocutaneous flap were performed","title":"Successful pre-operative local control of skin exposure by sarcoma using combination of systemic chemotherapy and Mohs’ chemosurgery"}
{"_id":"02d3f391-679c-aa21-e1c8-71bc921d3a5c","text":"Patients with a hip fracture usually have surgery on the next available trauma operating list. Some patients may be delayed by medical factors such as anticoagulation, however, surgery will proceed as soon as is determined safe by the treating team. All patients will receive a general or regional anaesthetic. Routine prophylactic antibiotics will be given to all patients immediately before surgery and all patients will be assessed for venous thromboembolism prophylaxis according to local policy. At the end of the operation, a dressing is applied to the surgical wound. This trial will involve two types of wound dressing: standard dressing and NPWT.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"02e669e0-9ad7-6b77-5fed-108cc154b460","text":"Sentinel lymph node biopsy is a minimally invasive option in patients presenting with MCC, to avoid the morbidity of elective neck dissection in the 80% of patients who are sentinel node biopsy negative. Mapping should happen at the time of wide local excision, obviating the risk of interruption of cutaneous lymphatics that could result in inaccurate localization of the sentinel node.","title":"Role of Sentinel Lymph Node Biopsy in the Management of Merkel Cell Carcinoma"}
{"_id":"02e8b15a-2686-fbf2-1500-5d3c95f04a97","text":"The stepwise regression analysis proved that the score obtained for general psychological resilience (defined as a general disposition of an entity, describing the capacity of the study participants to bounce back from difficult situations and negative emotions, and the capacity to evoke positive emotions) was a significant independent variable of factors constituting body image resilience in post-mastectomy women. Considering the time elapsed since the mastectomy for the study participants until the moment of the study and the results of the conducted regression analysis, we can identify a number of various component predictors of psychological resilience. Moreover, we can notice the significance of the time due to which various types of predictors can be distinguished for the very same variable. The statistical analysis proved that the variables constituting body image resilience are correlated in particular clinical groups by different predictors in different ways.","title":"Psychological Resilience as a Protective Factor for the Body Image in Post-Mastectomy Women with Breast Cancer"}
{"_id":"02ec18e8-157c-3886-d357-3167bf659493","text":"In this article we present the technique and 3 case examples where we have successfully applied this method.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"02ee3ec2-1b88-5386-e369-68d32732c3d7","text":"The accumulation of a photosensitiser is a pre-requisite of photodynamic inactivation. The mechanism of porphyrin photosensitiser accumulation has primarily been studied with respect to eukaryotic cells, in which hydrophobic porphyrin photosensitisers mainly accumulated in the membrane fraction and caused severe damage following illumination compared with hydrophilic porphyrin photosensitisers (Sandberg and Romslo 1980). When we consider bacterial cells to be targets for photodynamic action, negatively charged porphyrins do not appear to be very effective because they easily aggregate in water solutions and are electrostatically repulsed by the negatively charged membrane. Here, we chose PpIX as a photosensitiser for our analysis because it is naturally produced by bacteria and it is the closest structural analogue of haem.","title":"Photoinactivation of Staphylococcus aureus using protoporphyrin IX: the role of haem-regulated transporter HrtA"}
{"_id":"02ee7d5b-6bf6-ee62-5885-7ee00810f145","text":"The NinJa project was reviewed and approved by the National Hospital Organization research ethics committees, and this study protocol was approved by the research ethics committees of the Sagamihara National Hospital and the University of Tokyo Hospital, and all enrolled patients provided their written informed consent.","title":"Clinical characteristics of rheumatoid arthritis patients undergoing cervical spine surgery: an analysis of National Database of Rheumatic Diseases in Japan"}
{"_id":"02fcc87f-01fc-748e-1944-02ab6e0ba320","text":"Introduction: The use of ultrasound to perform central venous access allows the recognition of anatomical structures and the constant guide to the success, generating a benefit for the patient and the surgeon.","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"02feac4a-ca6d-2eaf-5d35-f3b025036157","text":"Surgery was performed within an interval of up to 6 h from lymphoscintigraphy in all patients.","title":"The Characteristics of Sentinel Lymph Node Biopsy in Cutaneous Melanoma and the Particularities for Elderly Patients—Experience of a Single Clinic"}
{"_id":"0300118a-e0b1-58ba-30aa-ac0ddbd40e5a","text":"Patients failing to complete the therapeutic regimen through non-attendance or failure of therapy were excluded, and recurrence of infection was noted. Failure to eradicate the infection was defined as recurrent infection from the same or different organisms. FU was continued in successful cases until inflammatory markers had returned to normal and the patient reported cessation of infective symptoms. Yearly FU appointments were then scheduled. The overall survivorship free from reoperation for infection and the overall survivorship free from reoperation for any reason is reported. The mean and standard deviations are provided using a population standard deviation formula. We used a Kaplan Meier survivorship curve to present survivorship free from reinfection following the primary DAIR procedure. This mode of analysis is similar to that used in previous literature in this field and allows direct comparison to other previous publications and different techniques for treating PJI.","title":"Debridement, antibiotics and implant retention (DAIR) is successful in the management of acutely infected unicompartmental knee arthroplasty: a case series"}
{"_id":"030b2954-f008-3014-13b8-ba2bc77637bc","text":"Delayed analgesic administration for acute abdomen was associated with female patient sex and less physician experience. Therefore, it may be useful to encourage inexperienced physicians to follow the guideline recommendations regarding early analgesic administration, which may in turn lessen care discrepancies and improve patient satisfaction.","title":"37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)"}
{"_id":"0311dbde-63cc-004c-7391-0f4cbc49865a","text":"CLL collected the patient data, reviewed the literature and was a major contributor in writing the manuscript. MTH advised about the writing of the article, interpreted the clinical significance of the aetiology and participated in the surgical intervention. CJL was the visiting staff member for the patient and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.","title":"Snapping hip caused by a venous hemangioma of the gluteus maximus muscle: a case report"}
{"_id":"03127ebf-5a87-abad-9716-912adbb7a2ff","text":"For whole latissimus dorsi flap, an 8-cm skin incision was made at the back, and patients had to change their position to the lateral position after completing breast surgery. We harvested the whole dorsi muscle flap without tension. And then the flap was rotated to the anterior chest wall through the tunnel and was sutured with the surrounding tissue for breast reconstruction.","title":"A Retrospective Study of Latissimus Dorsi Flap in Immediate Breast Reconstruction"}
{"_id":"03132b00-a703-b1b6-fa07-938abcb9d19e","text":"The surgeon on call at the UH performed and interpreted the clinical examinations and defined the management plan. At the RH, the chief physician of the emergency department was involved in all cases.","title":"Decision making in patients with acute abdominal pain at a university and at a rural hospital: does the value of abdominal sonography differ?"}
{"_id":"0319b965-5fa7-b47d-b7d0-b31aa370347f","text":"Flap harvest in this way was successful with a well-perfused flap transplanted to the hemi-glossectomy defect. The long pedicle length of the RFFF is advantageous in this situation, whereby shortening the pedicle length by moving the donor harvest site more proximal on the arm still permitted arterial and venous anastomoses to be performed in the neck without the need for vein grafts or deferring to an alternate donor site.","title":"The Allen’s test: revisiting the importance of bidirectional testing to determine candidacy and design of radial forearm free flap harvest in the era of trans radial endovascular access procedures"}
{"_id":"031d00ba-bfb9-450e-b95b-6d8e6855c7d7","text":"Adequacy of surgical resection margins for primary melanoma and the best approach regarding regional nodes are the two most important issues concerning many randomised trials.","title":"Surgical management of melanoma: an EORTC Melanoma Group survey"}
{"_id":"03214078-5dea-8c5a-c3ae-a517c8c245f3","text":"The orthopaedic healthcare professionals described how it was common for the lower limb to look different after reconstruction, but they believed that most patients were not too concerned with long-term scaring. For those who had undergone skin grafts this could result in them feeling as though the grafted skin was alien to them. Countering this feeling however was a sense of gratefulness that their limb had been salvageable.","title":"What is important to adults after lower limb reconstruction surgery: a conceptual framework"}
{"_id":"032e63ba-e7b5-76c3-14b2-97eef8792f9a","text":"In the same period, 21 adults with a suspected past clinical history of immediate reaction to AMX or AMX-C who were referred to the San Giovanni di Dio Allergy Unit were enrolled.","title":"The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults"}
{"_id":"0335bcb0-a0e3-f722-132f-dabbddbcc856","text":"Secondly, modifying the ring by ligating, excluding and excising one limb of the bifurcation in order to create a single continuous vein onto which a single donor vessel can be anastomosed potentially raises the risk of creating additional sites of turbulence at the points of ligation in the remaining limb. This would increase the risk of thrombogenesis or luminal narrowing and thus the chance of venous outflow problems. Lastly and perhaps most importantly, anastomosing two antegrade veins can be seen as advantageous as there are reports of retrograde anastomoses having an increased thrombotic risk and decreased flow rate compared to the antegrade [15]. Given the aforementioned reasons, the authors propose that by anastomosing within the ring, respecting the observed anatomy and the natural contour of the converging veins, this would preserve the integrity of the tunica intima promoting normal laminar blood flow.","title":"An unusual “venous circle” of the internal mammary vein encountered during microvascular anastomosis and implications for practice"}
{"_id":"033b686a-d9dc-90ac-1a1f-c3e317671313","text":"In summary, it is important to evaluate clinical NS preoperatively by physical examination and ultrasonography. Although biopsy scars should be excised in clinical NS cases where possible, we also recommend that excision should be considered even in cases without clinical NS. It is also important that skin incision design be carefully planned prior to performing a biopsy, as this will permit the future excision of biopsy scars if required.","title":"The significance of biopsy scar excision at the time of skin- or nipple-sparing mastectomy with immediate breast reconstruction"}
{"_id":"033cb273-23f7-79f5-a3ff-56e44dfaad43","text":"Furthermore, it is necessary to examine the function of the ultrasound to be able to approach the therapeutic goals and reach an ideal knowledge of ultrasound function. The mechanical index represents the threshold for acoustic cavitation. Since ionizing radiation delays the production of inflammatory cytokines in the skin tissue and reduces the healing period of damage, in this study, stem cells were used along with ultrasound waves to enhance the cumulative effect of the therapy procedure. The effect of ultrasound interaction on AdMSCs before (in vitro) and after transplantation (in vivo) in the skin was investigated in order to establish an effective stimulated mechanism for the regeneration of damaged tissue caused by radiation therapy.","title":"Low-intensity ultrasound combined with allogenic adipose-derived mesenchymal stem cells (AdMSCs) in radiation-induced skin injury treatment"}
{"_id":"033d2952-a604-1833-0c3a-d80ffc34238c","text":"In conclusion, venous drainage is vital in the survival of AVFs and this problem can only be partially improved by increasing the number of draining veins. Further studies are warranted to gain insight into this complicated issue.","title":"The complicated role of venous drainage on the survival of arterialized venous flaps"}
{"_id":"033d8f69-b63d-6131-3539-f3797dd2de6a","text":"Pelvic SLNs have minimal clinical impact on the outcome of melanoma patients especially in cases with negative superficial femoral\/inguinal SLNs. Removal of PSLNs should be considered when they are the most radioactive nodes or equal to the hottest superficial femoral\/inguinal SLNs in lymphoscintigraphy or during surgery.","title":"Pelvic sentinel lymph nodes have minimal impact on survival in melanoma patients"}
{"_id":"033df4f2-eff9-4bb7-9ece-1fd1867def7f","text":"Photodynamic therapy (PDT) is a minimally invasive treatment option that can kill cancerous cells by subjecting them to light irradiation at a specific wavelength. The main problem related to most photosensitizers is the lack of tumor selectivity, which leads to undesired uptake in normal tissues resulting in side effects. Passive targeting and active targeting are the two strategies to improve uptake in tumor tissues. This review focused on active targeting and summarizes recent active targeting approaches in which highly potent photosensitizers are rendered tumor-specific by means of an appended targeting moiety that interacts with a protein unique to, or at least significantly more abundant on, tumor cell surfaces compared to normal cells.","title":"Photodynamic Therapy: Targeting Cancer Biomarkers for the Treatment of Cancers"}
{"_id":"03445ffc-1482-435b-4d91-f4a3f1a2a3f3","text":"Scarring in the LIMA dissection bed in patients with a history of cancer and prior chest radiation should be carefully evaluated for the possibility of recurrent cancer. The gross appearance of tissue can be misleading and sending a biopsy for a formal frozen section histologic evaluation should be considered if there is any question of recurrent malignancy.","title":"Case report: recurrent metastatic breast cancer in internal mammary dissection bed discovered at the time of coronary bypass"}
{"_id":"0347a9a4-5811-0136-ba4a-9dd1a9cd5e3b","text":"These findings must be taken with caution because of the small number of articles and their quality. Future clinical trials using larger sample sizes and with higher methodological quality are needed. Overall, myofunctional therapy is expected to have a positive impact on patients with ankyloglossia.","title":"Effectiveness of Myofunctional Therapy in Ankyloglossia: A Systematic Review"}
{"_id":"03537456-a0b8-240b-c8c7-944370dc63ea","text":"The preventive use of topic products reduces the incidence of skin side effects in patients treated with radiotherapy for breast cancer. An instrumental evaluation of skin hydration can help the radiation oncologist to use strategies that prevent the onset of toxicity of high degree. All moisturizing creams used in this study were equally valid in the treatment of skin damage induced by radiotherapy.","title":"Preventing the acute skin side effects in patients treated with radiotherapy for breast cancer: the use of corneometry in order to evaluate the protective effect of moisturizing creams"}
{"_id":"0356b732-9e08-faa9-3881-323a5956fed4","text":"Conclusion: These findings suggest that increased basal activation status of basophils may contribute to develop anaphylaxis in adult patients regardless of atopy status, serum total IgE and ECP levels. BATs with applying each allergen will be useful to confirm the causative agent.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"035a7991-59a0-c3e2-0f05-bb88ebffabe4","text":"The application of negative-pressure wound therapy in preventing SSI may be effective in reducing postoperative wound complications and it may be an option to take into consideration especially in patients with a high risk of infection.","title":"Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines"}
{"_id":"0360a381-33b2-edfa-be10-2edbc54db8b4","text":"Regular follow up visits were performed at our institution or the referring center. At our institution, patients were scheduled for follow up visits every three months for the first two years, every 6 months for the three following years and annually thereafter. Each follow-up visit included at least clinical examination and CT or MRI of the head and neck region. In case of evidence for locoregional recurrence or distant spread, additional tests or imaging modalities were performed to confirm or exclude disease progression at the discretion of the treating physician. Missing data were completed by calling the patient or the treating physician.","title":"Intensity modulated radiotherapy (IMRT) combined with concurrent but not adjuvant chemotherapy in primary nasopharyngeal cancer – a retrospective single center analysis"}
{"_id":"036dd999-e23a-67ab-a12e-e489e3976a61","text":"Melanoma thickness is a relevant prognostic marker that is crucial for staging and its calculation relies on the histopathological examination. There is a risk of thickness underestimation with an incisional biopsy if the latter is not performed on a tumor area where the thickness is maximal. This occurrence may have an impact on a therapeutic decision, particularly regarding the excision margins and the need for sentinel lymph node biopsy.","title":"Predictive factors of melanoma thickness"}
{"_id":"037205cb-4215-554a-839d-b832ca264b6b","text":"With rising health care costs in Canada, concerns over the high costs of surgical care is well justified. Historically, the use of pedicled flaps in head and neck reconstruction has been overshadowed by the use of free flaps. However, free flaps are typically associated with longer operative times and increased length of hospital stays. Furthermore, free flaps have a requirement of intensive care monitoring in most centers for part of the post operative period. Due to these factors free flaps are associated with a much higher cost to the medical system and a more cost efficient option should be considered.","title":"Submental island flap reconstruction reduces cost in oral cancer reconstruction compared to radial forearm free flap reconstruction: a case series and cost analysis"}
{"_id":"0375d7fb-36d5-4ccb-f545-dab6b99e5c14","text":"This study aimed to describe the short-term outcomes of patients who underwent extensive CFR at a single tertiary cancer treatment institution and to identify the risk factors for perioperative death.","title":"Short-term survival in extensive craniofacial resections"}
{"_id":"0375f4cf-81d9-4bde-5e11-bfe0a30faa45","text":"If deemed clinically necessary, patients could receive additional surgical treatments deviating from the assigned study group after their initial surgical treatment. Those additional tonsillotomy or tonsillectomy treatments were offered in line with the standard of care for symptoms to maintain a pragmatic and ethical randomized clinical trial design. No additional surgical procedures were performed within 6 weeks of the initial study assigned surgery. Patients who were randomized in the study but changed their mind and decided to not undergo their allocated treatment were asked for permission to continue to collect follow-up data on their tonsil symptoms and any surgical procedures they underwent.","title":"Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults A Randomized Clinical Trial Laser Tonsillotomy vs Conventional Tonsillectomy in Adults"}
{"_id":"0376f6b7-e56d-7a62-7ab7-2408dc019001","text":"The extent of resection of primary lesions included total lower lip and adjacent oral mucosa. Eighteen patients received postoperative irradiation and 50 patients received no further treatment.","title":"Sensory Recovery with Innervated and Noninnervated Flaps after Total Lower Lip Reconstruction: A Comparative Study"}
{"_id":"0379e2af-d609-59fd-aa2c-36d3799b0b60","text":"The analysis of the current literature revealed a prevalence of studies applying noninvasive skin imaging on NMSC treatment monitoring applied to the BCC, while only one study dedicated to SCC persistent disease met the inclusion criteria for this review. This difference might be explained by the fact that low-risk BCCs are ideal candidates for a medical treatment approach, whereas SCC is more commonly treated with surgical procedures. Additionally, the most frequently used techniques for treatment monitoring are clinical evaluation and dermoscopy, while OCT and RCM have been employed in limited studies. Further, the heterogeneity among the studies was significantly large or extreme for all monitoring techniques.","title":"Non-Melanoma Skin Cancer Clearance after Medical Treatment Detected with Noninvasive Skin Imaging: A Systematic Review and Meta-Analysis"}
{"_id":"03812c2b-e23f-d022-1e01-5e88c9a49a7a","text":"The patient lies in the midlateral position or supine with a sandbag. A longitudinal incision is made from the axilla to the posterior iliac crest. We always mark out the skin paddle required.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"038b42c4-58a8-636b-f609-bb3cc49742ae","text":"On radiologic findings there are multiple calcification in soft tissue layer on humeral, antebrachial, femoral and crural bilateral. On tissue biopsy there are cystic space containing calcified material separated by fibrous tissue. Patient underwent treatment with bisphosphonate using zolendronate and surgical exicion","title":"Idiopathic calcinosis cutis universalis"}
{"_id":"03915401-e302-b1d7-9d0c-084a020a81db","text":"Retrospective analysis of resected keloids in patients referred to a Chilean radiation oncology centre between 2006 and 2013. Local recurrence was defined as new tissue growth on the surgical scar margin.","title":"Postoperative radiotherapy in the management of keloids"}
{"_id":"0393759d-bd75-5e59-4638-8ff6fafbadff","text":"DF is a rare soft tissue neoplasm that may be locally very aggressive causing significant functional limitations, pain and even major disabilities. The unpredictable course, the low incidence, the lack of knowledge about DF have been limiting factors toward a more rapid advancement of its management. Given the wide spectrum of treatments available for DF there is now the ability to tailor treatment to the patient.","title":"Misdiagnosed desmoid fibromatosis of the chest wall presenting in emergency like as recurrence of post-traumatic hematoma: A case report and review of the literature"}
{"_id":"0394367f-15fe-6b33-1737-35985bf49815","text":"Summary estimates were used to reconstruct 2 x 2 data in case such tables were not reported. Inconclusive or non-diagnostic test results were excluded from the 2 x 2 tables and were documented separately.","title":"Diagnostic accuracy of three ultrasonography strategies for deep vein thrombosis of the lower extremity: A systematic review and meta-analysis"}
{"_id":"0398e8e9-171e-1925-0cc3-2eacb57cf489","text":"In all of our patients with LC and APC type B injuries allowed to WBAT immediately post op we experienced only one early complication, with one ISS migration at three months requiring removal and re implantation of another screw. We noted a higher proportion of patients with metal work breakage (either screw or plate) compared with our RWB cohort but these patients did not experience loss of reduction nor were they symptomatic from broken metalware. Interestingly metalwork failure was only observed in the APC group. Hardware breakage is common following pubic symphysis fixation and is reported in the literature and not thought to be clinically important [8]. There is physiological movement at the fibrocartilaginous symphysis after the healing process has completed, and on repeated loading the stress exceeds the fatigue strength of the construct resulting in failure.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"039ff6aa-6912-4c1a-b9e4-72edb1998fcd","text":"The percentage of patients who accurately perceived the objective of pharmacotherapy increased over the course of pharmacotherapy. Beyond 1st line therapy the percentage of patients who were willing to receive treatment remained high, and more than half of the patients indicated that they would be willing to try another treatment when the standard treatment becomes difficult to continue.","title":"Change of genitourinary cancer patients’ perception and expectations over the course of pharmacotherapy"}
{"_id":"03aa9a25-7424-406c-5cb6-6ef5d4558166","text":"To optimize patient satisfaction after a revision surgery, the surgeon must be aware of the aesthetic and functional complaints reported by the patient, as well as perform a very detailed and objective nasal evaluation, to ensure that no alteration in nasal anatomy goes unnoticed and is not considered capable of being corrected during surgery.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"03af7cfb-858f-4073-4e76-0f762c27b81e","text":"BCC is the most frequent malignancy of the skin., It is usually located on the nose and could be diagnosed by incisional biopsy. The treatment of the lesion could be by nonexcisional and excisional methods which varies according to the risk factors of the tumor. cSCC is the second most common malignancy of the skin. Regional lymph node metastasis is the main difference of this tumor from BCC. These lesions could be caused from chronic ulcers or burn wounds. Definite diagnosis is dependent on the pathological report and the treatment of the lesion should be determined according to the level of the tumor.","title":"Non-metastatic Non-melanoma Skin Cancers: Our 3 Years of Clinical Experiences"}
{"_id":"03afcb5c-e944-3bea-d905-308cdaefeb76","text":"In chest wall tumors located ventral of the pulmonary apex, we suggest that a combination of the Grunenwald method and Masaoka anterior approach may be a useful option. In cases where margin is not enough, adjuvant radiation therapy should be considered.","title":"Resection and postoperative radiation therapy for desmoid fibromatosis of the chest wall in a young woman"}
{"_id":"03b75167-224a-2a0f-61c2-79f9ab881977","text":"Reconstruction after wide excision of MCC offers several unique challenges including a propensity for elderly patients with poor tissue quality and decreased immune function, large defects and a high probability of disease recurrence, and the risks inherent to adjuvant radiotherapy. For this reason, most reconstructive surgeons favor free tissue transfer as a modality for providing healthy, uninvolved tissue with an acceptable aesthetic outcome. There is clearly a need for higher quality of data in the area, as significant questions remain for the treatment for Merkel cell cancer, as well as the reconstructive methods utilized after ablative surgery. Recently, data has been published suggesting that wide surgical margins during tumor resection may not impact overall survival in patients receiving adjuvant radiotherapy [29]. This is a crucial question for the reconstructive surgeon as it may impact defect size and the probability of local recurrence. Additional data on radiotherapy and targeted chemotherapy for MCC may play a role in deciding the timing for reconstruction, as well as the selected technique. The decision on surgical approach by the reconstructive surgeon should be based on the individual patient and should take into account the details of the clinical scenario in addition to the location and size of the defect. Current free tissue transfer techniques allow the reconstructive surgeon to manage advanced MCC with acceptable functional and aesthetic results, while minimizing morbidity.","title":"The Role of Free Tissue Transfer in Merkel Cell Carcinoma of the Head and Neck"}
{"_id":"03b86323-a1e0-a478-e6e7-b7425137b523","text":"For all the reasons mentioned above, we have compiled this review which addresses the concepts and semantic frameworks of key allergic and hypersensitivity conditions with the idea that this should be accessible to all health care professionals in clinical practice, education and research. It is hoped that this revision will be globally accepted as a tool of improving the communication between health professionals and also support the tremendous efforts of the Joint Allergy Academies to update and standardize the allergy and hypersensitivity definitions throughout the new ICD-11.","title":"Dissemination of definitions and concepts of allergic and hypersensitivity conditions"}
{"_id":"03d3d3d1-52e2-9146-270d-f9743cc385c1","text":"Osteomyelitis must be treated with prolonged antibiotic therapy and consultation with an infectious disease specialist. The limited literature and our collective experience indicate that osteomyelitis in the setting of FD is difficult to diagnose and to successfully treat [50-54]. We have managed patients that developed osteomyelitis of the jaws after attempts at exposure and orthodontic movement of impacted teeth. It may resolve with prolonged antibiotic treatment and pain management, however en bloc resection of the FD lesion may be required for refractory pain and persistent infection.","title":"Clinical guidelines for the management of craniofacial fibrous dysplasia"}
{"_id":"03e78f7f-10a9-ea5b-2378-3ae7c772ff49","text":"Although RAS already represents a gold standard for many other surgical fields, its use in plastic surgery is still underestimated. While conventional systems such as the da Vinci have not found their way into the clinical routine of plastic surgery, novel robotic systems customized for microsurgery are aiming to simplify procedures.","title":"Robotic-Assisted Microsurgery and Its Future in Plastic Surgery"}
{"_id":"03eb772a-5b14-46b4-0681-2374ef77a871","text":"The 1990s saw a proliferation of free flap reconstruction for head and neck defects as they were demonstrated to be more reliable and result in superior functional and aesthetic outcomes compared to most prior techniques. In the past decade, algorithms were developed for flap selection based on evidence and experience, further improving outcomes and decreasing complications. Flaps are selected to minimize donor site morbidity, including perforator-based flaps, such as the anterolateral thigh free flap. Currently, advances in head and neck reconstruction are focused in further refinement, such as use of computer-assisted design and rapid prototype modeling to plan surgery. The future will undoubtedly bring further breakthroughs in reconstructive surgery in an effort to restore normalcy and allow for more complete oncologic resection with the goal of improving cancer cure rates and quality of life.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"03fd6e93-0300-276f-b361-03f6af221b76","text":"Wounds with substantial soft tissue defects may not be suitable for primary closure. When treating those wounds by secondary or tertiary intention as well as in plastic reconstructive approaches, the importance and particular nature of soft tissue cover of hand and foot must be taken into account in conservative as well as in surgical treatment.","title":"Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View"}
{"_id":"040605a8-a17e-bc04-a594-a009c04dc154","text":"Sunblocks are the products which protect against UVB rays while sunscreen protects against UVA rays. Sunblock comes under the physical category of protective lotion, containing both non-organic and organic constituents that get deposited on the surface of the skin when applied, shielding the skin from harmful UVB rays. These block the rays from penetrating the skin. Some of the ingredients found in sunblock are octocrylene, octyl salicylate, and octyl methoxycinnamate. The chemical type of protective lotions can be broadly referred to as sunscreens. This lotion permeates through the skin and absorbs the UVA rays before they can reach and damage the dermal layer. Zinc oxide and titanium dioxide constitute the sunscreen. Ecamsule is one of the ingredients present in sunscreen. This compound shields the skin from the photoaging UVA rays. A formulation which constitutes both sunscreen and sunblock ingredients serves as a protective agent against both UVB and UVA rays, and a combination of these two is more efficient in the protection of the skin than using them alone.","title":"Anti-aging and Sunscreens: Paradigm Shift in Cosmetics"}
{"_id":"0407ecf6-0b5a-d8fa-066b-28932463785c","text":"On the other hand, few participants expressed the decision that they have no desire to do reconstruction because they are scared from its side effects including the misconception that reconstruction would cause the cancer to recur. For example, the following participant said:","title":"Beyond the scars: a qualitative study on the experiences of mastectomy among young women with breast cancer in a country with crisis"}
{"_id":"040c0d37-d43f-01b8-c4e7-f730c71fe7bd","text":"Study participants will have a total of six visits over a two year period.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"04136779-85fc-cf53-6a9a-50aab8bb7317","text":"We observed a heterogeneous spectrum of cutaneous clinical manifestations as adverse event. Some patients had two or more skin toxicities as showed in Table 2 and Figure 1.","title":"Cutaneous side effects and types of dermatological reactions in metastatic melanoma patients treated by immunotherapies or targeted therapies: A retrospective single center study"}
{"_id":"0428111a-a406-1484-4a35-3b8fe89ad897","text":"The recurrence in the postoperative any follow-up period delineates the need for a sufficient resection margin all around the lesion during the surgery. Neoadjuvant chemotherapy can decrease the unnecessary resection around the mass as the margins of which can be shrunken after the neoadjuvant chemotherapy. In our patient, the diameter of the tumor decreased by 3 cm and findings of invasion to the mediastinal structures disappeared after neoadjuvant chemotherapy. It seemed that en bloc resection of the tumor with a vital tissue margin of 4 cm was not totally sufficient in our case due to recurrence after surgery although the size of the tumor had gotten smaller after neoadjuvant chemotherapy. Perhaps, the preoperative size of the tumor should have been considered as the basal measurement, and the decision for the resection extent should be marked as 4 cm vital tissue encircling the original mass before chemotherapy. Taking this into consideration, resection margins should have been like 7 cm of vital tissue from the center of the original mass in our case.","title":"A case of radiation-induced sternal malignant fibrous histiocytoma treated with neoadjuvant chemotherapy and surgical resection"}
{"_id":"042c12b9-76ff-cfdc-8cbb-7827606b0f75","text":"Patients with a history of a few squamous cell carcinomas and some actinic keratoses may be followed every six to 12 months, while those with many squamous cell carcinomas or aggressive tumors likely will need to be seen much more often [59].","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"042ff78e-823c-6d2f-d32e-bc0a422b1db3","text":"Multiple spinal lesions were defined when the spinal involvement presented beyond two vertebral bodies on MRI, with at least one completely uninvolved vertebral body between the involved vertebral bodies. Early surgery was defined as a surgical treatment performed under general anesthesia within 30 days after PVO diagnosis.","title":"Treatment outcomes in patients with pyogenic vertebral osteomyelitis who have cirrhosis"}
{"_id":"04398ca6-fb46-f803-265c-2c82abdc0874","text":"Concerning the surgical excision margins to be adopted for MTC excision, we reviewed the literature of the BCC and SCC standard surgical margin and recurrence rate risk.","title":"Metatypical basal cell carcinoma: a clinical review"}
{"_id":"043b200f-9e5b-059f-9f37-1c8da785afbf","text":"Although imaging is essential in the diagnostic process, cooperation between the physician and radiologist remains the cornerstone in accurately diagnosing childhood osteomyelitis.","title":"Childhood osteomyelitis: imaging characteristics"}
{"_id":"0442e698-602e-b883-2c56-2da4866320ff","text":"We suspected a malignant tumor because of the associated facial nerve paralysis and parotid pain. On the contrary, we considered the possibility of a benign tumor with inflammation due to the reduction in tumor size and pain. We planned a total parotidectomy including exeresis and reconstruction of the facial nerve. However, we also made preparations to preserve the facial nerve should a benign tumor be suggested during the surgery.","title":"Oncocytoma of the Parotid Gland with Facial Nerve Paralysis"}
{"_id":"044ecc03-43bb-b455-a155-78791a5af71a","text":"High-risk women with genetic predisposition for breast cancer are increasingly being offered bilateral prophylactic mastectomy for risk reduction. If an incidental tumour is found at surgery, the patient cannot then undergo sentinel node biopsy of the axilla and has to have a full axillary clearance associated with morbidity of lymphoedema often in young women. We look at the use of screening MRI in 16 women at our institution prior to surgery to see how this affected management.","title":"Screening breast MRI in high-risk women undergoing prophylactic mastectomy"}
{"_id":"044ed3aa-cc81-0da3-6ccf-222c36134f00","text":"US resident interest in global health is growing along with an increasing demand for surgical care worldwide. This is one of the first studies to identify, quantify, and characterize in detail the international experiences currently available to general surgery residents within the general surgery training programs in the US. These results can help general surgery residency applicants with an interest in global health and also pave the path for residency programs to develop future international experiences.","title":"Current status of international experiences in general surgery residency programs in the United States"}
{"_id":"045475a5-b655-49d6-54dc-2bc53b90b2e0","text":"A single centre retrospective chart review was performed for all patients with systemic reactions to subcutaneous immunotherapy requiring intramuscular epinephrine injection between January 2011 and October 2017. Each systemic reaction requiring epinephrine was reviewed for baseline patient characteristics, details of the reaction, and reaction severity. Research ethics approval was obtained through McMaster University.","title":"A single centre retrospective study of systemic reactions to subcutaneous immunotherapy"}
{"_id":"045b3f9f-067e-4b7b-c644-acf537f19ba7","text":"The objective assessment of the autonomic nervous system is not trivial.1 If there is suspected autonomic dysfunction on the basis of symptoms and examination, we recommend cardiovascular reflex testing, such as the Ewing protocol,25 42 as an initial assessment of the autonomic nervous system, with subsequent referral for a more comprehensive assessment to include tests such as the sympathetic skin response. A further development is that skin biopsies may eventually be used to assess the autonomic nervous system as new techniques have been developed to assess sweat gland and pilomotor muscle innervation, and found to correlate with autonomic dysfunction. However, we need more research before it can be used in routine clinical practice.1","title":"The clinical approach to small fibre neuropathy and painful channelopathy"}
{"_id":"045cb8b4-68f6-eb70-e6e6-cbba0eda224b","text":"Therefore, we supposed that LCP might be used subcutaneously to treat humeral fractures. Consequently, we designed a surgical method that uses a small anterolateral incision to reduce the fracture before an LCP and locking screws are implanted to fix the fracture via two small lateral incisions that connect a subcutaneous tunnel. This method might realize fixation in vivo using LCP as the principle of external fixation and avoiding drawbacks of an external fixator such as infection of screw channels and inconvenience for nurses. Meanwhile, aggravation of the radial nerve can be avoided completely because the plate and the nerve do not touch any more.","title":"Lateral Subcutaneous Locking Compression Plate and Small Incision Reduction for Distal‐third Diaphyseal Humerus Fractures"}
{"_id":"04627f63-31de-1c3c-5955-15a2e774b59c","text":"Dermal fillers can be used in simple and short procedures in surgery and rapid facial rejuvenation. There is growing interest in the use of fillers for tissue enlargement and improvement of skin aesthetic beauty.","title":"Comparative Evaluation of the Effectiveness of Novel Hyaluronic Acid-Polynucleotide Complex Dermal Filler"}
{"_id":"0466aa1d-45a4-6363-df66-7f3549cc47b7","text":"If the intervention can reduce the severity of psoriasis in a significant manner and is economically favorable compared to standard treatment, there is potential for implementing the intervention in dermatology clinics.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"0469d474-4c97-832f-7166-20fb8cd6f7aa","text":"Despite the rapid growth of plastic surgery in the last two decades, a large portion of population remains unaware of the spatiality. It is essential to institute programs to educate healthcare consumers and providers about the plastic surgery.","title":"Views of College Students on Plastic Surgery"}
{"_id":"0473f910-1ecc-e356-21c1-2de3e7f617e1","text":"In the future, the optimum temperature for local cooling is yet to be determined. Further studies are required to investigate the differences in treatment outcomes of cooling and warm massage in the treatment of skin ischemia caused by hyaluronic acid injection–induced embolism.","title":"Local Cooling as a Step of Treatment for Tissue Ischemia Caused by Hyaluronic Acid Injection-induced Embolism—A Report of 9 Cases"}
{"_id":"04754dda-8746-6821-9a2c-66474dcbfa83","text":"It should be noted that to preserve the AA from oxidation of air and light and to avoid its rapid degradation, the clinicians prepared the formulations extemporaneously and administered them immediately.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"047588b9-859d-de5d-6d8d-e5f3c132e748","text":"Reports have shown the development of new lesions appearing even 5 years after treatment, which demands the need for twice-yearly clinical evaluation and monitoring of patients for an extended postoperative period.","title":"Recurrent Dermatofibrosarcoma Protuberance: A Case Report"}
{"_id":"047650c4-148f-6f8a-4b6f-4261895d9c77","text":"The patient is a 66 year-old woman who was diagnosed with a primary desmoplastic BCC arising on the left aspect of the chin in April 2008, which was resected with Mohs surgery. A localized recurrence in the same location was identified in June 2010, and a wide local excision revealed invasion into the left mandible and involvement of one out of 18 lymph nodes. The patient received adjuvant radiation and remained in remission until 2014, when enlarging lung nodules observed on surveillance chest imaging were biopsied and confirmed the presence of metastatic BCC. The patient subsequently received the Hedgehog pathway inhibitor (HHI) vismodegib from September 2014 until February 2015. She initially responded but discontinued because of progressive disease.","title":"Responses of metastatic basal cell and cutaneous squamous cell carcinomas to anti-PD1 monoclonal antibody REGN2810"}
{"_id":"0476c6d6-0213-6c11-d8e8-e3817be6bd6b","text":"Three-dimensional printed PSI allows for accurate reconstruction of anatomic relations as well as efficiently restoring function. A PSI spares the need for adaptation in the operating theater, thus resulting in highly resistant implants which can easily withstand physiological forces. The application of PSI is expanding rapidly, and we will see many more innovative treatment modalities in the near future based on this technology.","title":"Printing the Future—Updates in 3D Printing for Surgical Applications"}
{"_id":"0478cbce-965e-b4b2-b2e9-61eda6c8dc41","text":"Skin hydration is an index to evaluate the function of skin barrier. As shown in Table 6, skin hydration of the three groups increased significantly from baseline to week one, four, or twelve after the treatment. One week and four weeks after the treatment, the skin hydration in the nanomicroneedle group and the intradermal microdroplet group increased and became higher than that of the intramuscular injection group; then twelve weeks after the treatment, the skin hydration in the intradermal microdroplet group was higher than that of the intramuscular injection group and the nanomicroneedle group.","title":"A Comparative In Vivo Study on Three Treatment Approaches to Applying Topical Botulinum Toxin A for Crow's Feet"}
{"_id":"047b2c37-1a66-dfd5-ebd4-1d81b386fbbc","text":"It was found that the presented 3D virtual models acquired with the described semi-automatic segmentation method provide more accurate information on intrabony periodontal defect morphologies than conventional diagnostic methods. Values between intrasurgical and digital measurements were found to be not significant. It can be concluded that virtual models have depicted the actual defect morphology accurately. However, further validation on larger sample sizes with standardized measurements has to be conducted. In the current study, virtual models only contained hard tissues. However, soft tissue models acquired with an intraoral scanner can be added to generate more realistic virtual models that can be manufactured with 3D printing technologies and used for surgical simulation.","title":"Digital three-dimensional visualization of intrabony periodontal defects for regenerative surgical treatment planning"}
{"_id":"047cc573-9e3a-5c62-bcd2-4c80d6cff338","text":"Reconstructive flaps have revolutionized the ability of surgeons to restore function and cosmesis for patients. While reconstructive flaps have been used to bridge large defects due to oncologic or congenital maladies necessitating large debridements, few cases have observed salvage flaps in traumas which provide additional challenges secondary to an injury trajectory. This case report details use of an osteofasciocutaneous fibular free flap and radial head prosthesis to restore forearm function in a 64-year-old female with a comminuted fracture of the proximal radius. The patient has sustained a 5.5 cm epiphyseal radial defect with an associated 20 × 15 cm overlying tissue defect after serial debridement. In review of the literature, only one nontraumatic case using a combined free flap and radial head prosthesis for proximal forearm defect to restore joint function has been reported. We suggest that, for proximal forearm fractures, this technique can be used to restore elbow joint function in limb salvage.","title":"Use of Osteofasciocutaneous Fibular Free Flap and Radial Head Arthroplasty in Trauma for Limb Salvage and Continued Elbow Function"}
{"_id":"048007e6-4821-5bec-f018-541acaef7965","text":"This study shows that with ILI procedures, 40% of the patient population will have untreated disease in the nodal basin. Some have suggested that the presence of iliac, hypogastric or subclavian nodal disease is a sign of systemic disease and patients should be staged as Stage IV disease. However the 6th edition of the AJCC staging manual stages these patients as advanced Stage III disease. Certainly anatomically the latter makes sense, since the superficial groin lymphatics flow directed into the deeper lymphatics of the pelvis through Cloquet’s node and anatomically the same is true for the relationship between the axillary and subclavian nodal basins.","title":"Regional Therapy for Recurrent Metastatic Melanoma Confined to the Extremity: Hyperthermic Isolated Limb Perfusion vs. Isolated Limb Infusion"}
{"_id":"04819ccc-ebfa-daf6-6471-676f399691ca","text":"The operator will use the muscle thickness of both sides of frontal muscle and depressor anguli oris muscle to calculate the affected\/healthy side ratio.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"0483d4b5-aeb4-5c75-13f8-7bbcda7ef68d","text":"P54 Ibuprofen and other aryl propionic derivates can induce immediate selective hypersensitivity responses","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"048c6b3a-f121-49de-0b2f-bfad844d49a1","text":"Although PDT is a fairly well accepted treatment in clinical practice for NCC, it has no yet to be fully explored by quantitatively assessment. Based on above evidences, this systematic review will clarify the effectiveness of PDT on patients with NCC and identify gaps in current practice and knowledge. We expect that the results from this clinical systematic review will help inform the design of clinical trials.","title":"Therapeutic effect of photodynamic therapy for nonresectable cholangiocarcinoma Protocol for a meta-analysis and systematic review"}
{"_id":"048c6cc5-09cc-82e1-257f-3f205f72cb17","text":"Recently, there has been a strong interest in the application of helium ions for treatment of cancer. Helium exhibits depth dose characteristics identical to protons along the longitudinal depth, but has reduced lateral scattering due to its larger mass. This advantage is interesting as the LET of helium ions is higher than that of protons. Distinct from carbon and other heavy ions, helium produces little to no fragmentation tail and therefore treatments are capable of gaining the benefit of a higher RBE value while also maintaining a sharp dose fall-off after the tumor.","title":"Neutron activation of gadolinium for ion therapy: a Monte Carlo study of charged particle beams"}
{"_id":"04914cd1-7235-ca8f-7fbf-d08ccb897b4e","text":"Participants will be excluded in the postrandomisation phase if it is established that they would be unable to adhere to trial procedures or complete questionnaires.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"0493dee9-18ae-dbe0-e64d-1a422777a9c3","text":"To establish network comparisons on the efficacy of antibiotic regimens on OM in animal studies.","title":"Comparing the efficacy of different antibiotic regimens on osteomyelitis: A network meta-analysis of animal studies"}
{"_id":"04960337-acd3-e6b8-d698-09e1eba051df","text":"Patients will be admitted for 5 days. They will receive intravenous corticosteroid treatment in the form of Methylprednisolone 1g per day for 3 days if admitted with Ophthalmology and for 5 days if admitted with Neurology. These are as per the normal treatment protocols. This may be followed by a tapering course of oral Prednisone according to clinical judgment of the treating team. Patients who do not respond or have incomplete recovery will be assessed and may receive plasma exchange at the discretion of the treating neurologists. Patients will then be followed up after admission at 1 month, 3 months, 6 months and every 3 months after that. They will be followed up for a period of 2 years. The NMOSD and MOGAD patients will be followed up annually for a period of 5 years.","title":"Optic neuritis: A South African hospital-based prospective study protocol"}
{"_id":"04984132-66b0-c0e1-9efc-5befec03de54","text":"CONCLUSIONS We built a dual mode TRC that can both perform US shock wave therapy and create a 3D image of the surrounding medium. Though the image resolution is quite low due the low frequency used, it is sufficient to visualize strongly reflecting structures like the rib cage. This could be particularly interesting in transcostal therapy of the heart or the liver. Preliminary results indeed show that selective propagation of the therapeutic beam through the intercostal space would increase the peak pressure on target.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"04a2c308-dd37-7d81-f74d-636f9729d29d","text":"Traditionally metastatic melanoma of the distal leg and the foot metastasize to the lymph nodes of the groin. Sometimes the first site of nodal disease can be the popliteal fossa. This is an infrequent event, with rare reports in literature and when it occurs, radical popliteal node dissection must be performed.","title":"Resection in the popliteal fossa for metastatic melanoma"}
{"_id":"04a68847-8703-7b3c-0a1d-82663d96a629","text":"The tip loading plate has cutouts in the same hexagonal array as the device. The tips are placed inside the cutouts with their proximal ends facing upwards. The activated cylindrical radioisotopes of Ytrium-90 are easily transferred from their containment vial to the inside of the tips with various instruments. A glass aspirating pipette attached to a vacuum or forceps can also be used.","title":"Novel design and development of a 3D-printed conformal superficial brachytherapy device for the treatment of non-melanoma skin cancer and keloids"}
{"_id":"04badd95-264d-d91f-30c1-c1bff1b273a1","text":"Leadership roles include the important concept of management of both personal and professional practice. Priorities need to be set and time managed to integrate work and personal life. Tools can be used to stay organised, and deliberately manage busy schedules. Effective delegation may be used to share the work of new projects:","title":"Leadership in healthcare education"}
{"_id":"04bc0fd7-ef12-ad85-dadf-d32ca9408443","text":"An evolving postoperative hematoma may be difficult to distinguish from swelling or simply a high implant position. The surgeon may be in surgery and unable to immediately examine a patient in the recovery room. An ultrasound examination makes the diagnosis with high reliability. Definitive arrangements may be made for the patient’s return to the operating room or discharge, without waiting to see if the degree of swelling changes.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery"}
{"_id":"04bd3d90-98ba-fbb0-28ad-5617ee77f990","text":"A custom construct of antibiotics and intramedullary femoral nail as outlined in this article is a safe and effective means of local antibiotic application for 2 stage revision for infection and large segment femoral bone loss.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"04ccf27e-37b0-3942-0b32-730daa072a1f","text":"The protocol and procedures used in this study were performed in accordance with the Guide for Care and Use of Agricultural Animals in Agricultural Research and Teaching (Anon 1988). An exemption for the use of archived samples was obtained from the Institutional Animal Use and Care Committee at Michigan State University on 30 August 2022.","title":"Novel Expression of GLUT3, GLUT6 and GLUT10 in Equine Gluteal Muscle Following Glycogen-Depleting Exercise: Impact of Dietary Starch and Fat"}
{"_id":"04ce32d9-8d5a-6564-c45d-6244d4aa680f","text":"Idiopathic scrotal calcinosis is a rare condition, characterized by the idiopathic deposition of calcium in the scrotal dermis leading to the formation of a single nodule or multiple nodules of different sizes. Surgical excision of the nodules reduces symptoms and improves cosmesis. We present a case of idiopathic scrotal calcinosis that had an en bloc excision of scrotal skin nodules and primary closure of the scrotal skin. Handling each hemiscrotum as a separate entity and preserving the median raphe with its uninvolved skin improved the cosmesis. Reported outcomes of surgery were satisfactory with no postoperative complications. At 30 months of follow-up, the residual scrotal skin had regained its laxity and the scrotum its normal configuration. There is the risk of recurrence of the calcific nodules post excision, but these may be smaller in size and with regained scrotal configuration that could be amenable to excision with further preservation of the native scrotal skin.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"04ce53c8-8437-8bee-b5ae-fc47c310f850","text":"Surgical excision of the metastatic melanoma was performed and considered successful, with no gross evidence of tumour reoccurrence. Despite the fact that surgical excision is considered a treatment option regarding equine dermal melanomatosis, there is no previously published study proposing surgical removal of distant malignant metastatic melanocytic masses. This is the first report of a successful surgical excision of a large (6 cm) metastatic melanocytic tumour from the skeletal muscle of the lateral thorax of a horse.","title":"Surgical excision of a malignant metastatic melanoma located in a skeletal muscle of the lateral thorax of a horse"}
{"_id":"04d5be89-c14d-973f-1e72-483cc152cebb","text":"Gustilo–Anderson type IIIc tibial open fracture with large bone defects in elderly patients with severe osteoporosis is a rare injury that may be a challenging clinical scenario.","title":"The successful treatment of a Gustilo–Anderson type IIIc distal leg injury with a large bone defect in elderly patient with severe osteoporosis: a case report"}
{"_id":"04dd0723-6ae9-6deb-043e-f9110f6a1673","text":"Patients who underwent secondary or nonradical surgery and breast reconstruction","title":"Ultrasound-guided transversus thoracic muscle plane-pectoral nerve block for postoperative analgesia after modified radical mastectomy: a comparison with the thoracic paravertebral nerve block"}
{"_id":"04e10611-9830-37b8-964c-4a886cbe72b4","text":"We have reported a successful case of using an intramedullary non-vascularized allogenous fibula bone graft to treat a periprosthetic femoral fracture in a patient with osteoporosis, resulting in solid fixation. The fibula bone graft not only acts as a structure for fixation but also allows the patient to achieve early weight-bearing and return to the previous functional score.","title":"Successful Plate Fixation with Long Intramedullary Fibula Bone Graft for Periprosthetic Femur Fracture: A Case Report"}
{"_id":"04e3c395-6d64-51e0-d83b-651a7ade2b44","text":"Figure 5 shows 2 weeks after the injection of BTXA into the glabellar lines. The patient tries hard to make wrinkles by raising her eyebrows. For deep wrinkles that one can spread by hand, the effect of botulinum toxin will be the most prominent.","title":"Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain"}
{"_id":"04ea12dd-6ca6-b672-fe54-4982b61ae22d","text":"The mechanisms underlying the destruction of bone tissue in osteomyelitis are only now being elucidated. While some of the tissue damage associated with osteomyelitis likely results from the direct actions of bacteria and infiltrating leukocytes, perhaps exacerbated by bacterial manipulation of leukocyte survival pathways, infection-induced bone loss predominantly results from an uncoupling of the activities of osteoblasts and osteoclasts. Bacteria or their products can directly increase osteoclast formation and activity, and the inflammatory milieu at sites of infection can further promote bone resorption. In addition, osteoclast activity is critically regulated by osteoblasts that can respond to bacterial pathogens and foster both inflammation and osteoclastogenesis. Importantly, bone loss during osteomyelitis is also brought about by a decline in new bone deposition due to decreased bone matrix synthesis and by increased rates of osteoblast apoptosis. Extracellular bacterial components may be sufficient to reduce osteoblast viability, but the causative agents of osteomyelitis are also capable of inducing continuous apoptosis of these cells by activating intrinsic and extrinsic cell death pathways to further uncouple bone formation and resorption. Interestingly, bacterial internalization appears to be required for maximal osteoblast apoptosis, and cytosolic inflammasome activation may act in concert with autocrine\/paracrine death receptor-ligand signaling to induce cell death. The manipulation of apoptotic pathways in infected bone cells could be an attractive new means to limit inflammatory damage in osteomyelitis. However, the mechanism that is the most important in bacterium-induced bone loss has not yet been identified. Furthermore, it remains to be determined whether the host would be best served by preventing osteoblast cell death or by promoting apoptosis in infected cells.","title":"Apoptosis-associated uncoupling of bone formation and resorption in osteomyelitis"}
{"_id":"04eac37c-3b1f-e512-b60a-75da42dba013","text":"The paradiscal regions of vertebrae are affected in 98% of TB spine lesion. The tuberculous lesion starts as a paradiscal inflammation. Gradually as disease progresses the vertebral end plates become structurally weak and intervertebral disc starts ballooning\/herniating into the diseased vertebral body. It is seen on plain X-rays as reduced disc height while truly on MRI the disc maintains its height and hydration for quite some time2 and gradually herniates into the diseased vertebral bodies. Since the line of weight transmission in thoracic spine is in the anterior half of vertebral bodies, the vertebral body loses more anterior height than posterior. Thoracic kyphosis increases and gradually an angular kyphosis appears. The severity of kyphosis depends on the number of vertebral bodies affected, severity of loss of anterior vertebral body height and segment of the spine affected. A case of dorsal spine or dorsolumbar spinal tuberculosis with three or more vertebral body affection is more likely to develop moderate to severe kyphotic deformity. In cervical and lumbar spine, the line of weight transmission is in posterior half of vertebral bodies hence it causes first obliteration of natural cervical and\/or lumbar lordosis and later on kyphosis starts appearing. By the time a kyphosis appears in the spine the disease is already in about three to four months of pathogenesis of the tuberculosis of spine. About 95% shows a clinically detectable kyphosis or reversal of normal lordosis, when patient reports for specialized treatment in developing countries.3","title":"Kyphosis in spinal tuberculosis – Prevention and correction"}
{"_id":"04eb2b59-ba30-5239-505b-d602ad994e54","text":"In conclusion we can say that frenotomy can be safely and effectively performed using harmonic scissors. The operating time is reduced, is performed under local infiltration anesthesia in adults and short general anesthesia in pediatric age group with no blood loss. There is also no need to apply hemostatic ligature which otherwise would block the salivary gland ducts. There is minimal postoperative pain, excellent healing and no recurrence.","title":"Harmonic Lingual Frenotomy for Ankyloglossia: A Newer Novel Technique"}
{"_id":"04fba98c-6006-f11c-f093-9a2ecc243ed9","text":"The axial scalp flap based on the supraorbital vessels or any other vessel allows for a big chunk of scalp tissue to be mobilized and either rotated or transposed to cover defects. This flap in many instances is able to cover most of the small or moderate scalp defects [3]. It is reliable and the donor site like in our patient is covered by the skin graft. On its own however it may be difficult to cover extensive defects of more than 100 cm2. The superficial temporal flap is also a reliable flap based on the superficial temporal vessels. The flap has been widely used either as a pedicle flap or as a free flap [2]. As a pedicle flap it is ideal in covering defects around the frontal and temporal area of the scalp [2].","title":"Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound"}
{"_id":"05031739-63a6-de34-58d0-e07452d84835","text":"The selection of the patients has been based on the following criteria of inclusion and of exclusion.","title":"Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol"}
{"_id":"0508e339-7fd1-cb65-ba0f-fdc97a733837","text":"We had similar results like other studies on NPWT method on expediting the rate of wound healing. Given the simplicity and low cost of this method and lack of distinctive side effects, it could be considered as an appropriate dressing. Further, by reducing hospitalization days, this method could reduce the costs imposed on both the patient and the health system. Also, this method can lead to better outcome in wound surface before and after treatment in NPWT group and significant change in wound surface reduction. We suggest a similar study with Negative Pressure Wound Therapy (NPWT) dressing to be conducted on more patients with infection following an open fracture and in that study the time of infection recovery and wound healing should be closely compared with conventional dressing.","title":"Comparison of negative pressure wound therapy (NPWT) &conventional wound dressings in the open fracture wounds"}
{"_id":"050fd743-0ab5-3f4a-7a48-b1c9357afe3c","text":"The precise role of BRAF and NRAS mutations in tumour progression has not yet been definitively established. Nonetheless, evidence suggests that BRAF and NRAS mutations arise early in melanoma pathogenesis and seem to be preserved throughout disease progression.16 There is evidence to suggest that BRAF mutation is associated with poorer prognostic outcomes in patients with metastatic melanoma.9,17 Several studies have also demonstrated that BRAF mutation is associated with poorer melanoma-specific survival in patients with early-stage disease.18,19 The above results suggest that tumour mutation status might be associated with aggressive tumour biology and might be an important factor involved in disease progression.","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"051a7a71-ef52-4b99-e365-cf280a5cfd49","text":"Global developmental delay is common in patients with CP and affected children are usually below the 25th or even the 5th percentile for age on the growth charts. Oral feeding and swallowing may be a problem due to uncoordinated muscle contraction or abnormal pharyngeal muscle tone. The nutritional status of the patients must be evaluated with a thorough history and clinical examination, as well as hematological and biochemical tests. Poor nutritional status predisposes the patients to delayed wound healing and a poor immunological response to infection. A significantly lower infection rate, a shorter period of endotracheal intubation and less hospitalization time after spinal arthrodesis has been reported in CP patients with a preoperative serum albumin of 35 g \/ L or above and a total blood lymphocyte count of 1.5 cells × 109\/L or above.29","title":"Development and treatment of spinal deformity in patients with cerebral palsy"}
{"_id":"05203668-5aba-0e1b-a6f9-c503b6481c74","text":"Patches or transdermal devices for its administration could be considered, reducing the contact of the AA with light and air or using stabilizers\/excipients able of slowing the degradation of the AA.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"05221f40-62e3-167e-f47b-8fc4a8b5f7ab","text":"We identified 95 consecutive patients with chronic osteomyelitis requiring radical excision of necrotic bone and compromised soft tissues with free flap reconstruction. The distribution of osteomyelitis by bone involvement is shown in Table 3.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"05255aea-6cc8-aaa6-6c31-8367a0e311b9","text":"There were nine lectures given during the first series, which occurred between February and May of 2005. Seven lectures occurred during the second year and five had occurred by the time this report was prepared during the third year.","title":"Evolution of a Novel Business Leadership Course for General Surgery Chief Residents"}
{"_id":"052586f1-dd39-c589-a3f1-b4e67ea12bdf","text":"The use of botulinum toxin is contraindicated in the patient with neuromuscular disease or myasthenia gravis.","title":"Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain"}
{"_id":"052a5e49-1d1d-4f31-1842-25b173de93ae","text":"Although the acquisition of SPECT\/CT images increases the time required for preoperative imaging, it has the key advantage of being able to precisely localize sentinel lymph nodes for removal by the surgeon. The anatomical landmarks for surgeons mainly relate to the depth of the node and the proximity to the femoral vein and femoral canal, in addition to the differentiation between nodes in the inguinal and pelvic regions. This is not obvious on planar scanning, but is better visualized on SPECT\/CT, enabling planning of the procedure, particularly in patients with a high BMI, when the nodes are located deep in the inguinal region and gamma probe activity is detected over a wider area.","title":"Investigating the role of SPECT\/CT in dynamic sentinel lymph node biopsy for penile cancers"}
{"_id":"052bf18a-ec4c-afb4-868a-bedb15f7c3d5","text":"While complications certainly must be considered, one study did show that hyaluronic acid gel injections could be safely and efficaciously administered. In this series of 41 patients, most patients were satisfied with their girth enhancement and no inflammatory reactions were noted.","title":"Penile Girth Injection Complications: A Case Report"}
{"_id":"052e0599-7e4b-470a-2263-e01eeb258b02","text":"Idiopathic pulmonary hemosiderosis causes recurrent episodes of alveolar hemorrhage over several years usually in infants and young adults. The end result is pulmonary hemosiderosis that causes centrilobular nodular opacities depicted on HRCT. Calcium is often added to the hemosiderin causing increased density of these nodules on imaging. Similar findings of multifocal calcific nodules can occur in patients with secondary hemosiderosis associated with mitral stenosis.[65]","title":"The calcified lung nodule: What does it mean?"}
{"_id":"053ae18f-68f7-53f6-5cd5-0839953e78d4","text":"Video recordings of the DISE procedures are provided as supplementary material.","title":"Does Frenotomy Modify Upper Airway Collapse in OSA Adult Patients? Case Report and Systematic Review"}
{"_id":"053c0e6e-557d-9a25-6dbb-3b2c8d4bfed2","text":"CONCLUSIONS PMI can address a key technological limitation of poor axial image resolution with current passive cavitation imaging techniques and provide a method capable of monitoring BBB opening with FUS and microbubbles. Limitations of this new technique will be discussed along with its similarities and differences with existing methodologies. This new USgFUS modality is not only a promising technique to be used for treatment of CNS diseases, but also for oncological, cardiovascular, and other medical conditions that utilize FUS in combination with microbubbles.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"053c17ab-69b2-3926-f09d-0bdaf7696070","text":"We present our experience of Ilizarov fixation in the treatment of established recalcitrant infected non-unions of the tibia and the suitability of this procedure in the Indian population with particular reference to bony union and identify the factors influencing the functional outcomes.","title":"Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study"}
{"_id":"053e15c2-51bd-6657-829b-2c28a0c5fc8a","text":"One of the factors which may reduce the risk of surgical site infection in the surgical wounds of major trauma patients is the type of dressing applied over the closed incision at the completion of the operative procedure. Traditionally, the surgical incision is covered with an adhesive dressing or gauze maintained in place with a bandage to protect the wound from contamination from the outside environment. Negative-pressure wound therapy (NPWT) is an alternative form of dressing which may be applied to closed surgical incisions. In this treatment, an open-cell, solid foam overlies the incision and is covered with a semipermeable membrane. A sealed tube is used to connect the foam to a pump which creates a partial vacuum over the wound.","title":"Wound Healing In Surgery for Trauma (WHIST): statistical analysis plan for a randomised controlled trial comparing standard wound management with negative pressure wound therapy"}
{"_id":"0540525b-084f-21a3-4c75-6fcfb27c055e","text":"In another study by Kesavi et al., reported that the most favorable point for anastomosis of dorsalis pedis artery on the foot is the segment distal to the ankle. If the course of dorsalis pedis artery is oblique it may result in impaired healing in fracture of distal end of tibia, fibula and malleoli due to external or internal fixation. Anomalous origin of dorsalis pedis artery like this and lateral deviation of dorsalis pedis artery passing anterior to inferior tibiofibular syndesmosis may get damaged during ankle arthroscopy.","title":"Variations in the origin, course and branching pattern of dorsalis pedis artery with clinical significance"}
{"_id":"0544f854-e23f-c537-9c6b-1fdc0638df4f","text":"Cells distant from vessel walls in deep tissues cannot accumulate AA, so supraphysiological levels are required to overcome this diffusion limit. These data show that AA is unable to diffuse effectively deep from the blood to extracellular tissue and oral and parenteral administration is unlikely to ensure effective concentrations near deep tumor masses.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"055105a0-380a-32ca-1f38-c06f76072ec7","text":"The CCP flap is simple to perform and reproducible and can be added to the armamentarium for the reconstruction of large upper neck defect following resection of primary tumour or recurrence involving the cervical skin in resource limited setting and in contraindication for microvascular reconstruction. Proper planning, meticulous dissection and adequate release or rotation and tension free closure would provide best outcomes.","title":"The contralateral based Cervico-pectoral rotation flap for large neck defects"}
{"_id":"055120d1-317c-e507-be6f-332fd2a617a4","text":"The development of perforator flaps in reconstructive microsurgery has been facilitated by improved knowledge of the arterial basis of flap perfusion. The subdermic vascular network is particularly rich and allows the harvesting of thin skin flaps. One single perforator vessel located in an eccentric position in relation to a skin paddle may support a large skin area thanks to the opening of potential vascular territories, which move to the peripheral border of the flap. The process of vascular adoption is promoted by the increase of blood pressure, which occurs in the perforator artery after closure of subcutaneous and intramuscular branches during flap harvesting. One of the main characteristics of perforator flaps is their versatility, as the flap may be selected on the perforator artery according to defect type.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"05535172-de45-74c9-3af2-c09baa9e78d2","text":"The patients were in good general health, with an ECOG score of 0 or 1 point. All of the 19 patients underwent surgery under general anaesthesia. The surgery method was as follows: radical surgery of the primary tumour was performed at the same time as extending the submental perforator flap for repairing the defect after tumour resection. Fifteen cases of laryngopharyngeal carcinoma were repaired using the extended submental perforator flap with the vascular pedicle contralateral to the main body of the tumour; 11 patients underwent throat preservation surgery, and 4 patients underwent extended total laryngectomy. Postoperative defects of the nasal cavity were repaired. In addition, the paranasal sinus of 2 maxillary sinus cancer cases was repaired using the extended submental perforator flap combined with a temporalis muscle flap. One patient with malignancy underwent orbital content resection, and the other patient had thin temporal muscles. The medial soft palate of the pterygoid process was completely removed in two cancer cases and the extended submental perforator flap was used to repair the oral and nasal surfaces of the soft palate (see Table 1).","title":"Application of prolonged submental perforator flap to repair the postoperative defect of upper airway malignancy"}
{"_id":"05584818-9349-918a-2a79-352bc8adba5c","text":"Based on early experience, this CCSA avoids donor-site morbidity and reduces operative time while maintaining a low complication rate, providing a viable alternative to the use of autologous costal cartilage when indicated in complex primary or secondary rhinoplasties with inadequate native nasal cartilage.","title":"A Canadian Experience With Off-the-Shelf, Aseptically Processed, Costal Cartilage Segment Allografts in Complex Rhinoplasty"}
{"_id":"055babfd-45fd-8a74-9f8c-590682190339","text":"CSF leak was documented in 3 out of 18 cases involving anterior cranial base resection followed by ALT flap reconstruction. One leak was low flow and was managed conservatively with the placement of a lumbar drain postoperatively. The remaining two cases were high flow and required a return trip to the operating room with neurosurgery for a formal skull base repair using a vascularized nasal septal flap in one instance and a fat graft combined with a pericranial flap in the other.","title":"Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction"}
{"_id":"05645dd0-bbeb-00fe-50c8-77c3521ce495","text":"Initial workers used Z-plasty to close transverse facial cleft but later on it was noticed that the Z-plasty left a more visible scar. This drawback of Z-plasty lead to development of straight line closure. Kawai described a technique to correct macrostomia with a simple straight line incision and incorporation of a small triangular flap to achieve proper positioning of the commissure with minimal visible scar. Eguchi reported vermilion square flap surgical technique that combines a lower lip mucocutaneous vermilion border flap with a lazy W-plasty to ensure a natural commissure and cheek skin closure. This technique was used in 8 patients with satisfactory results.","title":"Bilateral Transverse Facial Cleft as an Isolated and Asyndromic Deformity"}
{"_id":"0568f60b-3cfd-6b79-7b90-d4eb16b0e535","text":"Our technique can also be applied for anterolateral thigh flaps and vastus lateralis or rectus femoris muscle flaps, or with latissimus dorsi myocutaneous flap and a serratus anterior muscle flap.","title":"Salvage Operation Using the Free Latissimus Dorsi Muscle Flap for Necrosis of the Free Scapular Flap After Harvesting Both Flaps in a Chimeric Pattern"}
{"_id":"0569ad0a-faff-f522-5256-7f5dc6deecad","text":"A 41 year old male presented with suspected allergy. He gave a six months history of five episodes of lip and tongue swelling not associated with a rash. He found the tongue swelling frightening although it had never affected his breathing. The swelling generally occurred during the night and there was no temporal association with food or drugs. The patient was not taking any regular medications and there was no relevant family history. Six months previously he had been made redundant and was struggling to find a new job. Antihistamines helped to a degree but took up to two hours to resolve the swelling. Complement C3 and C4 studies were normal excluding C1 esterase inhibitor deficiency. On the basis of the history and the normal complement studies, a diagnosis of idiopathic angioedema was made. The patient was commenced on regular high dose non-sedating antihistamines which successfully controlled the angioedema until it spontaneously resolved three months later.","title":"Complexity of case mix in a regional allergy service"}
{"_id":"0569caab-e081-8d96-e2eb-85b0b0954f92","text":"All but one patent internal mammary artery or radial artery grafts had perfect patency and had superior perfect patency and overall patency compared to saphenous vein grafts.","title":"Patency of conduits in patients who received internal mammary artery, radial artery and saphenous vein grafts"}
{"_id":"056e3564-ff3a-c22c-35f3-4910fb470761","text":"The recent introduction of the 8th AJCC TNM classification system needs special attention because it specifically describes DOI as parameter in staging.24 The impact of using this system is described.25, 26","title":"Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy"}
{"_id":"057fbaec-e501-621c-cec8-bad77be90c5e","text":"LQ carried out the initial conception and design as well as collection of data and clinical records of the patient. GEL participated in its design and helped to edit the manuscript. HXQ and LQ made up the surgical team involved in the case and carried out the initial conception. YYL and HHY help to revise the manuscript. All authors read and approved the final manuscript.","title":"Traumatic neuroma in a patient with breast cancer after mastectomy: a case report and review of the literature"}
{"_id":"058766e1-b900-8a9d-f698-3b699bebd606","text":"Based on the data generated in this study, we plan to treat all future patients who need surgical debridement for osteomyelitis of the sternoclavicular joint with initial incision and debridement followed by two to three weeks of wound care along with antibiotic treatment followed by delayed resection of infected bone and pectoralis major muscle flap advancement into the acquired defect. We believe that this is the best management for patients who need surgical intervention for sternoclavicular joint osteomyelitis.","title":"Treatment of Sternoclavicular Joint Osteomyelitis with Debridement and Delayed Resection with Muscle Flap Coverage Improves Outcomes"}
{"_id":"058961ab-4f00-2a5f-bc08-09fa259dac20","text":"The cutaneous penetration pathways through the stratum corneum via intercellular\/intracellular routes, and through the appendageal pathway result in topical and transdermal delivery. The choice to treat skin diseases such as psoriasis, contact dermatitis and skin cancer with locally applied therapies is a promising approach as the drugs are directly administered in the skin layers.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"058ae2b0-b6bd-c895-df3c-223a11b4fb13","text":"Limitations to this approach lie in the necessity of concrete amount of both cortical and cancellous bone to be examined, the use of tools to obviate the irregularity and hardness of the bony slice, and the contamination by blood cells and bone dust.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"058d3877-f909-8574-983c-f7ee5fe338fd","text":"The cutaneous form of the disease generally presents as deep red papules, plaques or nodules that may change in appearance over time. The cutaneous form of the disease has been reported to have a marked female predominance and a wide age distribution and without a predilection for a specific site of the body [6]. Although categorized as cutaneous, the skin lesions can infiltrate into underlying structures creating not only cosmetic complaints but also functional deficits.","title":"Recurrent Cutaneous Rosai-Dorfman Disease"}
{"_id":"058e034f-5a8f-ff6d-1bcf-30658580cd33","text":"The substantial cost of health care delivery constitutes a substantial burden on the economies of industrialized nations. Ample evidence points to the magnitude of waste when patients unnecessarily undergo costly medical procedures. While medical societies develop guidelines to standardize approaches to medical care, these guidelines are mostly consensus based rather than evidence based and are inconsistently applied. They often fail to consider individual patient characteristics and differences among participating institutions. Strict reliance on established guidelines may therefore overlook patients who may benefit from a procedure while selecting some who are unlikely to benefit. Systematically refining guidelines to reflect relevant contextual factors concerning individual patients and institutions could substantially improve the chances of selecting the most appropriate patients.","title":"Improving Selection for Sentinel Lymph Node Biopsy Among Patients With Melanoma Improving Selection for Sentinel Lymph Node Biopsy Among Patients With Melanoma"}
{"_id":"059267eb-d44c-5e6a-9791-515d88d7d865","text":"Ethical approval was obtained from and in accordance with the local institutional ethics committee.","title":"Multifocal cutaneous angiosarcoma of the scalp—A challenging reconstructive case managed with skin substitutes"}
{"_id":"05939c54-0e4e-84dd-2ce6-15fc3617bbb1","text":"Combination therapies are the most promising approach to add the therapeutic value to therapy with a single drug. A major challenge for the combination treatment in melanoma is to overcome intrinsic and acquired resistance. The elucidation of signaling pathways underlying resistance is important in order to develop effective personalized targeted strategies for individual patients’ as multiple mechanisms or resistance develop during the initial treatment. Also, microenvironmental factors and immune response need to be considered in designing appropriate treatment strategies and developing markers predictive of response. In addition, the efficacy of the treatment could depend on using sequential of combined modalities. Finally, preclinical models and methods concerning the profiling of individual tumors need further improvement. Despite, these numerous challenges several combination therapies for melanoma entered clinical evaluation, as discussed during this session.","title":"Future perspectives in melanoma research. Meeting report from the “Melanoma Bridge. Napoli, December 2nd-4th 2012”"}
{"_id":"059e0f0c-a023-0587-0fea-f34208c30601","text":"The primary outcome parameter is the cumulative number of AK lesions observed between visits 2 and 6.","title":"Daylight photodynamic therapy versus cryosurgery for the treatment and prophylaxis of actinic keratoses of the face − protocol of a multicenter, prospective, randomized, controlled, two-armed study"}
{"_id":"059eb99f-0981-b321-f507-cbf0faf2aeb3","text":"Dynamometer investigation of the latissimus dorsi pulling test comparing the donor side - with the healthy contra lateral side","title":"Deep sternal wound infection – latissimus dorsi flap is a reliable option for reconstruction of the thoracic wall"}
{"_id":"05a05dfb-7a43-1881-4a78-a6a4939ecc45","text":"This is the first study to review the characteristics of academic leaders in Canadian OHNS programs. The primary goal of our study was to summarize the demographics, training characteristics, and academic productivity of contemporary leaders in OHNS training programs across Canada, with a secondary objective of evaluating the impact of academic appointment on research productivity.","title":"Academic benchmarks for leaders in Otolaryngology - Head & Neck Surgery: a Canadian perspective"}
{"_id":"05a0d967-1e39-eec2-50be-c9d1f59212de","text":"The advent of treating burns by early excision and grafting in the late 19th century brought up the need of finding a temporary wound cover before the more shallow burns have time to heal, in order to provide skin for an autograft. Allografts or homografts can be taken either from live donors or in the form of cadaveric skin that is usually preserved in a skin bank. The first reported use of cadaveric skin to cover a burn wound was in 1881. This might also be the first reported case of possible rejection: termed erysipelatous inflammation occurred and the graft was lost in the second week [1].","title":"Surgical management of extensive burns treatment using allografts"}
{"_id":"05a4531c-d8cd-14b9-fd52-bfe6b9f52018","text":"The objective of this study was to evaluate the thermographic image, changes in the thermal pattern in areas where the skin graft was performed in rat after surgical resection of chemically induced squamous cell carcinoma and to evaluate if thermographic could help in locating the identification of angiogenesis that favors the stimulation of the repair of surgical wounds.","title":"Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats"}
{"_id":"05ad669b-9bd0-de95-66fd-df390299db41","text":"Normally, there are 2 to 9 lymph nodes localized within the fat tissue surrounding the nerves and major vessels of the popliteal fossa. Popliteal lymph nodes are deep structures encountered under the investing fascia of the leg, and they receive the lymphatic drainage of the deep structures of the distal leg and foot. Although infrequent, the lymphatic drainage from the skin is direct to these lymph nodes in some individuals. The surgical procedure of popliteal lymph node dissection involves en bloc removal of all fibrous, fatty, and lymphatic tissue in the popliteal fossa, with careful preservation of the nerves and vessels.","title":"Popliteal lymph node dissection for metastases of cutaneous malignant melanoma"}
{"_id":"05ae3f06-8f2b-e0ae-fa4f-cbcaa3a797ee","text":"We observed that the mean time taken to perform a tomographic ultrasound scan on both legs was only five minutes while standard duplex ultrasonography took 20 minutes to perform. This is a significant benefit of tomographic ultrasonography in that it can be performed much faster. It also requires less expert personnel to perform this scan as the image reconstruction is done automatically. This has the potential to reduce cost and waiting lists for ultrasound scans.","title":"The Role of Tomographic Ultrasonography in Conduit Mapping before Coronary Artery Bypass Grafting"}
{"_id":"05ae70f5-c183-ac9c-1db2-a9548da93766","text":"Fat embolism is a common complication of orthopedic surgery. However, the exact component and risk factor responsible for this complication remains unelucidated. This study aimed to detect the origin of the pulmonary embolus and identify relevant risk factors of pulmonary embolism in total knee replacement.","title":"A study on dynamic monitoring, components, and risk factors of embolism during total knee arthroplasty"}
{"_id":"05b75687-53fc-f70e-76a7-c729f5e880d1","text":"In direct comparison the IW fs sequence depicts more subchondral bone marrow edema-like lesions and better demonstrate the extent of their maximum size. The DESS sequence helps in the differentiation of subchondral bone marrow edema-like lesions and subchondral cysts. The IW fs sequence should be used for determination of lesion extent whenever the size of subchondral bone marrow edema-like lesions is the focus of attention.","title":"Semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts of the knee at 3T MRI: A comparison between intermediate-weighted fat-suppressed spin echo and Dual Echo Steady State sequences"}
{"_id":"05bca2c7-7bcd-0350-a02a-1686e6a6978a","text":"Favorable therapeutic strategies could be selected according to the preoperative prognostic risk factors. Radiotherapy should be considered for local recurrence of PDT.","title":"Clinical prognostic factors for pediatric extra-abdominal desmoid tumor: analyses of 66 patients at a single institution"}
{"_id":"05c1eb70-31f3-4337-632d-83873cb6ee11","text":"Session results also demonstrated a trend towards positive behavior modifications by the students themselves regarding sun-protection practices and skin self-exams across the three time periods. One possible explanation for this finding is that behavioral changes can vary in the time that they are ultimately adopted. Another possible explanation is that the session was framed as an educational didactic session geared for patient care. Despite this, we believe that continuity of education in these practices could result in lasting change over time. The immediate outcome of our study is increasing student confidence in and likelihood of providing quality patient counseling. The 6-month follow-up data illustrated statistically significant lasting effects on medical student knowledge and attitudes regarding skin cancer prevention and patient counseling. These findings suggest that the session had an overall impact on patient care and improved overall comfort with the information and skills presented. This skill set alone is expandable across multiple medical disciplines as identifying common risk factors for skin cancer and patient usage of sun-protective practices could seamlessly make up part of the routine medical and social history.","title":"A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence"}
{"_id":"05c3c857-829e-eb2e-5a95-10782c929826","text":"A prospective study was conducted with 43 patients to be submitted to revision rhinoplasty and their respective surgeons, by applying a questionnaire about the patients’ epidemiological questions and subjective aesthetic-functional complaints as well as the respective functional deformities observed by the surgeons. Subsequently, these data were correlated with the purpose of observing the frequency of congruent reports between physicians and patients.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"05c883d5-309d-bdbf-1736-f5bb09d2d996","text":"Multiple intravascular fat emboli and focal areas of fat extravasation in the central nervous system of a young patient whose cause of death was a massive cerebral fat embolism","title":"Cerebral fat embolism after traumatic bone fractures: a structured literature review and analysis of published case reports"}
{"_id":"05c918db-b09e-0f5b-a7c8-f64c180ee68b","text":"We need to know more about what kind of supportive care is needed in individual situations and how to provide that knowledge to health care personnel. It is important to avoid early breastfeeding termination and to secure breastfeeding for infants in line with the WHO (2011, 2020) recommendations. The aim of this study was to develop a deeper understanding of the phenomenon of initial breastfeeding complications as they are lived and experienced by mothers and how these mothers can be supported.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"05cc360b-46de-5dc6-3992-6a3829a5dd80","text":"Rapid technology evolution has led to new challenges for the anesthesiologist in neurosurgical practice. This trend resulted in training in neuroanesthesiology to adapt to the changes. Neuroanesthesiology fellowship training has increasingly received the auspicious attention of graduates from anesthesia residency programs. Competency in neurological surgical procedures requires a multidisciplinary approach with anesthesiologists that hold profound knowledge in neurological sciences.","title":"Value of Neuroanesthesiology Fellowship Training"}
{"_id":"05cde756-fa16-60b1-67e8-ad63bfe29e64","text":"PDT has the potential to be a very effective local treatment modality for NPC, without the severe side effects seen with radiotherapy.","title":"Photodynamic therapy in the therapy for recurrent\/persistent nasopharyngeal cancer"}
{"_id":"05cded75-a107-18ab-3347-542340add613","text":"A systematic protocol of the ultrasonographic assessment of a selection of the most common sites of osteochondrosis in yearling horses is described in detail, facilitating the use of the protocol by veterinary practitioners with variable experience.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"05d2d577-39e9-e495-3315-924eabadcefe","text":"It is believed that, in general, it is possible that use of lower LEEDs combined with the chilled tumescence administered at the time of ablation to form a liquid halo offering thermal protection and increasing the distance to nerve branches would have attenuated patient symptomology.","title":"Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser"}
{"_id":"05d3dfd8-b501-49a7-315f-3be4f251c84e","text":"A wide local excision of the involved scrotal skin was made removing the nodules en block while taking each hemiscrotum as a unit. This required a semielliptical incision on the lateral aspects and a vertical paramedian raphe incision on the medial aspects. Dissecting was just below the dermis so as not to disrupt the dartoic muscle layer which was spared.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"05d678c9-c727-7963-ee54-ef25ab9f7e2e","text":"Our independent appraisal of the six systems were summarised and discussed. The discussion focused on differences in the interpretation of the criteria, disagreement about the judgements that we made and sources of these disagreements, the strengths and weaknesses of the six systems, and inferences based on the appraisals and subsequent discussion.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"05d7cbed-131f-223b-7bb9-df466c61df84","text":"Microscopic examination of the tissue specimen showed nodular aggregates of basaloid tumor cells with peripheral palisading of the tumor cells and retraction of the dermal stroma from the tumor aggregates. Calcification was also noted not only in the dermis and within a hair follicle adjacent to the tumor but also in the nest of tumor cells and in the necrotic debris associated with the basal cell carcinoma (Figure 2 and Figure 3).","title":"Basal Cell Carcinoma With Calcification: Case Report of Calcifying Basal Cell Carcinoma and Review of Calcinosis Cutis Associated With Basal Cell Carcinoma"}
{"_id":"05db5f8c-8d28-94f6-f64b-9b049cf0d32e","text":"The capability of GNPs in converting light to heat is one of their other unique features. This photothermal property is used for vaporizing cell water that in turn will reduce the ultrasound intensity threshold for the cavitation. Comparison of the properties of different studies on GNPs is shown in Table 1.","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"05ddd7e2-4c82-2490-f49f-24f8e7f28059","text":"the level of satisfaction presented by the patients was considered to be very good.","title":"Long-Term Evaluation in Aesthetic Rhinoplasty in an Academic Referral Center"}
{"_id":"05e35749-59eb-243d-d1ee-8d5cf35998b9","text":"Documentation has advocated replantation for similar cases. Nasal replantation was first reported by Fioraventi in 1570, who described the case of a gentleman who had had his nose amputated by a Spanish soldier. In 1828, Hottacker, a German physician who attended dueling matches, similarly demonstrated the ability of cleansed, amputated nasal tissue to survive replantation. He reported the successful replantation of nasal tissue in 12 of 16 cases by simply securing the amputated tissue to the defect with tape., One of the greatest barriers to the success of this method was the establishment of adequate venous drainage and lack of venous outflow that resulted in graft failure due to tissue vascular congestion. The advantages of this method included the matching of the replanted tissue with the surrounding skin in terms of color and texture.,","title":"Use of Forehead Flap for Nasal Tip Reconstruction after Traumatic Nasal Amputation"}
{"_id":"05e44e1b-f62c-8e46-0028-d4dcc98c15fa","text":"The question of immediate or delayed reconstruction is also very significant. There are very few absolute contraindications for immediate breast reconstruction, such as inflammatory breast cancer. Even in the setting of metastatic disease, one should discuss this with the patient. A possible reason to avoid breast reconstruction is the possibility that a complication might delay the delivery of chemotherapy or radiation treatment.","title":"Imaging of the Reconstructed Breast"}
{"_id":"05e7a947-4d35-6162-b842-b5d4b0e9bf7f","text":"Another participant recounted her experience in searching for a silicone breast as follows:","title":"Beyond the scars: a qualitative study on the experiences of mastectomy among young women with breast cancer in a country with crisis"}
{"_id":"05e979b7-578d-9b59-925f-427bf4afc1d6","text":"Seventy hospitalized acute SCI patients presenting within five days of the injury were included in the present analysis. Forty-two cases were subjected to color Doppler studies and 28 cases had to be subjected to venography due to lack of facility at some point of time. The clinical course of the patients was closely observed during the period of hospitalization. All except 14 were managed nonoperatively. Thromboprophylaxis was not given to any patient at any stage; however, treatment was instituted in those showing the features of DVT on investigations.","title":"Venous thromboembolism in acute spinal cord injury patients"}
{"_id":"05ea772e-64b4-bdd8-4ed7-04dae2f73180","text":"In contrast to these options, autogenous cartilage is widely accepted as ideal graft material for use in facial reconstructive and cosmetic surgery. However when solid carved pieces of cartilage are used to conceal residual deformities, the edges of on lay graft may cause unsightly irregularities after resolving edema in time. Although cartilage grafts permit shaping to some extent, because of its inherent physical and biomechanical properties, they tend to return to their original condition. This phenomenon is called wrapping which leads to late postoperative deformities.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"05f35192-c96f-24ab-ef71-71dce84b47dd","text":"This case suggested that deep cervical infection should be considered if a patient had history of ACDF even in the absence of esophageal perforation.","title":"Late deep cervical infection after anterior cervical discectomy and fusion: a case report and literature review"}
{"_id":"05f3e85e-e2d0-305a-bb0c-243a5922d67e","text":"Table 1 Study Population by Grouping of Breastfeeding Initiation or Not","title":"Breastfeeding challenges and support in a high initiation population"}
{"_id":"05f5beac-e540-5ffe-d365-bf95ba95f943","text":"A 46-year-old man presented with an acute pain in the anterior superior region of the left shoulder which also radiated to the left cervical region. The man during the physical evaluation also presented severe functional limitation of the shoulder movements in all planes of motion.","title":"Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint A case report"}
{"_id":"05fb13cf-3d19-f86c-3529-3438441c6594","text":"Histological examination of the tumoural biopsy shows that it is a well differentiated and infiltrating cutaneous squamous cell carcinomas. Given the patient’s young age, the clinical tumour size of 3 cm in this localization and the suspicion that she had a genetic variant of XP, it was preferred to proceed with an exhaustive imaging examination. A cervical, facial and thoraco abdominal CT scan showed limited tumour lesion at the tip of the nose without systemic or lymph node metastases, then the tumour was classified T2 N0 M0 Stage II with a high risk of recurrence.","title":"Cutaneous squamous cell carcinomas of the nose in a child treated with external radiation therapy: a case report"}
{"_id":"05ff17e8-b672-692a-c9e2-fb3d479d19dd","text":"Our study mapped pelvic LNM in patients with cervical cancer and showed that obturator was the most common site of metastatic. Therefore, more attention should be paid to obturator when performing a systematic lymphadenectomy and SLN. Patients with inguinal metastases have a worse prognosis than those with obturator metastases. In patients with inguinal LNM, clinical staging needs to be reconsidered and extended radiotherapy to the inguinal region needs to be strengthened.","title":"The distribution pattern of pelvic lymph nodal metastases in cervical cancer"}
{"_id":"060310d0-866c-7472-8ba7-4917fae540b4","text":"When comparing the response to treatment between the patients, the patient with neurovascular compression-related TN responded quicker after each treatment and seemed to experience a far higher quality of life and overall more consistent pain relief. The patient with MS-related TN and iatrogenic neuropathic pain also required two treatments with BTX-A before reducing and stopping medication for pain as opposed to patient 1 who reduced and stopped medication after one BTX-A treatment.","title":"Management of Trigeminal Neuralgia with Botulinum Toxin Type A: Report of Two Cases"}
{"_id":"060bfa45-7ad0-d07f-15ab-50be6285c0db","text":"Scrotal calcinosis is an uncommon disease with multiple scrotal nodules which is amenable to excision and direct closure but occasionally may require complex scrotal reconstruction.","title":"Scrotal Calcinosis: A Case Report and Review of Pathogenesis and Surgical Management"}
{"_id":"0614534d-af49-8d32-eb18-3a25ac73d778","text":"Most clinicians who utilize Juvederm have noted that it does inject easily through the syringe and that results are commonly observed for 6 to 12 months. Local injection site reactions are rare and there has been some discussion that the injection of Juvederm results in a more natural appearance than the other HA fillers, although no clinical studies with regard to this debate have been performed. Clinical examples of Juvederm are seen in Figures 3 and 4. A newer form of Juvederm, with lidocaine incorporated into the syringe itself, is now available in Europe, and pending FDA approval in the US at present.","title":"Soft Tissue Augmentation in Dermatology – 2009 Update"}
{"_id":"061467f9-5a64-fd30-7928-fbf4df1173cc","text":"This is the first Canadian study to review patients with systemic reactions to subcutaneous immunotherapy. Several best practice methods were employed throughout the study to optimize subcutaneous delivery of immunotherapy extract, and our recorded per injection incidence rate for systemic reactions was comparable or below the rate published in similar studies. The recommendations in the CSACI Immunotherapy Manual provide an approach to standardizing prescriptions for SCIT to maximize immunotherapy efficacy and reduce the risk of systemic reactions, though similar studies in larger multicenter settings are needed to confirm these observations. These observations provide important objective information to clinicians about the potential risks for systemic reactions in patients considering SCIT.","title":"A single centre retrospective study of systemic reactions to subcutaneous immunotherapy"}
{"_id":"0622ce93-46b2-2eb0-e5a1-3996bc9e35e6","text":"A Gustilo IIIB open tibiofibular fracture often results in tibia bone loss due to severe comminuted and contaminated fractured segments that have to be removed to prevent infection. 6 7 8 Fibula fracture is often not as severe as tibia fracture, because the fibula is a deep structure surrounded by muscle, whereas a lot of energy is absorbed by the tibia due to its more anterior and superficial location. The peroneal vessels are often saved for the same reason.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"062c3e10-1564-7ddf-7155-3a0f266e0369","text":"The leader in this procedure is nuclear medicine consultant who has expertise in understanding and performing radionuclide imaging procedures and is trained in SLN lymphoscintigraphy technique. Usually, the doctor decides the dose and is responsible for aseptic conditions and accurate injection technique, and the same was followed in our settings. Image interpretation and reporting were done by a team of two to three nuclear medicines consultants.","title":"Sentinel Lymph Node Mapping in Breast Cancer: Initial Experience of a Multidisciplinary Team"}
{"_id":"062fe0cf-6ce2-e23e-2e60-0f7f6646e10d","text":"In summary, most aspects of facial contrast were found to decrease with age in the four sets of faces; three groups that were ethnically homogeneous and one group which was ethnically diverse (Latin American faces). The decrease with age appeared to be stronger in Caucasian and South African faces than in Chinese and Latin American sets which were more diverse in the relationships between facial contrast and age.","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"0631516b-13a2-a8ca-252e-12326473cb4d","text":"According to the informants, good physician leadership meant giving enough freedom to subordinates: not intervening with minor details and allowing them to work undisturbed by trusting their expertise in their field and capability at their job.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"0631fdd7-e443-8be3-af4d-ed2922029573","text":"Heightened public awareness may be important to prevent subsequent cancers in skin cancer survivors as the skin cancer incidence rates continue to rise. Of particular relevance to general practitioners and dermatologists dealing with skin cancer survivors, is the need for enhanced surveillance for a new skin cancer. Further, our results provide information on shared risk factors for first and later cancers that may help in identifying individuals at high risk for subsequent cancers, and for whom particular attention ought to be directed.","title":"New malignancies after squamous cell carcinoma and melanomas: a population-based study from Norway"}
{"_id":"0634b797-c229-a59d-d069-95762169df13","text":"Because microsurgery offers a broad spectrum of techniques and skills, a training program must be developed that considers demands and requirements of the different staff in hospital and research units. Young physician’s medical students performing their doctoral theses and increasing numbers of researchers must be taught thoroughly and by standardized methods. Due to amendments of laws, changes in the education of resident students and the increasing lack of physicians, there has been an increase of non-surgeons involved more and more in research.","title":"Microsurgical training course for clinicians and scientists: a 10-year experience at the Münster University Hospital"}
{"_id":"06385d98-0901-51e8-3ee7-33853d6185db","text":"Besides, dicing or mincing the cartilage into desired small pieces that can pass from an injecting cannula using conventional blades is difficult and sometimes impossible. There are studies in the literature using otologic burr or other powered devices to mince the cartilage into injectable pieces, but the degree of damage to chondrocytes in the histologic evaluation may not support the possibility of long term survival.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"06442099-4d3b-0d97-a26c-f2fb063e9746","text":"International training adds a new dimension to surgical training by creating exposure to different surgical cases and techniques, building cultural competence, and enhancing attention to unique healthcare delivery models in underserved settings.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"06444b61-5c55-9c95-81b9-e6115a5973e8","text":"A 61-year-old female presented with Gustilo-Anderson Grade 3C compound fractures of the distal femur and Shatzker five tibial plateau fracture. She underwent initial debridement and a spanning external fixator in the acute setting and subsequently definitive fixation with a retrograde femoral intramedullary nail and lateral and posteromedial proximal tibia plates, with a bipedicled gastrocnemius flap and split skin grafts inset over the large skin defect in the same setting. The healing was complicated by tibia plateau fracture and she underwent a planned bone grafting 3 months later.","title":"The judet quadricepsplasty for elderly traumatic knee extension contracture: a case report and review of the literature"}
{"_id":"064481f6-1f42-4b40-3466-b869d0bcc26b","text":"It has been concluded in studies that technique of bone block grafting to correct diaphyseal defects of the radius or ulna is relatively easy to perform and has a high success rate3 but the massive amount of graft required for an 8cm gap is associated with multiple donor sites complication.4 Illizarov method being cumbersome in forearm with time to recovery being long was not opted for.5 Free vascularised fibular grafting(FVFG) is a successful form of treatment for large bony defects and use of modern techniques of fixation does not affect the risk of non-union when compared with traditional forms of fixation.6 Here we discuss a case pf gap non-union of radius treated with FVFG and fixation with 3.5 locking DCP.","title":"Vascularised fibular graft in the management of non-union of fracture shaft of radius: a less ventured entity"}
{"_id":"064e0166-a223-84c6-1ed4-1ac0a88cfa17","text":"Postoperative IRVF patterns have not been extensively studied in the perioperative period of laparoscopic surgery. This study shows that IRVF assessment is feasible with a widely available conventional ultrasonographic system and can provide information on the risk of postoperative AKI as well as any complications within the postoperative day 7. Patients who developed postoperative monophasic IRVF patterns were those who received larger amounts of intraoperative fluids and had higher intra-abdominal pressure, independently of mean arterial pressure. Although a low mean arterial pressure may represent a condition affecting intrarenal circulation, the lack of significant association with changes in IRVF patterns in the present study suggests that mechanisms other than the sole blood supply could be involved in the development of renal dysfunction. Some of these might be the increase in venous resistance to flow induced by high intra-abdominal pressure and reduction of parenchymal compliance due to increased renal interstitial pressure caused by fluid overload; both mechanisms ultimately lead to a “splanchnic tamponade” [20].","title":"Perioperative Renal Ultrasonography of Arterio-to-Venous Coupling Predicts Postoperative Complications after Major Laparoscopic Urologic Surgery"}
{"_id":"064e3315-d9ce-495f-78d5-a1c7448856d7","text":"However, the right flap then exhibited a disturbance in the perfusion with no capillary refill. A revision of the anastomosis revealed a thrombus in the arterial anastomosis. We performed a thrombectomy and successfully reconnected the vessels. At that point the patient received an intravenous injection of 500 mg of Aspirin, which is routinely used in our institution in cases of early diagnosed arterial thrombosis. After completing the revision of the right side, we observed an anomaly in the perfusion with no capillary refill on the left side. Inspecting the pedicle showed a thrombus on the distal end of the vein graft. The coupler ring and the thrombus were then removed, and the SIEV was again connected to the perforator with a 1.5 mm coupler ring. The flap again showed a pink color with normal capillary refill time and doppler signal. There were no other incidents during the operation. The duration of the surgery was 556 min.","title":"Use of the superficial inferior epigastric vein in breast reconstruction with a deep inferior epigastric artery perforator flap"}
{"_id":"065bc610-0fd8-57d9-e9ff-ba4867f8a7c3","text":"Deep Inferior Epigastric Perforator Flap (DIEP) surgical procedures have benefited in recent years from the introduction of 3D printed models, yet new technologies are expanding design opportunities which promise to improve patient specific care. Numerous studies, utilizing 3D printed models for DIEP, have shown a reduction of surgical time and complications when used in addition to the review of standard CT imaging. A DIEP free flap procedure requires locating the inferior epigastric perforator vessels traversing and perforating the rectus abdominis muscle, perfusing the abdominal skin and fatty tissue. The goal of dissecting the inferior epigastric perforator vessels is complicated by the opacity of the fatty tissue and muscle. Previous attempts to 3D print patient specific models for DIEP free flap cases from CT imaging has shown a wide range of designs which only show variations of perforator arteries, fatty tissue, and the abdominis rectus muscle.","title":"Hybrid modeling techniques for 3D printed deep inferior epigastric perforator flap models"}
{"_id":"0661a9c3-e3d7-21e7-b32b-ad6337834cc4","text":"Our hypothesis is based on the assumption that patients who have been diagnosed with metastatic melanoma since 2011 are more likely to have received immunotherapy. We tested our hypothesis by using SEER data to evaluate the standardized incidence ratios (SIRs) for second primary cancers.","title":"Assessment of Trends in Second Primary Cancers in Patients With Metastatic Melanoma From 2005 to 2016 Trends in Second Primary Cancers in Patients With Metastatic Melanoma, 2005-2016"}
{"_id":"06643881-d5d4-2c35-c795-6486a62d006a","text":"The ALT has gained popularity in Western countries but is not appropriate for all defects. Careful selection based on patient characteristics and defect size is critical as in all reconstructive surgeries. Special care should be made to identify patients at high risk for PAD, and if the reconstructive surgeon has any concerns, pre-operative colour flow Doppler's ultrasonography should be undertaken to better characterize the perforator anatomy and avoid inappropriate flap elevation in patients with silent claudication. Particular detail should be paid to flap thickness especially in patients with increased body habitus. Radiation therapy has a flap volume-reducing effect, and an overestimation of volume in patients who will be undergoing radiotherapy should lead to the best contour and cosmetic outcomes.","title":"Colour Doppler and Volume Changes—Anterolateral Thigh Flap: The Sunnybrook Experience"}
{"_id":"066609ab-6bfe-499d-a57c-7b07a867a0ff","text":"We offered limb salvage to four patients who had major vascular involvement. In this article we share our experience of extremity soft tissue sarcoma in patients, with major vascular involvement, who were successfully treated with limb conservative surgery along with vascular reconstruction.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"0667ca84-790d-8ca1-65fa-5fdaa1f693ae","text":"Studies were screened at title and abstract stage against the inclusion criteria listed in Table 1.","title":"Advancing leadership in surgery: a realist review of interventions and strategies to promote evidence-based leadership in healthcare"}
{"_id":"066be998-6394-940a-07ac-191bdf11c440","text":"Only a limited set of matched control samples could be analyzed due to logistical reasons previously explained. However, we minimized the risk of selection bias by choosing pairs at random after matching for age and sex.","title":"Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers"}
{"_id":"067138a1-9641-2252-e876-c0ecc3973108","text":"Although the saphenous vein is a widely used conduit for coronary artery bypass grafting, revascularization using the saphenous vein as an aortocoronary bypass graft has shown disadvantages of lower long-term graft patency rates and subsequently worse clinical outcomes, compared with revascularization using the internal thoracic artery. Of the various efforts to overcome the limitations of vein conduit that are resulting from structural and functional differences from arterial conduit, recent technical improvement in no-touch vein composite graft construction and outcomes of revascularization using no-touch vein composite grafts based on the left internal thoracic artery will be discussed in this topic.","title":"Techniques and Outcomes of the No-Touch Vein Conduit as a Y-Composite Graft"}
{"_id":"0674bf6a-69c3-d70e-f25e-3433fc0a019a","text":"NGS was performed to confirm the diagnosis and to identify any genetic alterations that might be relevant to the prognosis of this tumor. The tumor harbored an S45F mutation in CTNNB1, which has been correlated with a high recurrence rate. Therefore, we performed adjuvant radiotherapy on the resection bed at a dose of 56 Gy.","title":"Clinical application of next-generation sequencing for the management of desmoid tumors A case report and literature review"}
{"_id":"06766d41-3ac6-f1eb-0af4-d520cc1168f4","text":"In Table 3, we present PFS curves that fit 2‐phase EDNLRA models, the relative size and PFS half‐lives of the two subpopulations giving rise to 2‐phase decay, and our calculation of the proportion of remaining patients who would be from the rapidly progressing subpopulation at different time points of interest after therapy initiation. This proportion would be influenced by the proportion of the original patient population that consisted of the rapidly progressing subpopulation, by the PFS half‐life of the rapidly progressing subpopulation and by the PFS half‐life of the slowly progressing subpopulation. The optimum frequency of follow‐up scans would depend on rapid and slow PFS half‐lives and on therapy vs scan costs but would decrease as the proportion of rapidly vs slowly progressing patients decreased in the remaining population since the proportion of the overall population that would be expected to progress in a given time interval would decrease.","title":"Optimal frequency of scans for patients on cancer therapies: A population kinetics assessment"}
{"_id":"0679c7f4-9ba2-d331-740c-fcca78d661db","text":"We were able to obtain the total costs for all patients from the clinical coding department. We also referred to the computerised medical records to glean further information and cross check the accuracy of the records held by the coding department and the free flap database.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"06809f14-07aa-d397-63b6-2514777b468c","text":"In revisional surgeries with hyaluronic acid injection history, the prosthesis pocket was rinsed thoroughly and cleaned with a spatula to ensure no hyaluronic acid was left inside. The implant could be carved either before sedation or after the pocket space was done. The engraving of the implant was performed in a manner that resulted in the following:","title":"Design and Application of a Novel Silicone Nasal Implant"}
{"_id":"0681e029-5b10-4214-649a-fccf2e942f74","text":"There is a considerable disparity between the cost of effectively managing osteomyelitis and the remuneration according to the HRG code. Accurate cost analysis of these cases shows that the current tariffs are not nearly sufficient to cover the cost of treatment, even when there are no complications. This resulted in a total shortfall of £610,090 for all 60 cases This information is evidence for negotiation of proper renumeration.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"06830676-f8d6-e338-86d4-93a4417cc616","text":"There has been a successful partnership with our visiting nurses who have provided outstanding care to our patients for many years. Despite this, we have been forced to examine how we communicate with home care services once our patients are discharged from the hospital. This is particularly evident with new nurses who lack the experience of their seasoned colleagues or ones who have not cared for this patient population in the past. Protocols must be established in the form of an in-service training for nursing staff that accurately describes the procedure as well as what to expect during all phases of the postoperative period. Spending more time to educate the patient as well as providers outside the hospital setting can help prevent situations such as this in the future.","title":"Reconstruction of a Nasal Defect With a Radial Forearm Flap Following Trauma of a Paramedian Forehead Flap"}
{"_id":"06858b72-1252-ae01-03c4-9a607d3f835c","text":"Conclusion: 68% of the cases of MAS in our series presented without an underlying diagnosis. As MAS is difficult to diagnose in children with underlying rheumatological disorders, this difficulty is heightened in children without an underlying disease whose clinical and laboratory features cannot be applied to the existing diagnostic criteria, all developed for use with known underlying conditions. It is essential that awareness is raised of this serious disorder amongst general paediatricians to avoid delays in diagnosis and treatment which could potentially increase morbidity and mortality. There is a need for the development of diagnostic criteria which can be used in cases where the episode of MAS is part of the initial presentation of the underlying condition. In our series, the majority of cases of MAS present in this way.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"069304e5-c43f-f48b-f1a9-cdf33fd6ba28","text":"Environmental factors proved to be significant for the intensification of allergy symptoms in children whose flats were included in the study. A negative correlation between intensification of symptoms and the size of a flat as well as a positive correlation with the number of family members can be associated with an increase in the number of allergens (not only mites) under specific conditions.","title":"Abundance of domestic mites in dwellings of children and adolescents with asthma in relation to environmental factors and allergy symptoms"}
{"_id":"06938570-216e-27de-6cdc-2169fccdaaad","text":"The majority of respondents recognized the importance of the skin cancer risk factors presented to them. However, there was evidence people overestimate the cancer-protective effect of sunscreen because a substantial proportion did not judge sunbathing with sunscreen to be a significant risk factor. There was also evidence that people may underestimate the importance of sunburn in the aetiology of skin cancer. Only 40% rated getting sunburnt as either an adult or as a child as a ‘very’ important risk factor. Again, both men and those with lower levels of educational qualifications were consistently less likely to rate all items as important skin cancer risk factors. Worryingly, those who reported burning easily in the sun were no more likely to know that skin type was a risk factor for skin cancer, suggesting they are no more aware of their increased personal risk than those with lower risk skin types.","title":"SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample"}
{"_id":"0693bd86-1f1a-7aff-402a-a6f209570b0e","text":"One of the main risks of filter removal by open surgery is hemorrhage, mainly occurring in lumbar and iliac veins, due to a large number of tributaries from IVC. The lumbar veins at the anterior and lateral walls of the IVC are easy to find, but those at the posterior wall of the IVC are difficult to separate and can be easily damaged. The injury to the lumbar veins may be reduced by ligating the tissue near the posterior wall of the IVC in stages during surgery. Blocking the IVC immediately distal to the filter is the main method of reducing hemorrhage from the iliac vein tributaries, and preoperative CT imaging assessment is important.","title":"Removal of inferior vena cava filter by open surgery after failure of endovenous retrieval"}
{"_id":"06a070da-51b8-f536-50ee-789bf454877a","text":"We show that false-negativity after SLNB increases over time, indicating that this parameter should be estimated by the Kaplan–Meier method. It is well known that the risk of any nodal basin recurrence depends on the biology of a given tumor and on technical or individual factors. This study adds the observation that the number of SLNs excised is inversely associated with the FN rate. The beneficial effect of CLND on nodal basin disease control varies considerably across different risk groups. This should be kept in mind when individual decisions for or against CLND are taken. From a historical perspective, it appears that the long-term local control rates are superior to the respective results that have been reported after therapeutic lymph node dissection for clinically enlarged lymph node metastases. This assumption is supported by our data showing a significant association between nodal tumor burden and nodal basin recurrence after positive SLNB + CLND.","title":"Nodal Basin Recurrence After Sentinel Lymph Node Biopsy for Melanoma A Retrospective Multicenter Study in 2653 Patients"}
{"_id":"06a379ca-15d6-1bb4-d911-a7dea8f43f37","text":"The performed surgical treatment in 16 legs of 15 patients included one aorto-bi-femoral bypass, three femoropopliteal bypasses above and six below the knee and three local thrombendarteriectomies of the femoral bifurcation, as well as two thrombendarteriectomies in combination with implantation of a saphenous vein graft below the knee. All patients were discharged from hospital on the fourth to sixth postoperative day. While all 16 patients were be studied on days 0 and 1, only 10 of 16 patients could be studied on day 3 after the operation.","title":"Evaluation of Hyperspectral Imaging for Follow-Up Assessment after Revascularization in Peripheral Artery Disease"}
{"_id":"06aaf078-1220-7640-6293-9cf593d6a6ec","text":"This study demonstrated that cyanoacrylate provided external support to the graft without any chemotactic effect, and primary protection of the graft against damage due to extreme stress. However, in vivo studies are required to investigate the effects on the graft in the long term.","title":"Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model"}
{"_id":"06b0099a-3cd5-3a44-3d7d-dc0c48a8a380","text":"CONCLUSIONS This computer-aided system developed enabled rapid and flexible transcranial FUS applications for primates outside of the MRI scanner without the use of a stereotactic frame. It will greatly facilitate both preclinical and clinical use for BBB opening and drug delivery to treat neurodegenerative disease and brain tumors.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"06c83283-9ece-121a-9c80-b0370e6cedfa","text":"Formation of the iliac veins, including communicating vessels, during the initial stage of embryogenesis is complex and is still not entirely understood, although it has been reported that the internal iliac vein and its numerous visceral and parietal tributaries serve as important collateral routes in cases of obstruction of iliac-cava segments. Considering the variety of the descriptions in the literature, development of the iliac veins system may not be consistent, particularly with relation to the primordial origin of the hypogastric veins.14","title":"Endovascular treatment of pelvic venous congestion syndrome in a patient with duplication of the inferior vena cava and unusual pelvic venous anatomy: literature review"}
{"_id":"06d26b18-bf0b-54e3-91c0-dcf4b59e6e57","text":"ARM is a minimally invasive technique that can be readily added to ALND and that can help prevent arm lymphedema. The use of ARM for LAD mapping and avoidance of excision of arm lymphatics and nodes was associated with a lower incidence of arm lymphedema than classic ALND surgery in our study population. However, we recommend implementing future studies on the ARM procedure in a larger number of patients, to obtain statistically significant results.","title":"Prevention of lymphedema via axillary reverse mapping for arm lymph-node preservation following breast cancer surgery: a randomized controlled trial"}
{"_id":"06d6e4f8-7bb6-730b-5e64-53c0ee878cc1","text":"Immediate goals in this kind of resection are to achieve a clear histological negative margin and postoperative wound healing with acceptable morbidity. Literature review suggests a high probability of achieving negative surgical margin even in the presence of vascular involvement requiring resection and reconstruction of the involved vessel. Autologus reversed saphenous vein graft is the most commonly used for reconstructing the vessel. In cases where the vein is not available artificial grafts made of poly tetra fluoro ethylene (PTFE) or Dacron can be used.8 The incidence of graft related complications are more with artificial grafts.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"06e54c76-7252-e02c-3d27-f759526f527f","text":"The Bassett-Way operation, which emphasized en bloc resection of the vulva and both groins, has been replaced by radical wide excision and selective inguinal lymphadenectomy through separate groin incisions. The specific type of inguinal lymphadenectomy indicated depends on the stage and location of each cancer. Early stage lateral vulvar cancers can be treated safely by radical wide excision and ipsilateral superficial inguinal lymphadenectomy, whereas central vulvar cancers require bilateral inguinal lymphadenectomy. Deep inguinal lymphadenectomy, which involves surgical removal of the deep femoral nodes, is indicated in patients with centrally located early stage vulvar cancers, advanced stage vulvar cancers, and in patients with positive superficial inguinal lymph nodes. The deep femoral lymph nodes are always located medial to the femoral vein and can be removed without incising the deep fascia or dissecting the femoral vessels. Sentinel lymph node mapping should be offered to select patients with early stage lateral vulvar cancers as a means to avoid the postoperative morbidity associated with full inguinofemoral lymphadenectomy.","title":"Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva"}
{"_id":"06e815ed-4333-2fbe-fe52-466429447d08","text":"We present a large case series of patients with confirmed immediate reactions to BLs. We can conclude that changes in the pattern of use of some specific BLs in the frequency of prescribing antibiotics might be associated with changes in the sensitization patterns affecting the usefulness and sensitivity of diagnostic procedures.","title":"Changes in Sensitization Patterns in the Last 25 Years in 619 Patients with Confirmed Diagnoses of Immediate Hypersensitivity Reactions to Beta-Lactams"}
{"_id":"06f15157-ebd6-9b9a-25b1-34cbe5b3df0e","text":"Several studies [75,76] have confirmed the accumulation of nanoparticles applied locally on the surface of the stratum corneum or in hair follicles: these evidences demonstrate that the combination approach of nanoparticles and microneedle arrays could potentially facilitate deposition or the permeation of nanoparticles into the deeper layers of the skin. It has therefore been shown that it is possible to use microneedles to improve the delivery of drug-loaded nanoparticles to the deeper layers of the skin where most dermatological diseases originate. The combination of microneedles and targeted nanoparticle techniques may also provide an alternative route for delivering drugs into specific cells\/tissues.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"06f56e44-31be-0275-f9a0-7e202b1e132e","text":"The aim of our study was to investigate the postoperative factors that might be associated with increased hepatic venous congestion during the postoperative period in patients undergoing cardiac surgery. The investigation focused on the changes and relationships among hepatic waveforms and echocardiographic parameters, ventilator settings, fluid and vasoactive medications, and laboratory parameters of renal and liver functions during the first 24 h. Our goal in our prospective observational study was to determine which factors are associated with the increased congestion of the liver as measured by Doppler ultrasound in patients undergoing cardiac surgery.","title":"Association between Hepatic Venous Congestion and Adverse Outcomes after Cardiac Surgery †"}
{"_id":"06f73c48-8923-802d-b68f-6d38262ef4ff","text":"Two recent reviews include many of these applications.5,48 However, an important office application has not been widely recognized—diagnostic ultrasound for deep venous thrombosis (DVT) surveillance.35 The safety of buttock fat injection is a major concern because of the risk of fat embolism.49–51 This device may be used to evaluate the level of fat injection.24,52","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"06fd77ec-d8b7-5248-044b-7244269850fb","text":"MCC of the head and neck has a high propensity to metastasise to the lymph nodes, and recent attention has been focused on the use of SLNB. Accurate staging is required for appropriate treatment planning and development of clinical trials in head and neck MCC. It has been demonstrated that approximately one-third of MCC patients who only undergo clinical nodal evaluation are under-staged due to the presence of occult microscopic nodal involvement. Sentinel node status has a significant prognostication value, with nodal positivity reflecting high rates of recurrence or metastasis. Conversely, sentinel node negativity may be associated with a significant survival advantage.","title":"Head and Neck Merkel Cell Carcinoma: A 12-Year Single Institutional Experience"}
{"_id":"07019a44-7580-af98-31cb-c7d084291376","text":"Thorough resection planning with the support of local imaging and an interdisciplinary approach with adequate follow-up regimens is necessary to achieve the best possible outcome for patients with locally advanced skin cancer and to diagnose aggressive dissemination mechanisms.","title":"Resection of Skin Cancer Resulting in Free Vascularized Tissue Reconstruction: Always a Therapeutic Failure?"}
{"_id":"0706a5e0-5680-5273-07c9-c1a8d09c0ffa","text":"The correct diagnosis of low-grade PJI in TKA following either dry tap joint aspiration or uncertain results in the preoperative diagnostic workup remains one of the most difficult challenges for the orthopedic surgeon. An undetected low grade infection prior to a partial or complete exchange of the prosthesis may result in repeated revisions, prolonged hospitalization and increased morbidity and mortality. While Microbiological cultures are a useful tool in the detection of a PJI and offer the opportunity to establish a tailored antibiotic treatment, reported incidences of culture negative PJI from 7 to 42% show the urgent need for further improvement of isolation and identification of the respective organism.","title":"Poor performance of open incisional biopsy for the microbiological diagnosis of periprosthetic knee joint infection"}
{"_id":"070b81a0-0fc9-438d-1bad-5ab46391adfe","text":"In principle, to achieve the most natural and harmonious rejuvenation of the face, all changes that result from the aging process should be corrected. Traditionally, soft tissue lifting and redraping have constituted the cornerstone of most facial rejuvenation procedures. Changes in the facial skeleton that occur with aging and their impact on facial appearance have not been well appreciated. Accordingly, failure to address changes in the skeletal foundation of the face may limit the potential benefit of any rejuvenation procedure. Correction of the skeletal framework is increasingly viewed as the new frontier in facial rejuvenation. It currently is clear that certain areas of the facial skeleton undergo resorption with aging. Areas with a strong predisposition to resorption include the midface skeleton, particularly the maxilla including the pyriform region of the nose, the superomedial and inferolateral aspects of the orbital rim, and the prejowl area of the mandible. These areas resorb in a specific and predictable manner with aging. The resultant deficiencies of the skeletal foundation contribute to the stigmata of the aging face. In patients with a congenitally weak skeletal structure, the skeleton may be the primary cause for the manifestations of premature aging. These areas should be specifically examined in patients undergoing facial rejuvenation and addressed to obtain superior aesthetic results.","title":"Changes in the Facial Skeleton With Aging: Implications and Clinical Applications in Facial Rejuvenation"}
{"_id":"070e046d-108e-d3dc-c3ca-1ddbc022ac16","text":"An open surgical excision from posterior popliteal fossa cannot be considered as a definitive solution in most popliteal cyst patients. The frequency of recurrence, large popliteal skin scars, and limitation of knee motion after simple open surgical excision from posterior popliteal fossa lead to arthroscopic excision internal drainage of popliteal cyst through posteromedial portal.","title":"Arthroscopic internal drainage and cystectomy of popliteal cyst in knee osteoarthritis"}
{"_id":"07155069-8f79-b769-e186-fb26de09451d","text":"Conclusions: Our findings highlight the need to increase awareness of appropriate management of IA with epinephrine followed by consultation with an allergist across Canada.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"071ba371-153e-f235-337b-f699e0704dd0","text":"We investigated the plastic surgeons’ role according to anatomical injury using machine learning. Plastic surgery had contributed considerably to the face and external regions among the six AIS categories; however, there was no correlation between plastic surgical treatment and outcome of trauma patients. Nevertheless, we found that the random forest algorithm is a useful method for multivariate analysis and that when it is used in combination with conventional statistical analysis methods, it supports the interpretation of the results. To our knowledge, this study was the first application of random forest algorithm in investigating the role of plastic surgeons in the field of trauma care.","title":"The use of machine learning for investigating the role of plastic surgeons in anatomical injuries: A retrospective observational study"}
{"_id":"071d1c6b-a5bb-bdaa-6451-cd95b9ee4648","text":"Currently there is not a diagnostic tool able to perform an early detection of the allergic reactions, thus reducing the length of the challenge test and decreasing the onset of severe allergic reactions.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"0725d853-33b7-89e6-f07a-17863dabe542","text":"Genotype-directed disease surveillance has repeatedly been proposed as a potential strategy geared toward the detection of early intestinal and extra-colonic malignancy in FAP. Whether the specific APC mutation prompts different desmoid tumor surveillance techniques and schedules in certain groups of patients has not been previously determined. A recent review of extra-abdominal desmoid tumors did not reveal any specific surveillance guidelines much less one based on genotype [15]. These results could be used in future research to better understand the pathophysiology of desmoid tumor formation or to develop surveillance protocols for targeted codon mutations of the APC gene.","title":"Desmoid tumors complicating Familial Adenomatous Polyposis: a meta-analysis mutation spectrum of affected individuals"}
{"_id":"07277190-1902-8956-e1b7-c392c7eb937c","text":"Data and material supporting the results of this study can be made available by the authors as required.","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"072fdc7d-ff55-49b4-89c9-a406a6e726d8","text":"Calciphylaxis is a rare but dreadful complication of chronic kidney disease. It is characterized by nodular subcutaneous calcification and painful tissue necrosis which often results in ulceration and secondary infection, leading to a high rate of mortality. Pathogenesis of this disease is not well understood and there are very few, poorly studied treatment options for this disease.","title":"Non-healing painful ulcers in a patient with chronic kidney disease and role of sodium thiosulfate: a case report"}
{"_id":"0730c2d5-195e-f636-7307-1de0dfdce143","text":"Complications of cosmetic dermal fillers are becoming increasingly common and should be considered within a differential diagnosis for unusual orofacial and maxillofacial swellings. Clinical presentation can be variable ranging from firm submucosal masses to diffuse swellings, therefore consideration to any perioral soft tissue mass should warrant a full clinical history, with documentation of any previous cosmetic procedures. These adverse effects can often be difficult to manage; hence prevention of complications is paramount.","title":"Beauty is only mucosa deep: a retrospective analysis of oral lumps and bumps caused by cosmetic fillers"}
{"_id":"073506ac-afec-8ca7-76f6-7185a93751ad","text":"This article will focus on those diseases wherefore surgery or laser therapy is considered as a possible treatment option or which are potentially subject to surgical evaluation.","title":"Cutaneous lesions of the external ear"}
{"_id":"073c3bea-39ca-7938-7cfc-b3181b3bd2ea","text":"CT and MRI images more than 24 months post operation indicate Byran cervical disc prosthesis partly restored motion of the impaired segments in flexion-extension and lateral bending while maintaining the advantage of anterior decompression. Selecting appropriate prosthesis size and insertion position is critical to treatment result. In summary, cervical arthroplaty of Bryan disc can achieve good anterior decompression treatment effect and stability in replaced 1 or 2 levels, which makes it a new choice for the treatment of CSM in Chinese.","title":"Clinical report of cervical arthroplasty in management of spondylotic myelopathy in Chinese"}
{"_id":"0743e17f-5b46-4df6-7261-8c20821407cb","text":"Cervical congenital spine deformities may go unnoticed until adulthood. Even though the signs and symptoms are obvious to the clinical eye, they may not be appreciated by the patient. These deformities are a risk factor for degenerative cervical myelopathy and traumatic spinal cord injury. Early identification of cervical congenital spine deformities and modification of activities may reduce the risk of subsequent trauma and prevent degenerative vertebral disease.","title":"Congenital Cervical Hemivertebrae and Block Vertebrae in a 43-Year-Old Male"}
{"_id":"07472285-b21d-3d14-fe95-be237a49fa5f","text":"In our study, we demonstrated that bone transport for ankle arthrodesis in cases of septic pilon nonunion with ankle joint infection is a suitable salvage procedure to preserve the affected extremity. Despite profound bone loss with a mean defect size of 7 cm and an accompanying high rate of large soft tissue defects with the necessity of free flap transfer, it was possible to achieve bone union, restore the leg length, and achieve acceptable bone and functional results without infection, although various complications occurred during this complex treatment.","title":"Analysis of bone transport for ankle arthrodesis as a limb salvage procedure for the treatment of septic pilon fracture nonunion"}
{"_id":"074b81c7-0606-3b52-9289-c4e79d01919a","text":"All surgeries were performed by a group of ten plastic surgeons with variable experience in microsurgery. The majority of the surgeons operated in both university hospital and at least one of the community hospitals. More complex patients were usually referred to the university hospital. With the exception of three bilateral procedures, all bilateral DIEP flap breast reconstructions were performed at the university hospital.","title":"The difference in local, regional and distant breast cancer recurrence between the immediate and delayed DIEP flap procedure; a retrospective cohort study"}
{"_id":"074e6904-8b7b-b0de-082b-86d8a480b92b","text":"Burn is still considered devastating in emergency medicine leading to physical and psychological disabilities and has an increasing mortality and morbidity. Mainstay of post-burn reconstruction is release and split skin grafting. Pedicle flaps were shown to be cumbersome, to need several procedures and hospitalization and free flaps are still technically demanding and facilities are not available everywhere. Plaster of Paris is a useful material with many properties. It is used in art, architecture, fireproofing, and medical applications. The name POP was derived from an accident to a house which was built from a deposit of gypsum, near Paris. The house was burnt down and when rain fell on baked mud of the floors it was noted that the footprints in the mud set rock hard. Burns from plaster of Paris is an uncommon complication due to improper use of this material.","title":"Plaster Burn: Challenge to Plastic Surgeon"}
{"_id":"07520515-ffd3-6b2e-1ef2-4578990d6be4","text":"In our model history of breast diseases presented as a strong risk factor for recurrence, this is a novel concept yet to be described and evaluated.","title":"Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?"}
{"_id":"0754abe1-8823-e6a9-08a7-8d3c3651c04f","text":"P24 Drug desensitisation in oncology: the experience of an immunoallergology department for 5 years","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"0771a0df-54cd-5c14-2f60-a68ea57277a9","text":"As medicine advances and physicians are able to provide patients with innovative solutions, including placement of temporary or permanent medical devices that drastically improve quality of life of the patient, there is the persistent, recurring problem of chronic bacterial infection, including osteomyelitis. Osteomyelitis can manifest as a result of traumatic or contaminated wounds or implant-associated infections. This bacterial infection can persist as a result of inadequate treatment regimens or the presence of biofilm on implanted medical devices. One strategy to mitigate these concerns is the use of implantable medical devices that simultaneously act as local drug delivery devices (DDDs). This classification of device has the potential to prevent or aid in clearing chronic bacterial infection by delivering effective doses of antibiotics to the area of interest and can be engineered to simultaneously aid in tissue regeneration. This review will provide a background on bacterial infection and current therapies as well as current and prospective implantable DDDs, with a particular emphasis on local DDDs to combat bacterial osteomyelitis.","title":"Role of Implantable Drug Delivery Devices with Dual Platform Capabilities in the Prevention and Treatment of Bacterial Osteomyelitis"}
{"_id":"0774a928-78eb-b7d8-f96a-14e5573fc612","text":"You have the right to withdrawal from the study at any time of research.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"077ac319-e25d-f1b1-dfea-429c125705e1","text":"It is important to scan extremities for deep vein thrombosis once the massive pulmonary embolism is diagnosed. Retrievable IVC filters may be required preventing further clot traveling.","title":"Traveling Thrombus in the Right Atrium: Is It the Final Destination?"}
{"_id":"077b99d4-2458-7d8d-a604-48a5d28c816e","text":"In the present study, the VAS at rest and with a cough at 1, 6, and 12 h postoperatively were lower in group T than in group C at the same time point. The VAS at rest at 1 and 6 h postoperatively and with a cough at 1, 6, and 12 h postoperatively were lower in group E than in group C at the same time point. The consumption of sufentanil in the analgesic pump within 48 h after operation was significantly lower in groups T and E than in group C. These indicated that the ultrasound-guided preoperative single TPVB or ESPB for thoracoscopic pulmonary lobectomy could provide effective postoperative analgesia, reduce the VAS of the postoperative pain, and reduce the dose of postoperative sufentanil and remedial analgesics. Previous studies have shown that the duration of analgesia is 12–24 h for TPVB [18] and 10–12 h for ESPB [19]. It was found in the present study that the differences in VAS at rest and with a cough at 24 and 48 h after surgery were not statistically significant among the three groups, suggesting that a single administration of 30 ml of 0.5% ropivacaine neither in TPVB nor in ESPB could meet the requirement for analgesia throughout the postoperative period in patients undergoing thoracoscopic surgery. Whether the addition of adjuvants such as dexmedetomidine or dexamethasone to local anesthetics can prolong the duration of action of TPVB or ESPB will be investigated in further studies.","title":"Ultrasound-guided single thoracic paravertebral nerve block and erector spinae plane block for perioperative analgesia in thoracoscopic pulmonary lobectomy: a randomized controlled trial"}
{"_id":"077bdb2a-a791-faef-19da-05e9fb4b219e","text":"While imaging modalities such as ultrasound have attempted to determine nodal status, they have been far inferior to pathologic evaluation, with ultrasound having a sensitivity of only 6.6% [27]. Even in patients with high-risk features (extranodal extension, microsatellites, and greater than 3 positive lymph nodes), an international cohort study failed to identify a benefit for completion lymphadenectomy [28]. Since less than 14% of the subjects in MSLT-2 had melanoma in the head and neck region, the question of the applicability of these trials to the head and neck location remains. For this reason, a clinical trial to address this concern is being considered in the US cooperative groups in which head and neck patients would be randomized to active surveillance or completion lymphadenectomy.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"07852410-b8b1-54cc-db22-8ac8eda9fe77","text":"vii) Regularly review and update immigration policies to address any challenges or barriers faced by IMGs and to ensure a fair and efficient immigration process for all.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"0793a4a3-6f82-6cef-1e89-e9a2ef87e40c","text":"There is a gradient of oxygen that develops between the outer layers and the interior. The centre has a lower concentration of oxygen due to the consumption of oxygen and the excretion of carbon dioxide and there is no recuperation of oxygen consumed. This makes the biofilm more recalcitrant and resistant to adverse environments.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"0799df75-a5ad-e9c0-dd51-15ec11ecdb11","text":"The desmoid tumor originating from the mesentry of the jejunal pouch after total gastrectomy has not been reported. It was a surprise, as desmoid tumor is rare and it was difficult to think of desmoid tumor as differential diagnosis.","title":"Mesenteric desmoid tumor of the interposed jejunal pouch after total gastrectomy"}
{"_id":"07a28af6-4909-8b0b-140d-7ecf0b5a902f","text":"The American Society of Plastic and Reconstructive Surgeons has promoted ultrasonic liposuction but surgeons of other specialties have abandoned this technique as they consider the internal ultrasound to increase the risk of cutaneous burns, seroma formation, and provide little additional benefit over standard liposuction.","title":"Liposuction"}
{"_id":"07bb7ea0-f0d0-9c9b-c1b9-70c46036aaaa","text":"The early post-admission screening of trauma patients with duplex ultrasound for venous thrombosis is supported by our study. A subset of injured patients appears to be at particularly increased risk of developing DVT within the first 48 hours of admission, specifically those with hypotension on initial presentation in the trauma bay, patients sustaining pelvic fractures, and those with preexisting congestive heart failure. Larger prospective studies are needed to establish which other patient groups are at high-risk for the development of deep vein thrombosis shortly after hospital admission and may therefore benefit from prompt surveillance.","title":"Early Detection of Deep Venous Thrombosis in Trauma Patients"}
{"_id":"07cac46d-dd4f-ee60-597d-d90c0faf9db3","text":"The results of the present study show that small access parotidectomy with a 4–5 cm long postaural incision alone without preaural and hairline extension is feasible and safe in most patients with small to medium size (mean 3 cm and up to 6 cm) benign parotid tumor of both superficial and deep lobe. This approach can be offered to patients who are very concern with a visible surgical scar on their face and neck. Scar is particularly an important consideration for patients who have colored skin type or history of keloid formation. We can now offer small access postaural incision to our patients for their choice.","title":"Small access postaural parotidectomy: an analysis of techniques, feasibility and safety"}
{"_id":"07d30f42-9c8f-1eff-a1f7-787c41f8c2f8","text":"Over recent years, various treatments beside traditional excision have been tried in an effort to provide better results, in terms of reduction of recurrence, better patient acceptability, and improved cosmesis. Although many treatments are now used for BCCs, there is little research that accurately compares these different treatment modalities against each other for different types of tumours in different locations. As a result of the importance of a good cosmetic outcome when tumours arise on the face treatment decisions may differ significantly to those that would be made for BCCs arising elsewhere. We discuss and review the literature and evidence base for the treatment options that are currently available for facial BCCs.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"07d5d70a-ffb6-b24b-7f52-f29959a473af","text":"Our findings suggest that EPPU may be useful in excluding pathological findings in patients with suspected DVT, and may allow rapid discharge and avoiding unnecessary anticoagulant treatment. Future prospective studies are warranted to confirm these findings. This study will continue over the next few months.","title":"Point-of-care ultrasound in patients with suspected deep vein thrombosis (DVT)"}
{"_id":"07d6d4f7-119d-56ad-58c4-f0105173313a","text":"We report a cohort of patients with belly dancer dyskinesia treated successfully with BTX injections. Ultrasound guidance for injections increases the accuracy and reduces the risk of the complications. BTX injection under ultrasound guidance is a safe and effective treatment modality that should be employed as a first-line in the management of patients with belly dancer’s dyskinesia.","title":"Ultrasound-guided botulinum toxin A injection in the treatment of belly dancer’s dyskinesia"}
{"_id":"07da227c-1f07-5a13-b0ac-eaf450976590","text":"A retrospective review of patient notes was undertaken to confirm that a recurrence had been identified. All recruited patients had undergone the primary surgery for infection and the surgery for recurrence within our institutions. A total of 12 patients were excluded as records of the management of their recurrent infection could not be recovered, and these were excluded from further analysis.","title":"Microbial Persistence, Replacement and Local Antimicrobial Therapy in Recurrent Bone and Joint Infection"}
{"_id":"07dbe30f-18f1-0266-43b6-fea3580ae489","text":"Introduction: Today's healthcare requires leaders to lead and improve the healthcare sector. CanMEDS framework is the one defining the competencies required for all Saudi residency programs, including dental specialty. Senior residents should demonstrate readiness to transition to practice as a leader. It is imperative to understand the notion of medical education and its influence on the training of future dentists. The major significance of this study is exploring the current leadership development and the integrated training into the Saudi Board Dental Residency Program that has not been systematically studied.","title":"Developing Leadership Among Dental Residents: An Exploratory Study"}
{"_id":"07e041cb-de6b-131f-9545-3def234b8d3b","text":"Staphylococcus aureus (SA) is a significant and well-recognized causative organism of bacterial osteomyelitis. Osteomyelitis is an inflammatory bone disease characterized by progressive bone destruction and loss. This disease causes significant morbidity and mortality to the patient and poses therapeutic challenges for clinicians. To improve the efficacy of therapeutic strategies to combat bacterial osteomyelitis, there is a need to define the molecular epidemiology of bacterial organisms more clearly and further the understanding of the pathogenesis of SA osteomyelitis. We conducted in vitro characterization of the pathogenic capabilities of an isolate of SA ST398 derived from a clinical case of osteomyelitis in a goat. We also report a rodent mandibular defect model to determine the ability of ST398 to cause reproducible osteomyelitis. Our results indicate that ST398 can invade and distort pre-osteoblastic cells in culture, induce significant inflammation and alter expression of osteoregulatory cytokines. We also demonstrate the ability of ST398 to induce osteomyelitis in a rat mandibular model. When compiled, these data support ST398 as a competent osteomyelitis pathogen.","title":"In vitro and in vivo assessment of caprine origin Staphylococcus aureus ST398 strain UTCVM1 as an osteomyelitis pathogen"}
{"_id":"07e28450-d0bb-4b22-9c11-eacf7054d0c7","text":"The present study aimed to determine the indications for free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head.","title":"Indications for free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head"}
{"_id":"07e8719e-f2f3-aa3b-4a8d-d9f8fdd7a319","text":"Larger studies are needed to confirm our results, to optimize the early diagnosis and the overall management of the venous thromboembolism in critically ill patients.","title":"Ultrasound screening for asymptomatic deep vein thrombosis in critically ill patients: a pilot trial"}
{"_id":"07f95119-810e-263b-9da9-869c2ac4c60e","text":"Selection bias has been minimized as possible and collected data was analyzed using SPSS 16 following which descriptive analysis was done. Point estimate at 95% Confidence Interval was done for binary data along with analysis for frequency and proportion.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"07fcf349-7281-13f0-f996-d7d20c7026a5","text":"The median time that has passed since primary breast implant surgery for intact and ruptured implants is shown in Table 1.","title":"The Value of Ultrasound in the Evaluation of the Integrity of Silicone Breast Implants"}
{"_id":"07fd1aa8-7333-bebb-fb03-a7c97f66df9a","text":"With background knowledge of prevalent potentially curable diseases in the community like TB, it becomes desirable to consider this option when the patient follow-up is questionable. It is also advisable to biopsy the most abnormal node that may not necessarily be the most accessible one.","title":"Peripheral Lymph Node Excisional Biopsy: Yield, Relevance, and Outcomes in a Remote Surgical Setup"}
{"_id":"0802edcb-87f7-f74b-0942-0273001af7e1","text":"The current study shows that ABG via RIA offers a reliable solution to nonunion of open Gustilo-Anderson type III tibial fractures treated with ringed external fixator application. The same method of ring external fixation can furthermore be maintained with the addition of bone grafting. Furthermore, RIA may be utilized in treating docking site nonunion following bone transport. The high volume and concentration of MSCs in RIA ABG foreseeably contributes to the success of this procedure. All 15 patients in our series reliably went on to union at an average of six months. Complications were minimal, but infection occurred in 20% of cases and required formal debridement in all cases. Larger comparative clinical investigations are warranted to determine the relative efficacy of RIA over conventional ABG for complex tibial nonunion treated with Taylor Spatial Frame (TSF).","title":"Bone grafting via reamer-irrigator-aspirator for nonunion of open Gustilo-Anderson type III tibial fractures treated with multiplanar external fixator"}
{"_id":"080366dd-9275-8ffd-6970-1919eb1100fc","text":"The aim of this study is to investigate the role of halo-traction in the treatment of cervical infection patients associated with refractory kyphosis.","title":"The pre-surgical role of halo-traction in patients with cervical infection associated with refractory kyphosis: a retrospective study"}
{"_id":"0803717f-37c8-e211-b345-a8eced39b5f8","text":"Four sensation measurement points evenly distributed in each zone were used as the sensory assessment tool, when the incision is located in the zone, the sensation points should be more than 1 cm away from the incision. A dermal zone was considered effectively blocked by the TAP block, if there were 2 or more sensory assessment points in the zone that showed loss of temperature sensation to alcohol swab or pain sensation to pinprick. The zone was considered as negative (not effectively blocked) if less than 2 points showed pain or temperature sensory reduction.","title":"Analgesic efficacy of ultrasound-guided subcostal transversus abdominis plane block"}
{"_id":"0804e931-b571-9ab1-ca66-b3b2f96cdb7c","text":"Suture midface suspension has the following advantages over deep plane facelifts: minimally invasive technique, performed under local anesthesia and relatively short procedure. However this technique has the following potential disadvantages: since there is no periosteal release and undermining the potential for significant and lasting elevation and repositioning of the malar mound may be limited; it is a blind procedure; hence it may carry the risk for neurovascular damage and finally stab incisions are done in visible, prominent areas. In addition skin irregularities (dimpling and bouncing) may appear at fixation points and sutures passed under the thin skin of the lateral canthal area may be palpable by the patients. Fixation to deep fascial plains such as deep temporalis fascia and passing the sutures at the SMAS levels may prevent these possible complications.","title":"Suture midface suspension"}
{"_id":"0806db37-6b85-f8b8-1aec-9017d311885a","text":"The patients were followed up clinically every 3 months during the first 2 years, every 6 months for 3 years and in a yearly basis afterwards to monitor disease progression. Mammographic evaluation was performed every year during all the follow up period.","title":"Circulating miR-200c and miR-141 and outcomes in patients with breast cancer"}
{"_id":"0807fcf4-d37b-95a8-4ff3-2b7e82bce989","text":"Patients without positivity of hormone receptors did not receive chemotherapy for age or comorbidities.","title":"Waiting time for radiation therapy after breast-conserving surgery in early breast cancer: a retrospective analysis of local relapse and distant metastases in 615 patients"}
{"_id":"0809b0e4-a5a3-aedb-ec34-c45201ae7fab","text":"As seen in the previous sections, there are different ways of penetration through the skin, which in addition to providing protection for the body acts also as a selective barrier. These strategies can be seen as tools to gain access to the different types of skin stem cells and their surrounding microenvironment for different purposes. Regarding this, various strategies can be applied to promote the penetration of drugs to the skin (Table 1). The simplest approach is to remove the stratum corneum or physically bypass it, by creating both macroscopic pathways and micropores through which molecules can penetrate. Chemical penetration enhancers and drug delivery systems temporarily alter the barrier properties of the skin by interacting with the stratum corneum components through different mechanisms or optimize partition or diffusion characteristics of the drug [9].","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"08113005-650c-0300-facd-b2189fd63126","text":"The VFG is an excellent choice for reconstruction of multilevel cervical defects due to spinal tuberculosis. The rapid and ideal fusion, as well as the lower risk of tuberculosis recurrence in this case study indicates that VFG may be a favorable surgical option for long segmental cervical tuberculosis.","title":"Application of vascularized fibular graft for reconstruction and stabilization of multilevel cervical tuberculosis A case report"}
{"_id":"0814e1ce-1fe4-cd95-7504-b74245d8f8ff","text":"Our institution is a tertiary-level university teaching hospital with a very important department of gynecological oncology, receiving and treating a lot of patients affected by vulvar cancer from all over Italy. For this reason, we have overcome the scarcity of data available in the literature on the management of these patients and have developed a personal approach to reconstructive surgery planning and immediate postoperative period management. Our series demonstrates that it is possible to reconstruct difficult and extensive vulvar and perineal defects after previous surgery with a low rate of wound complications, following some principles. We must consider that about 85% of primary reconstructive surgery is accomplished in most centers employing a few traditional workhorse techniques: fasciocutaneous VY flaps and gluteal fold flaps for perineal defects; abdominal advancement flaps for mons pubis defects; and skin grafts for skinning vulvectomy in cases of intraepithelial Paget’s disease. The advancement flap and VY flap redistribute the tension over the suture but cannot eliminate it. Gluteal fold flaps can only repair defects of limited size and are not suitable for extended vulvectomy. Skin grafts in the vulvar area have a relevant risk of scarce engraftment due to poor wound healing typical of the female genital area affected by maceration and urinary and fecal pathogen contamination (28–30).","title":"Secondary post-oncologic vulvar reconstruction – a simplified algorithm"}
{"_id":"081db5d3-198e-a07d-648d-746703e01766","text":"In our study, anastomosis of pedicle of free flaps to great vessels was justified. Though anastomosis to branches has its own merit, there is situation like paucity of branches due to burn, surgery, radiotherapy or need for a vein graft or possibility of kinking in which the incidence of flap failure rises. So direct anastomosis of the pedicle to the side of common carotid artery and internal jugular vein was shown to be safe and worthy.","title":"Anastomosis of Free Flap Pedicle to Great Vessels"}
{"_id":"081e2800-30d8-0745-15ff-1b1c3c4ddb79","text":"Follow up requires both clinical examination and imaging, the frequency of which is determined by the tumor site and its histological grade. Expert opinion recommends following patients every 3 months for 3 years, then every 6 months of 2 years then annually.","title":"Neurofibromatosis 1 French national guidelines based on an extensive literature review since 1966"}
{"_id":"0820eb5b-5296-3878-0d96-480bb056d4dd","text":"Our literature review aims to give an overview of the studies investigating the role of SLNB, using radioisotopic mapping for SLN detection in patients who underwent NAC for BC before the investigation.","title":"Feasibility of Sentinel Lymph Node Biopsy in Breast Cancer Patients with Axillary Conversion after Neoadjuvant Chemotherapy—A Single-Tertiary Centre Experience and Review of the Literature"}
{"_id":"08223a09-90de-0540-1db7-75e8db2b3a97","text":"Another option is to combine brachytherapy and surgery simultaneously. In this way, the surgery slightly lowers the radiation dose of brachytherapy. Additionally, brachytherapy helps control bleeding in the immediate postoperative period. Brachytherapy can therefore be used as an adjuvant treatment to treat the source of possible remaining microscopic disease and reduce the probability of local recurrence. This treatment makes it possible to maintain the eyeball and preserve eyesight with good local control without jeopardizing the possibility of performing other required treatments in the future.","title":"Clinical Outcomes after Surgical Resection Combined with Brachytherapy for Uveal Melanomas"}
{"_id":"082a79b7-130f-5fd9-2851-5ee4a98d9783","text":"Despite the great influence International Medical Experiences (IMs) can have on young physicians and their impact on patients and communities, they are not offered in all training programs and are at risk of being reduced in some due to stringent guidelines for funding of graduate medical education.","title":"Loss of international medical experiences: knowledge, attitudes and skills at risk"}
{"_id":"082db8dd-739b-06e0-d5d4-fe9911e86311","text":"This study was a snapshot of medical students' perception and teaching of plastic surgery in the United Kingdom and Canada. Students at both medical schools had a different level of understanding about plastic surgery and factors for career choice which was reflected by their undergraduate medical curriculum.","title":"Plastic Surgery Inclusion in the Undergraduate Medical Curriculum: Perception, Challenges, and Career Choice—A Comparative Study"}
{"_id":"0836d6a7-e62b-94bd-1872-603e1a25c030","text":"Desmoid tumors are rare soft tissue tumors derived from fascia and connective tissue of the muscular layers. The abdominal region is the most frequent site of involvement, whereas involvement of sternal manubrium is rare. We report the case of a rare desmoid tumor in the sternal manubrium mimicking radiological and metabolic features of malignant tumor, which was successfully treated by sternal resection and reconstruction with autogenous rib grafts.","title":"A rare desmoid tumor arising from the manubrium"}
{"_id":"0836f36e-e123-6063-5e74-afe31a3e3253","text":"There were some therapeutic failures in this case that caused the skin necrosis with exposed tendon at the first surgery and caused a new skin necrosis at the donor site after the local flap, which prolonged the treatment period. Treatment failure occurred due to the delayed decision of the appropriate flap to use and insufficient consideration of the complications associated with EDB flap and friable skin management at the primary surgery.","title":"Therapeutic failure and eventual solution for skin necrosis and exposed tendon of the dorsum of the foot: A case report"}
{"_id":"08401cc7-71fc-39de-81df-2297409f74d6","text":"The FACE-Q rhinoplasty module was translated into Norwegian by strict adherence to the translation method used by Mapi Research Trust and the results of its application in our daily practice are presented.","title":"Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients"}
{"_id":"08444da4-e59d-e581-7ce3-6722f3f40491","text":"Correlation of the Breslow depth and mitotic index is well known in melanoma, both being markers of aggressive biological behavior. Practically, this correlation is so strong that recent studies sustain the idea that the mitotic index can be used as a surrogate to estimate Breslow thickness in incisional biopsies for planning surgical management [20]. These two features are mandatory for pathological reports in melanoma and are considered two of the most important prognostic factors in predicting the survival of melanoma patients [21]. Our study confirms this strong correlation and the importance of accurate evaluation of these parameters in diagnosis and research purposes. Thus, tumoral features that correlate with the Breslow depth and mitotic index are representing indicators of an aggressive behavior of the evaluated tumor.","title":"FOXP3 in Melanoma with Regression: Between Tumoral Expression and Regulatory T Cell Upregulation"}
{"_id":"0844af8c-39de-7e20-6590-a3507466ea70","text":"The results from this parallel controlled study suggested that manipulative acupuncture is an acceptable treatment for patients with severe Bell's palsy to improve facial blood perfusion and facial nerve function via HBGS grade, leading to increased efficacy and recovery rate and requiring fewer treatments to recover from the impaired facial nerve function to HBGS grade I. Therefore, further testing is required with a larger number of patients and participating hospitals.","title":"Efficacy of Manipulative Acupuncture Therapy Monitored by LSCI Technology in Patients with Severe Bell's Palsy: A Randomized Controlled Trial"}
{"_id":"08628ada-918b-2da5-3727-b97881bd1f2d","text":"The patient is a 55-year-old Caucasian male with a past medical history of hypertension, congestive heart failure, and right testicular cancer treated with orchiectomy and adjuvant radiation of unknown dose and treatment field in 1993 for presumed seminoma. He presented to the emergency room in 2012 with a painful right groin mass that had been increasing in size and had recently caused impaired ambulation.","title":"A 55-Year-Old Man with Stage IV Squamous Cell Carcinoma of the Right Groin after External Beam Radiation for Testicular Cancer"}
{"_id":"086b4cd2-c8f0-f49b-1d40-8611a4201f45","text":"In similar clinical cases, the pterional craniotomy is the traditional approach for accessing the tumor through the brain by opening the dura mater. Thanks to careful preoperative planning, a neurosurgeon has been able to identify a transorbital route for the resection of the tumor that enabled the removal of the bone of the orbit and provided access to the tumor, making the surgery minimally invasive and providing a low risk of brain damage.","title":"Current Practice in Preoperative Virtual and Physical Simulation in Neurosurgery"}
{"_id":"086bfba4-2b34-020b-b3dc-5b7f4a296b3c","text":"Patients should be asked to avoid extreme cold or heat for 48 hours. Massaging of the treated area and strenuous physical activity should be avoided for six hours. Patients are asked to sleep with their heads elevated for one night; skin care routine may be followed after 24 hours.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"08738245-bac6-d00f-a03d-87872ffc48fa","text":"An important point to note is the timeline of onset and severity of the CAEs. The median time to onset of rash in our series was 14.5 days. Development of a rash within 5–14 days is typical for a morbilliform or simple drug eruption; in contrast, patients with a systemic drug hypersensitivity eruption often have a more delayed presentation 3–6 weeks after drug initiation. Our patients had features of systemic hypersensitivity but presented earlier than might be expected for typical drug-induced hypersensitivity or DRESS syndrome. This seems distinct from the rash that patients have TT without history of prior immunotherapy in which the duration of medication exposure prior to rash onset is longer with less severe systemic symptoms. This could support the hypothesis that exposure to prior immunotherapy led to durable immune alterations which would then augment a hypersensitivity drug reaction caused by TT, thus explaining the more rapid onset and the severity of symptoms, a mechanism proposed by others too [14]. For now more pre-clinical data to identify molecular mechanisms linking ICB to TT that could drive these CAEs is required to support these claims.","title":"Cutaneous adverse reactions in B-RAF positive metastatic melanoma following sequential treatment with B-RAF\/MEK inhibitors and immune checkpoint blockade or vice versa. A single-institutional case-series"}
{"_id":"0887f51e-86d2-38e3-8143-a48c317ae3b6","text":"This cohort study was conducted to investigate the association between bleeding occurring within 14 days of primary breast cancer surgery and the rate of recurrence among patients with breast cancer in Denmark.","title":"Breast cancer recurrence after reoperation for surgical bleeding"}
{"_id":"0888f93b-309d-c5ff-aafc-1be3c4538ad1","text":"We have performed several IVC patches following penetrating injury to the abdomen over the last three years with favorable outcomes. In this study, we provide discussion of two such patients. Both patients had several additional injuries requiring resuscitation with balanced blood products and damage control laparotomy. Both patients did well with no complications related to the venous patch procedure. We recommend and consider IVC patching for similar patients with stenosis following repair and typically during the take-back following damage control surgery. While patching options include prosthetic and autogenous patching, we did use cadaveric aortic tissue for our patching in the second case described here [10]. We prefer this approach as it limits the negative effects of prosthetic material in the case of infection, allows tailoring of the patch to the size of the defect, and does not expose the patient to additional risks associated with vein harvesting. That said, autologous patching with vein is perfectly acceptable. We have a low threshold for using autologous vein to repair many vascular injuries, but on occasion in which the IVC injury is extensive, the size of the patch needed might exceed that of a saphenous vein that had been fashioned into a patch without spending the time to create a panel graft. This is especially true in the case of anterior and posterior injuries of the IVC.","title":"Patching of the Inferior Vena Cava Following Lateral Venorrhaphy in Penetrating Traumatic Injury"}
{"_id":"08892807-05f4-a81f-b18f-8af1ca6bad32","text":"The dataset contained 200 single breast craniocaudial mammograms that were acquired by digital technology and de-identified after being collected from the BreastScreen New South Wales Digital Breast Image Library. Malignant cases were biopsy proven while negative cases were assessed by the consensus reading of at least two senior radiologists following the negative screen reports of two clinical radiologists. The dataset included five categories of mammograms:","title":"Radiologists can detect the ‘gist’ of breast cancer before any overt signs of cancer appear"}
{"_id":"088f77c6-c5f0-9f57-5977-02a72ffbc976","text":"We found that the HATLFF has a high reliability in recommendation for frenotomy in a study of infants with tongue-tie and control infants. The two assessors had a high degree of agreement in each of the Appearance items and the first three Function items, however there was a lack of agreement between the assessors on each of the four Function items related to infant sucking. We found that it appears that the Function Score can be more simply assessed using only the first three function items (ie not scoring the sucking items).","title":"Reliability of the Hazelbaker Assessment Tool for Lingual Frenulum Function"}
{"_id":"08915a9f-da10-c4bc-3f43-87bdd018cf55","text":"This systematic review of 15 studies was performed to assess the utility of anti-infective bone graft substitutes in osteomyelitis treatment. Overall, the evidence of these studies is not sufficiently robust to determine the effectiveness of these individual bone graft substitutes for antibiotic drug delivery.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"08929907-1f88-63a9-2a50-95433d1e1efa","text":"To analyze the histopathological outcome of stereotactic biopsies of newly developed suspicious calcifications at lumpectomy scar site in patients with breast conservation surgery (BCS) to determine the incidence of malignancy and the association of mammographic appearance of recurrent microcalcification and their distribution. We also determined the association of disease recurrence with the presence of calcifications in original tumor and lumpectomy resection margins with the risk of recurrence.","title":"Recurrence Yield of Stereotactic Biopsy of Suspicious Calcifications After Breast Conservation Therapy"}
{"_id":"08980152-7a59-a904-d25e-5a5d2cb75bf1","text":"Our current findings suggest that the expandable external support device that was examined in a realistic sheep model of surgical myocardial revascularization proved efficacious in reducing vein graft irregularity and intimal hyperplasia and may have the potential to improve patency and longevity of vein grafts deployed during clinical coronary revascularization. In a further clinical investigation, the first trial with this expandable support system is currently being conducted in the UK, to determine the potential of this device in future surgical practice.","title":"Expandable external support device to improve Saphenous Vein Graft Patency after CABG"}
{"_id":"089e187c-4d6a-ad4e-3d41-a86099a5578c","text":"Plastic surgery for facial contouring and other aesthetic indications can be supplemented by fillers. Fillers have the advantage of achieving finer corrections.","title":"Dermal Fillers: Do's and Dont's"}
{"_id":"08aa0560-8674-2eef-7b20-12c83b8f77a6","text":"To report on skin tumor treatment with surface mould brachytherapy at our institution.","title":"Surface Mould Brachytherapy for Skin Cancers: The British Columbia Cancer Experience"}
{"_id":"08addb68-95a1-73d4-021a-ec6ec6833afa","text":"Figure 4 shows the cumulative graphs of friction coefficient changes during the experiment for the tested samples.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"08b32954-fca9-8db9-a0af-ad432ffa0c09","text":"Many classifications had been proposed for the ankylosis of the TMJ. It is based on location, type of tissue involving even extent of fusion. True complete bilateral intracapsular ankylosis was a bony fusion from the condyle to base of the skull reflects the most severe form.","title":"True bony TMJ ankylosis in children: Case report"}
{"_id":"08bad182-55af-5c7f-be2f-58638bed5ec6","text":"This study has several limitations; it is a pooled meta-analysis of a heterogeneous group of publications ranging from registry based reports, case series, and case reports. Although efforts were made to exclude duplicate studies through careful scrutiny of publications from the same author, group, or center we cannot be sure that individual patients were not included in more than one registry or seen at more than one center resulting in over-representation in the final dataset. This appears to have been unlikely given that duplicate identical clinical data could not be found in the final dataset. The study also necessarily suffers from the inclusion of studies over a period of time during which testing modalities for APC mutations has changed. For example, some studies based their results on protein truncation tests which provided a range of mutations, but did not reveal specific point mutations. Other studies based their results on sequencing which revealed specific codon mutations. This resulted in an accrual of data that can be challenging to compare. It is noteworthy that our search revealed only 274 published patients with FAP, a specified APC gene mutation, and desmoid tumors. This underscores the need for a common resource for the pooling of mutation analysis and clinical features of this and other relatively rare polyposis syndromes through expanded use of registries.","title":"Desmoid tumors complicating Familial Adenomatous Polyposis: a meta-analysis mutation spectrum of affected individuals"}
{"_id":"08d3ccad-38c6-8e41-56c3-0fc76f264825","text":"This prospective study includes a limited number of patients. The number of excised sentinel nodes were also low. Since the aim of this study was to analyze the individual lymphatic drainage pattern and SN‐distribution in patients surgicaly treated for parotid salivary gland tumors, we believe the results still be of value.","title":"Distribution of sentinel nodes from parotid tumors–A feasibility study"}
{"_id":"08d52a86-8422-d14f-9cfb-d0e3259aaf77","text":"Additionally, it is important to note that a significant number of patients who had a low ARISCAT risk in our study received a preoperative spirometry evaluation. This practice can overload the department responsible for administering spirometry and limits its availability for high-risk patients who might undergo surgery without preoperative spirometry, which may put them at increased risk of post-operative complications. Since clinical guidelines in Mexico only recommend the use of preoperative spirometry for patients with diagnosed lung disease, many surgeons conduct incomplete preoperative assessments, which put the health of patients with a high ARISCAT score. Therefore, there is a critical need to improve the quality of preoperative assessment by identifying patients with a moderate or high ARISCAT risk and performing spirometry on higher risk patients, which would optimize the use of available resources, and most importantly, reduce the risk of preventable complications and death.","title":"Preoperative risk assessment and spirometry is a cost-effective strategy to reduce post-operative complications and mortality in Mexico"}
{"_id":"08d8cb1e-5c98-0bfc-318a-21c0285dc799","text":"The aim of this retrospective cohort study was to evaluate the effects of orthodontic treatment performed with clear aligners on lower third facial ageing in adult patients through the use of WSRS by a panel of five aesthetic experts.","title":"Clear aligners’ effects on aesthetics: evaluation of facial wrinkles"}
{"_id":"08d949d3-6c86-b7f6-2f3b-98134c7be54d","text":"A femoral fracture was present in 71% of cases. We do not know whether these statistics are linked to the fact that men are more likely to be involved in road traffic accidents than women.","title":"Cerebral fat embolism after traumatic bone fractures: a structured literature review and analysis of published case reports"}
{"_id":"08d962ba-4321-06b7-9978-37db304b9276","text":"The PRISMA statement will be used as a template for the development and execution of this review. The systematic review protocol will be registered with the PROSPERO database before initiation. A standardized methodological approach to this systematic review will be based on guidance from the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0.","title":"Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol"}
{"_id":"08da9e0b-dd0f-2428-1f01-de3ed20c6ac2","text":"Filling out these two forms either by the child or the family will play an important role in the evaluation of perspectives for the treatment and guide the provision of holistic care of the disease.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"08db2321-42bd-0f82-ac6b-b2eb092eaf1b","text":"Other inflammatory markers such as procalcitonin have been less promising in the diagnosis of SSI (66). One study compared the level of procalcitonin in 17 patients with spondylodiscitis and 18 patients with herniated disks and found no elevation in either group.","title":"Surgical Site Infections Following Spine Surgery: Eliminating the Controversies in the Diagnosis"}
{"_id":"08ea634b-219d-9230-01eb-d29bdedcbc19","text":"Here we report a patient who underwent modified rotationplasty for an infected knee endoprosthesis as a left lower leg composite free flap for thigh and femur reconstruction.","title":"Modified Rotationplasty as a Composite Free Flap for Femur and Thigh Reconstruction"}
{"_id":"08ea674e-041b-5d68-c60a-52bc69ad0745","text":"Although we didn’t test for it we believe this technique will also other perineal aging consequences as vaginal dryness and vulvary pain. It is important to emphasize that a multidisciplinary approach is essential to asses before surgery the anatomical implication of the sexual dysfunction that will respond to surgical treatment and the psychosocial, relational and sexological aspects that need specific treatment.","title":"Novel technique of vulvo-vaginal rejuvenation by lipofilling and injection of combined platelet-rich-plasma and hyaluronic acid: a case-report"}
{"_id":"08ed6a3c-fefd-9172-4df4-46c445891e6e","text":"In this study, 43 out of 82 patients returned for regular check-ups which can be considered as a success because it is difficult for this category of patients to change their dental behaviour avoiding visiting a dental clinic. The reason for that could be that through their good satisfaction with their rehabilitation, patients realize the costly investment for the treatment and thus value the return of this investment in the form of sustaining good oral health.","title":"Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study"}
{"_id":"08eead9e-c36f-2f9b-b3bf-98098511c1d4","text":"Herein, we aimed to present a 50-year old female patient with MFH occurred in the radiotherapy field who had had surgical procedure for breast cancer 19 years ago and had followed by radiotherapy. Neoadjuvant chemotherapy was applied for MFH due to cardiac and mediastinal vascular invasion. Wide resection was carried out for the mass after having been decreased in size following neoadjuvant chemotherapy.","title":"A case of radiation-induced sternal malignant fibrous histiocytoma treated with neoadjuvant chemotherapy and surgical resection"}
{"_id":"08f0b50c-414b-7901-a599-d5513f32f0de","text":"All authors agree to publish and all participants will sign a data release consent form.","title":"Study protocol for comparing the efficacy of left-open single-flap technique versus double-flap technique after proximal gastrectomy: A multicenter randomized controlled trial"}
{"_id":"08f881cc-29bd-6599-6192-76faf915e07b","text":"Among the main limitations of our study are the reduced schedules for the examination of the infants due to technical problems related to the regulation of the patients by the Health Unic System, as well as the non-attendance of scheduled infants due to health problems and a public transportation strike.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"08f89c5c-bc13-3342-f6ed-ab2bc4f028af","text":"Naoshige described a method to repair full thickness defects of the nose using a glabellar flap as the lining of the nasal cavity and an expanded forehead flap for external closure. He considered his method useful in the reconstruction of a nose with a full thickness defect for which the flap donor site is limited. In our series, Glabellar flap gave good aesthetic results and it has a large available donor area that makes its use very important in case of large defects resulted from excision of locally advanced tumors [11].","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"08f99648-e367-cd7d-3187-776697cf0b3e","text":"Re-infection with different organisms was seen at similar rates to persistent infection with the same species in this cohort. Staphylococcus aureus and Pseudomonas aeruginosa are the organisms most likely to be persistently identified in recurrent infections. As a group, patients whose treatment for orthopaedic infection included local antibiotics did not exhibit higher rates of specific antimicrobial resistance compared with those not treated with local antibiotics. However, we did identify a few cases where bacteria developed aminoglycoside resistance regardless of their initial antimicrobial therapy. This should be considered in antimicrobial choice during surgery for recurrence.","title":"Microbial Persistence, Replacement and Local Antimicrobial Therapy in Recurrent Bone and Joint Infection"}
{"_id":"08fb101d-e854-e7a3-ed76-d3c7979e273c","text":"In this study, we aimed to clarify the clinical uncertainties and risk factors associated with the diagnosis and significance of UEDVT by retrospectively analyzing ultrasound data derived from a cohort of critical care patients. Moreover, we analyzed the sonographic features of detected thromboses in order to assess thrombus age.","title":"Sonographic and Clinical Features of Upper Extremity Deep Venous Thrombosis in Critical Care Patients"}
{"_id":"090c4bce-a95c-d74b-0130-ca932466d979","text":"From a surgical point of view, there was no difference between the immediate and delayed breast reconstruction regarding the postoperative complications and the recovery time.","title":"Prediction factors for breast reconstruction postoperative complications"}
{"_id":"0912d8ff-2c14-94a7-0d5a-a740504b2310","text":"All the patients underwent orthodontic treatment for preparation of the alveolar bone grafting. During the process of alveolar bone graft, a strip of septal cartilage graft was harvested from the lower border of the septum which also helps to correct the septal deviation. The cancellous bone graft harvested from the iliac crest was used to fill the alveolar gap and placed along the pyriform margin to gain symmetry. Through open rhinoplasty along the alar rim and additionally using Potter's incision extending to the lateral vestibule, the lateral crura of the alar cartilage on the cleft side was released from its lateral attachment and advanced medially as a chondromucosal flap in a V–Y fashion, in order to bring the cleft-side alar cartilage into a normal symmetric position. The harvested septal cartilage graft was used as a columellar strut. The cleft nostril sill was narrowed by a Y–V advancement at the alar base and any overhanging alar rim skin was carefully excised to achieve symmetry.","title":"Composite correction of a unilateral cleft lip nose deformity and alveolar bone grafting"}
{"_id":"09136eaf-cb83-9e34-23d8-d796f7fa1b34","text":"Standardised forms were utilised by chiropractic interns to gather data prospectively on infants presented by their mothers to the interdisciplinary breastfeeding clinic on the south coast of England between September 2015 and July 2016. These forms collected data on feeding abilities, birth type and any MSK problems in the infant. Descriptive data were analysed using Microsoft Excel.","title":"ECU convention 2017 research presentations Limassol, Cyprus. 25-27 May 2017"}
{"_id":"0917e7c7-2da7-0035-d721-56d102310a2e","text":"No recurrence of skin flap sagging or wound infection was observed 3 years after surgery Denture that was stabilized to right residual teeth with a clasp . Patient was quite satisfied to be able to masticate form an alimentary bolus and swallow without any teeth falling out","title":"Technique for secondary modification after maxillary resection and reconstruction for soft tissue flap fixation before prosthesis addition: a case report"}
{"_id":"09188b32-2685-a3d1-f926-8504167ebcf5","text":"Our post-operative outcomes were similar to a conventional rotationplasty patient. Therefore, we could extrapolate that using the lower leg as a spare parts free flap for thigh and femur reconstruction can prove to be a useful technique when combined with the principles of rotationplasty, leading to better limb length and performance with ambulation in the future for adult patients.","title":"Modified Rotationplasty as a Composite Free Flap for Femur and Thigh Reconstruction"}
{"_id":"091a2468-2790-09f3-582f-23f18b0dd5fa","text":"The skin tumors have a wide and extensive categorical differentiation based on WHO and are thus required to be meticulously evaluated for understanding the pattern of distribution of the specific tumor type in different sexes and various age groups.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"091bbfa5-7a9e-5a1c-7aac-448b65e51509","text":"The primary outcome was to determine the diagnostic test characteristics of an AADD strategy in all patients with suspected VTE, presenting through the ED. Secondary outcomes included proportional imaging reduction and the potential cost and time savings associated with this strategy.","title":"The application of an age adjusted D-dimer threshold to rule out suspected venous thromboembolism (VTE) in an emergency department setting: a retrospective diagnostic cohort study"}
{"_id":"091face1-5d2e-21f8-8970-b049145c18b2","text":"The gastrocnemius muscle is the preferred muscle for coverage of the knee, and either the medial or lateral head can be used. Use of the medial head is preferred because it is larger and more mobile and thus easier to conform to different size and shape defects. Use of the medial head of the gastrocnemius muscle does not result in significant loss of function because of the remaining soleus and lateral gastrocnemius.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"092197a3-7824-2c93-4cfc-7c9d2e2e53e2","text":"Patients were recruited for the study and underwent the stage I operations from 2016 to 2018.","title":"First‐year complications after immediate breast reconstruction with a biological and a synthetic mesh in the same patient: A randomized controlled study"}
{"_id":"0927400e-3020-7975-ca73-376ad5410b3d","text":"The majority of papers attempted prediction relating to biochemical recurrence, prostate cancer specific mortality or overall survival with a smaller subset predicting metastases. Sixteen of the 97 models identified related to brachytherapy with 72 for external beam radiation therapy and 9 a combination of the two. This could reflect more wide-spread use of external beam radiation therapy, and we might anticipate more tools relating to HDR brachytherapy (with or without EBRT) in the future. There is a dearth of externally validated nomograms focusing on brachytherapy and brachytherapy in combination with external beam radiation therapy particularly looking at overall survival and cancer specific survival outcomes.","title":"An appraisal of analytical tools used in predicting clinical outcomes following radiation therapy treatment of men with prostate cancer: a systematic review"}
{"_id":"092e4ec5-97a7-d923-4b97-7fa3bbb44fff","text":"We used the endonasal approach in over 1600 cases between 1973 and 1992. The advantages of the open technique included a clear well lit exposure of the nasal skeleton that allowed exact evaluation of the damage to the normal anatomy, better exposure of the septum for septoplasty and ease of harvesting cartilage grafts with minimal risk of perforating the septum. The ability to manipulate the upper and lower lateral cartilages under direct vision, precision placement of sutures and grafts lead to much more predictable results. The columellar scar healed well and became invisible in all types of skin, keloid formation did not occur. There was no difference in the resolution of oedema and temporarily impaired tip sensation between our endonasal and open rhinoplasty series.","title":"Secondary rhinoplasty"}
{"_id":"09308178-0c91-a67b-041f-c94335485fb0","text":"The other areas that interviewees found a new appreciation for included the evidence-based approach to medicine and the protocols designed to standardise patient care. On returning to the NHS, some of the interviewees explained how this new perspective empowered them to seek opportunities to help develop the service:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"0935d910-e2e2-8629-8c43-eea2aaf6f3af","text":"The secondary objective of this study was to examine the impact of academic appointment on research productivity, as measured by average annual publication rates before and after academic appointment. Although there was no significant difference in productivity between periods, we observed a trend of increasing productivity prior to appointment that peaked at 3 years post-appointment. In addition, there was a general decline over time beyond 3 years post-appointment. The observed trends must be interpreted cautiously due to the small sample size. One could speculate that the observed peak at 3 years post-appointment may correspond with an institutional three-year review or the completion of previous work leading up to the academic appointment. The subsequent decrease in productivity may be secondary to the increased administrative responsibility associated with leadership roles. On the other hand, some leaders were successful in maintaining their research productivity by incorporating new research interests in complementary areas such as medical education or curriculum development. The impact of administrative burden on productivity has particular importance to aspiring leaders considering the optimal time to pursue a leadership appointment.","title":"Academic benchmarks for leaders in Otolaryngology - Head & Neck Surgery: a Canadian perspective"}
{"_id":"093d40a2-a467-f912-0196-37e95f87b001","text":"In our retrospective series, the frequency of limb loss in DFO increased with more proximal initial foot DFO lesions, with almost half of patients losing their limbs with a hindfoot DFO.","title":"Foot Osteomyelitis Location and Rates of Primary or Secondary Major Amputations in Patients With Diabetes"}
{"_id":"093fb788-4018-c5bc-f00b-af847cd52581","text":"Treatment usually consists of surgical excision of the lesion including the involved minor salivary gland. While other techniques, such as cryosurgery and laser ablation were indicated for complete removal of the lesion.","title":"A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report"}
{"_id":"0942b0c7-9c4c-61fb-61e3-835aed3989ba","text":"Creating a treatment plan for patients with leg deformities who have undergone radiation therapy with or without chemotherapy can pose a difficult challenge. Because the osteocytes of neighboring bone are also destroyed, it may take years for the bone to revascularize and repopulate with healthy osteocytes [23]. The absence of healthy osteoblasts and precursors make lengthening procedures difficult due to unpredictable healing. Radiation damage to regional soft tissues is also an important consideration when planning a lengthening procedure. For these reasons, we decided to delay intervention to correct both the angular deformity and leg length discrepancy, and try to minimize further progression of leg deformity. At the time of surgery, Case 1 had a leg length discrepancy measuring 6 cm clinically. It was felt that epiphysiodesis of the growth plates in the healthy right knee should be the initial treatment, as it would halt progression of discrepancy and allow for some degree of correction, albeit unpredictable because of radiation damage to the growth plates of the left knee. Because of significant angular deformity, case 2 required an osteotomy to correct the defect. Future procedures are planned to address the anticipated leg length inequalities.","title":"Valgus and varus deformity after wide-local excision, brachytherapy and external beam irradiation in two children with lower extremity synovial cell sarcoma: case report"}
{"_id":"0942f46e-dc02-72f4-3e8e-74bbe38514af","text":"Although brachytherapy in older breast cancer patients has been associated with a higher risk of complications and subsequent mastectomy compared with conventional radiotherapy, brachytherapy does significantly reduce the median time period over which radiation treatment occurs (from 50 to 8 days in our study cohort), and it may be an attractive alternative for patients for whom travel burden is the primary barrier to completing RT. Ongoing clinical trial research suggests that safer, more effective brachytherapy techniques may present an alternative treatment option for elderly breast cancer patients in future.","title":"Travel, Treatment Choice, and Survival Among Breast Cancer Patients: A Population-Based Analysis"}
{"_id":"0944b368-1844-23bf-04aa-9cec6db46833","text":"A false positive test result may be realistic because normal naevus cells are present in one-third of the skin draining lymph nodes. Additional research should reveal whether adequate reference spectra for these kinds of conditions can still be defined.","title":"Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging"}
{"_id":"09498229-fa00-9a19-b518-9b3b4c50740c","text":"Malignant melanoma is the deadliest of all skin cancers. Historically, melanoma was very rare, but its prevalence has increased rapidly over the last 50 years compared to other cancers. Sunburn and congenital naevi are included among the risk factors of melanoma and may also be influenced by family history. At present, it is most effective to surgically remove lesion sites in patients with early melanoma after diagnosis, and lymph node dissection around the lesion is often considered because radiation or melanoma cells can be transferred to the surrounding lymph nodes. Immunotherapy with drugs such as nivolumab or ipilimumab or targeted chemotherapy for BRAF gene mutations is used to treat the surrounding lymph nodes in patients with metastatic melanoma.","title":"Computer-aided design and synthesis of 3-carbonyl-5-phenyl-1H-pyrazole as highly selective and potent BRAFV600E and CRAF inhibitor"}
{"_id":"09498451-410e-f6ce-82a9-70d6dcfb499e","text":"The primary efficacy outcome was the incidence of radiologically confirmed new or recurrent DVT or PE in 30 days, 3 months and 6 months using fisher exact test. The secondary endpoint of the study was to compare the safety of enoxaparin vs rivaroxaban in cancer patients for the treatment of DVT or PE.","title":"Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre"}
{"_id":"0956b0ea-e02a-1494-b2d4-aa4cc8fb26e6","text":"Further evaluation through transesophageal echocardiography revealed a normal heart and valves with no vegetation. Based on these findings, the diagnosis of SPE associated with DVT caused by Klebsiella pneumonia was made.","title":"Acute osteomyelitis, thrombophlebitis, and pulmonary embolism: a case report"}
{"_id":"0956e474-9214-4655-61bb-8715e764a35f","text":"Our population group all had established osteomyelitis with associated soft tissue defect, frequently having had unsuccessful previous operations over many years. At present the value of successful treatment is not reflected in the funding system.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"09584314-f681-47cb-cc9d-f930fdd0375a","text":"One year on, most people were satisfied with the treatment and care they had received. They were happy that their NMSC had been completely removed and that any scaring had healed. Some participants continue to check their skin but were still not sure what to look for. Interestingly, when they spoke about skin cancer they spoke about moles despite having had a non melanoma skin cancer.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"09594fc2-e5dc-a79c-5148-76b1965520b7","text":"Patients with invasive melanoma and their families will have complex social, psychological and financial issues. Life insurance and income protection insurance may be declined even for people with thin melanomas. The nature and intensity of these issues will vary from person to person and with disease severity. Psychologists with experience in palliative care should be involved when the patients’ needs and those of the family can no longer be met by the treating physician.","title":"Malignant Melanoma"}
{"_id":"09599b88-6dd1-d9b0-70c2-8f48464ba23d","text":"The aim of the study was to describe the profile and frequency of known risk factors or comorbidities of hospitalised medical patients with ultrasound-diagnosed DVT in an urban district hospital in KwaZulu-Natal.","title":"The profile and frequency of known risk factors or comorbidities for deep vein thrombosis in an urban district hospital in KwaZulu-Natal"}
{"_id":"0959b021-3b1b-05bf-c9ef-f7fa18bf9071","text":"Fat graft combined with paraspinal muscle flap could be an effective method to treat CSF leak during posterior thoracolumbar surgery. The proposed method significantly reduced postoperative drainage tube time and postoperative drainage volume. It also decreased the incidence and the degree of postural headache. The proposed method showed satisfactory clinical outcomes, and it is worthy of promotion.","title":"Repair of cerebrospinal fluid leak during posterior thoracolumbar surgery using paraspinal muscle flap combined with fat graft"}
{"_id":"09613294-2adb-7374-0123-6491ff658be5","text":"We presented a case in which a tandem duplicationof 17q11.2 was not associated with typical cutaneous findings of neurofibromatosis, but with neurofibromas. The patient displayed a conspicuous personal and familiar history of different types of cancer. Even though we could not have access to other members of the family to study the NF1 gene, the gene defection presented by the patient associated with many cases of lymphoproliferative disorders in the family suggests that the gene duplication can be part of a syndrome in which individuals are likely to develop hematologic malignancies. Since there is the lack of other similar published cases linking the presence of NF1 duplication with specific phenotypes, a comprehensive study about this type of mutation and its phenotype is warranted, mainly regarding the susceptibility to lymphoproliferative disorders. Opposed to other gene defects, like deletions and insertions, the real meaning of NF1 duplications and its role on cell cycle control remains unclear.","title":"Familial Lymphoproliferative Malignancies and Tandem Duplication of NF1 Gene"}
{"_id":"096b48e9-d255-c4b0-da18-ab45a6bfec80","text":"The questionnaire was in a simple tick-box style format and assessed whether the hospitals in which the consultants were employed stocked halo vest equipment routinely, their level of confidence to apply halo devices to adult and paediatric trauma patients, and whether they had received adequate training in application or had recent experience in halo vest application.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"097000c8-db3c-4efa-eecf-da7ecf8ba6eb","text":"From March 2018 to December 2022, 200 patients underwent endoscopic endonasal pituitary adenoma resection by a single author in our institute. We applied different graded skull base reconstruction strategies in different periods. Intradural fat graft packing was used to reconstruct the skull base in the early period, from March 2018 to June 2019, but fat graft was not used in the late period, from January 2020 to December 2022. The effect of these different graded skull base reconstruction strategies and whether intradural fat graft packing is necessary were evaluated by observing the incidence of postoperative cerebrospinal fluid leak.","title":"Intradural fat graft packing is not indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries"}
{"_id":"097985ef-353d-91ce-ca7a-b59d8d2c4813","text":"When queried, Google Trends provides the relative search interest for a term. This number represents the popularity of a term, and is calculated by Google Trends during a normalization process. This process starts with the interest in a term being divided by all searches made to Google within a given geographic area and timeframe. This value is then scaled from 0 to 100, depending on all searches for all topics. The resulting value is the relative search interest. These calculations mean that relative search interest for a term cannot necessarily be compared between different regions or timeframes. Instead, it is best used to illustrate trends or how interest has changed over time, not as a direct absolute measurement of how often a term was searched. In obtaining this data, no information about the identity of internet users was gathered or recorded.","title":"Changing Aesthetic Surgery Interest in Men: An 18-Year Analysis"}
{"_id":"098845da-e53c-bb79-7aed-bb9be2b42d9e","text":"The use of a mask in the presence of parents can improve acceptance before anesthesia induction with a parental presence in pediatric patients aged 2–3 years.","title":"Abstracts of the ICARE 2023 77th SIAARTI National Congress"}
{"_id":"098b761a-761a-7b04-e94c-6e7ef9dea2a4","text":"Interestingly, in multivariable analysis calcinosis was an independent factor that influenced discordance on gVAS in both directions. Though calcinosis is considered a measure of disease damage rather than activity according to IMACS, there is debate in clinical practice and the literature with regard to whether calcinosis represents disease damage and\/or disease activity and it is a common practice to treat calcinosis with increasing immunosuppression [14–16]. This result highlights the important impact of calcinosis on the reported and perceived JDM disease activity by physicians as well as patients, and further evaluation into the factors driving this as an independent predictor of discordance in both directions would be an interesting topic for further study. This result also emphasizes the need to monitor and treat this important clinical manifestation of disease. Though we do not know the type and extent of calcinosis of patients from the CLR, we suspect that patients with calcinosis and worse PF gVAS scores likely had lesions that contributed to functional limitations, pain and concerns regarding physical appearance, in addition to other factors not measured in the registry.","title":"Patient and physician discordance of global disease assessment in juvenile dermatomyositis: findings from the Childhood Arthritis & Rheumatology Research Alliance Legacy Registry"}
{"_id":"0990b25a-c1ef-3c8a-2d67-634bdc3aa3f0","text":"Conversely, some argue that the low rates of positive pathology make routine histological examination unnecessary. They advocate for relying on comprehensive clinical examinations and appropriate imaging techniques as sufficient methods for detecting local recurrence. This view is supported by studies indicating that local recurrence within mastectomy scars is not only rare but also typically evident upon clinical examination, thereby questioning the value of routine histopathologic analysis.","title":"Histologic Examination of Mastectomy Scars during Breast Reconstruction: A Systematic Review"}
{"_id":"09923234-8ef9-d63c-39e7-7ae5951392c1","text":"Osteomyelitis is difficult to differentiate from malignant bone tumors, as it lacks specific signs and symptoms. Distinguishing between the two potential diagnoses is important in order to initiate proper clinical management.","title":"Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases"}
{"_id":"0994626d-2626-089c-5842-027f73884204","text":"Although widely disseminated among surgeons, the knowledge that soft tissue takes approximately one year to return to the preoperative state is not always true.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"0998193b-7efa-2ea9-c69e-3ec90837f46f","text":"Understanding the underlying causes and the way they act could help the surgeons and patients to have a better outcome with fewer complications. Surgeons are also expected to inform their patients about the role of stress and anxiety and help them control it. Consultation or patients' referral to an experienced psychologist in different time periods before and after surgery could also be beneficial. Accordingly, assessing the missing factors and especially the role and power of each stressor in a rhinoplasty patient besides studying the appropriate prophylactic interventions are highly recommended in future studies.","title":"Post-Rhinoplasty Acne, Frequency and Role Players"}
{"_id":"099e4aff-6126-299a-9356-2f490b500616","text":"Osteotomy as a major procedure in rhinoplasty was considered in analysis. More increase in MCA1 and no significant effect on MCA2 were observed in patients in double osteotomy group comparing group of single osteotomy. It seems as if double osteotomy positively affects nose function by more increase in MCA1. Double osteotomy is positively affecting MCA1 considering the cases without septoplasty or cases with septoplasty.","title":"Does Cosmetic Rhinoplasty Affect Nose Function?"}
{"_id":"09a92a96-aa27-bebe-6921-81b5cc752ed3","text":"Cutaneous metastasis from colorectal cancer after excision of the primary is a rare occurrence and presents as cutaneous or subcutaneous nodules or as a rash commonly on the anterior abdominal wall.","title":"Late recurrence of large peri-stomal metastasis following abdomino-perineal resection of rectal cancer"}
{"_id":"09b73ce5-3ae8-416b-974d-c437dafbf338","text":"Patients whose DVTs are detected by ultrasound may be followed with weekly sonograms to document resolution. Those patients presenting with distal thromboses may be treated as outpatients and prescribed an oral anticoagulant, such as rivaroxaban or apixaban, reducing the need for injectable enoxaparin. A complete ultrasound screening examination of both lower extremities, including the calf veins, takes about 20 minutes for an experienced sonographer. Deep venous thromboses developing within the first week after surgery in plastic surgery patients tend to be limited to the calf veins.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery"}
{"_id":"09b93c91-7318-4f8c-cd34-648bf3b65348","text":"Repetitive single core biopsies of presumably the same location suffer from lack of accuracy due to uncontrollable distance between biopsy cores and cellular heterogeneity with high local variance. It also means repetitive trauma to the patient.","title":"Single punch, double biopsy"}
{"_id":"09bbbf9f-2e61-9f7a-3826-4cad49242493","text":"Keloids are benign dermal fibroproliferative tumors that grow beyond the boundary of the original wound edge and invade the adjacent tissue due to the extensive production of extracellular matrix and the abnormal proliferation of fibroblasts [1]. Keloids arise spontaneously or during the wound healing process of the dermis, and rarely regress without treatment. The treatment of keloids has long been a major problem for plastic surgeons due to the high rate of recurrence.","title":"Chondroitin Sulfate Promotes the Proliferation of Keloid Fibroblasts Through Activation of the Integrin and Protein Kinase B Pathways"}
{"_id":"09bf6738-e2ff-89f9-c318-e1685002e238","text":"Two female patients presented urticaria and abdominal pain right after chlorpheniramine injection.","title":"Chlorpheniramine-induced anaphylaxis Two case reports and a retrospective review of pharmacovigilance database"}
{"_id":"09bf75f7-1c5b-68d9-8c8b-6b55e2b69b74","text":"Meaning: The double opposing Dufourmentel flap is a reconstructive method that is useful when a large defect is difficult to close with a single transposition flap or when donor tissue is limited or has limited elasticity.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"09ce2cb6-653a-637f-087b-c723ea65133d","text":"Simulation images and intraoperative findings were reviewed to evaluate the usefulness of simulation images in planning tumor resection. First, the usefulness of the simulation of the cerebellar tentorium in determining the optimum route and required extent of incision of the cerebellar tentorium was assessed. Second, the agreement of the simulation images with the observed anatomical relationship between the tentorial sinus and bridging veins and the courses of tentorial and straight sinuses were examined. This study defined the tentorial sinus as coursing in the cerebellar tentorium and receiving flow from the cerebellum, occipital lobe, cerebral hemisphere, or brainstem, or without bridging vein [13]. We compared the presence or absence of tentorial sinus and the anatomical location between our preoperative simulation with the cerebellar tentorium and intraoperative findings from the operating microscope and ICG videoangiography. Similarly, we reviewed the presence or absence of bridging veins from the occipital lobe and cerebellum in the surgical fields and the site of bridging to the sinuses between the simulation and the intraoperative findings. We judged agreement between the simulation and intraoperative findings of the tentorial sinus and bridging vein as consistent, and the presence of structures only in the simulation or the intraoperative findings as inconsistent.","title":"Simulation of the occipital transtentorial approach incorporating visualization of the cerebellar tentorium using three-dimensional computed tomography angiography and gadolinium-enhanced T1-weighted magnetic resonance imaging: technical note"}
{"_id":"09d2b27e-f991-5537-d5b1-b21814f45c4f","text":"However, it is unknown how VTE and chemoprophylaxis rates reported in previous studies compare with those in large health systems such as the Veterans Health Administration (VHA). Our hypothesis was that the VHA would have similar rates of VTE and VTE chemoprophylaxis inpatient ordering and postdischarge prescribing among patients undergoing elective inpatient surgery for cancer compared with non-VHA hospitals, with variation by surgical specialty and procedure site. Therefore, the objective of this study was to determine VTE rates after major cancer surgery, as well as rates of chemoprophylaxis inpatient ordering and postdischarge prescribing within the VHA by surgical specialty and procedure site.","title":"Venous Thromboembolism Chemoprophylaxis Adherence Rates After Major Cancer Surgery Venous Thromboembolism Chemoprophylaxis Adherence Rates After Cancer Surgery"}
{"_id":"09d2d9b0-dfae-0bc4-6f76-0caf09181c23","text":"Imaging when musculoskeletal involvement is suspected in a patient with sarcoidosis allows the lesions to be localized and their extent and severity to be determined.","title":"Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis"}
{"_id":"09dc1a06-76c2-b242-2e97-cbede3e7738d","text":"I am now more goal oriented and I am able to put more indicators so I can trace my performance or the activity that I’m doing, so from the start I can think in a more strategic and systematic manner instead of being somewhat random so when I’m doing any activity or anything else, I am focused on the end-goal and I can do evaluation routinely and clearly from the start.","title":"Evaluating an e-learning program to strengthen the capacity of humanitarian workers in the MENA region: the Humanitarian Leadership Diploma"}
{"_id":"09e4aec6-33ee-fc7f-40db-089806dce1ca","text":"Vascular surgery with inguinal incisions carries a significant risk for SSI. Extensive need for incisions in the lower limb increases the risk of SSI. Incisional NPWT could be an important tool in the postoperative care of these anatomically and microbiologically challenging wounds. A central effect of incisional NPWT in inguinal or other lower limb incisions could simply be to provide a high-quality protective cover to the healing wound for a seven-day period. The constant suction that is being applied by the incisional NPWT-system provides a highly-adaptive surface that prevents kinking of the wound edges and a subsequent breach of the sterile barrier resulting in bacterial contamination during movements of the hip joint.","title":"Incisional negative pressure wound therapy for the prevention of surgical site infection after open lower limb revascularization – Rationale and design of a multi-center randomized controlled trial"}
{"_id":"09e9f306-e30b-316a-36b5-a68bf237c234","text":"Despite the increasing use of preoperative ultrasound evaluation for melanoma, there is limited research on the use of this technique for AM. The purpose of this study was to evaluate the accuracy of melanoma thickness measurements obtained by 18 MHz probes in comparison to histopathological examination for this subtype of melanoma.","title":"The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients"}
{"_id":"09ee4dd0-3f75-2370-1c8e-8ab2aa3c2824","text":"The first patient was enrolled into CLOTS 3 on the 8th Dec 2008. We expect to complete recruitment of 2800 patients by the end of September 2012 and to report the results in the first half of 2013.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"09fef6ee-57a6-0a9f-6973-5079d44f1931","text":"The aim of this study was to describe the etiological and epidemiological characteristics of patients with surgically treated radial nerve lesions of various origins in a single-center during a 20-year period.","title":"Etiological and epidemiological characteristics of surgically treated radial nerve lesions: A 20-year single-center experience"}
{"_id":"0a01067e-82da-e746-80b6-f69dba7104d3","text":"Because of the large size of the defect and also because the local resources were exhausted we chose the free tissue transfer consisting in a latissimus dorsi musculocutaneous flap as a covering solution. The criteria for choosing this flap were: the large size of the defect, the great reliability of this flap considering the radiation injuries in the recipient area and also less morbidity of the donor area.","title":"Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect"}
{"_id":"0a044d72-ac3a-183b-9d66-e78cc5a169a0","text":"Mohs total margins may result in a significant reduction in cancer recurrence rate at 5 years compare to conventional surgery. Moreover, duration of surgery was not increased when using Mohs technique when judiciously performed.","title":"Decreasing loco-regional recurrence for oral cavity cancer with total Mohs margins technique"}
{"_id":"0a0f47e5-6e6f-082d-8789-a92f772f9d72","text":"In our study, when treating dynamic wrinkles, intramuscular injection and intradermal microdroplets group showed more significant effectiveness than the nanomicroneedle group. The underlying mechanism is that nanomicroneedle can create microscopic columns in the epidermis and dermis with the expectation that this would permit molecules of BoNTA to reach the superficial orbicularis oculi in the lower dermis. And the transcutaneous penetration doses of BoNTA by nanomicroneedle may be partially reduced.","title":"A Comparative In Vivo Study on Three Treatment Approaches to Applying Topical Botulinum Toxin A for Crow's Feet"}
{"_id":"0a0f6c4e-f85c-5eb1-19a9-093e1feaa214","text":"Only one hospital in our study which is the main site for medical and nursing students’ training had better adherence in the first time dosing of antibiotics, in addition the OBGYN department showed a very high compliance to dosing time. Time of antibiotic administration before surgery is very important issue in prophylaxis and infection prevention, microorganisms are expected to enter body fluids and tissues from the time of incision until the injury is closed, during this time the antimicrobial level must be in the inhibitory level in serum [15].","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"0a10df9a-eaef-7ba0-7362-8fb10c1f199e","text":"These infections are usually treated with surgery and an initial course of intravenous antibiotics for 4–6 weeks. However, there is no evidence to support the superiority of intravenous therapy and, in recent years, there has been a growing body of literature showing that oral therapy is effective in treating these infections. A Cochrane review in 2013 found there was no benefit of intravenous compared to oral antibiotics in treating bone and joint infection. The authors judged the trials to be of moderate to high risk of bias and there was no statistically significant difference in the pooled results. Furthermore, most of the trials were conducted over 20 years ago, when there was a lower prevalence of bone and joint infections. The authors concluded that there was insufficient evidence from this review to inform a change in practice and there was a need for a randomised controlled trial to investigate this further.","title":"Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial [version 4; peer review: 2 approved]"}
{"_id":"0a11003e-5e8c-c522-491a-5106f7f3cf1a","text":"This demonstrated that aggrecan protein expression levels in spheroids before implantation can potentially be used as surrogate potency assay for the cartilage cell transplant to predict its regenerative capacity after implantation in human patients.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"0a156e25-a28b-1383-0129-c2843536fdf7","text":"We report the oldest patient in the literature to receive a free flap following trauma to the lower limb. At the age of 95, this gentleman sustained major trauma and his care during this episode required careful management with adjusted expectations of outcome and consideration of realistic goals.","title":"Managing complex trauma injuries in the elderly: a case report of a free flap and circular frame in a 95-year old patient with an open IIIB tibial fracture"}
{"_id":"0a1584dd-956b-44c6-7e89-f740079b0a05","text":"Here we show the result in detail and discuss about the mechanism of immune reaction after ID antigen administration.","title":"Intradermal Delivery of Antigens Enhances Specific IgG and Diminishes IgE Production: Potential Use for Vaccination and Allergy Immunotherapy"}
{"_id":"0a1eb02b-1dec-5916-7d8f-5f343c3f1a05","text":"Patients with skin disease rendering NIRS impossible and patients with amputation of the leg opposite to the side of surgery were excluded from the study.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"0a26f849-ebb8-a952-f8bc-3c392e36bfd4","text":"We present the case of a patient with exertional fat embolism on isolated exercise of his right leg two and four months after right total hip joint replacement. His immediate post-operative period had also been complicated by an acute episode of chest pain and hypotension, treated as acute coronary syndrome. To the best of our knowledge, this is the first reported case of exertional fat embolism following orthopedic surgery.","title":"Exertional fat embolism after hip joint replacement: a case report"}
{"_id":"0a2ab315-d8db-9671-4a46-547568032fe9","text":"Our research team comprises two men and one woman, all of whom are white British and aged 50 or above. All of us are University based researchers. One of us is also a semi-retired General Practitioner. One of us combines a full-time career with motherhood. Our ontological and epistemological standpoint in relation to this project can be described as critical realist, in that we believe stereotypes and professional identities are socially constructed through interaction, but that they are embedded in institutionalised structures and practices. We have reflected on our pre-existing assumptions about what are the desirable qualities for a surgeon to have, the right of women to pursue a career in surgery without discrimination or prejudice, and the extent to which institutionalised obstacles to their participation can and should be removed. We are not immune to the prevailing cultural stereotype of the surgeon but have critically engaged with its adequacy and validity and have attempted to set these value judgements aside when analysing the data. Our position in relation to the participants is largely that of the outsider – none of us are trainee doctors considering a career in surgery – but not exclusively so, as one of us is medically qualified, and one of us has experience of combining a career with motherhood. There are differences as well as similarities in our respective positions and we have used the former to generate discussion in our choice of questions and interpretation of the data. Selecting what to report is an inescapably partial process but where possible we have included verbatim quotations to enable participants to speak for themselves rather than through our mediation.","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"0a35c0e6-e59f-69cf-6a8b-257a8cb53439","text":"Perforator-based flaps have in recent years become the mainstay of autologous breast reconstruction practice. Imaging modalities ranging from Doppler ultrasound to CT angiography demonstrate varying utility in the preoperative identification and localisation of perforators. Despite these available radiological investigations, finding and quantitatively assessing perforators remain a time-consuming and tedious process that is often complicated by a number of factors including variable anatomy prior surgery and body habitus. Thermographic imaging shows promise as a novel modality for preoperative localisation of perforator vessels. This review summarises the currently available evidence for its application in perforator mapping for abdominal-based autologous breast reconstruction. We discuss the development of the technology over the years, its current use, its advantages and how it may impact on reconstructive breast surgery.","title":"Use of infrared thermography for the assessment of free flap perforators in autologous breast reconstruction: A systematic review"}
{"_id":"0a373a8a-509b-500b-afc3-3701d0956568","text":"The primary outcome was the proportion of new diagnoses of deep vein thrombosis out of all diagnostic imaging studies performed during the period of the study.","title":"Prevalence of venous thromboembolism in patients undergoing diagnostic venous ultrasound during the first SARS-CoV-2 pandemic: A personal history of VTE and a positive COVID-19 test are associated with the diagnosis of DVT"}
{"_id":"0a469c87-61f7-e8e1-5489-bc799f8e79f6","text":"The interventions are compared to the current standard of viewing the CT scan on a regular computer screen. Therefore there is no placebo or sham group in action, which could potentially harm a patient. The regular CT scans are available to the surgical team at all times, during planning as well as during operation. The interventions act as supplement to the gold standard and have the potential to not only aid the surgeon but also the teaching of residents and students. The trial is expected to show, which demonstration modality of 3D models is helpful for liver resection planning and which demonstration mode facilitates the highest usability and best outcome. Generating a 3D model of the liver is a time-consuming task [7] and costs of 3D prints and VR head-mounted displays and personal computers capable of displaying VR content make economical deliberations necessary and obvious. The results of this study may help in the decision process, whether these techniques should and can be applied on a regular basis or only for well-chosen cases.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"0a49ccbd-5419-3284-70ff-2c48c03e43c0","text":"In our future work, we want to implement data and test CNNs on different datasets and validate the bounding box technique on different kinds of images and MRI sequences. Furthermore, we want to investigate the role of the individual histological parameters reported in this article in relation to the radiomics data in the prediction of LNS.","title":"CNN-Based Approaches with Different Tumor Bounding Options for Lymph Node Status Prediction in Breast DCE-MRI"}
{"_id":"0a500c7a-7877-f873-ca36-dc6fe6586449","text":"We describe a patient who had cervical spine osteomyelitis caused by Blastomyces dermatitidis that resulted in cord compression and cervical spine instability.","title":"Anterior cervical corpectomy and fusion for blastomycosis causing destruction of C6 vertebra: a case report"}
{"_id":"0a64e233-8e83-1fbf-e630-c2b64005d5a7","text":"Power analysis with the 31 remaining vein samples that were located outside of the safety margins indicated that the minimally required sample size was 24 in this setting. Again, the calculated actual power of 0.96 suggested that the test was confidently representing statistical significance in discriminating the 2 groups for which prediction of the flap failure risk was made. Still, the number of patients of this retrospective study is considered comparably small.","title":"Early risk prognosis of free-flap transplant failure by quantitation of the macrophage colony-stimulating factor in patient plasma using 2-dimensional liquid-chromatography multiple reaction monitoring-mass spectrometry"}
{"_id":"0a70684f-56a2-7999-13c7-08178f526b0e","text":"The main treatment modalities for TBPs are surgery and radiotherapy. Total tumor resection without major complications like cranial nerve deficit is the main goal of the operation. Canal wall up or down tympnomastoidectomy with or without facial recess approach is commonly adequate for the removal of TMPs. However IFTA-A is frequently needed for the total removal of TJPs, especially in case of intracranial extension. As defined by Fisch in 1982 it includes a cervical extension of a post-auicular incision to maintain best neurovascular control by exposing jugular bulb, jugular vein and carotid artery following mastoidectomy, facial rerouting, cervical incision and blind closure of the ear canal.13, 14 Salt and pepper appearance meaning areas of high and low intensity on MRI is typical for PGs. Nevertheless DSA may be performed to confirm the diagnosis in case of suspicion. In surgical candidates DSA may be performed just prior to the operation for selective embolization. Ascending pharyngeal artery and its branches are known to be the main feeding vessel for TBPs. However in the present study in the order of incidence occipital artery, posterior auricular artery and ascending pharyngeal artery were found to be most common afferent vessels. In four cases with TMPs there was not any afferent vessel identified with DSA. Preoperative embolization is not advised for Fisch class A tumors while it is strongly recommended for Fisch class C and D tumors. The main objective of preoperative embolization is to reduce vascularity and thus bleeding during surgery. In the retrospective study of Murphy et al., intraoperative bleeding, operation time and hospital stay for TJPs, were shown to be significantly reduced after preoperative embolization. However preoperative embolization for TBPs may also cause permanent cranial nerve palsy.","title":"Temporal bone paragangliomas: 15 years experience Paraganglioma do osso temporal: 15 anos de experiência"}
{"_id":"0a7e58e0-8d4c-c6ce-8e76-1512490f7041","text":"If there are any signals of osteonecrosis or abscess formation, any gadolinium-based contrast would show further enhancement as seen in cases 1 and 2. Other MRI findings include cortical erosion with associated diastasis of the pubic symphysis cortical destruction, as seen in all our cases. In our experience, we often see symmetrical muscle oedema involving the adductor muscles, obturator internus and externus on either side of the pubic symphysis. All our patients presented with this appearance resembling Lorax and we would like to take this opportunity to name this the Lorax sign, inspired by the animated cartoon character of the movie Lorax. The symmetrical muscle oedema represents the moustache of Lorax and the obturator oedema corresponding to the eyebrows on coronal MRI sequences. Whilst this is not specific to PSF, we believe it is highly sensitive in patients with a background of prostate surgery and radiotherapy. Similar appearances can be seen secondary to osteomyelitis of the pubic bone and radiotherapy within the pelvis. Myositis from any cause can look similar, however, it would be unusual to only involve the adductor compartment.","title":"Imaging findings of urosymphyseal fistulas Patel et al"}
{"_id":"0a84d76e-d710-0f8e-b630-ba00457b6ac5","text":"All patients seeking rhinoplasty, even in addition to other nasal procedures such as septoplasty or turbinoplasty were included in the study. Patients younger than 18 years and with congenital or neoplastic nasal deformities were excluded.","title":"Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study Avaliação dos desfechos estéticos e funcionais em cirurgia de rinoplastia: um estudo prospectivo"}
{"_id":"0a892083-20ba-ff21-0a6c-cd126e168ae4","text":"This study was embedded in a clinical trial comparing standard wound management with NPWT. Patients were recruited who had an open fracture of the lower limb (where the bone protrudes through the skin). Due to exposure of the wound to air and debris, infection is a risk and early surgical intervention is required to clean the wound and remove damaged tissue. The primary outcome was the Disability Rating Index at 12 months. Consent for the study was taken if the patient had capacity. If it was judged that the patient did not have capacity, either a family or friend acted as personal consultee or a surgeon not directly related to the trial acted as a nominated consultee. After their surgery, when capacity was regained, participants were informed of the study. They were provided with a written information sheet which included a diagram of the NPWT supported by verbal discussion before deciding whether they would like to consent to continue in the study.","title":"Participation in a trial in the emergency situation: a qualitative study of patient experience in the UK WOLLF trial"}
{"_id":"0a91c5d9-323f-0503-c990-cfcde13c8304","text":"The power to detect a statistically significant excess risk of a second cancer in patients whose index malignancy was diagnosed before the age of 50 years was limited by relatively small numbers of index cases below this age cutoff. Nevertheless, the higher risk of CM in patients with a diagnosis of NHL or CLL after the age of 50 years may be a result of cumulative exposure to ultraviolet radiation followed by immunosuppression as a consequence of NHL, CLL or its treatment. The much higher risk of CM in male NHL and CLL patients is noteworthy and has been recorded in other studies (Travis et al, 1991; 1992; Tsao et al, 2002). We have no evidence that males are more aggressively treated than females or are more susceptible to developing skin cancer as a consequence of the treatment used for these patients.","title":"Evidence for an association between cutaneous malignant melanoma and lymphoid malignancy: a population-based retrospective cohort study in Scotland"}
{"_id":"0a956734-e62a-62fe-7077-b33d22755d07","text":"Study information was given to each participant and an informed consent was signed by a legal guardian. The protocol was reviewed and approved by the ethics comitee (Comité Étic d’Investigació Clinica de la Fundació Jordi Gol i Gurina) in Barcelona on February 28th 2002 prior to the initiation of the study.","title":"Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation"}
{"_id":"0a9a94f0-a7ab-08c5-91be-c9d5bf86843f","text":"In a study that supports and extends the concept of breastfeeding as a multifactorial health behavior, we found that a number of different factors had an independent and long-term prognostic influence on duration of exclusive breastfeeding. These factors included early skin-to-skin contact, intention to breastfeed, level of self-efficacy, and sense of security as well as the value mothers attributed to breastfeeding. Other factors showed a time dependency by primarily affecting the exclusive breastfeeding duration in the first months following birth. These included hospitalization in connection to birth, maternal obesity and low self-efficacy as well as a short previous breastfeeding experience. These characteristics pointed to target groups in special need of early breastfeeding support, as the characteristics specifically influenced breastfeeding in the first months and were no longer important if the mother managed to successfully establish breastfeeding of her infant. The dominating influence of psychosocial aspects among the factors with an independent and long- term influence on exclusive breastfeeding duration underlined the importance of including psychosocial aspects in effective breastfeeding support. Not only as prognostic factors to identify mothers in need of extra support, but also to include psychosocial aspects in the practical guidance helping the mother to gain positive breastfeeding experiences. Practices may include modelling and observational learning to help the mother master sub-skills of breastfeeding as well as addressing maternal uncertainties verbally and convincing her of her ability to successfully breastfeed.","title":"Multifactorial influence on duration of exclusive breastfeeding; a Danish cohort study"}
{"_id":"0aa25b73-0bb2-67dd-fc89-e7188769b3d6","text":"Several investigators have proposed various mechanisms of pathogenesis for subepidermal calcified nodules. Woods and Kellaway suggested two mechanisms for the formation of the subepidermal calcified nodule. The first mechanism is that calcified granules within the stroma create a larger calcified mass through calcification and degeneration of the stroma. Alternatively, the large calcified lesion occurs first and its subsequent reabsorption leaves the calcified granules that form the calcified nodule with associated tissue changes [17].","title":"Mobile Subcutaneous Calcinosis Cutis: A Case Report of a Mobile Solitary Subepidermal Calcified Nodule on a Woman’s Leg and a Review of Mobile Subcutaneous Tumors"}
{"_id":"0aa43182-4c54-f722-066e-0cbf0b8bb961","text":"The researchers of the study group will recruit participants and obtain written informed consent before inclusion into the trial. The participant is then reported to the study nurse using his or her unique serial number and the randomization is then performed by the study nurse.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"0aa84772-056a-4079-d7a2-822dd55a4c13","text":"monitor clinical signs and inflammatory biomarkers 48 to 72 h after the start of iv therapy and before switching to oral therapy (avoid switching in case of worsening of clinical conditions or increase of inflammatory biomarkers);","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"0aaac9f7-b1c9-2f87-6f87-f74cf0c8678b","text":"However it is not suited for treatment of gigantomastia in teenagers.","title":"Reduction mammoplasty"}
{"_id":"0ab249db-757c-ca96-983f-3808cdaf86fd","text":"Applications of ultrasound reported in dermatology are generally based on the measurements of skin thickness [23]. Such measurements have been applied to assess various skin conditions particularly fibrosis. Gottllober et al [24] used the change of skin thickness as an indicator of cutaneous fibrosis in their studies on five patients with cutaneous radiation syndrome. Huang et al [25] also reported a significant change of skin thickness in the head and neck region after radiotherapy using 20 MHz ultrasound. All these studies demonstrated the potential use of the ultrasound detection of skin thickness in assessing the postirradiation reactions of the skins. It is potentially helpful to use the ultrasonic properties to characterize the irradiated skin fibrosis because some changes of the skin structures are induced by therapeutic irradiation.","title":"An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy"}
{"_id":"0ab41638-ce01-3755-6e43-2db0d70ed3dd","text":"In particular, there are significant differences in leadership roles attained by female physicians as compared to male colleagues. While there was no statistical difference in the academic rank of the respondents within our survey, there was a significant lack of female representation in high level leadership positions such as program director and department chair. The reasons for these discrepancies are complex and likely interrelated.","title":"Canadian Women in Otolaryngology—Head and Neck Surgery part 1: the relationship of gender identity to career trajectory and experiences of harassment"}
{"_id":"0ac5e2ca-7e86-9ffc-f0f1-8c3600dcd3f1","text":"The MSAP flap is a small to medium sized flap most suited for subtotal glossectomy defects where optimal outcomes can be achieved in terms of speech clarity and restoration of oral intake.","title":"Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction – An outcome study"}
{"_id":"0acfdfa5-e00a-c9da-35f6-6457b68e6917","text":"Early ambulation within 24 hours was encouraged for mobilization of third space fluid shifts to expedite recovery and to prevent deep vein thrombosis. Prolonged sitting is to be avoided for 3 to 4 weeks following abdominal liposuction and pressure garments are to be worn for 3 to 6 months. It is important to support the heavy skin and subcutaneous fat of the obese patient longer than advocated to prevent it from gravitating down and forming folds, because skin retraction takes longer following megaliposuction. Pressure (finger tip) massage or an external ultrasound massage is advised for persistent edema, pain or firm and lumpy areas.","title":"Liposuction"}
{"_id":"0ad3c41a-ff9c-0b6a-994a-44d9eb050826","text":"In the future, it may be possible to establish a combined system allowing the plastic surgeon to perform specialized microsurgical procedures remotely from the office, providing services not tied to a single location.","title":"Robotic-Assisted Microsurgery and Its Future in Plastic Surgery"}
{"_id":"0ad3feb3-b4bb-03be-0445-11d9ef58f108","text":"The radial forearm free flap is an underutilized option for reconstruction of complex scalp defects. The radial forearm free flap was associated with few complications requiring surgical intervention and shorter duration of hospitalization. Younger patients and patients with smaller defects (≤ 7 cm in width) were more likely to be reconstructed with a radial forearm free flap. In addition, the radial forearm free flap was used more commonly for reconstructions of defects in the frontal region. The selection of microvascular free flap used in the reconstruction was not affected by the extent of the cranial defect. Surgical intervention for a recurrent lesion and history of prior radiation therapy correlated with patients requiring multiple microvascular free flap reconstructions.","title":"Reconstruction of scalp defects with the radial forearm free flap"}
{"_id":"0ad93fac-42d4-e2e4-110e-489c6a63f108","text":"The actual benefit of a local treatment should be considered in view of the limited life expectancy of metastatic patients. Therefore, it is important to provide an acceptable quality of life by improving the visual condition of affected patients.","title":"Photodynamic Therapy in Ocular Oncology"}
{"_id":"0add4e35-d391-4972-54e2-a25c5ca1caab","text":"Several methods of implant decontamination have been suggested, including mechanical therapies aimed at removing bacterial biofilm and smoothing the involved implant surfaces and chemical therapies such as application of antiseptics and local and systemic antibiotics. However, there is no consensus on the most effective protocol for detoxification of implant surfaces.","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"0ae00ed0-4237-100b-2b6a-5a5d5f4e4976","text":"Oral lesions with aggressive growth patterns, multiple lymphadenopathies, and comorbid systemic skin lesions, elevated serum lactate dehydrogenase and poor response to medical therapies should warn the doctors of the possibility of malignancy and the necessity of biopsy. Excisional biopsy without sacrificing organs or functions should be preserved for patients whose pathological diagnoses cannot be established through aspiration or punch biopsy.","title":"Oral and maxillofacial non-Hodgkin lymphomas Case report with review of literature"}
{"_id":"0ae10c56-7134-7d9a-117a-f1146e17ac8d","text":"Two additional patients had prolonged drainage and required oral antibiotics. A third had a stitch abscess that resolved with oral antibiotics and local wound care.","title":"Microparticulate Cortical Allograft: An Alternative to Autograft in the Treatment of Osseous Defects"}
{"_id":"0ae69306-b886-63d7-38e4-811ce2363133","text":"Our study found that the region of fellowship training has a significant impact on the rhBMP2 usage practice among US surgeons. In general, surgeons are more prone to adopt new techniques or procedures taught during their fellowship. In the light of safety and efficacy literature for rhBMP2, it is the professional obligation for fellowship training centers to teach the judicial and appropriate use of rhBMP2 in spine fusion surgery.","title":"Current Trends in Recombinant Human Bone Morphogenetic Protein 2 (rhBMP2) Usage for Spinal Fusion Surgery"}
{"_id":"0ae78465-bd91-d03f-2b15-c1dc0134d144","text":"A GPA can also be used in emergency situations as depicted in our second case [Figure 2] when the ensuing edema had caused venous compression and later thrombosis, needing vein graft interposition. A GPA was used to cover the wound until the flap pedicles across the anastamosis become stable and the edema subsided before secondary closure was possible after 2 weeks.","title":"The versatility of a glycerol-preserved skin allograft as an adjunctive treatment to free flap reconstruction"}
{"_id":"0af2872d-a8d0-707f-0229-935316d47d88","text":"IGAP and GT flaps were dissected in 21 fresh human cadavers to allow comparison of anatomical features. In a series of 60 patients, the authors used both the gluteal thigh and the IGAP flap to cover 76 ischiatic and perineal ulcers.","title":"Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps"}
{"_id":"0af98d83-f86e-f177-88b6-754d1135fa2c","text":"In this retrospective study, we aimed to assess whether deep ILNM is associated with PLNM and explore the prognostic value of deep ILNM in PSCC.","title":"Deep Inguinal Lymph Node Metastases Can Predict Pelvic Lymph Node Metastases and Prognosis in Penile Squamous Cell Carcinoma"}
{"_id":"0afacffc-2d3c-1748-ddec-f980ff03c48a","text":"Despite the increase in prevalence of allergic diseases, allergies of the eye are often underdiagnosed and subsequently undertreated. The most frequent clinical forms of ocular allergy are seasonal allergic conjunctivitis and perennial allergic conjunctivitis, which are usually mild. The primary goal in their management is to identify the potential allergens causing the symptoms so that they can be more easily avoided. However, this is not easy to achieve, and medication is used early to minimize symptoms of the allergic reaction and to avoid chronicity of the disease.","title":"Ocular Biodistribution of Once-Daily 0.6% Bilastine Eye Drops Reveals Highest Levels in Conjunctiva Up to 24 h Postadministration Ocular Biodistribution of Bilastine Eye Drops"}
{"_id":"0b011f0f-40eb-bc70-ce14-19de7eece3fb","text":"Patients undergoing surgery in the PMPF had trigeminal branches sacrificed owing to radical resection. Severe limitation of mouth opening developed in almost the totality of patients undergoing surgery in the PMPF\/DMS owing to extensive muscle resection in the masticator space with subsequent scarring and radiotherapy.","title":"Anatomical Computerized Exploration to Excise Malignancies in Deep Facial Compartments: An Advanced Virtual Reality Protocol for a Tailored Surgical Approach"}
{"_id":"0b04aee0-ac2c-0c5b-7f5f-eff4fb3eb517","text":"The inclusion criteria were adult patients with primary axillary hyperhidrosis that resulted positive to the colorimetric technique of Minor's iodine test and with a 3 or 4 score of hyperhidrosis disease severity scale, without medical conditions such as myasthenia gravis or drugs as aminoglycoside antibiotics that interfere with neuroglandular transmission, infection or skin diseases, and any other concurrent treatments for hyperhidrosis. All subjects were enrolled voluntarily and informed on other alternative methods for treatment.","title":"Treatment of Primary Axillary Hyperhidrosis with Botulinum Toxin Type A: Our Experience in 50 Patients from 2007 to 2010"}
{"_id":"0b108390-8c66-cdea-ff37-2fbc9c7ea812","text":"Since the first reports on SLNB for stage I and II melanoma lesions appeared, there has been an overwhelming enthusiasm for this technique. Several published series have shown various kinds of methods for identification, pathological examination and selection criteria for patients who could profit most from this staging method.","title":"Sentinel node status in melanoma patients is not predicitive for overall survival upon multivariate analysis"}
{"_id":"0b1bddae-f527-a31e-d88f-4831e4c650d9","text":"We report the case of a Ugandan boy who presented with failure to thrive (FTT) and rachitic features in infancy, but the diagnosis of FBS was made 3 years later due to limited diagnostic facilities and awareness regarding metabolic syndromes in our setting. Parental written informed consent and departmental approval was obtained to publish this case.","title":"Fanconi–Bickel syndrome in a Ugandan child – diagnostic challenges in resource-limited settings: a case report"}
{"_id":"0b1dfdc2-29d9-d3e4-b52b-2d03aa919379","text":"All of the nodules were painless. All of these cases received excision biopsy of the presenting nodules and made a definite diagnosis by histopathological examination.","title":"Traumatic neuroma in a patient with breast cancer after mastectomy: a case report and review of the literature"}
{"_id":"0b1e3fe5-c300-608a-2d94-6285eabaa480","text":"The CT scan detected osteolysis in the left and right dorsal to the tenth thoracic vertebra. From the perspective of the differential diagnosis, the presence of several infectious foci made bacterial osteomyelitis or primary malignant bone marrow tumours highly unlikely.","title":"Chronic recurrent multifocal osteomyelitis manifested as painful clavicular swelling: a case report"}
{"_id":"0b23f88e-7371-0115-9af0-c54a3b087bee","text":"This retrospective study investigated the most common postoperative complications after mandibulectomy and simultaneous reconstruction using only reconstruction plates, free fibula flaps or DCIA flaps in 190 cases. Potential risk factors for the occurrence of postoperative complications were analysed.","title":"Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study"}
{"_id":"0b245fcf-386d-cd2d-7d3b-761b2040a1c2","text":"Dual-tracer method utilizing blue dye injected intradermally in the operating room (methylene blue or isosulfan blue) can aid in SLNB localization. An incision is planned in the area of highest gamma probe signal and surgically planned with awareness about a potential future CLND, which will need to include the removal of this scar en bloc with the lymph node contents. Radioactive and blue lymph nodes are excised, and the basin is explored with the gamma probe for further sentinel nodes, which are defined as those having > 10% of the highest sentinel node signal count.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"0b24b6cf-3632-f78c-124b-509362b5fed6","text":"Studies were considered acceptable for inclusion in the review if they fulfilled the following criteria:","title":"Efficacy of Various Laser Wavelengths in the Surgical Treatment of Ankyloglossia: A Systematic Review"}
{"_id":"0b2aef35-ba3b-beef-5ac3-6d702b7d2487","text":"After the roll out of a massive vaccination campaign at our institutions, we collected data of vaccination and side effects in 6821 patients and health care workers who presented for their two doses between January and June of 2021. All patients received the mRNA-1273 vaccination at the recommended time intervals. The data were collected in our institutional patient database. Patients with cutaneous side effects were identified though the database after a query for cutaneous reaction. We analyzed the reports on acute side effects in the Departments of Dermatology at the University Düsseldorf and Münster and in one private practice in Düsseldorf. Every patient providing informed consent was included in this case series. Eleven patients were identified with the side effects of interest for our study during our vaccination program. These patients returned to the Dermatology Department or the Department of Infectious Disease to address the acute side effects after the vaccination dose.","title":"Delayed skin reaction after mRNA-1273 vaccine against SARS-CoV-2: a rare clinical reaction"}
{"_id":"0b2c5ed9-5cc8-dfbf-14ab-6d07e58a76ec","text":"The use of facial fillers has increased over the years because they are less invasive and present lower risks and faster results, along with shorter recovery time.","title":"Vascular complications with injection implants: treatment with hyperbaric chamber"}
{"_id":"0b2c9675-b197-33aa-b31d-b2cc4f556cd2","text":"To our knowledge, there has never been a systematic review and meta-analysis of local recurrence in giant cell tumours following cryosurgery. Thus, the objective of this study was to estimate the prevalence and risk of local recurrence of giant cell tumours of the bone treated with cryosurgery compared to other therapies and to assess the complications of cryosurgery in treating giant cell tumours.","title":"Global Prevalence and Risk of Local Recurrence Following Cryosurgery of Giant Cell Tumour of Bone: A Meta-Analysis"}
{"_id":"0b2db549-bc7f-10f0-d993-a8e83dea8a32","text":"The present study aims at assessing the information from the individuals treated in the Orthognathic Surgical Service of a Medical School.","title":"Service Profile of Orthognathic Surgery of a Medical School"}
{"_id":"0b307b1c-1475-cd39-3bbd-7b6ab49929d1","text":"We demonstrates that the time course is consistent with previous description, biologic subtype is associated with ITR, and regional nodes is the most common place for recurrences in this series of patients who developed ILRRs following mastectomy and contemporary adjuvant systemic therapies but without PMRT.","title":"Isolated locoregional recurrence patterns of breast cancer after mastectomy and adjuvant systemic therapies in the contemporary era"}
{"_id":"0b308b41-c3f2-5032-f350-d33a9d8d2753","text":"Potential disfigurement and scarring was a concern for many patients. Participants were concerned that they had no information about what was happening after the treatments.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"0b30ce1a-e6f0-f139-bb0a-f380400b4bcd","text":"After 5 minutes, a small low axillary incision was used to identify blue stained afferent lymphatics which were traced to the first blue stained sentinel node or nodes. All blue stained nodes were excised and sent in a separate pot labelled sentinel nodes.","title":"Sentinel node biopsy should be supplemented by axillary sampling in patients with small breast cancers"}
{"_id":"0b3c3df1-477b-a78a-0338-2e17ea5c7a76","text":"The patient also showed allergy provocation many times during the treatment at the variable doses. Emergency care was done when she showed anaphylactic reactions. Treatment was restarted after a week. The treatment was repeated for the same dose until allergy provocation was not occurred at the same dose according to the principle of overcome of the dose of allergy provocation. The treatment was finished after 12 months days with 310 times of treatment.","title":"Specific Oral Tolerance Induction Using IFN-Gamma in 2 Cases of Food-Dependent Exercise-Induced Anaphylaxis"}
{"_id":"0b44acde-6648-67a2-bc92-34aac18105a3","text":"As illustrated in Table A, the STF Decisions included civil, criminal, and regulatory decisions, with approximately 45% civil cases. It is important to understand when considering that there are only 14 reported decisions that complaints made to a regulatory body in Canada may only become public if they proceed to a hearing. Accordingly, the number of STF Decisions in the regulatory sphere cannot be assumed to represent the totality of complaints made to the regulatory body involving STF therapy. Given the accessibility of the regulatory process to patients as compared to civil litigation and the type of complications associated with STF therapy, it is reasonable to assume that it is in the regulatory venue that physicians will most often encounter allegations concerning lack of informed consent for STF therapy.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"0b45dd3c-8ef3-3f8b-87bb-585708b7dc0a","text":"The identification of a causative organism by culture both confirms osteomyelitis and allows tailoring of antimicrobial therapy, unfortunately cultures from samples obtained during surgery or biopsy are often negative. Current studies evaluating laboratory diagnosis of osteomyelitis are summarized in Table 1.","title":"Charcot foot and ankle with osteomyelitis"}
{"_id":"0b506f7f-29c9-eb56-8d71-bbbaf6fdc935","text":"In patients with suspected VTE, the goal of diagnosis is to rapidly and accurately distinguish those with the condition from those without it. This is essential because patients with VTE require rapid initiation of anticoagulant therapy, whereas those without the condition do not. The wrong diagnosis is problematic because failure to prescribe anticoagulant therapy to patients with VTE can enable thrombus extension and fatal PE and because inappropriate administration of anticoagulants to those without VTE can lead to fatal bleeding. Therefore, rapid and accurate diagnosis is essential.","title":"Recent advances in understanding, diagnosing and treating venous thrombosis [version 1; peer review: 2 approved]"}
{"_id":"0b52cf34-3a23-9392-76dc-a48b6e2a1fae","text":"A Kruskal–Wallis H test was used to assess whether the scores given by readers for various categories of mammograms included in the study differed significantly. The score given by the radiologists to each case was on the scale of 0–100. Before data collection, the radiologists were instructed that the score of 0 and 100 indicates complete confidence that cases are normal and abnormal respectively while the score of 50, which is the default value of the slider in the software, indicates that the mammogram has equal probability of being a normal or abnormal case.","title":"Radiologists can detect the ‘gist’ of breast cancer before any overt signs of cancer appear"}
{"_id":"0b61e065-f76f-af4d-c529-5f14f9f1f5e4","text":"Although the recent prolongation of the survival of patients with malignant brain tumours is primarily attributed to chemo- and radiotherapy, the surgical intervention remains crucial. The use of several new techniques in brain surgery can facilitate the extensive resection of these tumours and make it safer for the patient.","title":"New developments in surgery of malignant gliomas"}
{"_id":"0b6590ec-50fd-5e71-ab43-13f710f98cf1","text":"Cervical cord reperfusion injury is an extremely rare etiology of neurological deterioration following spinal cord decompressive surgeries. Clinicians need to maintain a high index of suspicion for this complication and should be familiar with its imaging appearance.","title":"Cervical cord reperfusion injury: a rare complication of spine surgery"}
{"_id":"0b65c346-f869-074a-5d59-2dfa7b1afd5f","text":"The aim of this study was to investigate the relation between the primary HNCM sites and all the possible lymphatic drainage pathways by lymphoscintigraphy, with a special focus on the unexpected SLN detection.","title":"The Lymphoscintigraphic Study of Unpredictable Head and Neck Cutaneous Melanoma Lymphatic Drainage"}
{"_id":"0b6a45aa-f73b-36d0-354f-d2262f5fb3f2","text":"Taken together, these results suggest that macromolecular substances > 10 kDa are one of the main risk factors responsible for anaphylactoid reactions caused by TW80, which can be removed by ultrafiltration. The direct increase in vascular permeability participates in the anaphylactoid reactions ignited by TW80, although a role for mast cell degranulation cannot be excluded as one of the main mediators of the reaction.","title":"Macromolecules in polysorbate 80 for injection: an important cause of anaphylactoid reactions"}
{"_id":"0b712813-63b2-2cfa-8acc-193f2be6b106","text":"Results indicated that increased vacations increased melanocytic nevi in children. The greatest percentage increase in nevi was due to vacationing in southern areas of high UV exposure whereas there were no associations with nevi and northern locations of vacation. The number of melanocytic nevi also increased as vacation duration increased from zero to one week to eight or more weeks. There were also linear increases in melanocytic nevi in cumulative groups which also had three to five or more than eight weeks of vacation. Only crude associations regarding cumulative sun exposure in the southern region could be made [15].","title":"Attitudes, Behaviors, and Risks of Sun Protection to Prevent Skin Cancer Amongst Children, Adolescents, and Adults"}
{"_id":"0b7684ab-85ea-aeb5-353f-050d1b555f6b","text":"In several colorectal surgery units throughout the world, the rate of abdominoperineal excision in patients with rectal cancer remains higher than what is recommended in the literature. Although the expected rate of APE and definitive colostomy in specialized units for the treatment of rectal cancer is around 15%, there are reports in the literature of AAP rates as high as 50% in these cases . A retrospective study of 4,471 patients included in the database of the American College of Surgeon’s National Surgical Quality Improvement Program between 2016 and 2018 and conducted by Taylor et al. found APE rates in the US of impressive 52.2%. Lack of an adequate technique and the difficulty of performing a low colorectal or coloanal anatomosis meant that APE became adopted liberally until the end of the last century .","title":"Surgical treatment of rectal cancer: prospective cohort study about good oncologic results and low rates of abdominoperineal excision Tratamento cirúrgico do câncer retal: estudo coorte prospectivo com bons resultados oncológicos e baixas taxas de amputação abdominoperineal"}
{"_id":"0b7caa5c-8869-9e3d-0a17-2fe5ae6b867e","text":"Advanced age was not associated with differences regarding positivity of SLN and recurrence but difference in overall survival was observed. According to our results and the low morbidity rate, we consider SLNB should not be omitted in such age group, since it improves staging and gives the possibility to evaluate adjuvant treatment.","title":"Role of sentinel lymph node biopsy for cutaneous melanoma in elderly patients: preliminary results in a Latin-American population"}
{"_id":"0b7d8560-8ff9-c84e-6dc6-a561bd3a7bd1","text":"Regarding patients, only a quarter of the sample reported receiving oral information at the pharmacy about the dose of medication to use. Almost a third of the sample have received information at the pharmacy about the duration of treatment and the number of times to apply the medicine and less than a third reported having had information at the pharmacy about the mode of its application.","title":"Knowledge and Practices of Community Pharmacists in Topical Dermatological Treatments"}
{"_id":"0b7f864e-a667-48e9-3eb2-b8d70ab62ceb","text":"On the basis of a conventional punch biopsy needle we have milled two parallel longitudinal rifts into the needles shat which are separated by a 100 µm thick metal sheet. Each rift can harbor a single tissue core.","title":"Single punch, double biopsy"}
{"_id":"0b836146-2d6f-7e8e-b2b2-37383e5104f0","text":"Any type of vascular surgery in this area should be planned preoperatively, since there are many variations of the vessels in this region and some patterns of vascular distribution can contraindicate fibular flaps. Knowledge about the lower limb arteries is extremely important in a number of conditions, since anatomic variations can cause difficulties with diagnostic and surgical procedures.","title":"Clinical features of a rare anatomical variation of the posterior tibial and fibular arteries Aspectos clínicos de uma variação anatômica rara das artérias tibial posterior e fibular"}
{"_id":"0b85ccf2-d008-d850-f541-b8a390bdc91c","text":"Bone marrow samples from the medullary cavity were collected by our central laboratory physician using a 5-mL syringe after opening the femoral cavity during surgery. Then, the samples were centrifuged at 3500 rpm for 10 minutes. The percentage of the supernatant was considered as the fat content proportion of each sample.","title":"A study on dynamic monitoring, components, and risk factors of embolism during total knee arthroplasty"}
{"_id":"0b86bcf3-f2b1-a444-a887-be7fb4a53de9","text":"We compared patients who underwent unilateral immediate DIEP flap breast reconstruction in the supine and lithotomy positions between October 2014 and July 2016 at Yokohama City University Medical Center by the same surgeon, who was a plastic surgeon who performed <5 DIEP flap breast reconstructions. All patients were consecutive, and the lithotomy group followed the supine group.","title":"Immediate Breast Reconstruction with a Deep Inferior Epigastric Perforator Flap in the Lithotomy Position"}
{"_id":"0b88c6ad-e61d-7daa-7f38-c47727682754","text":"Analysis of the AJCC Melanoma Staging Database data demonstrated that the mitotic rate was the second most powerful predictor of survival for localized melanoma after tumor thickness. Increasing mitotic rate (at least one mitosis per square millimeter) is strongly correlated with diminished survival rates and is now a component of the 7th edition melanoma staging system. It has also replaced the Clark level of invasion as a primary criterion for defining T1b melanoma—which is now defined as those lesions whose tumor thickness is ≤1.0 mm containing at least one mitosis per square millimeter regardless of tumor ulceration.","title":"Adjuvant Therapy: Melanoma"}
{"_id":"0b912c52-38e3-aa7b-a422-7ddad20de7f6","text":"In the Canton of Zurich, there was an increased risk of second primary cancers among men with PCa compared to the general population. Increased diagnostic activity after PCa diagnosis may partly explain increased risks within the first years of diagnosis, but time-stratified analyses indicated that increased risks remained and even increased over time.","title":"Incidence of Second Malignancies for Prostate Cancer"}
{"_id":"0b97e2d7-d42a-a07e-146f-d22b0bc76d3f","text":"Dermabrasion can help level areas with a rough texture or slightly irregular contour and can help blend areas with a color mismatch. It can enhance the final outcome in patients treated with full-thickness skin grafts and can be exploited when a smooth transition is required between local flap and native tissue. When needed, dermabrasion is usually performed three months after the surgical procedure.","title":"Reconstruction of the Nose: Management of Nasal Cutaneous Defects According to Aesthetic Subunit and Defect Size. A Review"}
{"_id":"0b999903-e930-179e-497b-10f5ecf71c10","text":"During the study period, the lymphoscintigraphy protocol remain unchanged and was performed by the same nuclear medicine team. The SLNB procedure was also accomplished by the same dermatologic surgical team of the hospital.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"0b99aa0d-58ea-287f-ff2e-687a71174e61","text":"IMPT is safe and effective in providing local and regional disease control for patients with skin malignancies of the head and neck region.","title":"Oncologic Outcomes for Head and Neck Skin Malignancies Treated with Protons"}
{"_id":"0b9e3778-9820-9467-9ee4-9cfffa7dbcd1","text":"Neck wound infection is the result of prolonged wound exposure and oral contamination during surgery. Many patients with oral cancer have poor oral hygiene because of pain. Prior chemoradiation and radiation therapy can also increase the risk of infection. Copious irrigation and obliteration of dead spaces are important for preventing postoperative wound infection. Once infection occurs, early drainage and thorough debridement and irrigation may enable primary wound closure over a drain; otherwise, the wound should be left open to allow further drainage. Serial operative irrigation and drainage procedures may be helpful in the worst cases. If there is dead space or vascular exposure occurs following debridement, pectoralis major muscle flap reconstruction of the neck may be indicated to protect the carotid artery, especially in patients who have had prior radiation therapy.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"0ba363cd-bfd6-6d8b-e961-e2653207edf3","text":"The Christensen system consists of a fossa and condyle prosthesis both made from cobalt-chrome alloy and is the system subject to the longest period of followup.","title":"Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis"}
{"_id":"0ba500b0-f77b-1f90-320a-af96d4ad0055","text":"Though the majority of people shows some kind of cutaneous hypersensitivity after bites from blood-feeding insects, these reactions are usually mild and of limited importance in everyday allergy practice. The pathomechanisms underlying large local and bullous reactions are still poorly studied. Concomitant mastocytosis may be a risk factor for anaphylactic reactions which are rare but have been credibly documented for various hematophagous insects. The currently available diagnostic tools are poor. Therapy focuses on avoidance measures along with antihistamine premedication and symptomatic treatment. In the recent past, numerous allergens from the salivary glands of various insect groups have been identified, which partly belong to the same protein families as the well-known allergens from bee and wasp venom. The proposed cross-reactivity between saliva proteins and Hymenoptera venom allergens is still obscure and needs to be clarified in future molecular studies.","title":"Insect hypersensitivity beyond bee and wasp venom allergy"}
{"_id":"0baed9e3-4201-f12e-f815-f040f903bda2","text":"Based on reflectance confocal microscopy, where images are parallel to the surface at horizontal orientation, which allows a broader analysis of the tumor architecture, this study aimed to present a new way of evaluating the tumor enucleation material from the horizontal histological analysis of the fragment resulting from the removal of the visible tumor obtained by enucleation in the first step of MMS.7, 8","title":"Horizontal histological sections in the preliminary evaluation of basal cell carcinoma submitted to Mohs micrographic surgery"}
{"_id":"0bb8ce06-9ee9-07c1-874e-39382c439498","text":"To perform chart review and identify and collect the data of patients stratified into the medium- and high-risk categories and who did not receive prophylactic therapy, the Athos - Hospital Assistance System of HEAB was consulted. Athos is a consolidated electronic medical records system with the information and anamnesis of a multiprofessional team in addition to the results of clinical and laboratory tests.","title":"Assessment of the adherence to and costs of the prophylaxis protocol for venous thromboembolism"}
{"_id":"0bbba471-8ec4-9d33-c59c-7e4b5288e464","text":"The value of “point of care” diagnosis has been recognized. Making the diagnosis in the plastic surgery office expedites patient treatment and reduces the inconvenience and expense of a patient visit to a hospital radiology department. Courses are now being offered to familiarize physicians with ultrasound use. Sonograms for DVT evaluation are ideally conducted by trained sonographers who are credentialed in vascular studies. The author does not perform any ultrasound examinations personally.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery"}
{"_id":"0bc2cb41-5310-68ce-66b6-260a4547a417","text":"Some surgeons argue that reconstructive surgery for microtia should be delayed till the child is 10 years old to reduce the complication associated with the chest deformity. The complication rate is significantly high in chest donor site if the cartilage is harvested at the age smaller than 10 years old. Our study would focus on complications associated with microtia reconstruction in the recipient site and further compared two age groups in terms of surgical time, tissue expansion, number of autologous costal cartilage harvested and complications after reconstruction.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"0bc7ffac-97e5-b566-e08f-69379b0836ea","text":"ICG angiography enables a standardized and reproducible real-time angiography of different tissues and provides a high sensitivity in detecting well-perfused and non-perfused tissue in the field of plastic reconstructive surgery. It has the potential to reduce flap related complications and to optimize and extend the possibilities of free flap surgery. Further studies in different applications fields are required to standardize application and enhance the possibilities of this method in plastic surgery.","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"0bcdb9b2-c00a-0574-36f6-ca07d1fa91d9","text":"While our study did not indicate that sun exposure affected non skin cancer risk, it is possible that the sample size may have been too small to do so, especially for specific types of cancers. However, we did detect an excess risk of melanoma following both BCC and SCC with significantly increased melanoma risk in participants reporting a family history of NMSC, but not a family history of melanoma which is a known risk factor for melanoma. [43] Melanoma risk was also increased among individuals who peel or develop moderate tans upon chronic sun exposure (compared to those who develop a deep tan). Former smokers had a significantly lower risk of melanoma after NMSC and a risk reduction was seen in current smokers but this could have been due to chance; several other studies have reported reduced melanoma risk in smokers, but no adequate explanation for this has been put forward except for the possibility of bias caused by competing risk due to unknown confounders. [44] Family history of melanoma did not contribute significantly to the model as in other studies, [45] but the numbers with such a history in our cohort were much smaller. We found that the excess risk of melanoma after BCC or SCC remained after accounting for known risk factors such as sun sensitive skin type. On balance, our findings raise the possibility of unmeasured or unknown shared genetic risk factors for melanoma and BCC.","title":"Non Melanoma Skin Cancer and Subsequent Cancer Risk"}
{"_id":"0bd4eefd-c272-5a0b-87f6-856500a05e0f","text":"The world of 3D printing is a rapidly evolving field in the medical industry as well as in most sectors of our lives and lately even assimilating into many households, which acquire the technology due to the cost-reduced options in the market and the possibilities hidden inside it for almost any of us (Figure 1). Nowadays almost everyone knows the technology exists.","title":"Printing the Future—Updates in 3D Printing for Surgical Applications"}
{"_id":"0bd7dec3-4df1-4554-e78c-887071029445","text":"Both parents of all children enrolled were required to sign an informed consent.","title":"Oral desensitization to milk: how to choose the starting dose!"}
{"_id":"0bdd272d-4a63-4d69-6742-08cce1c72276","text":"In patients undergoing PMRT with tissue expanders, incidental doses delivered by tangents to the axilla, as defined by the RTOG contouring atlas, do not provide adequate coverage. The posterior-superior region of level I and II is the region most commonly underdosed. Axillary volume coverage increased with increasing expander volumes in patients with bilateral reconstruction. Lung dose increased with increasing expander angle from midline. This information should be considered both when placing expanders and when designing PMRT tangent only treatment plans by contouring and targeting the axilla volume when axillary treatment is indicated.","title":"Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction"}
{"_id":"0be3f071-a0cc-3470-e0a3-a46419b1055e","text":"Implant based breast reconstruction is one of the widely applied techniques to restore shape and volume after mastectomy. In order to decrease implant related complications there should be adequate soft tissue coverage of an implant. Exposure of an implant could be a very disappointing complication to both surgeon and patient. Many cases end up losing their implant with associated financial and emotional burdens.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"0be47d6c-bc74-0f7a-3abf-cd68dc65d8f0","text":"The axillary nodal burden is high in patients with breast cancer in developing countries like India. One of two women with four or more positive level I and II ALNs may have residual disease in level III if it is not cleared during surgery. Intraoperative interpectoral space clearance should be considered in the presence of either palpable interpectoral lymph nodes or multiple positive ALNs.","title":"Merits of Level III Axillary Dissection in Node-Positive Breast Cancer: A Prospective, Single-Institution Study From India"}
{"_id":"0bf8828d-b096-76b0-6c0d-ab818a506d52","text":"The lack of vascularization and neurotization within the tissue engineered bone results in poor ossification and limits the clinical application of tissue engineered bone. The vascularization of bone grafts can be promoted by soft tissue flap wrapping, blood vessel embedding, and arteriovenous loop embedding centrally in vivo by microsurgical techniques, but this method has the disadvantage of uncertain neurotization effect. The neurotization of bone grafts can be promoted by peptidergic nerve tract embedding centrally in vivo by microsurgical techniques, but this method also has the disadvantage of uncertain vascularization effect. So each method has the superiority and disadvantage. Combination of different methods will be necessary and useful to improve the reparative effect of tissue engineered bone in the large bone defect. We give the concept of constructing the highly vascularized and neurotized tissue engineered bone simultaneously by microsurgical techniques according with the theory of biomimetics. The microsurgical techniques will play a more and more important role in the development of bone tissue engineering and eventually achieve the wide clinical application of tissue engineered bone to repair the bone defect of patients.","title":"Microsurgical Techniques Used to Construct the Vascularized and Neurotized Tissue Engineered Bone"}
{"_id":"0bf9e115-77c7-9b45-b036-f1a759615655","text":"The reconstruction methods for the epidural layer of the skull base are as follows.","title":"Intradural fat graft packing is not indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries"}
{"_id":"0c011f32-1a8c-d192-fe13-8163b374d420","text":"Difficulties in interpreting mammograms in breast cancer survivors might affect the quality of mammography screening and thereby decrease the benefit for breast cancer survivors, , , , wherefore it is important to monitor how large a proportion of recurrences is and new breast cancers that are found at mammography screening. There are very little data on this among breast cancer survivors and none of these included all breast cancer survivors.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"0c0e88c8-7df5-9fd1-3b62-52beeacbc057","text":"Despite the limitations of our study, we were able to identify key issues such as diagnostic approaches, disease monitoring, and treatment selections after failing NSAIDs as well as definition of disease activity. Results from this study will guide further discussion within a focused group to develop consensus treatment plans for children with CNO.","title":"Physicians' Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis"}
{"_id":"0c0f4ae6-06d1-d993-a406-bb72897e7c8c","text":"The blood supply of the LENI flap is based on branches of the facial and angular arteries including alar artery and lateral nasal artery branches. Occasionally, alar artery division is required leaving the LENI flap supplied by the lateral nasal artery branches without compromising its vascularity. Its robust vascular supply affords raising the flap even in the setting of previous surgical scars. Despite the extensive release of flap attachments, its vascularity is reliably maintained.","title":"Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction"}
{"_id":"0c104af0-8d8c-ce7e-b927-141b81989448","text":"Rectus abdominis free flap is a versatile flap that is well suited to a variety of reconstructive defects in the head and neck including maxillary or orbital defects. Vascularized by the deep inferior epigastric artery, this flap can be harvested with or without a skin paddle with a long pedicle. The versatility of this donor site is due to the ability to transfer large areas of skin with varying thicknesses and varying amounts of underlying muscle (63).","title":"Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know"}
{"_id":"0c1228ef-e1ee-93d1-dfa1-70702bba45c0","text":"Albeit showing that the detection of CTNNB1 mutants is possible in the plasma of patients harboring a desmoid tumor, the results of this preliminary study raise the hypothesis that most of the circulating DNA detected in their plasma is derived from non-neoplastic cells, most likely normal neighboring tissues being actively invaded. Our results open the perspective of using cfDNA as a biomarker to predict prognosis at the time of diagnosis and assess tumor dynamics to optimize the treatment strategy.","title":"Proof of concept: prognostic value of the plasmatic concentration of circulating cell free DNA in desmoid tumors using ddPCR"}
{"_id":"0c130be1-5ba7-f5ff-0352-9f6bca92f52a","text":"Spinal epidural abscesses are an uncommon cause of spinal cord injury but, depending on the size and presence of neurological deficits, urgent neurosurgical intervention may be required. We present a unique case of a patient presenting with a spinal epidural collection several days after a fall. While a spinal epidural hematoma was suspected based on the patient’s history and MRI findings, a spinal epidural abscess was found during surgery. The patient underwent laminectomy and instrumented fusion with successful treatment of her infection.","title":"Delayed Presentation of a Cervical Spinal Epidural Abscess of Dental Origin after a Fall in an Elderly Patient"}
{"_id":"0c2ce677-7d0f-f57d-928b-3bc911557962","text":"The nasolabial flap proves highly versatile in oral cavity reconstructions in oncological patients, coupled with a minimal morbidity of the donor region and good aesthetic and functional results. It is easy to carry out and has a high success rate, making it the ideal surgical option for small to medium intraoral defects in edentulous patients with other comorbidities.","title":"Versatility of nasolabial flaps in oral cavity reconstructions"}
{"_id":"0c2e1707-38bd-5c69-cad1-0a1df530bcc0","text":"This study retrospectively studied the details of 20 patients with COSTD who underwent flap margin incision prosthesis implantation at our center, including 7 patients who used NPWT to cover the closed-incisions of flaps postoperatively and 13 patients who didn’t. Our findings revealed that the use of NPWT was effective in reducing the occurrence of postoperative flap wound complications, improving subjective satisfaction, accelerating functional recovery of the lower extremity as well as reducing the corresponding treatment expenditures.","title":"Negative pressure wound therapy for flap closed-incisions after 3D-printed prosthesis implantation in patients with chronic osteomyelitis with soft tissue defects"}
{"_id":"0c31d2ba-3e8a-e6e0-ed2f-074ca15ee9da","text":"This study was approved by the ethics committee of Yokohama City University Hospital and was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all patients.","title":"Direct Oral Anticoagulant Therapy for Isolated Distal Deep Vein Thrombosis Associated with Cancer in Routine Clinical Practice"}
{"_id":"0c36cf10-fe67-eef7-3c11-c1458ea7bd71","text":"In developed nations, a significant proportion of patients with chronic post-traumatic cOM of the lower limb are group B (compromised) hosts according to the Cierny and Mader (CM) classification. 23 24 These patients have medical conditions which directly affect the ability to heal wounds or reduce the efficacy of drug treatment. Therefore, preoperative optimization and the anesthetic assessment are critical to achieve optimal results. In our unit, regional anesthesia in the form of an epidural is frequently used as it can limit the physiological impact of the surgery and improve postoperative analgesia and recovery. 25","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"0c3b0d9b-badf-d858-b054-fa3007fc8919","text":"The surgical intervention was performed 49 days after the patient’s initial presentation to our institution and 60 days after his presentation to the ED at which this lesion was first medically reported. The delay in the surgical intervention was due to difficulty with financial clearance for the procedure. During this delay, the patient continued to visit his local ED for bleeding control, and the lesion continued to increase in size. On the day of surgery, the final exophytic growth of the lesion measured approximately 8.5 x 7 cm. The patient underwent a wide local excision of his scalp SCC with a 1 cm circumferential macroscopically clear margin. The dissection proceeded with care taken to remain deep to the subgaleal fascia. However, during the resection, it was noted that the epicenter of the lesion extended to and involved the underlying periosteum. The involved periosteum was incised with a 1 cm macroscopically clear margin and was carefully elevated off the underlying calvarium. The resected periosteum was kept in continuity with the initial cutaneous resection specimen. The underlying calvarial bone was then carefully examined and was determined not to be involved with the disease process. The resection specimen was then sent for a frozen section for evaluation of circumferential and en-face margins. The frozen section confirmed all margins were clear of disease. The final cutaneous scalp defect measured 10 x 10 cm, and the underlying periosteal defect measured 5 x 5 cm (Figure 4).","title":"Exophytic Squamous Cell Carcinoma of the Scalp: A Case Report"}
{"_id":"0c3d1f0b-b5ae-9642-e15b-e636a3f621b5","text":"Pigs allocated to the sham group were not exsanguinated or fluid resuscitated. We euthanized the animals 300 min after the start of the intraosseous infusion by central venous injection of potassium chloride.","title":"Intraosseous fluid resuscitation causes systemic fat emboli in a porcine hemorrhagic shock model"}
{"_id":"0c3f4b52-9357-1e6c-5956-05cd85843def","text":"These findings contribute to our understanding of the characteristics and outcomes of melanomas located on the trunk, focusing on the comparison based on the affected area. The most frequent lymphatic drainage site for melanomas on the trunk was the axillary one, compared to cervical and inguinal. Moreover, the rate of positive SLNBs was higher for the axillary region, even in cases for melanomas located on the lower part of the trunk, emphasizing the importance of this region in terms of lymph node biopsy.","title":"Variability of Sentinel Lymph Node Location in Patients with Trunk Melanoma"}
{"_id":"0c429d02-a857-f642-2c59-9144a2b7a66a","text":"The animal ethics committee of the Erasmus MC approved the experimental protocols of the study. We investigated the pharmacokinetics of PpIX distribution using (multispectral-) fluorescence imaging and assessed PDT efficacy after the administration of different porphyrin precursors in a number of cutaneous murine and porcine models. An overview of these protocols and the number of animals in individual groups is shown in Table 1.","title":"Light Fractionation Significantly Increases the Efficacy of Photodynamic Therapy Using BF-200 ALA in Normal Mouse Skin"}
{"_id":"0c434f4c-4fbd-d5e0-f918-3b56dde3f6c3","text":"The treatment of bone and joint infections and resulting bony defects is a challenge to the orthopedic surgeons as there are two major problems to overcome: control of infection and filling the bony defect. A systemic antibiotic may not be effective to control the infection because of poor penetration into the bone.1 The treatment becomes more difficult and complex with the emergence of highly resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA).","title":"Decal bone matrix as a local antibiotic delivery vehicle in a MRSA-infected bone model: An experimental study"}
{"_id":"0c45a5b6-8138-f6b2-534e-81c29d9ba983","text":"3 Patients who rejected the fixator while on treatment and one patient who had a re-fracture after successful bony union were considered as poor results and therefore the functional results were considered as poor. One patient who had fair results in terms of bony union could not be contacted. Therefore functional result analysis was possible in 21 patients only.","title":"Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study"}
{"_id":"0c45d9d2-92fc-eda3-c7a7-3a2e550c5b73","text":"Anatomopathologists analyzed intraoperative frozen sections and provided definitive analyses within one week. Three patients underwent an early and brief new surgery because of a discordance between the intraoperative frozen sections and the definitive results. All final definitive margins were negative.","title":"Mucosal Melanoma of the Head and Neck: A Retrospective Review and Current Opinion"}
{"_id":"0c603784-71a8-30cd-2f6a-ad3f68a9ffd3","text":"In the next stage of statistical and clinical analysis of the results, the following characteristics of variables were taken: the body image after a mastectomy in women with breast cancer up to two years or more than two years after a mastectomy.","title":"Psychological Resilience as a Protective Factor for the Body Image in Post-Mastectomy Women with Breast Cancer"}
{"_id":"0c6086d1-e461-4b63-156b-80c5b11ee89f","text":"CONCLUSIONS The combination of HIFU and PEI shows a synergistic effect on tumor destruction at very low concentration of ethanol and lower acoustic power. This combination may become an effective minimally invasive treatment option that’s safer for patients with liver or prostate cancer. Utilizing these two FDA approved treatment in combination could lead to a disruptive and translational method of tumor treatment.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"0c6445ca-26c8-e9ed-cf6e-dcf541041633","text":"Rats were divided into seven main groups which were as follows:","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"0c65cfcd-1f2a-7b97-c417-deb5a0071dd4","text":"Our studies showed that direct anastomosis of facial vessels allows the AV loop to be set in for reconstruction of defects in the posterior half of the mandible. Defects in the anterior half, however, may require a venous graft between the facial artery and vein. The caliber of the facial vessels can allow anastomosis to be done easily using the surgical loupe or operative microscope.","title":"Mandibular reconstruction using an axially vascularized tissue-engineered construct"}
{"_id":"0c6b7164-1738-1bb4-41da-7fc6d8c8a53f","text":"One must keep in mind that not all tibial fractures are uneventful and complication-free that they might always cause a vascular injury, even in times when distal pulses were recorded as normal.","title":"The Changed Route of Anterior Tibial Artery due to Healed Fracture"}
{"_id":"0c6fcfa7-3506-24ec-a22e-944c5f8ed09a","text":"The present study investigated certain skeletal and dental characteristics in subjects with ankyloglossia. There was a slight male predilection in subjects with ankyloglossia. Moderate ankyloglossia was more common than mild and severe ankyloglossia. Ankyloglossia was more common in class I skeletal base followed by class II skeletal base and class III skeletal base. Maxillary intermolar width and maxillary intercanine width are significantly reduced in subjects with ankyloglossia suggesting maxillary constriction. Overbite and mandibular plane angle changed with the severity of ankyloglossia.","title":"Skeletal and dental characteristics in subjects with ankyloglossia"}
{"_id":"0c7a60f7-44a3-3d72-deb4-7c612c747ed7","text":"Most mild reactions seem to caused by alternative mechanism of hypersensitivity non IgE mediated, or rather mast cells and basophil activation with direct release of histamine or cytokine. In support of this mechanism for hypersensitivity is the fact that the reactions often occur midway through infusions of carboplatin rather than at the start, as expected for IgE mediated reactions. In our cohort, reactions occurred within minutes after initiation of the infusion or midway through the infusion or else at the end of infusion or several hours after the drug was delivered. This differs from the typical IgE mediated sensitivity and also intradermal prick tests to carboplatin appear not to be conclusive. There may, in fact, be a combination of the two mechanisms. The lack of sensitivity of skin tests could be accounted for by the low molecular weight of carboplatin which is not immunogenic in its native form.","title":"Rechallenge to Carboplatin in Children with Low Grade Glioma and Carboplatin Hypersensitivity Reactions"}
{"_id":"0c7e3b31-06e4-54dd-c6bf-ec11fda946d3","text":"Freehand fluoroscopic techniques remain widely used, but technological advancements in CT scanners and computing have permitted new techniques which provide a higher accuracy throughout the spine. Two broad methods of navigation currently exist: intraoperative CT scanning providing real-time 3D navigation and preoperative CT registration in relation to a fixed reference with intraoperative computer assistance. Potential causes of error in Computer Assisted systems include reference clamp movement due to vibration from drilling or difficulty of secure fixation to the vertebrae due to their small size [2]. These techniques are not clearly defined and separate and have many variations, overlaps and systems produced by different manufacturers.","title":"Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review"}
{"_id":"0c7e9c91-9af3-c78e-7000-abcbcd2a53b1","text":"Radiotherapy was given at the two different radiotherapy sites in Stockholm and dose plans were constructed according to local guidelines. Chemotherapy was given either as induction treatment or as concomitant treatment. Brachytherapy was mainly used for patients with tumors in the base of the tongue and for some cases with tumor in the mobile part of the tongue or the floor of the mouth.","title":"Early self-care rehabilitation of head and neck cancer patients"}
{"_id":"0c82e0ec-c52a-26a1-ab29-0958e19ed681","text":"Carefully evaluate if commencing an immunotherapy treatment during the pollen season in patients with pollen allergy.","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"0c8cf744-66a1-0f84-97f6-1abcffaa871e","text":"Very low rates of serious complications were identified following BTOA injections performed in secondary care; only one in five patients proceeded to subsequent surgery.","title":"Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis"}
{"_id":"0c9cb67c-5102-a81c-33a2-985b1caec124","text":"The 0.5 and 16 mL spheres in Figure 5 have similar mean count rates of 61 and 53 cps respectively for 1 MBq sphere activity at 18 cm SDD, thus affirming a very minimal effect of scattering on the measured count rates in the 16 mL sphere compared to the 0.5 mL despite an activity concentration ratio of 1:32.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"0ca0cf73-aeea-359c-f4d3-e8dfa7df7cbb","text":"The objective of this case report is to describe a clinical case in which an ankylosed maxillary central incisor was moved to the desired position with OD using simplified orthodontic biomechanics.","title":"Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics"}
{"_id":"0ca0d034-73dd-12e6-5940-ab0bf0b02398","text":"Our study of patients with infectious spondylitis indicated that prebiopsy empirical antibiotic therapy had a negative effect on microbiological diagnosis. Patients with positive cultures had a higher rate of infection control and better clinical outcome. Thus, we advocate no prebiopsy antibiotics for patients with infectious spondylitis who are scheduled for imminent biopsy or surgical treatment, because it may affect the culture results and clinical outcome. With improved endoscopic instruments and techniques, spinal infections can be successfully treated by minimally invasive percutaneous endoscopic debridement.","title":"Exposure of Prebiopsy Antibiotics Influence Bacteriological Diagnosis and Clinical Outcomes in Patients With Infectious Spondylitis"}
{"_id":"0ca0df07-68f3-98f5-69be-5254c15557fe","text":"We found that the primary tumors of all studied recurrent BCCs were excised with surgical margins less than 4 mm. We recommend follow up for all excised BCCs either those of low or high risk histological variants. Tumor size does not appear a considerable risk factor for local recurrence.","title":"Recurrent cutaneous basal cell carcinoma after surgical excision: A retrospective clinicopathological study"}
{"_id":"0ca65315-e56d-7b89-0a99-f0b0e80266e0","text":"Orthomorphic surgery was chosen in this case because it offered a more straightforward and targeted correction of the patient's facial asymmetry resulting from long-standing TMJ ankylosis. The surgical plan was based on an STL model of the upper and lower jaw, which allowed for precise visualization and simulation of the rotational correction. By rotating the lower jaw, the procedure aimed to achieve facial symmetry and improve both functional and aesthetic outcomes.","title":"Orthomorphic Correction for Facial Asymmetry in a Patient With Long-Standing Temporomandibular Joint Ankylosis: A Case Report"}
{"_id":"0cb1178a-8204-b369-c37c-b4b112010c75","text":"Sagittal balance is an important factor in determining whether a dorsal approach is suitable treatment; if the c-spine is kyphotic the cord will remain draped over the ventral compressive elements after dorsal decompression and the surgery will be unsuccessful.","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"0cb6cf86-f4b3-bc03-4ba0-3d57fcd2a3e4","text":"Table 5 shows a review of the literature over 20 years regarding overall survival and parotid and neck metastasis in CSCC, including our data.","title":"Parotidectomy and neck dissection in locally advanced and relapsed cutaneous squamous cell carcinoma of the head and neck region"}
{"_id":"0cb8a784-25d3-9cfb-0e47-c1f16505ca24","text":"Despite accurate detection with preoperative imaging, the small size of the subcostal SN can make their intraoperative localization challenging for the surgeon. The maximum subcostal node dimension in this case series was 8 mm (the smallest node measured only 5 mm by 2 mm by 4 mm) and all measured subcostal SN had at least one dimension measuring 3 mm or less. Awareness of the possibility and importance of these small subcostal SNs when reviewing preoperative imaging and during surgical resection is needed to assure SNs are not missed. Despite their small size, the intraoperative count of technetium 99 sulfur colloid radiotracer uptake was often similar to, or higher than, SNs in other basins (Table 1). The finding of recurrence in the subcostal location for patient R1, despite negative groin SN biopsies, suggests that metastasis to that location was likely present at the time of that SN biopsy but may have been missed due to low index of suspicion for a node in that site, or poor visualization of that node if the lymphatic channels may have been obstructed by tumor in the node. It is important to consider the operative risks of dissecting through the latissimus muscle to costal fascia and dissecting near the lung. Despite the potential risks, there was no reported morbidity including postoperative pneumothoraces or lung injuries in this series of patients with subcostal SNs. The morbidity of recurrence at this site, though, can be more significant as grossly present disease may require larger and more invasive resection.","title":"Subcostal lymph nodes: An unusual sentinel lymph node basin in cutaneous melanoma"}
{"_id":"0cbaf2d2-3f4b-1d33-28db-4e2761ff266b","text":"In summary, there is a huge promise to advance current cartilage therapies toward achieving a consistently successful approach for addressing cartilage afflictions. The results of the current in vitro study showed a biocartilage graft solution, which demonstrated chondrocyte formation. These findings confirm that the cells on the skin\/derm scaffold were able to produce cartilage tissue gradually throughout collagen type I and II matrix as well as on the surface of the substrate. Therefore, these results may be considered a valid and solid first step toward the generation of a complete and full-scale compatible portion of cartilage-like tissue containing both chondrocyte and essential substrates such as collagen type II and solid cartilage to support and replace injured tissues. Further in vivo research and investigation are necessary to establish whether this approach would be pertinent in the context of articular joint cartilage repair. Translational cooperation between research groups and clinicians is key to the safe and successful progression of tissue engineering for cartilage regeneration therapy, with the ultimate goal of providing all patients who have cartilage-related diseases with the opportunity to repair and conserve their joint rather than replacing it.","title":"Human Chondrocytes from Human Adipose Tissue-Derived Mesenchymal Stem Cells Seeded on a Dermal-Derived Collagen Matrix Sheet: Our Preliminary Results for a Ready to Go Biotechnological Cartilage Graft in Clinical Practice"}
{"_id":"0cbca3d2-bb9b-e504-c9c6-9a979038b79b","text":"We report a case of idiopathic tumoral calcinosis localized to the thumb without prior trauma or surgery. Initial physical examination and imaging studies were suggestive of more common etiologies of thumb pain. After treatment failure, a biopsy specimen revealed calcium phosphate salt deposition in the soft tissue around the metacarpophalangeal joint, which was treated by excision of the tumoral calcinosis masses. Tumoral calcinosis can occur idiopathically in the hand and digits and should be considered when other more common pathologies of thumb pain have been ruled out.","title":"CASE REPORT Idiopathic Tumoral Calcinosis of the Nontraumatic Thumb"}
{"_id":"0cbf7012-56fd-137f-9d72-bef4ca99f799","text":"The aim of this study is to analyze whether the use of rPPG is feasible for objective and reproducible monitoring of flap perfusion in patients after reconstruction with free fasciocutaneous flaps (FFCF) and to define thresholds for rPPG flap assessment.","title":"Continuous intraoperative perfusion monitoring of free microvascular anastomosed fasciocutaneous flaps using remote photoplethysmography"}
{"_id":"0cbfaf24-9850-8823-8202-d6b1e7c0ede7","text":"Although no generalizations can be made from our small case series, we would like to make other clinicians aware that there is a theoretical possibility of a correlation between delayed free flap breast reconstruction using the IMV as the recipient site and the onset of local breast cancer recurrence. We suggest that other clinicians with similar experience should formally report their results in the literature to generate more informative discussion.","title":"Internal Mammary Recipient Site Breast Cancer Recurrence Following Delayed Microvascular Breast Reconstruction"}
{"_id":"0cc919fa-81b3-c696-8d8b-dfb3b4c3ec5f","text":"Radiation therapy is a key treatment in the multidisciplinary management of cancer and can be proposed to older patients where frailty condition precludes surgery or upon completion of the surgery itself, without changing life expectancy, and maintaining a good balance between toxicity and results. In the absence of specific recommendations these patients tend to be undertreated because not deemed amenable for curative intent or over treated in the absence of a real benefit in survival with an increased risk of toxicity. Currently target of radiation therapy can be aged patients, even more than 90 years old, an extremely heterogeneous population in terms of health, functional and psychological status, social and economic wellness, with different health priorities.","title":"Management of The Elderly Cancer Patients Complexity: The Radiation Oncology Potential"}
{"_id":"0cca63c4-7c18-af7d-0e59-bd6914f75d0a","text":"For spine surgeons, dealing with unstable cervical spine has been usually challenging, and this becomes more difficult when facing a primary craniovertebral junction tumor. Primary spine tumor surgery should always include column reconstruction in order to guarantee biomechanical stability of the spine, but surgeons should always be aware that instrumentations could create interferences with postoperative radiations. However, although carbon fiber instrumentations have started to be used in thoracolumbar oncology for few years, these options are still not available for cervical spine. In the reported case, the adopted strategy to obtain adequate column reconstruction was based on the idea of reducing the amount of titanium needed for posterior fixation and maximizing the distance between the radiation target and titanium rods.","title":"3D-printed guides for cervical pedicle screw placement in primary spine tumor: Case report and technical description"}
{"_id":"0cce5183-4905-8618-95fb-e97198cbf99e","text":"Ultrasound is emerging as a promising tool for both characterizing and fabricating engineered biomaterials. Ultrasound-based technologies offer a diverse toolbox with outstanding capacity for optimization and customization within a variety of therapeutic contexts, including improved extracellular matrix-based materials for regenerative medicine applications. Non-invasive ultrasound fabrication tools include the use of thermal and mechanical effects of acoustic waves to modify the structure and function of extracellular matrix scaffolds both directly, and indirectly via biochemical and cellular mediators. Materials derived from components of native extracellular matrix are an essential component of engineered biomaterials designed to stimulate cell and tissue functions and repair or replace injured tissues. Thus, continued investigations into biological and acoustic mechanisms by which ultrasound can be used to manipulate extracellular matrix components within three-dimensional hydrogels hold much potential to enable the production of improved biomaterials for clinical and research applications.","title":"Using Acoustic Fields to Fabricate ECM-Based Biomaterials for Regenerative Medicine Applications"}
{"_id":"0cd2dd78-7e4a-807b-04f8-0a391476a898","text":"To take advantage of the CLI technique, a number of difficulties had to be surmounted. In particular, the patients’ ability to fixate and keep their eyes still during long exposure imaging was crucial to achieve sufficient image quality. The use of a fixation light combined with an integrated short-pass filter to decrease the amount of ambient light proved to be successful in this regard. Although the diffuse plaque boundaries in the Cherenkov luminescence images may be due to unintentional eye movements, it is probably to a greater extent caused by the relatively strong light scattering within the eyewall, especially in the scleral tissue. Another significant limitation of our technique is that only a small part of the fundus is included in the Cherenkov luminescence images, making it impossible to determine the position of the entire plaque. However, this problem may be solved by using a fundus camera with a wider field of view combined with a larger sized EMCCD sensor.","title":"Cherenkov Luminescence Imaging for Assessment of Radioactive Plaque Position in Brachytherapy of Uveal Melanoma: An In Vivo Feasibility Study CLI in Brachytherapy of Uveal Melanoma"}
{"_id":"0cd59923-01cb-a868-c63b-79f9f36338ed","text":"This study aimed to assess if the presence of ECE in positive SLNB was associated with axillary tumor burden in early breast cancer and its impact on overall survival and disease-free survival.","title":"Measurement of extracapsular extension in sentinel lymph node as a possible predictor of residual axillary disease in breast cancer"}
{"_id":"0cd5e31a-2aa8-3d02-d35f-1181afab821b","text":"A sparse signal is one that has many zeros and few nonzero values. The aim of the sparse approximation is to synthesize a given signal or measurement vector as a linear combination of a small number of sparsifying transform vectors .","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"0cda4ba1-67ec-789c-7a80-bd07d660447e","text":"The average volume of LAs required was around 34.5 cc for both blocks combined. No complications like vascular puncture or nerve injury were reported during the study. The time taken to complete the procedure was around 33 minutes, and the average time to achieve sensory block was around 9 minutes after completing the procedure.","title":"Effects of Ultrasound-Guided Lower Extremity Nerve Blocks for Below-Knee Procedures in the Emergency Department of a Tertiary Care Hospital, Central Gujarat"}
{"_id":"0ce04ea9-4251-9f58-c71f-52c2e60e6d8d","text":"This retrospective early report of skin malignancies of the head and neck region treated with IMPT suggests that IMPT is safe and effective in providing local and regional control of disease, particularly in the adjuvant setting for advanced disease.","title":"Oncologic Outcomes for Head and Neck Skin Malignancies Treated with Protons"}
{"_id":"0cee1920-c375-b5de-a915-5065023730fa","text":"The patient did not refer a previous history of herpetic manifestation nor other diseases, neither she was assuming medications before the vaccination.","title":"Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases"}
{"_id":"0cef4409-47d4-5324-dda5-edc2b810d145","text":"An appropriate animal model is critical for the research of stem\/progenitor cell therapy and tissue engineering for bone regeneration in vivo. This study reports the design of an external fixator and its application to critical-sized femoral defects in athymic rats. The external fixator consists of clamps and screws that are readily available from hardware stores as well as Kirschner wires. A total of 35 rats underwent application of the external fixator with creation of a 6-mm bone defect in one femur of each animal. This model had been used in several separate studies, including implantation of collagen gel, umbilical cord blood mesenchymal stem cells, endothelial progenitor cells, or bone morphogenetic protein-2. One rat developed fracture at the proximal pin site and two rats developed deep tissue infection. Pin loosening was found in nine rats, but it only led to the failure of external fixation in two animals. In 8 to 10 weeks, various degrees of bone growth in the femoral defects were observed in different study groups, from full repair of the bone defect with bone morphogenetic protein-2 implantation to fibrous nonunion with collagen gel implantation. The external fixator used in these studies provided sufficient mechanical stability to the bone defects and had a comparable complication rate in athymic rats as in immunocompetent rats. The external fixator does not interfere with the natural environment of a bone defect. This model is particularly valuable for investigation of osteogenesis of human stem\/progenitor cells in vivo.","title":"External fixation of femoral defects in athymic rats: Applications for human stem cell implantation and bone regeneration"}
{"_id":"0cfcb82b-9a71-4f37-2cea-8828ccec13a2","text":"Participants in this study underwent rhinoplasty with two different techniques of double lateral osteotomy in comparison with asymmetric dorsal hump reduction using rasp. Ninety patients were allocated in two groups by a quadruple block randomization. Patients were compared for the correction of nasal deviation 6 and 12 months after surgery. Their self-rated satisfaction with rhinoplasty outcome was also assessed using a researcher-made questionnaire.","title":"Comparison of Double Lateral Osteotomy and Asymmetric Dorsal Hump Reduction in Correction of Crooked Nose"}
{"_id":"0d0f5fdf-8323-9cc2-f971-84f590f75350","text":"Megavoltage photon beams are generally used to treat widespread skin cancer. These beams have a build-up characteristic near the surface before reaching electronic equilibrium. To treat superficial skin tumors with a megavoltage photon beam, a layer of scattering material that imitates skin called a bolus is used to increase the radiation dose at the skin surface. A previous study has suggested that a simple photon beam technique with various tissue-equivalent boluses such as water or rice could be used in the treatment of skin cancer. This technique has the advantage that it can deliver a uniform dose of radiation to widespread lesions. However, megavoltage photon beam treatment will inevitably deliver as much as the prescribed dose to deep-seated normal tissues. This increases the potential for complications such as fibrosis, edema, and joint contracture as a result of increased radiation exposure to underlying normal tissues such as skin, muscles, vasculature, and bones. Electron beam treatments that use beam spoilers could help overcome this issue. Previous studies have confirmed that this technique is useful in treating flat surfaces because the spoiler increases the surface dose and reduces the electron beam’s penetration range. However, because achieving a uniform and homogenous dose distribution using electron beams is challenging on irregular or curved surface lesions, conventional electron beam therapy is a poor option in the treatment of superficial tumors on the hands and feet. Therefore, there is a need to develop new radiation therapy techniques to treat superficial tumors while reducing the complications that arise from exposing deep-seated normal tissues that underlie superficial lesions to radiation.","title":"Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi’s sarcoma in the distal extremities"}
{"_id":"0d1006c6-a5ea-96c7-63fd-831d706e8f5c","text":"The deltoid branch of the thoracoacromial vein is located in the neighborhood of the cephalic vein. The functional results of intravenous port implantation via the deltoid branch of the thoracoacromial vein are similar to other entry vessels. It is a safe alternative entry vessel for intravenous port implantation.","title":"Deltoid Branch of Thoracoacromial Vein A Safe Alternative Entry Vessel for Intravenous Port Implantation"}
{"_id":"0d106f3c-39ea-b97e-b212-02b8392355c7","text":"No data about the patient quality of life and satisfaction with the overall outcome and breast among patients following breast reconstruction are available.","title":"A systematic review and meta-analysis of postmastectomy radiation therapy on prepectoral versus subpectoral breast reconstruction"}
{"_id":"0d1c114e-999d-ddc3-80f1-ba9e6f6735fa","text":"The patency of the graft was followed up postoperatively with Doppler US for all of them, and they were all patent.","title":"Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein"}
{"_id":"0d22fae3-72c2-c7f2-f405-965d1c20d851","text":"Three patients had a sternal bar supporting the sternum using a modified Ravitch technique. One patient had Ehler-Danlos syndrome, and in another we removed a large amount of costal cartilage and the patient needed support to stabilise a flail chest. A third needed extra support because he underwent repair of a second recurrence of PE deformities.","title":"Clinical experience of repair of pectus excavatum and carinatum deformities"}
{"_id":"0d2674df-e834-de9b-b286-f227f61948e6","text":"First, the developed technique is more effective for dose saving on normal organs underlying skin lesions. As expected, the previously reported plan comparison study and plan comparison result in this study shows that radiation exposure to underlying normal tissues is unavoidable when treating widespread skin lesions with a photon beam. Although the developed electron arc technique with a scatterer has less conformity and homogeneity than the conventional photon plans, it has the unique advantage that it saves the underlying normal organs with reasonable PTV coverage and homogeneity. This advantage makes this technique a superior candidate treatment method for widespread recurrent skin cancer, which is a special concern in radiation exposure to save the normal underlying organs on the arms and legs.","title":"Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi’s sarcoma in the distal extremities"}
{"_id":"0d28b956-e7b6-82d4-23bb-b372e7f63736","text":"All of the currently used approaches to grading levels of evidence and the strength of recommendations have important shortcomings.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"0d2c20a5-2469-2035-af36-5d434f7423ed","text":"Results No patients were found to be allergic to lignocaine or prilocaine. The most likely causes of the adverse reactions were found to be psychogenic.","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"0d30ddf4-444b-166c-e4fb-0998ef64e164","text":"All patients randomly allocated to tonsillotomy were advised to start a gag-reflex desensitization training method. Patients were advised to slowly reduce their gag reflex by touching their tongue base and tonsils with a tooth brush each time they brushed their teeth. This method has been previously shown to reduce the gag reflex intensity in most patients within 2 weeks.","title":"Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults A Randomized Clinical Trial Laser Tonsillotomy vs Conventional Tonsillectomy in Adults"}
{"_id":"0d34db3c-2926-0f7e-5e08-caa5cf9cb123","text":"This prospective study was conducted on 40 consecutive patients, of which 20 treated with sural artery flap and another 20 with perforator based propeller flap cover for soft tissue reconstruction in extremities based on predefined inclusion criteria. The clinical outcome of the flap was assessed after three months.","title":"The Clinical Outcome of Perforator Based Sural Artery and Propeller Flaps in Reconstruction of Soft Tissue of Extremities"}
{"_id":"0d3bf275-3cca-b266-03ae-55ff8d925ff5","text":"Once the osteotomies are completed, plating is performed in the leg to limit the ischemia time; however, rendering the fibula ischemic for the osteotomies and plating is also an option as the custom cutting guides reduce ischemia time. Once the fibula construct has been secured to the titanium plate, the flap is transferred to the head and neck for bony fixation. We prefer to inset the skin paddle into the soft tissue defect prior to performing the microvascular anastomosis. The additional soft tissue components can be placed into the maxillary sinus, or the second skin paddle can be de-epithelialized to provide additional coverage of the hardware or to fill the dead space.","title":"Evolution of Medical Modeling and 3D Printing in Microvascular Midface Reconstruction: Literature Review and Experience at MD Anderson Cancer Center"}
{"_id":"0d3dbc5a-3893-2d66-6e21-0c68f910245a","text":"The jejunal free flap is supplied by vascular arcades arising from the superior mesenteric artery and vein. A suitable segment located 20 to 30 cm from the ligament of Treitz is selected and the flap is isolated on a single arcade. The length of the jejunal segment required for the reconstruction is based on the pharyngeal defect, usually around 10 to 15 cm [88–91]. The flap can be split along the antimesenteric border to increase the diameter so that it is of suitable diameter to match that of the oropharynx and is inset into the defect in an isoperistaltic manner. Care must be taken to avoid redundancy as this may result in regurgitation and dysphagia. Warm ischemia time should be limited to less than 2 hours to avoid ischemia reperfusion injury. Intestinal continuity is restored in the abdomen and the wound is closed in a standard fashion after a feeding jejunostomy tube and a gastrostomy tube are inserted.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"0d4d0365-da18-9f5c-ed18-2dba699fb2f1","text":"Despite microvascular free tissue transfer being the mainstay of care in the reconstruction of larger maxillofacial defects, a significant number of patients experience postoperative complications due to impaired blood supply of the flap. In this context, the early influence of recipient bed perfusion remains unclear, but there is evidence that it is associated with free flap viability immediately after surgery.","title":"Recipient bed perfusion as a predictor for postoperative complications in irradiated patients with microvascular free tissue transfer of the head and neck area: a clinical analysis of 191 microvascular free flaps"}
{"_id":"0d4fc1c8-2b61-6b22-c4e1-95de20e51bf5","text":"Case presentation: A 38-year old female with a past medical history of migraines presents with a 3 year history of a cyclical pruritic erythematous maculopapular and plaque rashes—initially distributed to her periorbital and nasolabial areas before generalizing—starting on day 0 or 1 of her menstrual cycle, lasting 3 days before completely resolving. The rash was absent during her entire pregnancy in 2015 but she flared into an intense episode a few days after her C-section. OCPs were used in the past but they never caused this rash and they were discontinued because the patient experienced hair loss. Intradermal testing to medroxyprogesterone was negative. Skin prick testing with oral estrogen was negative. Diagnosis of estrogen induced dermatitis was based on clinical presentation. She currently prefers to manage with bilastine 40–80 mg orally at the time of menses which has decreased her symptoms by 50%","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"0d5182c0-c1bc-52ed-b701-447480e8a870","text":"We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico(r) device for NPWT in addition to standard treatment of infection or dehiscence in our institution. We considered as an initial favorable outcome the resolution of the infectious process and the closure of the surgical wound dehiscences in the treated cases and the good progression of the wound without complicating events in the prophylactic cases.","title":"NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY TERAPIA COM PRESSÃO NEGATIVA EM FERIDAS NO TRATAMENTO DE LESÕES GRAVES APÓS ARTROPLASTIA TOTAL DO JOELHO"}
{"_id":"0d5bb0d4-48a8-4eaa-cb3b-711f2384be66","text":"The saphenous vein is still the most widely used conduit in CABG surgery despite its poor long term patency. In the 1990's a new No-touch technique for saphenous vein graft harvesting for CABG was introduced where the vein graft is harvested with a pedicle of surrounding tissue. With the No-touch technique the vein graft does not go into spasm and the vessel wall does not have to be exposed to distension-induced trauma. A previous randomized trial has shown a significantly higher patency rate for vein grafts harvested with the No-touch technique compared to vein grafts harvested with conventional technique and the patency for No-touch vein grafts was comparable to the patency of the left internal thoracic artery, 8.5 years after surgery. The aim of this study was to evaluate whether the increased patency rate for No-touch vein grafts is reflected in clinical outcome.","title":"The no-touch vein graft harvesting technique for coronary artery bypass grafting surgery reduces mortality: a long-term follow-up study"}
{"_id":"0d5f4d68-6c0c-3f23-d323-6931248e5269","text":"The quantitative analysis method for photographic density of panoramic radiograph used in the present study has the limitations that separate pre-treatment or post-treatment steps were performed for standardization and measurement was made using additional software for research. It is encouraging that more precise research results could be obtained through the above process, but it adds the disadvantage that directly utilizing data under general treatment situations is almost impossible when considering both time and resources. The significance of this study is that it shows the feasibility of measuring photographic density using only a basic function in PACS and the resulting data can help in diagnosing osteomyelitis.","title":"Early diagnosis of jaw osteomyelitis by easy digitalized panoramic analysis"}
{"_id":"0d606acc-cdc6-95d7-6cd6-e8aa646d49fd","text":"Since the results of WHO trials 1 and 14 have been published, there has been minimal debate in Europe concerning radical lymph node dissection in melanoma patients, and SNB has eliminated any remaining ambiguity. Minor differences were described in SNB indications and methodology. Almost one-third of MUs agree to perform SNB at the request of the patient when the primary melanoma is thinner than 1 mm.","title":"Surgical management of melanoma: an EORTC Melanoma Group survey"}
{"_id":"0d63d907-f3bf-7c24-7ff9-ec058419ecf9","text":"Prophylactic mastectomy precludes the use of sentinel node biopsy as the breast is required for this procedure in order for the dye and tracer to be injected into the breast. Screening MRI prior to prophylactic mastectomy is essential in order for a sentinel node to be feasible in case a small tumour is present occult on conventional imaging.","title":"Screening breast MRI in high-risk women undergoing prophylactic mastectomy"}
{"_id":"0d6645ea-0b64-9d4e-9b49-87e136d93dbd","text":"We retrospectively reviewed the records of 17 patients with primary mucosal melanomas of the head and neck treated with a curative intent at the University of Miami and affiliated hospitals from 1990 through 2007 in an institutional review board-approved outcomes analysis. Patients were included if they had a previously untreated, newly diagnosed non metastatic primary mucosal melanoma of the head and neck region.","title":"Mucosal Melanomas of the Head and Neck: The Role of Postoperative Radiation Therapy"}
{"_id":"0d692c27-2a7b-72bc-4935-8a7e52dcc219","text":"Apart from these limits, our study has created an awareness of the existing level of application skill and availability of the halo vest traction device. No comparable study is available in the literature, and it may be of interest to perform similar surveys in other countries.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"0d6a660c-92af-e6de-be4b-630dd62cf5db","text":"The treatment of cancer is an ever changing field always in the search for most effective therapies able to increase cure rate or at least to prolong survival as compared to the therapy considered at the time as standard. Nevertheless, survival can not always be the unique goal of therapies. Treatments that while have the same effect upon survival turn out to be less toxic or have better impact in quality of life are valuable. Lastly but not the least, to have treatment options when the standard therapy is either not available of difficult to reproduce in particular settings is highly desirable with the potential to save lives that otherwise could be lost by the lack of adequate treatment. These options of treatment ideally had to have shown, 1) that are not inferior to the \"standard\" in terms of either survival or quality of life; 2) that can be delivered in setting were the \"standard\" is not available of if available its quality is poor; and 3) that the treatment option be accepted by the population to be treated.","title":"Radiation-sparing managements for cervical cancer: a developing countries perspective"}
{"_id":"0d6e7ce2-63ac-4917-cfd1-12d5981a7233","text":"In summary, LDMF for breast reconstruction after mastectomy is a procedure that has been erroneously maligned over the years for high capsular contracture complications. In reality, a lot of the data regarding capsular contracture rates in LDMF are outdated and skewed. Proper study of LDMF most likely was hindered by the rapid rise in the popularity of the TRAM flap in the early 1980s. Our data and others more recently published demonstrate very acceptable capsular contracture rates and aesthetic outcomes, particularly when an expander is utilized. We believe that LDMF should be utilized more often, as it is a technically straightforward procedure that gives acceptable cosmetic outcomes with few complications.","title":"Latissimus Dorsi Myocutaneous Flap for Breast Reconstruction: Bad Rap or Good Flap?"}
{"_id":"0d72a732-9ac2-2192-b754-b0889522b8c2","text":"When associated with CVD, DCC of the lower limbs may be the cause of ulcers refractory to conservative treatment. Management of the condition is challenging and there is no consensus on the best treatment.","title":"Dystrophic calcinosis cutis in chronic venous disease of the lower limbs"}
{"_id":"0d7b4c7f-bf66-3562-71a1-640daba5c059","text":"The below described final surgical approach is an example of a surgically justified option for a treatment which primarily met the requirement of the young patient not to have a more invasive procedure.","title":"Treatment of a chronic recurrent fistulized tibial osteomyelitis: administration of a novel antibiotic-loaded bone substitute combined with a pedicular muscle flap sealing"}
{"_id":"0d7e40b4-6494-b186-a8c0-1e55803d8c4c","text":"One of the most important points from the results is that there is no average duration of effect, as so many of the end points are beyond the end of the time allocated to the study. No fewer than five of the studies included in the literature review found the effects to be ongoing past the last patient follow-up. In one study longevity was found to be between 10-21 weeks, while another study estimated 3-6 months longevity, which is arguably not precise enough to be very helpful to patients as a guide. The figures are so diverse that there is no simple advice that can be gleaned from them to inform patients. The effects may last between two and over six months. Furthermore the manner in which these results are measured may render these results inaccurate, as these studies reflect the perceived endpoint and treatment intervals respectively, which are two different measures. Moreover, the majority of studies examined the duration of the effect of the toxin on maximal contraction, not on wrinkle appearance at rest, which is in fact arguably the pertinent issue, as this is what most patients seeking glabellar treatment with toxin would want to achieve. One factor that was less well assessed in studies was that of practitioner competence, as these studies were often single practitioners, and none were students or trainees. This is likely to be a hugely influential factor in the successful outcome and longevity of the treatment as it may influence dose, position of injection and also communication with the patient.","title":"A review of the longevity of effect of botulinum toxin in wrinkle treatments"}
{"_id":"0d80e47c-006f-a031-f9c6-0e4a0f04da88","text":"Skin flap quality is important for surgery using a biologic patch. In reconstructive surgery of the breast, only the side of the ADM in contact with tissue is useful for integration; the other side of the ADM is in contact with the implant. If tissue necrosis develops, the ADM cannot be integrated, and then both devices require removal at the very least. No ADMs were used in our study for patients where there was concern about the condition of the skin.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"0d831726-f6b1-b818-1145-e4efe0e46051","text":"Reconstruction of the irradiated scalp remains a challenge in reconstructive surgery. Unfortunately, many protocols developed for scalp reconstruction are not applicable in the setting of severe or diffuse scalp skin atrophy associated with high tumor recurrence rate and radiation-induced vascular impairment, such as in tinea capitis patients in Serbia. An algorithm has been developed based on the authors’ experience in managing these patients. The algorithm could be found useful for the reconstruction of scalp defects in patients after receiving radiation therapy due to any tumor if severe complications of the treatment occur in the setting of severe skin atrophy with limited reconstruction resources.","title":"Reconstruction of Moderately and Severely Atrophic Scalp—A Multicentric Experience in Surgical Treatment of Patients Irradiated for Tinea Capitis in Childhood and Surgical Algorithm"}
{"_id":"0d86e15f-5661-8b54-9b01-955cd127aa78","text":"The TCVs could be used safely as an alternative recipient site for patients whose vessels in the neck region are unavailable because of previous surgery or radiotherapy. In cases in which the transverse cervical vein is unavailable, the internal or external jugular vein should be dissected carefully and could serve as an alternative site for microvascular anastomosis.","title":"Transverse cervical vessels as recipient vessels in oral and maxillofacial microsurgical reconstruction after former operations with or without radiotherapy"}
{"_id":"0d8853b9-4caf-bdcb-cf6f-896261df189f","text":"An ipsilateral vascularized fibula segment was taken with its periosteum and peroneal vessels. The length of the vascularized fibula exceeded the length of the resected bone defect by at least 4.0 cm. Microscopic anastomosis was achieved using the distal end of the femoral circumflex descending artery.","title":"Evaluation of the Efficacy of Pasteurized Autograft and Intramedullary Vascularized Fibular Transfer for Osteosarcoma of the Femoral Diaphysis"}
{"_id":"0d91bd73-5df9-1e96-2c52-f94b3efc259a","text":"Our study found that PET\/CT was found to have higher level of accuracy in terms of sensitivity and specificity. Further large-scale research can help to find answers for such questions and provide final conclusive evidence on the inclusion of the imaging modality into the routine clinical practice guidelines for suspected periprosthetic joint infection patients.","title":"Diagnostic accuracy of positron emission tomography\/computerized tomography for periprosthetic joint infection of hip: systematic review and meta-analysis"}
{"_id":"0d9360e7-4612-eda4-a56f-64e8e9238efc","text":"Programs for quality assurance are increasingly important in surgical pathology. Many quality assurance (QA) techniques for surgical pathology were adopted from procedures introduced in cytopathology. Surgical pathology specimens have diminished in size such that the majority of diagnostic biopsies of prostatic lesions are now core needle biopsies. These specimens raise issues similar to those of cytology specimens, including concerns regarding adequacy and the representative nature of the biopsy. Due to sample size, some neoplasms may not be diagnosed on initial biopsy, raising concerns regarding false negative results. Cytopathologists have instituted QA procedures including review of all previously negative slides received within five years prior to the new diagnosis of high grade squamous intraepithelial lesion or gynecologic malignancy. No such requirement exists in surgical pathology for review of core biopsies.","title":"Histopathologic Review of Previously Negative Prostatic Core Needle Biopsies Following a New Diagnosis of Adenocarcinoma of the Prostate by Core Needle Biopsies: Implications for Quality Assurance Programs"}
{"_id":"0d93e23a-3ee5-ec5f-0e33-a7dbaa6473b6","text":"We preferred to use the drilling technique of which we had similar experience for the reconstruction of extensive ulcers refractory to traditional treatments.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"0d94257d-f8d8-0889-1a43-73d819834a3b","text":"A combination of both the clinical tests and the color Doppler ultrasound has a higher accuracy in detecting perforator incompetence and can reduce the number of negative explorations by the rate of 16 unnecessary explorations per 10 patients.","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"0d96e06a-f017-3c67-ec1d-429e24de96a0","text":"A 3D vascular centerline was created by intersecting surfaces defined by comparable liver segments. The segment correspondences between two projection planes Pn and Pm were estimated. Let the pair of transformed liver centerlines be Xn and Xm and their corresponding focal points be Fn and Fm. The surfaces Rn and Rm representing the projection beams for Xn and Xm were produced by connecting the centerlines and focal points. The issue of identifying the 3D centerline (C) in the curves Xn and Xm can be mitigated to the identification of the intersection line of the 2 surfaces Rn and Rm, as given in","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"0d9a9ab2-7277-b43e-e278-0657ab0137f7","text":"To compare the salvage rate and complication between internal fixation and external fixation in patients with small bone defects caused by chronic infectious osteomyelitis debridement.","title":"Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis"}
{"_id":"0dab1497-0b98-3735-5d38-07633ca362a7","text":"As the wound dressings are clearly visible, the patients cannot be blind to their treatment. In addition, the treating surgeons will also not be blind to the treatment, but will take no part in the postoperative research assessment of the patients. The clinical outcome data will be collected by independent research assistants who will not be blind to the treatment allocation. Questionnaire data will be entered onto the trial central database by a data clerk in the trial central office.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"0db1aba7-9dda-b388-65ec-ccf2188680db","text":"Immediate coverage of a large area of exposed skull is the first step in reconstructing a major scalp loss. In the 1970s, the free omental flap was used for scalp reconstruction, replacing removal of the external table and skin grafting only. Introduction of flaps and expanders has revolutionized reconstruction of major scalp losses. A free muscle flap is used to cover the exposed skull. Skin graft covers the muscle flap, and next, the expanded scalp is used to restore the scalp to its original shape.","title":"36-year Follow-up on Scalp Reconstruction Using Free Latissimus Dorsi Muscle Flap, Skin Grafting, and Scalp Expansion"}
{"_id":"0db468dc-88bf-e0a6-db3a-1bfbb9be7810","text":"Lymph node metastasis from cutaneous squamous cell carcinoma is uncommon. The popliteal fossa is rarely involved with metastasis. Popliteal lymph node dissection is uncommonly performed and not frequently discussed in the literature. We present a case of squamous cell carcinoma of the heel with popliteal and inguinal metastasis. This is followed by a description of the relevant anatomy of the popliteal fossa and the technique of popliteal lymphadenectomy.","title":"Popliteal lymph node dissection for metastatic squamous cell carcinoma: a case report of an uncommon procedure for an uncommon presentation"}
{"_id":"0db8bc8e-fc33-12cd-4afa-5d7b4dd96a5b","text":"A profound knowledge gap exists between fellowship applicants and program curricula. The majority of IEM fellows and program directors support the use of a standardized application process and deadline. This will enable the IEM community to effect change in our recruitment strategy and application process. Accurate and easily accessible information about each program can ensure the best fit for both candidates and IEM fellowship programs and greater career satisfaction for IEM fellows.","title":"Improving Knowledge and Process for International Emergency Medicine Fellowship Applicants: A Call for a Uniform Application"}
{"_id":"0db9201a-c109-6c9f-ee8b-3a5b4fa06971","text":"The use of an SVG bypass in neurosurgery has decreased largely because of improved endovascular therapies in many circumstances. The “gold standard” for the treatment of giant aneurysms remains surgical clipping. Nevertheless, a small but consistent number of SVG bypass procedures will be required for the treatment of complex cerebrovascular disease.13 Arterialized venous free flap transfers with the long saphenous vein will be favorable in the reconstruction of major arteries of the injured skin and soft tissues.132 Generally, synthetic materials are no longer used in grafting procedures in Peyronie surgery because of their antigenicity and inappropriate functional properties. Small intestinal submucosa may be associated with a high rate of operative failure and complications. SV grafting is the preferred autologous graft with acceptable outcomes.133 Arteriovenous grafts remain an important vascular access option for dialysis, and interventions to prevent progression of stenosis are being explored.134 Recent data indicate that the majority of patients on hemodialysis in the United States have prosthetic graft fistulas. The most frequent complications of prosthetic graft fistulas are thrombosis and stenosis.135 Endovascular interventions have replaced surgical repair as the primary treatment of the failing or thrombosed vascular access. Angioplasty is a fast, easy, and safe procedure that can extend the patency of a hemodialysis graft.136","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"0db9fbff-553f-8887-922c-e71e2e31a370","text":"The aim of this study was to assess whether flap design and duration of surgery can influence acute postoperative symptoms and signs after lower third molar extraction.","title":"Effect of flap design and duration of surgery on acute postoperative symptoms and signs after extraction of lower third molars: A randomized prospective study"}
{"_id":"0dbbf436-18a9-0091-5c0f-a9b86684be7e","text":"Fracture resistance in the oral environment is reduced due to water sorption and material degradation.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"0dbfc184-29c5-937b-c5f7-f0b80236efad","text":"Accuracy was defined as the percentage of patients in which the sentinel node status has accurately represented the lymph node status of patient. False negative (FN) rate was defined as the percentage of patients who had histologically negative SLNs but other positive axillary nodes. Fisher’s exact test and χ2 tests were used to analyse the impact of different factors on this method.","title":"Sentinel lymph node biopsy: technique validation at the Setúbal Medical Centre, Portugal"}
{"_id":"0dc8114c-ac90-8842-f3fe-593a8a74bd6f","text":"The DPF values for the four fields are shown in Table 2. It was also observed that the maximum values of the DPFs in the phantom (excluding the prosthesis) occurred at the beam entrance region of the Ti prosthesis. The prosthesis itself receives higher dose from 15 MV beams compared to 6 MV beams. This observation could be attributed to the longer range of more energetic electrons generated in the beam proximal to the prosthesis in the 15 MV beam. This actually means that the Ti prosthesis intercepts a higher proportion of the secondary electron fluence, and thus more dose is deposited in the 15 MV than for 6 MV.","title":"Dose comparison between Gafchromic film, XiO, and Monaco treatment planning systems in a novel pelvic phantom that contains a titanium hip prosthesis"}
{"_id":"0dd64c1d-49f5-bf69-2d80-b06ad95996a0","text":"After harvesting, the flap was sutured in the new position and the vascular anastomoses were performed in the next manner: the toracodorsal artery was sutured end to end to the left superficial temporal artery, with atraumatic 8.0 wires, the toracodorsal vein was sutured end to end to a commitant vein of the superficial temporal artery and the vein from the pedicle for serratus anterior was sutured to another commitant vein. We decided to perform two venous anastomoses taking into account the large size of the flap, and also the bad condition of the recipient vessels.","title":"Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect"}
{"_id":"0dd6d168-b601-e2c5-d5fb-5aa48a8b2c53","text":"We are presenting a case report on an unreported and unusual cutaneous manifestation of a chronic lymphocytic leukemia in a patient with an implantable cardioverter-defibrillator.","title":"Chronic lymphocytic leukemia skin infiltration mimicking an ICD pocket infection: a case report"}
{"_id":"0dda502b-1911-3641-214e-f3ee67a04b4e","text":"Desmoid tumors are rare, nonmalignant lesions of fibroblastic proliferations within connective tissue. Pediatric fibromatoses are often locally aggressive and invade into adjacent tissue walls and bone, making them difficult to fully expunge.","title":"Total Resection of Pediatric Desmoid Tumor of the Left Neck with Utilization of 3D Virtual Surgical Planning"}
{"_id":"0df5ddbe-96c2-548a-d8a6-7c57fbd87c06","text":"We found that fellowship directors at programs affiliated with academic institutions rated certain factors higher than their counterparts at programs that were not affiliated with an academic institution. This is a finding that has not been demonstrated in previous studies. We found that fellowship directors at academic programs placed higher value on an interest in pursuing an academic career, research experience, and exposure to well-known traumatologists during residency.","title":"The Competitive Orthopaedic Trauma Fellowship Applicant: A Program Director's Perspective"}
{"_id":"0df84dd8-7358-ebd8-1ba2-ada4199ae750","text":"Most adverse reactions to local anaesthetic injections can be avoided if the following procedures are adopted:","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"0dfeae0f-05b0-6a09-df2d-29e52d05a103","text":"Using the extensor digitorum brevis muscle flap spared donor site morbidity. It limited the surgical area to the foot. The nutrient vessels were spared from arteriosclerosis and could be anastomosed to the dorsal metatarsal artery in supramicrosurgical fashion.","title":"Vascular Surgery, Microsurgery and Supramicrosurgery for Treatment of Chronic Diabetic Foot Ulcers to Prevent Amputations"}
{"_id":"0e0188d5-bf3d-5651-5ce0-20da97067c51","text":"Preoperative evaluation of the mastectomy skin flap thickness after clinical evaluation, breast ultrasound, breast MRI and mammography can be used for estimating the possibility of immediate implant-based breast reconstruction, the appropriate prosthesis and the surgical procedure. There is a strong correlation between the preoperative measurements and the intraoperative findings and the association of all four methods leads to the best result.","title":"Assessment of Mastectomy Skin Flaps for Immediate Implant-Based Breast Reconstruction"}
{"_id":"0e067e60-c1d0-a3e1-f803-5f1acb62038c","text":"The superficial epigastric vein travels along the abdominal wall and drains into the femoral vein and then into the inferior vena cava via the common iliac vein. Bilateral distention of the superficial epigastric veins indicates development of collateral venous circulation due to obstruction of the common iliac veins or inferior vena cava. Inferior vena caval obstruction with distention of the superficial epigastric veins is known to occur in Budd-Chiari syndrome but has also been identified in past reports of iliac vein compression syndrome [5–7], as well as in the present case. Accordingly, distention of the superficial epigastric vein in a patient with leg edema should raise suspicion of iliac vein compression syndrome.","title":"Iliac Vein Compression Syndrome due to Bladder Distention Caused by Urethral Calculi"}
{"_id":"0e16c71b-4c48-2900-1807-727f0b410d73","text":"Recently, regional anesthesia techniques have been replaced by peripheral nerve blocks in the management of perioperative pain. Because of the widespread use of ultrasonography, it has been reported that peripheral nerve blocks showed similar analgesic efficacy with favorable rates of side effects when compared to central blocks.","title":"Comparison of ultrasound-guided transversus abdominis plane block, quadratus lumborum block, and caudal epidural block for perioperative analgesia in pediatric lower abdominal surgery"}
{"_id":"0e1f24ba-ad33-ae87-05e6-a18afc2de173","text":"Originally developed to treat chondral lesions in the knee, ACI has since been adapted for the treatment of chondral defects in other joints such as the ankle and less commonly, the hip. While encouraging results in terms of cartilage growth and improvement of joint function in the treated joint have been reported, little has been published on the potential morbidity caused by harvesting healthy tissue from the joint in ACI. What has been described regarding donor site morbidity in the literature to date predominantly relates to osteochondral harvest for mosaicplasty or OATS, which has obvious differences in potential issues for donor site morbidity than solely a chondral harvest due to the depth and size of the harvest taken. Donor site morbidity is an understandable concern as the integrity of the healthy, intact hyaline cartilage is violated.","title":"Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI) A Study of ACI-Treated Ankles and Hips with a Knee Chondral Harvest"}
{"_id":"0e1f99c5-fa41-8b84-80e6-3639b05a2d07","text":"• Acute infection of the remaining wound after primary tumor resection","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"0e24c307-de99-92b0-061c-5b021b5838d8","text":"Objectives: Within the United States, plastic surgery is a difficult field to match into for both US and international medical graduates. While the number of available residency positions has grown in recent years, this has not been mirrored by an equal increase in the number of international medical graduates who match. Furthermore, there are few reliable resources to guide international medical graduates who are interested in matching into US-based programs, so the process is often even more difficult and unpredictable than for US applicants. Methods: An anonymous survey was distributed electronically to international medical graduates who successfully matched into independent and integrated US plastic surgery residency programs. The survey assessed qualities such as medical school performance, test scores, research experience, and other relevant applicant information, and χ2 analysis was done to compare the survey results for integrated and independent track international medical graduates. Results: International medical graduates who successfully match tend to rank high and score well in their medical school classes, score between 230 and 250 on USMLE step 1 and 2CK tests, and have a mean of 2 years of research experience before applying to the match. International medical graduates in the independent track tend to have higher step 1 scores, whereas international medical graduates in the integrated track tend to have more research experience and additional nonmedical degrees. Conclusions: This is a survey-based overview that describes the characteristics of successfully matched international medical graduates. Limitations of this study include the inability to identify and survey the unsuccessful applicants as well as poor response rate of the successful candidates in the independent pathway who successfully matched.","title":"International Medical Graduates in the US Plastic Surgery Residency: Characteristics of Successful Applicants Kokosis et al"}
{"_id":"0e2f2aba-ab1e-0ba2-28f4-f4dfa094931b","text":"This work aims to describe the experience from a tertiary cancer center using vismodegib for advanced periocular BCCs.","title":"Vismodegib for treatment of periocular basal cell carcinoma – 6-year experience from a tertiary cancer center"}
{"_id":"0e32ecef-19df-8863-6d1a-262e60f189cb","text":"It was observed in some histopathological sections that fungus hyphae were present free in different tissue plans, enabling them to spread widely and rendering them difficult to identify during surgery, leading to further reasons for recurrence.","title":"The Surgical Treatment of Mycetoma"}
{"_id":"0e33c508-ca34-febb-4e8d-056cddf8a90c","text":"Peripheral arterial occlusive disease can cause partial or total obstruction of the arteries of the lower limbs, provoking reduced blood flow to the extremities. In the most critical cases there is a risk of limb amputation if revascularization is not possible.1 , 2","title":"The impact of peripheral arterial disease on exercise tolerance and quality of life in the elderly and the role of cardiovascular physiotherapy: review article"}
{"_id":"0e38038e-175f-9234-e550-562719dfa3a9","text":"Occasionally, a maxillary and mandibular defect is encountered and may be another indication for a two-free flap reconstruction. In such cases, a myocutaneous ALT or rectus abdominis flap is used for unilateral maxillary and buccal reconstruction and a fibula osteocutaneous free flap is used for mandibular reconstruction. However, limited mandibular defects combined with palatomaxillary defects can often be addressed with a single large ALT or RAM free flap when the mandibular defect does not involve the anterior mandible, such as might arise from a retromolar trigone tumor that extends superiorly or a posterior palatal tumor that extends inferiorly.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"0e3bf8e4-7b63-c716-8bf8-2da01ceae687","text":"To date, there has been fairly little data available on this combined use of Hydrus and OMNI, but a recent 2022 case series presented at the American Society of Cataract and Refractive Surgery (ASCRS) annual meeting showed an average IOP reduction of 11.29 mmHg in a series of 16 eyes that received combined Hydrus implantation with OMNI canaloplasty. Other than this recently presented data, we are not aware of any other case series published that has evaluated the safety and efficacy of combining these two procedures.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"0e40e48d-e9df-0129-3162-86050b8c74ad","text":"Table 3 Patients rating level of discomfort during assessment with POCUS higher than two in any of the three types of sonography","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"0e41162d-a2f9-927f-9b3a-7cdabf86c731","text":"Wide margin tumor excision alone is a reasonable option in the management of desmoid tumors.","title":"A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report"}
{"_id":"0e42d938-9020-662c-c997-409ad2274718","text":"Continuous awareness and education was continuously emphasized by the team to all healthcare professionals by sharing the main focus elements of ASP including Surgical Antibiotic Prophylaxis guidelines and the restricted list of broad spectrum antibiotic appropriate usage that requires preauthorization approval.","title":"Sixth Annual Mediclinic Middle East Research Conference"}
{"_id":"0e4cb058-3f04-512d-0344-106bece87235","text":"This review article is very important and informative for the attending psychiatrist in following the treatment strategy of schizophrenia with catatonic patients, particularly with underlying deep venous thrombosis. It also shows the importance of early diagnosis and treatment of catatonia with ECT and safe continuation of the anticoagulation treatment along with ECT. It further serves as a guide to evaluating the benefits and risks of conducting ECT in patients with schizophrenia with catatonia with underlying DVT and finding alternative treatment strategy and to conclude the overall benefits of avoiding treatment resistance and debilitation in a catatonic patient versus further deterioration and consequences by increasing the chances of embolization.","title":"Association of the Thrombo-embolic Phenomenon with Electroconvulsive Therapy Treatment in Schizophrenia with Catatonia Patient"}
{"_id":"0e53c161-6bd3-a2f4-71c7-8c1a9d7cf8d2","text":"There are numerous methods to mold and shape cartilage grafts for use in rhinoplasty. Each technique has advantages and disadvantages. We are going to introduce a new method for cartilage shaping with long lasting effects confirmed by follow up examination and pathologic evaluation.","title":"Evidence-Based Efficacy of Autologous Grated Cartilage in Primary and Secondary Rhinoplasty"}
{"_id":"0e6651b2-5f9d-88df-8e24-6e892676b529","text":"For accurate nodal staging, all blue and radioactive lymph nodes should be sampled during the sentinel lymph node biopsy for breast cancer. We report a case of anomalous drainage in which one of the sentinel lymph nodes was unexpectedly found in the level III axillary space.","title":"A level III sentinel lymph node in breast cancer"}
{"_id":"0e6e57cd-0df3-9b15-730f-bf7defc77062","text":"The laser system was employed as the light source of a wavelength of 630 nm for photodynamic therapy. Using a laser delivery fiber optic tool, the entire mucosa of the urinary bladder was exposed to diffuse radiation.","title":"Reactive Oxygen Species Produced by 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Cancer"}
{"_id":"0e71d1c6-e9ca-ece2-cd32-5107f46ede7d","text":"There is a lack of scientific literature concerning the return to sport protocol following a DVT event. Athletic individuals who desire to return to sport after a DVT need to be fully informed about their treatment and risk of reoccurrence, so that appropriate decisions can be made.","title":"Traumatic deep vein thrombosis in a soccer player: A case study"}
{"_id":"0e73eb83-f5fa-e8da-cb8d-a36da578a032","text":"Pregnant ladies and patients who are sensitive to fluorescein or methylene blue were excluded from this study.","title":"Evaluation of Axilla With Sentinel Lymph Node Biopsy (Using Methylene-Blue) and Reverse Axillary Mapping (Using Fluorescein) to Validate Optimum and Safe Axillary Dissection in Breast Cancer"}
{"_id":"0e79ffcf-6ab6-fc31-1f72-c96060a767e0","text":"The patient was discharged from hospital care 3 weeks after the confirmed P. aeruginosa infection under oral Ciprofloxacin therapy without any local or systemic signs of infection. No signs of infection whatsoever were noted on his visits to the outpatient clinic for another 5 weeks, allowing for a secondary reconstructive effort on the left lower leg. A stable weight-bearing bone construct and an adequate amount of well-perfused soft tissue to fill the defect left behind by the infection were identified as the main requirements, and so a reconstruction with a contralateral free fibula flap and an ipsilateral anterolateral thigh (ALT) flap was chosen. Figure 3 shows the left lower leg prior to the free flap transfer.","title":"Simultaneous Free Fibula and Anterolateral Thigh Flap in Lower Extremity Reconstruction Following Osteomyelitis in a Trauma Patient: A Case Report"}
{"_id":"0e7cdcef-3829-5b58-020e-1bbc46bf401e","text":"In the control group, the catheters were taped at the same positions as the PTB group on the skin surface before induction. The same dosage of local anesthetics was administered through the catheters 1 h before the end of the operation by another anesthesiologist who took over after induction without knowing the intervention method.","title":"Ultrasound-guided paravertebral blockade reduced perioperative opioids requirement in pancreatic resection: A randomized controlled trial"}
{"_id":"0e8667e1-dd0d-b11a-2e90-06e6b2085687","text":"This article evaluates the complications of the scalp as a primary donor site in the treatment of burns in the Beverwijk Burn Centre.","title":"The scalp as a donor site for skin grafting in burns: retrospective study on complications"}
{"_id":"0e8801b9-fa41-5097-ecdf-f50d2a08bbc7","text":"Taken as a whole, the data presented here demonstrate that co-administration can provide a very useful tool to increase the overall immune response. This can include, achieving an immune response in tissues that are not elicited when using only one route of administration, providing a higher level of response that can lead to fewer required doses or possibly providing a better response for individuals that are considered poor or non-responders. From a practical perspective, using the maize wafers for oral delivery also provides a low cost and low intrusive method that can easily supplement injected vaccines.","title":"Co-Administration of Injected and Oral Vaccine Candidates Elicits Improved Immune Responses over Either Route Alone"}
{"_id":"0e8f1ac7-9ab4-a10b-37ae-57a285a9ba5a","text":"Fluid resuscitation and analgesia are the mainstays of support for patients with advanced sepsis usually combined with vasoactive amines associated with mechanic ventilation.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"0e93d090-0e16-4239-b78e-fe3c1d3fc193","text":"Therefore, we make a conclusion that pasteurized autogenous bone graft combined with a vascularized fibula graft is a useful reconstruction method for large bone defects after resection of osteosarcoma in the femurs.","title":"Evaluation of the Efficacy of Pasteurized Autograft and Intramedullary Vascularized Fibular Transfer for Osteosarcoma of the Femoral Diaphysis"}
{"_id":"0e9ae5e6-094d-0da6-e588-5284ae7fec9a","text":"Based on the data above, this study showed that administering 20 mg atorvastatin daily did not differ significantly from 10 mg rivaroxaban daily for 3 months for thromboprophylaxis of DVT events in cancer patients with high risk of thrombosis undergoing chemotherapy with a lower risk of bleeding.","title":"The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy"}
{"_id":"0e9c7ec9-8362-9926-46e2-7ca0a9d0a660","text":"To solve this case, a therapeutic protocol was developed that involved the specific antibiotic treatment according to the antibiogram results associated with rebalancing of the patient and performing a series of reconstructive procedures during one surgical intervention that included: the coverage of the soft-tissue defect in the sacral region with gluteal flaps, the excision and the direct closure of the posterior thoracic lesion. One month after the first intervention, the surgical team performed the reconstruction with a tensor fascia lata flap for the trochanteric region. The patient was monitored for 18 months after the reconstructions, and the follow-up consults were performed every three months during this interval.","title":"The Role of Myocutaneous Flaps in the Treatment of Patients with Multiple Decubitus Ulcers"}
{"_id":"0ea9b1db-276f-6c19-5e33-edb09c02020b","text":"Reconstruction of the thorax wall after DSWI is still a challenge characterized by the fundamentals of plastic surgery: the need to restore form and function with minimal donor side effects.","title":"Deep sternal wound infection – latissimus dorsi flap is a reliable option for reconstruction of the thoracic wall"}
{"_id":"0ebb10c6-7d0f-8299-3a75-04a7c1d2a0ca","text":"Previously described limitations with global health ultrasound education projects include geographical distances and language barriers.5 We have been able to limit the burden of international travel by recruiting multiple visiting instructors and employing tele-ultrasonography to provide ongoing remote education. Additionally, fellows spend one month of the year at our home institution in the US, which allows them to gain firsthand clinical experience in a setting where POCUS is already integrated within the clinical workflow of the ED. We have mitigated potential language barriers by developing a curriculum that is executed in Spanish. All of our visiting instructors are fluent in Spanish and teleconferencing sessions are held in Spanish with the exception of our division of ultrasound quality assurance conference, which has simultaneous translation provided.","title":"A Novel Multimodal Approach to Point-of-Care Ultrasound Education in Low-Resource Settings"}
{"_id":"0ecc5d64-e430-e9c3-64de-c01a4b4dceb5","text":"The incidence of PONV and the requirement of ondansetron were found to be similar in both groups. The results of our study were similar to the study done by Gupta et al. Some studies have reported higher incidence of PONV probably because of nitrous oxide used by them for the maintenance of anaesthesia and intravenous tramadol of 100 mg given for postoperative analgesia at the completion of surgery in all patients, whereas, in our study, we had used air : oxygen mixture and given tramadol in patients on demand after NSAIDs failed to relieve pain. This led to high satisfaction scores in all patients of both groups like in previous studies.","title":"Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block Versus Erector Spinae Plane Block for Postoperative Analgesia After Modified Radical Mastectomy: A Randomised Controlled Trial"}
{"_id":"0ed0dca3-5801-f5a9-20c2-ad4fcf8426ba","text":"Treatment of large tibial defects caused by infection with trifocal bone transport using unilateral rail system could significantly improve postoperative functional recovery and reduce duration of regenerate consolidation and docking union. The present study provides novel insight for the treatment of large tibial defects caused by infection.","title":"Bifocal or Trifocal (Double‐Level) Bone Transport Using Unilateral Rail System in the Treatment of Large Tibial Defects Caused by Infection: A Retrospective Study"}
{"_id":"0ed1d244-483d-4bba-b4cd-6aa9aceb9e1d","text":"A result of our study design is that the sensitivity cannot be determined because no completion internal mammary lymph node dissection was done. Noguchi et al (2000) routinely performed biopsy of internal mammary nodes in the first and second intercostal spaces irrespective of the lymphoscintigraphy results and concluded that lymphatic mapping is an insensitive technique for identifying metastases to these nodes. The limited sensitivity in that study may be explained by the low visualisation rate of internal mammary sentinel nodes: 9% vs twice as many as in our study.","title":"Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients"}
{"_id":"0ed448e2-72d9-1cf9-141b-2b9ae4569370","text":"A total of 8 Patients with oropharyngeal head and neck cancer and N0 neck status and where resection of the primary tumor as well as a neck dissection was planned were used to evaluate the use of ICG in the identification of the sentinel lymph node. Only unilateral elective neck dissections were performed according to the clinical indication. In no way was the treatment of the patients altered or influenced by the additional use of ICG or sentinel node detection. Patient's informed consent was obtained before surgery.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"0ed889e6-8efb-6707-4930-51f59b97f4f2","text":"To our knowledge, there have been no reports so far on using virtual reality for lesions in the sellar area. Therefore, the aim of this study was to investigate the value of using virtual reality for surgery to resect sellar tumors.","title":"Stereoscopic virtual reality models for planning tumor resection in the sellar region"}
{"_id":"0edd704f-c5f0-a649-66b8-87f77bdb86bf","text":"The purpose of the study was therefore to determine the prevalence of DVT among postoperative patients at Mulago Uganda’s National Referral Hospital.","title":"Deep venous thrombosis after major abdominal surgery in a Ugandan hospital: a prospective study"}
{"_id":"0ee4a545-9592-7750-2b42-3c42f2a2f07c","text":"Hypospermia has also been reported by Auger et al. (2016) and it can be explained because semen volume depends on mechanisms that are influenced by the level of excitement during semen collection and the psychological condition of cancer patients can influence it.","title":"Semen quality before cryopreservation and after thawing in 543 patients with testicular cancer"}
{"_id":"0ee4c235-cc8b-21a7-9eed-e626f79229bf","text":"Bone edema was assessed either as an isolated condition or as a condition defined by gradually blurring edges that surrounded the erosion with a high signal intensity at the T2W STIR MRI sequence.","title":"Low-Frequency Magnetic Resonance Imaging Identifies Hand Joint Subclinical Inflammation in Systemic Sclerosis"}
{"_id":"0ee7c778-b8f1-cd5f-8495-1e37e4563621","text":"In all cases, preoperative lymphoscintigraphy and intraoperative gamma probe were used to detect and spare the sentinel nodes of the lower extremities. The flap harvest was performed after intradermal injections of Patent Blu to allow easier identification of lymph nodes and lymphatic collectors, without interfering with the evaluation of flap viability by fluorescence angiography. When the LNF was harvested independently of the DIEP flap, perforators to the overlying skin were included to allow the transfer of a monitor skin paddle. The recipient site was the axilla in all cases, associated with an extensive scar release to create space, decompress the vascular structures and identify the recipient vessels.","title":"Lymphatic Tissue Transfer: Ultrasound-Guided Description and Preoperative Planning of Vascularised Lymph Nodes, Lymphatic Units, and Lymphatic Vessels Transfers †"}
{"_id":"0eed6305-f329-f56e-ee41-ad43eb8fc534","text":"Wound covering for burns can be done with temporary bioactive skin substitutes.","title":"Surgical management of extensive burns treatment using allografts"}
{"_id":"0ef126fe-7386-aecc-bb6d-be09129f6625","text":"This study aimed to determine the proportion of individuals informed about the adverse effects of dermal fillers in the clinic before treatment and assess public knowledge about the associated risks. Using a Google survey, we aimed to investigate people’s knowledge of dermal fillers and assess how trustworthy the sources of information are that led to their awareness of its detrimental effects, as well as to evaluate physicians’ participation in changing people’s perceptions about soft tissue fillers and their harmful effects. Social media have increasingly replaced other information sources for individuals seeking guidance, specifically regarding their health. The study also aims to examine the reliability and integrity of social media in terms of dermal fillers and their adverse consequences, as well as physician-patient communication and whether the adverse effects and problems were disclosed to patients before treatment.","title":"Awareness and Knowledge of the Adverse Effects of Dermal Fillers Among the Saudi Population: A Cross-Sectional Study"}
{"_id":"0ef38788-5980-58fe-ad12-f297d54ff3d3","text":"PMs for breast cancer patients were performed by one experienced and qualified surgeon. PM consisted of excision of the tumour and the surrounding tissue at least 1 cm away from the tumour, extending from the subcutis to the pectoral fascia. We did not perform cavity shaving in PM patients in our centre. The decision regarding whether to pursue further surgical intervention for positive margins was left solely to the initial surgeon's discretion.","title":"Low rate of positive margins and re-excision after partial mastectomy in highly selected breast cancer patients: A Chinese single-institution experience"}
{"_id":"0ef4719c-eadb-4944-8150-080050878a63","text":"Sentinel lymph node biopsy is becoming more common in Melanoma and Breast cancer. History taking and examination should include presence, site, age and colour of decorative tattoos especially in the drainage areas to the axilla. History of removal of tattoos is also important as nodes may persist for several years. Raising awareness of this problem among surgeons and pathologists treating malignant melanoma is important. Investigation of axillary Lymphadenopathy should include tattoos in the drainage areas as a probable cause.","title":"Tattoo pigment in an axillary lymph node simulating metastatic malignant melanoma"}
{"_id":"0ef5d2b9-81b3-775f-8eb5-dba6ed2fd01b","text":"Patients with gastrointestinal food allergy are characterised by increased production of mast cell derived mediators upon allergen contact and present often with unspecific symptoms. The aim of this study was to evaluate urinary histamine and methylhistamine excretion in patients with food allergy and to compare their values with food-tolerant controls.","title":"Excretion of urinary histamine and N-tele methylhistamine in patients with gastrointestinal food allergy compared to non-allergic controls during an unrestricted diet and a hypoallergenic diet"}
{"_id":"0efc0e16-a0f2-e929-320d-ea0197ba6c30","text":"In conclusion, Botulinum A toxin shows a protective effect against IRI in musculocutaneous flaps. Tissue MPO levels at 24 h suggest that ischemic preconditioning and Botulinum A toxin injection have equal protective effect, whereas Botulinum A toxin injection is superior to ischemic preconditioning at day 10. However, tissue NO levels indicate that ischemic preconditioning offers superior protection against IRI at both 24 h and 10 days.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"0efddb52-fa57-16c9-8db6-f72c5f118517","text":"With the advance of knowledge regarding the vascular anatomy of pedicled perforators in the face, several very useful perforator flaps have been developed. These flaps can improve functional and aesthetic reconstruction for the face.","title":"Freestyle Local Perforator Flaps for Facial Reconstruction"}
{"_id":"0f06e0c0-4613-3956-65d2-7ad005247e2c","text":"Many studies highlight the need for preoperative angiography of the lower extremities before harvesting fibula free flap to identify possible congenital abnormalities or peripheral vascular disease that might pose danger to the vascularity of the lower extremities [23,24]. Angiography of the lower extremities in one female patient of our case series revealed lack of patency of the peroneal artery in both of her legs and she was excluded as candidate for fibula free flap harvest. The results of this study and others highlight the importance of preoperative imaging prior to fibular flap transfer to identify both acquired and congenital abnormalities in order to decrease the risk of vascular compromise to the lower extremity.","title":"The Value of Three-Dimensional Modeling on Repositioning and Soft Tissue Filling in Microsurgical Reconstruction of Secondary Mandibular Defects: A Retrospective Study"}
{"_id":"0f07c491-e951-8a91-935d-cd059ef386ea","text":"While none of the approaches discussed above have specifically demonstrated an improvement in wound healing, they present an attractive approach for exogenously shaping the inflammatory response. However, with that being said there is still much to understand regarding how to optimally manipulate the response. Both M1-like and M2-like macrophages have shown positive and negative impacts on wound healing, and their role and influence depend on when they are present during the process of repair;87 elucidating these complex interactions is therefore a pressing need. It will then be possible to combine these insights with an understanding of how macrophages respond to different wound matrices,88 in turn using synergistic insights to design biomaterials that steer wound repair towards regeneration.","title":"Using biomaterials to rewire the process of wound repair"}
{"_id":"0f0d8820-088c-c910-1b1b-e3a4ca97bbcb","text":"It is important to state that all six of these patients went on to have good outcomes and as of July 2017, none of these cases have had recurrence of osteomyelitis. Three of the cases required removal of metal work and one required a revision of a custom made endoprosthesis. These late procedures were all anticipated and other than that, there were no further operations after discharge in the six patients.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"0f0e4429-f54a-74ab-c913-4c30e24e9906","text":"A major difference in our report compared with the study by Weinberg and colleagues is our definition of when RBCs become 'old'. The different methods of defining old RBCs used in various studies have made comparing results problematic. Previous definitions have included mean, median, and maximum RBC storage age in addition to the number of RBCs transfused above 14 and 21 days of age [25–27, 32, 41]. The change from the use of non-prestorage leukocyte reduced RBCs to the transfusion of prestorage leukocyte reduced RBCs has also made it difficult to determine the optimal definition of old RBCs. Independent associations with the amount of non-prestorage leukocyte reduced RBCs more than 14 and 21 days old have been reported with sepsis [27]. The mean RBC storage age and the amount of non-prestorage leukocyte reduced RBCs of more than 14 and 21 days old have also been associated with increased MOF [26]. Optimally when comparing the effect of RBC storage age on outcomes the definition of fresh and old RBCs should not allow for mixing of RBC storage age between groups as was done in the study by Koch and colleagues [41]. In this study of more than 6000 patients, the fresh RBC group was defined as those who were only transfused RBCs of 14 days of storage or less and the old RBC group received only RBCs of greater than 14 days of storage. In smaller retrospective studies that are not large enough to have complete separation of fresh and old RBCs, it is more appropriate to use the maximum RBC age transfused than mean RBC age to define if the patient received fresh or old blood. This is because the adverse effects of RBCs have been measured with relatively small amounts transfused [10, 32, 41]. When mean RBC age is used to define patients who received fresh or old RBCs this method allows for the youngest RBCs to balance out or negate the contribution of storage age from the oldest unit transfused. For example a patient who receives 2 units at 40 days old and 8 units at 10 days old will have a mean of 16 days whereas for a patient who receives 10 units at 16 days of storage the mean will be 16 days. The patient transfused 2 units at 40 days would theoretically be at increased risk but using the mean RBC age to define fresh vs old RBC patient groups does not identify this difference whereas using maximum RBC age does.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"0f13588b-6190-5213-7684-f1448b0344d6","text":"However, these developments in flaps and scalp have lagged behind the advances in graft techniques and the era of alopecia reduction seems to have passed. It remains to be seen whether surgeons of the future, using improved techniques and better case selection will be able to stimulate a new era of alopecia reduction.","title":"A Review of Modern Surgical Hair Restoration Techniques"}
{"_id":"0f16b8ab-7b26-02f4-8bdb-34823e342a8b","text":"In cases of extensive tissue loss, either due to trauma or surgical intervention, primary closure of the wound is often unsuccessful. In open wounds, the defect is gradually filled by granulation tissue growing in from the wound margins and surface. Epidermal cells eventually spread from the wound edges to cover the granulation tissue and form scar tissue. Wounds left to heal by secondary intention require regular and intensive wound care measures. The degree scar contraction as well as adhesion to underlying structures is much higher than in wounds treated by primary intention.","title":"Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View"}
{"_id":"0f189245-c069-0699-011d-cb200e6bf790","text":"When the patient arrives at the CT scanner she is placed supine in a halfbody Vac‐Lok bag (Med‐Tec, Orange City, IO) on the scanner table. The patient is then positioned with both arms up and the scanner couch is driven through the scanner aperture to determine if the patient will collide with the CT scanner aperture. If the patient does not clear the scanner aperture we adjust the arm position so that the patient will clear the scanner aperture. If the arm position has been adjusted as much as possible and the patient still does not clear the scanner aperture, then the patient is scheduled for a regular simulation. If the patient clears the scanner aperture without problems we proceed with making the custom mold.","title":"On the use of virtual simulation in radiotherapy of the intact breast"}
{"_id":"0f26fcd8-cb5b-5677-ff7c-fb40828f2477","text":"Following surgery pressure dressing was applied over donor site for 5 days and antibiotic therapy was recommended for 5 days.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"0f290b81-edb5-222e-e321-8d08c82cab3d","text":"Despite the increase in number of postoperative breast MRI, there are few studies on imaging characteristics of recurrent breast cancer on MRI. Moreover, there have been no studies to the usefulness of postoperative MRIs according to the time of recurrence of disease in our knowledge. Thus, we investigated the usefulness of postoperative breast MRI focusing on the time interval of cancer recurrence and compared the detectability and imaging characteristics of recurrent lesion on MRI with conventional imaging modalities including mammography and ultrasound at the time of recurrence.","title":"Usefulness of postoperative surveillance MR for women after breast-conservation therapy: Focusing on MR features of early and late recurrent breast cancer"}
{"_id":"0f2e32e4-453c-2745-49f8-05bf63449eb6","text":"Desmoids are rare fibroblastic tumours whose treatment in any individual case presents a persistent challenge. We endeavoured to evaluate various clinicopathological factors contributing to tumour behaviour.","title":"Evaluation of outcomes in the management of primary sporadic desmoid-type fibromatosis at a specialist soft tissue sarcoma unit"}
{"_id":"0f38cd9e-70f7-22f4-3e89-4c1fba6ffe60","text":"This study demonstrates that VAC combined with a CSIS is a safe, reliable, and effective method to treat a wound infection after spinal surgery. This improved VAC procedure provides an excellent wound bed to facilitate wound healing and shorten the hospital stay.","title":"Vacuum-assisted closure combined with a closed suction irrigation system for treating postoperative wound infections following posterior spinal internal fixation"}
{"_id":"0f3b7234-db47-7b72-0f20-3e2b0f24168c","text":"The modified cytokine profiles suggested an age-related shift from a Th1 to Th2 response. Th2 cells are effective activators of B cells and trigger IgE responses. Since boiled shrimp or shrimp derivatives are considered a delicacy in Taiwan, the continually boosted B cells along with accidental ingestion of shrimp derivatives in adults and elderly might be the reason for a higher shrimp sIgE in the elderly population as compared to the adolescent group.","title":"Cross-reactivity of sIgE to mite and shrimp induced allergies in different age groups and clinical profiles of shrimp sIgE in vegetarians"}
{"_id":"0f3c3d2a-9645-ab36-b950-d99b536508ba","text":"Endoscopic endoresection was a useful method of exploring the ciliary body accurately. This is a new application and was successfully used here. The consistency of the tumor after brachytherapy is higher and bleeding is low, which helps us to perform the endoresection with good visualization. We used 20 g because of its greater consistency and because it was previously irradiated. In our view, it can provide a useful alternative in patients where exoresection can be ruled out because of the large number of medical appointments required in the immediate postoperative period. In exoresections, performing a complete posterior pars plana vitrectomy or not it depends on the size of the ciliary body tumor.","title":"Clinical Outcomes after Surgical Resection Combined with Brachytherapy for Uveal Melanomas"}
{"_id":"0f5e234a-08e4-3e6c-783e-481b7275422f","text":"Our study is unique in that it utilizes a smaller, portable, single-use negative pressure device which facilitates early mobilization of the patients’ arm and their overall mobility with no large restrictive vacuum devices. Additionally, we have identified a patient-centered, clinically important difference in hand function during the first postoperative week. The NPD allows patients to be more actively involved in their self-care and facilitates improved communication with retained hand and wrist function. Considering as well, the impact of additional shoulder immobility secondary to spinal accessory nerve injury or neuropraxia as a sequela of neck dissection; the impact of retained hand function could be even more profound and important to help patients manage their own care and recover more quickly. The differences in overall hand function are quite striking at one week postoperatively; and it is possible that this may play a role in earlier involvement in self-care and more rapid discharges from hospital. None of these effects persist beyond the one week follow up and are not likely to impact patients as they continue to recover at home. It is possible that certain patients at higher risk of wound healing complications may benefit most from NPD. The relatively small sample size included in our study did not allow for subgroup analyses examining the impact of specific comorbidities on wound healing complications.","title":"Donor site morbidity following radial forearm free flap reconstruction with split thickness skin grafts using negative pressure wound therapy"}
{"_id":"0f6396a9-74a8-3db9-0d07-33ce461292b9","text":"In our study we found no incidence of skin atrophy, telangiectasia or red spots in the patients’ facial and periorbital skin. There was just one incidence of dermatitis in nasal and facial skin areas that were in contact with adhesive tape that was completely resolved in second post surgical visit after giving up using adhesive tapes. This issue suggests that the incidence of dermatitis was probably caused by sensitivity to adhesive tape.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"0f6d7973-41d5-46e9-662b-dfd3b4b3d073","text":"We have preserved the nerve in all cases in this series aiming to minimize a substantial loss in the volume of the muscle due to its denervation. Only one patient was noted to complain of these involuntary muscle twitches but this also improved spontaneously with time.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"0f76dd72-2eb3-f4a6-157f-49a5db2d5048","text":"BTX-induced muscle atrophy and paralysis could represent one of the most commonly explored animal models that can be used in the bone metabolism research. Several animal studies have attempted to show that muscle paralysis by intramuscular injection of BTX in the hindlimbs and masticatory muscle atrophy induced by BTX injection could produce bone loss. Interestingly, one animal study using rodents showed that bone loss induced by intramuscular BTX injection seemed to be not solely the result of reduced mechanical loading, but bone loss could be directly affected by atrophic muscle itself. The majorities of studies which tried to identify the mechanism of bone-muscle interactions using intramuscular BTX injection were performed on animal, and only a few human studies have been carried out to elucidate this phenomenon.","title":"Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults"}
{"_id":"0f799ba5-71e0-4c79-7049-4b691d034ba5","text":"Hybrid external fixation is a good method for the treatment of comminuted tibial plateau fractures. It allows for early joint movement and reduces the risk of serious complications.","title":"Complex Tibial Plateau Fractures: Primary Fixation Using the Ilizarov External Fixator. A Two-year Study at Civil Hospital Karachi, Pakistan"}
{"_id":"0f7a3622-e144-5ed2-26c0-5efb94741809","text":"Other common subtypes of rash include lichenoid eruption and prurigo nodularis.","title":"Cutaneous Side Effects of Targeted Therapy and Immunotherapy for Advanced Melanoma"}
{"_id":"0f8a833d-5cd3-2f67-18c5-47b345610ec5","text":"Monthly journal clubs are the norm for the majority of postgraduate training programs.422 More frequent meetings may be difficult, especially if residents are expected to review numerous papers for each club or if a detailed critical appraisal is required.","title":"Planning and executing orthopedic journal clubs"}
{"_id":"0f9f635e-f4d2-c691-0699-0e308ac62c24","text":"A strategy for management of axillary clearance is proposed in Table 3","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"0fa936d0-80c2-dce2-bf9f-2d7d0ed9405d","text":"Diagnostically, ultrasound imaging has proven to be useful in reconstructive surgery for identification of perforators for a variety of flaps,3–10 including the anterolateral thigh flap,3–5 and the deep inferior epigastric perforator flap.6,7 Visconti et al.11 routinely use color Doppler ultrasound when planning lymphaticovenular anastomoses.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"0fb08b8e-915e-495c-d40d-a763a9e4edce","text":"A standard postoperative rehabilitation protocol was followed regardless of the fixation technique performed. All patients were non-weight bearing for at least 8 weeks after surgery. When radiographic and clinical healing appeared to be progressing toward union, weight bearing was advanced slowly from toe touch to partial weight bearing as tolerated over the subsequent 6 weeks, at the discretion of the treating surgeon.","title":"Decreased complications but a distinctive fixation loosening mechanism of fully threaded headless cannulated screw fixation for femoral neck fractures in young adults"}
{"_id":"0fb6df9c-9fb9-7232-ef8d-e161d9c83404","text":"The changes in PPD reflect the cumulative effect of the response of gingival tissue to the treatment by way of gingival recession and clinical attachment gain. PPD indicates the volume of subgingival area, which harbours the pathogenic microbiota and favors disease activity. Change in CAL following regenerative therapy is the single most commonly used outcome measure in regenerative therapy. This is based on reported correlation between gain in CAL and gain in bone height by various clinical studies [19]. The results of our study showed a CAL gain both in group A and B which was statistically significant. This is in accordance with the study where they concluded that both scaling and root planing alone and scaling and root planing combined with flap procedure are effective methods for the treatment of chronic periodontitis in terms of attachment level gain and reduction ingingival inflammation [20].","title":"Effectiveness of Platelet Rich Plasma and Bone Graft in the Treatment of Intrabony Defects: A Clinico-radiographic Study"}
{"_id":"0fb8d33b-936b-ff64-83d1-acce1703027e","text":"A noninferiority approach is justified because the use of shorter courses of treatment would benefit patients by reducing the selective pressure of broad-spectrum antibiotics commonly used in these infections. A superiority trial could be done by using a composite primary outcome including for example colonization and\/or superinfection by multidrug-resistant bacteria or severe adverse effects, but it would need a very high sample size that would make it unfeasible.","title":"Efficacy and safety of different antimicrobial DURATions for the treatment of Infections associated with Osteosynthesis Material implanted after long bone fractures (DURATIOM): Protocol for a randomized, pragmatic trial"}
{"_id":"0fbd02d9-6784-d647-fa19-674004ae0c93","text":"Squamous cell carcinomas on the skin of the hand are one of the more commonly encountered malignancies presenting unique clinical challenges. It is imperative that orthopaedic surgeons are familiar with this cutaneous malignancy due to the multidisciplinary approach required for optimal patient outcomes. A high index of suspicion should be utilized as presentation is variable and these lesions may appear inconspicuous and subsequently be misdiagnosed.","title":"Ray Resection for Recurrent Invasive Squamous Cell Carcinoma: A Case Report"}
{"_id":"0fc777a4-eb8a-a72e-941c-dedaf5033cb0","text":"As with other flaps of the head and neck, the fatty part within the reconstructions is likely to atrophy. The fatty part is visualized hypointense in postoperative CT scan and with the fat suppression technique in postoperative MRI. This atrophy is all the more important as postoperative radiotherapy is routinely performed for sinonasal carcinomas. Although flap fibrosis is a functional disadvantage in the context of extensive reconstruction, it is also the desired objective in the case of CSF leak repair.","title":"Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know"}
{"_id":"0fca2094-62b1-09f5-84df-dc5cbdf08480","text":"The composite (osteocutaneous) submental island flap has unique applications for reconstructing complex defects involving the upper facial skeleton. This flap can be used in patients requiring adjuvant radiation, and in those who have received prior radiotherapy and require salvage surgery. Caution should be used in patients who require more than one course of radiation to the same area. Further research is required to validate the effectiveness of the composite SIF in large patient cohorts.","title":"Composite submental flaps in facial reconstructive surgery involving the zygoma and orbit"}
{"_id":"0feb5b07-5342-317b-a092-99abf8db0518","text":"At present, surgical procedure based on autologous costal cartilage carving and transplantation remains the major treatment of total ear reconstruction. During the past decades, a variety of research and progress has been made in the field of auricular cartilage tissue engineering. The application of 3D printing and tissue engineering in medicine holds great promise for future innovation and more consistent results for microtia patients. The 3D printing approach can shorten operation time, avoid morbidity at the donor region, produce repeatable outcomes and reduce rejection rates compared to autologous costal cartilage transplantation. However, the prohibitive cost, limited application of printers and clinical translation obstacles are still confronted challenges before these potentially revolutionary choices become available to patients.","title":"The application and progress of tissue engineering and biomaterial scaffolds for total auricular reconstruction in microtia 10.3389\/fbioe.2023.1089031"}
{"_id":"0fecd2cb-ca72-e0f2-a590-c6d6b2a9370f","text":"Breast feeding has long term effects on the developing immune system which outlive passive immunization of the neonate. We have investigated the transfer of milk immune cells and examined the result of transfer once the recipients were adult.","title":"Trans-Epithelial Immune Cell Transfer during Suckling Modulates Delayed-Type Hypersensitivity in Recipients as a Function of Gender"}
{"_id":"0fefe9f4-7fb7-812f-7522-9445aba3589e","text":"This initiative coincides with a new era for the FDSRCS and Royal College of Surgeons of England and combined with the British Dental Journal, we hope that this series will be enjoyed by all members of the oral healthcare team.","title":"Faculty clinical articles: a regular update for the oral healthcare team"}
{"_id":"0ff73022-3585-8e3d-48a8-c4a7686f1777","text":"We conclude that the evaluation and management of foreign body granulomas secondary to dermal fillers include a proper history, recognition of the substance, and imaging and\/or tissue diagnosis if necessary to rule out any other sinister underlying condition in patients presenting with new orbital masses. Our case was uncommon, as it was inside the orbit, demonstrating that migrated fillers can cross the orbital septum. Most orbital granulomas secondary to fillers can be treated with injected hyaluronidase. However, our patient underwent transconjunctival orbitotomy for tissue diagnosis due to the location in the inferior orbit. Patients should be given information on the type of filler injected and counseled to seek evaluation to perform an appropriate treatment if a complication arises.","title":"A Case of Orbital Granuloma Secondary to Dermal Filler Injection"}
{"_id":"0ff94872-2e90-1f2f-0029-767caa4364c5","text":"This study had a few limitations. As we only researched the correlation between CAQ hand qualification status and DRF management, we cannot conclude to what extent current algorithms to standardize DRFs have affected modern surgeons. However, since our study still finds differences in treatment preferences between surgeons of different experience and training levels, our results elucidate that either of these methods is being underutilized or there are structural problems with them. Additional experiments could be done comparing algorithmic management of DRFs with subcategories for physician subjects based on levels of training. Moreover, our study evaluated physician experience discretely, with surgeons classified by practicing either shorter or longer than 10 years or treating either more or less than 100 DRFs per year. Future studies could analyze these data using continuous measurements so as to further represent how surgical experience affects DRF management.","title":"Distal Radius Fracture Management: Surgeon Factors Markedly Influence Decision Making"}
{"_id":"0ff9c3f6-f942-b612-acbe-8322d2c3fbfe","text":"The animal models described in Table 1 have been optimized to be reproducible when sufficient CFU count has been used in inoculation. Early studies by Guiboux et al and Fraser et al described rabbit and sheep spinal infection models and highlighted the efficacy of prophylactic antibiotics. , Results from these studies are inconsistent with reports from clinical studies as some patients will develop postoperative infection despite the administration of prophylactic antibiotics. These findings are of course confounded by the increased susceptibility some clinical patients will have to postoperative infection such as primary immunodeficiency, underlying comorbidities such as diabetes and other risk factors as discussed previously. These models may be further optimized to include longer time points, and higher inoculation doses to readily detect subsequent infection comparable to clinical patients.","title":"Preclinical models of vertebral osteomyelitis and associated infections: Current models and recommendations for study design"}
{"_id":"0ffe757d-3a4d-85cf-4e6c-4aee6e0a75a3","text":"Understanding the mechanism causing the distal tibia fracture is of major importance in order to choose the optimal method of treatment. The differences regarding the treatment principles between fractures caused by axial compression and those caused by torsional forces, render these two types of fractures totally different to each other, despite of the fact that they are sited at the same anatomic region.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"100395f4-fbec-ff02-8ec3-762b881978a0","text":"In addition, the posterior pudendal vessels and nerves in this flap provide excellent blood supply and sensation. Therefore, reconstruction using a neurovascular pedicled pudendal thigh flap is more advantageous than other surgical approaches for repairing large labial defects due to EMPD.","title":"Reconstruction of the labia majora using a neurovascular pedicled pudendal thigh flap after extensive vulvectomy for primary extramammary Paget's disease: A case report"}
{"_id":"1009906c-0ee3-c448-32c5-32d79d1e3cee","text":"We used the same technique as used for standard inguinal lymph node dissection.","title":"Video Endoscopic Inguinal Lymphadenectomy (VEIL) -a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma"}
{"_id":"100b19bc-33ca-3cf9-3e2c-008e0db09f16","text":"Trauma to the extremities often results in complex soft tissue defects requiring microsurgical reconstruction. The gracilis muscle is an infrequent choice for large soft tissue defects due to its diminutive size, but it can cover significantly large areas when its epimysium is cut and the muscle is “spread out.” The muscle has traditionally been used for functional transfers, small soft tissue defects like in the breast or the orbit, and coverage of exposed or osteomyelitic bone. It can also be split longitudinally according to the fascicular distribution of its nerve to suit the peculiar needs of a particular functional defect. It has an added advantage in that it is a Class II muscle with many secondary pedicles. These pedicles can each support a segment of the muscle, and one muscle may therefore yield multiple small flaps when split transversely. These split muscle flaps are of reliable vascularity with the added advantages of a single donor area.","title":"The transversely split gracilis twin free flaps"}
{"_id":"100e7bae-2d03-ab79-6452-c789bf5a758a","text":"Our investigation shows that these predictive factors are not clinically useful indicators for prognostic evaluation of patients with cutaneous melanomas.","title":"Lymphangiogenesis and Its Correlation with the VEGF Expression and the Sentinel Lymph Node in Cutaneous Melanomas"}
{"_id":"100f3aa0-fc10-df7a-e7b7-6d3d5d26a2b9","text":"Patients with tissue loss from diabetic neuropathy and PAD who may benefit from flap reconstructions must undergo thorough vascular assessment as part of preoperative planning to avoid inadvertent compromise of lower extremity angiosomes. The complications sustained by this patient should be taken into consideration for others with similar anatomy and comorbidities, as the factors that necessitate lower extremity flap reconstruction are the same that complicate its use.","title":"Steal syndrome from a superficial circumflex iliac perforator artery flap in a patient with a hypoplastic posterior tibial artery and severe diabetic peripheral artery disease"}
{"_id":"10104f30-0482-ab72-b733-2d761c3345ad","text":"Our study has several implications for hospitals looking to increase surgical service line volume from neurosurgery or other subspecialty practices. First, adequate OR and clinic time must be allocated, with resources provided for efficient care. If the surgeon needs to evaluate a new patient between cases, the OR manager should focus on increasing the surgeon’s overall productivity rather than fixating on daily operational objectives. Such a perspective will also increase the overall productivity of the OR. Second, there needs to be flexibility in new patient appointment scheduling. Rigid systems requiring that patients go through central scheduling are not conducive to expeditious access, especially when all immediate appointments are booked or the surgeon is not scheduled for the clinic on a particular day but nonetheless is available to see new patients [30]. Marketing efforts to promote the surgeon’s practice largely should be focused within the distance that patients are willing to travel for care and should concentrate primarily on the expertise and outcomes of the surgeon, not on general attributes of the hospital.","title":"Building a Brain Tumor Practice: Objective Analysis of Referral Patterns and Implications for the Growth of a Subspecialty Surgical Program"}
{"_id":"101878f2-fdfd-3de2-d819-60e7f4a82d8d","text":"We analyzed 387 patients who underwent implant-based breast reconstruction during the period from 2004 to 2017 in Hiroshima City Hospital. We retrospectively examined the risk factors for local recurrence and the outcomes of patients developing such recurrence after implant-based breast reconstruction.","title":"Risk factors of local recurrence following implant-based breast reconstruction in breast cancer patients"}
{"_id":"102392cd-2bce-5565-a94f-5af6dfe8f9e6","text":"Participants were asked if they had a personal or family history of skin cancer. Participants who had a positive family history of skin cancer scored significantly higher on the photo survey than those without a family history, but surprisingly, there was no significant difference in score between participants with and without a personal history of skin cancer. It may seem logical that if a patient had previously been diagnosed and treated for a skin cancer, he or she would be more knowledgeable about recognizing its appearance. Interestingly, this was not the case based on our data. This is a concerning finding, given that people who have a history of prior melanoma or nonmelanoma skin cancer are at substantially increased risk of developing another skin cancer. Of note, increasing subject age was correlated with lower knowledge scores. These points support the suggestion that when possible, dermatologists should take the time to review the characteristics of suspicious lesions with patients so that patients may know when to seek medical attention for a new or changing lesion.","title":"Assessing individual patients’ knowledge of benign versus malignant skin lesions in the dermatology clinic population"}
{"_id":"102c2732-07a6-6cf4-dcbc-6b515b864a6c","text":"We have emphasized the use of a cadaveric model for developing new and innovative methodology to implant very small electrodes more efficiently within a nerve by dissecting fascicles and implanting the electrodes into each one individually. Inter-fascicular implantation for electrostimulation could have better results than having them implanted randomly through different numbers of fascicles.[ The microsurgery technique could be practiced on cadaver models and detailed operating protocols could be established before beginning with a first patient. As a new microsurgical technique was to be introduced, cadaveric models were once again positioned with a high value and thus we enter into a new scenario of “the return of the cadaver” to emphasize perhaps their importance for routine teaching again.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"103ca873-c223-a6e2-648e-de7fa5b0d3f6","text":"The purpose of this study was to evaluate the efficacy of arthroscopic knee cavity internal drainage and cyst cavity debridement operation of popliteal cyst in knee osteoarthritis patients.","title":"Arthroscopic internal drainage and cystectomy of popliteal cyst in knee osteoarthritis"}
{"_id":"103ed1da-fe27-03cb-060b-c43631fa9bba","text":"This study will prospectively recruit adults into the following two cohorts: diagnostic accuracy and margin delineation. The diagnostic accuracy cohort will assess people with clinically suspicious lesions suspected of being diagnosed with melanoma and having an equivocal finding on dermoscopy or persistent clinical suspicion despite normal dermoscopy. Diagnostic accuracy will include the sensitivity and specificity of VivaScope in comparison with the histological diagnosis as the gold standard for patients. The margin delineation cohort will assess the ability of VivaScope to accurately delineate the margins of lentigo maligna compared with that of dermoscopy alone using margins taken during Mohs micrographic surgery as the gold standard. The primary study outcomes will be the diagnostic accuracy of VivaScope for the first cohort of patients and margin agreement between VivaScope and the final pathology report for the second cohort of patients.","title":"Evaluating the Diagnostic Accuracy of Reflectance Confocal Microscopy to Diagnose Skin Cancer: Protocol for a Prospective, Multicenter Study"}
{"_id":"103f1dab-a1e1-8a2f-0767-211895e120be","text":"Figure 5 shows the absolute conversion of DCT for two different sonograms that one of them is nevus and the other has BCC. Based on the analysis carried out on the collected data, it is found that the frequency domain in the cosine transmission of malignant ultrasonography tissue is lower than that of benign and healthy tissues. This is a great way to find the lesions or infected parts of skin in the image. By measuring the amplitude and frequency, the size of the affected parts can also be calculated.","title":"Early diagnosis of skin cancer by ultrasound frequency analysis"}
{"_id":"1042b5d9-cd46-81df-9de9-2918a37a6336","text":"Since no direct studies have investigated the additional reduction in sensory morbidity that LS images and TBM may provide during SLNB, an indirect assessment of this potential was performed by extracting sensory morbidity data on SLNB from studies comparing the morbidity of SLNB to that of ALND [1-20] as described below.","title":"Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature"}
{"_id":"1044be44-cd59-8516-328f-2d5a4203d88b","text":"Despite the number of surgical advances and innovations in techniques over time, radical vulvectomy frequently results in substantial loss of tissue that cannot be primarily closed without tension, the mobilization of surrounding tissues or even the rotation of myocutaneous flaps. The aim of this study was to evaluate the feasibility of leaving the surgical vulvar open wound for secondary healing in situations where primary closure of the vulvar wound is not possible.","title":"Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control study"}
{"_id":"104b5425-98cd-58f4-b5c2-346cc860d778","text":"The condition that indicates an immediate repair is the incompatibility of the wounds with life or with a reasonable postop recovery, in that case the reconstruction would be mandatory.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"106c20d4-8a69-509a-44ab-bb72522e689a","text":"Many of the patients came to their treatment with surgery plus radiotherapy after having received other prior unimodal treatments such as corticosteroids and surgery without success. The wide variety of treatments that are applied to keloids can be attributed, among other things, to the fact that most of the published evidence on the management of this disease is composed of institutional reports whose results are difficult to compare and interpret. Our proposal, faced with the lack of a randomised prospective study which compares surgery only with surgery plus radiotherapy, is to base our new recommendations on the prospective studies which will explicitly define the event ‘recurrence’ as the primary objective.","title":"Postoperative radiotherapy in the management of keloids"}
{"_id":"106d0d6a-dfcc-4b14-7961-4fb196e7d546","text":"As perfusion assessment technologies and microsurgical techniques have evolved, plastic surgeons have become increasingly aggressive and creative in offering reconstructive solutions to limb salvage problems. In the distal lower extremity, pedicled perforator flap transfer has grown in popularity as compared to the historically reliable option of free tissue transfer. Pedicled perforator flaps typically avoid muscle harvest and restore the thin, supple soft tissue in the distal extremity, where there is a relative lack of redundancy of soft tissues. They also allow for a shorter operative time and recovery in otherwise complex wounds of the foot and ankle. This case report highlights the indications, nuance, and post-operative course of a patient who underwent peroneal perforator flap for coverage of a complex ankle wound in the setting of a calcaneal fracture.","title":"A Propeller Perforator Flap in the Distal Lower Extremity: An Alternative to Free Flap Coverage Near the Ankle"}
{"_id":"106e1602-e948-38c1-e32a-afcdbe084fba","text":"Patients with a history of RIVDU who suffer from bone or joint infections have not been given adequate attention in the orthopaedic or infectious disease literature. More research is needed to determine how this patient population can achieve equivalent clinical outcomes while still discharging from the hospital in a timely manner. Future efforts should be aimed at designing a prospective study comparing the outcomes of RIVDU patients in different treatment scenarios. This would require active participation of orthopaedic surgeons, infectious disease specialists, home health care, and skilled nursing facilities.","title":"Outcomes of Orthopaedic Infections in Recreational Intravenous Drug Users Requiring Long-term Antibiotic Treatment"}
{"_id":"107067c3-8c51-6028-8e45-6dcdd088e9f3","text":"It was found from Figure 2 that the body-weight gain trend of the SP group was slower than that of the C group. The trend of body weight gain in the Lp and Ld groups was similar to that in the C group, while the body weight of the La group increased faster than that of the C group from day 7 to day 14. Moreover, as shown in Table 2, all mice in the experimental groups, except for the blank control group, showed allergic symptoms with different degrees after challenge. The mice of the SP group had allergic symptoms such as scratching the nose or head and accelerated breathing and diarrhea, while only some mice in the Lactobacillus groups had mild symptoms and scratching of the nose.","title":"Effects of Lactobacillus on the Differentiation of Intestinal Mucosa Immune Cells and the Composition of Gut Microbiota in Soybean-Sensitized Mice"}
{"_id":"10750a75-018f-c8a4-7bd7-bf432b887070","text":"Conclusion: Lack of continuous mentoring program and regular practice appear to be the is main obstacles to the widespread use and implementation of POCUS following a 2 day WINFOCUS USLS-BL introductory course in Slovenia.","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"10753441-c3d4-f7a9-7fbe-11fa872066da","text":"The site of fibular osteotomy was determined, leaving at least 6 cm of the fibula distally to maintain ankle stability and 3–4 cm proximally to maintain lateral stability of the knee. Even when only a short segment of bone is needed, it is desirable to remove the whole length of the fibula to facilitate peroneal pedicle dissection.","title":"Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection"}
{"_id":"10754e37-4bf9-8afb-342b-213cbb7379d5","text":"Patients were followed up in an outpatient setting by clinical examination one week postoperatively and then on a six monthly basis for the first three years and every year for the next 5 years. In addition, ultrasound analysis of regional lymph nodes was performed in patients with positive SLN. Tumor progression and survival status were gathered from the hospital clinical files or by writing to family practitioners and the observations were censored on December 31st 2010.","title":"Sentinel lymph node biopsy in melanoma: Our 8-year clinical experience in a single French institute (2002–2009)"}
{"_id":"107ddb77-ab86-1f7b-239e-e137e87da9bb","text":"Reduction of major dorsal hump necessitated the use of spreader grafts, which were harvested from the septal cartilages to prevent narrowing the internal nasal valves. Before harvesting the septal cartilage the caudal septum was shortened in cases of long noses and then the grafts were harvested leaving an L-shaped septum undamaged. This was followed by cephalic trim of alar cartilages and tip sutures or grafts according to the pathology.","title":"Triple Plane Dissection in Open Primary Rhinoplasty in Middle Eastern Noses Elshahat"}
{"_id":"10a018b8-dae1-ad88-c950-f9f332543a36","text":"Mesenteric desmoid tumor is rare and has few symptoms associated with this tumor, thus it is difficult to diagnose these lesions early. In this case identification of a solid mass at the intra-abdominal site after total gastrectomy, possibility of a tumor recurrence was first considered and later was considered as a solitary recurrent lymph node metastasis, the diagnosis of desmoid was never considered. Surgery is the treatment of choice for desmoid tumors.","title":"Mesenteric desmoid tumor of the interposed jejunal pouch after total gastrectomy"}
{"_id":"10a34fa4-c32a-a47f-9cf7-93d7902ee25e","text":"Patients were followed up every 2 months in the first year, every 3 months in the second year and every 4 months thereafter, for a period of 12 months to 60 months.","title":"Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa"}
{"_id":"10a404cb-64a4-aef9-dc79-01ed2310d858","text":"Previous work demonstrated that when reexposed to mouse allergens, ENA individuals have lower but still sizable CD4 T cell reactivity as well as absent polarization compared with an allergy group. Moreover, the protein targets of ENA reactivity are similar to those in symptomatic subjects (14). These observations prompt further investigation on additional differences in immune profiles between ENA and allergic individuals and whether the nonallergic status is a passive consequence or active response to mouse allergens.","title":"B cells modulate mouse allergen-specific T cells in nonallergic laboratory animal-care workers"}
{"_id":"10aedc09-0ebe-9fe5-caa6-e5b9b15bbd47","text":"The main limitations of the present study include its retrospective nature and the small number of patients who had positive SLN. We believe, however, that these limitations did not greatly affect the results of the study as the differences between NSLN positive and negative patients were too marked to have resulted from bias. Our results thus provide useful information on the risk factors for remnant NSLN metastasis under the condition of 1-2 positive SLNs. Prospective studies with larger number of patients are necessary to achieve an explicit standard for SLN-positive patients to avoid ALND, or evaluate appropriate treatment for patients with positive SLNs (1-2). The validation of these predictors in prospective studies may enable approximately half of early breast cancer patients with positive SLN to be staged with SLNB alone while avoiding the morbidity of unnecessary ALND.","title":"Positive non-sentinel axillary lymph nodes in breast cancer with 1-2 sentinel lymph node metastases"}
{"_id":"10b2ee5c-781f-de56-d418-fe6818a15e7a","text":"The treatment strategy of 106 Ru plaque brachytherapy has been established for more than 20 years in our clinic. We recently reviewed our treatments of 106Ru brachytherapy in patients with medium sized uveal melanomas from 2007 to 2015 with emphasis on 5-year outcome and toxicity.","title":"106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma"}
{"_id":"10b62e83-b1ef-9815-af80-c1d738daad3c","text":"Table 1 Main characteristics of the overall population included according to their antimicrobial therapy status","title":"Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units"}
{"_id":"10b662f3-799b-399a-bdcb-c6aa31778bbf","text":"This study examined the precision of a fibula positioning guide in mandibular reconstruction with the fibula graft. We found significant errors between reconstructions performed with or without the positioning guide, in the mean total 3D distance and the vertical error at the mesial point in the anterior fibula segment.","title":"Precision of fibula positioning guide in mandibular reconstruction with a fibula graft"}
{"_id":"10b69ed5-0492-a25b-cf9f-20dd72f22e8b","text":"All the patients including the seven patients who had a clinically palpable neck node at presentation were free of neck disease after radiotherapy and no neck recurrence was observed even until the last follow-up in these patients.","title":"Treatment of Advanced Carcinoma of the Larynx and Hypopharynx with Laser Followed by External Radiotherapy"}
{"_id":"10b8b771-1847-853b-1cf3-eb9849a38642","text":"The fifth sternebra was visualised as a triangular-shaped structure with a hyperechoic surface and acoustic shadow underneath. The pectoralis profunda muscle was visualised as a thick structure ventral and lateral to the sternum, separated from it and from the intercostal muscles by the rectus abdominis muscle, which appeared as a hypoechoic muscle with a thin and hyperechoic parasternal aponeurosis. The external intercostal muscle covers the lateral aspect of the internal intercostal muscle except for its most distal portion close to the sternum, where contacts laterally with the aponeurosis of the rectus abdominis muscle. The internal intercostal muscle extends distally until the lateral aspect of the sternum, appearing as a thick hypoechoic structure with a thin hyperechoic line on its craniomedial margin, corresponding to the internal intercostal membrane. The TTP is the virtual space between the internal intercostal and the TT muscles. This plane contains a variable amount of hyperechoic fat, mainly located adjacent to the lateral aspect of the sternum, and the internal thoracic artery and vein. These vascular structures appear as two rounded anechoic structures adjacent to the lateral aspect of the sternum. The TT muscle is seen as a hypoechoic structure extending immediately lateral to a bright hyperechoic line corresponding to the costal pleura. A small amount of fat was observed between the pleura and the TT muscle close to the sternum. The heart was visualised immediately dorsal to the costal pleura (Figure 2).","title":"Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers"}
{"_id":"10babbbc-a091-b781-6eef-6dfd05f46c9b","text":"The average time taken to commence knee mobilisation was 10.2 weeks. The patients were advised to do isometric quadriceps strengthening exercises during this period. The patients were then started on physiotherapy, emphasising on quadriceps strengthening and knee flexion. The prolonged period of knee immobilisation did not affect the postoperative knee range of movement significantly to deter normal activities. Four patients were able to achieve a knee flexion beyond 90º while the other six patients achieved between 60º and 90º of knee flexion.","title":"Giant Cell Tumour Around Knee Managed by Curettage and Zoledronic Acid with Structural Support by Fibula Cortical Struts"}
{"_id":"10cda95c-fd29-ace8-bd90-1cf06955cee6","text":"In this paper, we discuss a pedicled TRAM flap in which TAP catheters were placed intraoperatively under ultrasound guidance by the regional anesthesiologist in a patient who had a known sensitivity to narcotics. We hypothesize that with ultrasound guidance, TAP catheters could be placed precisely in the correct muscle plane, be used immediately, provide excellent postoperative pain control and reduce postoperative opioid consumption.","title":"Intraoperative Ultrasound-Guided Transversus Abdominis Plane Catheters Placed for Post-operative Analgesia Following Pedicled Transverse Rectus Abdominis Myocutaneous Flap Breast Reconstruction: A Case Report"}
{"_id":"10cf4f7a-5041-7784-137c-df5c3a5f2dee","text":"If you develop a delayed reaction to your Xolair injection (after you leave our facility) please either return to our Center or proceed to the nearest emergency room and then contact us as soon as possible.","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"10d0bd7c-0c1d-6ee6-c8c9-66d58694e247","text":"Blg was only broken down to smaller peptides after gastro-duodenal digestion although a sizeable amount of intact protein still remained. Digestion did not modify the IgE binding capacity of blg except for gastro-duodenal digestion performed in the absence of PC. These results are consistent with the quantity of intact blg remaining in the digesta. Overall both gastric and gastroduodenal digestion enhanced activation of sensitized basophils and proliferation of sensitized lymphocytes by blg. However, there was a tendency towards reduction in mean diameter of SPT following digestion, the PC alone during phase 1 digestion causing a significant increase in mean diameter.","title":"Effect of simulated gastro-duodenal digestion on the allergenic reactivity of beta-lactoglobulin"}
{"_id":"10d5161b-8f18-4599-44ab-db554b632d5f","text":"Now by including the rates of bone formation per cell in the integrations, we can also calculate the total volume of bone formed by osteoblasts at some time t over the length of the closing cone, viz,","title":"Bone Balance within a Cortical BMU: Local Controls of Bone Resorption and Formation"}
{"_id":"10dcad78-7f1d-fdc2-cc83-391527b7b5ea","text":"Some limitations remain in the utilization of the deltoid branch of the thoracoacromial vein. First, size variation and possible tortuous route of the deltoid branch of the thoracoacromial vein is a major concern for catheter implantation. This could be overcome with the assistance of an endovascular device and intraoperative fluoroscopy. In addition, the deltoid branch of the thoracoacromial vein is a good substitute for the subclavian vein with much less operative trauma and lower complication rate. Second, in 9% of patients the deltoid branch of the thoracoacromial vein could not be identified because of anatomical variation. The internal jugular vein approach with echo guidance should be considered as entry route only in patients lacking access to the cephalic vein and deltoid branch of thoracoacromial vein. Because deltoid branch of thoracoacromial vein and cephalic vein were located at neighborhood area and we could explore the two vessels from the same incision. Three different clinical scenarios would be encountered. For patients who were identified these two vessels and those with cephalic vein only, cephalic vein would be the first choice of entry vessel. For those who could be identified deltoid branch of thoracoacromial vein only, deltoid branch of thoracoacromial vein would be utilized for catheter implantation. Only those who absent these two vessels, internal jugular vein was considered as the choice of entry vessel. Therefore, only 5.5% patients needed the internal jugular vein approach for catheter implantation because no feasible cephalic vein or deltoid branch of the thoracoacromial vein was available. Despite these limitations, the deltoid branch of the thoracoacromial vein could provide an alternative entry vessel for patients without a feasible cephalic vein or for those who need repeat port implantation to fit therapeutic needs.","title":"Deltoid Branch of Thoracoacromial Vein A Safe Alternative Entry Vessel for Intravenous Port Implantation"}
{"_id":"10e296bf-9097-f05c-3dc0-751ce440bf30","text":"Breastfeeding should always be encouraged in patients with CMPA. Seven out of 11 infants with FPIAP were exclusively or partially breastfed at the time of diagnosis and all improved after dairy exclusion in maternal diet and supplementation with the casein-based eHF. One subject with FPIAP was exclusively breastfed for the first 2 weeks of life when he switched to mixed feeding with a pHF and developed blood in stools. After breastfeeding was discontinued, his clinical condition worsened and improved only when switching to an AAF, suggesting a possible protective effect of breast milk.","title":"Nutritional Management With a Casein-Based Extensively Hydrolysed Formula in Infants With Clinical Manifestations of Non-IgE-Mediated CMPA Enteropathies and Constipation"}
{"_id":"10e434a9-a7fb-072a-0ce1-a618c7e3deb7","text":"In our surgery we did a stable fixation of fractures with little periosteal damage and minimal soft tissue compromise. We did delay the surgery till the swelling subsided and wrinkles disappeared over the distal tibia. Average delayed time was six days in case of low energy trauma where as in high energy trauma it was 8.43 days (range: 4-18 days). While performing the approach to fibula we tried to limit the amount of dissection over the anterior surface of fibula. In our surgeries since we used the single incision we were not concerned about any skin breech between the two incisions that is usually a concern in conventional approaches. Traditionally a varus injury pattern is advised for medial plating. The anterolateral approach has a greater soft tissue coverage which decreases the trauma to an already compromised soft tissue envelope. We also operated on four tibial pilon fractures that had varus injury through anterolateral plating with a good functional and radiological outcome.","title":"Minimally Invasive Osteosynthesis of Distal Tibia Fractures using Anterolateral Locking Plate"}
{"_id":"10e6a514-ae11-a351-1139-202546f1bb8e","text":"This study is limited by its retrospective nature and its potential for selection bias, as the population submitted to surgery may be different from those allocated to the nonoperative group. However, our results show that complete microscopic removal is an independent prognostic factor for LR. Our series also reflects the historical heterogeneity of management strategies that most sarcoma centers have experienced over time.","title":"Sporadic Abdominal Wall Desmoid type Fibromatosis: treatment paradigm after thirty two years"}
{"_id":"10e6e380-342c-6831-d03d-c047acb763af","text":"Postoperative breast MRI shows very high detection rate for recurrent breast cancer including recurrent cancers that were not found on mammography or ultrasound. In addition to its high detectability, characteristic features of recurrent lesions are noted on MRI according to the time of recurrence. These results are not only the milestone for proving the usefulness of the postoperative breast MRI, but also the basis for determining the appropriate time interval for postoperative breast MRI after BCT.","title":"Usefulness of postoperative surveillance MR for women after breast-conservation therapy: Focusing on MR features of early and late recurrent breast cancer"}
{"_id":"10ffad35-d9a7-9ce4-61f9-bb3ad0d7383c","text":"The patients were age > 15 years old without a history of DVT or pulmonary emboli (PE) scheduled for laparotomy or vaginal gynecologic surgery between May and November 2020 were invited to participate. All of these patients were scheduled for a complete duplex ultrasound to detect lower limb DVT 72 h before and within 14 days after the operation. The patients without DVT were scheduled for an interview by telephone about DVT symptoms 30 days after the operation. The clinical variables were compared using univariate and multivariate analysis to identify the independent factors related to the development of DVT.","title":"Prevalence and risk factor of post-operative lower extremities deep vein thrombosis in patients undergoing gynecologic surgery: a single-institute cross-sectional study"}
{"_id":"110470eb-5213-4f14-66d1-dbcececb2342","text":"When performing a THR, it is not only the osseous exposure that is important but also the ability to access these bone structures with instruments. Given the depth of the hip within the musculature, it follows that improved ability to retract the soft tissues would be expected to correlate with better access for performing femoral or acetabular reaming. Optimal exposure and access are beneficial for reducing the forces required to retract musculature. Anecdotally, it is recognized by surgeons that at the end of a THR where DGT is used, due to the significant manipulation required to access relevant anatomy, the musculature (particularly the deep and middle gluteal muscles) becomes notably damaged. This observation was supported by our study findings in that less muscular damage occurred with DGO, which may correlate with improved access for femoral reaming.","title":"Approach to the canine coxofemoral joint using an osteotomy of the deep gluteal muscle insertion for total hip replacements"}
{"_id":"11070b27-e7ed-03ff-7990-217c42385b9a","text":"Reconstruction of soft tissue defects in the lower third of the leg remains challenging. Anatomical constraints limit the local options available for complex defects especially lower third of leg. Local flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. We present our experience with perforator flaps for reconstruction of soft tissue defects in the lower limb.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"110bc8ea-b073-d8f7-d0c4-cf4152c7544c","text":"The purpose of this temporary antibiotic PMMA spacer is to deliver high concentrations of local antibiotic while simultaneously preserving space for the definitive osseous reconstruction, to greatly enhance mechanical stability and to create an induced membrane that has biological activity and encourages bone graft incorporation by containing the graft and providing a more receptive recipient bed. The PMMA spacer should remain in the defect approximately 8–12 weeks. While the membrane develops, this intervening time period is used for virtual surgery and planning for secondary reconstruction, including design of a truss cage suitable for a given anatomic location. Consideration must be given to the type of skeletal stabilization that will be employed in the definitive construct (intramedullary (IM) nail or internal fixation using a plate and screws).","title":"Putting 3D modelling and 3D printing into practice: virtual surgery and preoperative planning to reconstruct complex post-traumatic skeletal deformities and defects"}
{"_id":"1117b647-e8c3-d8a5-5261-22bc26bb1bf5","text":"When the wound was inspected on day 3, it was found to be healthy and a flap was planned to cover the exposed tissues.","title":"\"A Free thenar flap – A case report\""}
{"_id":"1117c124-17bb-c426-83a1-3ac364905217","text":"Strengths of this study include the complete overview of diagnostic accuracy studies of the three CUS strategies for DVT and the use of a bivariate meta-analysis model, which incorporates any correlation that might exist between two diagnostic accuracy measures. Only studies with a low risk of bias and low concerns regarding applicability were included in the primary analysis, which increases the validity of the findings. Studies or subgroups of patients in which different reference standards were used were excluded from the analysis, thereby preventing differential verification bias.","title":"Diagnostic accuracy of three ultrasonography strategies for deep vein thrombosis of the lower extremity: A systematic review and meta-analysis"}
{"_id":"1121db90-76c0-ae87-5e4d-a1d668f3ea11","text":"In this study we reported our experience of using Medpor® in 56 patients who suffered from facial impairments. The defects were categorized into 4 groups with different surgery strategies with the lowest visible scar formations. The patients were followed for 1 to 3 years which did not reveal any complications and the satisfaction was remarkable. Extrusion occurred just in 1 patient with maxillary PNET following radiotherapy.","title":"Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study"}
{"_id":"11384df1-b9a9-ef70-e735-cf771b0e05a8","text":"This study also demonstrates that the section of both epigastric vessels does not match with any impairment of overall muscle blood supply, as proved by the substantially unmodified contrast agent uptake in postoperative scans.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"113a509c-3311-a449-d520-62d8984d9b48","text":"Patients with IFS performed showed a complete excision rate that is statistically significant. Both groups did not show a difference in recurrence rate. However, the reduction in need for a second operation and further treatment in the group with IFS performed was statistically significant. These findings prove that the use of IFS confers benefits to patients. While the financial cost of an IFS procedure is higher, this is offset by a lower emotional and mental burden due to the lower probability of requiring a second surgery or other treatment modalities such as radiotherapy and chemotherapy.","title":"Use of Intraoperative Frozen Section in the Surgical Management of Patients with Nonmelanoma Skin Cancer"}
{"_id":"11455a5b-c370-f613-ed8b-c2e826c9f3c7","text":"These two populations are not similar because of the differences in terms of the severity of the reactions, latency between last drug intake and symptom occurrence and ST results. These differences observed and discovered during the patients’ recruitment reflect the possible existence of different pathogenic mechanisms and triggers between children and adults.","title":"The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults"}
{"_id":"11466423-13cf-6dc6-024a-52f35b4f0043","text":"A final and potentially more immediately available possibility involves the concurrent administration of humanized anti-IgE (omalizumab) with standard IT. The concept is that the removal of IgE should dramatically reduce the risk of anaphylactic reactions and thereby may allow a more rapid induction of tolerance, the implementation of higher doses of allergen, or the administration of IT to patients who are considered to have contraindications to IT. For example, it may become easier to administer IT to patients with moderate to severe asthma or with a previous history of systemic reactions. Recent studies support such an approach and raise the exciting potential of a role for IT in patients for whom immunomodulating therapies might provide critically important clinical benefits.","title":"Update on Allergy Immunotherapy"}
{"_id":"11493aa5-71c9-cbf1-7965-962df92f7ead","text":"These data suggest a tumor suppressor role of XPC during cancer progression.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"114eeab7-d6af-2e71-174b-3914f1a31c97","text":"Reconstructive surgery dogma has long been that free tissue transfers allow for a safe and reliable reconstructive option for higher risk patients such as those with significant smoking and diabetes history. As compared to a pedicle flap, harvesting a free flap is a more arduous and time-consuming process. This exposes the patient to longer anesthesia times, longer ICU stays, greater healthcare costs and often a greater initial risk of flap loss. In actuality, there is a paucity of data in the literature that has directly compared free and pedicle flap perfusion over an extended time period.","title":"Comparative Perfusion Analysis of Free Muscle-Sparing Versus Pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps in Vivo in the Peri-Operative and Late Post-Operative Periods"}
{"_id":"1158567c-fb5d-1c27-4148-ccbb34d2b63d","text":"There is no current consensus on the treatment of tumoral calcinosis. Pharmacological treatment has been used with variable results in the literature. Surgical excision of the lesions may be performed when nerve root or spinal cord compression is present. Spinal stabilization can also be performed in selected cases.","title":"Tumoral calcinosis in the lumbar spine secondary to systemic sclerosis: a rare cause of radiculopathy in an adult with advanced disease Liberato et al"}
{"_id":"1159fe7e-4dcc-5191-5645-ac459edc9a64","text":"A complete inguinal dissection was carried out as mentioned previously. Dissection ended by liberating the specimen consisting of fibrofatty tissue along with inguinal lymph nodes after coagulation of the proximal part of the lymphatic tissue with harmonic scalpel at the deep portion of the femoral channel.","title":"Video Endoscopic Inguinal Lymphadenectomy (VEIL) -a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma"}
{"_id":"11626e47-6e7c-44d5-32f5-815ff0d5df73","text":"Swiss cancer survivors have an increased risk of developing a SPC compared to the general population, particularly patients first diagnosed before age 50 and those surviving more than 10 years. Cancer patients should remain under continued surveillance not only for recurrent cancers but also for new cancers. Some first and SPCs share lifestyle associated risk factors making it important to promote healthier lifestyles in both the general population and cancer survivors.","title":"The relative risk of second primary cancers in Switzerland: a population-based retrospective cohort study"}
{"_id":"11782e9b-e51e-ded5-5780-6d97d98b8409","text":"We reviewed the clinicopathologic data of breast cancer patients with SLN metastasis who underwent SLNB during surgery at Harbin Medical University Cancer Hospital between January 1, 2013 and December 31, 2020. Patients with SLN metastasis were examined by SLNB during surgery. Figure 1 depicts the selection of patients for model development.","title":"Toward Exempting from Sentinel Lymph Node Biopsy in T1 Breast Cancer Patients: A Retrospective Study"}
{"_id":"117db82c-e3ed-6f45-89e8-6124b0390b1a","text":"Currently we find that most of the population has some type of morphological and\/or functional change in the stomatognathic system. A growing number of dentofacial deformity correction centers in our country and a significantly higher demand for such services has raised the need for studying the prevalence of these deformities to plan and implement adequate treatment.","title":"Service Profile of Orthognathic Surgery of a Medical School"}
{"_id":"11889725-c748-2da7-bd2b-f01a088053ac","text":"Based on our clinical use in plastic surgery, laser speckle flowgraphy allows recognition of a poorly perfused area of a flap during surgery, and resection of the distal flap area can be performed based on this finding. This flowmeter contributes greatly to the detection of changes in cutaneous blood flow in flaps or grafted tissue earlier than macroscopic observation. It is used additionally to ascertain macroscopic findings before selection of the next step of treatment. When the laser speckle flowgraph is used for postoperative followup of flap patency, minute changes in the microcirculation can also be observed, which cannot be detected macroscopically.","title":"Free Flap Blood Flow Evaluated Using Two-Dimensional Laser Speckle Flowgraphy"}
{"_id":"118929af-6026-4e47-5b2a-c92cf7640c8a","text":"Surgical creation of tibial segmental bone defects followed by fixation with single LCP and cast immobilization was deemed a feasible and appropriate model for veterinary orthopedic research in tissue engineering.","title":"Locking compression plate fixation of critical-sized bone defects in sheep. Development of a model for veterinary bone tissue engineering"}
{"_id":"11937049-4e3a-89cb-ef60-5b8e158e3879","text":"The diagnosis was made according to the diagnostic criteria for DVT of the lower limbs established by the Vascular Surgery Group of the Chinese Medical Association Surgery Branch, and the diagnosis was confirmed by color Doppler ultrasound.","title":"Evaluation of Critical Factors of Postoperative Arrhythmia and Preventive Measures of Deep Venous Thrombosis"}
{"_id":"1193a4a2-969c-53fb-8c6a-3a15daa21f50","text":"The same surgical technique was used with both lasers: follow the vertical axis of the frenulum until the wound presented a linear shape. At this point the laser was applied transversely until the wound took a rhomboidal shape. Then, the palatine limit of the papilla was treated in those cases in wich the frenulum showed a low insertion.","title":"Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser"}
{"_id":"11943e22-3228-d24b-e847-021ee50cf880","text":"Our aim is to test novel interventions to decrease sunburn by increasing use of sun protection targeting Danes going on vacation to sunny destinations.","title":"Novel sunprotection interventions to prevent skin cancer: A randomized study targeting Danes going on vacation to destinations with high UV index"}
{"_id":"11964690-8c60-28c2-4214-381f2699c075","text":"6821 employees and patients were vaccinated at our institutions between February and June 2021. Every patient received two doses of the mRNA-1273 vaccine in our hospitals, and reported back in case of any side effects which were collected in our hospital managed database.","title":"Delayed skin reaction after mRNA-1273 vaccine against SARS-CoV-2: a rare clinical reaction"}
{"_id":"119a8073-4432-2085-2ef9-4b92a1f7a73d","text":"Optoacoustic signals acquired by the aforementioned system were tomographically reconstructed using standard backprojection. Multispectral illumination was used at the described wavelengths to separate individual contributions of absorbers. With use of linear regression spectral unmixing, known absorption spectra of the expected absorber (ICG) were inverted and multiplied with the acquired images to reveal the spatial distribution of the absorber in separate component images.","title":"Assessment of Nonradioactive Multispectral Optoacoustic Tomographic Imaging With Conventional Lymphoscintigraphic Imaging for Sentinel Lymph Node Biopsy in Melanoma Nonradioactive Multispectral Optoacoustic Tomography vs Lymphoscintigraphy for Sentinel Lymph Node Biopsy"}
{"_id":"11a11301-22e9-c7c9-11b7-74905b6e6fcd","text":"Limitations of the study are the small number of patients and the single institutional execution, however the initial experiences are promising.","title":"Fine needle aspiration cytology of lymph nodes in breast cancer follow-up is a feasible alternative to watchful waiting and to histology"}
{"_id":"11ab54fc-a316-26ac-c216-5c9125bcd627","text":"Meanwhile, the survival rate is the most important factor to distinguish the difference in local recurrence prognosis. In the study, the postoperative survival period and survival period after recurrence detection were not statistically significantly different between the two groups. Contrary to the concerns of some surgeons, there was no difference in local recurrence findings between autologous tissue reconstruction and implants or any statistical difference in terms of survival.","title":"Is There a Difference in the Diagnosis and Prognosis of Local Recurrence between Autologous Tissue and Implant-Based Breast Reconstruction?"}
{"_id":"11ad532f-dfec-d675-c1e0-a0e3a30b30d1","text":"Early debridement combined with implantation of RBGS mixed with vancomycin in the treatment of infants with OM achieved acceptable results in this series. Compared to those with simple isolated OM, patients with secondary pyogenic arthritis had a more virulent course.","title":"Clinical experience of debridement combined with resorbable bone graft substitute mixed with antibiotic in the treatment for infants with osteomyelitis"}
{"_id":"11b11abf-6cef-2599-16a5-f9ee034378f5","text":"Artificial bone has many advantages and several limitations because grafted artificial bone can be integrated into the host bone without rejection to obtain sufficient strength. The artificial bone should also act as a carrier or scaffold for cell growth to prevent scar formation and promote bone regeneration.7 Thus, it is important to overcome limitations such as limited availability and the invasiveness of the procedures, which are often associated with many problems.5,8,9","title":"Transplantation of human-induced pluripotent stem cells carried by self-assembling peptide nanofiber hydrogel improves bone regeneration in rat calvarial bone defects"}
{"_id":"11b8c903-0931-d6e0-8c4f-0ab16a0a4e34","text":"The presence of the nanoparticles will then be detected by producing a sound and a signal on the display of the device, whose intensity will be proportional to the intensity of the induced magnetic field that increases with proximity (Figure 3) to the iron particles, which have collected mainly in the sentinel lymph node.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"11b9a729-2ec0-8afb-b0b6-917380d3bdf0","text":"The anesthetic and surgical protocols were similar for all cases. Regional anesthetic was performed in all cases and included a combination of a neuraxial spinal anesthetic and minimal intravenous sedation. A single dose of pre-incision antibiotics was administered. The patient was positioned supine and a tourniquet was applied to the upper thigh and inflated to 250 mmHg.","title":"Biomechanical and Functional Improvements Gained by Proximal Tibia Osteotomy Correction of Genu Varum in Patients with Knee Pain"}
{"_id":"11ba4818-a44a-6aed-72a9-40c145bd11d6","text":"In cases of rhinoplasty without septoplasty, increase in MCA1 was significant only in group of single osteotomy without decongestant. Although changes in MCV2 were significant in both with and without decongestion groups of double osteotomy, but the net effects were not clinically significant comparing single osteotomies. Table 4 demonstrates that cases with rhinoplasty alone would benefit from double osteotomy in MCA1.","title":"Does Cosmetic Rhinoplasty Affect Nose Function?"}
{"_id":"11ba7c4b-48c1-95df-c6c8-84c7b5b463e1","text":"Recently the technique of facet distraction was published as a treatment option for single or multilevel cervical spondylotic radiculopathy and myelopathy [31]. In this study the authors described facet distraction by manual implantation of metal spacers within the articular cavity after wide removal of the articular cartilage; structural changes resulting from these spacers included an increase in interlaminar and interspinous process distance and restoration of buckled ligaments of the region as well as an increase in spinal canal diameter.","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"11bb3394-f0a6-e089-d4a0-cf16a401daba","text":"There is an urgent need to develop new innovative therapies for the control of advanced cancer. The combination of antigen-specific immunotherapy with the employment of immunomodulatory agents has emerged as a potentially plausible approach for the control of advanced cancer.","title":"Treatment with Imiquimod enhances antitumor immunity induced by therapeutic HPV DNA vaccination"}
{"_id":"11bb92e1-f7a3-3588-dc0a-57ac37d9bfd0","text":"Surgery remains the mainstay of melanoma therapy of any primary site and only early diagnosis combined with proper surgical therapy currently gives the chance for cure of patients affected by this malignant tumor. The main goal of surgical therapy is to provide the local control of the disease and to secure long-term survival of the patient without reasonable functional and esthetic impairment. Currently, appropriate surgery is dependent upon melanoma staging. The limited efficacy of systemic and adjuvant treatment for metastatic melanoma emphasizes the importance of effective initial surgical therapy. Appropriate surgery of the primary lesion allows achieving durable local control and may be curative for patients without metastases. There are two major issues that should be considered regarding surgery of the primary tumor: properly performed diagnostic biopsy and radical excision of the primary tumor (or excision of the scar after excisional biopsy). On the other hand, surgical approaches should be tailored to the individual clinical situation.","title":"Surgery of Primary Melanomas"}
{"_id":"11c45d82-45bd-7b78-d55f-73ad61b65855","text":"In summary, the results of this analysis of the patients included in China in the EINSTEIN DVT and EINSTEIN PE trials show that the performance of rivaroxaban was consistent with that observed in the global population, with a similar efficacy and a better bleeding profile to standard therapy of enoxaparin overlapping with and followed by a VKA. The data indicate that oral rivaroxaban provides a new, improved option for the treatment of DVT and PE in Chinese patients.","title":"Rivaroxaban for the treatment of symptomatic deep-vein thrombosis and pulmonary embolism in Chinese patients: a subgroup analysis of the EINSTEIN DVT and PE studies"}
{"_id":"11c471bb-c5d0-0361-852c-fdcd3a4a583a","text":"The eighth rib which was the thinnest one was used to construct the helix and crus helix of the framework. The third level formed the base of the framework, which maintained the prominence of the framework formed by the seventh rib. In case of adult who had larger cartilage, sixth and seventh cartilage for the entire fabrication was enough. All the structures were assembled using stainless steel wire and prolene to form a three-dimensional framework as shown in Figure 1. The extra piece of cartilage which was not used for the framework fabrication was buried beneath the skin in chest, which will be used for the framework elevation during stage 3 surgery.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"11cc02a7-5d90-5ba2-1147-d27b1950746e","text":"As we can see these are chronic infections of biofilm origin and thus have high resistance to host immunity and various methods of management has been elucidated earlier.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"11d706cf-945b-cf5a-a9ef-cb120e2eab6a","text":"Lateromedial and dorsopalmar radiographic views of the carpus showing the paths of the ultrasound transducer in the examination of the carpus. Images are acquired in a transverse plane sliding in a proximal to distal direction. Images are acquired in a longitudinal plane sliding in a lateromedial direction. The paths i-v are described in the text","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"11d82323-1b55-1bf5-6777-31de1354e525","text":"Another issue for patients with nodal metastasis is the appropriate extent of the dissection. Patients with cSCC and nodal involvement have usually undergone complete radical lymph node dissections of the involved regional basin, which involves the 3 levels of the axillar basin, the superficial and deep groin nodes, and the 5 levels of the neck. Additionally, complete dissections in the neck are often completed with superficial parotidectomy if the parotid gland is affected.","title":"Surgery for Cutaneous Squamous Cell Carcinoma and its Limits in Advanced Disease"}
{"_id":"11d9f594-e107-2506-34a9-fa5dc793dd30","text":"Table 6 The effect of retaining ARM nodes after the SLNB procedure on lymphedema","title":"Using the axillary reverse mapping technique to screen breast cancer patients with a high risk of lymphedema"}
{"_id":"11da04cf-302a-d515-7b3f-468d66954b3a","text":"The supermicrosurgery concept was introduced by Koshima et al.[ and has since been applied to the field of reconstructive plastic surgery. Numerous reports have demonstrated that the supermicrosurgery approach is effective in cases where the choice of a recipient vessel is complicated by the major vessel being located deep within the target tissue, increasing the risk of major vessel injury during recipient vessel dissection[ or in cases of occlusive vascular disease.[","title":"Validity of the use of a subfascial vessel as the recipient vessel in a second free flap transfer A retrospective clinical review"}
{"_id":"11dae0cc-05c5-a479-6dfd-9afcba70cd99","text":"There is a risk of anaphylaxis if the patient is allergic to the iodinated contrast agent. Both oral and written information on possible allergy will be obtained before examination to minimize this risk. No adverse events were observed in the pilot study apart from some dizziness, slight nausea and warmth in three patients (all symptoms that have been reported after the injection of iodinated contrast agent). These symptoms disappeared completely within a few minutes.","title":"The PROCEM study protocol: Added value of preoperative contrast-enhanced mammography in staging of malignant breast lesions - a prospective randomized multicenter study"}
{"_id":"11ea4233-012a-773e-f712-f419cf1a464a","text":"In conclusion, this is the first study to report that female asthmatic patients are at the highest risk of having Gemifloxacin-induced skin eruptions. The median onset time of such eruptions was two days after completing treatment. This study should remind physicians and patients to pay attention to a very delayed skin rashes after completing Gemifloxacin treatment.","title":"Female Asthmatic Patients Have Higher Risk to Develop Gemifloxacin-Associated Skin Rash, Highlighting Unique Delayed Onset Characteristics"}
{"_id":"11eb07dc-065f-b3d1-f23c-d2563414693c","text":"The time used for the ultrasonographic examinations was defined as the time used from when the transducer touched the patient’s skin for the first time to the examination had been completed and stored on the ultrasound system. The feasibility of the ultrasonographic examinations were assessed according to predefined criteria (see Additional file 1).","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"11ed8b64-599c-c5fe-8739-e398c7df866d","text":"We compared the proportion of false positive screenings among breast cancer survivors and women with no previous breast cancer.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"11f48a31-3954-eb5c-aee7-4d036d777af6","text":"In conclusion, we showed that anosognosia is frequent in EOD, either at the beginning or along the progression of the disease, that it is especially severe in clinical variants characterized by primary involvement of frontal brain regions, and that, in EOD, it is associated with the subsequent development of apathy. These results show that anosognosia should not be underestimated in EOD but rather considered a core important clinical feature. It should be recognized by clinicians and families as early as possible in patients with or at risk of cognitive decline, to allow better guidance and management for the patient and caregiver during the progression of the disease.","title":"Anosognosia in Early- and Late-Onset Dementia and Its Association With Neuropsychiatric Symptoms"}
{"_id":"11f7238e-a854-a654-6222-903d1880d832","text":"Follow-up LDI was continued until perfusion was completely restored or until the skin was confirmed to be necrotic. Photographic evaluations were continued until the facial skin had completely returned to normal.","title":"Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review"}
{"_id":"1202ac75-90d5-f165-59ca-db643b8d1df9","text":"When talking about 3D printing and personalized medicine, we use 3D imaging for planning and creating solutions based on the physical structure of a specific tissue.","title":"Printing the Future—Updates in 3D Printing for Surgical Applications"}
{"_id":"1208c59f-25f0-40f9-3e02-85151205c548","text":"A similar overview has not been conducted in the Canadian setting. Examination of the characteristics and productivity of Canadian academic leaders will provide an understanding of the pathways for promotion in a Canadian context. It may also reveal possible issues with diverse representation within academic leadership. Therefore, the aim of the present study is to summarize the demographics, subspecialty training, and academic productivity of contemporary leaders in OHNS training programs across Canada. A secondary objective is to evaluate the impact of academic appointment on research productivity.","title":"Academic benchmarks for leaders in Otolaryngology - Head & Neck Surgery: a Canadian perspective"}
{"_id":"12185c19-6648-3547-6e6d-db7b86e2597c","text":"Six prominent systems for grading levels of evidence and strength of recommendations were selected and someone familiar with each system prepared a description of each of these. Twelve assessors independently evaluated each system based on twelve criteria to assess the sensibility of the different approaches. Systems used by 51 organisations were compared with these six approaches.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"12195b01-e424-fdd2-3178-2c49cb0d19ac","text":"The role of NPs in increasing efficiency of ultrasonic treatments","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"122228e2-76ed-1e83-2ecb-10e1fea2b85b","text":"The aim of this study was to evaluate the use of attached surface probes with the O2C analysis system for monitoring flap perfusion of any flap that has a skin island and to compare attached surface probes and standard unattached surface probes in terms of technical feasibility, patient safety and perfusion measurement values.","title":"Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study"}
{"_id":"122c87b5-809e-3f7e-37be-d3044219714c","text":"However, the translation between an experimental rat model and the clinic is not necessarily linear. Rat and human metabolism is significantly different, so cell growth and bone recovery rates are different at the bench as opposed to the bedside. Rat tissue has a greater susceptibility to radiation, therefore lower doses of radiation are necessary to achieve the same level of tissue damage. Finally, these rats have not experienced damage to their craniofacial skeleton prior to this experiment. The scar contraction of distraction site caused by previous surgery or chemotherapy may be detrimental to the process of distraction osteogenesis. On the other hand, the skin flaps to cover the defect after tumor ablation may work to recover the circulation of tissue envelope over previous irradiated mandible.","title":"The effects of high dose and highly fractionated radiation on distraction osteogenesis in the murine mandible"}
{"_id":"12391975-8902-d1d7-14c6-52b621184bc9","text":"The primary outcome was breast cancer recurrence, which was assessed by contacting patients or the specialist every 6 months. Time to recurrence was measured from the date of surgery to the earliest date that recurrence was detected at any site. Clinical evidence such as radiographic examinations or pathologic findings was provided to confirm recurrence. Medical records were provided including demographic characteristics, clinical factors, and pathological factors related to breast cancer recurrence.","title":"Potential Influence of Anesthetic Interventions on Breast Cancer Early Recurrence According to Estrogen Receptor Expression: A Sub-Study of a Randomized Trial"}
{"_id":"123a55bf-50e3-94a9-c133-6640bf5e55b0","text":"A medial to lateral approach was adopted following division of the loop colostomy. The inferior mesenteric artery was identified and divided. Circumferential dissection of the total mesorectal excision (TME) was undertaken to the level of tumour involvement at the sacrum and vagina. A transverse vaginotomy was created in the posterior wall of the vagina as the final part of the abdominal phase of the procedure to assist the perineal phase of the dissection. Laterally the dissection was taken down to the pelvic floor on both sides. The abdominal component of the operation was now complete. The colostomy was refashioned in the left iliac fossa and the abdominal ports closed.","title":"Robotic abdominoperineal resection, posterior vaginectomy and abdomino-lithotomy sacrectomy: technical considerations and case vignette"}
{"_id":"1245e13d-988f-823d-bc07-a6cdd4de5454","text":"In a word, the expression of P53 immunohistochemistry showed relatively good consistency between preoperative biopsy and final pathology of EC. Hysteroscopic guided biopsy can improve the consistency of P53 expression between preoperative biopsy and final pathology compared to blind biopsy. Due to the discrepancy of P53 between preoperative biopsy and final pathology, the prognosis of patients can be better evaluated based on 4-tier P53 expression and classic clinicopathological parameters.","title":"Consistency of P53 immunohistochemical expression between preoperative biopsy and final surgical specimens of endometrial cancer"}
{"_id":"124a92fc-e261-d127-8c6b-2032617b8e21","text":"Though it would be compelling to suggest that larger surgical margins should be adopted when treating oral cavity carcinomas with primary surgical resection, currently no study has been performed relating surgical margins over 1 cm with an improved prognosis in these types of tumors.","title":"An Analysis of Tumor Margin Shrinkage in the Surgical Resection of Squamous Cell Carcinoma of the Oral Cavity"}
{"_id":"125c8593-b3b0-1e1f-4bf4-53fe3f7403bd","text":"We report a case of severe and refractory tibial osteomyelitis following IO access. The most likely mechanisms were either direct inoculation of the bone from initial insertion of the IO device or contiguous spread to bone following a subclinical or untreated soft tissue infection. Similar to other invasive procedures, sterile technique is paramount when obtaining IO access. Prior to device insertion, the skin should be cleansed with an antiseptic solution such as chlorhexidine. While a direct comparison of chlorhexidine with povidone-iodine prior to bone biopsy or IO device insertion has not been performed, prior studies have demonstrated chlorhexidine-alcohol to be superior in reducing surgical site as well as catheter-associated infections.15 It is also important to avoid IO device insertion at a site with active skin and soft tissue infection, whenever possible. Finally, infiltrated IO devices as well as those left in situ for greater than 72–96 hours carry an increased risk of infection and should be removed promptly once alternative vascular access can be established.","title":"Tibial Osteomyelitis Following Prehospital Intraosseous Access"}
{"_id":"125e049f-0344-b0e3-4c22-20e809670d20","text":"The inclusion in this study was subjected to the start of the vaccination campaign determined by the Regional Health Authorities. At the initial stages of this study, we could not foresee the impact of both the recommendation of a third dose and the Omicron variant influence in terms of community transmission. These facts made us slightly modify the blood draws calendar to consider the third dose administration when possible.","title":"Immune Response and Effects of COVID-19 Vaccination in Patients with Lung Cancer—COVID Lung Vaccine Study"}
{"_id":"125e5912-207c-1865-1965-2b41bc0e6df7","text":"Participants discontinued from the study due to the occurrence of an SAE will be followed in the relevant medical department.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"1263fd7d-c144-eb6a-3a03-c1f428cb1d17","text":"The findings of the present study have important clinical implications, and provide reassurance to patients and physicians that reoperation for postoperative bleeding does not increase the risk of breast cancer recurrence. Patients who undergo reoperation for bleeding are unlikely to need more aggressive adjuvant therapy. Breast cancer surgery involves a soft tissue surface and is often characterized by extensive dissection, which increases the risk of postoperative bleeding; the results may therefore be relevant to other soft tissue surgical procedures.","title":"Breast cancer recurrence after reoperation for surgical bleeding"}
{"_id":"126b140f-d767-e2e4-0e1f-e30d31b1dff4","text":"Overcoming the gender discrepancy specifically in academic oncology leadership may have a sustained and meaningful impact by increasing role models who can inspire graduating residents to pursue academic positions. Radiation oncology residents who are women are more likely to prefer having a mentor of the same gender, to prefer seeing equal numbers of men and women faculty, and to select residency programs based on gender ratios compared with their counterparts who are men. Similar feelings likely persist when choosing a job following training. Indeed, our study shows that MO and RO departments with women in leadership positions were associated with a significantly higher ratio of women faculty than programs without at least 1 woman in a leadership position.","title":"Women’s Representation in Leadership Positions in Academic Medical Oncology, Radiation Oncology, and Surgical Oncology Programs Women’s Representation in Leadership Positions in Academic Oncology Programs"}
{"_id":"12712752-46fa-534d-8f41-69e14e6a2045","text":"There were complications involving 6 breasts receiving an implant and ADM patch. The most common complication was a seroma persisting for some weeks after surgery. Three patients with seroma underwent percutaneous drainage and systemic antibiotic therapy. Two patients showed early vascular failure signs of the skin envelope and underwent immediate surgical revision to prevent ADM exposition. One patient developed cellulitis of the cutaneous envelope, manifested as swelling and fever, and she underwent removal of the prosthesis.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"12769d61-60f4-e4e3-d7b4-ca6f188f02ed","text":"Data concerning melanoma patients who underwent SLNB between 1996 and 2015 in a single center were prospectively collected. Cox regression analyses were used to determine variables associated with overall recurrence and distant first site of recurrence in SLNB-negative patients.","title":"Nodular Histologic Subtype and Ulceration are Tumor Factors Associated with High Risk of Recurrence in Sentinel Node-Negative Melanoma Patients"}
{"_id":"1296efff-2454-9ff2-9e7e-be9239502ae8","text":"• 3 of 4 cases develop systemic metastases during subsequent evolution","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"1298681d-7287-b048-f9f8-d0ea9fb5a4db","text":"This is the first study to evaluate factors that orthopaedic trauma fellowship directors consider when ranking applicants. With the increasing numbers of applicants and competition for orthopaedic trauma fellowship positions, we believe that our study provides those interested in pursuing a career in orthopaedic trauma with useful information.","title":"The Competitive Orthopaedic Trauma Fellowship Applicant: A Program Director's Perspective"}
{"_id":"12a221d8-2c84-d594-2e4a-6d7f2efc8d24","text":"The development of medicine has evolved from empirical medicine and experimental medicine to the current evidence-based medicine, which has a huge amount of medical data with characteristics such as objectivity and experimentation.","title":"Meta-Analysis and Data Mining-Based Study on the Expression Characteristics of Inflammatory Factors and Causes of Recurrence in Spinal Tuberculosis"}
{"_id":"12a517a0-d001-d477-6970-a586df60be17","text":"The findings of this study must be interpreted considering several limiting factors. Due to its retrospective design and small collective of possible low-grade PJI, there might be potential factors that impact these findings that were not accessible for analysis. In addition the underlying gold standard of this study may be impeded by the fact that the amount of perioperative tissue samples differs from three to five samples. Furthermore, while these results were collected over a period of nine years during which the MSIS and ICM criteria for PJI have evolved over time and novel markers and criteria have been added more recently that were not analyzed in the present cohort. Moreoverwhile serum CRP analysis was performed for every case, obligatory analysis of serum IL-6 was later added to our institution’s diagnostic algorithm for PJI and therefore only available in 34 cases (Table 2). Because of its high sensitivity for infection IL-6 could be a useful addition in the diagnostic of low-grade PJI and should further be evaluated. The lack of routinely performed histological analysis of the gained tissue samles presents a further limitation From 2010–2018 it only performed if an osteolysis was visible on the preoperative radiographs for additional investigation for malignancy.","title":"Poor performance of open incisional biopsy for the microbiological diagnosis of periprosthetic knee joint infection"}
{"_id":"12a8b6ec-2397-016b-058f-b5eaa29c47fe","text":"By far as we know, few reports exist with strong evidence on incidence and risk factors of DVT within the first 3 months of osteosynthesis for isolated FSFs. Since all patients with FSFs at our institution received DVT screening of the bilateral lower extremities after surgery, we designed this retrospective study to investigate the prevalence of DVT and to explore the risk factors associated with DVT within 3 months after surgery for isolated FSF.","title":"The incidence and risk factors of deep venous thrombosis in lower extremities following surgically treated femoral shaft fracture: a retrospective case-control study"}
{"_id":"12ac7d25-fedc-de88-815d-5f2134dd9596","text":"The presence of an epidural abscess on MRI should be regarded crucial in the decision-making process for early surgical treatment in patients with pyogenic spondylitis in order to improve clinical outcomes.","title":"Spinal epidural abscess as predicting factor for the necessity of early surgical intervention in patients with pyogenic spondylitis"}
{"_id":"12b19718-3e03-ec16-a6f7-c94d1f4af567","text":"Four of the five cases in this series had molecular characteristics associated with high metastatic risk, with three patients demonstrating monosomy 3 and one being positive for the BAP1 mutation. The finding that molecular characteristics are associated with higher mortality rates and metastatic disease suggests that tumour biology is likely a key factor influencing the rates of metastasis and extrascleral extension. However, there are other factors that could be involved, including extension through the needle tract from FNAB or the vitrectomy ports from pars plana vitrectomy. This is particularly relevant for the cases without intraocular recurrence. Three of the five cases underwent pars plana vitrectomy with silicone oil at the time of plaque placement, with removal of silicone oil within 6 months. Two of these three cases did not have intraocular recurrence. While insertion and removal of the trocars could be a possible contributing factor to later orbital recurrence, some of the cases presented did not undergo vitrectomy. The small sample size of this series and complex pathophysiology of extrascleral extension render it difficult to determine the aetiology of recurrence. A larger comparative study investigating the incidence of choroidal melanoma recurrence after iodine-125 brachytherapy, as well as prevalence of monosomy 3\/BAP1 in these cases, could be an area of future investigation and help elucidate risk factors for recurrence (Table 1).","title":"Extrascleral extension of choroidal melanoma after iodine-125 brachytherapy treatment: a case series"}
{"_id":"12b86fe5-4bd5-1774-8ae0-0261aec21ec4","text":"Even though a complete removal of the parotid gland decreases the risk of recurrence, the major disadvantage concerns the potential complication for injuries of the facial nerve. Scarring of the surrounding tissues determines anatomical changes that make it harder to distinguish between normal tissue and tumor with an increased risk of facial nerve damage. Facial nerve integrity monitoring can reduce morbidity in case of recurrence or in case of TP.","title":"Clinico-histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10-year retrospective study—a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma"}
{"_id":"12b939bd-39ed-15f5-cc11-a8c418a6bcdf","text":"As the first study to empirically examine the impact of relational and organizational endorsement of role, this study offers previously undiscovered insight as to the impact role perception to healthcare leaders concerned with physician leadership.","title":"The affect of vision and compassion upon role factors in physician leadership"}
{"_id":"12bbf5d7-e2ce-713b-8fc5-898788657186","text":"At the level of the medial aspect of the orbit, the lateral portion of the plexus associated with the Pty sinus fuses with dorsal offshoots of the intramandibular venous plexus and progresses dorsad to become the anterior lobe venous plexus. The largest portion of the anterior lobe venous plexus is located ventral and rostral to the eyestalk, and just ventral to the maxillary and premaxillary bones, in close association to the ventral lining of the preorbital and anterior lobes of the accessory sinus system. The anterior lobe venous plexus acts as a crossroads for numerous veins that converge on it. It has connections to intracranial blood via the ophthalmic plexuses that exit the orbital fissure, the melon via the facial vein and the infraorbital veins, and the ventral skull via the plexus of the accessory sinus system and maxillary vein. These collateral connections may be important for understanding compartmentalization of gases and observed distribution of gas and fat emboli.","title":"Vascularization of Air Sinuses and Fat Bodies in the Head of the Bottlenose Dolphin (Tursiops truncatus): Morphological Implications on Physiology"}
{"_id":"12cb4324-6bdb-0d34-8068-fb774cf8df46","text":"The use of skin allografts to temporarily replace lost or damaged skin is practiced worldwide. Naturally occurring contamination can be present on skin or can be introduced at recovery or during processing. This contamination can pose a threat to allograft recipients. Bacterial culture and disinfection of allografts are mandated, but the specific practices and methodologies are not dictated by standards. A systematic review of literature from three databases found 12 research articles that evaluated bioburden reduction processes of skin grafts. The use of broad spectrum antibiotics and antifungal agents was the most frequently identified disinfection method reported demonstrating reductions in contamination rates. It was determined that the greatest reduction in the skin allograft contamination rates utilized 0.1 % peracetic acid or 25 kGy of gamma irradiation at lower temperatures.","title":"Disinfection of human skin allografts in tissue banking: a systematic review report"}
{"_id":"12cb6fc4-1218-ab44-231c-f86c8bad8732","text":"Graduated compression stockings apply pressure of varying degree to the leg and thigh, the pressure being greatest at the ankle and decreasing proximally. The pressure gradient is able to prevent venous stasis.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"12cca696-711f-dffe-b828-49c75ea8382a","text":"Table 1 describes the pattern of antibiotic prophylactic use and types of surgeries included in the study; all operations included in the study received preoperative prophylactic antibiotic and most of them received postoperative antibiotic for 24 hours or more. The duration of the surgeries observed was between 30 minutes to two hours and therefore none of these surgeries needed operative antibiotic redosing.","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"12ccf81a-9f01-f95f-8145-0b793c30e43c","text":"Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy.","title":"Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series"}
{"_id":"12d15cc4-f39d-2153-8358-20a7f530a345","text":"Consider a downward dosage adjustment during the peak pollen season if symptoms worsen.","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"12d19e91-ae3f-25d9-1d06-a2d6d2b636f9","text":"The aim of this study is to develop a step- by step ultrasound protocol for on-farm screening of horses for the most common sites of osteochondrosis that can be performed by veterinary practitioners and produce standardised images.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"12d50ba8-151c-132f-8c7b-8243e4005b2c","text":"Dermoscopic evaluation presented in the study did not include post treatment long-term follow up, therefore no data on efficacy of brachytherapy was presented. The observations published above indicate which dermoscopic features diminished during brachytherapy, and which persisted. Further observation is needed to assess clinical significance of those findings and to establish further correlation between the persistence of selected dermoscopic features and the relapse rate of brachytherapy.","title":"Basal Cell Carcinoma Treated with High Dose Rate (HDR) Brachytherapy—Early Evaluation of Clinical and Dermoscopic Patterns during Irradiation"}
{"_id":"12d5fad2-f017-c4b5-6155-400875099e91","text":"The survival of patients with various stages from IVa to IVc was not significantly different. This finding seems to be contrary to what is expected. The stage is the main prognostic factor at the diagnosis and before commencing any treatment. However, many patients in our cohort were heavily pretreated with multiple surgeries and repeated RAI therapy. This history would fade much of the prognostic significance of the stage. So, the staging at the time of external beam radiotherapy would not add additional prognostic information other than more robust factors such as EBRT indication or histological type. In addition, the majority of patients in our cohort had stage IV disease and we know that the difference between subcategories of a given stage is not so much evident.","title":"The role of external beam radiation therapy in the management of thyroid carcinomas: A retrospective study in Iran Cancer Institute"}
{"_id":"12d9b965-83a6-f384-497a-e4d440082372","text":"One specific limitation of current methods of photodynamic therapy is that the visible light used to activate photosensitizer has a shallow tissue-penetration depth of several millimeters. This limits the application of photodynamic therapy to surface cancers in the absence of a technique to illuminate deeper tissue. Fiberoptic endoscopy can aid in the delivery of visible light to remote anatomical sites within the body that cannot be illuminated with an external light source. Another approach is to use nanoparticles which can emit the visible light needed to activate photosensitizer. Infrared light, as opposed to visible light, can penetrate tissue to a depth of several centimeters but cannot activate visible-light absorbing photosensitizers. Biocompatible nanoparticles can be designed to absorb infrared light and emit visible light in a process called upconversion. Upconversion is a process whereby matter absorbs long wavelength light such as infrared and emits visible light. Fluorescent dyes can be adsorbed to upconversion nanoparticles and photodynamic therapy can be achieved in deeper tissue upon irradiation with infrared light. Fluorescent upconversion nanoparticles also afford selectivity and control as they may be activated only by illumination of an area of diseased tissue, such as a tumor, with infrared light and are by themselves atoxic in the absence of infrared light. Also, fluorescent upconversion nanoparticle constructs can be monitored as to their location in the body and uptake by cancer cells, aiding in evaluation of exact doses required to treat the targeted cancer. One approach to cancer treatment that is increasingly gaining in popularity for clinical use is photodynamic therapy. PDT is a treatment that uses a combination of light-absorbing photosensitizer and dissolved oxygen to kill cancer. As a cancer treatment, photodynamic therapy is considered to be a milder approach, as oxygen is the active agent responsible for achieving cancer cell death as opposed to agents that are toxic to the body as a whole, such as chemotherapy drugs and radiation. Additionally, the light-absorbing photosensitizers are atoxic to the body in the absence of light. Photodynamic therapy is also a method that can be controlled with regards to the location of the treatment as it requires selective illumination of the treatment area with light. Selective illumination and light activation then enable selective damage of diseased tissue without damaging the surrounding healthy tissue. For example, if light-absorbing photosensitizer is injected into a patient, only the tumor needs to be illuminated with light which initiates the cancer cell-killing effect. Several photoactivated photosensitizers have been approved for clinical use in the treatment of cancers such as basal cell carcinoma, early lung cancer and malignant skin tumors. The treatment of cancer continues to be a challenging task and the combination of medicine with nanotechnology can advance photodynamic therapy by enhancing control with regard to specific treatment location and activation by sources of illumination in deep tissue. One specific limitation of current methods of PDT is that the visible light used to activate photosensitizer has a short tissue penetration depth of several millimeters. This limits the application of photodynamic therapy to surface cancers in the absence of a technique to illuminate deeper tissue. Fiberoptic endoscopy can aid in the delivery of visible light to remote anatomical sites within the body that cannot be illuminated with an external light source. Another approach is to use nanoparticles that can emit the visible light needed to activate photosensitizer. Infrared light, as opposed to visible light, can penetrate tissue to a depth of several centimeters but cannot activate visible-light absorbing photosensitizer.","title":"Photon Upconversion in Small Molecules"}
{"_id":"12d9fbfd-ceef-f75c-2760-6baca43d40e8","text":"In case of a subclavian obstruction the placement of a CS pacing lead via a collateral vein (where present and adequate in size) might be considered as a feasible option before attempting alternative and perhaps riskier approaches.","title":"Placement Of A Coronary Sinus Pacing Lead From A Sub-occluded Left Subclavian Vein Using A Collateral Vein To The Right Subclavian Vein"}
{"_id":"12e058bd-72f7-1ade-142a-fab2119f210d","text":"Our study showed a strong positive significant correlation in between the tumors sizes of TS, AP and CC with the radiological staging of the tumor. There was no study which exactly matches the present study but we found a study based on MRI comparing the volumes of the tumor to lymph node metastasis14. In our study a strong positive correlation was also observed among TS tumor thickness and level 2 lymph nodes. Thus indicating that for primary tumors of more than 4mm TS, the lymph nodes have a positive correlation for being positive for tumor. Madana J et al compared the CT measurements of Tumor thickness with histology and found them to closely relate to each other.17 Park JO found diagnostic accuracy with MRI and histopathological specimens in predicting the tumors size.18 However the availability and the patient tolerance of CT scan is better than an MRI Scan. Our population having SCC is mostly coming from lower socio-economic class. Therefore, CT Scan would be a better option for this class of patients.","title":"Relationship of Oral Tumor Thickness with the rate of lymph node metastasis in Neck based on CT Scan"}
{"_id":"12e38646-d694-fd63-e89f-8f9b1c914f71","text":"To estimate the posterior shift of the spinal cord, the distance from the rigid anterior wall of the spinal canal to the posterior edge of the spinal cord at each vertebral body or disk level between C2 and C7 was measured on MRI [18].","title":"Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy with Hypertrophic Ligamentum Flavum: A Retrospective Study"}
{"_id":"12e47a44-f007-9ff1-32ca-146a179c8268","text":"Our study showed no difference in loco-regional recurrence rates among these three groups. Our results lend weight to the argument that SLNB without ALND may be reasonable management for selected patients who can be treated with appropriate surgery and adjuvant systemic therapy. Further validation through a well-designed prospective randomized clinical trial with a larger study population and using a standard protocol is needed.","title":"Could axillary lymph node dissection be omitted in the mastectomy patient with tumor positive sentinel node?"}
{"_id":"12ef4f4a-b643-51cd-aa29-d3d9b9ef62b5","text":"Although NMSCs can be effectively treated with traditional treatments, there is great interest in new topical treatments related to the reasons discussed above.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"12f272b1-0db6-bc7d-2bd9-7d28f5d035c7","text":"Removing the mastoid process for advanced parotid tumors facilitates identification of the facial nerve and better preservation of the facial nerve function.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"12f5fa28-3ede-ee54-a4e7-a90fe163e324","text":"A selective literature research on risk factors and treatment modalities of limb occlusion after EVAR in the light of current guidelines and expert recommendations was performed.","title":"Abstracts DGG"}
{"_id":"12f5ff98-eca2-4af1-7cd6-589adfac2778","text":"The use of the pedicled latissimus dorsi flap for most head and neck reconstruction involves tunneling the flap through the axilla. The vascular pedicle is dissected to the axillary vessels. The latissimus is then tunneled from the axilla to the neck (Figure 11). The tunnel begins above pectoralis minor and below pectoralis major if it is still present. A portion of the clavicular head of the pectoralis major is sectioned lateral to the thoracoacromial vessels to allow a tunnel 4 fingerbreadths wide. Tunneling of the flap through the axilla still allows good reach to the posterior neck and scalp, as demonstrated in Figure 12. While the flap can in theory be swung posteriorly without tunneling through the axilla, this actually reduces superior reach of the flap. The latissimus dorsi can still be used if a previous pectoralis flap has been harvested, which makes the tunneling stage easier. Conversely, a pectoralis flap can still be utilized after a previous pedicled latissimus dorsi flap but only if the thoracoarcomial pedicle has been preserved. The donor site has rarely been violated in most head and neck patients. As such, this flap more than any other is especially useful when more common salvage reconstructive options such as the pectoralis major flap have already been performed—it is a great “salvage salvage” flap.","title":"Regional pedicled flap salvage options for large head and neck defects: The old, the new, and the forgotten"}
{"_id":"12f6eb30-a367-695f-a7e7-d4e988f4363d","text":"In alignment with improving flap perfusion and outflow, our team effectively utilized the entire fTRAM flap in a folded fashion, by creating an additional venous anastomosis between the donor superficial inferior epigastric vein of zone 4 and the recipient medial internal mammary vein. This provided our patient with the optimal reconstructive procedure that maximized flap viability while minimizing donor site morbidity. The supercharged fTRAM flap was an excellent autologous reconstructive option in this case due to the necessity of harvesting a large flap in a thin patient with minimal subcutaneous fat.","title":"Supercharged Free Transverse Rectus Abdominis Myocutaneous Flap: An Autologous Reconstructive Option for the Thin Breast Reconstruction Patient"}
{"_id":"12feade7-3ed9-03bd-78f3-6cdf77cd0c7d","text":"Island paramedian forehead flap provides esthetic and functional results in a single stage reconstruction of defects with various sizes and locations. This variation of forehead flap is a good choice especially for those patients that have problems with cost or problem with multistage reconstruction of nasal defects.","title":"Subcutaneous Forehead Island Flap for Nasal Reconstruction"}
{"_id":"13010f35-d588-77f7-5a73-ef29a6d7d111","text":"We perform microtia reconstruction in our center based on modified Nagata technique. Nagata advocated that first surgery should not be performed earlier than 10 years of age or chest circumference at level of xiphoid grows to at least 60 cm. We have been performing microtia surgery as early as patient reach 4 years old. Therefore, we divided patients into 2 groups to evaluate significant different on cartilage harvest, surgery and complication rate. The process of microtia reconstruction using tissue expander was performed in three stages.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"13019505-22b3-aa94-1a85-b4f80e4757ed","text":"The construction of instep flaps is based on the medial plantar vessels. The medial plantar artery is the smaller terminal branch of the posterior tibial artery. It passes distally along the medial side of the foot, with the medial plantar nerve being lateral to it. At its origin, it lies deep into the abductor hallucis and then runs distally into the intermuscular space between it and the flexor digitorum brevis, giving muscular branches to both, and terminates by anastomosing with a branch from the first plantar metatarsal artery to the medial side of the great toe. The cutaneous supply to the instep area is provided by one to three cutaneous perforators from the medial plantar artery on each side of the abductor hallucis muscle. The first and second perforators are found to have the larger diameters. The skin territory of a free instep flap based on the first and second perforators that can be harvested extends from the metatarsal heads to the heel, with maximal flap dimensions of 12cm in length and 7cm in width. Mourougayan [11] reported that the instep flap does not receive any significant myocutaneous blood supply. The flap [12] can thus be isolated purely on its neurovascular bundle without a cutaneous or muscle transposition base. It is this fact that broadens the instep flap’s potential for use as a free flap.","title":"Heel reconstruction with free instep flap: a case report"}
{"_id":"13022164-1b96-952f-11b6-3f284bc6561c","text":"With the studies indicating a rising incidence of breast cancer in Pakistan [17], a proportionate increase in diagnostic facilities is required; much more than it was in previous years to detect the disease at an early stage and thus reduce the mortality and morbidity associated with the disease and its toxic treatment. The number of nuclear medicine surgical oncology centers offering radionuclide sentinel node detection using gamma probes is very few across the country. In the densely populous capital city of the province of Punjab, there are only two such facilities operating in Lahore. With the addition of such a facility at our center, which is a highly specialized institute offering diagnostic and treatment services for cancer patients, a huge number of patients are expected to benefit. According to the institute registry, an average of 1000 patients are attended to in the breast screening clinic every year and >1200 mammography procedures are performed annually. The center has already established liaisons with five surgical units in the city, which have a high turnover of breast cancer patients. Additionally, training is provided at our center to conduct the procedure successfully, which leads to increased availability of the service in other centers of the country.","title":"Sentinel Lymph Node Mapping in Breast Cancer: Initial Experience of a Multidisciplinary Team"}
{"_id":"13036426-4f16-2a78-b3c2-e4e46ddc5a0d","text":"There are two types of hypersensitivity reactions to chlorhexidine [1, 2, 5, 6]. The immediate reactions are characterized by the onset of symptoms occurring within 30 minutes after exposure to the causative agent and are associated with the production of specific IgE class antibodies that bind to receptors on the surface of mast cells and basophils promoting the release of various inflammatory mediators. This type of reaction presents clinically as urticaria and angioedema and may progress to anaphylaxis compromising the cardiovascular and respiratory systems and leading to death. Allergy to chlorhexidine may also manifest as a delayed hypersensitivity reaction that occurs between 48 and 72 hours after exposure and usually presents as contact dermatitis. These late reactions are mediated by T lymphocytes and do not present a risk of serious systemic reactions.","title":"Perioperative Anaphylaxis to Chlorhexidine during Surgery and Septoplasty"}
{"_id":"13089209-e141-161e-8204-3d0f97ad2e55","text":"Surgery alone does not offer a complete cure for breast cancer. A high index of clinical suspicion is required to diagnose cutaneous metastasis or recurrence in carcinoma breast. Such recurrences are usually associated with distant metastases and have an abysmal prognosis. Therefore, early detection and treatment should focus on treating these patients to improve survival rates with minimal morbidity.","title":"A Rare Occurrence of Cutaneous Recurrence in a Patient of Post Modified Radical Mastectomy"}
{"_id":"130b67b1-c2f9-a6fa-0e2d-2dbe9ab12c79","text":"There were a total of 22 complications for a complication rate of 0.96. The most common complication was knee contracture (7 patients), all incidences of which were treated by quadricepsplasty. No hamstring releases were performed to treat flexion contractures of the knee. There was one case of osteomyelitis which was treated with pin site debridement and IV antibiotics. Six patients developed pin site infections and required a course of oral antibiotics. One patient suffered a subtrochanteric fracture following a fall, which necessitated modification of the Ilizarov frame. There was one case of neurological deficit with the patient developing a foot drop as well as decreased sensation in the foot which resolved over time. Four patients in this subgroup developed bone deformities over the course of treatment. Two patients developed procurvatum deformities. One patient developed a varus deformity which was treated by adjusting the frame. One patient developed a varus deformity of distal femur as well as recurvatum deformity of proximal tibia.","title":"Femoral Reconstruction Using External Fixation"}
{"_id":"1311477c-73b1-841a-a188-930af4e4eeae","text":"Diced cartilage is an excellent tool for filling and augmentation purposes, but it may also be difficult to be introduced in the tissue. Different techniques have been presented for this issue. Some investigators implanted diced cartilage into prepared subcutaneous pockets by syringe. Cartilage pieces were wrapped in surgical. The reports demonstrated the clinical failure of diced cartilage wrapped in surgicel and recommended the use of temporalis fascia for wrapping around cartilage before implantation. If a large amount of cartilage graft is required, harvesting of rib cartilage is often needed. Diced cartilage grafts can use all excised cartilage pieces with goad viability and less visibility in rhinoplasty.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"131171df-4fb4-b7f6-e16e-6edbe3ff073e","text":"Each of these patients underwent preoperative lymphoscintigraphy technetium sulfur colloid either the day before, or the morning of SSL. Approximately 750uCi of 99Tc sulfur colloid was administered intradermally at the site of the primary tumor. Subsequent scintigraphy was performed and dynamic and static images recorded.","title":"Reoperative Selective Sentinel Lymphadenectomy Combined With Lymphoscintigraphy Is Technically Feasible for Cutaneous Tumors of the Upper Extremity After Radical Dissection of Regional Lymph Node Basins for Breast Cancer Miranda et al"}
{"_id":"1316f64d-efe7-7268-0b21-ec6c1553d9be","text":"The relationship between allergen exposure to animal allergens (especially cats and dogs) and IgE sensitization or the development of allergic symptoms has been investigated in a number of studies. So far, the results are inconsistent. While many studies found a positive correlation between allergen exposure and incidence of allergies, this association could not be confirmed in other studies. Some studies even showed that high exposure to allergens can have a protective effect against IgE sensitization and allergies. A possible reason for these contradictory findings could be that nearly all studies examined the allergen exposure in one particular environment, mostly at home. Levels of animal allergens that additionally occur in other environments contribute substantially to the total exposure and should be further considered in epidemiological studies.","title":"Respiratory Allergens from Furred Mammals: Environmental and Occupational Exposure"}
{"_id":"132441b6-47e4-a0d2-8fcf-ad2a9466b6df","text":"In conclusion, the feasibility of in vivo CLI imaging using an integrated EMCCD and fundus camera has been demonstrated in a small group of patients undergoing ruthenium-106 plaque brachytherapy for posteriorly located choroidal melanoma. The overall image quality differed markedly between the patients, and the best images were obtained when CLI was performed along with the use of a weak fixation light and the integrated 600 nm short-pass filter in patients with moderately to markedly pigmented tumors treated with high activity plaques. Further refinement of the CLI technique and the use of more sensitive cameras with a wider field of view are needed to improve its clinical usefulness, which will be explored in future studies.","title":"Cherenkov Luminescence Imaging for Assessment of Radioactive Plaque Position in Brachytherapy of Uveal Melanoma: An In Vivo Feasibility Study CLI in Brachytherapy of Uveal Melanoma"}
{"_id":"132b8d83-c7b7-c14e-3054-a04bc77f526d","text":"A 20 year-old patient 3 weeks after a car accident had a type 3b Gustilo fracture and at the first hospital the wound had been debrided and an external fixator applied. At the time of admission in our clinic the wound was clean but a 12 cm tibia defect with necrosis and a large soft tissue defect at the upper tibia with destruction of the anterior and anterolateral leg muscles was observed. The patient declined amputation and requested salvage of the leg. RLD muscle flap with one rib was harvested and the rib was trisected forming 3 struts. The flap was set in place and anastomosis of the vascular pedicle was to the popliteal vessels. The postoperative course was uneventful and after three months assisted weight bearing was begin and the patient was able to bear weight fully after nine months. The X-ray at nine months shows considerable hypertrophy of the bones (Figures 8-14).","title":"Combined Rib-Latissimus Flap; the “Picket Fence” Concept for Reconstruction of Upper Tibia Defects"}
{"_id":"132cbeb3-fd71-60d2-ecc1-1ddf4a92488b","text":"The most appropriate therapeutic approach for Candida osteomyelitis usually consists of antimicrobial therapy either alone or combined with a surgical approach in about half of the cases. The type of antimicrobial therapy depends on the pathogen species and sensitivity. Fluconazole is the most commonly administered agent, since it has less adverse events than amphotericin B and a more favorable bone penetration than echinocandins [13].","title":"Candida albicans Osteomyelitis Pubis: The Possible Pathogenic Role of Pelvic Irradiation"}
{"_id":"134a8fe2-b814-a24a-9562-ba5b75b533e4","text":"Obstructive sleep apnea occurs when the passage of air through upper airways is hindered and breathing effort occurs during more than 10 seconds. Hypopnea refers to a decreased air flow in upper airways for at least 10 seconds. These events occur repeatedly and only during sleep, resulting in the typical signs and symptoms of OSAHS.","title":"Service Profile of Orthognathic Surgery of a Medical School"}
{"_id":"134aff04-d316-d475-623b-228c3c6c6f1f","text":"One of the problems with all these studies is that mother and family were not blinded to the investigator's findings, and it seems likely being told your infant is tongue tied might cause anxiety and influence how breast feeding goes. Nevertheless, based on these data, the majority of infants who are diagnosed with ankyloglossia do not appear to have difficulties breast-feeding, however there is a group of infants who do, and it raises the question of whether there is any causality between ankyloglossia and difficulties breast feeding and one way to try and answer this question is to release the tongue tie via frenulotomy and see if it helps.","title":"What is tongue-tie and does it interfere with breast-feeding? – a brief review"}
{"_id":"134f412f-654b-1ce6-f1b7-a10f084d8612","text":"Given the above, developing studies in babies diagnosed with ankyloglossia and submitted to lingual frenotomy is of great relevance. The electrical activity makes it possible to understand its impacts both on the behavior of the muscles involved in breastfeeding and on the functioning of breastfeeding.","title":"Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles Efeito da frenotomia lingual na amamentação e na atividade elétrica dos músculos masseter e supra-hióideos"}
{"_id":"13537460-1f85-1f30-ecd9-c4ec40203f54","text":"Perforator flaps may represent a good alternative to the free flaps in the areas were other local reconstructive procedures are not possible. This is a versatile technique and with decreased donor site morbidity limited to a single body area. There is a specific like to like soft tissue replacement leading to a better cosmetic and reconstructive outcome. The main drawback of the perforator flaps however is the higher risk of venous congestion.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"1354a37b-fd88-94af-e3d6-66fa599c0313","text":"In 2010, Jandali et al3 retrospectively reported a series of abdominally based flaps for breast reconstruction after cosmetic abdominal surgery. This series included 3 cases of free transverse rectus abdominis myocutaneous flap breast reconstruction after abdominoplasty and 3 cases of free transverse rectus abdominis myocutaneous or DIEP flaps after abdominal liposuction. In addition, De Frene et al6 reported DIEP flap reconstruction after liposuction. In this series, color Doppler was used to assess perforator patency. In both series, the authors suggested that vascular ingrowth after the initial cosmetic procedure may have enabled the subsequent reconstruction. While this may seem feasible for a transverse rectus abdominis myocutaneous flap reconstruction based on multiple medial and lateral row perforators, this seems less likely for a DIEP flap.","title":"CASE REPORT Case Report and Review of the Literature: Deep Inferior Epigastric Perforator Flap for Breast Reconstruction After Abdominal Recontouring"}
{"_id":"13551c16-123c-312d-48c4-9d62ba267c16","text":"IRB is not applicable to this case series and review of literature.","title":"Nodular Eruptions as a Rare Complication of Botulinum Neurotoxin Type-A: Case Series and Review of Literature"}
{"_id":"1355b8f2-31f9-9a80-d3ac-c3acfaaf9882","text":"In the prospective study described in the present paper, we investigated the results of resecting an isolated diaphyseal bone tumor of a long bone and performing reconstruction using pedicled vascularized fibula grafts in twelve young patients.","title":"Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection"}
{"_id":"1356103f-0f25-e4a4-e748-25e4d3fd32b6","text":"Faglia et al found a significant association between hindfoot location of DFO and major amputation in a series of 350 patients. The data of our study confirmed this result in a 1.7-fold larger episode sample group. There are several differences between both studies that are important to note. Contrary to Faglia et al, we included patients with CN to test CN as an additional potential risk factor for major amputation. Further, we introduced preoperative antibiotic therapy as well as duration and administration route of postoperative antibiotic therapy in the statistical analysis. Our statistical model differed as we tested the 3 anatomical regions against each other whereas Faglia et al did not introduce the midfoot area as a separate variable in their analysis. Finally, we performed separate analyses for overall and secondary major amputations.","title":"Foot Osteomyelitis Location and Rates of Primary or Secondary Major Amputations in Patients With Diabetes"}
{"_id":"135d6003-2df1-902d-e1a7-aed034588f5e","text":"Histopathological in situ component and tumor necrosis were either existing or not.","title":"Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?"}
{"_id":"135e99e4-809d-a4c7-e231-a1db960f6f73","text":"We concluded two findings: firstly, for accurate preoperative planning of a vascularized free fibula procedure, examination of the bilateral lower leg vasculature either by angiography or other imaging should be performed. Secondly, abnormalities are not in themselves reason to abandon the vascularized free fibula procedure. We contend that pedal pulses should be evaluated preoperatively and provided that adequate foot circulation can be confirmed (by temporarily clamping the vessels and releasing the tourniquet during the operation prior to harvesting the free vascularized fibula) the procedure should be successful without jeopardizing the donor leg.","title":"Assessment of vascularized free fibula transplantation revealing a congenital aplastic posterior tibial artery: a case report"}
{"_id":"13748c85-33dd-9378-eb6c-ab6da7ac02b8","text":"Our observations support the concept that an inflammatory response is an essential component of imiquimod treatment success. Patients and physicians should be prepared for the potentially severe inflammatory response and know how to manage this. Photographs of typical reactions are useful for informing potential patients. It is also important to be aware that there will be inflammation of any co-existing actinic keratoses. In our study all patients managed to complete the course of treatment although some required a rest period because of tissue reaction. It is possible that an altered dose regimen may reduce the impact of the inflammatory response without changing the therapeutic effect.15","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"1378d621-a0d6-2451-53ec-a5bc62d88545","text":"Cross finger fascial flap combined with thin split-thickness toe nail bed graft is a new and rewarding surgical method to reconstruct large area defect of the nail bed with distal phalanx exposure.","title":"Reconstruction of large area defect of the nail bed by cross finger fascial flap combined with split-thickness toe nail bed graft A new surgical method"}
{"_id":"13801e4d-29af-f452-bca4-933dfa3a2ad6","text":"Secondary intention healing is the least invasive wound management technique for small scalp wounds and may be appropriate for patients who are poor surgical candidates [2]. However, there are concerns related to the longer duration of healing and exposure of the scalp calvaria, such as osteomyelitis and infection. Secondary intention healing of the scalp may not occur in the setting of prior radiation therapy due to osteoradionecrosis of the bone. Poor blood supply to the area of exposed bone can potentially lead to serious complications progressing from osteomyelitis to meningitis and brain abscess.","title":"A Retrospective Cohort and Systematic Review of Non-Operative Management of Exposed Calvaria Post-Radiotherapy"}
{"_id":"138a45cd-7ffb-a4a7-c9d3-c60a2ca3f825","text":"Each case series and cohort study were assessed for methodological quality using a standardized critical appraisal instrument, the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Case reports and letters to the editor were not submitted to these appraisal tools. The primary endpoint was to describe the use of perforator flaps in the indication of HS defects in order to assess their safety and reliability. The secondary outcome was to identify risk factors for complications.","title":"Outcomes and Reliability of Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects: A Systemic Review and Meta-Analysis"}
{"_id":"139589d8-83b0-79c6-e90d-f27191454574","text":"Of the 15 women who underwent preoperative MRI, five were noted to have an additional area of malignant enhancement not seen on conventional imaging. The management of four of these patients was altered to take account of the previously unrecognised lesions. The information was specifically used by the surgeon as part of the surgical planning for the TM to incorporate additional volume resection and enable breast reshaping (Table 3).","title":"The Role of Magnetic Resonance Imaging in Preoperative Planning for Patients Undergoing Therapeutic Mammoplasty"}
{"_id":"13969350-6493-c4d8-f483-b56865078432","text":"The grouping by subspecialty was performed according to certain criteria. Radiologists who had completed at least 6 months of specific fellowship training were grouped by fellowship specialty. Such radiologists accounted for 17 of the 22 radiologists at our institution. Those who had not undertaken a fellowship( were asked to choose a field in which they felt most competent and confident based on their comfort level in practice. Those radiologists were offered additional training by joint reading, as well as specialty workshops on topics such as coronary computed tomography angiography.","title":"Subspecialized radiology reporting: productivity and impact on the turnaround times for radiology reports in a middle-income country Radiologia subespecializada: produtividade e impacto no tempo de resposta dos relatórios de radiologia em um país em desenvolvimento"}
{"_id":"13a19893-a817-d7ec-87b2-c1ae3ec27cd3","text":"Among the interesting findings was that number of LNs dissected in AND or SLNB management was associated with better overall recurrence. On the other hand, number of invasive nodes detected in AND and SLNB was associated with worse recurrence. These findings should be considered with caution regarding its clinical application as higher number of dissection will ultimately produce higher complications such as lymphedema.","title":"Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?"}
{"_id":"13a31e15-e7a9-2269-a1f4-f249de9758e5","text":"BCC is the most common cutaneous cancer in the midface area and is characterized by local spreading and an exceptionally rare tendency to metastasize. Radical excision has a significant advantage compared with other treatments because surgical excision ensures the highest chance of cure. Therefore, the main treatment for BCC is surgery, and the safe margins of the excised tumor excised are mainly decided by intraoperative frozen section diagnosis. Excision defects of the middle face may be covered with skin grafts, regional or local flaps, or even free flaps.","title":"Frontal axial pattern flap combined with hard palate mucosa transplant in the reconstruction of midfacial defects after the excision of huge basal cell carcinoma"}
{"_id":"13c94c49-203e-4fe2-034f-22ec22f7e3de","text":"Bone grafting was not performed at this procedure. Nevertheless, the union was achieved in all our patients. Aktagulu et al. reported 242 cases from 27 articles had bone union without any problems at docking site with the external fixator, without any bone grafting [31]. That further proving that Illizarov method is a very cost-effective and powerful method, in enhancing union of docking site and consolidation of distraction callus subsequently without the need of any bone graft. The advantage of this procedure in this study was not needed tertiary soft tissue procedure and additional bone graft to overcome this bone and soft tissue defect. This procedure can be done with lower medical expense for the treatment of such this condition. The other advantage of ilizarov method is the long defect of the bone can be filled with bone transport procedure without any graft added into the bone defect, including in the docking site. This can occur because of the ilizarov compression. The skin defect can also keep pace with this bone transport by primary closure. The primary closure of the skin defect is caused by approximation of the wound edge that caused by empty space after radical resection of long dead or infected bone segment without tertiary procedure. However, the disadvantages of the ilizarov technique is pin track infection and failure in distraction although the occurrence of these incidence is relatively minimal.","title":"The efficacy of ilizarov method for management of long tibial bone and soft tissue defect"}
{"_id":"13d47332-3c7d-fa18-ab16-2dfd74cb1b5e","text":"Is intradural fat graft packing indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries? This study aimed to review the methods and outcomes of our graded sellar floor reconstruction strategy without fat graft packing in endoscopic endonasal pituitary adenoma surgeries.","title":"Intradural fat graft packing is not indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries"}
{"_id":"13dd5b14-73b6-95a5-f785-c37d30bf84c6","text":"We found that patients with lower literacy degree were more satisfied with the procedure. Rhinoplasty surgery significantly improved patient quality of life regarding nose function and appearance.","title":"Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study Avaliação dos desfechos estéticos e funcionais em cirurgia de rinoplastia: um estudo prospectivo"}
{"_id":"13ddc731-df7a-9739-a9a1-174852e1fc52","text":"In other words, knowledge of the position of the perforator is crucial for Island TRAM flaps because this technique involves using a section of the rectus abdominis muscle to reconstruct the breast. The Island TRAM flap technique preserves the blood supply to the tissue by using perforator vessels that travel through the muscle from the deep blood supply to the skin and fat of the abdomen. By identifying the location of the perforator vessels, the surgeon can ensure that the tissue used for reconstruction has a reliable blood supply, reducing the risk of complications such as flap loss or fat necrosis. However, the location of the ideal perforator of flap that enables the Island TRAM, which has been developed and considered a novel technique developed from it, including the conventional TRAM flap, has not been clearly confirmed and studied. In addition, it was not possible to summarize whether only about five ideal perforators were really present in the hemiabdomen. For the success of surgery, it is recommended to preserve as many perforators as possible, but since these studies were lacking, our study should be believed meaningful. In this study, the perforator location of 50 patients in the recently developed Island TRAM flap surgery was identified and created and presented the mapping accordingly. Analysis of the results showed that there were an average of 5.86 and 5.88 ideal perforators on the medial side and lateral side when patients were bisected from hemiabdomen to zone I. According to DIEA's bifurcating system, it was possible to see that there was an almost symmetrically similar number of perforators in each branch. It was found that section III and section VII had the largest number of perforators on average, where there were at least three ideal perforators in the space between the umbilicus lower border and the arcuate line. On the other hand, the thickest perforators among ideal perforators were mainly identified as M2 and M3, and these blood vessels were considered to be the main ideal perforator.","title":"Deep Inferior Epigastric Perforators Topography for “Island Transverse Rectus Abdominis Musculocutaneous Flap” in Breast Reconstruction"}
{"_id":"13e1710a-6d31-e23a-c0ce-a8534dc8889d","text":"Saphenous vein segments were harvested from 12 male patients undergoing coronary surgery at our institution and patients provided their written informed consent before surgery. Patients also signed an informed consent for the use of their anonymized clinical data and biological specimens for non-genetic research purposes. The present investigation abides by the principles outlined in the Declaration of Helsinki (Ethical Principles for Medical Research Involving Human Subjects) adopted by the 18th WMA General Assembly in Helsinki, Finland.","title":"Efficacy of Intraoperative Vein Graft Storage Solutions in Preserving Endothelial Cell Integrity during Coronary Artery Bypass Surgery"}
{"_id":"13e3c85c-d48b-7157-6d2e-4ea5024d0ea5","text":"In this randomized study we found that compared to the traditional open method of harvesting long saphenous vein, a less invasive technique employing a Mayo vein stripper was quicker and provided significantly improved wound healing. There are other instruments available but the Mayo stripper has the advantage of being reusable and is therefore less expensive than disposable devices.","title":"Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest"}
{"_id":"13e4d1ac-814a-c611-d769-76313afb2ecf","text":"Intradermal and subcutaneous injections of UCA in the mammary areola region may have clinical application value for the identification and localization of SLNs in breast cancer patients. And it can identify some SLNs which cannot be identified using the dye method, which can be used as a new tracer of SLNB and complement other staining methods to improve the success rate.","title":"The value of contrast‐enhanced ultrasound in determining the location of sentinel lymph nodes in breast cancer"}
{"_id":"13e76559-d36a-f18c-6832-e54e1ee38a22","text":"The results of the procedure were noted in the form of intensity of pigment, perigraft spread of pigment, and the color match with the surrounding skin. At the same time, the texture of skin over the grafted area was matched with that of the surrounding normal skin. Perigraft spread of pigment was the best for facial lesions and lesions close to hair line and the poorest for ankle lesions.","title":"Split Thickness Skin Grafting in Patients with Stable Vitiligo"}
{"_id":"13fcfeca-c59d-e2ec-3f2c-c322b6498e5f","text":"Long term therapy corresponds to anticoagulation beyond 3–6 months when the primary goals of therapy are to continue to suppress thrombin generation in order to prevent recurrent VTE. The primary long term treatment of VTE is anticoagulation. In the past, oral VKA were the mainstay of long term therapy except for in cancer patients in whom LMWH has been preferred. DOACs also represent an attractive option for long term therapy of VTE in appropriate candidates. In patients with contraindications to initial anticoagulation, vena cava filters are employed. In these patients, it is important to routinely reassess patients for the continued presence of contraindications to anticoagulation on an ongoing basis as VCF are associated with an increased risk of recurrent DVT and IVC thrombosis. Since the majority of patients have temporary contraindications to anticoagulation, retrievable filters with a broad window of retrievability should be used. In patients on long term anticoagulation it is important to reassess the risks and benefits of continued anticoagulation on a routine basis given the changing medical circumstances of patients over time.","title":"Guidance for the treatment of deep vein thrombosis and pulmonary embolism"}
{"_id":"13ff3305-65c8-95f6-534e-b86317916641","text":"The first regulatory body an IMG comes into contact with is the GMC. Our recommendations are that the GMC would be wise to:","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"13ffed83-87d8-96fa-4675-1b05bbec0c22","text":"In this study, we focused on the lower limb because partial necrosis is more frequent for PPF (Perforator Propeller Flap) located on legs than in other locations. We retrospectively analyzed the records of patients who underwent propeller flap treatment in our hospital to assess the distance from the perforator to the propeller flap. The aim of the study was to determine the shortest safe distance from the perforator to the wound to increase the success rate and reduce the incidence of flap necrosis.","title":"Predictors of the surgical outcome of propeller perforator flap reconstruction, focusing on the effective safe distance between the perforator and the wound edge"}
{"_id":"14084603-4fc8-1537-4e00-1239cf0bb462","text":"Therefore, we have performed the wide ALTP flap transfer using a turbocharging procedure where the perforator from TB-LCFA was connected to the side branch of the DB-LCFA. This study retrospectively reviews our experiences in these turbocharged wide ALTP flap transfers. To our knowledge, there have been no organized studies except for some case reports on turbocharged ALTP flap transfer. This study aimed to describe the details of our turbocharging technique in the free transfer of a wide ALTP flap and demonstrate its effectiveness in reconstructing traumatic extensive soft tissue defects of lower extremities.","title":"The turbocharged wide anterolateral thigh perforator flap to reconstruct massive soft tissue defects in traumatized lower extremities: A case series"}
{"_id":"141524fc-0f20-6b60-d22d-c0c1bbc5b5e0","text":"We believe that this technique may be suitable for open supramalleolar distal tibial fractures, open diaphyseal fractures and open fractures of the subtuberosity proximal tibia. As local flap options are often more restricted in the distal region and the deformity needed easier to gain, the distal tibial open fracture is most suitable for this technique.","title":"Conversion of open tibial IIIb to IIIa fractures using intentional temporary deformation and the Taylor Spatial Frame"}
{"_id":"1415e627-0f0f-8e90-b289-8147fe43ff53","text":"We report a 16 year old competitive basketball athlete who underwent a combined anterior and posterior approach for resection of an osteosarcoma of the sixth cervical vertebra. Fourteen years after the index procedure, the patient eliminated spontaneously one screw through the intestinal tract via an oesophageal perforation and developed a severe dysphagia. Three revision surgeries were performed to remove the anterior plate because of the great amount of post-surgery and post-irradiation fibrosis.","title":"Screw migration and oesophageal perforation after surgery for osteosarcoma of the cervical spine"}
{"_id":"14267417-47be-380d-54bc-76a3732d8708","text":"The direct comparison between patient groups did not provide any significant difference. There was no significant correlation with the clinical data.","title":"In vivo exploration of synaptic projections in frontotemporal dementia"}
{"_id":"14289a59-f035-41bd-382e-69d9065b43a5","text":"Therefore, in management of locally malignant tumours one should not be lenient in the fair of development of large post surgical defect. Thus in the management of postsurgical defects, planning in reverse is very important. Another alternative treatment is Mohs micrographic surgery, but this is usually left for specific locations such as the face or eyelids, where large resections may lead to functional problems. Mohs micrographic surgery has the advantage of high oncologic effectiveness and maximal tissue savingand is increasingly accepted as the treatment of choice.","title":"Recurrent Dermatofibrosarcoma Protuberance and its Management with Radical Excision and Interval Skin Grafting: A Case Report"}
{"_id":"1430ed2c-5222-0e70-e55c-f59999318df8","text":"One such intervention currently being used throughout the NHS and globally is Negative Pressure Wound Therapy (NPWT), a technique that uses negative pressure to remove fluid from open wounds through a specialised sealed dressing placed into the wound cavity. The mechanism by which NPWT works is not yet fully understood but it is thought to be associated with the removal of exudate, increased blood supply to the area, and reduction of cytokines and matrix metalloproteinases.","title":"The College of Podiatry Annual Conference 2015: meeting abstracts Harrogate, Yorkshire, UK. 19–21 November 2015"}
{"_id":"14316532-d158-5268-cb38-f1b55410010f","text":"We also categorized a VTE as provoked or unprovoked. Patients with a preexisting cancer diagnosis as well as a fracture or trauma, surgery, pregnancy, or prolonged immobilization due to hospitalization within 90 days before a deep vein thrombosis or pulmonary embolism diagnosis were classified as having a provoked VTE, while those without these factors were classified as having an unprovoked VTE. 25 We defined prolonged immobilization as an inpatient stay of at least 14 days from the date of admission to discharge. 26 We considered an admission occurring on the same day as discharge from another admission a transfer between hospital departments rather than two separate admissions.","title":"Venous Thromboembolism in Denmark: Seasonality in Occurrence and Mortality"}
{"_id":"14390a22-5db6-bcac-87db-22acde250fdb","text":"The primary breast cancer in our case did not contain melanoma cells that might have arisen through collision between two histologically different primary tumours, nor was there any pathological evidence of metaplasia, neuroendocrine differentiation or cancer to cancer metastases. The presence of two metastatic cell phenotypes in the axillary lymph node with different immunohistochemistry profiles is likely to have occurred in a metachronous fashion with the melanoma metastasis being detected incidentally during axillary dissection for breast carcinoma. The involved lymph node in probability represented the true sentinel node draining the skin of the chest wall and the breast. It is possible that melanoma micrometastases was dormant in the axillary lymph node and did not progress to clinical significance following the melanoma diagnosis. Melanoma micrometastases may therefore not be prognostically equivalent to overt nodal metastases and may reflect the natural history of melanoma micrometastases in the sentinel lymph node [9]. Barnhill et al [10] demonstrated that melanoma micrometastases lack significant rates of proliferation, apoptosis and neo-vascularisation when compared with macrometastases as the angiogenic and lymphangiogenic factors may be suppressed by host immune responses.","title":"Breast carcinoma and malignant melanoma metastasis within a single axillary lymph node"}
{"_id":"14620a3e-26c9-8f10-77cb-786ab8e14b9e","text":"The results of this study suggest that the etiology of radial nerve lesions demanding surgery is most often accidental, rather than health related, and the resources should be directed toward the prevention of such accidents (both traumatic and iatrogenic). Future studies should focus on all aspects of the lesion to better guide the management and potentially predict outcomes of surgical treatment.","title":"Etiological and epidemiological characteristics of surgically treated radial nerve lesions: A 20-year single-center experience"}
{"_id":"14664493-5711-78c2-b140-d71cb47e993e","text":"Based on these assumptions, the main purpose of our study was to investigate whether patients in whom only one lymph node was found during SLNB have a worse prognosis than patients in whom two or more sentinel lymph nodes were found and examined.","title":"Effects of the number of removed lymph nodes on survival outcome in patients with sentinel node-negative breast cancer"}
{"_id":"1466e88d-f049-a367-ae7a-0bbb2bd8a421","text":"Moreover, with the recent increase in the numbers of diabetic patients, critical limb ischemia due to multiple and large occlusions of the lower limb vessels is becoming more and more common; therefore knowledge of these arteries is needed in order to avoid amputations.16","title":"Clinical features of a rare anatomical variation of the posterior tibial and fibular arteries Aspectos clínicos de uma variação anatômica rara das artérias tibial posterior e fibular"}
{"_id":"146f8b87-1c44-aa92-51dc-a812eb805d88","text":"We conducted a direct chart analysis of 597 patients with histological diagnosis of N-MSC treated with SXRT in an oncology hospital (Barretos Cancer Hospital) from 2000 to 2005. Every lesion was considered as an independent cancer and some metachronic lesions in the same patient were included in our study even before to 2000 or after 2005, in such a way that lesions treated from 1979 to 2013 were included in the analysis. In an attempt to standardize the classification all lesions were re-staged using the AJCC 7th edition reference. No patients had clinical evidence of regional lymph node or distant disease at presentation. No patient had underlining immunocompromised status.","title":"Head and Neck Non-Melanoma Skin Cancer Treated By Superficial X-Ray Therapy: An Analysis of 1021 Cases"}
{"_id":"1477dcb4-2e5e-b524-d91b-cfe8800cdbd9","text":"Pathology and immunohistochemistry studies of his pancreas, jejunum, and spleen showed transitional hyperplasia and spindle cells atypia with invasion of his pancreas and muscular layer of his intestinal wall. There was evidence of reactive hyperplasia of lymph nodes and mild congestion of his spleen.","title":"An unusual finding in a desmoid-type fibromatosis of the pancreas: a case report and review of the literature"}
{"_id":"147a3c4f-49f7-3489-ab1b-1e79a74ae750","text":"The limitations of the study are that it is retrospective and the sample size is small. However, our study is valuable in terms of the fact that little work has been done on this subject in Turkey and it supports future studies.","title":"The Use of Free Fibula Flap in Different Extremities and Our Clinical Results"}
{"_id":"14814aeb-668d-8d1b-4ac9-da98f05ade7a","text":"Evaluating SFN can assist in further classification of FM as well. It has been suggested that some patients in whom FM is diagnosed and are found to have SFN, may in fact have another cause for their SFN. Identifying SFN in patients with FM then allows for additional diagnostic studies to determine whether or not there is an alternative cause for the SFN and in doing so guides management. It has also been suggested that FM is perhaps a general term for a spectrum of diseases that have yet to be fully identified and defined. It is entirely possible that there is a centrally mediated process at cause in some cases of FM and a peripherally mediated process at cause in others and perhaps even at times a combination of the two. Additionally, some investigators have described that complex regional pain syndrome\/reflex sympathetic dystrophy (CRPS-I\/RSD) may actually be a form of SFN [2].","title":"Intraepidermal Nerve Fiber Density as Measured by Skin Punch Biopsy as a Marker for Small Fiber Neuropathy: Application in Patients with Fibromyalgia"}
{"_id":"148494ee-c78b-9057-da5d-ebc8342bd4fa","text":"Rhinoplasty is one of the most-performed cosmetic surgical procedures in the United States (352,555 procedures in 2020) and one of the most technically challenging procedures in plastic surgery, because of its limited access and the requirement for a three-dimensional framework.1","title":"Prospective Clinical Trial Evaluating the Outcomes Associated with the Use of Fresh Frozen Allograft Cartilage in Rhinoplasty"}
{"_id":"1490da68-6c7e-5429-93e1-cea1579a82a5","text":"A key finding of our study was that surgical specialties had consistently lower leadership diversity when compared with the average diversity of all residency programs, whereas primary care specialties typically had similar or increased diversity. All 4 surgical specialties had significantly lower proportions of minority program directors, female program directors, and female chairpersons than the average for all specialties. However, in terms of minority chairperson diversity, 3 of 4 surgical specialties showed similar diversity to the average across all specialties. In contrast, orthopedic surgery was the only specialty with significantly lower minority chairperson representation than the average. Our results suggest that surgical specialties lag in leadership diversity, which is similar to previous studies that have shown a gap between surgical specialties and primary care specialties in terms of resident and faculty diversity.","title":"Racial, Ethnic, and Sex Diversity in Academic Medical Leadership Racial, Ethnic, and Sex Diversity in Academic Medical Leadership"}
{"_id":"14947f02-9e54-7385-9b7d-6d82dbbf9af1","text":"No change of topical treatment before 16 weeks is allowed as this is the primary endpoint for the topical treatment effect, even though the licensed duration of treatment differs for the two products. The addition of cryotherapy after week 4 is permitted because of current practice in the UK. A failure of response after 4 weeks of podophyllotoxin, which is the licensed duration of treatment, would currently prompt consideration of alternative treatment. In order to retain participants in the study, continuation of podophyllotoxin up to 16 weeks is therefore permitted within the protocol. Use of cryotherapy after 4 weeks is at the discretion of the investigator; cryotherapy use is recorded. A cryotherapy-alone arm was not included as being beyond the remit of this study, and because of the implications for the size of the trial.","title":"Human papillomavirus infection: protocol for a randomised controlled trial of imiquimod cream (5%) versus podophyllotoxin cream (0.15%), in combination with quadrivalent human papillomavirus or control vaccination in the treatment and prevention of recurrence of anogenital warts (HIPvac trial)"}
{"_id":"14a4cb10-ee67-dc6f-3768-f49350cc0205","text":"Recurrence was defined as a lesion that histological examination has proven recurrent aggressive fibromatosis or a lesion that was deemed suspicious on imaging.","title":"The Management of Desmoid Tumors: A Retrospective Study of 30 Cases"}
{"_id":"14a81836-40a9-1f47-14f5-ec929d2e43cc","text":"A further benefit of respecting skin grafts is the quality of reconstruction that flaps can provide.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"14bda24d-cfda-f26c-9610-2a3724045046","text":"Primary cutaneous mucinous carcinoma of the eyelid is a rare neoplasm arising from sweat glands. These tumors often resemble common lesions, thus are often unsuspected until confirmed by tissue diagnosis. They are characterized by slow growth and local invasion with a high rate of recurrence. The preferred treatment is local excision with wide margins, but the location of these tumors often requires more narrow margins with reconstructive efforts depending on the extent and location of the tumor.","title":"Primary Cutaneous Mucinous Carcinoma of the Eyelid"}
{"_id":"14c4feed-2abd-1b45-c018-9a0de53f36f4","text":"Following plating there was an initial slight reduction in cell numbers at all plating densities.","title":"Aminolaevulinic acid-induced photodynamic therapy: cellular responses to glucose starvation"}
{"_id":"14c6e18c-566f-90e6-579b-c97dc5e8bf9d","text":"Using minced split-thickness skin grafts overlaid with Pelnac enables the reconstruction of full-thickness skin defects in a single step and can increase the rate while improving the quality of wound healing.","title":"Abstracts from the 12th Asia Pacific Burn Congress Singapore. 14-17 August 2019"}
{"_id":"14ca6c93-8b2e-5eff-a50d-e8887ae0ad9d","text":"Nurse practitioners have also been integral in the education of bedside nurses who care for children receiving immunotherapy. As a result of educational interventions, nurses are fully aware of the expected side effects of therapy and are confident in their ability to recognize toxicities before they become severe. Bedside nurses can follow the algorithms and contact front-line providers when appropriate. Consistency and reinforcement of standard practices have decreased staff anxiety over delivery of care, which in turn has decreased patient and parental anxiety as well.","title":"Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications"}
{"_id":"14cde018-9b5b-99c2-dcba-77877ec2cf8e","text":"Partial ankyloglossia is a limitation which restricts the possibility of protrusion and elevation of the tip of the tongue due to the shortness of either the lingual frenulum or the genioglossus muscles or both. The principal objective of this paper is to present our protocol of action for the treatment of ankyloglossia. The specific objectives are to study patients with ankyloglossia treated by the Service of Maxillofacial Surgery and the Service of Speech Therapy of our pediatric Hospital, describe the diagnostic procedures, the pre-surgical intervention, the surgical technique undertaken and the post-surgical rehabilitation taking into account the level of collaboration of the patients, and finally, describe the surgical complications and the referral of patients.","title":"Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol"}
{"_id":"14d2b7bd-1dc8-7b64-01fb-521b96e18969","text":"Matching patients with similar criteria as of DM was our limitation.","title":"Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium"}
{"_id":"14d90994-c2b7-0592-03b4-b92205c772fb","text":"The use of neuromuscular blocking agents has previously been suggested to facilitate the dissection of the latissimus dorsi muscle during breast reconstructive surgery. The aim of this study was to quantify the influence of deep muscle relaxation on the force required to lift the latissimus dorsi muscle during flap preparation.","title":"The effect of deep muscle relaxation on the force required during Latissimus Dorsi dissection for breast reconstructive surgery: results of a prospective, double-blinded observational pilot study"}
{"_id":"14dfdf0a-5631-3e62-67c7-4b1fe1ef1629","text":"However the inferior pedicle has been most associated with an Inverted T skin resection and a Superior Pedicle or superomedial pedicle with a vertical skin resection.","title":"Reduction mammoplasty"}
{"_id":"14e15c59-66a0-ed15-d230-010b75a4c3c2","text":"An intramuscular injection of botulinum A toxin was administered to the right latissimus dorsi muscle of 8 rats in this group. Four weeks after the application, the right latissimus dorsi musculocutaneous flap was raised in order to perform the IR procedure and the flaps were returned to their places. MPO and NO levels were measured in blood and tissue samples of 4 rats at the 24th hour and 4 rats on the 10th day of IR. Values ​​were compared with other groups.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"14e85053-bba1-d4ea-c5f4-45f58c35ac45","text":"Sensitive antibiotic therapy was performed until the infection had been resolved, depending on the clinical manifestations and laboratory indicators. The small soft tissue defects were treated by direct suture or local tissue flap. The larger soft tissue defects were managed by free skin grafting or flap transfer.","title":"Bone Defects in Tibia Managed by the Bifocal vs. Trifocal Bone Transport Technique: A Retrospective Comparative Study"}
{"_id":"14ec24c8-db0a-744c-ad18-f0e9a38ffe2e","text":"OAIs are a heterogeneous group of disorders that require tailored clinical care. For children with OAI sepsis, antimicrobials should be started immediately given the severe clinical risks of delay. For well-appearing children with OM, additional evidence is needed to prospectively compare complication rates and progression to sepsis and to more specifically define what time period is acceptable to withhold antimicrobial therapy while awaiting diagnostic interventions. For well-appearing children with SA, there are clear clinical risks to delaying drainage of an infected joint and therefore surgical procedures for SA should be expedited and highly prioritized from both a diagnostic and therapeutic perspective, which may render the question of antimicrobial delay obsolete in cases of SA under ideal availability of needed surgical resources. Less than 24 h of antimicrobials is less likely to sterilize source cultures, and therefore if antibiotics are initiated, treating teams should quickly expedite surgical procedures to increase the likelihood of microbiological confirmation before bone or joint sterilization. However, there may be undescribed benefits of “truly negative” cultures that are lost when empiric antibiotics are routinely started. Lastly, future studies should determine the impact of antimicrobial therapy on the yield of molecular diagnostic studies of musculoskeletal specimens as these diagnostic tools become more readily available and potentially make this debate obsolete in the near future.","title":"Delaying antimicrobials for pediatric bone and joint infections: Balancing clinical risks with diagnostic benefits"}
{"_id":"14f706a4-2ad5-d717-17b2-af21057d4f59","text":"A variety of local skin flaps makes it possible to reconstruct superficial defects larger than 2 cm. The mixed rotational and advancement Mustardé flap is suitable for defects that are located in the medial cheek and zygomatic areas and can be oriented within lines of skin tension.","title":"Challenges in the Complex Management of Neglected Cutaneous Melanomas in the Head and Neck Area: A Single Center Experience"}
{"_id":"14ffe747-4522-c87a-653e-a4ed599f9793","text":"Yancovitz et al. describe intra- and inter-tumour heterogeneity of melanoma in the context of BRAF V600E mutations . Hematoxylin and eosin stained sections of primary and metastatic lesions were subjected to laser capture microdissection to isolate the lesions of interest. They captured 30–300 cells for each lesion of interest. This is less than 5 times that captured with the microbiopsy device. The authors used the same DNA extraction kit as we did to isolate lesional DNA for analysis. These samples were then used to detect BRAF V600E tumour heterogeneity. Based on our analysis, we estimate that Yancovitz et al. isolated <1 ng of DNA in this study and were able to amplify BRAF exon 15 using conventional PCR followed by mutation analysis. We found that we can reproducibly isolate 5 ng of DNA from the superficial skin and in another publication show the use of the microbiopsy device in dysplastic nevi . This work sets the stage for future microbiopsy studies focused on BRAF mutational analysis in nevi in situ. The addition of RNA analysis to mutational studies would give additional insights into gene expression profiles of these lesions.","title":"Microbiopsy engineered for minimally invasive and suture-free sub-millimetre skin sampling v2; ref status: indexed"}
{"_id":"151b633a-7f57-7f5c-7e75-a4d2d0300a33","text":"The patient was released on the 7th day after injury with continuation of CS therapy in the form of tablets. The patient was engaged in physical therapy in the form of facial rehabilitation for acute facial palsy.","title":"Unusual Mechanism of Facial Nerve Palsy Caused by Penetrating Neck Trauma"}
{"_id":"1522285f-6e8b-8f60-5867-74ec1d7bcae7","text":"Despite the low quality of the overall body of evidence, a recommendation can be made that resection of canine cutaneous MCTs (< 4 cm) of Patnaik grade I and II with 2 cm lateral margins and 1 fascial plane deep results in low rates of incomplete excision and local tumor recurrence.","title":"A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs"}
{"_id":"1524d431-1a9f-d0b0-7c2c-039019d4df9f","text":"Brachytherapy can also be used in select cases. This most often involves placement of catheters immediately adjacent to or within the target volume and subsequent loading of a radioactive source to deliver dose. A brachytherapy approach can result in a favorable dose distribution and allow for dose escalation in some cases, but catheter placement is technically challenging in the head and neck region and outcomes are user-dependent. As a result, this approach should only be used in limited situations and by those with extensive brachytherapy expertise.","title":"Radiation Therapy in the Treatment of Head and Neck Rhabdomyosarcoma"}
{"_id":"152abc49-5b89-52d7-7d32-57c0ba44277c","text":"Bone scan is a useful clinical tool to explore the etiology of low back pain like spondylolysis and other less common etiologies in young athletes. It is also particularly important to detect the active source of pain when more than one bony abnormality is seen in anatomical imaging. The addition of SPECT-CT increases the clinical accuracy due to increased contrast resolution and anatomical localization.","title":"SPECT\/CT bone scintigraphy to evaluate low back pain in young athletes: common and uncommon etiologies"}
{"_id":"152f3f88-e528-81f6-d098-dd53349d9a63","text":"Adipose tissue was harvested from patients after informed consent was obtained under the Declaration of Helsinki guidelines. All procedures were performed in private Italian medical centers, so Institutional Review Board approval was not required.","title":"Guided Superficial Enhanced Fluid Fat Injection (SEFFI) Procedures for Facial Rejuvenation: An Italian Multicenter Retrospective Case Report"}
{"_id":"1534ffbb-8cbb-f14d-e191-bd5d0b07856e","text":"Two patients died due to severe burn injuries and sepsis and were excluded, leaving a total of 21 included patients. Patients were treated according to a standard burn care protocol in both centres.","title":"A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft"}
{"_id":"153a5a4e-00d2-4a40-72ba-5d4c28b64c9a","text":"The aims of the study were to evaluate the time course of the response of IgG antibodies to SARS-CoV-2 spike protein six months after the second and third vaccine doses in HIV patients in a real-life setting and to describe possible correlations with CD4 + cell count and plasma HIV viremia.","title":"Humoral Response after Two Doses of BNT162b2 mRNA Vaccine Has a Role in Predicting Response after Three Doses That Is Related to Plasma HIV Viremia and Nadir CD4+ Cell Count in HIV-Positive Patients"}
{"_id":"15428c29-551a-b939-c320-236ad0604a47","text":"The main limitation of this study is that only superficial lymphatic flow was observed. Further study is needed to observe lymphatic flow in the deep layer using lymphoscintigraphy or magnetic resonance lymphography.","title":"Lymphatic flow restoration after stripping surgery for varicose veins: A case report"}
{"_id":"1546b114-b96c-f44b-1182-f47bfbc498ed","text":"We designed a prospective, randomized study in which suprascapular nerve block with ultrasound guidance was effective for postthoracotomy shoulder pain. However, many etiologies and theories were considered for explaining ipsilateral postthoracotomy shoulder pain; the theory most emphasized in the literature was that irritation of the pericardium or mediastinal and diaphragmatic pleural surfaces resulted in pain transferred to the ipsilateral shoulder via the phrenic nerve.","title":"Preoperatıve Ultrasound-Guıded Suprascapular Nerve Block for Postthoracotomy Shoulder Paın"}
{"_id":"15498378-74d0-3675-dd11-429f3218db98","text":"Considering the yearly increasing numbers of new melanoma cases, the race in finding effective therapies remains tense. Preventive measures seem to be cost-effective (211) but they may not reach people at the greatest risk of developing skin cancer. Luckily, basic clinical research has taken huge steps during the past years and decades and enlightened the details of melanoma progression. Not only has our understanding of the several genes and signal transmitters involved in the pathogenesis of melanoma increased enormously, but we are also starting to realize the complexity of the microenvironment surrounding the evolving tumor. As reviewed here, hyaluronan, an abundant glycosaminoglycan surrounding skin cells, has also several functions affecting the development of melanoma. Hyaluronan may have controversial role in cancer as it is increased in certain cancer types but decreased in others. Although there are effective treatments available and promising therapies being studied in clinical trials, we still need a more detailed understanding of the complexity of the ECM, including hyaluronan, in melanoma progression. Future research should focus on investigating the gradual processes in the TME during tumor development and on finding new ways to modulate the matrix surrounding the tumor. The key to conquer cancer may not be just affecting the tumor cells or the immune reactions but also to modify the TME susceptible for treatment. Hyaluronan appears to be a potent molecular target for future therapeutic modalities and innovative research ideas should be supported. Considering the past advances in cancer biology, the breakthrough findings and the most effective treatments are yet to come.","title":"The Impact of Hyaluronan on Tumor Progression in Cutaneous Melanoma"}
{"_id":"1549e831-7979-f597-4776-b0e6c50cee16","text":"This case report presents a scenario in which a patient with signs and symptoms of a DVT had a normal initial workup and was subsequently found to have a DVT upon a follow-up visit. Primary care providers and emergency physicians should have a high level of suspicion for DVT in patients who have continued symptoms.","title":"The Role of Serial Ultrasounds in Diagnosing Suspected Deep Venous Thrombosis"}
{"_id":"154f3b93-d83d-7b10-c333-fec901557be2","text":"It is sometimes difficult to recognize which part of the tuberosity is to be resected because of the deformity of the irregular prominence of the bicipital tuberosity. To prevent the detachment of the bicipital tendon, resection is sometimes insufficient. In the current case, the intraoperative CT scan showed that the resection was insufficient to flatten the prominence and prevent impingement between the radius and the ulna. After assessment of the volume of remaining bone, we resected the abnormal prominence. At the postoperative follow-up, the patient’s pain and forearm rotation range of motion had improved. Intraoperative CT scan is a useful tool to assess the remaining volume and shape of abnormal bones during a bone resection. However, adequate identification of abnormal bones with a proper surgical exposure is easy for a skilled surgeon who can identify them without intraoperative CT scan. Intraoperative CT scan is not widely used, and current intraoperative fluoroscopy in proper position is also helpful when the surgical exposure is difficult.","title":"Enthesopathy of the bicipital tuberosity of the radius treated under intraoperative computed tomography"}
{"_id":"155ce178-ef0d-2855-5ac3-29f88c40af4c","text":"OBJECTIVES Focused Ultrasound (FUS) is a noninvasive medical technology used for transcranial therapeutic applications. However, due to the complex acoustic properties of the skull, it is practically hard to obtain a sharp transcranial focus without phase correction. The aim of this research was to analyze and investigate the major parameter of the skull which has the greatest effect on phase aberrations when the ultrasound propagates through the skull. The correction of this parameter may simplify the method of ultrasonic phase correction.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"15730c94-1c17-0cda-f0a5-5a49c2996ef7","text":"The mean time taken to perform a tomographic ultrasound scan for both legs was 5 minutes. The mean time taken to perform a standard duplex ultrasound scan was 20 minutes.","title":"The Role of Tomographic Ultrasonography in Conduit Mapping before Coronary Artery Bypass Grafting"}
{"_id":"157e3242-fb15-cd06-8e52-119d25e855a3","text":"The use of a standardized diagnostic protocol in bakers of a well-defined geographical area including mass spectrometry to test wheat proteins allergenicity of a cultivar utilized by allergic bakers in their workplaces.","title":"Glucose\/Ribitol Dehydrogenase and 16.9 kDa Class I Heat Shock Protein 1 as Novel Wheat Allergens in Baker’s Respiratory Allergy"}
{"_id":"157fda85-307b-f4fa-ec2e-d2ab89418984","text":"Long term side effects were minimal and were limited to minimal fibrosis and dry lips. Skin defects were more likely to be the result of tumor resolution than radiation induced. No chronic ulceration or mandibular osteonecrosis were noted.","title":"Novel high dose rate lip brachytherapy technique to improve dose homogeneity and reduce toxicity by customized mold"}
{"_id":"1584c11f-dfb0-4724-18a9-f9ab5a444930","text":"Recruitment to the margin delineation cohort must be from a Mohs center in the United Kingdom. The involvement of additional independent reporting clinicians for the margin delineation protocol is not possible because the handheld VivaScope 3000 is used to delineate the margin using the real-time images.","title":"Evaluating the Diagnostic Accuracy of Reflectance Confocal Microscopy to Diagnose Skin Cancer: Protocol for a Prospective, Multicenter Study"}
{"_id":"15877e7d-e4df-ccdf-f9e5-13ba437af58f","text":"Inexperienced team leaders mentioned that it is a problem for them that they do not have experienced senior consultants present at night time. One resident mentioned his nervousness about performing a laparotomy at night time because his consultant was half an hour away from the hospital. The absence of consultants is one of the reasons why residents find trauma surgery more stressful than elective surgery. They feel more alone in the trauma setting.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"158ce3f8-5d57-c737-d5d8-f031f37dc82c","text":"The need to overcome the challenges of a surgical career could be attractive:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"158fb81c-6ac2-a227-48aa-df2cc2ef5fb4","text":"Reconstructive options for the distal tibia are more limited as there are no widely available prosthetic implants and allografts are often the only choice aside from amputation. The possibility for excellent outcomes in children justifies an attempt at intercalary reconstruction despite the specter of multiple procedures and protracted treatment courses. Amputation should be discussed as a reasonable option in patients with challenging distal tibial reconstructions because of the relatively high function of below-knee amputations. In adults, the failure of intercalary allografts is higher and the need to reduce future limb-length discrepancy is not relevant. Megaprosthetic options should be strongly considered in adults for proximal tibial lesions. For soft tissue sarcomas with periosteal involvement and some limited cortically-based primary bone sarcomas, hemicortical allografts generally fare well and are viable solutions. Chemotherapy and radiation therapy, when appropriate, can improve survival when combined with surgical resection.","title":"Allograft Reconstruction for Sarcomas of the Tibia"}
{"_id":"15942952-4a00-228e-948d-6d1dd1f2b6bf","text":"In contrast to the analysis of local and regional recurrences, in situ carcinomas were excluded in the analysis of distant recurrence.","title":"The difference in local, regional and distant breast cancer recurrence between the immediate and delayed DIEP flap procedure; a retrospective cohort study"}
{"_id":"159c5ab8-4a18-17fc-6581-65f5d86e2e6e","text":"A quarter of our patients who had infection following GMCF were related to inadequacy of debridement. This is higher than reported by Daigeler who had a 4% infection rate. The success rate of treating osteomyelitis with muscle flap has been reported from 56% to 91% with poorer outcome in patients with medical morbidities and diffuse osteomyelitis. It is sometimes difficult to judge how much tissue to removed especially during debridement of acute infection.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"15a58919-8ebf-677c-c6f6-cc1bc9072e60","text":"The data suggest that the management of the newly diagnosed patient with malignant melanoma remains primarily a community-based surgical problem. An understating of the natural course of the illness and the role of surgical intervention in arresting its progression remains the most important determinant of satisfactory long term outcomes. In that vein, adherence to best practice patterns as elucidated by the NCCN standards should be paramount. Currently, reported variations in adherence to these best practice patterns in the surgical management of malignant melanoma can only have a negative impact on the overall survival of these patients. Yet, as shown herein, renewed attention to a key subset of admittedly underused NCCN guidelines for melanoma could lead to a significant improvement in outcomes. Approaches such as those suggested here may also enhance the use of the entire set of guidelines and narrow the reported variability in practice patterns.","title":"Adjunct primer for the use of national comprehensive cancer network guidelines for the surgical management of cutaneous malignant melanoma patients"}
{"_id":"15a70e8e-af74-b7d7-64a5-b04590e4fb22","text":"Cutaneous stem cells, gained great attention in the field of regenerative medicine as a potential therapeutic target for the treatment of skin and hair disorders and various types of skin cancers. Cutaneous stem cells play a key role in several processes like the renovation of skin structures in the condition of homeostasis and after injuries, the hair follicle growth and the reconstruction and production of melanocytes. Thus, gaining effective access to skin stem cells for therapeutic interventions that often involve active molecules with non-favorable characteristics for skin absorption is a valuable achievement. The topical route with high patient compliance and several other benefits is gaining increasing importance in basic and applied research. However, the major obstacle for topical drug delivery is the effective barrier provided by skin against penetration of the vast majority of exogenous molecules. The research in this field is focusing more and more on new strategies to circumvent and pass this barrier effectively. In this article the existing approaches are discussed considering physical and chemical methods along with utilization of novel drug delivery systems to enhance penetration of drugs to the skin. In particular, attention has been paid to studies finalized to the delivery of molecules to cutaneous stem cells with the aim of transferring signals, modulating their metabolic program, inducing physiological modifications and stem cell gene therapy.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"15ac88a5-9555-a9b4-0fb2-a6edddab5b4f","text":"It is declared in the written informed consent that patient data will be used for educational and research purposed. Our institution does not provide an ethical approval in the form of case series.","title":"A breakthrough in Maxillary LeFort II fracture reconstruction: Case series of rhinoplasty using diced cartilage fascia graft simultaneously with ORIF"}
{"_id":"15acd24c-1848-a69d-baa1-af9d2cd0fa28","text":"We found those who had both SLNB and AND were at higher risk of recurrence when compared to those who had isolated SLNB or AND alone, respectively.","title":"Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?"}
{"_id":"15b0cafe-f6af-4304-da00-a0c73028ceaf","text":"The ability to focus on the task and people is one of the main characteristics in the profession of a doctor, who is initially focused on humans; one can expect the following strategies of a doctor in a management position:","title":"Leadership and Emotional Intelligence: Current Trends in Public Health Professionals Training"}
{"_id":"15b78094-15ea-34c4-5f6d-c0317e67a26b","text":"The use of the tenting screws and resorbable membranes in combination with a mixture of particulate bone allograft and xenograft provides significant dimensional changes in alveolar ridge width for the placement of implants of the appropriate size in the desired location. Within the limitations of this retrospective study, the addition of biologic agents to the graft materials resulted in marginally improved bone density but did not make a significant difference in the amount of bone gain or the ability to place implants.","title":"Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study"}
{"_id":"15b7c371-a264-6b4b-a950-e7e28cbf9bed","text":"The patient consented for an excision biopsy of the scrotal nodules.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"15b88133-1a7a-34fa-453d-83fe07576e22","text":"The majority of providers initiate follow-up CT scan at 10 to 14 mm, although the prior study has suggested no further workup is needed for lymph nodes less than or equal to 15 mm. Most providers tend to continue follow-up CT scans for a longer duration for thoracic lymph nodes of larger size although the size remains unchanged or with minimal change. The majority of providers do not consider PET-CT for the initial evaluation of isolated thoracic lymphadenopathy and also for thoracic lymph nodes with increasing size before performing EBUS-TBNA or mediastinoscopy. Providers have variable responses regarding the timing interval of initial CT and follow-up CT. A few studies have provided limited recommendations on the management of isolated mediastinal lymphadenopathy. There is a need for a comprehensive and consensus guideline for the management of incidental mediastinal lymphadenopathy and its follow-up.","title":"Management of Isolated Thoracic Lymphadenopathy of Unclear Etiology: A Survey of Physicians and Literature Review"}
{"_id":"15ba26c6-e589-94b0-cc63-68a411a0a603","text":"This procedure enabled safe identification of the facial nerve, and facilitated reconstruction in facial nerve in patients with sacrificed facial nerves.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"15c54df2-d44d-be2a-45d5-dd5546087df5","text":"Table 9 SPT at start and after 5 years in bee and wasp allergic patients","title":"Insect sting allergy. A study from 1980 to 2003 of patients who started treatment with venom immunotherapy between 1980 and 1998"}
{"_id":"15c8732c-705d-a8d4-4086-44d09cc40f51","text":"The PAP flap was a safe and reliable option for breast reconstruction with a high success rate, but a low complication rate. Moreover, it might be more than an alternative to the DIEP flap in microsurgical breast reconstruction in selected patients, such as bilateral breast reconstructions, or preference of patients to avoid an abdominal scar or young women without redundant abdominal tissue. Additionally, more large samples and multicenter researches with standardized reports of perioperative parameters and clinical outcomes are needed for further evaluation in the future.","title":"A Systematic Review and Meta-Analysis on Microsurgical Safety and Efficacy of Profunda Artery Perforator Flap in Breast Reconstruction"}
{"_id":"15ca5e02-1e5f-aa2f-d35c-4fa773861c2c","text":"Decreasing dead space between graft and wound bed increases the chance of graft survival in FTSGs. Using pulley sutures to both decrease defect size and provide downward pressure on the skin graft is an excellent option to close defects. Use of this technique will assist dermatologists as they close large wounds, defects from tumors that need to be monitored, or those in high tension areas.","title":"Epidermal Pulley Sutures and Double Burow’s Full-Thickness Skin Grafts for Large, High-Tension Closures"}
{"_id":"15cec222-1dd0-9f78-54cd-00158ca04c7a","text":"These results confirm that the repeated exposure of the respiratory tract of mice sensitized with T. nattereri venom generates a weak anaphylactic response with mild symptoms, but is capable of triggering a late phase of inflammatory reaction in the lungs. The pulmonary eosinophilic inflammation triggered by airway exposure to VTn is also characterized by the influx of CD4 Th2 lymphocytes in the lung.","title":"Anaphylaxis induced by Thalassophryne nattereri venom in mice is an IgE\/IgG1-mediated, IL-4-dependent phenomenon"}
{"_id":"15d5321e-641a-93f4-37d4-3a1dfa870f7a","text":"Preclinical data in rats showed that all ansamycins were very effective against a bacterially inoculated Kirschner wire, with a 4-log reduction in CFU in the bone, without leading to resistance. Another study in mice showed that rifampicin reduced the number of CFU by approximately 2-log, which was superior to either cefuroxime or gentamicin when given in an acute infection but not at a chronic stage. A limiting factor of these studies is that effects on the numbers of intracellular CFU were not measured.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"15d5ca1f-655c-cfc5-22fc-ba8f11a4895a","text":"The formula used is for testing the sensitivity and specificity of a single diagnostic test:","title":"Evaluation of Axilla With Sentinel Lymph Node Biopsy (Using Methylene-Blue) and Reverse Axillary Mapping (Using Fluorescein) to Validate Optimum and Safe Axillary Dissection in Breast Cancer"}
{"_id":"15d6c40a-cf0f-aec1-306a-c2ec69c39962","text":"Histological analysis of the sublingual fascial layer in Rorqual (Balaenopterid) whales revealed collagen and abundant elastin fibers loosely organized into randomly oriented fibers forming three distinct layers [7]. It was hypothesized that the whales' sublingual fascia has a role in facilitating the gliding movement of the tongue relative to adjacent tissues during swallowing. These findings provoke curiosity regarding the histotopographical composition of the human lingual frenulum and how its structure and composition may correlate with a role in balancing tongue mobility and stability during functional tasks.","title":"Understanding the Lingual Frenulum: Histological Structure, Tissue Composition, and Implications for Tongue Tie Surgery"}
{"_id":"15dad697-3788-4153-cbd1-86f8d1f67c6b","text":"During the last three decades, cryosurgery has become widely accepted as a minimally invasive surgical technique and is currently used to ablate undesirable tissues in a large number of clinical applications, such as treatment of cancer and arrhythmias. This suggests that the new concept of cryosurgery enhanced by PEF could be more readily accepted among practitioners of cryosurgery. Cryosurgical probes and apparatuses can easily be modified for a cryosurgery\/PEF application. The shaft of any cryoprobe is metal and electrically conductive, and therefore could also be used as an electrode. In fact, many cryosurgical probes also have an electrical conduit through the shaft, housing a thermocouple for the purpose of measuring temperatures at the tip of the cryoprobe. This could be one possible path for the electric pulses. Another possible path could be through direct connection to the metal shaft. To deliver the electric pulse only at the thermally active tip of the cryoprobe, it would be sufficient to apply a thin layer of electric insulation along the cryoprobe shaft, as in typical electroporation needles. The pulsed electric field power supply can either be stand alone, or incorporated in the cryosurgery console and connected to the electrically conductive cryoprobe shaft.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"15e270cc-af29-147f-918c-c098dcec0d7c","text":"Dermatologist and pediatricians can safely do necessary procedures under general anaesthesia with the supervision of pediatric-trained anesthesiologists while considering other safety and risk precautions and the pediatric age group.","title":"Risk of General Anesthesia in Pediatric Skin Procedures with Projection on Tumescent Anesthesia"}
{"_id":"16023c71-5e71-08f7-7fe5-6a75e9eed7c0","text":"We suggest that patients who experience nonpruritic erythema after botulinum toxin injection should suspend subsequent injection plans for at least 3 months to prevent more severe consequences.","title":"Mild Allergic Reactions after Botulinum Toxin Injection: A Case Series and Literature Review"}
{"_id":"1603ccc1-32f3-6298-9368-4c4407f30195","text":"Although these data are just preliminary, we believe that the artificial dermis is a reliable alternative to flaps and should be considered an excellent option in head reconstruction for skin cancer, especially in older critical patients with large and deep defects, in patients with recurrent tumors, and in patients who require radiotherapy. Further future research is needed to increase the number of cases treated and to compare the results with those obtained with other ADMs.","title":"Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes"}
{"_id":"1605a25f-c0c0-14c0-75a0-d49b2194bc32","text":"More research is needed to characterize the reason female plastic surgeons are taking longer to advance to the next stage of their career. One explanation is that women delay their career for pregnancy and childrearing. Several studies have shown that female physicians bear a greater burden of domestic and parenting responsibility than male physicians. However, whether this leads to a delay in job acquisition is less clear. In fact, female plastic surgeons have been shown to be more likely to be unmarried, marry later, and delay having children compared to their male counterparts. Furthermore, increasingly more female surgical residents are choosing to have children during residency, and taking time off during residency would not affect time from FRCSC to first academic job. Another explanation is that female physicians are more restricted by location when applying for jobs since they are more likely than male physicians to have spouses that are employed full time. Having fewer job options available may extend the time to full employment. Finally, there may be systemic gender bias in hiring processes. Regardless of the reason, a delay in job acquisition represents lost time fully employed.","title":"What Does It Take to Become an Academic Plastic Surgeon in Canada: Hiring Trends Over the Last 50 Years Ce qu’il faut pour devenir chirurgien plasticien universitaire au Canada: profils d’embauche au cours des 50 dernières années"}
{"_id":"1608b552-b8ea-04a2-5fc8-879a48d1f98d","text":"Postoperatively the patient developed a wound healing disorder first at the proximal and then at the distal part of the flap. Debridement and VAC therapy was performed, and a secondary wound closure could be done some days later. Additionally, the patient developed a severe postoperative delirium and recurrent episodes of gastrointestinal bleedings. After 5 weeks of hospital stay the patient was discharged back to the nursing home.","title":"The Role of Free Tissue Transfers for Defect Coverage over the Body in Geriatric Populations"}
{"_id":"1608f37b-62f5-2ea7-0105-599c56dbae37","text":"The majority of included studies used unfocused cylindrical planar piezoelectric transducers to facilitate ocular drug delivery. Ultrasound sources, such as the piezoelectric crystal in the transducer head, may be considered as a collection of point sources radiating individual acoustic wavelets into the tissue 96. If the transducer diameter is considerably greater than the ultrasound wavelength, there will be many regions of constructive and destructive interference established in the tissue. This effect will be greatest in the zone nearest to the acoustic source and will become progressively less dramatic as the wave travels away from the transducer tip 97. This area of variable sonication pressure is termed the Fresnel zone (aka the Near zone), and the distance from the transducer (for a disk shaped transducer) where this effect will dominate may be described by 96:","title":"A systematic review of ultrasound-mediated drug delivery to the eye and critical insights to facilitate a timely path to the clinic"}
{"_id":"160fd1df-d139-e599-e91a-99e5e394562e","text":"The apparent lack of reliably observed contrast between tumor and normal tissue during surgery (and after) is believed to be one of the major factors leading to incomplete resection of tumors. Thus, surgical guidance systems need to help surgeons visualize the tumor margins precisely and guide them in making complete tumor resections during the initial surgery.","title":"Sensing Using Light: A Key Area of Sensors"}
{"_id":"161052cc-e01c-da2b-c68e-07dcfaa16131","text":"No statistically significant difference was detected in vaginal IgG for any of the treatments indicating that vaginal IgG is not induced at high levels in either injected or oral administration of HBsAg.","title":"Co-Administration of Injected and Oral Vaccine Candidates Elicits Improved Immune Responses over Either Route Alone"}
{"_id":"1616cd38-2306-46d7-cf42-d6740b4967c8","text":"Table 2 Sociodemographic characteristics of survey respondents who used injection drugs and associations with development of any injection drug use-associated bacterial or fungal infection","title":"Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder"}
{"_id":"161bf8bd-5f40-e599-6c2e-feb2d2e3a5e1","text":"The procedure of visual simulation surgery and clinical surgery. a Ultrasound scissors and forceps were placed, and the lymph nodes were dissected in the visual simulation surgery. b Endoscopic sentinel lymph node biopsy and axillary lymph node dissection in the actual surgery","title":"Three-dimensional visual technique based on CT lymphography data combined with methylene blue in endoscopic sentinel lymph node biopsy for breast cancer"}
{"_id":"1622163c-979d-e472-74e6-3c8cf99574fd","text":"This rigorous observational study of over 200 human liver biopsies showed for the first time that, with EM and new standardized fixation methods, extensive accumulation of fat in single fat droplets caused a special form of liver injury in the form of single parenchymal cell steatonecrosis, followed by inflammatory fat follicles and sinusoidal lipid emboli. The combination of fat and Mallory substance appeared in our EM observations that is not seen in LM. Apparently, degreasing of the liver is an essential therapeutic first step in the prevention of the progression to non-alcoholic steatohepatitis by reducing lipid toxicity. The role of EM can be of help in further discovering these pathophysiological cellular mechanisms related to NALFD and could be used in future research.","title":"Fat causes necrosis and inflammation in parenchymal cells in human steatotic liver"}
{"_id":"16278998-83e5-f5f7-ec9a-8af9c5d83139","text":"The carbide burr has also been found to be a reliable method for removing jammed cold-welded locking screws. This method entails burring through the screw until the plate disengages.13 As one might imagine this method generates a great deal of heat and debris, which can easily cause injury to surrounding soft tissue. If this method is used, it is recommended that plenty of irrigation is used and the surrounding soft tissue is protected.","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"1627ac9a-abdb-e8c2-4815-87e009631cbc","text":"Reconstruction of such a large scalp defect is a challenging endeavor, best approached with a multidisciplinary team. Combined efforts from a neurosurgeon and a plastic surgeon can be necessary to allow safe tumor excision and adequate flap reconstruction of the defect.4","title":"Invasive Squamous Cell Carcinoma of the Scalp and Calvarium: A Multidisciplinary Approach Stark et al"}
{"_id":"1628840b-0db3-f65d-6d3d-c3160376dd30","text":"We conducted a pilot study to test the methods. The questionnaire was applied to 10 mothers. The examiner assessed newborns for ankyloglossia observing the position of the lips at rest and the positioning of the tongue during crying. The lateral margins of the tongue were raised with the right and left index fingers and the examiner observed whether it was possible to view the frenulum. Thickness and attachment to the tongue and the floor of the mouth were assessed when the frenulum was visible [12]. The results of the pilot study revealed no need for changes to the proposed methods","title":"Does ankyloglossia interfere with breastfeeding in newborns? A cross-sectional study"}
{"_id":"162a7aae-761c-3f84-77d0-9a4cc7d172a1","text":"Histopathology of the resected specimens was grade 1 and grade 2 chondrosarcoma. According to the histopathologic examination of the resected specimen the tumour was marginally resected during the posterior approach and en bloc resected with disease-free margins during the anterior operation. Postoperative MRI and CT scan 6 months following the operation confirm the en bloc resection of the tumour (Figure 5).","title":"The Value of Cryosurgery in Treating a Case of Thoracic Chondrosarcoma"}
{"_id":"163dfaf4-864a-b710-652e-be4cd4f4c2db","text":"Melanoma patients with recurrent disease confined to an extremity can be offered one of two regional therapies that both give high complete response rates. Isolated limb infusion (ILI) is a newer technique performed with catheters and tourniquets that has a reduced potential morbidity, decreased efficacy and does not treat the regional nodal basin. Hyperthermic Isolated Limb Perfusion (HILP) is an open surgical technique that includes removal of the regional nodal basin as part of the surgical procedure. An analysis was performed of the rates of regional nodal disease in this patient population to determine the percentage of patients with stage III metastatic disease to the lymph nodes that would be under treated with the ILI technique. A total of 229 patients underwent a HILP for melanoma with regional lymph node dissection as is our standard between July 1987 and December 2009. Ninty-two of the 229 patients (40%) had metastatic regional nodal disease documented at the time of the HILP procedure. HILP is the only technique that addresses all micrometastatic disease on the extremity.","title":"Regional Therapy for Recurrent Metastatic Melanoma Confined to the Extremity: Hyperthermic Isolated Limb Perfusion vs. Isolated Limb Infusion"}
{"_id":"163f6f5f-fd12-5074-84d4-a4faca3720b3","text":"When examining the middle gluteal muscle, its insertional tendon was first identified by placing the distal end of the ultrasound probe on the greater trochanter and angling the proximal part of the ultrasound probe slightly toward to ilium. Once the insertional tendon was identified, the middle gluteal muscle belly was followed dorso-cranially, approaching the origin margins on the wing of the ilium when possible. When examining the internal obturator tendon and bursa, the ultrasound probe was again placed within the groove between the caudal aspect of the greater trochanter and the ischial wing, where the long axis of the sciatic nerve was identified. The internal obturator tendon was identified on the distal margin with its distinctive bursa\/fluid artifact, creating a fluid shadow at the level of the internal obturator tendon and bursa and assessed at the caudal distal margin of the gemelli muscle, all deep to the sciatic nerve.","title":"Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis"}
{"_id":"1640aff0-55d5-811d-8c20-baa4c3b25df8","text":"There are no recommendations regarding which method is the most optimal to use on the scalp, and both are used in Denmark. The present study reported our experience with patients receiving the two types of skin grafts after scalp-surgery with excision of a skin tumor. The hypothesis was that the two methods were equal regarding graft take and complications.","title":"Full- or Split-Thickness Skin Grafting in Scalp Surgery? Retrospective Case Series"}
{"_id":"164472a3-ab0a-5516-01f5-81d44a0f6ae2","text":"The authors declare they have no financial or other conflict of interests in relation to this research and its publication.","title":"The benefit of antibiotic-combined Mg-hydroxyapatite bone graft substitute over autologous bone for surgical site infection prevention in posterolateral spinal fusion: a retrospective cohort study"}
{"_id":"164bb837-14aa-462e-ef7a-6949b7497ee0","text":"All our cases were done in the emergency room under local anesthesia with tourniquet control. The flap size determined by the defect of the thumb following debridement was made over the proximal phalanx of the adjacent index finger. The width of the flap was so designed that it does not extend beyond the radial and ulnar midaxial lines of the proximal phalanx. The flap is raised from the distal to the proximal side and from the ulnar to radial side. The tourniquet was released following flap harvest to ensure viability of the flap. The tunneling, flap insetting, and grafting of the donor area were done without tourniquet control.","title":"First dorsal metacarpal artery islanded flap: A useful flap for reconstruction of thumb pulp defects"}
{"_id":"16526240-faa3-1c35-aa44-94ed0432b890","text":"Table 1 presents the characteristics of the 476 patients who met the study criteria and were enrolled in the study.","title":"Direct Comparison of Two Different Definitions with Biochemical Recurrence after Low-Dose-Rate Brachytherapy for Prostate Cancer"}
{"_id":"16677c3d-7dee-a45e-a41e-cc0a621cde1f","text":"The case described is a rare complication of varicella in an exceptional location. The rapid diagnosis and immediate institution of therapy were determinant for the good clinical evolution.","title":"RIB OSTEOMYELITIS: A RARE COMPLICATION OF VARICELLA OSTEOMIELITE DE ARCO COSTAL: UMA COMPLICAÇÃO RARA DE VARICELA"}
{"_id":"1669b548-ec9e-3bd8-7927-1296c516bd30","text":"In our review of legal decisions, the search terms used for the publicly available civil and regulatory body Canadian decisions between 2005 and 2019 produced a total of 14 STF Decisions which addressed a variety of medical-legal issues associated with STF therapy. We provide a brief summary of each of the STF Decisions’ key aspects in Supplemental Table S1.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"166b3200-739f-743b-0493-8d08fb0a9e2e","text":"This study confirms that the change in rules in 2005 has allowed a substantial expansion of subspecialty fellowships available to internal medicine graduates. Community hospitals have increasingly contributed to this expansion in programs as a result of the change in rules, adding to the subspecialty training choices available to internal medicine graduates.","title":"Sponsorship of Internal Medicine Subspecialty Fellowships Since 2000: Trends and Community Hospital Involvement"}
{"_id":"166f32e8-5bb7-628e-3d52-d9b96a53f36a","text":"In conclusion, endovascular treatment of PAA using appropriate stent grafts is safe in selected cases who are at high risk for surgery due to comorbidities or those who refuse surgery. It is also advantageous owing to its shorter operation duration and length of hospital stay, more rapid functional recovery, minimal blood loss and wound site infection, and potential avoidance of general anesthesia. The distal vascular bed and distal and proximal attachment regions must be carefully examined before endovascular treatment. It is reasonable to avoid endovascular treatment due to an increased risk for thrombosis in patients with a low number of patent distal arteries or impaired distal flow. In addition, PAAs may present with concomitant AAA and patients should be evaluated for possible AAAs. Limb salvage is possible with a second endovascular intervention even in patients with graft thrombosis.","title":"Popliteal artery aneurysms treatments: early midterm results of the use of endovascular stent grafts"}
{"_id":"1672ead6-e98b-fbb6-e8a2-f9b876701edd","text":"Acceptance and adherence to SN biopsy guideline recommendations in Australia over the past 20 years has involved a process of renegotiation and reframing of the evidence for SN biopsy in melanoma by clinicians from different professional groups and networks. This process has helped to refine the evidence for SN biopsy and our understanding of appropriate adoption. New effective systemic therapies have changed the balance towards accepting guideline recommendations.","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"16779843-afcd-0607-28c9-7305a9fa4059","text":"One of the barriers to adoption of cardiac surgical procedures through a minithoracotomy incision is postoperative pain. In this study, we found that use of a paravertebral catheter significantly reduced the need for postoperative oral opioids and significantly reduced hospital LOS.","title":"Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery"}
{"_id":"1678ec24-23ab-49e1-dec3-2d986d721fbd","text":"However, a major strength of this study is that, to our knowledge, it is the first case-control study to show the additional effectiveness of preoperative mechanical prophylaxis for preventing VTE following HFS in elderly patients. The second strength is that it focused on elderly patients aged ≥70 years with hip fracture, who were at a high risk of VTE. Moreover, elderly patients in the study group who received preoperative mechanical thromboprophylaxis were at higher risk of VTE due to having both a higher ASA grade and more comorbidities. Nevertheless, preoperative mechanical thromboprophylaxis showed significant effectiveness on the prevention of VTE in the study group. The third is that this study enrolled consecutive elderly patients aged over 70 years undergoing HFS at one hospital. The fourth is that we made relatively accurate and relevant definition and diagnosis of symptomatic VTE, confirmed by each specialist. When patients had the symptoms and signs corresponding to DVT or PE and other possible causes were ruled out after evaluation because signs and symptoms alone are not sufficiently sensitive or specific, 3D CT angiography was performed in these patients. The final diagnoses of DVT and PE were made by cardiovascular and pulmonary specialists, respectively based on clinical manifestations and radiologist’s interpretation of 3-D CT angiography. We believe that this process would lessen false positives in diagnosis of symptomatic DVT and PE and improve its accuracy. The fifth is that we could have a complete follow-up and access to all records because most patients stayed at our hospital or affiliated rehabilitation or nursing facilities for one month after HFS. Therefore, we could completely investigate complications including VTE and mortality within one month after surgery. These findings may strengthen the significance of our study.","title":"Does preoperative mechanical prophylaxis have additional effectiveness in preventing postoperative venous thromboembolism in elderly patients with hip fracture?—Retrospective case-control study"}
{"_id":"167c6a97-cab3-7ea1-d4d5-8c37899e7109","text":"Exposure was defined as a prescription filled for prophylactic low-dose anticoagulation within 7 days after discharge from the index hospitalization during which the index surgery occurred. The agents and dosing of eligible anticoagulants are presented in Table 7.","title":"Adherence to Extended Venous Thromboembolism Prophylaxis and Outcomes After Complex Gastrointestinal Oncologic Surgery"}
{"_id":"167da5b4-ac71-78f3-9273-0cb507d6a574","text":"The incidence of oesophageal adenocarcinoma has risen throughout the Western world over the last three decades. The prognosis remains poor as many patients are elderly and present with advanced disease. Those patients who are suitable for resection remain at high risk of disease recurrence. It is important that cancer patients take part in a follow up protocol to detect disease recurrence, offer psychological support, manage nutritional disorders and facilitate audit of surgical outcomes. Despite the recognition that regular postoperative follow up plays a key role in ongoing care of cancer patients, there is little consensus on the nature of the process. This paper reviews the published literature to determine the optimal timing and type of patient follow up for those after curative oesophageal resection.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"1682e1be-4eb4-68b9-e104-672b677aecfb","text":"A cross-sectional descriptive study was conducted between January 2020 and April 2021 to determine the frequency of bacterial and fungal infections associated with complications and adverse reactions to the use of modeling substances in 113 patients who consulted with a clinic specializing in reconstructive aesthetic surgery and the removal of biopolymers (Santuario Medical Center) in the city of Cali, Colombia.","title":"Infections in patients with adverse reactions to the use of unknown modeling substances for soft tissue enhancement in Cali, Colombia"}
{"_id":"1690163c-dfca-3372-606b-b6666e95e921","text":"Knowing gained from experience appeared to be important to how participants made sense of the study interventions. As they had no experience of injury or either of the dressings they felt their knowledge of the interventions was limited so taking part in the study was an easy decision. Direct experience of the NPWT led to a preference for this dressing. Experiential knowledge may, therefore, be a useful additional tool for informing trial participants about interventions.","title":"Participation in a trial in the emergency situation: a qualitative study of patient experience in the UK WOLLF trial"}
{"_id":"169151cc-2787-9c6f-ad5b-4086d111f0c1","text":"Our study addressed an important role in residency training related to the leader role as one of the competencies of the CanMEDS framework. This will open the gate for further studies and initiatives to improve leadership development in residency training programs.","title":"Developing Leadership Among Dental Residents: An Exploratory Study"}
{"_id":"169ae108-f85a-d6ff-38f9-211628351e58","text":"The patient was readmitted at 60 days with concern for the protrusion of his left distal femur into the ongoing wound bed and was taken to the operating room for excisional debridement and bone biopsy. The biopsy was negative for invasive osteomyelitis. In addition, at month four, he presented with a stage IV ulceration of his sacrum. Adequate offloading, wound care and nutritional support, and intravenous antibiotics were not able to be achieved in the postoperative care of this patient due to numerous factors. He was discharged in this state five days later on trimethoprim-sulfamethoxazole with the intent to heal by secondary intention and has since re-presented with progressive malnutrition and dry gangrene of the toes of his right leg. He has refused ongoing medical care. He has not required ongoing treatment for the infection in either hip and his surgical wounds continued to decrease in size.","title":"Combination of Girdlestone Pseudoarthroplasty and Negative Pressure Wound Therapy with Instillation and Dwell in the Treatment of Invasive Osteomyelitis of the Proximal Femur"}
{"_id":"169bc0ee-56a3-ab61-655a-67925f6c43ed","text":"Many improvements in the technique for surgical correction of PE and PC have evolved during the eight decades since the first repairs were performed. Adults with severe pectus deformities and asymmetric defects are at a greater risk of recurrence after a Nuss procedure. These patients may be better repaired initially with a modified Ravitch repair.7","title":"Clinical experience of repair of pectus excavatum and carinatum deformities"}
{"_id":"169eb4cf-99a0-b845-c094-5c859c754555","text":"In early stages of the disease, CT scan detects inflammatory changes closely related to the stylomastoid foramen and medially to the posterior belly of the digastric muscle, changes which have been proved to be crucial for the diagnosis of CSBO. Later the infection spreads to the contralateral side causing demineralisation of the bones.","title":"The routes of infection spread in central skull-base osteomyelitis and the diagnostic role of CT and MRI scans"}
{"_id":"16a61190-a838-da43-31c3-20ac21a7c876","text":"The first use of a laser was described in 1960 and not long afterwards laser ablation was first described in 1983 when a laser consisting of a light conducting quartz fibre was used to ablate tumour tissue. However, due to the technical difficulties of using the device and targeting the correct area, the technique lost interest. The development of more sophisticated and reliable lasers and use of more flexible and better quality guiding systems has resulted in a gained interest and opened up a number of applications for laser ablation [36].","title":"Ablative techniques for the treatment of benign and malignant breast tumours"}
{"_id":"16b108a9-4456-d193-96e2-86b5b9fc48c2","text":"Our study found no evidence that curative surgery for chronic osteomyelitis with simultaneous orthoplastic reconstruction including free soft tissue transfer was less safe or had worse outcomes in those aged ≥60 years compared to a younger cohort. This older group tended towards more favourable outcomes when looking at length of operation, flap failure rate and infection recurrence. Significantly fewer patients underwent unplanned re-operation in the older cohort compared to the younger group. This is unlikely to be due to a selection bias given the older cohort have a greater proportion of ASA grade III patients than the younger group with similar C-M staging in both groups.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"16b21f73-ff29-ad65-3dcc-c13e1fdc6f28","text":"Idiopathic calcinosis cutis is a rarer form of this disease process. It occurs without any underlying tissue damage or defects in metabolism and can present as papules, nodules, or plaques that may be ulcerated or with white chalky discharge.","title":"Idiopathic Calcinosis Cutis of the Hand"}
{"_id":"16b79c66-278d-0267-47fc-3f36bde08312","text":"The higher incidence of venous thrombosis in the proximal trauma group may be related to the nature of the trauma the limb suffered. Having a multi-level injury implies that the limb has undergone a more substantial direct force with shear and crush forces applied across a larger area compared to the control group patients. In this type of injury, veins are particularly vulnerable to endothelial damage, which may not always be evident at the time of the free flap reconstruction. When these veins with endothelial injury are used in the micro-anastomosis of the free flap, their physiology may be further stressed, gradually leading to venous thrombosis. Another possibility is that those patients with proximal trauma may have had a greater incidence of occult deep venous thromboses, which contributed to increased stasis within the draining venous system and increased the risk of anastomotic thrombosis.","title":"Proximal Trauma Increases Risk of Venous Thrombosis in Soft Tissue Reconstruction of Open Lower Limb Fractures"}
{"_id":"16b9ccd2-fe28-0e61-22b7-d5f6069cad39","text":"There is not a definite etiology of FD, but it is believed to arise from abnormal activity in the bone forming mesenchymal tissue.","title":"Conservative treatment of Fibrous Dysplasia"}
{"_id":"16c0b258-df5c-5df4-b4b2-fc660465cd0e","text":"CJOO drafted most of the initial manuscript and traced the patient in November 2010, JKW drafted parts of the manuscript and critically revised the whole manuscript before submission to the editor and publisher. Both authors read and approved the final manuscript.","title":"A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report"}
{"_id":"16ca4e5d-7ccb-e153-c512-1e0013baa1f7","text":"The split hemianterior tibialis turndown muscle flap was designed on the basis of the anatomic characteristics of its vascular supply, and the procedure is as follows.","title":"Split Hemianterior Tibialis Turndown Muscle Flap for Coverage of Distal Leg Wounds With Preservation of Function Gundlapalli et al"}
{"_id":"16cfe49c-578b-3a52-df98-492a7b20ecc9","text":"The uniqueness of this case is that it is the first filler infection reported after a surgical intervention to our knowledge. Any local procedure carrying a risk of bacteraemia may cause an inoculation of bacteria to the filler material or activate the dormant bacteria residing in the filler. Thereby, patients who have permanent fillers may need to use prophylactic antibiotics before surgical procedures which carry a risk of local or systemic bacteraemia.","title":"Abscess Formation After Tooth Extraction: A Long-Term Complication of Polyacrylamide Hydrogel Filler"}
{"_id":"16d299a9-26f8-7673-9d6a-52929659f286","text":"Immunotherapy outcomes in small studies have shown good data for increasing survival rates at yearly intervals in MM of the head and neck. Larger clinical trials are needed to accurately distinguish the efficacy and survival outcomes of immunotherapy when compared with treatment modalities, excluding immunotherapy. However, the ability to perform larger trials is limited by the rarity of MM of the head and neck.","title":"Immunotherapy as a treatment modality for mucosal melanoma of the head and neck: A systematic review"}
{"_id":"16d48a2b-17b6-98eb-7943-07f5d99191b2","text":"This study aims to investigate the incidence, occurrence timing and locations of preoperative DVT and identify the associated factors in this group.","title":"Incidence and risk factors associated with preoperative deep venous thrombosis in the young and middle-aged patients after hip fracture"}
{"_id":"16d95ebc-eece-6dc6-dcc7-c1739a80ad59","text":"As the histological results had no statistically difference between groups, we may recommend use of these two techniques in reconstructive and in aesthetic cases.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"16d9f71d-8547-12aa-7efe-cbfe03a3cf67","text":"As our defect was large and the donor tissue available had limited elasticity, the flap design was based on conversion of the defect to a square. The flaps were drawn so the line of translation of each flap would be parallel to the line of greatest extensibility. Two double opposing flaps were designed. Dissection was made deep to the galea. Scoring of the galea was not performed.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"16dbc26b-8eeb-74d3-b712-773ae0f9b6ec","text":"The proportion of plastic surgeons who received board certification between 2002 and 2013 who pursued fellowship training significantly increased over time (R2 = 0.7019; P = 0.0007; Fig. 1). An increasing proportion of surgeons pursued microsurgery fellowships (R2 = 0.5550; P = 0.0054; Fig. 2) or craniofacial fellowships (R2 = 0.6639; P = 0.0012; Fig. 3). However, the proportion of surgeons who pursued burn fellowships significantly decreased over time (R2 = 0.3827; P = 0.03199; Fig. 4). Proportions of those who completed otolaryngology, OMFS, aesthetic fellowships, international fellowships, head and neck fellowships, hand fellowships, NOS fellowships, or multiple fellowships have remained stable over time.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"16dd5fb2-83fb-b7f1-d78b-cad0968844de","text":"A retrospective review was performed on 24 patients with infected orthopaedic metalwork, including 3 upper limb and 21 lower limb cases, for outcomes relating to implant retention and infection resolution. Patients underwent a modified NPWT technique as an adjunct to antibiotic therapy and surgical debridement. Detailed medical and microbiology information were obtained from the patient records.","title":"Modified negative pressure wound therapy as an adjunct to antibiotics in the treatment of orthopaedic infected metalwork"}
{"_id":"16e0fcf3-7e90-bcff-4e66-3b572c7194a1","text":"Recent guidelines on pediatric bone and joint infections promote a timely switch from intravenous to oral antibiotics. These recommendations gradually find their way into clinical practice. Pediatricians who are specialized in infectious disease and regularly offer consultations for their colleagues may speed up this transfer.","title":"Impact of a pediatric infectious disease consultation service on timely step-down to oral antibiotic treatment for bone and joint infections"}
{"_id":"16e4384a-b6fc-eaa6-727b-09f91f6f5186","text":"The findings of this study revealed that our use of consensus criteria to carefully select patients with musculoskeletal infections for treatment with oral antibiotics led to zero treatment failures at one year and two years. This suggests that our criteria are highly effective at identifying patients who are likely to do well with oral therapy and in whom the time burden, cost, and risks of IV antibiotic therapy should be avoided.","title":"Excellent Outcomes With the Selective Use of Oral Antibiotic Therapy for Bone and Joint Infections: A Single-Center Experience"}
{"_id":"16e60155-38eb-a92e-2a2e-856e54a24a70","text":"All operations were performed by surgeons from the Sarcoma Group at each institution, and multimodal treatment was managed by clinical and radiation oncologists from ICESP.","title":"Sporadic Abdominal Wall Desmoid type Fibromatosis: treatment paradigm after thirty two years"}
{"_id":"16e9ee60-ba1b-14f9-11f7-f6504a8900d3","text":"This population-based study determined that breast cancer subtype was an independent predictor for the utilization of immediate postmastectomy reconstruction. Patients with HER2-overexpressing or triple negative breast cancer subtype that has relatively higher risk of local recurrence, were less likely to receive immediate breast reconstruction than those with luminal tumors. Further studies are needed to disclose more underlying reasons of different reconstruction incidences for distinct subtypes of breast cancer.","title":"Impact of Breast Cancer Subtype Defined by Immunohistochemistry Hormone Receptor and HER2 Status on the Incidence of Immediate Postmastectomy Reconstruction"}
{"_id":"16eb9e5d-03dd-6175-af3c-0f15d5e01024","text":"Limitations of our study include the lack of comparison to outcomes for LDKT of single renal arteries. Additionally, sample sizes for certain subgroups of patients were relatively small, limiting our ability to show significant differences between the WIT of single and multiple arterial anastomoses. Another limitation of our study includes the fact that this was an evaluation of consecutively transplanted living donor recipients performed at a single center by a single, highly experienced transplant surgeon. While the chances of achieving such successful anastomoses without post-operative complications being an issue requires a surgeon who is highly experienced in performing such techniques, these techniques can be easily duplicated and incorporated by other transplant surgeons to expand their surgical armamentarium.","title":"Creating a Single Inflow Orifice From Living Donor Kidney Allografts With Multiple Renal Arteries Reconstruction Techniques of Multiple Renal Arteries"}
{"_id":"16ee97fb-ac1a-5e51-c491-86311e0c543b","text":"The present study found that the participants did not carry out breast self-examination as often as would be desirable, as this is the first step towards the early detection of any pathology associated with the breast.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"16f08261-4cb9-9fef-b3cb-f7baff111dac","text":"There are no definitive recommendations, and the same guidelines as for neuraxial block may also be applied to plexus and peripheral nerve blocks.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"16f313c4-32ec-a8c7-33f5-edb58b44bf84","text":"Authors have reported good radiographic and clinical outcomes one case report with complete resolution or reduction in mass size over a 45-month period, obviating the need for a transoral anterior approach. In this patient’s case, fusion not only included C1 and C2 vertebrae, but was extended to the lateral masses of C6. Decompressive laminectomy was completed at the C4 to C6 levels to treat the associated central canal stenosis. Our surgical intervention for this elderly man showed a good outcome with resolution of the pannus compression on the medulla and radiographic reduction of the mass.","title":"Retro-Odontoid Pseudotumor with Cervical Medullary Compression: A Case Report"}
{"_id":"16f58267-6ff4-0b56-20e8-085b2e5542e5","text":"Several theories have been proposed for the role of surgery in precipitating local breast cancer recurrence. First, the insult of major surgery may upset the delicate balance between the immune system and dormant breast cancer cells.9 Patients with breast cancer are known to harbor micrometastases at different sites and surgical trauma may reactivate the dormant micrometastases, which could result in early local recurrence or distant metastases.11 Second, mechanical dispersal of dormant tumor cells in the IMLNs during IMV exposure is a possibility. Disruption of metastatic growth suppression may lead to uncontrolled cancer growth in tissues where the metastatic cells had been previously suppressed and not clinically apparent. In contrast to flap reconstruction, DBR with implants did not increase breast cancer recurrence rates after reconstruction.16 This perhaps suggests that it may not be the surgical trauma per se that may be implicated but other factors such as disruption of lymphatics.","title":"Internal Mammary Recipient Site Breast Cancer Recurrence Following Delayed Microvascular Breast Reconstruction"}
{"_id":"16fda838-2d2d-d85c-5569-ab3d5cd75b4a","text":"The major drawbacks of the presented study are its retrospective nature without the assessment of a control group and the low number of included patients. However the most studies focusing on the outcome of clavicular non- or malunions contain a comparable number of cases due to the general low incidence of non-unions of the clavicle. The low incidence is also the reason that we found no comparative study published in the literature. Another drawback presents the postoperative rehabilitation that was performed on an outpatient basis. Thus it was not performed in a standardized way and although physiotherapy should be done according to a standard protocol we cannot guarantee the patient’s compliance.","title":"Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft"}
{"_id":"16fe1755-6a3d-acbf-dc87-a7a4a3894e15","text":"We report satisfactory results from the correction of malocclusion after fibula reconstruction using sliding fibula osteotomy and sagittal split ramus osteotomy. The midline of the mandible returned to its original position and the degree of facial asymmetry was reduced. The implants reduced difficulties that the patient experienced with masticatory function.","title":"Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction"}
{"_id":"16ffb9f9-b33b-afa5-1f5c-20bfb6fc88c2","text":"An examination of the deformations in the stomatognathic system and the skeleton was conducted, as well as an examination of the trauma and tone of the jaw.","title":"Evaluation of Stomatognathic Problems in Children with Osteogenesis Imperfecta (Osteogenesis Imperfecta − OI) − Preliminary Study Ocena problemów stomatognatycznych u dzieci z wrodzoną łamliwością kości (Osteogenesis Imperfecta − OI) − Badania wstępne"}
{"_id":"1700b35e-b9ee-5a44-e6ab-f5f160088c92","text":"Similarly, our study only reports complications that are sufficiently severe to present in secondary care, and will not include, for example, minor infections treated with oral antibiotics in primary care. Our data define the risk of serious surgical site infection or significant tendon injury requiring intervention, and can inform the consent process regarding the most serious and most clinically important complications. It must be recognized that as the study is based within secondary care alone, only complications that require an inpatient admission or intervention will therefore be included. Whilst patients could present to any secondary care provider within the NHS in England and this would be detected by linkage through their individual identifier, presentations to primary care are not included. We believe that the low rates identified here are not due to misclassification bias or underreporting, but more that they only include the most serious events. Whilst this study adds to the literature by identifying the rates of the most serious complications within a national cohort, further work is needed to identify other complications that would not require admission or further intervention, for example within primary care observational datasets.","title":"Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis"}
{"_id":"17011a98-4b21-63c3-43ef-5f090ca3c17b","text":"Knee instability is a potential complication of harvesting the fibular head for such procedures. In the majority of cases involving fibular free flaps, the proximal head of the fibula is left intact at knee level to maintain stability and the distal fibula is retained to avoid problems with ankle instability.6 However, the inclusion of the fibular head in the autograft for carpal reconstruction created instability in the knee that was corrected with anchoring the remnant of the femoral collateral ligament and biceps femoris tendon to the lateral tibia. Potential donor site complications include chronic leg pain, lateral ligament laxity, leg dysesthesia, and foot.","title":"Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius"}
{"_id":"1707e934-86d0-168b-1a2c-83d875cc0581","text":"We report a case where we applied NPWT on a biological abdominal mesh in order to reduce wound dimensions over the implant and to prepare wound bed for a split-thickness skin graft which was subsequently used to definitely close wound dehiscence.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"1708d3bf-0b9f-8f9f-56e8-be1210eccc93","text":"The comparison of DuraGraft solution, HAB and PSS effects on endothelial structural integrity after 4 h of storage are showed in Table 1 and Figure 5.","title":"Efficacy of Intraoperative Vein Graft Storage Solutions in Preserving Endothelial Cell Integrity during Coronary Artery Bypass Surgery"}
{"_id":"170b4176-9b55-f2ed-fd1b-ce40bdeae6ac","text":"The patient then received postoperative external beam radiation therapy with a dose of 6600 cGy in 33 fractions. The patient had regular follow-up at the otolaryngology and the radiation oncology outpatient department with a follow-up period of 12 months. There was no local tumor recurrence noted in the endoscopy during postoperative monthly follow-up. Neck CT which was arranged 3 months later after completion of radiation therapy also revealed no local recurrence or neck nodal metastasis.","title":"Primary small cell neuroendocrine carcinoma in the nasal cavity A CARE-compliant case report"}
{"_id":"1714fcf9-cb18-625a-f8da-e912093d6cbf","text":"After the patient consented to a surgical treatment we started our surgical approach with extensive debridement of the affected areas on the abdominal wall and both thighs (Figure 2). A consecutive VAC therapy for the lesions on the thighs was mandatory to establish a clean environment. At this level, attempt to close the wounds on the abdomen via advancement flaps were unsuccessful.","title":"Calciphylaxis – a challenging & solvable task for plastic surgery? A case report"}
{"_id":"17231799-8778-d0f9-d178-152c8c2730d9","text":"Based on expert opinion, medical management for bone and joint infection was commonly believed to mandate high dose, intravenous, prolonged courses of antibiotic therapy, often for several months. 15 Recent trials including the OVIVA (oral versus intravenous antibiotics for bone and joint infection) and AVAPOM trials have sought to better define these parameters and, although data are limited, emerging evidence suggests that carefully chosen oral antibiotic regimens may be noninferior to intravenous therapy, 16 17 and, in some circumstances, the duration of therapy has become better defined. For example, for spinal OM, 6 weeks of therapy may be sufficient 18 and for certain prosthetic hip joint infections managed by debridement, antibiotics, and implant retention, 8 weeks are sufficient. 19 Close liaison with the bone infection physician and follow-up to detect any recurrence is advocated.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"17268cf9-c156-d9a4-b8ed-e6a87049e53c","text":"CG and EL have both made substantial contributions to conception and design, have been involved in drafting the manuscript and revising it critically for important intellectual content; and have given final approval of the version to be published.","title":"Loss of international medical experiences: knowledge, attitudes and skills at risk"}
{"_id":"17319f4c-f8f0-a367-e99e-c60be6c1e4a2","text":"Osteomyelitis in childhood can be a challenging diagnosis. Imaging plays a vital role in the diagnosis of childhood osteomyelitis, and the imaging findings are pivotal in the treatment decision. As in all clinical cases the most important aspect of the diagnosis of childhood osteomyelitis lies in good cooperation among the paediatrician, paediatric orthopaedic surgeon and paediatric radiologist.","title":"Childhood osteomyelitis: imaging characteristics"}
{"_id":"1733873b-c78b-ae56-d232-69dbaf4c8994","text":"Neurotropic melanoma is a rare but locally aggressive variant of melanoma. It is varied and often benign appearance makes diagnosis challenging and may contribute to advanced stage at presentation and propensity of local recurrence. Low rates of nodal and distant metastatic disease highlight the importance of local control. This is achieved through excision of lesion with wide margins of at least 2 cm and adjuvant radiotherapy where indicated. Potential exists for clarification in diagnostic criteria for NM and evaluation of adjuvant radiotherapy.","title":"Neurotropic Melanoma: The Management of Localised Disease"}
{"_id":"173770e0-c4fd-e850-552b-df1a57927790","text":"Mentorship has been found as a key factor for a successful and satisfying career in academic medicine and surgery. The present study was conducted to describe the current situation of mentoring in the surgical community in Switzerland and to evaluate sex differences regarding the impact of mentoring on career success and professional satisfaction.","title":"Mentoring in general surgery in Switzerland"}
{"_id":"17435b69-2318-6a44-5add-ef7eb38a2454","text":"The lingual frenulum is a mucous membrane fold found underneath the tongue. It helps the tongue to perform its function. There are few anomalies that can affect the lingual frenulum, such as ankyloglossia and absence of the lingual frenulum. We report a case of two lingual frenula to educate practitioners about the presence of such an anomaly.","title":"Double lingual frenulum: a case report"}
{"_id":"1747ad9d-6d74-8f14-820e-7fdb57dc32a5","text":"The difficulty of restoration with a maxillary obturator prosthesis depends on the extent of the surgical resection, with the acceptance that resections with an increasing horizontal component provide a much greater prosthodontic challenge. The number of remaining teeth is a key component in conventional obturator design [9] with the remaining dentition being used exclusively to retain the prosthesis by means of clasps which are often in the visual field and affect the resulting aesthetic outcome for the patient as well as placing significant forces onto them. In conventional maxillary defect preparation, the additional use of a split skin graft into the lateral aspect of the cheek is used to provide a scar band to aid with defect retention, and this brings added morbidity to the procedure especially for a paediatric patient. In conventional hemi-maxillectomy cases, gaining some form of retention from the defect is essential in providing the patient with confidence in the use of the prosthesis, and the discomfort associated with this can make paediatric patients anxious about placing and removing the obturator themselves. The advantages of providing “in-defect” support and retention by means of zygomatic implant placement addresses all of these potential difficulties and allows the construction of a simple highly polished acrylic prosthesis that does not require clasping of the teeth in the aesthetic zone, requires very little extension into the defect to affect a peripheral seal and most of all provides good support when the patient masticates on the defect side. No additional skin grafting is required, and the placement and retrieval of the prosthesis is comfortable and atraumatic. Maintenance of the prosthesis is simple with modifications to the peripheral seal as required at the chair side and replacement of the bar attachments from time to time.","title":"A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient"}
{"_id":"175c38fd-81ec-1a74-ddcd-c9de12fe606b","text":"A 74 years old male was admitted to the internal medicine department due to an acute exacerbation of his chronic back pain following a fall in his bathroom the previous night. He also reported an involuntary weight loss of 15 kg. His past medical history included hepatocellular carcinoma four years ago and an epidermoid carcinoma of the upper oesophagus five years ago. Both types of carcinoma were considered in remission at the time of his admission to hospital. He had been on oral dexamethasone for 2 weeks for his back pain and sorafenib as maintenance chemotherapy for his oesophagus carcinoma.","title":"Polymicrobial vertebral osteomyelitis after oesophageal biopsy: a case report"}
{"_id":"175d7399-b73b-7f50-fc36-7bd3bb11da56","text":"Sonidegib was the second SMO antagonist approved for the treatment of locally advanced basal cell carcinoma that recurred after surgery or radiotherapy and is not suitable for surgery or radiation therapy. In addition, the results of a multicenter, randomized, double-blind phase II trial have shown that 200 mg sonidegib for patients with advanced basal cell carcinoma is the most clinically appropriate dose.","title":"Targeting cancer stem cell pathways for cancer therapy"}
{"_id":"176858d5-f341-50bf-3557-d00445c36f56","text":"The surgical management is primarily driven by the necessity of histological diagnosis for correct tumor staging, then a radical excision may be accomplished as an isolated procedure or as the completion of the regional lymph node dissection.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"176b7456-1dd4-17c4-83ee-6a598bcc7548","text":"There is now ample evidence that demonstrate how radiotherapy in combination with immunotherapy can increase the tumor immune response and enhance the effectiveness of ICIs. For this reason, radiotherapy is increasingly acquiring a role not only in local control, but also in the systemic control of the disease combined with immunotherapy.","title":"Radiotherapy in the Treatment of Subcutaneous Melanoma"}
{"_id":"17701dbc-bf5a-0550-04e6-800f82f95520","text":"The adverse reactions were categorized as immediate and delayed. An immediate reaction was defined as occurring during the first 30 min after the vaccine administration, and a delayed reaction was when the onset occurred within 30 min and 7 days after the intervention.","title":"Simultaneous Influenza Vaccination and Hymenoptera Venom Immunotherapy Is Safe"}
{"_id":"1773a382-9669-34d0-5b77-a421d245ad1f","text":"DVT and PE caused by long period of immobilisation are life threatening medical complications following all major orthopaedic surgeries. Surgery of any kind is known to create prothrombotic state due to stress which may increase thrombotic complications post-operatively. The incidence of Deep Venous Thrombosis after spine surgery ranges from 0.3% to 31% and further studies are needed for the same. The reason for this variability in the incidence of Deep Venous Thrombosis is most likely due to the differences in epidemiological characteristics of the studied populations, lack of standard diagnostic and treatment protocol for DVT.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"17755703-a022-974f-f562-fcf09e65a65a","text":"The steps involved in the preparation of specimens are shown in Figure 4.","title":"Intramuscular Neural Arborization of the Latissimus Dorsi Muscle: Application of Botulinum Neurotoxin Injection in Flap Reconstruction"}
{"_id":"17839f5d-608d-c424-7aff-2057a46bba4a","text":"The false positives SLNs identified by planar imaging (4) and CrystalCam (2) may be due to the challenges associated with 2D imaging systems to differentiate an injection site or lymphatic channels from SLNs because of their poor resolution compared to SPECT\/CT imaging. Shielding the injection site would have help to localize SLNs situated close to the injection site and reduce the dead time of the handheld gamma camera, thus providing the possibility of measuring with a higher acquisition time at short SDD.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"1783ecd3-f38a-2225-e9cf-e1229177f5ad","text":"In our case massive PE developed at diagnosis. No APL-specific risk factors for thromboses or inherited or acquired thrombophilia were found in this particular case except for bcr3 isoform and estroprogestinic exposure. Despite the concurrent diagnosis of APL, the patient required both heparin and thrombolysis for PE. Two other attempts to treat major thromboses with thrombolysis were reported in APL, one patient was treated for Budd-Chiari syndrome17 and relapsed APL and a more recent one APL patient received local thrombolysis for arterial thrombosis at the onset of APL.18 One additional patient underwent to thrombolysis for PE when in remission of APL.19 The combination of ATRA and ATO, adopted in considering the low-risk APL category of our patient and the need for prolonged and sustained anticoagulation, demonstrated to be an efficient regimen, also significantly reducing the risk of prolonged thrombocytopenia due to chemotherapy. Two additional cases with severe thrombotic events at diagnosis successfully treated with anticoagulants with or without thrombolysis when in ATO and ATRA have been published recently18,20 and reported in Table 1.","title":"Massive Pulmonary Embolism at the Onset of Acute Promyelocytic Leukemia"}
{"_id":"178cdd6a-581d-977b-d04d-0309c3399efc","text":"The patient was treated with multipoint subcutaneous injections of triamcinolone acetonide in each breast every month.","title":"Bilateral breast myxedema caused by Graves’ disease and responsive to multipoint subcutaneous injection of long-acting glucocorticoid Case report"}
{"_id":"178f7b1f-d64f-9334-ff06-d35908bc6255","text":"Aging refers to the process of a series of changes in the chemical composition and structure of polymer materials due to environmental factors. These changes can cause a transformation in material properties.","title":"A Review of 3D Printing in Dentistry: Technologies, Affecting Factors, and Applications"}
{"_id":"17936acf-000d-b0f1-201d-210729e4217c","text":"Amongst the most severe reactions, we observed that these patients were between the ages of 16 to 53 years. All three patients were being treated for multiple allergies, and the reaction onset was within 30 min of the injection. Multiple risk factors for an increased probability of reaction and reaction severity were identified, with asthma in the past history of a majority of these patients, and a majority of these reactions occurring during winter. Furthermore, a majority of patients were receiving the first injection from a newly reordered vial. These patients all required multiple doses of intramuscular epinephrine and were transferred to the hospital for further management and observation.","title":"A single centre retrospective study of systemic reactions to subcutaneous immunotherapy"}
{"_id":"1797eb42-b707-ed2d-1a70-4995ee0aa445","text":"There is an expanding body of literature describing the need for the development of leadership skills among physician trainees during both undergraduate and graduate medical education. Most of this literature is focused on leadership and management skills needed to ensure high quality patient care. The development of leadership skills needed to ensure high quality medical education are equally as important in ensuring that our health education systems are prepared for the changing landscape of practicing medicine.","title":"Office of Student Affairs: Engagement and Leadership Opportunities for Medical Students, Residents, and Fellows"}
{"_id":"17a67943-7c02-469e-3c23-13c9728c64a8","text":"In conclusion, fat embolism syndrome remains a clinical diagnosis and should be strongly suspected in polytrauma patients developing respiratory distress. Early prone positioning in patients with ARDS helps treat refractory hypoxemia and can be life-saving. The relative contra-indication of unstable spine should not preclude in prone positioning of patients in severe ARDS provided a skilled staff well versed with practicalities of prone positioning is present.","title":"Prone Positioning for Management of Fat Embolism Syndrome in a Patient with Spine Fracture; An Unusual Scenario and Review of Literature"}
{"_id":"17b9ca09-e200-e172-8be8-fbec2682ed3e","text":"Surprisingly, we found that angulation of the fibula itself does not have much effect on malalignment. This is probably because most of our patients were children. We could therefore obtain bone union easily in spite of the angulation of the fibular osteotomy site. If there is no PFM or DFM, angular deformity of the fibula alone does not require surgical intervention or any other special treatment.","title":"Fibula-related complications during bilateral tibial lengthening 60 patients followed for mean 5 years"}
{"_id":"17bbe3f0-80a8-1781-535d-4e27954e6e30","text":"An overview of the tissue slices described in this manuscript is presented in Supplementary Table S1.","title":"Insights into S. aureus-Induced Bone Deformation in a Mouse Model of Chronic Osteomyelitis Using Fluorescence and Raman Imaging"}
{"_id":"17bff094-bef9-cb92-6301-26bd3e1aae42","text":"The average time to complete the ultrasound examination was 5 min. The average time to score all of the ultrasound images was 2 min (Table 2). There were no instances of clinic delays secondary to ultrasound examination. Patients found the examination protocol acceptable, with 100% reporting the exam was quick and painless. Others stated they enjoyed being able to see the structures we were examining and better understood the purpose of the research study. There were only three patients that chose not to participate in the study and they declined because of research burden and prior to learning about ultrasound examination.","title":"Findings and feasibility of major salivary gland ultrasound in childhood-onset systemic lupus erythematosus: a pilot study"}
{"_id":"17c02e18-34da-a740-cbc0-8506ed50b561","text":"Our patient had received a standard 1000 mcg dose of vitamin B12 from a single-dose vial. The Utah State Health Department and the USA Federal Drug Administration (FDA) were contacted regarding the case, and the remaining vials from the vitamin B12 lot were quarantined. The FDA recommended against culturing the remaining vials because a false positive result would be difficult to interpret and because no other infections from that lot had been reported either locally or nationally. Our patient had previously received a vitamin B12 injection from the same lot to the opposite hip without incident. The injection that preceded the infection had been administered by a board-certified medical assistant trained in intramuscular injections. She reported to have cleaned the skin with an alcohol wipe, to have waited approximately 15 seconds for the skin to dry before injecting the dose, and to have covered the insertion site with a Band-aid. Our patient does not remember her waiting for the skin to dry, nor a Band-aid being placed over the insertion site, and believes that the needle for the injection was removed from its cap by biting the cap. It is also important to note that our patient does have a pet dog, who may have introduced the oral flora to the skin either before or after the injection.","title":"Subcutaneous Eikenella corrodens, Actinomyces sp., and α-Hemolytic Streptococcus Abscess of the Thigh following a Vitamin B12 Injection"}
{"_id":"17c72e04-217d-f5c8-2e1e-8f34662757e7","text":"Analysis of the responses to questions concerning the source of information on reconstruction and patient satisfaction is shown in Table 6.","title":"Reasons of not having breast reconstruction: a historical cohort of 1937 breast cancer patients undergoing mastectomy"}
{"_id":"17cf7b47-cd5e-e7f7-5b7b-de5a02a86989","text":"Sentinel lymph node (SLN) biopsy has been widely accepted as a minimally invasive and highly accurate technique for detecting occult nodal metastases in breast cancer and cutaneous melanoma and has been validated as an independent prognostic factor for survival [13–17]. The utility of SLN biopsy for the staging of cutaneous SCC remains unproven and there is a lack of evidence-based practice guidelines. We contribute our institutional experience with SLN biopsy in patients diagnosed with high-risk cutaneous SCC and perform a review of current medical literature to define the predictive value and role of SLN biopsy in the management of occult nodal metastases from cutaneous SCC.","title":"Sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma: clinical experience and review of literature"}
{"_id":"17d7434c-211b-ec9e-16d0-6323b37b94bd","text":"Age is a primary social dimension. We behave differently toward people as a function of how old we perceive them to be. Age perception relies on cues that are correlated with age, such as wrinkles. Here we report that aspects of facial contrast–the contrast between facial features and the surrounding skin–decreased with age in a large sample of adult Caucasian females. These same aspects of facial contrast were also significantly correlated with the perceived age of the faces. Individual faces were perceived as younger when these aspects of facial contrast were artificially increased, but older when these aspects of facial contrast were artificially decreased. These findings show that facial contrast plays a role in age perception, and that faces with greater facial contrast look younger. Because facial contrast is increased by typical cosmetics use, we infer that cosmetics function in part by making the face appear younger.","title":"Aspects of Facial Contrast Decrease with Age and Are Cues for Age Perception"}
{"_id":"17d79a69-faad-c3bd-a5ff-d92d34b6beaa","text":"Thrombosis at the anastomosis site was found in two animals (one in group I and the other one in group II) at the end of the experiment. Further on, one animal in group II developed a large hematoma under the flap. These animals were excluded from this study and replaced with three other animals. The patency of the anastomosis sites was confirmed in all other animals and all survived uneventfully with no obvious weight loss. All rabbits were euthanized with overdose of pentobarbital and pneumothorax at the end of experiment and this method of euthanasia in this study was specifically approved by our Institutional Animal Care and Use Committee of Wenzhou Medical University. The rabbits used for detection of water content and epidermal metabolite levels were sacrificed 3 days after sample collection postoperatively and all others were euthanized 14 days after surgery.","title":"The complicated role of venous drainage on the survival of arterialized venous flaps"}
{"_id":"17d9cf29-97e4-5d0c-68dd-7affa1b20e73","text":"Only two flaps were reexplored due to venous congestion, out of them one flap with two skin pedicles had a loss of skin pedicle and we covered it with a staged groin fascio-cutaneous flap. The other flap survived after the evacuation of hematoma. Minor wound dehiscence was noted in two flaps which were managed conservatively.","title":"Experience of Saving Limbs With Free Fibula Osteocutaneous Flaps"}
{"_id":"17e61c14-cdfb-74f3-028e-eec6f311b042","text":"Calculation of time required for the procedure was done as follows: The initiation point for the femoral nerve block procedure was from time point a when the patient was placed in the supine position for this block. The endpoint of this procedure was at point b when the femoral nerve was found surrounded by LA on ultrasonography. Immediately after getting point b, the patient was shifted to a prone position for the popliteal sciatic nerve block (initiation of the popliteal sciatic nerve block procedure). When the popliteal sciatic nerve was surrounded by LA, time was noted as point c (completion of the popliteal sciatic nerve block procedure). The sensory assessment was done every five minutes after point c until complete sensory loss over medial and lateral malleoli was achieved. This point of complete sensory loss was noted as point d.","title":"Effects of Ultrasound-Guided Lower Extremity Nerve Blocks for Below-Knee Procedures in the Emergency Department of a Tertiary Care Hospital, Central Gujarat"}
{"_id":"17fd4b23-7ac4-8f50-7ba0-12cdb93c9798","text":"Chloral hydrate seems to be the culprit causative compound of THS and type IV seems to be the major type of hypersensitivity of THS. The CH patch test could be potentially useful for screening workers at risk of THS.","title":"Trichloroethylene Hypersensitivity Syndrome Is Potentially Mediated through Its Metabolite Chloral Hydrate"}
{"_id":"18036250-0706-75e1-3b26-03d99bf1a7c7","text":"The normal ovary of a postmenopausal woman is a small structure (mean volume 1.25ml ) usually situated lateral to the uterine fundus and in close relation to the internal iliac vein. In as many as 40% of transvaginal ultrasound (TVS) examinations the ovary may not been seen as typically they shrink with age and are sometimes very difficult to locate . For this reason in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) and other screening trials a pragmatic approach is taken whereby an annual screening examination may be judged satisfactory even if both ovaries are not seen, given that a good view has been achieved of the Iliac vessels in the pelvic side wall. However, the sonographer should always attempt to visualize both ovaries as this provides the maximum assurance that an early ovarian cancer has been excluded.","title":"Audit of transvaginal sonography of normal postmenopausal ovaries by sonographers from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) [version 1; referees: 2 approved"}
{"_id":"180b588f-d912-6da3-516c-0da8da28c137","text":"In this study, we have analysed the response of DFT1 cells to imiquimod at the transcriptome and proteome level in order to improve the current understanding of the direct anti-tumor effects of this small molecule in cancer. This analysis has demonstrated that imiquimod disrupts cellular homeostasis, leading to a myriad of molecular changes that are consistent with activation of oxidative and ER stress responses (Figure 7). These changes included positive regulation of PERK, an attenuator of translation at the ER, which likely altered protein production to favour other regulated pro-survival mechanisms such as cell cycle arrest and autophagy. Attenuation of normal protein translation by PERK could have also lead to the negative regulation of tumourigenic pathways, perhaps rendering the cells more susceptible to apoptosis. Lastly, a range of pro- and anti-apoptotic genes involved in ER and oxidative stress responses were also positively regulated in our study, suggesting that the interaction of stress pathways controls the onset of apoptosis in the treated cells. As genes associated with ER stress responses were positively regulated across multiple DFT1 cell lines in our study, and within human cell lines in previous studies, the stress-mediated pathways that were regulated in our study may pose as potential drug targets for enhancement of the direct effects of imiquimod during cancer therapy. This study is the first comprehensive transcriptome and proteome analysis of any imiquimod-treated tumor cell, and is the first proteomic analysis of any cell type of Tasmanian devil origin. Findings from this analysis will allow for improved mechanistic use of imiquimod as a cancer immunotherapy in both human and Tasmanian devil cancer trials.","title":"Transcriptome and proteome profiling reveals stress-induced expression signatures of imiquimod-treated Tasmanian devil facial tumor disease (DFTD) cells"}
{"_id":"181277e0-ae98-1af4-2ef9-bc4e4ba30d72","text":"In this study, no skin reactions around the periareolar injection site nor allergic reaction were observed, demonstrating that SNZ is safe when injected periareolarly even though it has been developed as an intravenous agent. SNZ consists of microbubbles and a capsule made of phosphatidylserine of egg yolk origin, so that SNZ is contraindicated for patients with an episode of egg allergy. Two other studies on the periareolar injection of SNZ for identification of SLNs have also reported that no serious side effects were observed 13, 18.","title":"Identification of sentinel lymph nodes by contrast‐enhanced ultrasonography with Sonazoid in patients with breast cancer: a feasibility study in three hospitals"}
{"_id":"181c4450-8194-b079-a296-ab6e33553751","text":"In reconstruction of ankle and distal leg, posterior tibial perforator flap, revers sural flap and lateral supramalleolar skin flap based on supramalleolar artery provided a wide variety of reconstructive options in management of the distal lower limb soft-tissue defects. Use of free flaps is more reliable than distally based fasciocutaneous flaps in patients with poor vascularity of the lower limb or in cases with extensive defects. We used medial gastrecnimus free flap in complex heel wound due to mine explosion.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"181d6317-b349-6374-d8ed-411345190d71","text":"The selection of the sample size length of 0.5 cm was based on the principle of having enough vein length to perform the study with meaningful results and not to waste biological human material.","title":"Efficacy of Intraoperative Vein Graft Storage Solutions in Preserving Endothelial Cell Integrity during Coronary Artery Bypass Surgery"}
{"_id":"18229b78-b103-49de-7e2b-e375324bbc78","text":"Clinical data from 36 patients with frenulum abnormalities that were examined at the Department of Oral and Maxillofacial Surgery demonstrated the usefulness of the CO2 laser in performing frenectomy and offered suggestions regarding the timing of this surgical procedure.","title":"Clinical Study of Laser Treatment for Frenectomy of Pediatric Patients"}
{"_id":"182f58d0-d91f-e210-95c6-0ab4bb1ca12d","text":"He was not readmitted in the first 30 days after discharge, but he was unable to comply with ongoing offloading and wound care. Despite this, his lateral incision healed well postoperatively but he presented approximately eight weeks after the initial presentation with a progression of the ischial pressure ulcers and septic arthritis on his contralateral hip with acute dislocation of his femoral head for which he underwent a Girdlestone procedure as well.","title":"Combination of Girdlestone Pseudoarthroplasty and Negative Pressure Wound Therapy with Instillation and Dwell in the Treatment of Invasive Osteomyelitis of the Proximal Femur"}
{"_id":"1831e89f-b31d-bc9c-ed15-1ffddad250d8","text":"Bone adapts to loading by altering its geometry and microarchitecture. Mechanical loading causes deformation of bones, and these strains activate mechanosensitive osteocytes that signal molecules to activate osteoblasts and osteocytes. Aforementioned results showed that wearing a SS and having BTX injection in masticatory muscles elicited decreased cortical thickness and density of TMJ condyles, the masticatory load-bearing area. Similar previous results in rodents showed decreased cortical bone thickness after removal of gravitational loading of the hindlimbs as a result of decreased periosteal bone formation and increased endosteal bone resorption. The effects of decreased masticatory loading on the cortical bone quality were more remarkable in post-menopausal females than in young females. Changes in sex hormone levels appeared to be the major cause, but the senescence of osteoblasts and of osteoprogenitor cells also played a role in the decreased bone remodeling capacity of the elderly. The diminished ability to adapt to mechanical unloading and reloading in aged rodents has been suggested and our results which showed decreased adaptability of the condyles to decreased masticatory muscle thickness and functional loading especially in post-menopausal females could be understood in the same manner.","title":"Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults"}
{"_id":"183b7c36-460c-b364-57cb-ca6a73566edb","text":"Lumbar vertebras are the most common region for epidural abscesses whereas involvement of the cervical spine is uncommon. Management of spinal epidural abscess is controversial. Several cases of successful treatment with antibiotic alone have been reported in particular in patients with stable neurological condition; however, signs of spinal cord compression represent a neurosurgical emergency because of its potential for causing rapidly progressive paralysis. In this paper, the authors report a rare case of spinal epidural abscess caused by brucellosis in Iran and then discuss about it.","title":"Cervical spine epidural abscess caused by brucellosis: A case report and literature review"}
{"_id":"18446288-d955-9d70-e9e8-96d1766035b3","text":"Therapeutically, ultrasound has long been used for liposuction assistance in an effort to reduce tissue trauma and improve skin contraction.1,2","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"18458902-8b36-3845-2184-b0862c5d0718","text":"Soft tissue augmentation dates back more than 100 years and is commonly used for temporary aesthetic enhancement in place of major surgical intervention. A subtle improvement to the lips and surrounding structures by the injection of soft tissue fillers is culturally associated with a more youthful appearance. When performed by an experienced cosmetic physician, filler injection offers high patient satisfaction with low complication rates. However, physicians performing the procedure must be well versed in cutaneous and soft tissue anatomy as structures within the injection field are vulnerable to inadvertent damage.","title":"Lower Lip Necrosis"}
{"_id":"18480635-2c61-5176-a7ad-eac1e6237956","text":"The upper and lower lips are distinct facial anatomic parts form majority features of lower 1\/3 of face, and their functional and aesthetic importance is undeniable. Although over 200 methods have been described for reconstruction of lip defects since 1000 BC and many have been considered to be ideal, none of them is perfect or suitable for the reconstruction of all kinds of defects.-","title":"Lip Reconstruction after Tumor Ablation"}
{"_id":"184a5e0f-ba4f-af37-7b8a-d78815baae4d","text":"An excisional biopsy should be performed in all clinically suspected CSCCs for histological confirmation. An incisional or punch biopsy may be performed, depending on the size and location of the tumor.","title":"The Multidisciplinary Management of Cutaneous Squamous Cell Carcinoma: A Comprehensive Review and Clinical Recommendations by a Panel of Experts"}
{"_id":"184ced31-2220-956a-bd57-3773e54735b4","text":"This patient underwent hyaluronic acid injection 12 months before preoperative consultation. The nose presented a wide back with insufficient tip projection.","title":"Design and Application of a Novel Silicone Nasal Implant"}
{"_id":"18508c68-bb5a-db6e-3d27-c7dcf8c4947b","text":"Current trends in clinical dermatology practice suggest an increase in the incidence of skin cancers in the region of the head and neck. This would include lesions of the face, an area of the body where cosmetic changes as a consequence of cancer treatment are paramount. Although elimination of the malignancy is the primary emphasis of treatment, the residual side effects of treatment cannot be discounted. While surgical excision remains the recommended approach to the treatment of skin cancers on the face, continued efforts to minimize the impact of treatment must always be carefully considered.","title":"Neoadjuvant Use of Photodynamic Therapy in Basal Cell and Squamous Cell Carcinomas of the Face"}
{"_id":"1857303e-0ae6-775f-165c-633983f53ae1","text":"All these parameters which were analyzed above are very difficult to be controlled by unilateral external fixators. When using olive wires of the Ilizarov device the bone fragments can securely be fixed. At the same time the talus, with an additional wire through its body can be centered in the mortise ensuring its symmetrical movement in relation to the tibia during full range motion of the ankle joint. This controlled mobilization can easily be done by using the correct hinges.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"185824c2-8dcf-862c-a992-b736aff5a593","text":"Reverse latissimus dorsi flaps are useful for covering skin and soft tissue defects of the back, such as those from meningomyelocele or pressure ulcer, and their application in such cases has been reported1,2; however, they have disadvantages including a thickened pedicle in the musculocutaneous flap and the limited arc of the flap. Therefore, the perforating branches of the intercostal arteries can be preserved in the latissimus dorsi flap and the musculocutaneous flap is trimmed to a muscle flap, so the area reached can be extended by “turning over” the flap. Applying this method, we further transected the perforating branch of the 9th intercostal artery and, after confirming the perforating branch of the 10th intercostal artery, turned over the muscle flap just proximal to that perforating branch. We continued to detach the perforating branch and latissimus dorsi so that the area covered by the latissimus dorsi reached the superior anterior iliac spine. The upper iliac crest can be reached by simply rotating and transferring the muscle flap alone, but with the present method it was possible to reach the superior anterior iliac spine by turning over and transferring the muscle flap. This enables reaching a distance about 10 cm farther than with rotation. The skin graft took place well and there were no tissue circulation problems.","title":"Case Report Reconstruction of Exposed Ilium With Reverse Turnover Latissimus Dorsi Muscle Flap"}
{"_id":"185c20b8-61aa-8890-09ea-44099383450c","text":"The applicability and limitations of a photodynamic threshold model, used to describe quantitatively the in vivo response of tissues to photodynamic therapy, are currently being investigated in a variety of normal and malignant tumour tissues. The model states that tissue necrosis occurs when the number of photons absorbed by the photosensitiser per unit tissue volume exceeds a threshold. New Zealand White rabbits were sensitised with porphyrin-based photosensitisers. Normal brain or intracranially implanted VX2 tumours were illuminated via an optical fibre placed into the tissue at craniotomy. The light fluence distribution in the tissue was measured by multiple interstitial optical fibre detectors. The tissue concentration of the photosensitiser was determined post mortem by absorption spectroscopy. The derived photodynamic threshold values for normal brain are significantly lower than for VX2 tumour for all photosensitisers examined. Neuronal damage is evident beyond the zone of frank necrosis. For Photofrin the threshold decreases with time delay between photosensitiser administration and light treatment. No significant difference in threshold is found between Photofrin and haematoporphyrin derivative. The threshold in normal brain (grey matter) is lowest for sensitisation by 5 delta-aminolaevulinic acid. The results confirm the very high sensitivity of normal brain to porphyrin photodynamic therapy and show the importance of in situ light fluence monitoring during photodynamic irradiation.","title":"The sensitivity of normal brain and intracranially implanted VX2 tumour to interstitial photodynamic therapy."}
{"_id":"18609fe2-5f99-ae49-d44f-64007d1ec12f","text":"Desmoid tumors of the mesentery are the most common primary mesenteric tumors displaying spindle cell morphology although they are very rare. They can occur in any age and can be multiple or solitary. The most encountered risk factor for developing a mesenteric Desmoid tumor is previous abdominal surgery. GIST can also develop in the mesentery and mimic clinical and radiological features of Desmoid tumors. Histologically, both tumors may look alike. We describe here a case of GIST with subsequent development of Desmoid tumor.","title":"Subsequent Development of Desmoid Tumor after a Resected Gastrointestinal Stromal Tumor"}
{"_id":"1862edf3-d120-d7b0-ee6c-b195cff6733e","text":"Other PSs have been employed to improve PDT effects; below are some of the most promising experimental studies that have correlated the effectiveness of PDT with changes in oxidative stress in skin cancers, whose main findings are briefly mentioned in Table 1.","title":"Oxidative Stress and Photodynamic Therapy of Skin Cancers: Mechanisms, Challenges and Promising Developments"}
{"_id":"18660c7d-adcf-b794-749b-0b2241919016","text":"Our paper reflects on a modified technique in which continuous saline irrigation at −125 mmHg continuous pressure was used along with direct wound closure in layers over the NPWT for patients with infected metalwork. This enabled the metalwork to remain in situ whilst simultaneously treating the infection, reducing the likelihood of leakage and loss of pressure that a standard technique would confer. The aim is to adequately suppress the infection to allow time for fracture union with the retained metalwork. The wound closure over the NPWT dressing has the benefits of preventing skin contracture and contributes to an infection barrier.","title":"Modified negative pressure wound therapy as an adjunct to antibiotics in the treatment of orthopaedic infected metalwork"}
{"_id":"186737a5-a344-657d-ff68-f9b1c3d637ba","text":"After obtaining a 3D virtual model of the defective cranial bone, the cranial implant is designed by completely filling the missing part of the skull which corresponds to the defect. However, designing a virtual 3D model of a cranial implant is a challenging task, which often lacks by finding the appropriate software and needs ample professional experience.","title":"Synthetic skull bone defects for automatic patient-specific craniofacial implant design"}
{"_id":"186af9df-aefd-c1f7-9177-750ab3bc7527","text":"The risk criteria determine the excisional margins recommended by the guidelines as follows:","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"1876b520-1c9a-283e-9361-e677895071fa","text":"Advanced parotid cancers more than 4 cm are firmly fixed around the main trunk of the facial nerve that can be hardly detected in narrow working space between mastoid process and parotid cancer. Even though facial nerve was preserved, facial nerve stretching during surgery has significantly serious effect on postoperative facial palsy.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"187a14be-c526-3586-3225-d17928a63789","text":"An electronic survey targeting thrombosis expert members of Thrombosis Canada was conducted.","title":"A survey of thrombosis experts evaluating practices and opinions regarding venous thromboprophylaxis in patients post major abdominal surgery"}
{"_id":"187e3752-5707-370b-f1b4-aadb34a47fd7","text":"Deep vein thrombosis is a rare condition with the highest prevalence in elderly and obese individuals. This case report elaborates on a patient with an atypical DVT who underwent a thrombectomy after venous ultrasound exemplified extensive thrombotic disease in the right lower extremity. In addition to the extensive thrombus burden, the presence of an IVC filter and IVC thrombus further enhanced the complexity of the case. During the procedure, the Inari FlowTriever system, though typically indicated for pulmonary embolism interventions, was utilized and successfully retrieved a significant amount of thrombus. A post-procedural venogram indicated improvements in flow throughout the right lower extremity venous system, and the patient showed symptomatic improvement without reporting complications.","title":"Thrombectomy of a Complex Deep Vein Thrombosis: A Case Report"}
{"_id":"188c2b89-d7e0-36cc-4dec-fc4b10e42349","text":"The data of all patients treated with CERAMENT® G at our institute from July 2013 to September 2016 for diabetic foot infections with ulcer formation and osteomyelitis were retrospectively collected and evaluated for this non-controlled retrospective pilot case series. Within this time frame, 35 of a total of 40 consecutive patients diagnosed with diabetic foot infections with ulcer formation and osteomyelitis, with or without Charcot neuroarthropathy met our inclusion criteria and were included in this retrospective single-arm case series.","title":"Multidisciplinary Approach for the Management and Treatment of Diabetic Foot Infections with a Resorbable, Gentamicin-Loaded Bone Graft Substitute"}
{"_id":"188cc06e-107f-6e38-a039-71d691577061","text":"Many strategies exist to reduce the risks of filler complications. A good working knowledge of the different side effect profiles of each available product is mandatory. Although unwanted reactions are rare when a proper injection technique is used, patients should be aware that unforeseen adverse sequelae can always occur.","title":"Fillers: Contraindications, Side Effects and Precautions"}
{"_id":"1894129e-c0ae-4d37-7a0c-9072299dbebc","text":"Most scalp defects can be managed with local scalp flaps with or without skin grafting at the donor site. Compared to local flaps, free tissue transfer is a time-consuming procedure with higher donor site morbidity, which is unsuitable for patients with comorbidity. The selection of a single or double rotation flap depends on the location of the defect rather than the size. Single or bipedicle transposition scalp flaps have a wider coverage scale, are less time-consuming, and are advisable in high-risk patients. Debridement of the outer surface of the cranium is mostly required in delayed presented cases of electric contact burn over the scalp region. Reconstruction with local flap with primary closure of donor site or grafted donor site placed in the less cosmetic area resulted in a better aesthetic outcome.","title":"Reconstruction of Scalp and Forehead Defects: Options and Strategies"}
{"_id":"189a17a0-169f-3a31-5843-10fc39f8d984","text":"The only Z0011 trial criterion that was not considered at our hospital was the presence of extracapsular extension identified as focal or smaller than 2 mm. These patients were treated with SLND. Patients with Z0011 exclusion criteria were treated with ALND.","title":"Survival and recurrence with or without axillary dissection in patients with invasive breast cancer and sentinel node metastasis"}
{"_id":"189f20fe-2b91-4fac-7bfe-291de18447b8","text":"The relationship between circulating tumour cells and the development of secondary disease is not fully understood. The presence of such cells in peripheral blood samples from early stages melanoma could indicate a dissemination of the tumour cells, and thus a high risk of metastasis. If confirmed circulating melanoma cells could represent a new prognostic marker with which to predict clinical behaviour, assess tumour progression, and improve patient management.","title":"Prognostic significance of the sequential detection of circulating melanoma cells by RT–PCR in high-risk melanoma patients receiving adjuvant interferon"}
{"_id":"18a04a08-ffda-d0b5-57a5-80ec9a5967b1","text":"Gap arthroplasty without interpositional graft was performed in five patients, and other TMJ surgical approaches were used in four patients for the management of TMJ ankylosis. These approaches were evaluated in this clinical study. Complete evaluations of ankylosis etiology must be confirmed, and sufficient excision while maintaining a wide gap space, combined coronoidectomy, and other additional operative techniques must be executed according to individual cases. Thorough physical therapy with an IOS and periodic follow-up for more than 2 years after surgery are also necessary to avoid recurrence and complications. IOSs enable more comfortable mandibular movement and act as a guide for mouth opening exercises in active postoperative physiotherapy for TMJ ankylosis patients.","title":"Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients"}
{"_id":"18a2afd2-d8ec-274b-5200-9745cec4c4e9","text":"Osteomyelitis is serious medical condition that can be difficult to identify, especially in patients with SCD. Although VOC is a much more common presentation, clinicians must consider the possibility of osteomyelitis when evaluating patients with SCD who present with fever and a swollen limb. Advancements in imaging such as MRI and radionuclide scanning may be helpful in differentiating the two conditions. If infection remains present despite antibiotic therapy, adequate surgical management is necessary to ensure optimal outcomes.","title":"Management of Osteomyelitis in Sickle Cell Disease: Review Article"}
{"_id":"18a3eb4b-241f-e8d9-28d5-957bd60cd087","text":"Subcutaneous BTX-A injection can result in relieving pain in intractable cases with TN with minimal adverse reactions and can be an effective treatment option.","title":"Botulinum toxin-type A: could it be an effective treatment option in intractable trigeminal neuralgia?"}
{"_id":"18aa2cc2-3781-e832-9ccf-1bb1bd403b6a","text":"Great diagnostic value of ultrasound examination of involutional changes in soft tissues of lower third of face and neck was noted to determine all causes of contour age-related deformities. These results were used to choose effective minimally invasive methods for correction.","title":"Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques"}
{"_id":"18ad9ab4-4f3e-6dc5-81d6-b9986215fdb4","text":"In clinical practice, this material is easy to inject with a 27 gauge needle; however, the 30 gauge needle supplied with the syringe makes the injection process a little more difficult than most of the other HA fillers. The addition of lidocaine is a benefit and most patients note a decrease in pain, almost immediately after the first injection into the skin.","title":"Soft Tissue Augmentation in Dermatology – 2009 Update"}
{"_id":"18ba27ad-f758-a820-499d-32b0eeb55616","text":"Accidental intramuscular injection of a synthetic filler other than hyaluronic acid and collagen should be avoided since the repetitive contraction of the muscle will often dislocate the filler and create unwanted lumps of material and cause it to migrate to distant sites.[9] The use of Radiesse in the lips is usually avoided for this reason, because the migration of the filler caused by the repetitive contraction of the orbicularis oris can cause superficial nodules of the filler to occur.[9]","title":"Fillers: Contraindications, Side Effects and Precautions"}
{"_id":"18bb2aed-65f0-9c6d-e952-56c64ef8072a","text":"The standard treatment of breast cancer consists of a radical mastectomy with the dissection of the axillary lymph nodes. This principle of radical resection has been considered the standard surgical treatment for a long time, because it was thought that the dissemination of tumor cells is firstly produced locally, in the regional lymph nodes and then distantly. As a result, an aggressive local control could have prevented the distant metastasis and would have decreased the mortality rate due to breast cancer.","title":"Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer"}
{"_id":"18cb138a-b284-9887-b456-7f2b6ad9547b","text":"For the present study our goal was to determine whether these aspects of facial contrast played any role in age perception and so we selected for each face the magnitude of change for each feature that seemed to maximize the change to apparent age while maintaining a naturalistic appearance. In practice, the magnitude of the manipulation was the same for most faces, but was made weaker in some faces in order to maintain a naturalistic appearance. The features were defined as described in Study 1. Only the manipulated faces (low\/high contrast) were presented to the participants. Example stimuli are shown in Figure 3 .","title":"Aspects of Facial Contrast Decrease with Age and Are Cues for Age Perception"}
{"_id":"18ccb084-1b79-a7d1-8378-021270a368be","text":"Internationally, the vast majority of cryoablation clinical trial participants treated with radiation therapy after cryoablation have received the standard 6-week course of whole breast radiation therapy with no significant adverse events. Global experience with the 4-week course of hypofractionated, whole breast radiation therapy is gradually increasing and will likely provide further insights when employed in upcoming cryoablation clinical trials. Presently, there are no published reports of external beam based accelerated partial breast radiation in patients treated with breast cryoablation. The lack of an open surgical cavity following cryoablation excludes the use of intraoperative radiation therapy and other forms of intracavitary partial breast radiation therapy.","title":"Breast Cancer Cryoablation in the Multidisciplinary Setting: Practical Guidelines for Patients and Physicians"}
{"_id":"18e8a4d9-9d1e-d262-904f-ce6bee7f178e","text":"When the mucous membrane was desired for compound nasal loss of skin and mucous membrane, the incision around the skin paddle was deepened to oral mucous membrane with a piece of gauze inside the mouth cavity till a part of mucous membrane equal to that of the defect was included in the levator anguli oris myocautaneous mucosal (LAOMCM) flap.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"18ea7056-f1ff-9dcc-8d85-39641e535cc1","text":"Participants safety will be ensured by screening for eligibility using a structured form completed by trial healthcare professionals. This will record evidence of eligibility and the presence\/absence of any inclusion and exclusion criteria. The Research Associates and Nurses will take a general medical and drug history to assess for other complicating diseases and medications. Any queries will be discussed with the trial nurse, chief investigator and the relevant physicians at the trial site. The eligibility will be signed off by the physician providing routine medical care.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"18f00b98-a15b-2c6f-8b2f-90031e7e3e02","text":"Two initial audits of the TABBY were undertaken at a large maternity unit in a secondary care NHS Trust, in Bristol UK from 2017 to 2019. TABBY was evaluated by five midwives on 262 babies with tongue-ties and experiencing breastfeeding difficulties who were referred for assessment to a tongue-tie assessment clinic using both BTAT and TABBY. Each pair of scores was recorded by one midwife at a time. A further training audit with 37 babies involved different assessors using BTAT and TABBY on each baby.","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"18f2c3a9-1946-176f-1f8a-5eb2181a94f7","text":"Augmentation rhinoplasty in cleft lip nose can provide patients with a stable and satisfactory nasal appearance. This technique of using L-shaped rib cartilage strut provides many surgeons with added option in their quest to improve the appearance of patients with cleft lip nose. In conclusion, augmentation of cleft lip rhinoplasty can be employed with satisfactory outcome among Oriental patients with cleft lip nasal deformity.","title":"Augmentation Rhinoplasty in Cleft Lip Nasal Deformity: Preliminary Patients' Perspective"}
{"_id":"18ff0421-fd69-7ee0-c726-a877d75e8e4b","text":"De Lorenzi presents a protocol with high doses of hyaluronidase , where the dosage of hyaluronidases is quantified on the basis of the regions of the face affected (for example: for the glabellar region 500 IU of hyaluronidase). We agree with the De Lorenzi that the use of elevated quantities of hyaluronides is required for the treatment of adverse events of vascular filler; however, we believe that a distribution per cm 2 is more precise. More treatments has been described but there is no international standard protocol for the treatment of these complications.","title":"Early hyaluronidase use in preventing skin necrosis after treatment with dermal fillers: Report of two cases [version 2; peer review: 2 approved"}
{"_id":"1901fb8c-c15c-2089-31f0-d368e7dff1b4","text":"We retrospectively examined preoperative MRI images of 684 axillae in 342 patients who underwent breast cancer surgery from June to October 2021. Lymphadenopathy was defined as cortical thickening or short axis ≥ 5 mm. The axilla was divided into ventral and dorsal parts on the axial plane using a perpendicular line extending from the most anterior margin of the muscle group, including the deltoid, latissimus dorsi, or teres major muscles, relative to a line along the lateral chest wall. We recorded the presence or absence of axillary lymphadenopathy in each area and the number of visible lymph nodes.","title":"The location of unilateral axillary lymphadenopathy after COVID-19 vaccination compared with that of metastasis from breast cancer without vaccination"}
{"_id":"190293a1-08ad-904f-99dc-7f491b872103","text":"In patients with trunk melanoma and negative sentinel lymph node biopsy, multiple lymphatic basin drainage may be an independent risk factor for nodal disease recurrence. This factor may help to identify patients with negative sentinel lymph node biopsy with a higher risk of nodal recurrence.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"190807cf-8a44-b5fa-23a8-82ed82f18a89","text":"The monofocal Ilizarov device was applied before bone reconstruction to keep the shape and size of the affected bone equal to those of the contralateral side bone. Full resection of the pathological bone was then performed and the resulting defect was repaired by a standard microsurgical osteoseptocutaneous fibula transplantation from the contralateral side. To ensure the safety of the free flap, rehabilitation of the affected limb and donor leg was only allowed from the seventh day after surgery. X-rays were taken before surgery and every 2 weeks after surgery. The Ilizarov device was kept in position until bone union was confirmed by both surgeons and the radiologist.","title":"Combining the External Fixation and Microsurgical Osteoseptocutaneous Flap Transplantation Methods for Limb Salvage"}
{"_id":"190ae8ea-29b4-1df4-fa5c-285199a396c0","text":"persistent fever along with a history of trauma on a long bone with signs of DVT of the limb in a child should raise concern for osteomyelitis and an MRI evaluation of the limb should be obtained.","title":"Acute osteomyelitis, thrombophlebitis, and pulmonary embolism: a case report"}
{"_id":"190bb748-80e5-d73b-998d-b2600da0dd4a","text":"There are several limitations to the study. The sample of bvFTD patients is limited and it comprises participants with a clinical diagnosis at a very mild to moderate stage, without genetic or pathological confirmation. Since plasma neuronal-derived exosomes levels of synaptotagmin and synaptophysin were shown to be decreased before dementia is diagnosed in patients with bvFTD, participants at very early stages could be studied in the next future. We discussed trends for significance in our bvFTD sample, and we compared the results to data previously obtained in AD participants, but we did not observe significant between group differences. The PET methodology using carotid artery activity as an input function for kinetic modelling was previously described. It certainly deserves further validation and currently it can only provide values of total distribution volume and not values of specific binding potential. A recent article on [11C]UCB-J PET acquisitions in AD showed that cerebellum could be used for calculating distribution volume ratio. However, cerebellar changes have been reported in bvFTD. Finally we used a validated measure of anosognosia that is certainly applicable to bvFTD but it does not allow to disentangle cognitive from emotional processes that are subserved by different brain regions.","title":"In vivo exploration of synaptic projections in frontotemporal dementia"}
{"_id":"19276ba2-df14-1abf-6928-198ad3772e39","text":"In our study, we were unable to conclude that cryotherapy prevents sensory neuropathy. While the greatest benefit of cryotherapy was observed at 3 months post-completion of paclitaxel treatment, it was not sustained in the long term which further limited the clinical significance of the intervention. This lack of efficacy may be attributable to the high rates of cryotherapy interruption. More research is necessary to optimize the cryotherapy regimen as cold intolerance remains an important factor in cryotherapy compliance. While results of this study dampen our initial enthusiasm of cryotherapy's role in preventing sensory symptoms related to CIPN, the observed effect of cryotherapy against small fiber neuropathy should be further explored with appropriate autonomic function and neuropathic pain outcome measures.","title":"Impact of Cryotherapy on Sensory, Motor, and Autonomic Neuropathy in Breast Cancer Patients Receiving Paclitaxel: A Randomized, Controlled Trial"}
{"_id":"192fb442-4aca-e318-6671-ad58c8c979b7","text":"The results of our study indicate a significantly higher prevalence of rhinitis and eczema in the ADHD group than in the control group. This finding is consistent with that of a previous meta-analysis on allergic diseases and ADHD, although only eczema was independently related to ADHD in that study. Furthermore, our study showed the number of allergic disease symptoms had a dose–response effect on ADHD, suggesting that patients with ADHD had more allergic conditions than their counterparts without ADHD. Various reasonable biological mechanisms linking ADHD and allergies were proposed. Allergic reactions result in an increase in inflammatory cytokines from TH2 or TH17 cells, which may stimulate the neuroimmune mechanism in the brain circuits, such as the prefrontal cortex and the anterior cingulate cortex, associated with emotional and behavior control. ADHD symptoms resemble cognitive disturbances caused by functional and structural changes in the aforementioned two brain circuits. Although neither the existing literature nor this study could provide a chronological sequence from the development of atopic disease to that of ADHD, we found total IgE levels and percentage of eosinophils to be elevated in children suffering from ADHD. Because it is unlikely that ADHD causes allergy, these findings support the hypothesis that allergies precede or coexist with ADHD because of some shared etiology. Although it is not confirmed at the present time whether or how allergy is involved in the etiology of ADHD, allergic symptom assessment may be considered in the comprehensive appraisal and management of ADHD in children.","title":"Attention deficit–hyperactivity disorder is associated with allergic symptoms and low levels of hemoglobin and serotonin"}
{"_id":"1933113f-ce22-d716-d1a9-f33f4f42c90c","text":"Aim: To present an update of the current situation of ESWL treatment and to analyse our series of patients and the efficacy of combined lithiasis treatment in different locations and sizes.","title":"Extracorporeal Shock Wave Lithotripsy and Combined Therapy in Children: Efficacy and Long-Term Results"}
{"_id":"193a7829-3a46-ca51-bb97-9d918206e607","text":"It does not require advanced training of microsurgical technique nor any special equipment and can be performed by any average orthopaedic surgeon. Morbidity of the donor site is minimal and operative time required is comparable to a total hip arthroplasty, and all problems and obstacles associated with vascularized fibular graft are avoided by this technique.41","title":"Osteonecrosis of femoral head: Treatment by core decompression and vascular pedicle grafting"}
{"_id":"193c611e-c683-63be-7133-98bfa2590093","text":"Pulmonary fat embolism is a serious complication after liposuction that can develop suddenly and progress rapidly. Early diagnosis and appropriate treatment are essential to reduce mortality and improve prognosis. Oil red O staining of BALF is helpful in the diagnosis of pulmonary fat embolism. Xylene and alcohol solvents should be avoided during the processing of specimens. Respiratory support and corticosteroid therapy are key in treating pulmonary fat embolism and ARDS.","title":"Rare case of pulmonary fat embolism and acute respiratory distress syndrome after liposuction and fat grafting: a case report"}
{"_id":"19480ec7-ac40-6197-cc4f-efa7eac14be2","text":"Proton therapy is effective in the management of nonmelanoma skin cancer with clinical perineural invasion. Although disease control and complication rates compare favorably to those previously published for photon-based radiation therapy, the risk for late toxicity is significant and patients should be appropriately counseled.","title":"Passively Scattered Proton Therapy for Nonmelanoma Skin Cancer with Clinical Perineural Invasion"}
{"_id":"1949d699-fe7b-b31e-5e0d-21f62c9dfb0c","text":"Arthrodesis was performed in two of the 12 cases of ankle involvement at the time of the initial surgery. Of the 10 cases evaluated, osteochondral destruction progressed in 3 cases. Two of the 3 cases were recurrent cases, and extended tumor resection including the surrounding joint capsule was performed in the other case.","title":"Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study"}
{"_id":"1949db20-c198-d088-0ab8-f53afafd80c6","text":"This analysis would have benefitted from more patients and a greater number of tumors. Few treatment failures limit the interpretation of statistical analyses to evaluate potential predictive variables or confounders for treatment failure.","title":"Same Day Biopsy and Treatment of Non-Melanoma Skin Cancer in Patients with Field Cancerization: A Retrospective Chart Study"}
{"_id":"19729111-7b1c-7fad-7eeb-f8c241590992","text":"Undoubtedly, the absence of a statistical analysis of the stratified sources to obtain adjusted estimates and the small sample of investigations analyzed represent the limits of this study.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"197e1155-7898-d49d-4f01-c6712a8e0220","text":"The selection procedure aimed to find and include the most important research publications on skin cancer. We only examined the article once if it appeared in several sources. The inclusion criteria of the acquired research articles were limited by the search strategies. For each selected article, we independently evaluated its eligibility by screening the titles of the search results and abstracts. After evaluating the papers that met the established inclusion criteria, our next step was to establish the exclusion criteria to omit articles that met at least one of the subsequent exclusion criteria (EC):","title":"Federated and Transfer Learning Methods for the Classification of Melanoma and Nonmelanoma Skin Cancers: A Prospective Study"}
{"_id":"19952246-3799-3693-10d8-5358c4ff7bff","text":"Recurrence can be seen as local or regional disease requiring reoperation or other treatment 6 months after the initial standard operation. It is diagnosed by ultrasound or ultrasound-guided fine needle aspiration cytology.","title":"Risk factors of lateral lymph node metastasis in cN0 papillary thyroid carcinoma"}
{"_id":"199749ef-20b1-fc49-9173-f8dd166d0386","text":"Clinical staging of presumptive LPD was based on distribution of disease according to the Ann Arbor clinical staging classification.","title":"Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital"}
{"_id":"19992f2c-f3ed-4540-3889-d6f0504a0be6","text":"The baseline arterial flow rate was measured on the proximal saphenous artery and obtained by the average of three measures with an automated record of the mean velocity by pulsed Doppler, and measurement of the internal diameter of the artery by color Doppler, by the average of two diastolic and one systolic measurement. The flow rate in the femoral artery was also measured similarly, by three pulsed Doppler mean velocity measurements and three transverse artery diameter measurements. Intra-observer repeatability of VI measurements was calculated based on 10 VI measurements by a single observer. Sequential measurements of two observers on different ultrasonic acquisitions assessed inter-observer variations.","title":"Microvascular assessment of fascio-cutaneous flaps by ultrasound: A large animal study 10.3389\/fphys.2022.1063240"}
{"_id":"19b5273f-b06a-e53a-3507-dfeb129b62db","text":"In this study, we have audited referrals to a regional allergy clinic to understand better the case mix of patients seen. It might be thought that a regional allergy service would spend most of its time and resources treating patients with allergy but this audit shows that of patients seen in the clinic only 43% were positively diagnosed as suffering from a type I hypersensitivity. This first group of patients with a diagnosed type I hypersensitivity were discussed in detail as part of a larger series in a previous study [11].","title":"Complexity of case mix in a regional allergy service"}
{"_id":"19c3b338-a547-9a78-0363-c0c6b4c50f7e","text":"A linear threading technique is done for volume augmentation and a microdroplet technique is used very rarely when one has to inject near the submucosal area.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"19c493e9-5ba6-183c-5907-f31dcb36fd04","text":"In 1970, only 15% of reported cancer incidence was attributed to LMICs. This has now increased to an estimated 59%, while LMICs bear approximately 71% of the worldwide burden of mortality due to cancer. Individuals in LMICs with cancer are considerably more likely to die of their disease, and orders of magnitude more likely to do so without palliation of associated symptoms. Given the observed trends and causal factors relating to distribution of worldwide cancer burden, it is clear that demand for treatment of cancer will remain or become a leading concern of healthcare systems in every country on the planet for the foreseeable future. Although highly developed countries are now seeing a decline in mortality rates associated with cancer, it remains the leading cause of premature death (between the ages of 30 and 69 years) in those countries. Cancer currently ranks as the second, third or fourth leading cause of premature death in most LMICs, after other NCDs, but should be expected to climb in the ranks as these countries follow in the epidemiologic patterns of more developed nations. Regardless, LMICs already have a greater relative gain to be realized in overall population longevity by preventing premature deaths from cancer than HICs do. Cancer is a severe and constant threat to public health and economic health in every region of the world through its impacts on rates of disability and death; in HICs, this threat is unrelenting and in LMICs this threat is rapidly worsening.","title":"A Review of the Current State of Global Surgical Oncology and the Role of Surgeons Who Treat Cancer: Our Profession’s Imperative to Act Upon a Worldwide Crisis in Evolution"}
{"_id":"19d9d5ab-0a67-8dfd-2457-7544e4f6074d","text":"For the four patients in this group, 3D printing mirror technology was used to print the model of the affected side and the healthy side before the operation. The osteotomy surface was determined by imaging data and CT scan data to provide data parameters for 3D printing of the defect on the affected side. The shape and size of the bone cement are based on the shape and size of the defect of the calcaneus on the affected side. Accordingly, 3D printing was used to produce a plastic mold that would suit the shape and size of the bone cement. The quality and size of the induced membrane can be managed by controlling the implantation of bone cement. In the first stage of surgery, skin flap transfer was used to repair foot skin defects, providing appropriate conditions for the application of Masquelet technology. In a meta‐analysis, Morelli et al. also explained the importance of soft tissue reconstruction for Masquelet technology; the bone defect area was debrided according to the osteotomy before the operation, and fresh blood was observed leaking out. The bone cement molded by the mold was placed into the bone defect area in pieces. The bone cement had a high degree of matching with the bone defect part, and there was no need to adjust the shape and size.","title":"Three‐Dimensional Printing‐Assisted Masquelet Technique in the Treatment of Calcaneal Defects"}
{"_id":"19dbcccf-fe88-450c-1892-df4e47422925","text":"Anterior cervical discectomy and fusion either as stand-alone implant surgical treatment or with the use of additional plating has for decades been the criterion standard treatment for cervical radiculopathy, and more than 100 000 patients receive this treatment in the US annually. Surgical treatment for cervical radiculopathy is increasing in most countries and is projected to increase by more than 10% in the next 20 years.","title":"Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy A Randomized Clinical Trial Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy"}
{"_id":"19dc21f5-ad8e-d356-bd61-a5f48c662fd0","text":"There are some limitations of this study. The sample size is relatively low. However, toe to hand transfers are seldom done operations and the mentioned plantar arterial dominancy is rarely seen. This technique has proved its versatility in these situations. Authors tried to express the complex operation with schematics. A missing comparison of preoperative imaging and intraoperative findings about dominant arterial system of the second toe is one of the limitations of this study. The preoperative visualization to evaluate anatomical variance of the second toe is the most useful way to avoid perfusion compromise of a toe flap. The surgeon will be able to make preoperative surgical plan precisely with these visualization methods. If the plantar arterial system is dominant the surgeon can easily adapt a dorsalis pedis arterial graft into surgical plan.","title":"A new method for second toe flap revascularization in plantar dominant artery pattern - dorsal metatarsal artery interpositional graft"}
{"_id":"19e19d69-ae68-9ae0-95a3-5fd8d2af8081","text":"To our knowledge, there are no cases described in the literature reporting two reactions at the same time after vaccination. We would like to emphasize that we consider it essential and unavoidable that vaccination be carried out even though it may be related to some reactions such as our case because the efficacy and safety far outweigh the possible side effects. Certainly, further studies are still needed to confirm our hypothesis.","title":"Herpes zoster and alopecia areata following mRNA BNT162b2 COVID ‐19 vaccine: Controversial immune effects"}
{"_id":"19e36f81-9bd9-8e92-cf82-bb5dedde1c07","text":"Even though the overall patency rate of IMA grafts is high, the present data indicate that the long-term patency rate of IMA grafts is low when the recipient's vessel is only moderately stenosed. Basically, these findings imply the decision to use an IMA should be carefully considered in light of the hemodynamic severity of the stenosis in the recipient's vessel. This might avoid the inappropriate use of an IMA as a graft to a recipient artery that does not need to be revascularized.","title":"Prophylactic Left Internal Mammary Artery Graft In Mildly-Stenosed Coronary Lesions. Still An Open Discussion"}
{"_id":"19e547f3-ce15-0e38-fadf-e62c3497abad","text":"Although early weight bearing appears to be safe in OW-HTO fixated with Tomofix plates, other factors influence the actual time at which patients start full weight bearing. Remarkably, the use of a walking aid was not related to pain or the function score at that time; patients in the E group did not experience more pain because of the early weight bearing, and their function score did not improve faster. In this group patients did have a shorter period of time to full weight bearing; furthermore, their walking distances increased more quickly. Although the patients in the E group had a shorter time to full weight bearing and were walking longer distances earlier in their recovery, this was not reflected in their Lysholm scores.","title":"Early full weight bearing is safe in open-wedge high tibial osteotomy RSA analysis of postoperative stability compared to delayed weight bearing"}
{"_id":"19e6bd5f-b662-8879-f4d2-76f096a331a1","text":"The aim of this study was to assess the imaging techniques in axillary LN staging and to evaluate the feasibility of SLNB even in patients clinically suspected of axillary LN metastasis on preoperative imaging techniques (SI).","title":"Feasibility of sentinel lymph node biopsy in breast cancer patients clinically suspected of axillary lymph node metastasis on preoperative imaging"}
{"_id":"19eba560-80ae-9048-8dc1-95203fd98814","text":"The relative risk of second primary cancers may be smaller than previously reported, possibly because the general population is subject to greater surveillance and screening. Premenopausal women with breast cancer and patients with malignancies of the bladder, head & neck, and cutaneous melanoma are at increased risk of second primary cancers. It may be appropriate to offer surveillance and advice to avoid known risk factors to these patients. Further research is needed to determine whether previous perspectives of increased second primary cancer risks have been partly due to differences in detection.","title":"Second primary cancer risk - the impact of applying different definitions of multiple primaries: results from a retrospective population-based cancer registry study"}
{"_id":"19ec3d20-b31d-e843-850c-45fac9e6ed23","text":"The incidence of open tibial fractures in the elderly is increasing due to the growing elderly population. Open tibial fractures with large bone defects are an increasing problem, and their treatment is challenging. Gustilo–Anderson type IIIc open tibial fractures with large bone defects are less common in elderly patients with severe osteoporosis than in young patients. However, the literature on the outcomes of open tibial fractures with large bone defects in elderly patients treated with modern techniques is limited.","title":"The successful treatment of a Gustilo–Anderson type IIIc distal leg injury with a large bone defect in elderly patient with severe osteoporosis: a case report"}
{"_id":"19f3c34b-2501-7724-2177-a9e0a38f3490","text":"Computed tomography simulation was performed immediately following the implant and the GTV was again generously contoured based on the preplan images and needle locations. The anus and rectum were contoured as the primary organs at risk. The patient received an interstitial dose of 25 Gy in 5 fractions over a 3-day period (Figure 1D). The dose to the anorectum was just over 2 Gy per fraction with this plan. The first treatment was given on the day of the procedure and the subsequent fractions were given twice a day on days 2 and 3 with at least 6 h between fractions. Each morning, a CT scan was taken to confirm needle placement and positioning of organs at risk. The patient was admitted to the hospital for the duration of treatment with an epidural to control pain. She tolerated the procedure well without any significant complications.","title":"High-Dose Rate Salvage Interstitial Brachytherapy: A Case-Based Guide to the Treatment of Therapeutically Challenging Recurrent Vulvar Cancer"}
{"_id":"19f988c0-7e06-972a-dd56-eac08dafaf7d","text":"We administered betadine ointment intravaginally during the first 4 weeks and then recommended sitting baths. During the first 4–6 weeks the skin paddle of the flap within the vagina was seen to keratinize more than the rest of the non-intravaginal skin island. This phenomenon subsided in all patients after this time period and no further particularities were reported.","title":"Interdisciplinary Surgical Approaches in Vaginal and Perineal Reconstruction of Advanced Rectal and Anal Female Cancer Patients"}
{"_id":"19fe7fab-530f-eb42-a7b1-69d541fe86c8","text":"The most common surgical approaches for eliminating the source of the embolus are thromboendarterectomy or resection and graft replacement. If the source of embolism is extensive atherosclerosis that extends to the suprarenal abdominal aorta or the descending thoracic aorta, there is a higher risk of patient mortality. Extra-anatomical arterial reconstruction with exclusion of the proximal source and endovascular exclusion has been recommended for patients at high risk.","title":"Successful Embolectomy of the Plantar Artery Occlusion Due to Thromboembolism"}
{"_id":"1a0087c7-ef13-0e7e-ad7b-51b6137d317d","text":"In all cases, local symptoms were considerably relieved within 3 days of treatment. In the patient who experienced the most severe side effects, significant pain relief and fading of skin discoloration were achieved 2 hours after treatment. There was no skin necrosis in 8 of the 9 cases. There was no significant increase in local purulent spots 5 days after injection in patients who were admitted 3 days after injection. One patient experienced significant local skin damage 3 days after treatment, and there was a small scar left, whereas 8 patients had intact skin with no scarring. All patients experienced residual redness in local skin areas after completion of treatment, which persisted for a maximum duration of 3 months.","title":"Local Cooling as a Step of Treatment for Tissue Ischemia Caused by Hyaluronic Acid Injection-induced Embolism—A Report of 9 Cases"}
{"_id":"1a050695-df08-90af-d1ae-15c63e65036e","text":"Cosmetic rhinoplasty is the surgery to reshape the nose. It is perhaps one of the most fascinating of all aesthetic procedures. According to the statistics of American Society of Plastic Surgeons, cosmetic rhinoplasty was the second most frequently performed cosmetic surgical procedure. The incidence of aesthetic rhinoplasty is increasing in the Asians. The main objective of the surgery for Asians is to modify the nose such that the facial results compare favourably with the current aesthetic ideals for white people. The difference between a good and a poor result can be 1 tot 2 mm.","title":"Component Rhinoplasty"}
{"_id":"1a0a524b-0369-617d-89a4-c8813afbb193","text":"All patients were phoned to inform them about the study and to seek oral consent for participation. Patients who had not undergone breast MRI as a part of their cancer follow-up were invited to undergo MRI of the breasts for the purpose of this study. Only patients for whom follow-up MRI scans were available or obtained were included in the study.","title":"Total Breast Reconstruction with Lipofilling after Traditional Mastectomy without the Use of Tissue Expanders"}
{"_id":"1a14b8ec-f665-5964-d5ab-206906c61856","text":"Breslow thickness were measured and recorded in 180 cases of the cutaneous or mucosal disease in patients with stage I-III diseases after surgery. Measurements of the thickness of the disease were not performed for the rest of the group. Sentinel lymph node dissection was not utilized in the treatment of this group of patients as the majority had non-cutaneous and more advanced diseases.","title":"Clinical presentation, histology, and prognoses of malignant melanoma in ethnic Chinese: A study of 522 consecutive cases"}
{"_id":"1a1793f1-8ab3-f623-b23a-301d9f5b135c","text":"A similar measurement was performed on the STIR sequence images displayed on the right screen using the automated ROI transfer option from the PACS toolbox. For comparison, the medial cuneiform bone was measured in a region with no visually perceptible bone marrow edema-like signal in both displayed sequences. The obtained SI values of the medial cuneiform bone were considered to represent healthy tissue. When precontrast and postcontrast measurements revealed the same SI value, this was referred to as unchanged signal. ROI sizes were recorded from reader 2.","title":"Short tau inversion recovery (STIR) after intravenous contrast agent administration obscures bone marrow edema-like signal on forefoot MRI"}
{"_id":"1a40624a-74ca-c84c-26fc-1442762cadf2","text":"The described study will give insight in systematic planning of liver resections and the comparison of different demonstration modalities of 3D reconstruction of preoperative CT scans and the preference of technology. Especially teaching of these demanding operations is underrepresented in prior investigations.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"1a42de02-62a9-e241-012c-4ae39ff66e4f","text":"The analyses of the co-cultures after 12 weeks of co-cultivation confirmed that spheroids derived from different donor samples displayed different biological activities, observed as a different degree of tissue regeneration by the spheroids in the artificial cartilage defect. Donor samples differed in age and gender but there were no obvious indications that this affected the potency of spheroids and confirmed observations in clinical practice where no significant differences in regeneration of condyle defects in male and female donors was observed [24]. The newly formed tissue mainly consisted of homogenous distributed cells filling up the defect, which was covered by a multi\/monolayer of elongated cells arranged parallel to the surface with a smooth appearance attached to the surface of the native cartilage tissue. In addition, thin and fibrous ECM structures were present, being part of the regenerative tissue, integrating with the top part of the native cartilage ECM. Cells of the regenerated tissue attached to cartilage defect borders and cells were present within edges and fissures of the cartilage showing a high level of integration of regenerative tissue with native cartilage tissue. Hyaline-specific proteins were present in the newly formed tissue, to a different degree in the different tissue components of the regenerated tissue as well as to a different degree in the different donors. The presence of the proteoglycan ACAN and GAGs confirmed the hyaline-like character of the newly formed tissue, which is most likely not in a fully mature state yet as suggested by the absence of COL II. Moreover, in some samples, COL II protein was present in the newly formed ECM fibers. In contrast, COL I protein was not detected in the newly formed tissue, suggesting that the newly formed tissue did not contain dedifferentiated chondrocytes.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"1a43162a-ff87-f56f-df7d-48dd1cee464f","text":"All patients refuse to be followed up according to the above protocol will be recorded as lost cases and analyzed together with cases meeting the study criteria at the end of the study.","title":"Study protocol for comparing the efficacy of left-open single-flap technique versus double-flap technique after proximal gastrectomy: A multicenter randomized controlled trial"}
{"_id":"1a4abc3e-a933-41bf-0c43-b61156e27f92","text":"A number of independent dose measurements in different set-ups have been published of which some show discrepancies with the Zeiss calibration.","title":"Present state and issues in IORT Physics"}
{"_id":"1a4b7201-1e73-f2e0-8ba7-409040e727e7","text":"Determination of cell viability was performed with the MTT assay as described previously 37.","title":"Imiquimod‐induced apoptosis of melanoma cells is mediated by ER stress‐dependent Noxa induction and enhanced by NF ‐κB inhibition"}
{"_id":"1a4b9af9-15e4-3b9c-15ae-50dab8237183","text":"We conducted a retrospective study of all patients who underwent elective primary TKA for knee osteoarthritis at an academic tertiary hospital in Singapore between 1 January 2011 and 31 December 2013. Ethics approval was obtained from the Institutional Review Board. Data was collected from both electronic and paper records.","title":"Short-duration chemoprophylaxis might reduce incidence of deep vein thrombosis in Asian patients undergoing total knee arthroplasty"}
{"_id":"1a4d8c6b-f787-56d0-0e1c-96f79ac2ca51","text":"The reported 5-year recurrence rates of non-melanoma skin cancers treated with external beam radiation therapy range from 5% to 15%; however, squamous cell carcinomas tend to develop resistance with each treatment.8,35","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"1a4f2d71-8547-e06d-5e8d-e6ca40c48cc9","text":"Our modified Plastibell circumcision technique under local anesthesia is a safe and reproducible alternative for infants between 1 and 6 months of age, whose parents desire circumcision and wish to avoid general anesthesia.","title":"Avoidance of general anesthesia for circumcision in infants under 6 months of age using a modified Plastibell technique"}
{"_id":"1a525a2e-1ce7-ff99-d9be-c8e4ed40e5f7","text":"The surgeon first made a wing-shaped open incision at the columella. The incision was extended along the nostril edge of the nasal columella to the right and left alar. Careful attention was required to ensure that the incision was located 2 mm away from the bilateral alar rims. The skin of the nasal columella close to the surface of the alar cartilage was lifted to expose a part of the bilateral alar cartilage. A subperiosteal dissection was then performed above the surface of the nasal bone and under the deep fascia. The upper dissection was limited slightly below the junction point of the 2 eyebrows according to a preplanned mark. The dissection led to the formation of an adequate prosthesis pocket where the implant could be placed. In revisional surgeries, removal of a previous implant or residual cartilage was needed. Silicone nasal implants were usually removed easily, but polytetrafluoroethylene (ePTFE) material was very hard to remove. The ePTFE was carefully dissected from the surrounding tissue, while avoiding damage to the skin around the nasal dorsum.","title":"Design and Application of a Novel Silicone Nasal Implant"}
{"_id":"1a57a4b9-796b-e8ba-b138-7f3b66c307e1","text":"The defect left behind from the excision in the recipient site was thoroughly washed with normal saline and hydrogen peroxide along with curettage from the medullary canal to the cortex. The FVFG was stabilized with an intramedullary nail that was reamed through the proximal and distal bones between the defect, reinforced at both ends with a side plate and screws, avoiding damage to the nutrient vessels of the fibula. Vascular anastomosis of the fibular artery was made with a branch of the femoral artery and the venae comitantes with a branch of the femoral vein using 8-0 Prolene sutures, and secure hemostasis was achieved. Further stabilization was provided using intramedullary nailing, a dynamic compression plate, and screws or K-wires.","title":"Free Vascularized Fibular Graft Transfer in the Reconstruction of Defects for Premalignant and Malignant Musculoskeletal Conditions of the Femur in a Tertiary Care Setting in Pakistan: A Series of Six Cases"}
{"_id":"1a57c775-491c-33d4-6c09-cc01542cffc5","text":"In recent years, many innovative therapies involving stem cells have been developed or are being tested. They mostly exploit stem cells of various origins (mainly mesenchymal) seen as tools aimed at tissue regeneration in different contexts. These particular cells have potential uses in the field of regenerative medicine, which concerns both surgical and aesthetic aspects. It should be emphasized that stem cells have so far been considered more as a therapeutic tool than as a target for focused therapies. In this context, it is essential to summarize strategies able to allow potential therapeutic approaches to stem cells from a topical point of view, considering in particular the skin stem cells as an important site of action for various types of therapies able to influence their metabolism and differentiation with the aim of solving important skin pathologies and aesthetic problems. The analysis of the potential therapeutic approaches to skin stem cells available from the topical point of view and related issues can be considered as an important contribution to the conception stage and development of research projects in this direction.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"1a592231-bdb6-5f36-9007-d01371a9d5a9","text":"Although limited in the literature, reports of immediate breast reconstruction have been produced., Immediate breast reconstruction with implant only autologus tissue alone or in combination with an implant did not warrant a higher recurrence rate compared to simple mastectomy and also it did not interfere with follow up or the detection of recurrent lesions.- In the appropriate setting nipple sparing skin-sparing mastectomy can be applied without affecting recurrence rates something that is in the author’s previous personal experience. The same applies for breast conservation oncoplastic approach in the treatment of wide excisions and local recurrence being no different provided adequate margins are achieved.","title":"Reconstructive and Oncoplastic Surgery for Giant Phyllodes Tumors: A Single Center’s Experience"}
{"_id":"1a59c297-bf9f-e686-27f6-0d58dcc175a4","text":"The prerequisite for internal fixation is thorough debridement. At the same time, the internal fixation needs to be managed to prevent planktonic bacteria from forming biofilms on the surface of the internal fixation, which causes infection recurrence. A local antibiotic delivery system can protect not only the implant surface but also the surrounding tissues from biofilm formation. No management was performed on the implants in previous studies, which resulted in high rates of recurrent infection even though the infected bone and soft tissue were removed.","title":"Antibiotic cement plate composite structure internal fixation after debridement of bone infection"}
{"_id":"1a5a624a-7576-054d-9da1-bd57449f5093","text":"This information, which will surely be supplemented by future studies, has provided the basis of knowledge for understanding HS as an inflammatory disease and supported the use of biologics in its management.","title":"Hidradenitis suppurativa: an update on connecting the tracts [version 1; referees: 3 approved]"}
{"_id":"1a5b9537-ca5c-d492-f3e1-a638f24a862c","text":"Patients diagnosed with head and neck cancer in Stockholm from January 1, 2004 to July 31, 2007 who were to receive external beam radiotherapy with curative intent were included in the study. Patients treated at the southern RT unit were offered experimental early preventive rehabilitation and formed the study group, while patients treated at the northern RT unit did not undergo any early rehabilitation and they made up the control group. Patients included in the study group met with a speech pathologist and a physiotherapist who were also part of the research team. Patients included were sent a letter about the study directly after diagnosis, to make sure they received information about the study before the start of treatment.","title":"Early self-care rehabilitation of head and neck cancer patients"}
{"_id":"1a5bba92-d9b6-72b5-fce5-ff4c596c0b47","text":"Currently, there is no agreement among authors in terms of which is the best method for processing fat grafts. In our study, we used decantation for a personal preference; in fact, we noticed that fat processed through decantation is more fluid and so more useful for scleroderma patients who present very fibrous areas, where the access and treatment are difficult. Many experimental studies designed to compare these 3 techniques were evaluated and the debate continues as to which is the best.","title":"Improvement of Mouth Functional Disability in Systemic Sclerosis Patients over One Year in a Trial of Fat Transplantation versus Adipose-Derived Stromal Cells"}
{"_id":"1a5d6117-2383-6479-f112-f4983ad894a3","text":"Rates of exclusive breastfeeding at 14 weeks have improved significantly in KZN over a 3 year period. However, a high proportion of babies are deprived of breastmilk even at this young age, and targeted interventions aimed at improving counselling and support for all mothers, including HIV infected and working mothers, are required to address failure to initiate breastfeeding and early breastfeeding cessation.","title":"Are we doing enough? Improved breastfeeding practices at 14 weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa"}
{"_id":"1a65aa17-aa4e-a202-3658-5a60bb92a864","text":"Our findings indicate that based on the pharmacological profiles, the ideal time to administer preoperative antibiotics for cefazolin is 40 minutes prior to incision, and for clindamycin is 45 minutes prior to incision.","title":"The Ideal Time to Administer Pre-operative Antibiotics: Current and Future Practices"}
{"_id":"1a67dcfb-bc2c-ae4a-41f1-ab167c36d589","text":"Related to this was a sense that better mentorship and capacity building right from pre-service training was essential to equip individuals with the necessary skills to take up managerial and leadership positions.","title":"‘Gender is not even a side issue…it’s a non-issue’: career trajectories and experiences from the perspective of male and female healthcare managers in Kenya"}
{"_id":"1a74e624-7701-fc85-34de-332e71f62aab","text":"It is our opinion that the best advantage of incorporating this innovative technology would be in cases performed with a minimally invasive endoscopic approach, especially in cases performed with robotic technology in which the lack of haptic sensation increases potential difficulty in the localising the fibroids. However, as demonstrated in our case, the use of HA3D technology is also useful when dealing with multiple fibroids regarless of the surgical approach.","title":"Incorporating 3D reconstruction in preoperative surgical planning of Multiple Myomectomy"}
{"_id":"1a76eb63-f96c-2f4e-5247-c96170e5649e","text":"The use of vascular ultrasonography for the great saphenous vein mapping in isolated myocardial revascularization surgery confers an adequate accuracy in the identification of the grafts, and seems to have a good relation in the evaluation of its quality, being able to measure its dimensions with precision. In this study, we observed a lower incidence of complications related to the dissection of the great saphenous vein in the mapped patients, with statistical significance.","title":"Use of Doppler Ultrasound for Saphenous Vein Mapping to Obtain Grafts for Coronary Artery Bypass Grafting"}
{"_id":"1a881e81-ac86-9998-9eb7-cc1ba8b95994","text":"In our experience the biological mesh behaved like a scaffold for granulation tissue which growth was stimulated by negative pressure therapy allowing a final closure with a split-thickness graft. The two procedures seem to combine perfectly together.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"1a886783-ce15-12ca-6eea-4ec03b23b253","text":"The question arises as to whether modern surgical planning and execution tools can achieve such symmetry in patients with laterognathy including those with severe craniofacial malformations. Therefore, the aim of the present study was to evaluate whether a standardized protocol of PSI-based orthognathic surgery with simultaneous PEEK bone augmentation improves facial symmetry of the soft and hard tissue.","title":"Simultaneous PSI-Based Orthognathic and PEEK Bone Augmentation Surgery Leads to Improved Symmetric Facial Appearance in Craniofacial Malformations"}
{"_id":"1a8dfd81-33d0-228f-fa97-c883f70c2cd1","text":"Perineal recurrence of prostate cancer is a rare complication of LDR brachytherapy, with only two previous cases described in the literature. 6 years had elapsed between brachytherapy and perineal relapse in one case and 4 years in the second. Our case describes a patient who relapsed 10 years after initial treatment, with no other surgical interventions in the interim.","title":"Perineal recurrence of prostate cancer post-brachytherapy Cooper et al"}
{"_id":"1a93bff3-f801-ac29-3c4a-7d9d008be5b4","text":"The standard procedure provided a first scan without a contrast agent and a subsequent scan with a contrast agent in the arterial phase by bolus tracking, with an enhancement peak in the abdominal aorta at the renal site at 100 Hounsfield units (HUs) and acquisition after 4 s.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"1a965c71-335f-381b-9010-54309a5e10dd","text":"Our results showed that ultrasound-guided bilateral TPVB is an effective rescue analgesic technique for moderate and severe pain which is not adequately controlled by conventional intravenous analgesia after upper laparotomy.","title":"Bilateral thoracic Paravertebral block for immediate postoperative pain relief in the PACU: a prospective, observational study"}
{"_id":"1a9994bb-619e-7707-4346-172e66fb2498","text":"This study reports the outcomes of ipsilateral fibular transposition for reconstruction of tibial defects in paediatric age group.","title":"The Huntington procedure: still a reasonable option for large tibial defects in paediatric patients"}
{"_id":"1a9ad3ec-7967-6267-e388-90b25fce56d0","text":"Duration of regenerate consolidation was defined as total time (days) needed for the appearance of consolidation of at least three cortices on the anteroposterior and lateral radiographs. Duration of docking union was defined as total amount of time (days) required to develop the signs of union (presence of bridging trabeculae on three cortices and absence of pain on dynamization). Radiographs were reviewed monthly to monitor the quality of regenerate during bone transport phase and every 2 months after docking to assess consolidation of the regenerate and healing of docking union. Fischgrund criteria21 was used to evaluate consolidation of the regenerate and healing of docking union, when three complete cortices had formed in the regenerate and bone healing was achieved in the docking site according radiographs evaluation. External fixation device cannot be removed until callus mineralization has occurred in the extended segment and docking union has been achieved.","title":"Bifocal or Trifocal (Double‐Level) Bone Transport Using Unilateral Rail System in the Treatment of Large Tibial Defects Caused by Infection: A Retrospective Study"}
{"_id":"1a9ef1ac-1667-1ffd-281e-f6ce87ffdf36","text":"This is the first study showing associations between multiple biophysical and clinical parameters of the facial skin with chronological age and lifetime sun exposure in a sample of different age groups. We demonstrated strong associations of chronological age with most parameters. However, after statistical adjustment for chronological age only few associations remained. This indicates that the variable chronological age as a surrogate for intrinsic ageing has a very strong influence on facial skin characteristics in Caucasian women in general. Relationships between skin colour, clinical scores, and skin elasticity seem to exist independently from chronological ageing and thus seem to be mainly influenced by extrinsic factors.","title":"Characterizing Facial Skin Ageing in Humans: Disentangling Extrinsic from Intrinsic Biological Phenomena"}
{"_id":"1aa14e00-1f6c-5aac-27c7-39d9ce45951f","text":"In apparent contrast to previous studies on associations between treatment of retinoblastoma and incidence of or mortality due to SPC, our data did not show an increased overall risk in the patients with heritable retinoblastoma treated with external radiotherapy. However, we observed that a higher proportion of sarcomas was found inside the irradiated field in heritable retinoblastoma treated with external radiotherapy compared with no external radiotherapy. Other studies have reported that chemotherapy is an independent risk factor for SPCs among retinoblastoma survivors, particularly sarcoma, but apparently less so for malignant melanoma and epithelial tumors. Chemotherapy has been used in Denmark only since 2003 on a limited number of patients equally distributed between radiotherapy treatments and is therefore of minimal importance for the results presented here.","title":"Incidence and Mortality of Second Primary Cancers in Danish Patients With Retinoblastoma, 1943-2013 Incidence and Mortality of Second Primary Cancers in Danish Patients With Retinoblastoma"}
{"_id":"1aa7ec04-8ff9-d5b9-4d3e-e74fd5122b69","text":"The first factor must deal with ethical dilemmas in plastic surgery. It is an effort to determine the terminology related measures, the scope of practice in this field and different specialists that have qualify for doing these procedures. In addition, the law should act as moral support, and surgeons that have license to practice plastic surgery, must be announced through relevant institutions, such as the Medical Council and Scientific Society of Plastic Surgeons in every country for the public and they must prevent unspecialized doctors to mislead the public with false titles and the purposes of just profit seeking. In this regard, governor and health ministry should help patients if it is necessary.","title":"Medical Ethics in Plastic Surgery: A Mini Review"}
{"_id":"1aa7ec6c-4f6b-fe07-5037-487605167ea8","text":"The common denominator of this procedure is that the presumed healthy tissue proximate to the zone of injury is rotated on a vascular pedicle to provide coverage.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"1aaa989b-2745-b678-25c9-defba4c8bcd1","text":"The growing practice of endoscopic surgeries resulted in a change in the therapeutic management of selected head and neck cancers, replacing the external approach in early stages.5","title":"Assessment of Margins in Transoral Laser and Robotic Surgery"}
{"_id":"1ab70958-fb4e-2b2f-57be-b6319e0b6584","text":"In conclusion, with all the dares forward, it is our conviction that standardisation in future PDT investigation is of great relevance and is perhaps even more essential than the detection of novel PSs. In fact, just the accessibility to several and different PSs and diverse light sources makes PDT an intricate and difficult therapeutic procedure, which must be assigned to expert clinicians since in the majority of subjects, it needs to be adapted to every specific patient to adequately increase the overall efficacy of the PDT as an anti-skin cancer therapy.","title":"Oxidative Stress and Photodynamic Therapy of Skin Cancers: Mechanisms, Challenges and Promising Developments"}
{"_id":"1ac4ea0c-7250-8fab-f35e-fcd3e0c6bef7","text":"Lateral supramalleolar skin flap offers a range of coverage similar to that of the sural flap, but the dissection is more difficult than sural flap and offers no advantages over it; the area of anesthesia in sural flaps is smaller than after transecting the superficial peroneal nerve. Theoretically, the sural flap does not cover as distally as the supramalleolar flap, but some authors testified that the distally based sural flap is more reliable than the lateral supramalleolar flap, especially regarding the venous congestion and have shown the usefulness of the sural flap for weight-bearing areas even when resensibilization is not performed; lateral supramalleolar skin flap is not recommended as a coverage in this areas. The global proportion of failures is almost four times greater when compared with that for the supramalleolar skin flap.14","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"1acceca2-0dd1-b0a1-f8b3-675d44aa97a5","text":"While the majority of respondents felt that an appropriately designed RCT in IBBR may be possible,51 qualitative interviews with key stakeholders identified a number of barriers to the successful conduct of a future trial.52 These included limited understanding of a pragmatic study design and the role of randomisation in minimising bias, issues around clinician equipoise and aspects of surgical culture not being supportive of RCTs.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"1acfb10a-e7b3-0d46-aa65-69c032eb20f8","text":"Preventative strategies that include public information campaigns to highlight the risks associated with exposure to sunlight, including the degree of exposure that is considered acceptable with regard to health and identifying patient types most at risk, remain important. The use of artificial tanning devices requires special consideration. It is now clear that there is a strong association between these devices and the risk of melanoma and SCC. As such, precautionary measures that discourage exposure to tanning appliances, especially among younger people, are required, as is legislation to prevent their use during childhood. Public health initiatives comparative to those that have successfully targeted cigarette smoking are now needed to limit recreational exposure to artificial UV sources.","title":"The Role of Optical Radiations in Skin Cancer"}
{"_id":"1ad10f60-77fe-3e2a-7e5e-5203d6ce5712","text":"Over time, rotational flaps and microvascular flaps have become the gold standard for reconstruction of surgical breccias with an exposed skull table. Their main advantage was the lack of waiting time for wound granulation and the elimination of the need for repeated dressings.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"1ad883de-e21f-7c21-67f7-eeaa99179a6e","text":"The missing information from the patient about her dermal filler injection obliged us to perform MRI. The combination of antibiotics and dental treatment allowed us to eliminate the source of infections and to be able to control the spreading of the bacteria in the injected materials.","title":"Infected Facial Tissue Fillers Caused by Dental Infection"}
{"_id":"1ad8ddd9-6cf1-35b4-b544-25c2aa935a61","text":"The number of studies about students engagement potentially facing a shift in the teaching paradigms using simulation has increased over the last 15 years:","title":"Implementation of microsurgery simulation in an ophthalmology clerkship in Germany: a prospective, exploratory study"}
{"_id":"1ae3f40f-d5f5-69aa-849d-e6254a0622bc","text":"The results were then categorized according to their theme as follows:","title":"Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis"}
{"_id":"1ae46636-10ab-bbd3-3dff-66a0e3e85b64","text":"Our experience demonstrates that the posterior tibial flap is a safe and reliable choice for the reconstruction of hypopharynx defects.","title":"Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma"}
{"_id":"1af84eb0-da2b-ef23-a51e-a4bfe8018a3f","text":"The interaction between bone growth stimulation and the absence of nasal breathing can lead to an abnormal orofacial development and reduction in the ideal size of the UAs, causing abnormal breathing during sleep over time, initially with flow limitation and then with progressive worsening of obstructive events, leading to Obstructive Sleep Apnea.","title":"Is ankyloglossia associated with obstructive sleep apnea?"}
{"_id":"1aff2822-8c8c-86a7-e868-8b1de7b74017","text":"There are no studies that have directly investigated the incremental reduction in sensory morbidity that lymphoscintigraphy images (LS) and triangulated body marking or other skin marking techniques provide during sentinel lymph node biopsy (SLNB) compared to using only the probe without LS and skin marking or using only dye. However, an indirect assessment of this potential for additional sensory morbidity reduction is possible by extracting morbidity data from studies comparing the morbidity of SLNB to that of axillary lymph node dissection.","title":"Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature"}
{"_id":"1b1123cf-7087-7dab-3ae1-c483920b5edf","text":"The patient denied a history of systematic diseases and a history of smoking.","title":"CTNNB1 p.D32A (c.95A > C) somatic mutation in stage I grade 1 endometrioid endometrial carcinoma with lung metastasis: a case report"}
{"_id":"1b1220e0-a1f0-d11d-88bd-d90763759dbb","text":"We have encountered different limitations related to the creation of the mold:","title":"High-dose-rate plesiotherapy with customized molds in non-melanoma skin cancer: efficacy and safety at 10 years—single institution experience"}
{"_id":"1b1c00c0-abde-d837-0aae-03f87b961f03","text":"The potential effect of residual confounders will be controlled by performing a multivariate logistic regression analysis; because the type of surgical treatment and the promptness with which it is performed may vary across sites, the sites will be classified into those with high and low cures rates as a potential confounder. Antibiotic therapy may also vary, such as the tendency to prolonged intravenous treatment. In order to standardize practice and variables collection, investigating teams will be trained at each center.","title":"Efficacy and safety of different antimicrobial DURATions for the treatment of Infections associated with Osteosynthesis Material implanted after long bone fractures (DURATIOM): Protocol for a randomized, pragmatic trial"}
{"_id":"1b22ccc3-9ce7-c524-1cd4-30c8c64d2c0f","text":"The mean differences between the right and left sides of the face after completed surgical treatment are 1–4 mm. At the level of zygoma, the greatest discrepancies can be seen between the left and right sides of the face. The discrepancies at the level of the jaw angle and occlusal plane are less than 2 mm in all groups but are consistently smallest in groups 4 and 5.","title":"Simultaneous PSI-Based Orthognathic and PEEK Bone Augmentation Surgery Leads to Improved Symmetric Facial Appearance in Craniofacial Malformations"}
{"_id":"1b2bc296-82ae-b0f9-e502-a616b87e16cc","text":"As surgical oncologists who offer BR and often encounter refusal or a lack of interest among our patients, we were curious about the reasons for this situation. Given the aforementioned data, the problem seems to be more complex than simply an insufficient service from BR providers. These were the reasons to look for factors making women with breast cancer neglect breast reconstruction.","title":"Patient’s Education Before Mastectomy Influences the Rate of Reconstructive Surgery"}
{"_id":"1b2ef6e2-3f05-5042-14e5-61096efab4b7","text":"The methods and use of intraoperative ultrasound in 33 canine and five feline patients and its ability to localize and identify anatomical structures and pathological lesions in canines and felines undergoing intracranial surgery are described from a case series. All were client-owned referral patients admitted for neurologic evaluation, with an advanced imaging diagnosis of an intracranial lesion, and underwent surgical biopsy or surgical removal of the lesion. Medical records, retrieval and review of imaging reports, and characterization of findings for all canine and feline patients show that intraoperative ultrasound guidance was used in intracranial procedures during the period of 2012 and 2019. Twenty-nine of the canine patients had intracranial tumors. The remainder had various other conditions requiring intracranial intervention. Three of the feline patients had meningiomas, one had a depressed skull fracture, and one had an epidural hematoma. The tumors appeared hyperechoic on intraoperative ultrasound with the exception of cystic portions of the masses and correlated with the size and location seen on advanced imaging. Statistical comparison of the size of images seen on ultrasound and on MRI for 20 of the canine tumors revealed no statistical differences. Neuroanatomical structures, including vascular components, were easily identified, and tumor images correlated well with preoperative advanced imaging. The authors conclude that intraoperative ultrasound is a valuable asset in intracranial mass removals and can augment surgical guidance in a variety of intracranial disorders that require surgery. This is the first known publication in veterinary surgery of using intraoperative ultrasound as a tool in the operating theater to identify, localize, and monitor the removal\/biopsy of intracranial lesions in small animals undergoing craniotomy\/craniectomy.","title":"Intraoperative Ultrasound Applications in Intracranial Surgery"}
{"_id":"1b306f59-146d-37db-e461-e7755af67ac6","text":"Free fibular graft was found to be effective for salvaging limb function where a massive bone defect resulted from wide tumor resection in the extremities.","title":"The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection"}
{"_id":"1b33b63a-1aa9-5615-8863-1cc6e5a79df4","text":"Laparoscopic surgical staging is the standard treatment of early-stage ovarian tumors with similar survival outcomes if compared with laparotomic procedures. In this article, we report a case regarding an incidental external iliac vein injury during a pelvic lymphadenectomy for fertility sparing treatment of early-stage ovarian cancer with a video showing the laparoscopic repair without any consequence or side effect. A 36 year-old obese woman with Body Mass Index 30 kg\/m2 referred at our hospital with an histological diagnosis of high grade ovarian serous carcinoma after a left laparoscopic salpingo-oophorectomy performed in another hospital. After an hysteroscopy with endometrial biopsy, a laparoscopic surgical staging with a pelvic and aortic lymphadenectomy with lymph-node dissection until the left renal vein, omentectomy, and appendectomy were performed. A thermal injury to the left external iliac vein occurred using the bipolar forceps during lymphadenectomy and was repaired after an immediate clamping of the site using endoclinch and the suction irrigator probe. The laceration on the iliac vein was successfully repaired using 10 mm laparoscopic titanium clips; after a follow-up of 42 months no recurrence was detected. In conclusion, laparoscopy is a safe and effective therapeutic option for fertility sparing treatment patients with early stage ovarian carcinoma with a significantly low morbidity and postoperative hospitalization, but it should be reserved for oncologic surgeons trained in advanced laparoscopic procedures and repair of vascular injuries potentially associated with high mortality rate.","title":"Left External Iliac Vein Injury During Laparoscopic Pelvic Lymphadenectomy for Early-Stage Ovarian Cancer: Our Experience and Review of Literature"}
{"_id":"1b424ca2-daf4-df04-b5c9-0434fefe6186","text":"Taking into account the fact that the most common etiology of scalp avulsion is hair entrapment in mechanical devices for agriculture purposes [2], the microsurgical replantation of the scalp may not be possible due to patient comorbidity, the absence of vessels suitable for anastomosis, and the contamination of the anatomical piece by oily substances and small metal fragments from the machinery.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"1b4e10f3-6e42-e9ce-bf1e-b27056954fa7","text":"Skeletal tissues respond to a variety of mechanical stimuli that regulate the proliferation and differentiation of mesenchymal stem cells and committed osteogenic precursors, as well as osteoblasts and osteocytes themselves. Recent publications suggest that altering the physical environment of skeletal tissue by mechanical means promotes healing.11 These reports led us to hypothesize that the application of negative pressure may effectively stimulate osseous healing in the CSD model. Negative pressure therapy (NPT) is the controlled application of subatmospheric pressure to a wound site delivered via a wound dressing that acts as a pressure manifold.1213 NPT stimulates healing across a broad spectrum of soft-tissue wounds, at least in part from the application of mechanical stress on cells and tissues in the wound environment.14 The application of stress results in stretching at the tissue and cell level that stimulates cell proliferation and differentiation required for healing via modulation of the extracellular matrix by cell-mediated mechanical signaling mechanisms.15","title":"Negative pressure therapy stimulates healing of critical-size calvarial defects in rabbits"}
{"_id":"1b568e22-4dc0-5d34-025a-bb6701125599","text":"The remaining three patients wished to become pregnant in the future and neither wished to be subjected to any possible donor site morbidity from a pedicled TRAM flap with the potential for abdominal wall weakness nor to undergo a complex free tissue transfer and hence have preferred to have the LD flap option.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"1b5a4b9c-97aa-de1f-3e37-240c13906787","text":"We discuss the role of intravascular imaging to guide the use of a distal protection device by describing the outcome of a young woman presenting with non-ST elevation myocardial infarction. Coronary angiography demonstrated an isolated minor stenosis in the proximal left anterior descending coronary artery with slight haziness beyond the lesion. Intravascular ultrasound confirmed an extensive thrombus overlying a bulky atherosclerotic plaque. A distal filter wire was therefore successfully used to reduce the risk of distal embolization.","title":"Intravascular ultrasound to guide the management of intracoronary thrombus: a Case Report"}
{"_id":"1b6394e7-222e-b14a-aa5c-0dfb19959a7b","text":"Vascularized fibular osteoseptocutaneous flaps are generally recommended as the first choice donor tissue for reconstruction of segmental long bone defects because the fibular flap has several advantages (12). When the fibular flap is not available however, the iliac osteocutaneous flap and serratus anterior rib flap become useful alternative donor sites .The LD muscle harvest has become a routine microsurgery procedure; adding the ribs to this flap is a bit difficult and needs meticulous care to preserve the perforator branches of intercostal arteries to the muscle and then these vessels act as the reverse flow to the rib when the ribs are elevated with the intercostal pedicle. The advantages of this flap are coverage of a large volume bone defect with simultaneous soft tissue coverage in one setting. The rib hypertrophies to the degree that it can bear weight and there is no need for any other bone graft. The previous studies have not reported the bisecting of the rib and bone filling as a one stage procedure for upper tibia defects. The LD-rib flap has both the long pedicle to bypass the zone of injury and also the volume of bone transferred is much larger than the fibula; the “Picket Fence” design uses four to six struts of vascularized rib; and last but not least the LD muscle is the largest muscle in the body and can cover large soft tissue defects. There is no need to harvest serratus muscle; LD is enough to vascularize the harvested ribs. From the above arguments it seems that LD-rib flap with “picket Fence” design is the best choice for upper tibia soft and hard tissue defects.","title":"Combined Rib-Latissimus Flap; the “Picket Fence” Concept for Reconstruction of Upper Tibia Defects"}
{"_id":"1b65bc6e-d366-5fce-ad9c-5ba8bad2c1aa","text":"Occasionally, Steinmann pins have been used to reinforce the bone cement used to fill the large subchondral defects following intralesional curettage. However, whether this is of real benefit in improving the stability of the defect is controversial.21 Large lesions can cause weakening of the structural stability of bone. Depending on the residual structural integrity of the host bone it may be necessary to augment the construct with internal fixation.","title":"Treatment of giant cell tumor of bone: Current concepts"}
{"_id":"1b6f7632-3c9c-e876-02c0-f1be367c88a4","text":"While currently in clinical practice the extent of 3D and 4D modeling is a virtual reconstruction of the patient, the use of physical 3D models has also begun to be introduced into cosmetic surgery. Three-dimensional printing of the postoperative outcome of rhinoplasty was one of the earliest uses of the method. Patients expressed high satisfaction with the model, citing increased confidence in the procedure goals and higher helpfulness when compared with solely using the computer 3D simulation. As 3D printing becomes increasingly cost effective, there is evidence to suggest the widespread incorporation of 3D modeling into other cosmetic procedure consultations in the future.","title":"Current and Future Photography Techniques in Aesthetic Surgery"}
{"_id":"1b762e3e-c8aa-4409-3d85-c39be04a43d7","text":"Basal cell carcinoma and squamous cell carcinoma are malignant epithelial tumors that frequently occur on the scalp.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"1b76744b-8a63-1e0e-4df1-4a5a089764ef","text":"The most important aspect of the anatomy is the understanding of the blood supply and nerve supply to the nipple areola complex. The Internal Mammary artery, Intercostal arteries and the Lateral Thoracic artery supply the breast.","title":"Reduction mammoplasty"}
{"_id":"1b87042d-8c7e-480b-8735-de9ddf7b2a8d","text":"Radiography is currently the recognised gold standard for equine orthopaedic screening, particularly in the case of pre purchase examinations. A major limitation of radiography is the inability to distinguish cartilage from the other soft tissue opacities of the joint. In radiography, the deformation of the subchondral bone margins, change in opacity of the subchondral bone and soft tissue swelling are signs suggestive of osteochondral disease. Subtle cases involving only the articular cartilage may be missed.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"1b896c78-acb3-6dfa-38eb-c56b3a5379a9","text":"In this study, we attempted to evaluate the adsorption and oxidation rate of the positively charged β-imidazolium-substituted porphyrins on a bilayer lipid membrane for a better design of therapeutic molecules against skin cancer and drugs against antibiotic-resistant bacteria. It was found that the main factor determining the efficiency of these porphyrins is their adsorption on the membrane. The adsorption of the positively charged porphyrins is better than that of the negatively charged derivatives due to the surface charge of the lipid membranes, which is typically negative. The pH of the solution influences the adsorption of the positively charged porphyrins in contrast to the negatively charged ones: for positively charged porphyrins, the adsorption is enhanced at low pH, while for negatively charged porphyrins, the reverse dependence is observed. The most probable reason for this is the aggregation of porphyrin molecules in water. The better adsorption of the positively charged porphyrins can be important for their application as photosensitizers in photodynamic therapy against cancer cells whose membranes are negatively charged.","title":"Lipid Membrane Adsorption Determines Photodynamic Efficiency of β-Imidazolyl-Substituted Porphyrins"}
{"_id":"1b89d076-118b-c800-833a-54cbeea5172e","text":"BCC usually occurs as a single lesion, even if the appearance of simultaneous or subsequent lesions is a not infrequent event.","title":"Usefulness of Photodynamic Therapy as a Possible Therapeutic Alternative in the Treatment of Basal Cell Carcinoma"}
{"_id":"1b8c8463-d76e-92d4-d04e-cb36113fcb86","text":"Thus, we conducted a retrospective study based on a database obtained from electronic medical records and imaging exams. All 169 selected patients had undergone a surgical procedure to treat CSM by the same surgical team from 2008 to 2015 in a tertiary hospital. Retrospective studies on databases can lead to information collection errors since we established no previous research protocol. To minimize this bias, we collected data by a complete evaluation of patients’ medical records and nursing staff and the physiotherapy team’s notes.","title":"EARLY COMPLICATIONS OF SURGICAL TREATMENT OF CERVICAL SPONDYLOTIC MYELOPATHY COMPLICAÇÕES PRECOCES DO TRATAMENTO CIRÚRGICO DE MIELOPATIA CERVICAL ESPONDILÓTICA"}
{"_id":"1b8d7b97-1a59-738a-52ef-5b2469b1a14f","text":"Free vascularized fibular grafting (FVFG) is an effective method of halting progression of osteonecrosis and promoting bone regeneration at necrotic foci and provides good outcomes for patients with ONFH at early stage [9, 10]. This study was performed to compare the FVFG outcomes in patients who had received maintenance doses of corticosteroids with patients who had not received corticosteroids treatment after FVFG and determine the effect of postoperative corticosteroids on FVFG outcomes.","title":"The Effect of Postoperative Corticosteroid Administration on Free Vascularized Fibular Grafting for Treating Osteonecrosis of the Femoral Head"}
{"_id":"1b8fa15b-c385-b600-a553-a2727e701650","text":"Some specialty variation for chemoprophylaxis may be justified given the low risks of overall VTE and postdischarge VTE. We found that patients who underwent urological procedures of the kidney and prostate were significantly less likely to receive inpatient VTE chemoprophylaxis compared with those who underwent any type of operation with general or thoracic surgery. Although patients who underwent prostate and kidney operations had the lowest rates of inpatient VTE chemoprophylaxis, rates of chemoprophylaxis for patients who underwent bladder operations were comparable to those for patients who underwent procedures with other specialties, and also had the highest rates of outpatient VTE chemoprophylaxis prescribing. This variation is likely due to practitioner preference and the perceived risk of bleeding after specific urological procedures balanced with the risk of VTE. Considering the overall national VTE rates for patients undergoing urological procedures of the kidney and prostate were 0.9% and 1.1%, respectively, the risks are likely being appropriately assessed at the practitioner level.","title":"Venous Thromboembolism Chemoprophylaxis Adherence Rates After Major Cancer Surgery Venous Thromboembolism Chemoprophylaxis Adherence Rates After Cancer Surgery"}
{"_id":"1b9926a3-20c4-23b8-d1de-6cfaaa2ca3ca","text":"The present work is expected to be valuable in optimizing cryosurgery scheme of the situation that the bifurcated artery is embedded into the disease tissue.","title":"Computational study of the effects of arterial bifurcation on the temperature distribution during cryosurgery"}
{"_id":"1b9ef6c5-e104-55ff-88e1-7d603edfcaee","text":"The proportion of women who did not return for follow-up at one year following treatment for premalignant cervical lesions is very high. Women who do not return for the review visit at six weeks and those who are treated with thermocoagulation are more likely not to return for follow-up at one year. There is a need to implement strategies such as telephone-aided reminders to prompt patients to return for follow-up following treatment for premalignant cervical lesions.","title":"High Rate of Loss to Follow-Up Among Patients Undergoing Treatment for Premalignant Cervical Lesions at Mbarara Regional Referral Hospital, Southwestern Uganda: A Retrospective Cohort Study"}
{"_id":"1baba60d-6c7f-f236-bb0a-7b742548285b","text":"It has been shown that chronic ischemia of leg tissue can decrease myocardial infarct size and improve left ventricular function by increasing coronary collateral vessel density and blood flow probably by RIPC [4]. Hence, IPC by repetitive clamping of the femoral artery before surgery may protect lower limb tissue from ischemic and reperfusion injury during and after clamping of the femoral artery for vascular surgery and may also protect remote organs as the heart by RIPC. However, patients with limb ischemia due to occlusive arterial disease develop collateral vessels to the femoral artery. Due to the great variability of these vessels bypassing the femoral artery, it remains unclear if effective ischemia and reperfusion cycles can be achieved by clamping the femoral artery [5].","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"1bae8938-cbc9-b332-d43e-32e87dc116f7","text":"Whichever operative strategy is employed, it is important to note that these techniques all rely on aggressive postoperative physiotherapy to maintain optimal results.","title":"Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis"}
{"_id":"1baf6b62-dd8a-9ad6-4924-00053f1a280f","text":"If n = 9, then the LDH-G50 of the hypersensitive population is 372 nM and has a standard deviation of 87 nM and the hyposensitive population has a mean of 972 nM and a standard deviation of 272 nM. Given the size of the two populations, 9 and 35, and the two distributions we expect that in the first quartile of the ranked data there would be all 9 hypersensitive cell lines and 2 hyposensitive cell lines.","title":"B-Lymphocytes from a Population of Children with Autism Spectrum Disorder and Their Unaffected Siblings Exhibit Hypersensitivity to Thimerosal"}
{"_id":"1bb4c555-3917-6e0e-c6e9-73ce4bcdb228","text":"During the thermal ablation of the tumor, the diffusion speed of the RMNPs might temporarily change as diffusion is temperature dependent. The extent of change depends on the gel used, the temperature reached and the induced structure changes in the tumor microenvironment. The impact of this on the final diffusion is subject to further study.","title":"Feasibility Study on the Radiation Dose by Radioactive Magnetic Core-Shell Nanoparticles for Open-Source Brachytherapy"}
{"_id":"1bb88746-ac34-dfbb-3024-92642286ac38","text":"However, once the FES has set in, there is no role of corticosteroids in its treatment and even can be detrimental to the overall outcome, given their propensity to decrease immunity and cause peptic ulcer disease which severely ill patients in Trauma ICU are already predisposed to. As an institutional policy we do not prophylactically administer corticosteroids regularly in our trauma patients.","title":"Prone Positioning for Management of Fat Embolism Syndrome in a Patient with Spine Fracture; An Unusual Scenario and Review of Literature"}
{"_id":"1bb97111-77e7-af02-a30e-ea04c5262662","text":"Sevoflurane preconditioning had a significant effect on the time course of rSO2 during IPC. Decrease during the first clamping interval was less prominent in the sevoflurane group than in the control group, but more prominent than in the group with IPC only during the second clamping interval. Albeit not significantly different from the control group, rSO2 exceeded baseline values immediately before clamping in the sevoflurane group only. Hence, sevoflurane preconditioning may have dilated collateral vessels of the femoral artery to an extend that rendered a further preconditioning effect by IPC impossible.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"1bbeae74-78d8-992e-659c-774a9589e580","text":"The efficacy of botulinum toxin treatment can be unpredictable and typically lasts about three months, although in our patient we found sustained efficacy for longer than one year in one eye with repetitive injections. Since there are relatively limited options for treatment of nystagmus, our data provide support for treatment consideration of retrobulbar botulinum toxin A injection, since treatment can be performed safely with significant benefit to the patient’s visual experience and function.","title":"Treatment of Nystagmus in Brainstem Cavernous Malformation with Botulinum Toxin"}
{"_id":"1bbebc9a-af96-e79d-a44e-0ef41d32da76","text":"Frenotomy can usually be performed in the office setting with the use of a grooved retractor and scissors, laser (neodymium-doped yttrium aluminum garnet [Nd:YAG], carbon dioxide, diode, erbium:YAG), or electrocautery, with or without topical anesthetic. Operative techniques include frenulectomy, horizontal-to-vertical frenuloplasty 2-flap z-frenuloplasty, and 4-flap z-frenuloplasty under general anesthesia.11","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"1bbf4380-b691-2588-996c-1ce0d0ae5e34","text":"Osteomyelitis is an infection of the bone that is often difficult to treat and causes a significant healthcare burden. Staphylococcus aureus is the most common pathogen causing osteomyelitis. Osteomyelitis mouse models have been established to gain further insights into the pathogenesis and host response. Here, we use an established S. aureus hematogenous osteomyelitis mouse model to investigate morphological tissue changes and bacterial localization in chronic osteomyelitis with a focus on the pelvis. X-ray imaging was performed to follow the disease progression. Six weeks post infection, when osteomyelitis had manifested itself with a macroscopically visible bone deformation in the pelvis, we used two orthogonal methods, namely fluorescence imaging and label-free Raman spectroscopy, to characterise tissue changes on a microscopic scale and to localise bacteria in different tissue regions. Hematoxylin and eosin as well as Gram staining were performed as a reference method. We could detect all signs of a chronically florid tissue infection with osseous and soft tissue changes as well as with different inflammatory infiltrate patterns. Large lesions dominated in the investigated tissue samples. Bacteria were found to form abscesses and were distributed in high numbers in the lesion, where they could occasionally also be detected intracellularly. In addition, bacteria were found in lower numbers in surrounding muscle tissue and even in lower numbers in trabecular bone tissue. The Raman spectroscopic imaging revealed a metabolic state of the bacteria with reduced activity in agreement with small cell variants found in other studies. In conclusion, we present novel optical methods to characterise bone infections, including inflammatory host tissue reactions and bacterial adaptation.","title":"Insights into S. aureus-Induced Bone Deformation in a Mouse Model of Chronic Osteomyelitis Using Fluorescence and Raman Imaging"}
{"_id":"1bbf53a7-8ef3-644c-7bcd-f51a0413e391","text":"The modified incision design is a versatile and reliable method to raise a submental flap, which ensures that this flap has wider indications, and requires less time than radial forearm free flap, easier to perform and higher success rate than traditional submental flap harvest methods, and the similar lower risk of recurrence and death as radial forearm free flap. It will make submental flap an effective complementary of free flap.","title":"Modified Incision Design for Submental Flap: An Excellent Design Method for the Reconstruction of a Defect after Head and Neck Tumor Resection"}
{"_id":"1bc6affd-75a2-a151-3d72-d37ce67a2385","text":"Regarding melanoma in situ, the authors would like to underline that imiquimod is currently not approved in the treatment of LM and LMM, however, more and more papers support its effectiveness for the treatment of lentigo maligna, as a single treatment or after surgery and cryotherapy. In literature are described cases of no recurrence of LM after treatment with Imiquimod 5% and also papers describing recurrences after this kind of treatment, this is also due to a complete clinical resolution did not always correlate with histological clearance and clinical suspicion for the residual disease is not always confirmed histopathologically.9, 10","title":"Case of large lentigo maligna melanoma of the scalp treated with 5% and 3.75% Imiquimod"}
{"_id":"1bdd07e5-a316-ae06-d193-3bfd4475da56","text":"Long-acting injectable antipsychotics provide the delivery of medication over an extended period of time requiring administration typically only every 2 to 4 weeks. The side effect profile of a long-acting injectable antipsychotic is predictable and similar to the oral formulation. However, injection site reactions may occur with this novel delivery system. The risk of an injection site reaction may be greater with the repeated administration of a lipophilic decanoate formulation and include pain, development of indurations, and fibrosis. Severe complications from injection site reactions have rarely been described in the literature with newer agents. We report the first case of a patient prescribed paliperidone palmitate every 3 weeks that developed severe sepsis requiring vasopressors and intubation due to delayed relayed recognition of a necrotizing infection at an injection site. Clinicians should be alerted to screen for injection site reactions when there is an unknown source infection in a patient receiving a long-acting injectable antipsychotic.","title":"Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention"}
{"_id":"1bde24f0-778b-2faa-7674-b95eab6ef79b","text":"The identified competencies were used to guide development of LI course offerings in an intentional fashion across the SOM curriculum. Promoting self-awareness and the ability to communicate effectively were foundational competencies that were placed early in the curriculum. The capacity to build collaborative relationships, teamwork skills, and learning through others were also deemed foundational competencies and located throughout subsequent phases of the SOM curriculum. Finally, the competencies of leading ethically and with integrity were targeted to the Individualization Phase in Year 4.","title":"Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy"}
{"_id":"1be25ded-2f04-5e6b-e22f-b3d1a8062f48","text":"The introduction of molecularly targeted therapies and the replacement of classic chemotherapeutics with substances of reduced toxicity make it possible to improve the quality of therapeutic processes and their effectiveness and safety. However, patients still experience side effects related to hypersensitivity and high cytotoxicity. They show a wide range of symptoms varying in severity and impact on the quality of life. Thanks to the implementation of premedication, desensitization and symptomatic treatment of side effects, it is possible to continue oncological therapy in most cases. In severe cases of systemic or skin reactions, it may be necessary to suspend drug usage, reduce doses or replace the drug. These actions are associated with a possible negative impact on treatment results and survival. It is necessary to further expand the knowledge on adverse immune reactions and ultimately create guidelines that allow for uninterrupted therapy.","title":"Immune Reactions in Major Types of Oncological Treatment"}
{"_id":"1bece570-28ba-c834-6728-09afc8acf71d","text":"personalised selection of study characteristics included in the analysis and interactive display of results tailored the individual treatment center or patient","title":"The Proceedings of the 19th International Cancer Imaging Society Meeting and Annual Teaching Course"}
{"_id":"1bfd72ed-07c7-ff26-6597-102884ecf6ac","text":"The model found six significant factors that increased the probability of surgeons holding any leadership position (Table 2) compared with baseline, including an MBA degree (26% increase, P < 0.0001), microsurgery fellowship (18% increase, P < 0.0001), craniofacial fellowship (29% increase, P < 0.0001), international fellowship (22% increase, P = 0.0067), hand fellowship (5% increase, P = 0.0145), and NOS fellowship (13% increase, P = 0.0413).","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"1bfeedc7-2675-10d4-eac4-78d1a07f4168","text":"maintain close observation for at least half an hour after injection,","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"1c0d3d0e-7f20-4568-3773-c0e810dfe56e","text":"Greater electrical activity of the muscle was observed during the sucking of the maternal breast in full-term infants when the lingual frenulum was attached of the middle third of the tongue and was visible from the sublingual caruncle. Lower electrical activity of the suprahyoid muscles during the sucking of the maternal breast was observed in full-term infants with the lingual frenulum attached at the apex of the tongue and visible from the lower alveolar ridge.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"1c10b4b0-44bc-221f-e8ed-81fd96a30f0f","text":"This study represents the first national pan-speciality survey to investigate the role of clinical fellowships among surgical trainees in the UK. Overall, three-quarters of current trainees intend to undertake a fellowship post. Variation in demand was positively correlated with the belief that fellowships are necessary to allow attainment of a level of clinical competence necessary for independent practice. There was little support among trainees for making fellowship training compulsory or for introducing national selection. The findings question whether the existing format of clinical training in surgery is able to deliver the necessary confidence and competence trainees require. The high proportions of trainees seeking periods of further sub-specialty training will also affect future workforce projections, both in terms of the breadth of services individual surgeons are able to provide and the increase in overall training time prior to entering consultant service. It is hoped that this analysis will aid future planning in this area and stimulate further studies into the perceived competence and confidence of surgeons completing their training programs.","title":"Clinical Fellowships in Surgical Training: Analysis of a National Pan-specialty Workforce Survey"}
{"_id":"1c1f8c95-7394-ae1e-40c7-75346e273b4f","text":"LM presents a difficult clinical problem and generally there is little consensus on the optimum form of management. The recommended guidelines for treatment of LM are surgical excision with excision margins into clinically normal skin of 2–5 mm.4,5 Others have suggested that up to 20% of cases of LM would require margins greater than this.6 However, lesions are commonly large and located on cosmetically important head and neck sites. Excision may result in a poor cosmetic outcome and it is difficult to justify this approach when the risk of malignant transformation may well be low. Amelanotic lentigo maligna also remains a significant problem and inevitably results in incomplete excision since clinical identification of disease extent is impossible.7","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"1c1fdac9-3c5a-8e94-969d-aff0422b8749","text":"To investigate the sequential changes of SIH depending on the body sites using a color patch method","title":"Sequential Change of Wound Calculated by Image Analysis Using a Color Patch Method during a Secondary Intention Healing"}
{"_id":"1c27107a-05a5-b61f-5bb1-27b519345fb1","text":"A short graft may be placed between the petrous portion of the internal carotid artery and the intradural portion of internal carotid artery or middle cerebral artery. Short vein grafts have some disadvantages compared to long ones in poor exposition of the petrous carotid artery, sacrifice of the great petrosal nerve, technical difficulty, and discontinuation of blood flow of the internal carotid artery for 30-60 minutes. A long saphenous vein graft proved more effective and safe in providing high-flow bypass in the anterior circulation.97","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"1c2d913d-3774-76a7-6710-19e5655efa78","text":"It was identified from the literature that publicly available datasets were the most preferred datasets until February 2023 and were most frequently used by researchers to evaluate their proposed architectures.","title":"Federated and Transfer Learning Methods for the Classification of Melanoma and Nonmelanoma Skin Cancers: A Prospective Study"}
{"_id":"1c317067-e49b-1354-f5e7-b9744bd9a3f5","text":"Higher cholesterol levels had not been addressed with regard to DVT after arthroscopic surgery. In our study, the mean cholesterol level in the group of patients with DVT was significantly higher than the mean level in those without DVT. It is likely that a higher cholesterol level could increase blood viscosity and decrease blood flow, leading to a high risk of DVT.","title":"Incidence and risk factors of deep venous thrombosis following arthroscopic posterior cruciate ligament reconstruction"}
{"_id":"1c328801-ad28-14e7-ab47-5dad297388ba","text":"Several program alumni commented on how their training during Afya Bora led to promotions in their workplaces. Specifically, they cited both skills learned during didactic modules and during experiential attachment site blocks, underscoring the importance of both modalities in adult learning theory.","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"1c3365fe-7a59-c6c6-56c0-cfbdb51286a2","text":"Perineural invasion should be considered in treating ACC of the EAC carcinoma because it is a common histological finding in ACC and is a possible route for tumor cell dissemination. However, the presence of perineural invasion is known to be an adverse prognostic factor only when a major nerve is involved, which can be detected preoperatively. In such cases, radical parotidectomy including the facial nerve is essential for oncological safety and reducing mortality. Otherwise, if a major nerve is not involved, there is no evidence that partial resection of the parotid gland rather than parotidectomy increases the rate of perineural invasion. Parotidectomy need not be performed to control preoperatively undetected perineural invasion, and a partial resection of the parotid gland is thought to be a sufficient treatment for EAC carcinoma with ACC. For suspected microscopic perineural invasion, postoperative radiation could be applied.","title":"Evidence Based Tailored Parotidectomy in Treating External Auditory Canal Carcinoma"}
{"_id":"1c348099-7983-2145-7621-da202934ef78","text":"Direct oral anticoagulants were an effective treatment for OVT, however warfarin should be commenced in those suspected of antiphospholipid syndrome awaiting confirmation or exclusion of the diagnosis.","title":"Choosing safe and effective anticoagulation to treat idiopathic ovarian vein thrombosis: using first principles of deep vein thrombosis management to treat a rare diagnosis: a case report and review of the literature"}
{"_id":"1c3d851a-8773-2ab5-3feb-9245e246e01a","text":"Introduction: It is very important for pJIA patients to control disease activity in the early phase of the disease and to switch biologic agents if the initial treatment is ineffective. However, in pJIA patients, there have been few studies designed to assess the target of treatment or predictive markers in which the initial treatments were continuously effective.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"1c42b799-9ab1-0e4f-96e0-ca0d5dfe910a","text":"Symptomatic DVT was confirmed by documentation of positive duplex ultrasonography for DVT and for symptomatic PE by high probability ventilation perfusion lung scan or CT pulmonary angiography. Readmission for VTE was recorded when a patient having been discharged from hospital was readmitted with VTE symptoms within a three-month period with imaging confirming a diagnosis of DVT and\/or PE.","title":"Venous Thromboembolism Following Colorectal Surgery for Suspected or Confirmed Malignancy"}
{"_id":"1c465b25-2bca-b385-846e-2dd7ff84f606","text":"The described technique of rib cartilage grafting is a safe, versatile tool for nose and midface augmentation. It can be a good and relatively simple alternative to orthognathic and distraction surgeries in cases of cleft lip deformity without malocclusion, and in cases with malocclusion it can be a complementary procedure to those surgeries when their results are insufficient. The described technique yields not only augmentation of the alar base and malar area retrusion but also improvement of nasal tip projection\/rotation and upper lip thrust; that is, it optimizes the aesthetic appearance of all the components of the midface region.","title":"Nose and Midface Augmentation by Rib Cartilage Grafts: Methods and Outcome in 32 Cases"}
{"_id":"1c4abc49-9c01-9422-48ae-c5d6049c0e05","text":"The development of innovative minimally invasive lymphatic imaging techniques during the last decades were pivotal for the investigation of current pathophysiologic concepts of lymphatic flow disorders and the introduction of new lymphatic interventional procedures. The term lymphatic imaging nowadays summarizes a spectrum of novel imaging modalities that have been established recently to visualize the lymphatic system. Historically pedal lymphangiography and lymphoscintigraphy have been used but due to their poor special and temporal resolution these modalities have little to no role in the current era (47). T2-magnetic resonance lymphangiography and dynamic contrast magnetic resonance lymphography are now mainstay in the diagnosis of lymphatic flow disorders (48, 49). Because of the huge variability in lymphatic anatomy and abnormal flow pattern seen in lymphatic disease a systematic assessment of every patient with suspected lymphatic disease is crucial before initiation of therapy.","title":"Current diagnostic and therapeutic strategies for the management of lymphatic insufficiency in patients with hypoplastic left heart syndrome"}
{"_id":"1c61b828-9ac2-47c7-51bc-0ac68c8b8868","text":"It is hoped that future prospective clinical trials will confirm these results, and that better scanning methods and parameters will be developed to assess ALN and accurately select patients with direct ALND and those who are exempt from SLNB. For those cases that are difficult to determine, the SLNB is performed first and then according to the Z0011 standard. Limitations of the study include: first, there may be biases due to the difficulty in making paired comparisons between MDCT imaging and pathologic findings in each lymph node. Second, this is a retrospective study with a relatively small sample size from a single institution, which may compromise the representativeness of the study.","title":"Imaging features of sentinel lymph node mapped by multidetector-row computed tomography lymphography in predicting axillary lymph node metastasis"}
{"_id":"1c69dfee-5238-99ff-3fd8-7e6b29c5e902","text":"Skin incisions, complications related to the soft tissue, wound breakdown and implant exposure were reviewed and recorded for the study. Complications were divided in to major and minor; major complications were those complications that resulted in to morbidities and required further interventions such as deep infections and failure of fixation. Events that did not require any further surgical interventions such as superficial skin infections were considered as minor complications.","title":"Minimally Invasive Osteosynthesis of Distal Tibia Fractures using Anterolateral Locking Plate"}
{"_id":"1c7a67b0-87aa-d157-0e14-5b19d6e6b9c4","text":"We presented a case of refractory tumoral calcinosis developing in a PD patient. The case was difficult to tackle as we had exhausted all conventional therapeutic measures aimed at restoring calcium and phosphate balance. Parathyroidectomy was performed to address worsening SHPT which led to only transient and partial respite. While hypercalcemia and the local inflammation in association with superimposed tuberculous infection of the shoulder lesions might have aggravated the progression of calcified deposits during the first relapse after total parathyroidectomy, the persistent and otherwise unexplained hypercalcemia after the treatment of tuberculous infection was most likely due to the presence of adynamic bone disease, given the low PTH and normal serum 1,25-hydroxyvitamin D levels. Even though a bone biopsy was not performed, we endeavored to exclude secondary causes of hypercalcemia such as multiple myeloma and malignancy. In retrospect, bone metabolism markers and measurement of bone density would have been informative of status of bone turnover, but these were not available at our centre. Our decision to embark on teriparatide therapy was based on a recent report of its use in the treatment of hypercalcemia associated with ABD [12]. There was clinically significant regression of tumoral calcinosis after teriparatide therapy. Severe but asymptomatic hypocalcemia persisted for about 2 months into therapy but responded to oral calcium carbonate. We hypothesize that the intermittent administration of teriparatide increased bone turnover and formation and allowed extraosseous calcium to redistribute back into the skeleton, causing transient hypocalcemia before a new equilibrium occurred. This case report also raises the question of whether parathyroid tissue should be routinely reimplanted at the time of total parathyroidectomy, a procedure that is variably performed across centers.","title":"Treatment of Severe Tumoral Calcinosis with Teriparatide in a Dialysis Patient after Total Parathyroidectomy"}
{"_id":"1c7f4b30-82b4-ab63-7fe7-7defc46c05c1","text":"All of the vaccine recipients were asked to remain in the follow-up booth of the vaccination center for at least 15 min after the injection, and those individuals who had past medical histories of severe food or drug allergic reactions, including anaphylaxis, were asked to stay in the follow-up booth for at least 30 min after the injection. Individuals who were anxious about the development of acute adverse events were also advised to stay at the follow-up booth for at least 30 min. After the first vaccine dose, all recipients were then guided to another booth to be explained the next vaccine dose schedule and to make a reservation for the second vaccine dose. Therefore, almost all vaccine recipients after the first vaccine dose stayed at the vaccination center for at least 30 min. Meanwhile, many recipients of the second vaccine dose could have left the center before 30 min after the injection.","title":"Reports of acute adverse events in mRNA COVID-19 vaccine recipients after the first and second doses in Japan"}
{"_id":"1c816ce3-fe89-1233-557d-00a46093bf55","text":"Methylene blue dye (2 mL) was injected into a single area of the peritumoral parenchyma approaching the axilla immediately after removal of the modified radical mastectomy specimen. If the tumor had been removed by a previous excisional biopsy, the methylene blue dye was injected into a single area of the parenchyma around the biopsy cavity approaching the axilla. The specimen was massaged for 5 min and the location of all blue lymphatic channels and lymph nodes was recorded.","title":"A Novel Finding of Sentinel Lymphatic Channels in Early Stage Breast Cancer Patients: Which May Influence Detection Rate and False-Negative Rate of Sentinel Lymph Node Biopsy"}
{"_id":"1c873cb1-41e9-1b2f-734e-4573edb27ff6","text":"There is no randomized study comparing 45 and 50 Gy external beam radiotherapy in cervical cancer. The total dose delivered to the high risk clinical target volume (CTVHR) and to organs at risk is the result of the sum of the dose delivered by external beam radiotherapy and by brachytherapy, with a significant impact of the relative contribution of each treatment. Numerous data suggest that the ability to achieve a dose distribution fulfilling all treatment planning objectives of the EMBRACE II protocol is improved when the external beam radiotherapy dose is 45 Gy compared with >46 Gy45.46 There is a direct association between the volume irradiated to 43 Gy during external beam radiotherapy and both acute and late bowel morbidity.47Finally, based on EMBRACE I data, it was not possible to identify any difference in nodal control between 45–46 Gy and >46 Gy schedules.48","title":"ESGO\/ESTRO quality indicators for radiation therapy of cervical cancer"}
{"_id":"1c8bad82-46cb-0f02-23f7-2a5493873e66","text":"Perioperative antibiotics were not administered before all samples had been taken.","title":"Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery"}
{"_id":"1c97cbdb-4b30-7226-82e1-411db3910222","text":"Students engagement, how to enhance it and how the result might have an effect onto the acceptance of a curriculum, the creation of innovative curricular changes and also the development of impactful extracurricular projects can be followed up in literature more frequently over the last 10 years.","title":"Implementation of microsurgery simulation in an ophthalmology clerkship in Germany: a prospective, exploratory study"}
{"_id":"1ca1a8df-8290-182e-2b79-222828e6dd20","text":"Radiology is also essential in defining treatment. The aim of imaging in HNC is to establish the extent and size of the tumour and to distinguish the recurrent tumour from post-treatment changes. Diagnostic imaging techniques are becoming increasingly powerful and make it possible to detect small amounts of tumour and to define its precise location. The implementation of AI algorithms in diagnostic radiology is enabling radiologists to perform higher value-added tasks, being more visible to patients and playing a vital role in multidisciplinary clinical teams.","title":"Qualitative and Quantitative Diagnosis in Head and Neck Cancer"}
{"_id":"1ca9d84b-d201-0de0-33c4-cf70ab523836","text":"Before the surgical intervention, a drawing was performed on the skin over the corresponding area of the first and eventually second SLNs detected with imaging techniques. In the operation theatre, the blue patent was injected in the site of the tumor and the surgical procedure was performed.","title":"Non-Sentinel Lymph Node Detection during Sentinel Lymph Node Biopsy in Not-Complete-Lymph-Node-Dissection Era: A New Technique for Better Staging and Treating Melanoma Patients"}
{"_id":"1cb0d7ea-ec70-ba52-db79-16bef3d924ec","text":"Femoropopliteal bypass occlusions are a significant issue in patients with critical limb ischemia and chronic total occlusion of the native superficial femoral artery, which challenges vascular surgeons and interventional radiologists. Performing a secondary femoropopliteal bypass is still considered the standard of care, although it is associated with a higher complication rate and lower patency rate in comparison with primary bypass. Over the past few years, angioplasty has been commonly used, with the development in endovascular technologies, to treat chronic total occlusions of the native superficial femoral artery, with a good technical success rate and clinical prognosis. The purpose of the study is to assess the outcome of endovascular recanalization of chronic total occlusions of the native superficial femoral artery, in patients unfit for surgery with critical limb ischemia after failed femoropopliteal bypass.","title":"Endovascular recanalization of chronic total occlusions of the native superficial femoral artery after failed femoropopliteal bypass in patients with critical limb ischemia"}
{"_id":"1cb52686-5372-7127-0581-b95ed09ad456","text":"Allergic rhinitis affects 20 to 30% of adults in both the United States and Europe and perhaps a somewhat higher percentage of children. In addition to nasal and ocular symptoms directly related to the allergic process, interference of these symptoms with sleep leads to daytime sleepiness and impaired quality of life. Patients miss work because of symptoms but an even greater problem is interference with work productivity, or presenteeism, which has been reported to be the biggest contributor to the total economic cost of allergic rhinitis. There has been increasing awareness that many patients with either seasonal or perennial symptoms but negative skin and in vitro tests for allergen sensitivity have local nasal allergy, diagnosable by the presence of allergen-specific IgE in their nasal secretions or a positive nasal allergen challenge or both. The pharmaceutical management of allergic rhinitis rests on symptomatic treatment with antihistamines that perhaps are more effectively administered intranasally than orally and intranasal corticosteroids. Allergen immunotherapy is very effective, even for local allergic rhinitis, and the shortcomings of subcutaneous immunotherapy of inconvenience and safety are reduced by the introduction of sublingual immunotherapy (SLIT). Use of the latter is currently somewhat limited by the lack of appropriate dosing information for SLIT liquids and the limited number of allergens for which SLIT tablets are available.","title":"Recent advances in allergic rhinitis [version 1; referees: 2 approved]"}
{"_id":"1cb96328-d053-dd5d-00a5-054ed72a54b3","text":"Patients were selected for SLNB according to the recommended guidelines at that time.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"1cbd1e9f-1c4b-bcc0-fc95-2025121ce7a1","text":"Surgical reconstruction may not be a simple task depending upon the size of the defect and may require multiple surgeries to obtain an acceptable result. Total treatment time may vary; however, completion of surgical nasal reconstruction has been reported to be upward of 26 months.2 Additionally, surgical reconstruction may have esthetic limitations in the ability to match the color and contour of the reconstructed nose compared to the preoperative appearance. For elderly or medically compromised patients that are poor candidates for prolonged treatment courses that are likely to require multiple surgeries, alternative treatment options should be considered.","title":"Prosthetic rehabilitation of the geriatric oncologic rhinectomy patient utilizing a craniofacial implant‐retained nasal prosthesis"}
{"_id":"1cc0802d-83ab-c7a1-9a86-3f2df0714dc3","text":"Thus, the primary objective of this study was to identify preoperative risk factors for postoperative complications. A secondary end point was to investigate the postoperative complications following ALND or ILND as a possible predictor for melanoma recurrence.","title":"Postoperative Complications following Nodal Dissection and Their Association with Melanoma Recurrence"}
{"_id":"1cc4c913-e814-fe77-f3e8-c81ce8693cec","text":"Over recent years, there has been a decreased interest in pursuing general surgery residencies in many countries worldwide [10–13]. Exposing students to surgical skills by means of a simulator such as Eyesi may be helpful in providing a window into a future surgical career and boost interest in surgical subspecialties. The majority of students in this study reported that the Eyesi Surgical simulator was a useful component of their ophthalmology clerkship.","title":"Implementation of microsurgery simulation in an ophthalmology clerkship in Germany: a prospective, exploratory study"}
{"_id":"1cc4ebba-a454-1665-fb00-95d06b4cce3f","text":"Untreated samples of blood perfused over type III collagen at arterial rates of shear promoted the growth of stable thrombi. Modulation by eptifibatide affected thrombus growth, while that mediated by 2-MeSAMP and aspirin affected thrombus stability. Using this technique, we confirmed the primacy of continuous signaling by the ADP autocrine loop acting on P2Y12 in the maintenance of thrombus stability. Analysis of the kinetics of thrombosis revealed that continuous and prolonged analysis of thrombosis is required to capture the role of platelet signaling pathways in their entirety. Furthermore, studies evaluating the thrombotic profiles of 20 healthy volunteers treated with aspirin, clopidogrel or their combination indicated that while three individuals did not benefits from either aspirin or clopidogrel treatments, all individuals displayed marked destabilization profiles when treated with the combination regimen.","title":"Development of a perfusion chamber assay to study in real time the kinetics of thrombosis and the antithrombotic characteristics of antiplatelet drugs"}
{"_id":"1cca68aa-10c1-17aa-fe51-ed941b56a455","text":"Special attention must be paid to good indications for the use of novel robotic systems. These may be lymphovenous anastomoses, followed by anastomoses in the context of free flap surgery, as well as replantation and nerve coaptation. For initial clinical application, the comparatively simple anastomoses of elective free flaps may be the entry point. Early identification of patient subgroups also needs to be emphasized since the new technologies could be of particular benefit here. As an example, the group of obese patients shall be mentioned, in whom difficult access to the operating site could be facilitated by a new robotic assist. The experience of other surgical specialties on the use of the DaVinci robot confirms here the need to collect data as early as possible in the context of studies and to achieve reimbursement, as well as the identification of patient subgroups that are most likely to benefit from the use of these new technologies.","title":"Robotic-Assisted Microsurgery and Its Future in Plastic Surgery"}
{"_id":"1ccd0f38-7a7a-671e-2ec2-697a1ff0dc07","text":"In case of IMN positivity adjuvant radiotherapy or systemic therapy may be offered, and clinical trials would be needed to determine whether it improves survival.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"1ccf93dc-d75f-d2c8-acb0-7f19ed461aaa","text":"Moreover, our clinical experience in the field of postmastectomy pain syndrome treatment showed a therapeutic effect of autologous fat grafting to reduce neuropathic pain.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"1cd51fd1-2e46-5b80-b0b1-c64ac68a5ac3","text":"Although preservation of the facial nerve has been recommended during parotid gland cancer surgery if nerve function was preoperatively normal, its applicability for SDC remains to be determined.32,33 In our subanalyses regarding patients with early SDC of the parotid gland, neither total parotidectomy in patients with early T stage nor nerve resection in patients without facial nerve palsy showed a survival benefit compared with those treated with partial parotidectomy and nerve preservation, respectively. Although these results should be interpreted while considering the possible selection bias because of the retrospective nature of the study, our results suggest that even in SDC of the parotid gland, partial parotidectomy with facial nerve preservation could be the standard procedure for primary tumors in early T stage without facial nerve palsy.","title":"Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients"}
{"_id":"1cd79c53-582b-2ccd-b573-1b97f67256e9","text":"The deep inferior epigastric perforator (DIEP) flap has become a mainstay for autologous reconstruction with generally low complications and risk of flap failure. The internal mammary vessels, which are a popular recipient vessel choice, can occasionally be found to be suboptimal intraoperatively.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"1cd966a3-9eac-df2f-f562-bb56b16f26ff","text":"In the present study, we evaluated the validity of chemoprophylaxis using enoxaparin for the prevention of VTE in patients undergoing urologic laparoscopic surgery. With the exception of economic limitations, this approach might be a valuable tool for prevention of perioperative thromboembolic complications. To select the most adequate type of DVT prophylaxis in patients undergoing urologic laparoscopic surgery, the establishment of an appropriate prophylactic regimen and patient risk stratification is required.","title":"Efficacy and Safety of Enoxaparin for Preventing Venous Thromboembolic Events following Urologic Laparoscopic Surgery"}
{"_id":"1ce2d7c4-1464-e8e5-a7b3-fcf679d5435d","text":"Red blood cells normally contain large amounts of enzymes capable of preserving hemoglobin from oxidative damage and capable of neutralizing the circulating H2O2 in the blood.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"1ce7763e-99e1-9067-2cac-9b0643764d7e","text":"Breast reconstruction by exclusive lipofilling after total mastectomy provides satisfactory quality of life scores at 22 months after the completion of the reconstruction. Furthermore, our results confirm that the technique is simple and associated with an absence of peroperative complications and mild postoperative morbidity.","title":"Breast Reconstruction by Exclusive Lipofilling after Total Mastectomy for Breast Cancer: Description of the Technique and Evaluation of Quality of Life"}
{"_id":"1ce8c4b8-8d9f-f3ff-1919-960d37f350a4","text":"The nose is one of the most prominent parts of the face and plays a significant role in peoples’ self-satisfaction as well as quality of life. Rhinoplasty is considered as one of the most numerous and delicate cosmetic surgeries all around the world that can be performed for functional issues, esthetic issues, or both. In this study, we aimed to evaluate the dissatisfaction of patients who had undergone rhinoplasty surgery and inform the surgeons to improve the surgical techniques to prevent probable future complaints.","title":"Patient dissatisfaction following rhinoplasty: a 10-year experience in Iran"}
{"_id":"1cf24ed4-6bc3-87d5-2e38-b6bd9f238729","text":"The combination of vascular and chemical delays increased the rate of viability. Nevertheless, there was no significant difference between vascular delay alone and combination of vascular and chemical delays. Chemical delay did not significantly decrease the delay period. Better histological and microangiographical results were achieved in delay groups compared to control groups. We concluded that the arch of the latissimus dorsi musculocutaneous flap can be changed and the flap can be used for various purposes with the delay procedures.","title":"The creation of new rotation arc to the rat latissimus dorsi musculo-cutaneous flap with delay procedures"}
{"_id":"1cf96070-39f0-a943-4114-e62263fd922f","text":"In this study the patients did not experience any complications during the follow up periods and the satisfaction was remarkable. Gathering these data gives rise to future review studies which can provide more organized evidences for replacing classic reconstructive methods by the presented material.","title":"Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study"}
{"_id":"1cfdb2a9-6c24-e8f3-732d-73dd0fedc96e","text":"Imaging is degraded in obese individuals due to the following phenomena:","title":"The Challenges of Ultrasound-guided Thoracic Paravertebral Blocks in Rib Fracture Patients"}
{"_id":"1d001b90-1799-3bcb-f92b-d680bc5d9c76","text":"In the PCA model, skin mast cells are passively sensitized with antigen-specific IgE and activated by systemic administration of the corresponding antigen. This leads to a massive release of allergic mediators and the permeabilization of capillary blood vessels. If Evans blue dye is applied together with the antigen, this effect can be visualized by extravasation of the dye. The extension of the blue stained skin area is therefore taken as a measure for the intensity of the early phase of the hypersensitivity reaction.","title":"Beta-escin has potent anti-allergic efficacy and reduces allergic airway inflammation"}
{"_id":"1d171877-af5f-691b-bd74-2d59a9abf17e","text":"Diagnosis is difficult with imaging alone and must be based on a combination of typical radiological features and biochemical profile.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"1d1740b5-957f-9f19-c47c-35e85c00dbef","text":"Treatment options include wide surgical excision with careful histological examination to exclude a focus of malignancy and carbon dioxide or Neodymium YAG laser is used for patients who refuse surgery.4","title":"GIANT CUTANEOUS HORN"}
{"_id":"1d17fd5a-88dd-bfcb-3787-bb41d18c4278","text":"Four-point venous compression ultrasound test (CUS) was conducted with linear probe and vascular preset. Patient was lying down on their back during the examination. The femoral vein was assessed distally from the inguinal ligament to the area located 2 cm distally to the junction of the common femoral vein and the greater saphenous vein. The collapsing of both common and deep femoral veins was evaluated. The popliteal vein was assessed from the level of the popliteal fossa right up to the level of its trifurcation. The direct pressure applied with the transducer was used in order to completely occlude the lumen of the vein. Should the vein lumen be completely occluded, a diagnosis of a DVT at this area was excluded. If the vein lumen could not be occluded, the test result was considered positive.","title":"Integrated Assessment of Heart, Lung and Lower Extremity Veins Using Hand-Held Ultrasound Device in COVID-19 Patients: Feasibility and Clinical Application"}
{"_id":"1d18e59a-5e56-7989-471d-66eb3099ebae","text":"Rhomboid cutaneous flaps have been used successfully for reconstruction of the breast and chest wall. Rhomboid opposing cutaneous flaps have been used for reconstruction of the nasal dorsum, albeit with extensive scarring, lateral forehead, and oral commissure. Double opposing cutaneous flaps have been used successfully for shoulder and for medial thigh reconstruction, and double opposing galeocutaneous flaps have been described for reconstruction of a large aplasia cutis congenita defect in a neonate. Double opposing rhomboid fasciocutaneous flaps have been used successfully for large defects following excision of extensive complex pilonidal sinus disease. We describe double opposing galeocutaneous modified Dufourmentel flaps for reconstruction of a large scalp defect with exposed cranium.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"1d1cd07a-f955-7c38-4989-11069943b6b1","text":"This was a retrospective chart review study monitoring the occurrence of dysphagia during a period of 12 months under BT therapy. It took place at the Movement Disorders Section, Department of Neurology, Hannover Medical School from July 2018 to July 2019.","title":"Dysphagia in cervical dystonia patients receiving optimised botulinum toxin therapy: a single-center retrospective cohort study"}
{"_id":"1d1d5070-320d-8f57-642d-58afd6393f92","text":"Annually, it is estimated that optimal breastfeeding of children under 2 years of age has the potential to prevent 1.4 million deaths in children under five of age in the developing world [5]. Optimal breastfeeding practices especially for infants < 6 months of age is not a single practice rather it constitutes several dimensions including timely initiation, colostrum feeding, exclusiveness, and whether or not the infant is given prelacteal feeds [6]. This multidimensional nature of optimal breastfeeding creates difficulty to assess its effect on health and nutrition of the infants. Measuring the effect of optimal breastfeeding for infants less than 6 months of age has been a great challenge because of absence of a single summary index that measures all the different breastfeeding recommendations of infants less than 6 months all at a time. For this reason in the ground, it is clearly need to develop composite indicators that can measure breastfeeding practices. Breastfeeding performance index (BPI) is an explanatory attempt to summarize key breastfeeding practices into single summary variable by summarizing the different dimensions of breastfeeding practices. According to study done by Senarath showed that creating a composite index to assess the overall breastfeeding performance among infants less than 6 months of age is feasible and applicable [7]. BPI can be effectively used to identify target groups for breastfeeding promotion interventions. The index could also be useful in establishing the association between breastfeeding and infant morbidity and evaluating the overall effect of interventions to promote breastfeeding. However, a detailed examination of the individual infant feeding indicators in the subpopulations with low BPI would still be needed when designing a public health interventions [7]. In addition, most previous researches on association between breastfeeding practices and health outcomes of infants have only considered the individual breastfeeding indicators like exclusive breastfeeding and bottle feeding practices.","title":"Higher breastfeeding performance index is associated with lower risk of illness in infants under six months in Ethiopia"}
{"_id":"1d20b13f-cf3f-80b2-d75b-9e14f3df8ebd","text":"In the design of prosthetics for organs with bilateral symmetry, the mirrored data from healthy side can easily be used; however, it is difficult to find a proper data source for nasal defects. A 3D model database of normal nasal shapes was established in the system to meet the needs of nasal prosthesis design.","title":"Development and application of a rapid rehabilitation system for reconstruction of maxillofacial soft-tissue defects related to war and traumatic injuries"}
{"_id":"1d21804d-8141-df90-8e1f-f83e6d7da6a8","text":"The main limitation of the TABBY is the same as for the BTAT from which it was derived- it cannot be used alone to select infants for frenotomy as it does not include any assessment of feeding, for which a separate evaluation is needed using a structured tool, consideration of maternal anatomy, and a sensitive interview with the breastfeeding mother. In this study, we were not able to determine what effect the use of the TABBY rather than the BTAT would have on frenotomy rates- further audits will be needed in the future with larger numbers in different clinical settings.","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"1d2f9a1d-d3d9-d0cf-b33f-eb530b30dc78","text":"Interposition vein grafts can be used to salvage compromised free flaps; they are most often used in patients who have undergone multiple microvascular flap surgeries of the head and neck. Although an increased postoperative complication risk was noted compared with standardized surgical techniques, vein grafts have a high success rate, even in difficult cases. The selections of healthy recipient arteries and veins as well as meticulous flap monitoring are the key determinants of successful microvascular surgery using interposition vein grafts. It is a reliable option for challenging head and neck reconstruction and a valuable alternative for salvage cases.","title":"The role of vein grafts in reconstructive head and neck microsurgery"}
{"_id":"1d3ee6c1-392a-cca5-662e-f7ffad08a456","text":"All the four cases had negative margins on histopathological examination and Vessel infiltration was proved histologically. Three cases were Gr III sarcomas and 1 was Gr II sarcoma. Preoperative histology was confirmed in all cases.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"1d45455c-a894-b27c-52e4-13642fc2e9e9","text":"MRI can demonstrate the extent of bone and soft tissue involvement in cases of PTO but an absolute requirement is that both the surgeon and imaging specialist need to be experienced with interpreting the images in order to not be distracted by physiological changes (such as bone oedema) or accompanying normal tissue healing. The increasing use of internal fixation of fractures makes MRI less useful in the early diagnosis of PTO.","title":"Accuracy of diagnostic imaging modalities for peripheral post-traumatic osteomyelitis – a systematic review of the recent literature"}
{"_id":"1d46560f-99f3-7536-5f7a-d46ad1b88d33","text":"All patients with convergence spasm having been treated with periorbital BoNTA injections in the department of neuro-ophthalmology were identified. Data were extracted from patient files concerning details and subjective effectiveness of botulinum toxin injections and relation to psychiatric or neurological disorders. Patients reporting with a history of closed-head trauma or organic neurologic pathologies possibly causing CS were excluded. A telephone assessment with a standardized questionnaire was performed to evaluate mental health issues as a trigger, as well as the long-term effect and satisfaction with periorbital injections.","title":"Periorbital injections of botulinum toxin a: a novel therapeutic option for convergence spasm in neuropsychiatric disorders"}
{"_id":"1d4df773-fa45-dddc-d6e9-f6e84c5cef28","text":"'It is ordained that every man enfranchised in the Fellowship and practising Surgery shall come to their Hall to the reading of the lecture concerning surgery every day it assembles. And every man in due course shall read the lecture himself or else find an able man of the said Fellowship to read it for him, and not to absent himself at his day of reading without reasonable cause, and without giving lawful warning before the day on pain of forfeit for every time 20 shillings.' (A living wage was then 50 shillings a year).9","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"1d4f4034-f885-af8d-c498-945bf53fcebf","text":"We agree that the sample size was a limitation. Moreover, results of cadaveric contrast spread may not be extrapolated to clinical cases due to several factors. The air in the neuraxial space was a major limiting factor in cadaver 2 to assess epidural spread. A pre-study CT scan of the cadavers would exclude several unwanted elements like air pockets and cervical scoliosis in areas of interest. MBD solutions have an unrestricted flow against the highly viscous latex injections, which solidifies immediately. Probably a combination of latex and MBD in future studies would enable us to understand the spread better. In the future, similar cadaveric injections followed by dissection in prone position will establish and solidify the concept of limited ventral spread from injection dorsal to first thoracic CTJ.","title":"Anatomic and radiological correlation of injectate spread from first thoracic costotransverse junction in cervical erector spinae plane"}
{"_id":"1d50497f-cd83-a931-9876-a395bbd0a0c8","text":"Delivering ultrasound in pulses not only reduces the total acoustic energy delivered to the tissues, but also allows for thermal dissipation to take place between pulses, resulting in a lower final temperature in the sonicated tissue compared to continuous sonication. This is particularly relevant for highly vascularised tissue, such as the liver or kidney, where blood flow quickly transports heat away from the sonicated area 116. Interestingly, more studies involved in transscleral or transcorneal drug delivery used continuous ultrasound application in a tissue where the minimal vasculature reduced any effect of thermal dissipation due to blood flow. These parameters also impact the duration of time the various mechanisms influencing ultrasound-mediated drug delivery will have to do work; acoustic streaming and the creation- and\/or cavitation- of dissolved or exogenously administered microbubbles occur only when acted upon by the ultrasound wave. Particularly relevant for BRB drug delivery using intravenously administered microbubbles, pulsing ultrasound allows time for the microbubble population to replenish within the targeted vasculature 117. Indeed, 2 studies using the same mechanical index will not have sonicated tissue to the same extent if they are using different pulse parameters. As such, perhaps an additional method of assessing the mechanical aspects of ultrasound on tissue should be implemented to incorporate cumulative ultrasound dose:","title":"A systematic review of ultrasound-mediated drug delivery to the eye and critical insights to facilitate a timely path to the clinic"}
{"_id":"1d53aa8a-b2e1-60ef-17d5-e52aa535544f","text":"Frozen section analysis is particularly useful in determining whether the sampled tissue is adequate and representative of the biopsied lesion. It is also used intraoperatively for the examination of resection margins to determine the level of excision or amputation of a bone tumour. Frozen section also has a diagnostic role, often indicating to an experienced pathologist the nature of the lesion. It is particularly useful in this regard in indicating whether a lesion is likely to be inflammatory or neoplastic; this may be helpful in directing the surgeon to take further samples for microbiological culture or carrying out cytogenetic and molecular genetic analysis. In some cases, the appearances of the lesion are sufficiently characteristic to permit a definitive diagnosis; in the appropriate clinical and radiological context, this may permit immediate surgical treatment of the lesion. A definitive diagnosis of bone tumour, however, should not be based on the examination of frozen sections alone. Gross specimens submitted for frozen section should be carefully evaluated for the presence of heavily mineralised tissues, such as fragments of cortical bone, which should be removed from the samples submitted for frozen section. Stained touch or imprint preparations can be used to provide supplementary information to a frozen section diagnosis and are particularly useful if the tissue is heavily mineralised. Imprint preparations are particularly useful in the diagnosis of round cell tumours of bone, such Ewing's sarcoma, lymphoma, and osteosarcoma, but may also occasionally suggest a diagnosis of osteomyelitis, eosinophilic granuloma or carcinoma.","title":"Guidelines for histopathological specimen examination and diagnostic reporting of primary bone tumours"}
{"_id":"1d559061-c61e-9ac6-1878-33bf7acc8ae5","text":"There is also literature supporting the use of C1 laminectomy for indirect decompression and reduction in pannus size. This strategy may be useful for patients unable to tolerate prolonged surgeries with significant blood loss and lengthy anesthesia exposure. There has been concern that C1 laminectomy without fusion may lead to further atlanto-axial instability. However, a reduction in neurologic symptoms can be feasibly obtained without progressive instability in most cases.","title":"Retro-Odontoid Pseudotumor with Cervical Medullary Compression: A Case Report"}
{"_id":"1d5aa96c-0b08-ef3b-b03d-db2d6cdfffd4","text":"A limitation of the bilateral fibular graft on one hand is the tumor location and on the other its expansion. Bilateral fibular grafts are favorable if the tumor is located meta- or diaphyseally in the long bones of the lower limb. Due to the rare occurrence of malignant bone tumors requiring diaphyseal resection the case number is low.","title":"Bilateral Fibular Graft: Biological Reconstruction after Resection of Primary Malignant Bone Tumors of the Lower Limb"}
{"_id":"1d6c8dc6-2f0f-0e64-2ab3-b23e940856ca","text":"Key informants acknowledged that some clinicians believed that the guidelines may be too restrictive and some patients with melanoma who were at high risk of metastasis and disease recurrence either fell outside the current guidelines for having a SN biopsy (e.g. some younger patients with melanomas < 0.8 mm) or did not meet the requirements for adjuvant systemic therapy (e.g. some patients with melanomas > 4.0 mm but who had no palpable or occult nodal involvement). It was acknowledged that evidence is still accumulating regarding criteria for a SN biopsy and that the importance of correctly identifying patients for SN biopsy had increased owing to the availability of effective treatments and clinical trials for patients with stage II and III disease. The speed at which evidence was accumulating and knowledge increasing meant that some of the clinicians felt that best practice means practising ahead of the current guidelines and consulting with trusted colleagues.","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"1d702144-57f5-c016-bcb5-a0a27b1c240d","text":"Nail dystrophies are often acquired following trauma either to the nail plate or the nail matrix. Various subtypes of calcinosis cutis exist; dystrophic calcinosis cutis occurs at sites of prior tissue injury. Our patient presented with nail dystrophy clinically characterized by a split midline ridge of his right thumbnail; additional investigation revealed calcinosis cutis. We speculate that his subungual calcinosis cutis was associated with a traumatic event to his right thumbnail matrix that he did not recall. Subungual calcification may be observed as an age-related normal variant in elderly individuals. However, it is usually associated with dystrophic calcinosis cutis in patients with benign tumors, autoimmune diseases such as scleroderma, or trauma. Less often, it has been noted in individuals with idiopathic calcinosis cutis presenting as a subepidermal calcified nodule. The diagnosis may not be revealed by a radiograph of the distal finger or toe and may only be established after biopsy of the nail matrix or nailbed or both of the affected digit.","title":"Subungual Calcification and Nail Dystrophy: A Case of a Man With Subungual Calcinosis Cutis and an Associated Split Nail Plate"}
{"_id":"1d71fbc0-66d1-f467-8acd-0824c5dd95a3","text":"The skin puncture point for inserting the needle is the starting or finishing point of incision. We always puncture the tumor in a laterally medial or mediolateral direction.","title":"Optimization of breast cancer excision by intraoperative ultrasound and marking needle - technique description and feasibility"}
{"_id":"1d785b3a-51b1-6bb9-ae45-b0708ed4485b","text":"Suction blister grafting (SBG) is a technique where the pigmented epidermis is harvested from the donor site by using suction to raise a blister which is then transferred to the vitiliginous area.","title":"TISSUE GRAFTS IN VITILIGO SURGERY – PAST, PRESENT, AND FUTURE"}
{"_id":"1d794468-29c0-4bc4-d79e-2be5b4549a4e","text":"The coordinating centre telephones and sends a postal questionnaire to the General Practitioners of all patients who survive to discharge from hospital about 24 weeks after randomisation. This establishes that the patient is alive prior to sending out a follow-up form and ascertain whether they have had any DVT or PE since discharge from the randomising centre.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"1d81a564-aeaf-a3bd-0c5c-f569a83b52c4","text":"This study did not require approval by an institutional review board because it was conducted anonymously. Patients gave their consent to use their answers anonymously.","title":"Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients"}
{"_id":"1d9e5424-6886-63e1-acc2-0d1d4c960ad4","text":"Despite the amount of preclinical data showing the possibility of effectively guiding and increasing drug and gene transfer in tumors, not enough clinical trials have been initiated especially in the therapeutic area of breast cancer and more importantly triple-negative breast cancer which nowadays still have limited therapeutic options. Taking into consideration that ultrasound represents in the clinical setting one of the main imaging tools for the screening, diagnosis, staging, surgical planning, and surveillance of breast cancer, it would be extremely important and advantageous to develop its therapeutic capabilities and maximize its clinical application in combination with ultrasound-sensitive carriers to deliver therapeutics to the tumor and avoid non-specific targeting and systemic toxic effects.","title":"Enhancing Targeted Therapy in Breast Cancer by Ultrasound-Responsive Nanocarriers"}
{"_id":"1d9fbfbe-5169-6dc0-fe3a-4bc513e098dc","text":"The procedure of popliteal lymphadenectomy was first described by Karakousis in 1980. Most later descriptions are based on it. Knowledge of the relevant anatomy and the surgical technique of popliteal LN dissection is important to avoid injury to important structures and to allow adequate LN dissection.","title":"Popliteal lymph node dissection for metastatic squamous cell carcinoma: a case report of an uncommon procedure for an uncommon presentation"}
{"_id":"1da0aa1e-7294-cdd2-b21c-a6c09a1fae88","text":"The case presented adds an interesting aspect that has never been described before.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"1da5456c-170a-f3a4-f806-a0152740b644","text":"4) A clinical history of rhinoconjunctivitis that remains troublesome despite treatment with either antihistamines or nasal corticosteroids during the grass pollen season.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"1dad980c-a390-5863-f785-286421d4aa72","text":"Our study showed that the scalp is a reliable donor site, meeting most of the criteria proposed by Chang et al. Therefore, we propose the use of the scalp as a primary donor site in young children and in adults with facial burns, provided that the skin was harvested with an accurate dermatome by an experienced surgeon and that complications like folliculitis are treated immediately with the appropriate antiseptic.","title":"The scalp as a donor site for skin grafting in burns: retrospective study on complications"}
{"_id":"1db0fe24-84c0-53e0-58cc-b01d0a2aa522","text":"Aminoglycoside antibiotics have been used as an important part of the antibacterial drug arsenal for more than 50 years. They are indicated for polymicrobial and Gram negative bacillus infections. As the prevalence of aminoglycoside resistance has remained low, and emergence of bacterial resistance during therapy has been rare, they are still useful in clinical practice.","title":"Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy"}
{"_id":"1db41d84-bedd-7364-f79f-bf17e746ac00","text":"The increase in deaths from iatrogenic allergy may be related to increasing exposure of medications and procedure, such as radiocontrast dye that can lead to reaction with first time exposures. We also found that epinephrine administration was delayed during reactions that occurred in hospital. This indicates that health care providers may require more education to more appropriately recognize and manage acute allergic reactions. Monitoring and further study of iatrogenic related allergies are needed.","title":"Anaphylaxis-related deaths in Ontario: a retrospective review of cases from 1986 to 2011"}
{"_id":"1db47822-6cd6-7385-b5df-4f8f28c50eab","text":"Nevertheless, strategies to combine the most effective targeted treatments with cancer immunotherapy, which is becoming the standard of care in advanced melanoma, will be useful to both improve the clinical management and achieve much longer survivals among patients with such a disease.","title":"Multiple Molecular Pathways in Melanomagenesis: Characterization of Therapeutic Targets"}
{"_id":"1db59527-427e-2a94-c8af-dd5e011060b3","text":"Although numerous studies apply these parameters to quantify facial skin ageing, an overall comprehensive picture, whether and how clinical characteristics and biophysical parameters are associated with each other is missing. Furthermore, because chronological age is the most obvious predictor for intrinsic facial skin ageing, we know little about the actual impact of external influences on facial skin biology irrespective of chronological age. Therefore, the purpose of this explorative study was to characterize facial skin ageing in females of three age groups and to identify possible associations between biophysical and clinical characteristics taking chronological age into account.","title":"Characterizing Facial Skin Ageing in Humans: Disentangling Extrinsic from Intrinsic Biological Phenomena"}
{"_id":"1db8952a-3058-00b4-dc8b-f3fc6624f1ca","text":"The co-incidence of synchronous intraepithelial neoplasia and early stage invasive lung cancer is not a rare phenomenon. The need for curative treatment and the invasive potential of squamous cell pulmonary carcinoma in situ have been a topic of controversy. Surgical resection still remains the treatment of choice. Varieties of endoscopic techniques such as brachytherapy were developed as an alternative to surgery in selected patients. External beam radiation therapy has been used traditionally in combination with endobronchial brachytherapy in the treatment of roentgenographically occult lung cancer, and can be offered for all patients, but is handicapped, because these tumors are radiographically invisible. We report the first case of a pulmonary carcinoma in situ that was successfully treated with stereotactic body radiation therapy.","title":"Simultaneous stereotactic body radiation therapy of a primary non-small cell lung cancer and synchronous carcinoma in situ in a medically inoperable patient: case report"}
{"_id":"1dc20b71-8582-b88a-4759-ab35f41c3819","text":"Monitoring seems to be most useful in difficult cases where the tumor is close to the nerve. Our study showed a significant difference between the groups when the facial nerve branches were wrapped around the tumor, and the tumor was located in the deep lobe.","title":"Prospective Assessment of Intraoperative Facial Nerve Monitoring in Patients Undergoing Partial Parotidectomy"}
{"_id":"1dc4dc7b-e5b8-9d2c-2700-b1e684d428f8","text":"Our report describes durable intracranial tumor response suggesting the efficacy of PD-1 inhibitor pembrolizumab for central nervous system primary leptomeningeal melanoma.","title":"Primary leptomeningeal melanomatosis successfully treated with PD-1 inhibitor pembrolizumab A case report"}
{"_id":"1dd55c46-304f-0f70-70f3-a60839f08775","text":"The aim of this paper is to explain the existing nuclear medicine imaging possibilities for diagnosing PTO, how these modalities are able to answer the diagnostic questions from the clinicians (trauma and orthopaedic surgeons) and to provide an overview of which nuclear imaging technique should be used at which time point of the diagnostic pathway.","title":"Nuclear medicine imaging of posttraumatic osteomyelitis"}
{"_id":"1dd78911-1df0-f858-fe76-0bc906e9a5b4","text":"The femoral artery was identified at the femoral triangle. At this point the muscular fascia was opened in all its extension.","title":"Video Endoscopic Inguinal Lymphadenectomy (VEIL) -a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma"}
{"_id":"1dd9d9b5-b62a-0cc6-9804-cce57b641ed1","text":"The sample sizes of the studies ranged between 80 and 2026. The mixed dentition ages ranged between 6 and 15 years and the primary dentition ages between 0 and 6 years.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"1ddcbc04-3d2c-fd68-8a1a-1f7df28817ec","text":"A community based cross-sectional study design was used to assess the BPI and its associated factors. The study sample was obtained from all mothers who had an infant between six and twelve months of age, in randomly selected Kebeles of the Sekela District.","title":"Four in every ten infants in Northwest Ethiopia exposed to sub-optimal breastfeeding practice"}
{"_id":"1ddd952d-8fe1-76af-44a3-cc90acc62210","text":"Besides the low number of studies included and the small numbers of patients included, most of the reviewed studies had poor methodological quality, resulting in relatively high risks of bias. Thereby, there was a lack of reported outcome data and statistical analysis in these studies, which made it difficult to make a clear statement of the cumulative results of the included studies.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"1ddf1d0f-4c44-4920-5d35-52126a514f6d","text":"Sonography was more important at the rural hospital than at the university hospital. Further costly examinations are generally ordered for verification, but these additional tests change the final treatment plan in very few patients.","title":"Decision making in patients with acute abdominal pain at a university and at a rural hospital: does the value of abdominal sonography differ?"}
{"_id":"1de21275-90cc-f0a3-96cf-c4bceaa1d293","text":"The elevated risk in the youngest age group is consistent with the findings of Scheifele and colleagues, who reported greater injection site morbidity following Td vaccination in 11 to 12 year olds compared with 14 to 16 year olds [6]. This may have been due to the shorter interval between completion of the DTaP vaccination series and the Td vaccination in the younger age group. In our study, it is also possible that differences in health care seeking behavior among children and young adults contributed to the observed differences in risk of local reactions resulting in a medical visit. That is, if adolescents 11 through 15 years of age were less likely to seek medical care for a local reaction than both younger and older persons this may have contributed to the differences in risk of medically attended local reactions observed.","title":"Frequency of medically attended adverse events following tetanus and diphtheria toxoid vaccine in adolescents and young adults: a Vaccine Safety Datalink study"}
{"_id":"1dea6a68-1067-3212-13ad-b6018a00e08d","text":"The osteogenic properties of active negative pressure drainage have been widely reported in clinical cases of various odontogenic cysts, where they are used as a sole treatment in young developing patients where radical treatment should be avoided [3]. Despite the increasing number of reports on successful treatment of odontogenic cysts with decompression, there are no studies on the negative pressure drainage effects on OM of the jaw bone. The aim of our retrospective study was to evaluate the effectiveness of decompression using active negative pressure drainage in the bone healing process following surgical treatments in the OM of the jaw cases.","title":"Decompressive effects of draining tube on suppurative and sclerosing osteomyelitis in the jaw"}
{"_id":"1df1643b-c99c-666c-e6de-651987b5c4a0","text":"As the anterior in fix or external fixator hold the anterior ring fractures till appropriate healing occurs without disrupting fracture hematoma or having interfragmentary screws fixation, we believe that posterior in fixator can cause the same effect with no need for sacral fracture compression using iliosacral screw with less demand to image intensifier use, beside avoidance of injury of sacral nerve roots.","title":"Does minimally invasive percutaneous transilial internal fixator became an effective option for sacral fractures? A prospective study with novel implantation technique"}
{"_id":"1df7d670-3f64-0c1e-1936-21a2b54f2581","text":"All patients underwent wide local excision of the tumor under general anesthesia. The resection margins were 2-3 cm and were tailored according to the involvement of the critical area. Peroperative frozen section was conducted in all the cases to confirm complete excision with negative margins. Immediate reconstruction was performed following the tumor excision.","title":"Resection and Reconstructive Options in the Management of Dermatofibrosarcoma Protuberans of the Head and Neck"}
{"_id":"1e086d08-f560-74bd-c225-c872b3336b30","text":"To rule out the possibility that the skin aging process changes the levels of candidate metabolite or saturation degree, we also performed a reverse MR assessing the causal effects of facial skin aging on the 249 metabolic biomarkers. We observed no significant effects of facial skin aging on any of the included biomarkers with the IVW method (Additional file 2: Table S15).","title":"Relationships between circulating metabolites and facial skin aging: a Mendelian randomization study"}
{"_id":"1e0ee0ff-fc8e-626e-0947-99520eee430b","text":"In this review, we will discuss the value of CR and MRI evaluated spine disease in RA and provide an overview of the modern surgical techniques as well as outcomes.","title":"Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis"}
{"_id":"1e1731ef-a42e-6121-e35b-45924626448f","text":"A 43-year-old Pakistani woman presented for gynecologic surgery for an ovarian mass. Seventeen years prior, she had an emergency TV replacement with a St Jude bileaflet tilting disc prosthetic valve for bacterial endocarditis of her TV. The reasons for choosing a mechanical valve at that time are not known. Anticoagulation with warfarin without an antiplatelet agent was maintained and managed largely by our patient along with her primary care doctor. After her TV replacement she had three episodes of TV thrombosis, for which she received thrombolytics. Two of these episodes occurred during the discontinuation of warfarin and initiation of heparin or low molecular weight heparin for pregnancy, necessitating the termination of her pregnancies. Her international normalized ratio on admission was at a therapeutic level of 2.5; heparin was initiated with a goal prothrombin time of 80 seconds and warfarin discontinued for the gynecologic surgery. A preoperative echocardiogram showed a mean gradient across the TV of 5 mmHg.","title":"Management of recurrent mechanical prosthetic tricuspid valve thrombosis in the perioperative period of noncardiac surgery: a case report"}
{"_id":"1e1cee98-e8b6-b1d6-1369-63cc2369b7d8","text":"There are various region-specific challenges to the diagnosis and effective treatment of venous thromboembolism in Latin America. Clear guidance for physicians and patient education could improve adherence to existing guidelines. This review examines available information on the burden of pulmonary embolism and deep vein thrombosis in Latin America and the regional issues surrounding the diagnosis and treatment of pulmonary embolism and deep vein thrombosis. Potential barriers to appropriate care, as well as treatment options and limitations on their use, are discussed. Finally, an algorithmic approach to the diagnosis and treatment of venous thromboembolism in ambulatory patients is proposed and care pathways for patients with pulmonary embolism and deep vein thrombosis are outlined for primary care providers in Latin America.","title":"Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care"}
{"_id":"1e2393b6-2636-1cbc-b43c-abb7e8c9806b","text":"There will still be patients who have underlying dysfunctional hearts or severe pulmonary hypertension affecting the RV function as well as IJV and IVC that can limit the usefulness and the use of the SAFE score. Also, using the functional status of the heart as a surrogate for the volume was a limitation, but it was used because of the ease and ability to do multiple exams daily. These limitations are present for other modalities used to test for IVV status as well. More studies are needed to identify the severity of the score and does it correlate with the standard method.","title":"Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score by Using Bedside Ultrasound in the Intensive Care Unit"}
{"_id":"1e291ec4-532a-5b38-c184-99d78b1997d3","text":"Confounding biologic dosing differences as a reason for the statistically significant improvement in LC with US-SRT instead of the image guidance factor was considered and determined to be unlikely since we calculate the biologic equivalent dose range in the four XRT\/SRT papers’ dose regimens using TDF1 method and were determined to have similar or even higher biological doses than in the US-SRT studies.","title":"Local control comparison of early-stage non-melanoma skin Cancer (NMSC) treated by superficial radiotherapy (SRT) and external beam radiotherapy (XRT) with and without dermal image guidance: a meta-analysis"}
{"_id":"1e298cb0-68d0-4130-9452-fcd5534e31a4","text":"The primary efficacy endpoint was the occurrence of proximal or asymptomatic DVT of the limbs diagnosed objectively through Doppler ultrasound of the lower limbs; symptomatic DVT of the upper extremities or distal DVT of the lower limbs; symptomatic or incidental pulmonary embolism; and death from VTE. The primary efficacy endpoint of the study was the occurrence of DVT confirmed by duplex ultrasound.","title":"The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy"}
{"_id":"1e2ee54a-a351-c28f-e93a-449f5d3d374c","text":"Dermatofibrosarcoma protuberans is a histologically and clinically low-grade soft tissue sarcoma with a high rate of recurrence following local excision. Current guidelines advocate wide local excision or Mohs micrographic surgery to achieve negative surgical margins. Pathologically confirmed complete margin control is currently recommended for treatment and is essential for local disease control.","title":"Nodular Fasciitis Complicating a Staged Surgical Excision of Dermatofibrosarcoma Protuberans"}
{"_id":"1e2ff539-f554-fbdd-20e1-88ab4538fa35","text":"With increasing incidence rates of prostate cancer diagnosis and subsequent treatment, the risk of iatrogenic complications such as that described in this case report will similarly rise. Moreover, improved survivorship of prostate cancer will increase rates of late complications of treatment. Thus, clinicians should consider seeding to the perineum in patients with biochemical failure who have previously undergone bracytherapy. Future studies are required to determine whether prompt diagnosis and expedient intervention in these patients improves prognosis.","title":"Perineal recurrence of prostate cancer post-brachytherapy Cooper et al"}
{"_id":"1e340f2a-86e4-2bf8-6dd3-7475a89c7edf","text":"To achieve the best results from the range of techniques available for breast cancer surgery, it is important to maintain a strong multidisciplinary collaboration between the surgical and nonsurgical teams involved. A key requirement for optimal outcomes is that the surgery for removing the tumor or breast is performed in a way that maximizes the chances of a good esthetic result from any concomitant or subsequent reconstructive surgery. This requires that the reconstructive surgeon be involved early in the treatment pathway, at a point where he\/she can take part in the decision on the technique to be used to remove the tumor.","title":"A Position Statement on Optimizing the Role of Oncoplastic Breast Surgery"}
{"_id":"1e370530-f2f2-5dea-943a-1635df9684a2","text":"The aim of this study was to investigate the presence of any correlations between the topographical location of cutaneous melanoma and the topographical location of sentinel lymph nodes.","title":"Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma"}
{"_id":"1e3d6845-af34-6a6d-4959-f49234b922be","text":"The aim of this case report was to describe the contribution of 3D imaging on the virtual pre-operative planning and treatment of a mandibular cementoblastoma. The contribution of a 3D virtual and printed model to optimise treatment planning and avoid complications is emphasised.","title":"Contribution of three-dimensional images in the planning of cementoblastoma resection Van Hoe et al"}
{"_id":"1e40f337-fbe4-2f17-57b2-c9e2f24fd1a2","text":"The subscapular system is an extremely versatile donor site for head and neck reconstruction. Potential osseous options exist even for pedicled flaps, but arc of rotation limits their utility in the head and neck. Vascularized anterolateral rib, for example, can be harvested with serratus anterior based off the thoracorosal system but will not reliably reach the anterior mandible. The latissimus can also be harvested with 12th rib but transferring such a flap through the necessary tunnel is a challenge to the rib vascularity if the pectoralis major flap has not been previously harvested. The lateral trapezius flap can be harvested with scapular spine providing adequate bone stock for lateral mandible if the vascular pedicle has been preserved. As mentioned above, the submental flap can be harvested with the bone of the mentum for pedicled facial reconstruction, but this is rarely enough bone to salvage any previous osteocutaneous free flap.","title":"Regional pedicled flap salvage options for large head and neck defects: The old, the new, and the forgotten"}
{"_id":"1e449d37-0939-3320-8d5b-fab60bc9a4d6","text":"In this study, attempting to assess the local recurrence is consistent with our research, we clarified the definition of salvage in the autologous group. Furthermore, medical treatment was conducted through a single and equivalent public insurance system. These can bring us the benefit of data accuracy because these kinds of social systems automatically control variables and factors that may bias statistics.","title":"Is There a Difference in the Diagnosis and Prognosis of Local Recurrence between Autologous Tissue and Implant-Based Breast Reconstruction?"}
{"_id":"1e452d6e-4b82-0369-7aa9-a3a680874de3","text":"Primary cutaneous actinomycosis is a rare clinical form with variable presentation. The tumoral presentation of actinomycosis as pseudocarcinomatous or sarcomatous masses is completely rare. The management of cutaneous actinomycosis needs proper antibiotic treatment and surgical resection would not be adequate alone. Herein, we report a case of primary cutaneous actinomycosis on the dorsal surface of the hand as draining and infiltrated lesions along with the scar of previous tumor excision that had not received proper antibiotics after the surgery.","title":"Primary Cutaneous Actinomycosis along with the Surgical Scar on the Hand"}
{"_id":"1e4b6374-818a-ea68-8264-419709c3a836","text":"The difference in health assessment between all three groups was not statistically significant compared to last year.","title":"Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients"}
{"_id":"1e4f970b-6183-4947-7bd2-6a089e59c37e","text":"Due to the severe consequences of deep infections in this patient group, a number of interventions are undertaken to try and reduce the risk of infection such as perioperative antibiotics, vigorous skin preparation and wound dressing. Wound dressing is one of the most important interventions to address the risk of postoperative infection. The role of a postoperative wound dressing is to minimise bacterial ingress into the wound, manage exudate from the wound site and protect the soft-tissues while they heal.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"1e4fb31c-de3e-9539-0fa1-ad87b45557df","text":"We conducted a secondary descriptive analysis on the subgroup of patients presenting a PVO with SND. Objectives were to describe characteristics of neurological complications and their management and to identify factors associated with a good functional outcome over time for patients with motor weakness.","title":"Characteristics of and risk factors for severe neurological deficit in patients with pyogenic vertebral osteomyelitis A case–control study"}
{"_id":"1e503e09-01b6-68af-f3d9-daef1426738a","text":"Our results showed that if BCC was detected at an early age and at an early stage, recurrence was lower. The H and M zones were the regions with the highest rates of optimal surgical outcomes.","title":"Adequacy of surgical margins, re-excision, and evaluation of factors associated with recurrence: a retrospective study of 769 basal cell carcinomas"}
{"_id":"1e51c75a-7f7c-6f43-4c83-dbad32ffe750","text":"ABG analysis and transoesophageal echocardiography may be helpful in suspected cases of PE.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"1e5dc476-49b7-c087-79ab-08ffbe80d118","text":"Unfortunately, the information on skin graft failure was not reliable because one out of five forms did not report such complication. This situation likely occurred because skin graft failure required a reconstructive surgical management that several centers demanded to a different surgical unit. This situation may be addressed by improving the information exchange among surgical centers involved in patient care.","title":"The surgical treatment of non-metastatic melanoma in a Clinical National Melanoma Registry Study Group (CNMR): a retrospective cohort quality improvement study to reduce the morbidity rates"}
{"_id":"1e6266cf-7f2e-295d-56eb-bdbbb59c0fc5","text":"Bacterial osteomyelitis has three pathways of infection: hematogenous infection, infection related to an adjacent pyogenic focus, or as a result of trauma. In the present case, it was suggested that MSSA entered the bloodstream through the inflamed skin and was hematogenously trapped in the rib bone marrow. It has been reported that infection tends to spread from osteomyelitis to the peripheral soft tissue and neighboring joints in newborns and young infants because the bone cortex and subperiosteal tissue are loose at that age. We also considered the present case to have been complicated with a lung abscess following osteomyelitis of the rib. If the lung abscess was the primary infectious focus, then this case could have been accompanied by pleural effusion, thoracic empyema, and other respiratory symptoms. In addition, the inflammation of the soft tissue of chest wall was observed at the same time as bone invasion. The present patient had neither a history of trauma nor scarring. Blood culture is positive in only 40% of patients with hematogenous osteomyelitis. Negative results of blood culture do not constitute a rationale for ruling out hematogenous osteomyelitis.","title":"Infantile osteomyelitis of the fourth rib causing the occurrence of a lung abscess"}
{"_id":"1e6f7ba7-6ffb-d795-d5f1-9fb49f7f874c","text":"This study is the first to shed light on postoperative outcomes and complications associated with COVID-19 after reconstructive breast surgery. Unfortunately, the IBR group was relatively small and had a lower incidence of COVID than the ABR and PBR groups. Therefore, no statistical testing could be conducted which limits our results of this group. Future research with larger sample sizes would be valuable to assess whether our findings in ABR and PBR patients can be extrapolated to IBR patients as well. A larger sample size would also provide additional power to confirm our results. Furthermore, with larger sample sizes pre- and postoperative COVID-infection can be more reliably compared to identify if either increases the risk of postoperative complications more. Another arguable limitation is that we did not take into account vaccination status in this study. Although vaccinations protect against perioperative mortality and morbidity, it remains unknown whether this also accounts for surgical site complications. Additional research into the hypothesized underlying pathophysiological mechanisms is also recommended to better understand how COVID affects postoperative recovery and develop risk-reducing strategies. Histopathological examination of tissue samples from patients with for example disturbed wound healing could reveal valuable insight regarding the pathophysiology.","title":"COVID-associated complications after reconstructive breast surgery: a retrospective cohort study"}
{"_id":"1e7399e3-b48a-9434-6d97-9954d9d427e4","text":"The injection of fillers for soft tissue augmentation is a rapidly developing treatment. Research has shown that from 2000 to 2017, soft tissue filling surgery increased by 300% in the United States. Although the incidence of complications is low and most adverse events are mild, the increase in the number of procedures has led to an increase in the number of complications.","title":"Early warm compress treatment can promote recanalization of vascular embolisms and reduce tissue necrosis after polymethyl methacrylate injection"}
{"_id":"1e81c844-2590-4e21-8d30-3d14c481c02e","text":"The current trend of burn wound care has been shifted from merely achieving satisfactory survival rate to improvement in the long-term form and function of the healed burn wounds and quality of life. The change in the trend has demanded the emergence of various skin substitutes in the management of burn injury.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"1e8bf1d3-9bb4-0cdd-2222-8c91118a604a","text":"Informed consent has been obtained according to guidelines from the Helsinki declaration and research ethics.","title":"Shear Wave Elastography to Guide Perineural Hydrodissection: Two Case Reports"}
{"_id":"1e8e4c7c-072c-f125-7428-bb145fb7ccbf","text":"The postoperative course was simple and no adjuvant treatment was used.","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"1e90d727-f906-c5a5-dc7e-2fe77e32232c","text":"The surgical options for mycetoma treatment range from wide local excision to repetitive debridement excisions to amputations as well as various skin cover techniques.","title":"The Surgical Treatment of Mycetoma"}
{"_id":"1e990f20-2644-bfc6-6f89-7cb66d47b66a","text":"Immigration and visa services are a crucial and increasingly time-consuming step for IMGs in their transition and settlement in the UK. In an endeavour to make this process as friendly and smooth as possible for applicants, it would be prudent to:","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"1e9a86bb-457d-689b-5217-06bcbb6149ca","text":"In addition to the risk of venous thromboembolism, according to risk factors attributed to the condition of the patient or to the surgical procedure, it is important to analyze risk factors for bleeding that may modify the choice of the best thromboprophylaxis. Risk factors for severe bleeding complications are described in chart 8.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"1e9b4f95-1793-c31d-ed75-ce8f973d3e44","text":"The nose is composed of intricate intranasal anatomy to serve its sophisticated functions. Although it only occupies a small area, it is the central focal point of the face and demands the highest level of understanding of the delicate interplay of form and function. Functional rhinoplasty, as opposed to aesthetic rhinoplasty, primarily aims to enhance nasal breathing and olfaction without altering the nose's appearance. The goal of this study is to describe the anatomy and physiology of the nose as well as the pathophysiology of nasal obstruction and the surgical approaches available for functional rhinoplasty. Whether when performed alone or combined with cosmetic rhinoplasty, functional rhinoplasty is a procedure that can bring significant benefits and improve the quality of life of our patients. Understanding nasal anatomy and physiology is key for successful management and outcomes. To provide optimal treatment for the patients, plastic surgeons must be familiarized with various techniques that have been documented.","title":"Functional Rhinoplasty"}
{"_id":"1ea55906-b8d3-f599-3e2e-b70c88ae7d1e","text":"The limitations of this study include its cross-sectional format and the sample selected. The inclusion of a population treated in a cancer center of reference in the public health system can select more complex cases. Due to the retrospective design of the study, we did not perform sample size calculation. The inclusion of only 111 patients may also impact the results of this study, although this is the largest series of its kind carried out in Brazil.","title":"Paramedian forehead flap in the treatment of nasal, non-melanoma skin cancer: a cross-sectional study Retalho frontal paramediano no tratamento do câncer de pele não-melanoma de nariz: um estudo transversal"}
{"_id":"1ea70925-1585-92b5-2477-0dc05bdabacc","text":"FNAC can be a routine evaluation for most primary breast cancer patients with benefits in expediting treatment. For those patients with positive findings of the axilla, sentinel node biopsy can be avoided.","title":"Sparing sentinel node biopsy through axillary lymph node fine needle aspiration in primary breast cancers"}
{"_id":"1ead61f1-7395-30ed-8e12-73437556de0a","text":"Infection and dehiscence after flap surgery may lead to removal of flap and a secondary surgical intervention is required to close large sized tissue defects . Prolonged hospital stay, high treatment cost, and late return to work are among disadvantages. When NPWT is used, granulation tissue formation increases with the mechanisms of increased blood flow, and aspiration of infected materials and exudates. NPWT increases blood flow in the applied area and thus works in favor of any flap tissue remaining even though partially lost. This gives an opportunity to use the same flap to close the wound in most cases , . So, on the basis of this case, it can be suggested that the usage of NPWT promotes wound healing and contributes to the flap survival in the presence of infection and flap dehiscence in recurrent pilonidal disease.","title":"MANAGEMENT OF FLAP DEHISCENCE AFTER LıMBERG PROCEDURE FOR RECURRENT PıLONıDAL DıSEASE BY NEGATıVE PRESSURE WOUND THERAPY (NPWT) MANUSEIO DA DEISCÊNCIA DO RETALHO APÓS O PROCEDIMENTO DE LIMBERG PARA CISTO PILONIDAL RECORRENTE PELA TERAPIA DE PRESSÃO NEGATIVA (NPWT)"}
{"_id":"1eb17b2a-e053-6ebf-6a41-00ac21c992e7","text":"Deep venous thromboses developing within the first week after surgery in plastic surgery patients tend to be limited to the calf veins.74,75","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"1ebab3b1-d5ae-b556-7c16-1a6eec8e81b5","text":"We hypothesize that HSI and thermal imaging can detect changes in perfusion in the lower extremity directly after EVT. We therefore performed HSI together with thermal imaging directly before and after endovascular revascularization procedures in the lower leg. We aimed to determine whether changes in HSI pre- and post-EVT are different in patients with and without successful intervention and which of the peri-procedural perfusion parameters are able to identify limbs that show clinical improvement 6 weeks after endovascular revascularization.","title":"Detecting Changes in Tissue Perfusion With Hyperspectral Imaging and Thermal Imaging Following Endovascular Treatment for Peripheral Arterial Disease"}
{"_id":"1ebb06c0-9632-9ae1-e675-c5fb1f023b08","text":"In case of indication for sentinel lymph node biopsy, we retrieved from the anatomopathological report the data about the positivity or negativity of the lymph node for metastasis.","title":"Role of vitamin D serum levels in prevention of primary and recurrent melanoma"}
{"_id":"1ebcb777-237e-0be5-3ee3-08a23b75abab","text":"Accurate diagnosis of osteomyelitis underlying pressure ulcers is essential, as overdiagnosis exposes patients to unnecessary and prolonged treatment with antibiotics, while failure to diagnose prevents successful treatment. Histopathological examination of bone biopsy specimens is the gold standard for diagnosis. However, bone biopsy can be an invasive procedure and requires the involvement of surgeons in order to be carried out optimally with the collection of multiple specimens for microbiological and histopathological examination.","title":"Diagnosing pelvic osteomyelitis in patients with pressure ulcers: a systematic review comparing bone histology with alternative diagnostic modalities"}
{"_id":"1ec8aa2a-2ecf-b1cd-75c7-33619c47a064","text":"The authors developed a survey to examine the experiences among members of The Aesthetic Society with patients who have a history of repetitive panfacial fillers and subsequently underwent facelift surgery (Appendix). Our aim was to understand if a history of repetitive panfacial fillers had potential effects on facelift surgery and the postoperative outcomes. This survey contained 10 closed and open-ended questions and was sent through email correspondence to the 4180 members of The Aesthetic Society. The survey was e-mailed twice, first in March 2022 and then in May 2022. Written consent was provided, by which the subjects agreed to the use and analysis of their data. The data were tabulated and examined to analyze the current techniques and perceived outcomes with repetitive panfacial fillers and facelift surgery. Categorial variables were reported as frequencies or percentages.","title":"Potential Effects of Repetitive Panfacial Filler Injections on Facelift Surgery and Surgical Outcomes: Survey Results of the Members of The Aesthetic Society"}
{"_id":"1ed59e43-63b6-3cdc-4a6f-a04ec44bd9ab","text":"Our intraoperative angiographic analysis not only optimizes the planning and dissection of the ALT flap but also can provide valuable information about the viability of a prospective flap. Thus, if the perforators are not visible on one thigh, the operation can be aborted and the contralateral thigh may be used. This could potentially avoid unnecessary flap dissection. In the rare instance that neither flap is available for coverage, the operation can be aborted and other reconstructive options can be pursued.","title":"Near-Infrared Laser-Assisted Indocyanine Green Imaging for Optimizing the Design of the Anterolateral Thigh Flap"}
{"_id":"1edb0ead-81b4-f98e-8e28-dd1303d71e91","text":"The lower sensitivity of the test obtained by medical students can be explained by the fact that the majority of thrombi were present in the portion of the IJV closer to the subclavian vein where IJV combines with the subclavian vein to form the brachiocephalic trunk. Indeed, the presence of thrombus in that location increases the complexity of the examination, because the correct visualization depends on a proper angulation of the transducer for the insonation of the supraclavicular fossa, while for an ideal compression technique, the probe should be placed in a strict perpendicular position. That is not always an easy maneuver to acquire from the beginners. This technical aspect for scanning this specific region was not emphasized during the training performed by the students. However, despite a short and probably incomplete teaching, the students were able to assign the diagnosis with good specificity, quite similar to that reported in the literature and to the performance of experienced physicians involved in the present study [15]. Moreover, the high negative predictive value achieved by experts and also by students has important clinical meaning since ruling out thrombosis is the target of the one in charge of cannulating the vein for CVCd.","title":"Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients"}
{"_id":"1ede634d-02f3-e99f-edd1-5336b728f2a6","text":"The most common site for breast cancer is the upper outer quadrant and either pedicle can be used in this situation. The superomedial pedicle is versatile and can be used for tumour resection in a number of locations. For tumours located in the lower pole of the breast, the tumour resection can be incorporated into the sector of breast tissue removed as part of the mammaplasty. For outer region tumours, the pedicle can be rotated and the defect filled with an extended pedicle or secondary pedicle [6]. The multiple scenarios where this pedicle can be used may account for the observed preference amongst oncoplastic breast surgeons.","title":"Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England"}
{"_id":"1edf25d2-21be-58a3-0b77-9d3045e6bf9c","text":"We observed that the residents who have basic knowledge could significantly improve their performance on some specific surgical procedures with this preoperative training method. We believe that this will be a step in creating more opportunities for preoperative training models or simulators for the residents.","title":"Excised Abdominoplasty Material as a Systematic Plastic Surgical Training Model"}
{"_id":"1ee0f9f4-f4a9-45c5-d4e6-f34bf3882208","text":"Information regarding a patient’s comorbidities in this study are only collected from HES and therefore may not be as rich as in primary care datasets, but may contain selection bias of the most pertinent comorbidities likely to affect outcome from secondary care intervention. HES APC also does not collect data on the use of orthoses, thus we cannot compare the use of adjuvant splints in this population alongside intra-articular injection, which should be recognized as a limitation. However, because HES APC is an administrative dataset repurposed to enable research, we have undertaken validation studies in order to minimize misclassification of cases. HES APC data has the significant advantage of preventing inclusion bias, as data is collected outside the main research team.","title":"Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis"}
{"_id":"1ee85f34-aa86-5e1b-e0f6-869006d57ded","text":"Autologous chondrocyte implantation has been used since 1994 as treatment for cartilage defects with good long-term results. Little is known, however, of the effect of the chondral injury needed to source the chondrocytes for ACI on knee function. There are many reports on the use of osteochondral grafting for locations such as the ankle, where the donor site has been the knee; a few of these studies make reference to donor-site morbidity, but often is not a focused outcome of the study. Chondral harvest from the knee for the treatment of the ankle is rarely performed nowadays as most chondral harvests are taken from the joint to be treated for various reasons, including restricting surgical trauma to a second joint and both anatomical and biomechanical differences between knee and ankle cartilage. A recent study has also demonstrated that chondrocytes extracted from the margins of both grade III and IV osteochondral lesions in the knee are comparable to those from non-weightbearing areas of the joint currently used for chondral harvest. Adopting this type of approach would eliminate any potential for donor-site morbidity, but there are no long-term clinical data on the outcome of the use of debrided edge cartilage as a source of autologous chondrocytes.","title":"Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI) A Study of ACI-Treated Ankles and Hips with a Knee Chondral Harvest"}
{"_id":"1ee91755-897e-187f-6533-0d9e54168061","text":"Considering all the above findings, we think the physical constitution and underlying heart disease regardless of the characteristics of the VOM would be the most important factors for complications related to the EIM in addition to how gently the EIM is performed. We have to keep in mind that the EIM could compress the vessel intima leading to injury to its wall, and we should refrain from any hasty injection into the vein especially in fragile and small lean patients with underlying heart disease and a poor compliant heart.","title":"Potential complications in patients undergoing an ethanol injection into the vein of Marshall"}
{"_id":"1ee9a10a-5383-b1c6-c7de-657fc922cfd4","text":"It was not easy to find a solution that would lead to a quick resolution of the problem that had been going on for months.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"1ee9dd2a-1c3b-fbf2-9c59-2d8e01816837","text":"Certain diagnostic tests are performed to confirm the diagnosis of PE.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"1ef2aea1-7511-8d5e-9398-42612a0673f6","text":"This consensus statement and suggested nomenclature reflect the underlying pathophysiology and clinical relevance of MR imaging findings of musculoskeletal infection outside of the spine more precisely than terms in current use, aiming to improve effective communication across clinical specialties in order to improve patient care.","title":"MRI nomenclature for musculoskeletal infection"}
{"_id":"1ef47833-d166-b1f0-c0c4-44e4e7b1e6c8","text":"The high reliability of treatment decisions based on run-off CTA with sufficient diagnostic confidence was shown by the high agreement of intended and undertaken therapy in patients undergoing revascularization. The higher rate of disagreement of the intended and undertaken therapy in patients with acute PAD can be attributed to intraoperative complications, additional interventional procedures to treat previously hidden stenoses in occluded arteries or technical failure of surgical procedures. However, DSA imaging would neither alter the depiction of an occluded vessel nor reduce the intraoperative complication rate. Overall, the observed failure rate of surgical treatment was comparable to that reported in the literature [14].","title":"Diagnostic Confidence of Run-Off CT-Angiography as the Primary Diagnostic Imaging Modality in Patients Presenting with Acute or Chronic Peripheral Arterial Disease"}
{"_id":"1efe3ceb-ff29-b547-83c6-44ebca3fc7b5","text":"SLNB for patients with thick primary cutaneous melanoma should no longer be considered controversial. Despite this, a significant proportion of patients do not undergo lymph node staging with SLNB. We have demonstrated that patients age 60 years and older are less likely to receive SLNB. To date, data do not suggest that limiting SLNB in the elderly is appropriate. Further research to assess whether use of SLNB in older patients is detrimental or beneficial is needed.","title":"Sentinel Lymph Node Biopsy in Patients with Thick Primary Cutaneous Melanoma: Patterns of Use and Underuse Utilizing a Population-Based Model"}
{"_id":"1f026b98-4d57-92fc-7aae-86b856356344","text":"In conclusion advances in technique and technology for commonly used reamer systems has facilitated the more aggressive fixation of fractures with reduced likelihood of fat embolisation and the development of FES.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"1f027e30-4a0f-95dd-23ba-b173a49b8dce","text":"The purpose of this study was to assess the feasibility, safety and efficacy of cryosurgical ablation for locally recurrent sarcoma and metastatic carcinomas.","title":"CT guided cryoablation for locally recurrent or metastatic bone and soft tissue tumor: initial experience"}
{"_id":"1f05bb99-505a-e939-9747-89bc6540c0ba","text":"At 30 days, the patient will be assessed either as an inpatient or over the telephone according to the relevant clinical parameters.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"1f07a207-6867-1ce7-d864-f12d4f8171c3","text":"The postoperative course should always be accompanied by the execution of myofunctional exercises in the home environment.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"1f0bf82c-1cfe-94b5-ae18-f8056646102b","text":"Our patient eight months postoperatively showed an infection in the temporal region, which after antibiotic treatment with ciproxin for two months had been eliminated.","title":"Cancer patients with large defects. Reconstructional options: A case study"}
{"_id":"1f1418ed-1080-d27a-9867-cf14e8d10a93","text":"At the study centers, melanoma patients aged 18 years or older referred for ILND will be screened for trial eligibility. Before enrollment, patients will receive oral and written information about the study and a folder explaining their legal rights. Patients will be excluded from the study if they are suspected of having residual tumor in the groin following ILND, have received previous groin irradiation or are suffering from dementia or any psychiatric disorder making them incapable of informed consent or adherence to follow-up. Furthermore, patients unable to communicate in Danish or English will be excluded from the study.","title":"Prevention of seroma following inguinal lymph node dissection with prophylactic, incisional, negative-pressure wound therapy (SEROMA trial): study protocol for a randomized controlled trial"}
{"_id":"1f201f0e-2213-ff25-6a04-9f62098e4411","text":"The self-assembly approach developed at the LOEX allows for the reconstruction of a fully autologous bilayered skin substitute. This method is based on the capability of cells to form an organized three-dimensional tissue without using any exogenous scaffold or biomaterial. The resulting skin tissue shares many properties with native human skin and minimizes the host response after transplantation. The self-assembly method generates a highly functional and mechanically stable skin substitute preserving epithelial stem cells, which is suitable for autologous grafting in humans.","title":"Improved Methods to Produce Tissue-Engineered Skin Substitutes Suitable for the Permanent Closure of Full-Thickness Skin Injuries"}
{"_id":"1f2131a3-45e4-82ce-06ea-dce5c79acc64","text":"Ankyloglossia in children poses a diagnostic challenge for dentists. Recent reviews have revealed very minimal information about what constitutes an abnormal lingual attachment and what criteria should be used to justify surgical intervention. Hence the purpose of this report is to describe ankyloglossia, its clinical significance, and what guidelines should be followed before planning surgical intervention.","title":"Clinical Guidelines and Management of Ankyloglossia with 1-Year Followup: Report of 3 Cases"}
{"_id":"1f2e2d09-4598-e753-75c2-9516c8637f58","text":"The authors stated that there is no conflict of interest to disclose.","title":"The efficacy of ilizarov method for management of long tibial bone and soft tissue defect"}
{"_id":"1f32f5a9-175d-08fa-06d4-5c89cf5c65f2","text":"Early weight bearing following pelvic fracture surgery in theory would afford the potential benefits of maintaining bone stock, muscle mass and joint range of movement whilst simultaneously improving the rehabilitation goals of the patient. There are added benefits of reducing the risk of venous thromboembolism and potential positive psychological benefits following trauma which would be beneficial when caring for these complex patients. Early weight bearing also can increase return to work and reduce the financial burden of trauma [7].","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"1f3bc83c-caab-dd53-3552-9c929fbbd3ab","text":"Four patients who were diagnosed with ORN of the mandible and 3 patients who were diagnosed with MRONJ of the mandible were included in the study. One of them was diagnosed simultaneously with ORN and MRONJ. Among the 7 patients, 3 patients also had pathologic fractures. All patients underwent surgery with wide dissection of the oral cavity and partial mandibulectomy. The defects were reconstructed with the FFF method at Samsung Medical Center from April 2019 to March 2021. This study was approved by Institutional Review Board of our hospital.","title":"Reconstruction of mandibular defects in osteoradionecrosis and medication-related osteonecrosis of the jaw using fibula free flap and management of postoperative wound infections"}
{"_id":"1f4985b7-dfb1-8b1c-3a10-10d06cf18a8a","text":"Adopting any new technique when it comes to grafting will need answers to several key questions. This includes the merits and demerits of the technique in question, and if it will prove to be safe to implement in the longer term.","title":"Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage"}
{"_id":"1f4e0d21-40a8-1601-ecfa-88f80b522ae8","text":"In future studies of premenopausal breast cancer, a more specific definition of insufficient milk supply should be used. Interview questions should attempt to identify women with problems breastfeeding whose problems arose at the level of the breast and not from mismanagement of breastfeeding or hormonal imbalance. Follow-up questions should be designed so as to narrow the focus on women who intended to breastfeed but could not do so successfully without supplementing with formula due to poor infant weight gain. It may also be useful to rule out breastfeeding difficulties that were due to the infant's inability to effectively transfer milk from the breast.","title":"Insufficient Milk Supply and Breast Cancer Risk: A Systematic Review"}
{"_id":"1f5171c3-69c2-03e0-8654-6dc1060c75a3","text":"99mTc-labeled colloid, a gamma-emitting radioisotope, is injected intradermally within 1 to 1.5 cm from the primary lesion. In the head and neck, injection can be done closer to the lesion. If the injection occurs the day before the procedure, a higher dose should be injected to ensure enough gamma probe signal, since the radiocolloid will decay and 99mTc has a half-life of 6 h. Preoperative nuclear medicine imaging is obtained to guide the surgery. Static and dynamic planar images are obtained on all possible draining lymph node basins. This includes the entire extremity for extremity melanomas, the pelvic lymph node region for lower extremity and lower truncal melanomas, and the bilateral axillary, inguinal, and cervical basins for truncal melanomas. Nuclear medicine skin marking of the sentinel node or in-transits can be very helpful for surgery planning.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"1f5377eb-351f-d447-5900-0247609c858c","text":"Pruritus is an underestimated problem in patients living with cancer. Cutaneous alterations due to chemotherapy and chemoradiation are very frequent and may provoke even life-threatening complications augmenting morbidity and mortality. It should also be observed that some cutaneous collateral effects that occur during therapy, such as pruritus, can affect poor adherence to the therapy protocol or cause the need for dosage changes or even discontinuation of treatment.","title":"The Impact of Immunological Checkpoint Inhibitors and Targeted Therapy on Chronic Pruritus in Cancer Patients"}
{"_id":"1f54fb1d-a048-348a-e30f-e51bc10a2efc","text":"The medical follow up of patients with NF1 relies on active partnership between multiple health care providers using a multidisciplinary approach.","title":"Neurofibromatosis 1 French national guidelines based on an extensive literature review since 1966"}
{"_id":"1f71995d-8fc7-082d-cdb9-dea560093d3c","text":"In respect to the present work, several limitations must be noted. First, we have documented the present data solely in a descriptive fashion. No comparison was undertaken in an effort to identify whether the reduction in lesion area was “statistically significant.” Our reason for not performing such analyses was twofold. First, the sample population required in order to provide a justifiable confirmation of the effectiveness would have to have been substantial. Given that the lesion size is likely to be highly variable from person to person both prior to and following treatment, the ability to distinguish a significant change is fraught with problems. In this vein, the more critical determination centers on whether or not a given lesion can be reduced in size and what extent of proportional reduction in size can be confirmed. As observed in the present work, 16 of 18 participants were documented to have reduction in lesion area following PDT with four exhibiting a complete response. Thus, the second and perhaps a more important reason for documenting the absolute and subsequent proportional change in lesion area as a more valuable index was predicated on the notion that it was always anticipated that surgery would be performed. PDT was used in an effort to reduce lesion area so that surgery could be optimized with the least likelihood of facial disfigurement. Therefore, if a lesion area could be reduced, surgical excision could be less extensive with subsequent cosmetic value without oncologic risk. It is our impression that the present data provide valuable information indicating that PDT should be considered as an adjuvant treatment modality for malignancies of the face. While further research is required, the present findings on PDT appear to provide support for continued use and exploration in the context of treatment approaches for BCC and SCC lesions of the face. Consequently, we believe the PDT offers a relatively simple and cost-effective means as a neoadjuvant modality for facial lesions with associated advantages in surgical efforts to reduce the cosmetic and aesthetic impact of surgical intervention.","title":"Neoadjuvant Use of Photodynamic Therapy in Basal Cell and Squamous Cell Carcinomas of the Face"}
{"_id":"1f735a64-df45-7da3-224e-73d14558c12f","text":"The occurrence of relevant treatment adverse effects combined with otherwise good results in terms of cancer control have led to a growing interest in evaluating the impact of treatment on quality of life (QoL).","title":"Salvage brachytherapy in prostate local recurrence after radiation therapy: predicting factors for control and toxicity"}
{"_id":"1f7620f5-361d-14a4-fa39-dbebfd53be30","text":"In one elective case of the first web space, we had a postoperative infection that healed with antibiotics and no further procedures.","title":"Retrograde Free Venous Flaps for Extremity Reconstruction: A Roadmap"}
{"_id":"1f7cc57e-d976-a09b-e527-81ae7eb9f24b","text":"The lateral autologous breast flap sling technique adds to the armamentarium for narrowing the wide breast and improving the lateral breast curve. It may be performed in combination with other revision procedures. The use of this technique is associated with a low complication rate and does not significantly increase the total number of reconstructive procedures or duration of reconstruction. This technique may be useful during initial free tissue transfer.","title":"The Lateral Breast Flap Sling: A Novel Technique for the Revision of Autologous Breast Reconstructions"}
{"_id":"1f872491-1435-7bfa-414e-f5831911c9e0","text":"Collectively, this study confirmed the relatively safe features of interstitial brachytherapy with similar curative effects compared with SBRT. Interstitial brachytherapy had fewer systemic side effects and a better protective role than SBRT on normal lung tissues. Besides, the serum levels of inflammatory cytokines and fibrotic cytokines in interstitial brachytherapy were significantly lower than SBRT group. Therefore, the therapeutic way of interstitial brachytherapy is expected to elevate the tumor control rate, prolong the survival period, and improve the quality of life by reducing the side effects of radiotherapy and increasing the radiation dose of radiotherapy.","title":"The occurrence and development of radiation-induced lung injury after interstitial brachytherapy and stereotactic radiotherapy in SD rats"}
{"_id":"1f8929d4-97fb-34ee-3202-0449f92abc33","text":"According to the quantified ARDA at the instance scale of ARDA, all the instances in the LCR images are highly correlated to ageing before the age of 9 years. When the threshold is increased, the changing patterns of ARDA in the age dimension remained unchanged, while the sphenoid and temporal bones show more obvious ageing correlations in the instance dimension as the distribution of ARDA is more concentrated in these two instances. From the perspective of the dynamic changes with age, the ARDA is significant but attenuates rapidly during the rapid development period. After that, the average ageing salience increases and tends to change slowly.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"1f8c20c7-428c-800a-bdf8-bde5bf4f370c","text":"Five significant factors that increased the probability of surgeons holding a chair or chief position (Table 3) in an institution compared with baseline included those in independent practice for 15–20 years (3% increase, P = 0.0217), those in independent practice for greater than 20 years (4% increase, P = 0.0284), an MBA degree (20% increase, P < 0.0001), craniofacial fellowship (10% increase, P < 0.0001), and international fellowship (13% increase, P = 0.0088).","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"1f8c5a40-cc29-8086-d290-7493ac705a9c","text":"There is also controversy regarding use of hardware during the primary surgical procedure in patients with cervical osteomyelitis. Similar to a periprosthetic joint infection, infection in the setting of spinal instrumentation leads to presumed biofilm formation. As such, removal of all hardware in a primary procedure is thought to be essential with return to operating room for hardware placement at a later date after eradication of infection. In cases of an unstable spine after primary hardware removal, various temporary stabilizing measures have been described including cervical external fixation, posterior spinal fusion, and rigid cervical collar application. Although there is a lack of literature regarding osteomyelitis after ACDF, newer literature suggests that use of hardware during the primary surgical procedure for cervical osteomyelitis may allow for appropriate eradication of infection. In a systematic review of 239 patient across 24 studies treated for cervical spine osteomyelitis, Wang et al found that primary placement of instrumentation during active infection did not increase the rates of hardware failure or wound complications compared with those of elective cervical spine procedures. Aryan et al further found that corpectomy followed by placement of titanium cages in the setting of osteomyelitis did not lead to recurrent hardware infections. Titanium implants are shown to have reduced propensity for biofilm formation compared with polyether-ether-ketone and stainless-steel implants, thus supporting its potential safety.","title":"Delayed Esophageal Perforation Diagnosed 12 Years After Anterior Cervical Diskectomy and Fusion: A Case Report and Review of Current Literature"}
{"_id":"1f8ef74d-801c-a739-0519-0e54226ca2c3","text":"During the anger facial expression, patient A showed more symmetric muscle activity after neurorehabilitation. Patient B showed more balance in this expression, and the similarity in the pattern of fuzzy entropy for this emotional motion between patient B and healthy individuals increased after the rehabilitation process.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"1f956fd7-805b-2f29-3160-210827c9c37b","text":"Historically, that was the first field of application of plastic reconstructive techniques after oncologic resections, due to the impossibility of amputation and the dramatic consequences of the second intention healing when it was achievable.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"1fa24497-2e2b-0913-bb3e-c9d157955286","text":"In conclusion, skin aging is a complex process that involves numerous biological and biochemical changes, and clinicians must have a thorough comprehension of skin aging physiology to devise an effective treatment plan. It is hoped that this narrative review will aid medical professionals in developing treatment plans to combat aging and gain a more complete understanding of the intricate process of skin aging.","title":"Skin aging from mechanisms to interventions: focusing on dermal aging 10.3389\/fphys.2023.1195272"}
{"_id":"1fa2bb6c-7be3-e43d-bd17-b6161b45d03f","text":"The choice of graft ultimately depends on the availability of autologous conduit and the size of the vessel being bypassed. The saphenous and cephalic veins are currently the most frequently used autologous conduits for upper extremity bypass operations.1,3 Venous conduits are not limited by length, and saphenous veins generally have a more compatible diameter than cephalic veins.5 Where vessel length is not an issue, arteries can be ideal for interpositional or bypass grafting because they are structurally homologous to the affected vessels. Smith and colleagues17 found no evidence of intimal hyperplasia and 100% graft patency from 7 to 24 months in 3 patients with hypothenar hammer syndrome treated with a segment of the deep inferior epigastric artery. These conduits could thus be indicated in patients who may need additional procedures in the future, such as smokers or manual laborers who must continue to expose the hand to repetitive palmar trauma.","title":"Surgical Treatment Options for Subacute Ischemia of the Hand: Case Report and Literature Review"}
{"_id":"1fa67dad-5561-c27a-d8dc-0304733c45e1","text":"Often lacSCC requires detailed evaluation both the bone and the soft tissues, so the combination of CT scan and MR offers a wide spectrum of information that may allow a precise planning of resection.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"1fbae28e-7f63-2c7e-2665-5ec828edebe1","text":"To address these patient complaints and the downsides of previously described techniques for lateral breast modifications, the lateral autologous breast sling technique has been developed. The technique consists of the release of the lateral aspect of the autologous flap, transposition of this portion of the flap to a more anterior and superior position, and securing it to the pectoralis major muscle along the anterior axillary line. We present the technique and case series of its use.","title":"The Lateral Breast Flap Sling: A Novel Technique for the Revision of Autologous Breast Reconstructions"}
{"_id":"1fc6175a-a650-0864-e736-559b31be7f5a","text":"Patient operated on in early September 2021 in another hospital for infiltrative squamous cell carcinoma of the scalp.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"1fc7272e-e8c9-7513-58bb-b87f674dd035","text":"The histological examination found a fusocellular proliferation made of long and wide bundles that are inserted between the bundles of the striated muscle (in fingers of gloves). The tumor cells have elongated and sometimes undulating nuclei and eosinophilic cytoplasm with imprecise boundaries in favor of a desmoid tumor, the proliferation is based on an abundant keloid-like collagenous background which becomes focally lax.Figure 4","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"1fcd5af8-3393-501b-afd4-4fd9025be3c2","text":"Genetic screening did not show any pathogenic variants but identified one of uncertain significance in BMPR1A gene, which is associated with autosomal dominant juvenile polyposis syndrome.","title":"A rare sporadic pancreatic desmoid fibromatosis with splenic vein invasion diagnosed by CT scan-guided core needle biopsy: a case report with possible differential diagnosis from metastatic colorectal or renal cancer"}
{"_id":"1fd0796a-c360-d477-fe1c-ac1692039336","text":"Methods 14 open-wedge osteotomies fixated with the angle-stable Tomofix implant were performed; patients were allowed full weight bearing as soon as pain and wound healing permitted. Radiostereometry was used to measure motion across the osteotomy at regular intervals. Improvement in pain and functional outcome were assessed postoperatively. The results were compared to those from a group of 23 patients who had undergone the same operation but had used a standard rehabilitation protocol.","title":"Early full weight bearing is safe in open-wedge high tibial osteotomy RSA analysis of postoperative stability compared to delayed weight bearing"}
{"_id":"1fd17fcf-169e-8613-5063-3c62c55e455e","text":"There was a possibility of embolization of the injected material into the ophthalmic artery when injection was performed in dorsal nasal and periorbital area. This risk would be minimal due to the vasoconstrictor effect of adrenaline, injected before placement of the graft and the possibility would be much less if blunted tip cannulas were used instead of sharp needles. We also performed a histological examination on the fresh samples of cartilage shaving to evaluate the gross structural properties. On the other hand we crushed pieces of the same cartilage blocks to the extent that it could be injected through 14-18 gauge needles and histological examination was performed on the fresh samples to determine the differences with cartilage shaving.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"1fd5d589-2bae-2f4f-dde2-4b26b1f50c71","text":"Histologic margin goals for CuSCC are not discussed within the NCCN for CuSCC and there are no previous papers that have addressed this topic. For oral mucosal SCC the importance of histological margin distance is well established. Loree et al orginally determined that a histological margin of 5 mm or more results in greater survival and less local recurrence than close or positive margins [6, 7]. It is also recommended that taking a gross 1 cm margin of mucosa will typically yield the recommended 5 mm histologic margin [8]. The precise relationship between gross margin and histologic margin is not known for CuSCC.","title":"Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck"}
{"_id":"1fdda129-e9f4-d4f5-39a4-dfdb67ed79ab","text":"The flexible electrode cable for external connection with the stimulator was housed with 2 loops within the previously prepared subcutaneous tissue spaces in order to reduce the tensile forces on the electrode. The loops were then anchored to the muscle and facial tissue with 4-0 silk wire suture and the wires were externalized percutaneously to enable the electrodes to subsequently be connected with the stimulator.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"1fe1e4ed-3652-2b24-6385-23b1344667eb","text":"A summary of the data relating to antibiotics with bacterial enzyme inhibition as a mode of action is shown in Table 2.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"1fe34acd-7a8b-b69d-bef9-7a9f67e6512c","text":"It should also be noted that even if raised titres to ESP are achieved after 2 injections, the elevated IgG2 titres to PSA are obtained only after the third injection. This is due to a combination of dogs which had only low titres after the second injection displaying augmented titres after the third, and some dogs which were still negative on this test after the second injection displaying detectable titres for the first time after the third.","title":"Use of a LiESP\/QA-21 Vaccine (CaniLeish) Stimulates an Appropriate Th1-Dominated Cell-Mediated Immune Response in Dogs"}
{"_id":"1fe3f156-d945-40f4-5cbc-160297872c14","text":"Reconstruction of nasal skin after tumor resection is imperative for full patient rehabilitation; and use of similar skin is necessary to achieve best esthetic and functional results.","title":"Subcutaneous Forehead Island Flap for Nasal Reconstruction"}
{"_id":"1fe7139b-9f57-15ab-756e-4bd37b258755","text":"This formal evaluation of the leadership development aspect of the IGH Programme will enable the programme team to better understand the programme so that it can be further improved.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"1fedd9a6-ecf7-b67a-8fc5-e51d197cccd6","text":"In cases of immediate hypersensitivity reactions to tetracyclines these drugs must be withdrawn from the treatment and substituted with alternative drugs with similar antibacterial spectrum. In view of the lack of sufficient information on whether selective responses or cross-reactivity occurs, this is the most conservative and safest approach that can be recommended.","title":"Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy"}
{"_id":"1ff54e4b-1365-0d87-9b54-882ba74da46c","text":"Alessandro Santin commented upon the role of regional lymphadenectomy in the light of observations referring to experiments of cytotoxic T cells activation [33]. This work suggests that cytotoxic T cells are activated by the recognition of tumour antigens only after tumour cells are at least partially degraded in the draining lymph nodes. Antigenic tumours become immunogenic enough in order to activate antigen-specific native T cells only during the interaction between the T cells and the tumour cells in an environment that enhances antitumor reaction, namely the lymph nodes. Although the activation is rarely complete, this analysis raises questions about the treatment plan that includes the removal of immunocompetent lymph nodes together with the lymph nodes with metastatic disease and immune suppression triggered by the tumour, when the sentinel lymph node technique is not employed.","title":"Immunological aspects predicting metastatic sentinel lymph node in early breast cancer patients"}
{"_id":"1ffc2db3-4600-b1a5-3fba-aa71d33501a6","text":"It should be noted that we used two light sources for selected porphyrin due to their differences in the absorption maximum in the phototherapeutic window. The application of the 635 nm emitting diode and 655 nm diode laser light allow us to excite the compounds with appropriate wavelengths and then determined applied light doses. Therefore, a more direct comparison between all the photosensitizers was possible. The same light source and experimental conditions were employed for each photosensitizer in in vitro photodynamic activity evaluation.","title":"Enhanced Cellular Uptake and Photodynamic Effect with Amphiphilic Fluorinated Porphyrins: The Role of Sulfoester Groups and the Nature of Reactive Oxygen Species"}
{"_id":"200032a6-fc62-acd6-1c50-8a4114b6db13","text":"As the demand for liver donors continues to rise, advancing anesthetic management and surgical practices to optimize liver transplantation outcomes is essential. This case serves as a valuable contribution to the growing body of knowledge on potential strategies for anesthetic principles and their unique application in liver transplantation. Further research and larger-scale controlled trials may be necessary.","title":"An Approach to Anesthetic Management of Venous Anomalies and Outflow Reconstruction in Liver Transplants"}
{"_id":"2001aa94-3424-c216-9e99-37c8a0847263","text":"Arthroscopic knee cavity internal drainage operation through posteromedial portal and popliteal cyst cavity debridement through superior posteromedial portal is an effective minimally invasive surgery method for the treatment of popliteal cyst without recurrence in knee osteoarthritis patients.","title":"Arthroscopic internal drainage and cystectomy of popliteal cyst in knee osteoarthritis"}
{"_id":"200229c8-9dc8-6916-de22-c08baf775fc2","text":"Inguinal nodal metastasis is the single most important prognostic factor for survival in a patient with carcinoma penis. In patients without inguinal lymph nodal metastasis at presentation, options include close surveillance or prophylactic inguinal lymph nodal dissection. The majority of patients on surveillance who develop inguinal nodal metastases do so within two to three years of treatment of the primary. Here we report a case who developed inguinal nodal metastasis 10 years after the treatment of primary. This raises questions about the natural history and biology of the disease, the optimum surveillance and whether a patient of carcinoma penis can ever be considered risk-free for metastasis.","title":"Carcinoma penis: How late can inguinal nodal metastases occur?"}
{"_id":"200230f2-9639-2091-d85a-45c90416476d","text":"Considering the absence of national guidelines and level I evidence, the small number of studies and the well-documented potential complications of anticoagulation in the orthopaedic group of patients, MVT should not be routinely treated. We can only recommend surveillance of MVT with serial Doppler investigations for a period of no less than 2 weeks in order to identify those clots which propagate proximally and to only start anticoagulation treatment if propagation occurs.","title":"Evidence for treatment of muscular vein thrombosis in orthopaedic patients"}
{"_id":"20036285-9e73-ee08-5b43-21d28e9fd674","text":"A total of 201 photograph images from 30 patients were collected. We calculated the sequential changes in the size of skin wounds over time by the color patch method. The degree of decrease in wound was calculated based on the initial skin defect size at the beginning of dressing and the final scar size after the follow up period. In addition, to evaluate the velocity of wound healing, we estimated the date corresponding to the half of the final decrement, which was resulted from the calculation by the color patch method.","title":"Sequential Change of Wound Calculated by Image Analysis Using a Color Patch Method during a Secondary Intention Healing"}
{"_id":"200e9f47-cbbb-e7fc-7d29-a70ecd3ad3f8","text":"Given the fact that the duplex ultrasound is the standard way to diagnose DVT, osteomyelitis may go unnoticed which misleads the diagnosis and hides the underlying etiology of the DVT. Thus, persistent fever along with a history of trauma on a long bone with signs of DVT of the limb in a child should raise concern for osteomyelitis and an MRI evaluation of the limb should be obtained.","title":"Acute osteomyelitis, thrombophlebitis, and pulmonary embolism: a case report"}
{"_id":"201107ae-7bd9-9a80-718e-2bb3912b6c78","text":"Extracorporeal shockwave lithotripsy and endoscopic intracorporeal shockwave lithotripsy have replaced the conventional submandibular gland surgery for sialolithiasis. Sialendoscopy can be used as a diagnostic and interventional modality for the retrieval of sialoliths from ducts of major salivary glands [10]. Transoral sialolithotomy with sialadenectomy or sialodochoplasty is the treatment method of choice for larger salivary gland calculi, while sialoendoscopy and extracorporeal short-wave lithotripsy have emerged as effective alternatives to conventional surgical excision for the treatment of smaller calculi. Procedures for fragmentation of sialoliths involving pneumatic and electrohydraulic devices have to be executed with caution due to the high risk of ductal injury. Smaller intraductal calculi extraction with the added benefit of biopsy may be obtained with sialendoscopy, which has the advantage of being both a diagnostic and an interventional procedure [11]. However, there is a high chance of fracture of larger calculi in the gland followed by likely dissemination of fragments into the gland parenchyma during the sialoendoscopy procedure, which is a matter of grave concern.","title":"Role of Ultrasonography Supplemented by Sialendoscopy in Submandibular Steinstrasse Sialolithiasis"}
{"_id":"2017c251-0b7a-3389-eaeb-7bb8bb907ca8","text":"We present a rare case of calcinosis cutis associated with chronic sclerodermoid graft versus host disease in a 59-year-old male, 13 years following allogenic bone marrow transplantation. The etiology of calcification was thought to be dystrophic. Further research is needed to understand the link between calcinosis cutis and chronic sclerodermoid graft versus host disease to assist with selecting appropriate management for these patients.","title":"Calcinosis Cutis Associated with Chronic Sclerodermoid Graft versus Host Disease: A Case and Review of the Literature"}
{"_id":"201d5104-6598-40ed-4f7b-2af83d959023","text":"Prolonged administration of systemic antibiotics is usually required to treat bacterial bone infections. But the conventional prolonged systemic antibiotic therapy is a insufficient method for achieving high local antibiotic concentration at the diseased bone site as bones are poorly perfused organ [1]. High systemic antibiotics doses to facilitate sufficient tissue penetration are not preferable because of possible toxic systemic side effects. But local sustained antibiotic release implantable delivery may offer considerable advantages over the traditional therapy by producing effective local antibiotic concentration at diseased site with limitation of systemic antibiotic exposure maintaining low systemic side effects [2].","title":"In Vivo Ciprofloxacin Release from Hydroxyapatite-Based Bone Implants in Rabbit Tibia: A Preliminary Study"}
{"_id":"201f3dcf-14f6-a2bf-6b56-a8a8d3033550","text":"One criticism of just comparing surgical numbers as reported in the US surveys is that the correlation between surgical volume and quality of training cannot be ascertained [9]. Therefore, in our survey we also assessed perceived confidence in performing the various surgical procedures mentioned above. Our data demonstrates that there was a statistically significant increase in the perceived confidence in all surgical procedures. This was also the case for procedures with a high baseline average confidence such as cataract surgery and indirect laser.","title":"Experience gained during vitreoretinal fellowships in the United Kingdom"}
{"_id":"2026a696-32c2-6d3b-2841-9440c69a13b4","text":"36.3% of relapsed patients relapse due to the unstable location of the spinal tuberculosis lesion. Postoperative fixation of the lesion is mainly internal and external to maintain the stability of the spine. The absence and destruction of the anterior midcolumn structures of the spinal cord during surgery for spinal TB lesion excision, bone graft fusion, and lesion removal results in poor spinal stability and severe retroconvex deformity, and spinal stability is a prerequisite for TB healing and bone graft fusion, and the final healing of spinal TB can only be achieved after the location of the spinal TB occurrence is stabilized.","title":"Meta-Analysis and Data Mining-Based Study on the Expression Characteristics of Inflammatory Factors and Causes of Recurrence in Spinal Tuberculosis"}
{"_id":"20289767-205d-4fd6-6f6e-9556e5bff81b","text":"One hundred and fifty three patients with palpable breast masses or abnormal mammograms underwent ultrasound and 3D Power Doppler ultrasound scan, in order to differentiate malignant from benign lesions preoperatively. Patients were recruited consequently from April 2007 to November 2007 and were referred to our breast cancer center for further evaluation of the mass and treatment. Twenty eight patients were not eligible and were excluded from the study because clinically or mammographic lesions were not visible on ultrasound or, they had cysts or, tumors were too big for 3D ultrasound or, patients gave no informed consent. The remaining 125 women, aged 18 to 70 years (mean age 45 years), had solid tumors and after clinical evaluation and ultrasonography, they were treated surgically with open excisional biopsy. In this study we compare primary ultrasonographic characteristics and diagnoses before surgery to histopathological findings after surgery. No data of preoperative cytologic results is included.","title":"The Contribution of Three-Dimensional Power Doppler Imaging in the Preoperative Assessment of Breast Tumors: A Preliminary Report"}
{"_id":"2033161f-382a-ad55-38ae-d0255c1a3ec8","text":"The data used in this diagnostic study are derived from the M-Path study, which was described previously. Practicing pathologists from 10 US states who actively interpreted melanocytic skin biopsy lesions as part of their usual clinical practice and planned to continue practicing for a minimum of 2 subsequent years were invited to participate. This study was approved by the institutional review boards of Dartmouth College, the Fred Hutchinson Cancer Research Center, Oregon Health and Science University, and the University of Washington. Informed consent was obtained from every participating pathologist using an online platform.","title":"Concordance and Reproducibility of Melanoma Staging According to the 7th vs 8th Edition of the AJCC Cancer Staging Manual Concordance and Reproducibility of Melanoma Staging by AJCC 7th vs 8th Edition Definitions"}
{"_id":"203324d6-f129-c0d2-e8e9-a48c8dca1e20","text":"Prophylactic anticoagulation was not used routinely after the operation because it may cause bleeding from wounds and increase the overall risk of postoperative bleeding. We encouraged patients to ambulate early. Those who could not get out of their beds were instructed to actively flex their lower limbs and perform ankle plantar flexion, dorsiflexion, and internal and external rotation, as well as wear elastic socks or elastic bandages. If the lower extremity deep venous thrombosis was clearly diagnosed, the patient was instructed to rest in bed and reduce massage or intense activity, to prevent the thrombosis from being propagated. Patients and staff were also instructed to pay close attention to lower limb edema, record the changes in lower limb circumference and pay attention to the circumferences of both the affected and the healthy sides. They were instructed to keep the affected limb warm and closely observe the changes in skin temperature. If patients were diagnosed with lower extremity deep vein thrombosis postoperatively, low molecular weight heparin could be injected subcutaneously and relevant coagulation indicators are reviewed regularly.","title":"Preliminary experience of oblique occlusion technique in robot-assisted infrahepatic inferior vena cava thrombectomy: step-by-step procedures and short term outcomes"}
{"_id":"20360968-2ea0-740a-d69c-b861087e7fb2","text":"Table 1 lists the relevant patient and tumor characteristics. Clinical PNI was defined as a cranial nerve deficit on physical examination and\/or visible tumor in a major cranial nerve branch on CT or MRI scan.","title":"Efficacy of elective nodal irradiation in skin squamous cell carcinoma of the face, ears, and scalp"}
{"_id":"204de287-8bd6-fcc0-bfac-dc608fc431e5","text":"The operation consisted of reconstruction of the cartilaginous nasal septum, which had previously been removed, using two vestibular labial mucosa flaps to reconstruct the mucosa, and cartilage from the ear conch for the cartilaginous septum. After this, the skin edges of the fistula were turned to recreate the inner lining of the nose and form a vascular base of wide area to accept the composite graft. The case concerns a female 74-year old patient who had undergone several oncological surgery for a relapsing basal cell carcinoma on the dorsum of the nose. The operation consisted of reconstruction of the cartilaginous nasal septum using two vestibular labial mucosa flaps to reconstruct the mucosa, and cartilage from the ear conch for the cartilaginous septum.","title":"Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose"}
{"_id":"2054ab5f-6480-c74d-5258-238faa9391c3","text":"This study was conducted to evaluate the VTE risk profiles of recently-admitted clinical and surgical patients and to assess the thromboprophylactic measures administered during the first 24 hours after admission.","title":"Evaluation of deep vein thrombosis prophylaxis in a general hospital"}
{"_id":"206534df-7796-f0b5-8856-36f9026ca0e0","text":"The assessment of a patient with foot ulcers stemming from peripheral vascular disease encompasses a thorough history and physical examination with the adjunctive use of the noninvasive vascular laboratory to confirm, localize, and grade lesions [36]. Precise, comprehensive anatomic imaging is the cornerstone of successful revascularization of the ischemic lower extremity in patients with diabetes mellitus. Contrast arteriography has been the mainstay for many years and remains the gold standard due to its superior image resolution and being the only modality used for both diagnosis and treatment. Coexistent renal insufficiency, however, makes conventional angiography impractical in significant percent of diabetic patients. CO2 angiogram and noninvasive Doppler studies are other alternative imaging options in this patient population. While multiple noninvasive and invasive methods are available to assess the peripheral vasculature, it should be obvious that not every patient requires an exhaustive battery of tests in order to evaluate his or her vascular status. In general, only those tests likely to provide information that alters the course of action should be performed. Differing clinical syndromes mandate the extent of peripheral vascular testing. It is imperative that flow-limiting arterial lesions are evaluated and reconstructed or bypassed if ischemic foot ulcers are to heal.","title":"Contemporary Evaluation and Management of the Diabetic Foot"}
{"_id":"20975f29-f790-d8c9-eb70-f84a9aa0b0a8","text":"This study indicates that COVID-19 is associated with elevated risks for postoperative complications after reconstructive breast surgery. In our cohort this was clearly indicated by a significantly higher incidence of minor and major complications, especially impaired wound healing in patients after autologous breast reconstruction or partial breast reconstruction.","title":"COVID-associated complications after reconstructive breast surgery: a retrospective cohort study"}
{"_id":"20987353-598c-6da2-7fa6-269b47cf3d7c","text":"As a result, it was found that a probable diagnosis in such tumor cases could be made by sufficient pre-op scannings before surgical operations and total excision and full treatment could be sustained by means of correct surgical techniques. Although angiolipoma has been rarely seen in lumbar posterolateral space, it can be seen in lumbar region and mimic schwannoma as producing symptoms and signs of spinal cord and nerve root compression.","title":"Lumbar Spinal Angiolipoma with Expanding Left Neural Foramen Mimicking Lumbar Schwannoma; Case Report and Review of The Literature"}
{"_id":"20a18ae6-12e7-4ba9-f8b9-527a2955f260","text":"Survivors of childhood cancer are at high risk for developing non-melanoma skin cancer and therefore are firmly advised to avoid or minimize sun exposure and adopt skin protection measures. We aimed to compare sun exposure and protection habits in a cohort of pediatric patients with a history of malignancy to those of healthy controls.","title":"Sun Exposure and Protection Habits in Pediatric Patients with a History of Malignancy"}
{"_id":"20a419ee-2c41-8c18-53ad-5ce00df24ff2","text":"The total number of patients and examinations per eligible study as well as the numbers of cancer detections per imaging modality are presented in eTable 2 in the Supplement. The total numbers of patients included in the eligible studies ranged between 48 and 874, and the numbers of examinations ranged between 58 and 5117.","title":"Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer A Systematic Review and Meta-analysis Surveillance Imaging After Mastectomy for Patients With Breast Cancer"}
{"_id":"20a84caa-3da9-16a5-348d-bd8055205ae9","text":"An omental biopsy can be attempted once the omentum is thickened. Conventionally, omental biopsy has been performed using laparotomy or laparoscopy, which also involve additional costs of hospitalization and the risks of anesthesia. The omentum is easily visible on USG when it is thickened. Since the omentum is easily accessible and it can be easily differentiated from bowel on real-time USG, an omental biopsy can be readily performed under USG guidance. The purpose of this study was to evaluate the usefulness of USG guidance for the biopsy of a thickened omentum.","title":"Ultrasound-guided omental biopsy: Review of 173 patients"}
{"_id":"20ae9cd1-beee-179b-17a0-a0fd9fdd19ff","text":"Along with feelings of limitless love and euphoric experiences of the expanding connection to the new life, the first encounters with the infant can come as a shock when overwhelming feelings of responsibility occur. When severe unexpected challenges to nourishing and nursing the infant arise, being able to interpret or understand oneself in a situation that is completely new becomes an existential turning point. It is important to get hold of situations that now claim the whole of one’s existence and that are nonnegotiable and for which there are no written methods. No one can tell you in advance what to do or what must be done that is consistent with the actual situations that occur. Much is at stake in such situations, and life becomes vulnerable.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"20b33215-af9f-0e24-fcdf-de3b5a61c5a6","text":"Skeletal stability is the key to protecting the soft tissue, and early definitive fixation is employed as soon as wound evolution has ceased. We regard this as important in a successful host response to infection. Many of these patients are pyrexial for many weeks despite empirical or directed antibiotic therapy. The underlying cause of this is frequently not determined, but is not thought to be a result of infection. Delaying fracture fixation until patients are apyrexial might result in long delays until fixation. The timing of wound closure or coverage was dictated by the surgeon’s judgement of the health of the wound, and negative wound cultures were not a prerequisite for this. It is recognised that wounds are likely to be colonised with bacteria, but this does not equate to acute infection.","title":"Factors influencing infection in 10 years of battlefield open tibia fractures"}
{"_id":"20bab791-4dc3-f583-8cef-f86249dd5200","text":"The patient, or their legal representative, are approached by a member of the clinical team looking after that patient to ascertain their interest in participating in the CLOTS 3 trial or to obtain their permission to pass their details onto any research staff involved. Written informed consent is sought where possible. If this is not possible the randomising clinician or nurse can gain witnessed verbal consent. Patients or legal representatives are given enough time to consider the trial fully and ask any questions they may have about the implications of the trial.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"20bb6286-41a6-a595-8e66-b75fc64f1f2f","text":"This is the first report about spontaneous rupture of abdominal wall after breast reconstruction using DIEP flap. The treatment procedure of this complication might be considered as a repair using onlay mesh in addition to primary suture.","title":"Spontaneous rupture of abdominal wall after breast reconstruction using deep inferior epigastric perforator flap following mastectomy for breast cancer"}
{"_id":"20bcba5a-1ad1-6bf5-b2ff-37035b4cdf4f","text":"The authors wish to thank the patients and their families for participating in the study.","title":"Positive non-sentinel axillary lymph nodes in breast cancer with 1-2 sentinel lymph node metastases"}
{"_id":"20c26804-cc69-0ac2-229c-61c959d82f86","text":"Diseases of the salivary glands are rare in infants and children (with the exception of diseases such as parotitis epidemica and cytomegaly) and the therapeutic regimen differs from that in adults. It is therefore all the more important to gain exact and extensive insight into general and special aspects of pathological changes of the salivary glands in these age groups. Etiology and pathogenesis of these entities is still not yet fully known for the age group in question so that general rules for treatment, based on clinical experience, cannot be given, particularly in view of the small number of cases of the different diseases. Swellings of the salivary glands may be caused by acute and chronic inflammatory processes, by autoimmune diseases, by duct translocation due to sialolithiasis, and by tumors of varying dignity. Clinical examination and diagnosis has also to differentiate between salivary gland cysts and inflammation or tumors.","title":"Diseases of the salivary glands in infants and adolescents"}
{"_id":"20ceb0ab-db69-990d-918b-802c2e00bce6","text":"Ideally wound closure or coverage is performed at the same time as fixation in accordance with the BOA\/BAPRAS standards. However, combat wounds can be extensive and involve a considerable proportion of the limb. Frequently the depths of the wound in the immediate fracture zone become visibly clean and viable before the totality of the wound has closed or been covered. In these complex wounds it is not uncommon for the metalwork to be covered primarily or with vascularised tissue transfers, while more distant portions of the same wound remain open, with topical negative pressure dressings in place. For this reason, in many wounds it is impossible to define a specific point that the wound is closed or covered.","title":"Factors influencing infection in 10 years of battlefield open tibia fractures"}
{"_id":"20d5832e-d82f-5a0a-cfec-bd71754df07a","text":"Another limitation could be that the intraoperative CBCT was obtained after pedicle screw placement but prior to rod placement and deformity correction. In that way, breaches resulting from pressure applied on pedicle screws due to rod placement and correction forces might be missed. However, we could not identify any clinically relevant effect of this possible phenomenon in our material.","title":"Intraoperative cone beam computed tomography is as reliable as conventional computed tomography for identification of pedicle screw breach in thoracolumbar spine surgery"}
{"_id":"20dc98fc-73ed-97d3-e85b-c1d76e8544fb","text":"A prospective analysis of patient hospital notes was performed for 100 consecutive new patients attending the JDA at CUH from November 2014 to September 2015. Data were collected using a pre-designed and piloted data collection sheet. The following data were collected for each patient:","title":"The orthodontic-oral surgery interface. Part one: A service evaluation and overview of the diagnosis and management of common anomalies"}
{"_id":"20ddf8a6-71f5-27d5-adf8-18e51ceb161e","text":"The main characteristics of the studies are shown in Table 2.","title":"Effectiveness of Myofunctional Therapy in Ankyloglossia: A Systematic Review"}
{"_id":"20de1996-508c-1771-d998-7d1aa153fe2a","text":"DECT has recently been suggested to overcome the limited diagnostic accuracy of CT in diagnosing metastatic disease of the spine. Particularly, VNCa images postprocessed from DECT data have shown the potential to close the diagnostic gap and suggested similar capabilities to MRI and PET\/CT for detection of spinal metastasis [12]. To facilitate the clinical transition of reports on VNCa performance in diagnosing occult malignant disease of the spine by conventional CT, this study sought to provide reference values for VNCa attenuation of the spine’s bone marrow among healthy individuals across different age groups and sexes, which are missing in literature to date.","title":"Dual-Energy CT, Virtual Non-Calcium Bone Marrow Imaging of the Spine: An AI-Assisted, Volumetric Evaluation of a Reference Cohort with 500 CT Scans"}
{"_id":"20e3efe5-7607-815c-81a4-f25deb7c6023","text":"In 2008, allowing for an increase in the number of women treated with mastectomy and immediate reconstruction, the decision at our institution was made to carry out mammography of the native and the reconstructed breast at follow-up. A literature review at that time revealed that mammography of the reconstructed breast may help diagnose recurrence before any symptom. This local practice is now audited to evaluate its impact, and whether it should continue.","title":"PB.20. Audit of 5 years of routine screening mammography of the reconstructed breast"}
{"_id":"20e4fc22-9de8-d558-bfe1-04188beb5618","text":"The anterior perichondrium was harvested with rib cartilage and the costal cartilage was removed to be sculpted. Sometimes it is required for dorsal onlay graft that two pieces of graft were sutured end to end or by overlapping after the edges were adjusted.5 To camouflage the transition between the segments and for soft-tissue padding, costal perichondrium or rectus fascia could be sutured over the dorsal onlay graft. Splitting the cartilage was done with a surgical blade or dermatome blade in an oblique fashion to the long axis of the rib. A graft length roughly two times the superoinferior diameter would be obtained by dividing the cartilage at 45 degrees to the long axis and longer grafts may be achieved by dividing the rib at lower angles.,","title":"Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty"}
{"_id":"20f1376e-4c3d-6147-efb3-caa842ec27b6","text":"The problem with partial flap or tip necrosis is that bone is exposed leading to reinfection and can therefore be considered the equivalent to total flap failure, thus requiring a new flap reconstruction. Finally, a systematic review and meta-analysis of 40 studies on perforator-pedicled propeller flaps in lower limb extremity defects reported a complication rate of 25.2% including a partial necrosis rate of 10.2% and complete necrosis rate of 3.5%. 56 While 55.2% of the 428 included cases were post-traumatic, neither a traumatic etiology nor acute cause was found to be a significant risk factor. However, age (over 60 years), diabetes, and arteriopathy were identified to be significant risk factors.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"20f68629-8f12-58c0-19ad-9e99d21601db","text":"In addition, by analyzing the length of hospitalization and cost in two groups of people, we found that compared with non DVT patients, the length of hospitalization in DVT patients will be longer, and the cost of DVT patients will also increase. In addition, DVT patients need to extend the use of anticoagulants after discharge. Most of the proximal DVT patients need to put in the inferior vena cava filter before operation and need to be hospitalized again to take out the filter, all of which need to increase the additional cost. Therefore, from the perspective of economy and hospital bed turnover, the prevention and control of DVT should be done well in the early stage of admission to reduce the incidence of DVT. It is beneficial to reduce the economic burden of patients and the medical burden of the whole society.","title":"Epidemiological status and risk factors of deep vein thrombosis in patients with femoral neck fracture"}
{"_id":"21037a79-a265-1076-adfe-1b29f920ff24","text":"The aim of this study was to investigate the effectiveness of the ultrasound-guided one-point PVB at the thoracic 7 vertebrae level in reducing postoperative pain in patients undergoing LC and to compare the outcomes of the preoperative and postoperative timing of this procedure on pain and intraoperative opioid requirement. The main findings can be summarized as follows: the patients treated with preoperative PVB required no opioids during surgery, and the analgesic effect of preoperative PVB was superior to that of postoperative PVB in the first two hours after surgery. Patients in both the preoperative and the postoperative groups requested less additional analgesia and reported less nausea after surgery. There have been previous reports of the additional analgesic effects of PVB when combined with general anesthesia. Furthermore, the preoperative and postoperative applications of PVB in LC were also compared. To the best of our knowledge, there has been no previous study which has compared ultrasound-guided unilateral preoperative and postoperative PVB and a control group in patients undergoing LC.","title":"The Efficacy of Ultrasound-Guided Paravertebral Block in Laparoscopic Cholecystectomy"}
{"_id":"2104d02f-9f01-07b5-47c1-a383a164f8af","text":"Although sentinel lymph node (SLN) biopsy is a standard of care for the evaluation of the axillary lymph nodes during breast cancer surgery, a substantial degree of variation exists among individual surgeons as to what represents an adequate assessment. The aim of the current study was to assess when metastatic disease was first identified within consecutively harvested SLN candidates for invasive breast cancers demonstrating a positive SLN.","title":"Re-emphasizing the concept of adequacy of intraoperative assessment of the axillary sentinel lymph nodes for identifying nodal positivity during breast cancer surgery"}
{"_id":"210fa636-dc54-a524-ec0e-98f2999f1708","text":"This study includes the largest cohort of patients reported to-date with non-vertebral osteomyelitis and represents the heterogeneity of cases that clinicians encounter in practice. One limitation of the study is that not all patients included in the analysis had a definitive diagnosis of osteomyelitis, and physicians largely based their diagnosis on the clinical picture and supported by radiologic diagnosis. This may reflect an overreliance among clinicians on radiologic studies to diagnosis osteomyelitis. In the setting of negative biopsy results, clinicians tended to adhere to their presumptive diagnosis and prescribe long course of antibiotics.","title":"Impact of diagnostic bone biopsies on the management of non-vertebral osteomyelitis A retrospective cohort study"}
{"_id":"21138c55-e246-7b58-77a8-bee1fc452508","text":"The turbinal flap is a mucoperiostal pedicled flap based on the middle and superior turbinates and pedicled on the ethmoidal artery system. Compared with other endonasal flaps, the turbinal flap has a double pedicle from the anterior and posterior ethmoidal arteries, which confers abundant blood supply. A vertical incision is performed at the middle turbinate anterior edge and a subperiostal dissection is carried out on the lateral side of the middle turbinate until the mucoperiostal flap is isolated from the bony framework and the flap elevated. This flap is adequate to cover defects along the entire ethmoid roof up to a size of 8cm2. It can also cover the medial orbital wall and medial portion of the roof of maxillary sinus (38).","title":"Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know"}
{"_id":"2118a98d-7d7b-5a60-aa68-8ee121b099b0","text":"This was a prospective diagnostic test assessment of a convenience sample of ED patients suspected of having a lower extremity DVT. This study was approved by our hospital’s institutional review board.","title":"Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis"}
{"_id":"212d2ad6-7151-7236-99ff-d006fd5114a4","text":"Despite the concerns for patients including costs and potential risks, a followup survey of 28 cancer survivors who attempted fertility preservation found that 92.3% felt positively about their decision to undergo fertility preservation with only one patient, diagnosed with metastatic cancer shortly after oocyte retrieval, expressing regret [45]. The fact that patients with cancer recurrence may die and leave a minor child with one parent is an ethical concern. It has been suggested that it may be unethical to enable a woman to reproduce if she is expected to have a shortened lifespan. A review of fertility preservation and reproduction in cancer patients by the Ethics Committee of the Society for Reproductive Medicine stated that this concern may not be persuasive given that the risk of recurrence for many patients may not be excessively high, and the child may have a meaningful life despite the death of a parent [27].","title":"Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review"}
{"_id":"21315cbe-2806-4948-8412-cd9ce22683f1","text":"Twelve determinants across six of the Flottorp domains [21] were identified as influencing acceptance and adoption of the sentinel node biopsy guideline recommendations in management of patients with primary melanoma","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"2135b789-8544-2610-b6fc-234fb3f0c37d","text":"In case the patient has a partial or complete flap loss and a secondary free flap transplantation is indicated, the patient will not be re-invited to join the study for randomization after the secondary free flap.","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"21394f07-32fd-ffda-b5a2-8c1c53dac8ed","text":"Patients with TWS also report symptoms consistent with cognitive dysfunction, spatial disorientation, anxiety and autonomic dysfunction. The degree that these functions and symptoms were impacted in our two cohorts varied as summarized in Table 2. A broader description of the range of symptoms and measurement tools available is summarized in Table 3.","title":"Third Window Syndrome: Surgical Management of Cochlea-Facial Nerve Dehiscence"}
{"_id":"213b02c3-d1c2-9be4-3e51-61c88e092e90","text":"New studies with a greater number of patients and long-term follow-up are needed to test the hypothesis that VEIL can retain the long-term oncological efficacy of the standard surgery and result in a lower morbidity. If this holds true, VEIL can become an attractive choice for the prophylactic inguinal lymphadenectomy in penile cancer patients. Other possible clinical indications for this new procedure may include prophylactic dissection for urethral and vulval cancers.","title":"Video Endoscopic Inguinal Lymphadenectomy (VEIL) -a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma"}
{"_id":"214d3ab7-4405-0662-67d2-d00efa62df16","text":"This is the same visit as the information, consent and randomisation visit and will be within 2 weeks of current anticoagulation treatment end date. Patients will be randomised electronically into one of two groups; Group O will discontinue warfarin after their usual clinical intervention, Group W will continue warfarin for a further two years.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"214d7651-44f3-f3fa-5add-16b68ac007a7","text":"The initial plan was to evaluate studies comparing NPWT to dressings following FRI in internal osteosynthesis of the extremity to perform a meta-analysis. In the initial literature screening, no such studies were found. We therefore decided to change the direction of the study towards any studies describing the use of either NPWT or dressings following FRI in internal osteosynthesis of the extremity.","title":"The use of negative pressure wound therapy for fracture-related infections following internal osteosynthesis of the extremity: A systematic review"}
{"_id":"214db55e-a7a2-4f69-3094-34611cb7ed3d","text":"The normal anatomy of the posterolateral aspect of the knee has been described in several studies; however, the degree of morphological variability in this region remains unclear. The lateral and posterolateral knee region is well known to display high rate of morphological variations regarding the proximal and distal attachments of the ligaments, relationships between the knee joint structures and the occurrence of additional bands.","title":"A proposal for a new morphological classification of the popliteus muscle tendon with potential clinical and biomechanical significance"}
{"_id":"2153c15d-bab1-52b5-ca4a-aeb8489790bc","text":"Postoperatively the patient was admitted to the intensive care unit for initial monitoring. Initial anticoagulant therapy was done with prophylactic doses of heparin, which was changed to therapeutic doses after 48 h.","title":"The Role of Free Tissue Transfers for Defect Coverage over the Body in Geriatric Populations"}
{"_id":"2155ffa8-2b3b-ba12-7eda-25bf93cf5800","text":"Another possible cause for avascular necrosis of the femoral head is the embolic disorder. An alteration of lipid metabolism causes an increase in circulating lipids due to a reduced lipolytic enzymatic activity. Circulating lipids accumulate in the liver causing fatty degeneration and adipose cyst formation. Rupture of the cysts or spontaneous diffusion of droplets from the liver leads to the formation of fat emboli in the bloodstream. From the pulmonary filter they can reach any other visceral site or bone. The subchondral region of the femoral head is an area of localization of fat emboli due to the small diameter and to terminal feature of arterial vessel at this level. Intraosseous fat emboli cause stasis through mechanical occlusion and also endothelial damage following their hydrolysis to free fatty acids. Another mechanism involved in the pathogenesis is an external compression of capillaries by the hypertrophy of marrow fat and cells with an increase of intramedullary pressure and reduction of blood flow.910","title":"Biophysical stimulation in osteonecrosis of the femoral head"}
{"_id":"215c7135-f30c-7823-1692-b496d6d0b2e3","text":"No patients were lost to follow-up. Patients with malignant tumours were reviewed every 3 months for the first 2 years and 6 monthly after that for a further 2 years with a plan for yearly review for the following 4 years. Computed tomography of the chest was performed every 6 months, and plain radiographs obtained of the operated area at each visit.","title":"The role of thallium-201 and pentavalent dimercaptosuccinic acid for staging cartilaginous tumours"}
{"_id":"215ee6b7-31b8-5075-8291-7e042ff52117","text":"When scc lesions recur or when residual disease remains after radical radiation, management options are limited. Further radiation is rarely possible because of the previous treatment having approached the tolerance doses of normal tissue within the treated field. Surgery may not be possible because surgical excision was not recommended initially, unless the recurrent tumour was small, localized, and located in a place where excision and reconstruction would not cause significant morbidity. Furthermore, operating in a previously irradiated field may be suboptimal because of radiation fibrosis and compromised vasculature. The high rate of local relapse combined with rapid tumour growth makes a reasonable case for exploration of the role of hyperfractionation and dose escalation, or of alternative treatment modalities such as high-intensity focused ultrasound.","title":"Treating recurrent cases of squamous cell carcinoma with radiotherapy"}
{"_id":"2160ca56-3d8f-2fd7-3359-d4f7d4641df2","text":"The resulting defect was very large and can be characterized as hemifacial.","title":"Cancer patients with large defects. Reconstructional options: A case study"}
{"_id":"2169ec29-33e2-c048-1781-fead5402ed04","text":"All patients had clinically negative nodes except for two patients, both affected by nasal vestibule SCC, who were treated by HDR interstitial IRT on the primary site and subsequently neck dissection.","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"216e2ee8-41bd-d376-c453-1ad492d8f9c4","text":"The repeated measures ANOVA followed by Tukey post hoc test was performed to evaluate the average eyebrow height and average eyebrow angle at the different experimental times.","title":"Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure"}
{"_id":"2178bf9b-b8be-e78e-df68-483581427c31","text":"Based on the preliminary data obtained after 21 days—the synergistic effect of combination therapy—we also showed that the stimulating effect in terms of skin hydration and elasticity is confirmed by the data 150 days after the treatment.","title":"HA PEGylated Filler in Association with an Infrared Energy Device for the Treatment of Facial Skin Aging: 150 Day Follow-Up Data Report"}
{"_id":"217a9e04-c5be-3f47-a5e0-5813ef8929bc","text":"Skin cancer risk and use of sun protection at work are largely neglected in Danish outdoor workers, more so than at leisure and on sun holiday where their risk behavior resembles that of indoor workers. This indicates an untapped workplace preventive potential.","title":"Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers"}
{"_id":"217f960d-c10c-c4d5-d6c8-d4cf5dcc6a45","text":"Pneumoperitoneum for laparoscopic surgery subsequent to autologous DIEP flap-based breast reconstruction may prove difficult as a result of loss of abdominal wall compliance. Prior to performing laparoscopy in such patients, surgeons should consider the details of the patient’s previous reconstructive procedure and assess potential risk factors for difficulty with insufflation. Lastly, careful abdominal examination should be performed to indicate whether laparoscopy for elective procedures should be delayed until abdominal wall compliance normalizes.","title":"Failed pneumoperitoneum for laparoscopic surgery following autologous Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction: a case report"}
{"_id":"21836436-240d-8b6f-fae8-5878e14e1102","text":"The parotid space harbors three groups of lymph nodes determined by the embryological development of the parotid gland. The first group of lymph nodes are embedded within the parotid fascia, the second group in the parotid parenchyma, and the last group such as the preauricular lymph nodes remain extrafascial and extraglandular. Although metastases to parotid lymph nodes are uncommon, it should always be considered in the differential diagnosis of a parotid mass. In this study we aimed to review and investigate the clinicopathological features and outcome of patients with metastasis of NPC to the parotid lymph nodes.","title":"Metastasis of nasopharyngeal carcinoma to parotid lymph nodes: a retrospective study"}
{"_id":"21891714-da44-2226-6d2e-09840017f046","text":"Transnasal endoscopic resection could represent an acceptable treatment for patients with sinonasal malignancy that decline the gold standard treatment of craniofacial resection. It is gaining a reputation as a safe and effective treatment. Topical chemotherapy has been shown to increase survival when combined with debulking surgery and is also an effective treatment option.","title":"Endoscopic Resection and Topical 5-Fluorouracil as an Alternative Treatment to Craniofacial Resection for the Management of Primary Intestinal-Type Sinonasal Adenocarcinoma"}
{"_id":"219619dc-ba2b-106f-da2d-e26001c37155","text":"Thrombolytic treatment may be an option when surgery is contraindicated and the patient is hemodynamically unstable but should be avoided in patients with thrombus that traverses at patent foramen ovale to the left atrium because thrombolysis may cause thrombus fragmentation and systemic embolization.","title":"Traveling Thrombus in the Right Atrium: Is It the Final Destination?"}
{"_id":"219d6c54-5f2f-75c3-be24-b1c9c2da578a","text":"Neuropsychiatric symptoms can be encountered in all forms of atypical parkinsonism but appear to be most prominent among patients with DLB.","title":"Neurological update: non-motor symptoms in atypical parkinsonian syndromes"}
{"_id":"21a13372-0b83-c78b-6d6a-5601cb7e5c00","text":"In this study we have established a feasible method for the evaluation of the anaphylactoid reactions caused by injectable drugs. Such findings provide technical support for the treatment of the serious clinical adverse reactions of injectable drugs, and promote the normal development and use of injectable drugs.","title":"A Reliable Method for the Evaluation of the Anaphylactoid Reaction Caused by Injectable Drugs"}
{"_id":"21a38dfe-2221-5589-feee-059b7e1be000","text":"We removed cross sectional slices of bone approximately 2 cm in thickness from the second rib of bowhead whale individuals with a chainsaw or battery-powered reciprocating saw, in order to study the patterns of change in bone properties with ontogeny. Because we were interested in the function of the ribs as a storage and control mechanism for bone tissue, we sampled the part of the ribs that we considered to be the least likely to be under strong selection for other functions, such as breathing and locomotion. Bowhead ribs have a prominent rugose area for attachment of epaxial muscles just distal to the costal facet, and we took a dorsal sample of the shaft of each rib 20 cm ventral to this area. We took a second slice of each rib 20 cm dorsal to the rib’s ventral (sternal) extremity. The ventral extremity of the rib is widened and grades into cartilage, and is possibly involved in the changes of the shape of the chest during breathing or diving.","title":"Severe Bone Loss as Part of the Life History Strategy of Bowhead Whales"}
{"_id":"21ab95db-adc7-88ff-2d30-0bfc6c060f31","text":"The aim of treatment is to establish joint movement with adequate mouth opening and to prevent recurrences. Though various techniques have been described, recurrence is a major problem in treating this condition.","title":"Interposition arthroplasty in post-traumatic temporomandibular joint ankylosis: A retrospective study"}
{"_id":"21b9e2a5-9a6d-5fe7-7a70-54df5304cbfc","text":"Digestion did not reduce the allergenic reactivity of blg to a clinically insignificant extent, PC inhibiting digestion and thereby protecting blg allergenic reactivity. SPT reactivity was reduced compared to blg immunoreactivity in in vitro tests.","title":"Effect of simulated gastro-duodenal digestion on the allergenic reactivity of beta-lactoglobulin"}
{"_id":"21bdd5c2-97e7-a0fa-7e0a-f5bc0f14e0aa","text":"At the study level there are several limitations that we anticipate. We expect the reported incidences of incomplete excisions to vary greatly from different studies. There are multiple reasons for this variation which may not be fully captured by our data collection; the size of lesions, seniority of surgeon and specific anatomical location are several factors which may affect the incomplete excision rate but are rarely reported in studies. Furthermore, the use of Mohs micrographic surgery by some operators such as dermatologists, may remove the most challenging and highest-risk tumours from their caseload which could reduce their incidence of incomplete excision.","title":"Global incidence of incomplete surgical excision in adult patients with non-melanoma skin cancer: study protocol for a systematic review and meta-analysis of observational studies"}
{"_id":"21c38ba5-1139-8001-4158-fd955b387083","text":"V to Y advancement flaps make less abdominal wall morbidity comparing VRAM flaps and the flap size is less bulky in comparison,. Although gracilis flaps may not be applicable to patients with larger pelvic defects.","title":"Inferior Part of Rectus Abdominis Muscle Flap Outcomes after Abdominoperineal Resection: A Case Series Pilot Study"}
{"_id":"21c8c462-7849-3be2-2ccb-0ab22ffffb4e","text":"The sample size of the present study was calculated for the minimum number of patients required for tramadol consumption to find a statistically significant difference in the results. However, there was insufficient power to analyze common adverse events related to nausea and vomiting, such as PONV and sedation scores with the current sample size.","title":"Comparing ultrasound-guided modified thoracoabdominal nerves block through perichondrial approach with oblique subcostal transversus abdominis plane block for patients undergoing laparoscopic cholecystectomy: a randomized, controlled trial"}
{"_id":"21ccd27b-f0c0-f750-e260-1c82c0971f39","text":"Neoadjuvant chemotherapy is a widely accepted treatment for breast cancer, and neoadjuvant chemotherapy and adjuvant therapy are equally effective options. The principal advantages include the possibility of conducting an in vivo evaluation of the sensitivity of the tumor to chemotherapy, the likelihood of reducing micrometastatic disease and the consequent need for a less extensive form of surgery with less morbidity 17.","title":"Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy"}
{"_id":"21de26e5-57e4-72fc-e6b6-ce8771064e21","text":"In our case, patient developed S. lugdunesis bacteremia associated with tricuspid valve IE and L5-S1 spondylodiscitis 5 weeks following a CT guided lumbar epidural injection. We think the likely explanation is that procedure was complicated by local spondylodiscitis which led to bacteremia and hematogenous spread to the tricuspid valve causing infective endocarditis. On the other hand, the tricuspid valve IE could be the primary nidus itself that caused metastatic infection to the spine and resulted in spondylodiscitis. Other possibility could be that patient had another nosocomial infection that is not related to the procedure and which led to bacteremia causing both tricuspid valve IE and spondylodiscitis. However, these possibilities are less likely as the site of the spondylodiscitis and myositis is the same site of the procedure. In addition, systemic emboli are usually caused by left-sided IE rather than right-sided IE which results in septic pulmonary emboli.","title":"Native tricuspid valve infective endocarditis with Staphylococcus lugdunesis: An unusual complication post spinal epidural injection – Case report and literature review"}
{"_id":"21e2c0d2-7b74-cd46-e17a-22d2e5086f3a","text":"Most of the children with basal ganglia ischaemic stroke recovered completely from facial paralysis, with the shortest recovery time being 1 week and the longest recovery time being 3 months. There was no significant difference in the recovery time regarding facial paralysis among the groups.","title":"Childhood ischaemic stroke in the basal ganglia can lead to fine motor and anxiety disorders: a retrospective analysis and follow-up of 109 cases"}
{"_id":"21e2cc32-a451-5872-0238-ef3fdf685811","text":"Our study found a very high proportion of loss to follow-up at one year following treatment of women for premalignant cervical lesions at Mbarara Regional Referral Hospital. Receiving thermocoagulation and failing to return for the review visit at six weeks were associated with loss to follow-up at one year.","title":"High Rate of Loss to Follow-Up Among Patients Undergoing Treatment for Premalignant Cervical Lesions at Mbarara Regional Referral Hospital, Southwestern Uganda: A Retrospective Cohort Study"}
{"_id":"21e3807b-0abe-1240-7f0a-243edd0ef3a1","text":"Urologists have also been involved in the reconstructive surgical care for FGM patients primarily in treating lower urinary tract symptoms associated with recurrent urinary tract infections and obstructive voiding patterns. Women with Type III FGM are at increased risk of recurrent urinary tract infections as well as urinary retention and incontinence.,","title":"The Role of Plastic Surgeons in Female Genital Mutilation Reconstructive Surgery"}
{"_id":"21e3b90e-ed9c-2f22-1c93-cc7f0682a5b4","text":"Inclusion of dimensions that are not within the constructs being graded was not considered a problem for most of the systems by most of us. Several people considered that it might be a problem for the USTFCPS and USPSTF systems. On the other hand, all of the systems were evaluated to be missing at least one important dimension by at least one person. The challenge of missing dimensions were considered less of a problem for the ACCP and ANHMRC systems. There was not agreement about any of the systems having a clear and simple approach to aggregating the dimensions, although this was considered to be less of a problem for the ACCP, SIGN and USTFCPS systems.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"21ea8ac7-cac9-bd88-55fb-db522ba7cd83","text":"Primary malignant melanomas arising from the central nervous system are rare entities. They pose difficulty with a definitive diagnosis owing to their nonspecific presentation and imaging findings. The correlation between immunohistochemical staining and imaging findings provides the most definitive method to diagnose primary intracranial malignant melanomas and differentiate them from other tumors. The mainstay of treatment includes surgery and combination therapy with radiotherapy, chemotherapy, and immunotherapy. However, there is still room for improvements in targeted therapies to provide more efficient treatments for primary cerebral melanomas.","title":"A Rare Case of Primary Intracerebral Malignant Melanoma"}
{"_id":"21eb1879-fd10-d0e8-59b6-2f902db6a1c7","text":"Care should be taken to avoid separating the skin flap and the pericranium beyond 10 mm above the orbital rim due to the risk of injury the neurovascular supply of the skin and pericranium. These are supplied by the superficial branches of the supra-orbital and supratrochlear nerves and the supra-orbital and supratrochlear arteries and its branches (superficial branches to the skin and deep branches to the flap). In order to avoid muscle atrophy, reduce postoperative pain and a produce a better aesthetic outcome we avoid elevating or cutting the temporalis muscles.","title":"Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note Técnica endoscópica endonasal utilizando duplo retalho para reconstrução de grandes defeitos da base anterior do crânio: nota técnica"}
{"_id":"21ef1844-ab9c-cfb5-c066-798d52319a68","text":"The duration of insertion of chest tube and postoperative pulmonary infection rate were lower than those in the control group. The reason was that the patients could act the respiratory function better under the good analgesic effect.","title":"The effect of ultrasound-guided intercostal nerve block on postoperative analgesia in thoracoscopic surgery: a randomized, double-blinded, clinical trial"}
{"_id":"21f563a1-ce15-4ca0-bf59-e5b47bce6429","text":"Use any investigational drugs or devices in the recent 30 days","title":"Efficacy and safety of GLucocorticoid injections into InfrapaTellar faT pad in patients with knee ostEoarthRitiS: protocol for the GLITTERS randomized controlled trial"}
{"_id":"21fee937-b442-952b-0d49-e9cff7a96528","text":"Detailed procedures: After covering the patient’s eyes and sterilizing the skin, practitioners will perform the intervention procedure. The injection needle with thread will be transversely inserted along the line downward from 1 cm above point 1 or 2 in the layer where the two target muscles are. The handle of the flat head acupuncture needle will be pushed to insert the thread in the target muscle after which the injection needle and the flat head acupuncture needle will be removed. Sterile cotton balls will be used to press local pinholes to prevent bleeding.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"2206d30c-2e8c-6841-c6a7-3bfe751dea66","text":"A careful strategy should be implemented in atrial fibrillation patients with left atrial appendage thrombus before elective cardioversion or ablative approach.","title":"Prevalence and Rate of Resolution of Left Atrial Thrombus in Patients with Non-Valvular Atrial Fibrillation: A Two-Center Retrospective Real-World Study"}
{"_id":"220a004a-03da-f580-f949-9badb1c6cf40","text":"Gender diversification of a physician workforce currently predominantly composed of men in the United States is an ongoing goal. While some progress has been made, with the number of women enrolling in US medical schools exceeding the number of men for the first time, women remain underrepresented in academic medicine.","title":"Women’s Representation in Leadership Positions in Academic Medical Oncology, Radiation Oncology, and Surgical Oncology Programs Women’s Representation in Leadership Positions in Academic Oncology Programs"}
{"_id":"220de0f6-d31e-aa77-c981-b12e9d649dfd","text":"One of the major issues emerging from the studies included in this review are the potential publication bias because smaller trials, like case reports and small clinical trials, showed some good results. This might suggest that the inclusion of these studies may have led to overestimation of the treatment effects.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"221418f6-8fee-092b-ab58-67831928e3ea","text":"It did not cause weakness of any muscle (either Extensor Hallucis Longus or Peronei) as it did not require reconstruction of muscle compartment as in open conventional technique. There was no ankle instability as we avoided distal 8 to 10 cm fibula, which is the minimal length of distal fibula required for ankle stability.6 Our patients did not have any complaints regarding body weight transmission on the affected limb as seen by other workers.7 By this technique, we could harvest maximum 20 cm length of fibula in an adult whose total length of fibula was 36 cm and minimum of 10 cm fibula in a child whose total length of fibula was 25 cm having minimal donor site morbidity with high satisfaction. Thus, this biological method appears to be an attractive proposition for harvesting of relatively longer fibular graft in different pathological conditions.","title":"Harvesting the free fibular graft: A modified approach"}
{"_id":"221c58cd-101d-639f-722d-83b53096a096","text":"Our study also showed CTC count could determine the degree of response to the treatment. In the current study, the patients receiving ADT plus cryosurgery had lower CTCs at 3 months and 1 year after treatment, and longer PFS than those receiving ADT alone. In comparison to the baseline, the number of CTCs at both 3 and 12 months was lower in the cryosurgery group, but not in the ADT alone group. Lower CTCs in the patients receiving ADT plus cryosurgery was evident in the subgroup analysis that included patients with low metastatic volume only, but not in the subgroup that included the patients with high metastatic volume. Such a finding is consistent with the survival benefit in patients with low metastatic volume only. These results suggested in the patients with low metastatic volume, those receiving ADT plus cryosurgery had lower CTCs and responded better to the treatment than those receiving ADT alone. No similar effect was found in the patients with high metastatic volume.","title":"Circulating tumor cells in patients undergoing androgen deprivation therapy with versus without cryosurgery for metastatic prostate cancer: a retrospective analysis"}
{"_id":"221c8287-1f59-3f35-857d-21d605c6efa2","text":"In this study, we aim to present our 14-year experience from two tertiary centers to identify the indications and complications of parotidectomy in patients under the age of 18 years in the Saudi population.","title":"Indications and Outcomes of Parotidectomy in Saudi Children: Experience From Two Tertiary Centers"}
{"_id":"221cee47-3599-4698-1338-ff45c4a38c88","text":"There is an ongoing call for leadership development in academic health care and medical students desire more training in this area. Although many schools offer combined MD\/MBA programs or leadership training in targeted areas, these programs do not often align with medical school leadership competencies and are limited in reaching a large number of students.","title":"Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy"}
{"_id":"221f32e9-72b6-e7c0-f8b0-624a3adeede4","text":"All responses to the sociodemographic questionnaire are shown in Figure 2.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"2223319c-e308-1e51-2aa4-8921b1f1a0aa","text":"This is also achieved with the placement of skin expanders on the forehead, an external nose can then be created with the use of the expanded forehead flap with local perinasal flaps and costochondral grafts.9 Surgical reconstruction of the external nose and inner cavities should consider factors such as the characteristics of nasal growth and psychological impact on the child. Reconstruction can be delayed at least until the preschool years, when facial development is nearly completed.10","title":"Congenital complete arhinia with alobar holoprosencephaly"}
{"_id":"2226a089-c8df-e826-93e0-1e6be91a82c1","text":"Usually procerus and corrugator muscles also require injection along with orbicularis muscle. One should be careful while injecting in the upper lid for fear of migration of toxin to the levator muscle which may lead to temporary ptosis. The recommended initial dose for type A toxin is 1.25-5 units per injection site. This dose may be increased if the response is not sufficient. The usual sites for injection are depicted in the Fig.1. Recovery of muscular function occurs in about three months time by axonal sprouting and formation of new neuromuscular junctions.","title":"Efficacy of botulinum toxin in benign essential Blepharospasm: Desirable & undesirable effects"}
{"_id":"222aa641-b98b-9e80-1b57-d2e526e34c65","text":"Retrospective data analysis of 136 patients treated for AE by either surgery or conservative treatment between 1971 and 2017 at the Department of Visceral Surgery and Medicine of the University Hospital Bern, Switzerland.","title":"Abstracts DGAV"}
{"_id":"222ab057-b794-d45f-1b22-d63e2b9662e8","text":"Microvascular free tissue transfer and standard pedicle flap transfer each have their strengths and weaknesses. With a strict comparison of perfusion, this data supports that free tissue transfer has an initial advantage within the first nine days after surgery. Defined in clinical terms, a free tissue transfer is less likely to have partial flap loss likely secondary to less kinking of the vessel with rotation and less external pressure due to tunneling yielding more degrees of freedom for flap inset in the free TRAM. In essence, this infers that free tissue transfer is useful in higher risk patients due to the initial reliability of blood supply and would provide more stable coverage for high risk wounds including exposed hardware or visceral structures.","title":"Comparative Perfusion Analysis of Free Muscle-Sparing Versus Pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps in Vivo in the Peri-Operative and Late Post-Operative Periods"}
{"_id":"222ed72c-0463-3157-cfc6-99f1e3fe4230","text":"The patient was started on low molecular weight heparin drip and evaluated by vascular surgery for thrombin injection the next day. Vascular surgery elected not to perform thrombin injection as pseudoaneurysm was found thrombosed in the vascular lab. The patient was started on apixaban for DVT for six months and instructed to wear a compression stocking and leg elevation to prevent stasis and complications of post-thrombotic syndrome. On follow-up evaluation one month later, the patient's symptoms had improved. The patient was recommended to continue apixaban and continue to follow up with the primary care provider.","title":"Iatrogenic Pseudoaneurysm: An Uncommon Cause of Deep Vein Thrombosis"}
{"_id":"222eeaee-0010-fd34-cef1-924feb6d9af9","text":"Nevertheless, several issues remain to be solved, including the oncological safety of arm lymph node preservation and the real effectiveness of reducing arm lymphedema. Although a correct axillary demarcation may preserve the axillary lymph nodes as much as possible in breast surgery, patients with higher BMI and increased axillary disease burden and axillary radiation may have higher risks of developing arm lymphedema. Further clinical studies are needed for developing an easy identification procedure to detect SLN location. This will eliminate the problem of false negativity in SLN mapping. Moreover, such information could be useful to reduce the morbidity of SLN biopsy procedure and to increase its reliability, representing an adjunct for practicing and shortening the learning curve required for a breast surgeon.","title":"New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery"}
{"_id":"2239e33d-db08-63bc-1306-1dc0d6141b36","text":"The nasal scaffold constructed by ear cartilage is also based on the nasal septum cartilage and maxillary nasal spine. A piece of the ear cartilage is folded cephalad and then stuck on the nasal septum, equivalent to the extended graft of the nasal septum and the support graft of the nasal columella. According to the hardness and length of the nasal septum cartilage, the ear cartilage stent can determine how much the ear cartilage overlaps with the nasal septum cartilage to extend the nasal septum and help shrink a short nose or nasal columella. It can also move back and forth to permit fixing onto the middle or posterior horn of the caudal margin of the nasal septum according to need, and reasonably raise the height of the nasal tip. The two auricular cartilages were folded in half and fixed on the caudal margin of the nasal septum to form two isolated \"tower\"-shaped cartilages. After suturing the two together, a cartilage scaffold resembling a triangle was formed. We use the prosthesis combined with ear cartilage transplantation instead of autologous tissue. The reason is that the amount of autologous ear cartilage taken out is not enough. If only autologous tissue is used, it is not enough to completely adjust the height of the nasal dorsum.","title":"A new technique for Asian nasal tip shaping: \"twin tower\" folding ear cartilage transplantation"}
{"_id":"223e45cd-d2ac-7c1d-7790-587be6acc0fb","text":"Does the active or inactive state of the fibroblast influence metastasis? In our experiments the TE skin model is only cultured for around two weeks—in some of these studies we wound the TE skin. It is likely that the fibroblasts are metabolically active in these models. This suggests an area for investigation—to deliberately introduce melanoma cells into TE skin environments with fibroblasts cultured to be either metabolically active or to be senescent to explore this further.","title":"Use of a Tissue Engineered Human Skin Model to Investigate the Effects of Wounding and of an Anti-Inflammatory on Melanoma Cell Invasion"}
{"_id":"2241796b-0ccb-5fe3-4176-bb6186edf197","text":"We believe that the combined injection of PRP and HA technique should be considered part of the therapeutic armamentarium used for perineal rejuvenation as well.","title":"Novel technique of vulvo-vaginal rejuvenation by lipofilling and injection of combined platelet-rich-plasma and hyaluronic acid: a case-report"}
{"_id":"22422b39-c2f1-b8ff-6a37-b97434885320","text":"The surgical procedures analyzed in the study were carried out by 23 surgeons familiar with EADV and EDF guidelines.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"224e6fb5-3ece-f815-e95c-2a3ad1c7f31d","text":"MMS is effective and should be considered for most skin cancers as described above. Previous studies evaluating the effect of MMS and the recommendations of the current NCCN guidelines for each skin cancer are summarized in Table 3.","title":"Evidence from Clinical Studies Related to Dermatologic Surgeries for Skin Cancer"}
{"_id":"22511c66-5ae2-3747-fd2c-469f78862c41","text":"We further found a significant association between hospital market concentration and increase in surgical market concentration, as more highly concentrated hospital markets were associated with an increase in both the number of surgeons per practice and in the surgical practice–level HHI. The Department of Justice considers a transaction that increases the market HHI by 0.01 in moderate or highly concentrated markets as possible for raising anticompetitive concerns and therefore warranting evaluation by the Federal Trade Commission. Therefore, our finding of a 10% increase in hospital market HHI associated with a 0.02 increase in surgical practice HHI is substantial from the standpoint of federal regulation on the horizontal integration of physician practices. Because we could not assess ownership of surgical practices by health systems, whether the observed increase in surgical practice market concentration was due to vertical integration of multiple practices into health systems or horizontal integration of multiple practices is unknown but warrants further study.","title":"Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US"}
{"_id":"2253bede-1084-3907-2dd8-e02e12663bcb","text":"The lesion was active (detectable by being rough when a ball ended probe is dragged across the surface) whilst the tooth was erupting and the area was caries prone by being sheltered by the gingivae but is now inactive (smooth when a ball ended probe is dragged across the surface). The patient's oral hygiene habits improved and the area around the gingivae has not undergone demineralisation indicating that during the last stages of eruption the biofilm was removed and cleaning has continued. The lesion shape follows the shape of the gingiva and the white area can be thought of as a scar from previous disease. Note this is an example of an incipient lesion that has not taken up dietary stains to form the arrested 'brown spot lesion'","title":"Contemporary operative caries management: consensus recommendations on minimally invasive caries removal"}
{"_id":"225499c5-afe1-8daa-7c58-836826badef5","text":"The main objective of the present study was to compare the upper lip frenulum reinsertion following frenectomies performed with the CO2 laser or with the Er,Cr:YSGG laser, especially because of the absence of publications on this subject and in the interest of the predictability of results obtained when using those techniques. We also compared bleeding and treatment time, wound healing and postoperative pain and swelling in frenectomies performed with both types of lasers.","title":"Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser"}
{"_id":"2256bf2d-3490-29b2-5682-ebafec41df03","text":"Presence of definite or probable DVT in the popliteal or femoral veins detected on a screening CDU scan which had not been suspected clinically before the scan (see below)","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"225cd046-68c3-fa2a-cc8d-7b8d4badea21","text":"One of factors associated with poor adherence in time of prophylaxis administration in our study is the administration of antibiotics by nurses on the ward at fixed clock rounds instead of adjusting this to the time before surgery, this is also the cause for inappropriate time documented in a study in a multicenter audit in Dutch hospitals [16]. The timely administration of first dose by anesthesia technician is also shared by American study which found that timely administration improves when antibiotic prophylaxis is given in the operation room [17].","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"225e8188-84e0-bade-07ed-35fe34bd035e","text":"With the arm in the proper position, the anterior border of the latissimus dorsi muscle can be easily palpated. This should approximate a line extending from the mid-axillary point down to a point between the anterior superior iliac spine and posterior superior iliac spine. The initial incision should be made at the inferior aspect of the anterior border of the latissimus dorsi muscle to prevent any inadvertent injury to the pedicle more superiorly. The inferior extent of the incision should be below the scapular tip and correlate with the length of the flap required to reach the primary defect. If a cutaneous skin paddle is harvested with the flap, careful skin paddle placement around the inferior aspect of the scapular tip is required to maximize the number of cutaneous perforators. After the initial incision, care is also taken not to shear the overlying subcutaneous tissue from the latissimus dorsi to preserve any musculocutaneous perforators.","title":"Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: contrasting shoulder morbidities across mysofascial flaps"}
{"_id":"226f58eb-afdd-1e9f-820e-1516ebc176e3","text":"Gap arthroplasty with intraoral distraction as a one-stage treatment and subsequent contouring surgery can be applied to correct ankylosis with moderate malocclusion and facial asymmetry.","title":"Simultaneous gap arthroplasty and intraoral distraction and secondary contouring surgery for unilateral temporomandibular joint ankylosis"}
{"_id":"226fabd6-7960-696e-6d01-dfae0422a0c3","text":"Objectives: Analysis of a single paediatric patient trajectory leading to the revelation of multiple members of his family suffering with MWS, description of evolving disease phenotype in patients from different generations. To stress an importance of disease awareness as well as interdisciplinary collaboration in detecting familiar conditions affecting both children and adults.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"2272bb1a-d719-9087-d367-d4ed685114b0","text":"There may be the rare occurrence in which the veins in both the second and third ICSs are inadequate. In this eventuality ETS anastomosis of the veins may be considered, although none of our cases required this option.","title":"Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification"}
{"_id":"2274c3ef-854c-4df0-54ae-a564427f8e38","text":"After performing the cutaneous incision, the lymph nodes and all the adipose tissue located in the lower anterior portion in relation to the axillary vein were removed from its entry into the thoracic wall up to the anterior edge of the latissimus dorsi muscle. The pectoralis minor muscle was preserved at the surgeon’s discretion. The thoracodorsal nerve and the long thoracic nerve were preserved.","title":"Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial"}
{"_id":"2277e848-ef41-1848-0c72-1c01bfe25d3b","text":"The purpose of this systematic review and meta-analysis was to examine the yield of surveillance imaging for patients with breast cancer who have undergone mastectomy with or without reconstruction in terms of overall cancer detection rate, clinically occult cancer detection rate, and interval cancer rate.","title":"Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer A Systematic Review and Meta-analysis Surveillance Imaging After Mastectomy for Patients With Breast Cancer"}
{"_id":"227b4770-27ad-e178-b6d8-1353bc67b5b0","text":"In contrast to local reactions, the signs and symptoms occurring in persons meeting the definition of a validated illness possibly indicative of a hypersensitivity reaction could generally not be definitively attributed to vaccination. We also did not identify any case of anaphylaxis that could be attributed to Td vaccine in this study. This is consistent with a prior study in the VSD of children up to 17 years of age who were vaccinated during 1991 through 1997, which identified no cases of anaphylaxis following 152,636 Td vaccinations [19].","title":"Frequency of medically attended adverse events following tetanus and diphtheria toxoid vaccine in adolescents and young adults: a Vaccine Safety Datalink study"}
{"_id":"227f18ef-11ed-6d63-65db-cdea5070a59a","text":"Systemic allergic reactions to grass pollen intradermal injections are a theoretical possibility. As a precaution, all participants in this trial will be observed after the first intradermal injection for one hour, and if there is no systemic reaction, for 30 minutes after subsequent injections (since the dose of allergen given does not increase at later visits). All injections will be given in a clinical area with resuscitation facilities in the presence of a physician. If a participant has a Grade 2 reaction (see above) they may continue in the study but the observation period will be increased to 1 hour after each subsequent injection. In the event of a further Grade 2 reaction, that participant will not be permitted to continue in the study. In the event of a participant experiencing a Grade 1 reaction, the clinical observation period for that individual will also be maintained at 1 hour after subsequent injections. In the event of a single Grade 3 or 4 reaction, that participant will not be permitted to continue in the study.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"2288d375-59aa-6752-981f-4b971d8ee7a9","text":"Through a transverse tear drop incision skin sparing mastectomy was completed. A subpectoral pocket was fashioned using the dual plane technique at the inferomedial aspect of pectoralis major muscle. This allowed expansion of the pocket at the level of the inframammary fold.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"228aa2e8-8632-7c3c-82e6-379dd390f9ca","text":"As many patients with cancer of the oesophagus\/GOJ where the SLNB method might be useful, will undergo neoadjuvant chemo-radiotherapy, it is important to better understand the effects of this treatment on the lymphatic drainage from the tumour and thereby the impact potential changes will have on the accuracy of a SLNB procedure.","title":"“Sentinel lymph node imaging with sequential SPECT\/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study”"}
{"_id":"228cd557-593d-2e6a-022b-a8d091b5c18d","text":"Skin bioprinting technology has huge potential to facilitate fabrication of physiologically-relevant tissue and enable better and more consistent functional outcomes in burn patients. The use of bioprinting for skin reconstruction following burns is promising, and bioprinting will enable accurate placement of all the different native skin cell types and precise and reproducible fabrication of constructs to replace injured or wounded skin. The use of 3D bioprinting for wound healing will facilitate faster wound closure, which is critical in the case of extensive burn injuries. Earlier intervention will reduce the potential for infections and contribute to faster healing, reduced scarring, and better cosmetic outcomes. This will also contribute to a reduction in the number of surgeries required and the length of stay in the hospital for patients. To facilitate successful clinical translation and use of bioprinting for wound reconstruction, the developed wound product should be simple and able to seamlessly integrate into the surgical workflow and operative process. Further advances in terms of development of standardized clinical grade 3D bioprinters and biocompatible bioinks will enable wider use of this technology in the clinic. Also, establishment of GMP-compliant cell manufacturing centers allied to medical facilities will facilitate wider adoption of this technology for wound reconstruction. This will also significantly aid in logistics and application of the technology. Overall, 3D bioprinting is a very transformative technology, and its use for wound reconstruction will lead to a paradigm shift in patient outcomes.","title":"Skin bioprinting: the future of burn wound reconstruction?"}
{"_id":"228dbc2d-8b46-b05e-fe53-142aa4cd3536","text":"We report the case of 79 year old gentlemen with a history of skin cancer involving the left ear who had radiation and surgical excision. He had presented with recurrent lymph node in the left upper neck. We treated him with radiation therapy concurrently with Cetuximab. He developed a skin rash over the face and neck area two weeks after starting Cetuximab, which however spared the previously irradiated area.","title":"Lack of Cetuximab induced skin toxicity in a previously irradiated field: case report and review of the literature"}
{"_id":"228f8547-fb56-68d2-1188-e9d116500994","text":"To conclude, the efficacy and safety of paravertebral block for operative treatment of unilateral breast tumors, excellent analgesia in early postoperative period, requirement of significantly lesser amount of postoperative analgesics, decreased incidence of PONV and negligible complications along with early ambulation and hospital discharge makes it an afferent block of choice for unilateral breast surgeries and is considered the gold standard, although increased induction time and chances of block failure are two drawbacks of this technique, although the latter can be overcome to some extent by using advance techniques such as ultrasound guidance.","title":"Use of Paravertebral Block as an Alternative to General Anesthesia for Breast Surgeries: A Randomized Control Study"}
{"_id":"22981c5c-2c62-7457-210a-7ecdcc523344","text":"After the rapid development of the relapsing tumor we had to create an even larger defect after to achieve complete tumour resection. Thus we were facing the demand for a larger soft tissue cover than after the first tumour resection. The favoring of the free latissimus dorsi muscle flap and its coverage with split thickness skin grafts was based on three advantages of this muscle flap: first all muscle flaps may solve defect problems even under extremely difficult local conditions by their vascularization. Secondly the large diameter of the vessels of the latissimus dorsi flap and its long, anatomically constant vascular pedicle promote safety of this operative procedure. Thirdly, the dimensions and thickness of this large, but flat free muscle flap can be nicely adapted to the convex surface of the skull. Covering the surface of the muscle flap with split thickness skin grafts leads to resistance against chronic mechanical stress and has a better aesthetic result. The particular problem in the presented case was to obtain a sufficient pedicle length, since the contralateral temporal artery was not available for anastomosis after the first tumour resection. Therefore, besides using the latissimus dorsi free flap with its long pedicle, it had to be combined with the preservation and use of the former radial flap vessels as new donor vessels. The concept of utilizing the vascular pedicle of a previous free flap while removing the rest of the flap is an interesting alternative to gain length and freedom of positioning a second required microvascular free flap. One disadvantage in the case of neoplasms involving the first flap might be an increased risk of local recurrence when preserving parts of the first pedicle. In the presented case, we tried to avoid this possibility by only preserving the proximal part of the pedicle.","title":"Unusual explosive growth of a squamous cell carcinoma of the scalp after electrical burn injury and subsequent coverage by sequential free flap vascular connection – a case report"}
{"_id":"229900dd-2d18-004b-161f-4cfd42acf085","text":"The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understand that his name and initial will not be published and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed.","title":"Optic Neuropathy following Botulinum Toxin Injection into the Medial Rectus Muscle for Diplopia"}
{"_id":"229f3779-6677-4160-5518-5ce96c3ee91c","text":"Symptomatic DVTs affecting the popliteal or femoral veins, which occur within 30 days of randomisation, will be counted in the primary endpoint. A symptomatic DVT is defined for the purposes of this trial as a DVT confirmed on investigation with associated clinical features including leg swelling, pain, obvious erythema or a proven pulmonary embolus. Sometimes these features may not be recognised prior to a positive screening CDU but if present the DVT should be reported as symptomatic. We will distinguish those DVTs which were identified primarily on a screening CDU from those which were diagnosed clinically and confirmed on subsequent investigation since the detection of the latter symptomatic DVTs is not blinded and hence prone to ascertainment bias. A secondary analysis excluding these symptomatic DVTs identified before any CDU will also be performed. Inevitably, some patients will not survive to have routine CDUs and many of these will not have a detailed autopsy to establish whether they had a DVT or PE prior to death. However, it is possible that there will be an imbalance in the number of such deaths between the treatment groups especially if IPC is very effective in reducing the risk of fatal PE. Therefore, we will firstly present the numbers Alive with no DVT, Alive with DVT, Dead without prior DVT, and Missing. We will carry out our analyses in two ways: comparing DVT with no DVT with dead and missing patients excluded; and comparing DVT + dead with no DVT + missing.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"229fdf5c-596e-f30c-6c7d-b8d032e19c50","text":"This patient was then referred to the Gynecological Oncology Group for further surveillance, and a new pelvic MRI was requested, three months after surgery. The exam did not show any signs of recurrence nor other abnormalities and patient was asymptomatic at this stage.","title":"Pelvic Desmoid Tumor: A Rare Case with Difficult Diagnosis and Treatment"}
{"_id":"22a3c429-8c62-4b2d-298f-82c3c5bbe162","text":"A systematic review of the clinical and histopathological features of COVID-19 vaccine-induced lichenoid eruptions as distilled from the prior literature and investigated in this case series supports the conclusion that a spectrum of features exists for each. The clinical variability within this spectrum has been discussed above and is summarized in Table 1. The spectrum of histopathologic features within the case series is discussed below.","title":"COVID-19 Vaccine-Induced Lichenoid Eruptions—Clinical and Histopathologic Spectrum in a Case Series of Fifteen Patients with Review of the Literature"}
{"_id":"22a666e6-effb-837d-0df2-83495402187b","text":"When performing aesthetic restoration of the nose, the reconstructive surgeon must take into account the concept of nasal aesthetic subunits. The nose is made of alternating concave and convex surfaces, or subunits, which are separated from one another by depressions and elevations of the surrounding nasal skin. When a large portion of a given subunit has been lost, replacing the entire subunit rather than simply patching the defect often produces a superior aesthetic result. This approach places the scars of flaps and grafts within the normal depressions and elevations of the nose where they are best camouflaged.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"22a6d78f-e47f-c0df-9c29-c5f079b54a7b","text":"Melanoma in a pregnant woman should be treated no differently to melanoma in a non-pregnant woman. Termination of a pregnancy may be considered if there is a pressing need to start radiotherapy or chemotherapy with traditional agents that will harm the fetus. HRT or oral contraceptives are not contraindicated in women who have had a melanoma. It is common to advise women to avoid pregnancy for two years after apparent successful treatment of a high-risk melanoma during pregnancy, in accordance with the risk of metastatic recurrence.","title":"Malignant Melanoma"}
{"_id":"22a7a0c0-a865-acfe-e432-b54e50375d8a","text":"One question that arises from this increase in mentorship is why did our points system not lead to increases in other categories of academic productivity as well? One likely explanation is that the barrier to entry for mentoring students is the lowest out of all the categories. Compared to the other endeavors, mentorship allows for schedule flexibility that is lacking in the others and represents a straightforward and guaranteed path to accruing points within the system. Furthermore, as in any behavior economic study, establishing causation can be difficult since it is nearly impossible to account for all of the changing dynamics in the environment. The statistically significant correlation found within this study along with the temporal relationship between establishing the points system and increase in mentorship activity over the next two years does suggest that the points system was at the least one factor that promoted mentorship. With the correlative data, we acknowledge that there is the possibility of post hoc ergo propter hoc fallacy.","title":"The Effect of a Points System on Incentivizing Academic Behaviors of Attending Ophthalmologists"}
{"_id":"22b375c1-d3d9-3175-679a-ceb9a69acf31","text":"The preliminary internal evaluation of the results of this study prompted major changes in our hospital’s clinical approach, with more conservative surgeries being performed and the elimination of ultrasonography, the findings of which would often cause patients to undergo radical lymphadenectomy in the absence of SLN biopsy results in the past.","title":"Survival and recurrence with or without axillary dissection in patients with invasive breast cancer and sentinel node metastasis"}
{"_id":"22c6a14e-7bb5-4493-ee68-d0bcc944b5b7","text":"To resolve these problems simultaneously, a combined serratus anterior and latissimus dorsi myocutaneous free flap was applied to cover the raw surface, to reinforce the abdominal wall and to fashion a new colostomy, as well as filling the pelvic cavity with a large muscle body with a long vascular pedicle. This is the optimal method for reconstructing severe abdominal wall defects associated with many complications.","title":"Combined serratus anterior and latissimus dorsi myocutaneous flap for obliteration of an irradiated pelvic exenteration defect and simultaneous site for colostomy revision"}
{"_id":"22ceee52-6bb4-ab6a-5515-7a0b859a406b","text":"Periodontal disease is characterized by the presence of gingival inflammation, periodontal pocket formation, loss of connective tissue attachment and alveolar bone around the affected tooth. Different modalities have been employed in the treatment and regeneration of periodontal defects which include the use of bone grafts, PRP and other growth factors.The purpose of this prospective, randomized controlled study was to compare the regenerative efficacy of PRP and bonegraft in intrabony periodontal defects.","title":"Effectiveness of Platelet Rich Plasma and Bone Graft in the Treatment of Intrabony Defects: A Clinico-radiographic Study"}
{"_id":"22d8b4b8-0be0-5ff3-426d-4f9c3970395a","text":"Little is known in this matter and future generations of plastic surgeons are growing. In order to improve this situation, we are developing strategies to improve speaking skills. Two different educational games are introduced in the Mexican Society of Plastic Aesthetic and Reconstructive Surgery. One of them is Pecha Kucha, that comes Japanese chit chat or the sound of conversation is a power point presentation style created in 2003 by architects Mark Dytham and Astrid Klein as a way to ensure brevity in the presentation of young designers. It follows certain rules as 20 slides in total or every slide in should last 20 seconds, in total 6 minutes with 40 seconds. Pecha Kucha has extended in different fields, now in plastic surgery training. The following paper presents the results of the survey done in the second edition of Pechakucha contest in plastic surgery residents’ members of the Mexican Society of Plastic Surgery.","title":"How to Improve Speaking Skills in Plastic Surgery Training? Survey in Residents Participants in Pecha Kucha Contest"}
{"_id":"22da1e97-85a2-eb0b-e8b6-c7228682a778","text":"Once the posterior extent of the pericranial flap is satisfactory, lateral incisions are made immediately above the superficial temporal lines and connected posteriorly. The pericranial flap is then elevated anteriorly from the skull all the way to the orbital rims, leaving the last 10 mm still attached to the skin (both skin an pericranium are elevated from the skull together beyond this point).","title":"Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note Técnica endoscópica endonasal utilizando duplo retalho para reconstrução de grandes defeitos da base anterior do crânio: nota técnica"}
{"_id":"22dc7cd6-5d78-540b-6312-b6e30314007a","text":"Results indicated the highest amounts of UV exposure were during sunny vacations and days off in the month of July. There were no significant differences in UV dosage for participants less than 20 years. However, there was a significant difference in the annual UV dose in teen years compared to childhood. There were also significant differences in exposure between females and males under 20 years of age with females receiving more UV exposure [17].","title":"Attitudes, Behaviors, and Risks of Sun Protection to Prevent Skin Cancer Amongst Children, Adolescents, and Adults"}
{"_id":"22ed2985-35d6-0e9f-e393-2bbf92b261bb","text":"On the first day of class, students are required to complete a questionnaire regarding the region of the world in which they are most interested. Students are divided into teams of 3-4 people according to their geographic region of interest. The teams typically choose one LMIC from that region, on which they will focus their assignments for the remainder of the course. Infrequently teams have chosen to focus on a population within a HIC that struggles with access to surgical care. Most assignments are designed to be completed in teams, but there are also individual assignments.","title":"Development of an Interactive Global Surgery Course for Interdisciplinary Learners"}
{"_id":"22eff088-7cef-e5be-6f11-bae4f5b4b6cc","text":"This was a cross sectional study that included three to six month old exclusively breastfed infants at the Aga Khan University Hospital, Nairobi.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"22f63fbe-4e45-6f47-c8db-22f1c2f1a151","text":"The increased cellular proliferation and angiogenesis and the detection of additional tumor-positive lymph node beyond positive-INs suggest the possible dissemination across the lymphatic pathways, even in case of detection of metastasis after SLNB of INs. The good prognosis of patients who underwent complete dissection of the lymphatic field beyond the metastatic IN can be explained by an early treatment of the lymphatic metastatic spread.","title":"Surgical management of tumor-positive interval node in melanoma patients An observational study"}
{"_id":"22fd804b-4fb7-a4b1-f222-4b8dcc371fc7","text":"Fixation of the fibula in fractures caused by axial compression which are treated by external fixation is not indicated. Anatomical reduction of the fibula does not allow fragment contact at the distal tibia metaphysis and has been associated with high incidence of delayed union or pseudarthrosis [18]. For open reduction and internal fixation of the fibula, one additional incision is required which may predispose to infection and at the same time reduction of the fibula itself may cause varus deformity. The stability of the ankle joint is not enhanced by fibula fixation because axial compression fractures are not accompanied by ligamentous damage [2]. If we reconsider that the major stabilizing element of the ankle joint is the deltoid ligament at the medial side [19], we can conclude that reduction and fixation of the fibula in such fractures has not a significant effect in the stability of the ankle joint.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"230e2ddb-dd01-6930-83a5-d3a2fadd7ed1","text":"Peripheral vascular disease may compromise long-term outcome. In a series of 120 patients with chronic OM, Hong et al identified peripheral vascular disease as the only significant risk factor for recurrence of OM. 23 A hand-held Doppler ultrasound is useful in the outpatient clinic. A CT angiogram or a Duplex ultrasound can indicate whether preoperative angioplasty may be required. Hahn et al reported their experience of microvascular reconstruction of the lower limb in patients with peripheral arterial occlusive disease and demonstrated no significant difference in the salvage rate (100%) when compared with the control (unobstructed, nonangioplastied) group (97.7%). They also found that preoperative angioplasty was not a significant predictor of increased complications or longer postoperative downtime. 26 However, only 8 of the 62 cases had OM.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"2314852e-fba7-50b8-25e8-2cb5b566ea8f","text":"All obtained data were statistically processed using a decision making tree and t test. The decision making tree is one of the data mining analysis techniques and is a method of predicting and classifying the target group to be researched into small groups based on decision making rules. As the analysis process is classified and expressed by a tree structure, it has the advantage that the analysis method can be easily understood and explained compared with analysis methods of discriminant analysis, regression analysis, or neural networks [14].","title":"Early diagnosis of jaw osteomyelitis by easy digitalized panoramic analysis"}
{"_id":"231d60ed-3635-0b02-4e1e-01d062b655ed","text":"A limitation of the current study was that preoperative imaging was not applied routinely to all patients with a suspicious lesion or to those who were being considered for biopsy. If there had been a sufficient number of preoperative images, these findings could have been compared with the endoscopic biopsy results. Under current conditions in Turkey, as there is a lengthy waiting time for an imaging appointment at our hospital, it is preferred to perform a biopsy in a short time to reduce the spread of the disease and provide diagnosis and treatment quickly, and, when suspicion of malignancy persists, to take repeated biopsies.","title":"The role of nasopharyngeal examination and biopsy in the diagnosis of malignant diseases O papel do exame clínico e da biópsia de nasofaringe no diagnóstico de doenças malignas"}
{"_id":"2325b2cc-eec4-8f28-a5ed-f49a78ff63e7","text":"The conduct of our study was approved by the ethics committee at the medical faculty of the university.","title":"A retrospective evaluation of 182 free flaps in extremity reconstruction and review of the literature Eine retrospektive Auswertung von 182 freien Lappen in Extremitätenrekonstruktion und eine Literaturübersicht"}
{"_id":"2328de8e-e6fb-6729-e89e-ed447f5ecac4","text":"From March 2012 to November 2013, 802 consecutive oncology patients who had received intravenous port implantation via the superior vena cava were enrolled in this study. The functional results and complications of different entry vessels were compared.","title":"Deltoid Branch of Thoracoacromial Vein A Safe Alternative Entry Vessel for Intravenous Port Implantation"}
{"_id":"232e4c67-b457-5726-b32c-d342f4a06f0d","text":"A high index of suspicion and careful examination of skin, particularly in the head and neck region including the scalp and mucous membranes, is required for patients with potential melanocytic abnormalities. Particular attention needs to be taken in those with a previous history of melanoma to check for recurrence.","title":"Neurotropic Melanoma: The Management of Localised Disease"}
{"_id":"232eac13-a584-c563-8507-6faeb5722170","text":"Increasing the duration of breastfeeding amongst women in South Africa is critical in order for the public health benefits of breastfeeding on child survival to be realised. There is an urgent need to develop and implement clear and consistent antenatal counselling messages to enable women to make appropriate infant feeding choices, especially for working women, together with early postnatal support to improve lactation techniques and prevent breast health problems.","title":"Early cessation of breastfeeding amongst women in South Africa: an area needing urgent attention to improve child health"}
{"_id":"23381277-d82f-423f-1a9a-0aa7f54a28e0","text":"The strategy that we advocate for the treatment of sternoclavicular joint osteomyelitis involves incision and debridement with or without negative pressure therapy for two to three weeks, followed by bone resection and pectoralis major muscle flap advancement.","title":"Treatment of Sternoclavicular Joint Osteomyelitis with Debridement and Delayed Resection with Muscle Flap Coverage Improves Outcomes"}
{"_id":"233e0d6c-990b-a531-9170-b0594b1c5b4d","text":"The number of subjects that presented at our Unit for the treatment of the Angle cl II condition is similar to that in other population studies.","title":"Service Profile of Orthognathic Surgery of a Medical School"}
{"_id":"23408a96-4f79-005f-51d2-f40ec43698bd","text":"Ischemic preconditioning of lower limb muscle tissue and pharmacological preconditioning with sevoflurane have an effect on tissue oxygenation in patients with lower limb occlusive arterial disease.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"2347cc5b-2a28-d85a-19a9-124b4ad2fc51","text":"Professional growth in the medical field is based on clinical skills and medical expertise, which can be incorporated by introducing a competency-based curriculum in medical schools. An established curriculum should include leadership and management as one of the component frameworks designed to build up health care professionals. The current recruitment policies regarding medical experts should also focus on leadership qualities so that newly inducted physicians can cope with the advanced queries of the health care system. All doctors should be well oriented in their professional as well as moral and ethical responsibilities.1 Maintaining and upgrading current knowledge about their respective disciplines are always placed as the priority. However, the dynamic involvement of professionals as leaders can also provide beneficial connections in the management of patients, thereby establishing a high quality of patient care. Medical management calls for a direction to be set that will inspire and motivate other health professionals. In general, more clinicians have taken on the role of healthcare management to close the growing gap between clinicians and administrators.2","title":"Medical Students’ perceptions and attitudes toward Medical Leadership and Management"}
{"_id":"23542892-2b08-e5c7-a8ec-35cf463a8855","text":"Histopathologic complete response was defined as the absence of tumor by punch biopsy.","title":"Sonidegib in Locally Advanced Basal Cell Carcinoma: A Monocentric Retrospective Experience and a Review of Published Real-Life Data"}
{"_id":"23576510-ff7a-b3db-edee-c22201392626","text":"The incidence of axillary node metastasis in SLNB and ALND specimens from patients undergoing operative treatment of a primary breast carcinoma was compared retrospectively.","title":"Is the sentinel lymph node biopsy more sensitive for the identification of positive lymph nodes in breast cancer than the axillary lymph node dissection?"}
{"_id":"235a950b-c491-5fe3-c657-dc19b8d23017","text":"One major objective of this population-based multicenter cohort study was to evaluate the prognostic significance of SLNB on survival and disease recurrence in different tumor stages of HNM patients. Additionally, further prognostic parameters were included in this study, aiming to stratify risk factors and indicating the individual necessity for adjuvant therapies.","title":"Head and neck melanoma: outcome and predictors in a population-based cohort study"}
{"_id":"235e56cb-412d-e5ce-8e72-f73c184d0550","text":"We are presenting the first reported case of failed pneumoperitoneum for laparoscopy in a patient who had undergone previous DIEP flap-based breast reconstruction. Recommendations for recognizing and addressing loss of abdominal wall distensibility in patients who have had breast reconstruction with abdominal wall tissue are discussed.","title":"Failed pneumoperitoneum for laparoscopic surgery following autologous Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction: a case report"}
{"_id":"236ff918-a8d1-d6cd-1f70-28827dc48548","text":"Cutaneous tuberculosis can present as either primary or secondary infection, or it can be associated with systemic tuberculosis. It can present with unusual clinical and histological features causing delay in diagnosis and treatment. Tuberculosis verrucosa cutis occurs as a single verrucous lesion over exposed areas of the body along with inflammatory borders and discharging sinus. Here, we are presenting a rare case of tuberculosis verrucosa cutis developing over a keloid. There is no report of such case in literature so far.","title":"Tuberculosis Verrucosa Cutis Developing Over A Keloid: A Rare Presentation"}
{"_id":"23779560-5e46-4244-382c-9f644cb72377","text":"DAP flaps are best performed under magnification. If a dominant perforator cannot be found, adipose tissue, which would contain some arterioles is preserved at the base to nourish the flap., It is important to leave a cuff of subcutaneous tissue around the perforator to preserve venous return. Division of the Cleland and Grayson ligaments will enhance the rotation of the propeller flaps.,, Innervated flaps can be performed by including a nerve branch supplying the flap or by dividing and coapting a nerve branch in the flap to a digital nerve stump though it is unclear whether this translates into improved sensation. Venous congestion is transient in most flaps and may take up to a week to resolve. Tight donor site closure should be avoided to prevent venous congestion. Donor sites wider than 1cm may be better covered with a skin graft or artificial dermis.","title":"Homodigital Pedicled Digital Artery Perforator flaps for fingertip reconstruction - a review of flap options"}
{"_id":"237c30fb-f0e7-2d14-07d5-4881eb2aabdc","text":"SPEN of the pancreas is a rare constituent amongst cystic pancreatic neoplasms with a definite predilection for younger females. Clinical suspicion of this tumour in an adolescent female with an upper abdominal mass devoid of exo- or endocrinopathy is paramount. Its indolent nature and its low metastatic potential make it a candidate for aggressive surgical resection, which results in very favourable disease-free survival and overall survival rates.","title":"Solid Pseudopapillary Epithelial Neoplasm of the Pancreas in the Paediatric Population: A Report of Two Cases"}
{"_id":"238b4846-7cb7-e24c-2388-5ed5f6c5a897","text":"Primary closure should not be forgotten especially in surgical defects with fewer stages and in non-aggressive histological subtypes in main anatomic sites where Mohs micrographic surgery is performed.","title":"Keep it simple. A ten-year experience in reconstructions after Mohs micrographic surgery"}
{"_id":"238d1a9d-5ec0-c26d-60e0-97fb91426d9c","text":"Thus, performing a fractionated PDT with ALA or reducing the light intensity and increasing irradiation time seems not successful in clinical PDT according to the present data.","title":"Effects of light fractionation and different fluence rates on photodynamic therapy with 5-aminolaevulinic acid in vivo"}
{"_id":"238d8368-672e-e769-c92b-01cb025032e3","text":"Inflammation at the wound site is also known to promote tumorigenesis and worsen recurrence rates. , , Wounds were therefore monitored for local recurrence over the course of 4 weeks using previously validated bioluminescence imaging techniques, and no significant difference in rates of recurrence were found for the treatment and control groups.","title":"Wound healing after excision of subcutaneous tumors treated with near‐infrared photoimmunotherapy"}
{"_id":"239ac543-1d2a-2dd1-81d9-7c17a9bb204e","text":"If a clinical improvement along with significant reduction in the use of medications is not observed after 1 year of therapy, the indication for AIT must be revaluated. It is therefore necessary to reassess the appropriateness of the selection of the allergic child and eventually the diagnosis of respiratory allergy. After the end of treatment, children should be checked at least once every year to verify the long-term effectiveness of AIT.","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"239e61b4-b7f7-cddc-7fcf-7d19a8e71ced","text":"Our study adds more real-world data to support the idea that oral antimicrobials can be highly efficacious in the treatment of musculoskeletal infections. We did not directly consider the differences in economic and quality of life measures between oral and IV therapy, but previous studies have noted decreased economic and quality of life burdens with oral therapy in comparison to IV therapy. We have no reason to believe the same would not be true for our study population.","title":"Excellent Outcomes With the Selective Use of Oral Antibiotic Therapy for Bone and Joint Infections: A Single-Center Experience"}
{"_id":"23b25cb0-0a8a-b54c-5781-dd57801a7b1f","text":"All the included trials also showed no significant difference in the number of patients needing additional analgesics or emergency analgesics, which proved that the analgesic effect of PVB and INB meets the needs of the majority of people.","title":"Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis"}
{"_id":"23c2bc4c-9282-9d45-7fac-c1d6068ff2bc","text":"First, I want to commend Per for highlighting a crucial statement he made in his JACMP Editorial in 2014 where he stated that medical physicists need to “become a more visible consultant and resource to health systems in safety assessments and QC program design, as well as becoming a competent manager of other technical employees.” While I do whole‐heartedly agree that safety assessment and QC program design are important for our profession to bring new value to our healthcare organizations, I believe that these skills are ones that medical physicists are intrinsically capable of learning, for they are skills that tend to be logistical and analytical in nature.","title":"MBA degree is needed for leadership roles in Medical Physics profession"}
{"_id":"23c60e72-fa60-3712-f5f8-29982b25836e","text":"These results indicate that BTX-A has a direct analgesic effect in patients with TN and can represent a therapeutic option for intractable cases.","title":"Botulinum toxin-type A: could it be an effective treatment option in intractable trigeminal neuralgia?"}
{"_id":"23c8a4a4-e719-5168-feca-694a33cf30bd","text":"Professional categories were widely viewed by men and women as playing a very dominant role in both appointment to health leadership positions and general career progression. Specifically, medical doctors were stated as being preferentially selected for leadership positions and having faster and clearer career progression pathways than other health workers. This sometimes resulted in tensions between medical doctors and other categories of health workers.","title":"‘Gender is not even a side issue…it’s a non-issue’: career trajectories and experiences from the perspective of male and female healthcare managers in Kenya"}
{"_id":"23ccd413-0150-d8d2-b575-eaf043c549f8","text":"A table of the schedule of study visits and specimen collections is provided in Table 1, and an overview of the timeline of the study interventions and assessments is provided in Table 2.","title":"Dietary supplementation with Bifidobacterium longum subsp. infantis (B. infantis) in healthy breastfed infants: study protocol for a randomised controlled trial"}
{"_id":"23d80e24-52ed-b4ff-8b5c-f3f5ec07be20","text":"Given the comorbidities of the patient population and the pathology encountered in extensive cranio-orbitofacial extirpations, complications and flap failures will certainly occur. With respect to the 3 CSF leaks encountered in our series, each case was for recurrent meningioma and required intradural resection. All were fixed successfully on the same admission with 2 of them requiring operative repair as mentioned above. In both cases that required a return trip to the operating room, the primary dural closure after the initial resection was accomplished with a DuraGen graft and not by vascularized fascia from the ALT flap. It is recommended that, when possible, primary dural closure with vascularized tissue should be accomplished.","title":"Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction"}
{"_id":"23da219d-ecc5-c5d8-dc4d-b9b53161652f","text":"Our results suggest that implementing ICU treatment with AAT may help critically ill patients recover from this stressful experience. Our findings indicate a new focus for study of its adjunctive therapeutic role in the care of critically ill especially with prolonged ICU stay.","title":"37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)"}
{"_id":"23db2527-bd0d-6fc8-9485-2c2305261969","text":"The increasing demand for cosmetic procedures in the orofacial area nowadays, results in a growing number of complications attributable to soft tissue fillers, including the development of foreign body granuloma. The purpose of this study is to present two additional cases of oral foreign body granulomas caused by liquid silicone and hyaluronic acid respectively and review the pertinent literature regarding the demographics, the clinical appearance, the histopathology and the treatment of these lesions.","title":"Oral foreign body granuloma to soft tissue fillers. Report of two cases and review of the literature"}
{"_id":"23dc9ae0-bf82-1e4d-cb35-861d6cb758d4","text":"Our proposed classification system provides a simple and clinically applicable algorithm to facilitate the choice between nerve resection or epineural dissection in patients undergoing limb-sparing surgery due to STS with sciatic nerve involvement. The significance of this classification lies in its potential to encourage a limited epineural dissection in eligible patients (type B) without compromising the oncological outcome or unnecessarily sacrificing the leg function. In addition, this classification may help establish limb-salvage surgery as the procedure of choice in patients requiring complete sciatic nerve resection (type A). The initial assessment of nerve involvement is radiological followed by an intraoperative confirmation. Hence, this classification may be used in the preoperative setting to inform and consent the patient on the expected procedure and its alternatives. It is essential to validate the proposed classification and to critically assess its applicability for different nerves separately, due to variations in their sensorimotor functions and in the degree of compensation following nerve resection.","title":"Limb-Salvage Surgery of Soft Tissue Sarcoma with Sciatic Nerve Involvement"}
{"_id":"23e7d577-62f4-707c-6050-978ed0abfc69","text":"These results for the identification of SLN by periareolar injection of a contrast agent as well as for that of CNB of such SLNs are of major interest and seem to be promising as constituting a less invasive method than SLNB for detection of SLN metastasis. The aim of our study was therefore to evaluate the feasibility of identification of SLNs by means of SNZ as well as the diagnostic accuracy of FNAC as a less invasive procedure than CNB for breast cancer patients with clinically negative axillary nodes. We hypothesized that, if the sensitivity of FNAC is found to be high enough, SLNB can be avoided for cases with negative FNAC.","title":"Identification of sentinel lymph nodes by contrast‐enhanced ultrasonography with Sonazoid in patients with breast cancer: a feasibility study in three hospitals"}
{"_id":"23e9e3af-f69e-6bc2-4321-80d30836ab8f","text":"In this analysis of a large cohort from a prospectively maintained population-based register, major medical but not major surgical POCs were more common in women aged 70 years or older than in those aged 50–69 years. Mastectomy significantly increased the risk of both major surgical and major medical POCs. Major medical and surgical POCs were associated with worse overall survival after mastectomy in women aged 80 years and older and those aged 50–69 years.","title":"Medical and surgical postoperative complications after breast conservation versus mastectomy in older women with breast cancer: Swedish population-based register study of 34 139 women"}
{"_id":"23ed9f78-a4c4-0bb0-ab78-ac5a6777e2c5","text":"Surgical antibiotic prophylaxis should be administered within 120 minutes prior to incision, when indicated according to the type of operation. Administration before 120 minutes or after incision is associated with a higher risk of surgical site infection. The exact optimal timing within this timeframe cannot be defined according to the available evidence but half-life and protein- binding of the antibiotic should be taken in to account, also according to the underlying conditions of the individual patient. The broadly accepted recommendation to administer AP within 60 minutes prior to incision could not be substantiated. However the evidence comes from studies with limited methodological quality and definitive randomized controlled trials are still needed. Future research should well describe and standardize aspects affecting the effect of timing. Also different pharmacokinetic properties should be taken in account. A protocol for a randomized control trial has been published earlier in 2015.[ We curiously await the results of this trial. No financial support has been received for this study.","title":"Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection A systematic review and meta-analysis"}
{"_id":"23ee34d7-dc9b-7c37-5c11-7e6f954b30bb","text":"In order to dissect contribution of each components to the clinical outcome of melanoma patients undergoing adoptive T cell therapy TILs from 142 patients enrolled in adoptive T cell therapy trials, 112 parental melanoma metastases and 15 melanoma cell lines derived from melanoma metastases were analyzed. Global transcriptome analysis of the tumors sample using gene expression array analysis, micro RNA profiling as well as genome wide single nucleotide polymorphism (SNP) association analysis of advanced melanoma patients who achieved CR and of those that progressed (NR) was performed. The results demonstrate that TILs that lead to complete tumor regression in patients share a gene signature distinctive of memory cells. Pathway enrichment analysis revealed down regulation of genes associated with differentiation as well as enhanced proliferation function in CR compared to NR patients. The data underscore the notion that these T cells are less differentiated but have enhanced proliferative phenotype consistent with recently published data [91]. These memory T cells which were designated memory stem T cells (TSCM cells) share the similarity of naïve phenotype comparing with effector T cells that have more proliferative properties and prolonged survival post adoptive transfer in preclinical model.","title":"Future perspectives in melanoma research. Meeting report from the “Melanoma Bridge. Napoli, December 2nd-4th 2012”"}
{"_id":"23f25c5a-3ceb-ef39-3eed-b820583c209c","text":"Method: We retrospectively analysed the costs of a consecutive series of sixty patient episodes treated at the Bone Infection Unit in Oxford from 2012 to 2015. Treatment involved excision of osteomyelitis with free tissue transfer for immediate soft tissue cover. We compared the costs of uncomplicated cases with those who returned to theatre and determined the profit \/ loss for the hospital from renumeration through the UK National Health Service Tariff Structure.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"23f303ae-648a-aecb-8443-3195edf67dec","text":"There are already numerous articles in the literature dealing with the lingual frenulum and its resolution, instead, although ULF is the most frequent type of frenulum and has the greatest impact on orthodontic treatments, there is little evidence about its surgical treatment. Herein, the purpose of this study is to review the surgical techniques that are currently available for the treatment of ULF, analyzing the advantages and disadvantages of each approach.","title":"Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review"}
{"_id":"23f989af-368d-57e2-4b1e-dd29fc012833","text":"The mother’s perspective of the different therapies for our patient’s condition was that she saw marked improvement in his wellbeing on starting orally administered phosphorus and vitamin D; he was no longer getting ill with recurrent respiratory tract infections, and she noted marked progress in development although minimal weight gain. She believed that this could in fact be a case of hypophosphatemic rickets due to changes in the laboratory parameters for alkaline phosphatase and serum phosphorus on follow up. However, she became doubtful when she saw other children treated for hypophosphatemic rickets at the endocrinology clinic with a good catch up in growth. In addition, she was worried that the marked abdominal distension in her child could be another disease. On starting a galactose-free diet, she was worried that her child would not survive without milk because it is the child’s mainstay food. She was surprised that there was weight gain after stopping the milk and was later convinced to maintain the therapy.","title":"Fanconi–Bickel syndrome in a Ugandan child – diagnostic challenges in resource-limited settings: a case report"}
{"_id":"24162c03-efc2-edf6-c61c-7933a96d0005","text":"Autologous fat grafting has now been extensively and successfully performed for more than two decades. Although most adipose grafts and adipose-derived MSC therapies are done with fresh tissue, cryopreservation of tissue allows for much greater flexibility of use. Over the course of five years, 194 cryopreserved adipose samples were thawed and then returned to the collecting physician for subsequent autologous applications. Samples were stored with a mean cryogenic storage time of 9.5 months, with some samples being stored as long as 44 months. The volumes of tissue stored varied from 12 cc to as large as 960 cc. Upon thawing, the volume of recovered whole adipose tissue averaged 67% of the original amount stored for all samples, while the samples that were stored for longer than one year averaged 71%. Recovery was not found to be a function of length of time in cryopreservation. No significant relationship was found between tissue recovery and patient age. While an average recovery of 67% of volume frozen indicates that the use of banked and thawed tissue requires a larger amount of sample to be taken from the patient initially, an experienced clinician easily accomplishes this requirement. As cryopreservation of adipose tissue becomes more commonplace, physicians will find it helpful to know the amount and quality of tissue that will be available after thawing procedures.","title":"Long-Term Biobanking of Intact Tissue from Lipoaspirate"}
{"_id":"241d79dd-4796-80ea-3425-d0260a7da3a8","text":"Complications included fractures at the site of inflammation in 2 patients. Both had a pathological fracture of a vertebral body at diagnosis. Another patient suffered from scoliosis due to wedging of a vertebral body, furthermore 1 patient had severe hyperostotic bone lesions and yet another one had bone length difference following surgical intervention.","title":"Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study"}
{"_id":"242856ad-741a-0e3d-9872-b45d38773c5d","text":"A summary of these studies and their findings can be seen in Table 1.","title":"Evidence for treatment of muscular vein thrombosis in orthopaedic patients"}
{"_id":"242b2d73-6693-8403-ba05-0d81ef6f2e65","text":"Any change in the protocol from the primary protocol that is approved by the Swedish Ethical Review Authority must be resubmitted for ethical approval and reported to relevant parties such as trial participants and trial registries.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"242e20d2-464d-de55-918a-8277d4a67b7b","text":"While further studies are needed to better understand the influence that dosage and timing that radiation has on vessel damage, there is a clear and statistically significant risk for total or partial flap failure as a result of previous irradiation [11].While our patient did not appear to have gross intimal changes of her donor anterior tibial artery, it is possible that microscopic histological changes and proinflammatory chemical changes contributed to flow compromise.","title":"Late lower extremity free flap vascular compromise and salvage in a Pediatric patient diagnosed with monophasic synovial sarcoma"}
{"_id":"2433a183-6416-8338-8f04-ed2d6636ec6d","text":"This study showed that breast cancer survivors have 30%‐40% less of their breast cancers discovered by mammography screening compared to women without previous breast cancer diagnoses. The lower sensitivity does not seem to be due to different behavior among breast cancer survivors, but some of it can probably be explained by cancers being obscured by postoperative or irradiation scars. To achieve a reasonable sensitivity among breast cancer survivors a lower screening interval or other examinations should be investigated.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"2435ff29-2230-7d47-4783-00996790aee6","text":"Limitations of this study include single center and relatively sample size. Further studies need to be conducted with more centers involved large sample sizes to overcome this limitation. However, the study still has its own value since this is the initial experience of an advantage flap of autologous breast reconstruction, which yields better aesthetic results and reduces psychological distress as a treatment of choice for many breast cancer patients.","title":"Deep Inferior Epigastric Perforator Flap for Immediate Breast Reconstruction following Mastectomy in Breast Cancer Patients: An Initial Experience in Vietnam"}
{"_id":"24388809-5720-8b62-b4a7-537257aa6c74","text":"The patient was depressed due to the continuous pus flow in the fistulas and therefore the absence of dentures (due to the persistence of mandibular osteomyelitis) prevented him from continuing his university studies. After a multidisciplinary team of dentists and psychiatrists, the decision was made to perform a second surgery with antidepressant treatment.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"24423637-f909-b4cc-bcf1-023efb6a4529","text":"Simple algorithm for the reconstruction of nasal and auricular defects with exposed cartilage in Asians","title":"Single-stage acellular dermal matrix reconstruction of defects in the nose and ears with exposed cartilage: a prospective case series"}
{"_id":"2444c37a-4707-8eb0-eea1-208188f4c96f","text":"The literature concerned with the isolated effects of negative pressure suggested that adipocytes can be suctioned below 700 mm Hg without undue trauma. Any claims of syringe suctioning being safer than machine suctioning should be carefully examined [24]. While a standard liposuction machine can generate up to one atmosphere (760 mm Hg) of negative pressure, a 60 cc syringe connected to a manometer can also generate nearly one atmosphere of negative pressure. It seems that absolute pressure and not the source of this pressure is the key variable in adipocyte trauma. The use of low pressure suction by means of larger bore cannulas appears to increase adipocyte viability.","title":"Modern trends in lipomodeling"}
{"_id":"244f0336-11c8-6c98-c4be-a72f773c6a1c","text":"With a variety of fillers flooding the market and with the aging of baby boomers aspiring to retain their youthfulness, careful selection of the patient, the dermal filler, and the technique can maximise patient satisfaction and lead to a successful outcome","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"24571627-9386-e4f8-280f-7982f7a825c8","text":"In 1998, a World health Organization study randomized 240 patients with truncal melanoma of 1.5 mm or more in thickness to ELND or nodal observation in order to evaluate the efficacy of immediate node dissection in patients without clinical evidence of regional node and distant metastasis. It was concluded that node dissection increased survival in patients with node metastases only [21].","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"245d9e2d-4429-e24f-feef-25fee777ec00","text":"Our results showed that majority of pediatric rheumatologists manage fewer than five patients with CNO per year. Similar to the prevalence of other pediatric rheumatic diseases such as systemic lupus erythematosus and juvenile dermatomyositis, CNO is uncommon and will need a collaborative effort across centers for future prospective clinical studies.","title":"Physicians' Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis"}
{"_id":"2461ed7d-c509-e72d-c531-136634702165","text":"All patients underwent preoperative computed tomography-assisted angiography and venography to assess the vascular condition of the recipient site and donor site of the ALTP flap. Preoperative mapping of the perforators in anterolateral thigh region was also performed using a hand-held Doppler. After drawing a line between the anterior superior iliac spine and the upper lateral border of the patella, we attempted to mark almost all perforators around this axis. Both orthopedic and plastic surgeons performed the surgical procedure simultaneously.","title":"The turbocharged wide anterolateral thigh perforator flap to reconstruct massive soft tissue defects in traumatized lower extremities: A case series"}
{"_id":"2467fddd-d368-87be-b104-c6c5bace121a","text":"A recent randomised controlled trial by Finnerty et al reported that ESP block provided superior quality of recovery at 24 hours postoperatively, reduced morbidity, and better analgesia after minimally invasive thoracic surgery compared to SAP block. The contrasting results as compared to our results can be explained by the different surgical populations studied. The acute pain after MRM is determined mainly by the somatic aspect, whereas, post-thoracotomy pain includes somatic and visceral components along with shoulder pain. The local anaesthetic administered in ESP block potentially spreads to the thoracic paravertebral space and provides better pain control than the SAP block in thoracic surgery.","title":"Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block Versus Erector Spinae Plane Block for Postoperative Analgesia After Modified Radical Mastectomy: A Randomised Controlled Trial"}
{"_id":"2471156e-f628-c227-b54d-c5ffe7cee91a","text":"Kieran Joyce and Daisuke Sakai contributed equally to the concept of the paper and writing of the article. Abhay Pandit provided substantial contributions to review format, revising the article critically and final approval. All Authors have read and approved the final submitted article.","title":"Preclinical models of vertebral osteomyelitis and associated infections: Current models and recommendations for study design"}
{"_id":"24730a5c-65ff-3a2a-8d7b-32f4168b2c53","text":"Few conditions result in most cases of thumb pain; however, it is important to consider less common disease processes when initial treatment fails. Though tumoral calcinosis may be suspected based on presentation alone, histological evidence of calcium phosphate deposition is required for diagnosis. In cases where synovial chondromatosis is also suspected, we believe that biopsy is essential to prevent inappropriate definitive treatment. Preservation of the joint capsule during lesion excision and early intervention of hand therapy are key to ensuring full functional return of digits.","title":"CASE REPORT Idiopathic Tumoral Calcinosis of the Nontraumatic Thumb"}
{"_id":"2478b96e-2c13-79d3-1456-a97d24ac035e","text":"The removal of the lymph node can begin after about 15 min from the injection, guided by finding the areas that have been dyed blue.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"2488de95-258c-846f-3783-99ab5ca03baa","text":"DVT is a serious medical diagnosis. Patients who avoid progression to VTE and resultant PE may still suffer from a myriad of symptoms associated with post-thrombotic disorder. Prevention of this condition must remain at the forefront of clinical discussion as reactive treatment is not without consequences.","title":"Deep venous thrombosis in a 41-year-old female with May–Thurner syndrome following abdominoplasty and medial thigh lift"}
{"_id":"248cc5cc-93b8-8203-36bb-f866b2a58ea8","text":"The principle limitation of this study was that it was limited to a very specific type of cognitive distraction and stress that would only form one part of a larger number of possible theater distractions. With higher fidelity simulation models and simulation environments it would be possible to incorporate a larger and more varied number of distractions. Another limitation of this study is the sample size. A larger, multicenter cohort of participants may be needed to gain more statistically significant outcomes in the analysis of cognitive distraction and stress and their affect in microsurgery performance. The authors feel it is also relevant to highlight the marked improvement in TTC from baseline to intervention in the novice group from session one to session two. They have attributed this to task familiarity and consolidation of skills during the interval period between the first and second session. For the majority of novice participants, but not all, the first simulation session was their very first microsurgical training experience.","title":"Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance"}
{"_id":"248e255d-81da-b037-1fa5-af0f735ad467","text":"All patients were free of infectious symptoms before start of immunotherapy and were nil by mouth for at least 6 h.","title":"Anaphylactic reactions in the build-up phase of rush immunotherapy for bee venom allergy in pediatric patients: a single-center experience"}
{"_id":"248ec87d-6ddf-2e20-6d5d-6f93de6c6341","text":"Pyogenic spondylodiscitis is a form of spinal infection that can result in severe back pain and even death. However, information is lacking on the relative effectiveness of various therapies. A retrospective chart review was conducted to investigate whether early surgical treatment of pyogenic spondylodiscitis coupled with intravenous antibiotics results in better patient prognoses than intravenous antibiotics therapy alone.","title":"Early surgery with antibiotics treatment had better clinical outcomes than antibiotics treatment alone in patients with pyogenic spondylodiscitis: a retrospective cohort study"}
{"_id":"24968ef9-80ad-464c-15de-0fbfd9d66437","text":"The majority of sporadic BCC show mutations that initiate the sonic hedgehog pathway and cause uncontrolled cell proliferation. Being the main driver in BCC pathogenesis and progression, the Hedgehog pathway represents a critical therapeutic target. Vismodegib is the first selective Hedgehog inhibitor approved for the treatment of laBCC or mBCC in adults who cannot be treated with surgery or radiotherapy.","title":"Vismodegib for treatment of periocular basal cell carcinoma – 6-year experience from a tertiary cancer center"}
{"_id":"249c7178-5b7e-7c07-34d3-7dd1ae3c1ef5","text":"We believe that this occurrence is rare in modern clinical practice and although the risk is real, patients can probably be safely selected for this approach.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"24ab5e19-6d4b-2deb-ce50-1634a35c339e","text":"Patients included women with symptoms and women with screen-detected abnormalities who were scanned by one of two breast radiologists or an advanced radiography practitioner trained to perform breast ultrasonography. These practitioners had between 5 and 20 years of breast ultrasound experience and work purely in breast imaging. The SuperSonic Imagine applications specialist was present for a week at the beginning of the study for practitioner training. Only women with lesions subjected to percutaneous biopsy were included in the study (women younger than 25 years old with clinically and sonographically benign legions do not undergo biopsy at our institution). In accordance with the applicable National Research Ethics Service guidance, ethical approval for the study was not required [17]. Written informed consent to use images was obtained, however, according to routine practice in our institution. Greyscale and elastography images were obtained within the standard ultrasound appointment. The combined echographic and elastographic examination time was between 10 and 20 minutes. Acquisition of the elastographic images added 3 to 5 minutes to the appointment time. The elasticity measurements were obtained by reviewing the images at a later time to ensure that the elastography examination did not interfere with clinic work flows.","title":"Quantitative shear wave ultrasound elastography: initial experience in solid breast masses"}
{"_id":"24ad26ee-a0e3-7616-3304-98327d85d5b0","text":"In addition, each patient undergoing the procedure was retrospectively surveyed and asked to comment on any scar, complication and if they would favour the procedure in the future. Those that had had a prior surgical biopsy were asked to state a preference too.","title":"Ultrasound-guided muscle biopsy: a practical alternative for investigation of myopathy"}
{"_id":"24afbdfa-b105-4d61-fff1-ec282cde809e","text":"Topical pharmacotherapy usually comes in the form of 5-fluorouracil and imiquimod creams. 5-fluorouracil and imiquimod disrupt the proliferation of neoplastic cells by inhibiting nucleic acid synthesis and activating the immune system to remove the malignancy, respectively.8 These medications are applied by the patient multiple times a day over a period of 2−3 months.35,44–46 The outcomes of topical pharmacotherapy are heavily dependent on patient compliance but exhibit cure rates ranging from 85%−90%.8,44–46 Common side effects of pain, erythema, and severe pruritis, along with the high associated cost of both medications, may result in poor patient compliance or premature cessation of treatment.","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"24aff907-2e1e-754a-226b-59d7b49e79c2","text":"This study is limited by several factors inherent in all retrospective reviews. Although the standard and dose escalated groups were well balanced in regards to most known factors, confounding factors may have influenced the total dose selection. In addition, only 159 total patients were reviewed. While this represents that largest study of its kind, this number may not allow the current study to detect small differences in the outcomes measured. Further, the difference in total dose between the two schedules is not profound. These results must be considered hypothesis generating; however given the unlikelihood of a randomized trial in this setting the high rates of local failure among patients with gross residual disease at the time of radiation certainly demonstrate room for improvement in treatment approach.","title":"Radiation dose escalation for loco-regional recurrence of breast cancer after mastectomy"}
{"_id":"24b4936f-dae6-b3d0-5911-abb1132ceb59","text":"Only patients over 18 years of age with BCC or SCC were included. Exclusion criteria for cases and controls included history of treatment with immunosuppressive drugs, having received an organ transplant or taking vitamin supplements in any form. We also excluded subjects with non-malignant lesions or other types of skin cancer or if we identified the coexistence of BCC or SCC.","title":"Vitamin D serum levels and non-melanoma skin cancer risk"}
{"_id":"24b9c36b-3694-c91c-865f-e277e1bf7b2b","text":"From the initial 78 citations identified through the database searches, four articles were retained for data abstraction after both relevance screenings were performed. Two studies were retrospective observational studies, one was a prospective case series and one was a prospective clinical trial. Assessment of the quality level of the body of evidence identified using the GRADE system was low. Excision of MCT at 2 cm and 3 cm was associated with comparably low rates of incomplete excision and recurrence.","title":"A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs"}
{"_id":"24bd28a5-991c-d861-8fa0-5fc44fb6430b","text":"Cartilage shaving does have the valuable advantage of being injected through skin or mucosa after redraping the skin flap in cases of primary and secondary rhinoplasty, which enables the surgeon to correct the deformity incrementally and to the desired extent with precise evaluation of the surface changes. It can be also used without the need to elevate the skin flap and establishment of general anesthesia, as an outpatient procedure. In the latter situation, local and topical anesthesia can be used to harvest the conchal cartilage and also to inject the prepared cartilage shaving into the limited area of the nasal surface deformity.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"24bdd007-51c8-966d-ccb4-5b472cdb78fb","text":"Syndesmotic stabilization commonly consists of one or two quadricortical screws or flexible suture devices made of ultra-high molecular weight polyethylene. Flexible suture devices have the advantage of allowing some degree of anatomic motion of the tibiofibular joint to reproduce more anatomic ankle joint biomechanics during gait. On the other hand, quadricortical screws may be stronger against resisting valgus forces on the fibula than sutures. Studies have shown little harm in anatomically placed syndesmotic screws in adults in the trauma setting, with their main downside being their reduction in talar rotation and translation in the ankle joint [10]. Syndesmotic fusion has the advantage of adding even greater resistance to translational forces in cases where syndesmotic screws can fail due to high stress, with the disadvantage of creating more rigid and constricting ankle joint kinematics.","title":"Donor-Site Complication of Severe Valgus Ankle Deformity in an Adult With Ehlers-Danlos Syndrome Following Free Vascularized Fibular Grafting"}
{"_id":"24c2d13a-79ba-fbad-4674-8c18b1a517eb","text":"A sample of 264 Chinese mastectomized women presenting to our outpatient clinics for a reconstructive consultation were consecutively enrolled from June 2012 to January 2014. Women were eligible if they were 18 years of age or older, had been treated with either a unilateral or bilateral mastectomy after diagnosis of BC, were not under adjuvant therapy or experiencing a recurrence, and had no other severe basic diseases. Exclusion criteria comprised development of malignancy in the contra-lateral breast, or the presence of distant metastases, or the occurrence of other major life changes at the time of survey which might affect psychosocial well-being.","title":"Psychosocial Predictors and Outcomes of Delayed Breast Reconstruction in Mastectomized Women in Mainland China: An Observational Study"}
{"_id":"24c375dd-d82a-973c-3ec6-98721e66c2f8","text":"In case of breast implants with a textured shell surface the producer employs a patented manufacturing process to make a specific textured surface so that all commercialized textured shells are structurally different.","title":"Determinants of surgeon choice in cases of suspected implant rupture following mastectomy or aesthetic breast surgery Clinical implications"}
{"_id":"24cbf634-841b-3213-e1ab-b70eceec5cd2","text":"The onset of pain reduction with BTA is established in a delayed manner after its administration, which in our study, was significant after 7 days, especially in patients with a localized pain pattern, probably due to the analgesic effect of the toxin that accumulates gradually, reaching a peak of effectiveness after a week of continuous muscle relaxation. Similar to the more common conservative treatment modalities, the analgesic effect of BTA appears after a period of continuous and sustained relaxation of pain generated by fatigued muscle fibers. The effect of BTA on MMPS lasts for at least 6 months in duly selected cases, since in our study, most patients in the BTA group reported at the last check-up that they had not reverted to pain levels experienced prior to the administration of BTA.","title":"Treatment of Localized and Referred Masticatory Myofascial Pain with Botulinum Toxin Injection"}
{"_id":"24d21a09-2cc2-b19b-82d7-cb3e44e78129","text":"It is possible to evaluate the lymph node status in patients’ cSCC by SLNB. Due to the frequent localization of these tumors at the head and face area with a complex lymphatic situation as well as possible changes of the lymph drainage caused by previous surgeries, the detectability of the sentinel lymph node is limited. The proportion of false-negative sentinel lymph nodes was high in the present study; only one patient with lymph node metastases in the course of the study already showed metastasis of the sentinel lymph node. While in melanoma it could be shown that wide local excision with subsequent linear repair does not have any impact on subsequent SLNB, there are only few data available for defect closure with local flaps [11]. However, the influence of surgery on lymphatic drainage is unknown in cSCC.","title":"Sentinel lymph node biopsy for high-thickness cutaneous squamous cell carcinoma"}
{"_id":"24d5de26-c622-4072-ce68-9df45f48f0cb","text":"This patient is a 41 year old female that underwent a composite mandibulectomy with resection of the oral floor for squamous cell carcinoma. She was immediately reconstructed with free fibula osteocutaneous flap for her mandibular and oral floor defect. The free fibula flap was harvested from her right leg preserving 6 cm of fibula proximally and distally for knee and ankle stability. A large, 14 × 18 cm skin paddle was harvested along with the fibula flap to reconstruct the floor of her mouth, the defect of which was extensive. The entire skin paddle survived and she went on to achieve bony union of both sides of the fibula graft and the single osteotomy. Fixation of the fibula to the mandible was performed using a Stryker Locking Reconstruction Plate from the right mandibular ramus to the left angle of the mandible. The vascular microanastomosis between the Peroneal artery and vein of the fibular flap was achieved in an end-to-side manner with the External Carotid Artery and Internal Jugular Vein, respectively. Her initial postoperative course was uneventful. She eventually began eating well, speaking and breathing without difficulty and her feeding tube and tracheostomy were removed. She did however require postoperative radiotherapy to the mandible, oral floor, and neck.","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"24d6ce6f-0d4b-8893-bd65-cfcd66b6bc4d","text":"Forehead lifts or browlifts also are a large part of a facial plastic surgery practice. This procedure is relatively straightforward in terms of its classical approach where excess skin is resected and the forehead skin is repositioned superiorly. 31 The incisions are placed along a coronal line within the hair-bearing scalp if the frontal hairline is low. A hairline (trichial or trichophytic) incision is used in patients with a high hairline. 32 These two approaches are most commonly used in women. In men, a third option is the midbrowlift where an incision is made in a deep brow furrow, and a fusiform ellipse of skin is resected. 32 A direct browlift, where the incision is made at the upper margin of the eyebrows, is rarely performed. Both mid- and direct browlifts may leave a visible scar, and they are more commonly used for functional brow surgery in patients who have significant brow ptosis contributing to a mechanical visual field defect. The newest approach is endoscopic surgery where several small incisions are placed behind the hairline and an endoscope is used for visualization during elevation of the forehead skin. With the endoscope under the forehead flap, the surgeon releases soft tissue from the arcus marginalis and temporal line of fusion, allowing redraping and fixation of the skin more cephalically. 33 34 The results are less dramatic, but it is an outstanding approach in the younger patient who seeks more natural and less-defined changes.","title":"Overview of Facial Plastic Surgery and Current Developments"}
{"_id":"24dd0846-3099-46eb-fb22-99645b13b9ad","text":"The Faculty of Dental Surgery of the Royal College of Surgeons of England and British Dental Journal have teamed up to provide a regular series of short articles on different aspects of clinical and academic dentistry. This series will provide concise insight into a diverse range of topics with the aim of providing regular ongoing professional development for all members of the oral healthcare team. We begin here, with a short update on the Faculty and overview of the series' aims.","title":"Faculty clinical articles: a regular update for the oral healthcare team"}
{"_id":"24e024a2-6070-f2b0-e668-ed258685b734","text":"This study has highlighted that ankyloglossia could be related to maxillary arch constriction both in the anterior and posterior regions and constriction of arch in the mandibular anterior region. Ankyloglossia also affects the overbite and the mandibular plane angle. Hence, subjects with ankyloglossia can be considered for surgical correction before orthodontic treatment, as improper tongue function due to ankyloglossia can affect the facial growth and also the outcome of treatment [9].","title":"Skeletal and dental characteristics in subjects with ankyloglossia"}
{"_id":"24e1c5b1-578c-b972-cc83-f317cdbdc98f","text":"In view of the extremely complex and cost-intensive training of competent microsurgeons, these systems potentially offer the possibility of benefiting from the experience of older surgeons for a longer period of time, even in the case of declining physical fitness. This circumstance may also contribute to the cost-effectiveness of microsurgery in the future. Simplification of supermicrosurgical procedures may allow more surgeons to perform the challenging operation and make treatments available for more patients.","title":"Robotic-Assisted Microsurgery and Its Future in Plastic Surgery"}
{"_id":"24eafdc8-db76-fa7f-d4f0-54feb11e2518","text":"This report presents a first case that the carbon ion radiotherapy has been effective for the unresected desmoid tumor.","title":"Carbon ion radiotherapy for desmoid tumor of the abdominal wall: a case report"}
{"_id":"24eeeae0-4f82-2b77-ecfe-b141dd775733","text":"At present, the association between TFE3 expression and DTF development remains largely unknown. It is hypothesized that TFE3 may be a useful diagnostic marker for DTF, and thus we sought to assess the expression of TFE3 in 46 DTF cases via immunohistochemical approach. In addition, we compared the resultant TFE3 expression patterns with other tumor types to evaluate the specificity of this marker for DTF lesions.","title":"Nuclear TFE3 expression is a diagnostic marker for Desmoid-type fibromatosis"}
{"_id":"24ef3784-da29-628e-41a8-b8a083b85dfa","text":"All of the patients in our facility received one or two surgical site drains and compression stockings after inguinal LND. Drains were removed only when they produced less than 10 ml of lymphatic fluid per day. Patients were discharged from the hospital when wound stability with non-irritated wound condition without purulent discharge was achieved and they were able to manage their surgical site drains, in case the drains had to remain longer. Patients were routinely controlled following their hospital stay until wound stability was reached, and all drains were removed. Wound infections were treated with either antibiotics or surgical revision. As this study was carried out over a span of 10 consecutive years, the possibility that postoperative standards may have changed throughout the investigation period was considered.","title":"Morbidity and oncologic outcome after saphenous vein-sparing inguinal lymphadenectomy in melanoma patients"}
{"_id":"24f02a9c-7467-8325-5548-798ac57a2cd2","text":"5-fluorouracil and imiquimod disrupt the proliferation of neoplastic cells by inhibiting nucleic acid synthesis and activating the immune system to remove the malignancy, respectively.8","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"24f436b3-5956-45a2-686f-ec2bc9f80d91","text":"For our primary analysis all performed eFTR procedures in patients in whom the primary outcome (luminal local tumor recurrence rate after scar resection) can be assessed will be included. Thus patients in whom the procedure could not be performed for technical reasons or needing additional surgery due to the presence of high-risk features following completion eFTR will not be included for primary analysis.","title":"Long-term oncological outcomes of endoscopic full-thickness resection after previous incomplete resection of low-risk T1 CRC (LOCAL-study): study protocol of a national prospective cohort study"}
{"_id":"24f5641f-9e00-8524-4ee2-e88f9e886113","text":"This male patient was quite young though the peak incidence is considered between the 4th and 6th decade of life[1]. The presentation was due to the discomfort in maintaining the day today activities and foul odor it emitted. The lesion was a cutaneous outward growth and it attained considerable size in a short period of time and presented a difficult dilemma for the diagnosis.","title":"Giant gluteal lipoma-like liposarcoma: a case report"}
{"_id":"24fc7b16-60cd-dee5-9769-e7c2368ae89b","text":"This case highlights how the Wells score for assessing probability of DVT does not take into account many situations where a patient would be in a hypercoagulable state. Particular consideration should be given to the combination of air travel in combination with oral contraceptive use as a risk factor for VTE. The current NICE guidelines for diagnosing a DVT specifies that proximal ultrasound scans should be obtained, which fails to catch any distal DVT. Even a distal DVT can have severe, life-threatening complications and should be managed similarly to a proximal DVT. A repeat leg vein ultrasound should be performed after the initial scan to rule out any evolving clot if the D-dimer is positive.","title":"Missed Massive Pulmonary Embolism and the Hidden Threat of a Distal Deep Vein Thrombosis"}
{"_id":"25040f2b-6953-519a-2c68-d0ec80b9f69b","text":"From 2010 to 2017, a total of 19 patients with infected tibia non-union and a bone defect less than 3cm, were treated with debridement and a monolateral frame fixation with acute shortening and lengthening. The patients were divided into two groups: one in which no bone graft was used at the docking site during early years of the study; and a later group in which autologous bone graft was used at the acute docking site primarily in addition to compression. Consolidation at the docking site was assessed both radiographically and clinically, and the results were statistically analysed.","title":"Role of Primary Autologous Bone Graft at Docking Site in the Treatment of Infected Non-union Tibia Using Rail Fixation System"}
{"_id":"25047c12-86c2-0234-3ce5-472bf9ddb0f0","text":"Following the rewarming process, OCAs were collected for the cell metabolic activity test. The bone side of the OCA was first removed. The remaining articular cartilage specimens were then cut into small pieces and incubated in 2 ml of DMEM for one hour to equilibrate, followed by the addition of 10% alamarBlue (Thermo Fisher Scientific, Waltham, MA) under standard cell culture conditions for 3 h. The amount of fluorescence of each cartilage piece was measured in 12–24 duplicates by the multimode microplate reader at an excitation wavelength of 544 nm and an emission wavelength of 590 nm. As alamarBlue is not cytotoxic, cartilage specimens from the convection and nanowarming groups were cultured in the medium for 3 days, and the same fluorescence measurements were performed daily to allow the characterization of cell activity changes over time. After the final fluorescence was read, cartilage specimens were dried and weighed. The average fluorescence read of blank samples (only alamarBlue solution without cartilage specimens) was subtracted from the fluorescence read of each cartilage piece and then divided by the cartilage dry weight to yield relative fluorescent units per mg of dry tissue. Results from the convection and nanowarming groups were normalized to the results measured from fresh cartilage at day 0 to obtain percentages.","title":"Nanowarming and ice-free cryopreservation of large sized, intact porcine articular cartilage"}
{"_id":"2507d77c-858a-1fd1-6b81-cb0e0f0e5e63","text":"We conclude that SLN biopsy remains an investigational staging tool in clinically node-negative high-risk cutaneous squamous cell carcinoma patients. It is obvious that larger, prospective studies with longer follow-up times are needed to establish the efficacy of SLN biopsy and define the optimal treatment of occult nodal metastasis for high-risk cutaneous SCC. It is unlikely that a large randomized controlled trial can be accomplished considering the relative low incidence of high-risk SCC and long accrual period that would be required. An alternative approach would be to contribute and analyze large prospective databases to define the role and limitations of SLN biopsy in this unique subset of SCC patients. Meanwhile, it is incumbent upon treating physicians and teams to closely follow these high-risk patients at greater risk for recurrence whether they undergo SLN biopsy or not.","title":"Sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma: clinical experience and review of literature"}
{"_id":"250bd0a1-11a1-7a98-d448-ebbf33a749ef","text":"From the results in Table 3, it can be seen that for intervention resource use there was a statistically significant difference between arms in mean antibiotic and intravenous therapy duration. There were no statistically significant differences between arms in mean number of antibiotic prescriptions, number of inpatient admissions or inpatient duration. For resource use during the post-intervention period there was only a statistically significant difference between arms for intravenous therapy duration. This is mirrored at a total level where the only statistically significant difference between arms was for intravenous therapy; the mean total number of days for which intravenous therapy was received was 34.62 days longer in the intravenous arm. Table 4 presents the mean costs in both arms for unadjusted complete cases.","title":"Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial [version 4; peer review: 2 approved]"}
{"_id":"25107ccd-bfe6-9cbd-f53d-436ce7093dfc","text":"In recent years, there is an increasing tendency to use diced cartilage grafts in rhinoplasty surgery for improving dorsum contour irregularities. This study was designed to compare graft resorption between three techniques of diced cartilage using surgical blade, electrical grinder and grater in rabbit model.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"25153b4f-bab8-2372-93f9-10fea8432e08","text":"For each tracing technique, the SLN identification rate was equal to the number of successful mappings divided by the total number of mappings performed. The SLN metastasis rate was equal to the number of patients with SLN metastasis divided by the total number of patients undergoing SLNB. The SLNB sensitivity was calculated by dividing the number of patients with SLN metastasis by the total number of patients with axillary lymph node metastasis. FNR was equal to the number of patients with false-negative metastatic SLNs divided by the total number of patients with metastatic axillary lymph nodes. Since ALND was not routinely performed after SLNB according to the 2014 ASCO guidelines [17], the sensitivity and FNR of SLN mapping by various tracers could only be analyzed exploratively.","title":"Short-term and long-term outcomes of indocyanine green for sentinel lymph node biopsy in early-stage breast cancer"}
{"_id":"2515e010-c449-9176-55c1-0b6ae3532f66","text":"When there was no information about whether a practice was recommended or not, it was coded as “no recommendation made.” When a conflict in recommended practices was identified within the same document, the recommendation that most differed from the WHO guidance was coded and included for analysis. When guidance had different recommendations based on maternal symptoms, the recommendation for mothers who had the most severe symptoms but were still physically capable of infant care was coded. When conflicts between guidance from the same country or idiosyncratic recommendations were identified through the guidance collection process, they were noted. Recommendations for the washing of breasts were noted. References to guidance documents from other countries within the country guidance were recorded as were publication dates of guidance.","title":"First do no harm overlooked: Analysis of COVID-19 clinical guidance for maternal and newborn care from 101 countries shows breastfeeding widely undermined"}
{"_id":"25166cce-2249-4338-7205-b8307fc47b41","text":"Our study used systemic MR analyses and provided a comprehensive atlas for the associations between circulating metabolites and the risk of facial skin aging. Genetically proxied unsaturation degree of fatty acids was highlighted as a dominant factor correlated with the risk of facial skin aging.","title":"Relationships between circulating metabolites and facial skin aging: a Mendelian randomization study"}
{"_id":"25194e2c-6f93-9c03-93dd-af0f7677396c","text":"Image alterations identified in children with varicella-associated osteomyelitis overlap with those observed in other cases of bacterial osteomyelitis. Plainly pathological radiological aspects of cortical reaction and bone destruction are not usually identified in the first two weeks of symptoms, which is why a chest radiography at the time of hospital admission is the standard (as noted in the case reported here), but it should not therefore rule out the diagnosis of osteomyelitis, while it has the additional value of excluding a bone fracture or tumor.","title":"RIB OSTEOMYELITIS: A RARE COMPLICATION OF VARICELLA OSTEOMIELITE DE ARCO COSTAL: UMA COMPLICAÇÃO RARA DE VARICELA"}
{"_id":"252a06ae-733a-cced-d2ab-256283aedbe4","text":"Despite the wide variety of imaging modalities available, XR should be ordered first to assess malignancy status of a bone tumor. Patients with suspected malignant lesion should be referred to an oncology referral center based on their XR only to avoid management delay. The additional diagnostic information provided by advanced imaging studies, CT and MRI, is moderate and should not delay the medical care. The relevance of further imaging studies should be determined at a referral center before a biopsy is performed. This study should help clinicians to provide better care of patients in case of bone tumor suspicion.","title":"The appropriate and sequential value of standard radiograph, computed tomography and magnetic resonance imaging to characterize a bone tumor"}
{"_id":"253250cd-64d7-a4ea-9c31-3c44136c1897","text":"OSM allowed obtaining large quantities of graft material without the risk of warping due to inclusion of both peripheral and central portions of the rib cartilage.","title":"Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty"}
{"_id":"2532b7b2-4b1c-b1f3-56e5-a1b7b8452962","text":"A complete ultrasound screening examination of both lower extremities, including the calf veins, takes about 20 minutes for an experienced sonographer.74","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"253dbbf3-391f-f418-fabc-3f9bba1cfdb2","text":"With the ROE questionnaire we can quantify the result from the surgical treatment proposed, assessing quality of life, respiratory function and the cosmetic result desired by the patient submitted to rhinoplasty. It is also possible to assess the improvement or worsening of the patients' complaints by employing the questionnaire before and after surgery.","title":"Long-Term Evaluation in Aesthetic Rhinoplasty in an Academic Referral Center"}
{"_id":"254ca672-698e-a6a8-4c61-b53f6b5f5c05","text":"Skin, being one of the vital organs and a protective barrier needs to be pampered and taken care of from early childhood. It is the most visible and the widest exposed organ and by far reflects the general health condition and the aging process in humans. Both intrinsic and extrinsic factors contribute to this complex biological process of skin aging. In recent times, skin health and its beauty is perceived as an indicator of one’s health which has resulted in an increasing demand for anti-aging products. Exposure to UV radiation is considered to be one of the factors responsible for aging termed as photoaging. In this review, we have discussed the various factors which may accelerate the process of skin aging. Various approaches and strategies to delay the process of skin aging have been emphasized upon. The patents filed in the area of anti-aging and sunscreen products have also been reviewed to gain an insight into the new formulations which have been developed as an anti-aging product. There has been a tremendous rise in the cosmetic and cosmeceuticals market with products having a dual activity of anti-aging and sun protection. Research is constantly on the rise to ensure the safety of these products. Alternatives to the current topical application of sunscreen are being considered to overcome the drawback of reapplication of the sunscreen often which can be a boon to the cosmeceutical market.","title":"Anti-aging and Sunscreens: Paradigm Shift in Cosmetics"}
{"_id":"254ed746-8e9d-e45c-1264-21dc5bbd857f","text":"Photodynamic therapy can be offered as an alternative to surgery to patients with early stage oral cavity cancers, after a careful work-up. Patients who have tumors thinner than 5 mm and no detectable lymph node metastasis are good candidates. Patients who are prone to develop multiple malignancies in the oral cavity such as patients with extensive leukoplakia\/erithroplakia are especially good candidates, because of the tissue sparing properties of PDT. The advantages and disadvantages, as well as additional treatments that might be necessary should be extensively discussed with the patient by the physician. The patients should receive light protection measures training by a dedicated nurse. This is essential to prevent any light toxicity at outpatient settings.","title":"A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer"}
{"_id":"254f376a-db31-5f62-8231-f150d01e4f29","text":"In addition, participants were asked about referral protocols and problems encountered with referral of patients with cervical spine injuries to tertiary spine centres.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"2551f521-92fb-466b-07ab-5dd9b3ab9928","text":"A propeller flap can be defined as an island flap that reaches the recipient site through an axial rotation [40]. Every skin flap can become a propeller flap, but an island flap that reaches the recipient site through an advancement movement or those that move through a rotation and are not completely islanded are excluded from this definition.","title":"A review and critical appraisal of central axis flaps in axillary and elbow contractures"}
{"_id":"2553f7f7-dd64-5faf-9655-eb87c5d0e631","text":"The deep brachial artery is a reliable recipient artery for free-flap transfers in the posterior upper arm for sarcoma reconstruction. This study provides detailed anatomical information on the deep brachial artery and its clinical application in six patients who underwent immediate reconstruction using free-flap transfer. The results of this study showed that the deep brachial artery is a suitable recipient artery for free-flap transfers in the posterior upper arm, with good blood supply and minimal morbidity. Regarding the type of free flap, the SCIP flap may be the best match considering the diameter of its pedicle. This information can help surgeons plan and perform free-flap transfers with greater precision and improve outcomes for patients undergoing sarcoma resection.","title":"The Use of the Deep Brachial Artery as the Recipient Artery for Free Perforator Flap Transfer: An Anatomic Study and Clinical Applications"}
{"_id":"2562bb3a-0fa3-a7da-b13c-3b1870c7a6eb","text":"The UK iBRA study48 used mixed methods including a national practice questionnaire,49 50 a randomisation acceptability survey51 and semistructured interviews52 with key stakeholders to explore the most appropriate design for a future RCT. This work suggested that a well-designed trial would be feasible and that key areas of uncertainty included the use of biological versus synthetic mesh and prepectoral versus subpectoral implant positioning.51 Prepectoral techniques, however, only emerged during the iBRA study and have gained popularity since with two-thirds of survey respondents now offering the technique. Ongoing work in the Pre-BRA study, an IDEAL 2a\/2b study evaluating the safety and stability of prepectoral reconstruction prior to definitive evaluation suggests that the technique is safe and sufficiently stable for evaluation in a clinical trial.53","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"2562ef93-67d1-4e09-337a-485ebe02ce22","text":"We have described a series of African children with JDM. Whilst our series is small, and our conclusion may be limited by numbers as well as all the problems inherent in a cross sectional study, there have been several differences which are at odds with the literature. Whilst the heterogeneity of this disease extends across populations, differences in the disease course, response to therapy and outcome may be due to genetic and local environmental factors, and this may account for the observed differences, particularly high incidence of calcinosis in our study group.","title":"Juvenile dermatomyositis in South African children is characterised by frequent dystropic calcification: a cross sectional study"}
{"_id":"256c1089-eb1d-d714-6938-915dc4d4b753","text":"Free radical mechanism: To maintain equilibrium in our body there is a constant generation and removal of the free radicals. An imbalance in this process results in the formation of excessive free radicals which are toxic to the body and cause aging.","title":"Anti-aging and Sunscreens: Paradigm Shift in Cosmetics"}
{"_id":"256df2a3-18e4-f79b-879a-2f5aaf640220","text":"While surgical excision has superior clearance rates, PDT and topical pharmacotherapy have demonstrated superior cosmetic outcomes than surgical excision, making them attractive alternatives for malignancies of the head and neck.8,46 Additionally, these interventions may be used to treat the skin adjacent to the malignancy to prevent the development of future malignancies.47,48","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"257f4711-3bbb-0f1b-11d9-daab209d4691","text":"Evaluation of breast cancer in patients with autologous tissue or implant breast reconstruction has been described earlier in this manuscript. Postoperative changes are also known to hinder the evaluation of breast cancer recurrence at the lumpectomy site. Although there is little published data, MRI may be useful in evaluating for recurrent disease in patients in whom conventional imaging is confusing due to considerable postoperative scarring. While scar may enhance on MRI for 1–2 years following surgery, a negative MRI may be helpful in excluding recurrent disease. This may be more difficult when the postoperative scar is still enhancing. In general, a scar tends to present as a thin rim or cloud of enhancement around the cavity, whereas recurrent tumor tends to be more clumpy or mass-like.","title":"MRI for breast cancer: Current indications"}
{"_id":"258248f4-9e9a-b1bb-c0c1-b063511cb371","text":"In summary, the average ageing salience shown in the ARDA maps and the quantified ARDA can also be well explained by findings from studies related to craniomaxillofacial.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"258a7060-7315-612c-7bb4-61eb4be8c476","text":"During IPC, a decrease of leg muscle rSO2 during each clamping of the femoral artery and a comparable increase of leg muscle rSO2 during each reperfusion was observed in 22 of 40 patients.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"258a7cc4-c63b-20e8-8f1b-6853423157c4","text":"Fig 7 shows the 3D printed PSP placed on the 3D printed reconstruction model. The virtual surgical reconstruction plans of both cases are shown in Fig 8.","title":"Optimisation of three-dimensional lower jaw resection margin planning using a novel Black Bone magnetic resonance imaging protocol"}
{"_id":"258b2e6c-ee30-d425-e208-511c7bb77df5","text":"Injection site reactions are a common side effect of the extended release injection formulation.","title":"Developing a clinical decision support for opioid use disorders: a NIDA center for the clinical trials network working group report"}
{"_id":"259e3516-23b2-cf87-ffff-92d7f508a9c6","text":"Since anterior and posterior fusion techniques have been compared without presenting any superiority, the objective of this study is to compare stand-alone laminectomy with laminectomy and fusion to determine which treatment has the lowest frequency of reoperations.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"25a1ef5b-becc-4f95-9b1a-021298bd4919","text":"A total amount of 40 mL of lipoaspirate was harvested from the abdomen. Afterward, it was decanted 15 minutes and only the layer containing adipocytes was used for fat injection. The fat infiltration was performed using a blunt injection cannula of 2 mm in diameter. Perioral region was injected using many radiating passages at the subcutaneous level for a total of 16 mL. The cannula was inserted in 4 symmetric sites: 2 located just upon and 2 just below labial commissures. Antibiotics were given to all patients as a precautionary measure.","title":"Improvement of Mouth Functional Disability in Systemic Sclerosis Patients over One Year in a Trial of Fat Transplantation versus Adipose-Derived Stromal Cells"}
{"_id":"25a9f6e3-2c86-9664-c809-a8bce8844787","text":"Our findings complement the available data on systemic reactions with subcutaneous immunotherapy and provide further information about the rate and nature of reactions requiring epinephrine [19]. The recommendations in the CSACI Immunotherapy Manual provide an approach to standardizing prescriptions for SCIT to maximize immunotherapy efficacy and reduce the risk of systemic reactions. Taken together, these observations provide important objective information to clinicians about the potential risks for systemic reactions in patients considering SCIT.","title":"A single centre retrospective study of systemic reactions to subcutaneous immunotherapy"}
{"_id":"25af60c9-987e-4ca7-d5f6-06282887c7b2","text":"Tissue transplantation is an effective technique in modern medicine for the cosmetic and functional reconstruction of tissue defects. It is now possible to reconstruct tissue after resection for cancer in the breast and neck, or to reconstruct limbs and fingers after trauma or due to congenital diseases. Because of the increasing expectancy that therapy should improve patient quality of life, plastic reconstruction using free flaps is rapidly developing. Although very high success rates of 90–99% have been reported for procedures performed by experienced teams, vascular thrombosis remains a major complication of these transplants, mostly via venous thrombosis occurring within the first 48 hours after surgery. Therefore, early detection and timely salvage surgery to resolve vascular occlusion in the postoperative period are required to prevent tissue necrosis.","title":"Multipoint Tissue Circulation Monitoring with a Flexible Optical Probe"}
{"_id":"25af89e8-6d0c-617c-f978-49296a9ede83","text":"Though majority of our patients were HIV negative, our experience with patients who were HIV positive with low CD4 count was discouraging. In one such patient, one free flap was lost and one abandoned on the table after realizing poor recipient vessels with severe arteritis. A salvage pedicle flap had to be done. Those who do not get arterial or venous compromise are also more prone to wound sepsis, which can result in flap loss. Two of the three flaps lost due to sepsis were of patients who were HIV positive.","title":"Free Flaps in a Resource Constrained Environment: A Five-Year Experience—Outcomes and Lessons Learned"}
{"_id":"25b847c3-4872-aeb2-8a5a-96c137708e22","text":"This study was carried out as a retrospective case series analysis of lower limb reconstruction by FVFG after resection of the primary musculoskeletal tumor between January 2011 and January 2016 at Shifa International Hospital, Islamabad, Pakistan.","title":"Free Vascularized Fibular Graft Transfer in the Reconstruction of Defects for Premalignant and Malignant Musculoskeletal Conditions of the Femur in a Tertiary Care Setting in Pakistan: A Series of Six Cases"}
{"_id":"25c1a5d6-da9e-0558-c81d-b51a0bfa7e8f","text":"The contralateral based cervico-pectoral (CCP) flap is simple to perform and reproducible and can be added to the armamentarium for the reconstruction of large upper neck defect following resection of primary tumour or recurrence involving the cervical skin in resource limited setting and in contraindication for microvascular reconstruction. Proper planning, meticulous dissection and adequate release or rotation and tension free closure would provide best outcomes.","title":"The contralateral based Cervico-pectoral rotation flap for large neck defects"}
{"_id":"25c231f1-7364-24c1-72e2-773705b49503","text":"The final questionnaire item concerned whether the patient would accept or decline being examined by the use of POCUS if the patient once again had to be examined for possible disease. The questionnaire was filled out either by self-completion or by assistance from a study investigator to solely read up the questions. All questionnaires were filled out immediately after the sonographic examination. The questionnaire was solely developed for this study and was not based on any previously validated questionnaires. The questionnaire can be found in its original form (Danish) and an English version in the Additional file 1.","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"25d1b7af-5f37-ff15-8ba8-e716299ec5c3","text":"Nevertheless, the program represented a substantial international student networking and exchange program, and reflected a new and additional role that the anatomist and the anatomy course can play in GH and the IoME.","title":"An International Partnership of 12 Anatomy Departments – Improving Global Health through Internationalization of Medical Education"}
{"_id":"25d3b0f8-cb78-6f21-2d50-a4b2857e7a73","text":"The struggle with the intentions of mastering the situation leads to an increased belief in themselves and strengthens their motherhood.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"25d748d2-6705-d2a8-648b-a6eeb2df43c3","text":"Among the variety of more than 150 free flaps and pedicled flaps performed in our institution per year four representative clinical cases with different indications for a reconstructive procedure at varying anatomical locations were selected to highlight the status of ICG angiography.","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"25de6d95-9163-6078-6340-4d66334fdc42","text":"Advantages and disadvantages exist for both the remote and integrated port expanders. Remote port expanders confer the theoretical advantage of allowing the surgeon to select the site of injection in a place that is easily palpable and away from the tissue expander and the mastectomy flaps, thereby avoiding dependence on a magnet for port location and minimizing the risk of errant needle puncture in the case of thick overlying autologous flaps. Disadvantages include patient discomfort due to the port's location in the axillary region as well as the risks of mechanical complications (Table 5).","title":"Two-Stage Prosthetic Breast Reconstruction With Integrated Versus Remote Port Expanders: A Comparison of Complication Rates Choo et al"}
{"_id":"25e04161-7810-490b-ce9a-972c9fc27beb","text":"A questionnaire was completed by patients visiting the Allergology outpatient clinic. Patients with food allergy were included. Outcome measures were the frequency of medication use of medication groups that might act as cofactor and the frequency that physical exercise, alcohol consumption and use of analgesics are associated with more severe food allergic symptoms.","title":"Cofactors in allergic reactions to food: physical exercise and alcohol are the most important Versluis et al."}
{"_id":"25e57254-8679-184c-6268-c39ab28eae5e","text":"DIEP flap is a new but reliable and safe technique for autologous breast reconstruction. Though patients opting for breast reconstruction still have a low risk of complication and reconstruction failure, this procedure should be used more frequently in appropriate patients to improve their quality of life.","title":"Deep Inferior Epigastric Perforator Flap for Immediate Breast Reconstruction following Mastectomy in Breast Cancer Patients: An Initial Experience in Vietnam"}
{"_id":"25e676da-ee68-e5c8-a3a4-3a70411d53bb","text":"Chole and Faddis studied, under electron transmission microscopy, 24 human cholesteatomas and 22 cholesteatomas in Mongolian squirrels. In the human sample, 16 presented 541 histological findings consistent with biofilm bacteria, whereas the material from the animal study showed 21 evidences of bacteria. These findings could be related with the activity of cholesteatoma, especially in persistent or recurrent infections and with resistance of topical or systemic antimicrobials. The authors suggested that the cholesteatoma matrix is an ideal medium for the development of a mixed microbiological biofilm. The authors stated that even though the bacteria in the biofilm are resistant to antibiotics by different mechanisms used by plankton bacterial, the exact mechanism of resistance to bacteria colony in biofilm is still unknown.","title":"Some considerations about acquired adult and pediatric cholesteatomas"}
{"_id":"25ea28f5-0e93-1d72-a98b-c465c8fbe819","text":"The surgical beak with exposed bone was left open and after numerous unsuccessful medications, the patient came to our clinic at the end of October.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"25eced90-0456-229e-d574-d530326d958b","text":"Moreover, it would be interesting to study if the increased postgraduate training trend was exclusive to residency leadership or if there is an overall trend among all emergency physicians to pursue postgraduate training.","title":"Demographics and Fellowship Training of Residency Leadership in EM: A Descriptive Analysis"}
{"_id":"25f5a822-d81e-e98f-4c14-c13ce383f6b7","text":"The limitation of this study is the relatively low number of cases that have been undertaken. Due to the nature of trauma and emergency surgery, and the extreme variables associated with the patient demographics it may also be hard to clearly define which patients will benefit from the use of BTA in their management. Further comparison of the previous audit to this case series highlighted the degree of contamination and preceding ventral hernia as possible indicators; this was due to the number of relooks required and progressive closure of the large abdominal wall defects leading to prolonged open abdomen. Further cases would need to be compared to give a stronger picture of identifiable indicators.","title":"Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases"}
{"_id":"25f64159-1d3f-d86e-adac-8a60b87a815e","text":"This study was performed to provide guidelines for the management of the parotid gland in treating EAC carcinoma when there is no clinical evidence of parotid involvement. The rate of direct parotid gland invasion and parotid node metastasis in patients with squamous cell carcinoma (SCC) and adenoid cystic carcinoma (ACC) of the EAC was examined according to the postoperative tumor stage. The data include those from a previous report from our institute.","title":"Evidence Based Tailored Parotidectomy in Treating External Auditory Canal Carcinoma"}
{"_id":"25ff173a-6bba-96ec-099f-27647811c211","text":"The study reported in this paper aims to explore what is important to patients during and after LLR to develop and refine a conceptual framework, building on a QES to further develop a preliminary conceptual framework identifying what is important to patients [2].","title":"What is important to adults after lower limb reconstruction surgery: a conceptual framework"}
{"_id":"2602bc2c-3d11-5128-7880-05ec31a04941","text":"Our study suggests that a proportion of patients with unplanned retention of ACS appear to function well without necessarily requiring further surgical intervention.","title":"Antibiotic-impregnated cement spacer as definitive management for osteomyelitis"}
{"_id":"2605a703-7e92-b14c-a0be-1470807d3efe","text":"Provincial guidelines for rectal cancer management that include preoperative radiation and tme as the surgical technique for rectal cancer excision have resulted in surgical outcomes similar to those achieved by others using that protocol. Distal-third rectal location and locally advanced cancers had high rates of margin positivity. Provincial practice guidelines have been amended to specify that all patients with stage ii and iii distal-third rectal cancer be treated with preoperative downstaging chemoradiation. To improve surgical outcomes, improved locoregional therapy is urgently required for patients with distal-third rectal cancer.","title":"Predictors of positive radial margin status in a population-based cohort of patients with rectal cancer"}
{"_id":"260d1e64-541a-6bda-3a46-4db9b1bf6faf","text":"So the closed wound has become a scar that mainly lacks “dermal qualities” such as flexibility and strength. However, it is misleading to conclude that thicker split thickness skin grafts should be used to provide the best outcome in terms of scar formation because donor sites heal more problematic after harvesting thicker split thickness grafts. Certainly in extensively burned patients, where donor sites may have to be used several times, it is therefore advised to use thin split skin grafts because these donor sites will heal quickly and spontaneously.","title":"Tissue engineering in burn scar reconstruction"}
{"_id":"261f7e9a-e228-9d5d-5ea4-50f58646c7af","text":"Methods: A total of 148 patients, 91 EOD and 57 LOD, were recruited and underwent extended clinical assessment and caregiver interview that included questionnaires aimed at measuring anosognosia and neuropsychiatric symptoms. Differences in anosognosia between EOD and LOD and between subgroups with different clinical variants were investigated, as well as correlation between anosognosia and neuropsychiatric symptoms. A regression analysis was applied to explore the association between anosognosia and development of neuropsychiatric symptoms during disease progression.","title":"Anosognosia in Early- and Late-Onset Dementia and Its Association With Neuropsychiatric Symptoms"}
{"_id":"2627d6c5-104b-c998-3173-0df26badf259","text":"Although it would be difficult to realize because of the rarity of these tumours, the contribution of radiotherapy to the treatment of desmoid tumours can only be answered by a prospective randomised clinical trial in a defined patient group, especially as modern three-dimensional radiotherapy treatment planning and the use of functional imaging may give a better indication of the incidence of recurrences and side effects.","title":"The impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients. A study of the Rare Cancer Network"}
{"_id":"262863c0-d087-9de3-83bc-b32cd77074d3","text":"We concluded that the increase in skin thickness at 5 weeks of radiotherapy was significantly greater in patients with severe skin reactions than milder skin reactions. In other words, we can predict the severity of acute radiation dermatitis by measuring the changes of breast skin thickness at 5 weeks of radiotherapy. Similar to our conclusions, Christopher [25] concluded that skin thickness measured by ultrasound at Week 5 was of greater significance in predicting parenchymal edema 12 months after radiation.","title":"The role of ultrasound quantitative parameters in the assessment of acute radiodermatitis after breast-conserving surgery"}
{"_id":"26292f96-9e9a-1de0-1005-856737f8ff60","text":"At the end of the feasibility phase, the overall mean recruitment at the five selected centres for this phase of the study will be estimated (with a 95% CI) and compared to the target rate of one patient per month per centre. The estimated recruitment rate and the overall rate of withdrawn patients in the feasibility phase will inform the design and the decision to proceed to the main RCT.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"262c78d0-d9a0-f699-fc70-6811f393f5c0","text":"Comparing the different brain parenchymal regions of interest showed the most pronounced CSF enrichment within the inferior frontal gyrus and the parahippocampal gyrus, which are located close to the leptomeningeal arterial trunks. This observation compares with the view that pulsations are the force behind parenchymal convective glymphatic flow.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"26345fae-8f69-ca83-f380-693707157ccf","text":"Circular external fixator provides multilevel stabilization of the fractured limb segments with minimal disruption of the soft tissue envelope. It is particularly useful where bone gaps need reconstruction by distraction osteogenesis.","title":"Bone transport for the management of severely comminuted fractures without bone loss"}
{"_id":"26369171-e160-dad7-d0cc-0479ae88e8bb","text":"The numerous dressings that had been done had achieved to no significant improvements for two months, so much so that the patient turned to our department.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"2639ba62-63e4-4991-20f1-8e3c588f5ea6","text":"This review article provides an overview of the different imaging modalities and imaging characteristics of childhood osteomyelitis. Levels of evidence for different modalities are presented.","title":"Childhood osteomyelitis: imaging characteristics"}
{"_id":"263b57a2-1927-6cbd-aef6-d15ab53c2941","text":"The clinical context and the radiological data made the diagnosis of pseudotumoral calcinosis in our patients with chronic dialysis. The management is based on the correction of the Ca\/ph product. The reduction of calcifications go through the correction of hyperparathyroidism or the increase of dialysis sessions with low‐Ca dialysate, while checking the aluminum level in the dialysate. Kidney transplantation can promote rapid decrease in calcifications and is desirable in cases of severe calcinosis. Surgery with as complete a resection as possible is recommended when there is a risk of vascular damage or on joint mobility.","title":"Bone Research Society 2021 Abstracts"}
{"_id":"263b635d-f397-9e7f-54a5-611578a8387a","text":"Detailed history, clinical examination was made and the Rhinoplasty Outcome Evaluation (ROE) questionnaire was asked to patients who underwent the septorhinoplasty as an interview and satisfaction score was recorded preoperatively. All patients were operated on by a single surgeon using both open and closed approach. Written consent was taken from the patient for the procedure. Our main aim was to correct both functional and aesthetic problems related to the nose and to assess the satisfaction of patients preoperatively and postoperatively. All the cases were done under general anaesthesia. The average time taken for the procedure was around 150 minutes. After completion of the surgery, a quilting suture was done on the septum and internal nasal packing was rarely used. All the patients were admitted for 1 day and routine antibiotics were prescribed for 1 week during discharge. The sutures and external nasal splint were removed after 1 week. Routine follow up was done after 2 weeks and 4 weeks postoperative period.","title":"Septorhinoplasty among Patients who Visited the Outpatient Department of Otolaryngology-Head and Neck Surgery of a Tertiary Care Center: A Descriptive Cross-sectional Study"}
{"_id":"263e4282-a99b-0f2c-6f9a-c2e38769b4b2","text":"Conclusion: Doppler ultrasound is a rapid method to distinguish between low flow and high flow priapism and helps in the acute decision making process.","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"2646bd06-7294-1c19-0ff3-53ff921ac563","text":"Compared to anaphylactoid reactions ignited by intravenous administration, the PCA reaction is a more sensitive test with visual results [17]. The PCA reaction seldom causes animal death, which is supported by the results of the current study. The advantage of the PCA reaction is that the degree of the anaphylactoid reaction can be quantitatively evaluated by the exudation of Evans Blue, and the principle of the test is to evaluate vascular permeability. The results of PCA supported that macromolecular substances are the components responsible for anaphylactoid reactions, and the reaction could be partly prevented by cromolyn sodium. Micropathological observations illustrated that the PCA reaction caused by macromolecular substances is associated with hydropic degeneration.","title":"Macromolecules in polysorbate 80 for injection: an important cause of anaphylactoid reactions"}
{"_id":"265724be-b998-3b22-025f-b6147d5bdd14","text":"A4 Betamethasone suppresses Th2 cell development induced by langerhans cell like dendritic cells","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"265780f5-6be7-269b-cb2e-0848c57332eb","text":"With our unique preparation of fresh tissue specimens for assessing frenulum histology, we have confirmed that tongue elevation alters the contour of the FOM fascial layer together with the overlying oral mucosa to form the elevated midsagittal fold recognized clinically as the lingual frenulum. There was variability between the specimens in the relative gliding between the mucosal and fascial layers, impacting the morphology of each of the frenulums examined. The mucosa appeared able to elevate into a fold of variable distance above the superior edge of the fascial fold. Genioglossus was also noted to be suspended at a variable distance from the FOM fascial layer, altering the position of genioglossus within the fold of the elevated frenulum and therefore the thickness and contour of the frenulum. These histological findings support the concept proposed in a previous paper [4] for a structural explanation for variability in frenulum morphology.","title":"Understanding the Lingual Frenulum: Histological Structure, Tissue Composition, and Implications for Tongue Tie Surgery"}
{"_id":"26597bd7-3d55-cf45-7925-e7bc1826fa51","text":"Table 1 Schedule of study visits and specimen collections for each infant and mother","title":"Dietary supplementation with Bifidobacterium longum subsp. infantis (B. infantis) in healthy breastfed infants: study protocol for a randomised controlled trial"}
{"_id":"265b909d-2aae-f50a-7537-4c771b9b67e9","text":"We believe that harvesting flaps in a chimeric pattern and delaying the decision about which flaps can be used, as in our case, may be a useful option to avoid other donor site violation.","title":"Salvage Operation Using the Free Latissimus Dorsi Muscle Flap for Necrosis of the Free Scapular Flap After Harvesting Both Flaps in a Chimeric Pattern"}
{"_id":"265c94f8-6763-4e7c-59d3-b81ebdbfa7f7","text":"The overall survival and locoregional recurrence in patients with metastatic axillary SLNs treated with SLND were similar to those in patients treated with complete ALND. The elimination of routine axillary lymphonodectomy and the implementation of SLND in women who met the ACOSOG Z0011 criteria at our hospital benefited the patients who could be treated with less aggressive surgery. The de-escalation of ALND to SLND in women with up to two metastases in the SLN treated with conservative surgery and radiotherapy is possible. Our study showed that the ACOSOG Z0011 recommendation is feasible even in developing countries.","title":"Survival and recurrence with or without axillary dissection in patients with invasive breast cancer and sentinel node metastasis"}
{"_id":"265e40c7-0f93-d4f2-23f1-cd3f306b818a","text":"P14 Drug hypersensitivity reactions in children and results of diagnostic evaluation","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"2661377e-0a32-b868-d5e7-8a85b649e91b","text":"The creation of a custom implant for patients in veterinary medicine with the use of additive manufacturing technologies has both benefits and pitfalls. Having access to a 3D metal printing medical solution centre, allows individuals to access this advanced expertise and service in a single location. A recent review of additive manufacturing in human medicine determined that the planning time costs for these types of surgeries is well worth the benefit, stating that an hour spent in production of an additive manufactured implant is equivalent in cost to 10 min saved in the surgical suite [26]. The use of patient-specific modelling has been proven in multiple studies to reduce surgical hemorrhage as well as reduce surgical time, which in effect decreases general anesthesia time and wound exposure [27]. The increased procedure time in human cranioplasty directly correlates with increased risk of surgical site infections which makes the importance of patient-specific implants that fit perfectly over the craniectomy site necessary [28]. Costs and cost savings for this procedure are unknown at this time but it is likely that this would result in a decrease in surgical and anesthesia times, and therefore costs may be similar to the current standard of care. Overall there are many potential benefits although the cost-benefit ratio has yet to be proven in veterinary medicine.","title":"Schedule feasibility and workflow for additive manufacturing of titanium plates for ranioplasty in canine skull tumors"}
{"_id":"26684a73-2e84-a1ea-ce1c-1ca5d48d551b","text":"After acceptance testing, commissioning of an IORT device requires the measurement of all machine specific data needed for future treatment. For mobile electron accelerators, the report of AAPM TG 72 [2] gives a list of Items to be measured during commissioning including depth dose distributions and beam profiles at several depths, output factors for every used beam energy and applicator, leakage profiles at various depths outside selected applicators, air gap factors, and beam output calibration for every energy. These measurements require high doses and a large amount of time for which both staff and a measuring vault with sufficient radiation protection must be available and planned in advance. For the commissioning of an accelerator with 6 energies and 16 applicators, Hensley reports a dose consumption of 5145 Gy [58]. For modern mobile accelerators with around 40 applicators and 3 to 4 energies this would extrapolate to 6000-7000 Gy. A considerable reduction of time and dose could be achieved if the use of an atlas of pre-determined dose distributions were permitted which would only need to be verified for a smaller set of applicators. Such an atlas could be provided by the manufacturers or a task group authorized by medical physics societies similar to the practice in brachytherapy. It would require updates for machine changes and the obligation that manufacturers report relevant changes. Measured data could be cross-checked with Monte Carlo simulations. Such simulations exist for several mobile IORT accelerators for various purposes [10, 59–61] and could be further developed to predict and verify measured data sets. Commissioning especially of small and beveled applicators and measurement of output factors should preferentially be performed with small detectors which integrate only a small portion of the non-flat dose profiles. Electron diodes can be used after test of their performance in the pulsed beams. They should be frequently re-calibrated since their sensitivity may change with the high doses applied with IORT accelerators. Commissioning of beveled applicators is difficult and must be performed with great care since the correct position of the clinical axis (the intersection of the inclined central beam axis and the patient surface) is not easily found with the usual measuring tools. Correct position of the clinical axis (or some other reproducible point under the applicator) is essential in order to determine reproducible output factors for beveled cones. The mobile accelerators have no positioning aids such as light fields or alignment lasers. Beam centering tools to find the central beam axis provided by water phantom software cannot be used due to the asymmetric dose profiles. A positioning tool described by Runz et al. [62] uses templates mounted on the chamber drive of a water phantom to align the applicator end with the water surface and define the position of the detector in relation to the central beam axis which at the water surface coincides with the clinical axis.","title":"Present state and issues in IORT Physics"}
{"_id":"267bfdd1-16f1-b09d-f35f-03a0bc5c485f","text":"Disposable sterile TEA devices will be used in accordance with national standards within the validity period.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"268659cc-5852-f907-cfa2-01d674b7d9fe","text":"Although systemic reactions caused by allergenic proteins present in venoms affect a small part of the world population, Hymenoptera stings are among the main causes of immediate hypersensitivity responses, with risk of anaphylactic shock. In the attempt to obtain therapeutic treatments and prophylaxis to hypersensitivity responses, interest in the molecular characterization of these allergens has grown in the scientific community due to the promising results obtained in immunological and clinical studies. The present review provides an update on the knowledge regarding the immune response and the therapeutic potential of Antigen 5 derived from Hymenoptera venom. The results confirm that the identification and topology of epitopes, associated with molecular regions that interact with antibodies, are crucial to the improvement of hypersensitivity diagnostic methods.","title":"Current Advances in Immunological Studies on the Vespidae Venom Antigen 5: Therapeutic and Prophylaxis to Hypersensitivity Responses"}
{"_id":"26a4bc3a-14db-e3a2-8303-d3a81982139c","text":"Immediate and late follow up was undertaken for the evaluation of:","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"26a62469-73e8-c0c2-510f-530ea19bd4ca","text":"There are various techniques of performing a skin biopsy and any particular technique chosen is based on the type of lesion, site of lesion and also on the proficiency of the dermatologist.","title":"Techniques of Skin Biopsy and Practical Considerations"}
{"_id":"26bc555f-22bc-4ddf-4368-ebbf7466334d","text":"In the present pilot study, the topical application of 1% BA or 1% NVX-207 twice a day for 13 consecutive weeks in equine melanoma patients proved to be safe and was well tolerated. The topical therapy resulted in part in clinically visible and measurable changes in small melanocytic lesions, which were reflected in skin depigmentation and reduction in tumor diameters and volumes. A significant beneficial treatment effect could be shown after treatment with BA towards the end of the treatment period.","title":"Effects of Topically Applied Betulinic Acid and NVX-207 on Melanocytic Tumors in 18 Horses"}
{"_id":"26c414e3-52b1-d0a3-93a4-61d47b048c1c","text":"Despite these differences, biochemical and biophysical changes in the dermis are common to both aging processes and are major contributing factors to the aging phenotypes such as wrinkles and loss of skin elasticity. The dermis of the skin consists of connective tissue that is rich in collagen, which provides mechanical support and structure. Recently, the changes in the dermal components in skin aging and treatments to reverse or combat them to reduce the signs of aging have become the focus of many dermatologists. Therefore, in this part, we will discuss these dermal aging processes in more detail.","title":"Skin aging from mechanisms to interventions: focusing on dermal aging 10.3389\/fphys.2023.1195272"}
{"_id":"26cc1c7f-1179-85c3-d638-04588a2ccf96","text":"The flap was carefully microsurgically dissected, and special care and planning was taken to the exact position of the skin island on the flap. The size of the skin island was planned to match the size of the sacral wound defect.","title":"AV loop free flap: an interdisciplinary approach for perineal and sacral defect reconstruction after radical oncological exenteration and radiation in a colorectal cancer patient"}
{"_id":"26cc6a3b-bfe2-5e8c-f591-d37bcfb0c29a","text":"The objective of this study is to discover a novel way to reconstruct scalp defects secondary to trauma or cancer, without having the patient undergo a big procedure.","title":"The 1-2-3 cm Advancement Flap Rule in Scalp Reconstruction"}
{"_id":"26d18f72-031f-e817-5e41-08ced6b6b9b9","text":"The goal of our study was to evaluate the sensitivity of the SLN procedure and the ALND for the identification of positive lymph nodes in breast cancer.","title":"Is the sentinel lymph node biopsy more sensitive for the identification of positive lymph nodes in breast cancer than the axillary lymph node dissection?"}
{"_id":"26d576b8-e2de-5341-48c7-9e161a2d4884","text":"This article provides further evidence to guide decision-making regarding resource utilization during challenging economic times. Comparable rates of local control and reconstruction can be achieved with LA techniques to reduce PPE consumption and staff aerosol exposure, as well as maintain high patient turnover and case volume.","title":"Keratinocyte Skin Cancers in General Surgery: The Impact of Anaesthesia, Trainee Supervision, and Choice of Reconstruction"}
{"_id":"26e42573-ff77-2853-c66e-999b89b4c28c","text":"Of the six patients, three received adjuvant therapy, two were as a result of close or positive margins, and the remaining one was due to a positive adjacent margin of the posterior tumor bed but with clear surgical margins, indicating the presence of a second tumor posterior to the one originally resected. The two patients who received adjuvant treatment due to close or positive surgical margins were treated with re-resection of the tumor bed following the recommendations of the NCCN guidelines.","title":"An Analysis of Tumor Margin Shrinkage in the Surgical Resection of Squamous Cell Carcinoma of the Oral Cavity"}
{"_id":"26e93c0f-1865-5050-2dae-c44beefa3ddf","text":"Evidence of being unlikely to comply with trial requirements following randomisation in the opinion of the investigator","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"26eb8c64-ba81-e8c8-814b-62ff6b0ec716","text":"The treatment of choice for primary oesophageal melanoma is radical surgical excision. Prognosis is generally very poor, with the principal determinant of outcome being the presence or absence of local lymph node metastases.","title":"Primary oesophageal melanoma - a case report"}
{"_id":"26ee9456-931e-31e2-6d2e-0e185e7283e5","text":"Biomechanical studies have shown that the stabilization of the cervical spine after posterior fixation and fusion is superior to that of anterior fixation and fusion for treating complete unstable fractures of the cervical spine [15]. However, some researchers have found that the stabilization is insufficient and that the anterior intervertebral injury is difficult to heal. Furthermore, the problem of how to perform anterior decompression cannot be resolved; auxiliary external fixation is usually required after surgery. Moreover, the surgical position is one of the key steps. Patients under anaesthesia are likely to cause secondary spinal cord injury without appropriate protection when changing their position from the supine to the prone position because of poor stabilization of the cervical spine fracture site.","title":"Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations"}
{"_id":"26fd96e7-c8a8-73f5-955b-49f2441c4a95","text":"In conclusion, breastfeeding is a protective factor against posterior crossbite and class II malocclusion in primary and mixed dentition. The protective effect increases in line with the months of breastfeeding. There is no clear evidence for breastfeeding providing protection against other malocclusion risks such as openbite.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"27079ad1-c15a-9607-c8d1-7dc1ddc1fcc3","text":"This cohort consisted of 63 patients with recurrence and 81 patients without recurrence who underwent surgery between 2005 and 2019 and were followed with mean follow-up period of around seven years. All 63 patients with recurrence had local recurrence without systemic recurrence, and blood analysis was performed at the time of recurrence diagnosis. Nonrecurrence patients did not have any type of recurrence during follow-up at the time of enrollment in the cohort.","title":"The usefulness of a three-protein signature blood assay (Mastocheck®) for follow-up after breast cancer surgery"}
{"_id":"27099a7d-2b6f-3a7c-5a5b-181ceb7831a4","text":"Common peroneal nerve palsy was detected in two patients with proximal tibial tumors in the immediate postoperative period. Both of them completely recovered within 6 months.","title":"Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection"}
{"_id":"270c8669-bf31-7c79-3606-ea4104e64eb0","text":"The attending team needed assurance that source of infection was from the left arm AV fistula and not the IJ or right arm fistula. Eleven days post admission, the patient had persistent bacteremia and given negative transthoracic and transesophageal echocardiogram; the infectious disease team recommended pursuing other diagnostic tests to confirm that the left arm fistula was the source of infection.","title":"F-18-Fluorodeoxyglucose Positron Emission Tomography\/CT Effectively Identifying Source of Infection in a Patient With Multiple Dialysis Arteriovenous Fistula Access Points"}
{"_id":"27118676-f7bc-7840-d3d7-fdc9a0bc838b","text":"Flap blood flow was monitored using a noninvasive mixed blood oxygen saturation monitor. This makes it possible to sensitively detect changes in intraflap blood flow before clinical signs appear, and it is considered useful as a continuous and noninvasive monitor for flap blood flow.","title":"A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy Takasu et al"}
{"_id":"2719c0fd-b4dd-3f35-eba4-54a1e8b08318","text":"Information on tumour characteristics, surgical procedures and oncological treatment with special detail regarding PMRT, complications and lifestyle factors were collected by individual medical chart review for each patient and registered in the retrospective Stockholm Breast Reconstruction Database, which is a pseudonymized digital database constructed in 2017. Cases were censored at the date of implant failure, and the date of the last revision surgery preceding implant failure was used for calculation of time from completion of PMRT to revision surgery as well as time from revision surgery to implant failure.","title":"Risk factors for implant failure following revision surgery in breast cancer patients with a previous immediate implant-based breast reconstruction"}
{"_id":"271dae6e-abb1-e86f-0f1a-487cedb1efca","text":"The ROI was set to the entire target area of suspected lymph node metastasis.","title":"Usefulness of 2‐D shear wave elastography for the diagnosis of inguinal lymph node metastasis of malignant melanoma and squamous cell carcinoma Y. Kawahara et al."}
{"_id":"27202b09-e842-93ef-5783-dd10a8780792","text":"Upfront surgery is not advantageous compared to more conservative treatments such as observation or medical treatment for patients with desmoid tumors.","title":"Upfront surgery is not advantageous compared to more conservative treatments such as observation or medical treatment for patients with desmoid tumors"}
{"_id":"2723deff-5386-dae3-349b-b851934c2aed","text":"A further implication for adaptive leadership at the head of service level is that there is a role to create disequilibrium (Tetenbaum & Laurence, 2011). In a time of turbulent change this will most likely take the form of transmitting disequilibrium from the environment and clarifying for the service what the implications of change are, identifying the challenges and then passing the problem over to the service for solutions. Such an approach follows from an expectation that leadership lies across the service and not solely with the formal authority of the leader. However, careful judgement is needed here to ensure that the PEP retains enough of their “containing” function for staff uncertainty and anxiety and that they are not left foundering.","title":"Leadership of education psychological services: fit for purpose?"}
{"_id":"272f53f6-5737-1093-ccf7-b10d2746f281","text":"Once experienced there was a strong preference for the NPWT as it was considered to have a multitude of benefits. It was described as clever technology that visibly drew away ‘dirty’ fluids from the body and provided a clean area that protected the wound. It was felt to have an active element leading towards recovery and was psychologically reassuring:","title":"Participation in a trial in the emergency situation: a qualitative study of patient experience in the UK WOLLF trial"}
{"_id":"27313bc4-41ca-1e3e-3984-cac92405024d","text":"Breast reconstruction with abdominal flap has evolved from initial methods of harvesting whole muscle, to muscle sparing and DIEA perforator-based flap. Efforts have been made to minimize the amount of tissue harvested from the donor site to reduce postoperative functional deficit and to reduce donor site related complications. Donor-related morbidity is known to be related to the amount of tissue that is harvested from the abdomen during flap elevation. However, even in muscle sparing or DIEP flap elevation procedures, too many perforators can be harvested, leading to abdominal fascia and rectus muscle disruptions, especially in cases when a larger flap volume is needed or when bilateral breast reconstruction is performed. Harvesting perforators from both medial and lateral rows to reduce fat necrosis was shown to lead to more fascial defect. Techniques using single perforator or single row perforator have their own drawbacks as it was shown that the frequency of fat necrosis was high with long-term flap volume decrease after these surgeries.","title":"Validating machine learning approaches for prediction of donor related complication in microsurgical breast reconstruction: a retrospective cohort study"}
{"_id":"273155e4-da58-9552-00df-586f0b3c7b17","text":"Lastly, and not the least, challenge in conjoined twins is the ventral abdominal wall defect that results after separation. Posterior iliac osteotomies, besides the use of prosthetic mesh to bridge the muscle gap, are well-known techniques that proved to be very helpful in this respect. In our case, we believe that modifying the site of tissue expander application to be partly resting on the lateral abdominal wall muscles was of great help as well. This might have induced stretching of the abdominal wall muscles besides their well-known effect on the skin. This has been recognized by surgical teams during midline closure of the lower abdomen of both twins that went much easier than expected. Reviewing the literature, we could find similar techniques used in managing cases with large ventral hernias. 20 21 Although some reports would place the expanders in between muscle layers of the abdominal wall, yet others have applied expanders in a subcutaneous position as in our case. 20 21 More invasive techniques have been reported in more severe cases that involve injection of air\/saline into the peritoneum to stretch the abdomen 6 7 9 ; however, the effectiveness of such techniques may be questioned for their low popularity.","title":"Ventrally Fused Conjoined Twins (Omphaloischiopagus): A Roadmap to Successful Separation"}
{"_id":"2734140c-f7ed-ab48-fb63-8d76ed28b59e","text":"In conclusion, the positive associations between breastfeeding duration and cognitive development up to age 14 among children from the MCS were not explained in full after adjusting for SEP and maternal cognitive scores. While the size of the fully adjusted coefficients for breastfeeding duration was modest, they were comparable to the coefficients for SEP markers and maternal cognitive scores. This suggests that the role of breastfeeding on the child’s cognitive scores should not be underestimated. While a small increase in cognitive outcomes may not be clinically meaningful at the individual level, it has the potential to be influential at the population level. All future studies should ensure proper control of both socioeconomic factors and maternal intelligence. Breastfeeding should continue to be encouraged, as any improvements in child’s cognitive are only one aspect of the benefits it provides.","title":"To what extent does confounding explain the association between breastfeeding duration and cognitive development up to age 14? Findings from the UK Millennium Cohort Study"}
{"_id":"2739f6bf-9b9f-8107-4d0a-220be1e691df","text":"Changing the cellular metabolic pattern and gene therapy are also possible ways for forward modulation and positive adjustment of stem cells activity. However, the various types of skin stem cells activity modulation are still in their infancy and there are plenty of obstacles to overcome to reach adequate effectiveness. Beside the problem of the skin barrier, one of the main concerns is the cell specificity and selectivity of the therapeutic intervention. Since the relationship between stem cells and skin problems is very important, we should set stem cells as targets, but there is still a paucity of study in these regards and thus it is quite difficult to envisage a general pattern.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"2744ae59-e12b-9cf3-ebf1-c44a288806fc","text":"With increasing prevalence of breast cancer in younger population worldwide and improved survival rate women are more conscious about individualized treatment options which may affect their quality of life in future18,19. Published and unpublished data from Pakistan revealed the fact that mastectomy is a dominant surgical procedure among surgeons. We are a low middle income country, most of the women are home makers with lack of insurance coverage and insufficient financial resources to choose personalized options, patients declined breast conservation as radiotherapy is a part and parcel of treatment with additional financial burden. Many declined reconstruction because of non-affordability, fear of reconstruction failure or complications which may lead to extended cost.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"274ac268-6f4f-4d8a-869c-31562d5b3023","text":"Thus, it is observed that important factors of facial aging are mainly present in the lower part of the face. Although the scale did not specifically include submental fat, it is implied that the lower part of the face is a crucial part of facial rejuvenation.","title":"The Study of a Validated Assessment Scale for a Localized Submental Fat Volume"}
{"_id":"2758833b-d897-0656-3753-d17d7920a0a7","text":"In summary, our study examined the prognostic significance of further axillary dissection for sentinel lymph node micrometastases in female breast cancer patients using a large amount of publicly available data. Our results indicate that in early breast cancer patients with micrometastases, complete ALND does not seem to be required and that SLNB suffices to control locoregional and distant disease, with no comparatively adverse effects on survival.","title":"The prognostic significance of further axillary dissection for sentinel lymph node micrometastases in female breast cancer: A competing risk analysis using the SEER database"}
{"_id":"276bf198-81c7-ccf2-d689-cc73d00d210b","text":"Subsequent analyses were conducted stratifying the study population by adults and teenagers. Prior vaccination remained a significant predictor for lower HAI scores in both groups, suggesting that those who had flu shots in the previous season, regardless of their ages, are less likely to respond well to annual flu vaccinations in the following seasons. This finding is consistent with previous studies indicating that prior vaccination status significantly influenced the HAI titers levels from post-vaccination (3, 4). The interactive effect between age and BMI was only observed in adults. This is perhaps due to the limited sample size and the lack of diversities in both age and BMI values among the teenagers. The age range for the teenagers was between 12 and 17 years old, and their BMI values were mostly at the normal level, with very few exceptions presenting overweight or obesity. The insufficient heterogeneity of BMI values in the enrolled teenage group prohibited a further investigation on its interaction with age in the logistic regression.","title":"Longitudinal Assessment of Immune Responses to Repeated Annual Influenza Vaccination in a Human Cohort of Adults and Teenagers"}
{"_id":"277017d8-c062-a080-36b3-44bcdb29ba45","text":"Expression of CD20 is associated with the presence of B lymphocytes, responsible for recognizing antigens without the involvement of the major histocompatibility system and for the production of antibodies and cytokines. Hence, the presence of B lymphocytes may have a significant impact on the occurrence of inflammatory reactions after procedures, including the administration of fillers based on hyaluronic acid. The increase in their percentage should be negatively considered in the context of the safety and durability of the procedures (Figure 3).","title":"HA PEGylated Filler in Association with an Infrared Energy Device for the Treatment of Facial Skin Aging: 150 Day Follow-Up Data Report"}
{"_id":"2776209a-8de7-8892-4364-9532902ac275","text":"The findings of this study highlight two issues that influence the proportion of women having surgery for breast cancer who retain a breast at 4-years. The first is whether the initial surgery undergone was BCS or mastectomy, despite the option of immediate or delayed reconstruction. The second is the influence of increasing age and the presence of comorbidities on the type of surgery undergone.","title":"The Proportion of Women Who Have a Breast 4 Years after Breast Cancer Surgery: A Population-Based Cohort Study"}
{"_id":"277f1d32-6e3a-2846-9a74-113358b52f4c","text":"Having a good practice of colostrum feeding increased the chance of TIBF by 4.03 times. The possible explanation might be mothers who had a poor practice of colostrum may take time to discard the first best and nutritious baby breast milk and this may delay the time of initiating breastfeeding. There is supporting evidence from a study conducted in Debre Berhan showing that not feeding colostrum was associated with delayed initiation of breastfeeding [44]. Delayed initiation of breastfeeding could be due to an attempt to discard colostrum, because milking or pumping out the colostrum may take more times even a day until it is removed from the breast and white milk starts to come out.","title":"Timely Initiation of Breastfeeding and Its Associated Factors at the Public Health Facilities of Dire Dawa City, Eastern Ethiopia, 2021"}
{"_id":"278118c3-fb4c-a921-e9ed-b5133aecd016","text":"Compared with intraoral donor sites, the bone availability of the skullcap is 3 times greater than that of the posterior region of the mandible and at least 2 times greater than that of the mandibular symphysis.","title":"Evaluation of bone availability for grafts in different donor sites, through computed tomography"}
{"_id":"27840d11-fc7a-d00d-81f5-25be2a5c4bf3","text":"Table 1 Origin of new referrals to CUH and internal referral to the JDA clinic","title":"The orthodontic-oral surgery interface. Part one: A service evaluation and overview of the diagnosis and management of common anomalies"}
{"_id":"27847e1f-ae7b-009f-e9e6-c5b265f68361","text":"Then the distal cut end of the fibula is held by a bone holding forceps and gently pulled outside to get access of the interosseous border [Figure 2a]. Then the special periosteal stripper [Figure 2b] is introduced through the distal cut end keeping the anterior slit laterally and shaft side containing the circular periosteal stripper medially to protect the neurovascular structure. In this way periosteum is elevated all around from the fibula especially medial part of periosteum blended with interosseous membrane by upward advancement of the periosteal stripper [Figure 2a] with gentle 20 to 30° rotation and also avoid traction injury to neurovascular structures running proximal to distal ward especially the segmental branches of peroneal vessel. The graft was gently rotated inside to ensure that it was free from the surrounding soft tissues and then it was delivered preferably through the distal incision [Figure 2c] to avoid injury to neurovascular structures. Compression bandage was applied with above knee plaster slab till removal of the stitches maximally up to two weeks followed by active range of motion exercises of knee and ankle. Gradual weight bearing was allowed after three to four weeks postoperatively depending on local wound and main pathology.","title":"Harvesting the free fibular graft: A modified approach"}
{"_id":"27972cf9-4d27-4751-128c-1a132a4134c2","text":"All patients underwent the same BTX injection procedure using an aseptic technique under ultrasound guidance. The patients responded well to the BTX injections after an unsatisfactory course of medical treatment. The patients reported complete abolishment of abnormal abdominal movements with no side effects.","title":"Ultrasound-guided botulinum toxin A injection in the treatment of belly dancer’s dyskinesia"}
{"_id":"27989831-8c79-228e-9893-2b444a9fd897","text":"Ultrasound screening avoids unnecessary anticoagulation and identifies patients with early subclinical thromboses. One need not wait for a large proximal thrombosis to propagate unseen and undetected. As proponents of chemoprophylaxis point out, the presenting clinical sign of VTE may be sudden death.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery"}
{"_id":"279fc6a2-7614-b5df-9756-ef0ce6176fe9","text":"CLND was performed on patients who reported a positive outcome to SNB and on subjects with clinically or radiologically evident lymph node involvement. SNB was performed routinely on all patients with a negative clinical examination of the regional lymph nodes. SNB was omitted in patients whose performance status was so compromised that adequate surgical treatment could not be performed.","title":"Merkel Cell Carcinoma: Evaluation of the Clinico-Pathological Characteristics, Treatment Strategies and Prognostic Factors in a Monocentric Retrospective Series (n=143)"}
{"_id":"27a4831c-9761-b33a-6cd7-d61854508568","text":"Rhinoplasty is commonly performed to improve the nasal obstruction and refine the nasal shape. One of the most complex procedures in rhinoplasty is the correction of the crooked nose. There are multiple techniques for correcting the curvatures of the dorsal septum. One of the main challenges among otorhinolaryngologists and aesthetic surgeons is to decide which technique results in better surgical outcomes after rhinoplasty. Osteotomy is usually the preferred approach to treat prominent humps, while mild humps can be treated just by a rasp.","title":"Comparison of Double Lateral Osteotomy and Asymmetric Dorsal Hump Reduction in Correction of Crooked Nose"}
{"_id":"27b99a34-b288-2d51-4f14-a066cd5f34b5","text":"Among a large number of patients with food related symptoms extensive differential diagnostics was performed to separate patients with various organpathological diseases, infectious disease and celiac disease from those with functional adverse food reactions.","title":"Excretion of urinary histamine and N-tele methylhistamine in patients with gastrointestinal food allergy compared to non-allergic controls during an unrestricted diet and a hypoallergenic diet"}
{"_id":"27bdd425-16aa-3188-ce35-4d60db6f4a42","text":"Once the intervention is done, the patient is taken back to the RDU, where the nursing team will follow up on the patient and make the appropriate patient care according to the indications of the radiologist, as well as monitoring possible complications. Once discharged, the nursing team hands the patient a document containing specific post-procedure and the opening hours of the RDU, as well as a phone number in case of questions or doubts. The radiologist is the final responsible of the discharge order, as well as the main responsible of the well-being of the patient while in the RDU. If a patient is not fit to discharge it is derived for longer hospitalization in the most suitable service and management of complications.","title":"Experience and results after the implementation of a radiology day unit in a reference hospital"}
{"_id":"27ceb8de-cba6-4e80-df8e-365a76d9cc8e","text":"In summary, by using consecutive tractography and histological examination, we demonstrated the regeneration of fibers in SCI lesions on canine hemisection SCI models, which might be attributed to the therapeutic effect of AFG. The present study shows AFG may be effective in spinal cord rehabilitation after injury and deserves further investigation.","title":"Effect of hierarchically aligned fibrin hydrogel in regeneration of spinal cord injury demonstrated by tractography: A pilot study"}
{"_id":"27d556f2-4447-fa41-f09c-146895d373d6","text":"When peripheral concerns such as prior skin history and smoking are minimal and the only desire is an excellent cosmetic result, flaps are a superior way to close defects.","title":"Reconstruction of Nasal Skin Cancer Defects with Local Flaps"}
{"_id":"27d7e149-fcd3-9412-e003-3b4689b8e623","text":"He received multiple skin grafting procedures and an amputation of the right hand. The burn to his scalp was treated with a burr hole to the outer cortex to allow granulation tissue to cover the scalp, and then the wound was skin grafted.","title":"The use of an omental flap for the reconstruction of a burn injury to the scalp: A case report"}
{"_id":"27d7e371-b467-543f-7770-bf4b93684cfe","text":"Pulmonary complications included conditions that required sputum suction and replacement or increasing the antibiotic strength.","title":"A novel technique for lymphadenectomy along the left recurrent laryngeal nerve during minimally invasive esophagectomy: a retrospective cohort study"}
{"_id":"27d9d567-3e63-c479-0701-8a48aaf17cad","text":"Since its regulatory approval as a cancer therapy, PDT has been subject of numerous studies and has proven to be an effective form of cancer therapy. Despite its potential and the growing body of knowledge on this modality, it is underutilized in the clinic. This review provides an overview of oncologic PDT as it is applied in the clinic today. Clinical studies performed in the last ten years will be employed to illustrate the efforts made to tackle the current limitations of PDT in the clinic. Finally, examples from the most recent preclinical studies will be given to show in which directions PDT is headed, both in the near and distant future. The aims of this review will therefore be: to analyze the current state of PDT in the clinic and to give insights as to how the future of PDT will look like as a (first-line) treatment for cancer.","title":"Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions"}
{"_id":"27e09729-d3f5-bc58-e4da-69a34dce2fc3","text":"The patients with radial nerve lesions were included in the study according to the following criteria:","title":"Etiological and epidemiological characteristics of surgically treated radial nerve lesions: A 20-year single-center experience"}
{"_id":"27e2c752-c251-83a6-3ffd-b905bedc9b9f","text":"In the last century, Medicine has enjoyed spectacular progress in the most diverse areas, specially as far as cosmetic surgery is concerned, allowing individuals to reach advanced ages not only fit and in good health, but also having a more youthful appearance. Gravity together with sun light exposure and the loss of skin elasticity because of the natural human aging process result in different levels of wrinkles on the face. Many procedures have been proposed in order to correct facial wrinkles, and today it is agreed that the best surgical option to correct such problem is rhytidoplasty1, 2.","title":"Subperiosteal facelift: a 5-year experience"}
{"_id":"27e6121e-62d4-d33a-b535-025cfac1a549","text":"Eyelid reconstruction procedures were performed after the results of pathologic examination confirmed the surgical margins were clean. Reconstructive procedures were chosen based on the size, location and shape of the defect and the anatomic structures involved.","title":"The Importance of Frozen Section-Controlled Excision in Recurrent Basal Cell Carcinoma of the Eyelids"}
{"_id":"27e8393b-0fdc-ea28-4762-916676d2c090","text":"If a thrombus was present in a vein distal to the CIV, one most proximal site was defined if the thrombus was present in only one leg, whereas two were used if thrombi were present in both legs. As for laterality, DVT was defined as unilateral if the thrombus was present in the veins of one side, and as bilateral if thrombi were present in both legs distal to the CIV, whether or not a thrombus was present in the IVC.","title":"A retrospective observational study investigating the factors associated with right heart failure in patients with primary acute pulmonary embolism and deep vein thrombosis"}
{"_id":"27ef8e17-4193-04c9-024e-d172b2eda05c","text":"Several patients experienced joint or muscle pain. In five cases swelling of joints was related to the injections disappearing later but sometimes steroids were given to alleviate the symptoms. In other cases rheumatoid arthritis or osteoarthritis proved to be the cause of these symptoms. During maintenance dosing SAR in one bee allergic patient occurred when an attempt was made to increase the dose above 0.1 mg, in one wasp allergic patient due to a higher than planned dose after a prolonged interval of IT, in one patient who received both venoms at the second maintenance dose, in one wasp allergic patient after a few maintenance doses and in one case there was an unexplained syncope one day later. In three of these cases there was a change in allergic sensitivity so that it was impossible later to reach an adequate maintenance dose again and IT was abandoned.","title":"Insect sting allergy. A study from 1980 to 2003 of patients who started treatment with venom immunotherapy between 1980 and 1998"}
{"_id":"27efb082-2690-00a8-5663-294ebe332bf9","text":"A cross-sectional study was conducted in the Department of Radiology, Aga Khan University Hospital, Karachi. All female patients between 20 and 95 years of age with a known diagnosis of breast cancer with mammographic and ultrasound imaging done at our institute were included. Patients with abnormal lymph nodes on mammography or on ultrasound, patients already operated for breast cancer, patients who already underwent axillary lymph node dissection and those whose histopathology reports were not available or who did not undergo surgery were excluded.","title":"Utility of Ultrasound and Mammography in Detection of Negative Axillary Nodal Metastasis in Breast Cancer"}
{"_id":"27f9ac38-36d3-d9ac-bbeb-5b32b37d5500","text":"Distribution of the erythema and induration seen in all subjects are shown in Figures 1 and 2. The erythema diameter ranged from 0 to 129 mm with two peaks: a higher peak at approximately 16 mm and a lower peak at approximately 52 mm. The induration diameter ranged from 0 to 35 mm and it also had two peaks at around 15 mm and 20 mm.","title":"Validity of Using Tuberculin Skin Test Erythema Measurement for Contact Investigation during a Tuberculosis Outbreak in Schoolchildren Previously Vaccinated with BCG"}
{"_id":"2807e6db-faa4-37ea-ef4f-5138d26f727a","text":"The lateral extension can be helped by the use of angled scopes and adequate instruments. If even under optimal conditions a gross total resection cannot be achieved with an endonasal approach, a second stage approach can be used this being a traditional craniotomy which will find the brain more relaxed, improved surgical corridor, smaller tumour and with no need or little need for retraction.","title":"Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note Técnica endoscópica endonasal utilizando duplo retalho para reconstrução de grandes defeitos da base anterior do crânio: nota técnica"}
{"_id":"280df68a-b096-7c25-8085-b52656abf566","text":"Patients who experience severe allergic reactions require immediate attention, and both infusions should be held immediately. Oxygen and albuterol may be indicated, and additional doses of diphenhydramine or other antihistamines may be given on an urgent or emergent basis. Epinephrine should be given immediately if there are signs of significant airway compromise or if airway issues are accompanied by cardiovascular collapse. Due to the concern that steroids may diminish the effect of immunotherapy, the use of steroids is reserved for those patients who are experiencing true anaphylaxis with cardiorespiratory collapse or for those who are unresponsive to two or more doses of epinephrine. Our team has worked closely with the rapid response team and intensive care personnel to explain the purpose of immunotherapy and to increase awareness of ways to avoid systemic steroids for reactions that can potentially be managed with other agents. Among 75 patients treated since initiation of this effort at our center, only 1 has required systemic steroids for a severe allergic reaction.","title":"Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications"}
{"_id":"2815497c-e276-38f1-4622-1e84248182cc","text":"Regarding safety of the BTX-A in the current study, side effects were generally tolerated and were mostly related to the injection sites, 4 cases developed mild facial asymmetry which was self limited and did not impose much impact on the patients especially in the setting of reduced pain. However, this adverse event could be overcome by a more posterior injection approach.","title":"Botulinum toxin-type A: could it be an effective treatment option in intractable trigeminal neuralgia?"}
{"_id":"2818b64b-7c53-c4e0-7dad-3f13a3b58437","text":"LIPUS is a noninvasive and effective adjuvant therapy to enhance callus maturation during DO. It also enhances callus consolidation and may have a positive effect on appropriate callus shape and type.","title":"Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure"}
{"_id":"2820ed24-686d-6123-d277-e8b724f4b76b","text":"The combined use of PDT with immune stimulation treatments might reduce this action and improve the efficiency in defeating the local cancer and reducing cancer relapse as well as the onset of micro metastases, and increase the global effectiveness of anti-tumour treatment.","title":"Oxidative Stress and Photodynamic Therapy of Skin Cancers: Mechanisms, Challenges and Promising Developments"}
{"_id":"282fa170-b845-e15a-2a22-71f588130d0f","text":"The standard and the modified techniques of submuscular plating after lengthening were safe with a shorter fixator-free period. The modified technique offered an easier way of plate insertion in a deformed bone. Both allowed early limb rehabilitation and protected the regenerated bone throughout the consolidation phase.","title":"Submuscular Plate Stabilisation After Lengthening: Standard and Modified Techniques"}
{"_id":"2832d632-4c37-92da-9c59-fdf4e52eeb65","text":"With that being said, no matter the strategy employed to shape the inflammatory response, the goal of this approach is to guide the growth of new tissue. In situations where wounds are not closed by surgical intervention, but instead heal via secondary intention, it is necessary to fill the wound site with vascularised granulation tissue.90 This new tissue then enables the migration of keratinocytes over the granulation tissue in order to close the wound.","title":"Using biomaterials to rewire the process of wound repair"}
{"_id":"283441f8-d8bf-af19-4b36-eb8795695b59","text":"The saphenous vein was harvested, and a presternal subcutaneous tunnel was developed to pass the vein graft from the left to the right flap recipient site. To maintain patency of the graft itself, the adipose layer was cored out until it was wide enough to ensure that the graft would be both tension and compression-free yet narrow enough to prevent a contour deformity or symmastia. Coupled end-to-end anastomoses were performed between the flap vein and vein graft (3-mm coupler), and between the vein graft and the right lateral IMV (2.5-mm coupler; Fig. 2).","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"28352e7a-7e0a-4e34-1b84-deeb9764a3c4","text":"Our purpose is to report the case of a patient with this neoplasia who was treated with ultraradical surgery followed by radiotherapy and who has had long-term followup.","title":"Primary Malignant Melanoma of the Uterine Cervix Treated with Ultraradical Surgery: A Case Report"}
{"_id":"2835dfa1-6b43-945d-f74c-775b65996027","text":"It is clear that surgery done by palpation cannot improve the objectivity and measurability of resection procedures. If we want to improve objectification and optimisation of excision in breast cancer, we have to make both the tumor and the surrounding tissue visible and measurable in real time, during the operation itself. The only means available to meet this demand is intraoperative ultrasound.","title":"Optimization of breast cancer excision by intraoperative ultrasound and marking needle - technique description and feasibility"}
{"_id":"28396bdb-0b0f-8935-d25c-edae97b0396b","text":"We investigated the association of several clinical and pathological variables with an increased likelihood of positive SLNB and factors that have an impact in melanoma-related death in our population.","title":"Prediction of Sentinel Node Status and Clinical Outcome in a Melanoma Centre"}
{"_id":"28409ba8-1e83-c906-e47a-82e62d590231","text":"As discussed in the previous section, PDT proves to be effective in inducing tumor responses as well as improving patient survival and QoL. Efficacy is seen when PDT is part of a multimodal approach, is used as a first-line treatment for premalignant or early disease and as standalone palliative treatment. Even though PDT shows great potential, there are still some limitations that prevent a firm position for PDT in standard care regimen of cancer. When reviewing the clinical trials and studies done over the last ten years, some general problems become evident.","title":"Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions"}
{"_id":"2841fd48-5f44-c9ee-fabe-4a3388929102","text":"PDT is based on light activation of a photosensitizer localized on the tumor tissue to generate highly reactive oxygen intermediates that irreversibly oxidize essential cellular components. This process causes tissue damage and necrosis and induces apoptosis 20. Three randomized controlled studies with long-term follow ups have compared the various effects of PDT protocols to those of simple surgical excision protocols for treating superficial BCC and primary nodular BCC. All of these studies have demonstrated statistically superior clearance rates for surgical excision over PDT 21-23.","title":"The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital"}
{"_id":"28451929-21c3-0478-84d2-2989028b5b70","text":"The three-dimensional virtual reality models were helpful for individualized planning of surgery in the sellar region. Virtual reality appears to be promising as a valuable tool for sellar region surgery in the future.","title":"Stereoscopic virtual reality models for planning tumor resection in the sellar region"}
{"_id":"28458d37-0808-a6a8-43cf-b58b2877c12f","text":"Afya Bora alumni overwhelmingly reported that the one year fellowship positively influenced both their work and career trajectory. Training health professionals in leadership skills through didactic modules with the opportunity to apply learned skills at attachment sites in the Afya Bora Fellowship has an impact on performance in the workplace and the potential to improve long-term institutional capacity.","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"2848bb43-3e26-d44b-a706-a03827387e39","text":"Overall, the findings of this study demonstrate that OPA has the potential to induce respiratory sensitization following inhalation exposure. Characteristics of the immune response to OPA suggest that exposure to this chemical may cause a type I hypersensitivity response as there was a large increase in the IgE+ B-lymphocyte population. The immune response to OPA is similar to other low and high molecular weight chemicals that are known to cause occupational rhinitis and asthma, indicating the need for the regulation of OPA in the workplace. The concentration range tested in the present study is at least 10 fold higher than air concentrations that can be found in the workplace [14]. Therefore, further studies with lower concentrations and longer exposure periods are important to better characterize the immunotoxicity of OPA and to facilitate risk assessment. Additionally, the understanding the interaction between skin and respiratory exposure will be important for risk assessment for OPA. Previous work with other low molecular weight sensitizers have shown that skin exposure can prime the immune system to respond to future airway exposures [41–44]. There is a high potential for skin exposure during manual reprocessing of medical devices with OPA. The potent sensitizing response to dermal exposure [9] may significantly lower the threshold air concentration of OPA required to elicit an immune response in the airways. Our laboratory is currently examining the interaction between skin and airways in the development of OPA-induced allergic respiratory disease using the mouse model.","title":"Inhalation of Ortho-Phthalaldehyde Vapor Causes Respiratory Sensitization in Mice"}
{"_id":"284a44d4-a609-58ac-7879-53d710973b97","text":"Perhaps the paucity of discussion in the MRI literature reflects both the more subtle MRI appearance and the lack of a standardized definition of the finding on this lower resolution modality. Also, periosteal reaction becomes a more important finding on radiography and CT which have decreased sensitivity for making a diagnosis of osteomyelitis, when compared to the more specific bone marrow signal alterations which are easily identified on MRI, often obviating the need for description and detection of periosteal reaction on MRI.","title":"MRI nomenclature for musculoskeletal infection"}
{"_id":"284d0b23-d8ab-0708-2211-6ab8b4c52247","text":"A patient was assigned to the TPVB group or the LA group by using a computerized random-number generator. Opaque envelopes containing a set of materials for either group were prepared prior to subject enrollment, which were sealed and numbered sequentially. After a participant agreed to participate in the trial, the next envelope in the sequence was opened by the coordinator who was not involved in the patient intervention.","title":"Single ultrasound-guided thoracic paravertebral block with a large volume of anesthetic for microwave ablation of lung tumors"}
{"_id":"2855338b-7165-e32b-b8f5-b7d3e2000ddd","text":"Injected MR venography offers the same type of information as CT venography by showing the filling defect with similar sensitivities and specificities.","title":"Imaging of Cerebral Venous Thrombosis"}
{"_id":"2855442d-bd3e-852e-e799-1ad13518c9da","text":"Any oral surgery including extractions must be carefully planned and best performed in specialized centers.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"28574d3a-b9a1-71d4-d526-28387c8c167a","text":"Age was shown to be a significant independent risk factor for blotchy pigmentation, although this was no longer significant when the analysis was further corrected for MC1R, possibly due to reduced sample size. Male sex was also independently predictive which is unexplained but may reflect unmeasured differences in sun exposure or sunscreen use. Higher educational level achieved was a risk factor for blotchy pigmentation, which is also unexplained. We looked at the correlations with higher educational level achieved in order to explain this: we saw a positive correlation with sunny holiday exposure and a negative correlation with all the other patterns of sun exposure, but have not identified obvious explanations for this finding. There was reasonable evidence to suggest that blotchy pigmentation is related to sun exposure: weekday sun exposure in warmer months was a risk factor for pigmentation and sunscreen use to stay in the sun longer was significantly protective. Carriers of ‘R’ variants of MC1R were less likely to have a high score for pigmentation in our analysis. ‘R’ variants are associated with the ‘red hair colour phenotype’4 and paler skin so that this is not unexpected, although other authors have reported the contrary.5 As previously reported,9 no significant association was found between smoking and increased pigmentation. We conclude therefore that blotchy facial pigmentation is more likely to be seen in individuals without MC1R variants who have greater sun exposure.","title":"The determinants of periorbital skin ageing in participants of a melanoma case–control study in the U.K."}
{"_id":"285cbc76-98c2-a0fa-ced2-aa81e7599534","text":"In our 3D system of navigation, surface rendering of the 3D-reconstructed CT scan and surface clipping (virtual removal) of the bone to one side of the saw plane allows the surgeon to see through the image of the bone and align the plane of the saw blade with the cut plan. This allows the surgeon to judge the plane of the cut in distance, pitch, and roll and obtain a negative margin from the closest edge of the tumor within the bone.","title":"Accuracy and reproducibility of virtual cutting guides and 3D-navigation for osteotomies of the mandible and maxilla"}
{"_id":"28636ecc-072d-137f-b1b7-69a3a806940e","text":"Considering that the delay in diagnosis and treatment may be related to the numerous barriers encountered during the search for health care, it is possible to understand how the interactionist care provided by friendship networks can help overcome these barriers of access and avoid delays in breast cancer diagnosis and treatment [42].","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"286c6fec-bf45-394f-eed8-cabd8c51f8f6","text":"Conclusions: The combination of dabrafenib and trametinib was well tolerated and patients reported a better global health and functional status with less exacerbation of symptoms.","title":"Melanoma and immunotherapy bridge 2015 Naples, Italy. 1–5 December 2015"}
{"_id":"286d9aeb-cbc6-cf0c-9054-cd4efcc9b302","text":"During the preoperative period, the patient presented left lower limb pain and was diagnosed with proximal DVT of the popliteal and posterior tibial veins. Full dose anticoagulation was immediately initiated with enoxaparin.","title":"An alternative approach to treatment of inferior vena cava filter perforation Tratamento alternativo para perfuração de veia cava inferior por filtro"}
{"_id":"2877b674-3c37-35df-679b-e505a2e20875","text":"Skin substitutes have important roles in the treatment of deep dermal and full thickness wounds of various aetiologies. At present, there is no ideal substitute in the market that provides an effective and scar-free wound healing. Further research should be carried out not only to compare different skin substitutes but also to evaluate new biological and synthetic materials that can be utilised in wound healing.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"287abc12-6867-bc05-9264-540bdffad468","text":"Consecutive patients who were diagnosed with thoracic esophageal cancer and underwent surgery at our hospital from January 2016 to June 2020, were included. A total of 393 patients were finally included in this study.","title":"A novel technique for lymphadenectomy along the left recurrent laryngeal nerve during minimally invasive esophagectomy: a retrospective cohort study"}
{"_id":"287f933f-2e39-9d6e-2575-a54df8c413d9","text":"With blunt dissection, the node packet can be rolled inwards on both sides. This manoeuvre is continued inferiorly as much as possible from both sides to define inferior apex of the nodal packet. The saphenous vein will be identified as it crosses the internal border of the dissection near the apex of the femoral triangle, and following it brings you to the saphenous arch until its junction with the superficial femoral vein at the fossa ovalis.","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"287fc152-da9b-2553-d4b4-d5f38d5e961b","text":"Child face is not a miniature form of adult face. As growth process takes place, the changes in the hard and soft tissues of the face bring about a significant change in structure and profile of the face.","title":"Age Changes of Jaws and Soft Tissue Profile"}
{"_id":"28817bdc-bc3d-a31a-27a4-637c2638fec6","text":"Prospective studies report far higher yet consistent rates of FES, while the incidence of FE at autopsy is significantly greater than the incidence of clinically suspected FES.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"2881e944-23b0-175c-9856-60d17c0e2835","text":"The aim of this review is to highlight the role of IOUS in contemporary breast cancer surgery and its changes over time, from being a tool for the localization of non-palpable lesions, to becoming an instrument that can make tumor excision optimal and even objectively measurable.","title":"Intraoperative ultrasound in breast cancer surgery—from localization of non-palpable tumors to objectively measurable excision"}
{"_id":"288290b4-0500-cc70-06b9-a93a844f51a3","text":"All the participants talked about the negative society view and stigmatization of patients with breast cancer. They reported that society often focused on their chest area and showed curiosity about their condition. They also mentioned experiencing pity and unsolicited comments from others, which further contributed to their distress.","title":"Beyond the scars: a qualitative study on the experiences of mastectomy among young women with breast cancer in a country with crisis"}
{"_id":"2882d432-fc50-f1fe-f289-a1700627b4b1","text":"Postmastectomy breast reconstruction is widely used in breast cancer patients for its aesthetic effect. Although several studies have casted suspicion upon the oncological safety of immediate breast reconstruction after mastectomy, the potential impact of different reconstruction methods on patient survival remains unclear.","title":"Immediate Postmastectomy Breast Reconstruction Showed Limited Advantage in Patient Survival after Stratifying by Family Income"}
{"_id":"288ab15f-f25f-2750-8c29-5ffb8e1ffcaa","text":"A retrospective case series of 22 dogs with iliopsoas muscle abnormalities and suspected plant material was reported. Preoperative visualization and subsequent retrieval of the plant material was performed during a single hospitalization. In all 22 dogs, the plant material (including complete grass awns, grass awn fragments and a bramble twig) was successfully removed via ventral midline laparotomy in which intraoperative ultrasonography was used to direct the grasping forceps tips to the foreign body and guide its removal. In 11 of these 22 dogs, the plant material was not completely removed during prior surgery performed by the referring veterinarians without pre- or intraoperative ultrasonography. Clinical signs resolved in all dogs and all dogs resumed normal activity after successful surgical removal of the plant material.","title":"Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs"}
{"_id":"288bd25a-c78a-25e9-8174-f5194deee0a6","text":"Successful Plastic Surgery Residency training is subjected to evolving society pressure of lower hourly work weeks imposed by external committees, labor laws, and increased public awareness of patient care quality. Although innovative measures for simulation training of surgery are appearing, there is also the realization that basic anatomy training should be re-enforced and cadaver dissection is of utmost importance for surgical techniques.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"289186a3-9966-e8b4-b913-8a755efd3742","text":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. As this is a retrospective study formal consent is not required.","title":"Correction of lower limb deformities with fixator assisted nailing"}
{"_id":"289a1178-ea59-b54c-711d-8560b386b7ff","text":"A fundamental understanding of ultrasound (US) functionality is essential to understanding its role in the physiology of fracture healing. Ultrasound is a modality that applies transcutaneous acoustic energy for diagnostic and therapeutic purposes. Sound waves produced by a piezoelectric crystal are transmitted through various body tissues to induce a number of physiologic changes implicated in tissue healing.1112 The proportion of sound waves absorbed by a specific tissue is directly related to that tissue's density. Bone typically possesses the densest tissue in a given area, allowing for the use of US waves to effectively target areas where bony abnormalities may exist.13","title":"Low-intensity pulsed ultrasound: Fracture healing"}
{"_id":"289f3253-86e7-0ace-9ced-e5864edff2f9","text":"Since drugs used to treat arterial thrombosis are believed to affect key mediators of thrombus growth and\/or stability we decided to develop a simple perfusion chamber assay that allows for mechanistic studies but also continuous monitoring of the pharmacodynamic activity of antiplatelet agents on the kinetics of thrombosis in real time.","title":"Development of a perfusion chamber assay to study in real time the kinetics of thrombosis and the antithrombotic characteristics of antiplatelet drugs"}
{"_id":"28a927ca-65fa-507b-88b9-11a3b65cc390","text":"The comparison of weight between three groups of study revealed a statistically significant difference between group 1 and two other groups. However the amount of weight loss in group 3 was lower but this difference was not statistically significant between groups 2 and 3. On the other hand, there was no difference in volume changes between three groups of study. In other studies like the study in 2005, the degree of volume change had been mentioned as the index of resoption rate in grafts.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"28ac65d2-5ec4-97e6-47c9-78b375b46ab6","text":"Baseline variation was observed in both FSO2 and CSO2, and the amplitude of that variation generally stayed within 20 points. Based on the observation that baseline variation in FSO2 and CSO2 tends to be linked, it is possible that the INVOS can detect slight changes in the patient's general condition, such as slight fluctuations in interstitial oxygen saturation due to blood pressure and oxygen administration. Although there was a wide range of absolute values for rSO2 depending on the patient, when broken down by flap type, rSO2 was high in abdominal flaps and low in latissimus dorsi flaps, while a pattern of low rSO2 in the legs was observed when broken down by reconstruction site. This led us to consider factors related to blood flow in the flap itself and factors related to blood flow in graft bed blood vessels. However, it is difficult to use the absolute value of rSO2 to monitor flap blood flow. Accordingly, it is important to monitor trends that indicate changes in flap blood flow.","title":"A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy Takasu et al"}
{"_id":"28b017ae-5b9f-c692-a28f-a3b271999c9f","text":"We present our experience with 31 retrograde free venous flaps, including composite flaps, used for the reconstruction of the extremities, with a focus on the surgical technique. We report an extremely high survival rate in medium and large flaps with almost no difficulties in healing. We demonstrate how these flaps can be routinely used in elective situations and report that the survival of these flaps is much larger than was previously believed. Upon reporting our results, we highlight and analyse our cases with their complications in order to contribute to the further understanding of these flaps.","title":"Retrograde Free Venous Flaps for Extremity Reconstruction: A Roadmap"}
{"_id":"28b17eb5-3f2b-edd8-afaa-8eb2f4e7b8b4","text":"Our earlier intervention, the FIFI study, resulted in increased rates of any breastfeeding at six weeks but failed to result in an increase in the proportion of couples fully or exclusively breastfeeding at this time and there was no difference between intervention and control couples in the proportion still breastfeeding at six months [36]. A limitation of this earlier intervention was that it only ran for six weeks and was of relatively low intensity, involving a breastfeeding focussed antenatal education for fathers led by a male facilitator, followed by the weekly delivery of printed educational and promotional materials to six weeks postpartum.","title":"A study to prolong breastfeeding duration: design and rationale of the Parent Infant Feeding Initiative (PIFI) randomised controlled trial"}
{"_id":"28b67c5f-c3fb-efd6-b3f9-7dd17c8132cd","text":"The failure to evaluate memory or cognitive compliance is likely to hinder treatment of underlying conditions of disease and comorbidity and may present safety issues for the patient. Many patients who are developing or have cognitive impairment do not receive a diagnosis and more than half of patients with dementia had not received a clinical cognitive evaluation by a physician [8]. This is not unusual if we think about how physicians were unaware of cognitive impairment in more than 40 percent of their cognitively impaired patients [9].","title":"Management of The Elderly Cancer Patients Complexity: The Radiation Oncology Potential"}
{"_id":"28b76b6d-20d7-b4bf-ce48-424d68fa8228","text":"A prospectively maintained database from 2002 to 2011 was retrospectively reviewed. The presented data is of a single surgeon in a tertiary melanoma referral centre where we receive referrals from all hospitals in the southern provinces in Ireland. A total of 317 patients underwent either an inguinal or axillary SLNB as a staging procedure in Cork University Hospital for stage I\/II malignant melanoma (Breslow >1 mm) in this time period. All patients who subsequently went on to either an axillary or inguinal lymph node dissection due to a positive SLN and who had no evidence of systemic metastases were included.","title":"Postoperative Complications following Nodal Dissection and Their Association with Melanoma Recurrence"}
{"_id":"28babcb7-4319-07ea-bfda-4fd63352a782","text":"Interpretation of images in the current study was facilitated by imaging normal carpi initially and by evaluating limb pairs when available. Prominent widened vascular channels should not be confused with fissure fractures or abnormal dorsal cortical or subchondral bone lucencies. Fissure lines in C3 were evident in several horses with complete frontal or corner but not sagittal Fx as linear lucencies evident on multiple planes, perpendicular to the main fracture on CT images. Interpretation of imaging findings is complicated as certain changes might represent a normal adaptive response of bone to training and imaging a larger number of horses without carpal lameness throughout training would be needed.","title":"Comparison of Radiography and Computed Tomography for Evaluation of Third Carpal Bone Fractures in Horses"}
{"_id":"28bfa39c-3846-f4f8-f9de-a98f2f629867","text":"Identifying the appropriate therapeutic strategies for the treatment of CMMs has always been challenging due to their resistance to standardized approaches and frequent relapses. Considering the high frequency of local relapse, the goal of both systemic and local therapy is a treatment that can guarantee R0 with a relatively minimal invasive approach. The choice of the most appropriate treatment depends not only on the site of metastases location and the extent of the disease or the patient’s conditions, but is also influenced by the availability of the different techniques according to different institutions and countries. Treatments vary from simple surgery resections to topical or intralesional local injections, or a combination of these techniques with the most recent systemic immune or target therapies [51] (Table 3).","title":"The Diagnosis and Management of Cutaneous Metastases from Melanoma"}
{"_id":"28c59186-5621-4d31-483c-453cf6bee0f3","text":"In conclusion, our study shows a high coexistence of multiple malignancies in patients with MM. Although we cannot definitively confirm a true association between NCC and MM, we believe that there are sufficient links for further investigation in order to identify new aetiological factors and therapeutic targets for these cancers.","title":"Appearance of malignant melanoma after a non-cutaneous cancer diagnosis"}
{"_id":"28cb5a9a-0af8-e0fd-750e-e2be2e3f26b8","text":"To keep the patients’ best interest in mind, the objective of the current study is to identify any clinical or pathologic characteristics associated with improved survival and determine the influence of immediate autologous tissue breast reconstruction on survival in breast cancer patients receiving PMRT.","title":"Comparison of Long-Term Outcomes of Postmastectomy Radiotherapy between Breast Cancer Patients with and without Immediate Flap Reconstruction"}
{"_id":"28da4571-cf5d-a866-6bb8-816ee4470a2c","text":"Brachytherapy for prostate cancer is a method where radiotherapy is directly delivered to the prostate via surgical insertion of the radioactive source. Brachytherapy can increase the amount of radiation delivered to the prostate cancer but sometimes at the cost of increased side effects. Here, we review promising early results from alternative non-invasive techniques that now exist and can deliver similar radiotherapy doses without the need for the surgical procedure required for brachytherapy.","title":"Virtual HDR Boost for Prostate Cancer: Rebooting a Classic Treatment Using Modern Tech"}
{"_id":"28dcf9c5-95b6-5ed5-f849-f0f3b81e1f35","text":"The same surgeon performed all lumpectomies. Although we did not find any statistically significant differences in the re-excision rates between the first 20 and last 20 cases, we experienced a learning curve at the beginning due to a new procedure in use which was not demonstrated by the re-excision data. Intraoperative and specimen US provide useful information to the surgeon for incision site and extension of margin shaving.","title":"Intraoperative ultrasound reduces the need for re-excision in breast-conserving surgery"}
{"_id":"28dd2158-68bd-440d-0382-63ad80c90885","text":"The presented results suggest an improved workup procedure of patients as histological biopsies were more often obtained. Surgical resection following a biopsy diagnosis resulted in a significant higher rate of negative resection margins, underscoring the importance of the diagnostic process.","title":"Time Trends in the Incidence and Treatment of Extra-Abdominal and Abdominal Aggressive Fibromatosis: A Population-Based Study"}
{"_id":"28e0bf94-d382-7cee-04d1-214c6f17c39e","text":"The tibialis anterior partial muscle flap has been described to cover defects localized in the upper third and middle third of the tibial shaft, but not for wounds of the distal leg.1,2 Rotation of the superficial part of the muscle on a proximal pedicle while preserving its tendon and function can be done to cover defects in the upper third of the leg.","title":"Split Hemianterior Tibialis Turndown Muscle Flap for Coverage of Distal Leg Wounds With Preservation of Function Gundlapalli et al"}
{"_id":"28e79442-9b6b-2637-5a7c-5db8e57e3880","text":"Vein “fishing” (effort to find a viable vein to inject the drug dilution after having penetrated the skin with the needle) was repeatedly addressed by participants as they noted that although they may miss on the first injection attempt, they do not always completely retract the needle out of their tissue and would continue to partially retract and adjust the angle in an attempt to find a vein. Additionally, one participant reported seeking a larger gauge needle due to difficulty finding a vein.","title":"Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage"}
{"_id":"28e80e11-aead-8dcf-07ee-92484963c329","text":"The lingual frenulum is located in the inferior surface of the tongue and is considered a median fold of tunica mucosa that connects the tongue to the floor of the mouth and allows the free movement of its anterior part [12].","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"28ed239f-6b49-4bc8-a4a9-ad68100a0a31","text":"Thorough gross and microscopic examination helped to detect these occult carcinomas and also helped in planning futuretreatments. We consider a thorough gross examination and sampling of mammaplasty specimens to be mandatory.","title":"Histopathological Evaluation of Reduction Mammaplasty Specimens to Detect Occult Breast Cancer: A Report from Southern Iran"}
{"_id":"28f5c8c0-bd7f-28b7-965f-f8fe7675fe5f","text":"Male protrusion of the chin was typical and largest in the second age category from 20 to 40 years. Chin prominence decreased with aging, but the width of the male mandible region increased. This widening of the lower third of the male face was related to the loss of the jawline, which changed from fluent to more fragmented, especially in the last age category.","title":"Three-dimensional analysis of modeled facial aging and sexual dimorphism from juvenile to elderly age"}
{"_id":"29015db7-65e1-6323-275e-d25c162bf783","text":"In conclusion, we describe an extremely rare case of desmoid tumor in the sternal manubrium mimicking malignant tumor, which was successfully treated by complete resection of the tumor and immediate sternal reconstruction with autogenous rib grafts. The patient has been disease free after 46 months of follow up without any other treatment. We consider that the sternal reconstruction with autogenous rib grafts is a simple and effective solution to a complex problem.","title":"A rare desmoid tumor arising from the manubrium"}
{"_id":"29038030-ef82-4a8e-cd1d-e0c483f2d463","text":"This study is aimed at evaluating the initial result of 30 breast cancer patients who underwent mastectomy and immediate breast reconstruction by the DIEP flap at Hanoi Medical University Hospital from June 2019 to June 2021.","title":"Deep Inferior Epigastric Perforator Flap for Immediate Breast Reconstruction following Mastectomy in Breast Cancer Patients: An Initial Experience in Vietnam"}
{"_id":"2903c334-6c46-d294-167e-8c1c3b7c55b8","text":"Restoration of the head and neck defects has always been a challenging issue for surgeons. In the past, most of these defects were reconstructed by adjacent tissues using pedicle flaps. Over the past two decades, the use of free microvascular flaps has become widespread. The fibula flap is one of the suitable free flaps to repair the head and neck defects. The use of this flap has been widely accepted in the reconstruction of hard tissue defects, especially the mandibular bone. The implementation of several studies regarding anatomy in this area in recent years has resulted in the promotion of scientists and researchers’ knowledge about the blood flow patterns of this flap.,","title":"Evaluation of Anatomic Variations of Fibula Free Flap in Human Fresh Cadavers"}
{"_id":"29084007-c9c0-7dfa-a9fd-a407e3289d6e","text":"It is also difficult to evaluate whether a perforator is healthy or can ufficeently supply blood to the vessel territory if a flap is designed using only a hand-held Doppler device. Furthermore, Doppler ultrasound is easy to use but is operator-dependent and has shown low sensitivity for the identification of perforators and high interuser variation.","title":"Clinical Applications of the Intercostal Artery Perforator Flap for Trunk Reconstruction"}
{"_id":"2908eef0-5ae0-1d21-aac1-e8abc9426840","text":"Photodynamic therapy begins with topical application of a solution containing photosensitive porphyrins, such as aminolaevulinic acid and methyl-aminolaevulinic acid, to the affected tissue.8,35 After a latency period of 4−20 hours, the photosensitive porphyrins are illuminated with visible light and produce radical oxidative species that are cytotoxic to the malignancy.8,35","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"290f6d8e-f618-9176-6c99-f41e4bf78c68","text":"Meanwhile, the plastic team elevated the flap and prepared the skin pocket on the chest wall, recipient vessels in the axilla or chest wall. The skin and subcutaneous tissue island were lifted off the external oblique fascia until the perforator was encountered. Once the preferred perforators were identified, the anterior rectus was incised around the neurovascular bundle. The incision in the fascia was prolonged laterally and distally towards the groin to facilitate the dissection of the main stem of the inferior epigastric vessels. Then, the rectus abdominis muscle was split longitudinally and inferiorly to expose the desired pedicle length. Branches of the intercostal nerves that pass anterior to the deep inferior epigastric vessels should be preserved.","title":"Deep Inferior Epigastric Perforator Flap for Immediate Breast Reconstruction following Mastectomy in Breast Cancer Patients: An Initial Experience in Vietnam"}
{"_id":"291224aa-4aab-fd1a-f8a4-bd336e646b12","text":"Pyogenic vertebral osteomyelitis is a highly morbid and debilitating disease process typically acquired via hematogenous seeding of bacteria in the highly vascular vertebral bone marrow.","title":"Burkholderia cepacia complex Cervical Osteomyelitis in an Intravenous Drug User"}
{"_id":"29152a6d-85bd-448c-604e-a57c042b5345","text":"The majority of the published evidence on NPWT relates to the first commercially available system. The challenge for newer NPWT systems has been to demonstrate delivery of similar or identical wound care outcomes. The results of this study demonstrate that there are no clinically significant differences in outcomes that can be observed between the two different commercial NPWT systems. The choice of which system to use is then no longer dependent on clinical efficacy or the size of the body of evidence but can become dependent on other factors such as cost, availability, and personal choice.","title":"A Retrospective Comparison of the Performance of Two Negative Pressure Wound Therapy Systems in the Management of Wounds of Mixed Etiology"}
{"_id":"291779fc-2774-6211-a2bf-62a2f85c6595","text":"The mechanism of action of most chemotherapeutic agents relies on the interference of cell proliferation to prevent uncontrolled cell division of cancer cells. However, healthy cells are also in a constant proliferation process, so that an antineoplastic will not discriminate between a healthy and a malignant cell, resulting in very severe adverse effects during treatment.","title":"Nanoliposomes in Cancer Therapy: Marketed Products and Current Clinical Trials"}
{"_id":"2918a487-d5e1-51a0-00d9-4651a3411b32","text":"Patients were screened by sampling the nasal flora with a nasal swab and subsequent analysis with either PCR testing or bacterial cultures up to four weeks before surgery. Approximately one week prior to surgery, patients who carried S. aureus were treated with topical mupirocin twice daily for three days. All patients in the study used chlorhexidine body wipes preoperatively and received appropriate perioperative antibiotic prophylaxis. Patients not carrying MRSA received weight-based intravenous cefazolin 30 to 60 minutes preoperatively followed by repeated postoperative doses every eight hours for 24 hours. Patients who carried MRSA were administered weight-based vancomycin preoperatively followed by repeated postoperative doses every twelve hours for 24 hours. Those allergic to cephalosporin were administered either clindamycin or vancomycin in a similar manner.","title":"Predictors of Staphylococcus aureus Colonization and Results after Decolonization"}
{"_id":"2919a8d7-1741-fa8f-4f41-a7fc9f4f10d3","text":"Fellows described a wide range of competencies learned through Afya Bora that were helpful to their work, in addition to a sense of confidence in their own leadership qualities that was not linked to any particular learned skill. Many fellows highlighted changes that utilized their leadership skills, as is evidenced in this quote:","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"291f9067-80a7-f39c-0151-d30cea7d2421","text":"Aggravation of the symptoms could be seen during the follow up with a neck extension muscle strength of 3 on the MRC scale and more significant swallowing difficulties requiring adjustments in food intake. The skin lesions had been present in the year prior to the onset of muscle weakness but could also be detected continuously after.","title":"Sporadic late onset nemaline myopathy with concurrent dermatological symptoms responding to immunosuppressive treatment"}
{"_id":"2923d5cc-2f94-5a66-a114-135e0419f892","text":"The group agreed that the goal is to have every patient with breast cancer evaluated by an oncoplastic team that is capable of offering the full range of oncoplastic surgical options. On the basis of the available literature, evidence, and personal observations, the group defined the following unmet needs in breast cancer surgery:","title":"A Position Statement on Optimizing the Role of Oncoplastic Breast Surgery"}
{"_id":"2929b296-3d8e-b57e-909b-78ae97fc239f","text":"The pedicle of the LENI flap distinguishes the flap from the simpler island or the simplest V-Y advancement flap. The lateral nasal muscles carry the blood supply from the lateral nasal and alar artery branches of the angular artery. The lateral nasal island flap is distinguished from the LENI flap by its deep flap release. The pedicle of the LENI flap extends past the nasal bones and the piriform aperture and is released from the bone. The skin island of the LENI flap can extend past nasal skin into the cheek but can also terminate more medially on the nose.","title":"Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction"}
{"_id":"292d82d1-a6a4-d510-9f06-20081395b206","text":"The implementation of new systemic treatment regimens contributes to improved treatment outcomes irrespective of the stage of the disease. To improve treatment outcomes in terms of the incidence of distant metastases, the impact of local curability on the length and quality of life of patients increases.","title":"Radiotherapy in Pancreatic Cancer: To Whom, When, and How?"}
{"_id":"2936f91c-1a7f-5a08-4e46-f94c68549437","text":"We believe that there is a pressing need to evaluate this relatively expensive technology. We, therefore, propose a multicentre randomised clinical trial comparing negative pressure wound therapy with standard dressings for patients with wounds associated with open fractures of the lower limb.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"29393189-f3fe-eac3-4806-662759d7bcbd","text":"Thrombosis treatments include the use of antiplatelet, anticoagulant, and fibrinolytic agents. Antiplatelets are generally used to prevent and treat arterial thrombosis, which is caused by atherosclerotic plaque rupture that leads to collagen exposure followed by platelet aggregation and thrombus formation. Treatments targeting platelets appear effective in this setting as platelets have an important role in arterial thrombus growth. However, venous thrombosis which occurs under low shear stress and is largely driven by a coagulation imbalance is treated with anticoagulants since venous thrombi contain an abundance of fibrin. Fibrinolytic agents may be used in both arterial and venous thrombosis settings.","title":"Thrombus Structural Composition in Cardiovascular Disease"}
{"_id":"29394174-6580-a988-41ac-1eb3039aa1d5","text":"The posttreatment was satisfactory with the disappearance of the pain and the recovery of the shoulder movements in all planes of motion.","title":"Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint A case report"}
{"_id":"2941f8a2-a78a-d58d-4589-7d714da162d6","text":"Full extension should be achieved at this point. Doppler is used to auscultate the dorsalis pedis and anterior tibial pulse at the ankle to confirm full extension without undue tension on the popliteal vessels. Moreover, the maximal extension and the adequacy of the distal pulses are analyzed to ensure that there is no vascular compromise with complete extension. The location of the distal pulses is marked to facilitate postoperative assessments.","title":"Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty"}
{"_id":"294472cb-af45-32e3-ec42-b06a2abb3d15","text":"Melanoma can metastasize to subcostal lymph nodes and be found at the time of SN biopsy or identified at recurrence. These small nodes are fed by lymphatic channels that run in the neurovascular bundle under the ribs. When lymphatic mapping identifies a subcostal SN, it should be excised.","title":"Subcostal lymph nodes: An unusual sentinel lymph node basin in cutaneous melanoma"}
{"_id":"294a3192-99df-28c6-654e-ae2fdc1525cd","text":"Next, the length of the skin mirror was measured with a tape along the movement path of the skin mirror from the reference point of the rotation arc to the metal plate exposed area, and about 1 cm was added to this to determine the length of the skin mirror. The shape of the flap was circular or oval, depending on the shape of the defect, and the distal portion of the flap was shaped like a teardrop with a length of about 2 cm. When the skin was sutured in the defect, the inlet of the skin mirror was cut in a straight line of the same size and sutured with the distal flap to reduce the pressure on the skin mirror. The size of the flap was set to be about 0.5 cm larger than the defect in men and about 1 cm larger in diameter than the defect in women with relatively large amounts of subcutaneous fat.","title":"Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap"}
{"_id":"295a3f83-4c6c-fbc3-e778-c5ae01ca248f","text":"Practice guidelines for uncomplicated skin abscesses following incision and drainage recommend antibiotic therapy to decrease the risk of infection [49]. Hygienic conditions and therapy are not easily available to the PWID who self-treat. Inadequate treatment and persistence of infection may precipitate hematogenous spread. Underlying tissue damage both locally and at distant sites would allow for adherence and propagation of bacteria. Increased medical management of uncomplicated SSTI among PWID would likely decrease rates of treatment failure and risk of progression to SBI. For participants with prior SBI hospitalization, adaptation of safer injection practices as a result of education and past experience were reported to occur yet did not lead to prevention of future SBI in this population. This may be related to limited knowledge and omission by healthcare providers surrounding the multiple potential amplifiers of bacterial infection risk during the injection process.","title":"Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage"}
{"_id":"295e515b-8a23-68de-8a95-f1c7b5066228","text":"He presented a 12 × 7 cm abdominal dehiscence which could not be closed neither directly nor with local advancement flaps because of excessive tension on wound edges. Moreover, patient clinical conditions made adoption of myocutaneous regional or distant flaps contraindicated. We subsequently considered NPWT as the best therapeutic option in order to reduce wound dimensions and to obtain secondary closure. For the first period negative pressure was set at −70 mmHg and was renewed twice a week (Figure 2). We decided to adopt a lower pressure at the beginning as we were not confident to apply it to a biological mesh.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"2961d713-5ebb-aa03-a4da-5c545f2543ce","text":"In our data, expert radiologists have an above-chance performance in distinguishing prior mammographic images belonging to women who are diagnosed with breast cancer, even when those prior images contain no apparent visible signs that cancer exists. This means that some women who will be diagnosed with breast cancer in the future may be identified even before lesions become visible, large and more challenging to manage. By identifying women at high risk, a reliable gist signal could be used to tailor screening pathways to facilitate early detection of the disease and personalized medical strategies can be implemented.","title":"Radiologists can detect the ‘gist’ of breast cancer before any overt signs of cancer appear"}
{"_id":"2963a3af-ddf9-981a-42a3-75772e556c80","text":"The endpoints included the first nodal or metastatic disease after negative SLNB in a patient not submitted to any other medical or surgical treatment so far.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"2964ce22-5274-148d-91ce-c956cbfa610b","text":"The LENI myocutaneous flap was used primarily in the lower third of the nose in this study owing to the referral bias to the tertiary referral center setting and owing to the flap’s unique applicability to the caudal nose.","title":"Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction"}
{"_id":"2967482b-8d28-20c4-a8f5-13529b800eb2","text":"If the small SCC can be easily cut and repaired by a local cutaneous flap, the locally advanced one poses severe challenges in terms of functional impairment and aesthetic demands.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"29677165-b237-68b2-fcd1-1e56c447b9e8","text":"The absence of a record of WS on the majority of patient records meant that the WS had to be calculated retrospectively, which could result in measurement bias, since the variable in the score that indicates a need to hypothesize “diagnoses more or less probable than DVT” is dependent on the investigator’s judgment. The sample was selected based on data on requests for DD assay and it is therefore possible that patients who were only investigated using imaging exams have been omitted from the sample.","title":"Evaluation of the diagnostic management of deep vein thrombosis in the emergency department of a tertiary hospital in Santa Catarina, Brazil: a cross-sectional study"}
{"_id":"296ea457-1d7c-1724-2ec8-22d9ec1fd85e","text":"The predictors we used to determine the impact on holding different types of institutional and national leadership positions included type of fellowship training, board certification year, MBA degree, ENT training, and OMFS training. The baseline used as the basis of comparison was plastic surgeons who did not pursue any fellowship and were in independent practice for 10–15 years.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"2974c38b-d0d8-374d-d55b-b2b373a50c73","text":"All of our patients wore GCS, as it is well documented in the literature that these decrease the incidence of DVT by passively applying constant pressure, which reduces the volume of blood that remains in the leg, decreasing vein distension and stasis.27 Some reports have shown that they reduce plasminogen activator 1 levels and the release of tissue plasminogen activator.28 Graduated compression stockings are highly effective, with reports showing a 60% reduction in DVT risk.27 We apply GCS prior to surgery, which has shown to be beneficial because patients are most susceptible to venodilatation and venous stasis at induction and during surgery.20 We also encourage patient mobilization from day 1 after surgery.","title":"Risk of Thromboembolism Following Body-Contouring Surgery After Massive Weight Loss Griffin et al"}
{"_id":"2978fe7e-ee81-06ad-f917-f51f53f35329","text":"The granulation tissue is present only in some minute areas mainly in the periphery.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"297ba672-4349-4e7f-fbd8-48468f6659aa","text":"The majority of patients underwent no surgical intervention for the opposite breast except one patient who presented with bilateral severe ptosis and a moderate breast size requiring simultaneous contralateral breast reduction at the time of mastectomy and reconstruction to avoid noticeable asymmetry. At the same time, her large breast skin envelope following skin-sparing mastectomy was utilized to allow for subtotal burying of the flap [Figure 6]. Another patient was offered contralateral surgery due to asymmetry because of size mismatch and moderate ptosis but she refused.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"297f4f26-830d-efe5-a8c4-d2d018d849c0","text":"To evaluate the advantages and outcomes of bilateral simultaneous endoscopic cartilage tympanoplasty in patients with bilateral tympanic membrane perforations.","title":"Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results Timpanoplastia bilateral transcanal por via endoscópica com cartilagem realizada simultaneamente: resultados iniciais"}
{"_id":"297f69e8-33e9-133b-5da8-e2fb35964d09","text":"A method is proposed to detect melanoma metastases in human lymph nodes using multispectral photoacoustic imaging. The method was conducted on a set of lymph nodes containing tumor positive and tumor negative nodes. Separation of important optical absorbers like blood and melanin proved possible based on the spectral information. Lymph nodes could be analyzed in image planes and also as entire nodal volumes (3D).","title":"Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging"}
{"_id":"29828aa4-8e44-f092-ebd4-237c378f65f2","text":"Two to five days after BTX is injected into a muscle paresis occurs which lasts for at least 3 months until it gradually starts to wear off. The subjective duration of action in a given patient seems to be stable, but there is a great variability between different subjects.","title":"Botulinum Toxin: Non-cosmetic Indications and Possible Mechanisms of Action"}
{"_id":"29869dcb-7dbc-6ef8-db3d-55e3d0ffe24d","text":"Good and satisfying results were achieved in all cases except for one case that was operated again for debulking of flap.","title":"Subcutaneous Forehead Island Flap for Nasal Reconstruction"}
{"_id":"29965950-1481-c6b9-08d0-fcde2d71daee","text":"The procedure is simple and utilizes common tools found in a clinical setting. Side effects are minimal with minor inflammation and bleeding being the most common though are easily remedied. Skin punch biopsies can be performed anywhere on the body though the most common sites are typically on the distal leg at 10 cm above the lateral malleolus, the proximal leg 10 cm above the lateral epicondyle of the femur, 20 cm distal to the iliac crest and the dorsum of the foot. These sites in particular have the most data available on them and therefore have well established age and gender adjusted normative values. Table 2 provides a step by step description of a typical biopsy.","title":"Intraepidermal Nerve Fiber Density as Measured by Skin Punch Biopsy as a Marker for Small Fiber Neuropathy: Application in Patients with Fibromyalgia"}
{"_id":"2998e511-ce09-65cb-a0f6-eaaad2cabe2e","text":"Trust was interlinked with beliefs about the knowledge differential between staff and patients in relation to wound healing. It was felt the clinical and research teams had greater knowledge and, therefore, should be making the decisions. Although those with knowledge of NPWT gained from medical family members would have preferred to have received it as part of their care:","title":"Participation in a trial in the emergency situation: a qualitative study of patient experience in the UK WOLLF trial"}
{"_id":"299c8a77-207c-af6a-e0c9-20b81c5607c9","text":"Inguinal nodal metastasis is the most important prognostic factor for survival in a patient with carcinoma penis. While the standard treatment for node-positive disease is a groin nodal dissection, the management of clinically negative groin is controversial. In patients with T2-T4 disease incidence of occult nodal metastases is high and prophylactic nodal dissection is recommended by many although there is no Level 1 evidence supporting this practice. Other options include wait and watch policy where patients are closely observed and lymph node dissection is done at relapse. The optimum surveillance has not been clearly defined. Most studies addressing the issue have examined patients once in three months for the first two years and once in six months for the next two to three years and then yearly thereafter. This is based on the premise that most inguinal metastases occur within the first two to three years. There have been no reported cases of inguinal recurrences beyond five years in any large series. Here we report the case of one of our patients who had inguinal nodal recurrence 10 years after treatment for the primary. This shows that a few patients can be at risk of inguinal metastases even after the initial period of active surveillance.","title":"Carcinoma penis: How late can inguinal nodal metastases occur?"}
{"_id":"299e1c3a-bec5-62b4-4665-46fd2538e32f","text":"ii) Adequate airway reconstruction must be possible with an anterior cartilage graft to ensure optimal stability of the laryngeal framework. The cricoid cartilage is a complete annular structure. Anterior midline division of the cricoid cartilage alone should not affect the stability of the larynx. If posterior grafting is necessary, then anterior and posterior midline divisions of the cricoid cartilage are required. While the laryngeal field is poorly exposed, the incision must be extended into a full laryngofissure to provide optimal exposure of the cricoid plate for the posterior cricoid split and adequate room for fixing the posterior costal cartilage graft into position. The aforementioned surgery will severely affect the stability of the laryngeal structure. Gustafson et al. reported that the postoperative reintubation rate was twofold and the postoperative tracheostomy rate was threefold higher in the patients who had undergone SS-LTR with anterior and posterior costal cartilage graft compared with single costal cartilage graft [6]. The most important reason for these postoperative outcomes is that the stability of the cricoid cartilage was severely compromised by the anterior and posterior costal cartilage transplantation [6]. A stent of proper diameter and length must be selected after surgery to ensure the stability of the airway structure and prevent the translocation of the graft [27]. The stent will result in the inability to extubate immediately following surgery. Only anterior costal cartilage transplantation was performed without affecting the stability of the larynx. It is recommended that no stent should be placed after surgery. The endotracheal tube can be removed immediately following anesthetic resuscitation and the patient can be returned to the general ward.","title":"Immediate extubation after single-stage laryngotracheal reconstruction for subglottic stenosis in children"}
{"_id":"29a0238b-30dd-d9f1-5062-0904662a8972","text":"The use of vascular ultrasonography for mapping of the great saphenous vein in coronary artery bypass surgery has properly identified and evaluated the saphenous vein, significantly reducing wound complications and unnecessary incisions. It would be advisable to use this noninvasive and easy to use method routinely in coronary artery bypass surgery.","title":"Use of Doppler Ultrasound for Saphenous Vein Mapping to Obtain Grafts for Coronary Artery Bypass Grafting"}
{"_id":"29a49672-927f-83fe-e192-88a7354664ad","text":"There are limitations to TIP and LPS because these assessments do not take into consideration compensation patterns that may affect the measurements. Common compensation mechanisms include floor of mouth elevation, neck engagement, jaw protrusion and facial grimace among others. Previously, we have shown that some patients augment the actual tongue elevation by engaging the neck muscles and elevating the floor of mouth as a possible compensation for restricted tongue mobility. Clinically, floor of mouth elevation can be controlled by providing the subject with feedback or by holding a gloved finger or grooved director behind the mandibular incisors and asking the patient to lift the tongue while pressing down on the floor of mouth. Assessment of resting tongue posture can also be assessed on CT scan or with BioGlo ophthalmic fluorescence dye applied to the tongue and UV light used to assess fluorescence in the palate. Each of these tools is limited as they only provide for an assessment in a single moment in time rather than usual or typical tongue resting position. Electropalatography with palatometer oral interfaces (such as SmartPalate System) could be used to allow subjects to assess tongue posture and oral movements in real time. , , Tongue pressure can be assessed with Iowa Oral Performance Instrument (IOPI) among other devices, , but are only reliable if performed in combination with electromyography of the neck and jaw to control the involvement of cervical and facial muscles that may confound intra‐oral tongue pressure measurements. The endurance in seconds with which the subjects can maintain lingual‐palatal suction may be a useful metric for investigation in future studies. Tables S1 and S2 are provided as potential resources for future research and clinical validation.","title":"Assessment of posterior tongue mobility using lingual‐palatal suction: Progress towards a functional definition of ankyloglossia"}
{"_id":"29ab8d66-638e-2b62-7107-e23ddd8725bd","text":"Mouse imaging on the scintigraphy system was performed by keeping the mice anesthetized under isoflurane and constant temperature of 37 °C. Dynamic scans were acquired with a 2 min frame with a total of 30 min duration, based on the injected activity and system specifications.","title":"Comparative Study of a Series of 99mTc(CO)3 Mannosylated Dextran Derivatives for Sentinel Lymph Node Detection"}
{"_id":"29b48d2b-b30f-ee7e-f529-ba1e8fda821a","text":"A retrospective review was performed using a prospectively maintained database of patients admitted to a trauma center during a five-year time period. Patients hospitalized for greater than 48 hours who received a screening venous duplex for DVT were included in the study.","title":"Early Detection of Deep Venous Thrombosis in Trauma Patients"}
{"_id":"29bc60ca-23ca-8b23-3e95-ede6f3373915","text":"For those patients who did not give consent prior to surgery, at the first appropriate time when the patient has regained capacity, the research associate will provide the patients with all of the study information. The patients will be given the opportunity to ask questions, and discuss the study with their family and friends. They will then be asked to provide written consent for continuation in the study.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"29bf59df-269d-382f-7861-f13c02b8ac8e","text":"One frequent argument for the choice of mastectomy without RT over BCS and postoperative RT is the omission of RT. RT implies a significant number of daily visits to the hospital which may be problematic, especially for older adults in rural areas, where travel to healthcare institutions can be a substantial obstacle. In addition, older women and their surgeons may be more prone to consider the loss of a breast as less traumatic than for younger patients. It is however reported that the benefits of BCS regarding quality of life and body image are also significant in older women, and several observational studies have reported a better overall and breast cancer-specific survival after BCS than after mastectomy. Adding the fact that the routine time frame for RT after BCS has recently been shortened from about 5 weeks to 1 week as a result of the FAST-Forward trial, the omission of RT should no longer be an argument for denying older women BCS.","title":"Medical and surgical postoperative complications after breast conservation versus mastectomy in older women with breast cancer: Swedish population-based register study of 34 139 women"}
{"_id":"29c20a7b-c40e-1d1b-f376-3f2fb1ef1063","text":"Surgical intervention can achieve good result in patient presenting with flexion deformity.","title":"A successful surgical treatment of a closed rupture of flexor digitorum superficialis in surgeon’s hand. A case report and review of literature"}
{"_id":"29d12d5c-283e-646f-4677-03b64faff5d4","text":"Postoperative hospital outcomes were obtained prospectively from our institutional database which is used to populate both the Society of Thoracic Surgeons database and the New York State database. Long-term mortality was evaluated with the Social Security Death Index.","title":"What Is the Best Proximal Anastomosis for the Free Right Internal Thoracic Artery during Bilateral Internal Thoracic Artery Revascularization? A Prospective, Randomized Study"}
{"_id":"29da58cd-d855-3cac-e957-dad4b019ad1f","text":"The present phase II study was open for patients with LARC without distant metastases and patients with local recurrences considered to be surgically curable, some with sufficient tumour shrinkage after preoperative treatment. During and after the inclusion and follow up of the study, the standard treatment has changed regarding radiation dose and inclusion of chemotherapy. We therefore waited with publication until long-term results were available. The present series of advanced and recurrent rectal cancer patients with good local control warrant consideration among the new therapeutic options. The secondary aim is the presentation of treatment-related toxicity.","title":"Long-Term Outcome in a Phase II Study of Regional Hyperthermia Added to Preoperative Radiochemotherapy in Locally Advanced and Recurrent Rectal Adenocarcinomas"}
{"_id":"29da9671-b83c-180c-713a-9633b8ba839e","text":"Lymph node dissection is often performed as a part of surgical treatment for breast cancer and malignant melanoma to prevent malignant cells from traveling via the lymphatic system. Currently little is known about postoperative lymphatic drainage pattern alterations. This knowledge may be useful for management of recurrent cancer and prevention of breast cancer related lymphedema. We mapped the complete superficial lymphatic system of a dog and used this canine model to perform preliminary studies of lymphatic architectural changes in postoperative condition.","title":"Lymphatic Territories (Lymphosomes) in a Canine: An Animal Model for Investigation of Postoperative Lymphatic Alterations"}
{"_id":"29e0cd5a-7254-9e26-b6b3-7ed8705c65f4","text":"Among other novel findings in our endeavor to find associated factors with recurrence, was the association of smoking with recurrence and the insignificant association of waterpipe use with recurrence. As the use of waterpipes continues to grow worldwide, it has become a global epidemic with recent reports from the middle-east indicating that it has even surpassed cigarette smoking to become the most common form of tobacco used in the region [18]. This is the first study to evaluate waterpipe use in BC recurrence.","title":"Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?"}
{"_id":"29e573ae-9847-9987-ba29-e73000de25f1","text":"Immediately after the harvest and with no pharmacologic treatment, the reversed SV was anastomosed in a parallel fashion to the posterior aspect of the left ITA to construct a Y-composite graft. We always performed the Y anastomosis first, before constructing distal anastomoses, because it was possible to perfuse ischemic myocardium after each distal anastomosis during off-pump CABG. After construction of the Y-composite graft, the left coronary artery territory commonly was revascularized first by using the left ITA while the distal end of the SV conduit was clamped with an atraumatic bulldog clamp and left to be dilated spontaneously by the native flow and pressure of the left ITA.","title":"Techniques and Outcomes of the No-Touch Vein Conduit as a Y-Composite Graft"}
{"_id":"29e6ef12-e03c-1a2d-2334-982464f3a15d","text":"Those whose babies were referred in exclusive use of infant formula and whose records did not contain precise information on maternal lactation conditions were considered missing data on the possibility of breastfeeding by the mother. Infants able to breastfeed were those referred to on EBF or mixed (breastfeeding plus infant formula), with no description of infant conditions that made lactation impossible, or in cases whose conditions were corrected before referral.","title":"Breastfeeding versus free distribution of infant formulas by the Public Health System"}
{"_id":"29ea4a09-3212-d751-051f-65bb07577574","text":"BTA is a safe and effective therapeutic strategy for the treatment of AGA without adverse effects, and BTA combined with FNS exhibited a superior therapeutic effect than BTA alone.","title":"Effectiveness and Safety of Botulinum Toxin Type A in the Treatment of Androgenetic Alopecia"}
{"_id":"29f36e19-4d21-4da3-c084-28fc406068b2","text":"The orbital location is extremely rare, especially in the pediatric population. The management of desmoid fibromatosis is based on the function preservation and the maintenance of a good quality of life, but in case of symptomatic patients or aggressive course of the disease or risk of functional damages, the surgical approach may be considered. Therapeutic alternatives to surgical resection are radiotherapy and systemic therapy.","title":"Orbital Desmoid-Type Fibromatosis: A Case Report and Literature Review"}
{"_id":"29f96930-b255-bc02-c18c-808f81243c98","text":"Patients without EC metastasis in specimens from both SLN biopsy and systematic lymphadenectomy were considered as true negatives.","title":"Sentinel Lymph Node Biopsy in Surgical Staging for High-Risk Groups of Endometrial Carcinoma Patients"}
{"_id":"29fe2b7d-2e57-3bf5-9bc3-fbf9d65aedc1","text":"Between January 2018 and November 2019, 10 patients who sustained composite tissue defects in the lower extremities caused by deep infections were treated by the combined use of IMT (Masquelet technique) and neurocutaneous flap in two level-one trauma centers in Shanghai as shown in Table 1. All of patients present septic composite defects in lower extremities were included in this study.","title":"Simultaneous reconstruction of septic composite defects in lower extremities: Combination of fasciocutaneous perforator flap and Masquelet technique"}
{"_id":"2a0160c0-b4a9-d205-b541-7e874d759fef","text":"Infection associated with IO access can be severe. Skin antisepsis prior to IO insertion and rapid device removal once alternative access is established can reduce the risk of infection.","title":"Tibial Osteomyelitis Following Prehospital Intraosseous Access"}
{"_id":"2a0324ed-8003-c328-e1b0-8d37d7417d6d","text":"Patient reviewed the case report and gave written permission for the authors to publish the report.","title":"Thoracic Paravertebral Block, Multimodal Analgesia, and Monitored Anesthesia Care for Breast Cancer Surgery in Primary Lateral Sclerosis"}
{"_id":"2a0c2903-8826-e9fe-daee-69f3287fb854","text":"Using photogrammetric methods, it was observed that males exhibited a significantly larger nasofrontal angle, and female patients showed a relatively larger nasofacial angle. The medial canthus and nose width index, nasal tip protrusion and nasal width index, and nasal width and ala length index were both significant in males and females. For the method of forehead expansion flap and costal cartilage transplantation, it could better improve the nasal facial angle and is better in shaping the nasal height and less flaring of the alar bases. By comparison, the method of local flaps and silicone prosthesis implantation can better improve the columella length and nasal tip protrusion index. The anthropomorphic data from our study may serve as a material for nasal and reconstructive surgery.","title":"Morphological Analysis of Nose in Patients of Tessier No. 0 Cleft With a Bifid Nose in China"}
{"_id":"2a1fc37c-1a9b-f0e4-349d-9d1b7df13bea","text":"According to age group, oral treatment options for the therapy of uncomplicated AHOM according to etiology are suggested and shown in Tables 6 and 7.","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"2a205c99-cbe2-3f3b-dc1f-8610628869f4","text":"Haematoma formation in our patients was noted to be closely related with intravenous injection of heparin. This would later result in compression of the veins resulting in venous congestion. Of the eight flaps lost due to venous congestion, six of them were of patients on intravenous heparin. Routine use of intravenous heparin has since then been stopped and is only used in cases of difficult anastomosis or once a clot forms on the table. Topical irrigation of heparin on the other hand seems to be a safe procedure.","title":"Free Flaps in a Resource Constrained Environment: A Five-Year Experience—Outcomes and Lessons Learned"}
{"_id":"2a268c50-bc72-536d-eb5d-f110321a08fd","text":"All three cases received right kidney donations as the renal function and volume of the right kidney were inferior to those of the left kidney. The saphenous vein is procured by incising the femoral region on the same side of the transplant iliac fossa when necessary. Each patient's characteristics and clinical results were summarized in Table 1. All of these recipients had no other potential donor, and they had informed consent for the procuration of major saphenous vein and the risk of vascular accident. After operation, none of them was administered with antithrombotic agent.","title":"Venous reconstruction using a Y‐shaped saphenous vein in kidney transplantation: A report of three cases Y Miyauchi et al."}
{"_id":"2a2bf753-149d-e6c4-17d7-5500468159e6","text":"When the biceps brachii and brachialis are paralyzed owing to musculocutaneous nerve injury, the forearm cannot flex the elbow joint in the pronated or supinated position. Thus, reconstruction using the radial tuberosity alone when there is also brachialis paralysis can be expected to yield poorer flexion strength when the forearm is pronated than when it is supinated. We hypothesized that a latissimus dorsi muscle flap could be sutured to both the radius and ulna to achieve flexion stability in both the humeroradial and humeroulnar joints. However, to the best of our knowledge, no previous report has mentioned this in the literature. The two cases in which this procedure was performed demonstrated that the flexion force in the supinated position was equal to that in the pronated position.","title":"Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports"}
{"_id":"2a2f9da6-e24b-7025-d9ce-71954730e74c","text":"Computed tomography scans from patients with tumors of the skull were considered and 3 cases were selected. Images were imported into a DICOM image processing software and tumor margins were determined based on agreement between a board-certified veterinary radiologist and veterinary surgical oncologist. Virtual surgical planning was performed and a bone safety margin was selected. A defect was created to simulate the planned intraoperative defect. Stereolithography format files of the skulls were then imported into a plate design software. In collaboration with a medical solution centre, a custom titanium plate was designed with the input of an applications engineer and veterinary surgery oncologist. Plates were printed in titanium and post-processed at the solution centre. Total planning time was approximately 2 h with a manufacturing time of 2 weeks.","title":"Schedule feasibility and workflow for additive manufacturing of titanium plates for ranioplasty in canine skull tumors"}
{"_id":"2a349a04-f6b0-bec8-c129-ec776df95bdd","text":"In the first stage, the tissue expander was placed subpectorally, and its exposed lower pole was covered with LD. Fixation of LD within the superior pole was subdermal with absorbable suture and within the lower pole fixation was done in continuous manner. The steps of tissue growth and implant exchange were just like our technique, however in our technique we had a tendency to place the expander over pectoral muscle and whole of expander was underneath LD. Fixation was carried out separately with absorbable suture and reverdin needle.","title":"Latissimus Dorsi Musculocutaneous Flap Inset Innovation in Breast Reconstruction"}
{"_id":"2a38e416-6a17-2903-fe9a-a0edacfcec90","text":"The presented study is based on a small animal model. Potential translation to clinical care is controversial and therefore our results have to be interpreted with caution. Nevertheless, rats remain the gold standard in the field of microsurgical research and during a time of recurrent ethical questions and surveys, preclinical studies still have to be performed.","title":"A comparative analysis using flowmeter, laser-Doppler |spectrophotometry, and indocyanine green-videoangiography for detection of vascular stenosis in free flaps"}
{"_id":"2a3b52c2-15bb-ad96-c664-3b569f5a5b20","text":"Most authors agree that skin care is an essential part of well-being and dermatologists should not deprive patients of this habit. The consistency of evidence and reported experience allowed the expert group making realistic suggestions on a treatment algorithm.","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"2a3c4edc-d7ca-0133-fb45-c57cb2c7af65","text":"The MICN offers a novel, all-internal method to induce healing of recalcitrant long bone nonunions through sustained compression. The optimal indications for this technology will be culled over time for maximum impact and cost optimization. This study does not prove that compression nailing is superior to simple exchange nailing or that it prevents further surgery. If found to be more effective than simple exchange nailing with a classic static nail for complex nonunions in a future controlled trial, the MICN implant’s expense may be offset by the savings of avoiding additional surgery. A recent investigation showed that the same implant used for lengthening introduced no additional cost in the medical system when compared with lengthening over nail which required an additional ambulatory surgery [26]. When compared to a prolonged course wearing a hexapod circular fixator which averages 216 days [18], the MICN with WBAT ambulation may result in earlier return to work, and the cost of the two options may be equivalent; however, there is no data to date to confirm this. The risk of refracture may be less with a IM nail than after immediate removal of an external fixator.","title":"The PRECICE magnetic IM compression nail for long bone nonunions: a preliminary report"}
{"_id":"2a3c62c1-2d2c-da86-0c66-34e5c85d0a80","text":"When the stage of tooth eruption in the cleft area is clarified, orthodontic treatment is discussed. If the alveolar ridges are aligned and teeth are in good position, pre-operative orthodontic treatment is not needed. Sometimes the alveolar ridges block the entrance to the cleft area. Pre-operative orthodontic treatment can then be necessary to expand the arch and facilitate surgical accessibility. The central incisor close to the cleft usually has a very thin bony septum towards the cleft. This should be considered if orthodontic treatment is performed on these teeth. Deciduous teeth that may interfere with the bone grafting should be removed two to three months before bone grafting. It was found that extraction of deciduous teeth during the bone grafting procedure correlated to less remaining bone and to persistent gingival retraction. The harmful effect of extraction of a deciduous tooth in connection with bone grafting may be related to osteoresorptive cells and an environment suitable for bone resorption.","title":"Alveolar bone grafting"}
{"_id":"2a3d5ded-2270-80cc-19cf-7ef10f3daf85","text":"Each patient was asked to provide open-ended feedback on exam acceptability. Ultrasound examination and scoring time were recorded for each patient to assess feasibility of the ultrasound protocol in a clinic setting. Time to complete each ultrasound examination was noted by the start and end time as documented on the images collected. Scoring time was calculated as time to complete the review of all images for each subject.","title":"Findings and feasibility of major salivary gland ultrasound in childhood-onset systemic lupus erythematosus: a pilot study"}
{"_id":"2a46f43d-d797-1c5f-8b4c-b2a286fba75c","text":"We indicated this mastoidectomy for locally advanced parotid cancers larger than 4 cm that invaded firmly around the parotid, recurrent large parotid cancers, and complete facial paralysis in order to identify facial nerves without stretching and maintaining surgical margins.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"2a4e1987-01ca-cca6-0830-5f415abc95b3","text":"Our university medical center is one of the largest medical institutions in our country, consisting of six general hospitals. This study was performed in the main institute among the six general hospitals. As the main institute of our medical center, our hospital serves as a tertiary referral center for not only the other five general hospitals but also numerous local hospitals.","title":"Treatment outcomes in patients with pyogenic vertebral osteomyelitis who have cirrhosis"}
{"_id":"2a58b909-944f-4463-dfe5-aacc6a5a3d45","text":"Periodontally healthy patients with an edentulous posterior maxilla who were more than 18 years of age were included in the present study. The exclusion criteria were as follows:","title":"Comparison between Micro-Computed Tomography and Cone-Beam Computed Tomography in the Assessment of Bone Quality and a Long-Term Volumetric Study of the Augmented Sinus Grafted with an Albumin Impregnated Allograft"}
{"_id":"2a58f8d9-3f0d-c4dd-66a4-723a6311144f","text":"The Principal Investigator in each centre must report any SAEs to the trial coordinator within 24 h of awareness of it. The SAE form will be completed and faxed to the trial coordinator who will then liaise with the Chief Investigator to compile all necessary information. The trial office will be responsible for reporting SAEs to the Sponsor and MREC within the required timelines.","title":"LIHNCS - Lugol’s iodine in head and neck cancer surgery: a multicentre, randomised controlled trial assessing the effectiveness of Lugol’s iodine to assist excision of moderate dysplasia, severe dysplasia and carcinoma in situ at mucosal resection margins of oral and oropharyngeal squamous cell carcinoma: study protocol for a randomised controlled trial"}
{"_id":"2a5963e8-524b-de1b-3954-883732449337","text":"The study was approved and given informed consent by the local ethics committee.","title":"Implant-based immediate reconstruction in prophylactic mastectomy: is the caudal dermis flap a reliable alternative to synthetic mesh or acellular dermal matrix?"}
{"_id":"2a5a10e5-fdff-91c8-28a4-63781f2b22b0","text":"The results of this structured literature analysis permitted us able to generate some hypotheses about fracture laterality, the presence of PFO and the underlying pathophysiological processes in FES that might help further our understanding of this pathology. Some limitations of the study also need to be acknowledged. Although we tried to include all case reports of adults with cerebral fat embolism published in the latest 58 years, in some of these reports, data were incomplete and as such not included in the study. Consequently, our results are based on the interpretation of the data analysis available from the detected cases.","title":"Cerebral fat embolism after traumatic bone fractures: a structured literature review and analysis of published case reports"}
{"_id":"2a649787-0985-7705-c212-da20ed8b2ef9","text":"There were three complications related to the microvascular anastomosis in elderly patients with free flaps, this included one case of life threatening bleeding. While neither age nor type of flap was significantly associated with MWC or reoperation, this finding raises some caution for this subgroup.","title":"Preoperative Radiotherapy and Wide Resection for Soft Tissue Sarcomas: Achieving a Low Rate of Major Wound Complications with the Use of Flaps. Results of a Single Surgical Team"}
{"_id":"2a6ad534-be09-8327-01ab-d25d399d1ec7","text":"The follow-up is similar to the standard arm, except for regional ultrasound which will only be performed at month 18 and 30 for stage III patients with a positive SNB but without subsequent lymph node dissection. A detailed flow chart for the experimental arm is shown in Table 1.","title":"TRIM study protocol - a prospective randomized multicenter Trial to assess the Role of Imaging during follow-up after radical surgery of stage IIB-C and III cutaneous malignant Melanoma"}
{"_id":"2a79590a-bfab-d251-a255-eceb5176703f","text":"Orthopaedic intervention in the SCD population carries a higher risk of complications in comparison with patients without SCD undergoing similar procedures.","title":"Management of Osteomyelitis in Sickle Cell Disease: Review Article"}
{"_id":"2a7bebd9-0b78-1cea-c399-aa0024c5a1eb","text":"While ArteFill has had a checkered history in the US market, it is a very good filler for patients with deep dermal defects, who understand that the filler being placed will last anywhere from one to five years, depending on numerous factors, including the level of skill of the injector and the proper placement of the product.","title":"Soft Tissue Augmentation in Dermatology – 2009 Update"}
{"_id":"2a7eb9a4-0683-067b-7401-13269caf75de","text":"Clearly, there is need for public education regarding the possible side-effects of getting intragastric BTA injections and for stricter and more vigilant monitoring of such procedures in medical centres. For its part, the Turkish Guidelines on Clinical Protocols for Obesity and Metabolic Surgery are clear that there is controversial and inconsistent evidence in the literature regarding the use of BTA injections for weight loss procedures. The guidelines also state the procedure has not been approved yet.3 Additionally, The Turkish Association of Bariatric and Metabolic Surgery also state that the patient should be notified about the current literature and efficacy of this procedure. Strongly, the association stresses that intragastric BTA injections should be administered only as part of clinical trials or scientific investigations that have been cleared by relevant research ethics committees. Deviations from these guidelines could open the medical professionals to malpractice suits.4","title":"Outbreaks of iatrogenic botulism in Europe: Combating off-label medical use of Botulinum Neurotoxin (BoNT) in bariatric procedures"}
{"_id":"2a8094fb-e38d-556c-ecfd-0aedfefb534d","text":"The treatment of symptomatic calcifications generally involves conservative or surgical treatments. Among the conservative treatments, minimally invasive techniques have been developed which have included the introduction of needles under ultrasound guidance as in the treatment of calcific tendinopathy of the supraspinatus tendon.[","title":"Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint A case report"}
{"_id":"2a84657b-9af9-3bd0-3c25-472003b1efca","text":"To ensure a sufficient axillary staging with SLNB in breast cancer patients the knowledge of potential risk factors that could decrease the detection rate of the SLN is of high clinical importance.","title":"Impact of Tumor Localization and Method of Preoperative Biopsy on Sentinel Lymph Node Mapping After Periareolar Nuclide Injection"}
{"_id":"2a865a98-013a-39b7-56c2-716b40111456","text":"The use of locally released antibiotics from synthetic recrystallized calcium sulfate may offer significant benefits in the management of surgical site infections. The ability to combine different antibiotics could enable a therapy tailored to the offending pathogens. The exposure time, type of antibiotic(s) released from SRCS and the challenge bacterial strain can all influence the kinetics of biofilm killing and thus, in vitro results with one set of conditions should not be over generalized.","title":"In Vitro Efficacy of Antibiotics Released from Calcium Sulfate Bone Void Filler Beads"}
{"_id":"2a890445-d48f-9392-403c-9b7f225d4b10","text":"External fixation is contraindicated in most cases with fractures from tortional forces. Open reduction and internal fixation of these fractures combined with ligament repair is usually adequate. External fixation is recommended only for fractures of the ankle joint caused by axial compression, because only then it is biomechanically superior and results in a lower complication rate.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"2a90aed0-621e-e40d-b7d6-6c5ef0939745","text":"The incidence of DVT in direct ARDS caused by bacterial pneumonia has not been investigated. We performed a single institutional study in patients with direct ARDS caused by bacterial pneumonia to identify the prevalence, risk factors, prognosis and potential thromboprophylaxis strategies of DVT in a Tertiary A hospital.","title":"Deep vein thrombosis in acute respiratory distress syndrome caused by bacterial pneumonia"}
{"_id":"2a95f52b-1d24-d87a-3964-e076f829d8c6","text":"Advanced and recurrent malignancies of the scalp are aggressive and challenging to treat. The radial forearm free flap is an underutilized free flap in the reconstruction of complex scalp defects.","title":"Reconstruction of scalp defects with the radial forearm free flap"}
{"_id":"2aa21d1b-4bed-5869-dcfc-e4b9778e1e2a","text":"In reconstructing a full-thickness alar defect, one must incorporate lining repair into the surgical algorithm ( Fig. 5 ). A good option is a bipedicled vestibular advancement flap, based medially at the junction of the anterior vestibular lining with the septum and laterally at the nasal floor. After making a superior incision in the vestibular lining, this bipedicled flap can be elevated and rotated inferiorly and carefully sewn into the inferior wound edge of the defect. A skin graft may be necessary to replace the donor site to prevent scar contracture leading to alar notching. Due to the delicate nature of this dissection, the vestibular advancement flap can provide coverage for roughly 1 cm of nasal lining. 1 31 For larger lining defects, more involved pedicled mucosal flaps can be used. The inferior turbinate can be elevated based on an anterior pedicle from branches of the angular artery and turned toward the ala. After removal of the turbinate bone, the mucosa can be peeled open to yield a flap of 1.7 cm in width and 2.8 cm in length. Further reach can be gained by elevating the nasal floor and inferior meatal mucosa in continuity with the turbinate. This flap does have the disadvantage of potentially needing a secondary surgery for pedicle division. 1 32 Another option is an ipsilateral septal mucosal flap based medially and anteriorly on the septal branch of the superior labial artery. This flap of mucoperichondrium is elevated posteriorly to anteriorly along the septum before making superior and inferior cuts to allow rotation of the flap laterally and anteriorly toward the ala. Using this flap will require a secondary surgery for pedicle division to relieve nasal airway obstruction. Additionally, there is donor-site morbidity related to crusting which may worsen nasal airway obstruction. 1 17 Surgeons must also keep in mind the possibility of combining different intranasal mucosal flaps to meet defect requirements.","title":"Comprehensive Algorithm for Nasal Ala Reconstruction: Utility of the Auricular Composite Graft"}
{"_id":"2aa569d1-532c-3a0a-e07c-5db3d594b20c","text":"Ultrasound-guided SAP block and ESP block have comparable postoperative analgesic efficacy after MRM. The safety and efficacy of these blocks underpin their routine use as part of multimodal analgesia protocols in patients undergoing MRM.","title":"Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block Versus Erector Spinae Plane Block for Postoperative Analgesia After Modified Radical Mastectomy: A Randomised Controlled Trial"}
{"_id":"2aa9d876-9bb7-efef-318b-04a7fcf97da4","text":"Two thousand one hundred consecutive non-selected patients with acute medical conditions of any kind requiring hospitalization in the internal medicine departments of the participating centers were recruited from February 2015 to July 2021. Ten centers associated to the ultrasound Study Group of the Italian Society of Internal Medicine participated in this study.","title":"Asymptomatic and symptomatic deep venous thrombosis in hospitalized acutely ill medical patients: risk factors and therapeutic implications"}
{"_id":"2aaa226c-3338-0376-b0a5-9d69d6e3b48b","text":"Our results did not show a statistical significant correlation between the development of postoperative complications and the risk of recurrence of melanoma. It is important to remember that this data applies to a cohort of patients with relatively very thick melanomas which inheritably carries a higher recurrence rate. However, it is not yet known if this data applies to patients with “thinner” melanomas.","title":"Postoperative Complications following Nodal Dissection and Their Association with Melanoma Recurrence"}
{"_id":"2aaa4f8a-7fd8-f7b4-ef80-9a75a53f1b6b","text":"One hypothesis for the alterations in surgical practice consolidation has been the response to alternative payment models. Accountable care organizations and bundled payment models have ushered in a new era of coordinated care and use management associated with an ever-increasing burden of reporting use and quality metrics. This proliferation of quality measurement has resulted in a high cost to the health care system. Practices must confront new requirements and regulations that, although improving the quality and efficiency of care for patients, require substantial time and financial resources from the physicians. Surgeons in solo or small practices may find it challenging to continue in this current landscape and might choose to join larger practices to distribute the financial and administrative costs of operating a surgical practice today. These issues may also have contributed to the change in reported physician burnout. Despite these concerns, emerging data suggest that the movement toward practice consolidation is independent of enrollment in accountable care organizations and seems largely responsive to secular market variations. Even with the shift toward larger surgical practices, we still found that 1 in 5 surgeons worked in a solo practice as of 2017. Given the large financial impact of COVID-19 associated with the financial viability of small practices, it remains unknown whether the decline in solo or small surgical practices will be accelerated as a result of the COVID-19 pandemic or balanced by an increased desire for practice autonomy.","title":"Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US"}
{"_id":"2ab2f954-493b-b3a7-0f5c-83e57a4e7777","text":"Patients were allowed to wash their face 5 days after the cast removal. They were visited one month and three months after the surgery in order to monitor any possible complication.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"2ab7d116-c761-5a23-660a-0c756798c95e","text":"We speculate that late skin sensitization to intradermal skin tests with BNT162b2v may be induced by sensitization to other compounds patients have been exposed to, such as HA and many others that contain PEG and\/or other ingredients, and that in some susceptible patients this may have led to the occurrence of late HSRs to this vaccine.","title":"Late Hypersensitivity Reactions to the BNT162b2 SARS-CoV-2 Vaccine Are Linked to Delayed Skin Sensitization and Prior Exposure to Hyaluronic Acid"}
{"_id":"2abbd49e-489b-7927-d64d-eb54e61ee0e1","text":"patient is discharged from the participating hospital. If the patient is transferred to a rehabilitation unit where it is practical to continue the IPC and monitor its use appropriately then IPC should be continued until independently mobile or the patient declines to continue or an adverse effect of IPC occurs. If IPC cannot be continued after transfer to a rehabilitation unit a discharge form should be completed at the time of transfer to the rehabilitation unit.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"2ac3dc8b-313e-a3fe-a23d-0e8e2a08bf3d","text":"Synovitis is a nonspecific term that applies to infectious and noninfectious conditions. Care must be taken to communicate any concern for infection when applying the term in this context.","title":"MRI nomenclature for musculoskeletal infection"}
{"_id":"2ac82ffd-dc62-c1dc-c03b-f3ce24b98bf7","text":"Confirmation of a drug effectiveness in the real‐life setting is becoming increasingly relevant. Factors such as patient preference and satisfaction with the prescribed therapy—which have a major impact on adherence to treatment—are paramount in how treatments perform in everyday clinical practice. Measurement of these parameters is becoming increasingly valuable because it can provide data on how satisfaction improves adherence and influences treatment choice.","title":"Patient satisfaction with calcipotriol\/betamethasone dipropionate cutaneous foam for the treatment of plaque psoriasis: The LION real‐life multicenter prospective observational cohort study"}
{"_id":"2ad95e3b-6fa9-94f5-0289-a9b3d9fa5341","text":"The technique of pedicled vascularized fibular graft for lateral tibial condyle reconstruction after en bloc resection of aggressive giant cell tumours was described by SP Chow et al. Early follow-up of two patients was presented in 1986. We present the 25 years follow-up of one patient with a literature review of alternative present day treatment options. The patient maintained community ambulant status despite developing late stage osteoarthritis. Although this procedure is performed rarely, it remains an alternative to the more sophisticated treatment options making it a useful method in centres with limited facilities and expertise.","title":"Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: long-term result"}
{"_id":"2ae81fa8-0532-12d3-0908-5e899f1a19e1","text":"Leadership is a nebulous concept and means different things to different people.1 This is because there is no single definition, no established theoretical approach or consensus about how best to identify leaders or help individuals become leaders. As such, leadership is difficult to define and difficult to measure, but is becoming increasingly cited as an important component in the transition and development of the National Health Service (NHS).2 Localism and clinician led services are concepts that are fundamental to the reorganisation of the NHS.3,4 The aim of this paper is to briefly discuss the approaches to the study of leadership and explore why it may be important in dentistry in the future.","title":"What is clinical leadership and why might it be important in dentistry?"}
{"_id":"2aef6c20-7c91-f07e-14d1-03379270ddf6","text":"Table 2 The frequency of motivating factors cited for application to the IGH Fellowship","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"2af87330-0785-d6b6-a18a-ebfdd9d77ffb","text":"The strengths of this study are the inclusion of both healthy subjects and subjects with chronic non-bacterial osteomyelitis. We included datasets from two institutions with two MRI vendors. In addition to the objective standard evaluation methods of AI models, we performed a subjective, more clinically directed evaluation. This is the first study of its kind and might serve as a valuable first step for developing an international ground truth database to serve for validation purposes applicable to research and clinical practice.","title":"Automated segmentation of magnetic resonance bone marrow signal: a feasibility study"}
{"_id":"2afb8cf0-7e7b-fd19-3cbc-ef759d937c06","text":"There are several solutions proposed in the event that the bone remains exposed, we considered the possibility of direct closure, but the surrounding skin was severely photodamaged with numerous actinic lesions and treatment of these would have further delayed closure of the surgical wound.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"2aff3501-a959-bb47-45ef-7212a9c9d8be","text":"Patients were more aware of skin cancer and were taking steps to avoid getting another lesion. They were checking for new lesions, although some were not sure what they were looking for. Participants also said they were spreading the word to others about the need to check their skin.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"2b0b8b6b-286e-d4a7-2983-bd675effc0f1","text":"In this study, we aimed to retrospectively evaluate the oncologic safety of SLNB in patients with breast cancer whose axilla was pathologically and\/or clinically and radiologically metastatic at the time of diagnosis and who had had a complete response after NAC.","title":"The Oncologic Safety of Sentinel Lymph Node Biopsy in Patients with Node-Positive Breast Cancer with Complete Response to Neoadjuvant Chemotherapy: A Single-Center Experience"}
{"_id":"2b1b4330-bbbd-089b-8873-54737bff763a","text":"Another important finding was the visibility of the upper pole of the implant after complete tissue healing. This has been seen with other SSM procedures. The upper edge of the implant is often visible because of skin adhesions to the muscle. To improve coverage of the upper pole of the implant, fat grafting was performed for 26 patients approximately 12 months after SRM. The great part of this patient received a full high prosthesis. In creating the prosthetic pocket, we occasionally elevated a flap of serratus muscle. However, this procedure is only used in cases of excessive lateral skin flap skeletonization or if the insertions of the pectoralis muscle are too high.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"2b1f930e-1fa0-1f77-feb0-1eb1e665da44","text":"Surgical margins were wide in six patients and marginal in four patients.","title":"Distal Fibula Reconstruction in Primary Malignant Tumours"}
{"_id":"2b201db9-89f5-5220-ce98-9ad5fb226088","text":"The indications for MRI and ultrasound overlap, and there is no clear consensus for the use of imaging diagnostics in the diagnostic of the Achilles tendon. Appropriate MRI protocols and novel MRI sequences may help to differentiate disease entities from similar clinical manifestations. The novel sequences are the future of Achilles tendon imaging because they enable treatment monitoring and early detection of tendinopathy. In infection, it allows assessing the involvement of bone in osteomyelitis. Administration of contrast enables the exclusion of abscess. The higher signal in the Achilles tendon and subcortical bone marrow edema at the insertion are MRI features of seronegative arthropathies. Achilles enthesitis revealed on MRI precedes the onset of systemic disease. MRI helps to differentiate true tumors from tumor-like lesions.","title":"MRI of the Achilles tendon—A comprehensive pictorial review. Part one"}
{"_id":"2b229b9f-0206-7a5a-9974-8f7b672ac9f8","text":"Despite the various disadvantages that characterize this method, the possibility of being able to perform an examination with a very low risk\/benefit ratio is of truly unparalleled value, which must lead to a greater interest in the development of this diagnostic exam.","title":"An Update of the Possible Applications of Magnetic Resonance Imaging (MRI) in Dentistry: A Literature Review"}
{"_id":"2b3428c7-473f-dcb2-7b26-240dbe62a55a","text":"RFA was first used in the 1900s by William Bovie and not much has changed in the technique since the first study. The technique has been used for almost a century for superficial and easy to reach tumours and lesions. In the meantime, the electrical scalpel was developed which is a form of RFA. Due to the development of imaging systems with an increased sensitivity and specificity and improved image guided modalities the RFA technique became available to treat more difficult to reach areas, and increasing the power output, larger areas could be ablated with a single probe [23].","title":"Ablative techniques for the treatment of benign and malignant breast tumours"}
{"_id":"2b361d93-136b-83a7-82c3-086d2871733c","text":"Performing electrical or manual stimulation near large nerves can be risky. Currently, there are no reported literature on the effects and methods of innocuous mechanical nerve stimulation through needle placement near large nerves without electrical or manual stimulation. However, in the last 15 years, we have investigated and observed that the facial nerve and assumed vestibulocochlear nerve and its pathways can be stimulated through placement of a thin injection needle with a hubcap close to the facial nerve, without electrical and manual stimulation, to avoid the known risks and to improve treatment effects.","title":"Integrative Treatment for Tinnitus Combining Repeated Facial and Auriculotemporal Nerve Blocks With Stimulation of Auditory and Non-auditory Nerves"}
{"_id":"2b370e75-b451-9ecf-d60f-30ff9f3577e6","text":"The use of local flaps has the advantage of coverage with hair bearing skin and of achieving an acceptable cosmetic outcome without need to disturb other areas. However this option is not easily applied in very large defects especially those with skin lacking pliability [2]. Although local flaps may be performed after extensive undermining to allow for closure of both the acquired and donor defects, it is preferable to be more cautious by creating a local flap large enough to cover the ablative defect in its entirety and to graft the donor site defect. Using this approach, complications can be minimized even in patients of large defects.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"2b3f42dc-bbd8-3cfd-1952-7e9ba8a91fce","text":"The aim of the current study was therefore to determine if positive margins following wide excision and adjuvant radiotherapy are as great a risk factor for local recurrence in node positive as in node negative patients, in the belief that the major risk in this group was dissemination rather than local recurrence.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"2b407cfa-52b6-5333-a362-e132966a2854","text":"The association of oxygen therapy in a hyperbaric chamber with the conventional protocol for treating vascular occlusion from facial filler procedures was found to be effective.","title":"Vascular complications with injection implants: treatment with hyperbaric chamber"}
{"_id":"2b4b5060-3542-64a1-ca91-a811e57e66e3","text":"Negative pressure wound therapy is effective for management of chronic and infected trauma and surgical wounds. Molecular evidence suggests that NPD improves blood flow and promotes the production of granulation tissue within the wound bed [5]. Several retrospective studies have found NPD to result in fewer graft-related complications as compared to traditional bolster dressings [6, 7] for head and neck cancer patients. The justification for the additional costs and supplies for the negative pressure system remains a barrier for universal implementation of these systems and there is not enough evidence to identify which patients would benefit from the additional healing potential.","title":"Donor site morbidity following radial forearm free flap reconstruction with split thickness skin grafts using negative pressure wound therapy"}
{"_id":"2b4c9f45-b6fd-ab1d-8b09-800d415de99c","text":"Complete and adequate resection of the ankylosed mass and postoperative active mouth opening exercises are essential in the treatment of TMJ ankylosis. Moreover, a more comfortable mouth opening guide and interdigitation can be achieved using an IOS, and newly organized fibrosis in the gap space between the newly made resected condylar head and temporal fossa can be suggested.","title":"Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients"}
{"_id":"2b4d0971-ee30-b773-d374-b368460ed5f6","text":"A spirometry evaluation was performed both immediately before surgery and in the postoperative period with the aim to evaluate respiratory function after the surgical intervention and to compare to baseline values. This evaluation was performed with the TriFlo Inspiratory Exerciser®, a device which consist of three air columns with different weights and coloured balls that move up when the patient inhales.","title":"Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study"}
{"_id":"2b562a93-9c15-751c-4f50-3ec7a5cd6d69","text":"They can be roughly divided into superficial and deep in terms of localization respecting the femoral vein.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"2b56aeb1-39bb-9fe7-c38d-805bbbaa918f","text":"The patients’ data were only retrospectively analyzed and the study was not randomized. Furthermore, the occurrence of side effects was documented during the patients’ anamnesis interviews before the next BT injection when these symptoms were no longer present. An objective clinical evaluation of side effects few weeks after the BT injections was not carried out. Besides, the group of patients with dysphagia was markedly smaller than the group of patients without dysphagia as well as the group of ABO treated patients was smaller than the group of INCO or ONA treated patients so that the results have to be interpreted cautiously.","title":"Dysphagia in cervical dystonia patients receiving optimised botulinum toxin therapy: a single-center retrospective cohort study"}
{"_id":"2b5765bb-2429-9254-a7d3-7f52683b898b","text":"The design avoids the ugly medial scar so often seen in inverted T resections but in larger resections the breasts are displaced medially and are unaesthetic.","title":"Reduction mammoplasty"}
{"_id":"2b6adc0d-ba23-191e-a219-9fed5fcaf1ad","text":"However, since the mitotic index was used as a criterion to propose SLNB in patients with thin melanomas in the 7th edition, and still remains as a prognostic factor, should surgeons continue to use this criterion to indicate sentinel lymph node surgery after the introduction of the new staging system?","title":"How does the mitotic index impact patients with T1 melanoma? Comparison between the 7th and 8th edition of the American Joint Committee on Cancer melanoma staging system"}
{"_id":"2b6c8104-d931-5fb1-4ecb-304e4f42bed1","text":"The left latissimus dorsi muscle was harvested with its vascular pedicle intact. Left superficial temporal vessels were used as recipients. After complete healing of the free flap, scalp and forehead skin were expanded and used to restore the scalp to its preinjury shape.","title":"36-year Follow-up on Scalp Reconstruction Using Free Latissimus Dorsi Muscle Flap, Skin Grafting, and Scalp Expansion"}
{"_id":"2b7486f3-26cb-bd34-f648-4ef21ed156a7","text":"Analysis of the findings and subsequent planning was performed in conjunction with those co-authors who also hold the position of ICOPLAST Director. Strategies to accomplish the ranked priorities were allotted timeframes based on ICOPLAST resources.","title":"Establishing Priorities for the International Confederation of Plastic Surgery Societies"}
{"_id":"2b75d118-c392-bd29-5ac4-ec650535ff5b","text":"Overall these studies surveilling in vitro and ex vivo mast cell and basophil degranulation suggest that IgE, in the absence of cross-linking stimuli, does not lead to type I hypersensitivity reactions and thus supported further safety evaluations of candidate IgE therapeutics in animal models.","title":"IgE Antibodies against Cancer: Efficacy and Safety"}
{"_id":"2b80ba05-c259-a7ad-987d-ede90dc3f723","text":"Hsieh et al[ used thin split-thickness great toe nail bed grafts to reconstruct defects of the nail bed. Although this method itself alone is not suitable for large area defect reconstruction of the nail bed with distal phalanx exposure, it could be used to acquire the nail bed grafts in our study. This technique allows access to abundant nail bed tissue in the great toe without producing deformities at the donor site. None of the donor great toes showed deformity according to our follow-up.","title":"Reconstruction of large area defect of the nail bed by cross finger fascial flap combined with split-thickness toe nail bed graft A new surgical method"}
{"_id":"2b814ac1-510a-78f2-7db9-cb1bcc0b28bf","text":"Osteomyelitis is a chronic infection of bones. Eradication of bone infection is usually with antibiotics and debridement, but it is slow and the infection can recur even after many years. It is now established that osteomyelitis is due to biofilm and a better understanding of the process is required. We review the development of biofilm and apply it to osteomyelitis management. The planktonic microbes' response to adverse conditions is the formation of biofilm. Bacterial infections in planktonic forms cause infections that can be controlled with antibiotics and immunisation, however the same microbe when its phenotype becomes biofilm is more resilient. The understanding of how planktonic bacteria convert to biofilm is one of the aims set out for this article.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"2b82f63f-4c87-f62c-22b7-54b3ebf1646d","text":"Intra-articular fractures of the distal tibia due to axial compression are usually complicated with cartilaginous problems and are requiring anatomical reduction of the articular surface. Fractures due to torsional forces are complicated with ankle instability and reduction should be augmented with ligament repair, in order to restore normal movement of talus against the mortise. Both Ilizarov and hinged external fixators are unable to restore ligamentous stability. External fixation is recommended only for fractures of the ankle joint caused by axial compression because it is biomechanically superior and has a lower complication rate.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"2b8578f0-8481-3353-870d-3fc340d653cd","text":"Our study suggested that DuraGraft storage solution provided more effective vein endothelium protection against disruption of flow induced apoptosis when compared to the most common storage solutions and during a period of time of 2 h from surgical harvesting. A longer time of ischemia may be associated with extended endothelium damage and none of the tested solutions were effective in protecting the vein graft.","title":"Efficacy of Intraoperative Vein Graft Storage Solutions in Preserving Endothelial Cell Integrity during Coronary Artery Bypass Surgery"}
{"_id":"2b86e7d2-3635-caf5-4a28-4d838ff40db7","text":"The POCUS was performed by operators who were experienced in ultrasound and use this technology on daily basis to assess their patients. This includes senior staff attending physicians, fellows in training, and advance practice providers. Mostly, the ultrasound examiner was not involved in the management of the ICU patient being included in the study, and the impression of the treating physician and the standard data collected were related to the examiner after the POCUS exam was done so that the decision of ultrasound was not biased by these other factors. No patients were excluded once enrolled, and measurements were completed.","title":"Sonographic Assessment of Intravascular Fluid Estimate (SAFE) Score by Using Bedside Ultrasound in the Intensive Care Unit"}
{"_id":"2ba126c9-623c-b073-92ca-d5ed31a233d1","text":"Skin sparing mastectomy with axillary dissection was performed in 15 patients and a total mastectomy with axillary clearance was performed in 6 patients. The reconstructive surgeon harvested an ipsilateral pedicled TRAM flap in all the cases, from the right side in 6 patients and from the left side in 15 patients. Entire width of the rectus muscle with overlying wide disk of anterior rectus sheath was harvested along with the skin island. A Proline mesh was used for repair of the abdominal wall defect in all the patients. The mesh covered the defect and spanned on to the normal contralateral side. The mesh was sutured to the edges of the defect and intact contralateral anterior rectus sheath and the semi-lunar line. The umbilicus was brought out through this mesh [Figure 1].","title":"Assessment of the abdominal wall function after pedicled TRAM flap surgery for breast reconstruction: Use of modified mesh repair for the donor defect"}
{"_id":"2ba51e14-8649-8d51-3948-ac96806c0540","text":"Consider temporary discontinuation of the treatment in case of any mouth ulcers or dental procedures.","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"2ba6ef83-e9f1-48a7-1eae-d357cc858fc3","text":"The pathophysiology of congenital pectus deformities is poorly understood. It is generally thought that abnormal cartilage growth results in displacement of the sternum either anteriorly in PC or posteriorly in PE.3","title":"Clinical experience of repair of pectus excavatum and carinatum deformities"}
{"_id":"2bb34b11-68f9-232b-3985-4015af82bea5","text":"The objective of this study was to evaluate the occurrence of unplanned positive margin following excision of primary bone and soft tissue sarcoma within a tertiary referral centre in patients who underwent planned surgery through a multi-disciplinary approach. We will also analyse the impact on patient outcomes and survival, as well as explore the possible techniques that can be implemented to reduce the occurrence of unplanned positive margins.","title":"Positive Margins Following Excision of Primary Bone & Soft Tissue Tumours in a Tertiary Centre and the Impact on Patient Outcomes"}
{"_id":"2bb9d674-47a2-eed0-9156-196980931e00","text":"The patients enrolled in this study were examined by computed tomography and color Doppler ultrasound of both the lower limbs to confirm or exclude VTE every time they were hospitalized. Patients with symptoms of PE underwent CT pulmonary angiography (CTPA) for the confirmatory diagnosis. Each thrombotic event was analyzed by an independent panel of experts in angiography, radiology, and clinical medicine to evaluate and confirm the event. The results were not affected by the slight gap caused by different personnel of the expert group.","title":"Early identification of lung cancer patients with venous thromboembolism: development and validation of a risk prediction model"}
{"_id":"2bbb2244-7b33-ca9c-fc6c-4128daf277a4","text":"Oncoplastic breast surgery (OBS) combines breast conservation and plastic surgery techniques with the aim of achieving safe oncological resection, as well as maintaining good cosmetic outcome. Several studies including two systematic reviews have reported on the oncological safety of OBS. The development of oncoplastic techniques in breast cancer surgery has significantly advanced the discipline over the years by minimizing breast asymmetry with the immediate reconstruction of sizeable resection defects, and not infrequently with symmetrization of the contralateral breast. This allows excision of larger tumour sizes with free resection margins, increasing the pool of patients eligible for breast conservation.","title":"Oncoplastic breast surgery in older women with primary breast cancer: systematic review"}
{"_id":"2bc67ec7-faab-69c0-34c3-b52c06c870bd","text":"The patients underwent a standard DIEP flap reconstruction but the points highlighted below may differ from unit to unit.","title":"Breast reconstruction with deep inferior epigastric perforator flaps"}
{"_id":"2bca2ec0-1c3a-e0ca-2d64-92ac3bf79c36","text":"Endovascular therapy is a fundamental treatment for peripheral arterial disease. However, the success rate of endovascular therapy remains poor, as a third of patients with critical limb ischemia ultimately require a major amputation for gangrene despite endovascular treatment. This failure rate has prompted investigation into methods of determining physiologic procedural success before and after treatment, before clinically apparent outcomes occur such as gangrene. The aim of this systematic review is to evaluate if in patients undergoing endovascular surgery for lower extremity atherosclerotic peripheral arterial disease, do changes in physiologic measures of perfusion during surgery correlate with clinical outcomes.","title":"Physiologic perfusion monitoring methods during endovascular revascularization for atherosclerotic peripheral arterial disease: protocol for a systematic review"}
{"_id":"2bd11b2e-a9aa-e111-cbb8-9d10e548a206","text":"Overall, this case further highlights the seriousness of the presentation of sudden onset back pain especially one which is persistent in nature. Our patient had other factors including fever and a raised CRP to indicate an infective aetiology for her symptoms. This is consistent with findings from a study showing that cases of spondylodiscitis secondary to infection by Streptococcus viridans tended to have raised blood inflammatory markers but not always have symptoms of systemic upset [5]. However, the insidious nature in which these symptoms can present highlight the fact that life threatening causes can often be overlooked on a general medical unit. In conclusion when assessing a patient presenting with back pain, a thorough history must be taken and osteomyelitis must be considered as a differential as well as associating causes such as infective endocarditis, as these carry a serious risk of mortality if left untreated.","title":"Streptococcus viridans osteomyelitis and endocarditis following dental treatment: a case report"}
{"_id":"2bd2ebfd-7c53-663f-5301-9ebb86da370e","text":"Osteomyelitis is an infectious disease affecting humans and animals that is difficult to diagnose and treat. Several classifications have been proposed to facilitate clinical decisions, but they are useful mainly for humans.","title":"Microbiological aspects of osteomyelitis in veterinary medicine: drawing parallels to the infection in human medicine Veterinary Quarterly"}
{"_id":"2bd574a4-7b94-876b-95ef-812d44dbaad7","text":"All cases with a primary diagnostic code of M86 for osteomyelitis AND who underwent surgery for this condition in the study period were included. Cases less than 18 years of age were excluded, as were all cases diagnosed with osteomyelitis that did not have surgery for this condition. Cases undergoing amputation for diabetic complications rather than osteomyelitis were also excluded.","title":"A retrospective cohort study comparing clinical outcomes and healthcare resource utilisation in patients undergoing surgery for osteomyelitis in England: a case for reorganising orthopaedic infection services"}
{"_id":"2bd8274a-2c9e-c109-173e-2bbfc210c076","text":"In theatre, the patient was given a general anaesthetic and was intubated with a cuffed endotracheal tube and pressure control ventilation commenced. No central venous access was attempted at any stage.","title":"Diagnosing Intraoperative Pneumothorax in Patients Undergoing Autologous Breast Reconstruction: A Useful Clinical Sign"}
{"_id":"2be296a1-0747-02d0-4253-7bad70c38acb","text":"We therefore think that the current results are reliable and reproducible and thus represent a first step toward scientific evaluation of the open incisional biopsy procedure. Based on the present results we suggest that performing an open incisional biopsy requires very thorough justification, if performed at all.","title":"Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery"}
{"_id":"2be83a3f-7d75-c342-ebde-c8d1c20171a0","text":"Little previous work has attempted to summarize the literature informing the timing of postoperative VTE. Globally, the first procedure-specific guideline in any field of surgery (urological surgery) was based on a series of systematic reviews and meta-analyses on procedure-specific risks of VTE and bleeding after urological surgery. To be able to account for the timing of VTE, the authors pooled the results from two large studies: a prospective study that included British women, of whom almost 900 had VTE within 12 weeks after surgery; and a retrospective study that included US surgical patients with 305 VTE events (172 among patients who had abdominal surgery) within 6 months after operation. VTE events occurred later when the results of these two studies were pooled than in the present work: 27 versus 47 per cent respectively of the VTE events occurred by the first week, and 54 versus 74 per cent by the second week. One important reason for the earlier occurrence of VTEs in the present study is that the previously published work did not take the use of thromboprophylaxis into account. As thromboprophylaxis is often used only during the first week after surgery, not taking it into account overestimates the proportion of late VTEs as VTEs that would have occurred early and were prevented by prophylaxis are missed, whereas those that occur later when prophylaxis is given less frequently are not missed.","title":"Timing of symptomatic venous thromboembolism after surgery: meta-analysis"}
{"_id":"2bf1008a-8520-6e42-8028-561b8a3d933a","text":"A high speed drill is used to create a gutter, through the outer cortical bone and cancellous bone to the thin inner cortical bone at the junction of the lamina and the medial aspect of the lateral mass. Using a 1 mm Kerrison rongeur the lamina and ligamentum flavum is then transacted laterally. Two Kocher clamps are then used to remove the dorsal elements en bloc. In patients with loss of lordosis or abnormal segment motion, at this stage once decompression is completed, then instrumentation can be performed. Many wiring techniques are not suitable as the posterior elements have been removed. Options for fixation include interfacet wiring, which is unpopular due to postoperative pain caused by violating an intact facet joint. Lateral mass fixation techniques are the most popular and include fixation of a plate or rod to the lateral masses using screws [8–11].","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"2bf3dd8d-0944-9022-7a5f-c32be7d037f9","text":"To review all cases of lymphoma diagnosed at a single institution in order determine the current role of the surgeon in the diagnosis and management of lymphoma.","title":"Does the surgeon still have a role to play in the diagnosis and management of lymphomas?"}
{"_id":"2bfc7b7e-0505-7472-c26a-6d60ebb17e7e","text":"Regardless of the route of AIT administration, parents must be informed on the cost, possible side effects and expectations of AIT effectiveness. Once started, AIT must be conducted regularly, arranging for periodic visits and frequent alerts to the family in order to maintain compliance. Based on the clinical data available, it can be assessed with the family whether to start a course of AIT even for milder cases of IgE-associated allergic diseases with the primary aim to prevent the development of asthma or new sensitizations. Currently there are no indications to prefer SLIT over SCIT. The advantages of SLIT are a greater safety profile and an easier administration route which does not require the presence of a doctor or a qualified health professional except for the first dose. The allergen choice must be based on careful medical history, results of allergy diagnostic tests and demonstration of a correlation between the identified allergen and symptoms. In case of poly-sensitized patients, the causal role of each individual allergen needs to be established in order to choose those most clinically relevant.","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"2c0778fa-237a-5419-e184-2c9eb15a4e3f","text":"In conclusion, the pseudarthrosis rate in pediatric cervical spine fusions remained high despite frequent use of halo immobilization and autograft. Patients with uninstrumented occipitocervical fusions are at particularly high risk with more than 1 in 3 developing a pseudarthrosis.","title":"Rate and risk factors for pediatric cervical spine fusion pseudarthrosis: opportunity for improvement"}
{"_id":"2c082d07-5894-d259-34bd-9b351c786fb3","text":"This study shows the impact of local recurrence on prognosis. It adds to the increasing body of evidence correlating positive margins with local recurrence and subsequent overall mortality. Although it has been suggested that positive margins may merely represent unfavorable tumor biology [10] it is clear that in there is now an imperative on the operating surgeon to achieve negative margins when performing breast conservation surgery in all cases. The difference in local recurrence in this study between margin negative and positive cases was less in patients with nodal involvement because of their reduced survival. The current improvements in outcome for breast cancer with enhanced long term survival in all groups indicates the necessity of minimizing local recurrence by good case selection and surgical technique that ensures complete excision of all tumors.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"2c09f13a-8cdf-c822-08a6-e289b96d38a4","text":"Comparing two reconstructive centers with and without implemented ERAS protocol, ERAS led to a significantly decreased LOS for all patients, especially in unilateral reconstructions. ERAS implementation does not result in an increased complication rate or flap loss. Revision rates and readmission rates are identically between groups. Postoperative pain can be well managed with basic analgesia using NSAID when intraoperative blocks are applied. The reduced use of opioids was well tolerated. With implementation of ERAS the recovery experience can be enhanced making autologous breast reconstructions more available and attractive for various patients.","title":"Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol"}
{"_id":"2c101adf-4b5c-d0f1-6246-b345cf3ebf8d","text":"Considering two cases of epidermolysis bullosa cases who were prone to stenosis adds to the merit of this type of anastomosis. End to distal side esophagotomy prohibited due to more dysphagia occurrence. In the sixth case who had the history of sever burn injury and four surgeries to treat the knee contracture, we decided to treat with free latissimus flap. There were paucity of recipient tributary and thick femoral vein wall due to inflammation. We had no choice except end-to-side anastomosis to femoral artery and vein.","title":"Anastomosis of Free Flap Pedicle to Great Vessels"}
{"_id":"2c2360a6-1619-1e3c-4cb5-37795869296b","text":"The numbers of each type according to sex and the body side are presented in Table 1.","title":"A proposal for a new morphological classification of the popliteus muscle tendon with potential clinical and biomechanical significance"}
{"_id":"2c24a002-afde-7921-7c88-6876a252b4e4","text":"The mention of the word 'cancer’ caused alarm and concern for most participants. Concern was mainly about how long they had had the cancer and if it could have spread and if they had other undetected skin cancers. Appearance and potential disfigurement following treatment was another concern. All patients felt they had a good rapport with the dermatologist, however some participants felt their information needs had not been met and thought they should have received more information especially when some patients compared the information given to them with that given to patients with other types of cancer.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"2c2614f4-1464-d9f1-8407-47fff10fa6dd","text":"The data that support the findings of this study are available from corresponding author Gry Assam Taarnhøj but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available.","title":"Electronic reporting of patient-reported outcomes in a fragile and comorbid population during cancer therapy – a feasibility study"}
{"_id":"2c29cc77-5354-062c-836c-e903ca29676c","text":"Diagnosis of HL should be based on the histopathological evaluation of an excisional lymph-node biopsy or surgical tissue sample. This should be preferred to large core needle biopsies which remain an acceptable alternative. Fine needle aspirations do not allow for sufficient material nor adequate analysis of the architecture of the tumor to be made for a reliable diagnosis and are not considered appropriate, regardless of the resource setting.","title":"Resources-Stratified Guidelines for Classical Hodgkin Lymphoma"}
{"_id":"2c317935-31bd-bcaa-ebae-003f7d67db43","text":"Metatypical cell carcinoma can be considered as a new entity of skin cancer, being an intermediate typology between basal cell carcinomas and squamous cell carcinomas. The behaviour of the metatypical cell carcinoma lies between these two varieties of skin cancer. It is difficult to perform a differential diagnosis based on morphological and clinical features – therefore it is only possible by accurate histology.","title":"Metatypical basal cell carcinoma: a clinical review"}
{"_id":"2c370611-1b91-e797-58f8-b92d0e08203e","text":"In order to examine the presence of anosognosia in elderly adults without cognitive impairment, we also explored the relationship between awareness of deficits and cognitive performance.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"2c3c9161-0e64-cdd1-c465-1a8e66613a0c","text":"Is there evidence that the aspects of life the items address are important to those who will be completing the questionnaire?","title":"Assessment of the quality of measures of child oral health-related quality of life"}
{"_id":"2c405ffa-898c-2162-841b-8cc324120f35","text":"The area A contained by the curve was calculated by","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"2c412332-2392-2bf5-c6ce-7183dec598c2","text":"Open tissue biopsy performed in cases with culture-negative or inconclusive synovial fluid aspirates prior to revision of THA has limited diagnostic accuracy for the prediction of PJI. The procedure does not reliably close the diagnostic gap in a substantial number of cases. In this difficult patient population, risk of an open procedure may outweigh benefits and alternative less invasive methods should be considered for the preoperative diagnosis of PJI.","title":"Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery"}
{"_id":"2c41905a-4206-e66e-7888-a85b941d864e","text":"Since June 2008, axillary lymph node ultrasound and FNAC have been used routinely along with core needle biopsy by an experienced breast surgeon (more than 20 years’ experience in breast ultrasound examination) for all patients highly suspicious of having a malignant lesion of the breast to evaluate the lymph node metastasis status.","title":"Sparing sentinel node biopsy through axillary lymph node fine needle aspiration in primary breast cancers"}
{"_id":"2c423a61-e0a4-63c9-e3f2-08e9744b9454","text":"IBR is feasible and cannot be considered a risk factor for complications or flap outcome. Our results support the current trend towards an increasing number of IBR. Especially in times of economic pressure in health care, the importance of a decrease of hospitalization cannot be overemphasized.","title":"Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study"}
{"_id":"2c4cc9ff-3064-a20b-54e8-4e7e92819832","text":"Patients referred to the rapid access Thrombosis Clinic at University Hospitals Bristol (UHBristol) for suspected DVT and subsequently diagnosed with a DVT on ultrasound. Patients are referred to the Thrombosis Clinic at UHBristol from both primary care and from within the hospital. The study population mainly comprises outpatients but patients diagnosed with a DVT through this service whilst an inpatient may be included in the study providing they meet the inclusion criteria.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"2c4d3844-0e2d-0f45-e80a-39b590c02a37","text":"Hollings Cancer Center Cancer Registry Data Reviewer and Southwest Oncology Group Breast Cancer Committee Member.","title":"Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction"}
{"_id":"2c50ab1c-657a-73c7-4d05-f1eb4c856532","text":"There have been no trials assessing the cost effectiveness of intensive follow up of patients after oesophagogastric resection as there have been with other common cancers [23,41]. It is therefore difficult to present scientific data supporting an intensive follow up programme with investigation for asymptomatic patients to detect disease recurrence particularly when there is no evidence that earlier detection affects outcome. Intensive follow up programmes with annual endoscopy and CT in asymptomatic patients, with further investigations if required are costly to the health service and do not impact on patient survival and often cause anxiety while awaiting the results. It seems sensible that investigations are performed in symptomatic patients so that treatment of benign complications or palliative therapy for recurrent disease can be commenced. However routine investigation of an asymptomatic population in whom there are rarely any curative treatment options available for recurrent disease cannot be recommended.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"2c5154e4-542a-c21d-089f-147b5c103453","text":"The algorithm could be found useful for the reconstruction of scalp defects in patients after receiving radiation therapy for any reason if severe complications of the treatment occur in the setting of severe skin atrophy with limited reconstruction resources.","title":"Reconstruction of Moderately and Severely Atrophic Scalp—A Multicentric Experience in Surgical Treatment of Patients Irradiated for Tinea Capitis in Childhood and Surgical Algorithm"}
{"_id":"2c518757-51c0-60ff-f621-e8bb6736b93f","text":"Patients must be diagnosed with MRI since it is nowadays a gold standard. Preoperative and postoperative scores are important in evaluating the patients’ condition and improvement. The results from our patient series also reinforce the notion that immediate surgery should be the preferred treatment method for cavernomas. Intraoperative neurophysiologic monitorization should assist the surgery in order to prevent complications. In conclusion, microsurgery is a gold standard method that we recommend for cases of cavernomas, which will not recur if gross total resection is achieved.","title":"Spinal Cavernomas: Outcome of Surgically Treated 10 Patients"}
{"_id":"2c54b73e-c08c-96ab-3ec0-59cd47d4f29f","text":"ICG as an SLN tracer is more accurate than MB and comparable to the combined methods and has good clinical safety. ICG can be considered a useful supplement or suitable alternative to traditional tracers.","title":"Short-term and long-term outcomes of indocyanine green for sentinel lymph node biopsy in early-stage breast cancer"}
{"_id":"2c586e46-f665-cee7-f005-18f5ea39cb2d","text":"Surgical reconstruction for these composite defects is quite difficult because multiple types of tissue from different anatomic sites are missing. Reconstruction of these complicated defects not only requires restoring the anatomy but also replacing the exact amount and types of missing tissue. The application of free flaps to reconstruct composite oral and maxillofacial defects has been well reported in the literature. However, few studies have discussed choosing different reconstructive solutions and designing free flaps based on a classification of composite oral and maxillofacial defects.","title":"Reconstruction of composite oral and maxillofacial defects by free flaps based on a new classification"}
{"_id":"2c5b8aa0-0c1e-9a25-1acf-28faf4d646e8","text":"Table 3 Maternal sociodemographic characteristics of participants who were breastfeeding at 6 months postpartum versus those who were not breastfeeding at 6 months postpartum","title":"Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study"}
{"_id":"2c61ddf3-ec90-7eb4-01b5-38c273bf1559","text":"Logistic regression models were used to analyze the effect of various predictors on the presence of positive lymph nodes. We constructed a multivariate model including the procedure and these predictors that have shown to be related to lymph node involvement in univariate analysis. The probability of finding positive lymph nodes was thus calculated in both groups correcting for relevant predictors of lymph node involvement.","title":"Is the sentinel lymph node biopsy more sensitive for the identification of positive lymph nodes in breast cancer than the axillary lymph node dissection?"}
{"_id":"2c639546-b5db-867b-5cad-8df5ebdd7522","text":"Yet, harvesting ribs requires general anesthesia, operating room settings, prolonged surgical time, and expensive surgical costs, and causes high risks of donor site morbidities, including pneumothorax, chest wall deformity, persistent pain, and hypertrophic scars.8,17,20–22 In addition, the use of autologous cartilage is restricted by the age and health condition of the patients.8","title":"Prospective Clinical Trial Evaluating the Outcomes Associated with the Use of Fresh Frozen Allograft Cartilage in Rhinoplasty"}
{"_id":"2c6457a0-556e-462c-50b8-2db95761a29f","text":"It is always a challenge to find alternative treatments leading to less complaints but this may not lead to major changes in tumour control and survival rates.","title":"Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up"}
{"_id":"2c65719b-52d9-5c5d-7a05-d6098a0871ad","text":"Acute radiation-induced dermatitis was considered as the differential for this new onset rash but was concluded to be unlikely as the rash did not appear to follow a dose-dependent distribution and its onset followed the CT simulation before the RT was even started. The defined erythematous nature of the rash in this patient is commonly associated with a cumulative radiation dose of 12-20 Gy and is typically not seen until 2-3 weeks following radiation treatment [12]. Our patient started experiencing symptoms following the thermoplastic mask fitting and within the first week of radiation therapy treatment. In addition, the patient presented to her first post-RT visit with the dermatitis reaction after only being exposed to 6 Gy total in 2 Gy daily fractions. This is not considered a sufficient enough radiation dose to cause the dermatologic symptoms of profound erythema the patient presented with. Moreover, the rash affected areas outside of the treatment field, as seen in the figures, including the forehead. This makes the dermatitis reaction unlikely to be caused by radiation due to the low radiation dose exposure at the time of symptomatic onset as well as its occurrence outside of the prescribed treatment field.","title":"Thermoplastic Mask-Induced Contact Dermatitis: A Case Report"}
{"_id":"2c68eaf9-2bdc-2acf-24b6-2e9b14cb66b5","text":"In our case, recurrence may be attributed to inadequate local excision during the previous surgery or simply to the nature of the disease. We also addressed this recurrent tumor with local excision; but with adequate margins and a selective lymph node dissection for occult metastasis. Malignancy was ruled out by histopathology which also ruled out any adjuvant treatment in the form of radiation. Accordingly, patient is on close follow up only.","title":"Recurrent Eccrine Acrospiroma of the Parotid Region: A Case Report"}
{"_id":"2c722a22-41b6-30bf-f3b8-97a4a0218c20","text":"None of the authors have any relevant financial disclosures or conflict of interest.","title":"Is fluoroscopy‐guided percutaneous bone biopsy of diabetic foot with suspected osteomyelitis worthwhile? A retrospective study 一项回顾性研究:怀疑骨髓炎的糖尿病足在透视引导下经皮骨活检是否具有价值?"}
{"_id":"2c73ca90-db16-65a0-7c29-768d5f0b17cd","text":"Despite the gaps, the reported studies in this review indicate that there is a possibility of adding PACT systems to the current therapeutic arsenals for combating microbial resistance, especially where the conventional antimicrobials have failed. We believe that as the field of PACT continues to grow, the development of even more robust photosensitizers is more likely, based on the improved understanding of the specific action mechanisms and disease targeting ability of the developed systems. Such changes will lead to an increased role of PACT in the management of microbial infections.","title":"Photodynamic Antimicrobial Chemotherapy: Advancements in Porphyrin-Based Photosensitize Development PACT: Advancements in Porphyrin-Based Photosensitizers"}
{"_id":"2c74f38a-0171-f07f-1526-7d4c01330dcd","text":"The anonymized transcriptions and analytic datasets are available stored at Center for General practice at Aalborg University, Denmark according to regulations by the Danish Data Protection Agency. Anonymized data are available on request by contacting the corresponding author.","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"2c824818-582f-3a1f-471b-209699f7fe35","text":"We suggest the difference in cancerous versus healthy cells structure and as a result their mechanical properties as presented by their modulus of elasticity, is the main cause for the selective difference in the effect caused by the shear stresses generated by ultrasound. Resulting in softer cells being more susceptible causing membranal rapture or porosity resulting in apoptosis.","title":"Cell stiffness predicts cancer cell sensitivity to ultrasound as a selective superficial cancer therapy"}
{"_id":"2c84fcc8-64ba-fea2-119a-c1776e2c1b52","text":"The authors report a case of a rare complication that occurred after botulinum toxin injection to the extraocular muscle, which was easily overlooked and successfully corrected by surgery.","title":"Vitreous hemorrhage and Rhegmatogenous retinal detachment that developed after botulinum toxin injection to the extraocular muscle: case report"}
{"_id":"2c8c718a-2f07-5a17-2c76-cdf787eea8ce","text":"We opted for anterior and posterior approach in view of the severe cervical kyphosis, with three levels of discectomy and bilateral uncovertebrectomy for adequate release anteriorly. Anterior surgery was also necessary to prepare a good fusion bed in an irradiated surgical area. Intervertebral cage filled with allograft was finally inserted to maintain the correction achieved. Posteriorly the facet joints were excised at the apex of the deformity and stabilized using cervical pedicle screw construct for superior rigidity and stability. Unique to our technique is that, we utilized a single cortical screw to buttress the cage inserted instead of conventional plating. This was meant to allow us further correction from posterior. We finally managed to restore and maintained the cervical lordosis, and ultimately attained fusion in an irradiated bed.","title":"Osteoradionecrosis in Subaxial Cervical Spine - a Rare and Devastating Complication: A Case Report"}
{"_id":"2c94928b-08ca-1f75-3318-5f1fc757b2e7","text":"Our results confirm that the finding of SLN metastasis in pure breast DCIS is a very rare occurence, if the primary tumour has been completely excised and microinvasion has been ruled out by a thorough histologic examination. Therefore, our current policy is to avoid routine SLN biopsy at the time of primary tumour resection in the presence of a preoperative diagnosis of DCIS. We reserve this procedure, as a second operation, for cases in which an invasive component is identified at the histologic examination of the surgical specimen. Only patients with a diagnosis of DCIS requiring a mastectomy or a wide resection close to the axilla should undergo concomitant SLN biopsy.","title":"Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast"}
{"_id":"2c9a7f70-50c9-1065-2415-89c2587a5b13","text":"The framework is crucial for restoring aesthetics and function after nasal reconstruction by fortifying the construct and maximizing airflow. Lateral alar structural grafts are designed to prevent alar retraction and external valve collapse during inspiration. Cartilage is typically harvested from the nasal septum, auricular concha or rib. Autologous materials are preferred, but are not immune to absorption and warping. Donor site morbidity, increased operative time and insufficient donor material are important considerations. Cadaveric homograft cartilage may be used and displays similar characteristics as autologous tissue, but the rate of absorption is greater than with autogenous tissue. Despite a successful framework reconstruction using cartilage, it is possible for the framework to collapse during inhalation. Autologous rib cartilage may not be sufficiently strong to support the airway in the long term. This may be attributable to its histologic character or to inadequate soft tissue ingrowth into the cartilage.","title":"Preventing nasal airway collapse with irradiated homologous costal cartilage versus expanded polytetrafluoroethylene: a novel animal model for nasal airway reconstruction"}
{"_id":"2ca0b268-642e-e6a7-da4f-382148e5f403","text":"The studies involving human participants were reviewed and approved by the institutional review board of Tianjin Medical University Cancer Institute and Hospital. The patients\/participants provided their written informed consent to participate in this study.","title":"A Single-Center Retrospective Analysis of Local and Distant Relapse of Breast Cancer Following Immediate Breast Reconstruction According to Molecular Subtypes"}
{"_id":"2ca32aa8-8bbf-99b6-c887-29a3bae56d5b","text":"A limitation of ultrasound is that the ultrasound waves are unable to penetrate bone, and as a result restrict ultrasonographic assessment of deeper structures. In this study movement and flexion of the stifle and metacarpophalangeal joints were used to better interrogate deeper articular margins. Despite this limitation, most common sites of osteochondrosis of the fore and hindlimb joints can be thoroughly accessed over the course of the examination. Diagnostic images could be acquired through the use of warmed alcohol as a couplant placed directly on haired skin. By removing the need to clip these weanlings, the screening process is more attractive to owners and trainers.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"2ca45e58-cc41-afa6-c59b-d7ca70e3743e","text":"There are a variety of specialists well equipped to manage melanoma of the hand, all with varying attributes. Plastic Surgeons, Hand Surgeons and Dermatologists may be comfortable performing both local excision and amputation, along with a functional reconstruction if indicated. In many centers, however a Surgical Oncologist or General Surgeon will prefer to perform the excision as they are in general more facile with current techniques and concepts of sentinel lymph node biopsy (SLN) and nodal dissections when they are indicated. There are many cases where both groups will be needed to offer the best care to the patient from both an ablative and restorative standpoint. A general knowledge of local referral patterns and preferences of consultants will aid in expedient management of this patient population.","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"2ca65afd-0fc6-992d-79aa-36b9c7db3d9d","text":"The thermographic analysis of the images was effective in evaluating the healing process, being the use of thermography feasible to evaluate changes in the thermal standard in the surgical bed, besides the beneficial effects of the US.","title":"Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats"}
{"_id":"2cab57fa-ab5f-f120-6ba4-82ce08a41303","text":"Data cleaning will take place by a series of logical checks on the electronic data using specific queries. Discrepant data entries will be checked with the source documents and the database amended if necessary.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"2cb2048d-997a-e9cb-7969-3d0abc883608","text":"This quality improvement study followed the Standards for Quality Improvement Reporting Excellence (SQUIRE) reporting guideline. Approval and informed consent were waived by the University of Michigan Medical School institutional review board because there were no human participants involved in this study.","title":"Comparison of Calculations of the Financial Impact of Fellowship Training by Data Source Calculations of the Financial Impact of Fellowship Training Differ by Source"}
{"_id":"2cb74766-cc48-232a-9322-f87313f07824","text":"Another perception of these satellite ophthalmologists was that compensation increases with a higher academic rank, which is not entirely accurate. Academic rank determines base salary to the extent that the base salary of physicians who stagnate in academic rank also stagnates. More important than increasing one's base salary, however, is that advancement provides leadership opportunities inside and outside the department, and publications and grants are linked to promotion to upper ranks and to appointment to leadership positions. In studying faculty members in leadership positions in 16 divisions of a large department of medicine, authors found that being mired in often time-consuming activities attached to lower level leadership positions could deter from productivity in terms of publications and grant awards. Leadership roles offer visibility and very likely affirm faculty members' sense of being valued.","title":"Satellite Faculty in an Academic Ophthalmology Department: Junior, Clinical, and Female"}
{"_id":"2cb7bede-0b74-54a6-6638-c2de59d829fe","text":"Macrolides inhibit bacterial protein synthesis by hindering tRNA attachment to the peptidyl transferase of the 50 S subunit of bacterial ribosomes, thus disrupting polypeptide chain elongation. The shared target with linezolid and streptogramins B can lead to MLSB resistance.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"2cb9e8cd-4bbf-f5d5-cfd7-f9cbadb8620e","text":"Surgical decision making in elderly and frail patients is often complex and occasionally the risks of a staging procedure outweigh the benefits. Increasing incidence and mortality rates of elderly melanoma patients emphasize the importance of an adequate management strategy for this group of patients.20,21 The present study shows that focused US follow-up after lymphoscintigraphy proved to be an acceptable approach in elderly or frail patients in whom it has been decided to avoid SNB. It allows early diagnosis of nodal metastases, albeit not as early as with SNB, and does not jeopardize MSS, RFS or DRFS.","title":"Focused Ultrasound Surveillance of Lymph Nodes Following Lymphoscintigraphy Without Sentinel Node Biopsy: A Useful and Safe Strategy in Elderly or Frail Melanoma Patients"}
{"_id":"2cc75048-642c-3f3f-c238-0e5200629da1","text":"In summary, Tables 1 and 2 show the correlation coefficients according to Spearman in an analysis between the arterial and venous degree of stenosis and the analysed parameter for each modality.","title":"A comparative analysis using flowmeter, laser-Doppler |spectrophotometry, and indocyanine green-videoangiography for detection of vascular stenosis in free flaps"}
{"_id":"2ccfa220-09a6-7d0c-e7b0-67becf2b643d","text":"Immediately after the surgical procedure, the lymph nodes were separated from the TLND specimen. Using the gamma probe it was possible to detect low amounts of radioactivity by touching the excised lymph nodes with the tip of the probe. Lymph nodes were considered radioactive whenever more than 4 counts were measured ex vivo in the absence of any background radiation.","title":"Individualized Surgery: Gamma-Probe-Guided Lymphadenectomy in Patients with Clinically Enlarged Lymph Node Metastases from Melanomas"}
{"_id":"2cd1e203-3da9-183d-7e7e-60f68907ee48","text":"Unfortunately, 3 months after the operation, the bars ulcerated a little portion of the skin graft above the lower part of the sternum and a second operation was then mandatory, to stop the broadening of the ulceration and minimize the risk of infection.","title":"Case Report: Surgical Reconstruction of a Massive Thoracic Wall Defect After the Resection of an Undifferentiated Radiation-Induced Sarcoma of the Breast"}
{"_id":"2cd486be-ba63-b111-5033-6a2f1ca4e583","text":"Breast reconstruction in breast cancer patients is an optional surgery that improves the quality of life while preserving the efficacy of chemotherapy and radiotherapy. Deep inferior epigastric perforator (DIEP) flap is a new but reliable and safe technique for autologous breast reconstruction. After mastectomy, immediate reconstruction is the preferred method because of its aesthetic result and convenience. This study is aimed at summarizing our experience in DIEP flap for immediate breast reconstruction.","title":"Deep Inferior Epigastric Perforator Flap for Immediate Breast Reconstruction following Mastectomy in Breast Cancer Patients: An Initial Experience in Vietnam"}
{"_id":"2cd72574-af41-fe4b-8d70-44fa0da74f80","text":"Here, we present the findings of 26 patients who underwent fibular graft reconstruction combined with other biological grafts, following wide resection of diaphyseal tumors in the extremities. We also discuss the radiological and clinical outcomes associated with this technique. We aimed to contribute to finding the most clinically useful procedure to reconstruct bone defects after the resection of extremity diaphyseal bone tumors.","title":"Long-Term Follow-Up of Biological Reconstruction with Free Fibular Graft after Resection of Extremity Diaphyseal Bone Tumors"}
{"_id":"2cddd0d9-f91b-db34-ba66-51fcd9f96f65","text":"The saphenopopliteal junction is located 2 to 4 cm proximally to the popliteal skin crease, where it is included in the popliteal vein, and it is seen in about 83% of the cases. This junction terminates in a normal fashion in only 62% of the cases, since the medial gastrocnemial vessels and small saphenous vein terminate in a common trunk in one-fourth of patients. In addition, the small saphenous vein is closely connected to the sural nerve from the apex of the calf to the ankle. Because of this close connection with the sural nerve and a high number of anatomical variations in the popliteal fossa, surgical treatment of small saphenous vein insufficiency is more complicated than is treatment of great saphenous vein insufficiency.","title":"Comparison of different approaches to small saphenous vein reflux treatment: a retrospective study in two centers"}
{"_id":"2ce70d4c-88f8-4480-59dd-032728ea6aca","text":"Systematic reviews have increasingly replaced traditional narrative reviews to update the best evidence for the most basic and clinical questions. The major advantage of systematic reviews is that they are based on the findings of comprehensive literature searches in all available resources, avoiding subjective selection bias, while narrative reviews can provide the authors’ experiential perspectives in focused topics.","title":"Perinatal psychological interventions to promote breastfeeding: a narrative review"}
{"_id":"2ce7705f-f2a1-e41a-bfed-1d3e58bd883a","text":"For the clinically stable patients, antibiotic treatment was discontinued 48 h after the most recent dose had been administered before surgery to improve the positive culture rate. For the clinically unstable patients, the antibiotic treatment was continued until surgery according to the Zimmerli algorithm20.","title":"One‐stage Debridement via Oblique Lateral Interbody Fusion Corridor Combined with Posterior Pedicle Screw Fixation in Treating Spontaneous Lumbar Infectious Spondylodiscitis: A Case Series"}
{"_id":"2ce8b846-9651-050f-e94b-dd4bd0c9a6bf","text":"Participants were randomized to either immediate IBBR with ADM (Acelity) and partial muscle coverage or to immediate IBBR without ADM using complete muscular coverage of the implant. Allocation to treatment was done using permuted block technique with random block size of 4 and 6. The randomization was computer based using a software module (Dynareg Systems) and stratified between centers to ensure balance between treatment arms. The trial inclusion and exclusion criteria were automatically verified by the computer program when randomizing a participant. Each participant was assigned a unique case number and recorded in a screening log kept locally. Physicians recruiting patients did not have access to screening log. The study was open label, with both surgeons and patients being informed about the allocation before their surgical procedure but concealed to participant until completion of baseline questionnaires to reduce allocation bias.","title":"Effect of Immediate Implant-Based Breast Reconstruction After Mastectomy With and Without Acellular Dermal Matrix Among Women With Breast Cancer A Randomized Clinical Trial Immediate Implant-Based Breast Reconstruction After Mastectomy Using Acellular Dermal Matrix"}
{"_id":"2cf6b14b-1aa8-0f18-a877-8da7789a3f6e","text":"Our series showed that the most common site of regional recurrence was along the cranial nerve branches in direct communication with the involved nerve. Gluck et al [16] published similar findings in a series of 11 patients treated with photon-based radiation therapy. Patients were treated to the involved skin and nerves at the time of presentation and 8 of 11 patients developed disease recurrence in previously untreated but contiguous nerves within the head and neck. This was the most common location of recurrence and is representative of the natural history of NMSC with clinical PNI. Because of this finding and results from our series, we recommend including contiguous nerves within the standard-risk clinical target volume to reduce the risk for this type of regional recurrence.","title":"Passively Scattered Proton Therapy for Nonmelanoma Skin Cancer with Clinical Perineural Invasion"}
{"_id":"2cf84cf3-ea0a-f551-8c32-2cd4158b6616","text":"Both Candida osteomyelitis and pubic bone osteomyelitis are extremely rare, thus rendering pubic bone Candida osteomyelitis an exceptionally unusual condition. Therefore, its diagnosis represents a challenge for the physician, and the level of suspicion has to be high especially in immunocompromised patients as well as in those who have previously undergone RT. A microbiological examination of a deep sample of the infected zone is the best way to achieve a correct diagnosis. Although the therapeutic approach against Candida osteomyelitis is already defined and effective, the pathologic mechanisms and diffusion of this rare infection are far from being fully understood. Likewise, the relation between RT and late-onset Candida albicans pubic osteomyelitis is still to be proven.","title":"Candida albicans Osteomyelitis Pubis: The Possible Pathogenic Role of Pelvic Irradiation"}
{"_id":"2cf8b2bb-dd21-d616-1832-788b9834bacd","text":"The patients were followed up on a weekly basis during the initial stages of treatment. After orthosis was applied, the patient was seen on a monthly basis for three months and then once every three months till the patients was three years of age. The patient was also followed up every six moths to one year till 5 years and then after 1-2 years till skeletal maturity is achieved.","title":"Mid-term results of ponseti method for the treatment of congenital idiopathic clubfoot - (A study of 67 clubfeet with mean five year follow-up)"}
{"_id":"2cfe7ccf-d45c-6fe1-9db8-428e738d869d","text":"The CO2 laser is the most used laser modality in tonsillotomy and is known for its good ablation and hemorrhage-controlling characteristics. An advantage of the CO2 laser is its ability to perform tonsillotomy under local anesthesia without sedation. General anesthesia has additional effects on postoperative and functional recovery, and obviating the need for general anesthesia may provide additional recovery benefit over tonsillectomy. However, there is a lack of evidence with sufficient quality regarding the clinical usefulness of tonsillotomy compared with tonsillectomy in adults.","title":"Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults A Randomized Clinical Trial Laser Tonsillotomy vs Conventional Tonsillectomy in Adults"}
{"_id":"2d02fe61-0b3d-31e3-4749-7cb4867f9e0d","text":"However, reconstruction using a composite graft has several disadvantages. First, it is impossible to perform histological analysis of the whole specimen for determining the effects of chemotherapy and the adequacy of the surgical margins. Second, it takes a longer operation time and requires specialist plastic surgeons. Third, the majority of the cases in the present study consisted of the reconstruction of the femur, which is considered to be less challenging than that of the tibia. Further investigation is required to show the applicability to expand this technique to patients with reconstruction of the tibia. Finally, some donor site complications which require surgical intervention such as claw toe deformity or peroneal nerve palsy may occur after the harvesting of vascularized fibula graft although there were no cases of such complications requiring surgical intervention in our series.","title":"Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized Autograft and a Vascularized Fibula"}
{"_id":"2d0c1ad8-da95-f858-fa58-d2f322a4d37d","text":"The objective of this study is to evaluate the effectiveness and safety of NPWT in the treatment of traumatic extremity wounds in a context associated with a high level of contamination and infection.","title":"Negative-Pressure Wound Therapy Versus Standard Treatment of Adult Patients With Conflict-Related Extremity Wounds: Protocol for a Randomized Controlled Trial"}
{"_id":"2d0c8915-bdb6-1c49-c497-8eb1357d58d9","text":"In conclusion, measuring tissue pO2 by means of luminescence lifetime imaging proves to be a helpful tool to evaluate the acute effects of PDT on the microcirculation. Only high-dose PDT with a high light intensity and a high light dose induces complete remission in our model. Moreover, it could be shown that fractionating the light dose enhances the effect of PDT only in surrounding but not in tumour tissue, since oxygen supply in tumour tissue is already maximal because of the characteristic structural and functional abnormalities of the tumour microvasculature. In addition, no significant effect of fractionated irradiation was shown in our tumour model regarding the therapeutic efficacy 28 days after PDT. The pO2-measurements correlate with the measurements of the tumour volume, only PDT inducing a significant reduction of pO2 in tumour as well as normal tissue 24 h after PDT resulted in complete remission of tumours 28 days after PDT.","title":"Effects of light fractionation and different fluence rates on photodynamic therapy with 5-aminolaevulinic acid in vivo"}
{"_id":"2d133307-5c7a-20ed-d9e2-a297fdcfa20f","text":"To determine the amount of ALA required to exert an antitumor effect in mPDT, we investigated the relationship between ALA dose and the amount of PPIX produced. In addition, to determine the optimal irradiation period in mPDT, we investigated temporal changes in the amount of PPIX in tumors after ALA administration.","title":"Metronomic photodynamic therapy using an implantable LED device and orally administered 5-aminolevulinic acid"}
{"_id":"2d184354-4cfb-e203-d019-7da608ba5087","text":"The specimen is removed in an impermeable sac and extracted after extending the camera trocar incision. Frozen section results determine whether deep ipsilateral dissection will be required. We typically begin to create the working space in the other leg while waiting for the results. If the primary tumour is high grade with infiltration to corpora cavernosum or urethra, risk for deep node positivity is high enough that one should proceed without frozen section results.","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"2d1ed061-2a02-ed2f-d93f-a2ee836508ae","text":"We advocate central group lymph node dissection when macroscopic lymph nodes are observed during the intraoperative evaluation of the patients with thyroid micropapillary carcinoma. If the tumor is unifocal, ipsilateral lymph nodes are dissected while if the tumor is multifocal, bilateral central lymph nodes are dissected. Since our team is experienced in this field, central lymph node dissections were performed with morbidity rates equivalent to total thyroidectomy. The actual disease stage was then determined by the evaluation of the lymph nodes in the surgical specimen. Although one might argue that this would not affect the prognosis, the additional information on the lymph node status of the patient would be useful in the follow-up and further planning of the treatment. In addition, performing dissection during the primary surgical treatment would prevent disease recurrence. Secondary benefits would be minimizing patients' anxiety due to the possibility of a secondary operation and preventing morbidity due to secondary interventions.","title":"An Approach to Macroscopic Central Lymph Nodes Detected during Surgery in Patients with Thyroid Micropapillary Carcinoma: Should We Resort to Dissection?"}
{"_id":"2d250931-e5c7-3736-b376-521b579ec10c","text":"Patients in the PICU are a heterogenous group, and the indication for pTP may be stronger in PICU patients considered to be at high risk of VTE. Recent recommendations suggest that PICU patients with at least two risk factors for VTE may benefit from pTP [11], but there is currently no data describing the incidence of VTE in this population. Such data is necessary to better understand the risk\/benefit ratio for pTP in high risk patients, and to adequately power randomized controlled studies investigating the efficacy of pTP in this setting.","title":"Incidence of venous thromboembolic events not related to vascular catheters in a prospective cohort of critically ill children"}
{"_id":"2d2609bc-3b54-45c3-0f4a-dda5bcce7ebb","text":"The piriformis fossa starting point for femoral nailing is directly in line with the medullary canal, whereas the starting point of a trochanteric entry nail is just lateral to the medullary canal. Traditionally, the piriformis fossa starting point is considered to be more challenging, especially in patients who are obese. One cadaver-based study comparing the difference in soft-tissue injury with each starting point showed a higher risk of vascular injury with piriformis nails, particularly to the medial circumflex femoral artery, but no injuries to the superior gluteal artery were found. Theoretically, a more medial approach, such as a piriformis fossa approach compared to a trochanteric entry, would increase the risk of a superior gluteal artery bleed because of the proximity of the guidewire and nail to the superior gluteal artery and its branches during insertion. However, the cadaver study did not document any injuries to the superior gluteal artery with a piriformis nail in particular, although the case report from Ward et al described a bleed associated with the piriformis approach.","title":"Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation"}
{"_id":"2d322f40-f728-2bba-62da-3add50449bdc","text":"Although PDT\/PCI has clearly demonstrated the induction of a significant anti-tumor immune response, light based therapies are limited by the rapid absorption of light in tissue. For this reason the therapeutic efficacy of PDT, using presently available PSs, has been clinically confined mainly to superficial relatively flat tumors limited to skin and head and neck surfaces as well as bladder and esophagus. Effective PDT has been shown to extend only up to a depth of approximately 4 mm in cerebral tissue[. It would therefore not affect the glioma cells in more distant infiltration zones in the resection cavity wall, which can be measured in cm. In addition, the tumor cells infiltrating normal brain that lead to tumor recurrence are protected by the blood brain barrier, so uptake of PS can be inadequate[. To overcome the difficulties of in situ light delivery and dosimetry in postoperative brain tumor resection cavities, PDT produced anti glioma vaccines are a related approach that takes advantage of the immune stimulatory effects of ex vivo PDT of tumor cell cultures.","title":"Photodynamic therapy mediated immune therapy of brain tumors"}
{"_id":"2d52e346-cb62-bd7b-829c-0e4a5c30e535","text":"There was no evidence of inflammation of surrounding tissues. The mass was firm on palpation and was not associated with pus discharge. The patient did not have problems in salivation or symptoms of ductal blockage.","title":"Dystrophic Calcification in the Oral Cavity Resulting in Mechanical Dysphagia: A Case Report and Review of Calcification in the Head and Neck Region"}
{"_id":"2d5b32f1-5b4b-86cf-9eb7-8ef30d5338c9","text":"HPV infected skin lesions are quite ubiquitous; however, data indicating that therapeutic radiation causes transformation of these lesions into invasive SCC are lacking. More studies are needed to determine the role that therapeutic radiation exposure may have in the development of SCC in HPV infected lesions. Additionally, it is important to advocate the appropriate utilization of active surveillance for patients with clinical stage I seminoma to avoid the risks of secondary malignancy and overtreatment.","title":"A 55-Year-Old Man with Stage IV Squamous Cell Carcinoma of the Right Groin after External Beam Radiation for Testicular Cancer"}
{"_id":"2d5cdd4b-511d-4bc8-b443-4961f7c5683e","text":"The number of surgical treatments due to dentofacial deformities has been increasing. Maxillary advancement surgery alone comprised the highest number in the sample.","title":"Service Profile of Orthognathic Surgery of a Medical School"}
{"_id":"2d5cf8d7-f218-d8d4-9749-b367274a4ec2","text":"Furthermore, the cervical or thoracic spine may tolerate a lower degree of compression than the lumbar spine due to cord involvement and the risk of venous thrombosis. It is our opinion that the involvement of the cervical or thoracic spine should significantly lower the threshold for urgent aggressive surgical intervention even in the presence of a stable neurologic exam due to the high risk of venous thrombosis of the spinal cord and subsequent neurologic decline.","title":"Challenges in the Diagnosis and Management of Spinal Tuberculosis: Case Series"}
{"_id":"2d5ed586-b8b1-a980-2967-ffd05a425371","text":"Group A patients were followed up until the time of death or until 2002, whereas Group B patients were followed up until the time of death or until February 2020. US, CT, and\/or MRI were performed every 3 months during the first year and every 6 months in the subsequent years for the evaluation of regional and cervical lymph nodes and distant metastases.","title":"Impact of Changing Surgical Strategies on Clinical Outcomes in Patients with Parotid Carcinoma: A 53-Year Single-Institution Experience"}
{"_id":"2d671ff0-e853-1c09-74d3-afe1cd97f3cf","text":"The insights obtained from examining the CMPA STF Data, the peer expert evaluations and STF Decisions illustrate the importance of thorough and detailed documentation of informed consent discussions in patient records, extending beyond a signed consent form, and detailed discussions about expected treatment outcomes and potential complications of STF therapy tailored to each individual patient in order to obtain informed patient consent. Additionally, the clinic context gives rise to issues of effective processes for delegation of discussions about expected treatment outcomes and complications, as well as the importance of a physician’s understanding of each patient through a thorough patient assessment, including their medical history and risk factors.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"2d721b29-d128-2e6b-2bc2-b9f4d6690769","text":"Although introduced for the treatment of maculopathies, photodynamic therapy (PDT) is now largely used in some eye cancers treatment. The selective tissue damage with PDT is achieved by sequestration of the photosensitizer in the target tissue and focal activation of the photosensitizer by low energy directed light. In this way, it is possible to achieve the destruction of the tumor tissue by safeguarding the surrounding healthy structures. Our study describes the clinical uses and efficacy of photodynamic therapy in ocular oncology.","title":"Photodynamic Therapy in Ocular Oncology"}
{"_id":"2d7f084b-eb81-979b-53aa-2d9a8ddbfe7f","text":"The local antibiotic delivery system seems to be a useful and safe method of treating the complex problems of open fractures and osteomyelitis, by maximizing the local concentration of antibiotics while minimizing their systemic toxicity.19 In avascular bones, it may not be possible for systemic antibiotics to achieve local therapeutic concentrations.20 Once microorganisms attach to bone or other biomaterials, the bacteria become metabolically less active and concomitantly cover themselves with a biofilm, rendering them unresponsive to usually therapeutic antibiotic levels. To be effective against bacteria in a biofilm, the desired antibiotic concentrations must be 10–100 times the usual bactericidal concentration.20 Giving the antibiotic by parenteral route or locally without any local drug delivery vehicle may not be beneficial due to the unpredictable antibiotic concentration.2 In our study, we chose the MRSA strain to create the osteomyelitis model as MRSA infections are even more difficult to manage. Vancomycin was selected as the drug of choice for the reason that it is effective against most gram-positive pathogens and infections with MRSA.14","title":"Decal bone matrix as a local antibiotic delivery vehicle in a MRSA-infected bone model: An experimental study"}
{"_id":"2d8396b9-b252-3ce4-3a94-e6ff9b33137e","text":"The presence of a focal defect in the cartilage surface may cause high contact stresses which often leads to tissue damage. Osteochondral grafts implanted flush to the cartilage surface can be used to reconstruct the articulating surface which can restore the contact pressure and area of the natural joint surface. The clinical application of osteochondral grafts in the knee involves implantation of either single or multiple (mosaicplasty) autologous or allogeneic grafts into osteochondral defects to restore the articular surface. The advantage of osteochondral grafting over microfracture or cell-based therapies is the immediate restoration of the articulating surfaces of the joint. However, a number of factors limit the clinical use of osteochondral grafts. These include tissue availability, donor site morbidity, disparity in congruency between the graft and host and lack of integration between the graft and host tissue. Despite the clinical adoption of biological interventions such as osteochondral grafting especially in young patients for whom a joint replacement may not be appropriate, a limited number of studies have been carried out to investigate the mechanical stability and tribological performance of these grafts. The success of osteochondral grafting in restoring the biomechanics and biotribology of the joint has been shown to depend on the restoration of the articulating surfaces. This study focuses on how variations in surgical technique and bone properties influence the primary stability of the graft prior to integration between the graft and host tissue.","title":"Biomechanical assessment of the stability of osteochondral grafts implanted in porcine and bovine femoral condyles"}
{"_id":"2d8ac775-19d0-643c-096e-e7f08d6b63ba","text":"In the new era of effective adjuvant therapy, accurate staging of patients with melanoma has become even more important than it was before. The current case report demonstrates how accurate staging can be accomplished in a patient with a melanoma in the umbilicus, a rare location at the crossroads of lymphatic drainage pathways. Dynamic lymphoscintigraphy indicated the SLNs and SPECT\/CT showed the node that eventually proved to be the only metastatic one in its unusual anatomic habitat in the pelvis.","title":"SPECT\/CT-Guided Surgical Removal of a Positive External Iliac Sentinel Node in Primary Umbilical Melanoma: Report of a Case, and Up-to-Date Review of the Literature"}
{"_id":"2d99237f-62be-1429-b441-16edc3c5dcc9","text":"NPWT has been shown to have a positive impact on wound status in a number of different indications, including diabetic foot ulcers, venous leg ulcers, and burns. In addition to the clinical evidence, there is an emerging body of evidence to suggest that NPWT may be a cost-effective intervention when compared to advanced wound care, on the basis that it can increase the number of wounds healed and also reduce the time taken to heal wounds, in a number of settings and indications. As the body of evidence on NPWT has increased, a number of international guidelines and consensus statements have been produced to provide guidance on the appropriate use of this technology.","title":"A Retrospective Comparison of the Performance of Two Negative Pressure Wound Therapy Systems in the Management of Wounds of Mixed Etiology"}
{"_id":"2da38b54-89d4-9fec-0bc9-7d9e1c30b1be","text":"High flow extracranial to intracranial saphenous vein bypass grafting is safe and effective in the treatment of complex intracranial aneurysms and the saphenous vein can meet the requirements of brain blood supply. A high rate of graft patency and adequate cerebral blood flow can be achieved.","title":"Safety and effectiveness of high flow extracranial to intracranial saphenous vein bypass grafting in the treatment of complex intracranial aneurysms: a single-centre long-term retrospective study"}
{"_id":"2da8f8a1-a52c-8319-934f-a33991eeeaa6","text":"Table 3 Comparison of infant feeding between the TD and the ASD children in different models","title":"Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: a national multicentre survey"}
{"_id":"2db132d3-f95d-fd4a-1bc1-582fd32e6ecb","text":"Two mutations in MAPK pathways can play a role in the development of melanoma, a type of skin cancer. One of these mutations is a mutation in the BRAF gene, which encodes a protein that is a key component of the MAPK pathway. This mutation leads to the activation of the MAPK pathway, which can promote the proliferation and survival of cancer cells. The other mutation is in the NRAS gene, which encodes another protein that is involved in the MAPK pathway. This mutation also activates the MAPK pathway and can contribute to the development of melanoma.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"2db53304-79e4-4f7c-90e0-ba45de458b2f","text":"Right colon and cecum were found to be the most common sites for the occurrence of primary colonic melanomas as depicted in Figure 1. This was slightly different from the data on metastatic colonic melanomas, where ascending colon and descending colon were reported as the predominant sites involved [17]. Figure 1 shows a comparison of the sites involved in primary and metastatic colonic melanoma.","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"2db585f9-990f-ea84-b8ca-3088a3c0903d","text":"Laboratory parameters were assessed on admission and at the end of acute care. Blood cultures were performed on admission before the start of antibiotic treatment. A minimum of three microbiological specimens were obtained during each surgical procedure.","title":"Spinal infection with intraspinal abscess or empyema and acute myelopathy: comparative analysis of diagnostics, therapy, complications and outcome in primary care"}
{"_id":"2dba16af-efc8-bbd0-41ee-db5aa62d999d","text":"Contingency tables were used to compare the number of stages with the histological diagnosis. The analysis showed that patients with superficial basal cell carcinoma were 9.03 times more likely to require more than one stage. A comparison between complications and histological diagnosis showed that patients with superficial basal cell carcinoma were 6.5 times more likely to experience complications.","title":"The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital"}
{"_id":"2dba416d-52c5-ae07-39cf-654a1ff54cb9","text":"Postoperative breast MRI showed significantly higher detectability for recurrent lesions than mammography and ultrasound. Early fast enhancement is the most important feature of recurrent lesions on postoperative breast MRI for both early and late recurrence groups. Due to its high possibility of recurrence, further work-up should be considered regardless of their morphologic features.","title":"Usefulness of postoperative surveillance MR for women after breast-conservation therapy: Focusing on MR features of early and late recurrent breast cancer"}
{"_id":"2dbc5c6e-2437-162c-3800-6909d65aa9bc","text":"Patients who had undergone mastectomy with breast reconstruction since 2010 operated on at the Hospital Universitario Torrecárdenas and in private clinics in the province of Almería by the same surgical team and met the criteria for inclusion in the study were selected. The type of sampling was by convenience through access to the patients’ medical records.","title":"Long-Term Quality of Life (BREAST-Q) in Patients with Mastectomy and Breast Reconstruction"}
{"_id":"2dce2c08-e802-1885-61bd-070e0906b272","text":"Those patients who reply with a positive response from willing general practices will be contacted to determine that they still wish to take part in the study. If still willing to take part then the research nurse or a member of the practice staff will access the patients’ primary care notes to assess their eligibility for inclusion into the study. If the patient is eligible then they will be followed up (at least 1 month before the end of their current treatment) to arrange their first visit to the GP surgery. Any additional travel costs and prescription costs will be paid to the patient from study funds.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"2dd524d5-8448-771b-f643-fad4a987e9c2","text":"This study suggests that gender diversity in academic oncology is a significant issue.","title":"Women’s Representation in Leadership Positions in Academic Medical Oncology, Radiation Oncology, and Surgical Oncology Programs Women’s Representation in Leadership Positions in Academic Oncology Programs"}
{"_id":"2dd70a71-5b19-79c7-10f3-1fcfa482625e","text":"There is little evidence on the best course of action in patients with moderate risk of thromboembolism regarding whether to use or not to use bridge therapy. Thus, the choice should be based on the individual characteristics of each patient and the proposed surgery. Whether the patient requires bridge therapy is decided by the attending physician.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"2dd96481-7e74-b9a4-d96d-7c41faca8d35","text":"There is a rare condition known as CPF that is associated with NF and CPT. Nearly 50% of CPF cases are associated with NF; the contributing mechanism is unknown. In light of the important role played by the periosteum in children and its osteogenic potential, we studied the treatment of CPF using periosteal flaps. The pseudarthrosis was mainly composed of a periosteal vascularized tissue capable of replicating bone. A VFPG transfer for treating challenging bone healing problems in children has recently been described. Our study presents two cases of CPF with different types of CPF, which were treated with distal base fibular periosteal flap without any bone grafting.","title":"Refracture, a Potential Complication of the Periosteal Flap Technique Without Bone Graft for Isolated Congenital Pseudarthrosis of the Fibula: A Report of Two Cases and Literature Review"}
{"_id":"2de774bd-3c72-3a03-b972-da35e952f25b","text":"The main causes of flap necrosis can usually be attributed to specific problems in the hemodynamic of the flap including arterial flow insufficiency, venous congestion, or possibly a combination of the two mechanisms. To solve these problems and improve the survival of skin flaps, numerous surgical methods and pharmaceutical agents have been proposed and thoroughly studied.3","title":"The Effect of Enoxaparin and Clopidogrel on Survival of Random Skin Flap in Rat Animal Model"}
{"_id":"2de9c002-aa98-a917-c8e4-cc933cfa3a0e","text":"Incidence of occult lymph node metastases according to pT classification was analyzed for both classifications and is listed in Table 4, showing in the 8th classification a decreased incidence in all T classifications, particularly for pT3 tumors.","title":"Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy"}
{"_id":"2dedf0d8-6b6b-2c9c-b40e-b753fe07ad56","text":"The mastectomy rate following conservative surgery depends on a number of factors, such as the relative size of the recurrent tumour with respect to the breast size, location of the tumour, availability of breast reconstruction, skill and experience of the surgeon, and patient preference. Therefore, we preferred not to give strict guidelines in the study protocol for the type of breast surgery used following recurrence, nor did we select the breast preservation rate as a study endpoint. Had the breast preservation rate been predetermined as an endpoint, the attitudes of the clinicians might have influenced the choice of the type of surgery more than in the present design, where no emphasis was given on the issue prospectively. Hence, it is possible that our study design may have been even less biased than after predetermining the breast preservation rate as an endpoint.","title":"Relative harms and merits of postoperative radiation following conservative surgery for low risk breast cancer"}
{"_id":"2df7aaef-32e0-b509-a444-ebaf4363d8a4","text":"Radial forearm free flaps are the most frequently used free tissue transfer for reconstruction of soft tissue defects in the head and neck following oncologic resections. The overall goal of reconstruction should be to maximize the function and cosmetic outcomes of the defect closure, while also minimizing the morbidity at the donor site. Forearm donor sites can rarely be closed primarily and typically require a split thickness skin graft for closure. Unfortunately, there are high rates of poor or delayed wound healing with resultant tendon exposure and skin graft failure [1–4] at the forearm donor sites.","title":"Donor site morbidity following radial forearm free flap reconstruction with split thickness skin grafts using negative pressure wound therapy"}
{"_id":"2dfb11cc-26e8-ef61-d59d-27fc6a6350f6","text":"Mycobacterium tuberculosis infection should be considered in children and adolescents with extensive enlargement of lymph nodes after splenectomy.","title":"Disseminated lymph node tuberculosis after splenectomy: an unusual case report in an adolescent"}
{"_id":"2dfbaa13-67b6-1554-4e36-c6921f85d7b2","text":"An ankle soft tissue defect with exposed tendon and bone was covered by splitting the tibialis anterior muscle longitudinally and turning down the split muscle flap on a distal intermuscular pedicle, while preserving its function. This turndown flap technique, to our knowledge, has not been previously described but is based on sound anatomical concepts. The split hemitibialis anterior turndown muscle flap was successful in covering an ankle wound with exposed tendon and bone and preserved active dorsiflexion of the ankle and active extension of the great toe despite using a portion of the muscle for wound coverage. The wound coverage remained stable at 6 months follow-up with active ambulation and no wound healing issues. Active dorsiflexion of the foot and active extension of the great toe were present.","title":"Split Hemianterior Tibialis Turndown Muscle Flap for Coverage of Distal Leg Wounds With Preservation of Function Gundlapalli et al"}
{"_id":"2dfc3c21-0802-9c6e-b80e-78f412e3dfd8","text":"The interviewees all reported on the qualities that they brought back with them to their work in the UK as a result of the IGH programme. Most commonly mentioned by the interviewees was confidence:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"2dff5173-71b1-3e44-ae41-daa95ab8b5f2","text":"Nerves are known to get entrapped at various anatomical sites clinically manifesting in paresthesia and paresis even in nonleprotic conditions. It is also known that inflamed swollen nerves due to any cause are more prone to entrapment.2–6","title":"Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities"}
{"_id":"2e0ca06a-3a90-9148-a326-6988c06c2a45","text":"Caution should be applied in the practise of these new techniques as their evidence base is largely anecdotal or based on small series.","title":"Cutaneous Scarring: A Clinical Review"}
{"_id":"2e134813-339b-3463-1100-2efafa5631fc","text":"Half of the recurrence samples had DCIS associated with IDC, suggesting that DCIS had been left behind or that within residual tissue after mastectomy further DCIS had developed and the absence of radiological follow-up allowed invasive foci to supervene.","title":"Comparison of Local Recurrence After Simple and Skin-Sparing Mastectomy Performed in Patients with Ductal Carcinoma In Situ"}
{"_id":"2e149017-2de7-8510-ff92-0548a3a1f8be","text":"We asked surgeons to consider the perspective of today’s graduates as they consider a career in surgery. This study provides information regarding the promoting and discouraging factors that board-certified surgeons in different stages of their career perceive for entering surgery as a career.","title":"The Surgeon’s Perspective: Promoting and Discouraging Factors for Choosing a Career in Surgery as Perceived by Surgeons"}
{"_id":"2e15a686-f4be-acd5-c7e8-0e565bb1b9b3","text":"The holes were drilled taking care not to injure the dura. The perforation was stopped when bleeding from the diploic spaces occurred.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"2e1c092a-0137-0969-01c9-3ea0464e1626","text":"Careful judgment is needed to balance the risk of leaving gross facial disfigurement and the risk of infection.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"2e2dbb42-07ac-4125-462e-f3bb0cf98689","text":"The purpose of this study was to evaluate the characteristics of IMGs who successfully matched into plastic surgery residency programs. Although we did not perform a direct comparison with the matched US graduates, the accolades of the IMGs compare similarly to their counterparts when examining the literature. Tadisina et al16 discussed the increasing accomplishments of US graduates matching into a plastic surgery residency program from 2009 to 2014. The number of publications ranged from 8 to 12 per applicant, and mean USMLE step 1 scores were 245 and step 2 scores ranged from 245 to 250. These numbers have increased over the years when compared with older studies,17 reflecting the increasing competitiveness in the match. However, they are similar to our findings for IMGs who successfully complete the match process. These findings suggest that IMGs who successfully match have proven themselves to be competitive when compared with US graduates.","title":"International Medical Graduates in the US Plastic Surgery Residency: Characteristics of Successful Applicants Kokosis et al"}
{"_id":"2e2f2c81-a8fc-6261-ec77-0acf34de8181","text":"This research fulfilled the criteria set by the Médecins Sans Frontières Ethics Review Board (MSF ERB) for review exemption as a retrospective analysis of routinely collected and anonymized data. The need for MSF ERB submission was deemed unnecessary according to MSF ERB policy.","title":"Post-traumatic osteomyelitis in Middle East war-wounded civilians: resistance to first-line antibiotics in selected bacteria over the decade 2006–2016"}
{"_id":"2e305d73-6b77-fec3-89b9-996800d61ab8","text":"In conclusion we were able to demonstrate that suspicious lymph nodes in preoperative imaging have influence on different factors. Resectability is more likely if the patient does not present with suspicious lymph nodes, but even if nodes > 1.5 cm are detected, resection and complete tumor clearance is still achievable. With a cut-off of suspicious lymph nodes of 1 cm a significant influence on RFS can be seen. The same applies for OS which is affected at a cut-off of 1 cm as well. It is important to classify these results in the correct way. Although suspicious lymph nodes in the preoperative imaging may be associated with a worse prognosis, in a considerable number of cases they are false positive. Explorative laparoscopy should be considered, especially if suspicious lymph nodes in distant localisations are detected in preoperative imaging to reduce operative trauma in case of irresectability. Surgery is the only chance of cure and therefore suspicious lymph nodes should be no reason to resign from surgery in most cases, because complete resection can still be achieved.","title":"Relevance of suspicious lymph nodes in preoperative imaging for resectability, recurrence and survival of intrahepatic cholangiocarcinoma"}
{"_id":"2e404c21-4cd8-23e4-ed35-1b4d5180bd22","text":"We found that infection at the injection site was positively correlated with skin disinfection before injection, age, and performing injections outside home, and the greatest contributor to infection symptoms was injections performed outside the home in Japanese patients who self-inject insulin for diabetes. Omitting skin disinfection before the insulin injection was not the factor that affects symptoms of injection site infection.","title":"Factors That Affect Symptoms of Injection Site Infection among Japanese Patients Who Self-Inject Insulin for Diabetes"}
{"_id":"2e44faab-aec6-5878-994b-0c863cb5bc87","text":"Mothers need to be gentle, respectful and persistent in offering breastfeeding to their child and expect that it may take several months or even more than a year before their child is ready to breastfeed. Development of trust and attachment takes some time [74] and therefore it is not surprising that the progression to breastfeeding might require a significant time investment. It is extremely important that mothers not attempt to force their child to breastfeed, this simply does not work but can create an aversion to the breast and harm the development of trust between child and mother. It is also important to note that while most children with a history of relational trauma will be initially reluctant to breastfeed, once committed to breastfeeding children generally become avid breastfeeders who clearly gain a great deal from the intimacy and comfort of breastfeeding, as will be discussed.","title":"Mental health, attachment and breastfeeding: implications for adopted children and their mothers"}
{"_id":"2e4ad051-0ffb-ff14-1532-e0257257a0da","text":"There is significant room for improvement of the biochemical diagnosis of VTE. Although some data point to the potential usefulness of the GHAs, a lack of standardization has hampered progress 29 and the clinical diagnostic value of ETP and OHP for diagnosis of VTE has not been formally assessed in a real-world clinical setting. This cross-sectional diagnostic study compares the diagnostic accuracy of OHP and ETP to D-dimer and FM for the assessment of suspect acute VTE in outpatients contacting the emergency department.","title":"Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers"}
{"_id":"2e4fea39-4578-36f1-61b0-59d72a2120a7","text":"Dermal filler injectors should be aware of the risk of filler-induced blindness and familiarize themselves with the visualization of the variable facial vascular anatomy. The implementation of a one-time MRA and subsequent AR visualization may be useful in the accurate planning of minimally invasive facial rejuvenation procedures.","title":"The Usefulness of Magnetic Resonance Angiography to Analyze the Variable Arterial Facial Anatomy in an Effort to Reduce Filler-Associated Blindness: Anatomical Study and Visualization Through an Augmented Reality Application"}
{"_id":"2e5113fb-c81a-c6f1-f62f-e0be70fe09e8","text":"The median nerve was exposed 2 cm above the proximal wrist crease and the adhesions were separated from the surrounding tissues. The flexor retinaculum was cut to its free edge up to the origin of the abductor pollcis brevis fibers. The adhesions inside the carpal tunnel if any, were surgically released. An epineurotomy was done along the length of the nerve taking care not to injure the blood vessels. The maximum thickening of the nerve was noticed just above the proximal edge of the flexor retinaculum.","title":"Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities"}
{"_id":"2e522ef5-e358-e966-90c9-191f937898c8","text":"About one third of cases of Staphylococcal osteomyelitis in the current study were caused by methicillin resistant Staphylococcus aureus. There is a need of tailoring antibiotic management of osteomyelitis based on culture and sensitivity results for the better treatment outcome of the patients.","title":"Methicillin resistant Staphylococcus aureus causing osteomyelitis in a tertiary hospital, Mwanza, Tanzania"}
{"_id":"2e5cf9fd-101f-fc73-15da-5c922f221f7b","text":"However, the imaging surveillance strategy for patients with prior breast cancer treated with mastectomy with or without reconstruction is more controversial. The National Comprehensive Cancer Network recommends against routine imaging for patients with breast cancer who have undergone mastectomy with or without reconstruction. However, the American College of Radiology categorized the use of mammography or digital breast tomosynthesis as potentially appropriate for patients with breast cancer treated with mastectomy and tissue-based reconstruction, but not after mastectomy with implant-based reconstruction or without reconstruction. These discrepancies in current guidelines reflect the lack of adequate evidence for or against surveillance imaging after mastectomy and might explain why breast imaging seems to be a common practice in contemporary clinical settings. Accordingly, there is a need to assess the clinical value of breast imaging in this setting by identifying the detection rate of clinically occult, nonpalpable recurrences that would have been missed through a physical examination.","title":"Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer A Systematic Review and Meta-analysis Surveillance Imaging After Mastectomy for Patients With Breast Cancer"}
{"_id":"2e65bf74-a65a-55ba-b3fd-913ad4eba22f","text":"It is known that weight loss by reduction in abdominal VAT mass improves metabolic profile. Intra-abdominal lipectomy has been shown to reverse insulin resistance in obese rodents and obese patients. However, surgical removal of VAT is highly invasive thus not clinically practical. A simple method of inducing selective VAT loss without surgery or systemic side effects could be a desirable treatment in obese patients.","title":"Selective reduction of visceral adipose tissue with injectable ice slurry"}
{"_id":"2e6fac56-c1fa-655f-f25c-297e51de7995","text":"The adequacy of surgery appears to be the most important milestone in the therapeutic history of melanoma. Surgery is fundamental in the initial stages of the disease including definitive treatment of primary lesions and locoregional disease. However, there is limited information regarding appropriate surgical treatment in the presence of lymph node metastases and if a radical lymph node dissection improves prognosis [24].","title":"Surgical management of melanoma: an EORTC Melanoma Group survey"}
{"_id":"2e76d456-ffca-4754-b1f0-04e432d3cf57","text":"In this retrospective monocentric cohort study, 151 patients who received 158 free flap reconstruction at our department between March 2018 and October 2019 were included. Patients who were transferred to peripheral hospitals and thus did not undergo postoperative follow-up were excluded.","title":"Seasonal Impact on Free Flap Surgery in Terms of Flap Loss and Wound Healing Disorders: A Retrospective Cohort Study of 158 Free Flaps"}
{"_id":"2e7f2127-749a-46a7-6131-423578a46289","text":"Based on the aforementioned studies, it could be concluded that missed positive nodes may lead to an understaging and thus to undertreatment of those SLN patients with occult metastasis within the SLNB. It also indicates a decreased negative predictive value for SLNB in settings where only a single SLN is detected. However, none of these studies investigated the outcomes in terms of OS, DFS, and local and distant recurrences for patients with a single SLN comparing them with those of patients with two or more SLNs assessed.","title":"Effects of the number of removed lymph nodes on survival outcome in patients with sentinel node-negative breast cancer"}
{"_id":"2e80c609-f0da-9075-26f4-a093065de86a","text":"This cohort study assesses the rate of venous thromboembolism after cancer surgery and the rate of chemoprophylaxis adherence within the Veterans Health Administration.","title":"Venous Thromboembolism Chemoprophylaxis Adherence Rates After Major Cancer Surgery Venous Thromboembolism Chemoprophylaxis Adherence Rates After Cancer Surgery"}
{"_id":"2e818dff-9bf7-2d61-a996-acc25e2ca260","text":"The study was conducted in accordance with the ethics principles set forth in the Declaration of Helsinki, and the institutional review boards at each hospital approved the study protocol. All patients provided written informed consent before randomization. We did not collect data on the number of patients who were approached and assessed for eligibility.","title":"Efficacy and safety of anticoagulant prophylaxis for prevention of postoperative venous thromboembolism in Japanese patients undergoing laparoscopic colorectal cancer surgery"}
{"_id":"2e8c10e4-bfb2-8d02-8ce0-46cacdf0190c","text":"Therefore, the objective of this study was to determine whether sonication of explanted vascular prosthetic grafts results in a higher diagnostic yield than conventional culture of vascular grafts and aids in establishing the microbiological diagnosis and clinical decision-making in VGEI.","title":"Sonication of Vascular Grafts and Endografts to Diagnose Vascular Graft Infection: a Head-To-Head Comparison with Conventional Culture and Its Clinical Impact"}
{"_id":"2e9294ae-7d83-ba36-866a-9a0b584cb34e","text":"Rhinoplasty as a widespread procedure in cosmetic surgery is performed on both soft and bony tissues and like other surgeries causes tissue traumas. Inflammatory responses to this trauma can result in morbidity of the patient, including ecchymosis and edema, which are prevalent and expectable outcomes in rhinoplasty. The most important cause of this complication is vascular trauma at the site of osteotomy. The extent and severity of these complications may be reduced by precisely observing surgical techniques, even they cannot be completely prevented.,","title":"The Effect of Hirodoid Cream on Ecchymosis and Edema around Eyes after Rhinoplasty"}
{"_id":"2e9727ab-3a70-3b92-dd00-c7ece04d43c5","text":"The prognosis of patients with myeloma has improved considerably over the last 15 years because of the advances in Haematological Oncology. We therefore need to become more proficient at treating the associated medical\/surgical complications related to the disease. One such complication is one or more VCF’s of the spine. Patients may present with significant spinal fracture pain or neurological compromise. These signs and symptoms may present at the time of the index procedure or when there is a relapse of the disease. Essentially, myeloma patients that present with spinal symptoms and signs need to be assessed to establish the source and nature of their pain and presence\/absence of neurological compromise and spinal instability.","title":"The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG)"}
{"_id":"2e9817fe-1ff3-7aca-6805-582a769e1f19","text":"NPWT-assisted wound closure is a magnificent tool for wound management. We had encouraging results with the use of NPWT in wound management. It is essential to have a thorough debridement of the wound before the application of NPWT and regular change of dressing every 48 hours to 72 hours as per the volume of secretion to prevent secondary infection and have a better outcome. In addition to NPWT, we would suggest having sequential concentric compression of the limb distal to proximal to encourage venous return as most of these patients have poor muscle pump. The effect can be extrapolated to all wounds with infection and discharge but must follow a thorough debridement and lavage.","title":"Negative Pressure Wound Therapy Assisted Closure: An Effective Mode of Management for Infected and Contaminated Wound With Non-Union Fracture Femur"}
{"_id":"2e99ff45-a630-fdd0-20fb-161e7be66df4","text":"For the establishment of CSBO, CT and MRI findings proved to be crucial. Both surgical and conservative treatment of CSBO are dependent on CT and MRI scan findings. Before the inflammation starts to spread towards the clivus, the fat tissues adjacent to the styloid process becomes stranded on enhanced CT scans and the tissue changes are obvious even on non-enhanced CT scans. We consequently strongly recommend that CT or MRI imaging of the skull base becomes compulsory in elderly diabetics with otitis externa lasting more than 2 months.","title":"The routes of infection spread in central skull-base osteomyelitis and the diagnostic role of CT and MRI scans"}
{"_id":"2e9c7e8a-f9ed-abbf-222d-5aa441aa5999","text":"Follow-up examinations were scheduled every six weeks either by an examination of the patient in the clinic or by mailing questionnaires to the patients. All patients are intended to receive a follow-up for 48 weeks. The duration of follow-up was chosen on the basis of our retrospective experience that the vast majority of beneficial effects became apparent after less than one year.","title":"Randomized multicenter follow-up trial on the effect of radiotherapy on painful heel spur (plantar fasciitis) comparing two fractionation schedules with uniform total dose: first results after three months’ follow-up"}
{"_id":"2e9fa097-9948-b1af-a8a9-beb6beda2e11","text":"The relationship between age and each aspect of facial contrast according to ethnic origin of face was tested using a Pearson correlation. Results are presented in details in Table 1. A negative coefficient of correlation indicates that the aspect of facial contrast decreases with age, whereas a positive coefficient indicates an increase of contrast with age.","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"2eac9c47-ae36-8ddd-2034-08f68450e34e","text":"The Consolidated Standards of Reporting Trials flow diagram for this trial is shown in Figure 2. Totally, 85 patients were assessed for enrolment in the study, with 80 patients meeting the inclusion criteria and were randomised into 2 groups of 40 each.","title":"Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block Versus Erector Spinae Plane Block for Postoperative Analgesia After Modified Radical Mastectomy: A Randomised Controlled Trial"}
{"_id":"2eaca86c-5f5f-fb10-0992-4b23046e8699","text":"All the patients in this study had clinically positive inguinal nodes detected on CT. In most cases, a biopsy of the inguinal LNs was not performed prior to inguinal node dissection. Patients with pathologically positive inguinal nodes were included in this study. Prophylactic inguinal LN dissection was not performed in cases of lower rectum adenocarcinoma or anal canal adenocarcinoma, without clinically positive inguinal nodes. Synchronous inguinal LN metastasis was defined as metastasis occurring within six months after the diagnosis of rectal or anal canal adenocarcinoma.","title":"Long-term outcomes after surgical dissection of inguinal lymph node metastasis from rectal or anal canal adenocarcinoma"}
{"_id":"2eb4d9bd-a73c-cece-c1bb-5c47af386fc4","text":"At the moment of the diagnosis CT scan revealed a bulky mass (8 × 7 cm) in the sigmoid colon with no cleavage plane with the bladder and the abdominal wall and perilesional fat micronodulations. First operation was performed in another hospital. In that occasion the cancer was entirely removed and colostomy in the transverse colon was created. Local resection was followed by chemoimmunotherapy since there were no more signs of progression.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"2ebc2e8e-7728-7b43-833b-fba58242f7e4","text":"Mohs micrographic surgery is an alternative to wide excision that is considered by some as the preferred treatment for DFS. It consists of a removal method that offers precise microscopic control of the entire tumor margin while maximizing the conservation of healthy tissue [12, 13]. It is performed by removing a thin margin of tissue circumferentially around and deep to the clinical tumor that is then examined under a microscope. The process is repeated until the tumor has negative histologic margins.","title":"Giant Darier–Ferrand dermatofibrosarcoma protuberans of the abdomen and pelvis: a case report"}
{"_id":"2ec230e1-e9db-42f9-92ec-0275cb5a2904","text":"Whether there is an increase in the degree of rotator cuff injury after MUA and to verify the safety of MUA on patients with rotator cuff injury.","title":"A multi-center, single-blinded, randomized, parallel-group, superiority study to compare the efficacy of manipulation under anesthesia versus intra-articular steroid injection in the treatment of patients with frozen shoulder and a diagnosis of rotator cuff injury or tear by MRI: study protocol for a randomized controlled trial"}
{"_id":"2ec34e8c-7cc1-6f4e-f771-964be9517373","text":"We present a novel pathological classification for DCIS with substantially better prognostic discrimination for ipsilateral recurrence than the classical categorisation based on cytonuclear grade alone.","title":"A new pathological system for grading DCIS with improved prediction of local recurrence: results from the UKCCCR\/ANZ DCIS trial"}
{"_id":"2ec48d4d-9e49-a1e0-a4c0-ed8c21102421","text":"LA BTA injections for refractory OAB are generally well tolerated in studies which report pain scores. EMDA of alkalinized lidocaine appears to be the most effective intervention in reducing pain during LA intradetrusor BTA injections. There may be a modest improvement in tolerability with intravesical, alkalinized lidocaine without EMDA. A reduction in the number of injection sites was also shown to improve tolerability. These interventions may help patients avoid the need for repeated spinal or GA injections. Intravesical lidocaine solution without alkalinization, dose reduction, and rectal opiate analgesia were not found to improve pain scores. Further research should address which subgroups of patients find the procedure most painful and would benefit the most from these interventions.","title":"Interventions to improve tolerability of local anesthetic intradetrusor Botulinum toxin injections: A systematic review"}
{"_id":"2ec674fe-e00e-3b14-3114-48a42344912b","text":"This article aims to describe the outcomes of a three-year GSR program and to analyze the effect of introducing a validated LSTP in the amount and complexity of abdominal surgical procedures performed by the trainees during their residency.","title":"IMPACT OF A SIMULATED LAPAROSCOPIC TRAINING PROGRAM IN A THREE-YEAR GENERAL SURGERY RESIDENCY IMPACTO DE UM PROGRAMA DE TREINAMENTO LAPAROSCÓPICO SIMULADO EM RESIDÊNCIA DE CIRURGIA GERAL DE TRÊS ANOS"}
{"_id":"2ecf9a2d-eb22-9d3b-2bfc-60f13cbe55d1","text":"However, due to the small sample size in our study, further studies are still needed to confirm the reliability. Moreover, in order to avoid the pain at surgical incision interfering with the test measurements, we only measured the area at left abdomen and left back, meanwhile local anesthesia was injected by the surgeon at laparoscopic puncture site and the incision at right costal margin after surgery. Although we measured the sensory at more than 1 cm away from the incision, the local anesthesia application could still effect the assessment of the zone in which it is located.","title":"Analgesic efficacy of ultrasound-guided subcostal transversus abdominis plane block"}
{"_id":"2ed23e0e-0a76-5da0-80ba-e07d5571ce8a","text":"All the patients received subcutaneous injections at 5-8 sites under aseptic conditions and taking standard precautions for injection procedure. The toxin was injected initially at five selected sites in the periocular region and the starting dose in all the patients was 2 units per injection site. Later on the dose and the sites had to be increased to 6 units and 8 sites respectively according to the individual response of the patients.","title":"Efficacy of botulinum toxin in benign essential Blepharospasm: Desirable & undesirable effects"}
{"_id":"2ed5d7fc-5e7a-1223-834c-8c3aac9a87d6","text":"Previous studies found differences in HSI values in patients with PAD compared with controls and a significant correlation with severity of disease. Besides that, HSI and thermal imaging have shown a good test-retest reliability for perfusion measurements. No studies to date have evaluated improvement of tissue perfusion with HSI after EVT. The measurement of temperature changes of the lower extremity after EVT have been investigated; however, the studies demonstrate conflicting results. Immediate assessment of tissue perfusion after EVT with HSI or thermal imaging could be used as an endpoint to determine success of revascularization.","title":"Detecting Changes in Tissue Perfusion With Hyperspectral Imaging and Thermal Imaging Following Endovascular Treatment for Peripheral Arterial Disease"}
{"_id":"2eda22be-fc49-a238-fb40-f926f7e9bdbd","text":"This work has introduced an approach for optimizing elaborate RGs which conform to a tumor volume, the results of which are compared to conventional manually prepared planar resection plans. The described approach efficiently optimizes the configuration of elaborate hull-type RGs such that the volume of healthy bone collaterally removed with the tumor is minimized. It was demonstrated that elaborate RGs based on the 3D convex hull of the tumor have less bone waste than manually prepared planar resections and that bone waste decreases as the complexity of the resection increases with additional planar and curvilinear facing cuts.","title":"Automated elaborate resection planning for bone tumor surgery"}
{"_id":"2edbe3c8-a294-d933-7897-0cadb2ba4ecf","text":"Nevertheless, the interventions and strategies shown to be most effective in our review include those which aim to raise awareness of the importance of leadership for surgical practice, those that attract people with established confidence in their technical surgical skills, and interventions aimed at surgeons who have been labelled with leadership deficits. Our findings suggest that perceived openness to leadership development, whether that be because surgeons’ have identified deficits or because their technical surgical skills are becoming more innate, was motivational for leadership development. Therefore, leadership interventions can build abilities and capabilities and give surgeons time to focus on their leadership, and an opportunity to practice leadership in the context of clinical practice.","title":"Advancing leadership in surgery: a realist review of interventions and strategies to promote evidence-based leadership in healthcare"}
{"_id":"2edc679f-47f1-8a4e-bb86-b4f4df117d8a","text":"The entrapment and loading efficiency of IMQ were calculated using the following equations:","title":"pH-Responsive Nanostructures Based on Surface Active Fatty Acid-Protic Ionic Liquids for Imiquimod Delivery in Skin Cancer Topical Therapy"}
{"_id":"2edc80e4-bcea-881b-2bf2-ae1edb7d78c4","text":"The colour and temperature of the flap were closely observed for 24 h after the operation, and vascular exploration was performed in cases of vascular crisis. Cases of flap necrosis were recorded, including cases of partial necrosis and total necrosis. The levels of healing observed in the donor and recipient areas after trauma were recorded.","title":"Application of an L-shaped anterolateral thigh flap in reconstruction after hemiglossectomy"}
{"_id":"2edf51ae-a581-df1a-6f2a-77bb9e419284","text":"The role of imaging is to confirm the involvement and to specify the extension of the lesions. CT scan is useful to evaluate the bone involvement. MRI is the examination of choice for the study of soft tissues and is essential in advanced forms.","title":"Malignant external otitis complicated by spinal cord compression: Case report"}
{"_id":"2ee3e1c2-87df-1fff-6a5f-148908765750","text":"It is very important to point out that all cases in this study were performed by guided implant surgery, virtually planned based on MRI and intraorally transferred by static guides. It is necessary to underline that the authors have reported a deviation between the virtually planned implant position and the resulting final implant position, a deviation of occlusal surfaces between the digitized and occlusal plaster models derived from the MRI data, and the visualization of important anatomical structures that was completely acceptable for clinical application. It is, therefore, possible to define that MR images are sufficiently accurate to show all anatomical structures relevant to dental implant planning, free from ionizing radiation, with an excellent risk\/benefit ratio.","title":"An Update of the Possible Applications of Magnetic Resonance Imaging (MRI) in Dentistry: A Literature Review"}
{"_id":"2ee4d926-cfda-fb41-5a59-6be1b86e6055","text":"It is essential in dermo-surgery where it is possible to avoid remove the aponeurotic galea which is a fundamental element for using skin grafts.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"2ee5f3a0-2274-ea7c-ada2-01f8de1bb036","text":"No recommendation on the extent of soft tissue defect which can be covered by a local flap can be given from the reviewed literature. In larger defects, free flaps which provide a good obliteration of dead space should be used. They also import well perfused tissue which can deliver antibiotics and immune cells to the area. Disadvantages of free flaps are the need of microsurgery, long operation time, and prolonged hospital stay combined with higher costs. They are also usually insensate, producing a later risk of pressure ulceration. Regardless of which coverage is used, the applied procedure should guarantee an improved bone vascularization and a good dead space management to avoid haematoma formation 8.","title":"Surgical Treatment and Outcomes of Calcaneal Osteomyelitis in Adults: A Systematic Review"}
{"_id":"2ee7ecb7-bf25-0d53-5d1e-b0237b5cbbe3","text":"A 16 year old woman was diagnosed Maxillary Le Fort I and II fracture due to a fall from motorcycle. There was comminuted nasal fracture without complaint about difficulty of breathing. An open reduction and internal fixation using miniplate was performed to treat the fracture using bicoronal approach, intra oral approach through upper gingivobuccal sulcus incisions and subcilliary lower eyelid incisions. Then, open rhinoplasty approach was performed. Cartilage graft was harvested from the conchal auricula then evenly diced into small pieces and being inserted into 1 cc dysposable syringe. Superficial temporal fascia was harvested and being sutured in cylindrical form covering the syringe filled with diced cartilage, just before final sutures the diced cartilage was injected into the fascia, then final suture was performed sealing the fascia, forming a diced cartilage fascia graft with a cylindrical tube shape. Then, the diced cartilage fascia graft was inserted into the dorsal nasal skin and fixed using a non-absorbable suture in the frontonasal area. Periosteal and alar cinch suture also performed during soft tissue closure.","title":"A breakthrough in Maxillary LeFort II fracture reconstruction: Case series of rhinoplasty using diced cartilage fascia graft simultaneously with ORIF"}
{"_id":"2eeb9e0d-67da-90b2-76dd-7149bd2ce719","text":"In this study, a change in the incidence of second primary cancers was found; screening for these cancers may be warranted in patients treated with immune checkpoint inhibitors for metastatic melanoma.","title":"Assessment of Trends in Second Primary Cancers in Patients With Metastatic Melanoma From 2005 to 2016 Trends in Second Primary Cancers in Patients With Metastatic Melanoma, 2005-2016"}
{"_id":"2eec2bf8-3e89-0707-87b7-b8776b640370","text":"Personalizing the starting dose according to the self allergic skin reaction has been resulted safe in 30 children referred to our hospital. Moreover avoiding antihistamines before or during oral desensitization, as other authors reported, makes clear the evaluation of the clinical reactions to the allergen and it gives us the possibility to slow down or go head with more reliability during the procedure.","title":"Oral desensitization to milk: how to choose the starting dose!"}
{"_id":"2efabe63-2c32-defd-1fd7-7f48c8233d54","text":"One of the greatest challenges in topical application of anticancer drugs is to obtain a drug amount in the skin sufficient to give a therapeutical effect. Nanocarriers could improve drug targeting due to their ability of addressing the tumor cells, contemporaneously markedly reducing the amount of drug applied on the skin, and avoiding the direct contact of the drug with the cutaneous surface [10].","title":"pH-Responsive Nanostructures Based on Surface Active Fatty Acid-Protic Ionic Liquids for Imiquimod Delivery in Skin Cancer Topical Therapy"}
{"_id":"2eff2e39-44a8-ab24-bb83-762934b52215","text":"After one month, the attending pain physician determined the type and frequency of treatment based on the needs and conditions of the patient. There was no restriction of treatment to the extent of the national insurance system as with normal medical care. Patient follow-up was simultaneously performed by a pain physician and a spine surgeon; the patient could express the desire to undergo surgical treatment to the spine surgeon at any time.","title":"Does a Positive Response to Transforaminal Epidural Steroid Injection Identify Patients Who Can Avoid Surgery for Two Years?"}
{"_id":"2f05b298-7126-6982-04c9-ea56078cc44c","text":"The saphenous vein is the most commonly used graft in coronary artery bypass surgery, since no suitable arterial graft is available. However, the frequency of late graft failure is a cause for research into graft protection. The objective of this study was to investigate the effect of synthetic adhesive cyanoacrylate administration on the saphenous vein graft for preventing vascular damage due to internal pressure on the graft.","title":"Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model"}
{"_id":"2f080f5b-9303-d2a8-eb95-fe2d0651a79f","text":"Specific cutaneous lesions along with BAL lymphocytosis, high CD4\/CD8 ratio and elevated serum ACE levels may be predictors of progressive disease in sarcoidosis. Punch biopsy is a simple technique with a high diagnostic yield and a low complication rate for cutaneous sarcoidosis.","title":"Diagnosis of cutaneous sarcoidosis; clinical and the prognostic significance of skin lesions"}
{"_id":"2f129eac-8b06-90c0-0e2b-d368d7a4b6be","text":"Our study shows that rhinoplasty, despite being a complex procedure, has proven benefits in terms of functional as well as aesthetic outcomes. The ROE questionnaire proves to be a valid tool for estimating patient satisfaction in our population. There is a need for further training and education of surgeons in Pakistan to improve the functional and aesthetic disabilities of nasal deformities.","title":"Satisfaction in Patients After Rhinoplasty Using the Rhinoplasty Outcome Evaluation Questionnaire"}
{"_id":"2f162bcf-9ad3-a7e9-f137-1a3d1ff27e1f","text":"It should be noted that reconstruction of composite oral and maxillofacial defects using a free flap has several noteworthy limitations. This technique might not be applicable in some patients with anatomical variation of the perforator vessels, especially for the construction of branch-based ALT flaps. Identification of the perforators and harvesting of a free flap are tedious jobs. There is a long learning curve. To harvest a free flap may be very complicated and prone to failure because of the anatomical variation, especially when performed by an inexperienced surgeon. The number of cases using free flaps to reconstruct oral and maxillofacial defects in the current study is still very small. Much work is still needed in accumulating experience and developing practical methods to estimate the anatomical variation preoperatively in the future.","title":"Reconstruction of composite oral and maxillofacial defects by free flaps based on a new classification"}
{"_id":"2f1f9723-d847-7165-57c0-3d82b26e3ecf","text":"The local coordinator completes a discharge form for all randomised patients on discharge from the randomising centre or in the event of earlier death. We can not blind the local coordinator to group allocation. If a patient is transferred to a rehabilitation unit on a different site to the randomising centre, and it is impractical to continue the allocated treatment or its monitoring whilst the patient is in that unit a discharge form is completed on transfer to that unit.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"2f20c48c-e034-720b-ab49-f7f623e5daae","text":"Calculations were made using each patient. A negative patient is a patient whom no positive result has ever been obtained and a positive patient, is a patient in whom at least one positive test has been obtained. As all patients with positive sentinel lymphnode had undergone lymphadenectomy, no nodal relapses were seen in our study population and relapses are distant metastasis.","title":"Prognostic significance of the sequential detection of circulating melanoma cells by RT–PCR in high-risk melanoma patients receiving adjuvant interferon"}
{"_id":"2f2cdf06-cafe-6bff-c674-ed736bb56a89","text":"Approximately 12 to 24 h after surgery, the patients were able to resume moderate activity with adequate protection from a neck support. Additional treatments such as intraoperative nerve root and spinal cord traction, dehydration drugs, and hormones were used postoperatively up to 3 days for some patients. Antibiotics were not routinely used before or after surgery. According to the degree of postoperative pain, the appropriate amounts of analgesic drugs were applied, and the length of postoperative recovery time before returning to normal work depended on the specific circumstances for each patient. The sutures were removed 7 to 10 days after surgery.","title":"Clinical application of large channel endoscopic decompression in posterior cervical spine disorders"}
{"_id":"2f2d56d9-6eab-71a3-06a8-caabfc3d5b76","text":"This study found that using simple acupoints for both acupuncture and manipulative acupuncture significantly improved the HBGS grade of severe Bell's palsy, resulting in a higher recovery rate at 8 weeks after treatment and at 6 months after the onset of facial palsy. Moreover, fewer treatments were required to recover the impaired facial nerve function to grade I.","title":"Efficacy of Manipulative Acupuncture Therapy Monitored by LSCI Technology in Patients with Severe Bell's Palsy: A Randomized Controlled Trial"}
{"_id":"2f2de1ca-06dd-5c14-b853-fe3fa619cf1c","text":"Curative surgical intervention is usually referred to as debridement, which refers to the removal of infected and necrotic bone and tissues. During surgery, sequestrectomy and the complete opening of the cloaca are essential to incite healing. Thus, cases with potential involucrum should be carefully inspected for the presence of sequestrum and cloaca, which should be communicated to the ordering team, with CT and MRI playing potential complementary roles in optimizing diagnostic accuracy. In contrast, resection of the involucrum is not required but can be performed to correct deformities and to avoid the formation of a new sequestrum within the remaining involucrum. Local treatment of the resulting bone cavity includes antibiotic beads and cancellous bone grafts.","title":"MRI nomenclature for musculoskeletal infection"}
{"_id":"2f32976d-42c1-b424-b038-164499cc83e3","text":"No new melanocytic lesions were detected in any of the horses during the treatment period.","title":"Effects of Topically Applied Betulinic Acid and NVX-207 on Melanocytic Tumors in 18 Horses"}
{"_id":"2f33887d-7645-33d0-06ad-00ff770e7244","text":"Surgical skills training were challenging in the past as the trainees were under constant pressure from their consultants or senior surgeons to produce competent apprentices. In the current situation, an increase in the number of surgeons prevents adequate chance to practise microsurgery. The training skills are cumbersome to be individually assessed. Futhermore, the consultants frequently face medicolegal issues pertaining to patient care. It is inappropriate and unethical to allow a trainee to start first hands-on practice on patients when capability is questionnable. A logical alternative would be laboratory-based training in order to improve basic skills and techniques. It is an opportunity for the trainee to prepare himself adequately prior to performing surgery in real operating theatre situations. Even trained microsurgeons have to undergo laboratory training to refine their skills.","title":"Microgrids: A Model for Basic Microsurgery Skills Training"}
{"_id":"2f36bb14-9332-e706-2b63-c5d11e58e931","text":"Calciphylaxis was already diagnosed histologically in the former hospital, where he was treated with Natriumthiosulphate intravenously for about 9 weeks. Initial symptoms were tender and painful lesions with defined edges in the upper and lower thighs and the abdomen, where some showed signs of necrosis. Further histological examinations showed typical signs of microthrombosis and calcification of the arterioles subcutaneously and substantiated the diagnosis of calciphylaxis.","title":"Calciphylaxis – a challenging & solvable task for plastic surgery? A case report"}
{"_id":"2f38673c-4ac4-6084-7fdc-2801f8df9080","text":"First, frenotomy is associated with breastfeeding improvements that vary individually but trend toward significance collectively during a critical time in infant development.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"2f397659-990b-96fb-a140-58fd9039b97e","text":"This study investigated postoperative breast volume changes following autologous free perforator flap breast reconstruction using 3D imaging. An average decrease of predicted breast volume over time was found, with a mean predicted breast volume decrease of 11.2% after three and 11.1% after six months postoperatively. Reconstruction timing and first postoperatively measured breast volume showed a statistically significant difference in starting breast volume and in the shape of the relationship between time and breast volume, whereas autologous technique and BMI only showed a statistically significant difference in starting volume and mastectomy indication in the shape of the relationship.","title":"“Three-dimensional evaluation of breast volume changes following autologous free flap breast reconstruction over six months”"}
{"_id":"2f3bcaa6-fb60-c03e-b3ad-1c70fa0a8cfe","text":"Reactive lesions are common oral lesions, and the treatment for all the common reactive lesions includes surgical excision and complete removal to prevent a recurrence, but it might result in a mucogingival defect.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"2f3bcf4d-1b9c-6aac-c7c3-033d65921f2e","text":"All the patients were re-examined by a radio-oncologist and the researchers. The times of examinations were just after completion of the radiation course, every 2 weeks in the first month, every 1 month for three month and six months after that and all patients were reexamined at the end of the study to determine their final Vancouver Scar Score. In every follow up visit, the patients were examined for developing any sort of adverse effects or complication. The Vancouver Scar scores of the patients before incision were compared with the scores of the patients in the final session to see the effect of radiation course.","title":"Surgical Excision Followed by Low Dose Rate Radiotherapy in the Management of Resistant Keloids"}
{"_id":"2f4483d6-78e6-20bb-07ac-709fa4e87a4f","text":"The patient later on went on to have multiple surgical procedures for injuries to spine and bilateral lower limbs. He was then followed for 8 weeks in the out-patient department following discharge during which he recovered well without any neurovascular deficit.","title":"Prone Positioning for Management of Fat Embolism Syndrome in a Patient with Spine Fracture; An Unusual Scenario and Review of Literature"}
{"_id":"2f45d532-97a9-a9de-c9cf-0311c8531c75","text":"The decision to join a larger surgical practice may also be associated with a desire to increase market power. Concentration of larger health insurers has decreased physician leverage and reduced earnings compared with physicians in areas of less substantial insurer competition. As a result, physicians in small or solo practices may find it challenging to compete with these larger, more concentrated organizations. This market reality may well push surgeons to consolidate into larger practices to increase bargaining power for reimbursements. There is emerging evidence that, similar to hospital consolidation, physician consolidation may result in higher prices and greater out-of-pocket spending for patients. We observed a substantial increase in the proportion of Medicare claims arising from large surgical practices over the same period as the shift of surgeons into these larger practices, suggesting an increase in market power. The effect that practice consolidation may have on clinical outcomes for patients remains unknown. The literature on hospital consolidation indicates possible harm in terms of both increased complications for some surgical procedures and decreased patient satisfaction, and whether these patterns also apply to consolidation of physician practices warrants further study. Our findings, therefore, provide baseline data for future studies on the associations between surgical practice consolidation and outcomes for surgical patients.","title":"Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US"}
{"_id":"2f46152c-d945-b5d3-2b24-ed81bef25449","text":"To evaluate the frequency and features of calcinosis in a cohort of patients with JDM and identify if there are risk factors.","title":"Calcinosis as a complication of juvenile dermatomyositis (JDM)"}
{"_id":"2f49c708-8eff-c4e6-c88c-a598f8ca5863","text":"Currently, the treatment of malignant melanoma offers the longest and the most studied experience of innovative treatments in malignant pathology. The algorithm of the therapeutic decision in advanced or metastatic melanoma must comprise: the timing of the therapeutic initiation, the sequencing of the specific oncological treatment (radiotherapy and chemotherapy still being therapeutic alternatives in selected cases), the diagnosis and the management of adverse reactions. We present the case of a patient diagnosed with metastatic malignant melanoma in November 2019, who progressed successively under new systemic treatment throughout the 3 years of treatment and experienced skin reactions of various degrees of severity. The comprehensive response to secondary hilar pulmonary lymphatic determinations under subsequent chemotherapy was specific to the presented case. The occurrence of vitiligo secondary to immunotherapy is a favorable prognostic factor, but the occurrence of secondary cerebral determinations is an extremely severe prognostic factor in malignant melanoma and a challenge in making the therapeutic decision. Previous treatment with immune checkpoint inhibitors may trigger a favorable response to systemic chemotherapy. The early and accurate diagnosis of the adverse events of the new therapies requires a multidisciplinary approach, because it can radically change the therapeutic decision.","title":"The Benefits and Challenges of the Multimodal Treatment in Advanced\/Metastatic Malignant Melanoma"}
{"_id":"2f4a5d61-d02e-c451-b7ea-2203940fbc70","text":"In this study, we reviewed a series of 50 patients treated with a standard surgical set up by the same surgeon, in order to better characterize the factors associated to a high recurrence rate.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"2f5390b6-36b8-3e37-9ed3-2a2bf7ecb40e","text":"The use of curettage under local anesthesia for treatment of actinic keratoses can be performed in isolation or in association with electrodessication, which appears to increase the resolution of potential remaining dysplastic cells and also to achieve hemostasis. An alternative to electrodessication is cryotherapy. As a monotherapy, curettage is especially indicated for patients with few lesions, especially hyperkeratotic actinic keratoses. The method is frequently used in the setting of patients with large clinical variability of keratoses as a complementary therapy for lesions resistant to field cancerization therapy, in addition to allowing the collection of material for histopathological analysis. Disadvantages regarding the method include the need for local anesthesia, the healing time, which can be prolonged when lesions are treated especially in the lower limbs, and the risk of dyspigmentation symptoms in the treated area.76, 130 Although curettage is widely performed in daily practice, the lack of randomized clinical trials evaluating the subject results in a low degree of recommendation of the procedure for actinic keratoses treatment.","title":"Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects"}
{"_id":"2f5d2179-a2c2-5527-9c82-1a7a8651e70a","text":"Despite there being no change in body image over the course of the study, participants continued to be concerned about their appearance at 8 weeks post treatment.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"2f5feaee-8a3c-1c66-cfea-26ecd0624bc6","text":"The patients undergoing bilateral reconstruction needed a slightly longer recovery time.","title":"Prediction factors for breast reconstruction postoperative complications"}
{"_id":"2f6965f4-5276-37a3-1afe-2f9e42d6df41","text":"Use of the SIEV is an excellent method to expand the microsurgical options in breast reconstruction with DIEP flap surgery. It provides a safe and reliable procedure to improve venous outflow in cases of inadequate outflow from the deep venous system. The SIEV could also provide a very good option for fast and reliable application as an interposition device in case of arterial complications.","title":"Use of the superficial inferior epigastric vein in breast reconstruction with a deep inferior epigastric artery perforator flap"}
{"_id":"2f7bc851-3983-bdb4-2071-22d323122bd5","text":"The primary aim of our study is to determine the incidence of malignancy in suspicious calcifications identified on mammograms after breast conservation therapy and evaluate the morphology and distribution characteristics. We will discuss the effect of other factors possibly associated with recurrence, such as time from completion of therapy and tumor resection margins after the surgical resection of the primary tumor.","title":"Recurrence Yield of Stereotactic Biopsy of Suspicious Calcifications After Breast Conservation Therapy"}
{"_id":"2f7f623a-a40f-edf6-df9b-2ed14fcf3133","text":"In conclusion, we confirmed that the final BT and nodal metastasis were significant factors affecting the survival rate in ALM patients. We also revealed that changes in BT did not affect the survival rate in ALM patients, even though BT may not be accurately measured through punch biopsy. Therefore, punch biopsy can be a useful modality for the diagnosis of ALM or ALM in situ that does not affect the disease prognosis.","title":"Effect of changes in Breslow thickness between the initial punch biopsy results and final pathology reports in acral lentiginous melanoma patients"}
{"_id":"2f80ed24-2c69-76a1-d4d8-8b2b0a41244f","text":"This study consists of the largest series of patients with drug-sensitive tuberculosis who developed type 1 immediate drug hypersensitivity while receiving treatment.","title":"Management of type 1 immediate hypersensitivity reactions to antituberculosis drug: succesful desensitization"}
{"_id":"2f88905b-0a4b-e031-4944-32ec7617fa2a","text":"Although most content posted related to marketing efforts, many influencers were also using social media to post about their personal lives and promote their ancillary businesses. Although marketing content was the most common, engagement levels were the highest for personal and educational content, and no significant differences in engagement were found between videos and photos.","title":"Content and Engagement Among Plastic Surgeons on Instagram"}
{"_id":"2f8c409a-675f-130c-ffda-6be9e21402a6","text":"The study population consisted of patients ≥16 years of age with a food allergy. The food allergy diagnosis was established based on patient reported allergic symptoms to food and a positive SPT or ImmunoCAP (conducted within a year before or after the reported symptoms) or food challenge for the same type of food. An exclusion criterion was inability to read or write the Dutch language.","title":"Cofactors in allergic reactions to food: physical exercise and alcohol are the most important Versluis et al."}
{"_id":"2f9671a2-cf03-208f-e3c9-fef681198ff5","text":"Aquaporins are cell membrane proteins that form pores in the membrane of biological cells. The expression of an aquaporin called AQP1 was shown by Zhang et al to be increased in pulmonary oedema caused by FES. Furthermore, this occurred proportionally to the severity of pulmonary oedema. Zhang proposed that AQP1 could be regulated by FFAs, and therefore upregulated during FES, raising a potential opportunity to target AQP1 as a therapy for FES.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"2f9c83a1-4c65-a94d-1399-3aa624340995","text":"Plantar arterial system dominancy is a rarely seen situation that makes the difficult toe to hand transfer harder, and there is no alternative method other than vein grafting in the literature. This is the first study to recommend the use of dorsalis pedis as an arterial graft instead of vein grafts. In conclusion, we think that this surgical method described will make these rarely performed transfers easier and affect the success rates positively.","title":"A new method for second toe flap revascularization in plantar dominant artery pattern - dorsal metatarsal artery interpositional graft"}
{"_id":"2f9dacd3-4b52-0839-54fb-6288b1df61cf","text":"Although T2-weighted sequences without fat suppression offer excellent contrast between cartilaginous surfaces and synovial fluid, the evaluation of cartilage is impaired due to the low signal intensity of the cartilage and the low contrast between cartilage and subchondral bone. Fat suppression techniques provide greater contrast at the interface between cartilage and subchondral bone(.","title":"Magnetic resonance imaging aspects after surgical repair of knee cartilage: pictorial essay Aspectos na ressonância magnética pós-reparo cirúrgico da cartilagem do joelho: ensaio iconográfico"}
{"_id":"2f9db618-4665-701a-5484-0bf76c56bf0a","text":"We will define survival of participants as the time from the start of PDT to the time of death by any reasons.","title":"Therapeutic effect of photodynamic therapy for nonresectable cholangiocarcinoma Protocol for a meta-analysis and systematic review"}
{"_id":"2fd44e1d-682f-ca41-acaa-95f49df1458f","text":"The sentinel lymph node is identified with a dual method consisting of radiocolloid and isosulfan blue. Three or more sentinel lymph nodes (SLNs) were removed in each patient. They were immediately examined on FS or seldom left to the evaluation of paraffin blocks. Axillary lymph node dissection was performed in patients whose sentinel lymph nodes could not be identified and in those with positive SLNs.","title":"The Oncologic Safety of Sentinel Lymph Node Biopsy in Patients with Node-Positive Breast Cancer with Complete Response to Neoadjuvant Chemotherapy: A Single-Center Experience"}
{"_id":"2fd54c73-0bb9-749f-7628-52ba758c7ede","text":"An effective cutaneous antiscarring agent would have profound benefits in relation to trauma and burns but in addition may have efficacy in the prevention of postsurgical abdominal adhesions and in the treatment of medical fibroses such as renal, pulmonary, and hepatic. This paper aims to update doctors of all specialties on the current state of the art regarding both research and treatment of cutaneous scarring.","title":"Cutaneous Scarring: A Clinical Review"}
{"_id":"2fd5f425-def4-03a8-aaaf-7185d2968e9a","text":"These figures are far less studied in children presenting with allergy-like symptoms in the pediatric primary care who have not received an allergy diagnosis so far.","title":"Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation"}
{"_id":"2fdb1b63-4a4c-73b6-6ff6-3dbd7d54011e","text":"Do patients with prostate cancer in the modern era have a higher incidence and risk of developing a second primary cancer after radiotherapy compared with nonradiotherapy treatments?","title":"Assessment of Second Primary Cancer Risk Among Men Receiving Primary Radiotherapy vs Surgery for the Treatment of Prostate Cancer Second Primary Cancer After Radiotherapy vs Surgery for Prostate Cancer"}
{"_id":"2fdc1920-c810-9f1a-8b7d-7396c4489ea5","text":"Patients with macromastia or grade III ptosis without macromastia can be treated with the same surgical approach. Despite different mastectomy weights, flap weights required to complete the reconstruction are similar. A Wise pattern can safely and effectively be incorporated into a mastectomy incision design. A limited circumvertical incision is initially marked for the mastectomy, and the final Wise pattern is incised only after completion of the reconstruction. This has the advantage of tailoring the breast skin surface area to optimally match the flap volume, as well as protect the mastectomy flap skin edges from inadvertent tissue injury from retraction. In cases of unilateral breast reconstruction a contralateral breast reduction or mastopexy should be performed in the immediate setting; this practice affords an opportunity to further fine tune breast symmetry discrepancies in a single revision procedure.","title":"Optimizing aesthetic outcomes for breast reconstruction in patients with significant macromastia or ptosis"}
{"_id":"2fe141fa-0dc6-e417-1e17-0ef99cf7dfc3","text":"Successful reconstruction of the scalp requires a comprehensive preoperative plan and meticulous intraoperative execution. The employment of tissue expanders and Orticochea flap provided additional scalp tissue for advancement flap closure. Our case demonstrates the use of both techniques as an effective method for scalp reconstruction by utilizing existing tissue to repair large scalp defects without extensive anesthesia, prolonged operative times, and potential surgical complications.","title":"Large Scalp Defect Reconstruction With Tissue Expansion, Orticochea Flap, and Acellular Dermal Matrix for Soft Tissue Augmentation: A Case Report"}
{"_id":"2fe20065-9e07-5111-84ab-ef5cd98d4959","text":"There are various local flaps used in the reconstruction of sternal defects, of which the pectoralis major muscle flap is considered a workhorse flap. Others include omental flaps, rectus abdominis flaps, and latissimus dorsi flaps. Another option is to use a free flap such as the anterolateral thigh or gracilis muscle flap, but the absence of recipient vessels as a result of their harvest during the primary cardiovascular operation is a limitation.","title":"Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap"}
{"_id":"2fe9a167-914f-b610-93d6-99857e4da7d7","text":"In clinically node-negative patients, a completion ALND can be safely omitted if SLNB before NAST is negative provided good clinical tumor response to NAST. Those patients with SLNB metastases upfront will receive nodal staging unaffected by NAST and be consequently offered adjuvant locoregional treatment according to current guidelines without the risk of undertreatment. They may also be enrolled into the Swedish-based SENOMAC trial, randomizing clinically node-negative patients with up to two positive SLNs to completion ALND or no further axillary surgery. A repeat SLNB is not recommended due to low identification rates and high false negative rates.","title":"Swedish prospective multicenter trial on the accuracy and clinical relevance of sentinel lymph node biopsy before neoadjuvant systemic therapy in breast cancer"}
{"_id":"2ff56d0a-5718-9418-bcb8-fc0b829ff7cd","text":"Coronal and sagittal diagrams show the location of posterior tissue releases along with the posterior edge of vastus medialis and lateralis. The femoral artery and common peroneal nerves are denoted by the red and brown lines, respectively. The hashed lines denote the location of the posterior capsule division and the arrows show where the posterior capsule is elevated off the posterior aspect of the femur and tibia.","title":"Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty"}
{"_id":"2ff7cc44-0f79-5fd1-8424-e7a7f1ad74ed","text":"Changes in education and accreditation often occur after changes in practice have already occurred. Neurocritical Care has emerged as a new subspecialty over the past 30 years based on perceptions and evidence that neurologists with expertise in this area improved patient care (5). Fellowships in Neurocritical Care have existed for a number of years, but it is unclear how the creation of a UCNS Neurocritical Care certification in 2007 affected the neurology community's perception of Neurocritical Care as a subspecialty distinct from Vascular Neurology and General Neurology. Here we present data that the accreditation of Vascular Neurology and Neurocritical Care fellowships appears to have accelerated the divergence of these subspecialties.","title":"Accrediting Neurology Fellowships Accelerates Subspecialization"}
{"_id":"30024f37-d9f0-807e-846b-2fb931969bfe","text":"The diagnosis of melanoma was based upon excisional biopsy or incisional biopsy followed by radical excision and histopathology analysis. An excisional biopsy was performed with narrow margins. Wide local excision with a margin of 1 or 2 cm depending on Breslow thickness.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"30032c49-4f22-c892-fd01-7d720caa4eeb","text":"Chronic osteomyelitis is a catastrophic sequel of delayed diagnosis of acute osteomyelitis.","title":"Chronic Osteomyelitis - Bacterial Flora, Antibiotic Sensitivity and Treatment Challenges"}
{"_id":"30051d86-977b-2daa-9670-e7bf5b40b41b","text":"In the freezing phase, argon will pass through the probe to allow the adjacent tissue to freeze. The argon gas in the probes reaches a temperature of approximately −180 °C at the tip of the probe and causes cell death within the −40 °C isotherm located approximately 1 cm inside the margin of the ice ball, while the periphery of the ice ball grows close to water freezing temperature. This is the reason why the tumor itself and an additional margin of tissue around it are treated. The exact cycle time is adjusted on the size of the lesion being treated. The cooling cycle is repeated a second time, with a similar procedure, to increase the effectiveness of the first cycle. Then the lesion is thawed passively. At the end of the procedure, the probe is heated with a flow of Helium gas to facilitate the removal of the cryoprobe stuck by ice inside the lesion. The cancer cells die at the end of the procedure and in the weeks following and are reabsorbed resulting in scar tissue.","title":"Cryoablation and Immunotherapy: An Enthralling Synergy for Cancer Treatment"}
{"_id":"30062d92-cb37-f50e-f3d6-2f702fd110cf","text":"Among the 16 patients, there was a variety of upper and lower limb as well as spinal trauma and elective cases. In all 16 patients, there was successful resolution of the infection with no early or unplanned removal of any metalwork required.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"3008d4be-e4bc-7159-d382-253bb7bd2b09","text":"Eighteen of the cases were diagnosed by means of total excisional biopsy, 1 of the cases was diagnosed by means of shave biopsy, whereas the others were diagnosed by means of punch biopsy.","title":"Are clinicians successful in diagnosing cutaneous adnexal tumors? a retrospective, clinicopathological study"}
{"_id":"3009a5c5-6e3e-ee49-b75a-d57649ea4d45","text":"Over the course of the follow up period, which ranged from 4 months to 8 years, the only complications encountered were two incidents of surgical wound dehiscense, two hematomas and one orocutaneous fistula. The patient who was affected by both the fistula and one of the hematomas was a known hypertensive with COPD and a heavy smoker. These complications were resolved with minor surgical interventions and had no repercussions on the survival of the flap. Only one patient required their flap to be thinned. We now present two case reports.","title":"Versatility of nasolabial flaps in oral cavity reconstructions"}
{"_id":"300df9de-e5b5-0d80-eb30-d9e03aae24fe","text":"Acetabular reconstruction using a revision implant and allograft bone for reconstructing pelvic bone stock is a reliable method of managing acetabular defects. The question remains whether to use treated or untreated allografts in hip revision surgery as both show good clinical results. Advantages of untreated fresh frozen non-irradiated allografts are their cost effectiveness, supposed better biological quality and availability in a local bone bank. A disadvantage is the slightly increased risk of disease transmission which can be minimized by sufficient donor-screening and sterile handling.","title":"No red cell alloimmunization or change of clinical outcome after using fresh frozen cancellous allograft bone for acetabular reconstruction in revision hip arthroplasty: a follow up study"}
{"_id":"3016910c-68b8-218d-73f0-422e721b0b88","text":"For categorization as SIEA or DIEP, the dissection of vessels alone was considered, independent of whether the vessels were subsequently used for anastomosis. The total flap weight was the total weight of flap tissue removed from the abdomen before flap trimming and shaping. Drain duration was defined as the number of days between the operation and removal of the last remaining abdominal drain. Inpatient drainage was collected from daily drain output charts within inpatient notes. For patients discharged with drains in situ, daily outputs were taken from patient-recorded values that were reported to the Plastic Surgery Dressings Unit. The total volume of abdominal fluid output was the sum of inpatient drainage amounts and seroma aspirations.","title":"Increased Production of Abdominal Donor Site Fluid Following Microsurgical Breast Reconstruction With Superficial Inferior Epigastric Artery Versus Deep Inferior Epigastric Artery Perforator Flaps"}
{"_id":"301818a5-3fac-4d32-4f97-808c7b9d5da9","text":"Rectus abdominis myocutaneous flaps have historically remained a mainstay of reconstructive procedures in lower abdomen, groin and anterior thigh defects. However, alternatives including pedicled anterolateral thigh flap have been reported as superior alternatives with promising results and less donor site morbidity. Gastrocnemius and soleus flaps could be used to cover the wounds around the knee and in cases of extensive damage to the lower extremity, a combination of both flaps have been recommended. We have shown combination of medial gastrocnemius faciocutenous and soleus muscle flap as vascularized flaps for large proximal leg defect with bone exposure due to explosion injured patient, reversed superficial peroneal neurocutaneous island flap that has been reported as an excellent alternative flap in soft tissue reconstruction of the ankle and foot as previously described.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"301cd8c0-aebb-99f8-4ad2-66bfed9ef768","text":"The latissimus dorsi muscle is supplied by two separate vascular systems. The dominant blood supply arises from the thoracodorsal artery, which is the terminal branch of the subscapular artery. It also has a secondary blood supply, which arises from segmental perforating branches off of the intercoastal and lumbar arteries. These vessels enter the deep surface of the muscle near the posterior midline and are responsible for perfusion of the inferior and medial latissimus. Because these vessels are disrupted in the process of harvesting the latissimus, the viability of this portion the flap can be tenuous.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"301fcf8e-0abe-342b-cadf-61d1e2319fc8","text":"Access to the right side chambers in the presence of this venous anomaly can be made either from femoral vein through an anomalous venous channel or through alternative venous accesses like basilic vein, subclavian vein or internal jugular vein. In the presence of anomalies of the IVC, positioning and manipulation of the recording catheters in right heart chambers is difficult from the femoral route, especially the RV and His bundle recording catheters. This form of venous anomaly also reduces the number of catheters that can be placed and manipulation of the catheter from the inferior route. Slow pathway modification with an ablation catheter is almost not possible. Conventional inferior vena cava approach for slow pathway ablation is difficult in complex congenital venous anomalies involving the inferior vena cava and contraindicated in the presence of IVC thrombus.","title":"Radiofrequency Catheter Ablation Of Atrioventricular Nodal Reentry Tachycardia In A Patient With Inferior Vena Cava Anomaly"}
{"_id":"3022c77e-ef51-de7e-5e64-5f258d64d02f","text":"The surgeon must recognize the importance of geometry in three dimensions and should be aware of spatial limitations as the implant is inserted into the skeletal defect. Moreover, if the original fixation is left completely intact it is the most highly constrained condition, and the implant design will be extremely critical to the success or failure of this tactic. If the fixation is to be slightly modified (for example by screw removal), the original construct can be considered less constrained. Although changing the original fixation completely is sometimes an attractive option, there is a trade-off between the freedom gained and the potential complete loss of orientation. Once the initial implants are removed, it can be extremely difficult to maintain the precise position of the bony fragments in space with respect to one another. Because the virtual procedure was completed using certain specific fixed landmarks, if the initial orientation is lost it can be very difficult to confirm whether the implant has actually restored the anatomical relationship of the skeletal elements completely to normal.","title":"Putting 3D modelling and 3D printing into practice: virtual surgery and preoperative planning to reconstruct complex post-traumatic skeletal deformities and defects"}
{"_id":"30253c2b-2f1b-7ab5-2880-79c5231caefd","text":"Our article describes our experience with using a frontal axial pattern flap combined with hard palate mucosa transplant to reconstruct midfacial defects after the excision of huge basal cell carcinoma.","title":"Frontal axial pattern flap combined with hard palate mucosa transplant in the reconstruction of midfacial defects after the excision of huge basal cell carcinoma"}
{"_id":"30256808-1178-3ccf-2253-9f477b9a90f1","text":"Perforator flaps may represent a good alternative to the free flaps in the areas were other local reconstructive procedures are not possible. The favorable results reported in the literature, as well as the results of our personal experience for lower limb reconstruction, are encouraging. We believe that when the characteristics of the defect are suitable for treatment, this technique should be regarded as one of the possible and viable reconstructive option.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"302cb347-32ca-de8f-7f8a-91262f103c9d","text":"Lastly, the temporary improvement observed in frenotomy group can be explained by several confounding factors. The two groups showed improvement in pain and breast-feeding score in the first three weeks of the study and subsequently the groups did not differ. Interestingly, both the groups showed a significant drop in pain score thereby confirming a placebo effect or a maternal adaptation response. It is well known that a newborn learns to properly latch after the first week of life [12]. Correlating this fact with the mean age of 6 days reported in the study, one may easily suspect that the problem could be due to improper technique rather than tongue tie. Mothers who are naïve to breast feeding could have learnt the proper technique and art by the two weeks’ time. Neonates of the frenotomy group might be sucking less vigorously due to surgical pain than the control group, thereby accounting for the reduced maternal pain scores. Other causes of nipple pain such as subclinical mastitis might have resolved by the end of second week thereby causing illusionary improvement in scores. Lack of control over these issues introduces the bias of confounding factors.","title":"Release of Tongue-Tie in Neonates"}
{"_id":"3031ada4-1f6a-eb5a-d49f-78683bd2166e","text":"The standard of care for treatment of BCC is wide local excision with pathologically proven clear margins of approximately 1 cm. Postoperative radiation dose not appear to affect recurrence rate or overall survival and is associated with unpleasant side effects and poor cosmetic result. Systematic chemotherapy is not indicated in the treatment of localized BCC and has been used in metastatic disease. Surgical excision remains the accepted treatment for primary and recurrence localized vulvar BCC [10]. Prognosis is favorable if managed appropriately.","title":"Vulvar basal cell carcinoma: A case report and literature review"}
{"_id":"303f168b-e937-3553-5545-f9add7d7cc2e","text":"We aimed to describe the demographic and professional backgrounds of current shoulder and elbow fellowship directors.","title":"Leadership Trends in Shoulder and Elbow Surgery Fellowship Directors: A Cross-sectional Study"}
{"_id":"303f2ae6-c817-7c44-fb3d-c39d10df022e","text":"We excluded patients who had undergone prior excisional treatment of PSD as well as those who had been managed by surgical techniques other than PC or OW.","title":"Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children"}
{"_id":"30456b81-0291-dddc-c63f-b00b5ae861c0","text":"A prospective cross sectional study conducted at the Medical City teaching hospital and Private Hospitals in Baghdad, during the period from 1st of January 2004 to 30th of September 2020. Inclusion criteria were Iraqi patients with parotid tumors who underwent partial or complete parotidectomy for various pathologies. Patient was excluded if there was a fixation of the tumor to the overlying skin, pre-operative FN palsy or recurrence of parotid tumor or refused to participate. The final sample of 460 patients with parotid tumors was selected after eligibility to inclusion and exclusion criteria.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"3048791d-d3c3-fa26-ed74-b14c4495bf80","text":"We found that the use of an Ilizarov fixator combined with FIN in treating a postoperative pseudarthrosis of the femur in a patient with severe OI (recessive form of OI, type VIII) provided longitudinal, rotational and angular stability. This approach ensured early functional activity and full weight-bearing, both favourable conditions for bone tissue regeneration. We should emphasize that the external fixator was applied for a short period only and for additional stability and not for progressive deformity correction or other manipulation. The combination of intramedullary and subperiosteal nailing together with subperiosteal titanium nickel mesh also seems to be promising for osteosynthesis in deformity correction of small diameter bones in children with OI.","title":"Use of flexible intramedullary nailing in combination with an external fixator for a postoperative defect and pseudarthrosis of femur in a girl with osteogenesis imperfecta type VIII: a case report"}
{"_id":"30498408-6946-5f6e-3731-c55448476faf","text":"The null hypothesis of this study was the absence of differences between the two groups of patients undergoing MRM. The alternative hypothesis was that a PVB combined with blocks targeting the LPN, MPN, LTN, and TDN yields more effective pain management during and after MRM than does that without blocks targeting the aforementioned nerves.","title":"Paravertebral Block Plus Thoracic Wall Block versus Paravertebral Block Alone for Analgesia of Modified Radical Mastectomy: A Retrospective Cohort Study"}
{"_id":"304bac76-4c0c-a9a9-5aea-24f1116e247d","text":"To the best of our knowledge, prior research has not assessed Canadian plastic surgery fellowship program websites. The objective of this study was to evaluate the comprehensiveness of Canadian plastic surgery fellowship program websites using established criteria. In turn, we aimed to identify potential areas of development and assess for any correlations between website comprehensiveness and the programs’ geographic location and medical school ranking.","title":"How Comprehensive Are Canadian Plastic Surgery Fellowship Websites?"}
{"_id":"304c4dfe-45b0-eaf4-5d89-cbfdc600a3e4","text":"Residency programs have considered the number and\/or quality of scholarly works produced over the course of training as a marker of excellence given that this represents one of academia’s most widely accepted currencies.23 Participation in research may be useful for programs attempting to boost their profile nationally or develop a more robust infrastructure for scholarship within their own department. Studies outside EM have shown that residents who participate in research during training are more likely to hold future academic positions in their field of interest than those who do not engage in research, which may be useful to programs trying to augment their profile nationally.24,25 Programs interested in this type of aim may wish to emphasize the quantity of publications, for example, or other aspects of scholarship such as presentations at regional or national conferences.","title":"Metrics of Resident Achievement for Defining Program Aims"}
{"_id":"3051c0a4-7043-2110-5d75-0a90be46cd1c","text":"This study examined the usefulness of the fibula positioning guide for boosting the accuracy of mandible reconstructions.","title":"Precision of fibula positioning guide in mandibular reconstruction with a fibula graft"}
{"_id":"305288ce-46cc-cb77-6fae-0a0556c0e259","text":"Buchanan et al believe that avoiding hospitalization minimizes nosocomial infections and improves access to the surgery because of reduced cost. Inpatient surgery may represent a financial barrier for prospective patients.","title":"Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures"}
{"_id":"30571dc5-886a-35c1-536b-a39612848864","text":"For lesions smaller than 1 cm in diameter we used a 3 mm margin for excision. We increased the excision margin 1 mm for every increase of 1 cm in diameter. We used a safety margin of 4 mm for morpheaform BCC and 5 mm for recurrent BCC.","title":"Basal Cell Carcinoma: A Single-Center Experience"}
{"_id":"305b23ca-cc0a-1d6d-0bda-0d972b6124a0","text":"This modified Plastibell technique under local anesthesia is a safe and effective option for children between 1 and 6 months of age. It avoids the risks of general anesthesia, is comfortable for the infant, and is associated with lower risks of bleeding when compared to traditional clamp techniques.","title":"Avoidance of general anesthesia for circumcision in infants under 6 months of age using a modified Plastibell technique"}
{"_id":"305faf46-d9a7-cde9-294a-9e5ce31ea6fb","text":"Multiple risk factors are responsible for the development of Deep Venous Thrombosis in addition with spine surgery but for segregation of patients pre-operatively into risk group there is still no universal criteria. Thair M Al-Dujaili et al in a prospective study of 158 patients who underwent spinal surgical procedures attempted to segregate patients according to risk profiles into risk groups pre-operatively. The American College of Chest Physicians Consensus Conference on Antithrombotic and Thrombolytic Therapy listed the major risk factors for development of Deep Venous Thrombosis. Joseph Caprini quantified these factors in a reproducible manner to help surgeons in evaluating preoperative risk-factor assessment.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"306f3fe0-9a01-face-99e2-887334515dac","text":"With the introduction of a full time academic plastic surgeon in the form of a clinical lecturer into the medical faculty at UEA, we are exploring the further possibility of integrating plastic surgery into other modules. Our key objectives are to increase the students’ understanding and exposure to the speciality at an early stage, provide knowledge of career opportunities, improve professional and public perception of the specialty and provide hands on surgical technical learning.We are in the process of incorporating congenital hand deformities, limb development and surgical management of rheumatoid or osteoarthritis in the locomotion module in year 1. Students would shadow the physiotherapists and assist in emergency plastic theatres to get a real essence of complex soft tissue trauma.In year 3, skin cancers, head and neck cancers are added to the senses module. Students would participate in minor operating theatres for simple excision of skin lesions as well as major reconstructive surgeries of head and neck cancers, for instance mandibulectomy with free fibular flap reconstruction to stimulate learning.Moreover, we aim to introduce common congenital deformities relating to plastic surgery such as cleft lip\/palate and hypospadias in the growth and development module in the fourth year. Students would encounter such fascinating conditions in our outpatient clinics and operating lists, which are less commonly seen in other medical specialities.Additionally, plastic subspecialties such as burn and hand surgery could be naturally built-into the final year modules: Emergency Care and the Mind. The casualty is a good place for students to learn basic wound management and practise their suturing skills. Important topics such as basic hand examination, hand trauma and hand infections would be taught in the emergency care module. Burns injuries are very commonly seen in casualty. It is important to educate students on the basic knowledge in assessing the type, the degree and estimate the surface area of burns, and subsequently formulating the initial management of burns. Furthermore, burns and body dysmorphic disorders could be integrated nicely in the Mind module. Students could gain insight into the psychosocial aspects and the challenges of reconstructive surgery in these conditions.","title":"Integration of plastic surgery into the undergraduate medical curriculum: the Norwich model and experience"}
{"_id":"30716b98-28b8-5469-7f98-13c9a577bf30","text":"Mohs micrographic surgery is an established technique in the treatment of cutaneous neoplasms. It offers higher cure rates and the main indications are non-melanoma malignant skin tumors. Few studies have been performed on the treatment of rare tumors through this technique.","title":"Mohs micrographic surgery in rare cutaneous tumors: a retrospective study at a Brazilian tertiary university hospital"}
{"_id":"3078bab9-05cc-b984-a7dc-af21ce0f585a","text":"More participants endorsed the negative attitudes than the positive attitudes associated with sun exposure, with 89% agreeing with the statement that their skin would age more rapidly if they spent time in the sun and 77% agreeing with the statement that they were concerned sun exposure may give them skin cancer. Two-thirds agreed that a suntan made them look healthier and half agreed that a suntan made them look attractive.","title":"SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample"}
{"_id":"307c1277-8448-00e2-05e0-0005adec6161","text":"The clinical symptoms and radiographic appearance of osteomyelitis can mimic those of bone tumors.","title":"Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases"}
{"_id":"307f3727-b997-0941-675b-f3e7bdc36797","text":"To date, the data provided by the literature on the risk of skin cancer in patients with psoriasis and the involvement of the different therapies used in this disease are still unclear. Data are summarized in Table 1.","title":"Psoriasis Therapy and Skin Cancer: A Review"}
{"_id":"30951a7c-62d8-5338-66dd-5bf772ebfc8f","text":"The aim for this study was to evaluate the outcomes of adult lower limb free flaps in traumatic lower limb wounds when there was a concomitant pelvic or ipsilateral lower limb injury proximal to the site of the free flap, which we hypothesized could affect free flap complication rates and patient outcomes.","title":"Proximal Trauma Increases Risk of Venous Thrombosis in Soft Tissue Reconstruction of Open Lower Limb Fractures"}
{"_id":"30a48168-fffc-9851-b499-79a1e5da50a8","text":"BoTN is designed to assess the efficacy and safety of subcutaneous botulinum toxin type A injections in addition to standard prophylactic treatment in therapy-refractory trigeminal neuralgia.","title":"Botulinum neurotoxin type A in the treatment of classical Trigeminal Neuralgia (BoTN): study protocol for a randomized controlled trial"}
{"_id":"30a4f952-4ed8-bed9-4187-b0b67ae10202","text":"When patients with a history of allergy who aim to perform corneal refractive surgery, surgeons must consider possible hypersensitivity reactions after treatment. More studies are needed to clarify the relationship between contact glass used in femtosecond laser corneal refractive surgery and IgE mediated hypersensitivity reactions.","title":"Hypersensitivity reactions after femtosecond laser small incision lenticule extraction: a case report of corneal infiltrates"}
{"_id":"30ac27f4-9423-2857-3970-1a74a1c09fe8","text":"Finding creative solutions is preceded by several considerations, and there are no easy decisions to make. This represents various forms of processing and deals with giving up on expectations and intentions to breastfeed, which had become a strong intention and struggle over time.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"30ad45d0-630d-ea12-bf15-0140a84ba46e","text":"Most of the available classifications concentrate mainly on terminal branches of FN and the anastomosis between them, while during parotidectomy what is important for any surgeon is first to identify the trunk of facial nerve, then identifying all the terminal branches regardless the anastomoses between them. So we aimed to mention a simple method of how to identify the facial nerve trunk in relation to fixed landmarks, also we make a new classification based mainly on the anatomical variations of the FN trunk branching-patterns that we observed among Iraqi patients during parotidectomy including a new branching pattern of facial nerve trunk that has not been described before, and also described the terminal branches pattern, all these will help to provide a map for the operating surgeons, especially newly graduated young surgeons to decrease the injuries of FNs during parotidectomy and reduction of morbidities and postoperatively incident complications related to injuries of FN. The objective of the current study was to assess facial nerve branching variation in Iraqi population.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"30ae8133-9061-5d05-5a4e-26563c4271b3","text":"It satisfies most requirements for an ideal technique to localize non-palpable breast tumors which are well visualized by ultrasound, while directing planes of surgery during the excision. This in turn is helpful in guaranteeing both negative margins and an adequate contour of resection in order to minimize the volume of excision.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"30b754e9-50f8-fa1f-8a50-903ce2f5bb59","text":"For composite tissue that contains different tissue types, the printing resolution will need to be improved to duplicate the intricate inner microarchitecture. The ability to print microscale features is necessary for optimal cellular function. Better control over the microarchitecture will enable fabrication of the skin capable of recapitulating the native form and function. Increasing the printing speed is another challenge; current approaches that facilitate higher printing speed such as extrusion bioprinting can compromise the integrity of cells and cause significant loss in their viability. CAD-CAM can also be used to predict the feasibility of the fabrication process by simulating relevant physical models using both classical formula calculations and finite element methods. Currently, the most widely used physical model for bioprinting is laminar multi-phase flow; although it is an oversimplified model and ignores issues related to inclusion of cells, the simulations are useful for checking and optimizing the feasibility of specific designs.","title":"Skin bioprinting: the future of burn wound reconstruction?"}
{"_id":"30b82082-8c9c-666f-7856-78e82014ed59","text":"Another very important aspect of patient management in these cases is the antibiotic regimen, and the duration of treatment which is beyond the orthopedic and trauma surgeon and consultation with an infectious disease specialist is paramount. The same is true for dealing with complications of antibiotics.","title":"Infected Nonunion of the Distal Femur in the Elderly with Bone Loss: Case Report and Treatment Options"}
{"_id":"30bdb712-851d-9f66-fe74-511305862fef","text":"Given that burning is created in the majority of young people in society that are parts of efficient members of present and future of society, is the necessity to properly treat the disease.Thus reducing the duration of treatment and absence from work will be of great interests to society.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"30be7416-12b9-09c0-9445-217488f4d9bb","text":"Numerous studies have been performed involving the use of rigid and elastic supports or fibrin glue for the outside of the venous grafts in order to reduce the stress on them.8-11 The objective of this study was to investigate the protective effect of perivascular cyanoacrylate administration against saphenous vein damage due to blood pressure in patients after CABG.","title":"Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model"}
{"_id":"30cae11e-63a7-e0eb-af0c-16e0bd6c80f0","text":"This retrospective study included 218 patients aged 27 to 60 years who underwent mastectomy and immediate implant-based breast reconstruction between November 2018 and December 2021. Patients who received radiotherapy and who used skin reduction techniques were excluded from the study. If the tissue removed from the 2 breasts in bilateral reconstruction fit different groups, these patients were also excluded from the study. Table 1 presents demographic data of the patients. Of the patients included, 196 had given birth and breastfed their infants.","title":"Implant selection in natural and stable direct-to-implant reconstruction with ten steps at nipple-sparing mastectomy"}
{"_id":"30ceeecb-d13d-09b1-0214-3080652974a1","text":"Depending on individual patient preferences, laser tonsillotomy performed under local anesthesia may be a feasible alternative to conventional tonsillectomy performed under general anesthesia among adults.","title":"Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults A Randomized Clinical Trial Laser Tonsillotomy vs Conventional Tonsillectomy in Adults"}
{"_id":"30d68fa8-0658-609a-f6a5-2246ff24beb7","text":"Ankyloglossia is a congenital anomaly in which the lingual frenulum is unusually short and thick, thus decreasing tongue mobility. In the context of the newborn or young infant it is a subject of ongoing controversy within and between medical specialties. The controversy involves not only the definition but also the management of this anomaly. A tight lingual frenulum is considered a minor malformation by some investigators. Usual treatments for ankyloglossia include speech therapy, as well as simple frenulotomy and frenuloplasty. The aim of this study was to compare the latter two methods with respect to postoperative results and complications.","title":"Tongue-tie Repair: Z-Plasty Vs Simple Release"}
{"_id":"30d842e0-9768-c3f5-40ab-b498d7e397da","text":"Studies have demonstrated various mechanisms by which anticancer agents cause mucositis. Cytotoxic anticancer agents can cause damage to the basal cells by inducing cytokine and free radical release, leading to the inhibition of apoptosis and mucosal epithelium formation. Furthermore, bone marrow suppression caused by anticancer agents can lead to secondary mucositis as a result of an oral infection.1","title":"A pilot study of the clinical evidence for the methodology for prevention of oral mucositis during cancer chemotherapy by measuring salivary excretion of 5-fluorouracil"}
{"_id":"30daac53-b017-826b-9f29-70dcb7f1006a","text":"The main obstacle to the use of topical retinoids is the high incidence of skin irritation. Patients may develop dermatitis with redness and tenderness of the skin. This usually occurs within two to four weeks after initiation of treatment and usually disappears when the treatment is continued. Nevertheless, many patients discontinue therapy because of these reactions. It has been found that derivatives of retinol such as RP do not produce the same irritant effects as retinoic acid and induce the same cellular and molecular changes observed with the application of retinoic acid [10].","title":"Topical Application of Retinyl Palmitate-Loaded Nanotechnology-Based Drug Delivery Systems for the Treatment of Skin Aging"}
{"_id":"30e54ade-d990-7197-2d6b-ffc88146ee5e","text":"Imaging is used to confirm the diagnosis and to carry out an extension assessment. A CT scan of the temporal bone is the first-line examination to look for bony extension, supplemented by an MRI scan to analyze the soft tissues and the deep cervical spaces and to look for signs of endocranial extension and also has a great interest in the follow-up of these immunocompromised patients who are subject to complications with insidious evolution.","title":"Malignant external otitis complicated by spinal cord compression: Case report"}
{"_id":"30e667df-6684-46a5-f984-50ac86bcb494","text":"Techniques for elevation of the abdominal flap have evolved to reduce morbidity of the donor site as much as possible. Examples include adjustments to the classic TRAM flap, muscle sparing TRAM flap, and DIEP flap. Each technique still maintains unique risks however, such as in the case of DIEP elevated with a single perforator, where the risk of fat necrosis is high when a large flap volume is harvested. In attempts to mediate this risk, surgeons try to harvest more perforator vessels, but this in turn leads to a larger fascial defect. There have been numerous studies regarding the risks of abdominal complication and defect closure in abdominal flap surgeries that state conflicting conclusions.","title":"Validating machine learning approaches for prediction of donor related complication in microsurgical breast reconstruction: a retrospective cohort study"}
{"_id":"30edf91c-efdf-538d-d04e-1e72b0f7b6e0","text":"A 60-year-old woman complained of a persistent rash on her back and chest that had been present for 6 months. The rash started 1 week after receiving the Janssen vaccine. Moderately intense pruritus was followed by the development of papules which evolved into larger plaques. Examination revealed large lichenoid plaques on the right side of the chest and on the thoracolumbar area of the back. This latter location showed a vertically oriented scaly violaceous plaque at the midline which extended laterally into the paraspinal areas. Smaller hyperpigmented plaques and patches were visible at the periphery. Skin biopsy of the large plaque on the back revealed lichenoid dermatitis and pronounced orthohyperkeratosis. An interesting finding was the presence of plasma cells in the dermal infiltrate.","title":"COVID-19 Vaccine-Induced Lichenoid Eruptions—Clinical and Histopathologic Spectrum in a Case Series of Fifteen Patients with Review of the Literature"}
{"_id":"30ee4079-0e9f-a988-0a99-add569489c46","text":"Although a high complication rate may be anticipated, the free vascularized fibula may be used to reconstruct large skeletal defects in the pediatric upper extremity after oncologic resection. Complications may include nonunion and fracture, both of which occur more frequently in the humerus. We advocate for the use of compression plate fixation at osteosynthesis sites to prevent nonunion and careful protection of the extremity to prevent fracture, especially, when the humerus has been reconstructed. The vascularized fibular graft performs very well in reconstructing large skeletal defects in the pediatric upper extremity. Vascularized physeal transplant is a viable option when longitudinal growth is desired.","title":"The Vascularized Fibular Graft in the Pediatric Upper Extremity: A Durable, Biological Solution to Large Oncologic Defects"}
{"_id":"30f375b8-e0c2-3217-c97f-82dc1e8d2f1e","text":"This study explores the experiences of team members working in a trauma team. Talking about conflicts and co-workers may be uncomfortable to the informants. As the interviewers were medical students the challenge of this was probably less compared to being interviewed by colleagues. It might have been tempting to team members to ascribe all team difficulties to the team leader. The fact that also team leaders underlined leadership as a crucial factor, and acknowledged their own insufficiency, suggests a high level of openness and willingness to disclose also their unpleasant knowledge.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"30f93ee4-fba6-bc51-f244-eec72477abeb","text":"Rhinoplasty remains one of the most complex and challenging operations in plastic surgery. Our study showed a high prevalence of patients considering revision rhinoplasty. Our findings show that cosmetic complaints were more common than functional complaints, and that the primary reason for seeking revision rhinoplasty was the desire for further esthetic improvement in an already acceptable result. This emphasizes the importance of detailed assessment and clarification concerning the patient’s expectations and actual surgical possibilities. Proper communication, listening to patients, and thoughtful consideration of risk factors associated with considering revision rhinoplasty should lead to more successful outcomes.","title":"Prevalence of considering revision rhinoplasty in Saudi patients and its associated factors"}
{"_id":"30f962f2-a0c5-fd9d-a032-ae4e3cd71256","text":"Pediatric patients younger than 18 years of age who have been identified with osteomyelitis will be included in this study.","title":"Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol"}
{"_id":"3100e8dd-0de4-a474-21c6-f48fa65d7dfa","text":"All grafts in the study were prepared by one resident of cardiac surgery, who harveste more than 100 vein grafts per year.","title":"Influence of Three Different Surgical Techniques on Microscopic Damage of Saphenous Vein Grafts—A Randomized Study"}
{"_id":"3106195e-461c-d0d8-411a-d70cc7c40028","text":"Table 3 local recurrence rate after Skin Sparing Mastectomy and immediate reconstruction in early breast cancer in previously published papers","title":"Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR) for early breast cancer: Eight years single institution experience"}
{"_id":"310dbaba-cd44-50b6-8a75-3c4ca7ec9804","text":"Thanks to these innovative solutions, a delayed reconstruction procedure can be planned safely with minimum patient discomfort and avoiding the problem of margin clearance.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"310f4028-91b3-1a96-ab3b-91c7b733481e","text":"We reviewed the medical records of all patients with breast cancer aged ≤40 years at diagnosis who were curatively treated between 2001 and 2012. Patients diagnosed with inflammatory breast cancer, ductal carcinoma in situ, or malignancies other than carcinoma were excluded from the analysis, as were those treated with neoadjuvant therapy or postmastectomy radiation therapy and those who refused radiation therapy after partial mastectomy.","title":"Local Recurrence in Young Women with Breast Cancer: Breast Conserving Therapy vs. Mastectomy Alone"}
{"_id":"3110c245-ef36-9372-0325-eac99bd9ec13","text":"The consensus criteria for LN management have undergone many changes in recent decades owing to the advent of SLNB procedures that use dyes or radiotracers to facilitate the identification, excision, and evaluation of SLN metastases. SLNB can enable clinicians to accurately stage metastatic spread with minimal risk of complications. Owing to the superficial nature of these tumors, melanoma, and breast cancer patients are particularly likely to benefit from SLNB given the great amenability of these neoplasms to preoperative tracer injection.","title":"Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions"}
{"_id":"3115d3a5-9819-ce47-1681-36a90002e908","text":"All patients were examined preoperatively by using a portable Super Dopplex D900 non-directional hand-held Doppler probe (Huntleigh Diagnostics, Glamorgan, UK) to predict the vessel perforators originated from the branches of the lateral circumflex femoral artery on the left or right anterolateral thigh. Enough separately and suitable perforators should be detected on at least one thigh. Patients without enough perforators on both thighs were excluded. All defects were soft tissue. The relevant surgical technique has previously been described [8], [9]. Briefly, a line was drawn between the anterior–superior iliac spine and the midpoint of the lateral border of the patella on the donor thigh in supine position. The locations of main cutaneous perforators were detected using ultrasound Doppler preoperatively. Skin paddles were designed around the detected perforators. The pedicle of the multipaddled ALT flap was supplied by the descending branch or transverse branch of the lateral circumflex femoral vessels. A medial incision was made above the rectus femoris muscle and continued underneath the deep fascia of vastus lateralis to identify the located cutaneous perforators with intramuscular dissection. Perforators were then dissected in a retrograde fashion until arriving at the descending branch of the lateral circumflex femoral artery. For some cases, a small segment of vastus lateralis muscle around perforator was included as additional volume to augment the dead space and decrease tissue retraction after postoperative radiotherapy. And partial deep fascial cuff and soft-tissue around the perforator was left to prevent the vessel spasm and facilitate the fixation of perforator. The integrity of lateral cutaneous nerve was preserved carefully to decrease the risk of postoperative lateral thigh paresthesia. All skin paddles of multipaddled ALT flap was checked for viability and then transferred to the defect with vessel anastomosis. We usually select two recipient veins for anastomosis, which can secure the venous return of the flap. Hemostasis and drainage should maintained adequately to prevent hematoma formation and the flap should be monitored carefully by clinical examination for color and capillary refill during the early postoperative period. For excluded cases due to insufficient perforators, contralateral or bilateral ALT flaps could be supplementary to reconstruct all defects.","title":"Multipaddled Anterolateral Thigh Chimeric Flap for Reconstruction of Complex Defects in Head and Neck"}
{"_id":"3117fb64-5557-029a-d9e4-a1ef36929ba7","text":"QUADAS tool results found that 3 out of 23 studies had a high risk of patient selection bias, 10 had a high risk of conduct and interpretation of index test bias, 5 had a high risk of patient flow and interval between index tests and reference standards bias, and 2 had a high risk of reference standard bias (Figure 2 and Table 2).","title":"A Systematic Review and Meta-Analysis on the Accuracy of Fluorodeoxyglucose Positron Emission Tomography\/ Computerized Tomography for Diagnosing Periprosthetic Joint Infections"}
{"_id":"3124d43c-d84d-66d7-4649-1f5c37ccc306","text":"After sternal infection had been diagnosed patients were re-admitted for wound debridement. The median hospital stay for revision surgery was 14 days and nearly all were treated with negative wound pressure. The patients had a median of four surgical debridements before a pectoralis major muscle flap was used.","title":"Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap"}
{"_id":"31333390-9bfb-7574-d135-cd7e5a55d0d7","text":"The lateral inset of the breast flap is incised and the full thickness of the flap is dissected free from the native lateral chest soft tissues in the sub-flap plane. Dissection is carried medially to a level medial to the lateral margin of the pectoralis major. Once the lateral flap is adequately mobile and the lateral margin of the pectoralis major exposed, the patient is placed in the seated position and the apex of the released lateral portion of the flap is tucked under native chest soft tissues to the proposed anchor point to confirm the adequacy of breast narrowing, improvement of the lateral breast curve, and effect of flap repositioning on volume redistribution to the upper pole. Once confirmed, the released lateral flap apex is secured to the lateral edge of the pectoralis muscle utilizing two to four simple or figure-of-eight 2-0 Vicryl sutures. The resultant excess lateral chest skin is tailor tacked to the lateral aspect of the new lateral breast curve and buried flap skin is de-epithelialized in the standard fashion with care to maintain anchoring sutures. If needed, closure of the lateral breast may be closed in a V to Y fashion. The incision lines are closed in layers and the use of closed suction drains is optional (Video 1).","title":"The Lateral Breast Flap Sling: A Novel Technique for the Revision of Autologous Breast Reconstructions"}
{"_id":"313729d8-4137-8b04-5dad-3e9ba1b58e23","text":"To analyze the effects of lingual frenotomy on the breastfeeding of infants, based on the electrical activity of the masseter and suprahyoid muscles and assessment of the breastfeeding.","title":"Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles Efeito da frenotomia lingual na amamentação e na atividade elétrica dos músculos masseter e supra-hióideos"}
{"_id":"313827e9-8018-b9c7-cd5b-e8573c246922","text":"Each observed operation in the study was classified as adherent or non adherent to each of the three mentioned aspects of compliance.","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"31424931-de83-d141-5360-5a10c1f04f06","text":"While mean ischemia time was longer in the DBR group, operative times in total did not differ between both groups. This can be attributed to the standard two team approach often utilized for autologous tissue reconstructions.","title":"Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study"}
{"_id":"3148a65b-d0f4-4a3d-8e97-57a61f554608","text":"ADSCs infiltration is an advanced method that is not performed by many laboratories in Italy. There are several intermediate and critical substeps required for effective cell manipulation and the entire process must comply with strict regulations. It is a procedure particularly useful in cases where not even the insertion of the smallest diameter cannula is possible, such as skin fibrosis. The main disadvantage is represented by its high costs due to cell preparation in specific laboratories and because it is performed in two separate sessions, thus increasing patient discomfort.","title":"Improvement of Mouth Functional Disability in Systemic Sclerosis Patients over One Year in a Trial of Fat Transplantation versus Adipose-Derived Stromal Cells"}
{"_id":"31518ca6-f86a-1c1d-a929-01b63589a95a","text":"For popliteal TLND, the popliteal fascia is removed, including the underlying lymphatic tissue in the popliteal space which is bordered by the biceps femoris and semitendinosus\/semimembranosus muscles superiorly and the two heads of the gastrocnemius muscle inferiorly. The branches of the sciatic nerve, popliteal artery, and vein are preserved. In order to clear the anterior popliteal nodes, the popliteal artery and vein are mobilized, and the lesser saphenous vein can be ligated.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"3156817b-f12e-559e-3244-1661f7d4157b","text":"The treatment for tumors of the floor of the mouth remains primarily surgical; adjuvant radiation therapy is offered in cases of advanced stage disease or to patients at a high risk of locoregional treatment failure. Despite the lower survival of patients with metastatic nodes, regional control is achieved in most patients submitted to neck dissection and postoperative radiation therapy. The main problem occurs in attaining local control of the disease in more advanced cases as per the T and pN staging systems, as seen in multivariate analysis. Half of the patients with regional recurrence had associated relapsing disease in the site of the primary tumor. The primary tumors of patients with the phenotype for metastatic nodes appear to be more locally aggressive, but recurrence in sublingual or mesiolingual lymph nodes left behind after neck dissection, which could be confused with recurrence at the site of the primary tumor, should also be considered5., 6..","title":"Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth"}
{"_id":"3166b4b7-391a-b357-16d7-25cb10e14bbb","text":"Cervical radiculopathy is caused by compression at multiple levels; if lordosis is maintained and the compressive pathology is primarily foraminal then dorsal foraminotomies are a reasonable alternative. However dorsal foraminotomy cannot correct kyphosis and may predispose to it.","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"316804e9-6208-9fb6-d78e-9bc41b14ed4b","text":"The open incisional biopsy technique for microbiological investigation alone shows a poor performance in this particular cohort with a sensitivity of only 47% and a specificity of 77% for a positive result in following revision surgery. As the indication for open biopsy in the present study was inconclusive prior diagnostic work-up and we did not routinely perform synovial biopsies prior to a planned revision of a TKA, our results could be influenced by the fact that patients with conclusive serum and synovial markers that already either ruled out or confirmed a PJI where not included in our cohort.","title":"Poor performance of open incisional biopsy for the microbiological diagnosis of periprosthetic knee joint infection"}
{"_id":"3168055d-d451-f31b-aff6-332bda4e774a","text":"High-quality, vascularized soft tissue coverage with rapid healing provides a physical and microbiological barrier between the bone and the external microbiome including nosocomial microorganisms. This prevents a new infection establishing in exposed bone. The soft tissue flap plays several other roles, including delivery of host immunity and antibiotics, and it may also obturate dead space. It can also provide soft-tissue padding over bony prominences to protect the underlying bone from trauma or pressure ulceration in the longer term. Moreover, ex vivo and preclinical data have demonstrated that flaps provide a biological milieu (including cytokines and growth factors) conducive to bone regeneration. 42","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"31681d05-1694-7b0b-07f9-823dd08a1848","text":"The resident’s development is continuously assessed based on the description of objectives and their individual training programme throughout the whole specialist training.","title":"Factors related to the role of programme directors in association with quality in postgraduate medical education – a cross-sectional study"}
{"_id":"316e8f77-9c49-a0b5-7d71-d5686a50ab5b","text":"The use of injectable fillers for enhanced nipple projection is a useful adjunct treatment in patients undergoing breast reconstruction. Advantages include the ability to obtain nipple projection in patients who opt to forgo nipple-areola reconstruction with local flaps, to augment reconstructed nipples in patients with thin mastectomy skin flaps especially following implant-based reconstruction, and to improve projection of the native nipple following nipple-sparing mastectomy. Another benefit of this adjunct treatment is that the injection is reversible. Filler injection is a safe and simple solution to the problem of insufficient nipple projection.","title":"Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique"}
{"_id":"31731f3a-50aa-5f38-6a42-2943ec65d75f","text":"Every patient who received BT-A at least once will be included in the safety assessment group. Patients who quit the study early should still participate in the following visits for safety assessment.","title":"Botulinum neurotoxin type A in the treatment of classical Trigeminal Neuralgia (BoTN): study protocol for a randomized controlled trial"}
{"_id":"3178cb4a-9b2e-32eb-b2ea-286c5ee9382c","text":"Autogenous cartilage grafting has been used extensively for augmentation of soft tissue or framework in craniofacial and cosmetic Surgery. Cartilage with its low metabolic rate and avascular structure is a special tissue that its nutrition is provided by tissue fluid diffusion. It has an anaerobic glycolytic activity and O2 consumption and it was shown to have a good survival after implantation.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"31853e89-d564-2448-e7ce-fd83332315f9","text":"Relationship between mitotic index of primary tumor and SLN positivity in pT1 group","title":"The long-term results and prognostic significance of cutaneous melanoma surgery using sentinel node biopsy with triple technique"}
{"_id":"318983fd-d17f-bef3-9f1a-103f7668c7e2","text":"Table 1 Pathological complete response rates in trials of preoperative radiation or chemoradiation with and without brachytherapy.","title":"Radiation-sparing managements for cervical cancer: a developing countries perspective"}
{"_id":"318ac853-0176-64ef-4c62-e7f9cf220ea6","text":"The small sample of patients and the lack of failed flaps or flaps requiring revision because of vascular compromise, which made it impossible to evaluate cut-off values for unattached surface probe measurements at a 3 mm tissue depth, were the limitations of the present study. However, this was a pilot study that evaluated the use of attached surface probes with the O2C analysis system for flap perfusion monitoring for the first time, and generally only few flaps require revision in microvascular head and neck reconstruction. In addition, the short 48-h time interval for the comparison of attached and unattached surface probes in this study was based on the observation that flap monitoring is most valuable in the first 48 postoperative hours, because of the high risk of vascular comprise during this period and the low salvage rates for failing flaps beyond this period.","title":"Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study"}
{"_id":"3190cac8-f99d-da64-b239-9c67c15e7037","text":"To remove any estimation bias and further investigate the significance of axillary dissection on BCSD and OCSD, we conducted Fine and Gray competing risk model and multivariate competing risk regression analysis. These results showed that there was no statistical difference in the cumulative incidence of BCSD or OCSD for subjects in the SLNB with complete ALND group compared to the SLNB only group. At present, the SLNB technique for lymph node staging has allowed many breast cancer patients to avoid the need for ALND when SLN is found to be negative, thus avoiding many post-operative complications and improving quality of life. Although many experts continue to believe that ALND is mandatory for SLN-positive patients, it is reasonable to question whether it is necessary for all SLN-positive patients to undergo the procedure.","title":"The prognostic significance of further axillary dissection for sentinel lymph node micrometastases in female breast cancer: A competing risk analysis using the SEER database"}
{"_id":"319c8949-7a90-e606-57cd-22c1e642af73","text":"Giant cell tumours are benign but locally aggressive and can potentially metastasise to the lungs. Reducing the risk of local recurrence while maintaining limb function and minimising adverse consequences is the best therapeutic strategy in treating giant cell tumours. Based on our observation through this meta-analysis, cryosurgery is one of the viable treatment options that can provide good oncologic and functional outcomes with minimal complication rates.","title":"Global Prevalence and Risk of Local Recurrence Following Cryosurgery of Giant Cell Tumour of Bone: A Meta-Analysis"}
{"_id":"31a7c45e-0c8f-58af-2896-2b23922c9713","text":"A section of the questionnaire was designed to assess athletes attitudes towards sun exposure. This section included questions on the participant’s concern about their risk of skin cancer from sun exposure, concern about their vitamin D status and whether they intentionally spend time in the sun to improve their vitamin D status or to tan; sunscreen use and, if appropriate, reasons for not using sunscreen or the sunscreen protection factor and reapplication were asked; clothing during training sessions including questions on sunglasses and hat use was collected.","title":"Knowledge and attitudes to vitamin D and sun exposure in elite New Zealand athletes: a cross-sectional study"}
{"_id":"31b13efc-9abc-a0cd-c3af-047a3ba16cc9","text":"We included 1 730 962 screenings of women with no previous breast cancer diagnoses and 31 078 screening of breast cancer survivors (Table 1). As expected due to an increased breast cancer risk among survivors, the breast cancer detection rate was higher among breast cancer survivors than among women with no previous breast cancer diagnoses. Breast cancer survivors were in general older and had a slightly higher proportion of their interval cancers detected in the first year after screening.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"31c35d2f-58f6-e9e4-ee41-792925429402","text":"There are certain ingredients in the sunscreen that might cause hormonal changes in the body. Oxybenzone is an organic filter which absorbs UV radiations especially UVB radiation, and it is systemically absorbed and excreted in urine and feces. Oxybenzone is one such ingredient which affects the estrogenic levels in the body, and it has the highest rate of photoallergy among other UV filters. However, it was speculated that this effect could only be seen in individuals who would use the product continuously for a longer period for about 35-277 years. Nanoparticles can also cause local and systemic toxicity. Titanium dioxide and zinc oxide are reduced to nanosized particles so there is a great concern that these particles would penetrate the skin and produce UV induced free radicals. Continuous use of the sunscreen will prevent the exposure of the skin to UVB radiations thus there would be insufficient vitamin D synthesis in our body. Thus the individuals might not acquire the normal vitamin D levels which are required by the body. The dietary supplement would help to maintain the normal vitamin D levels in our body. Some chemical ingredients in sunscreen might cause edema, erythema, and irritation. To increase the patient compliance, several sunscreens have preservatives, fragrances, and other excipients which might induce allergic reactions in sensitive individuals. Patients with photodermatitis are likely to develop photo contact dermatitis to sunscreen. Sunscreens containing p-amino benzoic acid (PABA) help to protect from UVB rays and is said to be water resistant. But in vitro studies have shown that PABA interacts with DNA followed by UV radiations and might cause photocarcinogenesis. Hence a careful selection of sunscreen is vital to reap its benefits.","title":"Anti-aging and Sunscreens: Paradigm Shift in Cosmetics"}
{"_id":"31cb2bf9-2375-28a8-c597-5496f62b8803","text":"We present a case of idiopathic scrotal calcinosis that had an en bloc excision of scrotal skin nodules and primary closure of the scrotal skin. Handling each hemiscrotum as a separate entity and preserving the median raphe with its uninvolved skin improved the cosmesis. The residual scrotal skin regained its laxity with the scrotum assuming its normal configuration at 30 months of follow-up. The patient gave consent for publication of this case report.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"31ce5ab3-53c3-c337-bf1e-cc565846d236","text":"Paucity of research exists on quality of life and patient’s satisfaction with the cosmetic outcome following different operative interventions on breasts in Pakistan which report various psychosocial and physical challenges such as anxiety, depression and fatigue faced by the patients. To the best of our knowledge there are no studies addressing this crucial matter. Therefore, to attenuate gaps in knowledge present study is designed to unravel patients’ data on quality of life and their satisfaction with the cosmesis following BCS, total mastectomy with and without reconstruction. We hypothesized that patients who underwent breast reconstruction were more satisfied psychologically, sexually, and happy with their outlook than those who underwent mastectomy. We also speculated that BCS patients scored higher in physical health as compared with other two intervention groups.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"31d0df2b-11df-9184-d649-3b26be6d8d51","text":"The program evaluation and associated data collection and reporting protocols were reviewed by the institutional Office of Human Research Ethics, which determined that it did not require IRB approval. We utilized the existing SOM evaluation platform to collect data on LI program outcomes from 2017 to early 2020 for StrengthsFinder and SBIA. For TeamSTEPPS, the Challenge Course, and Peak Performance we designed an electronic evaluation that was independent of the SOM platform. These activities are offered and evaluated in the spring semester and we did not have data for 2020 offerings due to COVID-19. Evaluations included an open text field that allowed students to provide comments.","title":"Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy"}
{"_id":"31d292c8-b422-360f-7b06-eb2dccb4732b","text":"Our study was performed in accordance with the Declaration of Helsinki and all the collected data were anonymized.","title":"Clinico-histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10-year retrospective study—a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma"}
{"_id":"31d5aa78-ffe9-b2d6-dbd0-c6e568737e93","text":"Materials and methods: Patient data and clinic test results were archived on a simple Excel spreadsheet. These were reviewed by the author and a chart review of the chlorhexidine anaphylaxis cases was undertaken.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"31d7c947-6474-8bd5-c60b-db58bb1a2732","text":"The GPs expressed little concern about the risks of their own use of ultrasonography. They said that misdiagnosis was only made by GPs with insufficient training, poor judgment of their own ultrasound skills or too much use of ultrasonography for explorative purposes. The GPs in this study were not concerned about overlooking pathology in their limited scans as they were reluctant to rule out pathology based exclusively on the scans. Overdiagnosis was described as a general concern in the healthcare system and not specifically related to their use of ultrasonography.","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"31dfdd65-0dc3-387c-f404-3f37f6b1f662","text":"We are very fortunate to have the support of the CTAAC of Cancer Research UK and hence NIHR portfolio status for this study. This provides support from the Clinical Research Network (CRN) and has enabled LIHNCS to reach a wider audience and undoubtedly helped in enhancing recruitment to this trial to date.","title":"LIHNCS - Lugol’s iodine in head and neck cancer surgery: a multicentre, randomised controlled trial assessing the effectiveness of Lugol’s iodine to assist excision of moderate dysplasia, severe dysplasia and carcinoma in situ at mucosal resection margins of oral and oropharyngeal squamous cell carcinoma: study protocol for a randomised controlled trial"}
{"_id":"31e01927-afdb-aa04-5022-b2e470805e0a","text":"Comparative analysis of the performance of the surgical planning methods based on 2D images and our proposed method is shown in Table 2. Figure 4 shows the accuracy of the surgical plans generated by the above-mentioned two approaches. The proposed ENURBS-VSP method generates the surgical plan for liver resection with higher accuracy compared to that generated based on 2D scan reports. Figure 5 depicts that the time taken to complete the overall surgical plan using the proposed VSP technique was significantly lesser compared to that taken by the 2D planning method. Hence, it is concluded from the simulation results that 3DVR using the ENURBS approach integrated with VSP can provide a proper and accurate preoperative plan before surgical liver intervention in a short period. Using this plan, the excision of a precise tumor segment from the whole liver organ can be achieved. So patients with liver cancer can effectively be treated.","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"31ef9854-4361-8958-c64c-b16ded091e25","text":"Table 3 Percentage of bone penetration of the main antibiotics used in AHOM","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"31f76c01-1836-9fcd-4643-e4016f3a6410","text":"The rotating tibial platform has been disengaged from all-polyethylene tibial components to allow delivery of the distal femur out of the wound. The posterior capsule is thinned in the coronal plane and longitudinal releases are performed (white arrows) after the path of the popliteal artery is ascertained by doppler to locate the peroneal nerve.","title":"Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty"}
{"_id":"31fbd92b-2be3-c79f-8b2d-2bd644017353","text":"The approach to training in the reviewed studies was significantly varied and ranged from 90 minutes to 20 hours. All of the training packages included a blend of didactic and hands-on learning, while only some required supervised attempts to assess proficiency. The educational approach of each study is summarized in Table 3.","title":"Can Non-Physician Providers Use Ultrasound to Aid in Establishing Peripheral IV Access in Patients Who are Difficult to Cannulate? A Scoping Review"}
{"_id":"320c6ae2-58f8-aedb-e03f-94a76222e114","text":"Further prospective studies are required in measuring ultrasonic skin thickness before, during and after radiotherapy treatment followed-up yearly after treatment for about 10 years to document quantitative skin changes. Warszawski et al [21] proved that the structural changes in the assessment of early and late skin reactions can be recorded by ultrasonic evaluation and much earlier than visible reactions by the naked eye of the examining physicians. However, results did not demonstrate any significant difference in skin changes over long periods.","title":"An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy"}
{"_id":"321831d0-455d-2aff-75cd-681ad18f2766","text":"Two English to Persian translators who were familiar with medical terms translated the questionnaire as the early Persian version. They were asked to prepare a translation for general population and using simple words, instead of professional terms. The two early Persian versions were evaluated by ENT specialists’ panel and the result was backward translated to English by a Persian to English translator who was not aware of the main English version. Considering the required revisions, the final questionnaire was used as shown in Table 1.","title":"The Persian Version of Utrecht Questionnaire for Evaluation of Aesthetic Rhinoplasty Outcomes: Translation and Validation"}
{"_id":"322467c7-fcad-2343-9884-e14e25cfea02","text":"No surgical exploration was implemented for any of the patients presented with paraesthesia for less than two years. Patients who continued to have this symptom over two years (permanent) were reviewed to assess their condition and were advised to undergo surgery to explore the area that could include undertaking microneurosurgical repair for the appropriate cases.","title":"Experience versus complication rate in third molar surgery"}
{"_id":"322e0444-e147-328f-0d6a-dbe8cca83689","text":"Since the Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg-University is a certified nationwide centre of excellence in hepatobiliary surgery, patient clientele include all types of benign and malign liver resections. With a case load of about 300 liver resections per year it is deemed realistic to recruit participants within 2 years. Patients will be screened for eligibility in the outpatient clinic and if eligible offered participation on a voluntary basis.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"3235fa0e-53b3-7dc7-f0f0-a3aa2291f151","text":"A study carried out by Ahn et al. presented the experience treating patients with high-risk premalignant and microinvasive head and neck carcinomas with 5-ALA-PDT [74]. The trial used noninvasive optical technologies to check the physiologic and photosensitizing qualities of the tissue to comprehend the relationship between lesion physiology and PDT effectiveness. However, considerably greater levels of oxygenation and blood volume were linked to higher rates of response to PDT in patients with tongue\/floor of mouth lesions as well as those who had intact disease at the time of PDT, even though the study did not identify a correlation between blood volume and 3-month complete response. The authors found a relation between poor lesion oxygenation and local recurrences but found no association between lesion oxygenation and marginal recurrence. This phase one study was the first clinical study confirming an association between tumor hypoxia with higher rates of recurrence after PDT, and it lays the foundations for an individualized PDT based on the oxygenation characteristics of the lesions.","title":"Reactive Oxygen Species Produced by 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Cancer"}
{"_id":"3236f3d7-5db9-b86c-a145-5b29001ede6b","text":"Finally, we conclude that high flow extracranial to intracranial saphenous vein bypass grafting is safe and effective in the treatment of complex intracranial aneurysms and the selected blood supply vessels can meet the requirements of blood supply.","title":"Safety and effectiveness of high flow extracranial to intracranial saphenous vein bypass grafting in the treatment of complex intracranial aneurysms: a single-centre long-term retrospective study"}
{"_id":"32375216-f909-3341-e234-e7aa4e09de9d","text":"The study demonstrated that the usage of systemic or local prophylaxis and preference of ePTFE graft can be useful in reducing the risk of vascular graft infections caused by staphylococcal strains with high levels of resistance.","title":"Systemic and local antibiotic prophylaxis in the prevention of Staphylococcus epidermidis graft infection"}
{"_id":"3245504e-2ae9-a152-035b-e6f84f8018b8","text":"MRI can optimize planning for patients indicated for surgery and can minimize the area of resection by mapping extent of the ulcer and soft tissue infection [23, 24]. A marker should be placed adjacent to shallow ulcers that may not be visible at imaging. The field of view should be tailored to include the entirety of the ulcer and soft tissue infection.","title":"MRI nomenclature for musculoskeletal infection"}
{"_id":"324b75b3-6583-fb54-d2c3-8088bbf88e7f","text":"We have proposed a technique for augmentation of venous outflow in SGAP flaps through anastomosis of a second perforating vein. By using this method, one of the most devastating complications associated with microsurgical reconstruction can potentially be avoided, allowing the SGAP flap to more reliably be used for breast reconstruction.","title":"A Novel Technique for Augmenting Venous Outflow in the Superior Gluteal Artery Perforator (SGAP) Flap Carruthers et al"}
{"_id":"32570295-e5a6-b65c-c207-18b7555ace6f","text":"The pain scores of the three groups showed statistically significant differences. The nanomicroneedle group showed lower pain score than the intramuscular injections group and the intradermal microdroplet group.","title":"A Comparative In Vivo Study on Three Treatment Approaches to Applying Topical Botulinum Toxin A for Crow's Feet"}
{"_id":"32579a3e-fffb-a173-8f17-1ee68d4c7aa0","text":"Lipoaspirate samples were collected from male and female adult patients undergoing voluntary liposuction. All of the samples were obtained with written consent from the donors according to the instructions from the local institution review board at the University of Arizona. No paid compensation was given to subjects. Tissue was collected into sterile vessels and then allowed to separate by sedimentation. In this manner blood, tumescent fluid and oils were removed from tissue. The separated tissue was packaged into syringes and then shipped via overnight or local courier. Upon receipt at the processing laboratory, syringes were placed upright at room temperature for a further round of sedimentation. Any remaining fluids were removed from each syringe along with a small amount of adipose tissue into a sterile tube. The samples were pooled into a single sterile tube when multiple syringes arrived for processing. This extract was used for viability and sterility testing. If no tumescent fluid were present in the packaged syringes, a small amount of adipose tissue was removed and then vigorously mixed with sterile PBS to facilitate testing.","title":"Long-Term Biobanking of Intact Tissue from Lipoaspirate"}
{"_id":"325e3d12-86e2-9e81-796f-004fec0415db","text":"There is no single modality which can demonstrate bony edges and bone edema with high performance at the same time. CT and T1 weighted MR images are more successful in demonstrating bone edges. Transition between soft tissues and bone is sharper in CT and T1 weighted MRI. However these modalities cannot supply sufficient information about bone edema. Axial PD weighted MRI of shoulder is the mostly used sequence being able to present both bony and soft tissue components of instability synchronously. PD weighted MRI is also able to demonstrate bony edema which is a sign of the magnitude and location of bone trauma and a common source of pain. However there is a very smooth transition zone between bone and soft tissues, making segmentation of bone edges more difficult.","title":"Segmentation of Bone with Region Based Active Contour Model in PD Weighted MR Images of Shoulder"}
{"_id":"3260db31-d4e4-c28c-a63b-8ee3f5fc501f","text":"All publications reporting on the use of anastomotic couplers for venous anastomoses in human free tissue transfer will be included. In vitro, animal or cadaveric studies will not be included. Any studies reporting on multiple anastomosis procedures such as hand-sewn anastomosis or venous couplers for arterial anastomosis will only be included where the data for venous anastomosis is clearly distinguishable from the other procedures.","title":"Protocol for a systematic review of venous coupler devices versus hand-sewn anastomosis for microsurgical free flap reconstruction"}
{"_id":"3260f94d-47d0-55f6-fd37-0dbb32513599","text":"According to the guidelines for the prevention of venous thromboembolism in Chinese orthopaedic surgery, Color Doppler ultrasound examination has gradually superseded venography as the primary diagnostic procedure, which is a preferred method for the diagnosis of DVT with high sensitivity and accuracy. All patients underwent the preoperative ultrasound examination of venous thrombosis in the fractured lower extremity 1-2 days before surgery. Regardless of the size of the thrombosis and whether all the vessels were blocked, all patients were treated according to a venous thrombosis diagnosis in the lower extremity, and the location of the thrombosis was recorded. Color Doppler ultrasound was performed in all patients by 1 physician and then reviewed by another physician. Patients with venous thrombosis were classified as the DVT group, while the rest were classified as the non-DVT group.","title":"Study on the Risk Factors of Preoperative Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture"}
{"_id":"3263f891-6b51-f103-bd9d-b4cd83d263d6","text":"Significant weight loss and altered anatomy after RYGB and SG procedures do not appear to affect the pharmacokinetics and pharmacodynamics of prophylactic rivaroxaban. A single dose of Rivaroxaban was well tolerated and considered safe in this trial.","title":"Abstracts DGAV"}
{"_id":"326a7c19-0df0-0c2a-5a9e-ee2e87f3d341","text":"We review here 50 cases of pregnancy associated desmoid tumors including 10 cases from our own institution. These appear to be a unique form of desmoids comprising 8 to 18% of all desmoid tumors in cancer registries. They are usually sporadic but may be associated with the FAP syndrome. If we exclude patients with FAP there does not appear to be any common features that mark women at risk for this problem. The patients in our series were perhaps older (mean age 32 years) than pregnant women without desmoids. The age(s) were not given for the patients in the series reported by Rocha et al. [23]. Most, patients, both in our own series and our review had a prior pregnancy often with a caesarian section. While desmoids have been reported to arise in caesarian section scars this appears to be uncommon. The most common site is in the abdominal musculature particularly the right rectus abdominus muscle. Since these tumors are known to arise in areas of trauma we have speculated that this results from stretching of the abdominal muscles and fascia during gestation. This suggestion of causation does not explain however the development of desmoids in other areas during and after pregnancy indicating that other factors are also involved. The most likely factors are the hormonal and immunologic changes that occur during pregnancy.","title":"Desmoid Tumors in Pregnant and Postpartum Women"}
{"_id":"3274b1dc-c5ea-5150-69b2-bc85b7674072","text":"Hypersensitivity reactions to biologicals may be characterized by severe anaphylaxis that can be rapidly progressing and fatal, and therefore establishing its cause is pivotal to long-term risk management, but more importantly, the optimal management of reactive patients must ensure the patient the most effective therapy for the treatment of the underlying disease in a safe manner.","title":"How to Prevent and Mitigate Hypersensitivity Reactions to Biologicals Induced by Anti-Drug Antibodies?"}
{"_id":"327dd0e5-b11f-8df1-d0ee-0fbf868fa140","text":"Given the sheer volume of students going on IME and the variety of locations they visit, more stringent oversight of IME educational experience should be considered. International electives are likely to continue growing in popularity and applying North American professional norms is especially challenging in resource-limited settings.12 One approach to dealing with the issue of medical students performing procedures beyond their scope is to increase procedural skills training in PDT in addition to discussion of cultural awareness and ethics. Our research found that a majority of medical students would support this initiative.","title":"Procedural skills training for Canadian medical students participating in international electives"}
{"_id":"3288b455-e9a6-4697-e517-efd954656a3e","text":"The present study presents indication, methods, functional outcome and problems of bilateral fibular grafts for defect reconstruction after resection of primary malignant bone tumors in the long bones of the lower extremity.","title":"Bilateral Fibular Graft: Biological Reconstruction after Resection of Primary Malignant Bone Tumors of the Lower Limb"}
{"_id":"32991c38-fddd-1e8c-da37-21c42936e03f","text":"Methods: This was a prospective study carried out at a single center in which consecutive patients were submitted to radical axillary or ilio-obturator dissection using SJ. Control group data of seroma output and drainage removal were obtained from a recent Author’s analyses published in 2012 in which were analysed patients submitted to nodal dissection with conventional electrocautery. Daily drainage volume was compared with historical control group on days 3, 10 or 15 and day 20. Duration of drainage was compared with historical control group.","title":"Melanoma and immunotherapy bridge 2015 Naples, Italy. 1–5 December 2015"}
{"_id":"32a38417-cda2-ff9f-9683-e07bcac29e8a","text":"Usually a pectoralis major flap is used to close massive defects concerning large amounts of soft tissue9, 5 as the main problem is the loss of soft tissue bulk.","title":"Cancer patients with large defects. Reconstructional options: A case study"}
{"_id":"32a4a436-7062-3a16-18db-5b5ad47afdba","text":"The interstitium has a net negative charge due to the glycosaminoglycans present therein. Small particles and neutral or negatively charged particles can be absorbed into the lymphatic vessels whereupon they can accumulate within LNs, while NPs with a positive charge are primarily restricted to uptake by DCs at the site of injection and direct transport through the lymphatic vessels.","title":"Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions"}
{"_id":"32a5c811-0545-ef5d-052b-94174fcdf8c0","text":"Given the patient's rapidly progressive neurological decline, it was decided to proceed urgently to the operating room to allow for decompression and stabilization of his spinal cord and to obtain a tissue diagnosis. The patient underwent a C6-T3 posterior instrumentation and fusion along with T1 laminectomy and partial C7 and T2 laminectomies. This accomplished the goals for spinal cord decompression and stabilization. Blood loss at this point approached 600 mL given the bleeding from the tumor itself. In the frozen section, we were unable to identify what the lesion was, and so it was decided to hold off on the anterior corpectomy until we had a more definitive diagnosis. A few days later, the permanent pathology returned with a diagnosis of aggressive VH.","title":"Rapidly Progressive Myelopathy Caused by Aggressive Vertebral Hemangioma"}
{"_id":"32afc182-d32c-436f-507d-2bfc88086139","text":"Presented results strongly suggest that radiation-sterilized bone allografts can be successfully used for reconstruction in oral surgery procedures. Allogeneic bone material is a good bone replacement formulation in case of maxillary and mandibular alveolar process reconstruction and may be used in out-patient healthcare. The use of allogeneic grafting reduces the number of operational sites and minimizes the physical burden for the patient. The use of PRF membranes allows fixation of bone allografts as well as faster union with the patient’s self-bone. Orthodontic treatment facilitates scheduling and performance of augmentation and allows ultimate implant-prosthetic restoration of the dental defect improving the final aesthetic outcome.","title":"Evaluation of safety and efficacy of radiation-sterilized bone allografts in reconstructive oral surgery"}
{"_id":"32b79a96-2480-61ff-c60a-4bca8dae8b36","text":"BTA can invoke many kinds of hypersensitive reactions, some of which can be delayed-type or even fatal; hence, it is of crucial importance to pay close attention to atypical and early symptoms that may indicate the presence of BTA allergy in patients.","title":"Mild Allergic Reactions after Botulinum Toxin Injection: A Case Series and Literature Review"}
{"_id":"32b81a66-7d4d-253c-eaef-735fb0bd8632","text":"Treatment options for a primary choroidal melanoma as in this case would include brachytherapy, proton beam radiotherapy or enucleation, whereas breast metastases are often reviewed following systemic chemotherapy or external beam radiotherapy.","title":"Concomitant primary breast carcinoma and primary choroidal melanoma: a case report"}
{"_id":"32bb3fd3-e9b3-7f01-12f9-27252bb56872","text":"This report describes the case of a patient with ulcers of the left lower limb secondary to CVD, with onset around 24 years previously and refractory to treatment because of concurrent DCC.","title":"Dystrophic calcinosis cutis in chronic venous disease of the lower limbs"}
{"_id":"32be5679-5750-58c3-3ea7-27db0e13a303","text":"Core needle biopsy is now performed routinely for patients with suspected breast cancer to obtain a pathological diagnosis before surgery; because of this, many patients are diagnosed with breast cancer preoperatively. However, in some patients, the diagnosis was confirmed with intraoperative frozen pathological examination because a pathological diagnosis preoperatively for these patients was difficult to obtain. In the present study, patients with a confirmed diagnosis before surgery were more likely to choose mastectomy, as were those with a confirmed diagnosis to surgery interval of more than 3 days, which was shown to be an independent factor influencing the choice of a mastectomy. This factor has not been mentioned in previous studies. A possible reason why the patients with a confirmed diagnosis chose to have a mastectomy was that they were scared and panicked when informed they had breast cancer and wanted the lesion to be removed completely. Those with a longer interval between diagnosis and surgery may have been more susceptible to external factors, such as family, friends, and other patients.","title":"Non-doctoral factors influencing the surgical choice of Chinese patients with breast cancer who were eligible for breast-conserving surgery"}
{"_id":"32c2a321-6c6b-1e52-ce54-41f338e7b506","text":"The inclusion criteria were traumatic scalp avulsion with a follow-up period of at least 6 months after the surgery. The exclusion criteria consisted of patients with a concomitant cranial bone fracture and patients with a general contraindication to surgery.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"32cb067c-6e67-b24c-5f85-c73576885c77","text":"All surgical procedures were performed by the same surgical team aseptically. A soft padded dressing was used to cover the flap in order to guard against pressure when the rabbit was lying down. Analgesia and antibiotics were administered for three days postoperatively. At each study endpoints, the patency of the inflow and outflow vessels was checked in all the rabbits. Only those with confirmed patency were included and those with occlusion were replaced accordingly. The detailed animal handling procedures at different study endpoints were shown in Figure 2.","title":"The Effect of Hemodynamic Remodeling on the Survival of Arterialized Venous Flaps"}
{"_id":"32e37de8-2ed1-d258-84e7-24dd176a19b3","text":"Dimensions of tumor surgical margins in oral cavity squamous cell carcinoma specimens decrease from surgical resection to histopathological processing. Most of this shrinkage occurs between the clinically determined pre-incision and immediately after tumor resection in the post-resection measurement. These findings suggest that it might be prudent to consider surgical margin shrinkage when outlining initial margins to ensure adequate and complete resection of the tumor.","title":"An Analysis of Tumor Margin Shrinkage in the Surgical Resection of Squamous Cell Carcinoma of the Oral Cavity"}
{"_id":"32e572e0-1fca-4e30-1834-75c437ca202b","text":"This study was determined to be exempt from our Health Sciences Institutional Review Board. A web-based survey questionnaire was sent to the PDs of all 29 American Shoulder and Elbow Surgeons recognized shoulder and elbow fellowship programs. PDs were contacted using publicly accessible email addresses found on individual program websites or on the American Shoulder and Elbow Surgeons website. Respondents were asked to indicate their fellowship program size (number of training positions per year) as well as the number of applicants interviewed and ranked each year.","title":"Factors considered in ranking orthopedic shoulder and elbow fellowship applicants: a survey of program directors"}
{"_id":"32e66087-3c60-a729-70ad-e8c343aeb020","text":"Moreover, dealing with another important type of skin cancer called squamous skin carcinoma, genetic mutations in stem cells located in the bulge area seem to be able to lead to a more aggressive carcinoma than the same genetic alterations occurring in other cell populations of human skin [39]. Additionally, in this case further studies are needed to develop new therapeutic strategies able to target selectively cancer stem cells responsible for metastasis or their specific functions rather than normal epidermal stem cells.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"32e90816-f4e8-bcf8-4647-a2508802501d","text":"We report a case in which a filler granuloma due to a large amount of filler injection was mistaken for breast implant rupture. Complications such as infection and granuloma due to alloplastic filler injection have been reported in Korea and have become increasingly problematic in recent years. However, in most reported cases, complications occur only after filler injection. Complications are relatively rare in patients who have undergone both implant augmentation and filler injections. Even in the literature, there is only 1 case of implant rupture 1 year after AQUAfilling injection.[ In this case, it was not clear whether the cause of the implant rupture was the implant itself or AQUAfilling. Complications related to breast fillers have been increasing recently, but they do not show consistent symptoms, and it is not easy to predict aesthetic outcomes. Therefore, surgeons should make a sufficient surgical plan to explain the limitations of postoperative aesthetic outcomes to patients. In particular, in patients who undergo both implant augmentation and filler injection, it is much more difficult to determine the cause of complications and predict surgical outcomes. Accurate history taking and establishment of a surgical plan with sufficient radiographic imaging are necessary to achieve better surgical results and minimize postoperative complications.","title":"Breast filler granuloma mistaken for implant rupture: A case report"}
{"_id":"32ee8809-95a4-577e-0452-2b2ded6043a8","text":"It was anticipated going into this exploration that there may be a difference in the results involving role conflict for part and full time physician leaders; however, there were no significant differences found related to part or full time status. Therefore, a more detailed exploration of how part or full time status may be impacted by organizational climate may be beneficial.","title":"The affect of vision and compassion upon role factors in physician leadership"}
{"_id":"32ee94aa-1b1d-8d44-8264-0c2ecf86df2a","text":"The incidence of osteomyelitis in Norway remains high. It was particularly common in children under 3 years of age. There appears to be a decrease in the proportion of patients with acute osteomyelitis and of patients with long bone involvement. Subacute osteomyelitis patients have more moderate laboratory results and a different presentation on MRI than acute osteomyelitis patients. A blood culture is insufficient to identify microbes in most patients.","title":"Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study"}
{"_id":"32f01cb8-b4d0-3153-0f30-7ea3d02ef786","text":"According to the retrospective observation, longer period of local recurrence detection was observed in autologous reconstruction group. On the other hand, there was no statistical significance in tumor size at the time of recurrence and survival rate between the two groups. Further studies are required whether autologous and implant groups do not have a difference in the diagnosis of local recurrence and the survival prognosis.","title":"Is There a Difference in the Diagnosis and Prognosis of Local Recurrence between Autologous Tissue and Implant-Based Breast Reconstruction?"}
{"_id":"32f34a5f-66a8-628c-14fd-764198174fff","text":"Methods: Systematic literature reviews were conducted using the PubMed, Medline and Google Scholar databases to identify all English studies published in peer-reviewed journals between 1991 and 2018 that evaluated the prevalence of markers of allergic inflammation to aeroallergens and total IgE in CSU patients.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"32f4c467-3fc6-f8a1-fb4b-41b8c8d9a05d","text":"Patients without EC metastasis in specimens from SLN biopsy but showing EC metastasis in specimens from systematic lymphadenectomy were considered as false negatives.","title":"Sentinel Lymph Node Biopsy in Surgical Staging for High-Risk Groups of Endometrial Carcinoma Patients"}
{"_id":"32f53126-b98b-1762-874b-c2a7a870ddc5","text":"All the patients who were suspected to have skin tumors on the basis of history and clinical examination were asked to get a skin biopsy done and those who consented to get a biopsy done were included in the study. In the first step, a self-designed proforma containing questions on socio-demographic data and clinical details of the patients was administered then depending on the type of lesion punch biopsy, excisional biopsy, incisional biopsy and shave biopsy was done. The histopathological diagnosis was then considered to be the final diagnosis and the confirmed tumor cases were further classified according to World Health Organization (WHO) 2018 classification of skin tumors.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"32f9b9dd-866f-c64b-cb48-2a607a55394d","text":"The intraoperative anatomical evaluation of biliary system is done by intraoperative cholangiography.","title":"Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein"}
{"_id":"330822d3-ee70-eec6-585f-f6f56485d082","text":"Antibiotics that are suitable according to the results of cultures and antibiotic susceptibility tests are applied intravenously for at least 3 weeks or until the ESR and CRP levels return to normal limits.","title":"L-shaped corticotomy with bone flap sliding in the management of chronic tibial osteomyelitis: surgical technique and clinical results"}
{"_id":"33093c32-4c12-4001-c3d2-19730288772c","text":"Patients who use acetylsalicylic acid will continue this medication. Acetylsalicylic acid will not be started in patients after a free flap, in case the patients did not use this medication before the operation.","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"330a1019-c462-e9a3-3c41-a07a64369cbf","text":"The advantage of local delivery system of antibiotics is that it provides a high drug concentration at the site of infection without systemic side effects. It can penetrate avascular areas of wound and the bone and is effective against the sessile bacteria in a biofilm.2 The most comprehensive information regarding local drug delivery has been provided by combination of polymethyl-methacrylate (PMMA) with gentamicin which has been used extensively in the past.3-5 The use of PMMA as a drug delivery vehicle has few disadvantages like need for a second surgery for the removal of beads or limited choice of antibiotics which can be combined with PMMA as not all the antibiotics are heat stable.6 Further, gentamicin is not the agent of choice for infections with MRSA. After complete elution of the antibiotic, PMMA may even act as a foreign body for the growth of surviving bacteria.7","title":"Decal bone matrix as a local antibiotic delivery vehicle in a MRSA-infected bone model: An experimental study"}
{"_id":"330c5103-5b06-7475-bfe8-d440b1ef3c9b","text":"At the Department of General, Oncological, Metabolical and Thoracosurgery first paravertebral block was performed in 2000 for analgesia of multiple rib fractures. Since then we performed a lot of PVBs mostly for breast surgery and thoracosurgery with very good analgesic effect and great preservation of pulmonary function.","title":"Thermal imaging evaluation of paravertebral block for mastectomy in high risk patient: case report"}
{"_id":"330dbab3-b92e-6be9-17d7-0891cba7e0f0","text":"These three studies provide us with an overview for a potential new treatment and give us empirical confirmation of the mechanism of AA in the skin. In this context, AA shows a not yet described mechanism of action for NMSC skin cancers and new research in this area could be considered for the development of new drugs, based on a mechanism of action similar to AA.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"3316e0ad-6bea-7f72-d542-85af9d8be606","text":"Surgery was performed by a team of breast surgeons working closely with plastic and reconstructive surgeons. The responsibilities and tasks of each surgeon were clearly defined before surgery. The breast surgeon was responsible for the ablative procedure, including tumour resection and sentinel node biopsy. If a sentinel node biopsy indicated metastasis or if metastasis to the axilla was diagnosed preoperatively, the breast surgeon also performed axillary exaeresis. The plastic surgeon was responsible for reconstruction and contralateral reduction mammoplasty or mastopexy. If a contralateral procedure was required, the operation was performed simultaneously with the ablative procedures to minimise time in the operation room.","title":"Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery"}
{"_id":"332037e9-81f6-19c4-6f1e-bbec2c4b0f6c","text":"In challenging situations, good leadership appeared as clear and collegial guidance in which leaders backed up their people rather than primarily serving their interests.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"33215e7f-bbe9-f744-a7dc-56ab28ea4770","text":"Informed consent procedures will be implemented in strict compliance with relevant Chinese laws. Original informed consent will be retained in writing by the investigator.","title":"Study protocol for comparing the efficacy of left-open single-flap technique versus double-flap technique after proximal gastrectomy: A multicenter randomized controlled trial"}
{"_id":"3326d95a-0628-9d40-3b0c-fc34efe1c88e","text":"Safely injecting along the nasolabial groove can be challenging due to the variable course of the facial artery. In the lower two-thirds, the facial artery generally runs at the muscular plane or deeper. We therefore advocate keeping the needle tip in the superficial subcutaneous plane in this region and then moving deeper to the preperiosteal plane near and above the alar base. At the nasal dorsum the vascular network is located entirely in the subcutaneous plane so injections are kept deep in the preperichondrial and preperiosteal planes.","title":"Complications after cosmetic periocular filler: prevention and management"}
{"_id":"33271aef-0110-9f80-9264-86397abd9f4f","text":"There is an obvious demand for a full assessment of each pediatric cervical EG patient with a rational surgical procedure tailored to the extension and location of the lesion. Limitations of the current study are common to retrospective research in which the data are only as precise as available medical records. Besides, our study has limited power as a result of small numbers and uncontrolled variables. Despite the limitations, our results strongly suggest the application of aforementioned procedures on the specific site of cervical spine and contribute to the individualized surgical treatment of pediatric cervical EG patients complicated with neurologic deficit and\/or spinal instability, which is characterized by minimal surgical trauma and effects on spine growth without recurrence. The neural status and symptoms of these patients were significantly improved by the surgical intervention and EG-related cervical deformity was corrected by instrumentation. After all, surgeries for pediatric cervical spine is demanding and require thorough pre-operative planning and special technical expertise to supply an ensurance for the safety and effectiveness both in the operation and in the long term.","title":"The surgical strategy for eosinophilic granuloma of the pediatric cervical spine complicated with neurologic deficit and\/or spinal instability"}
{"_id":"332eca7d-2b32-67e7-48c5-e9adf0b5aed0","text":"The patient was aware of the potential risks and benefits of this reconstruction. He was fully engaged in the decision making process, and was an active participant in all aspects of his care. He was compliant during his stay, stopping smoking and adhering strictly to any instructions provided. He was very pleased with the resultant improved function in his range of motion.","title":"The Use of a Tetraminos Chimeric Free Flap in Lower Limb Trauma"}
{"_id":"332fde66-b9c5-4f35-bc52-b3acd94416bf","text":"We observed either no effect or a negative association between total time exposed to formula feeding and neurodevelopmental scores in this healthy, well-nourished population. This finding confirms what is already known about the advantages of breast over formula feeding and challenges classical theories about infants not expressing a preference for one type of milk over another, as long as their hunger is being satiated.","title":"Late weaning and maternal closeness, associated with advanced motor and visual maturation, reinforce autonomy in healthy, 2-year-old children"}
{"_id":"3334782b-e412-8fba-8b14-1367aacb6922","text":"Each patient will be assessed in the current UK national audit framework for hip fracture patients. This means they will contact by telephone 4 months after surgery. As per the feasibility aims of this study, we will also assess each patient at 30 days. This may be in person as an inpatient or over the telephone is the patient has been discharged.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"3335441f-9fda-de80-6dee-bef275607391","text":"The cavity was not filled in our procedure. Bone cavities left behind the following curettage were filled up with blood, which clotted and eventually ossified to form mature bone. Prosser et al reported on 166 cases of GCT left empty after curettage, which gradually filled up with new bone that consolidated with time. Iliac crest bone graft was not used to fill the cavity in any patient due to the postulated increase in recurrence reported by several studies when the cavity was filled with bone graft. Gouin et al ascribed an odd’s ratio of 3.9 for recurrence of the tumour when the cavity was filled with cancellous bone graft. Gao et al had a threefold increase in recurrence when the bone graft was used compared to bone cement.","title":"Giant Cell Tumour Around Knee Managed by Curettage and Zoledronic Acid with Structural Support by Fibula Cortical Struts"}
{"_id":"334c87aa-05dd-be50-dd63-41f298420ef4","text":"The increase in plaque score from baseline to 3 months may be due to patient apprehension due to injury to the site when brushing. This was, however, reduced after 6 months due to continued patient education and motivation. The results revealed that patients in both the groups exhibited oral hygiene at a similar level.","title":"The Efficacy of Low-Level Laser Therapy Combined with Single Flap Periodontal Surgery in the Management of Intrabony Periodontal Defects: A Randomized Controlled Trial"}
{"_id":"3355460c-8988-acb0-26d8-e84326706a12","text":"Our findings might also have an implication on the regional treatment of melanoma patients. As only 15% to 30% of patients with positive SNs have an additional disease in NSN, investigators have suggested that CLND might not be necessary in all patients with a positive SNB.42–44 Since the probability of NSN metastases was reduced in our study in the US group of patients, a preoperative US combined with FNAB should be considered as stratification criteria in randomised trials comparing different regional therapies in SN positive melanoma patients.","title":"Lower tumour burden and better overall survival in melanoma patients with regional lymph node metastases and negative preoperative ultrasound"}
{"_id":"335568ef-b31c-b026-8e45-01db794bb9a6","text":"The chemicals that are released by composite resins and by-products of biodegradation of the material may elicit local and systemic adverse reactions. One of the clinically relevant tests for assessing local tissue reaction to a foreign material is implantation study. The local adverse reaction comprises pulpal and mucosal effects, which may include irritation, inflammation, epithelial proliferation and oral lichenoid reactions. The present study showed that Medental micro-hybrid composite resins elicited a slightly lower cellular inflammatory response on the 2nd and 14th days, but the vascular congestion was slightly higher on the 2nd day of implantation. As reported in culture experiments, the difference in the cellular inflammatory responses may be related to the higher filler content in the Medental product. Ergun et aldiscovered that the composite resins that had the highest rate of survival among the five tested composite resins was the one with the highest weight (87%) of filler content. Srivastava et alalso reported that flowable composite resins with higher resin content showed maximum toxicity compared to nano composite resin and compomer.","title":"Relative biocompatibility of micro-hybrid and nano-hybrid light-activated composite resins"}
{"_id":"335a57f4-597f-82cf-1c44-931fb191b573","text":"Desmoid tumours of the brachial plexus are rare and may occur in extra-abdominal sites. The tumours are of fibroblastic origin and, although benign, are locally aggressive. Their relationship to critical neurovascular structures in their anatomic locations presents a challenge to the operating surgeons trying to adhere to the principles of surgery. Surprisingly little neurosurgical literature exists which was devoted to this topic despite the challenge these lesions present in surgery both at surgery and in choosing adjuvant therapies. We report a case of a large brachial plexus tumour in a patient which was diagnosed radiologically and histopathologically and the patient underwent surgical excision with good outcome. Desmoid tumours histologically are benign and are usually composed of proliferating, benign fibroblasts in an abundant matrix of collagen. They do not transform into malignant tumours or metastasize. Surgery is the mainstay of treatment; however, adjuvant radiation and chemotherapy remain controversial.","title":"Desmoid Tumour of the Brachial Plexus"}
{"_id":"3361d161-86d2-abc3-8e53-522b5f61a88d","text":"In this study, we chose early intervention to treat this difficult problem with a little technical advancement. In our experience with simple treatment principles over years of managing infected wounds, these wounds can be treated without trouble. The most important principle is en bloc resection, which refers to the radical debridement of the infected tissue. The purpose of the study is to establish simple but useful surgical principles by comparing wound-healing times between infected wounds and clean surgical wounds when those wounds are treated with the same principles.","title":"Retrospective study of the efficacy of vascularized tissue transfer for treating antibiotic-resistant bacteria-infected wound Comparison with clean and antibiotic-sensitive bacteria-infected wound"}
{"_id":"3362c966-8b87-0e3d-bb3a-056200af8f6e","text":"A questionnaire consisted of nine questions regarding the basic knowledge about plastic surgery was randomly distributed among college students. The students were given 20 minutes to fill out the forms.","title":"Views of College Students on Plastic Surgery"}
{"_id":"3365331c-eb1a-af33-ffa0-398ffa606058","text":"The aim of this review is to present a pictorial essay emphasizing the various patterns of calcification in pulmonary nodules (PN) to aid diagnosis and to discuss the differential diagnosis and the pathogenesis where it is known. The imaging evaluation of PN is based on clinical history, size, distribution and the gross appearance of the nodule as well as feasibility of obtaining a tissue diagnosis. Imaging is instrumental in the management of PN and one should strive not only to identify small malignant tumors with high survival rates but to spare patients with benign PN from undergoing unnecessary surgery. The review emphasizes how to achieve these goals. One of the most reliable imaging features of a benign lesion is a benign pattern of calcification and periodic follow-up with computed tomography showing no growth for 2 years. Calcification in PN is generally considered as a pointer toward a possible benign disease. However, as we show here, calcification in PN as a criterion to determine benign nature is fallacious and can be misleading. The differential considerations of a calcified lesion include calcified granuloma, hamartoma, carcinoid, osteosarcoma, chondrosarcoma and lung metastases or a primary bronchogenic carcinoma among others. We describe and illustrate different patterns of calcification as seen in PN on imaging.","title":"The calcified lung nodule: What does it mean?"}
{"_id":"336554ee-9327-d11d-e34f-41762faab745","text":"In this study, we conducted a comprehensive screening for VTE using doppler ultrasonography (US) in critically ill children admitted to the PICU for ≥ 72 h and with at least two risk factors for VTE. Ultrasound evaluation of the great veins was performed to ensure that also asymptomatic VTEs were included in the study. Our main objective was to provide new data on the incidence of VTE in a group of PICU patients considered to be at high risk of VTE.","title":"Incidence of venous thromboembolic events not related to vascular catheters in a prospective cohort of critically ill children"}
{"_id":"33690b3a-ce39-403d-fa56-6e7e1c151b74","text":"This study confirms the importance of a preoperative biopsy in solitary pathological proximal femoral fractures due to the risk of sarcoma in patients with and without a history of cancer. However, biopsy delays the time to definite surgery, results can be inconclusive or false, and it risks completion of impending fractures.","title":"The Importance of Awaiting Biopsy Results in Solitary Pathological Proximal Femoral Fractures Do We Need to Biopsy Solitary Pathological Fractures?"}
{"_id":"33724da0-1163-22e0-98dd-87eaa6e9180c","text":"As we could observe in our patients, the initial phase of dye uptake within the flap tissue can be defined as safely perfused tissue. The method is independent of the investigator, reproducible as well as contactless and with a high spatial and temporal resolution. It is an external device and therefore the use is not limited to the operating room. Due to the short half-life, multiple measurements are possible at short intervals. Additionally it can be applied for postoperative flap monitoring in critical cases or if flap perfusion is not distinct by using other methods.","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"337413df-55d2-7864-96d7-570eefe0dee5","text":"Histologically, it is necessary to cut the lymph node every 2 mm and examine all sections extemporaneously. Particular attention must be paid to avoid using all material and allow for proper standard histological examination after fixation.","title":"The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management"}
{"_id":"337ac768-1b19-05d4-43e6-2f00e813290c","text":"TPVB is an old method of regional analgesia that was first described in the beginning of last century. In 1905 Hugo Sellheim from Leipzig described anatomical space lying alongside vertebral column. Following this discovery Sellheim and Lawen decided to inject small doses of local anesthetics into this space and to observe the effects [1].","title":"Thermal imaging evaluation of paravertebral block for mastectomy in high risk patient: case report"}
{"_id":"337fcdd7-fe50-1967-706f-3ec8cf528fb6","text":"The complex wound from sternotomy dehiscences presents itself as a challenge to surgical teams. Treatment should include debridement of necrotic tissue and preferably coverage with well-vascularized tissue. We propose that the unilateral pectoralis major muscle flap is an interesting and low morbidity option for the reconstruction of sternal wound dehiscences, with proper sternum stability and satisfactory functional and aesthetic outcomes.","title":"Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence"}
{"_id":"3381db15-d4d7-3cb7-2e50-3e215755ad76","text":"Despite an extremely fragmented tibia with large bone defect, this patient had a well-protected ipsilateral fibula which was fractured only a few centimeters from the distal end. During surgery, we observed that the proximal connection of the peroneal artery was intact and decided that transfer of this large vascularized fibula segment would be an ideal alternative for replacing lost tibial bone. After preparation of the two ends of the tibia, we transferred the vascularized fibula medially and placed it in between the two poles of the tibia. Our preferred fixation method with a monolateral external fixator does not allow early weight bearing before callus formation. Conversion to a circular frame after the soft tissues have healed would have been an alternative which is more stable. Although referred to in the literature, we did not experience complications of pin loosening and secondary deformities in this patient or in our previous patients to whom we performed limb lengthening procedures with monolateral external fixators [1].","title":"Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture"}
{"_id":"33824a82-5d09-a2aa-d72a-50143f6b64c2","text":"Idiopathic OVT is a rare condition. Given limited evidence in the literature, a range of treatments have been trialled, generally following the principles of DVT management with anticoagulation and follow up imaging which have been summarized in Table 2. While this review has demonstrated that DOACs can effectively treat idiopathic OVT, warfarin may be a more prudent choice in patients with suspected antiphospholipid syndrome until it can be confidently excluded to reduce risk of thrombus extension and embolism.","title":"Choosing safe and effective anticoagulation to treat idiopathic ovarian vein thrombosis: using first principles of deep vein thrombosis management to treat a rare diagnosis: a case report and review of the literature"}
{"_id":"33827167-9368-8033-8b24-5937398e40ac","text":"A large number of questions regarding the mechanisms of anaphylaxis remain unanswered. One such question is the following: what determines the rate at which the allergic reaction propagates from the point of entry of the allergen in the mouth to full-blown systemic response? We present here a study based on the principle of the original experiments by Prausnitz and Küstner. The aim was to study the importance of different serum profiles of patients with peanut allergy on the dissemination of the allergic reaction.","title":"A study of the mechanisms of Anaphylaxis through passive transfer of IgE-mediated cutaneous reactivity"}
{"_id":"338a762a-7a68-80f6-6d2d-159febfe50db","text":"Based on the pattern and timetable of the ossification of the tarsal bones in idiopathic club feet, a weaning protocol was designed and has been in use since the adoption of the Ponseti treatment method by our department.","title":"Prolonged use of foot abduction brace reduces the rate of surgery in Ponseti-treated idiopathic club feet"}
{"_id":"339176fb-6ba4-88e1-7445-c15330b2280b","text":"Desmoid tumors are benign but locally aggressive tumors of mesenchymal origin which are poorly circumscribed, infiltrate the surrounding tissue, lack a true capsule and are composed of abundant collagen. History of trauma or surgery to the site of tumor origin is elicited in up to one in four cases and they most commonly develop in the anterior abdominal wall and shoulder girdle but they can arise in any skeletal muscle. The clinical behavior and natural history of desmoid tumors are unpredictable and management is difficult with many issues remaining controversial, mainly regarding early detection, the role, type and timing of surgery and the value of non-operative therapies. We report a case of anterior abdominal wall desmoid tumor in a 40-year-old male with a previous history of surgery.","title":"Desmoid Tumors: A Clear Perspective or a Persisting Enigma? A Case Report and Review of Literature"}
{"_id":"33953095-923e-0994-2ebc-3120e6052190","text":"An overview of the complete results of the reader study is shown in Table 2. All three observers evaluated the bone-equivalence image to have a higher image quality than the conventional radiograph for assessing bony structures and a better visualization of diagnostic details, such as trabecular structure or compact bone limits, corresponding to a detail level commonly used in clinical practice at which the differentiability of trabecular and compact bone structure is an important requirement as to the quality of conventional X-ray images in clinical routine. In addition, one of the readers considered the overall image quality of the bone-equivalence image to be better than of the traditional X-ray image while the other two readers did not find an appreciable difference between the two images as to this criterion. Also, all three observers considered the diagnostic acceptability of the bone-equivalence image to be higher than the one of the conventional X-ray image referring to the evaluation of the bony structure.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"3397b966-8687-10ac-56fa-8a8739403088","text":"The therapeutic efficacy of PDT depends on the properties of the light used to activate the PS. In a superficial approach it has to both penetrate skin and tissue to reach the target site and be able to activate the PS in situ. In an intraluminal or interstitial setting the placement of multiple light sources is an important consideration. The penetration of light in tissue is a complex process, which is dependent on the optical properties of the tissue at the wavelength of light used. There is significant heterogeneity between tissues and even within tissues, with numerous molecules influencing light scattering and absorption. At shorter visible wavelengths, efficacy can be limited due to the absorption by endogenous chromophores such as haemoglobin, whereas at longer wavelengths water can absorb light. This limits the range of wavelengths to optimally penetrate tissue between 600 nm and 1300 nm. However, light with a wavelength longer than 850 nm doesn’t provide sufficient energy needed to activate the PS to its triplet state and to generate singlet oxygen. As such, the “therapeutic window” for the majority of PDT applications lies in the red region of the spectrum between 620 and 850 nm achieving optimal tissue penetration and PS activation [88].","title":"Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions"}
{"_id":"33a5fbee-a2ce-37b7-e80a-9d8aebf3e663","text":"All patients diagnosed with CSM referred for a surgical consultation to the orthopedic or neurosurgery departments at the participating centers will be eligible for inclusion in the study. Patients will be enrolled if they meet the inclusion criteria (Table 1) and sign informed consent.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"33b8059b-9749-1cb6-6336-f7a4dec48f91","text":"Our study is limited by our small sample size, and by the fact that it is only a case series with a single institution experience and no control group. We did not calculate sample size as this is an innovative technique and we aimed to show our early experience with all patients who underwent BTA injection prior to hernia repair. Our results may not be representative of other patient populations or surgeon expertise. Also, we have a short follow-up which does not allow us to properly evaluate recurrence. Despite this, our study is an addition to the literature on the use of BTA, which while limited, is growing with reports of favorable outcomes and safety profiles, which has driven innovative approaches that could be measured at a larger scale in a prospective randomized controlled fashion.","title":"Preoperative botulinum A toxin as an adjunct for abdominal wall reconstruction: a single-center early experience at an Academic Center in New York Toxina botulínica A pré-operatória como adjuvante na reconstrução da parede abdominal: experiência inicial em Centro Acadêmico em Nova York"}
{"_id":"33bf9fbf-f61a-1c81-9670-1033f6fae915","text":"Surgeons must keep up with this process, and lead future changes to reach the goal of complete recovery for every patient.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"33c0d13a-4cce-aa34-b3db-d21ba5b00113","text":"A retrospective review dealing with treatment of desmoid tumors in the head and neck was recently published. Tostevin et al22 published data from 6 children with aggressive fibromatosis occurring in the head and neck. They concluded that primary excision is not always possible in this location, even though adjunctive modalities may not be feasible in children because of high rate of complications and interference with growth.22","title":"Congenital Desmoid Tumor of the Cheek: A Clinicopathological Case Report"}
{"_id":"33c93ce1-17be-b764-c746-81444199e3ca","text":"The tissue banks and their regulations are still new to most of the developing nations.","title":"Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: long-term result"}
{"_id":"33dd8fa5-db20-1d4d-0148-3549785c0fe7","text":"The patient underwent surgery for orthomorphic correction of the mandibular asymmetry following the release of the ankylotic mass. The main advantage of this orthomorphic correction is its ability to alter the entire area of contour defect in any desired dimension as a single unit. A significant limitation of this technique was the inability to establish perfect symmetry. This was because it repositioned the deformed mandibular segment but did not correct the straightened contour of the body of the mandible. Modifications of this technique can be used in a number of ways, including as a technique for bridging small osseous defects of the mandibular body [2]. In our case, we advanced and did a sliding genioplasty to increase the pharyngeal lumen to aid breathing and relieve the patient of obstructive sleep apnea. No case has been recorded where orthomorphic correction was used to treat not only mandibular deformity but also obstructive sleep apnea.","title":"Management of unilateral temporomandibular joint ankylosis & orthomorphic correction in a patient with Marfan syndrome: A rare case report"}
{"_id":"33de0f9d-130f-0800-3e28-3706ee6e7d2d","text":"The management of patients with a history of recurrent mechanical TV thrombosis who require noncardiac surgery is complex. The elective replacement of a mechanical TV with a bioprosthetic valve before noncardiac surgery to lower the thrombotic risk would be considered too radical. Thrombolytics are the initial treatment for thrombosed mechanical valves but would be more dangerous in the postoperative state [1-3]. Reoperation of prosthetic valves has been shown to be low risk overall and new generations of bioprotheses have been shown to last longer [16]. The situation is unusual in that there are not many mechanical TVs placed, yet less so given the significant risk of thrombosis of the right-sided heart valve. Having to stop anticoagulation therapy in patients with mechanical valves for a period of time is common and pertinent to primary care physicians and surgeons, which makes education regarding valve choices and management of thrombotic complications important.","title":"Management of recurrent mechanical prosthetic tricuspid valve thrombosis in the perioperative period of noncardiac surgery: a case report"}
{"_id":"33e15561-fb5c-aba1-672e-882058eb92ab","text":"Wrinkles are mainly caused due to lack of elastic feature of the skin. A specific skin fibroblast elastase inhibitor can be used to prevent UVB induced wrinkle formation and thus help to maintain the linear configuration of elastic fibers and skin elasticity. Hyaluronic acid and botulinum toxin have also been widely used as anti-wrinkling agents.","title":"Anti-aging and Sunscreens: Paradigm Shift in Cosmetics"}
{"_id":"33e569b8-b76b-513d-a74e-56a968419594","text":"Although ultrasound is most commonly used for diagnostic imaging, it has been adopted for a variety of therapeutic applications since the 1950s.29 Therapeutic ultrasound often utilizes acoustic pressures and intensities well above those of diagnostic ultrasound (DUS) in order to elicit some form of biological effect or response. Typically, the ultrasound beam is focused to a point within the body, thereby selectively targeting a specific tissue of interest and avoiding bioeffects in the tissues lying between the ultrasound transducer and the target tissue.","title":"The role of ultrasound in enhancing mesenchymal stromal cell‐based therapies Liu et al."}
{"_id":"33e8c5cf-7b1e-1db3-ed14-fc498ccafcaa","text":"Five of the six variables examined in this paper are non-modifiable. Initial fixation with stabilisation prior to internal fixation was the only modifiable variable studied and was not found to be associated with subsequent infection. Though other modifiable risk factors such as limb ischaemic time and transfusion requirement could be examined, the severely injured nature of these casualties would preclude any deviation from established initial treatment algorithms for consideration of the reduction in the risk of later infection. It is also worth noting that it has not been definitively established whether patient-reported outcomes are superior in limb salvage or amputation following severe tibial injury in service personnel [24, 25].","title":"Factors influencing infection in 10 years of battlefield open tibia fractures"}
{"_id":"33ea480e-e2dc-2e5b-3aad-0c029c530403","text":"This is a cross-sectional study conducted in Saudi Arabia using a self-reported online questionnaire distributed through social media channels. The sample included 1370 participants who were all Saudi nationals over the age of 16 who had undergone primary rhinoplasty at least 1 year prior.","title":"Prevalence of considering revision rhinoplasty in Saudi patients and its associated factors"}
{"_id":"33ef15db-aef7-4f6b-89f3-cdcc3fda30d4","text":"In clinical practice, there are few contraindications for performing primary excision. Refraining from primary excision can be due to patient declining surgery or presenting with a very poor overall health condition.","title":"Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection for Melanoma"}
{"_id":"33efd158-4e8e-2e5e-bc03-6706f433edf1","text":"In this retrospective study, we found that the oncological outcome, both in terms of survival and groin recurrence rate of patients with clinically suspicious positive groin lymph nodes, treated with a lymph node debulking followed by radiotherapy, was not compromised compared with patients who had a complete IFL matched for the variables extranodal spread and diameter of the metastasis > 15 mm. Recurrences with a distant component were predominant in both groups.","title":"Selective Removal of Only Clinically Suspicious Positive Lymph Nodes Instead of a Complete Inguino-Femoral Lymph Node Dissection in Squamous Cell Carcinoma of the Vulva"}
{"_id":"3403e6d0-0014-ea0c-719b-2834564b78c3","text":"Based on our early experience and review of the literature, we developed a new sequence of treating sternoclavicular joint osteomyelitis with incision and debridement followed by delayed bone resection and muscle flap coverage (Figure 2). Thus far, we have had a high success rate with each of five patients recovering from this sequence of operations without wound complication or recurrence. It appears to be superior to immediate bone resection and flap coverage for treatment of this condition. The time of open wound care of was approximately 3 weeks between the first and second operations, which is significantly less than the previously described median length of wound care of 12 weeks for open drainage alone.","title":"Treatment of Sternoclavicular Joint Osteomyelitis with Debridement and Delayed Resection with Muscle Flap Coverage Improves Outcomes"}
{"_id":"34082fb9-fd90-d5c9-4dc0-8844d7c3a73b","text":"Table 2 Clinicopathological characteristics, treatments after local recurrence and outcome of patients with local wall recurrence","title":"Risk factors of local recurrence following implant-based breast reconstruction in breast cancer patients"}
{"_id":"340f8e59-7bf8-8d2e-e4af-aca00db8153d","text":"Based on these studies, and on clinical experience with SCC and BCC, we adopted a surgical margin of 3 to 5 mm for the head and neck lesions and of 5 to 10 mm in the other areas, using the wider margin in cases of rapid growth clinical history.","title":"Metatypical basal cell carcinoma: a clinical review"}
{"_id":"34108424-8cf8-3915-c736-62962c3d868b","text":"After my mastectomy it took me a long time to be able to even look at myself in the mirror, let alone touch my scars. A few months after my mastectomy I started radiation and from day one you are supposed to moisturize the radiated area a few times a day. I had to get my husband to do it for me because touching myself made me feel sick. Eventually, I mustered up the courage to do it myself, but it took a bit of time.","title":"Every Story Is Different: Experiences With Body Changes Related to Cancer"}
{"_id":"34140eea-b523-dd61-402c-d3c759e7295c","text":"The patient was not aware of her exact bra size because she only wore sports bras because of her asymmetric breasts. She complained of pain and being able to feel the edges of her implant through her skin, and she was dissatisfied with her breast asymmetry. Her goals were to be larger in size and to have her asymmetry corrected.","title":"Preoperative MRI to Improve Aesthetic Outcomes in Secondary Mastopexy Augmentation: A Step-by-Step Approach"}
{"_id":"3417672c-da9a-a870-fb2c-ef0bfdbbf39d","text":"It is crucial for the elderly patients that evaluating the general body state and vascular condition of the extremities. Preoperative color ultrasonic Doppler are routinely utilized to not only locate a robust peroneal artery perforator closest to the defect, but also confirm the condition of the artery and vein in the lower extremities.","title":"Reliability of distally based sural flap in elderly patients: comparison between elderly and young patients in a single center"}
{"_id":"3417c8be-2963-b6f0-6da9-fb2aaef1d003","text":"Tumors involving only the mastoid process can be safely managed with removal of the mastoid process. Because large rongeur bone forceps are more useful and safer than electrical burr for head and neck surgeon lacking otology technique.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"341c5e64-5139-befe-f786-82b1bfa67668","text":"A limitation of this study was that it did not evaluate adverse responses after the recipients went home. Thus, the rate of allergic reactions, regardless of the time since vaccination, might have been much higher. Another limitation of this study was that past medical histories of recipients who had acute adverse events at the vaccination site could not be comprehensively collected. As a result, we could not statistically evaluate the impact of the past medical history on the occurrence of acute adverse events among the participants.","title":"Reports of acute adverse events in mRNA COVID-19 vaccine recipients after the first and second doses in Japan"}
{"_id":"3422291c-aa1b-7909-223c-4dc1690e90af","text":"In comparison with traditional onlay bone graft, we developed wrapping autogenous cortical and cancellous bone grafts. The former can also provide vital osteoblasts with both of osteoinductive glycoprotein and BMP, whereas the cylindrical critical bone graft, particularly characterized by modality of wrapping cancellous bone have osteoconductive effects.[ At the same time, this manner of graft contribute to keep the cancellous pieces compacted contact with previous pseudarthrosis and to form sealing environment in location, allowing production of high concentration of glycoprotein and bone marphogenic protein which improve biologic environment and may be key factor for facilitating union of CTP.","title":"Wrapping grafting for congenital pseudarthrosis of the tibia A preliminary report"}
{"_id":"3424fb73-180a-642d-f933-d743b72ac239","text":"The ability to practice these types of transferrable skills gives medical trainees insight into microsurgical fields of medicine and provides a preview of what a residency and future career in a microsurgical field might look like. To our knowledge, Eyesi Surgical has not been widely implemented in medical school curriculums. Feedback received after briefly introducing the simulator to other cohorts of students showed that simulator training was valuable hands-on experience. The students appreciated the opportunity to try out devices which allowed them to determine whether surgical interventions – mostly controlled on a microscope – are an option for them in their future career. The combination of feedback from the instructor as well as the simulator helped to provide students with real-time feedback about what subspecialties might be appropriate options for them to consider pursuing after medical school.","title":"Implementation of microsurgery simulation in an ophthalmology clerkship in Germany: a prospective, exploratory study"}
{"_id":"3429be37-efef-0740-b938-09a8e9ebda75","text":"With adequate surgical experience and recent refinements in surgical technique free flap success rates should be in excess of 95%. Venous thrombosis is the most common cause of failure. Careful monitoring over the first 48 hours by experienced staff should allow for early identification of flap compromise. Rapid re-exploration in this clinical setting is crucial to maximise the chances of flap salvage. If salvage is not feasible or unsuccessful then non-surgical methods of salvage may be employed with some possibility of success. With flap loss there are a number if choices on the reconstructive ladder for defect correction. The use of a second free flap is feasible, but may be more technically demanding.","title":"Salvage of failed free flaps used in head and neck reconstruction"}
{"_id":"3429f785-67f1-f42f-86fd-2cc2c60a3e61","text":"Older age was also noted to correlate with an increased risk of a false‐negative SLNB. This is in accord with previously published results and has been postulated to relate to decreasing lymphatic function with increasing age 34, 35. Indeed, lymphatic dysfunction has been demonstrated by measurement of radiocolloid transit to and uptake within sentinel lymph nodes, with the authors concluding that age‐related alterations in lymphatic function may lead to alternate metastatic patterns with decreased nodal positivity 35. These findings suggest that older patient age may necessitate special considerations in interpretation of SLNB results.","title":"Regression in thin melanoma is associated with nodal recurrence after a negative sentinel node biopsy"}
{"_id":"342a8f82-b022-6a64-225e-7ba16af80f9b","text":"To assess the primary safety and oncological outcome of percutaneous cryoablation in patients with non-visceral metastases of the abdominal cavity after prior surgery.","title":"Percutaneous cryoablation: a novel treatment option in non-visceral metastases of the abdominal cavity after prior surgery"}
{"_id":"342e725c-f7a0-a466-9608-ad823b324518","text":"Suspicious lesions should be removed completely with a 2 mm margin; use of incision or punch biopsies is deprecated because accurate histological staging is impossible and the treatment is dependent on the histology. In our patient, punch biopsy was performed before diagnosing melanoma. A planned excision was performed when bony involvement was found.","title":"Direct bony invasion of malignant melanoma"}
{"_id":"3435a99d-fb0c-1cde-842a-eb4ea49a6365","text":"After fibula harvest, the lateral collateral ligament of the knee was reconstructed via fixation of the biceps tendon to the proximal tibia with heavy suture. A single branch of the deep peroneal nerve to the proximal anterior tibialis muscle belly was divided with subsequent primary repair to allow for harvest of the proximal head of the fibula.","title":"Composite-Free Vascularized Fibular Epiphyseal Flap and Proximal Humeral Allograft for Proximal Humerus Reconstruction in a Pediatric Patient"}
{"_id":"343bfdc5-2a2f-f5dd-edcc-76f0f05e5a0b","text":"We have shown that ND was able to detect NMSC without sacrificing melanoma sensitivity but misclassified benign nonmelanocytic lesions. Although there are promising results for other technologies, dermoscopy is still the only widely used tool for skin lesion diagnosis. Nonmelanocytic lesions are an important aspect in melanoma detection, and more research is needed, especially on features for differentiating between melanomas and seborrheic keratoses.","title":"Computer-Aided Decision Support for Melanoma Detection Applied on Melanocytic and Nonmelanocytic Skin Lesions: A Comparison of Two Systems Based on Automatic Analysis of Dermoscopic Images"}
{"_id":"3440ef9c-cf85-48a7-b0a9-3604b4b6d7f4","text":"Table 2 Evaluation of the bone and functional results according ASAMI classification","title":"Reconstruction of massive tibial defect caused by osteomyelitis using induced membrane followed by trifocal bone transport technique: a retrospective study and our experience"}
{"_id":"34528564-460c-c792-cc0e-789bbc6a4485","text":"We will include only trials with participants whose diagnosis of NCC was established by imageology examination or pathological examination of surgical specimens. According to the definition of cholangiocarcinoma, trials with participants with cancer of gallbladder and ampulla of Vater will be excluded.","title":"Therapeutic effect of photodynamic therapy for nonresectable cholangiocarcinoma Protocol for a meta-analysis and systematic review"}
{"_id":"346ffd3e-49ee-02ab-f0eb-a4176fce3cfc","text":"The limitations of this technique are represented by the impossibility to regenerate defects above the bone peaks, so a combined regenerative and resective approach should not be underestimated in cases that require it. The use of GalvoSurge in fact would allow the removal of particular matter resulting from the release of titanium particles around the surface without affecting the healing process. In the literature, there is much debate about the influence of metal particles on tissues. In fact, this same particulate could result in a negative modulation of osteoimmunology and could result in an aseptic foreign body reaction around the implant.","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"347bfe81-5d2d-3af0-1ff4-286ddb94429c","text":"The lips are the focal centre of the lower face. It is always important to consider antiviral prophylaxis in a patient with a history of herpes simplex episodes.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"3480c9e7-7218-5f8e-a85d-194efddb0895","text":"For most midface defects, a soft tissue flap is often needed to fill dead space or provide coverage of the skull base or closure of the palate. In these circumstances, an MFC flap can be connected to a branch of the pedicle of the ALT flap or another fasciocutaneous flap. The distal continuation of the lateral descending circumflex vessels is well-suited in terms of size match and length to serve as the recipient vessels for the MFC. The engineered chimeric flap then allows independent positioning of the MFC flap for the bony reconstruction, while the soft tissue flap can be used to fill the dead space of the maxillary sinus or to reconstruct the palate as needed. The added pedicle length of the ALT flap is generally sufficient to reach the recipient vessels, either the facial vessels at the level of the mandible or the superficial temporal vessels. Early experience using the MFC and the chimeric design has demonstrated high success rates without an increase in donor site morbidity, hospital stay, or recovery time [62].","title":"Innovative Strategies in Microvascular Head and Neck Reconstruction"}
{"_id":"34840ceb-9233-f04c-5e59-8d386365a199","text":"Of note, we failed to show a positive action of HU in preventing recurrences after the first incident episode of splanchnic vein thrombosis. The reason of this finding is difficult to explain; it could be speculated that in patients with splanchnic vein thrombosis, hypercythemia is less frequent24, so that cytoreduction in this setting could be less crucial than otherwise. Moreover, given the unique environment of the splanchnic venous system, it is likely that the mechanisms of SVT formation differ from the mechanisms of arterial and VTE at common sites. Liver endothelial cells isolated from two patients with Budd–Chiari syndrome25 and spleen endothelial cells26 have been found to carry the JAK2 V617 mutation, so that aberrant endothelial cells may eventually contribute to SVT pathogenesis. Therefore, the occurrence of SVT, occurring either as the heralding presentation of MPN or as a complication during the course of the disease, poses an important clinical decision on the use of cytoreduction. We suggest to prescribe HU only in the presence of hypercythemia or in the case of progressive disease.","title":"Hydroxyurea prevents arterial and late venous thrombotic recurrences in patients with myeloproliferative neoplasms but fails in the splanchnic venous district. Pooled analysis of 1500 cases"}
{"_id":"348a85ac-af15-bc75-a154-9336c4a49772","text":"CSF leakages as a result of gunshots on the other hand provide extra challenges. There is usually extensive soft tissue loss. The injury may be associated with fractures of the vertebral bones that may need to be stabilised. The defects in the dura are likely to be wide either due to the tract of the bullet or as a result of the bone fragments blasted away with the bullet.","title":"Island Latissimus Dorsi Muscle Flap and a Perforator Flap in Repairing Post-Gunshot Thoracic Spine CSF Fistula: Case Presentation"}
{"_id":"34931f84-6cbf-d33e-9636-8f86b25cfc07","text":"Therapeutic decisions regarding the positivity of an SLN are still discussed in the literature. The absence of standardization and criteria to quantify the tumor invasion load in SLN makes it difficult to define a methodology that points to a positive SLN at risk. The Rotterdan criterion states that the larger the TB, the greater the chance of involvement of the ganglionic chain, and SLNs with TB greater than 1mm could benefit from a complete dissection , . However, it is not uncommon for other methodologies to be found in the literature. Despite the heterogeneity of methods and results, there is a consensus that the chance of involvement of non-sentinel lymph nodes is proportional to the size of the TB in the SLN , .","title":"Evaluation of tumor load in sentinel lymph node in patients with cutaneous melanoma Avaliação da carga do tumor em linfonodo sentinela nos doentes portadores de melanoma cutâneo"}
{"_id":"3498aceb-73ee-c78e-6a3b-f66e848af91a","text":"Although further studies are needed to determine the appropriate dose of the dual-imaging nanoparticle probe for effective sensitivity and safety, the results of this animal study revealed a novel method for improved node detection by a dual-modality approach for sentinel lymph node biopsy.","title":"Dual-modality imaging with 99mTc and fluorescent indocyanine green using surface-modified silica nanoparticles for biopsy of the sentinel lymph node: an animal study"}
{"_id":"349aaf92-c254-2e25-9f0b-6b3bc72ed2e3","text":"On the other hand, the delay of a possible surgical resection of a tumor can lead to complications that are difficult to treat surgically; the extension of the tumor into the surrounding soft tissues means that the only surgical solution is a radical one, such as amputation or disarticulation.","title":"Melorheostosis: A Review of the Literature and a Case Report"}
{"_id":"349da7d6-6cff-e1ee-15dd-0eea2db2a39d","text":"It is often hard to study and be familiar with ‘all’ the fillers. It is appropriate to understand one or two and use them well. One should be aware of what makes each filler unique and where each filler might have its optimal place for injection. Learning proper injection techniques is important and learning from your peers is an opportunity that will allow you to acquire the skills you need to make you the best injector possible.","title":"Soft Tissue Augmentation in Dermatology – 2009 Update"}
{"_id":"34a1989d-43fa-f2ff-6c38-fc8e03cccdba","text":"Lesions arising in DFC were approached with both open and endoscopic approaches.","title":"Anatomical Computerized Exploration to Excise Malignancies in Deep Facial Compartments: An Advanced Virtual Reality Protocol for a Tailored Surgical Approach"}
{"_id":"34a27116-c043-854f-1ccb-7af3895f10e8","text":"All flaps survived with no postoperative major complications, and the oral mucosa healed without problems, except in the pediatric male patient who required secondary suture. The process of osseous consolidation of the free flap to the mandible was observed on the radiographs at 40 days postoperatively when the intermaxillary fixation was withdrawn. Dental occlusion was satisfactory in all patients. No tumor relapses or sequelae occurred in the donor areas, and no patients experienced swallowing or speech alterations.","title":"Functional and Aesthetic Osseous Free Flap Mandible Reconstruction Using a Low-cost Method: Long-term Results"}
{"_id":"34a510fd-764c-35a2-b23e-5bcbf1bb725b","text":"Based on our results topical pharmacotherapy may be as effective as surgical excision in terms of tumor resolution in patients with OSSN. There was no difference in recurrence rate of OSSN between topical pharmacotherapy and surgical excision indicating similar long-term efficacy of both treatment options in OSSN. Our results underline the urgent need for future randomized studies in the field that is lacking at present.","title":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis"}
{"_id":"34a91b12-ebc3-9cb4-870b-dc3d6b46f757","text":"It is also important to recognize that more studies with larger number of patients and students are necessary to corroborate the results. Furthermore, what to teach and how to teach students to be as accurate as well trained persons needs more research.","title":"Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients"}
{"_id":"34ab91ce-7ba9-c552-53e7-b1368b38191e","text":"During the surgical procedure of case 1 we found a formation of hard consistency above and partly within the supraspinatus tendon at the same site the first calcific deposit was removed from; in case 2 we found similar macroscopic characteristics of the ossification, with a tendency to infiltrate the tendon. The histologic features showed in both cases areas of chondrometaplasia and ossification that were diagnosed as a particular form of OT, without supposing such a kind of evolution before the intraoperative assessment.","title":"Ossifying tendinitis of the rotator cuff after arthroscopic excision of calcium deposits: report of two cases and literature review"}
{"_id":"34ac0bce-106c-fb80-51f5-e3295998e788","text":"Axillary node dissection is combined with mastectomy or lumpectomy in invasive ductal cancer for staging and local control. The extent of the dissection is based on the level of nodes removed. A low axillary dissection removes level 1 nodes, and all three levels are dissected in a full clearance. This extensive surgery could be avoided if the status of the axilla could be predicted by sentinel node status.","title":"Recent advances in imaging breast cancer"}
{"_id":"34ad2f18-8e1b-cf58-c092-f09b991273e8","text":"All the most significant studies discussed here are summarized in Table 3.","title":"Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: The Current and Future Role of Radiation Therapy in the Era of Immunotherapy"}
{"_id":"34b492e6-5c38-d206-7ad7-49cf069ab738","text":"An HAI composite score was created by summing the increasing folds of changes in HAI titers among the 4 influenza strains included in the vaccine formulation in a given year (22). The score was considered as the major outcome assessing overall vaccine-elicited immune responses and was calculated as","title":"Longitudinal Assessment of Immune Responses to Repeated Annual Influenza Vaccination in a Human Cohort of Adults and Teenagers"}
{"_id":"34b5e7d9-dae4-e687-b71b-844bcdc12edf","text":"Psoriasis patients treated with MTX have a 2.8 times higher chance of developing NMSC compared to those who were not treated with MTX. Patients with psoriasis who will potentially be on systemic treatment for many years could have a substantially increased risk of skin cancer. Several factors help determine the correct systemic medication in patients with psoriasis; however, this information should be taken into consideration. Increased awareness of an increased risk of NMSC in patients with psoriasis treated with MTX can decrease morbidity and mortality.","title":"Psoriasis Patients Treated With Methotrexate Have an Increased Risk of Nonmelanoma Skin Cancer: A Systematic Review and Meta-Analysis"}
{"_id":"34baed45-e4e9-62a2-4fa3-6e2824fadeb3","text":"ALND denotes removal of the 1st and the 2nd levels of axillary nodes. The 3rd nodal level is removed only when clinically pathologic nodes are identified in the second level.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"34bcf9f4-1b7b-03b1-72e6-c3b02ffdc0f6","text":"In a profile view, the most striking feature is lower jaw which is far retrusive than the face above. The general tendency seems to be for the mandible to grow from the more retruded to a less retruded position and this is usually true regardless of the individual facial type. The maxilla tends to be positioned in a forward direction much more slowly than does the mandible, resulting in a decrease in the convexity of the facial profile. This differential growth in an anterior direction determines the final facial type at the completion of growth [6].","title":"Age Changes of Jaws and Soft Tissue Profile"}
{"_id":"34be49c1-02b3-eebf-bf0a-a118486c7f2e","text":"This study aimed to evaluate the use of attached surface probes for monitoring flap perfusion with the O2C analysis system in microvascular head and neck reconstruction for the detection of vascular compromise.","title":"Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity"}
{"_id":"34c1a520-79ca-4dd0-6a14-b6f30837df18","text":"The use of immediate NPWT following flap coverage provides reliable and effective management. We recommend setting the vacuum machine at 100 mmHg under intermittent negative pressure and using a U-shaped foam dressing for fasciocutaneous flap and complete foam dressing coverage for muscle flap. The U-shaped design for fasciocutaneous flap reconstruction allows for easy flap observation and monitoring, and eliminates fears of the vascular pedicle compression under negative pressure. This study was limited by its small sample size and lack of control group. A randomized controlled study with a larger sample size is needed to fully assess the effect of immediate application of NPWT after flap reconstruction.","title":"Immediate application of negative pressure wound therapy following lower extremity flap reconstruction in sixteen patients"}
{"_id":"34c9f2a3-5019-fff4-670f-b25ef6d93302","text":"Biopsies were taken from skin that was cleaned with 3 alcohol wipes, without betadine or chlorhexidine. The participants with lesions had a 3 mm punch biopsy of the lesion for histopathology and a 2 mm punch biopsy of the lesion for microbiology. They also had a 3 mm punch biopsy of contralateral normal skin for histopathology and a 2 mm punch biopsy of contralateral normal skin for microbiology. Normal volunteers had a 3 mm punch biopsy for histopathology and a 2 mm punch biopsy for microbiology.","title":"Toward an Objective Diagnostic Test for Bacterial Cellulitis"}
{"_id":"34cacb7a-77bd-45ec-070d-cc2ee6b58183","text":"This is the first study that has divided the abdominal region and the back into small dermal zones to assess the analgesic efficacy of the subcostal TAP block. Using this innovative method, we are able to accurately assess the blockade efficacy on different areas of the abdominal region and the back and also predict postoperative analgesic efficacy. Effective TAP was defined as either loss of cold temperature sensation or loss of pain sensation. The median effective dose for each zone, defined as effective analgesia, was obtained in 50% of patients. This method is very sensitive in detecting the analgesic efficacy of dermal zones and shows the precise block area of the abdominal region and the back. The time to the peak plasma concentration of levobupivacaine is 30 minutes after injection.[ The 6 assessment time points are divided into 3 time points before 30 minutes after injection, and 3 time points after 30 minutes. We were looking for an area located on the abdominal region and the back that results in effective analgesia both before and after the anesthetics reach peak plasma concentration so that we may utilize TAP method in the postoperative analgesia of abdominal\/back surgery more effectively.","title":"Analgesic efficacy of ultrasound-guided subcostal transversus abdominis plane block"}
{"_id":"34da495c-5861-d0bf-d14e-99ab8cddfcbf","text":"We studied the mandibular and parotid regions in the goat aiming at good orientation of the anatomy, specially the vascular anatomy. Our goal was identification of the best vascular axis to be used in creating the AV loop. The study included 6 fresh cadaveric adult male goat heads; 3 right and 3 left.","title":"Mandibular reconstruction using an axially vascularized tissue-engineered construct"}
{"_id":"34dc1333-44f8-f502-b14b-1fa63f4cb2f6","text":"The color change that is a graft complication is primarily in the form of pigmentation, which was observed in both groups.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"34eaf734-8b8d-6686-3791-805fde81b9d2","text":"In addition, while the present data suggest substantial promise, an expanded sample size in the context of a randomized controlled trial comparing hydrogen peroxide to other known topical treatments such as 5-fluorouracil will assist in elucidating the efficacy of this novel treatment. Multiple applications of HP33 could also be studied to determine whether a cumulative effect exists and further to understand the ideal number of applications to yield a clinically significant result. Finally, long-term follow up to monitor for recurrence of lesions treated with hydrogen peroxide will allow us to determine if the complete resolution of lesions that we have observed is sustained. Collectively, the above concerns will offer a fruitful area for continued research into the application of hydrogen peroxide in non-melanoma skin cancers.","title":"33% hydrogen peroxide as a Neoadjuvant treatment in the surgical excision of non-melanoma skin cancers: a case series"}
{"_id":"34ecb875-71cd-2fef-14f7-049d415db1cf","text":"Our findings emphasize the importance of VTE screening at cancer diagnosis.","title":"One-Year Incidences of Venous Thromboembolism, Bleeding, and Death in Patients With Lung Cancer (Cancer-VTE Subanalysis)"}
{"_id":"34ed1627-3457-7982-fccf-5b8411764025","text":"More recent reports on TXA reactivity have focused on retrospective cases. In the 5 cases reported by Imbesi et al. [5], many had systemic reactions following the parenteral or oral administration of TXA, but skin testing and blood tests to confirm allergic reactivity were not performed in 4 of the cases. In the fifth case skin prick and intradermal testing was performed with neat TXA. The application of Naranjo ADR probability scoring to these 5 cases suggests certain causality in 3 cases and probable causality in the other 2 cases. Our case had definite allergic reactivity with an elevated serum mast cell tryptase and intradermal testing positive at 1 in 500 dilutions.","title":"Tranexamic Acid: An Exceedingly Rare Cause of Anaphylaxis during Anaesthesia"}
{"_id":"34f63849-fd3b-7630-cbc4-eabdf186ea02","text":"None of the hospitals studied is following guidelines for perioperative prophylaxis. This explains the low adherence to appropriate surgical antibiotic prophylaxis in Palestine, with high rate of broad spectrum antibiotic use; long duration and inappropriate time of first dose.We recommend adopting guidelines for surgical prophylaxis in addition to the need to train all health care providers accordingly. Role of anesthesia technician in administering prophylactic antibiotic seems to be important and needs to be emphasized.","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"35052487-f093-e334-2e0a-206e63c7dee3","text":"Objective: This article serves to review latissimus dorsi myocutaneous flap as an option for breast reconstruction postmastectomy. Since the introduction of the latissimus dorsi myocutaneous flap in the late 1970s, its use has always been as a secondary technique, particularly after the development of the transverse rectus abdominus myocutaneous flap in the 1980s. Methods: A literature review of the history of latissimus dorsi myocutaneous flap utilized for breast reconstruction as well as a review of our institution's experience with latissimus dorsi myocutaneous flap and tissue expander placement was performed. Results: There remains a paucity of published studies investigating latissimus dorsi myocutaneous flap for breast reconstruction. Most studies have small numbers and do not utilize tissue expanders. More recently several small studies have been published that show acceptably low complication rates with aesthetically pleasing outcomes when latissimus dorsi myocutaneous flap is employed with a tissue expander. At our institution, we have employed latissimus dorsi myocutaneous flap with tissue expander placement for both delayed and immediate reconstruction with subsequent replacement with a permanent implant with a capsular contraction rate of 10.5%. Our data and others more recently published demonstrate very acceptable capsular contracture rates and aesthetic outcomes, particularly when an expander is utilized. Conclusion: The latissimus dorsi myocutaneous flap remains an excellent choice for breast reconstruction with a low risk of complications.","title":"Latissimus Dorsi Myocutaneous Flap for Breast Reconstruction: Bad Rap or Good Flap?"}
{"_id":"3507bfc3-b601-20c9-d2e1-6556b3252c2f","text":"As virtual planning gains more popularity, especially with virtual reality developing rapidly and PSI becoming a standard of care, printing 3D models will lose its current popularity, yet an interesting application gaining momentum is surgical guides. These allow for accurate surgical resections or osteotomies based on preoperative imaging. Using these guides with the intention of inserting PSI is essential as accuracy is of very high importance, especially when metal implants are used which are extremely difficult to amend during surgery.","title":"Printing the Future—Updates in 3D Printing for Surgical Applications"}
{"_id":"3511db3b-e19b-267b-fbb1-4d5b3411a949","text":"Ethical clearance was obtained from the Ethical Review Board of Bahir Dar University College of Medicine and Health Science. The supporting letter was written from the Amhara Public Health Institute of the West Gojjam Zone Health Bureau. The zonal health bureau also wrote a permission letter to the woreda administrative and health offices. Finally supporting letters were written from woreda health offices to selected Keble administrators. Written informed consent was obtained from each study participant before the interview after explaining the purpose of the study to the respondent. Confidentiality of the information was assured and the privacy of the respondent was maintained by removing personal identities from the questionnaire. Only individuals who had consented to participate were included in the study. No one coerced study participants in any way to participate. Lastly, the participants were also informed that they have the right to abstain from the study or to withdraw at any time.","title":"Four in every ten infants in Northwest Ethiopia exposed to sub-optimal breastfeeding practice"}
{"_id":"35130378-ff17-32fe-c571-e1bc13da350f","text":"Two nomograms for predicting BCSS and DFS demonstrate good performance and validity and can provide individualized estimates for oncological outcomes and survival that can enhance clinical evaluation, counseling, and management of expectations in patients with invasive disease seeking breast reconstruction.","title":"Novel nomograms for predicting survival for immediate breast reconstruction patients diagnosed with invasive breast cancer—a single-center 15-year experience"}
{"_id":"3513b056-0358-ff08-b85d-78c5c4772b7a","text":"Treatment of cutaneous squamous cell carcinoma require the physician to be familiar with the characteristics of high-risk tumors and patient groups. Surgical resection remains the treatment of choice and MMS is especially useful in high-risk patients or in functional and cosmetic areas. Aggressive tumors metastasizing to the neck requires consideration of multimodal therapy with surgery and radiation. Chemotherapy is potentially useful in cases of extracapsular extension or in residual neck disease. Close surveillance, especially within the first two years after treatment, is recommended. Continued research is necessary to assess the utility of nonsurgical modalities of treatment as well as the use of sentinel lymph node sampling. Anti-EGFR antibodies have shown effectiveness with other cancers of the head and neck and have potential in treating cSCC in the future.","title":"Cutaneous Squamous Cell Carcinoma of the Head and Neck"}
{"_id":"3516dc29-3e3a-5685-8476-ac30a0feb390","text":"Endothelial injury was determined from the diameter of the saphenous vein, which remained unchanged in the group supported with cyanoacrylate, whereas severe distention of the saphenous vein occurred in the control group.","title":"Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model"}
{"_id":"3517bcfd-9bf5-9c6f-d60b-d772df3e2254","text":"Our study demonstrates the successful development and clinical application of the first dedicated artificial intelligence and VR platform for the planning of pulmonary segmentectomy. This is the first study that shows an immersive virtual reality-based application for preoperative planning of segmentectomy to the best of our knowledge.","title":"Virtual reality and artificial intelligence for 3-dimensional planning of lung segmentectomies"}
{"_id":"35198d2a-8243-9b8d-a978-2d0ced38fa0b","text":"PAI may also be valuable in the imaging of perforator vessels in anterolateral thigh flaps, usually used in the reconstruction surgery of the head and neck. In investigating this hypothesis, Tsuge et al. performed in vivo imaging of anterolateral thigh perforators and their furcate architecture in the subcutaneous tissue of healthy subjects, using a PAI system with a hemispherical detector array that acquires data in a spiral pattern within a plane [103]. The microvessels in the subcutaneous layer, particularly those in slanting or horizontal alignment, were visualized up to a depth of 13 mm while the PAI system demonstrated a limitation in visualizing subfascial vessels. Mapping of the vasculature in 3D revealed the branching architecture of perforators, suggesting the potential of PAI to be used as an intraoperative imaging modality during thin anterolateral thigh flap surgery.","title":"A review of clinical photoacoustic imaging: Current and future trends"}
{"_id":"351ac7ff-9b51-8675-54b7-533f350733e7","text":"The present case vignette study was designed to identify which treatment options for single-tooth or multiple-tooth gap are preferred by specialists and the influence that a modification of descriptors in the case presentation has on this decision. It was thus shown that co-morbidities such as required endocarditis prophylaxis and bisphosphonate therapy tended to lead to the rejection of certain therapy techniques as well as to a general refusal of therapy. Interestingly, neither patient age nor fear of surgery influenced the surgeons' decision.","title":"How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons"}
{"_id":"351be22d-a882-d77d-19df-124192d8b91c","text":"In contrast to the above listed findings, some studies have not shown any correlation between ulcer site or location of DFO on amputation rate. However, one study only analyzed the overall amputation rate and did not differentiate between minor and major amputations.","title":"Foot Osteomyelitis Location and Rates of Primary or Secondary Major Amputations in Patients With Diabetes"}
{"_id":"352083a2-a48e-c554-5b16-c86656d172d2","text":"A systematic literature review on the empirical treatment of uncomplicated AHOM in children was carried out in order to evaluate the available data from the studies published between 2009 and March 2021.","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"3520f493-aeef-9aa1-2966-a670cfdd7776","text":"She underwent an uncomplicated delayed DIEP reconstruction and was subsequently transferred to the flap monitoring unit for ongoing assessment of the flap. During her inpatient stay, her DIEP flap was lightly scratched using the tip of a nail as part of flap monitoring to assess capillary refill time. The flap immediately demonstrated the classic red linear indurated streaks characteristic of dermatographia, this was then compared to a scratch on the other breast (see Figure 1).","title":"Deep inferior epigastric perforator flap demonstrating the triple response of Lewis phenomenon – A case report and insights into aetiology"}
{"_id":"352c0581-e1b9-50be-8e6f-6500a02dcb1b","text":"Do you have anything to add at the end of the interview?","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"352f6429-2114-597f-b238-6d4881a497bb","text":"The studies involving human participants were reviewed and approved by Yale Institutional Review Board. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.","title":"Predictive accuracy of elevated mitotic rate on lymph node positivity and recurrence in thin melanomas"}
{"_id":"35331b27-687d-7bab-823d-02d535c5c7e2","text":"The lack of equipment and expertise to apply the halo vest device for unstable cervical spine injuries is highlighted in this study. Training of all trauma surgeons in the application of the halo device would overcome this deficiency.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"35363e95-8501-95ea-c082-ca8231496113","text":"The ultimate translation of this knowledge of how Anti-tuberculosis drugs interact with HLA would be applicable to preclinical drug screening programs to improve the safety and cost effectiveness of drug design and development.","title":"Risk assessment studies on HLA association with drug induced hypersensitivity caused by anti tuberculosis drugs – an in silico approach"}
{"_id":"3539e893-c464-2438-f465-ca0a847a3c83","text":"The objective of this report is to describe a case of varicella complicated by acute osteomyelitis in order to raise awareness about a rare complication of a very frequent disease in pediatric age.","title":"RIB OSTEOMYELITIS: A RARE COMPLICATION OF VARICELLA OSTEOMIELITE DE ARCO COSTAL: UMA COMPLICAÇÃO RARA DE VARICELA"}
{"_id":"353b5845-f236-2803-9659-a604971aab46","text":"Understanding the intersection of technology and plastic surgery has been and will be essential to positioning plastic surgeons at the forefront of surgical innovation. This account of the current and future applications of artificial intelligence (AI) in reconstructive and aesthetic surgery introduces us to the subset of issues amenable to support from this technology. It equips plastic surgeons with the knowledge to navigate technical conversations with peers, trainees, patients, and technical partners for collaboration and to usher in a new era of technology in plastic surgery. From the mathematical basis of AI to its commercially viable applications, topics introduced herein constitute a framework for design and execution of quantitative studies that will better outcomes and benefit patients. Finally, adherence to the principles of quality data collection will leverage and amplify plastic surgeons’ creativity and undoubtedly drive the field forward.","title":"A Practical Approach to Artificial Intelligence in Plastic Surgery"}
{"_id":"353c68d9-ba3c-7450-7054-0fb03201c9fb","text":"All patients were seen 1 and 2 weeks after stage I, during TE fillings, and before the exchange to the permanent implants. They were also seen 1 and 2 weeks and 3 and 12 months after stage II. Adverse events from the time of preparation for anesthesia until 12 months postoperation were registered. Systemic complications that could not be said to be related to one of the breasts were not included in the analysis. The definitions of complications are given in Table 2.","title":"First‐year complications after immediate breast reconstruction with a biological and a synthetic mesh in the same patient: A randomized controlled study"}
{"_id":"353fd141-92b8-7e81-f8a3-4cd361d9971b","text":"Patients with severe PAD were more likely to experience intermittent claudication and underwent revascularization more often than patients with PCA. Severe PAD may be better recognized clinically by decreased ABI metrics, which may prompt referral for revascularization procedures. However, our observations suggest underrecognition of CLI among patients with PCA. Prior studies have shown that patients with PCA were more likely to have diabetes, to have chronic kidney disease, and to undergo limb amputation. Weinberg et al have shown by angiography that patients with PCA have high rates of PAD with predilection for the infrapopliteal arteries. In prior studies, for the subset of patients with PCA and CLI, there was angiographic evidence of extensive disease with long lesions and small vessel diameters. Accordingly, our hypothesis is that the mechanism for increased risk for amputation in patients with PCA was likely due to presence of a combination of the following factors: underrecognition of CLI, extensive atherosclerotic disease with long lesions, and small vessel diameter more likely to occur in patients with diabetes and chronic kidney disease.","title":"Association of Ankle-Brachial Indices With Limb Revascularization or Amputation in Patients With Peripheral Artery Disease Association of Ankle-Brachial Indices With Limb Revascularization or Amputation"}
{"_id":"354642ff-5fd3-a2f6-fdd5-2c3fca957f11","text":"Single accessory bands were found in Type IIa and IVa. The presence of an accessory band attached to the popliteal oblique ligament suggests that the PPM helps prevent hyperextension in the knee and excessive external rotation. In addition, the oblique popliteal ligament has an attachment located on semimembranosus muscle, suggesting that the PLT may affect the semimembranosus muscle.","title":"A proposal for a new morphological classification of the popliteus muscle tendon with potential clinical and biomechanical significance"}
{"_id":"35485a1e-34e6-f8bf-aff5-5d69d17d3983","text":"She was taken to the operating room and underwent resection of the primary site. A RFFF measuring 5 × 4 centimeters was designed overlying the radial artery with the distal aspect of the skin paddle placed approximately 3 cm proximal to the left flexor wrist crease. The flap was raised in standard fashion. During the flap elevation, significant fibrosis was encountered at the distal aspect of the pedicle as well as along the flexor retinaculum underlying the pedicle.","title":"The Allen’s test: revisiting the importance of bidirectional testing to determine candidacy and design of radial forearm free flap harvest in the era of trans radial endovascular access procedures"}
{"_id":"354928ef-ef87-dffc-5535-09c4807c9deb","text":"The analysis of the current literature coupled with data from the Herniamed Hernia Registry provides an insight into the complexity of abdominal wall surgery and where training of such operations stands to date. It can be reemphasized that the use of a tailored approach to inguinal and incisional hernia surgical repair perhaps is now making more tightened demands on the surgeon since a plethora of defined surgical techniques are now recognized, with each having their own learning curves. These techniques must consequently be firstly taught and then mastered. Based on the guidelines [2–14], implementation of such a tailored approach is a prerequisite now for low-risk and effective abdominal wall surgery.","title":"The reality of general surgery training and increased complexity of abdominal wall hernia surgery"}
{"_id":"355642d2-fc17-b40c-fa92-734699eea95f","text":"2 out of 8 patients received a postoperative laser treatment. One was a Nd:YAG laser to clear obstruction of the Hydrus by iris and the other was SLT for inadequate IOP control. It is unclear if the Nd:YAG laser procedure had a meaningful effect on the postoperative course and the SLT may have delayed the need for more incisional surgery. 2 out of 8 patients were frank failures and required additional incisional glaucoma surgery.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"3567d5f7-2831-eeb3-c16e-c9524a3f0ace","text":"A final limitation of our study is the fact that in the bypass surgeries performed, the use of the GSV was often not limited to its supragenual segment. In several cases the length of the bypass required resulted in the additional intraoperative dissection and use of the infragenual segment of the GSV. Intraoperatively, in three patients the diameter of the infragenual segment of the vein turned out to be too small to be used as a bypass conduit. In these cases the GSV of the contralateral lower leg, the small saphenous vein of the contralateral lower leg and a prosthetic graft were used respectively to complement the supragenual GSV in order to acquire a bypass conduit which is long enough. This observation does not hamper the validity or significance of our results but retrospectively highlights that an extension of our preoperative mapping to the infragenual GSV could have presented useful additional information for the surgeons.","title":"Mapping of Autogenous Saphenous Veins as an Imaging Adjunct to Peripheral MR Angiography in Patients with Peripheral Arterial Occlusive Disease and Peripheral Bypass Grafting: Prospective Comparison with Ultrasound and Intraoperative Findings"}
{"_id":"356b5add-0793-16c2-24be-2486b4e1cc85","text":"Our analysis covered 11 retrospective observational studies published between 2003 and 2018, including 3754 mastectomy scars. The malignancy recurrence rate was 0.19%, consistent with previous reports, with a number needed to treat of 144.93–188.68 patients. The timing of breast reconstruction postmastectomy averaged 19.9 months, without statistically significant association between reconstruction timing and recurrence rates. Postreconstruction follow-up periods ranged from 60 to 87 months. The postreconstruction adverse outcomes ratio was 2.21%.","title":"Histologic Examination of Mastectomy Scars during Breast Reconstruction: A Systematic Review"}
{"_id":"357e2ba3-766c-82f0-7834-1e47e21bf71e","text":"In case of suspected cerebral venous thrombosis on nonenhanced CT, the examination should be followed by CT venography or MR venography.","title":"Imaging of Cerebral Venous Thrombosis"}
{"_id":"35873257-1efa-cebd-9b54-f859c022eb32","text":"What is the clinical utility of temporal bone CT in pediatric acute infectious and traumatic pathologies?","title":"Utility of Temporal Bone Computed Tomography in Pediatric Emergency Medicine"}
{"_id":"35898760-0a12-dcd4-d6ee-e8112deaa28d","text":"The thoracoacromial axis provides a nearby recipient site as a potential option in the vessel depleted neck. We report six cases of free flap salvage in head and neck reconstruction in which the thoracoacromial axis was used as the recipient site for microvascular anastomosis, with the aim of assessing the safety and reliability of the thoracoacromial vessels in these challenging clinical situations.","title":"The thoracoacromial axis in salvage head and neck reconstructive surgery, a case series"}
{"_id":"358a7abf-6126-f12a-6981-1f386be1de50","text":"Cutaneous examination of the nails on his hands showed a midline ridge with a linear split of the right thumbnail extending from the distal lunula to the end of the nail plate (Figure 1). His other fingernails and toenails were without dystrophy. A roentgenogram of his right thumb did not reveal any abnormalities of the soft tissue or bony structures.","title":"Subungual Calcification and Nail Dystrophy: A Case of a Man With Subungual Calcinosis Cutis and an Associated Split Nail Plate"}
{"_id":"35961b86-ee1b-4baa-27ff-d4e633469e9e","text":"Although this is a small study, potentially viable skin grafts that meet microbiological criteria for transplant were obtained from all specimens. Therefore, we conclude that it is possible to obtain skin grafts from tissue from living donors obtained after skin reduction surgery.","title":"Methods in obtaining split-thickness skin grafts from skin reduction surgery specimens"}
{"_id":"359b94cd-ac12-16f5-56f5-edae05206bcc","text":"The aim of the study was to compare the effectiveness and safety of oral and intravenous glucocorticoids.","title":"Abstracts and short papers from the 5th Congress of the Polish Thyroid Association, Poznan, 3-5 September, 2015"}
{"_id":"359d64b3-e713-ceff-bce3-86ee01aec966","text":"Table 1 Factor loadings of the final 3-factor solution of job satisfaction","title":"Supervisor leadership in relation to resident job satisfaction"}
{"_id":"35a64877-32a9-0e94-bc16-0fb8a3f68c35","text":"According to symbolic interactionists, researchers need to understand the meanings given by the participants to experiences lived in a particular context in order to achieve a full understanding of the social process. This idea is based on three main premises. The first is that the humans act towards things on the basis of the meanings they ascribe to those things. The second is that the meaning of those things is derived from the social interaction that one has with one’s fellow. The third is that these meanings are handles in and modified through an interpretative process used by the person in dealing with the things they encounter [28].","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"35ae152c-a0d1-f030-38f6-bae25bea8f74","text":"The periodontium is an intricate mosaic of cells and proteins that are primarily responsible for the attachment of teeth. This intricate mosaic bears the brunt of microbial and environmental factors, causing the periodontium to elaborate cytokines that are destructive to the periodontal tissue, leading to an apical migration of the epithelial attachment and loss of periodontal soft and hard tissues.","title":"The Efficacy of Low-Level Laser Therapy Combined with Single Flap Periodontal Surgery in the Management of Intrabony Periodontal Defects: A Randomized Controlled Trial"}
{"_id":"35afa70f-1256-5c2b-0c52-452bc1f10107","text":"Special emphasis was made on patients with larger tumors. Twelve out of the 39 patients had a tumor with a depth of 5 mm or more. There was no significant difference in local control or in side effects between both groups observed.","title":"106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma"}
{"_id":"35b39016-cca0-535a-bf14-a8c3820a150b","text":"Some studies have reported that allergen immunotherapy is well tolerated and produces significant clinical response in most of patients with atopic dermatitis after 2 to 12 months, but in most of these studies there is no control group and the requirement of controller medications is not evaluated [11–14]. We observed that patients with immunotherapy presented an important reduction of symptoms and affected surface body area and used of topical immunosuppressors and oral steroids after 6 months of treatment. This clinical response in the active group was observed independently of patient sensitization status (mono- or polysensitized). These results indicate that immunotherapy is an effective treatment with important clinical repercussion in patients with atopic dermatitis and may reduce the risk of adverse effects from prolonged use of oral and topical immunosuppressors. Because this was an open study, in order to avoid placebo effect, we considered significant clinical response only in those patients that presented changes in subjective and objective scales greater than 30%, and reduction no less than 20% in topical steroids and tacrolimus. Even with these high cutoffs, we found that most of patients with immunotherapy had a very good symptom control and most of them did not require oral steroids in the last six months of followup.","title":"Clinical and Immunological Changes of Immunotherapy in Patients with Atopic Dermatitis: Randomized Controlled Trial"}
{"_id":"35c3c93b-8d4f-63b8-f307-15a47f3aabee","text":"The patient received very good intraoperative analgesia with high cardiovascular stability and very good respiratory function preservation.","title":"Thermal imaging evaluation of paravertebral block for mastectomy in high risk patient: case report"}
{"_id":"35ce5efa-2bea-9efb-b60a-3b26ff47b47e","text":"Sound waves are used in this approach. After transmitting sound pulses into the body, some of the sound waves get reflected back to the probe, while some travel on farther until they arrive another boundary and get reflected. The reflected waves are sensed by the probe and relayed to the machine. The changes in the property of sound waves are used in this technique. Sonography is used to assess skin lesion depth and margins before doing the biopsy and also used to classify adjacent lymph nodes whether it has become cancerous or not. This is added to a patient's protocol to clarify lesion depth, identify margins for excision, and determine lymph node. It has the ability to differentiate benign from malignant skin cancer. It is used to identify metastatic lymph nodes visually, which avoids unnecessary removal of lymph nodes. The main advantage is that it gives the accurate results of measuring skin cancer lesion thickness.","title":"Skin cancer detection using non-invasive techniques"}
{"_id":"35da0b4e-80a4-ec93-99c2-e0f925d1aa3f","text":"This retrospective cohort study has attempted to compare both the incidence of postoperative seroma formation and the duration of seroma drainage following inguinal lymphadenectomy for metastatic melanoma between two methods of wound drainage. Whilst there was no randomisation of the cohort between the two systems, the cohorts were well matched in terms of demographics, disease burden and extent of surgery. There was a significant bias towards younger patients for the 2-LNPWT system, which probably reflects the perceived ability of the patient by the treating clinician to manage the bulkier vacuum pump system and\/or the opportunity to return to the outpatient department to have the system changed by the clinic nurses.","title":"Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma"}
{"_id":"35dac14f-c322-b9e3-e855-5e8de04432d9","text":"The statistical evaluation of the data was based on the Student t test for comparing means.","title":"Cost-minimization modeling of venous thromboembolism diagnostics: performing limited compression ultrasound in primary health care reduces costs compared to referring patients to a hospital"}
{"_id":"35e4a53c-44d7-de4b-5635-830f29371139","text":"The patient noticed a small tumor in the anterior abdominal wall for the first time 6 months post partum. This tumor, initially neglected by the patient, was gradually increasing in size and associated with a sustained pressure in her cesarean scar inciting the woman for consulting 10 months after its discovery.","title":"Huge desmoid tumor of the anterior abdominal wall mimicking an intraabdominal mass in a postpartum woman: a case report"}
{"_id":"35eb4e9f-660a-c73e-05d1-7d557c3225eb","text":"In our experience the easier and faster-to-dissect lateral row perforators can be used preferentially as an adequate basis of the bipedicled DIEP flap as there is sufficient perfusion of Hartrampf zones IV or III across the flap midline. This is in contrast to the situation in a unipedicled DIEP free flap where the more centrally located medial row perforators are to be preferred. Usually the medial row perforators are larger than lateral row ones and single (medial row) perforator unilateral DIEP pedicles are commonplace. When based on the lateral row we prefer to use at least two perforators in unipedicled flaps to be assured of overall flap perfusion and especially venous drainage. However, if two DIEA pedicles are being used then one lateral row perforator on each side should be adequate.","title":"Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification"}
{"_id":"35ed86c3-7e35-c279-cb6a-b34dbeb57780","text":"The study was conducted according to the guidelines of the Ethical Committee for Medical Research and with approval of the National Data Inspectorate in Norway.","title":"The impact of change in a doctor's job position: a five-year cohort study of job satisfaction among Norwegian doctors"}
{"_id":"35ede3f1-67ed-a29f-3162-4be8f250bb5e","text":"Panoramic tomography for case vignette 2 before extraction of tooth 35. The bone height in region 35–37 is sufficient for placing implants","title":"How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons"}
{"_id":"35f30487-0510-7062-40fb-f1bc131568c6","text":"We believe that the ALA dosage and the wavelength of light are important factors that allowed us to show a robust antitumor effect of ALA-mPDT.","title":"Metronomic photodynamic therapy using an implantable LED device and orally administered 5-aminolevulinic acid"}
{"_id":"36005a02-bac5-aa35-bdc2-57d5cf316db6","text":"In a similar manner, used a hierarchical model for age prediction and investigated how features taken from a 3-D face image were affected by aging overcame a common age estimation research limitation of sparse and unbalanced datasets by developing a system for crowd density and age prediction. In the presence of imbalances in the face image dataset, the developed system could make use of the cumulative attribute approach to learning a regression model.","title":"A novel genetic-artificial neural network based age estimation system"}
{"_id":"36048894-35f9-fabd-47de-790084b95ee8","text":"Reconstruction of bony defects of the middle or distal tibia after bone tumor resection using pedicled vascularized fibula is a useful limb salvage procedure. The procedure can be performed relatively quickly and inexpensively and has a low rate of late complications. It leads to a good outcome regarding the union, hypertrophy, and function.","title":"Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection"}
{"_id":"3604c0bf-f2f8-c829-09d3-aa518d2e1eb0","text":"Recommendations for psychological support for mothers were coded in alignment with the WHO recommendations regardless of whether it was connected to separation from infants. Recommendations that infants separated from their mothers should be provided with a specific alternative caregiver were included as recommending psychological support for infants.","title":"First do no harm overlooked: Analysis of COVID-19 clinical guidance for maternal and newborn care from 101 countries shows breastfeeding widely undermined"}
{"_id":"360582f8-96a0-75ab-3853-ca9532e2655a","text":"Our study contribute to a better anatomical knowledge of the TMJ of the dromedary camel by means of CT and MRI and is a useful initial reference for clinical studies. CT is an excellent method for the detailed assessment of the bony structures. MRI is a valid imaging modality for the evaluation of the soft tissues. The FSE T1-weighted sequence should be the baseline to identify the anatomy, and FSE T2-weighted sequence will better enhance the study of the articular surfaces and articular disc. The after processing of CT and MR images allowed us to appreciate different bone structures and soft tissues of the TMJ, assisting in the interpretation of the images.","title":"Computed Tomography and Magnetic Resonance Imaging Features of the Temporomandibular Joint in Two Normal Camels"}
{"_id":"360fc1d1-73dc-19d6-65f4-7061d62130a6","text":"Muellner et al16 measured rSO2 during arterial occlusions with an ischemia model of the brachioradialis muscle that used the INVOS 3100 and tourniquets in healthy adults. This study reported that the rSO2 value rapidly dropped from 75 to 25 within 10 minutes of the start of ischemia and, 1 minute after ischemia was corrected, surpassed the preischemia value by rising to 80, after which the value returned to 75. This is believed to be due to the fact that the rSO2 value in the INVOS reflects arterial inflow. Specifically, when the rSO2 value that dropped because of ischemia rose rapidly after the ischemia was corrected, large amounts of arterial blood continued to flow into the tissue over a short period of time immediately following the release. This resulted in a higher value than the value achieved when the preischemia value was temporarily reached. Ultimately, once the inflow returned to preischemic levels, the rSO2 value returned to equilibrium.","title":"A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy Takasu et al"}
{"_id":"36115327-9e48-96bc-9fef-ef549c3f0865","text":"Data on specific IgE sensitization prevalence in children with allergy-like symptoms seen in the primary care setting are rare. Early diagnosis of allergic diseases is important to prevent clinical manifestations, exacerbations or expansion of allergic diseases to other organ systems. The present study aims to assess the usefulness of early serological diagnosis in children with common allergic symptoms.","title":"Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation"}
{"_id":"361a5b90-d468-8efd-5f10-1dc2f63d9d8f","text":"In a cohort of carefully selected patients with STS and sciatic nerve involvement, the extent of sciatic nerve resection had no significant impact on disease recurrence or survival. Precise classification of neural involvement may therefore be useful in selecting the appropriate degree of nerve resection, without compromising oncological outcome or unnecessarily sacrificing leg function.","title":"Limb-Salvage Surgery of Soft Tissue Sarcoma with Sciatic Nerve Involvement"}
{"_id":"361b6d03-889f-02ea-3d25-e45d31cfa10b","text":"CMNI Playboy reduced the odds of reporting physical MBA victimization and similar explanations to those outlined earlier in relation to perpetration may apply, namely those for whom a pre-occupation with meeting and or interacting with potential sexual partners exists, there may be a lack of interest in engaging in MBA given any such involvement can be counter-productive to the primary purpose for attending licensed venues. In essence, those committed to finding a prospective sexual partner may devote little time and attention to engaging with other males, lessening the likelihood of involvement in MBA. Further, it is possible that this particular subscale represents, in part, a participant’s relationship status in that those endorsing a desire for multiple sexual partners may be more likely to be single, which as a consequence lessens the likelihood those who are heterosexual will encounter situations where they feel compelled to defend a female partner from the unwanted and or provocative approaches of other males in public drinking contexts with such behaviours a common source of angst and or conflict. The absence of or reduced exposure to such scenarios among those who are single and who, by extension may be more likely to endorse a desire to be a playboy or promiscuous, may significantly protect them against many of the situations which so often inspire episodes of MBA victimization.","title":"Male Barroom Aggression among Members of the Australian Construction Industry: Associations with Heavy Episodic Drinking, Trait Variables and Masculinity Factors"}
{"_id":"3622a5ef-7e4d-4b48-e97b-1236680955ea","text":"It is important to observe that patients who have lower limb trophic ulcers find it hard to remain standing up during ultrasonographic examination and find it more comfortable and secure in horizontal decubitus. Choosing this position for the US examination also enables comparison with the CT method, which is performed in a horizontal supine position. During the US examination, it is necessary to apply a minimum of pressure to the skin, which ensures correct coupling between the transducer and the gel-coated skin, but could contribute to reducing the measurements taken with the method.","title":"Correlations between ultrasound, tomographic, and intraoperative measurements of the great saphenous vein used as an arterial graft"}
{"_id":"36236c32-0bb1-0df2-8010-89da0dd004de","text":"Those with mastectomy who received radiotherapy had earlier recurrence than those who only had mastectomy without radiotherapy; this is attributable to the more advanced stages of patient who receive concomitant mastectomy and radiotherapy and is expected.","title":"Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?"}
{"_id":"362b632b-5945-7d6e-9d0b-c59322f692fa","text":"Although ALND provides additional prognostic information such as the number of involved lymph nodes and may decrease the rate of regional recurrence, its impact on survival seems negligible coupled with an increased morbidity as compared to SLNB.[","title":"Positive non-sentinel axillary lymph nodes in breast cancer with 1-2 sentinel lymph node metastases"}
{"_id":"362caf93-8944-1e86-5d2a-f0e89e415809","text":"The distribution of histological subtypes in our patient cohort was different from general population findings. As a whole, DTC that usually absorb RAI shares the biggest contribution , while in our cohort only near a third of patients had 131I absorbing DTC. The use of EBRT for treatment of differentiated thyroid carcinomas has declined overtime since overwhelming evidence for usefulness of RAI therapy and more comprehensive surgeries. Nevertheless, sometimes EBRT is the only available option to help patients with DTC for better quality of life and relieve of pain or airway obstruction with the primary or metastatic disease. A minority of patients with unresectable primary or recurrent disease in the neck would also benefit from addition of EBRT to RAI and surgery. Aside from DTC, the main indication for EBRT in thyroid cancers is for eliminating residual disease in the neck following resection of ATC or MTC that have no other effective therapy. Anaplastic thyroid carcinoma does not take up 131I, hence, EBRT and maximal safe surgical resection are the treatment modality of choice. For the MTC, also there is not any available therapy other than surgical resection and due to the high probability of residual disease in the bed of surgery and neck lymph nodes, EBRT seems to be effective. These reasons explain why the distribution of histological subtypes are different in our cohort than general population.","title":"The role of external beam radiation therapy in the management of thyroid carcinomas: A retrospective study in Iran Cancer Institute"}
{"_id":"363d2f8c-8353-6878-3842-90d30c5867c8","text":"The patient experienced deep venous thrombosis in the right common iliac vein during her postoperative course. That was due to venous congestion induced by a stenosis of the repaired common iliac vein and was treated with heparin followed by warfarin. She received 600 mg\/day medroxyprogesterone acetate (MPA) for 15 months as a postoperative adjuvant therapy and showed no evidence of disease during a follow-up period of 2 years and 3 months.","title":"Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach"}
{"_id":"363d7e2c-22cd-b460-d953-67d1f44e455f","text":"The interest in vitiligo research has recently focused on skin stem cells, more particularly on stem cells residing in the hair follicle due to their potential in therapies aimed at improving pigmentation. The poor progress made by recent research on the treatment of vitiligo is mainly due to a still poor understanding of the mechanisms underlying the activation of melanocyte stem cells and their proliferation and migration, aimed at repopulating the surrounding basal epidermis. Closely linked to this line of research, there is the study of the most suitable drug delivery methods for the treatment of this cellular population [18].","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"364747a2-23ab-49fb-d9fb-ff565fb6fb61","text":"These different degrees of clinical presentation call into question whether it is time to rethink traditional recommendations and start treating the patient on an individualized basis. In fact, there is growing evidence of good outcomes in patients with primary hematogenous OAI treated with a minimally invasive approach consisting of stricter surgical indications and short courses or no intravenous therapy.","title":"Minimally invasive management of pediatric osteoarticular infections"}
{"_id":"364c9298-60c5-ae21-af72-5746adbe0154","text":"Within the limited service provided at present, however, it appears that care is being effectively triaged. The vast majority of women who were experiencing problems with breastfeeding were seen by a breastfeeding counselor in the hospital, both in the intensive care unit and the general ward. Women experiencing difficulties were also significantly more likely to receive outpatient help in an MCHC. The breastfeeding difficulties experienced by women in this study were similar to those reported in a previous study on breastfeeding in Israel [11]. The majority of problems experienced by these women are amenable to intervention, which stresses the need for providing early support. It is also important to provide universal support to identify situations where the mother does not perceive a problem until a point where harder to remedy.","title":"Breastfeeding challenges and support in a high initiation population"}
{"_id":"364d3a74-32ad-dad7-a550-d6b7f38252fd","text":"The pedicle was placed on right frontal bone and dura, and the muscle chimeric component was used to fill the nasocranial communication by means of bone and dural anchoring stiches. The monitor skin island was located at the right emicoronal suture, allowing a tension-free scalp closure and reducing compression on the flap pedicle. Between superficial temporal vessels and vessels of the flap pedicle, we found only a minor discrepancy of caliber, which was not a significant hindrance for micro-anastomosis. The skin paddle size was 4–8 cm, and the pedicle length after the muscle branch to the rectus femoris muscle was 13 cm. The donor site was then closed primarily without undermining. The reconstruction with the chimeric ALT perforator flap with skin paddle and muscle component allowed the separation of the anterior skull base and the nasal fossa with muscle, using the skin paddle as an external on sight area for monitoring the vitality of the graft.","title":"Chimeric Anterolateral Thigh Flap in Skull Base Reconstruction: A Case-Based Update and Literature Review"}
{"_id":"364fb82c-6240-1bcb-6ef9-696f073e0a5a","text":"Pinching of the skin to assess the tension of closure of the flap after harvesting is done to identify the maximum width of the design. The flap dissection can be started laterally or medially. We preferred to start the incision superiorly and elevate from the distal superior aspect toward the flaps’ medial aspect. The incision was extended downwards to the deep fascia, where the dissection started medially till the level of the ASIS, the interval between the tensor fascia lata and the Sartorius muscle. Structures visualized during the dissection included the perforating vessels, which were ligated and the lateral femoral cutaneous nerve of the thigh as it leaves the deep fascia to enter the subcutaneous tissue. The nerve may require transection depending in its course. After identifying the lateral aspect of sartorius, the muscular fascia is incised along the lateral aspect, and the flap elevation plane is now conducted deep to the muscular fascia. As the dissection continued medially, the superficial circumflex iliac vessels became visible in the plane above the Sartorius heading into the muscular fascia. Skin incisions extended inferiorly and medially to relieve tension in order to avoid transecting the pedicle. All muscular branches were ligated to reduce blood loss. The fascial plane was incised around the pedicle at the medial aspect of the sartorius muscle, and the vessels (artery and vein) were dissected from their origin. The flap was mobilized on the vascular pedicle. The artery may arise either from the femoral vessel\/ trunk\/ or parent vessel supplying the SCIA and DCIA or may arise from the common trunk that becomes the SIEA (superficial inferior epigastric artery). The vein arises from either the saphenous vein or a branch of the superficial femoral vein. The donor area is closed after slight undermining superficial to the deep fascia. In cases of excessive tension, a layered closure over the suction drains and slight hip flexion were required. The hip can be extended over the course of a few days.","title":"Versatility of unilateral propeller groin flap for coverage of large scrotal defects and its impact on testicular function"}
{"_id":"3653d202-686a-ff4f-9be4-e834c8b790c5","text":"VolR is a type of data visualization technique which creates a three-dimensional representation of data. It uses the data from all voxels in the 3D volume to create a 3D image that provides a more accurate representation of the underlying structures. VolR images are created by computing the intensity of light passing through the volume at each point, and can be used to create images that are more realistic and show the relationships between different structures. CT and MRI data are frequently visualized with Volume Rendering in addition to other reconstructions and slices. This technique can also be applied to tomosynthesis data","title":"Exploring the Potential of Three-Dimensional Imaging, Printing, and Modeling in Pediatric Surgical Oncology: A New Era of Precision Surgery"}
{"_id":"3655af98-9da3-cf9a-4b79-039326daed34","text":"Free vascularized fibula flaps are widely used for many reconstructive scenarios, including physeal transfer first described by Innocenti et al. They are beneficial compared with other vascularized grafts because of the presence of an articular surface for creation of a neoarticular joint and a tubular structure for reconstruction of long bone defects. In the proximal humerus, survival of the physis and creation of a neoglenofibular joint have been successful, but a high rate of graft fracture is noted, usually within the first year before enough graft hypertrophy has occurred because of the diameter mismatch between the fibula and humerus. One study looked at 11 proximal humerus physeal transfers and reported a 66% graft fracture rate within the first year.","title":"Composite-Free Vascularized Fibular Epiphyseal Flap and Proximal Humeral Allograft for Proximal Humerus Reconstruction in a Pediatric Patient"}
{"_id":"36570d2e-1c1c-dc42-5fa9-9d8591e401ec","text":"Suzuki described the lesions as being characteristically along the boundary zones of the major vascular territories and suggested a link between the hypoxic brain condition in FES and the mechanical aggregation of fat globules and blockage of entire brain capillaries. These characteristic findings can be useful for differentiating FES from primary intra-axial brain injury in patients with polytrauma.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"365cdac4-9560-89fe-cd84-93fc077a7af8","text":"In daily dental practice it is common to treat the patients being intervened with oral anticoagulants in order to prevent or treat thromboses. Patients receiving oral anticoagulants have a greater risk of haemorrhage during odontological treatments.","title":"Implications of apixaban for dental treatments"}
{"_id":"365d904e-8089-039f-075d-0e378eda55e6","text":"The tumor weights in all groups as well as the inhibition rates are plotted as bar graphs and red full lines in Figure 5. The similar inhibition trends shown in CaEs-17 xenografts were also seen in Hepatoma HepG2 xenograft experiments.","title":"Preclinical Study of Antineoplastic Sinoporphyrin Sodium-PDT via In Vitro and In Vivo Models"}
{"_id":"3660c9ca-d15b-a7c6-2cd2-983fd8422b4b","text":"In order to further understand the risk factors and incidence of VTE, the objective of this study was to examine the incidence and risk factors for VTE in patients undergoing EAPS.","title":"Venous Thromboembolism following Elective Aesthetic Plastic Surgery: A Longitudinal Prospective Study in 1254 Patients"}
{"_id":"366249df-48d0-0390-8676-4ec1c3de0cad","text":"CT and MRI both performed with the patient supine may underestimate the extent of venous dilatation that is demonstrated by ultrasound and venography where provocation with the Valsalva manoeuvre can be employed.","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"3663bca9-9351-0f20-ee1f-eed3bfcb9dd6","text":"Secondary outcome consists of usability and subjective task load using SUS and the NASA TLX. A system is less likely to be used, if it is complicated or the controls are hard to remember or challenging to conduct. Thus these scores will show if implementation into daily clinical use is feasible for the different demonstration modes. The described systems are being tested in order to simplify liver resection planning and teaching, thus these measures are critical to determine usability and likelihood of daily use.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"36659dc5-c436-c61b-b7a9-7a4ae3576955","text":"The trial will be stopped in the event of five grade 3 reactions or a single grade 4 reaction. In addition the trial may be prematurely discontinued by the Sponsor, Chief Investigator or Regulatory Authority on the basis of new safety information or for other reasons given by the Data Monitoring & Ethics Committee\/Trial Steering Committee regulatory authority or ethics committee. The trial may also be prematurely discontinued due to lack of recruitment or upon advice from a Trial Steering Committee who will advise on whether to continue or discontinue the study and make a recommendation to the sponsor. If the study is prematurely discontinued, participants will be informed and no further participant data will be collected.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"366bca38-f773-bde0-2596-b1ac7e0edc65","text":"Bone transport technique is an established treatment to deal with segmental bone defects due to infection. Hybrid fixator system combining traditional internal and external fixators may be associated with a greater risk of infection recurrence; antibiotic-coated internal implants maybe a promising choice to circumvent this well-known issue. Additionally, we have demonstrated that number of previous operations as well as duration of external fixation are useful prognostic indicators for predicting outcomes. To achieve successful healing and functional results, meticulous surgical planning is necessary in order to avoid additional surgeries and long external fixation times.","title":"Infection-free rates and Sequelae predict factors in bone transportation for infected tibia: a systematic review and meta-analysis"}
{"_id":"366f981f-57d8-2e79-1c6a-c57ada31b3f9","text":"Minimally invasive techniques have been used to treat both benign and malignant breast lesions as an alternative to surgical excision but reduction in complications, improve cosmesis and reduced hospital stay, still require to be demonstrated. However in order to improve complete histopathological ablation rates and make it possible to set up comparative trials to determine the most promising technique, the existing techniques require optimization, improved anaesthesia, better imaging and better immobilization.","title":"Ablative techniques for the treatment of benign and malignant breast tumours"}
{"_id":"36788660-e76c-5024-da1a-d789d46a2670","text":"Novel candidate vaccines would be expected to have a high safety profile including reduced immediate side effects due to a decrease in IgE-mediated degranulation of effector cells and a reduced capability of the TCE to activate T cells, which could result in mild or absent LPR. We hypothesized that the conservation of a native like tertiary structure with concomitant reduction of the IgE-binding capacity would keep the ability to induce strong protective allergen-specific IgG immune responses, which in turn would be able to compete with IgE for epitope binding on the native allergen. The use of freshly prepared serum pools were used to reduce the risk of epitope biased selection.","title":"In Vitro Evolution of Allergy Vaccine Candidates, with Maintained Structure, but Reduced B Cell and T Cell Activation Capacity"}
{"_id":"367afcaf-9be1-b616-d4d6-b1076465a4e6","text":"Outcome differences can also be attributed to the cortical and subcortical reorganization that occurs in above knee amputees and rotationplasty patients. Absence of afferent information following amputation results in reorganization of contralateral sensorimotor regions of the brain. Lower limb amputees have decreased functional connectivity between the contralateral sensorimotor cortex and sub cortical motor regions involved in coordinated controlled movement of the lower limb. Previous studies have also mentioned modifications in the cerebellar gray area, reduction in thalamic volume and a disrupted basal ganglia-thalamus-cortex pathway in these patients.","title":"Modified Rotationplasty as a Composite Free Flap for Femur and Thigh Reconstruction"}
{"_id":"367d7f57-e959-6341-0ec4-db7e3abc15a8","text":"The highest grades of dimensional modification appear to happen to the rectus muscle in ipsilateral breast reconstruction, but a limited cohort study does not allow a correlation with specific disadvantages in terms of pain and motor impairment.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"36843ce3-3a98-c4d7-a749-35f4c8ebec52","text":"Two focus groups, 1 on each site with up to 12 staff, will be undertaken with staff involved in the management of the trial or the management of patients in the trial. This will include surgeons, emergency department staff, theatre staff, ward staff and research staff. The participants will consider the factors that facilitate and inhibit the daily process of running the trial. This will include optimal timing and method to approach the patient with the participant information. Focus groups are a good way to access a range of views on a topic and provide opportunities for debate and challenge within the group.20 Managing the dynamics of a group is important to ensure all participants have a chance to share their views and strong views are contained. Attention will be paid to this through the use of basic ground rules and good facilitation of the group. The focus group discussions will take place in a quiet room away from interruptions. The interviews and focus groups’ meetings will be digitally recorded and transcribed verbatim. Analysis will be line-by-line, identifying codes, building categories and themes by drawing on the work of Miles and Huberman.21 NVivo9, a software package for qualitative data, will be used to help with data management. The intention of the patient interviews is to understand how patients make sense of their treatment and to specifically address any issues related to their consent to participate. The focus groups will develop a greater understanding of the factors that facilitate and inhibit the process of the trial. The qualitative data will be used to provide indepth understanding of the process to augment the quantitative data.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"368509b3-6076-9864-d654-8d1253553b4d","text":"Patients will be included for the trial if they meet all of the following criteria:","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"36973262-97a0-c99c-ce01-b9b411ae2c21","text":"Unstable pelvic fractures that require surgical stabilisation are typically composed of anterior and posterior segments. Surgical management of pelvic fractures aims to restore bony anatomy and subsequently maintain this position until bony union or ligamentous stability. Anterior fixation is often achieved with open reduction and fixation using plates and screws, whilst the most common modality of fixation for the posterior injury remains ilio-sacral screws (ISS). Some fracture patterns and associated soft tissue injuries require the usage of external fixators for stabilising the anterior pelvic injury in conjunction with internal stabilisation posteriorly. Posterior fractures with significant comminution or displacement that cannot be reduced closed, may require open reduction prior to internal fixation.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"369e4011-ffb3-ea9a-d956-cb44c118487c","text":"The best surgical approach for long-term outcomes is controversial and is dependent on the patient’s disease severity and location of the lesions. A recent systematic review and meta-analysis assessed for recurrence rates with varying methods of surgical management. The lowest rates of recurrence occurred following wide excision therapy when compared to local excision and deroofing procedures. This study also indicated that recurrence rates were lowest with skin grafts and skin flaps compared to primary closure, although this was limited by retrospective analysis and lack of randomization of closures . Wide excision followed by secondary intention healing was also shown to be functional and aesthetically acceptable to patients . Bias may exist in the discrepancy between recurrence rates and type of closure owing to the fact that primary closure is possible only with smaller wound sizes compared to larger excisions that simply cannot be closed by primary intention. Although this has not been formally assessed, the size of the wound may play a role.","title":"Hidradenitis suppurativa: an update on connecting the tracts [version 1; referees: 3 approved]"}
{"_id":"36a18e9c-6e65-1295-760e-003f6ebd3ab4","text":"Our findings contribute to available literature in setting up the recommended standards for melanoma centers, thus improving the quality of surgery offered to patients. Such quality indicators can be used by other hospitals to direct quality improvement efforts.","title":"The surgical treatment of non-metastatic melanoma in a Clinical National Melanoma Registry Study Group (CNMR): a retrospective cohort quality improvement study to reduce the morbidity rates"}
{"_id":"36a6a659-aa9f-fb17-f232-a60395c18cfe","text":"The diagnosis must be established after a full thickness biopsy of the suspicious lesion, with the exception of small lesions suitable for excisional biopsy. Incisional biopsy should include a representative sample from the border of the lesion to help the pathologist in differentiating a primary mucosal melanoma from mucosal melanoma metastasis. Clinical research in mucosal melanoma is necessary, because less than 20% of patients are alive five years from the date of initial diagnosis. The general therapeutic consensus is to attempt a complete surgical excision of the primary site with clear margins followed by postoperative radiation therapy for microscopic or macroscopic residual disease or nodal involvement.","title":"Surgery of Primary Melanomas"}
{"_id":"36c1790d-f368-899c-e60f-c85cf440088f","text":"Dental restoration with osseointegrated implants is performed three to six months after fibula free flap reconstruction. In patients with significant subcutaneous adipose tissue in their fibula free flap skin paddle, thinning of the fat is usually performed simultaneous with placement of the implants. Partial or total hardware removal is sometimes necessary in order to place the osseointegrated dental implants.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"36c563e5-e7e8-c3c3-bbcf-e6e83570eae7","text":"Harvested fat was repeatedly washed using antibiotic based saline to get rid of blood and tumescent fluid, then transported into centrifuge tubes where one spin for one minute and with 3000 RBM was done. The pure fat was transferred into multiple syringes ready to be injected.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"36c878b8-f72a-c6a7-678d-58719419710a","text":"Discussion: Doppler ultrasound can be useful in the differentiation of high vs low flow priapism. Patients with low-flow priapism can have thrombosis of the corpora cavernosa or corpus spongiosum and decreased or absent of color flow or spectral Doppler in the cavernosal arteries with increased resistance Index if flow is present. Flow in the superficial dorsal vein and increase resistance index in the dorsal artery may be present. Low flow priapism represents 95% of the cases. Patients with high flow priapism can have normal or elevated arterial Doppler velocities. Flow suggesting arteriovenous flow fistula may be present. Usually occurs after a local trauma.","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"36d22492-fd05-e486-1424-98ac03f78c68","text":"As a rule, they adopted a distance of 15 mm from the bone invasion limit and a distance of 10 mm from the soft tissue involvement.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"36e8aa30-d3d2-acfc-f99e-b2cd71b086b3","text":"Patients were evaluated at baseline and at the end of the application of the topical treatment. Lesions were counted and photographed at baseline and at every clinical examination.","title":"Non-Invasive Analysis of Actinic Keratosis before and after Topical Treatment Using a Cold Stimulation and Near-Infrared Spectroscopy"}
{"_id":"36ea392b-b3c6-9863-574c-5f6ba2d4a340","text":"In this study, it was aimed to investigate the prevalence of type 1 hypersensitivity reaction under tuberculosis treatment and the management of hypersensitivity.","title":"Management of type 1 immediate hypersensitivity reactions to antituberculosis drug: succesful desensitization"}
{"_id":"36fa4fc7-8748-576a-e2b0-aa6ebd6eeea4","text":"Osteomyelitis is an infectious process with a spectrum of clinical demonstrations from a localized small sclerosing lesion to a generalized suppurative destructive one. It represents the interactions between host immunity and microbial virulence. With a fully competent immune defense, intact osseous tissue is able to restrict the infectious pathogens or kill them. Remodeling capacity of the involved bone has an important role in reactive bone formation following the inflammatory processes. These reactive calcifications may show snowflake, cotton-wool or even sun ray appearances. It is a critical rule that traumatic, infectious and benign reactive lesions are more common than malignant pathoses in the oral cavity. Osteomyelitis may share some radiographic features with primary or metastatic malignancies of the jaw. In the presented case, we would put the localized sclerosing osteomyelitis in top ranking of our differential diagnosis if we remembered that chronic traumatic conditions may induce osteomyelitis by causing microinfarctions. The patient suffered from an untreated convulsive disease. Panoramic view of his jaws signified a sclerotic thickening of cortical bone around the mandibular premolars and some hyperostotic reactions in the lower left quadrant. These findings indicate a chronic occurrence of heavy occlusal trauma in a young bone with a high remodeling capacity.","title":"A Localized Sclerosing Osteomyelitis at the Periapex of a Vital Tooth: Report of a Misdiagnosis"}
{"_id":"37031e6f-8532-f5d5-751a-9c4fc285b815","text":"Skin punch biopsy became an attractive tool for confirming the diagnosis of amyloidosis. Deposition of amyloid in skin correlates with worsening small nerve fiber pathology and severity of neuropathy symptoms and staging. , The sensitivity of a punch skin biopsy for detecting amyloid in individuals with ATTRv was reported to be high when collected from both the ankle region and thigh, and the highest deposition rate was reported at the ankle region. Accordingly, two skin biopsies from the ankle region may provide the best sensitivity for detecting amyloid.","title":"Ser77Tyr transthyretin amyloidosis in Israel: Initial manifestations and diagnostic features A. Dori et al."}
{"_id":"37096e13-cf67-fd09-d6c8-cb4422be0e5f","text":"Many of the interviewees explained that their career choices had changed direction following the fellowship. For some this meant applying for roles that were more senior than they would have prior to the fellowship, for some it involved applying for additional roles with a leadership or management aspect and for some it involved completely changing the course of their career. Many of them described it as a useful talking point for interviews and for their CV that set them apart from their peers:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"37117bf8-7fbf-1b57-c00b-a9a739e6c9a4","text":"In this series, 19 fractures achieved bony union within 21 weeks and 2 cases showed delayed healing at 10 months after surgery, no angular malalignment or malrotation was identified. This technique is to preserve the blood supply and soft tissues at the fracture site while providing adequate stabilization of the fracture. It included 2 cases with 3 nails fixation of tibia and 15 cases with retrograde fixation of the fibula. Other complications were 2 cases of overgrowth (10 mm, 11 mm) and 1 case developed restricted dorsal extension at the metatarsophalangeal joint of the hallux, 1 study[ reported 5 patients developed clawing of the hallux following a fracture of the tibia, and relieved by performing a tenolysis proximal to the medial malleolus, the operative findings demonstrated that the etiology was associated with a localized subclinical compartment syndrome. Our patient refused to accept the further treatment because he did not have any limitation during physical activity.","title":"Elastic stable intramedullary nailing for severely displaced distal tibial fractures in children"}
{"_id":"3716ae5d-d1e3-c63a-2df4-a2e1dc32ea63","text":"We propose that using risk stratification algorithms is a useful and effective method to prevent VTE. A particularly difficult scenario is the treatment of very high-risk patients taking warfarin because of previous DVTs or PEs. For these patients, our hospital policy states that warfarin be stopped and an IVC filter be fitted 1 week before surgery. Our standard postoperative regimen of 5000 units of subcutaneous dalteparin is then prescribed with removal of the filter a week later when the patient is mobile. When VTE prophylaxis is being considered prior to surgery, clinicians should follow the local hospital guidelines in conjunction and agreement with the surgical team's experience and evidence-based medicine.29 The American College of Chest Physicians2 published guidelines on the prevention of VTE for various surgical specialties, but it was not specifically applicable for plastic surgery patients. Therefore, Davison et al30 in 2004 modified the Caprini model to make the VTE prophylaxis more suitable to plastic surgery patients.","title":"Risk of Thromboembolism Following Body-Contouring Surgery After Massive Weight Loss Griffin et al"}
{"_id":"371cc116-a735-d1fc-5053-8411dbfbf481","text":"Per operative complications are not related to the time needed for the arterial anastomosis, but a significant increase in the rate of complications was noticed to be due to a prolonged time of venous anastomosis.","title":"Prediction factors for breast reconstruction postoperative complications"}
{"_id":"37398861-72ec-8ee5-975b-c0f953ca7e40","text":"Short-term donor site morbidity cannot be avoided in reconstructive surgery when using free flaps. Whenever switching to a free flap with less donor site morbidity than the RFFF is not possible, we conclude, on the basis of the reviewed literature, that small RFFF donor defects should be closed directly or with straightforward local advancement flaps if possible. The authors themselves mostly trust in a safe and reliable way of covering the RFFF donor site with autologous STSG after a classic subfascial flap raising technique. We consider it worth repeating that the paratenon of the exposed muscles should be left untouched to achieve an accurate wound bed and thus to avoid mobilizing and oversewing the surrounding muscle bellies.","title":"Reduction of Donor Site Morbidity of Free Radial Forearm Flaps: What Level of Evidence Is Available?"}
{"_id":"3739e975-3b92-6920-37f6-1b863fd75252","text":"Inguinal lymphadenectomy is the treatment of choice for patients with penile cancer and inguinal lymph node metastases. We describe the performance of the robotic bilateral inguinal lymphadenectomy technique without repositioning the robot in a patient with penile carcinoma and high risk for nodal metastases and no palpable lymph nodes.","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"373acb1c-0639-2bd8-b7ca-706df73c9be4","text":"Most Rhomboid flaps may be performed under local anesthesia in an office setting. Intravenous sedation or general anesthesia may be considered in patient with significant comorbidities and cases where more extensive flap procedures are needed.","title":"Rhomboid flap: Indications, applications, techniques and results. A comprehensive review"}
{"_id":"3741d466-8305-e7f6-4794-4e70e1e8138d","text":"Optimal cutoff values for ESR and CRP in patients with diabetes-related foot infections to diagnose osteomyelitis","title":"Diagnosis and Treatment Modalities for Osteomyelitis"}
{"_id":"37439a89-d204-4f4f-4cee-c92af0455aac","text":"At this point it is time to consider definitive fixation of the bone\/implant composite, with particular attention given to the use of either an IM nail (Figure 1) or a plate (Figure 2) as the means of providing immediate stability. IM nails are highly constraining devices and require the bones to be positioned and aligned correctly during both the virtual procedure and the actual procedure. Plates are inherently less constraining and allow greater latitude in terms of design considerations. Intra-medullary nails are mechanically advantageous in diaphyseal bone segments, but plates are better suited to metaphyseal or juxta-articular locations where a normal articulation needs to be preserved. Intramedullary nails are often used as the stabilizing element when the goal of reconstruction is an arthrodesis, including hind foot fusion nails to achieve an ankle arthrodesis or a long fusion nail to achieve a knee arthrodesis. Regardless of which type of adjunct fixation the surgeon prefers for a particular application, the design engineering team needs to consider the specific configuration of the remaining intact skeleton, the truss scaffold and the means used to provide stability of fixation to allow the composite construct to successfully incorporate.","title":"Putting 3D modelling and 3D printing into practice: virtual surgery and preoperative planning to reconstruct complex post-traumatic skeletal deformities and defects"}
{"_id":"37454a3b-0cca-57c5-53ec-815c2f3d6a24","text":"We extracted the catheter in order to prevent venous occlusion and continued fluid and drug replacement from the right external jugular vein. We placed a central venous catheter through the internal jugular vein after the surgery had been completed.","title":"A Rare Central Venous Catheter Malposition: A Case Report"}
{"_id":"374816b6-8c71-c2ae-3fde-c6233ad9927a","text":"Many surgeons feel that there is no necessity to try to reduce postoperative swelling and trismus as it is a prophylactic phenomenon and usually subsides after 3–5 days in any event.","title":"Experience versus complication rate in third molar surgery"}
{"_id":"375313e5-d998-0c5d-c799-22bce3196115","text":"The relative risk of CM was highest in the first 2 years following the diagnosis of either NHL or CLL, and remained elevated throughout in NHL patients. The higher SIR early on after NHL or CLL diagnosis suggests a possible detection bias because of increased medical surveillance of patients with malignancy. Although this may have resulted in a small increase in the overall SIR, the main effect of this bias would be to bring forward in time the diagnosis of some cases of CM that may have gone undetected until several years later.","title":"Evidence for an association between cutaneous malignant melanoma and lymphoid malignancy: a population-based retrospective cohort study in Scotland"}
{"_id":"3753d2c6-d81f-e543-93e9-ec40aeacb4ed","text":"The purpose of this study was to estimate the capability of various imaging modalities and their sequence to differentiate benign from malignant bone tumors; provide the actual diagnosis; and orient the next medical step.","title":"The appropriate and sequential value of standard radiograph, computed tomography and magnetic resonance imaging to characterize a bone tumor"}
{"_id":"3757daa5-5b65-df40-98d7-5784518d2658","text":"Magnetic resonance imaging (MRI) plays an important role in the diagnosis of osteomyelitis, especially during the early phase of the disease. The findings of sequential MRIs during the course of treatment in acute osteomyelitis in children have not yet been reported in the literature. We present a case of acute epiphyseal osteomyelitis in the distal femur of an infant. We monitored imaging changes by sequential MRIs and radiographs. MRI was more useful than radiograph for early diagnosis and evaluation of therapeutic response.","title":"Sequential MR Images and Radiographs of Epiphyseal Osteomyelitis in the Distal Femur of an Infant"}
{"_id":"3759aff3-a6fd-524c-8c06-4cfcc549fca7","text":"A literature review in 2013 aiming to look at aspirin in DVT prevention in orthopedic surgery, by Drescher et al, 13 looked at eight studies comparing aspirin to anticoagulants. For hip and knee arthroplasty, aspirin performed as well as anticoagulants in the studies they screened, with a reduction in bleeding risk. Another similar review published in 2015 by Sahebally et al 14 found that aspirin appeared as effective as LMWH with a potential for lower bleeding rates, and concluded aspirin could be used as prophylaxis against DVT in those with a high risk of bleeding in orthopedic surgery. Both these reviews looked up to 2013.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"37618d3b-d3e7-82a4-2efc-39c1eabab165","text":"This study brings a new perspective on the importance of assessing ankyloglossia and breastfeeding difficulties, reinforces the benefits of exclusive breastfeeding and the need for breastfeeding instructions, as well as the need to evaluate breastfeeding before making a decision regarding frenectomy.","title":"Does ankyloglossia interfere with breastfeeding in newborns? A cross-sectional study"}
{"_id":"37767744-8614-6137-4eac-de9efe0c7074","text":"Surgical wounds (SW) are considered acute, planned and carried out with overlapping edges, which heal by primary intention and have a tendency to regress spontaneously and complete within the expected period. When there is no edge proximity the healing of surgical wounds is by secondary intention. These wounds require more time to heal due to the space between the edges and need greater granulation tissue formation for completion until contraction and epithelialization occur .","title":"Factors associated with the healing of complex surgical wounds in the breast and abdomen: retrospective cohort study"}
{"_id":"377ee0c3-0936-443f-162a-bc00b159d7fe","text":"A major strength of our study is the very mature follow-up interval for the patients who are now at a median follow-up of 8.3 years for disease-free patients. This is the first study highlighting prognostic significance of molecular profiling of SLN in melanoma patients using not only immune genes. Our study controlled for other important clinical variables including SLN status and showed that gene expression profile is a strong predictor of disease progression regardless of SLN status. This finding may be particularly relevant for patients with Stage IIB\/C\/IIIA disease since it remains unclear whether these patients should always receive adjuvant therapy. Limitations for our study include the relatively small cohort of patients evaluated which derived from a single referral center.","title":"Sentinel Lymph Node Gene Expression Signature Predicts Recurrence-Free Survival in Cutaneous Melanoma"}
{"_id":"37952b74-14aa-0627-c8f1-2594e992c454","text":"The follow up protocol depended on the grade and stage of the primary tumour. Provided that follow up cystoscopies were negative, patients with Ta grade 1 tumours would undergo cystoscopy 3 months after initial diagnosis followed by cystoscopy after 9 months and consequently annually for 5 years. All other patients would have cystoscopies every 3 months for the first 2 years, every 4 months the 3rd year, every 6 month the 4th and 5th years followed by annual cystoscopies thereafter.","title":"Reproducibility and Prognostic Value of WHO1973 and WHO2004 Grading Systems in TaT1 Urothelial Carcinoma of the Urinary Bladder"}
{"_id":"37a0a2bd-519e-4d30-db6a-9cede51a8d99","text":"The Joint Committee on Surgical Training is an advisory body to the four surgical Royal Colleges of the UK and Ireland for all matters related to surgical training and works closely with the surgical specialty associations in Great Britain and Ireland.","title":"Education of trainees, training and fellowships for head and neck oncologic and surgical training in the UK: United Kingdom National Multidisciplinary Guidelines EDUCATION OF TRAINEES, TRAINING AND FELLOWSHIPS: UK GUIDELINES"}
{"_id":"37a54a7c-6545-420f-ae26-f1b72143b9b8","text":"Diagnosis of SAMVs is confirmed with a Doppler USG, which shows high flow patterns. DSA helps to find out the many feeders to the lesion and also whether intracranial involvement is present or not. DSA can be used to differentiate other vascular lesions like aneurysms and sinus perircanii. MR angiography helps estimation of the form and extent of the lesion and also any intracranial extension. MR angiography helps planning the incisions before surgery, so that uninvolved major scalp vessels could be preserved. The skin flaps are planned around these vessels for placement of expander and subsequent reconstruction of hair bearing scalp.","title":"Excision of Large Scalp Arteriovenous Malformations with Aesthetic Scalp Reconstruction"}
{"_id":"37ac1692-2cc5-58bd-ba09-c2f0d766acc8","text":"The participants of this study discussed two aspects of competence with regard to leadership. These components of competence included the medical expertise required to be a physician and the transferable skills, which physician leaders possess.","title":"Exploring medical students’ perspectives of physician leadership"}
{"_id":"37acc7e6-6f15-c054-fa51-8b42d12c2b7c","text":"Superficial positioning of the drug in the structure of the lipid particles provides a high concentration of active compounds in the skin immediately after application. Whereas, dispersion of the drug inside the core of SLNs creates a drug storage that allows controlled drug release. An excess of surfactant molecules in the formulation containing SLNs may additionally act as a penetration enhancer. SLNs applied to the skin may either penetrate the stratum corneum or preferably enter and gather in skin appendages permitting the contact between active compounds and stem cells [66].","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"37b27e7f-a7eb-7d2b-6343-ba21e312ded7","text":"Our study found that FDG PET\/CT has an important role as a diagnostic tool for PJI with high sensitivity and specificity. Further studies exploring its accuracy in different PJI locations remain necessary.","title":"A Systematic Review and Meta-Analysis on the Accuracy of Fluorodeoxyglucose Positron Emission Tomography\/ Computerized Tomography for Diagnosing Periprosthetic Joint Infections"}
{"_id":"37b94fee-17d7-d3e9-90f5-e84b8818ffe7","text":"How to Avoid a Lawsuit [23]? A simple lumbar puncture in a cancer patient leading to complications described related to the medication injected or because of a new onset neurodeficit can have serious medicolegal implications if certain simple, basic steps are not followed or casually ignored. We have described some points that should be addressed seriously when involved in such injections.","title":"Implications of Intrathecal Chemotherapy for Anaesthesiologists: A Brief Review"}
{"_id":"37bb4d7c-e494-e475-db63-6e079882c2a3","text":"The external nose and external ear are organs maintaining their shape with cartilage, and repair and reconstruction are performed when these are deformed or lost due to congenital anomalies or trauma, in which a frame prepared with silicone, costal cartilage, and other biomaterials or transplants is transplanted to the affected region. Since silicone is an artificial material, it may have a negative influence after transplantation. Costal cartilage is a superior onlay graft, but its collection is very invasive and it has a risk of development of pneumothorax and thoracic deformity. Moreover, a frame made of costal cartilage may be deformed after transplantation. A new treatment strategy applying tissue engineering has been attracting attention as a method to overcome these problems. Chondrocytes are collected from the cartilage tissue of patients, and cartilage is regenerated by culturing and processing these cells and transplanting them into a defective site. This treatment may enable impaired cartilage tissue to recover its original structure and function, which cannot be achieved by conventional treatment methods. However, many obstacles remain before the application of this method to clinical settings. One of which is the establishment of a method to evaluate the quality of chondrocytes and the cell source of regenerated cartilage.","title":"Glial Fibrillary Acidic Protein as Biomarker Indicates Purity and Property of Auricular Chondrocytes"}
{"_id":"37c1bf2b-3341-b846-e33e-468726e734a0","text":"The virtual models of the tumor and the bone were automatically registered with the actual anatomical structures of the patient. The surgeon used the app buttons and sliders to tailor the visibility of each augmented model and assess the alignment of the projections. The surgery followed the pre-established surgical plan, and the tumor was completely resected. The surgical procedure continued without incidences.","title":"HoloLens 1 vs. HoloLens 2: Improvements in the New Model for Orthopedic Oncological Interventions"}
{"_id":"37c25ba9-ba4e-07f6-539f-b979246619c6","text":"Repetitive decrease of leg rSO2 during repetitive clamping of the femoral artery and measurable effects of sevoflurane preconditioning on leg rSO2 would justify the design of a large randomized study to investigate the effects of ischemic and sevoflurane preconditioning on clinical outcome.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"37d4c730-78a0-617e-9136-1d2b13deab08","text":"A “leak test”, to show that there was no leakage in the thoracic wall, was performed as per routine with the collaboration of the anesthesiologist. The rectus abdominis muscle and external abdominal oblique muscle were lifted with retractors or hooks and saline was injected into the cavity formed and the increasing thoracic pressure by 20 to 30 cm H2O via anesthesiologist.","title":"Minimally Invasive Harvesting Technique for Costal Cartilage Graft: Donor Site, Morbidity and Aesthetic Outcomes"}
{"_id":"37dbd01c-42ee-a127-9bc3-56b77081bba1","text":"This article has outlined examples of how targeted 1–2 week outreaches by AAO-HNS otolaryngologists-head and neck surgeons have supplemented training in head and neck surgery on the African continent through building relationships with and supporting colleagues who have completed UCTKSHNS Fellowships. These workshops have provided rewarding international collaboration while seeking to avoid some common pitfalls associated with short-term humanitarian medical efforts. The most important thing that the authors have learned from their early experience is that the success of each individual workshop has largely depended upon the leadership of the UCTKSHNS Fellowship graduate, who has served as a point person in each respective country to best organize and optimize patient and physician participation. The leadership of the UCTKSHNS Fellowship graduates in facilitating these workshops specifically served to provide continuity of care for patients, create enthusiasm and increased participation from the local medical community, and bridge cultural and language gaps between visiting surgeons and patients on the African continent. Focus of future efforts should include more formal outcome measurements to guide continued improvement and modifications in patient care and educational endeavors. Organizing groups of AAO-HNS members who can provide coordinated ongoing support to international otolaryngology-head and neck surgery colleagues in developing countries remains a challenge, but provides a great opportunity to advance the teaching and practice of head and neck surgery in developing countries.","title":"Educational workshops with graduates of the University of Cape Town Karl Storz Head and Neck Surgery Fellowship Program: a model for collaboration in outreach to developing countries"}
{"_id":"37e0e97d-de03-16a2-6fc7-edc23b552334","text":"The management of skin diseases requires a pertinent diagnosis, which in many occasions constitutes an intricate process. Skin biopsy is an established diagnostic procedure which connects clinical diagnostic methodology with the invisible to the unaided eye microscopic field of skin pathology. Taking under consideration the potentials and limitations of optical microscopy and the indications of performing an invasive technique, dermatologists often rely on skin biopsy for enhancing their diagnostic abilities. The aim of this study was to investigate the favourable clinical diagnoses set by dermatologists when performing skin biopsy, the diagnoses reached by the dermatopathologists after microscopic examination, as well as the relationship between them, and finally to comment on the instances that skin biopsy fails to fulfill the diagnostic task.","title":"Skin Biopsy in the Context of Dermatological Diagnosis: A Retrospective Cohort Study"}
{"_id":"37e85990-e3c6-2df8-4a1d-44c5dddfe95c","text":"Early free flap complications include both arterial and venous thrombosis at the anastomotic site. Reconstructive surgeons are aware that deep vein thromboses can cause a free flap to fail; however, there are no reports in the literature regarding the incidence of free flap failure in the presence of superficial vein thromboses.","title":"Superficial Vein Thrombosis 21 cm Distant From the Venous Anastomosis of a Free Flap Causing Intermittent Venous Congestion"}
{"_id":"37eb3ffb-9b44-3610-752a-a643b3773847","text":"Chronic bone infections often present with complex bone and soft tissue loss. Management is difficult and commonly delivered in multiple stages over many months. This study investigated the feasibility and clinical outcomes of reconstruction in one stage.","title":"Simultaneous debridement, Ilizarov reconstruction and free muscle flaps in the management of complex tibial infection"}
{"_id":"37f1b306-2683-321d-f1b4-63feeccb6191","text":"A desire to share and\/or develop enhanced clinical expertise was the main motivation for many of the clinical fellowship programs. Division heads and fellowship directors expressed the importance of being able to train individuals beyond the skills learnt in specialty and subspecialty programs, identifying unique patient populations in need of these skills and\/or new or emerging advances and treatments in their field. For trainees, additional expertise led to added confidence in the clinical realm and provided new opportunities for future clinical practice.","title":"Fellowship training: a qualitative study of scope and purpose across one department of medicine"}
{"_id":"37fbcad1-9231-29c2-ecc7-32d461c052d8","text":"Osteopetrosis is a rare genetic bone disease caused by a functional abnormality of the osteoclasts. Until now there is no codified management for the complications of this pathology and few cases cited in the literature.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"380c8807-99c3-d55e-a211-25f88b3246e4","text":"A study by Fiore et al. compared the efficacy of high intensity laser treatment and ultrasound for patients with low back pain.22 Each group had VAS and ODI scores assessed after 15 sessions of treatment. There was significant amelioration of the VAS and ODI scores in both groups at the end of treatment. When the laser group is compared with the ultrasound group, it appeared the laser group had significant superiority for VAS and ODI scores. Another study by Boyraz et al. assessed the pain and quality of life with lumbar disc herniation patients receiving three different therapeutic methods of HILT, US and medical treatment. All three forms of treatment were effective; however they concluded HILT and US treatment were effective in the long term.23","title":"Comparison of high-intensity laser therapy and combination of transcutaneous nerve stimulation and ultrasound treatment in patients with chronic lumbar radiculopathy: A randomized single-blind study"}
{"_id":"380e7fe6-3d59-ebdb-e068-e1f0c5d85be6","text":"We observed two main lymphatic drainage pathways draining from the areola in the direction of the axilla: one was directly toward the axilla and the other was toward and through the outside of the mammary gland (Figures 1 and 2). When lymphatic drainage pathway or sentinel lymph nodes were not clearly visible in green color, fluorescence imaging was used for directional guidance. The lymphatic flow through the mammary gland was primarily directed to the axillary lymph nodes, and the flow toward the parasternal lymph nodes or the supraclavicular lymph nodes was not observed in our study.","title":"Sentinel lymph node biopsy for breast cancer patients using fluorescence navigation with indocyanine green"}
{"_id":"3810df90-b2d6-e3f0-1fd4-89505a877cd2","text":"The TTP-PECS blocks and TPVB block interventions were performed 30 min before the surgical incision. After the nerve blocks were completed, the sensory level was tested with a pin prick every 10 min by another anesthesiologist not involved in the operation. Successful block performance was defined as dysesthesia of the skin or absence of pain in any segment from T1 to T12 within 30 min after blocks. Simultaneously, any adverse effects related to the regional anesthetic technique were also recorded.","title":"Ultrasound-guided transversus thoracic muscle plane-pectoral nerve block for postoperative analgesia after modified radical mastectomy: a comparison with the thoracic paravertebral nerve block"}
{"_id":"381504b6-08ae-910b-e332-34baa82bec84","text":"In consideration of the limited consensus on this subject, the aim of this narrative review is to investigate on major prognostic factors of localized NMSC and shed light on the role of postoperative RT for patients with BCC and cSCC.","title":"Localized Non-melanoma Skin Cancer: Risk Factors of Post-surgical Relapse and Role of Postoperative Radiotherapy"}
{"_id":"3815f557-4dae-9622-184f-ae9de00a7a57","text":"Many biofilms and biologic debris were observed in the electron microscope before brushing, but most of the biofilms and debris disappeared in the electron microscope after brushing. In the case of electron microscopy after betadine soaking, cells and debris were shrunk, but dead cell debris and biofilms remained enough to work as a scaffold for secondary biofilm formation and regrowth of surviving bacteria.","title":"Effectiveness of Toothbrushing Technique for Biofilm Removal and Postoperative Infection Control after Spinal Fusion Surgery: A Retrospective Study"}
{"_id":"38163854-5d08-c6a4-a5d8-b498d0b38796","text":"Sentinel node biopsy using dual localisation with radioisotope and Patent Blue V dye was introduced into Portsmouth Breast Unit for staging the axilla in breast cancer in 1999 as part of the ALMANAC trial. After the initial trial results in 2004, SLNB was adopted as the standard of care for all patients with clinical or radiological T1 cancers. Axillary clearance without sentinel node biopsy remained the standard approach for those with more advanced tumours. During 2006, the application of SLNB was extended to tumours up to 3 cm in diameter. From December 2007, after the introduction of intra-operative assessment using a PCR-based assay, SLNB became the index standard for axillary assessment of all breast cancer patients irrespective of T-stage, unless there was clinical or radiological evidence of nodal involvement. All operations were performed or supervised by consultant surgeons, unless a dedicated breast surgical trainee had completed accreditation with the SLNB technique. Sentinel nodes were sectioned into 2 mm slices and alternate sections analysed by PCR and conventional histology.","title":"The Axillary Nodal Harvest in Breast Cancer Surgery Is Unchanged by Sentinel Node Biopsy or the Timing of Surgery"}
{"_id":"381c9b15-0f4b-6ada-392e-bf212dd6e51c","text":"Eminectomy which is one of the popular and most effective treatments for habitual temporomandibular joint luxation was first described by Myrhaug in 1951. There are few reports which described eminectomy being performed under local anesthesia and conscious sedation. We present a case series of habitual luxation of the TMJ treated by eminectomy performed under local anesthesia and conscious sedation and general anesthesia. Five patients were examined and found to have recurrent luxation of the TMJ. The age of patients ranged from 18 to 93 years. Bilateral eminectomy of the TMJ was performed for two patients, and unilateral eminectomy was performed for three patients. Two were examined under intravenous propofol sedation and local anesthesia, while three patients were examined under general anesthesia. One patient died from ileus one month after surgery. The follow-up period except for the case that died from ileus ranged from 12 to 33 months. No recurrent dislocation of the TMJ has been identified. Based on our experience and two other series in the literature, eminectomy with sedation and local anesthesia can be considered and might be a good option in elderly patients.","title":"Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series"}
{"_id":"381f5534-d542-21e8-8dbb-f8322cf76519","text":"Brachytherapy is a form of radiation therapy where high doses of radiation are directly applied to the malignancy.35,49 The direct application of radiation maximizes the therapeutic effects of radiotherapy while minimizing the exposure of surrounding tissue to radiation.35,49","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"38229a9f-fb0a-ddeb-a04f-257ae6ce3ee9","text":"Treatment of VAT with slurry, similar to subcutaneous adipose tissue, did not induce any observable local or systemic side effects or lab chemistry abnormalities. The safety of the slurry was confirmed by a recent human study in which slurry was safely injected into subcutaneous adipose tissue. Although more studies are needed to investigate the safety of using slurry to target fat in other areas of the body such as visceral fat, the data from this study and the pre-existing human safety study for subcutaneous adipose tissue, make the translation of our technology to human patients for reducing VAT possibly attainable in near future. We speculate that contraindications for using large volumes of injectable slurry could include chronic kidney disease and congestive heart failure as slurry consists of a hypertonic solution. Other contraindications are known history of cold sensitivity, cryoglyobulenima, and cold induced vasculitis. A limitation of our study was that we used a surgical approach to expose VAT for slurry treatments since we were working with small animal models that make injections of 10ml slurry challenging. However, in patients, we envision the use of laparoscopy or image guidance to inject or infuse ice slurry directly into the intra-abdominal cavity to selectively target and reduce intra-abdominal VAT. We have previously shown that due to the presence of ice particles, slurry can easily be visualized using ultrasound. Although ice slurry is a selective treatment, the safe placement of the needle into the abdominal VAT while avoiding any injury by the needle to important anatomic structures will require further testing and development. In our future study, we plan to examine the feasibility of slurry injection in visceral fat under ultrasound guidance in large animal models.","title":"Selective reduction of visceral adipose tissue with injectable ice slurry"}
{"_id":"38274130-b5bd-cd47-30f3-7fa1d9ffae0d","text":"According to the authors, this is the first study to investigate the consequences of this specific set of therapies utilized in RDT, as well as the first to use a small animal model to research radio dynamic treatment using 15 MV radiation.","title":"Reactive Oxygen Species Produced by 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Cancer"}
{"_id":"38319bac-3057-3e91-900d-3859ad172170","text":"The carcinogenic process in actinic keratoses follows the multi-stage carcinogenesis model: an initial mutation in a tumor suppressor gene leads to a precursor lesion, and later mutations in oncogenes lead to invasive properties. This progression can occur by the classical pathway, in which there is progression of keratinocytic dysplasia from more superficial epidermal layers toward the basal layer and the dermis, or by the differentiated pathway, a more aggressive and common pathway in which keratinocyte dysplasia located only in the basal epidermal layers evolves into invasive SCC by adnexal invasion.","title":"Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects"}
{"_id":"383c9b00-0ed5-91d5-3098-ae4de9091a59","text":"In spite of the fact that the cumulative mortality is quite similar for both ER categories, the mortality chronology is definitely different for ERP and ERN tumours (Figure 6). For patients with ERP tumours, the mortality risk includes a slow increase in level reaching a plateau at the fifth-sixth year, while for patients with ERN tumours the rise is much steeper with a spike at the third year. ERN tumours show a further mortality peak at about 60 months while for ERP tumours a second mortality peak is blurry indistinct and hardly detectable at the same time. The hazard rate curve of patients with ERN tumours crosses the corresponding curve of patients with ERP tumours between the sixth and the seventh year and persists at a lower level afterwards.","title":"Recurrence and mortality according to Estrogen Receptor status for breast cancer patients undergoing conservative surgery. Ipsilateral breast tumour recurrence dynamics provides clues for tumour biology within the residual breast"}
{"_id":"383ed2bc-569b-6dd0-e41c-75417a457940","text":"To examine the potential effects of circulating metabolites on the process of skin aging.","title":"Relationships between circulating metabolites and facial skin aging: a Mendelian randomization study"}
{"_id":"383fe7d1-99ff-fdea-c142-19824cc3a144","text":"Although high rates of negative surgical margins can be achieved with TLM and TORS, decision-making on the need for adjuvant treatment should take into consideration not only the pathology report but also other important parameters during surgery such as the feasibility of exposure and the surgeon’s judgment with regard to the completeness of excision. In order to have better evaluation and understanding of oncologic results it is necessary to form a consensus on how to assess and define surgical margins in transoral endoscopic surgery.","title":"Assessment of Margins in Transoral Laser and Robotic Surgery"}
{"_id":"38487416-0084-780a-3e1f-8f18702c6482","text":"The study results suggest that the hyaluronic acid fillers enriched with glycine and proline treatment resulted as being a useful procedure for augmentation, contour and volume definition and elevation of the eyebrow region with a high-level aesthetic result.","title":"Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure"}
{"_id":"38489c9e-c8a6-2162-5971-813e89e57274","text":"The present series included patients who visited the Taipei Veterans General Hospital, whose diagnoses were questionable on clinical and radiographic grounds, and who later were proven to have inflammatory lesions of the bone on histologic analysis of biopsy specimens. We reviewed all patients who had osteomyelitis of the femur mimicking malignant bone tumors.","title":"Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases"}
{"_id":"38526bce-357f-86ac-7ee0-f9b439111bf1","text":"The handheld camera was statistically inferior to the planar imaging with a conventional gamma camera in the localization of higher‐echelon nodes due to its small FOV and the short acquisition time used in this work. The results of this study show that planar scintigraphy with conventional gamma camera remains the preferred modality for higher‐echelon nodes localization.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"3853a6cc-29ea-0f61-dc85-b3b864f42cec","text":"One patient was diagnosed with an undisplaced tibial plateau fracture after 2 months from DAIR following a fall. This healed without the need for a further surgical procedure. Table 2 summarises the characteristics of the patients who underwent more than one surgery.","title":"Debridement, antibiotics and implant retention (DAIR) is successful in the management of acutely infected unicompartmental knee arthroplasty: a case series"}
{"_id":"3864bfbc-5a77-4dea-6da0-583323e25dca","text":"The diagnosis of DVT was determined as clinically suspected DVT or PE confirmed by imaging and requiring therapeutic anticoagulation or resulting in death. Patients who had a recent DVT diagnosed prior to surgery and those who developed arterial thrombosis were excluded from the current study5 which was approved by the ethics committee of our hospital.","title":"Analysis of deep venous thrombosis after Gynecological surgery: A clinical study of 498 cases"}
{"_id":"3865ba2f-bc5d-101e-6cc2-a38783d36f16","text":"Traditional repair of incisional inguinal hernias with mesh, is challenging due to difficulty in identifying appropriate safe anatomical regions for strong and stable mesh anchoring, with few reports concerning this complication and no standardized procedures for repair.","title":"Successful laparoscopic trans-peritoneal repair of an incisional inguinal hernia, resulting from deep lymph node dissection for melanoma: A case report"}
{"_id":"386ce0b1-032e-380b-ec8b-df05c6430769","text":"Anatomy was chosen as a commonality for student networking because this subject field is generally taught at an early stage and is represented in all medical and dental school curricula around the world. In addition, the topic of body donation and associated concerns about the topic of death are areas that are shared by young students in this phase of learning.","title":"An International Partnership of 12 Anatomy Departments – Improving Global Health through Internationalization of Medical Education"}
{"_id":"386fd58e-e528-f9d7-faba-6093a7ac335a","text":"The study will consist of a pragmatic multicentre external pilot RCT with an embedded QRI to determine the feasibility of recruitment and randomisation to either a subpectoral or prepectoral implant reconstruction following mastectomy.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"38718e83-4f6c-e908-2c84-b00a73f23f86","text":"It may be useful to specify whether the specimen was received fresh or in fixative and to record details of specimen transport to the laboratory; it should be noted if this has led to a delay or problems in processing. 10% neutral buffered formalin fixation is routinely used in most laboratories and is generally suitable for bone specimens. Fixation in absolute alcohol is useful for identifying glycogen in Ewing sarcoma cells. Small biopsy fragments containing only cancellous bone fragments or tumour tissue containing small amounts of bone can be decalcified and fixed in one overnight step through the use of 5% trichloracetic acid or ethylene diaminetetracetic acid (EDTA) dissolved in 10% buffered formalin.","title":"Guidelines for histopathological specimen examination and diagnostic reporting of primary bone tumours"}
{"_id":"389e7e6f-972d-591f-a2b6-6c5660011a79","text":"Implications for D&I Research: The study showed the training had less impact in the first six months compared with the second six months. Implementation leadership was also associated with changes in implementation readiness. Providers reported barriers related to competing demands, lacking necessary infrastructure to support implementation, and not feeling vested in the practice. This suggests that resolving barriers before proceeding with training and having a consistently engaged leadership throughout training may increase impact and decrease the training dosage needed for implementation.","title":"Proceedings from the 10th Annual Conference on the Science of Dissemination and Implementation"}
{"_id":"389f13c7-71e1-d89d-f315-a2eb9a3184ba","text":"This study could not analyze all the breast implants that are commercially available in the global market. This study focused only on breast implants that were manufactured in or imported to Korea and approved by the KFDA. The study identified the accuracy of ultrasonography in limited patients. The result found in this study are hard to generalize because ultrasonography is operator dependent.","title":"Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant"}
{"_id":"38a50056-67de-3e1e-a8c7-eb24184f59ab","text":"Patients whose DVTs are detected by ultrasound may be followed with weekly sonograms to document resolution.61 Those patients presenting with distal thromboses may be treated as outpatients and prescribed an oral anticoagulant, such as rivaroxaban or apixaban, reducing the need for injectable enoxaparin.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"38a5c43c-eec1-87f5-7256-482e0072798a","text":"Patients suffering from local recurrence seem to have an improved overall survival compared to a patient with regional or locoregional failure. This could be due to the still manageable tumor extent and in the case of tumor growth less aggressive tumor biology. Patients with regional recurrence or distant disease have a poor outcome.","title":"Clinical outcome and prognostic factors in recurrent oral squamous cell carcinoma after primary surgical treatment: a retrospective study"}
{"_id":"38a94c86-883c-0cb7-3b88-3feb6e983446","text":"Confocal microscopy is a specialised form of standard fluorescence microscopy (also called widefield fluorescence microscopy) that uses particular optical components to generate high-resolution images of material stained with fluorescent probes. Confocal microscopy differs from conventional widefield fluorescence microscopy in that the optical path of the laser light is designed to place in front of the image detector, an aperture at a point where the image is focused in conjunction with the focal plane of the image. This aperture removes all other light bringing the image into sharp focus without distracting light. These images are put together to form a full image and by controlling the depth of penetration of the laser, 3-dimensional images can be formed. This method of viewing bacteria has helped to view biofilm and understand their behaviour since 199920.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"38ad458a-2d77-8922-1391-1ee9c775ea02","text":"Interestingly, the melon fat appears to be drained by veins that are concentrated along the periphery of the fat body, with large veins avoiding a direct course through the main substance of the melon fat. Conversely, the IMFB is densely invested with veins. As we must assume that anatomical structures are not the result of evolutionary processes resulting in meaningless manifestations, we are compelled to believe that this distinct difference may be reflective of a functional role. It is possible that this reflects different functional needs to modulate physical characteristics of the fat bodies.","title":"Vascularization of Air Sinuses and Fat Bodies in the Head of the Bottlenose Dolphin (Tursiops truncatus): Morphological Implications on Physiology"}
{"_id":"38af89d5-cfe0-fd57-b765-2257c351a97a","text":"In this study, we describe a heterogeneous cohort of patients that had received injections of different types of filler materials for aesthetic purposes. The patients were treated for painful and inflamed granuloma formations surgically in 10 of 17 cases. Six patients were treated conservatively in a successful manner, and one died because of the preexisting condition of the final stage of AIDS.","title":"Complications and Disasters After Minimally Invasive Tissue Augmentation with Different Types of Fillers: A Retrospective Analysis"}
{"_id":"38b1f183-1dcd-1861-0f67-10b02d34993c","text":"In 1914 Flaherty [7] described the technique in more detail using a drill to make holes in the outer table of the skull and then proceeded to graft once the granulation tissue was formed.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"38b49df9-cdd2-b394-ec65-99396345425a","text":"The meshing of the graft allows larger areas to be covered due to graft expansion. It also allows coverage of areas with variable contours, where a sheet might not adhere well.","title":"TISSUE GRAFTS IN VITILIGO SURGERY – PAST, PRESENT, AND FUTURE"}
{"_id":"38bceca8-a4cd-ef2b-0d57-f4a8604a0b70","text":"Topical imiquimod treatment of chronically sun-exposed and eventually photodamaged skin without overt clinical signs for AK is able to detect early malignancies before they can be clinically diagnosed as AK and the subsequent inflammatory reaction usually clears them at this subclinical stage. Giving treatment without an obvious reason may be judged as overdoing, but the issue of overtreatment when applying imiquimod to patients, who do not show skin lesions, can be devaluated by the fact that imiquimod is able to detect subclinical lesions at their earliest stage of development; therefore imiquimod may have a potential role in the prophylaxis of NMSC.","title":"Visualization and Treatment of Subclinical Actinic Keratoses with Topical Imiquimod 5% Cream: An Observational Study"}
{"_id":"38be1471-9408-04a2-4808-a5cafe5d441b","text":"Neoadjuvant chemotherapy was an effective method in this related case, and we recommend its use in such cases. In planning the surgical resection of the tumor after neoadjuvant chemotherapy, when possible, the size of the tumor before chemotherapy should be considered as the initial size and surgical margins should be determined accordingly. Complete surgical resection is the desired outcome after neoadjuvant chemotherapy which might provide downsizing as happened in our case saving vital tissues to be resected. En bloc resection of the tumor occupying an area of 4 cm vital tissue apart from all along the wound margins with the structures such as the lungs, thymus, and pericardial tissues that may be invaded by the tumor. Afterwards, total closure of the defect by reconstruction using synthetic materials like meshes should be provided to protect the structural stability.","title":"A case of radiation-induced sternal malignant fibrous histiocytoma treated with neoadjuvant chemotherapy and surgical resection"}
{"_id":"38c0ece5-b8db-7940-ae7c-aa0be781421d","text":"With the majority of patients who reported good to excellent improvement in their nasal symmetry and profile, L-shaped strut augmentation rhinoplasty with rib cartilage graft presented a viable option in cleft lip rhinoplasty. Using this technique, we were successful in providing our cleft lip nose patients with a perceivable and satisfactory improvement to their nasal deformity.","title":"Augmentation Rhinoplasty in Cleft Lip Nasal Deformity: Preliminary Patients' Perspective"}
{"_id":"38c3e449-5ead-064b-9320-4d874eb38ef2","text":"Of the authors who examined the association between breastfeeding and occlusion development, three studies concluded that breastfeeding favors better occlusion and two found greater malocclusion prevalence in the absence of breastfeeding or with up to six months’ breastfeeding. In contrast, three groups of researchers found no association between these two variables.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"38c9449a-d5b6-7854-348d-48ca8dc13039","text":"For the multidisciplinary plastic and orthopedic surgical team, the prospect of the best functional outcome is not only related to the objective of anatomical extremity salvage, but also to the ability to perform complex and definitive anatomical and functional reconstruction. In other words, if performed without a certain diagnosis or clear margins, or in the event of a change in the clinical situation, the possibility that such a reconstruction might have to be revised or discarded in the future presents an argument for delayed reconstruction or at least for a customized approach with defect temporization until all necessary information and parameters are known.","title":"Upper extremity sarcoma: impact of current practice guidelines and controversies on reconstructive approaches"}
{"_id":"38ccb2ef-4596-7344-623d-f2ea0c2c2ac1","text":"Combined cross-leg and free flaps can be useful in management of large soft tissue defect associated with severe lower leg injuries.","title":"Transplantation Treatment of Extensive Soft-Tissue Defects in Lower Extremities with a Combination of Cross-Bridge Flap and Combined Free-Tissue Flap Covered by Vacuum Sealing Drainage: One Case Report"}
{"_id":"38cfeb29-64a4-830d-1138-594899f81f24","text":"Several parameters have been associated with higher risk of CCS development and subsequently worse prognosis.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"38d4f64f-467b-6cf7-bdb6-9b0950d97938","text":"P71 Use of an electronic device and a computerized mathematic algorithm to detect the allergic drug reactions through the analysis of heart rate variability","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"38d7e120-ebdb-dbc4-8151-3a7743ece68a","text":"Technical failure was defined as any subsequent amputations above the level of a Syme amputation or the need for surgical bypass. All the patients who were enrolled into the PTA treatment arm received PTA as the only form of treatment (apart from medical therapy for risk factor modification).","title":"Critical limb ischaemia in a diabetic population from an Asian Centre: angiographic pattern of disease and 3-year limb salvage rate with percutaneous angioplasty as first line of treatment"}
{"_id":"38da94e6-55d7-c8bb-9f0b-51332c16e249","text":"The second key element of the TTOP intervention aims at improving the relationship and communication between the patients and their health care provider; both their treating physician and the nurse.","title":"Development of an adherence-enhancing intervention in topical treatment termed the topical treatment optimization program (TTOP)"}
{"_id":"38f3d37d-fead-8c3a-7292-6592a024c734","text":"The studies involving humans were approved by the Ethics Committee of Xiangya Hospital of Central South University. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required from the participants or the participants’ legal guardians\/next of kin in accordance with the national legislation and institutional requirements.","title":"The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients"}
{"_id":"38fa44fe-ef18-a025-c669-c21aab396e6d","text":"This article underscores the specialty of plastic surgery and its substantial role in the multidisciplinary work of regional trauma centers. The characteristics of trauma patients who received plastic surgery treatment are also identified in the severity analysis. We thus argue that plastic surgical care is imperative for trauma patients, and expect to be implicated in trauma system planning.","title":"A quantitative analysis of trauma patients having undergone plastic surgery"}
{"_id":"3904428d-9b00-4f49-b367-8b631bbf45af","text":"Paravertebral nerve block is a new type of anesthesia and analgesia that has emerged in recent years. The analgesic effect is similar to that of epidural anesthesia, and the complication rate is low. It is an ideal postoperative analgesia method. Paravertebral nerve block refers to the use of a puncture needle to enter the paravertebral space through the lateral edge of the lamina, that is, the spinal nerve passes through the intervertebral foramen, and the local anesthetic is injected into the outer mouth of the intervertebral foramen. Anesthesia and pain relief during unilateral organ surgery may be achieved by using a local anesthetic that blocks the sympathetic and somatic nerves of many contiguous segments on one side of the injection site. There has been a lot of interest in the investigation of paravertebral nerve block because of its major benefits in clinical anesthesia. Because of this, the paravertebral nerve block was performed using ultrasonic imaging equipment. A randomized, double-blind clinical experiment was done on patients having elective retroperitoneal renal surgery to investigate the analgesic efficacy of paravertebral nerve blockation during and after surgery in this paper. It also examines the influence of combination anesthesia on emergency reaction during these procedures and analyzes the safety of paravertebral nerve block [20].","title":"Evaluation of Analgesia Effect after Ultrasound-Guided Laparoscopic Renal Surgery"}
{"_id":"3905caab-34bc-09a5-d264-7b4857a1e652","text":"The results of this preliminary study have some limitations that should be addressed.","title":"Hyper accuracy three-dimensional (HA3D™) technology for planning complex liver resections: a preliminary single center experience"}
{"_id":"39070467-60e3-6e8a-821f-044761870760","text":"To assess the treatment of osteosarcomas of the femoral diaphysis through wide en bloc excision and reconstruction of the defect by pasteurized autograft combined with vascularized fibular transfer.","title":"Evaluation of the Efficacy of Pasteurized Autograft and Intramedullary Vascularized Fibular Transfer for Osteosarcoma of the Femoral Diaphysis"}
{"_id":"391288aa-e155-8c39-380e-ca94f42df2b2","text":"We evaluated objective metrics between academic plastic surgeons from three Doximity program tiers to determine predictors and guide future and\/or current surgeons seeking promotion from assistant professors to associate professors to full professors. Furthermore, we evaluated academic plastic surgeons at the same professorship level from three different tiered programs to guide those seeking lateral movement between programs. Independent predictors following comparisons were used to synthesize the Doximity-tiered Promotion Ladder of Academic Plastic Surgery.","title":"The 2020 Evidence-Based Promotion Ladder of Academic Plastic Surgery"}
{"_id":"3915a5c6-f226-3bd0-a817-db1f1952066b","text":"Back pain reappeared 19 months later after surgical treatment. The patient suffered marked weakness in both limbs, along with obvious muscle atrophy and sensation deficiency of warmth and pain in left lower limb. MRI demonstrated a cystic mass with solid content and peripheral strengthen in enhanced scan.","title":"Repeated recurrent epidermoid cyst with atypical hyperplasia A case report and literature review"}
{"_id":"391789ea-0385-bac7-94f1-7465755bef19","text":"The lymph nodes levels to be removed are chosen regard to the primary site of cSCC development, but the second and third level and often the fourth one are included in the resection most of the time, because the contiguity with the internal jugular vein, the anatomical terminal of all the lymphatic pathway.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"3918c6ee-564f-2bf0-348d-a9c591b350a9","text":"Autologous bone has been favored for use in spinal fusion in both the lumbar and cervical spine due to its superior capacity for incorporation and osteoinduction. The incidence of donor site morbidity following iliac crest bone graft harvesting has been cited as ranging from 8-39%.6 Donor site pain which represents the most common postoperative symptom often delays mobilization.12 Increased operative time and postoperative stay are widely cited as disadvantages of autologous iliac crest bone grafts, especially if graft site complications occur.12 Many studies have demonstrated improved fusion rates for allograft bone without the complications of bone graft harvesting.12–15 The advantage of allograft bone is that it avoids the morbidity associated with donor site complications and is readily available in the desired shape.16 The disadvantages of allograft include delayed vascular penetration, slow bone formation, accelerated bone resorption and delayed or incomplete graft incorporation.","title":"Fibular allograft and anterior plating for dislocations\/fractures of the cervical spine"}
{"_id":"391a9c17-f61f-89c9-8024-3b5dec8f29ec","text":"Sagittal plane from the CBCT of region 36 for case vignette 1. The alveolar ridge height is sufficient to place an implant","title":"How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons"}
{"_id":"391e06be-e927-6da1-eccc-e8788dcf8c7a","text":"The clinical challenges presented as a result of biofilm formation on prosthetic joints have underscored the need for innovative solutions in this area. Given that current therapies can often lead to recurrent surgeries and increasing morbidity [26], alternative methods to remove biofilm or prevent their formation altogether are desperately needed. Prevention of biofilm formation depends on numerous factors, and many intrinsic methods have been tested that approach the problem in a variety of ways. Future testing in in vivo models and in human trials may reveal which of these methods provides the best results, and could potentially eliminate the need to consider biofilm treatment altogether. However, a number of challenges remain with intrinsic methods, particularly the ability to maintain this anti-biofilm effect for long periods of time. In contrast, challenges of the extrinsic methods include a number of techniques that will require direct contact with the implant. However, if the biofilm can be removed in one surgery, especially in a minimally invasive procedure, this type of approach would still be a great improvement over existing protocols. Those methods that allow for a non-invasive approach in treating the biofilm have the greatest potential for change to present day treatment guidelines, and therefore hold much promise. There may even be a future for preventative intrinsic methods and extrinsic treatments to work in concert. The hope is that one or more of these new technologies will provide numerous benefits to future patients in prolonging the useful life of their implant.","title":"Physical Approaches to Prevent and Treat Bacterial Biofilm"}
{"_id":"3923c043-691f-ab3a-1d2b-b3a20dc05a4d","text":"Even patients of these facilities perceived that therapeutic decisions were not exclusively in the hands of the physicians. A patient from the same facility states during the group discussion:","title":"Cooperative leadership as a condition for patient-reported rehabilitation success"}
{"_id":"3925ccec-d275-1c1c-c33d-541ff657aa66","text":"Moreover, we were unable to retrieve the data for the pre-pandemic cohort with regards to numbers of inpatient and outpatient scans. We are therefore unable to state confidently that this ratio of inpatient and outpatient scans is comparable between the two cohorts.","title":"Prevalence of venous thromboembolism in patients undergoing diagnostic venous ultrasound during the first SARS-CoV-2 pandemic: A personal history of VTE and a positive COVID-19 test are associated with the diagnosis of DVT"}
{"_id":"39284403-cb57-00b6-7911-b14283a40606","text":"Subsequent ischemia and disc necrosis can arise with the development of osteomyelitis, as observed in this special patient cohort. By this, the correlating level of the spinal and vascular infection becomes explainable. From this point of view, osteomyelitis might be the focus of infection. Osteomyelitis may also pre-exist and perfusion is limited by the endograft. However, the impact of TEVAR and EVAR on spinal cord ischemia is well established and is based on perfusion of the same collateral network that supplies the spine [21]. The pattern of extensive anterior vertebral bony destruction and paravertebral abscess formation next to the endovascularly treated aortic aneurysm suggests direct spread from the adjacent infected aortic stent graft and native aneurysm sac as a likely route of per continuitatem vertebral column infection, resulting in a double infection of the graft and the vertebral body. Due to the endovascular nature of the stent a haematogenous spread of pathogenic agents might also be a possible route of infection.","title":"Destructive per continuitatem spondylodiscitis after endovascular abdominal or thoracic aneurysm repair (EVAR\/TEVAR): rare and untreatable?"}
{"_id":"3928c5c8-995e-36f1-d71d-dcdc67ea8894","text":"Fresh or cryopreserved allogeneic skin from cadavers is the most reliable wound cover, although its use has a small risk of disease transmission.","title":"Surgical management of extensive burns treatment using allografts"}
{"_id":"392cff7e-84d0-dcf3-061d-99c9e14865af","text":"Evaluation 2: This was conducted with 37 babies at the frenotomy clinic to assess how well the tool could be used in training. Two experienced midwives used the BTAT to assess tongue function of a baby whilst a less experienced midwife or health care assistant (not familiar with BTAT) used the TABBY to assess each baby during December 2018 and January 2019.","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"3931c80e-c397-bedd-14f3-7d107a028beb","text":"In this study we report a sample of children with pediatric bacterial osteomyelitis who were hospitalized over a period of 11 years. Our results show that a severe presentation with sepsis and hypergammaglobulinemia at onset is associated with a higher incidence of sequelae. In this context, assaying IgG levels may be a valuable adjunct to the laboratory workup of these children to guide the clinician toward prompt recognition and treatment of pediatric bacterial osteomyelitis.","title":"Clinical report and predictors of sequelae of 319 cases of pediatric bacterial osteomyelitis"}
{"_id":"39396a6b-5f5b-0918-2c1e-6632eaf05732","text":"The mastectomy can be performed using any preferred technique. However, it is essential to minimise diathermy or retraction injury to skin flaps. Any mastectomy for cancer should prioritise clearance over the index lesion. The mastectomy needs to be carried out in the normal breast oncological plane, ensuring as much as possible that all breast tissue is removed, but the limits of this plane need to be respected. Overlying skin only needs to be removed if a clear plane of subcutaneous tissue is not present. Preservation of pectoralis fascia enables easy fixation of implant coverage.","title":"Prepectoral implant-based breast reconstruction: a joint consensus guide from UK, European and USA breast and plastic reconstructive surgeons"}
{"_id":"39425633-b89a-aa3f-11c1-22c7041b253c","text":"Chemotherapeutic agents may be employed in cases of advanced local or metastatic disease.6,7 Hedgehog pathway inhibitors, such as vismodegib and sonidegib, may be used to treat advanced basal cell carcinoma.8,35 These medications selectively inhibit the smoothened protein receptor, which is frequently involved in the pathogenesis of this malignancy.8,35 These medications are primarily used to shrink large tumors before surgical excision due to the severe side-effect profile associated with extended treatment.8,35 Advanced and metastatic squamous cell carcinomas may be treated with a wide variety of systemic chemotherapeutic agents, though these treatments are associated with inconsistent response rates and severe side effects.35","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"3947e0b9-c592-472e-27dd-0dc6c0665b48","text":"None of these studies have investigated the factrs which may be the cause of acne formation and their role. Therefore, due to the lack of studies on the incidence of acne after rhinoplasty and the leading factors, we aimed to study its incidence and the role of each possible factor.","title":"Post-Rhinoplasty Acne, Frequency and Role Players"}
{"_id":"394919e2-6b11-c37a-943b-e3127394b09b","text":"Regardless of the fact that adipose-derived stem cells have a function in combined grafting, molecular and immunohistochemical investigations should be conducted in future clinical studies. They may also be suitable for future use in combined grafting for difficult wounds, such as wound beds with poor granulation or small exposed tendons without paratenon.","title":"Nanofat grafting under a split-thickness skin graft for problematic wound management"}
{"_id":"394bfecb-38b8-665a-96af-2bec4a4c994b","text":"A consensus statement has been published to assist with issues arising for radiation oncologists in patients after oncoplastic breast surgery. The statement highlights the importance of a multi-disciplinary approach and suggests that for optimal multidisciplinary collaboration, radiation oncologists should participate in or observe various types of oncoplastic procedures as part of their ongoing education. Other authors have also strongly suggested that surgeons arrange a preoperative referral to radiation oncology whenever the use of complex oncoplastic surgical techniques is anticipated. Similarly, the surgeons should also have a working knowledge of the techniques involved in the planning and delivery of radiation therapy. While not always achievable, the consensus panel suggests that surgeons attempt to be present with the radiation oncologists during target contouring and radiation boost planning. Through such partnerships, the challenge of translating geometric information from one medical specialty to another for the optimal treatment of the patient can be overcome [62].","title":"Breast Radiotherapy after Oncoplastic Surgery—A Multidisciplinary Approach"}
{"_id":"394c4e6d-bc27-8b82-f8b4-2c6daafb0b1b","text":"All trauma patients were routinely started on prophylactic dose of Enoxaparin daily on admission except one patient. This patient had suffered intra-cranial and liver hemorrhages therefore was not started on prophylactic anticoagulation until deemed safe. After the free flap reconstruction, all patients either remained on prophylactic enoxaparin or were changed to prophylactic Heparin 5,000 units BD or TDS depending on surgeon preference.","title":"Proximal Trauma Increases Risk of Venous Thrombosis in Soft Tissue Reconstruction of Open Lower Limb Fractures"}
{"_id":"3953fc0f-747e-68c6-ddd3-06887707ca40","text":"There were two patients who suffered complete flap necrosis and were subsequently closed with a pedicled flap and direct closure, respectively; both these patients could have been closed initially without a free flap, however, as mentioned previously, the indications for flaps in our series and the choice of flap was made on the basis of reasons other than closure alone (filling of dead space, introduction of vascularized tissue, reduction of wound tension) and influenced by factors, including the size and suitability of donor tissue and potential donor site morbidity. In the first case, a free gracilis was felt to be a more suitable donor for an anterior arm defect with lower donor morbidity than the pedicled latissimus dorsi that was subsequently required for salvage; in the second case, a free latissimus dorsi was used to fill the dead space in a large posterior thigh defect that eventually had to be closed directly. Unfortunately neither of these patients benefited from the theoretical advantages of their flaps.","title":"Preoperative Radiotherapy and Wide Resection for Soft Tissue Sarcomas: Achieving a Low Rate of Major Wound Complications with the Use of Flaps. Results of a Single Surgical Team"}
{"_id":"39578842-b68f-f896-b3fe-b95cc2c2d1f8","text":"The incidence of surgical site infections is considered a relevant indicator of perioperative and postoperative care quality. The aim of this study is to analyze and evaluate SSIs after elective cervical spine surgery under the guidance of our preventive multimodal wound protocol.","title":"Incidence of surgical site infections after cervical spine surgery: results of a single-center cohort study adhering to multimodal preventive wound control protocol"}
{"_id":"395a6818-50e7-098f-b77d-3139032c3a41","text":"More specifically, MRI not only provides excellent soft tissue contrast but also allows for the evaluation of specific tissue components in different sequences.","title":"An Update of the Possible Applications of Magnetic Resonance Imaging (MRI) in Dentistry: A Literature Review"}
{"_id":"396d81ac-9f0a-ed41-1b1e-fb331f8e83f0","text":"Objectives: To describe all the cases of MAS presenting to a paediatric rheumatology clinical network over a 9 year period, specifically investigating underlying diagnosis, if the episode of MAS was part of the initial presentation or later in the disease course and the applicability of the current published diagnostic and classification criteria.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"39741012-4ab2-f520-26f9-c5089cd9fa62","text":"Previous studies implied that the treatment and anticipated survival rate should be analogous to the cases of malignant neoplasms of the same histological type. Surgery is the gold standard in treatment of this kind of lesions. The presence of a malignancy might require a more aggressive approach, hence, depending on the nature and the location of the tumor – total or subtotal parotidectomy is indicated. Intraoperative frozen section biopsy might add important information that could alter the management and improve the final outcome of the treatment. Our case seems to confirm that a routine use of this examination may have influenced the extent of the surgical management in the way that the total parotidectomy and the elective I and II level lymph node removal would be performed. Thus, re-operation would not be necessary.","title":"Synchronous multiple unilateral parotid gland tumors of benign and malignant histological types: case report and literature review Múltiplos tumores síncronos unilaterais de glândula parótida de tipos histológicos benignos e malignos: relato de caso e revisão da literatura"}
{"_id":"39790643-9fbe-dc0b-aa1c-4be7af4489a5","text":"While ultrasound has been used to quantify fracture callus formation and to assist with diagnosis of nonunions, its use to stimulate fracture healing in animal models has only recently been explored. One of the earliest English language publications related to the use of ultrasound to assist fracture healing in an animal model was published in 1983.34 Bilateral transverse fibular fractures were created in adult Wistar rats. Ultrasound was administered to one of the bilateral fractures in each rat, at an intensity of 500 W\/cm2 for 5 min at a time, 4 days a week, at different stages post-fracture. They demonstrated the greatest effectiveness of ultrasound treatment to be present when ultrasound was delivered during the first 2 weeks postfracture.","title":"The science of ultrasound therapy for fracture healing"}
{"_id":"39821934-8c0b-1d2c-154a-5d264222c055","text":"Carvalho-Júnior JC conceived the original idea and was responsible for the application content development. Haddad A contributed to the original idea and was responsible for the review of the manuscript. Ferreira LM contributed to the original idea, provided orientation during the research development and was responsible for the review of the manuscript.","title":"UNIFESP Info Plastica – An informative application covering the most frequently performed plastic surgeries worldwide"}
{"_id":"39859fb3-0021-d7a9-4fb7-6953d46a85da","text":"Cutaneous melanomas commonly metastasize into the regional lymph nodes and their involvement in metastatic melanoma is associated with a significantly worse prognosis. The sentinel lymph node is the first lymph node on the direct lymphatic drainage path from the primary tumor. Positive sentinel node results are commonly followed by a complete dissection of the lymph nodes.","title":"Lymphangiogenesis and Its Correlation with the VEGF Expression and the Sentinel Lymph Node in Cutaneous Melanomas"}
{"_id":"39890479-0d79-1997-9886-ec19c7f1b3f9","text":"Thus, the recommendations that the Italian panel suggest for empirical therapy in uncomplicated AHOMs in children between 28 days and 18 years are the following:","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"39894b7c-a625-3128-1592-c1add916c2d5","text":"In conclusion, this survey highlights the need to support and improve the training and career progression of surgical IMGs in the UK. The GMC, immigration and visa authorities, hospital HRs departments and HEE can all make important steps and changes to support and raise awareness of the challenges faced by IMGs. By addressing these challenges and exploring ways to mitigate them, the NHS can attract and retain more talented overseas surgical trainees, ultimately benefiting patients and the healthcare system as a whole.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"39916cec-1ffc-721a-1602-f54ccab7a0dc","text":"The annual incidence of osteomyelitis in Norway remains high. ESR values and MRI scan may help to identify osteomyelitis patients and differentiate acute and subacute osteomyelitis.","title":"Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study"}
{"_id":"399b42e4-3230-bfb2-a000-22d3cb5f4136","text":"Where the clinical status of the mother will make direct breastfeeding impractical, expressed breast milk is agreed on as an ideal feeding option, and this will not require pasteurization [31]. Formula feeding is an acceptable alternative if breastfeeding is not possible. It was recognized that preventing women in rural Africa from breastfeeding their children is likely to be associated with significant deleterious economic and health impacts and there is currently no evidence to advise exercising caution in this regard as long as hygienic practices are followed.","title":"African League Against Rheumatism (AFLAR) preliminary recommendations on the management of rheumatic diseases during the COVID-19 pandemic"}
{"_id":"39a1f3e7-2aeb-92c6-9613-a94a805d17b1","text":"SLNB can identify patients who might benefit from immunotherapy, and the determination of predictors of SLNB positivity can help select the proper population for this type of therapy. The absence of TILs is a reproducible parameter that can predict SLNB positivity in melanoma patients, since this study was made with several centers with different dermatopathologists.","title":"Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group"}
{"_id":"39aeefc0-aa0c-0831-c9ad-f6e6cd037078","text":"In both the patients, neck vein cannulation was risky and screening ultrasound revealed a complete overlap of the femoral vein by femoral artery precluding its cannulation by traditional longitudinal or transverse approach. However, due to unavailability of safer alternatives, femoral vein cannulation was done under ultrasound guidance using oblique approach technique by the operator experienced in the oblique approach","title":"40th International Symposium on Intensive Care & Emergency Medicine Brussels, Belgium. 24-27 March 2020"}
{"_id":"39b7e4c6-bc2b-f771-b0d7-14574cbd5864","text":"All breast cancers diagnosed in breast cancer survivors, ie, both recurrences and new breast cancers were included in the analyses. Breast cancer survivors have a larger risk of getting a breast cancer than women who have never had a breast cancer diagnosis before. Due to this, the detection rate (number of breast cancers detected at mammography screening per screened woman) as well as the interval cancer rate (number of interval cancers per screened woman) might be higher among breast cancer survivors than among the general population, even though mammography screening is as efficient for breast cancer survivors as for the general population. A comparison of these numbers will therefore not necessarily tell whether breast cancer screening is as beneficial to breast cancer survivors as to the general population. The proportion of screen‐detected cancers and interval cancers that are detected at screening give an estimate of the sensitivity ie, the odds of having the breast cancer detected at screening given that you have breast cancer. A low sensitivity tells that many breast cancers are not found at screening, ie, the screening is not that efficient or a large amount of the cancers are very fast growing. Sensitivity is not affected by the total number of cancers in the population, wherefore we used this measure to compare whether mammography screening is as efficient in breast cancer survivors as in women without previous breast cancer diagnoses.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"39bb7556-3f4a-5c67-6e8c-30f4474bbf75","text":"The atlas database for the HNC cases consisted of image sets of 11 patients with different diagnoses in various stages randomly chosen from the clinical data. For use as a single atlas, one male and one female patient image set were subjectively selected by a radiation oncologist as being the most representative out of the available cases. The same male atlas was used for all male patients, and the same female atlas for all female patients. For all HNC atlas cases the lymph node regions of the patients were segmented in accordance with a generally adapted guideline for head and neck target and risk organ delineation [1].","title":"Clinical evaluation of multi-atlas based segmentation of lymph node regions in head and neck and prostate cancer patients"}
{"_id":"39bfbf16-dbb5-adeb-2ac0-ae3accf57a72","text":"Serial debridement and bone stabilization before early soft tissue reconstruction according to reconstructive ladder were shown to be essential steps.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"39c6d727-841c-c2a0-4b71-75d84b13289c","text":"Sentinel lymph node biopsy has been established as the preferred method for staging early breast cancer. A prior history of mastectomy is felt to be a contraindication.","title":"Axillary sentinel lymph node biopsy after mastectomy: a case report"}
{"_id":"39c76a64-cf87-26ac-6f0c-ed0d40b3677f","text":"The pathogenesis of seroma has not been fully understood. Seroma is formed by acute inflammatory exudates in response to surgical trauma and acute phase of wound healing. Extensive dissection in mastectomy and axillary lymphadenectomy damages several blood vessels and lymphatics with subsequent oozing of blood and lymphatic fluid from a larger raw surface area when compared with breast-conserving procedures leads to seroma formation. Fluid accumulation elevates the flaps from the chest wall and axilla thereby hampering their adherence to the chest wall bed and delay healing [10].","title":"The value of mastectomy flap fixation in reducing fluid drainage and seroma formation in breast cancer patients"}
{"_id":"39cc4183-ec59-22ff-2828-3dc7cfd8421b","text":"Breastfeeding has the single largest potential impact on child mortality of any preventive intervention like water and sanitation [19]. Breastfeeding is an effective child health intervention that does not require extensive health system infrastructure. Improvements in rates of exclusive and continued breastfeeding can contribute to the reduction of child mortality inequalities in developing countries [19]. The findings of this study support the hypothesis that good breastfeeding performance protects against infant morbidity. This implicates the importance of improving all dimension of breastfeeding in the first 6 months of life for preventing infants from illness. Along with this, it is clearly depicted that BPI may be useful to identify target groups for breastfeeding promotion interventions. The index could also be valuable in establishing the association between breastfeeding and infant morbidity and evaluating the overall effect of interventions to promote optimal breastfeeding.","title":"Higher breastfeeding performance index is associated with lower risk of illness in infants under six months in Ethiopia"}
{"_id":"39d24d91-c879-e8c6-267c-fd108371e32a","text":"Temporal long saphenous vein grafting from the axillary artery via the extrapleural route can be safely used in particular situations during abdominal surgery to salvage the RGEA graft in situ.","title":"Long great saphenous vein grafting as temporary coronary bypass for extended left hepatectomy: report of a case"}
{"_id":"39d7c499-b6b0-a757-5750-7191e7877270","text":"Free flap failure can lead to functional and cosmetic morbidity, as well as result in additional operative procedures, prolonged hospital stay and increased health care costs. Moreover, free flap failure with the development of oropharyngocutaneous fistula may increase the risk of lethal complications such as rupture of great vessels. All series report a certain incidence of flap failure. Early detection of flap compromise via careful monitoring and appropriate surgical revision can lead to significant improvements in overall success rates and is the subject of this review","title":"Salvage of failed free flaps used in head and neck reconstruction"}
{"_id":"39da860b-59ef-84d4-7428-e2ff3cf9103d","text":"An old study investigated the combination of IL BCG injections into metastatic melanoma skin nodules with percutaneous RT in 19 patients. The combination approach appeared to give some advantages over treatment with BCG alone, mostly in patients with numerous small metastases and those with a small number of larger metastases. However, the results of this study should be validated by other studies, because the timing and dosage of both BCG and RT was not well defined and the number of patients was limited [36]. Studies of radiotherapy in combination with intralesional therapies are show in Table 2.","title":"Radiotherapy in the Treatment of Subcutaneous Melanoma"}
{"_id":"39e824e8-60be-18c5-ea54-ac1d52590379","text":"Understanding the variation in secondary surgery along with causative factors for this variation may impact how, where and by whom treatment is delivered. There are many controversial elements of cleft palate care, including use of postoperative antibiotics10 and the importance of hospital volume and provider volume.11 12 Timing of primary cleft palate closure is also controversial: some providers advocate performing repair before 9 months of age to improve speech outcomes,13–15 while others delay palate repair until 12 or 18 months of age when the palate has grown larger and the risk of harming future facial growth may be reduced.16 17","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"39ea7e3a-7c78-191f-491b-ca4331da83b6","text":"One indication for the treatment of AK is to prevent the progression to SCC. Currently there is no up to date incidence data for SCC for the time periods studied in this paper. Further studies could examine if the treatment of AKs correspond to a reduction in cutaneous SCC. These studies would determine if the high cost of treating AK is justified.","title":"Cost for the treatment of actinic keratosis on the rise in Australia v2; ref status: indexed"}
{"_id":"39ebac89-ee95-db92-2917-2cf0189e5d52","text":"Conclusions: The majority of children studied due to suspected drug hypersensitivity reported cutaneous symptoms and nonimmediate reactions. Most reactions occurred before 3 years of age, which according to the literature, concerns the age when infectious rashes are more frequent. We verified a seasonal pattern in the occurrence of the suspected drug reactions that is similar to that described for the most common viral infections in childhood, while the peak for antibiotic consumption has been reported in autumn. Confirmation of hypersentisitivity to the suspected drug was possible in 10 of 364 patients, while a possible viral etiology was documented in 14 of 74 patients. Our findings reinforce the idea that many of the cutaneous reactions which motivate the study in our department are probably caused by infections and not by drug hypersensitivity.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"39ede586-fc37-c02c-d4a9-65e8d107d22f","text":"After sufficient hemostasis, the epidermis at the proximal end of the preset submental flap was removed as appropriate to extend the pedicle, and the submental flap at the distal end was advanced into the nasopharynx through the cervical and parapharyngeal space. The flap was flattened to fully cover the defect of the nasopharynx and\/or sphenoid sinus cavity. According to the positional relationship between the posterior nostril and the submental flap, two groups of suture traction lines at the lower part of the flap could be used to fix the submental flap to the nasopharynx. A moderately sized posterior nostril embolus was made with iodoform, and the submental flap was moderately compressed and fixed on the nasopharynx.","title":"Reconstruction of nasopharyngeal defect with submental flap during surgery for nasopharyngeal malignant tumors"}
{"_id":"39f7890d-29e7-8373-741c-d6d19717f4ef","text":"Fungal skull base osteomyelitis (SBO) is a severe complication of otitis externa or sinonasal infection, and is mainly caused by Aspergillus species. Here we investigate innate and adaptive immune responses in patients with Aspergillus SBO to identify defects in the immune response that could explain the susceptibility to this devastating disease.","title":"Th17 cytokine deficiency in patients with Aspergillus skull base osteomyelitis"}
{"_id":"39f9bb6b-8203-1a49-2d54-dc76f2e783b6","text":"In summary, the present paper has adopted three dimensional numerical simulation method to investigate the thermal effects of arterial bifurcation on temperature responses during cryosurgery based on single and multiple cryoprobe system. We have investigated in detail that the blood velocity distribution in arterial bifurcation and its effects on the iceball growth. The results indicate that complex blood velocity distribution could induce the inhomogeneous convective heat transfer between solid tissue and arterial bifurcation. Thus the iceball near arterial bifurcation presents strong irregular geometry. The blood flow of bifurcated artery has significant heating effects on the target freezing domains. It is also noteworthy that the artery wall is easily suffering from cold injury, which should be paid by special attention. In order to protect the artery wall, nanoparticle and external fields [19, 20] could be applied to enhance heat transfer near artery wall with low temperature.","title":"Computational study of the effects of arterial bifurcation on the temperature distribution during cryosurgery"}
{"_id":"39fd1453-5d8e-b0ce-7a91-5b11bc6bdc80","text":"In conclusion, this study was conducted to better understand the effect of PS on the qualitative prognoses of severe trauma patients. We found that higher trauma severity generally affected the prognoses of severe trauma patients, and that PS involvement only significantly contributes to discharge disposition to home.","title":"Association between the participation of the plastic surgery department and qualitative prognoses in severe trauma patients: A retrospective observational study"}
{"_id":"3a00897c-9a9b-c1c9-c519-1605f8c62e4e","text":"Before the introduction of SLNB the standard of treatment for palpable metastatic inguinal lymph nodes in patients with cutaneous melanoma was inguino-iliac\/obturator lymph node dissection. This was due to the fact that up to 40% of patients with palpable metastatic inguinal lymph nodes had metastases in the iliac or obturator nodes.6","title":"Inguinal or inguino-iliac\/obturator lymph node dissection after positive inguinal sentinel lymph node in patients with cutaneous melanoma"}
{"_id":"3a18bbf3-07fe-5721-1a86-2e23ac4aac2a","text":"Reconstructive options for scalp and cranial defects have a wide range of options from primary closure for small defects to free tissue transfer for defects that are larger and more complex.3","title":"Scalp Reconstruction: A Review of the Literature and a Unique Case of Total Craniectomy in an Adult With Osteomyelitis of the Skull Tutela et al"}
{"_id":"3a1af2f9-6be5-2800-3d81-b976c60a6029","text":"In conclusion, our case shows that external tissue expansion demonstrates excellent potential as a method to salvage failed reconstruction in the head and scalp. Further studies with larger sample sizes are needed to assess the efficacy of external tissue expansion with other types of head\/neck wounds.","title":"External tissue expansion to salvage failed scalp and forehead reconstruction: a case report Salvage of Scalp Reconstruction via ETE"}
{"_id":"3a2469db-b99c-0af1-a14c-496d5aae25bd","text":"Many of the interviewees expressed how their reflections on seeing different styles of leadership influenced the way that they viewed their own leadership abilities and skills.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"3a2ad151-ae8d-3991-e99e-46b8a7b9b02e","text":"Artificial fillers would likely have an increased likelihood of inflammatory or allergic reactions compared to autologous fat injections. Both artificial fillers and autologous fat injections could develop bleeding, infection, swelling, or other complications discussed above. The work-up and treatment would largely be similar if not the same for other artificial fillers as well as autologous fat injections aside from the fact that allergic reactions would theoretically be decreased in autologous fat injection.","title":"Penile Girth Injection Complications: A Case Report"}
{"_id":"3a32bd5a-2947-01cd-87fa-6594d95d128d","text":"There are two types of pathologic osteonecrotic disorders: medullary and corticocancellous involving the joint.2 Medullary osteonecrosis is caused by interference in the blood supply to the medullary cavity, which results in the death of the cells of the trabecular bone. Corticocancellous osteonecrosis involving the joint is usually much more pernicious and causes much more patients distress; the vascular compromise usually occurs in the proximal femur, and both the trabecular and the subchondral bone die and the region does not calcify as in the medullary disease.","title":"Biophysical stimulation in osteonecrosis of the femoral head"}
{"_id":"3a3a9cf0-de8f-e92f-477d-34e878848673","text":"All subjects were visited by both infectious disease and orthopedics specialists and site of biopsy was chosen by at least one of them. Bone biopsy, surrounding tissue and wound discharge sampling were done by orthopedic specialist at operation room under sterile condition. Samples were transferred to laboratory by transport medium straightaway.","title":"Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran?"}
{"_id":"3a3d7395-6a23-33e5-fbc0-5d8806670e83","text":"We believe that transrectal biopsy should only be done to confirm the existence of local recurrence once biochemical recurrence has been established.","title":"Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution"}
{"_id":"3a42ed38-c938-dabb-3770-b0613146ddfa","text":"Four patients who were diagnosed with ORN of the mandible and 3 patients who were diagnosed with MRONJ of the mandible were included in the study. Among the 7 patients, 3 patients also had pathologic fractures. Partial mandibulectomy and FFF reconstruction were performed at the Department of Oral and Maxillofacial Surgery, Samsung Medical Center from April 2019 to March 2021.","title":"Reconstruction of mandibular defects in osteoradionecrosis and medication-related osteonecrosis of the jaw using fibula free flap and management of postoperative wound infections"}
{"_id":"3a48264e-df9a-de63-f7f4-391436fea9c0","text":"Another advantage of this partial latissimus dorsi muscle flap is that the flap length and width are adjustable. This eliminates concerns about selection of the improper implant. Further, if the length of the flap is found to be sufficient, the anterior serratus branch of the thoracic dorsal vessels can be preserved. This can help to avoid atrophy of the anterior serratus muscle and protect its function.","title":"A Retrospective Study of Latissimus Dorsi Flap in Immediate Breast Reconstruction"}
{"_id":"3a4ab411-03d0-098b-08e5-f309e3b3e821","text":"Delayed microvascular reconstruction after major head and neck tumor resection with temporal mucosal wound coverage by skin substitutes is feasible. No disadvantages in terms of perioperative morbidity, functional outcome or survival have been observed.","title":"Delayed Reconstruction after Major Head and Neck Cancer Resection: An Interdisciplinary Feasibility Study"}
{"_id":"3a4c205c-ce0a-7a62-96de-d0b3ce10cb05","text":"We report on a case of hypersensitivity to bepotastine besilate in a patient with chronic spontaneous urticaria.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"3a523d2d-f041-3d94-075f-ed04265f895b","text":"Diffusion of radioactivity injected around the tumor into the breast may preclude identification of a SLN near the tumor site due to radioactive shine-through. Shine–through occurs in lesions in the upper outer quadrant close to the axilla. SLNs located less than 115 mm from the injection site may be poorly localized secondary to high background activity. Another pitfall in lymphoscintigraphy is radiopharmaceutical within the needle hub simulating a lymph node.","title":"Sentinel Lymph Node Evaluation: What the Radiologist Needs to Know"}
{"_id":"3a5978e0-88c8-7c84-ff7c-29de2f2cfab1","text":"The majority of the cases reported in the literature have demonstrated that surgical excision of lipomas has good results for functional recovery. In this case, however, the palmar digital branches of the ulnar nerve for the ring and little fingers passed through the mass and the branch for the little finger was firmly attached to it. This may have been the cause of the tingling sensation in the ring and little fingers. Therefore, to enable a complete excision of the mass, the branch for the little finger was temporarily transected. After complete excision of the mass, the transected branch was coapted again under microscopy.","title":"Giant lipoma in the hand A case report"}
{"_id":"3a5e75e7-84cc-e6a5-e4b8-b9d9216024eb","text":"The positioning of the external fixator is applied in a way that does not make the surgical resection any more difficult.","title":"ANKLE ARTHRODESIS WITH INTRAMEDULLARY RETROGRADE NAIL FOR BONE TUMORS. PRELIMINARY RESULTS AND SURGICAL TECHNIQUE ARTRODESE DO TORNOZELO COM CAVILHA INTRAMEDULAR RETRÓGRADA PARA TUMORES ÓSSEOS. RESULTADOS PRELIMINARES E TÉCNICA CIRÚRGICA"}
{"_id":"3a6726af-4d3f-78c5-3c5c-622e81a40b1e","text":"Based on our data, we believe that strict adherence to the two-point technique is insufficient to adequately evaluate the proximal vessels of the lower extremity for DVT. We believe that POCUS sonographers should perform sequential compression of the proximal leg veins that includes the femoral vein.","title":"Two-point Compression Ultrasound Technique Risks Missing Isolated Femoral Vein DVTs"}
{"_id":"3a676d79-ca8e-0d22-80ed-185a1cd72987","text":"With the development of perforator flaps newer and more reliable flaps have become available for lower limb reconstruction. According to the Gent consensus, perforator flaps are composed of skin and subcutaneous fat nourished by perforators arising from deep vascular systems, which reach the surface by passing mostly through muscle and intramuscular septa. Although perforator flaps technique requires microsurgical dissection, it does not require vascular suturing and can thus be defined a microsurgical nonmicrovascular flap as reported by Georgescu et al. Avoiding vascular sutures makes the surgical act quicker in comparison with microvascular flaps.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"3a6ae840-82eb-28ec-20c8-7a6f2283ba15","text":"To date, no data have been published showing the proportion of patients with inguinal or incisional hernia exhibiting one or more characteristics of a complex hernia. Therefore, an analysis of data from the Herniamed Registry was performed and the findings are presented below.","title":"The reality of general surgery training and increased complexity of abdominal wall hernia surgery"}
{"_id":"3a847b18-6aa3-cf49-38c9-97a67f4de07c","text":"We present a rare case of EPC in a DIEP flap. There are several areas that could be explored in future research with regard to EPC, including sentinel node biopsies with BCS and the efficacy of adjuvant endocrine therapy in overall survival rates for patients with associated DCIS or micro invasion. Nonetheless, EPC generally offers a good prognosis and early detection and resection remain the gold standard treatment.","title":"Encapsulated Papillary Carcinoma in a Deep Inferior Epigastric Perforator Flap Breast Reconstruction: A Case Report"}
{"_id":"3a8f17eb-a6fd-8474-7127-80ab8c1aa0b8","text":"In the current literature, there is a lack of uniformity in the grading of ankyloglossia. For this reason, we propose the use of the HATLFF scoring system in assessment of ankyloglossia, which has been shown to correlate with breastfeeding difficulty and success of intervention, and more specifically, the use of the “function impaired” HATLFF score as an indication for division","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"3a93da27-3b4e-21a0-5e82-f164d9be9e45","text":"The small access postaural approach, however, has limited exposure to upper pole and far anterior region of the parotid gland. Preaural extension along the pre-lobule sulcus and tip of tragal cartilage may be necessary as decided intraoperatively to gain exposure to upper pole and far anterior areas. For some patients with large size tumor in the lower pole, hairline extension posteriorly can be done as decided intraoperatively to gain exposure to the lower pole. For the more difficult cases, both preauricular and hairline extension can be added simultaneously in converting to a full modified facelift approach to gain a much wider exposure to all regions of the parotid.","title":"Small access postaural parotidectomy: an analysis of techniques, feasibility and safety"}
{"_id":"3a97b3e0-963e-cf3b-187d-1764e9191aca","text":"Our series is the continuance of a work begun in 2001 and carried out in collaboration with the Office of Evaluation of New Sanitary Technologies by Lain Entralgo Agency and sponsored by Carlos III Institute.","title":"Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution"}
{"_id":"3a9974cb-c58d-55d5-8990-40309132f654","text":"Table 3 Symptom scores at various time points in previously untreated and pretreated patients with achalasia","title":"Treatment of achalasia: the short-term response to botulinum toxin injection seems to be independent of any kind of pretreatment"}
{"_id":"3a9e5aa7-9cac-29d3-1609-b5453c69784a","text":"Rhinoplasty is one of the most common aesthetic procedures in the world. It is the most common aesthetic surgery procedure in Iran. Achieving complete patient satisfaction is almost impossible but improving the aesthetics and function of the nose is the aim of surgery. This report describes a 34 years old woman with a large bump in the tip of the nose after three times cosmetic rhinoplasties. The first time was done 4 years before referral to our center as a reduction rhinoplasty operation. The next two subsequent surgeries were performed for revision and correcting the dorsal irregularities and supra tip bulge.","title":"Fibrinolysinoma after Direct Injection of Fibrinolysin for Treatment of Nasal Tip Swelling: A Case Report"}
{"_id":"3aa1b57c-1416-c40c-0685-4fdd9930882e","text":"Despite its inherent limitations, this study suggests that palatal musculature reconstruction via intravelar veloplasty or reorientation via Furlow double z-plasty improves the resolution of COME in the population with cleft palate. Institutional protocols that include tympanostomy tube placement at the time of palatoplasty trended toward improved COME.","title":"Timing of Tympanostomy Tube Placement and Efficacy of Palatoplasty Technique on the Resolution of Chronic Otitis Media: A Cross-sectional Analysis Brgoch et al"}
{"_id":"3aa82d5d-eba1-46d3-78e1-a9d188569dc7","text":"Biofilm formation is an important consideration with any infected implant. Biofilms are characterised by microcolonies of bacteria encased in a protective extracellular polymeric matrix. They can develop on any abiotic device implanted into a living organism. Given that one of the most common types of device implanted is a joint arthroplasty, most of the research has been carried out in orthopaedics. Currently, there is no widely accepted treatment for biofilms other than removal of the infected implant.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"3aaa039a-65eb-77c7-d67a-a590f2e9a1ce","text":"The palmar skin of the hand has a good regenerative capacity. Minor superficial defects or surgical wounds without involvement of underlying structures will heal via secondary intention within weeks. Larger defects on the hand usually need some kind of reconstructive procedure to ensure adequate healing, protect exposed tendons neurovascular structures or bones, and prevent scar contractions.","title":"Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View"}
{"_id":"3aae2805-a292-54fe-32ff-109b328a44a1","text":"Hybrid fixators may be associated with a greater risk of infection-recurrence in the treatment of tibia infected nonunion and chronic osteomyelitis. The number of previous surgeries and external fixation time can be used as predictors of outcomes. Proper fixators and meticulously designed surgery are important to avoid unexpected operations and shorten external fixation time.","title":"Infection-free rates and Sequelae predict factors in bone transportation for infected tibia: a systematic review and meta-analysis"}
{"_id":"3aae3c69-41c9-929e-08dd-f5882c92108c","text":"Dissection began with the removal of the skin and superficial fascia from the area of the knee and leg, up to the gastrocnemius muscle. Following this, the lateral and medial head of the proximal part of the gastrocnemius muscle were isolated from each other. The medial head of the gastrocnemius muscle was then partially removed, and the lateral head of the gastrocnemius muscle was separated at the musculotendinous junction, thus exposing the proximal part of the soleus muscle and plantaris muscle. The knee joint capsule was then thoroughly dissected, as well as the PPM and all structures around it.","title":"A proposal for a new morphological classification of the popliteus muscle tendon with potential clinical and biomechanical significance"}
{"_id":"3ab90f09-357b-c204-ba28-c5e82501e749","text":"With technological development of pulmonary angiotomographies, diagnostic identification of subsegmental PTEs increases and the best therapeutic management in these cases is uncertain. Changes are often small and may correspond to false positives, and true subsegmental PTE is generally associated with small DVTs. The risk of progression or recurrence of VTE in the absence of anticoagulation is small in relation to larger PTEs.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"3abb855a-e39d-921c-e651-7c77eb394d82","text":"The increasing number of living CM patients and the increased risk of developing a second primary tumour incited us to analyse the clinical characteristics of cutaneous melanoma and to define the frequency, site, and type of second primary cancers in our patients.","title":"Clinical Characteristics of Cutaneous Melanoma and Second Primary Malignancies in a Dutch Hospital-Based Cohort of Cutaneous Melanoma Patients"}
{"_id":"3ac10744-7328-a481-6d73-f3bb1e054ed8","text":"Herein, we show that antigen passage cellular patterning was altered in IL4raF709 mice at Ts conditions compared to WT BALB\/c mice. Activation of antigen passage formation predisposed IL4raF709 mice to oral food sensitization at Ts conditions. Tn housing of IL4raF709 mice altered the antigen passage landscape and increased penetrance of food sensitization and reactivity. Tn housing of WT BALB\/c mice altered the SI antigen passage cellular patterning (GAP to SAP) and landscape promoting passage formation from the villus to the crypt region. Activation of antigen passages and oral exposure of Tn conditioned housed IL4raF709 and WT BALB\/c mice to egg antigen significantly exacerbated allergen-specific IgE and IgG1 responses and led to hypovolemic shock that coincided with the activation of mucosal mast cells following systemic and oral allergen challenge.","title":"Thermoneutrality Alters Gastrointestinal Antigen Passage Patterning and Predisposes to Oral Antigen Sensitization in Mice"}
{"_id":"3ac1f190-bb1a-5254-0891-fd872909a3d3","text":"Intraoperative assessing and postoperative monitoring of the viability of free flaps is of high relevance in reconstructive microsurgery. Today different methods for the evaluation of tissue perfusion are known. Indocyanine Green angiography is an emerging technique among plastic surgeons with a broad scope of applications especially in microsurgical free flap transfer. We demonstrate the value and clinical application of this technique based on representative selected cases where Indocyanine Green angiography was used in microsurgical free flap transfers from different anatomic donor sites during the operation. Hereby perforator selection, flap tailoring, changes of blood flow and patency of anastomoses was judged and decision making was based on the angiographic findings. This method has proven to be valid, reproducible and easy to use. The application is not limited to the evaluation of skin perfusion, but is also applicable to muscle tissue or chimeric or composite flaps. Reliable judgement is especially given for the extent of arterially perfused tissue following complete flap dissection. Moreover, this real-time angiography revealed a high sensitivity for the detection of poorly perfused flap areas, thus supporting the conventional clinical judgement and reducing complications. In summary Indocyanine Green angiography has the potential to reduce flap related complications and to contribute to enhancing and extending the possibilities of free flap surgery.","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"3ad8446c-eb3f-a104-24d7-db17768379f2","text":"Three studies examined the relationship between breastfeeding and the presence or absence of interdental spaces in primary dentition. Two concluded that breastfeeding for up to six months is related to an absence of maxillary spaces, while the third related the existence of breastfeeding to diastema and primate spaces.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"3aeae1e2-d387-d5fb-dedb-9bd3aa3d24ee","text":"In this cohort study, patients with prostate cancer who received primary radiotherapy were more likely to develop a second primary cancer than those who did not receive radiotherapy, with increasing risk over time, especially 10 years or more after treatment. Overall, the incidence and risk of developing a second primary cancer were relatively low in both groups. Although the long-term toxic effects of radiotherapy are important to discuss when counseling patients on the risk-benefit profile of prostate radiotherapy, they need not deter physicians from recommending radiotherapy if appropriate. Patient selection and shared decision-making remain important when considering prostate cancer treatment options. Physicians caring for patients who have previously received radiotherapy for the treatment of prostate cancer might consider further evaluation if symptoms occur that potentially indicate the development of a second primary cancer.","title":"Assessment of Second Primary Cancer Risk Among Men Receiving Primary Radiotherapy vs Surgery for the Treatment of Prostate Cancer Second Primary Cancer After Radiotherapy vs Surgery for Prostate Cancer"}
{"_id":"3aec5ed9-5da9-c187-794f-293c36dc7f1b","text":"Conclusion: This study suggests some clinical factors associated favorable allergen reactivity change may affect good clinical outcomes in early phase of immunotherapy.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"3aec8d49-bd7e-b74b-a198-0cb2edc38ace","text":"Venous embolism after facial injection of fillers has been rarely reported in the literature. We herein describe a case of superior ophthalmic vein embolism following autologous fat injection into the forehead area.","title":"Superior Ophthalmic Vein Embolism Following Forehead Augmentation with Autologous Fat Injection"}
{"_id":"3aedd028-a8c7-29ff-71fb-146c684e63d2","text":"This study showed that in terms of technical feasibility and patient safety, attached surface probes are comparable to the standard unattached surface probes used with the O2C analysis system for flap perfusion monitoring. However, cut-off values for attached surface probes that indicate sufficient flap perfusion need to be determined to maintain the reliability and usefulness of the O2C analysis system as a method for flap perfusion monitoring.","title":"Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study"}
{"_id":"3af06aae-42c6-003a-4446-2cdb41583906","text":"In our study, tissue and serum NO levels were measured at 24 h and 10 days after IR. NO levels at 24 h were significantly higher in the groups that underwent ischemic preconditioning and Botulinum A toxin injection, with a greater increase in the preconditioning group. This suggests that while the protective effect of NO against IRI was present in both groups, ischemic preconditioning was superior to Botulinum A toxin. Although the IR-only group showed a statistically significant increase in tissue NO values on day 10, this increase was also observed in the serum values.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"3af3c980-b07d-6d7e-575c-5f9e903d8b3b","text":"The aim of the study was to evaluate retrospectively the results obtained in patients undergoing surgery in which we use EDB as skin muscle flap coverage and as tissue to fill cavities after surgical treatment of chronic osteomyelitis in the foot, ankle and distal leg, as well as to determine its clinical feasibility and analyze possible complications especially on the donor area.","title":"Extensor digitorum brevis flap on the treatment of lower limb injuries"}
{"_id":"3af3e997-e81d-0990-636c-588cff9a5af3","text":"The upper angle of the popliteal fossa is formed by the biceps and semimembranosus muscle. Medially to the edge of the biceps femoris muscle, the common peroneal nerve is identified through a layer of fat tissue. An ascending sharp dissection is made superficially to the nerve until the level of its origin from the sciatic nerve. This careful dissection continues distally until the surface of the peroneus longus muscle. At this point, the tibial nerve is also dissected in the popliteal space superficially to the popliteal vessels and both nerves are hooked with vessel loops to allow gentile lateral traction (Figure 2).","title":"Popliteal lymph node dissection for metastases of cutaneous malignant melanoma"}
{"_id":"3afab70e-b9df-a756-a6f2-521c77a37451","text":"To investigate further on whether different antithrombotic or cytoreductive agents can play different roles in the prevention of recurrent thrombosis in MPN patients, we took advantage of several large databases built in the last decade, pooling a cohort of 1500 patients with MPN and previous thrombosis.","title":"Hydroxyurea prevents arterial and late venous thrombotic recurrences in patients with myeloproliferative neoplasms but fails in the splanchnic venous district. Pooled analysis of 1500 cases"}
{"_id":"3afe4a6b-fc35-a484-20cb-d190339d9083","text":"Due to the significant repercussions of untimely fracture healing, substantial research has sought to elucidate the effectiveness of adjunctive therapies for accelerating fresh fracture healing. One such treatment that has gained much attention is ultrasound therapy.","title":"Low-intensity pulsed ultrasound: Fracture healing"}
{"_id":"3b072e70-b9e8-9083-7d47-de62ab049d67","text":"Accurate visualization of the SLN is required for the best results. Conventional lymphoscintigraphy provides planar images with views in only anterior or lateral projection and poor spatial information on the location of pelvic SLN. In our study, we have done planar imaging only in anterior and posterior projections without lateral images. We firmly believe that it does not limit the comparison of planar versus SPECT imaging. According to our experience lateral images compared with anterior and posterior projections have no role for the detection of other “new” SLNs. It is very important to image lymph nodes in anterior and posterior projections with and without lead shielding located above injection sites. Other situation is in the detection of SLNs in patients with breast cancer and melanoma where lateral planar projections are necessary.","title":"Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT\/CT"}
{"_id":"3b0a7fdc-f38c-3221-2ee1-4617fb977da9","text":"In addition, results showed that the oblique incident angle and flat chestwall thickness also played an important factor in increasing the skin dose in postmastectomy patients. As severity of skin toxicity is radiation-dose related, this suggests a possible relationship with breast reconstruction complications and an impairment of the skin thickness with radiation due to skin fibrosis.","title":"An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy"}
{"_id":"3b0d61ca-bc88-a577-5329-79d28b208e2b","text":"Mandibular advancement guarantees the expansion of the retrolingual space and therefore the advancement of the position of the tongue.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"3b0dcfd7-e58e-39b7-0706-18bc220a924f","text":"This case is an example of a patient with a remote cancer history and prior chest radiation with a challenging LIMA dissection due to unrecognized recurrent malignancy. The gross appearance of her recurrent tumor was initially suspected to be scarring from radiation fibrosis and only a formal histologic evaluation yielded the diagnosis of malignancy. The recurrent breast cancer in this patient did not appear confined to a lymph node, but may have arisen from undetected metastases to the internal mammary lymph nodes (IMN) that run along the LIMA. IMNs are a major pathway of lymphatic drainage for the breast and IMN involvement has been reported in approximately 20% of breast cancers at the time of presentation [3]. Routine biopsy and pathologic evaluation of IMNs is generally not performed due to their deep location. Risk of IMN metastasis correlates with axillary lymph node involvement and increases with the number of involved axillary lymph nodes; however, involvement of IMN alone is not an independent predictor of overall survival or disease free survival [3, 4].","title":"Case report: recurrent metastatic breast cancer in internal mammary dissection bed discovered at the time of coronary bypass"}
{"_id":"3b0f9fbb-9be3-76a2-4106-6c6a5a2624a9","text":"However, there is a group of patients in whom endovascular procedures are unsuccessful because of difficulties obtaining vascular access or related to obstructions caused by extensive calcification of the vessel. In such patients, classic arterial bypass surgery may be a treatment option. For patients in whom a bypass constructed with a synthetic graft shows signs of infection and must be removed, it is necessary to employ complex procedures to avoid loss of the limb.","title":"Hybrid treatment for lower limb revascularization in a patient with vascular graft infection: a case report"}
{"_id":"3b0fcdc1-75d0-0fe4-f5fa-7a7ad2225426","text":"Numerous studies have documented that male facelift patients are at greater risk for hematoma than their female counterparts. Baker et al initially reported that strict perioperative blood pressure control with clonidine significantly reduced the incidence of hematoma in men. Since that time, others have corroborated this. Even with perioperative blood pressure control regimens, hematoma rates remain higher in male patients than in females.","title":"How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications"}
{"_id":"3b12a605-3538-905f-5a48-e42fc7911d85","text":"Table 2 Univariate and multivariate Cox proportional hazards regression model estimates of clinicopathological and molecular characteristic associated with the development of disease recurrence in patients following a positive and negative sentinel lymph node biopsy","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"3b15e9aa-e6a5-d340-028b-72cb0840ce6b","text":"MMS and surgical excision remain the standard of care for treating BCC. However, new targeted molecular therapies now provide effective treatment options for patients with locally advanced or metastatic BCC. Topical therapies may be effective in treating superficial disease in many cases, although careful surveillance is needed to confirm tumor clearance. Further randomized prospective studies are needed to examine the long-term effectiveness of these alternative modalities and their ability to decrease overall morbidity.","title":"Emerging concepts and recent advances in basal cell carcinoma [version 1; referees: 2 approved]"}
{"_id":"3b18750f-fffa-968e-0c21-8036fbbc1ebc","text":"Thus, the comparison of the microscopic photographs of the results of the treatment of a malignant tumor by photodynamic therapy allows us to observe a clear picture of what happens in the irradiation zone on the 21st day after sessions with different exposure parameters.","title":"On the Pathomorphological Pattern of the Efficiency of Photodynamic Therapy of Murine Melanoma B16 Using a New Photosensitizer Based on Chlorin e6 Conjugate with a Prostate-Specific Membrane Antigen"}
{"_id":"3b255f41-3f42-6f1f-a262-dc2a22f237ab","text":"Great variation in practice is evident from our study of radiation treatment for breast cancer patients with reconstruction. Further research on the impact and delivery of radiation to a reconstructed breast may validate some of the observed practices, highlight the variability in treatment practice, and help create a treatment consensus.","title":"Breast reconstruction and post-mastectomy radiation practice"}
{"_id":"3b267c8c-bdde-9127-2405-2546c1a51fa1","text":"Our case highlights a rare location and manifestation of tumoral calcinosis secondary to SSc. As the use of MRI as the first imaging tool to investigate radiculopathy increases, it could make the diagnosis of tumoral calcinosis challenging if its typical imaging features are not recognized.","title":"Tumoral calcinosis in the lumbar spine secondary to systemic sclerosis: a rare cause of radiculopathy in an adult with advanced disease Liberato et al"}
{"_id":"3b2e9d4d-a058-4cda-46c6-38b2795decb4","text":"The dissection was continued upwards below the levator anguli oris taking care not to injure the infraorbital artery which lies between the levator anguli oris above and the levator labii superioris below, as it emerges from the infraorbital foramen, so the dissection continued to 1 cm below the orbital margin where the vascular pedicle can be seen and preserved.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"3b310143-1a6b-0a8f-92f5-94c584fb863c","text":"Regarding the status of the mandibular region after cancer surgery and irradiation, our AV loop model can be quite suitable for further clinical applications. In most of the cases of head and neck cancers requiring mandibulectomy the facial vessels could be preserved. Being medium sized vessels, the facial vessels can be used even after exposure to irradiation as recipient vessels for free flaps [34] and thus can be technically suitable to construct the AV loop.","title":"Mandibular reconstruction using an axially vascularized tissue-engineered construct"}
{"_id":"3b34136a-0004-a83f-696a-e3ca09905c93","text":"While the workflow and process described allows for access to this technology, there will be a lag of approximately 2 weeks from case submission to printed plate availability. In most cases, this planning time will not affect outcomes but may not be favorable to all owners. In addition, due to the highly specialized nature of these procedures, cost to the owner for the preoperative planning, surgery and postoperative recovery will still be a significant consideration. Despite these potential limitations, many patients that are already undergoing this complex procedure would ultimately choose to provide the best standard of care for the greatest outcome.","title":"Schedule feasibility and workflow for additive manufacturing of titanium plates for ranioplasty in canine skull tumors"}
{"_id":"3b347f24-fdf6-119d-b296-d7e7563ba510","text":"Our study showed an increased complete excision rate and reduced need for secondary surgeries and adjuvant therapy in patients with IFS. However, a longer operative duration was required. Use of IFS may be useful in patients with NMSC lesions in sensitive regions requiring complex reconstruction after tumour excision.","title":"Use of Intraoperative Frozen Section in the Surgical Management of Patients with Nonmelanoma Skin Cancer"}
{"_id":"3b34ef9b-7dc2-1410-7f44-324d1cf189ab","text":"DF is a rare benign primary bone tumor, histologically similar to the soft tissue desmoid tumor. Microscopic infiltrations of tumor are present beyond the perceived macroscopic margin. In our case, we described a rare bone tumor affecting simultaneously both the left iliac bone and the left sacral wing with interposition of macroscopically normal tissue.","title":"Computed tomography and magnetic resonance imaging of desmoplastic fibroma with simultaneous manifestation in two unusual locations: a case report"}
{"_id":"3b367025-d789-f5a0-1547-12d0757f3af3","text":"All data managements and analysis are done using unidentified data. The participating spine surgeons will only have access to data generated on their own site and cannot see the other recruiting centers.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"3b3adf0c-941b-21d1-2949-13ce90e198c2","text":"Although the exact pathomechanism remains unclear, this study provides evidence for the hot season being a risk factor for enhanced flap loss due to increase in venous and arterial thrombotic events. Larger multicentric prospective studies are necessary for confirmation and more insight into the involved pathomechanisms.","title":"Seasonal Impact on Free Flap Surgery in Terms of Flap Loss and Wound Healing Disorders: A Retrospective Cohort Study of 158 Free Flaps"}
{"_id":"3b43c484-76e9-e53d-6267-a3796c50b31f","text":"After 12 weeks of diabetes, the operation was then carried out in the form of an adipocutaneous flap graft surgical procedure under anaesthesia. The flap graft size was 4 × 10 cm for all animals. The flap graft was raised in pedicular form at the left caudal superficial epigastric artery and vein. The right caudal superficial epigastric artery and vein and the right and left cranial epigastric arteries and veins were ligated. Ischaemic preconditioning was then carried out for three hours using the different procedures described below. At the end of the procedure, the flap was placed on a silicone film and sutured in place to prevent any neo- and revascularisation from the wound base.","title":"Ischaemic Preconditioning Suppresses Necrosis of Adipocutaneous Flaps in a Diabetic Rat Model Regardless of the Manner of Preischaemia Induction"}
{"_id":"3b4a1d61-b7fc-cf80-447e-c72e46c4010f","text":"Many practitioners rely on consent forms to ensure that they have obtained informed consent. There is no question that a signed consent form is one component that will help a physician establish that informed consent has been obtained in the context of STF filler therapy.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"3b50dca0-2f45-ce54-04a2-4de12803c1c0","text":"The risks associated with this study are predominantly the risks associated with the injury and the surgery: infection, bleeding and damage to the adjacent structures such as nerves, blood vessels and tendons. Participants in both groups will undergo surgery and will potentially be at risk from any\/all of these complications. Allocation of the trial intervention will take place at the end of the initial surgery so that there is no difference between the groups in terms of surgical risk.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"3b53e710-1847-6aa9-49b7-48e3adddb1e1","text":"Gustilo type IIIC open fractures of the tibia are high-energy injuries necessitating long treatment periods and usually multiple surgical procedures and eventually resulting in high morbidity rates and even amputations. We present here a case involving a type IIIC open tibial fracture with massive loss of the entire tibial diaphysis, which we treated by performing acute tibialization of the fibula after revascularization of the posterior tibial artery in a single-stage emergency operation.","title":"Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture"}
{"_id":"3b560bd8-60d1-0c0b-c374-75620604e1cc","text":"The chosen surgical technique for moderate-severe ankyloglossia in our centre is the frenectomy and lingual plasty. The myofunctional training begins one week before the surgical intervention so that the patients learn the exercises without pain.","title":"Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol"}
{"_id":"3b6477de-45f7-ef0e-2f0d-51ad6fd7c147","text":"Cervical cord reperfusion injury is an extremely rare etiology of neurological deterioration following spinal cord decompressive surgeries. Clinicians need to maintain a high index of suspicion for this complication and need to exclude other possible surgical complications. Early diagnosis and management with high-dose corticosteroid therapy are vital to restore the spinal cord function.","title":"Cervical cord reperfusion injury: a rare complication of spine surgery"}
{"_id":"3b65434e-bbb5-e166-f18a-cca5d2ab340f","text":"Symptomatic scars can be improved and patients with troublesome scars should be referred to a plastic surgeon.","title":"Cutaneous Scarring: A Clinical Review"}
{"_id":"3b792009-808f-0a7c-cbcf-7d26d0e056ff","text":"Not indicating ALND in the forementioned patients would by itself yield a mathematical advantage in patient quality of life, but a fine tuning selection of subgroups with differing axillary involvement could be worth study, as differing rates of axillary recurrence and mortality are expected.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"3b7ef148-b5c7-9422-e5ff-5d5a0f168c61","text":"The study was approved by the multidisciplinary breast cancer board of the London Breast Institute.","title":"The Evolving Role of Marked Lymph Node Biopsy (MLNB) and Targeted Axillary Dissection (TAD) after Neoadjuvant Chemotherapy (NACT) for Node-Positive Breast Cancer: Systematic Review and Pooled Analysis"}
{"_id":"3b7f3f50-404e-4c33-d39e-902a414a7d7a","text":"This study analyzes an extensive series of 619 patients with a confirmed diagnosis of immediate hypersensitivity to BLs over a twenty-five years period. We found that the sensitization pattern notably changed over the 25 years.","title":"Changes in Sensitization Patterns in the Last 25 Years in 619 Patients with Confirmed Diagnoses of Immediate Hypersensitivity Reactions to Beta-Lactams"}
{"_id":"3b812d2c-9331-a918-6579-d1815dd6c37f","text":"In conclusion, a TLS of supervisors in surgery has a positive effect on the residents’ capability to optimize their job demands and resources during training to gain control of the work environment. This effect is rooted in the positive influence of that leadership style on the environment for training, on role modeling and on resources for the resident.","title":"Supervisors’ transformational leadership style and residents’ job crafting in surgical training: the residents’ views"}
{"_id":"3b821bab-a26d-3454-601e-efcd356b67b7","text":"Application rates to surgical residencies have shown a downward trend recently. Introducing students to surgeons early in medical school can increase interest in surgery as a career and enhance the instruction of important surgical topics. Directors of undergraduate medical education have unique insight and influence regarding the participation of surgeons in pre-clinical education.","title":"Surgeon Involvement in Pre-Clinical Medical Education: Attitudes of Directors of Education"}
{"_id":"3b913e97-da50-e196-b4ad-27ade2ab335c","text":"Peripheral vascular disease is defined as decreased arterial perfusion to the lower extremities by any cause, and can be clinically identified by intermittent claudication or the absence of arterial pulses in the lower extremities. Although patients with subclinical status may be asymptomatic, the condition can become clinically significant through the worsening of thromboembolic lesions by a natural course or surgical events such as TKA. In particular, arterial complications following TKA can lead to delayed wound healing or skin necrosis, deep infections, and amputations of affected limbs. The development of septic conditions from periprosthetic joint infection in elderly patients can sometimes be life-threatening.","title":"Asymptomatic peripheral vascular disease in total knee arthroplasty: preoperative prevalence and risk factors"}
{"_id":"3b94f7a4-5211-f191-51dd-9559d672000a","text":"Importantly, the device described here may significantly lower the overall cost of treatment compared to conventional electron therapy. By improving dose distribution and tumor control, there is also the possibilty of reducing patient visits over time by preserving cosmesis and reducing risk of tumor recurrence. While it does require the purchase of a reliable printer, the design of a device such as this may be widely implemented across radiation institutions once it is validated for clinical use. The long-term goal of work such as this is to improve the ability to target irregular skin lesions, particularly those over sites like the nose or ears, by taking advantage of 3D printing technology. A successful, clinical device will expand affordable care options to many skin cancer patients, and improve patient comfort and compliance.","title":"Novel design and development of a 3D-printed conformal superficial brachytherapy device for the treatment of non-melanoma skin cancer and keloids"}
{"_id":"3b9928c6-33c4-99a7-722d-fcd6d185cc5a","text":"Aiming at defining the best decontamination protocol, De By et al. analysed in 2012 the decontamination methods used in 17 European cardiovascular tissue banks and found major methodological differences among the various laboratories, highlighting the need to validate and standardize the procedures [12]. The differences between the protocols lie in the composition and concentration of the decontaminating solutions as well as the duration and temperature of incubation. Despite the antiseptic measures adopted in all the processing phases, a high percentage of tissues still remain contaminated, thus preventing their clinical use. The goal of every tissue bank is to achieve germ-free allografts after decontamination and the choice of the correct composition and the modalities of use of the AB cocktail are crucial. An extensive retrospective analysis of our contamination data for all tissue types was carried out with the purpose of validating a more effective decontamination procedure. In particular, the results of microbiological cultures carried out on retrieved tissues over a period of 4 years were submitted to a longitudinal analysis in order to evaluate the tissue contamination rate and the decontaminating efficacy of the AB cocktail which is currently used at our tissue bank.","title":"Evaluation of allograft contamination and decontamination at the Treviso Tissue Bank Foundation: A retrospective study of 11,129 tissues"}
{"_id":"3b9dec76-7e3f-09f6-6db9-5e2de657046d","text":"Some authors have studied the relationship between breastfeeding and occlusion and reached very different conclusions, from the absence of any association between breastfeeding and occlusion to a specific relationship between a shorter duration of breastfeeding and the appearance of particular types of malocclusion, such as posterior crossbite, open bite or class II malocclusion.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"3ba7057e-37ac-5351-da5a-f878be40410b","text":"Scimitar syndrome is a rare congenital anomaly characterized by total or partial anomalous pulmonary venous drainage of the right lung to the inferior vena cava. We present a seven year old girl with a systolic murmur who was diagnosed as having a Scimitar syndrome with unusual drainage of the right pulmonary veins. The unique technique of surgery in this patient was appropriate to the unusual, previously not described anatomy.","title":"Unique technique of surgery in an unusual variety of Scimitar syndrome: A Case Report"}
{"_id":"3bb19d60-aa06-2094-5ad3-72ff08f526f5","text":"An important differential considered was multiple epidermal cysts of the scrotum.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"3bb1ff8b-75af-a854-6e96-3ad920f0033b","text":"This is the first evaluation of the DystoniaDiary app, which was specifically developed for patients with CD and facilitates them in monitoring their most troublesome symptoms.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"3bb234ba-b850-a666-32f8-60407120f289","text":"This study showed that even though the detection rate is higher, breast cancer survivors had 30%‐40% less of their new breast cancers detected by mammography screening compared to women without previous breast cancer diagnoses. Whereas out of 81% breast cancers found at initial mammography screening of women without a previous breast cancer only 52% of breast cancers were found at initial mammography screening of breast cancer survivors. At subsequent screening 73% of new breast cancers were detected at mammography screening of women without previous breast cancer diagnoses and 45% of breast cancers were detected at mammography screening of breast cancer survivors. A significant difference was found both for women who had a diagnostic breast imaging 0‐21 months prior to mammography screening as well as for women without such a diagnostic breast imaging.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"3bb6cc21-4227-d566-79db-7bee3dc7d9db","text":"In SCC treatment, radiotherapy is usually reserved for postoperative sterilization of the surgical field after regional dissection for lymph node metastasis.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"3bbcd6ee-fcd3-a0f2-fccd-a2a8ae598852","text":"The disadvantages of MMS consist of a longer duration of the operation and higher costs.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"3bbd3486-67df-3660-d430-1f71384efaae","text":"To develop a new international plastic surgical society from scratch is a formidable challenge. In a concerted effort to embrace all national plastic surgical societies in an equitable manner, this survey was constructed to provide a snapshot of the ICOPLAST membership demographic and to identify the needs, visions, and ambitions of plastic surgeons globally. The ultimate aim of this survey was to establish a set of priorities to assist in developing a balanced strategic plan for ICOPLAST activities.","title":"Establishing Priorities for the International Confederation of Plastic Surgery Societies"}
{"_id":"3bc140fc-7eb8-9d02-c214-7d6c1991e13f","text":"Scrotal calcinosis is a rare benign entity defined as the presence of multiple calcified nodules within the scrotal skin. There are controversies about the origin of this entity. In fact, it is still debatable whether scrotal calcinosis is an idiopathic growth or dystrophic calcification of dartoic muscles. It is also unclear whether scrotal calcinosis originates from inflammation of epidermal cysts affected by mild to moderate inflammation of mononuclear cells, from foreign body granuloma formation followed by resorption of cyst walls or from eccrine epithelial cysts.","title":"Scrotal calcinosis due to resorption of cyst walls: a case report"}
{"_id":"3bc4040b-b151-e0bc-eac2-99b5027fdaec","text":"The majority of the in vitro methods that have been proposed profits from a rationalistic approach based on the notion that allergenic medicines and chemical allergens share similar processes of cell activation. To identify medicines that may have the potential to elicit in vivo hypersensitive reactions, this assay can be simply introduced into drug development [137].","title":"Evaluation of Delayed-Type Hypersensitivity to Antineoplastic Drugs—An Overview"}
{"_id":"3bc7d9dd-67b3-c15b-0246-9083e50893e9","text":"On a larger scale, the disparity of time allotted for BT training varied from no formal training to more than 5 months with the average time being 3 months. Time constraints on the treatment team were also indicated by the respondents, for example, in having limited time to train the residents in these modalities, which may be partially due to the urgent nature and short timeframe of BT procedures.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"3bcdbb85-dc09-e486-d7b0-055120ee9b62","text":"Local chest wall ultrasound over the flaps and axilla will be done 2 weeks after removal of drains to document or exclude the presence of any collections. The total amount and duration of drained fluid and the formation of seroma were recorded.","title":"The value of mastectomy flap fixation in reducing fluid drainage and seroma formation in breast cancer patients"}
{"_id":"3bd2c85e-7224-f56e-a75e-59b03f40ef23","text":"A total of 30 patients enrolled in this retrospective study were successfully treated by SIH without any side effects, and their final scar size was decreased more than the first one from the result of calculating by the color patch method. Facial area especially on the thin and concave area showed significantly higher decrease rate compared with the non-facial area. This result correspond well with those of the earlier study, which reported that wounds in concave areas of the face healed by secondary intention had a high chance of healing with an excellent cosmetic outcome, especially if these wounds were small, superficial, and located near the medial canthus and medial cheek [5]. Another interesting finding was that the final scar shape on antecubital fossa was corresponded to RSTL. This result accounts for that mechanical stress depending on the movement influences on the process of SIH. Also, this may be used as a data when explaining to patients about the final scar before the treatment initiation. Actually, if patients with skin defect on this area undergo primary closure, they usually experience pain due to tension when moving, and they are likely to be at a higher risk for scar widening. Even if skin graft was conducted on this area, cosmetic results can be unacceptable if the skin texture of graft is different from the wound site and another scarring of donor site occurs.","title":"Sequential Change of Wound Calculated by Image Analysis Using a Color Patch Method during a Secondary Intention Healing"}
{"_id":"3be1bad9-5714-a546-3978-6d97e247cc6d","text":"We present an algorithmic approach to the reconstruction of larger post-Mohs defects treated in a practice with both a plastic surgeon and Mohs surgeon. The aim of the study is to present post-Mohs reconstructive choices made by our team compared with closures done by solo dermatologists.","title":"Nasal Reconstruction of Post-Mohs Defects >1.5 cm in a Single Cosmetic Subunit Under Local Anesthesia by a Combination of Plastic Surgeon and Mohs Surgeon Team: A Cross-sectional Study and Review of Algorithmic Nasal Defect Closures"}
{"_id":"3be300d9-f383-fce9-3669-7e971fa9415f","text":"Our results suggest a correlation between lymph node metastasis and tumor immune-microenvironment in cT1 breast cancer. TIL density may be a predictor of SLNM in breast cancer without lymph node metastasis on preoperative imaging.","title":"Prediction of lymph node metastasis by tumor-infiltrating lymphocytes in T1 breast cancer"}
{"_id":"3be3ed19-a493-5dd1-c663-ab8490d41d54","text":"The internal mammary artery is responsible for about 60% of the blood supply to the breast, the medial or superomedial pedicle being based on the anterior perforating branches of this vessel especially the 2nd and 3rd, which anastomose with the branches of the Lateral Thoracic artery.","title":"Reduction mammoplasty"}
{"_id":"3becc4b1-61df-dc5f-dc14-c3e921c09389","text":"The number of men using their frozen semen for reproductive purposes was recorded as well as the number of patients discarding their samples, either by themselves or as part of a standard procedure after death. No further follow up of patients undergoing fertility treatments could be performed.","title":"Semen quality before cryopreservation and after thawing in 543 patients with testicular cancer"}
{"_id":"3bf110a4-8808-98c9-c102-c1de52ae3314","text":"Most studies evaluating the habits, attitudes and behaviour about sun exposure and photoprotection in sportspeople who do sport outdoors have been done in Spain mainly on groups of runners or athletes, collecting the information through validated and self-administered health questionnaires on photoprotection and sun exposure habits based on previous research on prevention behaviours in sportspeople. The number of articles has also increased over the years, likely in relation to the increase in skin cancer by the end of the first decade of this century [5].","title":"Knowledge, Behaviour and Attitudes Related to Sun Exposure in Sportspeople: A Systematic Review"}
{"_id":"3bf71bc2-1623-3668-5101-3968173a55dd","text":"• Recommendations should not vary in relationship to baseline risk if there is not adequate evidence to guide reliable determinations of baseline risk.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"3bf76b3b-21c8-70cc-9755-18aad62128d4","text":"Our center delivers universal health coverage and has radiation facility attached to the scheme and hence suitability of the patient to undergo breast conservation and patient’s choice were the only considerations in choosing the mode of surgery. The findings may not be generalizable to the rest of the country where availability of RT and affordability may be major concerns for choosing the treatment options. Small sample size is another limitation due to a considerable proportion of patients lost to follow-up or not willing to participate in the follow up after 5 years. Small sample size did not allow further sub analysis between the groups. The MRM patients had poor survival compared to the BCT patients in our group. This also could be due to smaller sample size, however, survival comparison is beyond the purview of this paper. Both, BCT and MRM have shown equal survival as widely accepted and demonstrated in the literature [3, 4]. The findings of this study are, however, interesting and point to that BCS may not be the golden standard in all populations, especially when resources are scarce. Larger studies from different centers in India would be required prior to establishing national guidelines regarding the standard of care for surgery for breast cancer. It points to that long term follow-up is necessary to correctly assess the outcomes after treatment for breast cancer.","title":"Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India"}
{"_id":"3bf7b781-0fc9-c69c-e0a3-366ff6c0109d","text":"The spheroid characteristic ACAN protein expression is a promising parameter to predict the regenerative capacity of spheroids and can potentially be used as a surrogate potency assay. In summary, the observed correlations of the spheroid characteristics with tissue regeneration capacity would fulfill the general requirements of a potency test. It would allow for the quantitative measurement of a biological activity associated with indication-specific functions of the product [10]. Analysis of ACAN protein expression can be performed quantitatively and moreover is associated with articular hyaline cartilage regeneration.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"3c02c511-1cc6-146a-92b1-435061df0a15","text":"Calciphylaxis is a serious medical condition that is typically associated with end-stage renal disease and presents as the sequelae of calcifications in arterioles with subsequent ischemia of affected tissues. Classically, calciphylaxis produces ulcerated and necrotic skin lesions. These may be biopsied to aid in confirmation of the diagnosis. Herein we report a case of a large necrotic breast lesion in the clinical setting of calciphylaxis, and we emphasize that a multidisciplinary approach to diagnosis and management is important to avoid unnecessary oncological resection.","title":"Calciphylaxis of the Postmenopausal Female Breast: An Uncommonly Encountered Mimic of Carcinoma"}
{"_id":"3c0bf4ed-da59-7473-ca07-fad5bb51fb04","text":"The recommended treatment strategy for stage 3 bisphosphonate-related osteonecrosis of the jaw (BRONJ) is currently rigid plate fixation without bone reconstruction. However, bone reconstruction after resection of a stage 3 defect could have a more favorable outcome with better patient satisfaction. A recent systematic review summarized case reports and series of microsurgical reconstruction after resection of BRONJ using a vascularized fibular free flap. Cases of reconstruction with an iliac crest free flap were also described. Although the exact indications for each type of free flap have yet to be established, it is widely accepted that vascularized free flaps produce better outcomes than rigid plate fixation without bone reconstruction.","title":"Refinements in the reconstruction of bisphosphonate-related osteonecrosis of the jaw"}
{"_id":"3c1cef92-3b9e-9242-d9ba-f8694cc5d8f5","text":"Oculocutaneous albinism which is characterised by impaired melanin biosynthesis is the most common inherited pigmentary disorder of the skin and it is common among Blacks in sub-Saharan Africa. All albinos are at great risk of developing squamous cell carcinoma of sun-exposed skin, and Black albinos in sub-Saharan Africa are at about a 1000-fold higher risk of developing squamous cell carcinoma of the skin than the general population. In Black albinos, skin carcinoma tends to run an aggressive course and is likely to recur after treatment, very probably because the aetiology and predisposing factors have not changed. Prevention or reduction of occurrence of squamous cell carcinoma of the skin in Black albinos might be achieved through educating the population to increase awareness of the harmful effects of exposure to sunlight and at the same time making available effective screening programs for early detection of premalignant and malignant skin lesions in schools and communities and for early treatment.","title":"Oculocutaneous Albinism and Squamous Cell Carcinoma of the Skin of the Head and Neck in Sub-Saharan Africa"}
{"_id":"3c2059d5-82db-e5d5-93dc-dd502d448bc0","text":"Antibiotic resistance remains a significant global health issue. Bacteria inherently evolve resistance to antimicrobials over time which is accelerated through selective pressures generated by antibiotic exposure. Orthopaedic trauma surgeons should be aware of evidence-based prophylaxis and treatment strategies to effectively prevent and manage postoperative infection without contributing to the development of antibiotic resistance through indiscriminate prescribing.","title":"Antibiotic resistance: still a cause of concern?"}
{"_id":"3c26336d-4103-b6de-1b8e-927f52332592","text":"One third of the mastectomy areas (14 of the 41 reconstructed breasts) had been treated with radiotherapy before lipofilling. This study is thus too small to enable a statistical assessment of the effect of radiotherapy on the survival of the grafted fat. Irradiated breast fields have been suggested to require larger volumes of fat, transferred over more lipofilling procedures, and are associated with greater degree of necrosis in the transferred fat. The scarring induced by radiotherapy also increases the amount of rigottomy needed before transplantation. In contrast, fat transfer has been shown to improve skin quality in an irradiated or scarred area, and is at times used for that sole purpose also in mastectomy areas. Thus, we do not consider irradiation damage in the mastectomy region a contraindication to breast reconstruction with lipofilling, but discuss the possible lower fat take and the subsequent need for a higher number of transfer procedures with the patient.","title":"Total Breast Reconstruction with Lipofilling after Traditional Mastectomy without the Use of Tissue Expanders"}
{"_id":"3c2ea472-ddf3-b9f0-ecc7-5f27384ff65e","text":"A suspicion of sensitization through foods or cosmetics is possible as the patient reacted the first time she received this drug.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"3c31d3a7-44a5-e648-e590-6131ad06e1eb","text":"The incidence and severity of complications encountered during bone transport have changed dramatically with studies, experience and meticulous prophylactic intervention. The complication rate was 3.1 per patient in our study, among which pin tract infection, muscle contraction and axial deviation were the top three common complications. Pin tract infection is a universal problem which can be successfully treated or even prevented from further development if it is detected in an early stage; regular dressing and improvement of patient's hygiene also plays an important role since it can spread into bone infection if not being managed properly. Muscle contraction was a result of tension generated on the muscle due to distraction and imbalance of strength between flexors and extensors which accounts for 25% of total complications in our study. Muscle contraction of most cases in our study were improved by physiotherapy, or subcutaneous Achilles tendon lengthening or applying the apparatus across the joint to distract out the contraction if needed.","title":"Bifocal or Trifocal (Double‐Level) Bone Transport Using Unilateral Rail System in the Treatment of Large Tibial Defects Caused by Infection: A Retrospective Study"}
{"_id":"3c41b454-9759-fe3b-2d29-6af04284e3a9","text":"Parents commonly seek multiple types of care for feeding problems for their babies. Evidence is emerging for the impact of musculoskeletal (MSK) dysfunction in infants with suboptimal breastfeeding, yet there is a deficit of research into common clinical practice in musculoskeletal health in infants. Research does implicate birth trauma as a key factor for the onset of MSK dysfunction in the new-born. The goal of this study was to assess Infants presented to an interdisciplinary chiropractic and midwifery breastfeeding clinic for any MSK dysfunctions, as well as to collect data on type of birth and feeding problems for each case. An aim of this study was to identify specific MSK dysfunctions which may be implicated in suboptimal breastfeeding.","title":"ECU convention 2017 research presentations Limassol, Cyprus. 25-27 May 2017"}
{"_id":"3c4256b0-735d-c472-9ca9-3d3132c3d704","text":"Leaders who held multiple roles within a single organization were only counted once with their highest leadership role documented. If leaders held positions in multiple organizations, all leadership roles were documented.","title":"Leadership Amongst Regional and National Surgical Organizations: The Tides Are Changing"}
{"_id":"3c43d35c-282f-32d4-0f8a-e293f9b3f7e6","text":"The ultrasound guidance improves visualization of the layers of the abdominal wall and allows safe needle placement and anesthetic injection in the correct plane.","title":"Transversus Abdominis Plane Block in Colorectal Surgery: A Meta-Analysis"}
{"_id":"3c541100-7a2c-0e49-fb1e-35f1dbfec118","text":"The FOM connective tissue was identified to have a high proportion of Type III collagen, shown as green on polarized light imaging of PSR stained slides (Figure 9). Type III collagen was of the highest density in the midline FOM in the location of the lingual frenulum and was less prevalent in the lateral aspects of the FOM fascia.","title":"Understanding the Lingual Frenulum: Histological Structure, Tissue Composition, and Implications for Tongue Tie Surgery"}
{"_id":"3c58e28c-0c75-dc94-aea7-135b3e509d9c","text":"Although some adverse effects may occur with HA, its enormous advantages led to its use in facial rejuvenation. With social media as a major source of information, many respondents reported unlikely adverse effects as common ones, suggesting that information sources need to be corrected by physicians to raise awareness of the adverse effects of cosmetic procedures and enhance informed decision-making by patients.","title":"Awareness and Knowledge of the Adverse Effects of Dermal Fillers Among the Saudi Population: A Cross-Sectional Study"}
{"_id":"3c5b4118-b92f-453a-fb18-871fd0ba3e65","text":"The small access postaural approach is a further milestone in cosmetic consideration of parotidectomy with advantage of no visible scar on the face and neck. It is a feasible and safe approach for most small to medium size benign parotid tumors in the central and lower pole regions of the parotid gland. It is versatile and can be extended readily to preaural and\/or hairline regions to increase exposure, as decided intraoperatively whenever necessary, without compromising the surgical exposure and risk to the patient.","title":"Small access postaural parotidectomy: an analysis of techniques, feasibility and safety"}
{"_id":"3c64328a-3cbf-0b2e-2061-8fa82dc96661","text":"To our knowledge, this is the first study that gives detailed information on absolute recurrence risks of VTE following various types of surgery in combination with patient characteristics. Our results indicate that there is much heterogeneity in risk dependent on these factors. Given that VTE is the most preventable death in hospitals, and 60% of VTE cases occur during or following hospitalization, it is important to acknowledge the high recurrence risks associated with surgery when a patient has a history of VTE.","title":"Risk and Risk Factors Associated With Recurrent Venous Thromboembolism Following Surgery in Patients With History of Venous Thromboembolism Recurrent Venous Thromboembolism After Surgery in Patients With History of Venous Thromboembolism"}
{"_id":"3c661ef5-0abc-fa0f-859d-f6642fda1ab2","text":"The rate of retention through the study visits of participants will be recorded.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"3c86374d-7e69-f2bc-6910-0bd91dfd4114","text":"Major targets to be pursued when facing this kind of reconstructions should be maintenance of similar skin color and rebuilding of the nasal structural lining and support, in order to avoid airway stenosis.","title":"Surgical Treatment with Locoregional Flap for the Nose"}
{"_id":"3c987f43-c450-f1f6-02cd-9b3f28186f0c","text":"Many microorganisms to survive in diverse environments convert their phenotype to a sessile form. An understanding of biofilm is essential for us to control this form of microorganism, as 90% of bacteria exist in this phenotype and if we want to control communicable diseases and infections we need to know biofilm morphology. Recent evidence reveals that biofilms are structurally complex dynamic systems that have both the characteristics of primitive multicellular organised organisms and complex ecosystems. Biofilm have been isolated from various conduits in hospital including drainage conduits of ICUs and respirators and their tubing.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"3c9aa64b-975a-bc56-2d08-d46fdbcbb97b","text":"For deep burns that are too extensive to be closed in one procedure, wound excisions can be staged — typically at intervals of about one week — as sufficient autologous skin grafts become available to close the excised wound. Alternatively, the burns can be completely excised within the first several days after the injury, and a temporary skin substitute used to close the wound remaining after all available autologous skin has been harvested and grafted.","title":"Surgical management of extensive burns treatment using allografts"}
{"_id":"3c9c2ee3-d4e6-fd39-06fb-8ae9d38a35ed","text":"Limitations of the current study stem from its retrospective design. All recurrent BCCs were referrals and no data were obtained regarding the type of initial excision. Similarly, it was not possible to reevaluate the first histological specimens to examine for BCC residues at the margins of dissection. Referral bias may exist, as small lesions might have been excised without margin control during primary surgery or followed up long enough to examine recurrence and more extensive lesions were preferentially sent to our department. In addition, a relatively small number of patients was analyzed in this study, especially in the recurrent BCC group.","title":"Histological and Clinical Features of Primary and Recurrent Periocular Basal Cell Carcinoma"}
{"_id":"3c9c8b07-dfbc-c792-8f40-af2964cb0b38","text":"It seems that intraoperative real-time imaging of breast tumor resection could be the gold standard in the future, after substantial efforts in the education of surgeons and in creating protocols for optimal breast tumor excision.","title":"Intraoperative ultrasound in breast cancer surgery—from localization of non-palpable tumors to objectively measurable excision"}
{"_id":"3c9cbea2-8053-04c6-8121-8b023cb723a6","text":"18 additional patients had undergone SLNB at the Royal Surrey Hospital, London. 8 were negative for signs of metastasis at time of biopsy whereas 10 were positive. All patients were negative for signs of metastasis at time of primary tumour excision and were matched for Breslow thickness.","title":"Prediction of melanoma metastasis by the Shields index based on lymphatic vessel density"}
{"_id":"3c9d4fdc-4606-1eea-59de-9112870b23f8","text":"The conclusion drawn from this traditional review is the importance of the treatment of refractory schizophrenia with catatonic patients with electroconvulsive therapy. Patients with distal deep venous thrombosis can be safely administered with ECT therapy with the continuation of anticoagulation, while those with proximal DVT, ECT should be halted and anticoagulation treatment should be continued until the resolution of DVT to safely resume the ECT sessions. Early diagnosis and treatment of schizophrenia with catatonia patients with ECT therapy is recommended to prevent life-threatening complications in the patient. Recombinant transcranial magnetic stimulation (rTMS) could be a potential alternative for the treatment of refractory schizophrenia with catatonia when there are safety concerns with ECT therapy. Nonetheless, more studies are needed to support our assertion.","title":"Association of the Thrombo-embolic Phenomenon with Electroconvulsive Therapy Treatment in Schizophrenia with Catatonia Patient"}
{"_id":"3c9d5072-0e79-de47-4c2e-37a4fd79b014","text":"This paper describes an unusual radiological appearance of implanted cartilage on CT scan in a patient who had recently undergone deep inferior epigastric perforator (DIEP) breast reconstruction surgery following a mastectomy for ductal carcinoma in situ. The purpose of this paper is to alert medical practitioners involved with DIEP breast reconstruction surgery, as well as general radiologists, to the possibility of surgically implanted costal cartilage undergoing calcification and then appearing on imaging studies as a malignant process. Information on the patient was gathered from clinical records, imaging reports and pathological samples. A literature search was performed to identify similar cases and the results showed that this occurrence has never before been described and therefore represents an advancement of knowledge about the imaging characteristics of reconstructed breast tissue.","title":"The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan Case report: The appearance of cartilage in breast reconstruction as a mass on CT"}
{"_id":"3c9f9ca8-f890-0486-5ddb-6f28fde888a0","text":"The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4–6 mm however this is based on limited evidence and specify a goal histologic margin. The objective of this study was therefore to examine the reported histological margin distance following WLE of advanced CuSCC and its association with recurrence and survival.","title":"Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck"}
{"_id":"3caa5dcb-03fd-9952-1c3d-f82ddbce922b","text":"Breast cancer surgery frequently involves an axillary clearance procedure for nodal metastases. Injury to the thoracodorsal nerve is one of the complications related to the axillary dissection. The thoracodorsal nerve innervates the latissimus dorsi muscle which facilitates in certain movements of the arm. Moreover, it can be used as a nerve graft in long thoracic nerve injury whether in trauma or surgery. Understanding the anatomy structures and good surgical technique in the axillary clearance procedure can identify and prevent such an injury to the thoracodorsal nerve. Here, we demonstrate a simple and effortless technique for identification of the thoracodorsal nerve during axillary surgery.","title":"How I do it: Simple and effortless approach to identify thoracodorsal nerve on axillary clearance procedure"}
{"_id":"3caf58ba-0c21-6880-1b65-d6eb9e2c44bf","text":"A 63-year-old male patient with arterial occlusion underwent reconstruction surgery with a free latissimus dorsi flap to treat exposure of an artificial joint in the right knee. The descending genicular artery and the great saphenous vein were anastomosed with the thoracodorsal artery and the accompanying vein. Artificial dermis was affixed over the muscle flap and the INVOS was placed over the skin paddle. Thirty minutes after the patient was returned to his hospital room, the FSO2 value dropped rapidly from the 70s to the 40s over approximately 15 minutes. At that time, no clear change in flap color was observed. The decline continued slowly after this as well and, when the FSO2 value dropped below 40 three hours after the patient was returned to his hospital room, arterial occlusion was diagnosed because of the pale color of the flap, after which arterial reanastomosis was performed. Figure 3a to c shows the postoperative progression of the FSO2 value.","title":"A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy Takasu et al"}
{"_id":"3ccd7c6b-c363-2dc2-0b46-1dc2d9065bcd","text":"Our case series is quite small because most of the soft tissue defects were small and able to be covered using gastrocnemius muscle flap. Arnold and Mixter improvised the technique in order to gain more versatility of the gastrocnemius flap by detaching the muscle origin and scoring the overlying fascia. However, this technique could only increase the size and reach of the flap by a few centimetres. Lamaris et al in their cadaveric study found that the reach could be increased further when a posterior midline incision was used compared to medial incision. The average increase in reach was 2.02cm and total surface area of 20.3cm2.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"3cd92728-cd7a-4d86-863a-21d55de4caf9","text":"Public health is by its very nature an eclectic enterprise. It is a collective movement that draws on people from across many disciplines and sectors working in concert to achieve its goals of protecting and improving the health of populations. In this paper we focus our attention on public health physicians, the medical actors in public health, whilst acknowledging that they are only one group of actors. Public health physicians are medical practitioners from a wide range of medical specialities with specific training in the principles and practice of public health. They are in a unique position to contribute to public health through their understanding of, and familiarity with, medical practice. This familiarity allows them to straddle the worlds of clinical and public health. As physicians they are often selected for leadership roles in the public health sector and accorded status and privilege by society that, we argue, can be a potent tool for effecting positive change on a stage much wider than just that of the health sector.","title":"Educating public health physicians for the future: a current perspective from Aotearoa New Zealand"}
{"_id":"3cdab976-8254-53bc-43f4-611fa13f1ae4","text":"The main limitation of this study is that although studies examined analyze the same clinical parameters, they use different classifications and compare one type of laser with the traditional surgical technique or only two types of laser appliances with each other. As a result, it is impossible to make an exact comparison between the traditional surgical technique and the different types of laser techniques.","title":"Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review"}
{"_id":"3cdbec2b-4aa2-fc85-e84e-1f8aed0eae9f","text":"The timing and reconstruction success rate of combat related injuries of the lower extremity were previously determined showing that acceptable infection rates and low rates of flap loss, despite reconstruction of wounds in the sub-acute period within one week and three months of injury. we did not use a delay reconstruction in our cases. Important factors that determined the timing and type of reconstructive procedures in lower extremity war injuries were hemodynamic stability, concomitant trauma, exposed vascular structures and severity of the injury. Providing rapid cover for the repaired vascular structures using myocutaneous or muscle flaps was of great importance.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"3cdfaeb0-8736-34d8-d24f-78c3894c7a89","text":"Another challenge in this trial is to optimise adherence to the IPC. To be a fair test of the device we need to achieve levels of adherence close to those which would be achieved if we knew that it was effective. However, in a randomised trial one has to achieve a balance between cajoling patients to persist with treatment which they might find uncomfortable whilst allowing them to stop the treatment without having to give a reason as stated in the consent procedure. Inevitably, adherence wanes over time because some patients find the IPC uncomfortable or staff became concerned by the condition of patient's skin. It is for this reason that we are planning to perform a secondary analysis of proximal DVTs up to 14 days.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"3cdfcbe9-36d4-ca5c-d50e-a580a6e3fbb5","text":"Patient rating of their symptom control or severity may be very subjective. It appears that some patients (as in the example in Figure 7) may perceive their condition as always being the same irrespective of any treatment. It is not clear if this reflects a high degree of tolerance of their symptoms by the patient or reflects a true lack of effect of the injected treatment. An alternative explanation is that the DystoniaDiary was not a suitable instrument to detect symptom control for this patient. Other patients (as in the example in Figure 6) perceive their condition as changing over time in response to treatments, suggesting that at least in some cases, this approach could be used to monitor treatment response over time.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"3ce916f9-efe3-ad6f-ca98-3f3ad589821b","text":"Studies on defibulation demonstrated that it is a low risk procedure with high satisfaction rates for facilitating childbirth and other long term complications from the infibulated scar.","title":"The Role of Plastic Surgeons in Female Genital Mutilation Reconstructive Surgery"}
{"_id":"3ceb95e6-cc23-1c42-3d78-8c00c2f75609","text":"The impact of PSM on clinical endpoints in endometrial cancer has been studied extensively. One study in Stage II endometrial cancer with extension into the cervix suggested that minimizing PSM at the cervical junction with an extended (radical) hysterectomy and removal of parametria should reduce LRR and possibly improve survival. Additional work has shown an increased rate of local recurrence in patients undergoing extra-fascial hysterectomy as opposed to radical hysterectomy, presumably due to the reduction in positive surgical margins at the cervical junction. Most recently, an NCDB study showed increased hazards for death among patients with PSMs.","title":"Positive Surgical Margins in the 10 Most Common Solid Cancers"}
{"_id":"3ceced04-4606-84fe-ca2c-840db30b107f","text":"The ROMEO study evaluated the effectiveness of OMNI canaloplasty and trabeculotomy in conjunction with cataract surgery in reducing IOP. It demonstrated that in patients with mild to moderate open angle glaucoma and IOP >18 mmHg, 79% of patients achieved 20% or greater IOP reduction on the same or fewer IOP lowering agents, and without needing secondary surgical intervention out to 12 months. A subsequent 2021 study showed similar efficacy in IOP reduction between phakic and pseudophakic eyes when standalone OMNI canaloplasty and trabeculotomy were performed.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"3cedfdcd-3b63-ef9c-7c72-96b57cfcb2ff","text":"For the calculations of LC lesions classified as SCC in situ were excluded.","title":"Head and Neck Non-Melanoma Skin Cancer Treated By Superficial X-Ray Therapy: An Analysis of 1021 Cases"}
{"_id":"3cf0a2e4-2648-85d3-eddc-442ad227bb1c","text":"Cauterization byproducts can also contaminate the fiber resulting in unwanted increase of fluorescence background. A sequence showing the ability to clean the fiber in the oral cavity using saline is demonstrated in Supplementary Video 2. A clean fiber placed inside the oral cavity of the swine was situated a few centimeters away of any tissue before cauterization, after cauterization, and after cleaning using a saline solution. The smoke and projections from cauterization resulted in a fluorescence signal that can be observed in all 4 ms-TRFS detection channels. Saline flushing removed such fluorescent debris. The cleaning process requires only a few seconds and does not affect the standard surgical procedure or present any risk for the patient (Supplementary Video 2).","title":"Autofluorescence lifetime augmented reality as a means for real-time robotic surgery guidance in human patients"}
{"_id":"3cf270bb-8153-995d-42f6-30b50c0180dd","text":"This paper describes the experience of a reference hospital in uveal melanoma surgery, and the results of an alternative approach to conventional brachytherapy as the initial approach. Our results show that a strategy based on surgery and combined with brachytherapy achieves optimal results, with different degrees of complications and a good long-term survival rate.","title":"Clinical Outcomes after Surgical Resection Combined with Brachytherapy for Uveal Melanomas"}
{"_id":"3cf34467-ffaf-f436-68da-9ca47e557f5f","text":"Our study summarizes the training backgrounds of Canadian academic plastic surgeons and demonstrates the importance of fellowship training and graduate degrees in the attainment of an academic job, as well as location of residency program. It also demonstrates that women are at a disadvantage when applying for academic positions with a longer time to being hired despite equal and possibly greater qualification. Trainees interested in a career in academia should consider obtaining graduate degrees and additional fellowship training. They should also strongly consider completing their residency training in the city they would like to eventually be hired. Future research should focus on identifying reasons for gender-based discrepancies in hiring practices.","title":"What Does It Take to Become an Academic Plastic Surgeon in Canada: Hiring Trends Over the Last 50 Years Ce qu’il faut pour devenir chirurgien plasticien universitaire au Canada: profils d’embauche au cours des 50 dernières années"}
{"_id":"3cf4e601-8a19-23ac-28c9-74a3aad038df","text":"One question relevant to this topic is the impact of dental phobia from a social economic perspective. The comparably high cost for implant treatment under general anesthesia versus removable dentures could be the major reason for primary limitation for choosing this therapy. However, if more patients were able to choose this therapy it could in the long run reduce other costly health care consumption such as depression treatment and medication. This is a discussion worth pursuing in further studies.","title":"Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study"}
{"_id":"3cf710ea-7ac8-ffae-bd8e-a56eda1cf356","text":"These structures to be preserved vary according to the different areas of the body.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"3cfb73ad-8737-a7a4-5700-00142288339a","text":"The results of the current study have shed light on the effects of photodynamic therapy for melanoma and its CSCs. It is obvious that PDT benefits from the use of photosensitizers in combination with gold nanoparticles. The best gold nanoparticles for biological applications are those that are biocompatible and have a low intrinsic toxicity. Due to their large surface area to volume ratio, they can be functionalized with a variety of other ligands in addition to photosensitizers [43].","title":"In Vitro Photodynamic Treatment Modality for A375 Melanoma Cell Line Using a Sulphonated Aluminum Phthalocyanine Chloride-Photosensitizer-Gold Nanoparticle Conjugate"}
{"_id":"3d04049e-0604-3a61-7177-bb745310e990","text":"Table 1 summarizes the main clinical and laboratory characteristics of the two cases.","title":"Case reports of hypercalcemia and chronic renal disease due to cosmetic injections of polymethylmethacrylate (PMMA) Relatos de casos de hipercalcemia e doença renal crônica devidas a injeções de polimetilmetacrilato (PMMA) por razões estéticas"}
{"_id":"3d048ca0-a6a3-54b6-a6d4-236445b1fbf1","text":"The conventional treatment group included the following procedures: After general intravenous anesthesia, the patient took the supine position. A 5 cm incision was made on the right costal margin to cut the 7th or 8th costal cartilage segment. We carved the cartilage according to the needed shape preparing for the nasal tip scaffold and nasal tip cartilage complex.","title":"3D Printing Technique Assisted Autologous Costal Cartilage Augmentation Rhinoplasty for Patients with Radix Augmentation Needs and Nasal Deformity after Cleft Lip Repair"}
{"_id":"3d055da6-389b-85a5-3b13-333d9d9c2da5","text":"The following is a report of an unusual case of a pancreatic desmoid-type fibromatosis in which a very rare variation in the immunohistochemistry findings was demonstrated: slides were immunopositive for S100 protein and not immunonegative. Most desmoid tumors are immunonegative for S100 protein with just a few cases being positive for this protein.","title":"An unusual finding in a desmoid-type fibromatosis of the pancreas: a case report and review of the literature"}
{"_id":"3d05d580-4761-2817-83dd-e9885bde0e5e","text":"During the first 6 months, usual pathologic processing of mastectomy specimens was performed per standard department protocol and in line with previously described protocols in the literature. Radiographs of total mastectomy specimens were not routinely obtained by the pathology department at our institution, regardless of the presence of microcalcifications. The following general steps were performed:","title":"Routine Use of a Standardized Mastectomy Diagram by Surgeons Improves Accuracy and Timeliness of the Final Pathological Report"}
{"_id":"3d0cb0a2-477d-4a58-62ef-8884f31edd9a","text":"This study is limited by the small sample size of subjects and insufficient longitudinal samples beyond 50 days and in the second cycle ARE. Further details on the time course and mechanisms of the regulatory process of CD4 T cell responses in nonallergic individuals may be elucidated by large-scale longitudinal studies over at least 3–6 months and transcriptomic studies with a focus on B cell subpopulations in the future. In addition, one important limitation of this study is that lymphocyte responses to allergens typically take place in lymph nodes, where the immune cell composition is drastically different than in circulation. It would be very interesting to assess this research question in vivo by the use of fine needle aspirates in future studies.","title":"B cells modulate mouse allergen-specific T cells in nonallergic laboratory animal-care workers"}
{"_id":"3d128db1-4e2b-f6ed-201b-7749255dfd9b","text":"The purpose of our study is to investigate the risk factors for postoperative deep infection among patients who underwent instrumented spinal fusion surgery for degenerative spinal disease and to present their relative risks through a comprehensive analysis, including all possible core information. To overcome these limitations, our study used a domestic national claims database that covers the entire population.","title":"Risk Factors for Postoperative Deep Infection after Instrumented Spinal Fusion Surgeries for Degenerative Spinal Disease: A Nationwide Cohort Study of 194,036 Patients"}
{"_id":"3d1b8980-67ea-acc1-f2ca-222e96998622","text":"Surgery is an important part of the management of patients diagnosed with DFO. It consists in some selected patients, to remove all or part of the infected bone(s) or even to amputate all or part of the foot. Despite the use of sophisticated imaging techniques, it is however difficult to remove all the infected tissue while respecting the principles of an economical surgery. Bone biopsy performed at the margins of the resection permits to identify residual osteomyelitis and to adjust the post-surgical antibiotic treatment. Some recent studies have reported the way to perform bone margin biopsies and have assessed the impact of the bone results on the patient's outcome. However, the real impact of a residual osteomyelitis on the risk of recurrent DFO is still debated and questions regarding the interpretation of the results remain to be solved. Similarly, the consequences in terms of choice and duration of the antimicrobial treatment to use in case of positive bone margin are not clearly established.","title":"Surgical techniques for Bone Biopsy in Diabetic Foot Infection, and association between results and treatment duration"}
{"_id":"3d284ea3-a25d-98f1-4d18-c48093fdfc90","text":"This study focused on patients undergoing any type of reconstructive breast surgery. It must be noted that our IBR group was notably smaller than our ABR and PBR groups. This is due to the fact that the primary inclusion center of this study, Maastricht University Medical Center, is a renowned tertiary referral hospital for autologous breast reconstruction in the Netherlands.","title":"COVID-associated complications after reconstructive breast surgery: a retrospective cohort study"}
{"_id":"3d287086-d5e9-03a3-ce78-f02b28b369cd","text":"Arteriolar endothelial function, microvascular regulation and responsiveness to specific stimuli are impaired in patients with PAD which may play a central role in disease development and progression. The impaired microvascular reactivity expresses the imbalance between vasodilators and vasoconstrictors, such as nitric oxide and endothelin, respectively. One study reported the assessment of microvascular reactivity by hyperemic response to contraction and cuff occlusion using BOLD imaging. Moreover, in response to chronic metabolic demand in PAD, vascular remodeling include increased diameter and density of microcirculations to accommodate the increased blood flow. Studies suggest that progression of the peripheral arterial disease can lead to disruptions in blood distribution and flow in the muscles of the lower extremity, thus creating the conditions that result in intermittent claudication. Many of these studies are performed using MR and CT-based imaging methodologies.","title":"Contrast-free ultrasound imaging for blood flow assessment of the lower limb in patients with peripheral arterial disease: a feasibility study"}
{"_id":"3d341f66-1f01-1967-3463-4d0d7d618e5a","text":"Our hypothesis was that the growth in the neurosurgeon’s surgical practice occurred from a few patients referred by each of many physicians, as opposed to many patients referred by a few physicians.","title":"Building a Brain Tumor Practice: Objective Analysis of Referral Patterns and Implications for the Growth of a Subspecialty Surgical Program"}
{"_id":"3d357b1c-f7bf-f1e7-b873-13c2aeeb98e1","text":"Pediatric malignancies differ from those of adults due to their increased risk of long-term effects from cancer treatment. Because desmoid tumors are more aggressive in juveniles, early detection and total excision are key factors in foiling the potential damage of desmoid tumors’ mass effects in the head and neck.","title":"Total Resection of Pediatric Desmoid Tumor of the Left Neck with Utilization of 3D Virtual Surgical Planning"}
{"_id":"3d3f4bd0-ae34-f6d0-4168-1858d432d368","text":"In conclusion, we report a case of cervical vertebral osteomyelitis which appears to be an exceptional complication of surgical tracheotomy. Our observation remains uncommon but may inform clinicians to consider it when progressive febrile tetraplegia after a tracheotomy occurs.","title":"Cervical anaerobic vertebral osteomyelitis following surgical tracheotomy: a case report"}
{"_id":"3d4554fb-3ab2-f7c4-17a4-6fe139bb8963","text":"In this cross-sectional diagnostic study, the OHP and Innovance ETP assays could not discriminate patients with VTE among emergency department outpatients with suspected VTE. The GHAs further indicated that the patients with suspected VTE were in a prothrombotic state, due in part to an increased fibrinogen level. These data suggest that OHP and ETP are sensitive to acute phase effects and comorbidities that are unavoidable in outpatients at the emergency department. In conclusion, the ETP and OHP do not seem to improve the diagnosis of acute VTE.","title":"Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers"}
{"_id":"3d48e204-4a1e-76bb-60ee-ffcaed34c2be","text":"In terms of minor complications, there were 3 instances of wound infection and 3 hematomas over the entire case series. All 3 wound infections were treated with surgical drainage and debridement, and all 3 hematomas were treated with surgical evacuation. Two of the wound infections and one of the hematomas occurred in the ALT subset to give an incidence of 6% and 3% for infection and hematoma in that patient population.","title":"Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction"}
{"_id":"3d4962d7-2a5a-77f3-1f20-e08320c3b5a1","text":"The pembrolizumab was continued for a total of 18 cycles from June 2014 to June 2015. The retroperitoneal disease remained stable for six months and then started to progress. There has been no recurrence of tumor in the neck over the last 12 months from radiation.","title":"High-Dose Radiation as a Dramatic, Immunological Primer in Locally Advanced Melanoma"}
{"_id":"3d4ceb10-0850-c421-b0aa-c9e05983ac4d","text":"The thought of being “checked up on”, especially within the first week of starting treatment, will presumably make patients more apt to pick up their prescription from the pharmacy and begin using their medication. Contact with patients in the beginning of a new regimen may help to ensure they are complying with treatment as directed. It can also be a suitable time to discuss adverse reactions and side effects from the drug that may be affecting the patient. Scheduling a return visit shortly after starting treatment is a strategy to combat fear of potential side effects, especially in mothers of young children with a fear of using topical steroids [2]. Early contact can provide an opportunity for readjustments to the plan if needed.","title":"Interventions to Increase Treatment Adherence in Pediatric Atopic Dermatitis: A Systematic Review"}
{"_id":"3d520057-e2e9-2a85-f687-0769fdfd8117","text":"The current study has some limitations. As uncommon melanomas, our small sample size did not allow for adequate comparison between patients with stage III and stage IV disease. Limited availability of CT scan for the purposes of cancer staging may have underestimated the presence of metastatic disease in our cohort and lead to incorrect staging.","title":"Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country"}
{"_id":"3d577444-4fa3-0f4c-e6fb-4d66c0871df6","text":"The findings of this study suggest that patients with heritable retinoblastoma have a high risk of developing an SPC, primarily sarcoma and malignant melanoma. Patients with heritable retinoblastoma treated with or without external beam irradiation showed the same overall increased risk, but an increased proportion of sarcomas was observed inside the radiotherapy field in patients with heritable retinoblastoma treated with external beam irradiation.","title":"Incidence and Mortality of Second Primary Cancers in Danish Patients With Retinoblastoma, 1943-2013 Incidence and Mortality of Second Primary Cancers in Danish Patients With Retinoblastoma"}
{"_id":"3d5b3854-5824-a384-b3a6-54c522ba8580","text":"We present a case of a clinically confirmed hypersensitivity reaction to ethambutol in whom a previously described protocol was ineffective. This new adapted successful desensitization protocol underscores the importance of lower incremental doses with more steps and the use of antihistamines and prednisone to induce immunological tolerization. Because the mechanism of the initial reaction appears to be a hypersensitivity type IV reaction, these reactions have been shown to be responsive to a slower reintroduction of the offending agent, so that reaching the target dose may require few weeks. The mechanism of desensitization may relate to a suboptimal T cell antigen presentation.","title":"Hypersensitivity Reaction and Tolerance Induction to Ethambutol"}
{"_id":"3d668089-56e1-1c2d-4d8a-104b92a78d32","text":"The study protocol was conducted according to the principles of the Declaration of Helsinki and was approved by the Scientific and Medical Ethical Committee of GDHOD. All the subjects gave written informed consent before inclusion in the study.","title":"Trichloroethylene Hypersensitivity Syndrome Is Potentially Mediated through Its Metabolite Chloral Hydrate"}
{"_id":"3d753912-5130-3b8f-eeaf-1e5ad30c9600","text":"The present study is the first to provide direct comparisons of patient outcomes for an early stage of pyogenic spondylodiscitis patients receiving treatment with antibiotics only versus those receiving antibiotics treatment coupled with early surgical intervention, which early pyogenic spondylodiscitis was defined as neither neurological deficit nor complications such as sepsis was present. Notably, the outcomes for patients who received the surgical treatment included improved functional results, better kyphosis correction, and shorter hospital stays, findings that call into question the validity of the non-surgical approach to treatment that has heretofore been generally accepted. Based on our results, we suggested all patients who are at an early stage of pyogenic spondylodiscitis and are suitable for surgery should be treated surgically immediately after the confirmation of diagnosis to achieve better outcomes; however, conservative treatment is indicated if the patient is not suitable for surgery.","title":"Early surgery with antibiotics treatment had better clinical outcomes than antibiotics treatment alone in patients with pyogenic spondylodiscitis: a retrospective cohort study"}
{"_id":"3d763359-9bd6-7d18-fefd-4a3d753aecad","text":"Little research has been carried out with regard to normal mammary blood flow parameters in both the lactating and non-lactating breast. Current knowledge of known parameters is given in Table 2. If the ultrasound machine used does not automatically calculate flow rate (volume of blood moving through the artery per unit of time) this can be manually calculated with the equation given below:","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"3d78fa93-4d3f-5342-b33d-9b2cef8f39a1","text":"Rhinoplasty surgery significantly improved patient quality of life regarding nose function and appearance.","title":"Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study Avaliação dos desfechos estéticos e funcionais em cirurgia de rinoplastia: um estudo prospectivo"}
{"_id":"3d7a7d6d-4fda-95ae-22cd-fe75f58364b4","text":"While our patient experienced only swelling in the tongue and throat, along with an itching sensation in these localisations when he consumed prawn in the restaurant A; he experienced swelling in tongue and throat, laryngeal edema accompanied by dizziness and sensation of fainting and hypotension, suggesting anaphylactic reaction, when he consumed prawn in the restaurant B.The patient favoured prawn a lot and did not quit consuming prawn in spite of all these complaints. He had about 3 or 4 such allergic episodes when he had applied to our clinic.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"3d846130-a758-2f10-2654-4229b15b95bd","text":"In 1947, he went to UK for higher studies and worked under the guidance of Sir Harold Gillies, the father of modern plastic surgery, from whom he imbibed his interest in plastic surgery. He obtained his Fellowship of the Royal College of Surgeons and stayed in UK for nine years. His close association with eminent plastic surgeons in UK and exposure to this new, challenging branch of plastic surgery inspired him to take up plastic surgery as his career.","title":"Padmashri Noshir Antia: Lotus of Indian plastic surgery"}
{"_id":"3d8696d6-beca-85d7-8e2d-3ac49cacfc53","text":"Our study revealed better results for facial lesions, especially in younger patients with dark skin, shorter duration of disease, and segmental type of vitiligo. As there is a risk of graft displacement on the neck and other mobile areas, longitudinal strips of grafts arranged parallel to the skin creases can be used at these sites. Furthermore, postoperative use of corticosteroids and topical psoralens with UVA, were found to enhance the pigmentation and reduce the time of appearance of complete response. The main drawback of this procedure is that expertise is required for taking a thin graft. However, in properly selected patients with good operator expertise, STSG was found to be a satisfactory tool for reducing patient morbidity and improving the quality of life in our patients with vitiligo, as can be judged from the enthusiastic patient response that we continue to get.","title":"Split Thickness Skin Grafting in Patients with Stable Vitiligo"}
{"_id":"3d885edf-c97d-5769-157d-82a074b2f06a","text":"Two weeks after NPWT application and once local infection has been controlled patient was discharged. At that point he still presented a 6 × 4 cm dehiscence of the abdominal wall. Moreover granulation tissue have been started to cover biological mesh and we decided to increase the negative pressure to −90 mmHg in order to further improve granulation tissue growth and to obtain a total coverage of the biological mesh.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"3d929db9-293b-c162-637e-adb8e3272913","text":"Postoperative rehabilitation programs were similar for all individuals. Partial weight bearing under crutch protection was allowed immediately after surgery except if there was a concomitant fracture of the contralateral lower limb or pelvis. The timing of full weight bearing depended on callus formation and was usually 6 to 8 weeks after the surgery, when some callus formation was noted on the plain film.","title":"Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails"}
{"_id":"3d9b490c-8cd0-eaa6-28c5-eec936491dec","text":"While breastfeeding initiation rates in Israel are exceptionally high, exclusive breastfeeding rates drop quickly over the first few weeks after birth. Theoretically, there is an extensive system of support for breastfeeding women within the Israeli healthcare system during this critical time period, however, in practice the breastfeeding support needs of many women are currently not being adequately met. Funding is needed to assure that trained personnel exists in practice and has the time, protected from other duties, to provide the needed education and guidance to new mothers. Counseling hours should be tailored to assure adequate coverage of high risk groups such as women after cesarean delivery and newborns requiring care in the neonatal intensive care unit. The majority of problems experienced by women in this study are amenable to intervention, which stresses the need for providing early and universal support. Assuring adequate education of all health care professionals working with breastfeeding dyads regarding breastfeeding physiology can reduce inappropriate supplementation. Funding for adequate staffing in MCHCs to assure timely continuity of care and expanding extended hours of post-discharge support can help build the skills and confidence of the mothers that aid successful lactation. Building such a constellation of support is what is likely needed to reach recommended duration of exclusive breastfeeding.","title":"Breastfeeding challenges and support in a high initiation population"}
{"_id":"3d9da00a-9f75-7c7d-0fe7-ef7cda20c355","text":"All of the patients were inpatients and the hypersensitivity reactions that developed after drug treatment were confirmed by Allergy and Immunology specialists. Patients who did not receive desensitization in accordance with the scheme and patients with non-tuberculosis mycobacterial infections were not included.","title":"Management of type 1 immediate hypersensitivity reactions to antituberculosis drug: succesful desensitization"}
{"_id":"3da6c11b-c4af-24b9-857f-4ecea7864434","text":"The deltoid branch of the thoracoacromial vein is located in the neighborhood of the cephalic vein. The functional results of intravenous port implantation via the deltoid branch of the thoracoacromial vein are similar to implantation by other entry vessels. It is a safe alternative entry vessel for intravenous port implantation.","title":"Deltoid Branch of Thoracoacromial Vein A Safe Alternative Entry Vessel for Intravenous Port Implantation"}
{"_id":"3da6e23f-4927-00b2-252c-40ce06fd0016","text":"For Group OSTAP, the OSTAP block was applied to the patients in the supine position immediately following endotracheal intubation. The anesthesiologist of the surgery room placed the ultrasound linear probe along the subcostal margin of the upper abdominal wall and obliquely from the xiphoid to the right iliac crest in the midabdominal line. The rectus abdominis muscle and the underlying transversus abdominis muscle were identified near the costal margin. The needle was guided into the transversus abdominis fascia. 25 ml of 0.25% local anesthetic solution was injected between the rectus abdominis and transversus abdominis muscles along the oblique subcostal line. The same process was then repeated for the other side.","title":"Comparing ultrasound-guided modified thoracoabdominal nerves block through perichondrial approach with oblique subcostal transversus abdominis plane block for patients undergoing laparoscopic cholecystectomy: a randomized, controlled trial"}
{"_id":"3db7a72b-124b-c6af-aa26-a563a68397d5","text":"The earliest recorded procedures to reduce overly large breasts in females were developed by reconstructive and aesthetic surgeons in the last two decades of the 19th century. These developments paralleled similar developments in aesthetic nasal surgery.","title":"Reduction mammoplasty"}
{"_id":"3dc0a7aa-b4eb-feff-ac4b-2604910d9d79","text":"Approximately 12 hours before surgery, the patient is admitted to the nuclear medicine department for the injection of the radioactive tracer. Using a 27 gauge needle, 0.5 mCi of 99mTc sulfur colloid is intradermally injected around the MM site and lymphoscintigrams are obtained between 10 and 150 minutes after the initial injection. The location of the first draining lymph node is detected using a gamma probe and marked on the underlying skin with a permanent marker. In the operating room the surgeon rechecks the SLN location with a gamma probe for proper marking of the planning incision.","title":"Increasing the Efficacy of SLNB in Cases of Malignant Melanoma Located in Close Proximity to the Lymphatic Basin"}
{"_id":"3dc25abe-1fc7-0a2c-db80-df8ada0ff5a4","text":"When assessing possible implications of the implant type, no significant differences in the OARs dosimetric characteristics were observed between the three groups.","title":"No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction"}
{"_id":"3dc2ce13-c977-a935-9563-567e7e2ca8cb","text":"So, after a brief discussion concerning the chemical modifications of cellulose to allow the mobilization of the photoactive dye, this review is organized considering first the porphyrin and analogues of natural origin and then the synthetic counterparts according to their charges.","title":"Porphyrin Photosensitizers Grafted in Cellulose Supports: A Review"}
{"_id":"3dcd658b-884f-0690-5dca-7260d0ceaabd","text":"In the management of complex wounds, there are clinical benefits to be gained from a holistic approach involving topical NPWT in combination with wound bed preparation and infection control strategies. We have found the gauze-based VISTA system to be versatile and capable of being applied to a wide variety of wounds that because of their location, extent, and level of exudate would be difficult to manage with conventional dressings. The gauze wound filler used in the VISTA system also has some positive advantages for the surgical team regarding its conformability and ease of application to large and irregular wounds. Finally, there are benefits for the patient in terms of comfort and reduced pain on removal compared with that sometimes reported with PU foam.","title":"Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective"}
{"_id":"3ddf47c5-e4a3-9140-2e95-89a9b80e4754","text":"The superficial temporal vessels have been shown to have comparable diameters to the cervical vessels, with increased proximity to defects in the midface and scalp. Yet, because of their variable diameter and tortuous anatomy, these vessels have been considered to be at risk for postoperative vasospasm and thrombosis, and its use has been restricted to selected cases.10, 11 The aims of this study are to demonstrate a prospective study in midface and scalp advanced oncologic reconstruction using free tissue flap and to compare the postoperative outcomes based on superficial temporal versus cervical recipient vessels.","title":"Recipient vessels for free flaps in advanced facial oncologic defects"}
{"_id":"3de3c00c-1573-1c4e-b0aa-0c27748c784c","text":"The treatment of advanced periocular basal cell carcinomas becomes a challenge as surgery may involve highly mutilating procedures. Vismodegib is the first selective hedgehog inhibitor approved for the treatment of locally advanced tumors or metastatic disease.","title":"Vismodegib for treatment of periocular basal cell carcinoma – 6-year experience from a tertiary cancer center"}
{"_id":"3de538f2-6ac7-d22f-ab28-411b36129e50","text":"Propeller flaps are an important addition to the armamentarium for management of soft tissue defects. The concept of propeller flap has evolved over the past few decades with increasing knowledge of the location and vascular territory perfused by perforators. Since central axis propeller flaps are eminently suitable in many cases of axillary and elbow contractures, this review discusses the definition, classification, design modifications, and indications of such flaps primarily for these applications.","title":"A review and critical appraisal of central axis flaps in axillary and elbow contractures"}
{"_id":"3de755a7-3d12-20e7-af12-b849c0bcbabd","text":"Adjuvant radiotherapy is highly recommended for high-grade malignancies like carcinoma ex pleomorphic adenoma, due to a high risk of locoregional recurrence. Due to the fact that the surgical treatment was not optimal in this case, the patient was qualified for radiation therapy in order to minimize the risk of subclinical microscopic spread of the disease.","title":"Synchronous multiple unilateral parotid gland tumors of benign and malignant histological types: case report and literature review Múltiplos tumores síncronos unilaterais de glândula parótida de tipos histológicos benignos e malignos: relato de caso e revisão da literatura"}
{"_id":"3dedf60d-6e8d-2689-6f72-a78426b342aa","text":"Receiving an investigational medical product as part of another clinical trial","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"3dfb9056-053a-70bd-76f4-95a5ef7c6d8d","text":"Ultimately, the tissue expander was removed from these 2 patients. The most common complication after stage II surgery was infection, which was meticulously managed with daily dressing and antibiotic. Furthermore, the exposure of the cartilage was observed in total 15 cases after either stage II or stage III surgery. The most common site for cartilage exposure was upper portion of the helical rim. We believe that the sharp edges of the cartilage might cause constant pressure on the overlying flap which lead to tissue necrosis and cartilage exposure.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"3e04b940-ab9c-ba04-dd53-301fd19f02f0","text":"Further, the phototoxicities observed in the in vivo experiments were also of importance. The skin toxicity had not been quantitatively evaluated in this article. In our experiments, only acute skin toxicity was observed, which appeared the next day after PDT irradiation at the illumination site and neighboring areas of mice with the presentation of swelling and edema. The whitened color indicated impaired blood vasculature which lasted for the following three to four days. The incrustation took place approximately at days 4–5 after irradiation. The color of the scab in the Photofrin group was yellow and that of the sinoporphyrin sodium group was white. The duration of swelling varied with different treatment groups. Swelling of the illumination spots continued for seven to 10 days for animals in the Photofrin and high sinoporphyrin sodium dose group. After the swelling retreated, the tumor sites in the treatment groups tended to be flat and began to shrink. The local injuries after PDT irradiation were described in one study which showed that severe hypoxia was the main physiological change in the tissues [10]. This observation indicated that PDT at the high dose level may cause acute and severe phototoxicity. No persistent skin toxicity has been observed under indoor light illumination in our experiments.","title":"Preclinical Study of Antineoplastic Sinoporphyrin Sodium-PDT via In Vitro and In Vivo Models"}
{"_id":"3e099e93-bd6b-5c0f-4692-b80d8822f2be","text":"The differences in the results of various studies may be related to the type of cryochamber being used and the coolant medium, in addition to the time of exposure to cryogenic temperatures.","title":"Whole-Body Cryotherapy Decreases the Levels of Inflammatory, Oxidative Stress, and Atherosclerosis Plaque Markers in Male Patients with Active-Phase Ankylosing Spondylitis in the Absence of Classical Cardiovascular Risk Factors"}
{"_id":"3e0cbf5d-4c29-8ddc-f3c7-1d3c4f6f80a7","text":"This increase in self-confidence has not only led more women trainees to believe that they can effectively perform the role of surgeon as it stands, but also that they will be able to transform the profession from within, in ways which challenge the traditional gendered stereotype of the surgeon:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"3e11e297-18a7-fdd2-5d02-fc1e9c8fb71a","text":"There is a need to increase the number and distribution of pediatric ophthalmologists and ensure they are adequately trained and equipped to provide high quality surgery. A minimum of five more CEHTFs with the full complement of competent allied eye health professionals are required to meet WHO recommendations. Advocacy with the Ministry of Health to address these challenges is very important, working in partnership with NGOs.","title":"Limitations in cataract surgical services for children in Ethiopia: a nationwide survey of pediatric cataract surgeons"}
{"_id":"3e1c25ec-ccf5-b3ab-9f0c-998a71edeb6c","text":"Highly congested veins and simple trunk veins were found using angiography in the AVF group; while a fairly uniform staining and plenty of small vessels were observed in the hemodynamic remodeling group. The metabolite levels of the remodeling group are comparable with those in the arterial perfusion group. There was no statistically significant difference in the percentage of flap survival between the arterial perfusion group and hemodynamic remodeling group; however, significant difference was seen between the AVF group and the hemodynamic remodeling group.","title":"The Effect of Hemodynamic Remodeling on the Survival of Arterialized Venous Flaps"}
{"_id":"3e2185ba-0acf-09f7-0a69-137f0d849150","text":"However, bone loss at sites of infection is primarily due to an uncoupling of the control of bone forming osteoblasts and bone resorbing osteoclasts. Bacteria or their products can directly increase the osteoclast formation and activity. In addition, inflammatory mediators produced at the site by infiltrating leukocytes or bacterially challenged osteoclasts themselves can further promote osteoclastogenesis and bone resorption. Importantly, the production and activity of osteoclasts is critically regulated by osteoblasts, and these cells have recently been found to respond to the principle causative agents of osteomyelitis via TLR and NLR family members. Osteoblasts exposed to bacteria express an array of soluble and cell surface molecules that have the potential to promote immune responses and directly or indirectly enhance osteoclast activity at sites of infection.","title":"Apoptosis-associated uncoupling of bone formation and resorption in osteomyelitis"}
{"_id":"3e28044b-01e8-f266-353c-6866031e5c45","text":"Informed by an extensive literature review looking at sex disparities for female faculty in surgery, the content of the interview was developed jointly by a leadership coach and members of the MWSC. The interview included 7 items referring to the surgeon’s experience with the Michigan Medicine Department of Surgery along with 7 items about nonspecific areas of interest. Each interview lasted 45 minutes to 1 hour. Interviews were recorded then transcribed for analysis.","title":"Defining Barriers and Facilitators to Advancement for Women in Academic Surgery Defining Barriers and Facilitators to Advancement for Women in Academic Surgery"}
{"_id":"3e36b7f8-565d-6c4b-0a20-d8c63bd37e06","text":"Ellipses were designed as an eccentric parallelogram before infiltration with local anaesthesia and without stretching the skin. A precise margin of apparently healthy skin was taken around the outer border of the ink marking the tumour: Peripheral clearance margins of 3 mm around tumours in facial areas and 5 mm margins around lesions in other sites. Although, in cases with a clinical history of rapid growth, in which a standard 5 mm surgical margin have been adopted for head and neck lesions and 10 mm for other regions.","title":"Metatypical basal cell carcinoma: a clinical review"}
{"_id":"3e3705ad-7c25-24d1-4a2e-f1703455e3cc","text":"Empirical antibiotic use is also important, but to use antibiotics suitable for each patient, it is important to cultivate the pus or blood from the infection focus and consult with infectious medicine experts to select the appropriate antibiotics. If complication management after surgery can be thoroughly performed, FFF is a very useful method for reconstructing ORN and MRONJ defect sites.","title":"Reconstruction of mandibular defects in osteoradionecrosis and medication-related osteonecrosis of the jaw using fibula free flap and management of postoperative wound infections"}
{"_id":"3e38d9c2-d1ee-e5c2-364d-d8e586437ab0","text":"It is relatively easy to try the first line allergy medications for symptomatic relief for suspected allergy in LEL subjects with or without supporting laboratory results. However, if their responses are suboptimal, a question will arise whether it is necessary to proceed to the second line allergy treatment because of the cost and time required for such procedures. In addition, the presence of problematic behaviors may raise doubt concerning how the subject will tolerate the proposed procedures. This was in fact our initial concern. However, supporting laboratory data and well documented seasonal changes in problematic behaviors, made us proceed to the second line allergy treatment. The presented 2 cases revealed remarkably favorable responses, and illustrate the importance of optimal control of allergy symptoms in LEL patients in terms of behavioral symptoms, and even cognitive development. Clinicians should seek the second line allergy treatment measures if there is sufficient clinical evidence that supports expected efficacy of such measures.","title":"Marked improvement of neuropsychiatric symptoms following control of allergy symptoms with the use of humanized murine anti-IgE antibody (omalizumab) in 2 patients with severely limited expressive language"}
{"_id":"3e3f7abf-3fe2-7f6f-a56e-1b6e04374558","text":"To evaluate patients with T1 melanoma who underwent sentinel lymph node biopsy and to compare those who were classified as T1a with those classified T1b, according to the 7th and 8th Edition of the melanoma staging system, regarding a positive biopsy result. The authors also aimed to assess whether there is any difference in the results in both staging systems.","title":"How does the mitotic index impact patients with T1 melanoma? Comparison between the 7th and 8th edition of the American Joint Committee on Cancer melanoma staging system"}
{"_id":"3e404804-6855-960e-5b37-32bc008b09d1","text":"For the affected child, this may manifest in a number of ways during breastfeeding, including poor latch, irritability with feeding, short intervals between ineffective feeds, poor weight gain, or the frank inability to breastfeed. Symptomatic ankyloglossia can also manifest as difficulty with speech later in infancy3,4 and maxillofacial malformation.5 I","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"3e4d8175-035e-49df-2b3e-ee4486064d39","text":"All patients with PSI + were consecutively enrolled in a monocentric study with an ambispective design from January 2012 to September 2017. The study collected prospective data on the clinical management and outcome of patients with PSI data from May 2015 until September 2017. The prospective dataset was completed by collecting dataset of the same structure retrospectively from January 2012 to May 2015. Intra-spinal affection was defined as the presence of an ISA or ISE.","title":"Spinal infection with intraspinal abscess or empyema and acute myelopathy: comparative analysis of diagnostics, therapy, complications and outcome in primary care"}
{"_id":"3e50a387-abd0-d5b9-c4ac-7c31b2228d4a","text":"The second half of the session focused on facilitated scanning of inpatients who were identified and amenable to practice scans prior to the session. These patients had lower extremity duplex ultrasound exams ordered or already completed prior to the educational session to allow for post scanning correlation of POCUS findings. We found that that a facilitator could be paired with approximately five or six interns at the bedside during a half-hour scanning session, which allowed all learners a chance to practice compression ultrasonography. Appropriate facilitators included credentialed faculty or senior residents with prior experience with POCUS for DVT. Facilitators were provided with a validated checklist of procedural steps to observe and evaluate interns’ ability to correctly identify vascular anatomy (Supplementary File S2). While we did not utilize the checklist beyond serving as a tool to ensure immediate training efficacy regarding skill acquisition, it may serve as a useful instrument to validate this or similar curriculum and longitudinally determine if learners are retaining material appropriately.","title":"An Introductory Curriculum for Internal Medicine Interns in Point-of-Care Ultrasound to Detect Lower Extremity Deep Vein Thrombosis"}
{"_id":"3e516457-c960-f325-111d-bcbafa5b18a6","text":"El-Khatib 11 reports experiencing venous congestion in all of the five flaps in his case series, Zhang et al 13 refer experiencing some degree of venous congestion on their case series, two of the island flaps on Couceiro and Sanmartín case series 6 experienced venous congestion, the authors report finding a higher degree of venous congestion and flap necrosis on the island flap group, their findings were not completely conclusive owing to the limited size of their study.","title":"The First Dorsal Metacarpal Artery Flap Family: A Review"}
{"_id":"3e533302-ec99-2240-725e-6a5c42f063f7","text":"Methods: Longitudinal analysis of 237 patients was carried out utilizing baseline levels of inflammatory and","title":"Sixth Annual Mediclinic Middle East Research Conference"}
{"_id":"3e5687e1-9ed2-a052-1539-debed226f9be","text":"Various locoregional flaps have been described but the presence of chronic inflammation, fibrosis and lack of adequate vascularised local tissue is an important limiting factor in doing so.","title":"The Gracilis Muscle Flap: A “Work Horse” Free Flap in Diabetic Foot Reconstruction"}
{"_id":"3e5aa290-b611-ab2b-3737-6c6db8f6254c","text":"Given the low risk of malignancy, conservative management with close observation is often a reasonable consideration. For cases in which surgical resection is sought for cosmesis, superficial parotidectomy is most commonly recommended since WT occurs predominantly in the superficial parotid lobe. Benefits of resection must be weighed against the risk of iatrogenic facial nerve injury and overall risks of anesthesia especially in the case of bilateral tumors. The multifocal nature of WT has made extracapsular dissection more prone to recurrence as residual disease may be left behind [11].","title":"Multifocal Warthin's Tumor: An Uncommon Presentation of Bilateral Cervical Lymphadenopathy"}
{"_id":"3e5c494c-30da-e776-c659-ceb3bb168f91","text":"An incision is made through the skin and the saphenous vein is exposed by lifting the edges of the skin. This enables the identification of the correct dissection plane. The diathermy knife can consequently be used safely. The subdermal vessels are ligated to avoid overuse of diathermy.","title":"Surgical Aspects of No-Touch Saphenous Vein Graft Harvesting in CABG: Clinical and Angiographic Follow-Up at 3 Months"}
{"_id":"3e60cfdc-cae7-f081-31ec-1b869d66e084","text":"Allergic skin reaction could have been ruled out in the initial stage itself as the facial erythema was confined only to one side of the face and other systemic signs like itching, hives, breathing difficulty, or gastrointestinal symptoms were not present and the erythema happened also with different types of food.","title":"Recurring Facial Erythema in an Infant"}
{"_id":"3e61239c-2f2d-36c4-e2d5-40deb4a5c7c4","text":"Infectious lesions of the external ear are rarely subject to surgical intervention. Nevertheless drainage of the subperichondral space and surgical removal of necrotic ear tissue following infectious diseases of the external ear are sometimes necessary.","title":"Cutaneous lesions of the external ear"}
{"_id":"3e678d47-4fcb-fa45-8185-ff1a54e7f534","text":"Targeted therapies have a crucial role in patients with advanced melanoma. They have significant benefits in the prognosis, but they are frequently associated with cutaneous side effects that may affect quality of life of patients. Cutaneous adverse events are usually low grade and manageable. Understanding and managing skin toxicity could improve the quality of life and prevent the interruption of the tumor therapy leading to a better clinical outcome. Although current targeted therapies have been shown to reduce melanoma mortality, advanced melanoma is still a significant therapeutic challenge to clinicians. New therapeutic approaches are currently being developed, and they will probably include combination therapies as the association of BRAF inhibitors and immune-checkpoint inhibitors. New potential side effects will likely emerge introducing these novel combination therapies.","title":"Cutaneous Side Effects of Targeted Therapy and Immunotherapy for Advanced Melanoma"}
{"_id":"3e67a8c9-effa-7658-4e70-46821efe04aa","text":"To compare the benefits and harms of CLND in patients with cutaneous melanoma and positive SLNB.","title":"Lymphadenectomy after a positive sentinel node biopsy in patients with cutaneous melanoma. A systematic review"}
{"_id":"3e6cf8a8-6bf9-3e2b-948b-22f8eecc2a2c","text":"In the case of typical bony lesions of the phalanges of the hands, extending the diagnosis to MR imaging is not necessary.","title":"Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis"}
{"_id":"3e6d47b9-b160-24a8-b7f0-36d219c5a25b","text":"Information on skin cancer needs to be tailored to the individual both at the start of treatment and during the follow up months, ensuring that the participants’ needs and expectations are met. There is a real need to raise awareness of the signs and symptoms of NMSC especially in elderly populations. Knowledge about recognising the signs of skin cancer is particularly important since 44% of patients will develop additional lesions within 3 years [31]. Targeting education at individuals in the community who regularly come into contact with skin should help in early identification of NMSC. This is important since skin cancers caught early are easily treatable and delay in presentation leads to larger and more complex lesions which in turn may increase patient morbidity and increased health care costs.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"3e748d78-50b6-4d35-293d-fabcbda9b444","text":"CTb injection sites within the cortex and corresponding FG injection sites in the cervical cord (C4\/C5) for each rat are shown in Fig 1A and 1B. The CTb injection sites were focussed within the forelimb regions of the primary and secondary motor cortex and the adjacent primary sensory cortex and were confined to the cortex of the right hemisphere. FG injections were confined to C4\/C5; for two rats, the core of the FG injection site was within the ventrolateral funiculus and for one rat the core was in the intermediate grey matter. For all three rats, there was considerable spread of FG within the grey matter ipsilateral to the injection site but there was no spread of FG into the contralateral grey matter. Fig 1C and 1D show CTb injection sites within the MLF and the corresponding FG injection sites in the cervical cord (C4\/C5). In the MLF, CTb labelling was visualised bilaterally and there was some spread of CTb into the raphe obscurus and tectospinal tract. FG injections were confined to C4\/C5; for all three rats, the core of the FG injection site was within the ventrolateral funiculus and there was considerable spread of FG within the grey matter ipsilateral to the injection site but no spread of FG into the contralateral grey matter.","title":"Corticospinal and Reticulospinal Contacts on Cervical Commissural and Long Descending Propriospinal Neurons in the Adult Rat Spinal Cord; Evidence for Powerful Reticulospinal Connections"}
{"_id":"3e810cf9-ec34-096b-5a76-65ab347a2159","text":"Patients with functional satisfaction and with a straight and smooth dorsum seem to be the most important benefits that were achieved with this technique using alar cartilage spreader grafts, an alternative that can be offered to improve airflow and to prevent deviated and inverted “V” deformities.","title":"Alar cartilage—an alternative for spreader graft in primary rhinoplasty"}
{"_id":"3e85ae00-cd2e-cf2a-e765-a6160adfcb1c","text":"One patient developed significant muscle necrosis in addition to skin complications. Patient 13 developed thigh ischemia and subsequent partial necrosis of his quadriceps and hamstrings as well as necrosis of his skin flap. He underwent debridement of the skin as well as the quadriceps and hamstring muscles, ultimately requiring an additional 15 debridement surgeries with wound VAC changes over a period 2 months after his original rotationplasty before his wounds completely healed. This case was responsible for 40% of the unplanned surgeries performed in this series. Despite the extensive surgical treatment required postoperatively, he ultimately recovered and had an excellent outcome at his most recent follow-up appointment 3.5-years postoperatively with active hip flexion and extension with excellent gait using his prosthesis.","title":"Rotationplasty for Severe Congenital Femoral Deficiency"}
{"_id":"3e871586-6330-e5e6-d5a1-f92c198dc377","text":"Trial participants will not be blinded after assignment to interventions as they have online access to their medical records by a centrally managed system. Radiographic assessment is not possible to blind.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"3e88ce97-9c4f-babf-a887-13858c8d489f","text":"The success of treating chronic osteomyelitis in patients requiring free flap reconstruction does not appear to be related to age, but may be associated with availability and quality of recipient vessels and blood flow within the affected limb.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"3e8a355f-4d60-5c1f-5247-e0cb7894b3b0","text":"MBA educational background: take the proportion of the number of top managers with MBA degree to the size of the top management team.","title":"The Influence of Top Managers on Environmental Information Disclosure: The Moderating Effect of Company’s Environmental Performance"}
{"_id":"3e8b116c-89a5-ee6d-f761-09bf81743126","text":"In our study, all the tumours could be completely resected with 2.5 cm lateral margins, but this does not include four out of seven patients who had a prior diagnostic excision biopsy where the lateral margins were not recorded. Other studies of Mohs micrographic excision for DFSP showed a comparable clearance rate for lateral margins (Table 1","title":"Dermatofibrosarcoma protuberans treated by micrographic surgery"}
{"_id":"3e93087e-4fb4-66d9-072f-6c2a45d1335c","text":"In conclusion, our study supports the finding that sperm banking is an effective method of fertility preservation in cancer patients. Fertility preservation is very low among Chinese male patients with cancer. Therefore, reproductive physicians and oncologists are required to discuss fertility preservation techniques before gonadotoxic therapy in all male cancer patients. Sperm cryopreservation is a quick and effective technique for preserving fertility. The development of local clinical guidelines and organisation of conferences to promote fertility preservation should be encouraged.","title":"Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience"}
{"_id":"3e956c8e-9ebf-ca1c-76d0-04b4f010c599","text":"The main concern of our patients at 12 months after diagnosis was that they were still not sure if they would recognise skin changes that might be skin cancer. It is interesting to note that whilst most of our participants at 12 months were still aware of the need to be cautious in the sun, they talked about checking skin for moles with no mention of Non Melanoma Skin Cancer. Knowledge of the risk factors for skin cancer has been found to increase skin surveillance, which in turn is associated with thinner melanoma tumours [30].","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"3e99ff92-c2b5-7e90-ac9f-7c7f15e9768f","text":"In addition to presenting two cases of desmoid tumors that were successfully treated with surgical resection, this study provides a literature review of desmoid tumors after gastric cancer surgery. Desmoid tumors should be considered in the differential diagnosis of intra-abdominal tumors after gastric cancer surgery. When surgically removing tumors suspected to be desmoid, complete resection with adequate margins can prevent recurrence.","title":"Desmoid tumor occurrence following gastric cancer surgery: A report of two cases"}
{"_id":"3e9d34aa-efea-76f1-c4e5-d709cc6c6608","text":"Although ultrasound has shown great potential for the treatment of different conditions, there is a critical need for further studies and the design of standardized protocols (with established parameters of use). This is fundamental for understanding the mechanisms involved for regenerative medicine. While ultrasound continues to be extensively studied, there remains a paucity of human studies. Clinical trials mainly concern the bone field and an improvement in therapeutic treatment of certain diseases. The extensive number of preclinical studies should lead to a better understanding of how ultrasound improves stem cell therapy for the treatment of different conditions or diseases.","title":"Ultrasound Therapy: Experiences and Perspectives for Regenerative Medicine"}
{"_id":"3e9d6b13-d987-3abc-fe19-695a9ecc7101","text":"A 29-year-female patient had undergone nasal surgery which resulted in a pinched nose. Exposure of the skeleton with the open transcolumellar technique showed that that the lateral crura were missing having been surgically removed in the previous surgery. This lack of support to the soft rissues of the nasal ala caused collapse and the pinched nose appearance. The missing crura were reconstructed with anatomical alar septal cartilage grafts and a columellar strut to reform and stabilize the triangular nasal base.","title":"Secondary rhinoplasty"}
{"_id":"3e9d95ea-4d24-32c9-aeb9-9c6816148f99","text":"There was recognition that the process of change was already happening, not least because of the example set by the many successful women in surgery:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"3ea63747-9a05-a060-dfe0-1ce6215fbf74","text":"None of the patients with incomplete data who experienced anaphylactic symptoms were referred to a specialist.","title":"Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands"}
{"_id":"3eaa3235-08ec-8d2e-7986-cc73060a3003","text":"We found that there is an overall low prevalence of fellowship and secondary board certifications among residency leadership. The majority of PDs are male, with a near-even split among associate and assistant PDs. The Western region had the highest percentage of fellowship and secondary board certification among all levels of residency leadership. The results from this survey not only define the current demographics of fellowship and secondary board certification among EM residency leadership, but also suggest a growing trend of postgraduate training among residency leadership. PDs averaged the longest time in residency leadership and had the highest percentage of secondary board certifications. With regard to length of time in residency leadership position, no differentiation was made for whether this was at a single or multiple institutions. Assistant PDs who had the least experience had the highest prevalence of completed fellowships, and the least prevalence of secondary board certification. It is possible that there is a trend away from obtaining secondary board certifications and towards completion of fellowship training for those interested in obtaining a residency leadership position. This trend further varies by region. The Western region, considered by many to be a competitive academic EM job market, had the highest percentage of fellowship and secondary board certifications, as nearly 46% of assistant PDs have completed either a fellowship or secondary board certification. We speculate that the growing competitive job market for residency leadership positions may be, in addition to other variables, what drives residents to pursue postgraduate fellowship training. We recommend that emergency physicians contemplating a career in academic EM, and more specifically in residency leadership, should pursue additional training. We plan to repeat this study in 10 years, and it is our belief that the current trends will continue to reflect the changes already taking place.","title":"Demographics and Fellowship Training of Residency Leadership in EM: A Descriptive Analysis"}
{"_id":"3eabd6cc-50e5-6401-dc82-76f7b1db8c58","text":"A very small number of studies examined the effect of breastfeeding on palate depth and facial pattern. It would be useful for future studies to include these variables.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"3eb210ff-7e6a-9dc6-9bfc-97865d446c3f","text":"To date, this is the largest reported cohort of children with MLN. Practice patterns may vary among centers and may not reflect the published LN consensus treatment guidelines. More research is needed to confirm the trends observed in this analysis of the CARRA Legacy Registry data.","title":"Proceedings of the 2016 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting Toronto, Canada. 14-17 April 2016"}
{"_id":"3eb9a602-83dc-82f8-f9ff-386200a7687f","text":"In the current study we quantified facial skin ageing in females combining the clinical and the biophysical perspective. Furthermore we tried to disentangle primarily intrinsic from extrinsic ageing phenomena.","title":"Characterizing Facial Skin Ageing in Humans: Disentangling Extrinsic from Intrinsic Biological Phenomena"}
{"_id":"3ec2723e-258e-7de4-710c-23d9df886b71","text":"Different types of reactions can occur depending upon the material used and these are discussed here.","title":"Fillers: Contraindications, Side Effects and Precautions"}
{"_id":"3ec7aef7-679d-1293-928e-0636f9cd4f51","text":"Staphylococcus aureus ATCC 25923 and Escherichia coli ATCC 25922 were used as control strains.","title":"Methicillin resistant Staphylococcus aureus causing osteomyelitis in a tertiary hospital, Mwanza, Tanzania"}
{"_id":"3ed2534b-2ef7-2118-f806-8410cb8e6906","text":"Lateromedial and plantarodorsal views of the tarsus, showing the paths of the ultrasound transducer in the examination of the tarsal joints. Images are acquired in transverse plane extending in a proximal to distal direction, and in longitudinal plane extending in a lateromedial direction. The paths i-v are described in the text","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"3ed329a3-501a-290f-7e59-77113545cc79","text":"Composite defects are common after ablative surgery for the treatment of advanced oral and maxillofacial cancers. The key problem in this scenario is that different types and multiple layers of the missing tissues need to be reconstructed simultaneously. In addition, three-dimensional reconstruction requires donor tissue with a flexible folding capability and several islands of tissues. A well-designed free flap could provide flexible and multiple blocks of tissue to replace the missing tissue in these complicated defects. Understanding the features of the defects can guide the design and harvesting of the free flap. Clinical evaluation of composite oral and maxillofacial defects is an important step in the reconstruction of these defects.","title":"Reconstruction of composite oral and maxillofacial defects by free flaps based on a new classification"}
{"_id":"3eeca783-9489-f89f-b57e-5df0f91f9a17","text":"i) Provide IMGs with courses and materials to prepare them for training programmes, ensuring that these resources are universally accessible and also highlighting any potential differences with the training system in their country of origin.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"3ef23b5c-47db-7363-a916-0ad15e19d661","text":"Excision of the soft palate tumour proceeded as follows. In two cases, the main body of the lesion was located in the middle of the soft palate. The medial soft palate of the pterygoid hamulus and part of the posterior bones of the hard palate were removed with an adequate safety margin.","title":"Application of prolonged submental perforator flap to repair the postoperative defect of upper airway malignancy"}
{"_id":"3ef3b820-9c01-cd3f-02e7-8b5f8102c5ed","text":"Although other groups have reported upregulation of hedgehog pathway members in metastatic tissue as compared to primary specimens, this is the first report of an association of SMO levels with significantly decreased survival in metastatic melanoma patients. The protective effect of elevated GLI3 levels underscores the role of hedgehog pathway activation in more aggressive disease. We also report that a clinically relevant inhibitor already in phase II clinical trials inhibits melanoma growth in vitro and in vivo. In ongoing clinical trials in advanced basal cell carcinoma, this daily dosed oral inhibitor has been well tolerated with little toxicity. Thus, our findings could be readily translated into clinical trials of a SMO inhibitor in combination with vemurafenib in patients whose B-RAF mutant tumors express GLI2 and SMO at moderate levels.","title":"Hedgehog Pathway Blockade Inhibits Melanoma Cell Growth in Vitro and in Vivo"}
{"_id":"3ef7b7e3-6d26-f627-7bc2-9ceb070f1b2a","text":"There is little consensus in the literature regarding the frequency of follow up visits. Many of the follow up protocols used in the literature are fairly rigorous and are often part of clinical trials looking at postoperative outcomes such as disease recurrence and survival in patients undergoing potentially curative resection.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"3efcffa1-6448-23bb-8039-635a99af0bff","text":"Another target of gene therapy are cancer stem cells, seen as a distinct subset of the cancer cell population able to generate tumorigenesis and metastasis that are the driving force of a vast majority of skin cancer types. Genetic or epigenetic alterations in tissue stem cells or in some of their differentiated derivatives can lead to uncontrolled self-renewal and tumorigenesis [84]. If a genetic lesion occurs at the level of the oligopotent progenitor cells in the hair follicle, tumors of various epidermal cell types can occur and if the lesion is at the level of the bipotent basal cells, a squamous or basal cell carcinoma might result. Successful cancer treatment must target both the non-cycling stem cells and the dividing cancer cells. This may be achievable if specific stem cell signals leading to proliferation or activation of gene expression that blocks apoptosis are knocked down using gene therapy. With progresses in innovative approaches utilizing specific inhibitory RNAs, such as the kind of therapies may now be possible but critical difficulties in delivering the inhibitory active in a targeted manner to the cancer stem cells have yet to be developed. Liposomal carriers and virus-based expression vectors may be used as delivery systems to provide sufficient concentrations of siRNAs in the target site [91].","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"3eff7b13-e4f8-1342-0d32-af51247bd7c8","text":"For the convenient extraction of information from the images of wounds and scars, the authors designed the color patch method and applied it to measure the sequential changes of the size and color of wounds during the secondary healing process. Herein, we evaluate the error rate of this method for measuring skin defects, and compare the therapeutic results of SIH between facial and non-facial area.","title":"Sequential Change of Wound Calculated by Image Analysis Using a Color Patch Method during a Secondary Intention Healing"}
{"_id":"3f09dba3-9a99-5921-072b-3569eedad4f4","text":"PRO data will not be monitored during the study for the purposes of providing information about the clinical care of individual trial participants, since patients’ awareness of any fluctuations may impact on the study outcomes.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"3f0cd176-4e44-a517-9864-d3180b3e0cc7","text":"Implantological and augmentative procedures may be performed by any dentist, though advanced training in implantology is recommended to acquire specialist knowledge. Maxillofacial surgeons as well as oral surgeons receive a well-founded education in the field of implantology within the scope of their training as a specialist surgeon.","title":"How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons"}
{"_id":"3f1028ef-32c8-b420-d1e1-bbba2c608c12","text":"Though the majority of recurrences usually occur within the first two years, late recurrences are known and long-term surveillance is recommended in these patients.3536 Even though the increasing grade from I to III is not a reflection of the biologic aggressiveness of the tumor, various authors have documented an increased rate of recurrence in Grade III lesions.1518 This could be due to the difficulty in achieving complete clearance once the tumor has breached its normal anatomic boundaries and extended into soft tissue.","title":"Treatment of giant cell tumor of bone: Current concepts"}
{"_id":"3f10b602-a458-1949-b605-a39c1f07e591","text":"The main objective of dermatologic surgery is to completely remove malignant skin lesions while having a minimal aesthetic and functional impact.","title":"Preoperative Evaluation through Dermoscopy and Reflectance Confocal Microscopy of the Lateral Excision Margins for Primary Basal Cell Carcinoma"}
{"_id":"3f15b75c-d1dc-88b3-b380-db04a18516a5","text":"The primary outcome is the presence of definite or probable symptomatic or asymptomatic DVT in the popliteal or femoral veins detected on compression Doppler ultrasound scan, or any symptomatic DVT in the popliteal or femoral veins confirmed on compression Doppler ultrasound, contrast venography or MRI direct thrombus imaging within 30 days of randomization.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: statistical analysis plan"}
{"_id":"3f1885c9-2648-83d4-ed36-e55790aa1de3","text":"Rhinoplasty is one of the most common surgical procedures performed among Iranians. An important issue to be considered by nasal surgeons is anatomical variations between different ethnic groups. Working on Iranians with the existing ethnic variety encourages the need for an analysis of this particular population.","title":"Structural Characteristics of the Iranians Nose: An Anatomical Analysis"}
{"_id":"3f1e6657-b0ee-5c8e-aab5-e6b811b8befd","text":"Finally, it should be noted that further prospective randomized research is warranted to assess the efficacy and establish the role of lipofilling in implant based reconstruction.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"3f248bb0-c521-1009-f9e8-08ef40f76988","text":"Surgical decisions are mostly based upon predictions of future well-being however in case of complex surgeries like mastectomy with reconstruction, physical functioning, and cosmetic outcome after implant both played a vital role in patient’s thinking process and often lead to an over expectation of future well-being28. This over estimation may result in regret or disappointment with their postoperative results. The reason could be lack of awareness or improper perioperative counselling where one might be unable distinguish between aesthetic breast augmentation surgery with oncological reconstructive surgery and assume higher baseline appearance after the procedure28–30. The decision of reconstruction after mastectomy is highly preference sensitive and various reasons are considered in decision making such as age, cultural and social background, marital status and extra cost for the procedure28. Patients assumption of appearance clothed and unclothed also highly influences their choice of going for reconstructive surgery after mastectomy, although patients seems to have negative opinions of unclothed appearance after reconstruction compare to clothed appearance, this may be the result of how media portray clothed appearance of women after reconstruction especially celebrities, but overall our study showed women who had reconstruction of breast were more satisfied with their sexual life comparing to other two groups31. We used Breast-Q questionnaire that is surgery specific for all three surgeries with different modules filled by each respective group.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"3f24afa3-72ba-da04-5aed-f8c992715a78","text":"HDR Interstitial Brachytherapy used either as a primary treatment modality or as a boost in buccal mucosal cancers provides results comparable to that of surgery, with the advantages of organ preservation, better cosmetic and functional outcomes.","title":"Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa"}
{"_id":"3f2e5eb7-05b8-f3d1-df33-d27134ce7e9c","text":"All methods were carried out in accordance with relevant guidelines and regulations. Data analysed were fully anonymised and as such the Ethics Committee of Instituto CUF waived the need for approval.","title":"Risk factors for development of new skin neoplasms in patients with past history of skin cancer: A survival analysis"}
{"_id":"3f3498da-870c-393a-9ea4-81aaf7a0925c","text":"Distribution and Number of Sentinel Lymph Nodes and Axillary Lymph Nodes","title":"Evaluation of Axilla With Sentinel Lymph Node Biopsy (Using Methylene-Blue) and Reverse Axillary Mapping (Using Fluorescein) to Validate Optimum and Safe Axillary Dissection in Breast Cancer"}
{"_id":"3f3b43f2-2eb1-d4b0-12e1-b69dcf246e31","text":"Although existing studies suggest that the time required to perform peripheral nerve blocks is shortened with the use of ultrasound, the time required to perform an initial ultrasound exam is not included in the total time reported in any of these investigations. Given the limited number of lower extremity studies, it is difficult to comment on the specific advantages of ultrasound with the exemption of a reduced local anesthetic volume required for lumbar plexus blocks. Routine use of ultrasound without the use of a nerve stimulator for deep nerve blocks may give a false sense of security regarding avoidance of complications, as the tip of needle may not be visualized at all times or not at all because of the depth of the neural structures. Consequently, cases of recognized or unrecognized arterial punctures have been reported even with the use of an ultrasound.","title":"Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review"}
{"_id":"3f537ceb-2c80-0215-6d67-c15099e983d8","text":"Desmoid tumors are locally aggressive fibrous tissue tumors with a tendency for local recurrence despite adequate surgical resection. Asymptomatic or non-progressive tumors may be carefully observed. Surgical resection is favored when functionally and cosmetically acceptable however combined modality management is useful in recurrent or unresectable tumors. Radiation may be indicated after margin positive resection or if unresectable with impending functional problems. Systemic therapies should also be considered in cases where the tumor is unresectable, especially in cases where radiation toxicity may be also unacceptable.","title":"Desmoid tumors: clinical features and treatment options: a case report and a review of literature"}
{"_id":"3f6283d6-1ce1-3649-ddb3-ff5ce0de1164","text":"The aim of our study was a comparison of semiquantitative assessment of subchondral BMLs and subchondral cysts using the DESS and IW fs sequences at 3 T MRI. Due to lack of a definitive reference standard, this study is primarily aimed at demonstrating how visualization of subchondral BMLs and cysts differs by sequence and at highlighting the strengths and weaknesses of each sequence for assessment of those lesions.","title":"Semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts of the knee at 3T MRI: A comparison between intermediate-weighted fat-suppressed spin echo and Dual Echo Steady State sequences"}
{"_id":"3f6300c3-619d-73b7-84e5-b227a84c524c","text":"In VIBF group, patients were allowed to a partial weight bearing with double crutches at 1 month after surgery and encouraged to gradually bear more weight until they could walk with full weight bearing. External fixators were removed after bone union confirmed by X-ray.","title":"Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects"}
{"_id":"3f6d630a-2221-322c-66c8-5221e5e4ba1b","text":"This study compared the clinical and functional outcomes of patients initially treated with observation or medical treatment with those of patients treated with local treatment (surgery alone or surgery with adjuvant radiotherapy) to confirm whether observation or medical treatment is an appropriate first-line management approach for patients with desmoid tumors.","title":"Upfront surgery is not advantageous compared to more conservative treatments such as observation or medical treatment for patients with desmoid tumors"}
{"_id":"3f6ec9cd-8106-849c-8884-c2f70db1494d","text":"Making an accurate diagnosis is the major clinical intervention that can be made in such patients [12]. However 8.4% of patients seen in the clinic had symptoms suggestive of a type I hypersensitivity (eg reactions with a temporal association with food or other triggers) but for which no evidence of type I hypersensitivity could be elicited from the history or proven by allergy testing. Some of these patients probably did have a type I hypersensitivity to an as yet unidentified allergen but others may have had idiopathic reactions with a coincidental temporal association with food or other triggers. Some of this group had severe symptoms including anaphylaxis.","title":"Complexity of case mix in a regional allergy service"}
{"_id":"3f6f566a-2a56-5497-d6c0-6903ca60af91","text":"In contrast, those who had been able to use the skills that they had developed on the programme were very positive about the opportunities they had encountered.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"3f703062-afdc-6af4-5e61-2f6c90c9d310","text":"Most CRs provided all the incidences of cases in one or more years of the study period. Registries covering large areas sampled cases from a defined incidence period using a randomized procedure. Supplementary Table S1 shows the criteria for sampling the cases. The process of identifying eligible cases for the analyses is shown in Figure 1.","title":"Association of Sentinel Node Biopsy and Pathological Report Completeness with Survival Benefit for Cutaneous Melanoma and Factors Influencing Their Different Uses in European Populations"}
{"_id":"3f79bead-e194-35ae-6d7a-8ff960f74031","text":"This large retrospective multicentre study demonstrated substantial variation in the hazard of secondary palate surgery for children with cleft lip and palate. Performing primary palate repair before 9 months of age substantially increases the hazard of secondary surgery, and choosing to perform palate repair after this age may be one approach to lowering rates of secondary surgery. Additional research is needed to identify other factors contributing to variation in palate surgery outcomes, along with testing of evidence-based interventions to decrease rates of secondary surgery. At present, these results suggest that cleft centres may be able to improve outcomes for their patients by adopting treatment practices from the best-performing centres. Performing cleft palate repair before 9 months of age may increase the risk of secondary procedures, unless the surgeon and centre have demonstrated successful long-terms outcomes.","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"3f96d62e-21e3-ae97-fe4c-a413dba78a0e","text":"The flap completely recovered and had a normal examination until 5 weeks postoperatively when the patient presented again with acute venous congestion (Fig 4). Her superior mastectomy skin had been closed in clinic 2 days prior. The congestion was noted to resolve in the supine position and again upon release of the superior incision. The patient was then monitored in the hospital with leech therapy for 5 days. The flap congestion completely resolved, and the patient had no further complications or fat necrosis of the flap. Her open wound was allowed to heal by secondary intention, and she was offered scar revision but declined. Her final result can be seen in Figure 5 over 1 year later.","title":"Successful Salvage of Delayed Venous Congestion After DIEP Flap Breast Reconstruction Katira et al"}
{"_id":"3fa27e4c-e59c-8dff-1d0a-dab17c66b17e","text":"We are confident that our procedure is quite fast to perform. The US beam allows us to quickly identify the needle while the angle between SP and TP is reached. The needle tip is inserted into the skeletal muscle plane of the ESM by maintaining the contact with SP of vertebra. The US guidance and the contact with bone allows us to quickly place the needle and the catheters onto the anesthetic target, without delay for surgical operation, as the emergent laparotomy. The flow diagram depicts the main steps for a safe and quick procedure of the block, as shown in Figure 5.","title":"A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report"}
{"_id":"3fa45433-611f-bd91-03d8-8dc38ca5d04d","text":"Microsurgery of the nerves of the upper extremities for interfascicular electrode implantation is described for the first time. Design of electrode implantation in cadaver specimens was adapted with a trocar delivery of cables and electrodes transcutaneous and stabilization of the electrode by suturing along the nerve. In addition, the overall operating arena environment with specific positions of the multidisciplinary team necessary for implantable electrodes was elaborated to assure optimal operating conditions and procedures during the organization of a first-in-man implantation study.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"3fa71647-86d3-31e9-e3d5-7013ac5404de","text":"Our observations revealed that the implementation of the complete margin control frozen section technique exhibited an eradication rate and subsequent recurrence rate comparable to that of the conventional Mohs micrographic surgery technique, widely regarded as the gold standard in the existing literature. This intriguing finding highlights the paradox that a faster and more expeditious technique can demonstrate a non-inferior profile when compared to the established benchmark in the field.","title":"Recurrence of Basal Cell Carcinoma Treated with Surgical Excision and Histopathological Analysis with Frozen Section Technique with Complete Margin Control (CMC-FS): A 15-Year Experience of a Reference Center"}
{"_id":"3fb3635b-4c2e-6057-facb-7a305310b447","text":"The absence of effective measures in the PHC network to sensitize women to preventive breast care and patients’ pilgrimage in the formal health care network have delayed early detection of breast cancer and led women to breast amputation, thus resulting in an irreparable biopsychosocial injury.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"3fb52110-915c-4d47-541f-25e96dea5697","text":"Studies on clot properties in patients who developed thrombosis at unusual location suggest that prothrombotic plasma clot phenotype contributes to such thromboembolic events, indicating that venous thrombosis is associated with certain common fibrin characteristics and the location of the event is largely driven by anatomical peculiarities or abnormalities.","title":"Prothrombotic Fibrin Clot Phenotype in Patients with Deep Vein Thrombosis and Pulmonary Embolism: A New Risk Factor for Recurrence"}
{"_id":"3fbe3f10-002d-0782-c5e3-f6b0038a9e6f","text":"While the overall results of this study are encouraging, there are some limitations. First of all, the size of the considered database is limited. It is necessary to include more patients and cases in order to confirm these initial findings. Secondly, the diagnosis of the lesion and the subsequent effect of the treatment was analyzed only visually, and we have no histological results to confirm the NIRS analysis results and interpretation. Moreover, with the expansion of the dataset and with the inclusion of histological data and other clinical data, a sophisticated machine learning study to classify the skin area using feature selection or a feature importance analysis can be employed to help answer some important questions, such as how accurately we can use the parameters computed on the NIRS data. Thirdly, while the acquisition protocol is easy to perform, there are some limitations to its standardization. Specifically, while the orientation and alignment of the NIRS probes should not substantially affect the acquired NIRS signals as long as they cover the same lesion area, we did not specifically test the probes’ position robustness. Furthermore, the ice pack application is an important step in the acquisition protocol but requires further studies to standardize the optimal application location with respect to the probes and lesion.","title":"Non-Invasive Analysis of Actinic Keratosis before and after Topical Treatment Using a Cold Stimulation and Near-Infrared Spectroscopy"}
{"_id":"3fc52ee3-8137-5709-9b68-454d2e58721f","text":"High flow extracranial to intracranial saphenous vein bypass grafting is safe and effective in the treatment of complex intracranial aneurysms and the saphenous vein can meet the requirements of blood supply. A high rate of graft patency and adequate cerebral blood flow can be achieved.","title":"Safety and effectiveness of high flow extracranial to intracranial saphenous vein bypass grafting in the treatment of complex intracranial aneurysms: a single-centre long-term retrospective study"}
{"_id":"3fca4547-c5d5-7c42-f7b7-c461d1dd4ac4","text":"Vital dyes are substances that are injected into the lymph nodes and allow their localization by presenting a bluish coloration. There are various types such as isosulfan blue, methylene blue and sulphan blue, although the most widely used is Patent Blue V which consists of an internal salt or calcium compound of diethylammonium hydroxide.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"3fcd6799-27d3-97d0-7526-b210048045ab","text":"In theory, a device to do video signal processing and visually present margins with a delay of 10 seconds might be usable and be of value in clinical practice. It could be implemented as an examination tool for use before or during surgery.","title":"Photoplethysmography for demarcation of cutaneous squamous cell carcinoma"}
{"_id":"3fcf3374-d6f6-4c7c-2a32-597e664aa7e0","text":"In summary, ASD is a rare occurrence of condyle dislocation anterior to the glenoid fossa and should not be classified together with lateral vector dislocations. When ASD is identified, surgical management should be anticipated and planned due to the low likelihood of success for manual reduction especially when treatment provision is delayed. There is no proper evidence to suggest or guide which surgical intervention would provide the best long-term outcome for the management of ASD. Condylotomy especially with piezoelectric surgery is a viable and safe option especially when intraoral approach is preferred.","title":"Long-Term Follow-Up following Condylotomy in a Case of Traumatic Unilateral Anterosuperior Mandibular Condyle Dislocation"}
{"_id":"3fd6f5ed-9a08-f0b0-241b-19dde2b3597c","text":"In this study, based on analysis of a large cohort of 13,848 candidates in the SEER database from 2010 to 2018 and incorporating a range of combined factors into a competing risk regression model, we found that the SLNB with complete ALND group did not show better prognoses than the SLNB only group for female breast cancer patients with SLNB micrometastases. To our knowledge, this is the first study based on a large population to explore the prognostic significance of further axillary lymph node dissection for sentinel lymph node micrometastases in female breast cancer directly through a competing risk model.","title":"The prognostic significance of further axillary dissection for sentinel lymph node micrometastases in female breast cancer: A competing risk analysis using the SEER database"}
{"_id":"3fde9d1c-b2f7-0a5b-8f89-aa8398097c49","text":"In conclusion, the miofrenuloplasty is an advanced, but effective and highly predictable procedure for full functional tongue release in the hands of an experienced surgeon. The indication for this technique is ankyloglossia caused by the MFGG complex. The condition for obtaining a predictable result is cooperation with the patient and the speech therapist.","title":"Miofrenuloplasty for Full Functional Tongue Release in Ankyloglossia in Adults and Adolescents—Preliminary Report and Step-by-Step Technique Showcase"}
{"_id":"3fe0caab-f06a-44ed-bbea-d8302d657179","text":"We fully recognise that developmental experts with different conceptual frameworks may not interpret our results in the same way. We more than welcome other contributions and hope they will be used for the design of future studies to explore alternative interpretations, avoiding the limitations of our project.","title":"Late weaning and maternal closeness, associated with advanced motor and visual maturation, reinforce autonomy in healthy, 2-year-old children"}
{"_id":"3fe2cf23-be45-8017-0d1e-c803cddf79ca","text":"Another important novel finding of our study was that in those patients experiencing dysphagia this phenomenon did not occur regularly, but only in about one third of the injection series applied, further reducing the relevance of this phenomenon.","title":"Dysphagia in cervical dystonia patients receiving optimised botulinum toxin therapy: a single-center retrospective cohort study"}
{"_id":"3fe4a57f-d51d-5a30-62f3-a922abcf812f","text":"Ultrasound is a portable, focussed and readily available modality that can be used to evaluate for insertion site haematomas, peri-cannula thrombus or deep venous thrombus. Spectral colour Doppler is a powerful tool to evaluate distal limb perfusion as the arterial return cannula can lead to obstruction\/occlusion with decreased forward flow in the access artery. It can also be used for evaluating thrombus in the access vein. Interpretation of spectral Doppler waveforms with comparison of flow in the contralateral vessel can help in differentiating slow flow, which may be due to a systemic cause such as poor cardiac output, from slow flow in the access artery from either the access cannula itself or thrombus.","title":"Imaging adults on extracorporeal membrane oxygenation (ECMO)"}
{"_id":"3fe97e88-3dbf-9b68-1187-9fcad1622e1c","text":"The demographic profile of respondents highlights the need for ICOPLAST to be a responsive organization and sensitive to a broad spectrum of ages and cultures. Further, the high value placed on the abovementioned initiatives reflects the need for ICOPLAST to plan a comprehensive portfolio of professional deliverables in several domains.","title":"Establishing Priorities for the International Confederation of Plastic Surgery Societies"}
{"_id":"3fe9ee23-3c5b-3003-62a8-8e1d3568f3a9","text":"Flap type and postoperative wound infection were both independent risk factors influencing the flap survival rate in the foot and ankle. However, postoperative wound infection was a risk factor for the pedicled flap but not for the free flap. Microvascular anastomosis is a major cause of free flap necrosis. To reconstruct complex or wide soft tissue defects of the foot or ankle, free flaps are safer and more reliable than pedicled flaps and should thus be the primary choice.","title":"Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis"}
{"_id":"3feaf13d-0452-59ad-9463-2162507b9b2d","text":"This catastrophic complication is caused by a tear in one of the large gluteal veins and fat embolism to the heart and lungs.49–51 Alarmingly, cadaveric dissections show that even superficial fat injection into the gluteus maximus muscle leads to fat (or rather its surrogate, apple sauce) accumulation around the deep gluteal veins, because there is no deep muscle fascia to act as a barrier.51","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"40000636-ae41-60ba-f943-2ac259a29d73","text":"We believe there is a bias in our study which must be taken into account when assessing the methodology employed. It happened with the letter sent to the patients explaining the reason for the visit, we believe that many of the patients who did not come for this evaluation were pleased with the outcome and therefore were not interested in this study. In the papers already published, the ROE questionnaire was sent to people by mail.","title":"Long-Term Evaluation in Aesthetic Rhinoplasty in an Academic Referral Center"}
{"_id":"400328e2-d2d2-9ca5-2ebb-b444e39a672f","text":"In summary, we found that endonasal septoplasty using an autologous septal cartilaginous batten graft to treat caudal nasal septal deviation can be a useful technique that may be performed with relative ease and simplicity. Our results showed that endonasal septoplasty using a septal cartilaginous batten graft had good surgical outcomes without an open scar or severe complications. This technique can improve the NOSE scale subjectively and VAS objectively for at least 6 months. A longer-term follow-up period can be explored in future studies.","title":"Endonasal Septoplasty Using a Septal Cartilaginous Batten Graft for Managing Caudal Septal Deviation"}
{"_id":"40066c02-0926-baf6-2230-803b8ce13294","text":"The primary endpoint was revision surgery during hospitalization and the primary outcome was the revision rate.","title":"Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study"}
{"_id":"400b1121-707b-8255-ce5c-78a885329147","text":"The optimal therapy for RHThIT is an ongoing debate because prospective randomized controlled studies are lacking.","title":"Traveling Thrombus in the Right Atrium: Is It the Final Destination?"}
{"_id":"400c57c9-72a9-e89f-a603-ed41a892bc03","text":"In our case, the patient was examined within 48 h of trauma in supine position. The fascial defect had sharp edges and the gap was seen constantly at rest as well as during dynamic study. The superficial fibers of the EDL muscle were seen protruding through the defect into the subcutaneous tissue at rest. Isometric contraction on dynamic study showed the herniated muscle to decrease in size and disappear. Excessive probe pressure on hernia to see any reduction was not possible due to the acute local tenderness and overlying subcutaneous edema.","title":"Isolated partial tear of extensor digitorum longus tendon with overlying muscle herniation in acute ankle sports injury: role of high resolution musculoskeletal ultrasound"}
{"_id":"40112c8d-d69f-74f0-1cb4-5f8d34e247f1","text":"The patient is instructed in postsurgical oral hygiene maneuvers as follows:","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"4017ee3f-cc06-054f-b1e1-7caab8ea986d","text":"Limiting CT of the spine to the smallest area necessary to answer the clinical question has a dramatic effect on the estimated cancer risk for individual patients. Cancer risks are summative, so spine CT imaging needs to be considered in light of the total radiation risk to the patient over their lifetime [101].","title":"Diagnostic imaging for spinal disorders in the elderly: a narrative review"}
{"_id":"401fefbc-3c4d-d5f3-b861-327c46865ab9","text":"The Best-BRA study will determine whether it is possible to recruit and randomise women to a study comparing prepectoral and subpectoral IBBR and determine the feasibility of progression to a definitive large-scale pragmatic trial.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"402160c7-e163-d5bf-e7ae-519899a97cfd","text":"Implications for practice: Topical pharmacotherapy is as effective as surgical excision in terms of tumor resolution in patients with OSSN. There was no difference in recurrence rate of OSSN between topical pharmacotherapy and surgical excision highlighting similar long-term efficacy of both treatment options in OSSN.","title":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis"}
{"_id":"40239546-e711-7253-ea57-f369f1c29af6","text":"Technological advancements in genetic testing and sequencing have significantly improved our ability to identify somatic and germline changes associated with melanoma. These advancements have expanded our understanding of the hereditary risk for melanoma, facilitated genetic risk stratification, and influenced personalized management and treatment approaches. Continued advancements in genomic technologies will undoubtedly contribute to further unraveling the complex genetic landscape of melanoma and improving patient outcomes.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"40266bf6-6dee-daad-14b3-3b845af7ac93","text":"In our opinion, a preoperative color Duplex scanning of the lower IMAPs to ensure the presence at least of the 4th IMAP is highly advisable, or even a must in order to avoid flap vascular complications, as elevating the lower pole breast tissue as a medially based flap without at least visualizing the 4th interspace IMAP by color Duplex prior to surgery will not often be opportune.","title":"Color Duplex Assessment of 4th and 5th Internal Mammary Artery Perforators: The Pedicles of the Medially Based Lower Pole Breast Flaps"}
{"_id":"40351f8b-29b1-ac29-dd22-2f1f7357887a","text":"Flaps are increasingly popularized in reconstructive surgery and there is need to test and increase their reliability. Color Doppler ultrasound has been stated to be valuable in flap planning. The aim of this study was to conduct a systematic review and meta-analysis of the literature of Color Doppler ultrasound targeted pedicled perforator flaps and provide information on outcomes and complication rates.","title":"Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps—a systematic review and meta-analysis"}
{"_id":"4039ef9a-b387-fdb5-e142-191fdabff5d5","text":"Worksite observation of outdoor workers use of sun protection at work can be used as method to help validate our findings and describe the use of different measures of sun protection more in-depth.","title":"Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers"}
{"_id":"403ab12b-28b0-5ef0-a815-27d4f8bc12e8","text":"Postoperative radiotherapy uses a computed axial tomography (CAT) scan on which the surgical wound bed and the organs at risk are outlined. With the help of a treatment planning system which simulates the penetration of the electrons into the area outlined, the linear accelerator is programmed to deliver the prescribed dose in order to control the excessive proliferation of fibroblasts in the surgical wound bed.","title":"Postoperative radiotherapy in the management of keloids"}
{"_id":"405043fa-df4a-5bf5-fc17-ba2f25569aa3","text":"Vismodegib is a safe and effective treatment for locally advanced basal cell carcinoma. To prevent recurrences, the drug should be used continually when tolerated. The role of neoadjuvant vismodegib before surgery is being investigated and might add an important step in searching for a definitive treatment for these cases.","title":"Vismodegib for treatment of periocular basal cell carcinoma – 6-year experience from a tertiary cancer center"}
{"_id":"405e1cb8-0eef-5ecf-68a1-81599dce2a7f","text":"A decision for lateral pelvic sidewall lymphadenectomy was taken in this series of patients when there was either radiological or intraoperative evidence of malignant lateral pelvic sidewall lymph nodes, or the tumour invaded the lateral pelvic compartment and had to be removed en bloc with the lymph nodes. Tumours within the lateral pelvic compartment are considered to have poorer prognosis [13, 18, 19]. The fact that younger patients had to undergo lateral pelvic sidewall lymphadenectomy may indicate that their tumour was more aggressive, a factor that may need to be taken into account when considering young patients for exenterative pelvic surgery. However, further studies investigating the tumour histopathology of these patients are essential to conclude this.","title":"Extended lymphadenectomy for locally advanced and recurrent rectal cancer"}
{"_id":"405f222a-4da3-fc99-70eb-b7dfe4579dc9","text":"Our study has several limitations, including a study population composed mostly of older men, which limits generalizability. Although we can comment with confidence on the low rates of prescribing of postdischarge VTE chemoprophylaxis in the VHA health system, actual outpatient VTE chemoprophylaxis rates of self-administration are unclear. Although patients receive training on administration of enoxaparin injections, there is a limitation in that there is no documentation of actual reported or measured patient home administration. It is possible that actual patient postdischarge VTE chemoprophylaxis is functionally lower than the low rates reported in this study. Additionally, inpatient compliance in the data set is a best estimate given variations in timing of when a patient leaves the operating room and how many doses of VTE chemoprophylaxis would be appropriate. Furthermore, variations in the documentation of hospital discharge time further complicate estimations of VTE chemoprophylaxis adherence on the last day of a hospital stay.","title":"Venous Thromboembolism Chemoprophylaxis Adherence Rates After Major Cancer Surgery Venous Thromboembolism Chemoprophylaxis Adherence Rates After Cancer Surgery"}
{"_id":"40634dff-8c77-7956-bcbb-aeb32f4cdd16","text":"The first appointment at the GP clinic will inform as to the nature of the trial. For those patients willing to participate the research nurse will obtain written informed consent.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"40675d0d-6f19-781d-ba08-22553cb070db","text":"With respect to C8161 cells their invasion post wounding is shown in Fig 4G. The most striking finding was that the dermis appeared to be very compact and intact in the presence of these cells even following wounding. Detailed examination showed extensive invasion of these C8161 cells throughout the dermis despite the compact integrity of the dermis. These cells were identified as melanoma on the basis of their large nuclei and the fact that they did not stain for keratinocytes and were far too plentiful for fibroblasts (which also had smaller nuclei). This invasion was not affected by the addition of ibuprofen as shown in Fig 4H where dermal integrity remained very good but C8161 penetration was extensive throughout the dermis.","title":"Use of a Tissue Engineered Human Skin Model to Investigate the Effects of Wounding and of an Anti-Inflammatory on Melanoma Cell Invasion"}
{"_id":"406fb3b3-35da-fda6-aa89-9ba5cc2263b7","text":"In sum, our study supports the current praxis of treating cervical lymph nodes with END while treating OSCC. Improvements in radiological diagnostics are needed to detect occult metastasis in OSCC. The limitations of radiological diagnostics must be considered when devising a surgical treatment plan.","title":"Reliability of the pre-operative imaging to assess neck nodal involvement in oral cancer patients, a single-center study"}
{"_id":"40775dbc-9880-0583-d8a4-af750546781a","text":"Frequently the deformities of the nasal septum and nasal pyramid occur due to the fractures of the facial and nasal bones especially in children younger than five years of age. The incidence increases with increasing age and peaks between 16 and 20 years. Numerous observations on the retarded growth of the nose after submucous resection caused the above-mentioned restriction in surgery at a young age. If the septum is determined to be the reason of nasal obstruction in a childhood, a clinical dilemma arises. Recent basic researches, assessment the results of the thesis of the negative influence of surgical trauma in growth and development of nasal and skull bone.","title":"Justification for Rhinoseptoplasty in Children – Our 10 Years Overview"}
{"_id":"4079265c-5520-5f15-d56d-1150d48fdaf5","text":"Previously described surgical techniques include incision and drainage with drainage with simultaneous muscle flap coverage or simple incision and debridement with healing by secondary intention. A recent review of these two surgical approaches for treatment of SCJ infection in 20 patients showed problems with each method. There was a 50% complication rate with immediate flap closure including hematoma, dehiscence, and seroma. On the other hand, the patients who underwent open wound care required therapy for a median of 12 weeks [2]. We had similar finding in our small series in patients treated with these two methods. We had 50% wound complication with resection and immediate flap and prolonged wound care when no muscle flap was used. The debridement and open wound care had a very low success rate in another surgical series which showed that this approach was only successful in one out of six patients with the other five patients requiring additional procedures [23]. Open wound treatment in this patient population who often suffer from medical comorbidities results in prolonged length of time to healing and inconvenience to the patient, poor cosmetic result, increased costs, and possible introduction or worsening of osteomyelitis when bone is left exposed for long periods of time.","title":"Treatment of Sternoclavicular Joint Osteomyelitis with Debridement and Delayed Resection with Muscle Flap Coverage Improves Outcomes"}
{"_id":"40941099-d691-b317-8631-48ae75d0f3c4","text":"A table summarizing number of adverse events in the non-intervention vs. intervention group will be used to compare if there are any differences between the groups in regard to AEs and to investigate if any increased use of topical drugs in one of the groups is associated with an increased risk of AEs.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"40966fde-b013-3412-49d4-8b9c8bb43e42","text":"Despite the serious adverse reactions linked to DTH, at present, there are no validated in vivo or in vitro methods for assessing the sensitizing potential of a drug during the preclinical phase. The following section provides an overview of in vivo and in vitro methods.","title":"Evaluation of Delayed-Type Hypersensitivity to Antineoplastic Drugs—An Overview"}
{"_id":"40a2b7f5-28be-61ef-667d-2411d85ab217","text":"Grafts require additional surgery and elderly patients are at risk for graft failure or necrosis. Secondary intent healing is an option for these patients but results in prolonged heal times. Previous studies assessing secondary intent heal time in post-Mohs scalp wounds with exposed bone and periosteum have demonstrated an average time to reepithelialization of 186 days.","title":"Utility of synthetic hybrid-scale fiber matrix in dermatologic wounds"}
{"_id":"40b2fe92-f49a-132b-f3b0-3164082ad76a","text":"The analysis of TFS between ICI cessation and subsequent therapy initiation revealed longer TFS without toxicity for patients with advanced melanoma who received nivolumab plus ipilimumab compared with nivolumab or ipilimumab. Regardless of treatment, a small proportion of the TFS involved grade 3 or higher TRAEs.","title":"Treatment-Free Survival: A Novel Outcome Measure of the Effects of Immune Checkpoint Inhibition—A Pooled Analysis of Patients With Advanced Melanoma"}
{"_id":"40b47ba9-23c2-bb09-7aa8-4a69ff9b0a64","text":"That way the foot and ankle can be maintained in a proper position for the arthrodesis – with ankle neutral dorsiflexion, 5 degrees heel valgus and external rotation of the foot in relation to the tibia comparable to that of the normal contralateral side, of approximately 5 to 10 degrees. Also under fluoroscopy the relation between the calcaneus and the tibia, can be confirmed, allowing the proper valgus inclination that will permit the correct nailing positioning because by this method the normal lateral offset of the calcaneus in relation with the tibia is corrected.","title":"ANKLE ARTHRODESIS WITH INTRAMEDULLARY RETROGRADE NAIL FOR BONE TUMORS. PRELIMINARY RESULTS AND SURGICAL TECHNIQUE ARTRODESE DO TORNOZELO COM CAVILHA INTRAMEDULAR RETRÓGRADA PARA TUMORES ÓSSEOS. RESULTADOS PRELIMINARES E TÉCNICA CIRÚRGICA"}
{"_id":"40b94335-3456-0a00-8ea1-5058f59c64b1","text":"Routine thromboprophylaxis is not used in our institution and the prevalence and incidence proportion of proximal DVT in Asian medical critical care patients were both substantial. Patients with older age, female gender, an intravenous femoral catheter, and the absence of platelet transfusion all had a higher chance of developing proximal DVT.","title":"Incidence of proximal deep vein thrombosis in medical critical care patients"}
{"_id":"40ba0120-2491-98a8-6249-58750086ec49","text":"This systematic review aimed to analyze the main value of MRI for PJIs diagnosis and summarize various helpful MRI appearances in identifying infected prostheses for THA or TKA patients.","title":"Diagnostic value of magnetic resonance imaging for patients with periprosthetic joint infection: a systematic review"}
{"_id":"40c01371-5fac-4a1d-7e15-c5cc787ecf71","text":"Flow chart for our randomized controlled trial on the efficacy and safety of TEA for FEMA after PFP","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"40c40c41-40f1-e1da-91b1-43181a04b2be","text":"Analysis will be carried out at the end of the study, as there is likely to be insufficient power for interim analyses. Quality control of data collection will be conducted by a trial management committee throughout the study and by a statistician independent of the research team.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"40c5882b-0079-2e52-a4f2-e7451aeccb49","text":"The incidence of lower limb arteriosclerosis obliterans has increased with the aging of the general population. The number of patients with lower limb peripheral artery disease has also increased along with the number of patients undergoing dialysis and individuals with risk factors for atherosclerosis, such as diabetes mellitus, hypertension, and hyperlipidemia.","title":"Repeated acute lower limb ischemia due to complete occlusion of an artificial vessel graft: A case report"}
{"_id":"40cb88a1-6533-b69a-da83-dcd05251cbb2","text":"Interim analysis will be conducted when 75 patients have been included to assess the frequency of the event rate and inclusion rate to adjust the intended size of the study population.","title":"Efficacy and safety of different antimicrobial DURATions for the treatment of Infections associated with Osteosynthesis Material implanted after long bone fractures (DURATIOM): Protocol for a randomized, pragmatic trial"}
{"_id":"40d3fc35-00e8-7c4e-ba8c-638ba69d4ad0","text":"Reduced dosages may result in unacceptably short durations.23 While a higher dose may be found to last longer, this must be weighed against higher doses potentially spreading to adjacent muscles with potentially adverse effects, and also the increased cost to the patient.","title":"A review of the longevity of effect of botulinum toxin in wrinkle treatments"}
{"_id":"40d5435f-b25b-61b3-f762-4b7790c8a748","text":"In this study, we applied confocal laser scanning microscopy as well as Raman spectroscopic imaging to extensively characterise S. aureus-induced pelvis deformation during chronic hematogenous osteomyelitis on a microscopic scale. Bacteria were localised in all regions of the bone and osseous, and soft tissue changes as well as inflammatory lesions were characterised with the different imaging modalities and put into relation to classical histopathological staining, such as hematoxylin and eosin staining as well as Gram staining. Bacterial abscess communities and lesions were also found in the macroscopically not-deformed side of the pelvis.","title":"Insights into S. aureus-Induced Bone Deformation in a Mouse Model of Chronic Osteomyelitis Using Fluorescence and Raman Imaging"}
{"_id":"40e358db-4d00-2173-c038-a840fa9141c4","text":"Written informed consent was obtained from the patient for the publication of this manuscript.","title":"Repeated acute lower limb ischemia due to complete occlusion of an artificial vessel graft: A case report"}
{"_id":"40e4789d-ee65-872e-573b-a1bc45a2b75f","text":"Regarding the Korean papers, it is mentioned that in the Asian population, there are lower rates of DVT, 18 25 26 which explains why VTE prophylaxis is not routinely prescribed in Korea. 27 This may be why Yhim et al 22 found no statistically significant difference between the rates of DVTs in those prescribed aspirin and those prescribed no thromboprophylaxis. Yhim et al 22 did use a large national database; the data may not be accurate and the quality of data are often poor due to the issue of data capture. It may be difficult to compare the results from Korean populations with Caucasian populations.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"40e52c42-8bda-4062-7223-a19cab8f3aa7","text":"In our study most cases of primary BSC excision of pT1 and pT2 tumors have good clinical outcome with none of the patients developing disease recurrence or metastasis. Positive margin is a significant risk factor for recurrence of a disease. In most cases reported inadequate excision rate was associated with facial area. Tumors developed on face lead to challenges in resection and reconstruction, issues to achieve adequate surgical margin, and problems in providing a decent aesthetic outcome.","title":"Clinical and epidemiological analysis of basosquamous carcinoma: results of the multicenter study"}
{"_id":"40e7370b-5483-115f-5786-50257ccdc4eb","text":"Questionnaires were completed anonymously by mothers at presentation to the Interdisciplinary Breastfeeding Clinic. Data regarding the method of feeding, feeding experience of both mother and infant and common feeding difficulties were included. Postal follow up questionnaires were sent six to eight weeks after a single appointment at the clinic. Data were analysed using Microsoft Excel. The study took place between April 2015 and August 2016.","title":"ECU convention 2017 research presentations Limassol, Cyprus. 25-27 May 2017"}
{"_id":"40e857b0-0f72-6d56-bf8e-5f682de6d3f1","text":"The FMC concentration was a useful early indicator of deep vein thrombosis after knee surgery. Monitoring the FMC concentration could enable selective identification of patients with a high thrombus volume, which is associated with a high risk for pulmonary embolism.","title":"Fibrin monomer complex on postoperative day 1 is correlated with the volume of deep vein thrombosis after knee surgery"}
{"_id":"40f3711a-82e2-1917-c298-8c035bdf923e","text":"This systematic review includes studies that examine the surgical techniques that are available for treatment, including traditional surgery and laser surgery.","title":"Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review"}
{"_id":"40f8f2b8-7c80-64fd-6927-2e5e1138a59d","text":"Across many parts of Latin America there is a lack of knowledge regarding the pathology of VTE, leading to late consultation. Furthermore, even if a clinician has adequate evidence to suspect a diagnosis requiring anticoagulation, therapy is occasionally not started until the diagnosis has been confirmed, which in some institutions results in an additional delay of several days while waiting for confirmation by ultrasound.","title":"Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care"}
{"_id":"40fbcd6c-3a33-7d8a-7bec-cee265951064","text":"Certainly, ultrasonography and histology studies will be able to demonstrate the sensitivity and specificity of the imaging method. Ultrasound could also become the main imaging tool for dermatology nail evaluation, both for inflammatory conditions such as psoriasis and PsA, but also to perform differential diagnoses with certain benign or malignant tumors or with various subungual collections. Ultrasound can also guide nail biopsy. The methodology for quantifying the Doppler signal at the periungual level in PsA can also enter the research agenda, considering that it has variability in healthy controls. Even though dispose of a core domain set published by GRAPPA that includes entheses and nails [42], we do not yet have standardized methods for measuring the nail parameters or the distal entheses. The development of these standards would enable comparison of therapeutic studies on the core set of domains.","title":"Nail Ultrasound in Psoriasis and Psoriatic Arthritis—A Narrative Review"}
{"_id":"40fd83a3-dbaf-9851-2d4a-a364922a449f","text":"Future research should focus on identifying future AK trends, cost effectiveness of field treatments versus cryotherapy for AK, the association between AK and SCCs and the role of field treatments for clinical and subclinical AKs in preventing SCCs.","title":"Cost for the treatment of actinic keratosis on the rise in Australia v2; ref status: indexed"}
{"_id":"41038040-9e0b-c24b-445d-8b219a7361a8","text":"This study proposes a classification based on the final angiogram as a reference standard to determine the expected effect on localized change in perfusion directly after EVT. In this way, in only 11 calves and 9 feet was the completion angiogram scored as “good” in terms of improvement of the arterial inflow of the tissue where HSI and thermal measurements were performed. Although 96% of the target lesion revascularizations were technically successful, a direct change in localized superficial tissue perfusion was not expected directly after EVT in these limbs. The ability of angiographic results to discriminate between limbs with and without clinical improvement at 6 week follow-up was low. The low sensitivity suggests that presence of uninterrupted flow in the larger arteries does not always lead to clinical improvement. A possible explanation is that the microvasculature is too much affected to regenerate. Local tissue perfusion measurements may better appreciate the microvasculature and may therefore better identify limbs that will show clinical improvement. This is in line with previous findings, in which the predictive value of successful recanalization is poor. Moreover, the change in perfusion values was not different between the limbs classified as a good angiographic result and the limbs that were not. These findings reinforce the fact that conventional diagnostics, such as DSA, are not able to accurately detect changes in local tissue perfusion and the need for a non-invasive perfusion imaging technique such as HSI seems beneficial.","title":"Detecting Changes in Tissue Perfusion With Hyperspectral Imaging and Thermal Imaging Following Endovascular Treatment for Peripheral Arterial Disease"}
{"_id":"4103b452-b3f5-6371-e933-e5857feb2ffe","text":"In summary, asthma and rhinitis prevalence in children living in the Tropics is higher than that reported in temperate countries for the same age groups. An overall increase of allergies from ISAAC I to III was observed, similar to that in temperate countries. In addition a trend for increasing allergy symptoms in places closer to the Equator was observed, suggesting an effect of latitude that deserves more study.","title":"Particularities of allergy in the Tropics"}
{"_id":"41058fbc-bc1c-af02-3867-0c9d4132742b","text":"With similar clinical outcomes compared to standard care, our results do not support the use of NPWT in routine treatment of conflict-related extremity wounds at civilian hospitals in resource scarce settings.","title":"Cost analysis of negative-pressure wound therapy versus standard treatment of acute conflict-related extremity wounds within a randomized controlled trial"}
{"_id":"4115cae3-c8fd-070d-4105-66fe07c87f84","text":"Table 1 shows available shell surface types of breast implants from 8 manufacturers.","title":"Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant"}
{"_id":"41175543-16bb-a941-1ebf-4a930a5778a5","text":"Sensory nerve supply to the nipple areola complex comes from the 4th lateral intercostals branch, which enters laterally through the 4th interspace and runs medially under the deep fascia for a few cms. It then courses upwards through the breast tissue to supply the nipple-areola. Some sensation is also provided by the 3rd and 5th lateral intercostal branches in the lateral breast area and the 3rd to 5th anterior branches of the intercostal nerves.","title":"Reduction mammoplasty"}
{"_id":"4122683f-c138-8e47-b492-ce928df1f00d","text":"One factor that is impossible to convey in the data reported is the variability in the fat present in the ventral floor of the orbit. It is possible that variable amounts of periocular fat could impact the effectiveness of the PC technique when administered in live patients. In the PC technique, the needle is advanced deep into the orbital region, in the direction of the maxillary foramen, but it is not possible to visualize the precise location of the advanced needle. Due to the nature of the injection, it is critical that the needle used for this technique be as thin and as short as possible to avoid damage to adjacent structures.","title":"Cadaveric Evaluation of Injectate Distribution for Two Maxillary Nerve Block Techniques in Cats"}
{"_id":"4128bdc7-77c3-df39-c60b-71f7e819e475","text":"We had no harvest induced alopecia in our study as it was predictable. Given the fact that hair follicles are situated in deep layer of scalp not damaged during harvesting partial thickness graft. Crust formation is due to accumulation of exudative fluid and blood clots on top of the donor site. Crust formation occurred in seven patients in case group resolved 35 days after release of the last layer of dressing. The mean time to release of dressing last layer from donor site was lower in case group which was statistically meaningful. This is brought about by rapid re-epithelialization in the scalp. Crust presence in association with the last dressing layer will cause dryness, pain and range of motion limitation, this was particularly prominent in lower limb in control group. The release of the last layer of dressing would diminish all these complications as was the case in case group in this study. Long term severe pain in lower limb donor site following partial thickness skin graft harvesting is essential in patients. The resultant defect from partial thickness graft harvesting acts like a second degree burn which is extremely painful aggravated by adhesive dressing compounded by dried secretion. This may secondarily lead to prolonged limping and limitation in daily activities-. Almost every patient complains about donor site complications in the follow up sessions while they are relatively content with the recipient site, almost all of these complications were resolve in our study by harvesting from scalp. We had no complaint about itching or discoloration in donor site after 90 d postoperatively, we also did not have any hypertrophic scar in case group, while most patients in control group were complaining of these complications requiring further measures.","title":"Outcome of Comparison between Partial Thickness Skin Graft Harvesting from Scalp and Lower Limb for Scalp Defect: A Clinical Trial Study"}
{"_id":"4130c249-6731-31c0-cead-b830c2f140ed","text":"We used the number of programs and fellowship positions accredited as of July 2000 as a baseline for analyzing the trends in fellowship training between July 2000 and June 2008.","title":"Sponsorship of Internal Medicine Subspecialty Fellowships Since 2000: Trends and Community Hospital Involvement"}
{"_id":"4130d5c5-f6a2-4ab8-8870-5448dad2298f","text":"Fifty-one patients with anaphylaxis followed the recommendation of allergists and underwent RCM skin test and the other 53 patients refused to perform skin test because they did not have a scheduled follow-up CT in the near future.","title":"Anaphylaxis to Iodinated Contrast Media: Clinical Characteristics Related with Development of Anaphylactic Shock"}
{"_id":"41317bb1-3ecc-39b3-0a80-3b24a39952f0","text":"The research was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. The patients have given their written informed consent on admission and pre-operative to use their prospective data base and files for research work (and as it is a retrospective study on the previous patients data and records so no need for new consents).","title":"Successful use of venous graft from native liver with hepatocellular carcinoma during living donor liver transplantation with no impact on recurrence rate: A retrospective cohort study"}
{"_id":"41370dbc-e41c-a389-bc57-9421e0ea3058","text":"From August 2014 to December 2018, more than 89 patients who were diagnosed with scalp injury visited two surgeons in the Department of Oral and Maxillofacial Surgery at Brong Ahafo Regional Hospital. We herein report three patients with frontoparietal scalp defect from motor vehicular accident and include clinical photographs with each patient’s description and treatment procedures. The patients or their parents provided written informed consent for surgical reconstruction and approved the use of their photographs in scientific publication. This case series report was evaluated and approved by the Institutional Review Board of Seoul National University (S-D20200021).","title":"Scalp injury management by a maxillofacial surgeon in a low-resource hospital"}
{"_id":"413e6878-119a-f9c2-ee77-7711ed787538","text":"Plain radiographs remain the principal investigation and are particularly useful when reviewed serially. New periosteal bone formation on X-ray suggests living, vascularized bone. By contrast, dead sequestered bone is unable to form new bone or remodel, and remains radiodense, sclerotic and unchanging.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"414372f7-3c1f-34b5-5a08-adcd9af69a83","text":"This paper presents the study of cellular effects of ultrasound generated using a multi-well device based on PiezoPaintTM transducers. The aim is to demonstrate the potential of PiezoPaintTM as a platform to develop therapeutic solutions for the treatment of abnormal scarring. To explore the potential of the technology, human dermal fibroblasts were treated and evaluated in terms of adhesion, proliferation, and deposition of ECM proteins. The secondary aim was to develop a device that could be used to test the effect of ultrasound on cell cultures in vitro, overcoming the limitations of current available transducers.","title":"Exploring the Potential of Ultrasound Therapy to Reduce Skin Scars: An In Vitro Study Using a Multi-Well Device Based on Printable Piezoelectric Transducers"}
{"_id":"4143d59f-fccf-f422-2f15-586cb4cf95a2","text":"To characterize the situation of breastfeeding and the adequacy of prescription of infant formulas to infants assisted by a secondary care program of the Public Health System.","title":"Breastfeeding versus free distribution of infant formulas by the Public Health System"}
{"_id":"415103da-92c7-40d5-28b3-ab32db9bc3bf","text":"An immediate evaluation should be performed to assess whether replantation is possible due to the increased risk of infection in the case of massive necrosis of the scalp. When this is not possible, reconstruction with a skin graft, in an emergency setting, is generally feasible with satisfactory functional and esthetic results.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"4151f083-64ae-406e-d944-87854977a046","text":"This abstract is not included as it has already been published:","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"4165cf63-c1c9-a138-0f5d-d4bfa09809b8","text":"Cryopreservation of compacted fragments of cancer cells was implemented based on the protocols for cryopreservation of human ovarian tissue [13] with modifications and peculiarities as described below. The model tissues were frozen and thawed subjected to the process for ovarian strips.","title":"Increasing of malignancy of breast cancer cells after cryopreservation: molecular detection and activation of angiogenesis after CAM-xenotransplantation"}
{"_id":"416c23b4-bf19-52ef-3dc4-a46ce1292d90","text":"Most of the identified studies reported mean scores which may not encapsulate the small number of outlying patients who experienced very severe pain. These would be the key patients to identify as they are the ones who may require spinal or GA. The effect of patient factors including age, sex, and underlying pathology on tolerability was not well explored in the identified literature. Specific pain studies in the wider literature have identified that women are more sensitive to pain than men on most pain sensitivity measures. Age effects of pain sensitivity are relatively weak. Within the literature identified in this systematic review, Briskin and Atiemo was the only study to look at specific patient subgroups. They found VAS to be lower among neurogenic patients compared with that of idiopathic OAB patients. The majority of the studies were small and had a predominantly female cohort. There were also heterogenous mixes of idiopathic and neuropathic patients. Consequently, larger studies identifying which subgroups of patients tolerate the procedure most poorly would be valuable as these patients would benefit the most from the interventions identified in this review. Reitz et al. found a notable increase in bladder sensation and pain perception in patients who exhibited bladder cold sensation when tested with ice water instillation. Understanding which patients experience bladder cold sensation may allow the prediction of lower tolerability as well. Although it would be more cumbersome to assess this for every patient than simply having a prediction based on a subgroup study, it is an example of how identifying relevant subgroups can be informative of the likelihood of experiencing more pain.","title":"Interventions to improve tolerability of local anesthetic intradetrusor Botulinum toxin injections: A systematic review"}
{"_id":"416cc610-ffd4-e94b-ce99-054548e4254c","text":"This is the reason why the best injuries to treat are shown to be those of the upper limbs and lower limbs. Of these, the worst to treat are injuries to the popliteal artery. This is not only our experience but was thoroughly discussed in the literature.","title":"A decade of civilian vascular trauma in Kosovo"}
{"_id":"4177b3cd-b910-2e68-1429-32af0b0c28cf","text":"Ultrasound has been used to quantitate changes in fat volume after fat injection of the breasts and buttocks. This device has also been used to measure decreases in thickness after nonsurgical fat reduction including cryolipolysis. Other novel applications include evaluation of facial hyaluronic acid injection and subcutaneous thickness after botulinum toxin injection.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery"}
{"_id":"417bc448-424f-8edb-1794-90a7620ddf31","text":"Lipofilling is one of the new tools added to the disposal of reconstructive surgeons. The indications of this technique are still being explored in many aspects of breast reconstruction. This case report demonstrates a possible salvage and protective value for lipofilling in implant based reconstruction especially in cases where adjuvant irradiation is anticipated. In cases of implant exposure without infection fat grafting can provide a protecting layer of fat around the prosthesis.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"418091c2-10e8-f425-ecce-00baf7857633","text":"Operations have their recognised place in the treatment of goitre. The indications for operative treatment have been the same for many years. Advances in medicine and changes in surgical approach have both influenced the development of minimally invasive techniques. These have also affected the duration of hospital stay, shortening it significantly, and resulting in a reduction in the real financial costs of the medical services provided.","title":"Abstracts and short papers from the 5th Congress of the Polish Thyroid Association, Poznan, 3-5 September, 2015"}
{"_id":"4182d0b6-a938-2021-9603-cdbfbf070da2","text":"The authors found that the flap survived in the previous case, partial necrosis along the skin suture boundary occurred in one case, which healed with the use of prophylactic antibiotics and dressings alone, and venous congestion occurred in one case from the day after surgery. Discoloration occurred but healed well with Colossus alone without the use of medical leeches. In the authors’ case, the better results compared to other studies were flap coverage performed in the same setting of plate exposure occurring after minimally invasive metal plate fixation, and the size of the flap was relatively small. In addition to the fact that it was in the site, it is thought that the fact that the authors designed and colossalized the flaps and provided technical modifications also helped.","title":"Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap"}
{"_id":"4187e42b-5029-3879-8cf8-c7bec98226b0","text":"The risk of AK increases with age and the ageing of the Australian population may increase the burden of AK on the Australian health system.","title":"Cost for the treatment of actinic keratosis on the rise in Australia v2; ref status: indexed"}
{"_id":"4189360a-f0db-e160-dd42-d0a27f9ca24b","text":"For the first time, we report the correlation between imaging and clinical changes to the abdominal wall in patients who have undergone autologous breast reconstruction with a DIEP flap.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"418ab5a8-d15d-8058-f211-22dd352298ac","text":"A few participants did not have any experience working with FP outside the formal training environment, as FM was not part of the internship rotations during their internship and community service. However, there were a number of participants who had very positive experiences of working with FPs during their internship or community service:","title":"Perceptions of specialists in the public sector, on the role and value of family medicine"}
{"_id":"418c32fc-c149-f862-8981-48efbec9e0e1","text":"The current study assessed in detail the risk of second primary tumours for men diagnosed with PCa in the Canton of Zurich. We found a weak increased risk for overall cancer, but a complex pattern was observed when looking at specific cancer types and PCa treatment and stage. Urological cancers were consistently more prevalent among men with PCa, irrespective of their cancer treatment or cancer stage. The increased risk of second primary tumours increased over time and was most pronounced 10 years post diagnosis for men who underwent radiotherapy.","title":"Incidence of Second Malignancies for Prostate Cancer"}
{"_id":"41937208-d6bf-d2f7-042b-299db37538f2","text":"This study’s findings suggest that it is important that shared decision-making among patients with prostate cancer includes discussion of late toxic effects, including the risk of developing a second primary cancer, and that the possibility of developing a second primary cancer after radiotherapy be considered during evaluation of symptoms among survivors.","title":"Assessment of Second Primary Cancer Risk Among Men Receiving Primary Radiotherapy vs Surgery for the Treatment of Prostate Cancer Second Primary Cancer After Radiotherapy vs Surgery for Prostate Cancer"}
{"_id":"419d4f20-2371-0bdf-5406-fc7030f3d443","text":"Lately, there has been a great deal of interest in this field of research due to its high significance in morbidity and mortality. Regardless, there is a small amount of literature that addresses the incidence of DVT by comparing osteosynthesis and arthroplasty as surgical treatments. Current recommended anticoagulation protocols might be inadequate for specific groups of cancer patients undergoing osteosynthesis or arthroplasty.","title":"Deep vein thrombosis following the treatment of lower limb pathologic bone fractures – a comparative study"}
{"_id":"419f5ab9-2e57-1e5d-d2a7-35901664b262","text":"The present study tests the efficacy of a sun safety intervention based on the principles of behavioral economics theory. Sunless tanning products will be promoted among beach visitors as a safe alternative to sunbathing. Participants will also be made aware of the sun damage on their skin via sun damage imaging and be given information on skin cancer risks, consequences, and methods of protection. The promotion of sunless tanning within the context of a skin cancer prevention intervention has potential to impact sun exposure by giving sunbathers a healthy alternative to achieve a tan.","title":"Design and methods for a cluster randomized trial of the Sunless Study: A skin cancer prevention intervention promoting sunless tanning among beach visitors"}
{"_id":"41abafbc-9a67-63e8-3d5d-063008397394","text":"We detail the design of a nursing intervention to standardize breastfeeding counseling, as well as the evaluation of its effect on adolescent mothers. This intervention has the advantage of having been designed using standardized language from the Nursing Intervention Classification and using the same standardized language to evaluate its effect through the Nursing Outcome Classification, using standardized language facilitates the use of interventions and the measurement of their effect in different populations, as well as consolidating the use of a specific nursing language.","title":"Lactation counseling for maintaining exclusive breastfeeding in adolescent mothers: a trial protocol"}
{"_id":"41b37436-165e-b4e6-2f07-a149a83fdc0d","text":"Aims The aim of this study was to review the clinicopathological characteristics of dermal filler cases from 2006 to 2016, reported at a specialist oral pathology unit.","title":"Beauty is only mucosa deep: a retrospective analysis of oral lumps and bumps caused by cosmetic fillers"}
{"_id":"41bdd23c-a074-bd99-34c3-5dd54b34217e","text":"Axial MRI of the left popliteal fossa showing two enlarged nodes in close proximity to the popliteal vessels.","title":"Resection in the popliteal fossa for metastatic melanoma"}
{"_id":"41c1026c-fc81-960e-c16c-2504f4065147","text":"The large variation in methodology makes it difficult to compare outcomes systematically. Cancellous bone is the preferred bone graft type in small bone defects66 and also for antibiotic impregnation it seems superior. Cortical bone is less accessible to antibiotics than cancellous bone and resulted in lower antibiotic elution concentrations.28 Allografts are most commonly used, but from the perspective of antibiotic binding and elution, both human and bovine bone perform similar.28 As a result, only general principles can guide towards the best choice. Xenografts require processing to eliminate potential disease transmission and enhance biocompatibility. Processing can also be applied to the more commonly used allografts. Autograft bone is without risk of immunogenicity but its use is restricted by its limited quantity and donor site morbidity.51,66","title":"Current Insights in the Application of Bone Grafts for Local Antibiotic Delivery in Bone Reconstruction Surgery"}
{"_id":"41caa816-e35d-ec1e-b9b5-c3dec8954486","text":"Occurrence of DVT among patients who had major abdominal general surgery in Uganda was low and cancer was the most common associated risk factor.","title":"Deep venous thrombosis after major abdominal surgery in a Ugandan hospital: a prospective study"}
{"_id":"41ccb00f-feb6-5ad1-34bf-53500d3beadd","text":"An excisional surgery was initially proposed to the patient, but given her young age, the parents preferred another therapeutic alternative to minimize the risk of mutilation and its psychological repercussions. The case was then discussed in a multidisciplinary consultation meeting and the decision was made to opt for exclusive radiotherapy. Concurrent chemotherapy was not proposed because of the suspicion of a genetic variant of XP in the patient.","title":"Cutaneous squamous cell carcinomas of the nose in a child treated with external radiation therapy: a case report"}
{"_id":"41ccfbc5-c033-6dab-5954-ce75b58f9d3f","text":"The aim of the present study is to analyze the electrical activity of the suprahyoid muscles in infants, based on the lingual frenulum attachment to the tongue and the floor of the mouth, during the sucking function in breastfeeding.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"41cf2de5-2a1b-b765-9f24-38abb379023b","text":"As shown in this study, the incidence of graft rejection, in two primary graft groups following excision and delayed graft after granulation tissue formation was equal and were not significantly different.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"41dbb4dc-5848-711e-7636-531f6cfd35be","text":"Objective: Reconstructive surgeons are aware that deep vein thromboses can cause a free flap to fail; however, there are no reports in the literature regarding the incidence of free flap failure in the presence of superficial vein thromboses. Methods: A 38-year-old white male patient with poorly controlled type I diabetes mellitus presented with a chronically infected ulcer overlying an osteomyelitic right distal tibia. This region was reconstructed with a musculocutaneous latissimus dorsi free flap. Results: A superficial vein thrombosis was found 21 cm distant from the venous anastomosis of a free latissimus dorsi myocutaneous flap causing venous congestion. After early exploration, this flap was salvaged by resection of the compromised superficial venous system and the use of an interposition vein graft as no other suitable recipient vein was available. Conclusions: This case may serve as a reminder to explore early and be aware that the crux of a complication may be at a distance from the operative field. Consideration must be given to the possible need for interposition vein grafts when a suitable local deep or superficial recipient vein is not available in the lower limb.","title":"Superficial Vein Thrombosis 21 cm Distant From the Venous Anastomosis of a Free Flap Causing Intermittent Venous Congestion"}
{"_id":"41ddd7e7-dd4e-46fc-9842-5aacafcb8a05","text":"The objective of the present prospective study was to evaluate the state of the immune system in pancreatic cancer patients exposed to localized cryosurgery to assign further schemes and algorithms for chemotherapy and immunotherapy and to assess the efficacy of their combined use.","title":"Immune Status of Pancreatic Cancer Patients Receiving Cryosurgery"}
{"_id":"41e0e7a2-5347-41bf-94d3-57ad0388b1e5","text":"On ultrasound diagnosis of a lower limb DVT, each potential participant was assessed for eligibility and, if appropriate, offered an invitation letter and patient information leaflet. If interested in principle, the patient was asked to provide a contact telephone number and convenient contact time. The chief investigator would then contact the potential participant by telephone after 24–48 h to ask them if they wished to participate in the study and to answer any questions they may have. If they agreed, a first follow-up appointment was scheduled for 7 days post diagnosis. Written consent to participate in the study was obtained from each participant at the first follow up visit by the chief investigator in accordance with Good Clinical Practice. Each participant will remain in the study for 2 years post diagnosis.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"41e47290-3d39-a3b2-b413-00d71ae950fc","text":"Seroma formation following modified radical mastectomy with axillary lymph node dissection for breast cancer is a most common wound complication. In our experience seroma occurs in approximately 50% of patients undergoing mastectomy. Postmastectomy seromas usually vanishes within a few weeks after operation.","title":"Surgical resection for persistent seroma, following modified radical mastectomy"}
{"_id":"41e522d6-42fc-46dd-6c5b-1c047c7d96ea","text":"The datasets generated and analyzed during this study are not publicly available because data analysis on another section of the dataset is not complete but are available from the corresponding author with reasonable request.","title":"Complications and misdiagnoses associated with infant frenotomy: results of a healthcare professional survey"}
{"_id":"41ecb628-5faf-655f-e1ea-e70d62ad12bc","text":"The postoperative monitoring of flap viability in microvascular free flap reconstruction is essential for the timely correction of any vascular compromise, and the use of unattached surface probes with the O2C analysis system has been shown to be a reliable method for monitoring flap perfusion as a prerequisite for flap viability. Attached surface probes have been developed for the O2C analysis system because of their advantages, such as limited interference from changes in probe pressure and the location of the measurement area, and they provide the basis for continuous flap perfusion monitoring over 24 h a day. Nevertheless, flap failure due to damage to the flap microvasculature, infection and bleeding due to probe fixation sutures, and technical errors due to probe detachment or disconnection are the potential disadvantages of attached surface probes. Therefore, in the present study, attached surface probes were compared with unattached surface probes in terms of technical feasibility, patient safety, and perfusion measurement values. To reduce the influence of the moist environment during measurement, which is generally more pronounced for intraoral flaps, only extraoral flaps were investigated.","title":"Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study"}
{"_id":"41f64082-0b03-317f-ff3c-8b0ce616f23e","text":"This study aimed to clarify the intramuscular nerve arborizations of the LD muscles by applying the Sihler staining method. Findings of this study will propose secure and effective BoNT injection points on the LD flaps.","title":"Intramuscular Neural Arborization of the Latissimus Dorsi Muscle: Application of Botulinum Neurotoxin Injection in Flap Reconstruction"}
{"_id":"420011fb-19f0-3065-02c2-d0d79bb9c7a4","text":"Half of the participants detailed the challenges they encountered in acquiring information and resources related to breast prosthetics, emphasizing the necessity for improved access to these services within their region. For instance, when asked if they were informed about the available services at the hospital to assist them in enhancing their appearance, one participant stated:","title":"Beyond the scars: a qualitative study on the experiences of mastectomy among young women with breast cancer in a country with crisis"}
{"_id":"42076ba1-f6b2-4c5b-62a0-596b286e184e","text":"2-Wound sepsis was encountered in three patients: two had free Latissimus while one had a pedicled Trapezius flap and all were treated conservatively by simple drainage and antibiotic based on culture and sensitivity.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"420c8f41-9628-bb17-9c86-684b3e029f7d","text":"HNBCC commonly presented as pigmented ulcers over the cheek and nose of elderly female patients of Chinese ethnicity in our locality. This corroborated with studies conducted in other Asian countries but contrasted with those of Caucasian populations in that HNBCC commonly presented as nonpigmented nodules in the male population. Tumour excision with a 2 mm skin margin for HNBCC with well-defined margins yielded a tumour control rate comparable with other large-scale studies. Various reconstructive techniques could be adapted in cases where primary skin closure could not be achieved after adequate tumour resection. Reexcision of lesions with inadequate margins improved local tumour control.","title":"Basal Cell Carcinoma of the Head and Neck Region in Ethnic Chinese"}
{"_id":"420ceb92-2601-1b05-b4e5-ab4282ed2ebd","text":"The diagnosis of Frey syndrome is more challenging for pediatricians as this is often confused with food allergy. Allergic reaction accounts for majority of food associated skin reactions in children. This case was considered initially an allergic reaction to food, but the allergy test and other blood investigations were negative.","title":"Recurring Facial Erythema in an Infant"}
{"_id":"42111c40-d77b-ced9-0943-9378e4a9b001","text":"Thrombosis is still an enigmatic disease. In most cases, the reason for why any particular thrombosis to occur remains a mystery and unanswered questions include why patients with documented congenital thrombophilia are free of events during a long period of life. The incomplete penetrance of many prothrombotic mutations is another clear evidence of the complex nature of thrombosis, which requires from different genetic (even for strong congenital risk factors such as antithrombin deficiency) and environmental factors, many of them unknown. Moreover, venous and arterial thromboses are traditionally regarded as two different diseases with respect to pathophysiology, epidemiology and treatment strategies. However, this categorical distinction is too strict and it is becoming increasingly apparent the similarities between both disorders6. Exceptional cases are excellent models that may open new perspectives or help to identify new factors or mechanisms involved in thrombosis. The case reported here, a woman who had severe and recurrent venous and arterial thrombosis along her life, who suffered from complications related to the thrombotic events (mainly severe pulmonary arterial hypertension, stage 3 chronic kidney disease and disabilities related to ischemic stroke) and with an evident inability of vitamin K antagonist to prevent thrombosis, has provided really interesting information concerning both the strong thrombophilic defect present in the patient and a potentially new prothrombotic risk factor.","title":"Transient desialylation in combination with a novel antithrombin deficiency causing a severe and recurrent thrombosis despite anticoagulation therapy"}
{"_id":"421adcb2-6ec8-4f98-ab10-6c662397277e","text":"In conclusion, our study demonstrated that BTA injection was safe and effective in restoring VMO and VL muscle balance and treating clinical symptoms of PFPS; further work should be targeted at managing existing OA change by regenerative technique or intraarticular BTA injection. However, there were still several limitations to this study, including the relatively small sample size and the lack of radiographic image comparison before and after BTA injection.","title":"Improvement of Pain and Function by Using Botulinum Toxin Type A Injection in Patients with an Osteoarthritic Knee with Patellar Malalignment: An Electromyographic Study"}
{"_id":"421e0183-0a48-c32b-6901-97529b5d5705","text":"The transection was carried down to the junction of the right hepatic vein with the inferior vena cava. The right hepatic artery was then divided. The right hepatic vein was clamped at the junction with the inferior vena cava and divided. The stumps of the right portal vein and right hepatic vein were closed with continuous nonabsorbable sutures. The falciform ligament was sutured to the anterior abdominal wall. A drain was inserted into the right subphrenic cavity before wound closure.","title":"Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein"}
{"_id":"4223ddb6-86df-7984-0e92-d73aa71ab408","text":"The reason to perform SLNB is that earlier detection of occult nodal disease may increase survival or otherwise positively impact the local disease management.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"422c8530-4d7a-9603-2d29-e2490b6dce45","text":"Three major questions arise while discussing the revaccination concept of the BCG vaccine. The first question is: what is the impact of repeated BCG vaccination on tuberculin skin test (TST) responses. Uyan et al [13] evaluated the TST response after BCG immunization in children and observed that the mean induration diameter increased after repeated BCG vaccination and simultaneously increased scar counts. From this study, it is confirmed that repeat BCG immunizations alter the TST response and therefore affect the use of TST in the diagnosis of TB infection in this group of children. Another important question is whether a repeat dose of BCG causes tuberculosis or not. We have searched the literature to answer this question and we have not found any evidence which suggests that repeat BCG immunization causes TB. In fact, Menzies et al have reported that a repeat BCG immunization is rarely the cause of TB infection [18]. Thirdly whether repeat BCG dose will give enhanced protection in humans even though, observed in invitro PBMC studies can only be decided after proper controlled animal model and clinical studies.","title":"Assessment of immune response to repeat stimulation with BCG vaccine using in vitro PBMC model"}
{"_id":"422e7a58-9f21-91de-4ac1-e074000bd453","text":"Widespread use of nonmedical fillers for cosmetic purposes has led to an increase in the reported number of late adverse reactions following injection and represents a serious health problem. The aim of this study was to identify microbial infections in patients with adverse reactions to the use of modeling substances in Cali, Colombia.","title":"Infections in patients with adverse reactions to the use of unknown modeling substances for soft tissue enhancement in Cali, Colombia"}
{"_id":"423627e8-63c9-5993-970d-3e77453ea64d","text":"In summary, our results demonstrate the in vivo relevance of anatomic lymphatic pathways in ITM formation in 46 evaluable patients with melanoma of the leg. Together with clinical risk factors that we have confirmed, this knowledge may be used for a better risk assessment in the follow-up of melanoma patients and to develop a model for ITM in melanoma of the leg in the future.","title":"Conventional and three-dimensional photography as a tool to map distribution patterns of in-transit melanoma metastases on the lower extremity"}
{"_id":"4237f88e-0358-ed01-d16a-2f161c3d9fe7","text":"A study was conducted by E. Borisova and his team on fluorescence spectroscopy; they noticed that excitation spectrum are usually identical to the absorption spectrum, as the fluorescence intensity is directly proportional to the absorption. The non-melanoma skin cancer can be diagnosed by the fluorescence polarization imaging technique, in which the tunable monochromatic light source along with CCD camera is employed to detect the tumour cells. As a result, two fluorophores were retained in tumours. Hyperspectral fluorescence is the one of the technique used to diagnosis the skin cancer in which the two ultrafast lasers were used operating at the wavelength of 355 nm that excites the auto-fluorescence between the bio-molecules that resides in the skin tissue. Auto-fluorescence technique is used to capture the images of the pigmented skin lesions, in which both the fluorescence and reflectance were studied. The excitation source used in this method is fibre coupled laser operated at the wavelength of 785 nm and the illumination of a light source is filtered by bandpass filter in order to acquire the fluorescence imaging and the reflectance imaging were obtained by the selection of components of the long pass filter. Auto-fluorescence technique is used to select the sampling points for the Raman spectroscopy, based on that the classification of various skin lesions was performed. Fluorescence spectroscopy is used to determine the distribution of biological substances by employing the fluorescent agent. The excitation source that causes fluorescence has been integrated with fiber optic probes to examine the tissue and it was recorded by using spectrograph. Fluorescence spectroscopy technique can also be used to classify the benign from malignant tumors with the help of fluorescence spectra by in vivo method. As a result, the normal tissues were found to be the wavelength of 440 nm and the non-melanoma tissues were found to be at the wavelength of 436 nm. Fluorescence spectroscopy has the ability to distinguish the cancerous cells from the non-cancerous cells. The monochromatic radiation is used as an excitation source at the wavelength of 300 nm. From the tissue two sets of fluorescence were emitted at the wavelength of 340 nm and 440 nm. The difference in intensity between the two fluorescence will decide whether the tissue is a malignant or a benign tumour.","title":"Skin cancer detection using non-invasive techniques"}
{"_id":"4252379c-6984-69e3-b45b-7d5c04490629","text":"Incisions placement over the mastectomy flaps need a special mention, as it is imperative to avoid incisions that can compromise flap vascularity and ultimately cosmetic outcome although keeping oncological safety at the forefront. Incisions placed on the lateral aspect or in the inframammary fold can avoid complications. Incisions placed around the Nipple should best be avoided in order not to jeopardize the blood supply.","title":"Implant-based Prepectoral Breast Reconstruction: The Importance of Oncoplastic Plane, its Blood Supply and Assessment Methods"}
{"_id":"4258dd2b-8c8b-83dd-ff19-e223982269de","text":"Give explicit instruction on what to do when signs or symptoms of anaphylaxis are experienced in the community; and","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"425c82a5-7947-551c-fa30-b0ee738762dc","text":"3D printing is a promising era that may have a huge influence on the field of medicine. A wide-ranging study is necessary on large samples and over a long period to address possible advantages of 3D printing in surgical procedures. It plays a certain role in manufacturing implants and prosthetics for patients, and 3D printing also plays a vital role in planning and training for surgical procedures as well as other aspects of medical education.","title":"Three-Dimensional Printing Surgical Applications AlAli et al"}
{"_id":"426252f0-ceb6-4365-45f6-cbd79a380703","text":"to the RFFF group that required a minimum of one night ICU stay, and had a mean length of ICU stay much greater than this. It is institutional policy that all patients receiving any free flap spend a minimum of one night under intensive care monitoring.","title":"Submental island flap reconstruction reduces cost in oral cancer reconstruction compared to radial forearm free flap reconstruction: a case series and cost analysis"}
{"_id":"4263f5f3-1256-93e2-dc88-9f3ecd43d66b","text":"When looking at patients who have hypersensitivity reactions to TPN, one must consider that their reactions may be due to factors other than allergens. More studies are needed to clarify the relationship between high osmolality TPN infusions and non-IgE mediated hypersensitivity reactions.","title":"Hypersensitivity reactions to high osmolality Total Parenteral Nutrition: a case report"}
{"_id":"42671493-80ee-8c85-2f9c-df80c119cf75","text":"From these twenty patients that underwent the combined therapy for skin laxity, successfully confirmed by cutometric measurements of skin elasticity, three patients were randomly selected for detailed histopathological tests. Base measurement method was cutometry and histopathological tests were supportive in terms of determining detailed tissue reactions that stand behind the results.","title":"HA PEGylated Filler in Association with an Infrared Energy Device for the Treatment of Facial Skin Aging: 150 Day Follow-Up Data Report"}
{"_id":"426d1451-d228-66ac-14bb-cd3e64b1c538","text":"The de-identified datasets analysed during the current study are not publicly available due to conditions of ethics approval but may be available from the corresponding author on reasonable request subject to appropriate approval from an ethics committee.","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"4277f0ac-7a0c-1c9f-ea58-8416fba08d6d","text":"Further research should also address the question on whether RTX doses currently used might play a role in determining the immunogenicity of the drug and whether repeated treatments at regular intervals may affect and mitigate it. Indeed, in our cohort, given the large timespan to retreatment, possible effects of repeated exposure to RTX in terms of tolerization could not be investigated. A deeper comprehension of the immunological and clinical impact of ADA in RTX treated SLE patients warrants the conduction of longitudinal studies in order to better define which patients should stop RTX and\/or be switched to alternative anti-CD20 agents.","title":"First exposure to rituximab is associated to high rate of anti-drug antibodies in systemic lupus erythematosus but not in ANCA-associated vasculitis"}
{"_id":"427c323d-f369-0804-3a19-298595ab7c15","text":"The main limitation of this study was the small sample population that was included due to the reduced time frame in which this study took place. A multicentric study to replicate the results would be necessary to validate these findings, in which a larger sample size would increase the power and therefore increase the validity of the hypothesis that there is a shrinkage between the clinically examined pre-incision margins previous to surgical resection of oral SCC and the margins measured after histopathological tumor processing. It would also be prudent to take into consideration the different anatomical locations of tumors in the oral cavity since previous studies have observed different margin discrepancies according to tumor site [7-9,11]. Though surgical margin shrinkage has been theorized as a cause for close or positive histopathological margins, occult infiltration should not be dismissed as a cause for the observed margin discrepancy.","title":"An Analysis of Tumor Margin Shrinkage in the Surgical Resection of Squamous Cell Carcinoma of the Oral Cavity"}
{"_id":"427d6a4c-5cce-407d-392c-1d0e93be2060","text":"There were no complications related to pedicle screw placement. One superficial wound infection that healed within 3 weeks occurred in the posterior group.","title":"Comparison of anterior and posterior approaches for treatment of traumatic cervical dislocation combined with spinal cord injury: Minimum 10-year follow-up"}
{"_id":"427da142-22e2-1cc0-a07e-c49f53b87ef5","text":"In all our cases of adnexal skin carcinomas of the head and neck region, surgical excision was the treatment of choice, the excision and reconstruction being conducted simultaneously by the same team.","title":"Adnexal carcinomas of the head and neck"}
{"_id":"427ec873-8b5e-266f-55c5-ea13144d6c37","text":"Scientific knowledge about fat and fat tissue transfer is updated continuously. Fat presents a unique regenerative complex as well as a high energy resource related to tissue repair and regeneration. Although many techniques have been described, there have been no meticulously controlled comparative trials to truly determine which method may be the standard.","title":"Modern trends in lipomodeling"}
{"_id":"428767ca-2563-442a-bf5a-25f9952f6b52","text":"While a wide range of treatments exist for actinic keratosis and skin field cancerisation, the long‐term benefits of the most common topical therapies are poorly defined. This report reviews the efficacy of the most commonly used topical therapies to treat regional or field lesions. Limited clinical and histopathological data are available on clearance rates at 12 months post‐treatment for the most commonly used agents, with varied outcome measures making any comparison difficult. In general, total field clearance rates at 12 months are suboptimal for the most commonly employed agents. Given the increasing incidence of actinic keratosis and skin field cancerisation due to an ageing population, further research into the efficacy of therapies is critical to guide treatment choice.","title":"A review of actinic keratosis, skin field cancerisation and the efficacy of topical therapies R SINCLAIR et al."}
{"_id":"4287dbf5-a4c3-a3c4-fe65-a72afec2aeaa","text":"Defects of the lower extremity were classified into upper third leg defects, middle third leg defects, and lower third leg defects for ease of discussion. Once the decision of surgical closure of a wound has been made, appropriate debridement was undertaken before a final coverage option was chosen. If the wound is suitable for the flap cover, it has been covered with a muscle or fascio-cutaneous flap within 72 hours in case of immediate flap coverage group and any time after 72 hours in late flap coverage group.","title":"Immediate Versus Late Flap Coverage for Traumatic Soft Tissue Defects of Lower Extremity: A Comparative Observational Study"}
{"_id":"428ce2dc-eb59-126b-bc15-2622614cd79a","text":"The advantages of using nHA-ATB beads as a local antibiotics carrier were; thus, their ability to provide a sustained, local, high concentration of antibiotics at the site of infection and lower systemic side effects compared with intravenous antibiotics. It could be left inside the body without the need for subsequent removal and act as a bone graft to provide bone regeneration capability in the bone defect. However, the drawbacks of using local antibiotics beads such as the nHA-ATB beads in this study compared to the standard intravenous antibiotics treatment would be the additional cost of the product and additional surgical time in filling the defects with the beads.","title":"Efficacy and Safety of Antibiotic Impregnated Microporous Nanohydroxyapatite Beads for Chronic Osteomyelitis Treatment: A Multicenter, Open-Label, Prospective Cohort Study"}
{"_id":"42927d7f-ca49-a83b-35fc-819fc70e90db","text":"in the case of dexdor tiva boluses of both dexdor and propofol were required but with halved dosages compared to the standard treatment;","title":"Abstracts of the ICARE 2023 77th SIAARTI National Congress"}
{"_id":"429ac7fa-7698-c330-b479-c8d28ad8a275","text":"Isologen is a collagen product that is created as an autologous implant derived from the skin of the patients. A 3 mm punch biopsy is normally collected from the area behind their ear and delivered to isologen for culture. After weeks of cultivation, 1 to 1.5 cm3 of fibroblasts and extracellular matrix components are transported back to the physician for injection. Isologen has no risk of infectious agent transmission from an animal or human donor, and it does not cause hypersensitivity to foreign proteins. However, it requires several procedures and is very expensive.","title":"Injectable fillers: current status, physicochemical properties, function mechanism, and perspectives"}
{"_id":"429cb58a-dd31-fa08-c92a-d4d8f288dbf5","text":"Table 2 shows pooled estimates of sensitivity and specificity stratified by US technique used. Optimal sensitivity is achieved by using duplex or triplex, while optimal specificity is achieved by using compression alone.","title":"Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis"}
{"_id":"42a04c51-66d0-30b3-4759-c0e5b253241e","text":"The free instep flap is significantly better than the cross-foot flap and is more acceptable to patients because it never requires prolonged hospitalization and immobilization in awkward positions. The major disadvantage of the free instep flap is sacrifice of the medial plantar artery and sometimes the tibialis posterior vascular system. Fortunately, the medial plantar artery is not the dominant artery of the foot and is expendable. Moreover, surgeons frequently encounter a discrepancy in the diameter of microvascular anastomosis in the proximal foot with relatively smaller vessels, and this technique also requires a team specially trained in microvascular surgery.","title":"Heel reconstruction with free instep flap: a case report"}
{"_id":"42a0663e-671f-0b83-9afd-a87ae2dafeba","text":"The advantages of the sural flap as compared to other covering methods are the simplicity of the design and dissection of the pedicle flap that can be carried out with a loop magnification and without the need for microsurgical instrumentation or anastomosis, the preservation of the principle vascularization of the lower limb and the need for only one operation. The sural pedicled flap constitutes a well vascularized cutaneous islet and reliable flap offering the possibility of covering a broad range of areas with cutaneous defects in the distal tibia, heel, and up to the rear foot. The sural flap can be especially useful in cases of injuries with serious compromise to the circulation of the major arteries of the lower limb as long as the peroneal artery is intact or when a microsurgical procedure is contraindicated. One of the few disadvantages of this flap is that by sacrificing the sural nerve, an inevitable anesthesia area appears over the lateral aspect of foot, which is usually well tolerated by the patient. The survival index of the flap exceeds 90%. It can be used in an emergency situation, and it does not expose it to the failure of the flap.32","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"42b6f17c-342a-d412-150e-a9a99604d551","text":"Using ACGME resident case logs, notable intraspecialty and interspecialty variations in hand surgery training patterns among graduating orthopaedic and plastic surgery residents were observed. Orthopaedic residents perform more bony trauma surgeries, while plastic surgery residents perform more nerve repairs and amputations. Future research into competency-based case volume minimum requirements may help educators minimize variation in hand surgery experience and optimize resident preparation for fellowship and subsequent clinical practice.","title":"Variability in Hand Surgery Training Among Plastic and Orthopaedic Surgery Residents"}
{"_id":"42be853b-c35d-ce6a-6a93-c2bedbdfcc49","text":"The potential benefits of offering a simultaneous contralateral reduction\/mastopexy at the time of TM are avoidance of further surgery and achieving symmetry. This is of particular importance in large breasted women undergoing big resections who would otherwise be significantly asymmetrical. Bilateral surgery is resource intensive requiring longer operating times or additional surgeons with several respondents suggesting that funding for contralateral surgery was not always available. An important consideration is the deleterious effects of radiotherapy in terms of shape\/size of the index breast resulting in unpredictable asymmetry in the future [12]. This may account for the 13% of respondents who would never offer symmetrisation at the time of the initial surgery.","title":"Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England"}
{"_id":"42befb67-acae-573a-141a-bd97e45f04ba","text":"The results of this survey highlight the challenges faced by overseas surgical trainees in the UK, including difficulties in securing a job in the NHS, obtaining an NTN, and adapting to differences in surgical practice between the UK and their home country. This aspect received an average score of 64, suggesting that overseas surgical trainees need assistance in familiarising themselves with the specific protocols, procedures and cultural variations of surgical practice in the UK.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"42bf49e2-810c-f6ee-e805-ca95c8a87a3c","text":"In conclusion, there is preliminary evidence that MRI has a noteworthy value of distinguishing suspected PJIs in patients with TKA or THA, but the definition of specific MRI features related to PJIs diagnosis lacks consensus and standardization. Large-scale studies with robust quality were required to help make better clinical decisions in the future.","title":"Diagnostic value of magnetic resonance imaging for patients with periprosthetic joint infection: a systematic review"}
{"_id":"42c2042e-5ee3-f95d-5118-12f27df08fd7","text":"Table 2 Total volume of lymph drained and duration of draining, according to type of scalpel","title":"Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy"}
{"_id":"42c3b4de-2b4b-a8ac-88c8-9150c33b4efc","text":"However, the factors contributing to the difference in the detection period between the two groups are various, such as the staging differences and pure detection issues. Therefore, it is unreasonable to conclude that autologous reconstruction has a more disturbing effect on local recurrence detection than implant reconstruction based on the results of this study. Large samples and prospective studies are necessary to identify whether and why autologous reconstruction and implant reconstruction have the different detection period after local recurrence.","title":"Is There a Difference in the Diagnosis and Prognosis of Local Recurrence between Autologous Tissue and Implant-Based Breast Reconstruction?"}
{"_id":"42cddc03-acf3-4403-9b9e-581d238c0469","text":"We hypothesize that there is no difference in the number of patients experiencing one or more minor complications at 3 and 6 months postoperatively.","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"42dddbef-644d-6ce5-305f-698a3878c8f9","text":"Discovery of specific mutations leads to development of clinically useful inhibitors of critical signaling pathways but usually is limited to specific type of tumor. However, the importance of the immune response and the role of microenvironment in cancer development, progression and metastasis has been recognized as potential therapy target to improve cancer patients survival in many tumor types, including melanoma. For example, the critical role of the microenvironment in the growth of cancer is supported by the role and the therapeutic potential of angiogenesis. Current data indicate that secreted stromal factors that can mediate drug resistance and predict response to treatment based on microenvironmental factors could be shared between various tumors. Thus, promising studies of microenvironment and immune response in different type of tumors can benefit melanoma and vice versa as discussed in this section.","title":"Future perspectives in melanoma research. Meeting report from the “Melanoma Bridge. Napoli, December 2nd-4th 2012”"}
{"_id":"42e4b5ca-672d-50ee-6880-e8ea764bb804","text":"This group has high levels of vasculitic disease associated with high levels of dystrophic calcification, in which the there are lower levels of muscle enzymes, particular CK. This is strongly suggestive of low grade chronic inflammation in this group, and aggressive immunosuppressant use with high dose corticosteroid, early introduction of methotrexate and the use of cyclophosphamide and intravenous immunoglobulin is now employed. This regimen is also used for the younger children, whom we have shown in this series to be at higher risk of contractures and thus long term disability. Muscle enzymes are also an unreliable marker of disease, and clinical measurement of muscle strength is now used rather than laboratory evidence to measure response to therapy. Our patients, particularly in the face of high levels of calcinosis, are at high risk of the developing Staphylococcus Aureus infection, an observation which has lead our unit to institute the practice of routine cloxacillin prophylaxis. There would thus appear to be a role overall for more rapid and aggressive therapy even in the face of what appears to be mild disease in African children.","title":"Juvenile dermatomyositis in South African children is characterised by frequent dystropic calcification: a cross sectional study"}
{"_id":"42e60bfc-ede0-363b-722d-090d2a538899","text":"Superior gluteal artery bleeds, although rare, should be considered in antegrade femoral nail cases complicated by postoperative anemia. In both cases presented in this report, the only early sign of bleeding was continued anemia despite serial transfusions. Not until POD 4 in our case and POD 7 in the Ward et al case did either patient show signs of bleeding on examination. We recommend close examination and early imaging for patients who have undergone antegrade femoral nail placement and are experiencing progressive anemia. Early diagnosis of superior gluteal artery injury will decrease the time to embolization and thus may decrease length of stay, morbidity, and mortality.","title":"Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation"}
{"_id":"42e7f1ff-0dd5-81b8-95dc-cef598e5d714","text":"Our study was limited by not assessing all surgical organizations within the United States and therefore not accounting for all leadership positions. Additionally, we did not collect data on membership demographics of each organization to assess whether leadership was proportional to its membership regarding gender. Leader credentials were collected via internet search of organizational and institutional websites and were not all self-reported. We were not able to account for name changes and are therefore not able to recognize if publications from previously listed names were excluded.","title":"Leadership Amongst Regional and National Surgical Organizations: The Tides Are Changing"}
{"_id":"42e84e10-910b-2073-17ac-805d8f55162a","text":"The records of consecutive palpable soft tissue lesions of the trunk and extremities that had FNAB performed as at the fine needle aspiration cytology clinic of the Department of Pathology University College Hospital were reviewed for a period 5 years. All cases included for analysis had adequate smears in terms of material available on the slides for assessment. Lesions in the head and neck, the breast, lymph nodes, intraabdominal and intrathoracic locations were excluded from the study. Only cases with sufficient clinical information and a definitive final cytologic diagnosis were included in the study. Furthermore, records for corresponding cases that had open excision biopsy out of these cases were also retrieved. All the cytology smears and histology were reviewed by the author to ascertain the correctness of diagnosis.","title":"Fine needle Aspiration Biopsy (FNAB) in the initial evaluation and diagnosis of palpable soft tissue lesions and with histologic correlation"}
{"_id":"42ee5676-940a-efc1-f5e0-1e388d227fb9","text":"Desmoid tumors are locally aggressive fibroproliferative neoplasms that can lead to pain and dysfunction due to compression of nerves and surrounding structures. Desmoid tumors often progress through medical therapy, and there is frequently a delay of multiple months before radiation can provide symptomatic relief. To achieve more rapid symptomatic relief and tumor regression for unresectable desmoid tumors causing significant morbidity such as brachial plexus impingement with loss of extremity function, we have selectively utilized a combination of imatinib and radiation therapy. Here, we retrospectively review four patients treated with concurrent imatinib and radiation therapy. The treatment was typically tolerated with minimal toxicity though one patient developed avascular necrosis of the irradiated humeral head possibly related to the combined treatment. All the patients treated have had a partial response or stable disease on imaging. Improvement of symptoms was observed in all the treated patients with a median time to relief of 2.5 months after starting radiation therapy. Concurrent radiation and imatinib may represent a viable treatment option for unresectable and symptomatic desmoid tumors where rapid relief is needed to prevent permanent loss of function.","title":"Concurrent Imatinib and Radiation Therapy for Unresectable and Symptomatic Desmoid Tumors"}
{"_id":"42f3bff2-8ba0-e81d-48d2-96cac833eb7d","text":"Claudication in the young population is a rare condition derived from varied neurogenic and vascular conditions. We report a case of bilateral claudication of the lower extremities in a young athlete after intense training. Apart from tenderness to deep palpation of the popliteal fossa, physical and laboratory examinations did not reveal any abnormal findings. According to the patient’s symptoms, sciatic nerve entrapment to the popliteal fossa was suspected and bilateral surgical exploration of the sciatic nerve was performed. The sciatic nerve was found to be entrapped before its division to the tibial and common peroneal nerves from the terminal branch of the small saphenous vein (SSV) into the popliteal vein (PV). The terminal section of SSV was subsequently ligated and resected to relieve the pressure on the sciatic nerve. One year after surgery, the patient was able to run long distances as well as sprint and train without any restriction. Rare conditions may lead to pseudoclaudication in young individuals and athletes during exercise. Normal physical and laboratory tests must raise the suspicion of sciatic nerve compression from fibrous bands or abnormal anastomotic veins that may also exist bilaterally. Surgical exploration along with sciatic nerve release remains the only treatment solution when conservative treatment fails to alleviate the symptoms.","title":"Bilateral Sciatic Nerve Compression Due to Abnormal Termination of the Small Saphenous Vein Into the Popliteal Vein: A Rare Mechanism of Pseudoclaudication of the Lower Extremities"}
{"_id":"42f61361-9c7d-39d8-e639-cbfe62e9e82b","text":"Based on our experience in this case, we propose searching for fat globules at deep veins near fracture sites such as the femoral vein in lower limb fractures and the IJV in upper limb fractures. There is currently no algorithm for point-of-care ultrasound in trauma patients to look for fat emboli. We will like to suggest scanning any vein proximal to the fracture site, followed by inferior vena cava and both sides of IJV. To confirm the diagnosis of fat emboli, ultrasound can serve as a useful tool to aspirate the fat globules under direct visualization. Larger systematic studies are needed to test out this hypothesis and determine whether diagnosis of fat embolism can be established earlier. This new idea may lead to prevention of FES complication and decrease in mortality.","title":"Fat embolism in right internal jugular vein: incidental ultrasound finding during internal jugular vein cannulation"}
{"_id":"430601eb-7e75-1515-1428-27639e2b20d4","text":"The surgeon can locate the LS based on the signal strength (Figure 4) as well as the visually brown coloration that the magnetic tracer gives to the lymph node; it can then be removed and a histological examination can be performed. This process is repeated until any remaining lymph node has a signal reading of less than 10% of the first LS removed.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"43067f62-a1d0-8be0-c3de-d95573a0536d","text":"All patients underwent routine ultrasound examination of bilateral lower extremity veins for DVT screening on the 3rd day following TKA. The diagnosis criterion for DVT was made according to Rabinov and Paulin in 1972 [11]. Proximal DVT was defined as thrombosis of the popliteal or more proximal veins with or without concomitant calf vein thrombosis. Distal DVT was defined as thrombosis affecting the calf veins. Patients with DVT on either side of the leg were assigned to the DVT group. DVT patients were all treated with LMWH, and ultrasound reexamination of both lower limbs were done every 3 days to observe the change and outcome of thrombosis. Proximal DVT patients were restricted from getting out of bed, and all DVT patients were discharged from the hospital when the thrombosis improved such as the reduction of thrombosis size and blood vessel recanalization. After discharge, anticoagulant therapy is still required for DVT patients for at least 3 months according to the guidelines.","title":"Predictive value of preoperative erythrocyte electrophoresis exponent for acute deep vein thrombosis after total knee arthroplasty in patients with knee osteoarthritis"}
{"_id":"4309f402-5d72-19d5-fe2c-808f42bf5469","text":"Objectives: To compare the treatment approaches and disease outcomes of children with JDM followed in two large European tertiary care centers.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"430a5005-78f3-b6a5-e8d3-3d615a8ce453","text":"Conclusion: Color Doppler monitoring may provide information on CPR quality and it might be useful for early detection of ROSC and prognostic stratification of patients with CA.","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"430e40cd-83c5-c3ba-dc10-db3530b1f97c","text":"The relationship between temperature and electric field is discernable from Figures 4a and 4b. As in the 1D Cartesian study, temperature and electric field are inversely proportional due to the dependence of electrical conductivity on temperature. For this reason, the electric field is highest in the frozen and cooled regions. This result corroborates both the hypothesis of this paper and the results in the 1D Cartesian study. Because of decreased electrical conductivity in the frozen and cooled tissue, the highest electric fields are confined to those regions. Figure 5b shows that the fields beyond the frozen and cooled regions are orders of magnitude lower than those in the frozen\/cooled regions. This suggests that freezing\/cooling temperatures have the effect of magnifying the high electric fields in those regions. The effect of low temperature on confining the electric field is effectively demonstrated in Figures 6c and 6d. The zoom panel demonstrates that the electric field is confined within the cooled region, which again validates the original hypothesis of this study.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"430f3a5d-afd9-d90f-59a5-ee43af8e668b","text":"The aim of this article is to reintroduce a simple reconstructive surgical technique well known by all plastic surgeons, safely into a new horizon of application dimensions, with almost unlimited extents, expecting sound healing with satisfactory function and aesthetic results. The use of FTSG with these large dimensions could be of help in some clinical situations in which the alternative complex reconstructive tool, may not be easy from either the patient general or local conditions. It could also be of help in some centers with shortage of facilities for more complex flaps either local, regional, or free.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"43114d68-88dc-a2ee-8e19-609285c25a88","text":"This is the first reported case in English literature of a patient with PLS who underwent a successful mastectomy surgery for breast cancer under an ultrasound guided thoracic paravertebral block, multimodal analgesia, and monitored anesthesia care.","title":"Thoracic Paravertebral Block, Multimodal Analgesia, and Monitored Anesthesia Care for Breast Cancer Surgery in Primary Lateral Sclerosis"}
{"_id":"4323f2b2-4c9d-045e-a203-da12985ec69c","text":"Decellularisation is a novel technology that removes cells and DNA from tissue while preserving the underlying tissue matrix.8 Depending on the manufacturing method used, decellularised bone allografts can retain the advantageous biological aspects of allografts such as osteoconductive growth factors and have similar mechanical properties to a fresh-frozen allograft, without evoking an adverse immune response.9 These properties suggest that a decellularised IBG could have increased rates of regeneration and incorporation with the host environment, potentially decreasing the occurrence of aseptic loosening of hip replacement components.10","title":"Cost-effectiveness of decellularised bone allograft compared with fresh-frozen bone allograft for acetabular impaction bone grafting during a revision hip arthroplasty in the UK"}
{"_id":"432e24d9-484b-3bb5-4048-5b9b38b899aa","text":"In view of this it would appear that examining the grossly evident lymph nodes only is sufficient and there was consensus that dissection of the hilar fat, for the purpose of identifying lymph nodes, is sufficient.","title":"The ISUP system of staging, grading and classification of renal cell neoplasia"}
{"_id":"4334ea7b-8f36-2f33-0c74-ea58b4807232","text":"The phenomenon of large fat droplets escaping from the hepatocytes causes fat embolies in the sinusoid and is a candidate for the blocking of sinusoidal blood flow quite frequently observed in our preparations (Table 1). Forces exerted on the growing fat droplet might push it towards the sinusoidal side of the cell where a thin rim of cytoplasm is ruptured and the fat droplet escapes into the space of Disse on its way to the sinusoid. Once arrived in the sinusoid, the intact lipid droplet, still intact, will settle as a sinusoidal embolus. In addition, we observed neither large empty holes in parenchymal cells nor ruptured cytoplasm or holes in the endothelial lining. This could mean that the fat droplets escape from living cells which restore their structure after the fat discharge.","title":"Fat causes necrosis and inflammation in parenchymal cells in human steatotic liver"}
{"_id":"433c3fd4-0648-63d2-7ae5-51086ca6d201","text":"A discrepancy between the clinically determined margins intraoperatively and the histopathological results after tumor specimen processing has been observed in tumors of the oral cavity. Obtaining clear surgical margins is critical in decreasing the risk of local recurrence and the need for adjuvant treatment or margin re-resection after primary surgical resection. Surgical margin shrinkage could lead to seemingly smaller margins on the pathology report, which in turn could lead to more patients receiving adjuvant treatment or a second surgery for margin re-resection.","title":"An Analysis of Tumor Margin Shrinkage in the Surgical Resection of Squamous Cell Carcinoma of the Oral Cavity"}
{"_id":"4348464a-f68c-87f6-7951-6e9cf71ac3c5","text":"Figure 5 shows the ROC curves of the implemented experiments, obtained by plotting the true positive rate against the false positive rate at various threshold settings. It is possible to note that when the SLVB and SLIB options are used, the model performs worse than when a random classifier is used.","title":"CNN-Based Approaches with Different Tumor Bounding Options for Lymph Node Status Prediction in Breast DCE-MRI"}
{"_id":"4349452e-91db-7a56-3e5b-56437fa0a899","text":"Reviewer A changed the sentinel lymph node assessment in three of the 21 cases with observation of dynamic images. Reviewer B changed the sentinel lymph node assessment in one of the 21 cases with observation of dynamic images. But there were no cases in which a decision was changed in the same way between reviewer A and B. Diagnostic confidence values with the observation of dynamic images scored by reviewer A were increased in five of 21 cases, and decreased in one case. Diagnostic confidence values with the observation of dynamic images scored by reviewer B were increased in four of 21 cases, and there were no decreased cases (Table 2). Average diagnostic confidence values with observation on dynamic images were higher than that without dynamic images except for cases in which popliteal lymph nodes were determined to be sentinel lymph nodes by reviewer A. However, significant differences as calculated by the Wilcoxson’s sign-rank sum test were not present (Table 3).","title":"Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities"}
{"_id":"43519921-8723-5f4f-cb64-04c2d744b5b1","text":"There are a number of methodological issues relevant to the interpretation of the study findings. Doppler ultrasound was employed as a highly sensitive, specific, and reproducible noninvasive method of measuring lower limb blood flow [21, 22]. Peak systolic velocity was chosen as the primary outcome variable as it represents the most consistent nonartefactual wave form detected by ultrasound. It was not possible to blind the sonographer to the intervention allocation, due to the requirement to undertake the ultrasound examination of popliteal vein close to the upper end of the stocking and this may have biased the results. Participants were instructed not to move their legs throughout the duration of clinical measurements to provide an accurate stable baseline measurement and to ensure that the findings related to seated immobility. While every effort was made to ensure that the participants kept their legs relaxed, it cannot be guaranteed that this was achieved at all times. Although it has been demonstrated that the right and left legs have similar venous haemodynamics [23], participants had the interventions randomised to either the right and\/or left leg to avoid any potential difference. We studied healthy participants without vascular disease to minimise risk to the participant, to achieve accurate ultrasound measurements, and to ensure that our findings were generalisable to the healthy worker.","title":"Efficacy of Micromobile Foot Compression Device in Increasing Lower Limb Venous Blood Flow"}
{"_id":"4354c318-efc8-f314-d5d0-efd0a7495409","text":"Acute radiation dermatitis is a frequent complication of whole breast radiotherapy. When the degree of dermatitis exceeds grade II as defined by the Common Terminology Criteria for Adverse Events,10 patients not only experience pain but also tissue compromise can lead to bleeding and infection as well as delay in treatment. To date, no single topical or systemic product has been shown to be effective in preventing this dermatitis and preparations commonly used after dermatitis begins generally result in symptomatic relief alone. Grade III and IV complications in the skin can subject patients to opportunistic dermal infections, worsening pain, and treatment delays, which sometimes can lead to lower tumor control rates.12-14","title":"Safety Profile of Amnion-Derived Cellular Cytokine Solution (ACCS) Following Topical Skin Application in Patients Receiving Breast Radiotherapy Trombetta et al"}
{"_id":"435842e0-567d-58d2-e346-c4deb156354c","text":"The cephalic vein is present in the forearm fascia and ascends along the radial border of the radius from the forearm.8 In the arm, it ascends along the lateral bicipital groove on the lateral side of biceps muscle. It then enters the deltopectoral groove to lie between the pectoralis major and deltoid muscle.9 In the upper part, the thracoacromial artery and its branches lie in close proximity to the cephalic vein. It pierces the costocoracoid fascia and drains into the axillary vein. The place where the cephalic vein enters the costocoracoid fascia is the pivot point of the flap.10","title":"Use of Cephalic Vein for Venous Anastomosis in Head and Neck Reconstruction: A Case Series Rahman et al"}
{"_id":"436162ac-c2b9-801b-fa78-0a256dc5e510","text":"Conclusion: This is an update on the first Canadian data to report on the safety and efficacy of pediatric oral immunotherapy in private practice for peanut and tree nut allergies. A suspension medium allowed for safe dosing titration. As knowledge of immunotherapy increases, allergists will need to become comfortable utilizing these approaches for the active management of food allergies.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"436e90fa-a0ce-06ca-7558-48f9ac51b755","text":"Distal lymphatic tissue was coagulated with harmonic scalpel and cut at the vertex of the femoral triangle. Lymphatic tissue dissection was carried upwards along the saphenous vein till we reached the femoral vessels above the femoral ring.","title":"Video Endoscopic Inguinal Lymphadenectomy (VEIL) -a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma"}
{"_id":"437db221-c1e9-77d9-6c08-d6eb9df13ab5","text":"Considering the importance of a reliable coverage after bone debridement and the relative medical condition of the patient precluding a free flap or multiple stages operations, a reconstruction by a big rotation flap was planned.","title":"Usage of a rotational flap for coverage of a large central forehead defect"}
{"_id":"43856a35-48e2-3ff7-affd-4c923d9d096b","text":"There are no formal withdrawal criteria in this study other than at the request of a participant. All patients are free to withdraw their consent at any time; if they elect to withdraw from the allocated treatment strategy during the randomised treatment phase, they will meet a secondary endpoint but may still be followed up and be included in the analysis provided that appropriate consent is given.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"438acbe2-7d33-7d2a-5fb6-dcd853e5ab6b","text":"Cutaneous metastasis following colorectal cancer resection is a well-recognised entity though rare. Any unusual skin lesions especially on the abdominal wall skin, previous incision scars or near the stoma should be biopsied early to rule out metastatic disease and systematic work-up should be carried out to rule out any metachronous tumour or metastasis elsewhere in the body. For isolated cutaneous or subcutaneous metastasis, wide local excision would be the preferred surgical option followed by adjuvant chemotherapy depending on the histopathological status.","title":"Late recurrence of large peri-stomal metastasis following abdomino-perineal resection of rectal cancer"}
{"_id":"4395b1fc-d880-c624-2dfe-aaff6dfdcf05","text":"Reconstruction of periocular defects following excision of cutaneous malignancy can present difficulties for oculofacial and reconstructive surgeons. The intricate anatomy of the eyelids and face requires precise restoration in order to avoid postoperative functional anesthetic concerns. Various reconstructive procedures based on common principles, location and size of the defect, can be applied to achieve restoration with the best possible functional and aesthetic outcomes.","title":"Principles of Periocular Reconstruction following Excision of Cutaneous Malignancy"}
{"_id":"439aa302-267b-0e5c-833d-fb4ce195ca9f","text":"Normal blood flow can usually be restored by dilating the short-range lumen of the vessel with a forceps dilator. 8 However, if normal blood flow is not restored after using the forceps dilator, the long-range lumen of the recipient vessel might be narrowed. In this situation, the long-range recipient vessel can be manipulated and dilated using a DeBakey vascular dilator. A DeBakey vascular dilator with a streamlined tip with a diameter equal to or smaller than the recipient vascular diameter should be selected to minimize injury to the recipient vessel, and a step-by-step use of the dilator from small caliber to large caliber is required. 4 Excessive vessel traction and grasping should be avoided during manipulation. 9 The DeBakey vascular dilator must be inserted into the lumen very gently with care to prevent vascular intimal injury. The advance and retreat of the DeBakey vascular dilator can be repeated several times until the normal blood flow of the recipient vessel is gushed out.","title":"Mechanical Dilation of the Recipient Vessel with the DeBakey Vascular Dilator in Lower Extremity Reconstruction: A Report of Two Cases"}
{"_id":"439e7979-df80-da34-16c5-b869a2b49652","text":"For all liver tissue specimens we adopted a stringent and rigorous procurement and isolation protocol. Following explantation or resection, specimens were immediately placed on ice in a sterile sealed draw string bag and processed within 1 hour. There were however exceptions to this, in cases were hepatic resections or liver transplants were carried out at in the late evening or at night, liver tissue was kept sterile on ice overnight. The significant exception to this protocol was in the use of donor liver tissue. In all cases the donor liver was assessed for transplantation by the clinical team at the Queen Elizabeth Hospital, Birmingham and if deemed unsuitable for liver transplantation it was then used for hepatocyte isolation. Precise time between explantation or resection of the liver and commencement of the isolation procedure was recorded in each case.","title":"Isolation of Primary Human Hepatocytes from Normal and Diseased Liver Tissue: A One Hundred Liver Experience"}
{"_id":"43a1ff0a-5f39-ab45-71a7-e3260c15fa20","text":"The duration of FAB treatment was found to be the most influential on the functional results and on rate of surgery. Close follow-up and longer FAB weaning program reduced the rates of recurrence.","title":"Prolonged use of foot abduction brace reduces the rate of surgery in Ponseti-treated idiopathic club feet"}
{"_id":"43aa621b-f53b-2dc1-bda0-02dee6dda95c","text":"Repaired area was left open during follow up period. Patients were being prescribed with antibiotic and analgesic for 3 days. Patients were allowed to drink and eat normally right after local anesthesia surgery or after relieved from general anesthesia effect. Follow up visits were performed at 3 months after surgery and annually after that if there is no complication. At some patients, V-Y advancement flap surgery was performed two or three times to achieve maximum results.","title":"Reconstruction of whistling deformity using V-Y advancement flap after primary cleft lip repair"}
{"_id":"43aa72e7-fa2b-572b-5fa7-9a30e50ac29d","text":"Due to the evidence of regional lymph node metastasis the patient was counseled regarding adjuvant therapeutic options. The treating physicians queried recognized experts in the field of radiation therapy for gastrointestinal malignancies via email and a consensus developed that external beam radiation therapy might be reasonable, although it was admitted that no data are available regarding the use of this modality for this disease entity. Ultimately, a decision was made to administer external beam radiotherapy to the abdomen in an effort to eradicate any possible residual disease not removed during surgery and to reduce the risk of locally recurrent disease. No chemotherapy was advised due to the rarity of distant metastases and the lack of response of these neoplasms to conventional systemic therapy.","title":"Locally advanced duodenal gangliocytic paraganglioma treated with adjuvant radiation therapy: case report and review of the literature"}
{"_id":"43ac6755-9e3a-a7fa-cfbb-d6dc3cde1e2b","text":"This case report illustrates the use of a radial forearm free flap and endoscopic techniques for reconstruction of soft tissues and bone after significant tissue defects. After osteomyelitis was controlled, a subtalar arthrodesis was performed.","title":"Arthroscopic Subtalar Arthrodesis after a Calcaneus Fracture Covered with a Forearm Flap"}
{"_id":"43af4235-3aea-ee72-e48c-7214c11f57c8","text":"Baseline characteristics of the patients are given in Table 1. Children with discitis rarely presented with fever and had lower CRP values on admission compared to children with osteomyelitis and bacterial arthritis. Children with osteomyelitis and bacterial arthritis predominantly presented with pain and fever, children with bacterial arthritis often had additional joint swelling.","title":"Impact of a pediatric infectious disease consultation service on timely step-down to oral antibiotic treatment for bone and joint infections"}
{"_id":"43af581e-61cc-a149-f370-01d67f7dd315","text":"Patient files lacking information required for this study and those who had refused to sue the physician were excluded from this study.","title":"Litigation After Nasal Plastic Surgery"}
{"_id":"43b05e37-2cee-3af0-ebcc-4970f67616f3","text":"In this study, the use of CSP to decrease seroma formation and reduce the time to closed suction drain removal was investigated in patients with metastatic melanoma undergoing RLND.","title":"Collagen sealant patch to reduce lymphatic drainage after lymph node dissection"}
{"_id":"43b27a49-f82c-30d4-d66d-53867982af24","text":"The last enrolled patient will be followed up for 12 months after the start of treatment (D0). All other patients will be followed up until the final visit of the last enrolled patient. Patients will therefore be followed up for a maximum of 48 months and a minimum of 12 months following start of treatment. All patients will be assessed by the schedule summarised in Table 2. Treatment will be discontinued if the patient withdraws consent, if the treating physician deems it necessary for medical reasons or if a serious adverse event occurs - after discontinuation, patients should be assessed by CT as soon as possible to assess response to treatment.","title":"Radioembolisation with yttrium‒90 microspheres versus sorafenib for treatment of advanced hepatocellular carcinoma (SARAH): study protocol for a randomised controlled trial"}
{"_id":"43b7c49d-980b-1c6b-d07d-08852fd8f39a","text":"This series supports the modified NPWT technique as a safe, reliable and effective adjunct therapy to resolve metalwork infection. The same results have been reproduced as the previous cohort in a different centre.","title":"Modified negative pressure wound therapy as an adjunct to antibiotics in the treatment of orthopaedic infected metalwork"}
{"_id":"43b8b22d-83e8-95ac-a403-bcd5582a79c6","text":"The three patients with positive SLNB were classified as T1b under both the 2001 and 2009 AJCC melanoma staging systems and had a median BT of 0.81 mm and a median MR of 2\/mm2. All three patients had CL IV tumors with absence of ulceration and regression and no associated nevus. Deep margin involvement on initial biopsy exam was absent in this cohort. In this cohort of T1b patients with positive SLNB, the average BT and MR were not significantly different when compared to the 15 reclassified T1b patients with negative SLNB.","title":"Impact of the 2009 (7th Edition) AJCC Melanoma Staging System in the Classification of Thin Cutaneous Melanomas"}
{"_id":"43bb8bd9-e7a3-e128-01b4-13ed5f0760f1","text":"• Intraoperative cone beam computed tomography can be used to assess need for revisions of pedicle screws making routine postoperative CT scans unnecessary.","title":"Intraoperative cone beam computed tomography is as reliable as conventional computed tomography for identification of pedicle screw breach in thoracolumbar spine surgery"}
{"_id":"43c62f9c-d2c7-2302-3127-2ad2473bbb2f","text":"The current study supports the use of the MarginProbe in lumpectomy surgery in the absence of routine intraoperative pathologic assessment. The device provides surgeons with intraoperative assessment of lumpectomy margins, allowing directed reexcision of positive margins and reducing the proportion of patients with positive margins at the conclusion of surgery. A decrease in reexcision procedures can reduce the burden of breast cancer surgery for the patient and the health care system.","title":"A Randomized Prospective Study of Lumpectomy Margin Assessment with Use of MarginProbe in Patients with Nonpalpable Breast Malignancies"}
{"_id":"43c7b4d3-8885-a97f-3d25-c9c0706eb0c7","text":"The present study demonstrated that the color Doppler combined with the clinical examination would combine the high sensitivity of the color Doppler and higher positive predictive value of the clinical examination. The color Doppler examination, when used alone, would have resulted in an average of two unnecessary explorations per patient (20 unnecessary explorations per 10 patients), whereas the color Doppler combined with the clinical examination on an average has led to only four unnecessary explorations per 10 patients.","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"43c83120-34aa-e72c-16b2-4e35906e1307","text":"The nose is not only the centrepiece of focus of the face for aesthetic reasons, but it is also critical in maintaining an adequate airway for breathing.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"43e12e07-bd77-9794-c254-cd71c0bec12f","text":"The plates created in this study were designed to cover the bony defect that would be created by surgical excision. In cases where intraoperative modification may be necessary based on the characteristics of the tumor, a staged procedure or creation of several plates may be necessary to allow more accurate planning of the implant after the defect is made. Due to the nature of these plates, it is possible to cut them to size in some regions, although care must be taken to ensure that there are still enough holes available for fixation. The creation of plates designed for more extensive intraoperative modification could be considered in future design iterations. A benefit of our design is that they utilize the same self-cutting, self-tapping screws as titanium mesh, therefore aside from the plate and guide, the surgical equipment necessary for this procedure is identical to traditional mesh cranioplasty procedures.","title":"Schedule feasibility and workflow for additive manufacturing of titanium plates for ranioplasty in canine skull tumors"}
{"_id":"43e37df3-1d46-3c8d-aad1-6fbaa2d61e8c","text":"Local dissolution of the subcutaneous fat occurred postoperatively in 3 patients whose incision healed by second intention after dressing change. There were no cases of infection. In 6 patients who had suffered preoperative radial nerve palsy, the radial nerve was dissected and separated for neurolysis during surgery. Through intraoperative exploration we found that no nerve was broken or tore; the nerve pull and compression caused by the fracture end are common factors that might lead to paralysis of the radial nerve. To protect the radial nerve and avoid secondary damage, some methods can be used such as temporary fixation of the fracture, gentle implantation of the plate during surgery, and placement of the screws as far as possible away from the anatomical position of the radial nerve. Using reduction of fracture and neurolysis, the nerve function was recovered 4 months after the operation. All patients had good alignment, and no malunion, nonunion or delayed union was observed. No complications such as screw and plate fracture occurred. No patient suffered postoperative radial nerve injury or secondary radial nerve injury in the process of removal of the internal fixation devices.","title":"Lateral Subcutaneous Locking Compression Plate and Small Incision Reduction for Distal‐third Diaphyseal Humerus Fractures"}
{"_id":"43e48543-404c-5fe0-0b57-407f6507a3e0","text":"VRAM flap reconstruction of defects following APR—with or without vaginal wall resection—is an effective technique that reduces major perineal wound complications and wound healing delay in patients undergoing APR and irradiation without increasing early abdominal wall complications. To the best of our knowledge this is the largest hitherto reported series of reconstructing the vaginal wall during rectal and anal cancer surgery in a one stage procedure. Although the abdominal skin of the flap island is not accomodated to the moist milieu of the vagina we did not observe long term problems of the skin surface in the vagina and patients report of a possible proper sexual function with the reconstructed vagina. This type of interdisciplinary reconstruction has proven to be technically feasible in almost all cases despite of previous abdominal surgical incisions. The tpVRAM flap is reliably perfused, helps to reduce long term wound healing desasters in the irradiated perineal\/vaginal\/gluteal region and adds enormously to the quality of life in female patients with advanced or relapsing rectal, anal or vaginal cancer.","title":"Interdisciplinary Surgical Approaches in Vaginal and Perineal Reconstruction of Advanced Rectal and Anal Female Cancer Patients"}
{"_id":"43e5a232-5671-04c7-8476-d163dbbe20bd","text":"The optimal amount of time between smoking cessation and facelift surgery is unknown. Whether the risk of wound healing problems in a former smoker approaches that of a never smoker is also unclear. While 4 weeks is a frequent time interval quoted, data to support a reduction in wound healing problems in facelift surgery could not be found. A search of the available literature identified a retrospective review of patients undergoing free transverse rectus abdominis myocutaneous flap breast reconstruction that provides some evidence-based recommendations. These authors found that smoking-related wound complications (mastectomy flap necrosis and abdominal flap necrosis) decreased when the time interval between smoking cessation and surgery was at least 4 weeks. Additionally, when such data are discussed, a reduction in wound healing complications rather than a reduction in the overall complications needs to be clarified.","title":"How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications"}
{"_id":"43f0e881-ea3b-e36e-a73c-be845b530bb9","text":"The ultimate goal of aesthetic rhinoplasty is to create a harmonious and natural-appearing nose that assimilates into the surrounding face with no visible sign of previous intervention and that allows a patient to breathe comfortably without restriction.","title":"Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients"}
{"_id":"43fc8c84-68fa-6e0b-bbf6-910f07424126","text":"Several studies have also provided evidence that brachitherapy boost ensures better OARs sparing from exposure to medium to high radiation doses in deeply seated lumpectomy beds, compared to EBRT and high-energy electron beams.","title":"The Role of Interstitial Brachytherapy for Breast Cancer Treatment: An Overview of Indications, Applications, and Technical Notes"}
{"_id":"43fe685e-5e5b-0afe-2a38-556f96034fdc","text":"In conclusion, we explored the efficiency of external and internal fixation in reconstruction of bone defect caused by debridement in Chinese patients and found no difference between two groups under the circumstance of complete control of active infection. Patients who underwent internal fixation experienced higher level of daily living scales and lower level of anxiety. It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled.","title":"Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis"}
{"_id":"4403dbea-9a7c-f121-920c-9972fc5c7bfe","text":"There may be history of orthopedic or plastic surgical procedure or parenteral lipid transfusion.","title":"Emergency management of fat embolism syndrome"}
{"_id":"4405e836-b563-05fa-6d4f-e462195395f6","text":"At present, there are no data from clinical trials to inform specific antimicrobial regimens for vertebral osteomyelitis and associated infections, nor are there guidelines on the duration of antibiotic therapy. The choice and duration of therapy cited in case reports may be associated with the extent of infection or with patient‐specific considerations, offering little value to prescribing guidelines. Given the increasing incidence of spine‐related infections and the significant morbidity and mortality of this condition, further, preclinical research and clinical trials are needed to elucidate the variable onset and progression of this debilitating complication. It is challenging to design and undertake clinical trials for this complicated disease process, considering the low incidence and high heterogeneity of induction and presentation of infection with various implicated organisms.","title":"Preclinical models of vertebral osteomyelitis and associated infections: Current models and recommendations for study design"}
{"_id":"440edb46-6d0e-e03c-6000-852fe03cdc15","text":"These factors should be considered in conjunction with the risk-benefit analysis of anticoagulant treatment and its efficacy for earlier regression of thrombi in VTE treatment, since insufficient anticoagulation can increase the risk of PTS and facilitate organization of the thrombus.26 Killewich et al.27 have reported evidence of lysis of thrombi and recanalization of venous segments in the first week after initial diagnosis. Mapping with CDU makes it possible to employ methods that quantify the recanalization process, such as those described by Porter et al.28 and Prandoni et al.29","title":"Analysis of recanalization of deep venous thrombosis: a comparative study of patients treated with warfarin vs. rivaroxaban"}
{"_id":"441c13f6-b04c-ab7e-6298-fa8159fd2e46","text":"Females remain a minority in leadership positions at AUA sub-specialty societies despite increased female representation in recent years. Future efforts should promote the advancement of women to positions of leadership to reflect the changing landscape of the urology workforce and surgical specialties.","title":"Do Women Have a Seat at the Table: Trends in Female Representation Among the Board of Directors in American Urological Association Subspecialty Societies"}
{"_id":"441e4470-8262-abd8-19b0-cd119ba41a0d","text":"Local recurrence did not seem to have a negative impact on overall survival, while it was associated with lymphovascular invasion and higher tumor stage and grade.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"44207081-4738-6295-3c4e-0f2f5a48565e","text":"For soft tissue reconstruction of the head and neck, the radial forearm fasciocutaneous free flap has a reliable, long (up to 20 centimeters) vascular pedicle. The flap is thin and pliable and can be made sensate by neurorrhaphy of the lateral antebrachial cutaneous nerve to the inferior alveolar nerve. This flap can also be designed as an osteocutaneous flap by inclusion of the anterior (volar) cortex of the radial bone. Up to 14 centimeters of unicortical radius nourished by periosteal branches from the radial artery may be harvested for selected osseous defects. However, the use of the osteocutaneous radial forearm free flap is typically not a first line option due to the limited thickness of the bone that may be harvested without disturbing the structural mechanics of the hand and the risk for radial bone fracture in the forearm after harvest [47].","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"442b9a12-05f7-60a6-210f-f24a855ea9b2","text":"The use of soft tissue flaps is associated with a low rate of MWC and reoperation. Our results suggest that a high rate of flap usage may be required to observe a reduction in complication rates.","title":"Preoperative Radiotherapy and Wide Resection for Soft Tissue Sarcomas: Achieving a Low Rate of Major Wound Complications with the Use of Flaps. Results of a Single Surgical Team"}
{"_id":"44330b57-cb03-011d-f51d-15179d3cc050","text":"Updates to staging systems for solid tumors may cause changes in daily clinical practice. In the 8th edition of AJCC staging for melanoma, one of these changes was made in category T1.","title":"How does the mitotic index impact patients with T1 melanoma? Comparison between the 7th and 8th edition of the American Joint Committee on Cancer melanoma staging system"}
{"_id":"443abf2b-c849-6e00-8a48-9229a272be52","text":"Patients treated without any microbiologic sampling of their suspected infection or having their treatment based only on microbiologic identification without susceptibility testing were considered to have a low level of microbiologic confirmation of infection. In patients undergoing susceptibility testing of their microbiologic samples, appropriateness of AT was assessed by the principal investigator at the end of the therapeutic course. In order to replicate real life conditions as much as possible, all positive microbiologic cultures were analyzed [22] but appropriateness of AT was only considered for true pathogens. Therapy was judged appropriate if, according to the susceptibility testing [21], all bacteria considered true pathogens were targeted by at least one of the drugs administered. The other cases were classified as inappropriate AT. The antibiotic selection was judged appropriate or inappropriate on the basis of the culture results obtained. Considering that severe infections encountered in ICU cases require emergency AT, the scientific committee classified the delayed introduction of AT at the time of susceptibility testing as arbitrary and inadequate AT. Fungi were excluded from the analysis of appropriateness and antifungal therapy was not considered.","title":"Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units"}
{"_id":"443de1c5-1a94-c3bd-6737-c6050f0670bc","text":"Tal did not observe recurrent lesions after 20 and 30 months, and the same held in cryosurgery treatment. Sarraf et al had a case series study in which treatment of gingival pigmentation of adolescent patients was very satisfactory. A study by Darbandi and Shahbaz showed that after four weeks all the pigmentated areas were cured, with no recurrent lesions in any of the patients. In studies by Kavashima and Tal a slight recurrence was observed after 3 and 6 months, by Er:YAG laser treatment, respectively. Nakamura used CO2 laser and did not report any recurrent lesions 12 months after the treatment, but after 2 years, recurrent lesions were observed in 4 patients. Mokeem did not see any recurrent lesions 18 months after the treatment by bur abrasion technique, while Pontes reported completely recurrent lesions after 12 months in all the samples.","title":"Management of Physiological Hyperpigmentation of Oral Mucosa by Cryosurgical Treatment: A Case Report"}
{"_id":"444252f0-da2a-df5a-5ae9-a8c52ac30ed1","text":"The locations of lymphomatous nodes corresponded to the distribution of lymphadenopathy as a whole, with the majority of palpable nodes being in the cervical, inguinal and axillary chains and as such were amenable to simple excision. The majority of lymph node biopsies were performed mainly by general surgeons whilst ENT and ophthalmic surgeons performed a total of ten biopsies. The remaining four lymphomas were biopsied using ultrasound-guidance by radiologists.","title":"Does the surgeon still have a role to play in the diagnosis and management of lymphomas?"}
{"_id":"4447f0d6-fdc5-61f1-63a1-cedb0b7fbdda","text":"Satisfied neurological improvement was obtained by ADF and PDF for patients with KCSM. Cervical kyphotic correction caused significant improvement of AS, and was more favorable with ADF than with PDF. Surgeons should pay full consideration of the merits and shortcomings of each approach when deciding on a surgical plan.","title":"Cervical alignment and clinical outcome of anterior decompression with fusion vs. posterior decompression with fixation in kyphotic cervical spondylotic myelopathy"}
{"_id":"44566c57-6105-e9f4-6f03-6675b68a2869","text":"Wounds or defects in the lower leg are difficult to treat as the vital structures are covered with only skin and minimal soft tissue. The repair of these wounds either requires tissue with adequate blood supply or a microvascular free-tissue transfer. Over the last 3 decades, free flaps have been the treatment of choice for these hard to cover wounds. Transpositions of local muscles on a distal pedicle are not consistently reliable and alternatives include the cross-leg flap and the use of free flaps.","title":"Split Hemianterior Tibialis Turndown Muscle Flap for Coverage of Distal Leg Wounds With Preservation of Function Gundlapalli et al"}
{"_id":"445d362b-466f-20a5-0fc2-9b9e3c2a17f6","text":"Skin scar is often created in cases of deep burns of grade II and grade III and IV that will usually requires kin graft.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"445d5433-3b8a-f519-269d-987595ab5064","text":"Our indications for HGT are if at least one of the following criteria is present:","title":"Management of spinal deformities and tibial pseudarthrosis in children with neurofibromatosis type 1 (NF-1)"}
{"_id":"4464bc69-a002-c00b-9037-42d17db019cb","text":"In addition, results may be biased by the fact that psoriasis patients are usually followed up with by dermatology specialists, thereby increasing the possibility of an earlier diagnosis of malignant skin lesions compared with the general population without a diagnosis of skin pathology.","title":"Psoriasis Therapy and Skin Cancer: A Review"}
{"_id":"4466cd22-1852-e907-2807-6d41ea1e4d22","text":"All the rabbits survived the study. One rabbit at 4 weeks had a dislocation of the patella on the control side. None of the rabbits developed any infection or wound dehiscence.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"446eee09-845e-96de-2276-acda6ad4a49a","text":"Vascularized muscle flaps may fill the unhealed dead spaces with healthy and well vascularized tissue. This allows covering of the wound and provides adequate local blood supply with faster and complete absorption of antibiotics.","title":"Use of muscular flaps for the treatment of hip prosthetic joint infection: a systematic review"}
{"_id":"4471aee8-1bea-a952-ae7f-cddcb2ed87c9","text":"Ageing is a natural physiological process that leads to some well-defined changes in the body, such as loss of skin elasticity, bone resorption, retardation in mechanisms of repair and is a major risk factor of many chronic and acute diseases. It is also a process that continues to occupy a wide range of research fields as the more specific and the subtle manifestations of ageing on the structure and function of various body systems require far greater understanding that current knowledge permits. The eye lens, because of its growth mode as a continual accrual of new cells over existing tissue without concomitant tissue loss, retains a chronological record of its growth, development and ageing processes. Hence, it offers a unique opportunity to study ageing from the physiological and pathological perspective. The lens can be clearly viewed within the living eye to discern changes in its structure; its function can be measured clinically and can manifest pathological changes that occur with systemic disease [3].","title":"The eye lens: age-related trends and individual variations in refractive index and shape parameters"}
{"_id":"447337ff-57f9-d333-a9ac-04e7f2fe1bdc","text":"A review study in 2014 13 comparing aspirin with other anticoagulants found no difference between aspirin and other anticoagulants in arthroplasty surgery—a conclusion supported by many papers in this study. Sahebally et al 14 suggested that aspirin is an effective thromboprophylactic and calls for more studies comparing aspirin and anticoagulants. The conclusions from recent systemic reviews, Drescher et al 13 and Sahebally et al, 14 and this study suggested that aspirin is not inferior to anticoagulants.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"447ae270-f295-83db-684e-7c9d60870f9a","text":"The present study draws attention to the increased probability of altered lymphatic drainage, resulting in new nodes being found in sites other than the ipsilateral axilla in patients who have had previous radiotherapy or previous operations. Because the altered lymphatic drainage can be detected only by lymphoscintigraphy, we suggest a lymphatic mapping injection followed by lymphoscintigraphy to identify the SLN in patients who have new or recurrent breast cancer and previous procedures (SLND or ALND), rather than proceeding directly to an axillary dissection. It should be kept in mind that if ALND was done or axillary radiotherapy carried out, it is highly unlikely that the SLN will be found in the axilla. SLN mapping with a radiocolloid is essential.","title":"Management of sentinel node re-mapping in patients who have second or recurrent breast cancer and had previous axillary procedures"}
{"_id":"44806cd7-b2ab-9113-08de-caf398fadf3b","text":"Combining BRAF inhibitors with immune checkpoint inhibitors has shown synergistic effects and improved outcomes, particularly in patients with resistance to BRAF inhibitors.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"44809100-96c3-2c20-51f5-40dc6ceabe82","text":"With regard to the reasons for choosing the extended LD flap; eight out of 14 patients preferred the dorsal donor site. Two other patients were thin for a TRAM flap and one had a significant abdominal scar that precluded a TRAM flap.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"4480971f-2710-3162-b6ea-29c2dee485ec","text":"The use of radiotherapy for local disease control and palliation should be used judiciously and sparingly depending on the patient’s presentation, need for urgent response, and prior treatment history and response. MRI and CT scans are crucial to differentiate between a soft tissue myelomatous mass in the spinal canal from bony encroachment. The reason for this is that radiation therapy is very effective in reducing the size of a soft tissue myelomatous mass but not effective if there is bony neural compression and does not stabilise the VCF.","title":"The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG)"}
{"_id":"4484b3d0-649b-8ee1-376d-3cde2cbf3800","text":"The demand for MMS is exceedingly on the rise as an increasing number of patients seek to undergo this procedure for the treatment of more complex and cosmetically challenging skin cancers. Hence, there is a need for additional dermatologists to be trained in MMS to fulfill the pressing requirement. By receiving adequate training in MMS, dermatologists would be able to provide their patients with the best possible care and have increased chances of successful outcomes. On top of that, they would have their reach extended to sophisticated lesions involving ever so cumbersome areas, which were previously and are largely still being dealt with by plastic surgeons to this date.","title":"Rise in the Number of Complex Skin Cancers Necessitates Establishing Mohs Micrographic Surgery Fellowships in Pakistan"}
{"_id":"44882dd1-44fe-66d9-37dd-56c6937dfd59","text":"In this review of desmoid tumors in the pediatric population, we will first provide a general summary of the current data regarding desmoid tumors, including the surgical management of this complex disease. We will also specifically review the literature on the initial treatment and outcomes of children with desmoid tumor in recent large series of patients.","title":"Desmoid Tumors in the Pediatric Population"}
{"_id":"448b4a36-a9c9-a766-50c6-540483d3031a","text":"Criteria for formally halting the trial will be when the last patient visit has taken place.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"44a3b282-b185-ba49-94ce-9a19dd647d8c","text":"This study initiates the cryopreservation of large OCAs. By incorporating vitrification and nanowarming, our method enables faster sample rewarming compared to convection warming, thereby reducing the potential for sample injury due to ice formation. Quantitative analysis of cartilage chondrocyte cell metabolic activity and cell viability revealed that our method outperforms the traditional convection strategy in preserving large OCAs. Tissue level characterizations also showed that our method did not adversely affect cartilage material and mechanical properties. These results demonstrate the feasibility of this nanowarming and ice-free cryopreservation method for large-size OCA cryopreservation.","title":"Nanowarming and ice-free cryopreservation of large sized, intact porcine articular cartilage"}
{"_id":"44a756dd-45d3-9b23-75e9-2b4d9827b8ee","text":"Thus it appears that once the periosteum is transplanted in articular cartilaginous defects, the grafts are taken up by 4 weeks and the cambium layer of the periosteum starts proliferating into chondrocytes. Initially, the arrangement of the cells at 8 weeks is wooly; however, as time elapses and the graft is subjected to normal stress and strains, the cells start arranging into columnar pattern and by 48 weeks they assume the configuration of an almost normal looking hyaline articular cartilage histologically and can be a promising substitute for articular cartilaginous defects as supported by similar other studies.19–21 Methods have to be evolved to retain and fix these periosteal grafts securely intraarticularly. Considering the results of our experimental study the periosteal grafting for the repair of full-thickness articular cartilage defect may evolve into a good method.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"44a90e6e-80f6-2540-1f10-a2c2ea3a2b99","text":"Despite rarity desmoid tumors should be kept in mind of an otorhinolaryngologist as a differential diagnosis in children with head and neck mass.","title":"Huge Facial Desmoid Tumors with Neck Extension: A Case Report"}
{"_id":"44b8fed8-8600-d578-5262-61a61af01379","text":"The presence of limited statistical power and wide confidence intervals in this study prevents us from making a direct conclusion about the possibility of a significant results of this study. It is necessary to conduct a multicenter clinical trial with a larger sample size to further strengthen the evidence of the efficacy of atorvastatin as DVT prophylaxis in cancer patients undergoing chemotherapy, so that atorvastatin could be proposed in clinical guidelines as DVT prophylaxis in cancer patients undergoing chemotherapy.","title":"The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy"}
{"_id":"44bd1fcc-9647-f5ce-cc19-608d8abd6f39","text":"The inclusion criteria were all patients with DVT confirmed by CDU for whom at least three follow-up vascular ultrasound examinations were available. From almost 500 CDU examinations performed during the period to evaluate DVT, serial examinations for 77 patients who fulfilled all criteria were selected. The exclusion criteria were patients for whom only two vascular ultrasound reports were available, and patients who had not been treated with either of the two classes of medications assessed in this study.","title":"Analysis of recanalization of deep venous thrombosis: a comparative study of patients treated with warfarin vs. rivaroxaban"}
{"_id":"44bf73ea-5a84-8805-0352-3f6da85171ac","text":"Key departmental stakeholders should be included in the selection of appropriate metrics for program aims. Defining new metrics will often cause a change in how resources are deployed, so buy-in from the department chair, as well as the residents that will be directly affected by any changes, will be especially crucial. Benchmark performance levels should be set based on historical performance in the chosen area; if a residency program has never sent a graduate to fellowship, it may be unrealistic to achieve a goal of 80% of graduates choosing this option in the next few years. As the program grows and changes, the excellence metrics may need to evolve also. A program with an interest in developing a track record of resident scholarly publications for example, may want to turn its attention to academic leadership positions after several years of success.","title":"Metrics of Resident Achievement for Defining Program Aims"}
{"_id":"44c491e5-2574-fe00-6dac-910695bb0812","text":"In general, the typical duration of parenteral antibiotic treatment of osteomyelitis runs 4 to 6 weeks. Trials of extended courses of either parenteral or oral antibiotics have not suggested improved outcomes compared with 6 weeks of therapy. If patients are deemed to be stable enough for discharge, outpatient intravenous antibiotics may be administered through a peripherally inserted central catheter line.","title":"Management of Osteomyelitis in Sickle Cell Disease: Review Article"}
{"_id":"44c5b7a5-2016-672d-6cb2-85324b4f6fbd","text":"The use of the subgluteal donor site can provide up to 15×3 cm graft in adults with possibility of direct closure of the donor site. After limited removal of subcutaneous fatty tissues, it heals without any noticeable changes of the gluteal contour. We cannot declare that there is only limited sites of donor skin that can be closed directly as it used to be believed in harvesting FTSG. The subgluteal crease area can supply the largest hairless FTSG at a most hidden and directly closed site. In this article we introduce this relatively new donor site of FTSG with new application as FTSG is the second step in reconstructive ladder.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"44cbf276-738e-3157-a733-4cdbeebbd9e6","text":"All adult patients undergoing inpatient surgical operations (January 2012–December 2019) at a single quaternary care center and Level 1 trauma center were abstracted from institutional electronic health record database and stratified into patients admitted before and after venous thromboembolism risk-stratification tool implementation. Bivariable analyses compared venous thromboembolism chemoprophylaxis prescription and venous thromboembolism events with implementation and screening among all surgical patients as well as in general surgery patient subset.","title":"Electronic health record risk-stratification tool reduces venous thromboembolism events in surgical patients"}
{"_id":"44cf23e9-4b3b-fa13-753f-e1b8c5395d4b","text":"P22 Assessment, classification and treatment of calcinosis as a complication of juvenile dermatomyositis: A survey of pediatric rheumatologists by the Childhood Arthritis and Rheumatology Research Alliance","title":"Proceedings of the 2016 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting Toronto, Canada. 14-17 April 2016"}
{"_id":"44cf81b9-ae10-c681-073d-a0ad3cec872c","text":"Obesity is a major medical problem and presents unique challenges for a proceduralist. While technology has come a long way over the past years with the development of new machines, many shortcomings still exist.","title":"The Challenges of Ultrasound-guided Thoracic Paravertebral Blocks in Rib Fracture Patients"}
{"_id":"44d35a82-ef96-7be1-54d3-640a58ea8eaa","text":"The 44 patients were retrospectively reviewed and divided into two groups: the VBG and MT groups. A total of 27 patients who underwent VBG were compared with 17 patients who underwent MT. All 44 patients received proper initial management for severe trauma or multiple trauma on arrival at the hospital. The bone and soft tissue defects were managed after the general conditions were stabilized.","title":"Comparison of the clinical outcomes between vascularized bone graft and the Masquelet technique for the reconstruction of Gustilo type III open tibial fractures"}
{"_id":"44d5afc0-ba1f-5dd5-906e-4eaa465dc090","text":"From the results we conclude, with regard to the problem addressed that it is recommended to perform implant treatment on patients with dental phobia and SPR under general anesthesia. Consequently, implant-supported prosthesis would due to the availability of general anesthesia become a treatment option for these patients who otherwise would stay refusing any contact to the dental professionals who in turn have usually excluded implant treatment in cases involving patients with phobia or SPRs.","title":"Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study"}
{"_id":"44d6a019-08a3-35c9-e262-8932d50f92c4","text":"The infiltrative growth pattern of desmoid tumors and their proximity to important anatomical structures make them difficult to manage. Mutilating surgery should be avoided, while surveillance or radiotherapy remain valid options.","title":"Recurring desmoid tumor of the neck: A case report"}
{"_id":"44dd3e63-8543-d66a-2bc3-982cc36f81b4","text":"This study was approved by the Western Sydney Local Health Network Human Research Ethics Committee.","title":"Immediate and Long-term Complications of Direct-to-implant Breast Reconstruction after Nipple- or Skin-sparing Mastectomy"}
{"_id":"44e0222f-ef61-dcc6-a839-bd8a7fb16c93","text":"The research shows that using composite materials containing nanohybrid fillers allows for much more durable and aesthetic dental fillings.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"44e28828-3722-0155-b0bb-0bdbcbadb324","text":"In some cases, resistance to BRAF inhibitors is driven by alterations in upstream or downstream components of the MAPK pathway. Targeting these alterations with specific inhibitors or combination therapies can overcome resistance.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"44eb1ce7-b8f0-84e2-07a4-04aeeed79ccc","text":"There is a general agreement that a radiocolloid with the majority of particles ranging between 100 and 200 nm in size can be considered the best compromise between fast lymphatic drainage and optimal retention in the sentinel lymph node [9].","title":"Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer"}
{"_id":"44ef86fe-3243-c067-dacb-e5b244fae735","text":"There are few good quality longitudinal studies to confirm the incidence and prevalence of CVD in the general population and there are discrepancies between those that do exist in terms of their methodology and consequent results.3 However, CVD is considered one of the most common diseases of the lower limbs in the adult population, with an ever growing demand for treatments.","title":"Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser"}
{"_id":"44f543cb-eeaa-2b47-a67d-f30f467fda55","text":"A potential limitation of our study is that anosognosia BA perfusion correlates were not tested separately in the different dementia types. We did not present results from this analysis because the number of patients and the statistical power per dementia type were not the same (and in some cases was very small) and could lead to a biased conclusion. For this reason, we analyzed dementia types altogether and made adjustments for ACE-R.","title":"Anosognosia in Dementia: Evaluation of Perfusion Correlates Using 99mTc-HMPAO SPECT and Automated Brodmann Areas Analysis"}
{"_id":"44f71d6a-1a60-6add-5467-6d69ec240053","text":"• Baseline risk should be taken into consideration in defining the population to whom a recommendation applies. Baseline risk should also be used transparently in making judgements about the balance of benefits and harms. When a recommendation varies in relationship to baseline risk, the evidence for determining baseline risk should be assessed appropriately and explicitly.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"44f877f8-6b8c-a0e4-3ef9-ce8010b0b857","text":"This explorative investigation of a large and mature database provides evidence that the bimodal DM dynamics, previously observed in patients undergoing mastectomy for early breast cancer, is also present in patients undergoing more conservative resections with or without RT. The peak recurrence timing for these patients (Figure 1) is comparable to that observed in patients undergoing mastectomy [1,16]. These data further support our hypothesis that surgical synchronization of distant recurrence occurs even after smaller operations. This supports the concept that local treatment modalities do not appreciably modify the growth traits of the DM process. In Figure 1, the early risk level for patients not given RT is considerably lower than the corresponding risk of patients receiving RT. This counterintuitive finding may be reasonably related to the fact that the omission of RT over the resected breast area results in very high rate of IBTR as first event that may in turn partially obscure the competing DM rate. In spite of this, the DM risk pattern for these patients emerges unmistakably, confirming that RT to the chest wall does not eliminate or even delay the first early recurrence peak. In a similar way one can explain the finding that patients receiving TaRT show a moderately lower first peak height than patients given QuaRT, who experienced lower IBTR rates, as it was already noted [13].","title":"Recurrence and mortality according to Estrogen Receptor status for breast cancer patients undergoing conservative surgery. Ipsilateral breast tumour recurrence dynamics provides clues for tumour biology within the residual breast"}
{"_id":"44f969ee-ebae-a453-5738-4fc9a869b08c","text":"Previous re-excision of the scar may decrease the efficacy of sentinel node biopsy because it interferes with the lymphatic drainage of the site. Almost all patients with a high-risk invasive melanoma who are considering participating in an adjuvant therapy clinical trial subsequent to re-excision of the scar will require CLND for staging. Elective lymph node dissection should not be considered appropriate surgery with the exception of biopsy proven nodal disease.","title":"Malignant Melanoma"}
{"_id":"44f9a5dd-bc96-d4ab-1818-18502e6be7d5","text":"The pedicled myocutaneous flaps are useful alternative for the reconstruction of complex facial defects if micro vascular free tissue transfer facilities and expertise are not available. Studies show that early restoration of facial anatomy and function with minimal limitation in mouth opening can be achieved with these flaps., An ideal pedicled flap should be thin, pliable, with a long vascular pedicle and good facial color match. The myocutaneous platysma and submental flaps are commonly used for the reconstructions of small to medium sized facial, oral and neck defects.- The submental flap is thin skin, long vascular pedicle, close proximity to facial and intraoral defects in the well hidden donor site concealed under horizontal ramus of the mandible, make the submental flap preferable. But this flap can also be associated with some limitations such as risk of nodal metastasis, difficulty in clearing the level I lymph nodes and in addition to its contraindications which include previous radiotherapy, ligation of the facial artery or prior neck surgery., On the other hand flexibility, good color and texture match are the features of platysma flap for reconstruction along with good functional outcomes due to capability of closing medium sized defects associated with head and neck can be pedicled either superiorly, inferiorly or posteriorly. But it is also the fact that the defect of bigger sizes can lead to greater scar with long surgical time and compromised surgical outcomes. Insufficient mass, partial dependence on the facial artery and venous congestion of the platysma flap lead to its contra indication in cases where the patient presents with bulky nodal disease with a need to sacrifice vessels or external jugular vein.,-","title":"Submental versus platysma flap for the reconstruction of complex facial defects following resection of head and neck tumors"}
{"_id":"450f3d86-1768-a586-fafc-fd3dd80beb0e","text":"One of the main problems with gastrocnemius musculocutaneous flap (GMCF) is the potential donor site morbidity, particularly when a wide skin paddle is taken, due to the exposed soleus muscle raphe and Achilles tendon that do not take skin graft very well. To overcome this, we have limited the width of the skin island whenever possible and extended its length distal to the muscle to allow primary closure of the donor site.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"450ffd26-42d1-cf8a-55b1-63520de64a47","text":"In our case, FVFG could help achieve satisfactory clinical outcome even with 13 years nonunion of Garden IV femoral neck fracture that developed through adolescence. This result may broaden the surgical indication of FVFG, but needs additional original clinical studies for confirmation.","title":"Clinical Outcome of Free Vascularized Fibula Graft for Nonunion of Garden IV Femoral Neck Fracture of 13 Years Duration: A Case Report"}
{"_id":"451068d2-d414-c68a-59dd-244c0cc2e63e","text":"Finally, a rare variant of papillary carcinoma with a DF component has been reported. However, a dual tumor with a classic CPT component with malignant epithelial proliferation and another component with mesenchymal proliferation is necessary. Our patient did not show DF in the primary tumor or in the lymph nodes evaluated later.","title":"Papillary thyroid carcinoma with desmoid fibromatosis: a case report and review of literature Carcinoma papilar de tiroides con fibromatosis desmoide: reporte de caso y revisión de la literatura Carcinoma papilífero de tireoide com fibromatose desmóide: relato de caso e revisão da literatura"}
{"_id":"451098bd-431c-b1c9-64cc-8304d09a8471","text":"The evaluation and comparison of thrombosis after implantation of access ports at the forearm is somewhat complicated since the clinical relevance and also consequence often has not been evaluated on a comparable basis in previous studies. Patients with clinical symptoms of arm vein thrombosis are evaluated carefully at our site. Still, patients treated for thrombophlebitis and thrombosis of the cephalic vein were considered as patients with thrombosis after forearm port implantation with outpatient treatment while the clinical relevance of this complication is low to non-existent. We found a slightly increased risk of thrombosis in the cephalic vein without statistical relevance. The cephalic vein typically has a small diameter with an unfavourable ratio of port catheter diameter compared to vein diameter [13]. Therefore, catheter placement in this vein leads to a relevant reduction of blood flow through supporting thrombosis and thrombophlebitis. Occlusion of the cephalic and basilica vein usually does not cause typical clinical symptoms of arm vein thrombosis such as arm swelling etc. This leads to the conclusion that the cephalic vein is the first choice for the access for forearm port catheter placement. Even with the increased risk of thrombosis associated with access ports at the forearm, the risk of clinically relevant symptoms seems to be more favourable when the catheter is placed in the cephalic vein [14].","title":"Risk factors assessment for radiographically guided port implantations with forearm access"}
{"_id":"4510f1f6-cd3d-bcf9-1347-79dc7254484e","text":"For this reason, the treatment of the condition of ankyloglossia can aid in the improvement and in a few cases in the resolution of OSAS.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"4513a221-b8b8-d043-b997-3239691b3e05","text":"When expanding the wound, the scar skin and fibrotic tissue of the outer wall of the steel plate should be excised. If there is a sinus, the outer wall of the sinus should be incision, and the fibrous capsule inside the outer wall and the sinus cavity should be removed [9]. If necessary, make a transverse incision at the bottom of the sinus wall, so that the sinus wall can be loosely attached to the base after the fibrous capsule is removed. If the fibrotic scar of the outer wall of the sinus is so severe that it can not be well attached to the base, it can be removed as appropriate. Free bone fragments should be removed. The necrotic periosteum and tendinous tissue at the base of the wound were also removed as clean as possible. Scratching the aged granulation at the bottom can cause bleeding in the wound, which can lead to fresh wounds, thus activating the wound healing process. The protein-like tissue attached and precipitated in the holes of the steel plate, in the steps formed between the edge of the steel plate and the bone surface, in the gap formed by the incompact adhesion between the steel plate and the bone, and in the gap at the broken end of the bone should be carefully cleaned to remove. During the skin flap transplantation, the denatured and necrotic bone cortex should be chiseled off 1–2 mm, the peptone in the steel plate steps and spaces should be removed, and the exposed bone or steel plate should be covered with artificial dermis. The gap between the steps formed at the edge of the steel plate and the bones under the plate should be closely filled, so that the dead space will not remain after the flap transplantation and avoid infection and necrosis caused by effusion under the flap after operation.","title":"Analysis of the therapeutic effect of artificial leather embedding combined with fascial sleeve flap transplantation on chronic wounds of lower limbs with bone and plate exposure"}
{"_id":"45145477-86b5-56b8-274e-ff85cc826f5f","text":"This study was performed at the Research Laboratory of the Institute of Medical Research (IMR) at the Evangelical Faculty of Parana in cooperation with the Ivo Pitanguy Institute, after being approved by the Ethics Committee on the Use of Animals at the Evangelical Faculty of Parana and the Ivo Pitanguy Institute registered under number 11678\/2014, from Jan 2015 to Jul 2015.","title":"Expression of NF-κB-p65 and α-SMA in the Study of Capsules formed by Surface Textured Implants Versus Foam Covered Silicone Implants in a Rat Model"}
{"_id":"452f9fec-559d-b37d-0062-b779684974c7","text":"Her parents and siblings were tested but did not have the mutation, consistent with a de novo origin of the mutation.","title":"APC mosaicism in a young woman with desmoid type fibromatosis and familial adenomatous polyposis"}
{"_id":"4534e365-ea93-8e18-a358-288825fc650c","text":"On many occasions, the rehabilitation of the tongue and the dyslalia as a result of ankyloglossia are resolved parallelly. This fact is explained through the free movement of the tongue and the work of the lingual muscles.","title":"Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol"}
{"_id":"453cbd0b-3129-0a19-f72a-7817f40f1f5e","text":"The disparity will become an increasing problem for the NHS with increasing privatization. There is a clear incentive for non-specialist Units to perform simple treatments without adequate soft tissue or bony reconstruction, even if they have a low chance of success. The tariff system will cover the cost of this ineffective treatment and eventually, the patient can be referred to a more specialist Unit which will need to bear the loss. This will inevitably mean that these complex poorly re-numerated cases will form an increasing burden to the NHS.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"454554d8-bf22-4d5b-b279-2dc0231c5400","text":"Once the femur was prepared, the profunda femoris vessels and greater saphenous vein were ligated and superficial femoral and popliteal vessels were transected. The intervening segment was removed (Figure 3). The lower limb was rotated 180º externally, ensuring a satisfactory limb position. The tibia was then secured to the lateral femoral shaft and the vascular anastomosis was performed between the popliteal artery and superficial femoral artery and the greater saphenous vein ends. A Chopart foot amputation was performed and the plantar foot surface was maintained as a healthy surface for future weight bearing. Proximally, the posterior thigh skin flap was rotated to close the lateral defect and the incisions were closed in layers.","title":"Modified Rotationplasty as a Composite Free Flap for Femur and Thigh Reconstruction"}
{"_id":"4549ae9f-832e-c9b0-8b14-af2333ad05dd","text":"Data collected during this study could be used to inform the types of BT treatments and the number of cases per treatment type that training centers could accommodate based on typical caseloads. Additional effort would be needed to identify ways for residents to receive additional training experiences if their program did not offer the minimum requirements. Potential solutions include virtual offerings, simulations, and workshops. Medical physicists should review the current AMP requirements and determine whether residency training programs should be designed to give program directors confidence to attest to form 313A (or equivalent) for BT. Alternatively, the medical physics community may petition the NRC to update or modify AMP criteria to better reflect modern medical physicist training and preparation. Addressing this challenge is important, as it represents a potential barrier for physicists to practice BT.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"4557313a-1142-1f63-70cb-e43189046f62","text":"It is always important to strive for and complete an operation with efficiency. Efficient technical skill and operative logistics for intraoperative time reduction is essential, especially for older patients. Reduced intraoperative time could possibly decrease the risks of postoperative complications such as delirium and other medical conditions such as pressure ulcers and deep venous thrombosis. This can be achieved by two team approach both during the ablative part of the surgery (reconstructive team raises flap while ablative team resects tumor) and during the reconstructive part of the surgery (one reconstructive team finishes raising of the flap and closes the donor site while the second reconstructive team finds appropriate recipient vessels and performs the flap inset). Although not a routine preoperative investigation in the setting of multiple previous microvascular reconstructions, preoperative CT angiography to evaluate existing vessel options may facilitate the flow of the surgery and decrease operative time.","title":"Third Repeat Microvascular Reconstruction in Head and Neck Cancer Patients Aged 65 Years and Older: A Longitudinal and Sequential Analysis"}
{"_id":"455e1e18-4a43-d8f0-2304-945752e384ee","text":"A type C defect with bone involvement is quite common after radical surgery for oral and maxillofacial cancers. The reconstruction of bone, including the mandible or the upper alveolar bone, is normally needed to obtain a satisfactory reconstructive result. However, for some advanced patients with a high potential risk of recurrent cancers, simple reconstruction without restoration of the bone or with a metal plate to replace the bone may be a better choice. Postoperative radiation can be performed as early as possible to increase the possibility of curing the cancer. In this study, we showed a case with a type C defect reconstructed only for the soft tissue using a perforator-based ALT flap without bony reconstruction, just like the procedure for a type A defect.","title":"Reconstruction of composite oral and maxillofacial defects by free flaps based on a new classification"}
{"_id":"4563e2ee-8729-77cb-1cc2-2d72c18b45d8","text":"The findings of this study certainly support the provision of mammography as the primary surveillance tool in breast cancer survivors, as only 2 patients out of 81 who were diagnosed through clinical exam had a normal mammogram. Conversely, over half of recurrences within the study period were detected through annual mammography. Separately, the need for ongoing annual mammography and the age at which radiological surveillance should cease remain controversial. Other national guidelines, such as those published by the National Institute of Clinical Excellence in the UK, have argued that as the risk of recurrence in many patients falls over time to risk levels in line with unaffected females, many of these breast cancer survivors could be managed under the auspices of the national breast screening programme.","title":"Assessing Mode of Recurrence in Breast Cancer to Identify an Optimised Follow-Up Pathway: 10-Year Institutional Review"}
{"_id":"456e73ec-29bf-ebfe-b3eb-11667fbc2738","text":"Occasionally, the venous congestion can be a problem for the flap and thus either surgical delay or supercharge of the flap has been recommended. Some other reverse adipose-fascial flaps can also be used to cover a wound in the distal leg. Other advantages of this procedure are in risk factor existence. These risk factors could impair successful defect coverage such as diabetes mellitus, and peripheral vascular disease. The aim of this method is to present an alternative option for reconstruction of large defect with combination of fasciocutaneous and muscular flap instead of free flap. Although, the entire soleus muscle used as a flap has a limited arc of rotation.","title":"Synchronous Soleus and Reverse Sural Flap for Large Soft Tissue Defect Reconstruction of Leg"}
{"_id":"457572f6-d68a-7477-3764-d886b70e9419","text":"P86 Analysis of a population with immediate hypersensitivity to corticosteroids: an 11 year review","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"4575bd3d-2367-0e57-4fb3-50e8b679ddbf","text":"An option for further reconstruction after DIEP is the implantation of the costal cartilage removed while accessing the internal mammary vessels into the DIEP flap. This can later be moulded into the shape of a nipple and has been shown to result in a satisfactory reconstruction for many patients.","title":"The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan Case report: The appearance of cartilage in breast reconstruction as a mass on CT"}
{"_id":"45807039-c997-1e57-aa82-7aa6bd596cb2","text":"This article is one of the first to describe the use of BTA as an adjunct in the setting of emergency laparostomy. A previous audit of all laparostomies undertaken at our centre from 2010 to 2017 identified 33 cases; of these 23 achieved primary fascial closure using the same techniques without BTA. The addition of BTA as an adjunct improved primary fascial closure rates by the same group of surgeons using similar techniques to close the open abdomen from 70% to 83%. In addition, this control includes all laparostomies, whereas our practice is to reserve the use of BTA for the most difficult abdominal closures, where we predict failure by conventional methods. This means our higher closure rate with BTA occurs despite this subgroup being the most likely group to fail.","title":"Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases"}
{"_id":"4581e67c-8f42-00fc-7c43-1b8106c1cf8f","text":"There are many different methods used for immediate breast reconstruction, but the advantages and disadvantages between distinct methods are not reported and compared directly.","title":"A Retrospective Study of Latissimus Dorsi Flap in Immediate Breast Reconstruction"}
{"_id":"45826d66-e438-589c-d808-6e71a63e5cb6","text":"When the packet consisting of the fibrofatty tissue and lymph nodes was dissected at the saphenofemoral junction, it was completely liberated. The packet was then placed in an endoscopic specimen retrieval bag and withdrawn from the apical port of the femoral triangle. The port incisions were closed following the placement of a fully fluted pediatric stomach tube via the port of the apex of the femoral triangle, and the drain was connected to a continuous vacuum suction device. The post-operative surgical field was oppressed with a saline soft bag. The same procedure was performed on the other side for inguinal lymph node dissection.","title":"Preliminary experience of performing a video endoscopic inguinal lymphadenectomy using a hypogastric subcutaneous approach in patients with vulvar cancer"}
{"_id":"45989d30-ccc5-45e7-4e71-18f52afb3add","text":"In the four patients described here, concurrent imatinib and radiation therapy was effective at relieving pain and improving neurologic symptoms attributed to large unresectable desmoid tumors. None of the patients developed disease progression after treatment, and one patient had a dramatic decrease in tumor volume.","title":"Concurrent Imatinib and Radiation Therapy for Unresectable and Symptomatic Desmoid Tumors"}
{"_id":"45bc636a-78e2-bf6e-57c3-5f0c3046ee16","text":"There is increasing evidence that radiation can work to produce quantitatively superior results with immunotherapy for local tumor control at the site of irradiation, but much excitement is focused on a completely different qualitative responses than can emerge between radiation and immunotherapy, systemic abscopal cancer eradication. While the optimal radiation dose, fractionation, and modality to be used in combination with immunotherapy remain to be determined, some preclinical evidence suggests that higher doses of radiation such as those delivered during hypofractionated regimens generate more immunologic responses. Recent technologic advances in clinical radiation therapy have now made it possible to deliver ablative radiation doses precisely to tumors using stereotactic radiation techniques such as SBRT\/SABR. Thus, stereotactic radiation in combination with immunotherapy agents represents an exciting and potentially fruitful new space for improving cancer therapeutic responses.","title":"Immune Modulation and Stereotactic Radiation: Improving Local and Abscopal Responses"}
{"_id":"45c068ce-4a46-ba7a-2be7-e24aa5e6f872","text":"Inclusion of the Eyesi Surgical Simulator in the medical school curriculum has the potential to bring additional ‘hands-on’ experience to medical students during their clinical rotations. Students have expressed interest in this type of experience, whether it be directly with patients or in a simulated environment. Practice on the simulator allows students to gain a better understanding of microsurgical techniques and additionally boosts self-confidence. Exposing students to surgical techniques early in their medical career can help to reduce the barriers that prevent students from pursuing a career in a surgical specialty. Practical experience and specifically surgical simulator experience should be integrated into the medical school curriculum to help better prepare students and help them find the right discipline that suits both their skills and interests.","title":"Implementation of microsurgery simulation in an ophthalmology clerkship in Germany: a prospective, exploratory study"}
{"_id":"45c5a47a-c1ef-f1dc-b224-c7859b089873","text":"Some of the common temporary fillers available in India are described here:","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"45ca896f-d321-68f2-95ea-a46b21b7add0","text":"The main clinical characteristic of DFSP is the high local recurrence rate, which is probably related to the presence of neoplastic tissue with radial spreading up to 3 cm from the site of the primary lesion. The cases reported here presented with clinical histories of 10 and 14 years respectively. Previous attempts of surgical tumor removal were unsuccessful. Given their respective histories, a surgical approach that involved closer healthy tissue margins would involve a risk of relapse too high for these patients.","title":"Half forehead reconstruction with a single rotational scalp flap for dermatofibrosarcoma protuberans treatment"}
{"_id":"45cf5742-f1bb-9bb6-eae9-ccecf8f56dc3","text":"Two 10 ml samples of peripheral blood were collected into EDTA tubes from an arterial line at the commencement of surgery and another 2 samples were collected at the end of surgery from the same source. The samples were stored on ice and sent to the laboratory for processing within the same day. The immunobead RT-PCR technique was performed as described above using the beads commercially labelled with the BerEP4 antibody, CELLection Epithelial Enrich Dynabeads (Dynal, Invitrogen), to ensure optimal isolation of circulating HNSCC expressing the EpCam protein. Each patient sample was incubated with 4 million beads on a low speed rotating wheel at 4°C for between 1 and 4 h and then processed for RT-PCR using the method described above.","title":"Long term survival following the detection of circulating tumour cells in head and neck squamous cell carcinoma"}
{"_id":"45d0d5ca-3086-ae67-ae7d-cb9a1a915e73","text":"Saphenojugular anastomotic technique was adopted as an effective treatment for malignant or benign superior vena cava syndrome since the early 1960s, with promising results.8485 To avoid graft kinking and compression, Panneton et al86 modified the saphenojugular bypass by tunneling an externally supported ePTFE graft subcutaneously to protect the SVG, in that the ipsilateral SVG was turned cephalic and tunneled through an ePTFE graft and anastomosed end-to-end in a spatulated manner with the contralateral SVG tunneled down from the internal jugular vein. The graft patency was promising as confirmed by duplex ultrasound scanning.","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"45de2c79-9f61-3e07-324e-9121f1f3b797","text":"Infections of the spine can lead to significant morbidity as infections can lead to either direct compression of neural elements or indirect compression secondary to development of deformity and resulting in neurological deficits. Infections of the spine can also be difficult to diagnose and can present with subtle and often missed signs on initial presentation. In this review, we will explore the initial presenting symptoms, the diagnostic tests used to identify spondylodiscitis, the causative organisms, and the treatment of spondylodiscitis. We pay particular attention to the cervical spine as infections of the cervical spine can lead to rapid and profound neurological deficits if not appropriately and rapidly treated.","title":"Cervical spine spondylodiscitis: Review of literature on current treatment strategies"}
{"_id":"45f1b2a4-8bf7-03c6-bc1e-0db22f30d5dd","text":"A selective literature research on the natural course and treatment indications in the light of current guidelines and expert recommendations on IMH\/PAU was performed.","title":"Abstracts DGG"}
{"_id":"45fd8404-7af5-de71-efb2-069360236048","text":"Skin carcinogenesis is a multistep process with several stages along its malignant evolution.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"45fdb4c3-d411-27c9-7376-d1c277eb1878","text":"In addition, when a physician is performing an invasive procedure to treat a malignancy, one usually endeavors to treat all known disease. With the usual ILI procedure the catheters are positioned approximately 10–15 cm below the inguinal crease if not more distal. Levels of effective ILI or HILP can be estimated post-operatively with the level of cutaneous erythema that is noted in the post-operative period. Invariably, the regional nodal basin is not treated with the ILI procedure due to catheter positioning being too distal. With HILP, the nodal basin is removed to gain access to the vessels. By doing so a therapeutic node dissection is accomplished when micrometastatic disease is present. The following report is given to determine the percentage of patients that are inadequately treated with the ILI procedure due to microscopic disease in the regional nodal basin at the time of the surgical procedure.","title":"Regional Therapy for Recurrent Metastatic Melanoma Confined to the Extremity: Hyperthermic Isolated Limb Perfusion vs. Isolated Limb Infusion"}
{"_id":"46008981-8b2e-749a-baed-1ab3acab0903","text":"We employed the VR prototype for surgical planning using a standard VR setup to two real cases of patients with liver tumors who were scheduled for surgery at a University Hospital for Visceral Surgery. Surgeons (N = 4) used the VR prototype before the surgery to plan the procedure in addition to their regular planning process. We used semi-structured interviews before and after the surgery to explore the benefits and pitfalls of VR surgical planning.","title":"Virtual Reality for Surgical Planning – Evaluation Based on Two Liver Tumor Resections"}
{"_id":"4606d9a4-c085-b82d-1495-e6f7cf955ed5","text":"In the case of SAP blocks, the local anesthetic is injected between the serratus anterior and latissimus dorsi muscle. A comparison between SAP and paravertebral blocks for minimally invasive coronary bypass surgery demonstrated that patients receiving the SAP block had higher postoperative opioid consumption.","title":"Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery"}
{"_id":"460d0d3f-d210-e74c-4518-9c2ee331acc0","text":"In the United States, where axillary lymph node dissections are considerably more extensive than in those trials, and where the risk of axillary recurrences is extremely low, there has been general consensus that directed radiotherapy to the axilla is generally unnecessary, although it may be considered in cases where the nodal dissection is less extensive, or in select cases of extensive nodal involvement or gross extranodal extension that raises the concern of residual microscopic disease in that region.","title":"Postmastectomy Radiation Therapy: An Overview for the Practicing Surgeon"}
{"_id":"460de00a-af4d-401e-5c11-fc6093b387ea","text":"Intravenous antibiotic administration is critical in preventing infection in open fractures, but the optimal duration remains controversial. Currently, coverage for gram-positive organisms is recommended with the addition of gram-negative coverage for type III open fractures and anaerobic coverage against Clostridium species for those wounds with fecal or soil contamination. Systemic antibiotics administered within 66 minutes of open injury are protective against deep infection. Importantly, timing of surgical debridement appears not to influence infection risk if performed within 24 hours of injury. Although duration of antibiotics is still debated, high-quality evidence suggests intravenous antibiotic administration no longer than 24 hours after wound closure optimally prevents postoperative infection after open fracture. Routine administration of antibiotics beyond this point is unnecessary in most clinical scenarios and potentially contributes to the development of antibiotic resistance. A summary of our institutional recommendations for prophylactic antibiotic administration is listed in Table 1.","title":"Antibiotic resistance: still a cause of concern?"}
{"_id":"46137e9c-be9a-9839-997d-3d0c2da00cc3","text":"Although the same patient may experience different toxicities during each immunotherapy cycle, the outpatient provider can speak to the family about what toxicity management strategies worked best for specific toxicities. This information can be used to adjust the plan of care for future cycles, with the goal to improve symptom management and safely deliver immunotherapy.","title":"Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications"}
{"_id":"461d9c46-d3f1-78f7-7225-c42f1849c681","text":"When all these data are taken into account, ischemic preconditioning and Botulinum A toxin have similar biochemical effects in the prevention of IRI on days 1 and 10. Our finding of lower MPO levels in the Botulinum A toxin group compared to the preconditioning group at 10 days may show that the Botulinum A toxin continued to protect the tissue from neutrophil-mediated damage on day 10, while the relatively lower tissue NO level in the Botulinum A group may indicate a reduced protective effect of NO or reestablishment of oxidant-antioxidant balance.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"461f971f-e574-b31e-5443-c4810d2ef05f","text":"This series adds to the small body of literature describing the successful treatment with this highly conformal technique. Here, we describe in detail how two unique cases were treated so that it may be replicated for other women who may also benefit.","title":"High-Dose Rate Salvage Interstitial Brachytherapy: A Case-Based Guide to the Treatment of Therapeutically Challenging Recurrent Vulvar Cancer"}
{"_id":"462694c3-361a-829a-1760-ec6512eb3537","text":"Objective To investigate patients considered to have experienced allergic reactions to local anaesthetics administered for dental treatment.","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"462f5489-af6d-4ea5-fc30-f8bdf93883c7","text":"Excellent results over the years have made it possible to perform SLNBs in cases of multifocal neoplasms but only if the overall diameter of the foci is less than 3 cm and always with clinically negative axillary lymph nodes (the multifocality of a neoplasm is the presence of multiple foci in the same breast quadrant).","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"46350893-e70b-6b29-6e4c-f2430cecfa30","text":"In the cases reported in this paper, the infants overcame the initial difficulties in breastfeeding and maintained their normal growth course in the first 6 months of life.","title":"Does neonatal ankyloglossia interfere in the growth of infants during the first 6 months of life? A case series nested in a cohort study"}
{"_id":"4638ffd6-3622-da41-67be-0ac034ea2b7d","text":"Because the study was conducted with patients belonging to a single race who benefited from the national healthcare service, the environmental factor was automatically controlled to increase the reliability of the study. Altogether, this study followed a systematic approach to determine whether there exist variations in the recurrence detection and survival period of patients when treated with different breast reconstruction methods. It is expected that this will be a reasonable basis for the assumption that breast implant or autologous tissue reconstruction does not cause harmful effects in the diagnosis and treatment of local recurrence.","title":"Is There a Difference in the Diagnosis and Prognosis of Local Recurrence between Autologous Tissue and Implant-Based Breast Reconstruction?"}
{"_id":"463f2921-6847-5d31-a759-fc7557309535","text":"All thirteen patients in the present case study were managed initially by the treating clinician, primarily with or without hyaluronidase injections in addition to other treatments prior to admission to the Taipei Mackay Memorial Hospital. Using LDI and needling, in all patients were accurately located the ischemic areas affected by dermal filler emboli and achieved satisfactory outcomes. Although two patients demonstrated skin necrosis, we did not encounter complications from the procedure in any of the other cases. Results of these cases suggest that LDI can be used to determine precisely the target area for treatment and to trace its effects. LDI allowed the accurate identification of areas with vascular occlusion following inadvertent intravascular injection of the dermal filler material with greater precision than visual examination or photographic evidence. These findings thereby support our initial hypothesis that LDI can reliably identify skin perfusion defects without interference from other factors.","title":"Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review"}
{"_id":"4640fdb1-8947-d50e-6f04-b94f976565c3","text":"The aim of the study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of Staphylococcus (S.) epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials.","title":"Systemic and local antibiotic prophylaxis in the prevention of Staphylococcus epidermidis graft infection"}
{"_id":"46432b2b-607c-7714-1946-27efe4baa6e9","text":"Severe allergic reactions to vaccines are rare but can be life-threatening, and it is prudent to raise awareness of this hazard among vaccination teams and to take adequate precautions while more experience is gained with this new vaccine. Patients with a history of severe allergic reactions may be vaccinated with adequate medication and by physicians experienced in the management of anaphylactic reactions if the ongoing investigation in the UK allows this recommendation. PEG is currently considered to have most likely triggered the severe allergic reactions in the 2 affected patients in the UK, but further investigations are awaited.","title":"Severe allergic reactions after COVID-19 vaccination with the Pfizer\/BioNTech vaccine in Great Britain and USA Position statement of the German Allergy Societies: Medical Association of German Allergologists (AeDA), German Society for Allergology and Clinical Immunology (DGAKI) and Society for Pediatric Allergology and Environmental Medicine (GPA)"}
{"_id":"4649cacc-4130-ad2a-4851-e8453c5fba2f","text":"In summary, antibiotic therapy alone seems to have a significantly lower success rate than previously assumed in the case of unexpected intraoperative bacterial cultures from samples taken during prosthesis revision surgery. This underlines the importance of using preoperative diagnostics that are as accurate as possible in order to exclude a periprosthetic infection prior to a revision operation. It is conceivable that the success rates in type 1 infection can be improved by longer antibiotic treatment, a revision with irrigation, debridement and exchange of mobile components, or even an early one-stage septic exchange of the new implanted prosthesis. However, further studies are required to analyze this.","title":"Antibiotic therapy alone does not have a high success rate in cases of unexpected positive cultures in intraoperative samples from hip and knee prosthesis revision"}
{"_id":"464bcac5-1da1-68f7-e9b4-a543e4790611","text":"In certain cases, such as monitoring of buried free muscle flaps or surveillance of arteriovenous loops during preparation for free flaps, the need for an implanted Doppler probe becomes more apparent. Until the cost of implanted Doppler probes is reduced, their widespread use is likely to be limited to special cases such as these.","title":"Cook–Swartz Doppler Probe Surveillance for Free Flaps—Defining Pros and Cons"}
{"_id":"4654b1ad-f2b1-6c23-8d4d-84a92235c934","text":"Flow measurement with a transonic coronary flow probe is always performed after weaning off cardiopulmonary bypass.","title":"Surgical Aspects of No-Touch Saphenous Vein Graft Harvesting in CABG: Clinical and Angiographic Follow-Up at 3 Months"}
{"_id":"4661a972-a196-1099-6151-4199fd584d1e","text":"Submucoperichondrial BTA injection can be considered an effective therapeutic option in patients with persistent AR and idiopathic rhinitis. In comparison with other injection techniques, submucoperichondrial BTA injection has fewer side effects with a longer period of effectiveness, and is easy to perform and is more tolerable for the patient.","title":"Effect of Botulinum Neurotoxin A Injection into the Submucoperichondrium of the Nasal Septum in Reducing Idiopathic Non-Allergic Rhinitis and Persistent Allergic Rhinitis"}
{"_id":"46629fca-76c9-d5fc-eaa2-d7702eaa9334","text":"Deep vein thrombosis (DVT) is a serious complication in stroke patients and may lead to the devastating consequences of a pulmonary embolism. Both pharmacological and physical methods are used to prevent DVT. New insightful research is exploring drugs and laboratory diagnostic parameters that will aid in the early diagnosis and timely management of DVT.","title":"Deep Vein Thrombosis in Acute Stroke - A Systemic Review of the Literature"}
{"_id":"46649c16-9c2c-a73e-6c62-541027d46318","text":"The standard treatment for patients with node negative IB3–IIA2 cancers not treated with surgery and for patients with stage IIB–IVA cancer in the absence of distant metastatic disease is concurrent chemoradiotherapy plus brachytherapy.26–28 Omission of a brachytherapy boost from the treatment package is associated with poorer overall survival.29 30Brachytherapy is the only radiotherapy modality that allows dose escalation to >85–90 Gy without exceeding organs at risk dose constraints and should not be replaced by any external radiotherapy, including intensity modulated radiotherapy or stereotactic body radiotherapy techniques.31 32Several randomized studies have failed to demonstrate the benefit of neoadjuvant chemotherapy before external beam radiotherapy.33","title":"ESGO\/ESTRO quality indicators for radiation therapy of cervical cancer"}
{"_id":"46670f4a-967d-f128-91e9-f0d33f93cc82","text":"The child was admitted to the paediatric ward for further investigation. A CT of the abdomen and pelvis with intravenous (IV) contrast was done which showed a 9 x 9 x 8 cm cystic mass in the distal pancreas. Subsequently, an open biopsy was done because the technology of EUS biopsy was not available. The histology reported a solid pseudopapillary neoplasm of the pancreas and the patient was transferred to a specialized paediatric oncology hospital.","title":"Solid Pseudopapillary Epithelial Neoplasm of the Pancreas in the Paediatric Population: A Report of Two Cases"}
{"_id":"466929fd-0380-b9aa-851a-62130c2931df","text":"Lack of palpable pulse in the dorsalis pedis or tibialis posterior arteries of the foot, or signs indicating impairment of blood flow on Doppler ultrasonography were defined as peripheral arterial disease. Diabetic peripheral neuropathy was defined as the inability of the patient to perceive sensation on at least 1 of 4 plantar sites tested with the 10 g Semmes-Weinstein monofilament. Ulcers were classified based on the diabetic foot ulcer classification of University of Texas (UT). All patients were managed in accordance with DIME, which is a well established and widely recognized wound care protocol.","title":"Antibiotherapy with and without bone debridement in diabetic foot osteomyelitis: A retrospective cohort study"}
{"_id":"4671114c-2438-992f-b23e-f838e2f40113","text":"The positive correlation of high ACAN protein expression and potency of spheroids suggests that ACAN protein levels determine the potency of spheroids to regenerate tissue within cartilage defects after implantation. The level of ACAN protein expression is indicative for the differentiation state of chondrocytes [27, 28]. An increased differentiation state of chondrocytes results in a higher production of ACAN protein. This suggested that chondrocytes that are in a more differentiated state have a higher regenerative capacity as less differentiated chondrocytes. Limitation of the study however is the lack of a direct correlation of the ex vivo potency assay to clinical performance and tissue regeneration in patients. This was due to the fact that the clinical studies and the condyle chip assay were performed separately. It would be important to confirm the correlation of ACAN expression and potency of spheroids in a clinical setting to confirm the proof-of-concept and predictive ability for potency of this ex vivo model system.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"467410bd-9e78-0448-ac3a-b9b0229165bc","text":"This is the largest study of the microbiology of recurrent bone and joint infections reported to date. We find that a broad range of organisms are involved in recurrent infection and that prior microbiological results are not a reliable predictor of organisms identified at recurrent infection. These findings support the practice of giving broad empiric antibiotic treatment after sampling in patients with recurrent infection, until antibiotic treatment can be targeted according to new culture results. While we must continue to identify opportunities to reduce the use of broad spectrum antimicrobial agents, treating narrowly based on previous microbiological results would fail to adequately treat many patients with recurrent bone and joint infection.","title":"Microbial Persistence, Replacement and Local Antimicrobial Therapy in Recurrent Bone and Joint Infection"}
{"_id":"467622a3-89e8-d023-96e2-4bd1cb5f5e21","text":"We evaluated our models in a validation cohort; each regression model was used to predict the specific outcome for the additional ERCPs recorded in 2017 and 2018.","title":"SASE, S uccess and A dverse event S core in E ndoscopic Retrograde Cholangiopancreatography: a Novel Grading System"}
{"_id":"4678ddf9-ac55-34d1-433e-0ed936346f39","text":"Surgery was performed according to a standard procedure in patients with either a positive sentinel node or clinical groin disease. The incision was carried from the apex of Scarpa’s triangle to about 5 cm superomedial to the superior anterior iliac spine. The dissection was carried through adipose tissue to the femoral vascular sheath, the femoral vessels were exposed, and the saphenous vein was sectioned at its femoral entrance and at the apex of Scarpa’s triangle. A separate incision was made in the lower abdominal musculature, leaving the inguinal ligament intact, to provide access to the retroperitoneal space. External iliac vessels were exposed by blunt dissection and retraction of the peritoneum. Dissection of the iliac lymphatic tissue was extended up to the common iliac bifurcation. The obturator dissection was brought through by gentle mobilization of the external iliac vein and the obturator nodes ventral from the obturator nerve were removed. The operation was completed with transposition of the sartorius muscle and insertion of a suction drain. Patients were invited to wear compression socks from the day after the operation up until six months later. No patient underwent adjuvant radiation or systemic therapy.","title":"Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors"}
{"_id":"467c14cc-cc30-67d2-3f34-6166440bbb33","text":"We are aware of the obvious limitations of our study, being the relatively small number of patients analyzed and the retrospective nature of the study. We also recognize that longer follow-up will be needed to compare the tumor control rates with those after different treatment regiments. Nevertheless, this report provides strong evidence for the need of reporting pre-treatment morbidity rates along with the observed toxicity rates to enhance comparability with other studies.","title":"Acute and late toxicity in prostate cancer patients treated by dose escalated intensity modulated radiation therapy and organ tracking"}
{"_id":"4682acca-f952-261a-3105-ed785558a495","text":"Acute cervical osteomyelitis due to an epidural abscess and pyogenic spondylodiscitis in an immunosuppressed patient with progressive myelopathy is a challenge for the reconstructive surgeon. This report presents our novel approach to treat such a condition in a 56-year-old patient in whom antibiotic treatment and decompression of the medulla by laminectomy of C4–C6 failed.","title":"Free Vascularized Fibula Graft as Primary Salvage Procedure for Acute Cervical Osteomyelitis Caused by Epidural Abscess"}
{"_id":"46860c8f-9d79-558f-45d9-61ac3552ba8d","text":"Medpor can be used as dorsal and spreader graft in reconstruction of severe nose deformity with lowest complication rate and without infectious complication and extrusion.","title":"Use of porous high-density polyethylene grafts in open rhinoplasty: no infectious complication seen in spreader and dorsal grafts"}
{"_id":"468ef673-5a7f-4f9d-b167-0ba0a994eac4","text":"In our hospital, we have conducted a multidisciplinary approach to iris and ciliary body melanoma by combining resection surgery with brachytherapy in a few of the initial cases described [8]. The objective of this paper is now to describe our experience over 15 years in the treatment of iris and ciliary body melanoma using a combined approach of resection surgery with brachytherapy or brachytherapy alone. Based on our experience, we aim to describe the best surgical approach, complications in the follow-up and clinical outcomes. The results show how challenging this approach is and we hope it will help to establish the best approach for the treatment of these tumors.","title":"Clinical Outcomes after Surgical Resection Combined with Brachytherapy for Uveal Melanomas"}
{"_id":"469070b9-9a7f-947a-2ff2-5c19709d822d","text":"As can be seen in Table 1 almost all the research is based on trials of one brand; the end result of each is arguably only specific to that brand. This could be another variable on the longevity of effect in itself. Most of the research published has been carried out with editorial assistance or funding by one of the major pharmaceutical companies who produce the toxins. As such visibly unbiased discussion is lacking. The toxins are expensive and a large scale trial with all three of these licensed preparations would require significant funding.","title":"A review of the longevity of effect of botulinum toxin in wrinkle treatments"}
{"_id":"46994671-7498-d84a-f4e4-d755b25cbb8c","text":"In contrast, the boundary positions between branches originating in the ventral and dorsal divisions of the sacral plexus differed between the gluteal and thigh branches. The gluteal branches originating from the sacral plexus are inverted at the inferior border of the gluteus maximus. The boundary displacement observed in the present study may have been caused by a downward shift of the inferior border of the gluteus maximus with the growth of the muscle, which in turn shifts the courses of the gluteal branches.","title":"Origin, course, and distribution of the posterior femoral cutaneous nerve and the spatial relationship among its branches"}
{"_id":"469b90b7-e120-b595-6a14-25f829b357f6","text":"This case also highlights a potential pitfall in frozen section biopsy process before MMS. Prior retrospective studies have demonstrated high rates of accuracy in frozen section biopsy diagnoses for nonmelanoma skin cancers. In addition, Machan et al reported that the majority of patients prefer to have the biopsy and MMS in the same day. In this case, given the clinical exam and this patient’s history of multiple squamous cell carcinomas in the past, the squamous cell carcinomas diagnosis was presumed before frozen section. The patient’s economic and travel situation also warranted frozen section biopsy and same day MMS. Although nonmelanoma skin cancers have been proven to be ideal for frozen section processing, angiosarcoma is not ideal for frozen section processing because the classic dermal vessels and channels with malignant cells are collapsed and obscured by the freezing process. Although frozen section biopsy provides advantages in efficiency and patient satisfaction, this case highlights one of the limitations of the frozen section biopsy process for some pathologic diagnoses and the importance of immunostaining for diagnosis confirmation.","title":"Cutaneous angiosarcoma of the scalp in a pediatric patient with xeroderma pigmentosum"}
{"_id":"469e855f-bdd6-778e-9588-2e059466664d","text":"Sexual dysfunction is the least commonly discussed autonomic manifestation among patients with atypical parkinsonian disorders, yet appears to be one of the most commonly reported patient symptoms, particularly in MSA and PSP.","title":"Neurological update: non-motor symptoms in atypical parkinsonian syndromes"}
{"_id":"469f77d7-d519-8f10-432e-e3447c41234f","text":"New technological developments in the field of ultrasound allow for much improved visualisation of smaller vessel DVT and residual thrombus so there is justification for a new study in this field using the latest ultrasound technology. The research undertaken into the response to treatment of lower limb DVT and predictive factors for recurrence and PTS could inform a more tailored approach to anti-coagulation therapy for the future management of the presenting DVT and for preventing recurrence.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"46aafa2b-421c-f27b-abeb-47787bd16aaa","text":"Virtual surgery planning is best described as an online collaboration between the surgeon, the orthopaedic engineering professional and the biomedical design engineer. During this planning session, the patient’s bony anatomy is studied and manipulated to restore to normal before discussing the implant solution and method of fixation. The surgeon explains the indication and the expected approach, and instructs the engineers on the desired surgical technique. Some surgeons prefer to look through the individual slices of the CT scan, suggesting they have less confidence in the reliability and accuracy of the 3D model; other surgeons have explicit trust in the fidelity of the 3D model. It is often useful to have some transparency in the model to be able to fully assess certain aspects of the pathoanatomy during the planning session.","title":"Putting 3D modelling and 3D printing into practice: virtual surgery and preoperative planning to reconstruct complex post-traumatic skeletal deformities and defects"}
{"_id":"46bbec88-3c8a-2b97-542c-4ad5e6ded39c","text":"This paper describes a simple technique of axillary and breast massage which improves the successful identification of blue sentinel nodes using patent blue dye alone.","title":"Three stage axillary lymphatic massage optimizes sentinel lymph node localisation using blue dye"}
{"_id":"46c06545-76f6-2767-6b84-a690d6d820c9","text":"The work used cryodestruction methods that have been used since the middle of the last century in all developed countries for the treatment of tumors of different localization and do not require any permits or consents. In this paper, we study the reactions of various systems of the body in the process of treating tumors, which allows us to expand our understanding of the indirect influence of cryomethods on various aspects of the pathophysiology of tumors in the process of local exposure and to determine changes in the immune system of the body. This study is not a clinical trial. Therefore, all CONSORT 2010 items do not require a response, since the studies were carried out within the framework of permitted surgical and immune methods. Sponsors did not participate in the design, execution, interpretation, or writing of the research or writing. All subjects gave their informed consent to inclusion before they participated in the study. All clinical, laboratory and immune studies were carried out in accordance with the ethical standards of the Helsinki Declaration.The study protocol contained ethical aspects and information on how the principles of the Helsinki Declaration are ensured.","title":"Immune Status of Pancreatic Cancer Patients Receiving Cryosurgery"}
{"_id":"46c254a7-9763-836d-e736-54402e5764f1","text":"The continuous assessment is made using known and agreed assessment methods.","title":"Factors related to the role of programme directors in association with quality in postgraduate medical education – a cross-sectional study"}
{"_id":"46c4b1ec-b42a-5a69-d722-66816cc2f3e5","text":"The aim of this meta-analysis is to synthetise all evidence comparing FF and PF in the lower limb to define the advantages\/disadvantages of each technique. Our aim is to help guide plastic surgeons in choosing the most adapted surgical strategy for their patients depending on their needs and expectations.","title":"Free versus Pedicled Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies"}
{"_id":"46c809c8-e288-c2fe-f578-e8df4b9c3529","text":"We searched for an explanation for this different result from our study. We observed that the flap revision rate was lower if there was at least one deep venous recipient vessel.","title":"Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team’s Experience"}
{"_id":"46cba083-ddff-cd7b-5cc9-bfc08a074624","text":"The sentinel lymph node identification is usually carried out by preoperative localization using Tc99 colloid and gamma camera or by intraoperative localization using hand held gamma probe or by dye technique. Majority of the centers use a combination of techniques and it has been reported that the triple method using all of the above gives the best results [8-10].","title":"Fallacies of preoperative lymphoscintigraphy in detecting sentinel node in breast cancer"}
{"_id":"46d000f6-1d04-cd57-7218-c38972c7b970","text":"The strengths of our protocol is certainly the result with no residual mark of skin suffering that has been seen in our cases, while the major limitation is the necessary execution of the protocol within 72h from the damage.","title":"Early hyaluronidase use in preventing skin necrosis after treatment with dermal fillers: Report of two cases [version 2; peer review: 2 approved"}
{"_id":"46d0799d-eb5c-d9d6-4eca-2001f638f0c7","text":"Written informed consent was obtained from the patient for publication of this case presentation and any accompanying images.","title":"Calciphylaxis – a challenging & solvable task for plastic surgery? A case report"}
{"_id":"46db2a01-cb81-5b5b-f32f-16011d2b8fcf","text":"This paper will discuss the advances in the surgical management of breast cancer over the last 30 years while also providing an overview of emerging surgical options and the future they bring to the sphere of breast cancer management.","title":"Evolving Trends in Surgical Management of Breast Cancer: An Analysis of 30 Years of Practice Changing Papers"}
{"_id":"46e93e5e-ca14-070a-565c-31f2325d54ab","text":"When bone invasion is suspected, a preliminary study with computed tomography is the best support to calculate the entity of bone resection.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"46ef1d96-7fad-8390-9788-77e40694f039","text":"Modern management of CABG surgery patients emphasizes an early return to normal activities. In this regard early mobilization after surgery plays an important part in the process of recovery. In turn, any reduction in morbidity from the saphenous vein harvest procedure will promote early mobilization and speed rehabilitation.","title":"Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest"}
{"_id":"46f02351-0695-8061-a281-2d7a78c26e31","text":"The patient was posted for elective surgery. Closure of the sinus venosus atrial septal defect via an autologous pericardial patch was planned as shown in Figure 3.","title":"Successful Surgical Management of Incidentally Diagnosed Scimitar Syndrome With Anomalous Connection of the Left Hepatic Vein to Coronary Sinus and Persistent Left Superior Vena Cava"}
{"_id":"46f028eb-d873-86c3-22ff-9818abd0bc94","text":"We also reviewed the postoperative outcomes after surgical intervention for idiopathic scrotal calcinosis.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"46f21f5d-0bbc-85c3-38c7-f6d0787ad7f5","text":"Every effort must be made to avoid tooth extraction in a patient who has received radiotherapy for head and neck cancer with reference to the risk of ORN. Irreversible pulpal pathology or apical pathology should be managed with endodontic therapy where possible. If the coronal tooth structure is compromised in these situations it is still pertinent to consider and evaluate the potential for endodontic therapy followed by coronectomy, thus avoiding tooth extraction. Both the field and dose of radiation should be determined when considering extraction to establish risk. It is now imperative that, on the cusp of this paradigm shift, general dental practitioners begin to liaise with the oncology team looking after the patient to determine the risk of ORN and whether prophylaxis is required. Should multiple teeth require extraction then a staged approach should be taken. This reduces the size of the wound. Loose bony fragments or any bone that is likely to sequestrate from the socket should also be removed at the time of tooth extraction. Achieving primary closure should be evaluated on a case-by-case basis as the amount of trauma to the bone and tissues should be minimised as far as possible. Where doubt exists referral to oral and maxillofacial surgery, oral surgery or special care dentistry is appropriate as collaborative and shared approaches to care are to be encouraged where complexity increases.","title":"The dental management of a mouth cancer patient"}
{"_id":"46f2ba95-1f69-6c3b-c176-591b882431a4","text":"This study thus assumes particular importance because it allows one to identify communication gaps between pharmacists and patients, with negative implications in the adherence and clinical outcome of topical treatments. Future studies focused on the establishment of guidelines to improve the communication of dosage regimen instructions by pharmacists to dermatological patients, could overcome the problems recognized in this study. Furthermore, training programs for the continuous education of the pharmacist should be implemented to solve the identified problems found in this study.","title":"Knowledge and Practices of Community Pharmacists in Topical Dermatological Treatments"}
{"_id":"46f69b49-4355-dca3-a673-a8fbff98aedc","text":"If BFP excisions are made carelessly and too much is removed in patients with slimmer faces, there is the danger of a postoperative gaunt look. Careful evaluation of the face and conservative BFP excision for patients predisposed to the gaunt look is imperative to determine the viability of surgery. Other potential risks associated with BFP excision are injury to the mandibular nerve and the facial nerve. This type of nerve damage might be caused by blind or rough dissection extending over the BFP space. To avoid such injuries, BFP dissection should be always carried out visually and moderately.","title":"Aesthetic Values of the Buccal Fat Pad Excision in Middle-Aged Patients"}
{"_id":"4700986a-98e4-d684-65c8-fd4722638469","text":"The current analysis showed a detailed assessment of risk of second primary tumours following PCa diagnosis. There was a clear increased risk, but patterns by disease stage and treatment were complex and varied for different tumour types. Overall, the findings illustrate the need for careful management of men with PCa as they are more prone to develop another primary tumour.","title":"Incidence of Second Malignancies for Prostate Cancer"}
{"_id":"4708d199-4bff-1b92-0644-b4b4d591f7d6","text":"Better understanding the factors that influence decision of nonreconstruction can help us adapt the information to serve the patient’s personal needs.","title":"Reasons of not having breast reconstruction: a historical cohort of 1937 breast cancer patients undergoing mastectomy"}
{"_id":"47226f08-d1c2-3c38-ca7f-4dde4a0b6333","text":"Total serum antibody, when evaluated by the WHO International Standard, is the accepted method to assess whether a protective response has been raised against hepatitis B. When this method was applied to the assessment of the serum immune response following co-administration, the results indicate that two doses of co-administered vaccine were equivalent to three doses of the injected commercial vaccine. Saving one dose can be significant in terms of cost and logistics when immunizing the general public. This may also indicate that a more robust response is possible that can lead to better protection for poor or non-responders to the injected vaccine. In addition to the serum response, the IgA response using the oral route of administration gave a robust IgA response in both serum and mucosal tissues. This may be beneficial for pathogens that enter through the mucosal route, including hepatitis B transmission in adults.","title":"Co-Administration of Injected and Oral Vaccine Candidates Elicits Improved Immune Responses over Either Route Alone"}
{"_id":"47394efb-dafb-e633-f32f-d1b1cc61d0b3","text":"The virtual simulation software allowed the surgeon to navigate each patient’s anatomy and hide the different structures of the liver as appropriate, to identify the exact location of the tumor and its proximity to blood vessels or biliary branches. Furthermore, virtual simulation of the resection and 3D liver volumetry helped the surgeon during the preoperative planning.","title":"Hyper accuracy three-dimensional (HA3D™) technology for planning complex liver resections: a preliminary single center experience"}
{"_id":"47462bb3-ca2a-0260-8de9-b86a966b4b73","text":"Chronic Q fever infection has a slow healing course. Therefore, the recommended antimicrobial therapy of chronic Q fever infections is a very prolonged duration of at least 18 months. One of the unique features of the present case was the need for prolonged drainage for source control.","title":"Q Fever Vertebral Osteomyelitis Complicating Vertebroplasty"}
{"_id":"474a3d15-1ec3-bcbc-cdc2-7abdc644ff36","text":"Seventy nine patients were randomly assigned to the USS group or the Control (C) group. Of the 80 eligible patients 1 patient randomized in the USS group was excluded due to insufficient data collection at home. The patient characteristics and the surgical details for included patients are summarized in Table 1. There was no significant difference in baseline characteristics between the two groups.","title":"Impact of the Ultrasonic scalpel on the amount of drained lymph after axillary or inguinal lymphadenectomy"}
{"_id":"474c0ace-178a-1f59-5e44-2f1b1bbf5236","text":"Autogenic iliac bone graft is able to offer the activity of osteoblasts and osteogenesis induced by bone morphogenetic protein (BMP) and glycoprotein, meanwhile enclosing bone graft could help keep cancellous bone fragments in close contact around pseudarthrosis of the tibia, allowing the formation of high concentration of glycoprotein and BMP induced by chemical factors because of established the sealing environment in location, all of which could enhance the healing of pseudarthrosis of the tibia.","title":"Wrapping grafting for congenital pseudarthrosis of the tibia A preliminary report"}
{"_id":"474cccb4-f776-a54d-ff00-1cd4907d87b3","text":"The original approach by the Canadian Task Force also did not include explicit judgements about the strength of recommendations, such as how trade-offs between the expected benefits, harms and costs were weighed and taken account of in going from an assessment of how good the evidence is to determining the implications of the results for practice.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"474f42f4-1cd5-ad87-544e-ca8989d2fdee","text":"Inadequate follow-up of newly diagnosed patients in terms of recurrence and metastasis and the retrospective application of our proposed algorithm are the limitations of the present study.","title":"Adequacy of surgical margins, re-excision, and evaluation of factors associated with recurrence: a retrospective study of 769 basal cell carcinomas"}
{"_id":"4751182f-7a4c-93e5-1f0b-2d707e9e1ce0","text":"Unproductive suction that some newborns have due to ankyloglossia and that occasionally causes pain for the mother during breastfeeding and the excessively long breastfeeds which determine the infant's weight gain can be resolved as a result of the action of a multidisciplinary team. A complete oral examination (morphological and functional) must be undertaken which includes the tongue, particularly when feeding problems exist. It is important to rule out abnormalities that can be the cause of sucking problems in breastfeeding.","title":"Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn: Breastfeeding Sessions, Myofunctional Therapy, and Frenotomy"}
{"_id":"4753d40f-733e-6746-62b5-780d13e8ae93","text":"In conclusion, this study has confirmed that the MMC causes a marked increase in lower limb blood flow and is easy to wear and comfortable when in operation. The increase in peak systolic venous velocity and other measures suggest that the MMC may provide an attractive strategy to reduce venous thromboembolism risk in situations associated with prolonged periods of immobility, such as long distance travel. The MMC also has potential to be used as an alternative to the conventional tethered IPC systems commonly prescribed for postsurgical venous thromboembolism prevention in the hospital setting.","title":"Efficacy of Micromobile Foot Compression Device in Increasing Lower Limb Venous Blood Flow"}
{"_id":"475848c1-0157-745d-5069-89fd4ef783ce","text":"In the aesthetic secondary mastopexy-augmentation patient, the preoperative MRI is also beneficial to evaluate for breast cancer, implant integrity, and a great adjunct for preoperative planning and execution. Although not a mandatory prerequisite, it is recommended in complex mastopexy cases. Although one can assume that the dominant blood supply to the NAC is from the superior medial intercostal vessels, to make this assumption in the secondary mastopexy or secondary mastopexy-augmentation patient can result in significant patient morbidity if major lift or implant volumes are added in the subglandular position. Once we identify the predominant or remaining blood supply on the preoperative MRI, we then draw out the pedicle in the preoperative marking area or in the operating room to remind ourselves not to dissect or raise skin flaps in this area. Occasionally, the handheld Doppler is used to map out vessels in the operating room in the position that we are going to operate. It is important to remember that when a patient is undergoing an MRI, they are in the prone position. When marking in the preoperative area, the patient is standing, and when marking on the operating room table, the patient is in the supine position. Taking note of these different positions can make one more comfortable marking over time.","title":"Preoperative MRI to Improve Aesthetic Outcomes in Secondary Mastopexy Augmentation: A Step-by-Step Approach"}
{"_id":"47593980-54a0-90ef-9074-255a5ab80f87","text":"The high fatality rate and lack of effective treatments for cerebral fat embolism highlight the need for preventive measures. We recommend the following measures to minimize the incidence of this life-threatening complication of autologous fat grafting:","title":"Case report and literature review: fatal cerebral fat embolism following facial autologous fat graft"}
{"_id":"475ee623-5105-eee2-8897-e0526c401972","text":"Therefore, which flap do we use to reconstruct extensive scalp defects to achieve a good clinical and surgical result for our patients? Our decisional workflow depends on the characteristics of the patients and the experience of the surgical team. In patients with previous abdominal surgery, the OM flap would be contraindicated, as well as the LD flap in previous axillary surgery. Considering that complications and hospital stay time are similar among the three flaps, we must take into account the availability and location of recipient vessels in order to select a flap with sufficient length of vascular pedicle. If the caliber of the temporal vessels is not good or we foresee that the anastomoses will be difficult due to the distance to the recipient vessels, the OM flap should be avoided because of its shorter vascular pedicle length. We must evaluate the possibility of working in two teams simultaneously and shorten the surgical time, in these cases, we must consider using the ALT flap or the OM flap. Moreover, from the esthetic point of view, if this aspect is a priority, we should consider reconstructing the defect with an OM flap or an LD flap covered with an STSG, avoiding the use of the ALT flap.","title":"Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps"}
{"_id":"47603c3a-b746-76e4-e80d-51baaf3b24ba","text":"A small group of myeloma patients present with a soft tissue myelomatous mass within the spinal canal that can result in spinal cord or cauda equine compression. These patients often present with neurological deficits and each case needs to be assessed individually. MRI scanning is clearly imperative but a CT scan with soft tissue windows will help to delineate whether the neural compression is due to bone or soft tissue. If the compression is due to a soft tissue mass with associated neurological impairment, then this may be amenable to steroids\/chemotherapy and immediate radiotherapy. Patients with cord compression and no neurological deficit may not need radiotherapy because chemotherapy and steroids have been shown to result in excellent resolution of the soft tissue myelomatous mass. Ideally, if patients can be treated with steroids, radiotherapy and chemotherapy and have a very good resolution of their symptoms in 24 h, then they may not need surgical decompression and stabilisation. All decisions regarding patients with spinal cord compression need to be taken into conjunction with an experienced spinal surgeon. Clearly, if a patient has spinal cord or cauda equina compression and has significant neurological sequelae then they may require urgent surgical decompression and associated fixation. The aim however in patients with haematological malignancies should be to try and avoid placement of screws\/fixation of the spine. The metalwork has a higher than normal risk of failure because the bone is very weak due to MM causing secondary osteoporosis. In addition, there is a higher risk of metalwork infection because the patients are immunosuppressed during their conventional chemotherapy, immunotherapy and stem cell transplantation. After resolution of the intraspinal mass with chemotherapy, radiotherapy and steroids the fractured vertebra may need to be augmented with cement to treat the acute fracture pain but also to give mechanical support to the anterior and middle columns of the spine57 thereby preventing further collapse of the vertebral body. Further collapse, particularly into kyphosis, may lead to spinal cord compromise because of the deformity.","title":"The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG)"}
{"_id":"4761613d-0481-9484-8963-6862d859ff54","text":"When an adverse event occurs as a result of a dental local anaesthetic injection, the true nature of the problem should be considered carefully. It is important NOT to suggest that an allergic response has occurred when the clinical events are consistent with well-recognised common causes of adverse reactions to dental injections. Most adverse reactions are avoidable with attention to technique.","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"476aad3a-e630-48f1-8b5d-9e5a5fc53f53","text":"Adipose tissue is selectively susceptible to cold injury. Our laboratory was the first to demonstrate that controlled topical cooling of adipose tissue induces subcutaneous fat reduction via cryolipolysis. Selective cryolipolysis with topical cooling has been widely used in patients to reduce subcutaneous fat in various body parts, and studies have not shown any changes in serum lipids or markers of liver function. Although this non-invasive method of fat reduction is appropriate for targeting subcutaneous fat, VAT is well beyond the depth limit for treatment by topical cooling. We recently developed a novel method of selective fat reduction using a biocompatible injectable ice slurry. Similar to topical cooling, slurry is able to induce cryolipolysis and selective reduction in subcutaneous adipose tissue without any damage to surrounding tissues. Injection of slurry in subcutaneous adipose tissue was also shown to be safe in human subjects and effective in inducing cryolipolysis. This simple and injectable method of selective fat reduction can potentially allow adipose tissue at any anatomic location to be targeted, thus expanding the medical indications and applications for which selective cryolipolysis can be used. In this study, we hypothesized that injectable ice slurry can be used for safe and effective reduction of VAT and lead to weight loss in obese mice. Using histological and transcriptomic studies we also sought to determine the potential mechanism of slurry induced VAT reduction.","title":"Selective reduction of visceral adipose tissue with injectable ice slurry"}
{"_id":"476b6060-2709-148e-3684-cee36db72096","text":"The trial is expected to define the role of NPWT in SSI prophylaxis for lower limb revascularization in high-risk vascular patients. The results of the study will be used to inform current best practice for perioperative care and the minimization of SSIs.","title":"Negative pressure wound therapy for high-risk wounds in lower extremity revascularization: study protocol for a randomized controlled trial"}
{"_id":"476c6af8-06d6-dd22-e105-2966801ef88f","text":"Limitations include the impossibility of analyzing age-standardized incidence. Based on the Verhulst model, results suggest that it is still relevant to follow up TC incidence and sperm cryopreservation in order to confirm or refute the potential decrease already observed in this disease.","title":"Sperm cryopreservation incidence in men with testicular cancer: towards a stabilization in testicular cancer incidence? Results from the CECOS network"}
{"_id":"477304ce-635b-f6e0-4752-28f585090884","text":"Topical drug therapy is an important treatment modality in psoriasis treatment, and patients with psoriasis are often unclear about the dosage and method of topical drug administration. The correct dosage and method can greatly improve the therapeutic effect of drugs on the lesions and reduce drug wastage. Evidence 7 to 11 indicate the specific dose usage and need for topical medications in patients with psoriasis vulgaris. Skin lesions are important factor that aggravates the treatment burden, and thus their removal is an urgent requirement. Skin lesions cause a further deterioration of quality of life, including that of physical, mental, and social health status. Nevertheless, it can have a positive side regarding its educational role and behavioral improvement in patients that can promote their health self-management. Medical practitioners should actively train patients in applying correctly drugs topically by rubbing and teach them to use more effective methods and approaches for the treatment of different skin lesions as well as medications to promote their recovery. For example, important points are how to calculate the precise dosage of topical medications and how to choose the massage technique to be applied, as well as the sealing packs and wet compresses to promote the absorption and efficacy of topical medications.","title":"Self-management of psoriasis vulgaris treatment burden: A Review"}
{"_id":"4773f13f-1112-23f7-e5dd-14555987cda3","text":"In these cases, management of lymph node dissection is necessary for definitive surgical treatment, but there are no clear answer and no established evidence about how to treat lymph nodes in the literature. Some surgeons do not examine the popliteal fossa, do not perform popliteal node biopsy, or consider the presence of popliteal metastasis positivity as an indication for inguinal dissection.","title":"Long-Term Treatment Outcome after Only Popliteal Lymph Node Dissection for Nodal Metastasis in Malignant Melanoma of the Heel: The Only “Interval Node” Dissection Can Be an Adequate Surgical Treatment"}
{"_id":"4779ac98-9ae7-a690-9ac8-3e1e7e4eef8c","text":"This case series demonstrates a novel use of combined Hydrus implantation and OMNI canaloplasty in a heterogenous group of phakic patients with uncontrolled IOP on maximum tolerable medical therapy.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"477a9b4d-8630-ad49-da63-0c2f9163750e","text":"The following issues could have been related to the necessity for a repeat frenotomy procedure.","title":"Complications and misdiagnoses associated with infant frenotomy: results of a healthcare professional survey"}
{"_id":"477d1c48-eaa8-8efe-b3b9-5030cb86e3fb","text":"The utilization of fresh frozen cartilage allograft for revision labiaplasty provides an exciting and promising addition to the evolving field of gender affirmation. Effective in providing structural as well as aesthetically desirable results elsewhere, cartilage graft can demonstrate similar outcomes when utilized for labiaplasty.","title":"Revision Labiaplasty After Penile Inversion Vaginoplasty Using Costal Cartilage Allograft"}
{"_id":"477ef09e-ba97-e6ce-72e6-700a0a8fa11f","text":"Cervical cancer is a leading cause of mortality in women worldwide. Staging and management of cervical cancer has for many years been based on clinical exam and basic imaging such as intravenous pyelogram and x-ray. Unfortunately, despite advances in radiotherapy and the inclusion of chemotherapy in the standard plan for locally advanced disease, local control has been unsatisfactory. This situation has changed only recently with the increasing implementation of magnetic resonance image (MRI)-guided brachytherapy. The purpose of this article is therefore to provide an overview of the benefits of MRI in the evaluation and management of cervical cancer for both external beam radiotherapy and brachytherapy and to provide a practical approach if access to MRI is limited.","title":"A practical review of magnetic resonance imaging for the evaluation and management of cervical cancer"}
{"_id":"47916530-ed84-cd78-1290-548a76203ce3","text":"Table 1 Comparison of all Afya Bora Fellowship alumni to the subset of survey respondents","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"4792a583-b03b-1887-2fe8-57b4b680770d","text":"Our results show that US is a very reliable alternative in evaluating breast implant integrity and could be the investigation of choice for implant rupture, while MRI could be advocated only in inconclusive cases. Uneven implant shell was found to be the most important US sign of breast implant rupture. Based on the findings, we recommend performing a US examination after breast augmentation surgery with silicone gel-filled implants annually.","title":"The Value of Ultrasound in the Evaluation of the Integrity of Silicone Breast Implants"}
{"_id":"479efb17-eea1-f587-699e-96105d099411","text":"Direct volume measurements were performed by using a water displacement technique undertaken by the same team member (breast care nurse) in the operating room on each occasion which is performed as a standard procedure due to ongoing studies since 2008. The excised breast tissue was placed in a cylinder of known volume. The specimen was then submerged in the cylinder, and the volume of the displaced water was measured. The validity and reproducibility of this method was confirmed by submerging breast implants of known volume into the cylinder and assessing the water volume displaced.","title":"Intraoperative ultrasound reduces the need for re-excision in breast-conserving surgery"}
{"_id":"47a1df1c-1f73-ccfb-9177-7e104b6a0bba","text":"Following this initial screening, we found 152 articles that met our inclusion criteria. The full texts of these remaining articles were reviewed to identify reports of true single-stage procedures. All patients within these studies were required to have met appropriate diagnostic criteria for chronic osteomyelitis including classical radiological features, with positive microbiology tissue cultures or histology. Articles excluded at this stage included those where multiple or staged debridements had been planned or where external fixation was utilised for stability, which would require additional procedures for adjustment or removal.","title":"A systematic review of the single-stage treatment of chronic osteomyelitis"}
{"_id":"47a81f10-f841-c6bc-2cbd-49dd45844e62","text":"This case report highlights the importance of MRI in diagnosing any knee swelling, which can vary from normal joint effusion to extensive tumor-like conditions that can be benign or malignant. It also tells us about the involvement of soft tissue structure around the joint, extra-articular involvement, and some bony involvement details. MRI helps categorize the disease in diffuse and localized forms and delineates the involvement of different structures around the joint. It helps in surgical planning and also helps in assessing the need for radiotherapy since the recurrence of this condition is higher.","title":"Magnetic Resonance Imaging (MRI) Findings in a Case of Pigmented Villonodular Synovitis of the Knee"}
{"_id":"47a855b3-659a-4b0e-7206-a835718a5130","text":"The superficial sural artery was marked out with the aid of a Doppler probe in the midline of calf one palm breadth below the knee joint crease. A pattern of the defect was cut out and the flap was planned in reverse dimensions and then marked out with the help of the pattern. An island subcutaneously pedicled fasciocutaneous flap based on the median superficial sural artery and the distal perforators of the peroneal and posterior tibial artery was harvested. Authors in this studies included as many superficial veins as possible in the subcutaneous pedicle. A diagrammatic presentation of the flap pointing surgical anatomy in placed at Figure 1; the shaded area depicts the proximal extension of flap territory in upper third of leg, the mesentery like structure connects sural neuro-vascular structures to deep fascia.","title":"The Clinical Outcome of Perforator Based Sural Artery and Propeller Flaps in Reconstruction of Soft Tissue of Extremities"}
{"_id":"47aa8251-9841-6b8f-6ce4-90f18a88e7e2","text":"• Complications can occur throughout the postoperative course and early detection is critical","title":"Imaging of lumbar spinal surgery complications"}
{"_id":"47af94ec-4648-52d0-f39e-159b3c451307","text":"By conducting this survey and collecting data on the difficulties faced by overseas surgical trainees, the study aims to raise awareness about these challenges and provide valuable insights for stakeholders involved in surgical training. The findings from this survey can inform policymakers, educators, and healthcare leaders on potential areas for improvement and support mechanisms that can enhance the training experience for foreign graduates in the UK. In this study, a comprehensive survey consisting of 33 questions was designed by three surgeons from the Kingston Hospital NHS Foundation Trust. The survey was disseminated via TUGSS and was distributed globally to surgical doctors via email and social media. This survey targeted the overseas surgeons who are currently practising or aiming to practice in the UK. Surgeons were invited to share it freely via social media platforms. The survey was designed in English and closed for data analysis on November 5, 2022.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"47b19664-bbda-995c-d0e9-0922237b3603","text":"An impairment in semen quality was found in almost half of the samples from patients with testicular cancer, only few patients had azoospermia or severe oligozoospermia; sperm cryopreservation significantly reduces sperm motility and total motile sperm count and very few patients use their frozen sperm for reproductive purposes.","title":"Semen quality before cryopreservation and after thawing in 543 patients with testicular cancer"}
{"_id":"47b6a875-5430-aa58-0ca5-f78913a3da58","text":"DM dynamics is not influenced by the extent of conservative primary tumour resection and is similar for both ER phenotypes across different metastatic sites, suggesting similar mechanisms for tumour development at distant sites despite apparently different microenvironments. The IBTR risk peak delay observed in ERP tumours is an exception to the common recurrence risk rhythm. This suggests that the microenvironment within the residual breast tissue may enforce more stringent constraints upon ERP breast tumour cell growth than other tissues, prolonging the latency of IBTR. This local environment is, however, apparently less constraining to ERN cells, as IBTR dynamics is similar to the corresponding recurrence dynamics among other distant tissues.","title":"Recurrence and mortality according to Estrogen Receptor status for breast cancer patients undergoing conservative surgery. Ipsilateral breast tumour recurrence dynamics provides clues for tumour biology within the residual breast"}
{"_id":"47c1cc83-2c85-365d-a622-bd9c7c7c3412","text":"The foundation of the Fellowship rests on four pillars, with the goal of training physicians proficient and credible in climate and health science capable of assuming leadership positions, disseminating knowledge and influencing policy:","title":"Creating climate-informed physician leaders: The evolution of a physician fellowship in climate and health science policy"}
{"_id":"47c78fa0-9aff-83aa-0368-c409862fb504","text":"The flap was still intact and attached to the adjacent attached gingiva.","title":"A Novel Single-Stage Procedure for Increasing the Width of Attached Gingiva and Eliminating the Aberrant Frenal Attachment"}
{"_id":"47cb4388-4b7c-97eb-706f-35eea682015b","text":"The analysis of the differences between groups in consecutive checkpoints is shown in Table 3. Significant variations in pain intensity were found for the BTA group versus SS group from day 14 and versus LD group from day 7, which was maintained until the end of the study, indicating that the improvement was prolonged.","title":"Treatment of Localized and Referred Masticatory Myofascial Pain with Botulinum Toxin Injection"}
{"_id":"47d32d55-739b-6f1c-4b0b-78072fadf52f","text":"The objective of this study was to investigate the prognostic factors for developing parotid and neck metastasis in reCSCC and laCSCC of the head and neck region and to evaluate the parotid treatment and neck dissection treatment results.","title":"Parotidectomy and neck dissection in locally advanced and relapsed cutaneous squamous cell carcinoma of the head and neck region"}
{"_id":"47dbc69a-d2fb-5fbb-318a-c3515954229a","text":"Ward et al hypothesized that the patient's superior gluteal artery was injured with the guidewire when the surgeon was trying to find the proper starting point. We hypothesized that such an injury likely occurred in our case and therefore recommend extreme caution with guidewire placement and particular attention to not overmedializing the starting point. To avoid medialization of the guidewire, an incision of sufficient size and location is key to find the correct starting point for the guidewire. An incision that is too small or too close to the greater trochanter may force the guidewire medially and disrupt the proper angle for entry into the greater trochanter. Fluoroscopy is crucial to visualize the greater trochanter for guidewire placement. AP and lateral x-rays are important for determining a correct entry point, especially if the leg is rotated or abducted\/adducted for reduction. Small variations from a true AP or lateral x-ray may be deceiving by giving the impression that the guidewire is at an ideal starting point, but the position may be more medial than desired.","title":"Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation"}
{"_id":"47e1b76e-7d0f-60da-db1d-6da19cef627a","text":"Further investigations undertaken to stage the tumour included a repeat CT scan which presented no evidence of significant bony involvement or erosion. An MRI scan showed no significant asymmetry or signal abnormality in the region of the hard palate, and there was no evidence of loco-regional metastasis of this tumour.","title":"A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient"}
{"_id":"47e27673-c600-ee06-b679-c18336c8da22","text":"There is no clear evidence for the superiority of colloids over isotonic crystalloids in fluid resuscitation, and crystalloid resuscitation has been associated with a lower mortality rate in trauma patients, although the data from this study was not powered enough to influence clinical recommendations. There is divergent data to suggest that, specifically, in the development of ARDS, fluid resuscitation with albumin solutions may be beneficial, because the oleic acid will bind to albumin reducing its potential to induce oedema. Furthermore, the use of albumin when combined with furosemide in patients with ARDS tends to improve oxygenation and may reduce length of ventilation60.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"48003bf5-3c99-4fc0-7a98-3beae65bdab4","text":"The proportion of women diagnosed with breast cancer who retain a breast at 4 years is strongly associated with age, and presence of comorbidities. There was significant variation between Cancer Networks indicating that women’s experience in England was dependent on their geographical location of treatment.","title":"The Proportion of Women Who Have a Breast 4 Years after Breast Cancer Surgery: A Population-Based Cohort Study"}
{"_id":"4804c64e-f40a-83a2-a6e3-1daed946afac","text":"Limitations of this study were that the follow-up time is relatively short and no direct comparison with standard treatment or analysis of the risk of treatment failure was implemented. Osteomyelitis may recur years later, despite what appears to be a successful recovery. A longer follow-up period is needed to avoid overestimating the efficacy of the treatment. A future randomized controlled trial is considered to improve understanding of the efficacy and safety outcomes of using nHA-ATB beads in chronic osteomyelitis patients. In addition, the cost of the treatment analysis by using nHA-ATB beads in comparison to standard treatment should be performed to justify the financial benefit of using it as an alternative product of choice for chronic osteomyelitis treatment.","title":"Efficacy and Safety of Antibiotic Impregnated Microporous Nanohydroxyapatite Beads for Chronic Osteomyelitis Treatment: A Multicenter, Open-Label, Prospective Cohort Study"}
{"_id":"4808989a-c423-97dc-2f9f-502046f94937","text":"There are several ways in which the PEFs could be delivered during cryosurgery. Currently, typical PEF devices operate only between two electrodes at a time, even when multiple electrodes are inserted in the tissue. Therefore, in a first application modality, one thermally active cryoprobe would be connected to one pole of the power supply. The second pole (or ground) could be connected either to a second cryoprobe inserted into the tissue or to a remote ground pad; for instance on the leg, like during radio frequency ablation. The combined Cryosurgery\/PEF effect takes place primarily in regions of tissue in which there is freezing and thawing. Therefore, we anticipate that in typical procedures, the PEF will be delivered at the onset of freezing and through freezing and thawing. To take advantage of the ability of medical imaging to detect the extent of freezing, we anticipate that real time imaging with ultrasound or CT will be employed during the Cryosurgery\/PEF procedure and in this way ensure that the PEFs are delivered only in the desired cooled area, with real time control over delivery. In this study we have shown only a few of the possible combinations in which this procedure could be used. It is quite obvious that multiple combinations of cryoprobes or different combinations of cold and heat are possible as a way to increase or reduce the magnitude of the PEFs in desired regions of tissue.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"4815beeb-092d-5b55-c13e-9f517c36e8a4","text":"Despite the small number of cases, our experiences can demonstrate that even in late haematogenous infections, caused by rare microorganisms, such as the two cases described, using otherwise well defined guidelines and procedures available to modern orthopaedics for the treatment of infectious complications, it is possible to achieve fast recovery and successful long term results without risking further recurrence. The fast and meticulous eradication of the infection is paramount as such serious infections can be life threatening. The advantages and disadvantages of available treatment options have to be weighed, with emphasis on the patients' medical status. Not confining treatment to established patterns can result in quick and effective treatment even in very serious infections such as Salmonella infections.","title":"Successful treatment of late Salmonella infections in total hip replacement - report of two cases"}
{"_id":"481859fd-992b-bc62-2715-d5824f44bf08","text":"Limitations of the CLOTS trial 3 include the imperfect blinding of the ultrasonographers which could bias detection of our primary outcome, and our inability to blind patients and caregivers which might bias assessment of some of the secondary outcomes. Other limitations included: lack of screening logs; lack of central verification of negative scans or 100% source data verification, but we consider these are unlikely to introduce bias or alter the external validity of the results.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"4823fdcd-73ad-a473-eed4-9d49ba86fe4a","text":"This study suggests that SXRT is a reasonable treatment of N-MSC and should be considered as an option when deciding therapy.","title":"Head and Neck Non-Melanoma Skin Cancer Treated By Superficial X-Ray Therapy: An Analysis of 1021 Cases"}
{"_id":"482e4adf-9143-61a4-12d2-b786a3faa4e9","text":"All patients provided informed consent for inclusion in the study and consent was obtained from Case 3 patient for publication of individual information and accompanying images. The study was authorized by the Medical Ethics Committee of Nanjing Drum Tower Hospital and was performed in accordance with the ethical standards of the 2013 Declaration of Helsinki.","title":"Antibiotic-impregnated cement spacer as definitive management for osteomyelitis"}
{"_id":"483e3257-95cc-9b83-1874-af5c92aa4b97","text":"In the last couple of years it has been demonstrated that the axillary conservative surgery indication, limited only to the dissection of the sentinel lymph node (not completed by an axillary lymphadenectomy, the way it was recommended in previous studies), can be extended in case there is only one or two sentinel metastatic lymph nodes, if a limited breast resection followed by the conventional irradiation of the whole breast with fractionate doses is performed in these patients.","title":"Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer"}
{"_id":"484745bb-d789-a270-22ab-e4d6bf1e0984","text":"When comparing the TNM classification and stage grouping of the patients to the staging based solely on harvested SSLNs, for 283 of 285 patients the staging remained the same. The N category would have changed in six out of seven patients who had positive PSLNs. The patient who had metastases only in PSLNs would have been upstaged from IIA to IIIB group. In addition, one patient would have been upstaged from IIIC to IIID group.","title":"Pelvic sentinel lymph nodes have minimal impact on survival in melanoma patients"}
{"_id":"4847cf11-b0b6-a224-7131-a163624b1373","text":"Retrospective descriptive study in 3 pediatric rheumatology centers in Bogota during a period of 20 years. Two groups were identified according to the presence or absence of clinical and radiological signs of calcinosis after a minimum of 2 years of follow up.","title":"Calcinosis as a complication of juvenile dermatomyositis (JDM)"}
{"_id":"484a95ab-3881-071a-3124-857761e9c842","text":"On the basis of these positive results, we have been working closely with our radiation oncology department to design and implement an IRB-approved protocol to perform a larger study to prospectively evaluate the influence of postoperative radiation on implant-AlloDerm constructs. Our radiation oncologists limited the size of the current study as they believe immediate tissue expander and even autologous tissue reconstruction following left-sided mastectomy might prevent adequate delivery of radiation and necessitate an excessive cardiac radiation dose. They have since determined that most women with implants can be sufficiently treated, and that a preoperative chest computed tomography simulating pre-XRT mapping can help identify this small subgroup of patients who are not good candidates for preradiation implant or autologous reconstruction based on their chest wall dimensions.","title":"Immediate Breast Tissue Expander-Implant Reconstruction With Inferolateral AlloDerm Hammock and Postoperative Radiation: A Preliminary Report"}
{"_id":"484cbe65-1fc1-6169-ef78-70d8343c454d","text":"Topical biologics are heavily dependent on the healthcare personnel administering the topical. In any type of wound, effective debridement is key to the ability of the growth factor to reach the endothelial cells. Hence, the skill of a healthcare worker also plays a large role in the efficacy of the biologic, and this would be a factor that is difficult to standardize across RCTs.","title":"Topical Biological Agents as Adjuncts to Improve Wound Healing in Chronic Diabetic Wounds: A Systematic Review of Clinical Evidence and Future Directions"}
{"_id":"48568a6d-3df6-c3d2-8ab5-bf6f2a375b05","text":"This study found high prevalence of Staphylococcal osteomyelitis among patients underwent surgical treatment at Bugando Medical Centre with a third of these patients infected with MRSA. Fever was statistically significant associated with positive Staphylococcal osteomyelitis. There is a need to tailor antibiotic management of osteomyelitis based on culture and sensitivity patterns for the better outcome of the patients.","title":"Methicillin resistant Staphylococcus aureus causing osteomyelitis in a tertiary hospital, Mwanza, Tanzania"}
{"_id":"4859bfff-ba37-a986-e30e-0a24da472e12","text":"The compound free microvascular fibular flap seems to be suitable to minimize the number of surgical procedures and to maintain as much functional capability as possible for the patient. Moreover our results illustrate the versatility of this osteocutaneous flap in the reconstruction of extremities after sarcoma resection since most long bones of the extremities could be bridged. We emphasize that the vascularized fibula graft should be considered a reconstructive option for salvaging limb function where a massive bone defect results from wide resection of malignant tumor in the extremities as it may leads to an improvement of the quality of life for the patients.","title":"The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection"}
{"_id":"485bf0d2-80cd-af50-29f1-de7da28ff47a","text":"The great saphenous vein is the major superficial vein of the lower limb, and also the most often used as arterial graft material for lower limb revascularization. Prior knowledge of the quality of the vein can guide choice of therapeutic strategy, avoiding surgery that is doomed to failure. Discrepancies between intraoperative findings of the quality of the great saphenous vein and imaging tests are also frequently observed.","title":"Correlations between ultrasound, tomographic, and intraoperative measurements of the great saphenous vein used as an arterial graft"}
{"_id":"485d6bf0-6d57-dd05-fe10-46e441a0b233","text":"TPVB injects the local anesthetic into the paravertebral space, which is anatomically close to the pleura. There is a risk of accidentally injecting the local anesthetic into the blood vessels or hemopneumothorax with traditional blind penetration. The ESPB technique is to inject the local anesthetic between the plane of the erector spinae and the transverse process of the thoracic spine, which can greatly avoid the occurrence of pneumothorax due to the anatomical positioning of the transverse process of the thoracic spine with improved safety [20].","title":"Ultrasound-guided single thoracic paravertebral nerve block and erector spinae plane block for perioperative analgesia in thoracoscopic pulmonary lobectomy: a randomized controlled trial"}
{"_id":"48697759-0485-933a-c231-8390a37ccea4","text":"Nine lymph nodes that were palpable and sized more than 1 cm or had suspected metastasis detected on PET\/CT or 2DSWE were eligible for analysis, with a histopathological image available for each.","title":"Usefulness of 2‐D shear wave elastography for the diagnosis of inguinal lymph node metastasis of malignant melanoma and squamous cell carcinoma Y. Kawahara et al."}
{"_id":"486b4603-5cff-77b1-3481-eda3500cf361","text":"Most common manifestation of immediate hypersensitivities to cefaclor was anaphylaxis in which IgE mediate response is the major pathogenic mechanism. Detection of serum specific E and IgG subtypes to cefaclor-HSA conjugate may be useful to diagnose cefaclor anaphylaxis. The IgG subtype- mediated response was suggested in some cases of cefaclor anaphylaxis.","title":"Allergic diseases of the skin and drug allergies – 2026. Immunologic evaluation of the patients with cefaclor hypersensitivity"}
{"_id":"486c8b3c-a7cc-222c-cbfc-0bfb436f1461","text":"BAP1 is a protein that is encoded by the BAP1 gene. This protein plays a role in the regulation of cell growth and division. It is also involved in the repair of DNA damage. Some studies have suggested that BAP1 may play a role in the development and progression of melanoma. The precise role of BAP1 in melanoma is not yet fully understood. It was suggested that BAP1 may interact with other proteins involved in DNA damage repair, such as TP53 and BRCA1, in the context of melanoma. BAP1 may also interact with signaling pathways that are involved in the regulation of cell growth and division, such as the MAPK and PI3K pathways.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"487453b5-30a7-65f5-95c6-190056035703","text":"This study aims to identify the knowledge of pharmacists about dermatoses and their treatment, and to compare the perspectives of pharmacists with those of patients regarding treatment information, with the future goal of establishing clear guidelines on the communication of dosage regimen instructions by healthcare professionals to dermatological patients and promote treatment adherence.","title":"Knowledge and Practices of Community Pharmacists in Topical Dermatological Treatments"}
{"_id":"4877c891-39fa-5fcf-e9ae-390012149b9e","text":"We examined specific clinical characteristics associated with NMSC recurrences following MMS.","title":"Clinical Characteristics of Non-Melanoma Skin Cancers Recurring within 5 years after Mohs Micrographic Surgery: Single Institution Retrospective Chart Review"}
{"_id":"4878f6c3-5311-3d99-a74f-052f18f00309","text":"Table 3 summarizes the randomized prospective trials that assess SBRT in a strategy of treatment intensification for IR and HR disease.","title":"Stereotactic Radiation Therapy versus Brachytherapy: Relative Strengths of Two Highly Efficient Options for the Treatment of Localized Prostate Cancer"}
{"_id":"487eec88-7dc4-d92b-50db-211eacbb2a8e","text":"First, to confirm the stability of luminescence of the wirelessly powered implantable LED device in a mouse, the device was implanted into the subcutaneous cavity just below the tumor to monitor the light emission.","title":"Metronomic photodynamic therapy using an implantable LED device and orally administered 5-aminolevulinic acid"}
{"_id":"487ef6de-05e3-9aca-bae5-52c90a00e053","text":"Intraoperative ultrasonography is a safe and readily available tool that improves success of surgical removal of plant material within the iliopsoas abscesses via ventral midline laparotomy. Moreover, ultrasonographic findings of unusual plant material can be useful in planning and guiding surgical removal, by providing information about the size and shape of the foreign body.","title":"Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs"}
{"_id":"48893dba-12fd-2d52-2b63-a957df61ba8a","text":"The technique of sentinel lymph node biopsy used in this study was described by Cabanas in 1977 and further developed by Horenblas et al. In summary, it involves injection of nanocolloid at the base of the penis followed by lymphoscintigraphy, with radioactive tracer seen to drain into the left and right inguinal basins. The sentinel nodes are marked and, with the aid of patent blue dye, injected circumferentially around the penile shaft. The nodes are removed through a small inguinal incision.","title":"Trial of ligation versus coagulation of lymphatics in dynamic inguinal sentinel lymph node biopsy for staging of squamous cell carcinoma of the penis"}
{"_id":"488f11ec-237a-ef66-7eec-2bca4bb898dd","text":"Surgical treatment aims to achieve negative resection margins, removing any adjacent organs and structures involved. The resection of a retroperitoneal sarcoma of remarkable size is a challenge for the surgeon owing to the anatomical site and the absence of an anatomically evident vascular lymphatic peduncle that makes it hard to obtain safe margin and to the adherences with the contiguous organs. Therefore, the retroperitoneal liposarcoma shows a high rate of local recurrence after surgical excision. Dedifferentiated histologic subtypes and negative surgical margins are associated with poor prognosis [11].","title":"Giant recurrent liposarcoma of the retroperitoneum – A surgical challenge: A case report"}
{"_id":"4891f73a-f92b-1c3b-5cb6-4096cd26b2de","text":"While some referred to surgeons losing their medical skills and having a limited capacity to engage with patients, not all saw this stereotype as problematic, and it was often discussed in humorous terms:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"489ce946-ffc7-15aa-52d8-699dd9889df4","text":"Of the 16 women, one patient had a small tumour selected on MRI that was occult on conventional imaging and was able to undergo sentinel node biopsy. In the remaining 15 patients, one small 3 mm lesion was found at surgery and the patient had to have axillary dissection.","title":"Screening breast MRI in high-risk women undergoing prophylactic mastectomy"}
{"_id":"48ab6d27-0de2-ac6f-2b42-c1156d6b701f","text":"In order to reduce the risk of implant related complications soft tissue coverage of the implant should be adequate. In patients where this soft tissue coverage is either deficient or not approved by the patient, lipofilling can play a role as an adjunct procedure that provides additional support to implant coverage.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"48af9acf-f259-e3ec-eb80-07cf6068db51","text":"75 hands of 40 patients were undertook the reconstruction in CGMH in the past 3 years.","title":"Abstracts from the 12th Asia Pacific Burn Congress Singapore. 14-17 August 2019"}
{"_id":"48b43570-b8fc-50f6-c598-e002d21ca027","text":"Another function of this organ is represented by sensitivity, in fact it consists of numerous nerve endings that detect changes in temperature and pressure and mediate the sense of touch and sensitivity in general.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"48bb9ca5-fc91-d0ce-e9b1-8514ae438b61","text":"The primary outcome of this review was incidence of DVT in patients prescribed aspirin for VTE prophylaxis hip or knee arthroplasty surgery.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"48bf9210-50f3-10bb-b995-38ff7b899cc7","text":"The aim of this study was to examine whether the 21st century surgeon still has a role to play in the diagnosis and management of lymphoma.","title":"Does the surgeon still have a role to play in the diagnosis and management of lymphomas?"}
{"_id":"48c7aed1-d6f0-42db-4597-ea7b35ba1e52","text":"Calciphylaxis cutis is a possible adverse event observed with FGFR inhibitor therapy. Although considered a rare disease in the general population, clinicians treating with FGFR inhibitors should be aware of this possible adverse event as early identification and intervention may improve patient outcomes. The precise mechanism of calciphylaxis cutis in association with FGFR inhibitor therapy is unclear and warrants further investigation.","title":"Calciphylaxis Cutis Associated With Fibroblast Growth Factor Receptor (FGFR) Inhibitor Therapy: A New Challenge"}
{"_id":"48cd132c-ec92-e93d-22f3-f77e6eb034ca","text":"Although most cases of hematogenous osteomyelitis resolve with antimicrobial therapy alone, surgical intervention may be required in patients who do not respond to antibiotic treatment for the suspicion of an underlying complication, to control the focus of infection and preserve joint function.","title":"Minimally invasive management of pediatric osteoarticular infections"}
{"_id":"48ce778b-0ff2-a222-a3c5-be96a4e44864","text":"Synthetic materials have been used for repairing nasal trauma, but they can yield an unnatural appearance and are prone to infection or dislocation. Chondrocytes provided from fully mature nasal septum cartilage are the other alternative to reconstitute the nasal alar lobule and to repair articular cartilage defects with regenerative properties that has warranted their translation into clinical scenarios [160]. As chondrocytes have limited proliferation potential and tendency to dedifferentiate, addition of MSCs for cartilage tissue engineering in regenerative medicine has become one of the most intriguing candidates without undesirable features in rhinoplasty and rhinosinusitis [160].","title":"Achievements and Challenges in Transplantation of Mesenchymal Stem Cells in Otorhinolaryngology"}
{"_id":"48f01917-7389-cf15-283a-905ea390d771","text":"When node metastasis of lacSCC are detected with SLNB or during the preop examination and imaging, there is indication to remove the lymph nodes of the corresponding anatomical region.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"48f395c8-15ce-d5b0-d2cf-046d7a5d5eae","text":"The identification of sentinel lymph nodes in the head and neck area is still controversial although now more and more used in the clinically N0 neck situation. SLN biopsy is regarded valuable for two main reasons. One is the possible better identification of the anatomically first drainage lymph node in the drainage basin and should have the highest risk for being the first affected in the case of metastatic disease. Once the node or nodes are identified the node can be sent for frozen section and when positive a complete neck dissection is performed. If negative the patient received a procedure with lowered morbidity with a high chance of the neck being treated effectively and efficiently. Secondly the other alternative is to progress to a planned neck dissection and merely mark the SLN and request intensified pathological workup of the SLN that may lead to an upstaging of the neck of 34-40% [14,23,24].","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"48f9713a-13d6-0753-23dd-159b1756b1b8","text":"A review of the literature showed that ultrasound guidance improves the safety and effectiveness of several kinds of puncture procedures, including nerve blocks. There are two approaches to blocking the mandibular nerve: intraoral and extraoral. This review found that the role of ultrasound guidance is more important in the extraoral approach. There are also two approaches to the blocking of the maxillary nerve and the trigeminal ganglion under ultrasound guidance: the superazygomatic approach and the infrazygomatic approach. The infrazygomatic approach can be further divided into the anterior approach and the posterior approach. It is generally believed that the anterior approach is safer and more effective. This review found that the effectiveness and safety of most oral and maxillofacial nerve block operations can be improved through the use of ultrasound guidance.","title":"Application of ultrasound guidance in the oral and maxillofacial nerve block"}
{"_id":"4905bd9b-9552-9f22-9f31-7c3d0650e4c3","text":"For low-risk malignancies, tumors should be resected along with their subcutaneous fat using 4-mm lateral margins.6,7,18 In lower-risk areas of the face such as the cheek and forehead, 3-mm lateral margins may be used to improve cosmesis; however, the use of smaller margins increases the risk for incomplete excision and recurrence.19 For high risk malignancies, it is recommended that surgeons utilize lateral margins > 10 mm and excise down to the first underlying anatomic plane.6,7,18,20","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"490cd3a0-f7e9-f21c-6a94-35f777c4be1b","text":"The present study offers additional evidence that may support the role of delayed decompression surgery for BP. We recommend facial nerve decompression for BP within the first 2 weeks when indicated. Nonetheless, our results suggest that patients with severe BP may benefit from decompression surgery up to 90 days after the onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings and to better define the role of delayed surgical intervention in the treatment algorithm of BP, especially for patients with persistent paralysis beyond 3 months.","title":"Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience"}
{"_id":"490d4ecb-a1c3-9dd2-f1de-153e80d44ff5","text":"Individuals with GMC have an abnormal pelvic morphology, with acetabular retroversion caused by ilial rotation rather than dysplasia of the acetabular wall.","title":"CT-based morphological study of the pelvis in patients with gluteal muscle contracture"}
{"_id":"4911e9e1-e27d-77a0-96bc-1ef9036e9c6e","text":"Debridement, interbody fusion with TMCs, and combined posterior instrumentation can be an effective and safe method for treating thoracic and lumbar spinal TB via posterior-only approach. This method can thoroughly debride the focus of infection, improve neurological function, and reconstruct the spinal stability. The presence of the TMCs anteriorly at the site of the infection focus had no negative influence on the course of infection healing; it also stabilized the affected segment maintaining sufficient sagittal profile. Meticulous surgery combined with a standard regimen of chemotherapy is the key point to the early eradication of spinal TB and minimization of surgical complications.","title":"Debridement, internal fixation, and reconstruction using titanium mesh for the surgical treatment of thoracic and lumbar spinal tuberculosis via a posterior-only approach: a 4-year follow-up of 28 patients"}
{"_id":"49231fd9-fdb2-fae5-10f2-a47eec788dd8","text":"The damaged tissue does not offer ideal circumstances for a local flap due to its lowered susceptibility to infection and reduced perfusion. In radiated tissue, the free flap is the best opportunity and superior to the local flap [3]. Primary or secondary direct wound closure is even contraindicated as a superficial skin closure under tension with both wound edges being radiated is no adequate reconstructive concept.","title":"AV loop free flap: an interdisciplinary approach for perineal and sacral defect reconstruction after radical oncological exenteration and radiation in a colorectal cancer patient"}
{"_id":"4927e6cc-1c28-3a59-6f49-7f1ee5c6e7a1","text":"Nerve stimulation and ultrasound have been introduced to the practice of regional anesthesia mostly in the last two decades. Ultrasound did not gain as much popularity as the nerve stimulation until a decade ago because of the simplicity, accuracy and portability of the nerve stimulator. Ultrasound is now available in most academic centers practicing regional anesthesia and is a popular tool amongst trainees for performance of nerve blocks. This review article specifically discusses the role of ultrasonography for deeply situated nerves or plexuses such as the infraclavicular block for the upper extremity and lumbar plexus and sciatic nerve blocks for the lower extremity. Transitioning from nerve stimulation to ultrasound-guided blocks alone or in combination is beneficial in certain scenarios. However, not every patient undergoing regional anesthesia technique benefits from the use of ultrasound, especially when circumstances resulting in difficult visualization such as deep nerve blocks and\/or block performed by inexperienced ultrasonographers. The use of ultrasound does not replace experience and knowledge of relevant anatomy, especially for visualization of deep structures. In certain scenarios, ultrasound may not offer additional value and substantial amount of time may be spent trying to find relevant structures or even provide a false sense of security, especially to an inexperienced operator. We look at available literature on the role of ultrasound for the performance of deep peripheral nerve blocks and its benefits.","title":"Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review"}
{"_id":"4928f8b6-44dc-209a-cf3b-a32a221fd938","text":"In summary, we reported 19 children with IMT in this study. The tumor locations vary, and the most common site of tumors in our series was the abdomen. Pathological and immunohistochemical tests are the gold standards for IMT diagnosis. CT can help define tumor anatomy and guide surgery. Complete surgical resection is preferred and can limit the recurrence. But whether the tumor is completely removed or not, tumor location and invaded area might be related to recurrence and death. Chemotherapy seems to achieve little after palliative surgery in patients with serious local invasiveness and further studies are needed to detect more promising treatment options.","title":"Inflammatory Myofibroblastic Tumors in Children: A Clinical Retrospective Study on 19 Cases"}
{"_id":"492fdcad-de2a-a22e-b649-06670dad16ab","text":"Sample size calculation was based on a pilot study that showed the difference of VAS scores were 1.6 between the two groups within 24 h postoperative. Choosing a difference of 1 score as the minimum desired difference between the groups, 37 patients per group were required to achieve a significance level of 0.05 with a power of 95%. Combined with the number of operations in our department and to compensate for dropouts, we planned to recruit 67 patients in each group.","title":"The effect of ultrasound-guided intercostal nerve block on postoperative analgesia in thoracoscopic surgery: a randomized, double-blinded, clinical trial"}
{"_id":"4930eb27-0f94-3f9d-664f-337b76288356","text":"Intraoperative ultrasound guidance for excision of palpable breast cancers is feasible and gives results in terms of pathologic margins that are comparable with those achieved by standard palpation-guided excisions.","title":"Intraoperative ultrasound reduces the need for re-excision in breast-conserving surgery"}
{"_id":"49335e2a-bcb0-11a2-ffe2-f1785d44ba57","text":"This study showed that even in the absence of clear clinical signs of flap failure, poor clinical results of lymphedema treatment and low recanalization rates of lymphatic flow were observed in cases where blood flow in the transferred LNs could not be detected at 2 weeks after VLNT. These results suggest that the partial impairment of blood flow into the LNs after VLNT is one of the causes of poor outcomes. Herein, a mouse LN flap model was also developed for the first time to clearly distinguish partial ischemic flaps from congestive flaps and to observe the histological changes in LNs.","title":"Clinical and Histological Effects of Partial Blood Flow Impairment in Vascularized Lymph Node Transfer"}
{"_id":"4933afa1-84eb-474e-4e38-ddad82cd0a01","text":"As with most of the competitive specialties, objective differentiators play a substantial role in the evaluation of applicants. Demonstrated involvement and interest in research is currently ranked highly by program directors when determining whom to invite for interviews [7], and with the upcoming changes to the scoring of the USMLE exams, it is not hard to imagine that research productivity will increase in importance to program directors when stratifying applicants [8]. Research production does not just facilitate program director stratification, however. Reading the literature to develop ideas before publishing is a critical skill for learning the fundamental knowledge of the field and approaching possible mentors with research ideas or partially completed manuscripts is a strong strategy for initiating these important relationships. Our analysis of medical student first-author publications in plastic surgery may be a useful resource for current and future medical students who desire a career in plastic surgery and, thus, need to accumulate the requisite research output and mentorship to make them competitive residency applicants and successful academic surgeons.","title":"A Review of Medical Student First-Author Publications in Plastic Surgery"}
{"_id":"4933b8df-9465-4303-536a-5665774a5d69","text":"There are several advantages of integrated port tissue expanders. Integrated tissue expander insertion allows for the use of the existing mastectomy pocket and avoids having to create a tunnel and additional pocket for the port. Integrated expanders now have tabs to secure them in the proper position to avoid lateral displacement and axillary expansion. The newer expanders also have a wide self-sealing zone around the port to minimize the risk of leakage with errant needle access. Modern integrated port tissue expanders are more anatomically shaped, with increased distension at the lower pole producing expansion in the teardrop shape of the natural breast. The texturing present in these tissue expanders has been believed to lessen the risk of capsular contracture and facilitate the expansion process. While no rigorous head-to-head comparisons have been made, these observed benefits have led to the routine use of textured integrated port expanders over remote port expanders.","title":"Two-Stage Prosthetic Breast Reconstruction With Integrated Versus Remote Port Expanders: A Comparison of Complication Rates Choo et al"}
{"_id":"493ef6e1-4681-15be-0251-f637cf1a8759","text":"Only two patients required a single dose of 650 mg of paracetamol to treat a mild postoperative pain; one patient from either group. None of the cases showed swelling of tissues adjacent to the surgical area.","title":"Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser"}
{"_id":"4940d68b-398b-bd0e-3ef9-4bbbe772af47","text":"The surgical aims for DCKS are adequate decompression, correction of kyphosis, and solid instrumented fusion. Laminoplasty applied in cervical fusion as a decompression method seems to lead to a favorable functional recovery and reduces the complications of perineural adhesion that typically occur after laminectomy. In addition, laminoplasty affords an additional fusion bed at the hinge side and this advantage benefits solid fusion mass formation for the patients who suffered from DCKS.","title":"Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis"}
{"_id":"4942bc7b-0bf4-2960-b84e-fdb5bfc06de7","text":"Over the past two decades, our comprehension of the association of skin stem cells with their surrounding microenvironment, known as the niche, has increased significantly. Studies have shown that in many skin and hair disorders, the state of the microenvironment capable of regulating and influencing stem cells results altered. Therefore, developing the capability of manipulating and rehabilitating the stem cells microenvironment may open up new scenarios and therapeutic assets usable in the case of skin and skin appendages problems for both pharmaceutical and cosmetic purposes. The fields of application of this knowledge reside in regenerative medicine, cancer therapy, prevention of aging, treatment of skin and hair diseases and improving skin and hairs well-being and appearance. It is thus of great interest to develop a specific approach that targets the skin stem cells by the use of a delivery system capable of overcoming the skin barrier.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"49451d7b-dc69-34db-8ef0-c9172b1d9549","text":"The present study demonstrates that excellent postoperative outcomes can be achieved with the use of ACAF. Though further study is required to confirm the conclusion, this novel technique has the potential to serve as an alternative revision technique for cervical OPLL after initial posterior surgery.","title":"A novel revision surgery for treatment of cervical ossification of the posterior longitudinal ligament after initial posterior surgery: preliminary clinical investigation of anterior controllable antidisplacement and fusion"}
{"_id":"4953fa8a-ea23-6b14-82ca-be06da3cc2fd","text":"The existence of this rare condition seems to us to be important to recall, in order to evoke it rapidly in a chronic hemodialysis patient in front of any deep cutaneous lesion of tumoral appearance, alternatives to surgery being possible and most often desirable.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"4954ba8e-9943-529a-65b6-e6a36d53501e","text":"On the basis of the annual ACGME Data Resource Books for academic years 2002 through 2018, an increasing proportion of pathologist trainees took specialty fellowships during those years and thus have been excluded from being counted as pathologists by the AAMC method. It is likely that the increasing percentage (now 97%) of new-in-practice pathologists with subspecialty training has resulted in the decreasing number of practitioners in the AAMC reports. A future area of work to document the actual changes in the workforce over multiple periods is needed, specifically comparing numbers of trainees with subspecialty training entering the profession with those retiring.","title":"Reevaluation of the US Pathologist Workforce Size Reevaluation of the US Pathologist Workforce Size"}
{"_id":"4959eedf-2768-541d-53a7-0fbbfa39f1d8","text":"The authors prefer to use the free fibula flap for the majority of maxillectomy defects. With the increased understanding of perforator flaps and microvascular surgery, the skin paddle of the fibula flap can not only be harvested with reliability and success, but multiple skin islands can also be designed when more soft tissue is needed [22]. Since the fibula can tolerate multiple osteotomies, a single fibula can provide ample bone length to reconstruct a total maxillectomy defect. Aside from the length, the fibula also has sufficient bone stock, which offers the opportunity to support dental implants. With proper planning and patient selection, dental implants can be placed at the time of the primary reconstruction. The patient-specific cutting guides can be engineered to incorporate predictive screw holes for the custom-printed titanium plate so the screws will not interfere with the predictive drill holes for the dental implants. This may afford patients who require adjuvant radiotherapy the potential for complete dental rehabilitation and would otherwise not be candidates for secondary dental implants following radiation.","title":"Evolution of Medical Modeling and 3D Printing in Microvascular Midface Reconstruction: Literature Review and Experience at MD Anderson Cancer Center"}
{"_id":"495be3d0-f6cb-7319-18e7-1a334f4d6605","text":"Data supporting the use of SLN mapping techniques with an established management algorithm have prompted the NCCN guidelines [2] to include SLN mapping instead of full lymphadenectomy in select endometrial cancers with low risk of recurrence and in which full mapping is achieved. Lymphatic mapping to identify the sentinel lymph nodes, or the first nodes along the drainage route of a tumor, is becoming an acceptable practice in the management of low-grade endometrial cancer, though its application remains controversial. Optimization of this technique to improve sensitivity and specificity will further increase the utility of the practice with the goal of reducing morbidity imposed by a full nodal dissection.","title":"Molecular Imaging of endometrial sentinel lymph nodes utilizing fluorescent-labeled Tilmanocept during robotic-assisted surgery in a porcine model"}
{"_id":"49623d51-9cd8-d75c-4e55-bb7d08f87b99","text":"The aim of the present study was to investigate the presence and degree of anosognosia in groups of patients with EOD and LOD, including different clinical presentations, by also studying its association with neuropsychiatric symptoms and dementia progression overtime. We hypothesized that anosognosia increases along disease progression and that it might be associated with development of neuropsychiatric symptoms during the course of disease.","title":"Anosognosia in Early- and Late-Onset Dementia and Its Association With Neuropsychiatric Symptoms"}
{"_id":"49637dcf-24d1-d97e-a85c-caedec5be220","text":"After hemiglossectomy defect reconstruction, the changes in configuration and volume of the oral cavity generate resonant and articulatory alterations, thus intelligibility of the patient’s speech is lowered. However, very few works have been done to evaluate phonetic changes in the hemiglossectomy patients. This study compared the postoperative speech and swallowing function of 12 patients underwent free thin ALT flap reconstruction after hemiglossectomy with that of 34 patients underwent FRF flap reconstruction after hemiglossectomy, and analyzed the effects on the speech intelligibility and acoustic spectrographic characteristics of the formants of oral vowels in Chinese language, specifically the first 3 formants.","title":"Functional assessment: Free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects"}
{"_id":"4966ad65-ceb9-95b0-45bc-6be50ce0d745","text":"Our study confirms that moisturizers have an important value in the prevention of radiotherapy-induced skin damage and indicates that an instrumental assessment of skin hydration can help the radiation oncologist to use strategies that prevent the onset of toxicity of high degree.","title":"Preventing the acute skin side effects in patients treated with radiotherapy for breast cancer: the use of corneometry in order to evaluate the protective effect of moisturizing creams"}
{"_id":"497084b6-ffc9-936b-436d-c531b2d1650b","text":"A detailed questionnaire with 15 multiple questions was made regarding the practices of individual physicians on the follow-up of isolated mediastinal and or hilar lymphadenopathy. There were clear instructions on how to fill out the questionnaire.","title":"Management of Isolated Thoracic Lymphadenopathy of Unclear Etiology: A Survey of Physicians and Literature Review"}
{"_id":"497515bb-c105-4a8d-965d-186b6c88f833","text":"The patient was taken immediately to the operating room and anaesthetised. All devitalized bony and soft tissues were excised on the side of the open tibial fracture. The tibial bone defect was nearly 25 cm after debridement, and the remaining two ends of the tibia were stabilized with a unilateral fixator. Two Schanz pins were placed in the proximal part of the tibia, and one each was placed in the distal tibial end and in the talus. The tibial nerve was compressed but intact at the ankle. At the same level, the posterior tibial artery was also compressed and thrombosis detected in a 1-cm segment. The thrombotic segment was excised and end-to-end primary arterial re-anastomosis was performed to revascularize the distal lower extremity. It was decided to manage the bone defect by transferring the ipsilateral fibula which was entirely intact but for a simple fracture at the level of the ankle joint.","title":"Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture"}
{"_id":"497a5b1e-5cba-7b88-9e9a-9c40ed6dd7e0","text":"In the scalp and neck region, Caucasian ethnicity remains the most affected one due to correlation with light skin phototype and melanoma development.","title":"Melanoma of the Scalp and Neck: A Population-Based Analysis of Survival and Treatment Patterns"}
{"_id":"497e192e-60bf-644d-053c-c5c4ac6fb1b3","text":"FC and EC reviewed literature about the selected topic and collaborated in drafting the manuscript. GR examined and corrected the final version of the manuscript. All the authors read and approved the final draft of the manuscript.","title":"Allergen Avoidance in Allergic Asthma"}
{"_id":"4994fca0-baae-f2e7-6068-92ba235a8e63","text":"Further exploration regarding optimal approaches to diagnosis and management of hypersensitivity reactions to biologics is of high importance, as these medications can offer transformative disease control for many patients with allergic diseases. As such, the allergist and immunologist plays a crucial role in both diagnosing and managing hypersensitivity reactions to these agents.","title":"Hypersensitivity reactions to biologics used in the treatment of allergic diseases: clinical features, diagnosis and management"}
{"_id":"49964e07-6c69-af74-0eff-daa8cfc44320","text":"Flap perfusion monitoring with attached surface probes for the O2C analysis system detected vascular compromise accurately and concordantly with unattached surface probes.","title":"Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity"}
{"_id":"4997244a-00be-45d6-fb4d-7822d12238b6","text":"The labial frenum is considered pathological if it is abnormally large or wide and if no attached gingiva is apparent along the midline [5]. In the present case report, we observed a wide lateral frenum with insertion into the gingival border that caused anterior and posterior segmentation of the alveolar crest.","title":"Surgery Management of Rare Hypertrophic Frenum in an Infant"}
{"_id":"4997cb0c-2d73-8632-0d73-7f0c2a4306be","text":"This report on routine use of MarginProbe provides additional support for use of the device. Use of the device was associated with a significant decrease in the rate of re-excision procedures. This provides the surgeons with added confidence when performing lumpectomy surgery, reduces the burden for the health care system, and increases the assurance of patients in this surgical treatment approach for breast cancer.","title":"The impact of use of an intraoperative margin assessment device on re-excision rates"}
{"_id":"499c068f-28a5-ea62-7eb1-fe4cabb3d3df","text":"When characteristics of the defect are suitable for treatment with a propeller-based local flap, this technique should be considered as one of reasonable options for surgical reconstruction. Microsurgical techniques facilitate the management of complex trauma in emergency and may allow planning reconstructive procedures and limb salvage in elective orthopedic surgery.","title":"Perforator-based propeller flaps treating loss of substance in the lower limb"}
{"_id":"499cb16f-192f-939f-84a9-d46beb9209d8","text":"As the number of patients being treated with drugs interfering with haemostasis is increasing, the anaesthesiologist is faced with a dilemma in administering anaesthesia to such patients. General or regional anaesthesiologist may be considered depending on the type of surgery, urgency of surgery and degree of anticoagulation as judged by investigations.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"49a1352e-173e-80ea-d6ec-41873dcfe795","text":"Many soft tissue tumors recapitulate features of normal connective tissue. We hypothesize that different types of fibroblastic tumors are representative of different populations of fibroblastic cells or different activation states of these cells. We examined two tumors with fibroblastic features, solitary fibrous tumor (SFT) and desmoid-type fibromatosis (DTF), by DNA microarray analysis and found that they have very different expression profiles, including significant differences in their patterns of expression of extracellular matrix genes and growth factors. Using immunohistochemistry and in situ hybridization on a tissue microarray, we found that genes specific for these two tumors have mutually specific expression in the stroma of nonneoplastic tissues. We defined a set of 786 gene spots whose pattern of expression distinguishes SFT from DTF. In an analysis of DNA microarray gene expression data from 295 previously published breast carcinomas, we found that expression of this gene set defined two groups of breast carcinomas with significant differences in overall survival. One of the groups had a favorable outcome and was defined by the expression of DTF genes. The other group of tumors had a poor prognosis and showed variable expression of genes enriched for SFT type. Our findings suggest that the host stromal response varies significantly among carcinomas and that gene expression patterns characteristic of soft tissue tumors can be used to discover new markers for normal connective tissue cells.","title":"Determination of Stromal Signatures in Breast Carcinoma"}
{"_id":"49a15fe4-d4af-3f4f-75df-c46c6b1fc6a3","text":"Finally, statistical analyses of the risk of a second primary tumour in CM patients could not be performed as a consequence of the relatively small number of patients registered. We recommend to continue this registry to attain a larger cohort and achieve more statistical power. Furthermore, the use of a standard oncologic questionnaire by the physician might improve the quality and quantity of information on risk factors for CM.","title":"Clinical Characteristics of Cutaneous Melanoma and Second Primary Malignancies in a Dutch Hospital-Based Cohort of Cutaneous Melanoma Patients"}
{"_id":"49ad535a-8599-93bb-3592-7050219c4bf6","text":"All patients were also treated with antibiotics targeted to their infective organism, from samples taken during the first debridement. There was no standardised antibiotic formulary due to the heterogenic nature of the patients and each patient’s antibiotic regimen was decided based on microbiologist advice.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"49ad7dfa-c224-86ed-63ac-01a2e8d7649b","text":"The growth of the global surgery paradigm presents an opportunity to leverage international cooperation to expand and enhance education and training programmes which ultimately benefit the surgical patient, worldwide. This paper provides a framework from which to further study global surgery education and training. Our review suggests that significant effort has been directed towards global surgery programmes in HIC academic institutions and HIC surgical trainee placements in LMICs. The ultimate impact of the identified categories on the surgical patient remains to be determined; however, a clearer understanding of the forms that global surgery education and training interventions take may allow for more strategic decision making by all partners.","title":"Global Surgery Education and Training Programmes—a Scoping Review and Taxonomy"}
{"_id":"49aecb48-8c5a-1e8f-5e51-417a97dc3b04","text":"The clinical tests can serve as an additive tool with the color Doppler to improve the specificity and can avoid negative exploration [2]. To the best of our knowledge, no study is available in the literature, that compares the efficacy of the clinical tests combined with color Doppler versus color Doppler alone to identify the perforator incompetence during the surgery. Hence, this study was planned to compare the clinical tests combined with the color Doppler Vs color Doppler alone to correctly identify the incompetent perforators in the lower limb varicose vein patients planned for the surgery and to assess the concordance of the clinical tests and the color Doppler to correctly identify the perforator incompetence in the lower limb varicose vein patients planned for the surgery. The study results might help in determining the usefulness of adding the clinical test with color Doppler to avoid negative explorations in the perforator incompetence surgery.","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"49b4d756-5206-90bd-d1aa-3cd19e6e9f89","text":"The procedure performed in patients undergoing the anterior approach involved performing a discectomy or corpectomy associated with the placement of an intersomatic device and fixation with a plate for decompression and arthrodesis, whereas in patients undergoing the posterior approach, the surgical procedure comprised laminectomy associated with fixation with screws of lateral mass and bars.","title":"EARLY COMPLICATIONS OF SURGICAL TREATMENT OF CERVICAL SPONDYLOTIC MYELOPATHY COMPLICAÇÕES PRECOCES DO TRATAMENTO CIRÚRGICO DE MIELOPATIA CERVICAL ESPONDILÓTICA"}
{"_id":"49d192a1-b59f-29dc-12a7-ca14a96cc251","text":"Table 1 Age distribution of most frequently involved pathogens in pediatric AHOM","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"49d2b69f-4785-7b8c-88b5-a9caeb367899","text":"We strongly recommend using the latest AJCC standards and WHO classification when reporting stage.","title":"Guidelines for breast cancer management in Bosnia and Herzegovina"}
{"_id":"49d475fd-062e-7925-8278-e49f49e0e81f","text":"CTA became a mixture between microsurgical techniques and immunosuppressive agents for the prevention of rejection.","title":"Transplantation of composite tissue allografts. Scientific bases and clinical applications"}
{"_id":"49da83cf-2ef3-15d6-527d-4f5a9fd56828","text":"Sentinel lymph node biopsy is an essential staging tool in patients with clinically localized oral cavity squamous cell carcinoma. The harvesting of a sentinel lymph node entails a sequence of procedures with participation of specialists in nuclear medicine, radiology, surgery, and pathology. The aim of this document is to provide guidelines for nuclear medicine physicians performing lymphoscintigraphy for sentinel lymph node detection in patients with early N0 oral cavity squamous cell carcinoma.","title":"The EANM practical guidelines for sentinel lymph node localisation in oral cavity squamous cell carcinoma"}
{"_id":"49dbae93-aab4-b720-86fd-18b82203babb","text":"Patients were placed under general anaesthesia and intubated using laser resistant endotracheal tube. Laser safety measures were implemented to minimize the risk of complications from the laser surgery. Patients were placed in suspension laryngoscopy and an operative microscope with CO2 laser micromanipulator was used for glottic cancer excision. Carbon dioxide laser settings were 2-4 watts in ultrapulse mode. Depending on size, the tumours were removed either en bloc or via a tumour splitting technique. After primary tumor excision, margins were taken from the surgical site using either steel phonomicrosurgical instruments or CO2 laser at 2 watts based on our randomization list. The same phonomicrosurgical instruments were used to retract specimens for both cutting techniques. The locations of margins were diagrammed on the laryngeal template to assist the pathologist in their orientation.","title":"CO2 laser versus cold steel margin analysis following endoscopic excision of glottic cancer"}
{"_id":"49ddaac5-9553-759f-1146-9d9be95e2cc0","text":"The free gracilis flap is a safe and effective free flap in small to medium-sized diabetic foot defects with minimal donor site morbidity and speedy flap harvest. The good wound healing and excellent foot contour offered by it without the need for secondary debulking procedures makes it our “work horse” free flap in diabetic foot reconstruction.","title":"The Gracilis Muscle Flap: A “Work Horse” Free Flap in Diabetic Foot Reconstruction"}
{"_id":"49e0a9f9-794c-ca84-d7b8-a060255d4374","text":"This work aims to better understand the current trend in treatment of the tumors in pelvic cavity and present a novel organ repositioning device that was originally suggested by Parsai et al. and presented at AAPM annual conferences,12, 13 and later investigation was carried out to do the safety and feasibility studies in physically moving the rectum away from the path of a direct radiation during external beam and brachytherapy treatments using fresh cadaver. The result of that study will be presented in a follow‐up manuscript. The foundational methodology is to actuate a Nitinol shape memory wire that has been placed in an endorectal balloon, actively moving the rectum away from the path of radiation beam in a controlled manner. Such a device would not only work to mitigate morbidities to the rectum, but will also create the potential to deliver an ablative dose to tumor volume or to escalate the dose when needed.","title":"A novel and innovative device to retract rectum during radiation therapy of pelvic tumors"}
{"_id":"49e492a5-9365-d71b-57c6-9bd1b9560e85","text":"There is limited literature discussing corrective cosmetic measures that may be employed following skin loss secondary to flap necrosis following abdominoplasty. Here we describe a case where a multi-layer anatomic approach was used to excise a previously placed skin graft and repair the defect that resulted from significant flap loss following elective cosmetic abdominoplasty. This case has been reported in line with SCARCE criteria [11].","title":"Anatomic reconstruction for major tissue loss following abdominoplasty: A case report"}
{"_id":"49e653bb-ba6a-fe92-6495-57ee343fc05d","text":"Semi-structured interviews will be conducted with orthopaedic surgeons and their professional network to explore how surgeons learn about best practice and leadership configurations. Questions will explore perspectives of participants regarding medical education, continuing professional development and the influence of leadership and mechanisms of DL on evidence-based practice. The longitudinal interviews will elicit the values and views participants’ hold regarding evidence-based practice, how clinical leadership (both their own and others) influences practice and importantly how their views change and develop over time. The longitudinal design will provide a unique representation, as it aims to tracks changes or lack of changes in participants’ narratives as they undergo professional training and are exposed to different leaders and different approaches to leadership. Longitudinal topic guides will draw on the extant DL literature and an ongoing realist review of leadership configurations in surgery which in being conducted by the research team. Two surgeon members of the study advisory group will pilot interview topic guides to check questions are clear and meaningful.","title":"Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol"}
{"_id":"49eab734-41a4-79a6-b537-feb8261046a0","text":"All patients were encouraged to perform partial weight-bearing exercises such as walking with clutches as early as the third or fourth day after the surgery. Distraction was started after a latency period of 7 to 14 days at a rate of 0.25mm three or four times a day (Figure 3). The distraction rate was modified according to the regeneration quality evaluated by radiographs. Radiographs were taken regularly every 2 and 4 weeks at the outpatient department visit during the distraction period and the consolidation period, respectively. At the same time, the physical examinations were performed for the evaluation of the limb function, and the detection and treatment of the concomitant complications were also carried on. The external fixator was removed when the radiographs showed the appearance of consolidated bridging callus and the limb length was restored.","title":"Management of Osteomyelitis-Induced Massive Tibial Bone Defect by Monolateral External Fixator Combined with Antibiotics-Impregnated Calcium Sulphate: A Retrospective Study"}
{"_id":"49edbc7d-0ebf-a4ad-9c78-199d3ab96a5a","text":"The results of studies according to the Recognition of Other People's Emotions scale indicate that respondents with high levels can have an effective impact on the emotional state of other people, which in turn is an important professional quality of an organization's physician. As for the groups of respondents who showed an average level according to this given scale, as a rule, such people can also have an impact on their interlocutor, but it is less effective than that of people with a high level according to this scale.","title":"Leadership and Emotional Intelligence: Current Trends in Public Health Professionals Training"}
{"_id":"49ee8cf4-9e5c-2f0f-8f84-6cd2a62819b2","text":"Our study reviewed that MMS has better outcomes that WLE in terms of postulated cure rates and the head and neck zone are associated with higher chances of recurrence rate despite the clinical variant of DFSP. It has also been observed that neoadjuvant chemotherapy with imatinib as a pre-surgical course in therapy of inoperable and\/or metastatic cases of DFSP, including fibrosarcomatous variant has turned these debilitating tumors into resectable with remission and potentially curative. On the other hand, radiation therapy is recommended as a post-surgical procedure if there is suspicion of positive margins. Thus, in high recurrence zones an augmented approach is recommended.","title":"The efficacy of Mohs micrographic surgery over the traditional wide local excision surgery in the cure of dermatofibrosarcoma protuberans"}
{"_id":"49f1a2a3-6f67-ab95-6a1f-d9d4a26f5fcf","text":"Since then, with more advantages and the use of minimal invasion through the abdomen by laparoscopy instead of open laparotomy, the use of an omental flap is recommended method in scalp and neck reconstruction.","title":"The use of an omental flap for the reconstruction of a burn injury to the scalp: A case report"}
{"_id":"49fa5178-6610-0629-2dff-1efb51d8bf30","text":"After the injection, a gentle massage is given to the site to facilitate lymphatic drainage and the radiocolloid is given time to reach the lymph node.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"49fcd614-938e-4c1a-79b4-7507d869ac20","text":"To evaluate the contribution of MP in reducing the rate of re-excision procedures, the re-excision rates with use of MP were compared to those from a corresponding historical set. For each surgeon, the historical set consisted of a consecutive series of cases from a time period shortly before she started using MP. The set was from a duration of time similar to that for which MP was in use, ensuring that the fraction of cases (for each surgeon) in the historical set will be distributed between surgeons in the same manner as the cases in which MP was used. As seen in Table 6, the total number of cases in the historical set and the number of cases per surgeon are similar to those where MP was used.","title":"The impact of use of an intraoperative margin assessment device on re-excision rates"}
{"_id":"4a05e803-4fae-cb17-2295-62a969a0f225","text":"It has been shown that the survival and recurrence rates after breast conserving surgery are almost identical to those of patients undergoing total mastectomy and radiation therapy, and that the choice of treatment should be made after the patient is fully informed of the risks and benefits of each procedure by the surgeon. In this study, tissue expander\/implant or TRAM after mastectomy provided an improved prognosis with regard to shoulder function recovery than did mastectomy or breast conserving surgery followed by an LD flap reconstruction. This is important information for patients and surgeons when choosing the most appropriate option for breast cancer surgery.","title":"Quantitative analysis of shoulder function and strength after breast reconstruction A retrospective cohort study"}
{"_id":"4a0a3cb0-6eff-9f12-9e80-518ad422fa85","text":"The majority of the participants expressed that they had not received adequate psychological care at the hospital, highlighting the need to have an in-house psychologist in the treatment plan of cancer patients specifically in addressing these distressing conditions where they live. They mentioned that the psychologist could play a positive role in supporting the patients psychologically and socially. For example, one of the participants said when she was asked, what are the needs you feel should be available at the hospital to feel that you had received adequate psychological care.","title":"Beyond the scars: a qualitative study on the experiences of mastectomy among young women with breast cancer in a country with crisis"}
{"_id":"4a0a83aa-cc2a-b787-e073-6b6bfb533493","text":"Surgical site infection following spine surgery is a major cause of increased morbidity following spine interventions and an immense burden on the health care system. A high index of suspicion should be kept in the first 3 months after the procedure. The diagnosis is usually suspected based on the symptoms and physical exam findings. However, a number of laboratory and imaging techniques are available to speed up the confirmation of the diagnosis and the recovery of the offending organisms, which would allow early targeted therapy.","title":"Surgical Site Infections Following Spine Surgery: Eliminating the Controversies in the Diagnosis"}
{"_id":"4a18dd45-63f1-1130-a4e9-c28e90deedbf","text":"A more common approach to restore sensation to the sole of the foot is the use of fasciocutaneous perforator flaps such as the ALT with coaptation of its sensible nerve to the lateral femoral cutaneous nerve or branches of the sural nerve. The flap can be thinned to 3–6 mm intraoperatively to reduce later shearing of the tissue [75], or it can be thinned in a separate operation via liposuction after completion of the healing process. Up to a width 10–12 cm of the ALT the donor site can be closed primarily.","title":"Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View"}
{"_id":"4a2f511a-15ed-5b01-8cdf-8ca679219c80","text":"Here, to investigate the link between perceived age and biological age we have investigated the strength of relationship between how old women look for their age and skin, hair and lip aging features. Additionally, we investigated the impact on such relationships of using different types of photographic image to generate perceived age. To determine whether future investigations into the identity of factors that influence facial aging should focus on genetic or environmental factors, we have utilized monozygotic and dizygotic twins to estimate the influence genetic factors have on perceived age as well as on skin, hair and lip aging features. Furthermore, we have constructed composite images of individuals who look either young or old for their age to demonstrate the striking differences in perceived age that can occur between individuals of the same chronological age.","title":"Why Some Women Look Young for Their Age"}
{"_id":"4a331ec5-8207-674e-530d-ee231f28731c","text":"Superficial irregularities are commonly encountered in regions with minimal subcutaneous fat. To avoid this complication, filler must be placed deeply. In the tear trough region, we use a serial puncture technique to advance the needle to the periosteum along the inferior orbital rim and deliver small boluses of product working from medial to lateral. Similarly, in the temporalis fossa, we inject deeply under the fascia of the temporalis muscle in the area of maximal volume loss attempting to avoid vessels and nerves while providing a nice contour. In areas that require more superficial injection such as along the nasolabial groove, using hyaluronic acid fillers with higher cohesivity will diminish surface irregularities[. Any lumps or bumps noticed early on are addressed with manual massage, while persistent irregularities generally must be dissolved with hyaluronidase.","title":"Complications after cosmetic periocular filler: prevention and management"}
{"_id":"4a579172-1205-1003-41f6-536c02893566","text":"Initially, the dissection of both hemithoraxes was performed following the same protocol described above. Then, the thoracic wall was sectioned bilaterally and longitudinally to its sagittal midline to expose the mediastinum and the dorsal aspect of the ventral chest wall. The first aim of the evaluation of the spread was to identify the number of stained intercostal nerves. A nerve structure was considered stained when all its quadrants were dyed for more than one centimetre in length.","title":"Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers"}
{"_id":"4a5a100f-01f4-7d66-41d6-f3570ca37d9a","text":"Ankyloglossia is a congenital anomaly that can affect breastfeeding. The aim was to evaluate the prevalence of ankyloglossia in newborns and breastfeeding difficulties reported by mothers; assess possible factors that may interfere with breastfeeding.","title":"Does ankyloglossia interfere with breastfeeding in newborns? A cross-sectional study"}
{"_id":"4a61bf83-1bac-89b6-a7d0-e14c93ed4c94","text":"The functional outcome of tongue reconstructions using MSAP flaps can be optimal as shown in our study with a relatively quick return to oral intake and good speech quality restoration. Tongue resection, especially after subtotal glossectomies, requires a relatively smaller flap that can be easily mobilized by the remaining tongue muscles, but also be large and firm enough to allow complete adherence to the hard palate during phonation. This balance in size and volume is crucial in obtaining a good functional result in terms of tongue mobility for swallowing and sealing off spaces in the oral cavity during phonation for good speech. (Fig 3) ALT flaps and free radial forearm flaps also provide optimal and desirable functional outcomes in tongue reconstructions. The major difference between the three flaps, however, is the donor site morbidity in our opinion when considered in conjunction with the defect size and indication.","title":"Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction – An outcome study"}
{"_id":"4a647bfc-8e17-9534-b422-c4516ffb0dd2","text":"Microvascular bone flaps have overall less skin perforation than reconstruction plates. BMI and expected total radiation dosage have to be respected in choice of reconstructive technique.","title":"Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study"}
{"_id":"4a65c836-b56f-22cc-a36d-7d0070cd212f","text":"Although rare, true aneurysms of the PTA have been described in the literature and they can often compromise vessels and nerves.15 Pseudoaneurysms of the PTA are also uncommon, but it has been reported that they can cause nonunion of tibial fractures and symptoms of lower limb ischemia due to thrombosis and distal embolization.14","title":"Clinical features of a rare anatomical variation of the posterior tibial and fibular arteries Aspectos clínicos de uma variação anatômica rara das artérias tibial posterior e fibular"}
{"_id":"4a6dacaa-2b26-277f-3e91-b7a2f3580230","text":"We present this case to create awareness in orthopaedic colleagues regarding calcinosis cutis of lower limbs.","title":"Multiple Scattered and Small Lesions of Lower Limbs: Idiopathic Calcinosis Cutis: A Case Report"}
{"_id":"4a71977f-c52a-2220-7f8a-0dee0838c403","text":"The fact that there are reported cases of recurrence after complete resection signifies the aggressiveness of this tumor and the dilemma in the management of this condition and necessitates a better understanding of the tumor and its pathological course [8].","title":"A Sporadic Giant Mesenteric Desmoid-Type Fibromatosis in a Teenage Female: A Report of a Rare Case"}
{"_id":"4a72c261-3f69-c1db-0d10-43733c4048b3","text":"The learning curve in cases of a PPF that requires a rotational angle of more than 90 degrees is longer than in cases of KDPF. The intraoperative transformation of the PPF into a KDPF is a useful training model for young surgeons, because the transformation is possible even in cases of technical error during the exploration of the perforator vessel. The young surgeon must keep in mind that the transformation into a keystone flap is no longer possible once the propeller flap is incised on its entire surface and the harvest done.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"4a79c981-1234-f92e-b5b3-8246396031de","text":"Histopathological findings for the signs of infection were evaluated. Histopathological findings in bone specimens were defined as acute osteomyelitis when necrosis, destroyed bone and infiltrations of polymorphonuclear granulocytes at cortical sites and inside the bone marrow were present. Congestion or thrombosis of medullary or periosteal small vessels was also a frequent finding. It was defined as chronic osteomyelitis when there was destroyed bone and infiltrations of lymphocytes, histiocytes and\/or plasmatic cells at cortical sites and inside the bone marrow. All cases of osteomyelitis exhibited areas of fibrosis in variable forms and medullar oedema.","title":"Section’s osseous slice biopsy during major amputation of lower extremity: preliminary results of prospective cohort study"}
{"_id":"4a7e8669-4392-0bdd-b4d3-18f5271e6496","text":"We report a case of vascularised fibula osteocutaneous flap used for composite cervical spinal and posterior pharyngeal wall reconstruction, in a patient with recurrent skull base chordoma, resected by an anterior approach via median labio-mandibular glossotomy approach. Bone stability and pharyngeal wall integrity were simultaneously restored","title":"Vascularised fibula osteocutaneous flap for cervical spinal and posterior pharyngeal wall reconstruction"}
{"_id":"4a804f36-d09f-247c-588f-64a3614fb0a7","text":"The quality of the surgical bed also plays an important role in the satisfactory vascularization of the artificial dermis. Nowadays, there are few experimental and clinical data on its application on bare calvaria.","title":"Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes"}
{"_id":"4a810824-1f8d-3959-59cb-6ce4609a9c6f","text":"The importance of lymphatic drainage compared to other potential routes for clearance of brain water and solutes is currently not known. Using phantom devices with known concentrations of a given contrast agent in conjunction with MRI acquisitions, it should be possible, however, to quantify lymphatic drainage. An MRI based quantification routine could thereby determine lymphatic failure as a pathogenic factor behind brain disease.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"4a843077-571a-5761-f0f8-4995cc79a8a2","text":"A final reconstructive modality to mention is free tissue transfer. This form of reconstructive surgery requires expertise in many areas particularly that of microvascular surgery. In a free tissue transfer procedure a flap is designed about an artery and vein to a particular angiosome of tissue. It is then transferred to the recipient site where microvascular anastomosis is completed to establish blood flow to the flap. The advantage of free tissue transfer is that the surgeon can be more selective in the type of tissue transferred whether it be for the addition of bone to the flap or necessitating a more reliable and thinner flap. Common free flaps employed in reconstructing the hand include the lateral arm flap, anterolateral thigh flap, temporoparietal fascia flap with skin grafts, and many others [32].","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"4a865225-0f48-638e-c5e4-d04c0db115b2","text":"As is the case in PD, symptoms of anosmia may precede the development of core diagnostic features in DLB. More recent research suggests smell and taste disturbances may also be reported by patients who develop other atypical parkinsonian syndromes albeit not as commonly as that observed in PD.","title":"Neurological update: non-motor symptoms in atypical parkinsonian syndromes"}
{"_id":"4a8cb77d-f008-c61d-2f38-5090f7c47753","text":"Combination approaches to therapy provide a rational strategy to potentially overcome resistance, and have shown a great deal of promise in melanoma. While toxicity remains a concern in some instances, the field continues to rapidly evolve and it is likely to become a mainstay of future therapeutic approaches.","title":"Updates in Therapy for Advanced Melanoma"}
{"_id":"4a97a5d0-b3eb-c34a-226a-a035fc487361","text":"This kind of statement regarding the need for improvement of interdisciplinary cooperation was not found in the rehabilitation facilities with a lower level of patient success.","title":"Cooperative leadership as a condition for patient-reported rehabilitation success"}
{"_id":"4aa12c72-5950-d571-93f9-d2600bde8ff2","text":"The crossover rate in the current study is more than previously reported after NST. The employment of a dual opto-nuclear probe with ICG infrared camera is superior in the identification of arm lymphatics and nodes. The higher observed rate of overlap might partially explain why more patients develop clinically significant lymphedema after NST even after SLNB alone. The triple mapping provides valuable data regarding the competency of lymphatic drainage and would have the potential to serve selecting patients for lymphovenous by-pass procedures at the index procedure. NST reduces the metastatic involvement of the ARM nodes. However, conservative axillary staging with sparing ARM nodes after NST necessitates further studies with larger sample size and longer follow-up.","title":"Triple mapping for axillary staging after neoadjuvant therapy: Axillary reverse mapping with indocyanine green and dual agent sentinel lymph node biopsy"}
{"_id":"4aaf6f2f-b575-b6c8-6a5f-6a86d4ce50e0","text":"In this review, we aim to analyze the clinical features of calcinosis cutis and calciphylaxis associated with autoimmune diseases and the main treatment strategies evaluated up to now for treating this potentially disabling disease.","title":"Calcinosis Cutis and Calciphylaxis in Autoimmune Connective Tissue Diseases"}
{"_id":"4aafe067-a0d5-aa12-41ec-fd8da54938ba","text":"During the same period 219 other patients were seen at our clinic and all received skin prick tests for chlorhexidine 2 %. All of these patients had completely negative tests with a no wheal and no flare.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"4ab46e93-90de-246c-9742-717f0ef6726d","text":"Physiological changes in the human can be roughly divided into two stages, development and ageing. The developmental and ageing forms of face can reflect the differences between these two stages. The age range from 4 to 40 years chosen in this study could basically cover the development and ageing periods. Children under the age of 4 years are rarely examined with lateral radiographs, and X-ray examination cannot be performed on research subjects for research purposes due to medical ethical reasons. Thus, we chose the age of 4 years as the lower limit of our study age range. In the related research on age estimation using traditional manual feature extraction methods and deep learning, the performance of age estimation decreases with the age of the subjects during the ageing period, which is also a challenge for related studies. In the study of age estimation using orthopantomogram images and 3D facial images related to LCR images, the estimated age performance is significantly worse after the age of 40 years. In addition, the number of orthodontic patients in northwestern China decreased rapidly from the age of about 15 years as shown in Table 3, which also results in poor performance of age estimation and theinability to obtain accurate and generalized ageing characteristics. Therefore, the age of 40 years was set as the upper age limit for this study.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"4ab62b34-e221-3010-d2ef-164a8f5d98ed","text":"Tumor cells can use multiple mechanisms to escape recognition by the immune system. They can decrease the amount of TILs in the tumor microenvironment, prevent the activation of TILs or even induce factors to recruit tumor favoring TILs. It makes sense that an effective approach to the treatment of breast cancer is also a multifaceted treatment approach.","title":"An update on the use of cryoablation and immunotherapy for breast cancer"}
{"_id":"4ac2adf0-7445-f93f-a4ed-4cf1e811834f","text":"Although the technical aspect of pectus repair is more tedious in adults than in children, postoperative recovery and long-term results have been similar.9 The costal cartilages are usually thicker in adults and occasionally they must be scooped out from the perichondrial sheaths with a rongeur rather than being removed with a small elevator. Minimising injury to the perichondrial sheaths during removal of cartilage segments is considered essential in order to permit maximum cartilage regeneration.10 Placing minor fragments of fresh autologous cartilage into the empty perichondrial sheaths appears to support costal cartilage regeneration and does not increase the risk of infection.11","title":"Clinical experience of repair of pectus excavatum and carinatum deformities"}
{"_id":"4ac4222f-1d17-ca9e-cdc6-a7af9e5c6cdc","text":"Another core objective of the fellowship is to foster an environment where fellows become effective educators. Development of skills in education and academics is facilitated through many opportunities for teaching at CU SOM and other institutions. All fellows help administer and teach a fourth-year medical school elective course in Climate Medicine at CU SOM. Based on personal interest, they also participate in continuous evaluation of curricular design for this course while simultaneously gaining expertise in academic innovation in climate change and health. Lastly, all fellows help build a forthcoming 300-h professional development course for clinicians titled Diploma in Climate Medicine at CU SOM.","title":"Creating climate-informed physician leaders: The evolution of a physician fellowship in climate and health science policy"}
{"_id":"4acb4c70-367b-c8b3-91c0-e49e5b554c8d","text":"Although the majority of our patients had in situ breast cancer and small invasive breast carcinoma with extensive in situ component, more recently SSM has been used to treat more advanced disease with local recurrence rates increasing with more advanced stages [28].","title":"Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR) for early breast cancer: Eight years single institution experience"}
{"_id":"4adcaf8e-799c-723e-a9d0-050bd0f03fc2","text":"These data must be interpreted in the context of the study design. Misclassification of diagnosis or procedure could bias patient selection, although the direction of this bias is difficult to assess. Referral of more complex patients to specific hospitals or surgeons within the study cohort could explain between-hospital and between-surgeon variation, although that is unlikely given the non-overlapping referral patterns of most participating hospitals.25 Children may have had additional medical conditions that influenced timing of primary palate repair; we excluded children with complex chronic conditions,22 but we cannot eliminate the possibility of confounding by other medical conditions. We may have overestimated time to secondary surgery for censored individuals, as these children may have received secondary palate surgery at an institution other than their initial treating hospitals and this would not be in the dataset. Extent of variation among hospitals observed in figure 1b may not generalise to all children’s hospitals; the hospitals included in this figure were selected based on the large number of children undergoing palate repair at these hospitals during the observation period and may be outliers among all children’s hospitals.","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"4add9992-3390-a5f8-c3bf-2c2fbc686dc6","text":"Limitations of our study included the inability to evaluate multiple procedures over time in the same patient owing to the small number of combined outcomes because most individuals had only 1 limb outcome at follow-up. The majority of revascularization procedures occurred soon after ABI testing and, in many cases, the test results may have prompted the intervention. However, the decisions on patient management were made at the point of care by clinicians and patients and not influenced by the investigators. This study included mostly white, insured individuals who underwent ABI testing at 1 academic institution. Hence, the generalizability of the study findings should be considered limited to individuals with characteristics similar to those of the study cohort.","title":"Association of Ankle-Brachial Indices With Limb Revascularization or Amputation in Patients With Peripheral Artery Disease Association of Ankle-Brachial Indices With Limb Revascularization or Amputation"}
{"_id":"4ae3d071-2c26-308a-ad76-6cb7f5501c28","text":"Iliac crest bone graft along with anatomic locking plate fixation allow for a sufficient biomechanical stabilization and lead to radiographical bony union in non- and malunions of the clavicle with a high degree of patient satisfaction. However, complications at the donor site such as secondary fractures of the anterior superior iliac spine constitute relevant complications. Hardware removal should be individually discussed and the time of removal should be considered carefully.","title":"Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft"}
{"_id":"4ae48974-fad4-fc2c-1402-51c66510782b","text":"In this study focusing on immediate and delayed breast reconstruction, the results showed that there was no statistically significant difference between the two groups of patients in the assessment of quality of life in the domains of the SF-36 questionnaire.","title":"Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients"}
{"_id":"4ae89c55-5ae4-ce35-451d-37b6faa15e18","text":"Acute osteomyelitis and septic arthritis are two infections whose frequencies are increasing in pediatric patients. Acute osteomyelitis and septic arthritis need to be carefully assessed, diagnosed, and treated to avoid devastating sequelae. Traditionally, the treatment of acute osteoarticular infection in pediatrics was based on prolonged intravenous anti-infective therapy. However, results from clinical trials have suggested that in uncomplicated cases, a short course of a few days of parenteral antibiotics followed by oral therapy is safe and effective. The aim of this review is to provide clinicians an update on recent controversies and advances regarding the management of acute osteomyelitis and septic arthritis in children. In recent years, the emergence of bacterial species resistant to commonly used antibiotics that are particularly aggressive highlights the necessity for further research to optimize treatment approaches and to develop new molecules able to fight the war against acute osteoarticular infection in pediatric patients.","title":"Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis"}
{"_id":"4af6bd58-97d8-b25a-5b34-d723262332fa","text":"We have been continuing to develop the techniques for preserving and transporting cell sheets in preparation for future commercialization. We continue to research the vitrification method to facilitate the cryopreservation of cell sheets while maintaining their macro- and microstructures to ensure a high rate of the viability of the constituent cells. The circulating vitrification bag and vitrification storage box are useful for the long-term preservation of vitrified cell sheets, which will make the clinical application of cryopreserved cell sheets even more feasible.","title":"Polydactyly-derived allogeneic chondrocyte cell-sheet transplantation with high tibial osteotomy as regenerative therapy for knee osteoarthritis"}
{"_id":"4af6ff3f-713e-c776-3b85-8ab2f9884ea4","text":"In the technique described here, collected fat is injected subcutaneously in all regions of the face. In areas such as the temporal region, we also inject to the superficial temporal fascia and superficial muscular aponeurotic system. The treatment and the introduction of cells with regenerative potential to all areas of the face, including supportive tissues and fibromuscular layers may be the main factors contributing to the increase in elasticity and functionality of all facial tissue observed. This increase in elasticity is believed to be the reason for the increased volume of grafted fat that can be injected in subsequent procedures.","title":"Total Facial Autologous Fat Grafting for Treating Skin Manifestations in Scleroderma"}
{"_id":"4af81edc-2a0e-f3e8-aad6-ff005464bad6","text":"The studies involving human participants were reviewed and approved by Peking University Third Hospital. The Ethics Committee waived the requirement of written informed consent for participation. Written informed consent was obtained from the patient for the publication of this manuscript and of potentially identifiable images or data included in this article.","title":"Rare case of pulmonary fat embolism and acute respiratory distress syndrome after liposuction and fat grafting: a case report"}
{"_id":"4af923df-f713-5766-0923-04498c98c419","text":"The only case of paresthesia occurred after a procedure involving the left internal saphenous vein and normal sensitivity returned within 6 months. There is an up to 7% risk of nerve damage after laser ablation because of the possibility of thermal insult from the veins.6 The result is aggravated if tumescence with chilled saline is not administered. The same patient also had headaches after spinal anesthesia. Another patient complained of pain within the dermatome of the left lumbar nerve, also in response to the anesthesia, with remission after anticonvulsant and antiepileptic medication for 15 days.","title":"Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser"}
{"_id":"4aff0127-9e35-4bf9-85f7-aa1908904265","text":"The gluteal branches run along the inferior border of the gluteus maximus and are distributed in the inferior gluteal region. As previously mentioned, the dorsoventral origin of the gluteal branches from the sacral plexus corresponds to the lateromedial order of their distribution. Two problems regarding cutaneous branches distributed in the inferior gluteal region need to be solved. One is the branch penetrating the gluteus maximus muscle in the lateral part. The other is about which branches in the medial part should be considered gluteal branches of the PFC.","title":"Origin, course, and distribution of the posterior femoral cutaneous nerve and the spatial relationship among its branches"}
{"_id":"4afffd0f-7d1e-ad48-4f58-09d8b244601f","text":"The main purpose of deep curettage was to erase the main bulk of the tumour within its clinical margins. The purpose was not to remove all parts of the tumour in an attempt to prevent damage afflicted to surrounding tissue, as reflected by the favourable post-treatment cosmetic results obtained.","title":"Pre-Treatment Deep Curettage Can Significantly Reduce Tumour Thickness in Thick Basal Cell Carcinoma While Maintaining a Favourable Cosmetic Outcome When Used in Combination with Topical Photodynamic Therapy"}
{"_id":"4b036233-a240-258b-7b21-3ac0cb159eb6","text":"Surgical approach was implemented in all cases. An envelope mucoperiosteal flap was reflected and bone was removed with a round bur in a straight handpiece. Sectioning of the teeth was carried out using a fissure bur. The sectioning in all cases was performed from the root bifurcation area to the occlusal surface; no other sectioning technique was implemented. Bone removal and sectioning of the tooth was performed under continuous irrigation with sterile saline solution at room temperature. The wound was carefully irrigated and any bony spicules removed. The flap was then repositioned and sutured with 4–0 Vicryl. No lingual flap was employed in any of the cases. No patient in this study underwent coronectomy.","title":"Experience versus complication rate in third molar surgery"}
{"_id":"4b14eb13-9a44-3ef5-d313-6ffedd9fa896","text":"Table 2 Univariate and multivariate analysis of the effect of covariates of RFS for 66 patients","title":"Clinical prognostic factors for pediatric extra-abdominal desmoid tumor: analyses of 66 patients at a single institution"}
{"_id":"4b158a76-f70d-f47e-5d12-52f59a0c45bd","text":"The azygos system of veins varies greatly in its mode of origin, but the variation in which the azygos vein is a continuation of the inferior vena cava (IVC) is rare. During an oesophagectomy, the azygos vein typically is transected as a requirement of the surgery. In this case, the enlarged azygos and its arch were a continuation of the IVC. During our procedure, we first established a bypass between the right femoral vein and the jugular vein in case of injury to the azygos vein, and we then performed a McKeown oesophagectomy without transecting the azygos vein. Our experience suggests that an oesophagectomy in cases with an azygos vein continuation of the IVC is feasible. An adequate medical examination and careful reading of the imaging is crucial for the safety of these surgical procedures. An appropriate surgical approach should be selected according to the location of the tumour, the size of the tumour and its anatomical features. The establishment of a veno-venous bypass and protection of the azygos arch in patients whose azygos vein is a continuation of IVC is necessary.","title":"Oesophagectomy in a patient with azygos vein continuation of the inferior vena cava: report of a case"}
{"_id":"4b18c83b-6005-0fad-1fe6-a09930231d09","text":"All patients presenting with lymphadenopathy should undergo FNAC, this being of critical importance for cervical lesions as lymphadenopathy presenting in this region may represent metastases from primary squamous cell carcinomas of the head and neck. Given the limitations of FNAC, all suspicious lymph nodes should be biopsied if the FNAC is reported normal or demonstrates reactive changes only, this being performed mainly by general surgeons. Thus at present the 'surgeon' still has a role to play in the diagnosis of lymphoma.","title":"Does the surgeon still have a role to play in the diagnosis and management of lymphomas?"}
{"_id":"4b22c478-c312-91e4-dcfe-6fb842f2b87a","text":"Safety monitoring procedures will be documented in a standard protocol and overseen by the project director and consulting dermatologist. Study staff will contact the study dermatologist immediately to determine the best response to an adverse event involving sunless tanning or sunscreen products. The committee will review all events that have occurred and look for trends in the data. Adverse events, serious or otherwise, as mandated by the University of Massachusetts Medical School must be reported to the university IRB within 24 hours of the event. The PI will comply with this mandate and will also provide reports to the sponsor (NCI) and the FDA (when the adverse event is a result of sunscreens and sunless tanning products provided by the investigators). Summaries of adverse events are also required in annual reports by the University of Massachusetts Medical School. Any temporary or permanent suspension of this research (by the FDA or UMass IRB) will be reported by the PI to the NCI grant program director within 24 hours of that action.","title":"Design and methods for a cluster randomized trial of the Sunless Study: A skin cancer prevention intervention promoting sunless tanning among beach visitors"}
{"_id":"4b275404-3416-8fe4-c60d-341c8e385951","text":"Ultrasound of the axilla, with core needle biopsy of the suspicious lymph nodes improves selection of breast cancer patients for SLNB or ALND with a higher accuracy than triage based on clinical and ultrasound evaluation alone. This is a benefit to the patient in terms of morbidity as it avoids unnecessary ALND. However, the study also reinforces evidence that ultrasound, even with core biopsy, does not have a 100% negative predictive value to forgo operative axillary staging based on current standard of care.","title":"Preoperative Ultrasound-guided Core Biopsy of Axillary Nodes for Staging of Clinically Negative Axilla in Breast Cancer Patients – A Pilot Study"}
{"_id":"4b2ea826-25e9-29b4-4b84-df0b868619cb","text":"Head-preserving operation of core decompression and various types of bone grafting certainly gives excellent results in early stage of osteonecrosis. Despite the many reports on the utility of various operative procedures, no single method has uniformly demonstrated the arrest of disease or prevention of collapse of the femoral head effectively. The vascularized fibular grafting is associated with better clinical and radiographic results than is nonvascularized fibular grafting in precollapse hips.6 However, the successful use of free vascularized bone grafts requires a meticulous process of procuring the vascular fibula with microanastomosis to the recipient site. The microsurgical procedures require specialized training, equipment and expertise. The vascular pedicle bone graft by using part of iliac crest based on deep circumflex iliac vessel described in this article is easy to perform and does not require any special equipment or technique, and still has the advantages of the vascularized bone graft. We analyzed and report a series of patients of osteonecrosis of femoral head treated by core decompression and vascular pedicle grafting of part of iliac crest based on deep circumflex iliac vessels.","title":"Osteonecrosis of femoral head: Treatment by core decompression and vascular pedicle grafting"}
{"_id":"4b35195f-e3c7-acb6-9003-130738f15714","text":"The number of surgical procedures analyzed was 1669. All patients with histological confirmed diagnosis of NMSCs were included in the study and all medical records of patients were retrieved for data analysis. Medical records reporting punch biopsies and histological diagnosis of melanomas were excluded from the study.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"4b38b8c5-c5db-a016-1b96-87d0e2d5ad83","text":"A desire to share and\/or develop enhanced clinical expertise was the main motivation for many of the clinical fellowship programs. Division heads and fellowship directors expressed the importance of being able to train individuals beyond the skills learnt in specialty and subspecialty programs, identifying unique patient populations in need of these skills and\/or new or emerging advances and treatments in their field. For trainees, additional expertise led to added confidence in the clinical realm and provided new opportunities for future clinical practice. There’s a huge clinical need for people with this training so to be able to provide that training is important (Fellowship director) Having the extra expertise in “XX” allows me to go to an underdeveloped area of the country afterward and be able to have a bit more authority in being able to present myself as a specialist in that particular topic (Fellow)","title":"Fellowship training: a qualitative study of scope and purpose across one department of medicine"}
{"_id":"4b45ee8f-fb93-0f16-ba96-4d341ff47e02","text":"Long-term evaluation every 3 months for 1 year included clinical assessment for local relapses and tumor development at other locations. Response rates were based on the tumor area by measuring the diameter.","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"4b487ea3-e4ff-52a7-9443-1ee4921d4de2","text":"Another goal could be to do the flow analysis to visualize margin detection during resection. It would be beneficial to study the spatial resolution of the flow algorithm, which we will investigate in future studies.","title":"Photoplethysmography for demarcation of cutaneous squamous cell carcinoma"}
{"_id":"4b520b65-3a71-3358-5f6b-349f99d93717","text":"As the first step in this procedure, the exact pattern of the contralateral normal ala is determined just superior to the melolabial sulcus. The flap is designed as an interpolation flap in which the final scar of donor site closure lies exactly in the melolabial sulcus. The flap is traced 1 mm larger in all dimensions to allow for postoperative contraction. The inset is thinned distally, leaving only 1-2 mm of subcutaneous tissue in the area of the inset. The donor site is closed by undermining adjacent cheek skin and advancing it, inferiorly and medially. Closure of the donor defect before closure of the primary defect brings the base of the flap closer to the nose, thereby facilitating subsequent closure of the primary defect with minimal wound closure tension.","title":"Reconstruction of Nasal Skin Cancer Defects with Local Flaps"}
{"_id":"4b54d52c-f8cb-3817-df22-1f5c0749d3af","text":"The following Figure 1 represents the flowchart that describes the process flow of the experimental study.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"4b5ba72e-8f12-766c-72ea-77423551c93d","text":"OBJECTIVES Breast cancer is the most common cancer as well as the second leading cause of cancer death among women. There is a need to develop a breast imaging technique for reliable identification and differentiation of breast masses based on stiffness. Recently we have shown that Harmonic Motion Imaging (HMI) can be used to differentiate relative stiffness and monitor HIFU ablations in small lumpectomy human breast specimens. The objective of this study is to apply HMI on post-surgical mastectomy breast specimen with or without skin to mimic the in vivo environment and characterize tumor at different depth for better tumor localization and identification before and after HIFU treatment.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"4b60e10a-5c15-7fca-23f8-2620ee233ff2","text":"Negative pressure wound therapy is a highly effective treatment strategy for infected sternal wounds as a temporary dressing between debridements until the wound is clean enough for definitive closure.3 Negative pressure wound therapy acts to increase local blood flow, remove fluid and necrotic tissue, reduce bacterial count, accelerate wound contraction, and provide a moist environment for wound healing.4 Negative pressure wound therapy has been shown to reduce the time to definitive wound closure and the cost associated with prolonged hospital stay.3","title":"Sternal Wound Reconstruction With Omental Flap for Poststernotomy Mediastinitis"}
{"_id":"4b671363-c766-dfe0-a137-2c59189b4f6a","text":"The goal following any craniotomy should be to mobilize the patient as soon as possible, in addition to providing MP and chemoprophylaxis with the caveats detailed below.","title":"Posterior Fossa Hemorrhage Following the Use of Low-Molecular-Weight Heparin: Lessons Learned and Recommendations for the Treatment and Prophylaxis of Postoperative Venous Thromboembolism"}
{"_id":"4b6b28fa-f757-622b-1e48-d660f3c05484","text":"The aim of this retrospective study was to delineate the differences between permanent and non-permanent filler complications, treatment options as well as salvage strategies in severe cases of filler complications. A detailed analysis of histopathological features and the used materials was included.","title":"Complications and Disasters After Minimally Invasive Tissue Augmentation with Different Types of Fillers: A Retrospective Analysis"}
{"_id":"4b716b97-1cf5-f773-37d0-2fac97765eee","text":"Our study was limited primarily by its retrospective nature. As such, limitations include possible selection bias and the potential for not adequately adjusting for unmeasured confounding variables. As a result our findings can only be hypothesis generating and are not intended to be interpreted as hypothesis testing. A significant limitation of our study was the inability to match RBC volume according to the timing of RBCs transfused. RBCs transfused after the development of DVT could not have influenced the development of DVT, although this risk should be equal in both RBC age groups studied. However, storage age of RBCs administered to the patients in this study was not chosen specifically by anyone. The age of RBC administered was according to blood bank policy and was consistent during the study period. Therefore, the risk of selection bias regarding the age of RBCs transfused is small. Although we did not include all potential confounders such as time from injury to operative control of bleeding, ICU practices etc., we were able to include a large number of variables that have been associated with mortality in trauma and our regression analyses were strong according to the high area under the curve measured in the model. The only difference noted in the primary patient population was an increased incidence of penetrating injury in the decreased RBC age group. However, the mechanism of injury was not associated with mortality and therefore is not a confounding variable on RBC age and mortality. Another potential limitation is that DVT screening did not occur for all patients included in the study. DVT screening occurred in 91% of patients included. Some may have been transferred out of the ICU before it was ordered, some may have died before it could be performed, and others may not have received one due to physician error in not ordering one. The timing of DVT screening was also not uniform or standardized. This may have introduced sampling bias. Although the use of each method of DVT prophylaxis method was similar between study groups, the inability to compare the timing of DVT prophylaxis initiation from admission is another limitation. Finally, our analysis of DVT was limited by our inability to adjust for confounding variables.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"4b784ba8-3411-de5e-6238-db19e6e3f3aa","text":"Background: The forehead is a donor site for facial reconstruction but has no generous donor site for its coverage. All options of the reconstructive ladder can be used. A large rotation flap was used to reconstruct a big central forehead defect following failed previous repair in an elderly diabetic patient after a motor car accident.","title":"Usage of a rotational flap for coverage of a large central forehead defect"}
{"_id":"4b7a8571-9bfc-66a4-20f0-085ecdc30ad0","text":"An internal nasal splint was kept to maintain pressure over the grafted area for prolonged period of over six months.","title":"Complex Nasal and Periorbital Reconstruction Using Locoregional Flaps: A Case Report"}
{"_id":"4b7d63cb-6368-7ec1-6d13-d220a4fb8134","text":"Although CTBL in group L did not show non-inferiority to group D, the local injection of TXA was considered to be superior for suppressing bleeding considering the risk of the adverse effects of using a drain.","title":"The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial"}
{"_id":"4b7e738c-e1c1-40bb-0f82-d1cbab422839","text":"Condylotomy can be performed transorally, which avoids the cutaneous scar and risk for facial nerve injury. Risks to the other surrounding structures such as maxillary artery meanwhile differ among the different devices used to perform the osteotomy. Osteotomy around the condyle can be performed using piezosurgery, drill, saw, osteotome, and even gigli saw. The use of piezosurgical instruments has the advantage of not damaging the soft tissue and at the same time allowing and improving precision in osteotomy. This allows access to this limited area with minimal damage to the surrounding tissue. The fact that the joint was dislocated anteriorly provides an advantage for the surgeon to access the condyle in the reported case.","title":"Long-Term Follow-Up following Condylotomy in a Case of Traumatic Unilateral Anterosuperior Mandibular Condyle Dislocation"}
{"_id":"4b843822-04e5-d5a9-186b-2eb761901318","text":"Interviews will be performed with both patients who agree to continue in the trial and those who decline to be further involved. The research team is aware that ethically patients do not have to provide a reason for their choice and should not be coerced in anyway. However, in light of the limited knowledge in this area, the value of understanding what trauma patients’ think and feel about research in this context would be substantial and would help to inform the recruitment process in the main trial. The researcher would take an exploratory, non-judgemental stance while allowing the patient to tell their story. As interviews will take place with participant refusers after they have withdrawn from the trial, the interview cannot be construed as coercive in relation to the trial.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"4b8a9ee7-9b7a-b931-db86-8d22beea1968","text":"Skin biopsies were optional and performed within 3 days of blood sampling. Skin biopsies consisted of a single 0.60 cm punch biopsy from the edge of the MRSA SSTI and a single 0.60 cm punch biopsy from a distant uninfected site for those with MRSA infections. Participants colonized or negative for MRSA underwent skin biopsy at a random body site. Tissue was fixed in zinc formalin.","title":"MRSA Infections in HIV-Infected People Are Associated with Decreased MRSA-Specific Th1 Immunity"}
{"_id":"4b8ad08f-91f1-abb4-46f7-7cbc6c46b2c8","text":"Physician leaders were expected to be capable of making decisions and to have visionary talents. Natural-born leaders were not expected, and a job title was not perceived enough to earn credibility as a leader to subordinates and peers. The status of a respected leader was earned by showing not only capability for leadership but also an understanding of medicine and a physician’s work and life. This was assumed to be difficult without prior knowledge of working as a physician because it takes medical education and years of work experience to properly internalise medical ethics and the responsibilities of physicians. A meaningful vision for the organisation and hassle-free working conditions were seen to contribute positively to the desired level of job satisfaction.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"4b8f3e87-cf3b-2904-1f77-f0a1ba06a58d","text":"The American College of Surgeons and the CoC have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator.","title":"Positive Surgical Margins in the 10 Most Common Solid Cancers"}
{"_id":"4b8fcd77-86c4-88cd-fae2-a2a1662f4455","text":"Some of the patients with infected nonunion before surgery or having a high risk of fracture after surgery were treated with external fixation material. Skeletal stabilization was performed appropriately in both groups: 20 patients with infected nonunion received external fixation (15 unilateral external fixation and 5 Ilizarov frames), and 15 patients with a high risk of fracture after surgery received external fixation (10 unilateral external fixation and 5 plaster fixation). The patients without infected nonunion before surgery or having no a high risk of fracture after surgery were not treated with external fixation material. The drainage tubes inserted in each patient were retained for 24 h postoperatively.","title":"Combination therapy with vancomycin-loaded calcium sulfate and vancomycin-loaded PMMA in the treatment of chronic osteomyelitis"}
{"_id":"4b91d3eb-677c-2275-4a0f-041bdc1b9a71","text":"Patients with cSCC and a tumor thickness of at least 5 mm who underwent surgery between 1999 and 2014 at the Department of Dermatology at the University Hospital of Tübingen were included. The diagnosis was histologically confirmed in all patients and the primary tumor was completely resected whereby 3D histology was used. The tumor thickness cutoff is based on published data on risk stratification [5].An increased metastasis rate has been described for tumors with a thickness of more than 2 mm, increasing with thickness. The tumor thickness of 5 mm was also chosen to take into account the risk that the tumor thickness might be underestimated due to tumor factors such as ulceration or for technical reasons in histological processing. Other risk factors such as immune status of the patient, histological subtype or localization of the tumor were considered in individual cases; however, only patients with a tumor thickness of more than 5 mm were included in the present analysis.","title":"Sentinel lymph node biopsy for high-thickness cutaneous squamous cell carcinoma"}
{"_id":"4b956fd8-2ee7-d42b-6875-1210cb424ec0","text":"The wide excision of CM results in defects that can be reconstructed by undermining and primary closure of skin, using in advantage local skin tension lines, by skin grafts and by local or distant flaps. These principles are well known but several questions are still being asked: primary closure or a more elaborated reconstruction, skin grafts or flaps? Should a specific lesion inherit the area specificity or should it be treated as a usual CM? Should the reconstructive ladder be climbed systematically, or should we use the elevator in our advantage?","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"4b99a585-0456-b223-7ffa-ff0e31ba5d48","text":"A variety of BT sources are used by the survey participants for treatments. Individual respondents could select multiple sources for this question. The distribution of sources utilized for BT treatments by the programs is presented in Figure 2.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"4ba6b6e5-fa79-4810-dff2-b2a15f0f89eb","text":"A properly executed BFP excision can achieve distinct facial slimming for the capacious face and can also contribute to improving lower face sagging due to BFP ptosis in middle-aged patients.","title":"Aesthetic Values of the Buccal Fat Pad Excision in Middle-Aged Patients"}
{"_id":"4baae869-d008-3714-b8d4-4e9bd00785ad","text":"The SLNB positivity probability is below 3% in T1a melanomas but can be up to 5–10% in T1b melanomas, with the caveat of historical Breslow thickness reporting with two decimals (< 0.75- vs. > 0.75-mm thickness) instead of one decimal as it is now required by the 8th edition of the American Joint Committee on Cancer TNM staging system [29, 30]. Therefore, SLNB is not indicated in T1a melanomas, unless there is uncertainty about the real microscopic depth staging (positive deep margin). Other pathological features can also predict a higher probability of positive SLNB in thin melanomas, namely mitotic index > 2\/mm2, young age, and lymphovascular invasion [31]. Therefore, SLNB can be discussed and considered in T1a melanomas with these adverse pathological features, even though their presence in < 0.8-mm-thick melanomas is very rare.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"4bac1c45-e647-f2e3-4d3c-99ddda780a07","text":"In these series, all patients were managed initially by the orthopedic trauma services. Their wounds were debrided by the primary service, then referred to the plastic surgery department. An open tibial wound in the junction of the middle and distal thirds of the leg was reconstructed successfully with the synchronous regional muscle and fasciocutaneus flaps. Twelve patients had primary healing of their tibial wounds were without any complications.","title":"Synchronous Soleus and Reverse Sural Flap for Large Soft Tissue Defect Reconstruction of Leg"}
{"_id":"4bada329-2b95-bcfa-1d04-fdf692b96841","text":"The use of PDT in NSCLC is typically classified into its use in early stage, otherwise operable cancers or late stage cancers.","title":"Photodynamic Therapy in Non-Gastrointestinal Thoracic Malignancies"}
{"_id":"4bb6935f-1d41-c12d-ed1d-2dc26de321aa","text":"In addition, because the severity of the skin rash has been associated with treatment efficacy [7], one should consider the possibility that the therapy may not be as beneficial in the absence of a skin reaction. Our patient had a recurrence in a previously irradiated area where skin sparing was noted during his re-irradiation. Despite the re-irradiation and subsequent surgical resection he proceeded to develop a recurrence in the same area. He is now deemed unresectable and is undergoing palliative chemotherapy. Although we should be cautious in the use of concurrent epidermal growth factor inhibitors in the radiation treatment of recurrences in previously irradiated areas, further research at the molecular level is necessary to obtain a better understanding of the etiology and variability of the skin toxicity induced in patients undergoing combined therapy.","title":"Lack of Cetuximab induced skin toxicity in a previously irradiated field: case report and review of the literature"}
{"_id":"4bb7fca0-8e56-097d-b6c3-6c9007aea78a","text":"In conclusion, we developed a pragmatic visual and analytic assessment system to evaluate the degree of blue staining in extirpated lymph nodes when SLN mapping is performed using methylene blue dye. The scoring system and quantitative image analysis program have strong agreement which shows the validity of the visual assessment. This assessment workflow allows for standardized reporting of clinical research to improve comparability and consistency of results in SLN mapping of various cancers utilizing methylene blue. The validated visual scoring system provides an accessible and objective measure in a clinical setting when image analysis is not available. This visual scoring system can be utilized ex vivo in a patient-side manner, however, it is important to note that it is primarily intended for validation based on photographic imaging and analysis for standardizing reporting in research. It is not yet known if methylene blue staining patterns and uptake has significance for patterns of metastasis and outcomes, but a scoring and digital quantification system is required to investigate such research and is an objective of future directions.","title":"Quantitative and Semi-quantitative Methods for Assessing the Degree of Methylene Blue Staining in Sentinel Lymph Nodes in Dogs"}
{"_id":"4bbc10bd-6457-f78c-622f-6a5fe074b276","text":"An additional risk of this treatment is the recurrence with the possibility of provoking a dependency on the injections and prolongation of the underlying disease course, although we could not see this in our patients. This underscores the importance of detailed consenting and explanation regarding the role as a supporting therapy, as done in our clinic. In contrast, we had several patients with good effect who told us that they would actually not need further treatment. In these cases, we offered to come back whenever they would need it and four patients came back for single injections after one to 3 years. Unlike in patients with blepharospasm, where injection intervals can be reduced to 6 weeks as needed, we would not recommend to do so in patients with convergence spasm.","title":"Periorbital injections of botulinum toxin a: a novel therapeutic option for convergence spasm in neuropsychiatric disorders"}
{"_id":"4bcada42-18ba-b3f4-d525-134640eb4ac4","text":"In summary, we strongly advocate including tumor thickness and a distinction between vulval and non-vulval mucosal melanoma when designing a staging system if it is to have a prognostic value. We also advocate considering the establishment of separate therapeutic regimens for mucosal melanoma due to a more aggressive systemic disease. We further suggest considering melanoma of the vulva to be classified as a primary cutaneous neoplasm. The importance of tumor thickness in N0M0 patients, resectional status, lymph node affection and disseminated disease has to be validated by studies with larger cohorts.","title":"Primary Localization and Tumor Thickness as Prognostic Factors of Survival in Patients with Mucosal Melanoma"}
{"_id":"4bcaecbc-8536-b837-6ee4-7c72ce9f5f3e","text":"Eligible for inclusion in this trial are female and male patients aged ≥ 18 years if they meet the following criteria:","title":"Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial"}
{"_id":"4bd2afb8-6812-dd1f-1f71-3a019b83c760","text":"We designed a data collection tool in REDCAP to ease the management of data extracted from the cervical cancer screening registers. After selecting the registers of interest, we identified the patients who had undergone treatment for premalignant lesions. Data on their demographic characteristics and the treatment given were then collected. We also examined whether or not they returned on the scheduled date or within three months after the scheduled date. Loss to follow-up was defined as failure to return for review on the scheduled date or three months thereafter.","title":"High Rate of Loss to Follow-Up Among Patients Undergoing Treatment for Premalignant Cervical Lesions at Mbarara Regional Referral Hospital, Southwestern Uganda: A Retrospective Cohort Study"}
{"_id":"4bd423a1-b9a6-5e86-6a63-e091580564d2","text":"The main objective of this study was to calculate the recurrence rate of this benign tumour following multimodal therapy with surgery plus external radiotherapy in a Chilean institution which receives patients who have had surgery in multiple centres in the country which have a common therapeutic focus.","title":"Postoperative radiotherapy in the management of keloids"}
{"_id":"4bd9e166-a0d5-a2f7-5e63-c0cee0eb7131","text":"This Research project is kindly supported by a grant from ARUK.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"4be080b5-0b7d-b5d8-3e10-03e4aa0cc510","text":"The deep infection was resolved uneventfully after the single surgical intervention retaining spinal instrumentation. Good clinical outcomes of the initial surgery were maintained until the final follow-up without recurrence of SSI in all 3 cases.","title":"Deep surgical site infection after posterior instrumented fusion for rheumatoid upper cervical subluxation treated with antibiotic-loaded bone cement Three case reports"}
{"_id":"4bf0e926-7179-a47a-01f7-cea0fb3b7e5d","text":"In addition, by counting the nuclei of the immune cells separately, the inflammatory response reduction effect on the stained tissue could be confirmed. These cells were identified by the shape of their nuclei by designating 15 identical regions on each tissue slide. About 85% of the immune cells were reduced in the PUCD treatment group compared to the inflammation induction group. A graph of the degree of immune cell reduction is shown in Figure 12.","title":"The Novel Digital Therapeutics Sensor and Algorithm for Pressure Ulcer Care Based on Tissue Impedance"}
{"_id":"4bf3bc5d-321d-9730-451b-38058de678c2","text":"The increasing role of survivorship programmes in such patients who have undergone breast cancer treatment is of particular importance. Survivorship is no longer focussed solely on monitoring for recurrence, but now encompasses a number of other factors that includes the management of both physical and psychological effects of treatment, as well as adherence to adjuvant treatments such as tamoxifen. It is plausible that the management of survivorship should take place in an alternative setting where physicians (such as primary care providers) or nurses are better equipped to deal with the range of challenges that patients with cancer now face, but with the option of easily accessing specialist breast input as needed. Previous evidence has also demonstrated that attending clinics for follow-up can increase anxiety levels in patients, and that the use for the example of a nurse-led telephone follow-up clinic can minimise anxiety, as well as building a trusting relationship which patients value.","title":"Assessing Mode of Recurrence in Breast Cancer to Identify an Optimised Follow-Up Pathway: 10-Year Institutional Review"}
{"_id":"4bf5c42a-28cf-b28b-0993-0cab75127d24","text":"This case report illustrates the diagnostic challenges and surgical management of a patient with an embedded dental instrument fragment in the tongue, emphasizing the invaluable role of intraoperative ultrasound.","title":"Facilitating the removal of a foreign body in the tongue by intraoperative ultrasound guidance: A case report"}
{"_id":"4bfbc15d-39de-4fdd-389e-bd92d343d3a1","text":"The evaluation criteria on treatment of ankylosis are restoration of normal motion and function in patients and no ectopic bone formation around the joint to restrict its motion. For growing patient, the ramus should have growth potential. In order to achieve the above goals, complete resection of the bony ankylotic mass laterally around the residual condyle, protect the residual condylar cartilage carefully and use fat graft to eliminate dead space out of the residual condyle are the key points of sucessful treatment. Also release the muscles on the affected side and cut both coronoid process can improve mouth opening when it is not bigger than 30mm during operation. In this study, case 1 and case 9 only got 28 and 30 mm mouth opening during the last follow-up, CT showed no reankylosis. They did not take mouth opening exercise after operation, it maybe the soft tissue scarring limited the mouth opening. So, physical therapy such as mouth opening exercise is highly recommended after operation. All 9 growing patients after LAP in this study had the residual condyle grew and remodelling. Early operation to release bony fusion can avoid the aggravation of jawbone deformity and stimulate condyle growth. However, for patients with severe jawbone deformity, secondary correction of the jaw bone deformity should wait until after all growth has completed.","title":"Evaluation of the condyle remodeling after lateral arthroplasty in growing children with temporomandibular joint ankylosis"}
{"_id":"4c03b39b-547b-8510-b499-c7727a7a5526","text":"Two out of these six patients had acute rejection episodes in the early postoperative period; both of them had tolerated it and gradually improved with the proper postoperative care and adjusting the dose of immunotherapy.","title":"Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein"}
{"_id":"4c183162-7047-cc92-fb3f-ff845295a610","text":"It is necessary to report such cases because of their distinctive morphological characteristics, extremely low frequency and aggressive behaviour. A high index of suspicion allows for an earlier diagnosis and improved prognosis.","title":"Oral malignant melanoma of the lower jaw—a case report with immunohistochemical investigations"}
{"_id":"4c1ab157-607f-7a68-a4de-add4ccf19b42","text":"All studies were based on retrospective settings, as no prospective randomised trials that specifically examine radiotherapy in the context of MPNST have been conducted. In our study, improvement in the rates of local control was not observed with adjuvant radiotherapy. The rate of adjuvant radiotherapy use in our study was lower than that in previous studies, probably due to the low rate of positive margins. Our results indicate that the mainstay of therapy for MPNST is surgical resection, with the goal of achieving complete removal with negative margins, and that the addition of radiotherapy following surgery may be considered in the adjuvant setting, especially when the surgical margins are positive due to the deep location of the tumour or its large size.","title":"Clinical Outcomes and Prognostic Factors for Patients with Malignant Peripheral Nerve Sheath Tumour"}
{"_id":"4c1e8e72-ac39-aae4-75f0-eab2b4a9fe1b","text":"Research funding was received through SUNY Downstate Department of Dermatology and UC Davis Department of Dermatology startup funds.","title":"Red Light Phototherapy Using Light-Emitting Diodes Inhibits Melanoma Proliferation and Alters Tumor Microenvironments"}
{"_id":"4c1efe62-05c5-81e4-1fbc-a626188cc24c","text":"The laser tip was placed 12 mm away from the apex and was kept stationary with no advance into the canal in all laser samples. Irrigation with saline was achieved between every two cycles.","title":"Efficacy of Smear Layer Removal at the Apical One-Third of the Root Using Different Protocols of Erbium-Doped Yttrium Aluminium Garnet (Er:YAG) Laser"}
{"_id":"4c204df6-6e91-e5ea-eb4e-5cb57e8da1d5","text":"In summary, this study is the first report about the accurate calcification volume of costal cartilage and costa using DECT. The results showed an age and sex related calcification changes of the costal cartilage and costa. A gradual calcification of the costal cartilage took place before 40–50 years old and a sharp bone loss of the costa happened after 40–50 years old in females. However the males did not undergo significant calcification changes of costal cartilage and costa during their whole lives.","title":"Characteristics of Chinese Costal Cartilage and Costa Calcification Using Dual-Energy Computed Tomography Imaging"}
{"_id":"4c233a0a-050a-bcd8-0531-41094aafd51c","text":"Rhinoplasty with septal cartilage is also a common procedure. The nasal septal cartilage plays an important role in supporting the nasal dorsum and tip and separating the 2 nasal cavities. The nasal septal cartilage in Asian patients is inherently and insufficiently developed, especially in patients who need augmentation rhinoplasty. Therefore, most of the time, the harvested septal cartilage cannot provide sufficient material to achieve an ideal tip projection. Rhinoplasty with implants can reduce the risk of injury to the nose and other parts of the human body when compared with rhinoplasty involving harvesting cartilage, because removal of cartilage from the back of the ear, chest wall, or nasal septum represents an additional injury to the patients.","title":"Design and Application of a Novel Silicone Nasal Implant"}
{"_id":"4c24481a-6f45-a763-9cf5-11f2daddb00f","text":"Fibroblasts can be derived from quiescent connective tissue fibroblasts at proliferation sites, but there is also ample evidence that at least some of them originate from myeloid precursors in the blood or bone marrow that migrate to injury sites.","title":"Expression of NF-κB-p65 and α-SMA in the Study of Capsules formed by Surface Textured Implants Versus Foam Covered Silicone Implants in a Rat Model"}
{"_id":"4c2fa39e-957a-9d25-4cd3-bbbbb6cea899","text":"To our knowledge, there is a limited literature comparing these 3 most common breast reconstructive techniques. The inclusion of sensory and esthetic subjective outcomes also provides an added value to this study. Furthermore, the median long follow-up periods between the time of reconstruction and time of study strengthen the importance of our outcomes. Our data are coherent with the existing literature, but provide additional findings in the differences and expected outcomes. The main significance is that surgeons should extensively discuss the risks and benefits of each technique and should favor DIEP over the LD flap if possible when an autologous procedure is required. Patients should be thoroughly informed about the realistic expectations and potential complications when they make choices about breast cancer surgery. A potential reconstructive failure must always be addressed during preoperative consultations, as well as alternative options if an adverse event occurs. Surgeons should be cautious and meticulous when it comes to patient and procedure selection to achieve the best possible outcomes. Patient emotional well-being and satisfaction rates are of great significance when attempting to identify the ideal reconstructed breast.","title":"Defining the Ideal Breast Reconstruction Procedure After Mastectomy From the Patient Perspective: A Retrospective Analysis"}
{"_id":"4c2ff6eb-842c-1f45-f4cc-5a11bdb899c9","text":"I had lost 40 pounds. Physicians encouraged me to eat as much as I could. The radiation treatments destroyed my salivary glands meaning a painfully dry mouth, chronic irritation of oral tissues and difficulty swallowing with choking episodes from both liquids and solids. Baby pureed apple sauce added moisture to enable me to swallow more easily as liquids were simply swallowed and were ineffective. I had to physically work to swallow which quickly caused muscle fatigue and more difficulties. I would choke on dried saliva in my throat. It sounded like I was a heavy smoker. These episodes occurred frequently when I was trying to speak and eat at the same time. Do you ever get together socially when there is no food or drink? Each time I had to explain to strangers that cancer treatment caused my problems with speech, eating and the reason for carrying apple sauce. I could see they thought I was an alcoholic smoker, the typical head and neck patient profile, if they were health care professionals. For example, 9 years post my cancer a senior resident informed me a first diagnostic step was to determine my level of alcoholic liver damage. I was so diminished I could not respond before the resident left the room.","title":"Every Story Is Different: Experiences With Body Changes Related to Cancer"}
{"_id":"4c366ea1-a71b-5275-eee6-a56ba5bfda2b","text":"Abnormal or variations in the branching patterns of the popliteal artery results due to arrest of normal development of limb vessels according to Senior. The lower limb vessels arise from sciatic artery, a branch of the umbilical artery. Sciatic artery persists in most vertebrates, but in mammals the femoral artery, as the continuation of the external iliac artery, becomes the main artery for the lower limbs. Anastomoses are formed between the sciatic and the femoral arteries. When the femoral artery continues as the popliteal artery, the sciatic artery regresses. Its middle and distal portions persist to form the popliteal and peroneal arteries, whereas the anterior tibial and posterior tibial arteries are derived from the femoral artery. So regression and persistence of the sciatic artery and its connection with the femoral artery in the popliteal region are the main reasons for the variations in the arteries of the leg.","title":"Variations in the origin, course and branching pattern of dorsalis pedis artery with clinical significance"}
{"_id":"4c393bd0-5ea4-f108-afe9-5dd657843c58","text":"This RCT attempts to evaluate the potential benefit of NPWT on closed inguinal incisions after two distinct vascular procedures at high risk of SSI. Outcome of this trial could have implications on postoperative wound care in both vascular and non-vascular surgical patients.","title":"Incisional negative pressure wound therapy for the prevention of surgical site infection after open lower limb revascularization – Rationale and design of a multi-center randomized controlled trial"}
{"_id":"4c3cb621-8df9-8f71-3f30-1d84a3f7fc19","text":"In cases of jeopardize skin we suggest performing an immediate surgical revision in order to preserve the implants and prevent their exposition and contamination.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"4c5c2c32-9a98-c537-d2d8-3c67554bea31","text":"With respect to the elevated risk of CNS tumors, we cannot exclude the possibility that the second primary cancer, reported by the clinicians as a CNS tumor, could in some patients be a metastasis from the primary CMM. As CMM but not SCC is likely to spread to the brain, this may explain why no such association was observed between SCC and risk of CNS tumors.","title":"New malignancies after squamous cell carcinoma and melanomas: a population-based study from Norway"}
{"_id":"4c5ecba6-ee19-b0f9-ac47-209fa4e62c37","text":"Most studies on the anatomical-functional alterations of the lingual frenulum are concerned with establishing a relationship between the pathologies and the quality of natural breastfeeding or phonetic disorders, a problem with which frenulum shortening is already related. The objective of this integrative review was to find evidence that links this condition to the establishment of changes in craniofacial development.","title":"ANKYLOGLOSSIA AND ITS INFLUENCE ON GROWTH AND DEVELOPMENT OF THE STOMATOGNATHIC SYSTEM A INFLUÊNCIA DA ANQUILOGLOSSIA NO CRESCIMENTO E DESENVOLVIMENTO DO SISTEMA ESTOMATOGNÁTICO"}
{"_id":"4c603fef-db84-373b-9a85-63e8e43f2b03","text":"In Denmark people do not have a strong tradition of wearing hats and nor is there a large commercial availability of quality hats. By making hats available and using attractive quality, we aimed to increase this behavior. A study showed that a brief instruction to sunscreen application increased the provided protection [37]. The sunscreen application instruction was based on a recently developed application instructions for use of sunscreen to counter the described problems and deficits of current sunscreen use. It describes every part of the body, the needed volume of sunscreen for that body part and application patterns. The package included a hat and the availability intended to increase the use. The hat was foldable for easy packing. The sunscreen flaws to avoid as well as the benefits from applying 2 layers of sunscreen was also included.","title":"Novel sunprotection interventions to prevent skin cancer: A randomized study targeting Danes going on vacation to destinations with high UV index"}
{"_id":"4c64950f-2354-21ce-8f4b-055733f9d777","text":"Pasteurized autogenous bone graft combined with a vascularized fibula graft is a useful reconstruction method for large bone defects after resection of osteosarcoma in the femur.","title":"Evaluation of the Efficacy of Pasteurized Autograft and Intramedullary Vascularized Fibular Transfer for Osteosarcoma of the Femoral Diaphysis"}
{"_id":"4c67523b-c6bf-e315-6a3a-54f063d483b4","text":"Advantages of microvascular reconstruction include a rich blood supply, transfer of healthy composite flaps of bone and soft tissue that have not been subject to irradiation [18], and a high rate of successful wound closure. Disadvantages include long operative time, significant technical demands, donor site morbidity and the occasional need for two flaps to achieve adequate bone and soft tissue coverage. The significant risks associated with free tissue transfer often exclude their use in both the elderly and the infirm. Perhaps the most troubling clinical consequence of free tissue transfer is that commonly associated wound healing complications can force delays in the initiation of adjuvant therapy jeopardizing prognosis as well as quality of life. A less invasive reconstructive method that would utilize local tissues to restore structural and functional integrity while avoiding donor site morbidity would clearly be desirable.","title":"The effects of high dose and highly fractionated radiation on distraction osteogenesis in the murine mandible"}
{"_id":"4c6acd6e-0e99-c553-7594-4b522b95f5f8","text":"Your Xolair dose will be chosen based on your body weight and the results of a blood test that measures your level of IgE. You will receive 1-2 injections of Xolair in your upper arm every 2 to 4 weeks depending on these factors. Unless your weight changes significantly, the dose and injection schedule should not change once your treatment has started.","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"4c708cd9-6623-d82a-d19e-eb339314f6c4","text":"We have successfully transferred free ALTP flaps for traumatic lower extremity reconstruction in patients with DVT in either donor or recipient veins. So, herein, we describe our experience treating DVT in this rare but critical situation. The primary goal of this study was to determine the incidence of DVT in donor or recipient veins in lower extremity reconstruction cases using free ALTP flaps. The secondary objective was to suggest a basic surgical algorithm for dealing with DVT encountered in free ALTP flap reconstruction.","title":"Deep vein thrombosis in donor or recipient veins encountered during lower extremity reconstruction with a free anterolateral thigh perforator flap: How do we deal with it?"}
{"_id":"4c7474d6-b859-e1fa-70bf-ed9881954293","text":"Chronic osteomyelitis is considered a great challenge for the orthopedist. The characteristic bone histology and the ability of bacteria to adapt to this particular microenvironment make these infections among the most insidious in the human body. Osteomyelitis is an inflammation involving the osteoarticular apparatus and its medullary canal that evolves in a progressive destruction of bone tissue. The characteristics of this phenomenon are bacterial colonies organized and protected by biofilm, a polymeric matrix the colonies excrete, often a polysaccharide. It is hard to breach this barrier, and antibiotics and disinfectants do their best to kill these shielded bacterial colonies. Furthermore, bacterial colonies enter a semidormant state that stretches pharmacodynamic effects of chemotherapies and the immune system, both specific and nonspecific. In this report, we present a case of recurrent squamous cell carcinoma in a patient with chronic osteomyelitis for which surgical amputation of the limb was initially avoided.","title":"Squamous cell carcinoma in chronic osteomyelitis: a case report and review of the literature"}
{"_id":"4c786f40-274f-a49c-5955-b067cffacf5a","text":"Our study about using alternative techniques of diced cartilage preparation with an electrical grinder and a grater demonstrated the possibility and comparability of results of these two methods with conventional technique of dicing cartilage with surgical blade. In spite of reduction in weight of grafts prepared with electrical grinder and grater, the weight reduction was lower in grater group but the difference was not statistically significant. Volume change measurements as the index of graft resorption was in the same range between all three groups.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"4c87d445-da27-ead1-0be2-cd998c90c7f0","text":"Noninvasive neuroimaging with CT and MRI allows for the rapid diagnosis of cerebral venous thrombosis and thus affects the prognosis by improving the speed of management and monitoring. It provides two types of findings: direct signs corresponding to the visualization of the thrombus or venous thrombosis and indirect signs such as the presence of cerebral ischemia or hemorrhage.","title":"Imaging of Cerebral Venous Thrombosis"}
{"_id":"4c89656b-1d49-6c79-02f0-f6085ffc015a","text":"Posterolateral incisions were taken according to the site of biopsy and the position of the tumor. During the decomposition, the superficial peroneal nerve was identified and was retracted laterally. The flexor muscle of the thumb was exposed from peroneal muscle gap, and the muscle fibers were cut to the flexor muscle of the thumb, and, the remaining fibula periosteum and some muscle fibers were separated in the fibula. In the separation process, resection of the distal fibular of 12 cm in length should be performed and proximal vascular ligation should be also retained to form a distal pedicel fibula bone flap and peroneal artery including its branch vessels.","title":"Reconstruction with double pedicel fibular graft and ankle arthrodesis for aggressive chondroblastoma in the distal tibia"}
{"_id":"4c9e8c4a-c136-3541-46fc-5e929fe5d2cd","text":"Our study was intentionally limited only to patients who underwent diagnostic imaging for acute DVT. We assumed that the clinical judgement of clinicians referring patients for diagnostic imaging has not changed much despite the pandemic. The only patients that clinicians would find it difficult to obtain scans for DVT are the critically ill patients on ITU and these were studied separately. We demonstrated a significant association of VTE with COVID-19 (clinical presentation rather than PCR test). This implies that a combination of any suspicion of DVT, with clinical picture suggesting COVID-19 should prompt clinicians to prioritise diagnostic imaging and instigate treatment.","title":"Prevalence of venous thromboembolism in patients undergoing diagnostic venous ultrasound during the first SARS-CoV-2 pandemic: A personal history of VTE and a positive COVID-19 test are associated with the diagnosis of DVT"}
{"_id":"4ca3d413-f8a8-862d-b13e-30a83597e72a","text":"Iliac bone flap with deep circumflex iliac artery is a common option in the treatment of Osteonecrosis of the femoral head (ONFH), and dissection of iliac bone flap is the key step for successful operation. This paper aims to introduce a new operative technique for dissecting iliac bone flap with deep circumflex iliac artery based on analysis of its advantages.","title":"Comparison of retrograde anatomy iliac bone flap grafting versus anterograde anatomy iliac bone flap grafting for treatment of osteonecrosis of the femoral head"}
{"_id":"4ca817a0-22db-6163-7b0c-9bda2f27cd15","text":"In this review we discuss the clinical and diagnostic strategies to prevent and mitigate HSR toward biologicals, especially when related to the development of immunogenicity.","title":"How to Prevent and Mitigate Hypersensitivity Reactions to Biologicals Induced by Anti-Drug Antibodies?"}
{"_id":"4caa344b-c50d-42c7-e542-299492447591","text":"The nasoseptal flap can be considered a milestone in the development and growth of the endoscopic endonasal surgery of the skull base and it has become the workhorse to close the CSF leaks inherent to this technique. It is easy to obtain and versatile, reaching from the clival region to the anterior fossa.1, 4","title":"Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note Técnica endoscópica endonasal utilizando duplo retalho para reconstrução de grandes defeitos da base anterior do crânio: nota técnica"}
{"_id":"4cab542d-215d-7ef1-44d7-107cbc3a2ae0","text":"PAI of en face margins provides a robust and rapid means of total margin analysis. It was demonstrated that a single metric of maximum BP could discriminate tumor from normal tissue with high diagnostic accuracy. These promising results support the potential for PAI to improve the efficiency of standard MMS thereby removing logistical hurdles of current workflows and pushing the limits of tissue sizes accepted for the procedure in various operative settings. This work has broad implications for additional tumor types where intraoperative margin status and tissue preservation is critical for patient outcomes including head and neck cancers.","title":"Paired-agent imaging as a rapid en face margin screening method in Mohs micrographic surgery"}
{"_id":"4cc2e6dc-9017-6cb1-587d-cfd093a00b64","text":"The Cartesian coordinate model was chosen for analysis because it provides a simple model which provides fundamental insight into the biophysical processes that occur during the combined application of cryosurgery and PEF. The Cartesian model utilized the boundary conditions specified in Figure 2.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"4cc73f03-c03c-4466-ee74-e51a4695b078","text":"Another important observation which can be made from our results as well as those in the literature is that when the treatment fails, the majority of recurrences occur within the first year and only 10% appear during the second year of follow-up. Thus the definitive result can be estimated with good certainty in the medium term. The rate of recurrence at two years was 35%, hence placing our study at the high end of the expected range of recurrences for a total dose of 15 Gy.","title":"Postoperative radiotherapy in the management of keloids"}
{"_id":"4cc7533a-a98c-23a7-6920-6c8fc5530d58","text":"Findings: Seven students matriculated through the first course in the sequence, offered in Spring 2017. Five are currently completing a summer implementation project focused on utilizing course learnings to develop and implement an initiative that addresses a current gap in care. Following their summer projects, these students will take the second course in Fall 2017, in which they will debrief their summer projects and learn more advanced topics in implementation research. Projects range from improving health data quality in Malawi to decreasing unplanned ED visits after bariatric surgery.","title":"Proceedings from the 10th Annual Conference on the Science of Dissemination and Implementation"}
{"_id":"4cc96b9b-b49f-eeae-5bca-930411d8b169","text":"Cervical vertebral osteomyelitis readily responds to conservative treatments if detected early but can lead to significant morbidity if fulminant due to adjacent infectious and inflammatory changes. Osteomyelitis affecting the cranium can lead to thrombosis of the subjacent cerebral venous sinus, often seen in untreated mastoiditis resulting in lateral or transverse sinus thrombosis [1]. Extracranial thrombosis of the internal jugular vein can result from adjacent oropharyngeal abscesses resulting in Lemierre's syndrome. We describe a patient presenting with spontaneous cervical osteomyelitis affecting the odontoid process with thrombosis of the adjacent internal jugular vein extending intracranially into cerebral sinuses.","title":"Pyogenic Odontoid Osteomyelitis with Sinus Thrombosis"}
{"_id":"4ccd1810-eb81-e0e3-73e3-29311426154f","text":"The data collected include patient specifics as well as intraoperative and postoperative outcome data, patients are asked for written consent to recording and publishing these data anonymously. On the written consent form participants are informed, that they can withdraw from consent at any time. In case of withdrawal the data will not be used. There is no further data collection or obtainment of biological specimens in this study, hence this is not applicable.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"4cd25b2b-fce9-47c2-67b0-40d68fd752d4","text":"The proposals of the patients from the national board were taken into account so that at the time of the international patient board, a preliminary checklist for physicians (or other health care professional) and a preliminary patient questionnaire concerning the topical treatment were created. Both preliminary tools, which additionally included items resulting from the literature search, were discussed during the interview with the international patient board. Regarding the checklist, new aspects which were identified during the interview were included in the checklists which were later placed for discussion during the expert qualitative focus group. Regarding the questionnaire, all points collected during the meeting were covered by the current items of the item pool. Later analysis of the results of these interviews revealed that all aspects reported by the patients were already included in the element pool that had been created from the literature search. In general, the patients from both boards expressed their wish for a holistic approach from health care providers, with time to talk and learn about the disease and the therapy, both at the start of a treatment as during the course of the therapy\/disease.","title":"Development of an adherence-enhancing intervention in topical treatment termed the topical treatment optimization program (TTOP)"}
{"_id":"4cd4f4b0-f7e0-fac3-c7e4-6f43497bd143","text":"Wide local excision with three dimensional safety margins was carried out and was guided by intraoperative frozen section in all patients prior starting the reconstructive procedure. Any infiltrated margin was dealt immediately by re-excision.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"4cdd8f9e-b9c7-147d-d991-55576d5a7e09","text":"We presented one of the few cases of a free latissimus flap for upper extremity reconstruction in an infant with a discussion on the challenges of free tissue transfer in the young pediatric population. For patients, parents, and physicians, it is important to understand the risks involved in these extensive reconstructive procedures. Surgeons should use their best judgment and weigh the benefits of the reconstructive outcome with the potential risks of anesthesia for infants potentially susceptible to neurotoxicity.","title":"Free latissimus dorsi flap for upper extremity reconstruction in a 9-month-old"}
{"_id":"4cdebdbd-59fa-4a7c-1842-d48b30c4a009","text":"Table 2 Characteristics of patients for whom re-SLN scintigraphy procedures were performed","title":"Management of sentinel node re-mapping in patients who have second or recurrent breast cancer and had previous axillary procedures"}
{"_id":"4ce58e6d-9b32-7662-bfe6-60cbcd48029e","text":"We undertook a retrospective review of all patients who had a mastectomy for pure DCIS at the University Hospital of South Manchester between 2000 and 2010, after hospital ethical approval was obtained.","title":"Comparison of Local Recurrence After Simple and Skin-Sparing Mastectomy Performed in Patients with Ductal Carcinoma In Situ"}
{"_id":"4ced70c4-f9be-2198-5b23-61e5467d288f","text":"Jarvik and Deyo concluded that for patients 50 years of age and older, or those who have red flag findings that suggest systemic disease, conventional radiography with standard laboratory tests can almost completely rule out underlying systemic disease and that CT and MRI should be used only in surgical candidates and patients in whom systemic disease is strongly suspected [55].","title":"Diagnostic imaging for spinal disorders in the elderly: a narrative review"}
{"_id":"4cf14df7-4795-6406-e631-655da993b18f","text":"We agree with other authors that the management of this type of collision tumor must be individualized. Mohs micrographic surgery is a technique that can be individualized as per the needs of each patient. The combination of paraffin and frozen sections is a very good tool for the treatment of basal cell carcinoma and melanoma in collision tumors.","title":"Combined Mohs Micrographic Surgery in a Collision Tumor"}
{"_id":"4cfaac87-904c-3f15-1d31-b53a4f54aa48","text":"In contrast to AAV, ADAs were highly prevalent among rituximab-treated SLE patients already after the first course of treatment and were found to effect on both clinical and immunological responses. The high frequency in SLE may warrant implementations of ADA screening before retreatment and survey of immediate and late-onset infusion reactions.","title":"First exposure to rituximab is associated to high rate of anti-drug antibodies in systemic lupus erythematosus but not in ANCA-associated vasculitis"}
{"_id":"4cfdd61d-e80f-8319-2c45-221de1fa3ed6","text":"Simulated biopsies can increase the confidence of diagnostic radiology residents that are learning to perform breast biopsies before they perform real biopsies on live patients. Providing simulation training and thereby improving resident confidence may help reduce physician error and patient harm due to poor biopsy techniques.","title":"Outcomes of Simulation in Resident Imaging-Guided Breast Biopsy Training"}
{"_id":"4cff6d62-9f91-404f-dc10-827d7cdf8ee4","text":"We conducted a retrospective study of all patients who underwent elective TKA from 1st January 2004 to 31st December 2014 at an academic tertiary hospital for osteoarthritis of the knee. Ethics approval was obtained from the Institutional Review Board. Electronic and paper records were reviewed. The data was collected from case notes review, anaesthetic assessment chart reviews and electronic notes. Inclusion criteria were all patients who had underwent elective TKA during the specific time period. Patients who had total knee arthroplasty due to fractures, had unicompartmental knee arthroplasty and who were pre-operatively non ambulatory or minimally ambulatory, were excluded from the study.","title":"Chemoprophylaxis in addition to mechanical prophylaxis after total knee arthroplasty surgery does not reduce the incidence of venous thromboembolism"}
{"_id":"4d0dadf1-dfa6-e49b-96a1-38b1b9ededd6","text":"An increasing number of breast cancer patients undergo immediate or secondary breast reconstruction, but the ideal method in terms of patient satisfaction remains ambiguous. We compared the 3 most common breast reconstruction techniques to determine patient satisfaction and objective outcomes.","title":"Defining the Ideal Breast Reconstruction Procedure After Mastectomy From the Patient Perspective: A Retrospective Analysis"}
{"_id":"4d13e766-bff1-30be-2e64-bb715cd33c49","text":"When the surgeons have a 3-dimensional concept and image of the location of SNs prior to surgery, they are then able to fine tune their surgical approach. An example of this ability to fine tune surgical approach can be applied to a hypothetical case of an upper outer quadrant breast lesion. Initially, the surgeon may plan to attempt to reach the SN via the tumor excision site in an attempt to reduce morbidity. However, when provided with LS images and skin markings the surgeon might realize that this is not the optimal approach from a standpoint of morbidity reduction, and would be able to plan an alternative approach that further minimizes morbidity. It is conceivable that more experienced, better informed surgeons are more likely to utilize LS because of its benefits, and that these surgeons perform a more delicate dissection resulting in less morbidity. However, the exact contribution of LS vs. the skill level of the surgeons that directly contributes to this reduction in morbidity can not be independently deduced from the data in the articles.","title":"Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature"}
{"_id":"4d1431e7-66ea-3dd8-47e0-cc0252347bb9","text":"When local gluteal flaps or transpelvic VRAM cannot be performed due to previous radiotherapy or abdominal surgery, then a free flap would be the best option, but dissection of gluteal vessels or branches of gluteal vessels are tedious and complicated as recipient vessels. Our surgical algorithm for plastic surgery reconstruction after sacral chordoma resection is displayed in Figure 7.","title":"Anatomical Considerations and Plastic Surgery Reconstruction Options of Sacral Chordoma Resection"}
{"_id":"4d174895-a960-944f-613a-a49ef4876911","text":"Whenever a patient presents with s\/s of acute CTS the possibility of a hemangioma involving the median nerve should be kept in mind in the differential diagnosis. Surgery can be limited to decompression only if a plane of cleavage cannot be found. If symptoms recur or progress later, total resection and grafting may then be carried out, although the results are not satisfactory22","title":"Acute carpal tunnel syndrome due to a hemangioma of the median nerve"}
{"_id":"4d1c40b6-a721-671a-fce5-d5e811bec5bd","text":"Restenosis and intimal hyperplasia are the main problems that occur after endovascular revascularization with percutaneous transluminal angioplasty or stenting. Despite the popularity and advancement of endovascular revascularization for CLI, improving the clinical outcome and preservation of limb function remain challenging following revascularization in long femoropopliteal lesions.","title":"Clinical Effect of Revascularization Strategies and Pharmacologic Treatment on Long-Term Results in Patients with Advanced Peripheral Artery Disease with TASC C and D Femoropopliteal Lesions"}
{"_id":"4d32a249-e599-41c5-3124-7ffb1a4c96b7","text":"On CT, differentiation of the thrombosed ovarian vein from the appendix can be difficult; visualization of a tubular retroperitoneal mass with central low attenuation extending cephalic to the inferior vena cava is characteristic of ovarian vein thrombosis. MRI can provide additional information in patients with a strong clinical suspicion for the diagnosis but equivocal CT findings or in patients with a contrast dye allergy [13].","title":"Ovarian vein thrombosis"}
{"_id":"4d38a525-cbab-8cc0-ca88-50fc72bd495f","text":"Surgery with admission of patients to the hospital costs very much;","title":"Oral surgical procedures under local anaesthesia in day surgery"}
{"_id":"4d39dbfb-9665-92d8-21df-26f519beeed2","text":"One of the benefits of BTA is that it can be added to any of the above methods. The chemical component separation it produces allows relaxation and elongation of the abdominal wall muscles, while preserving their structural integrity for any future abdominal wall reconstruction. The limitation is obviously that BTA takes several days to become therapeutic [10], meaning it should ideally be injected early in patients where substantial oedema or pre-existing fascial defects mean closure is expected to be a sequential affair over multiple laparostomies. As BTA can be injected during laparostomy or as a standalone procedure it implores further teaching of surgeons, anaesthetists, and radiologists to improve access to this adjunct. Improved refinement of the use of BTA may lead to improved primary fascial closure, in turn likely reducing ventral hernia or use of permanent bridging mesh, which comes with its own complications.","title":"Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases"}
{"_id":"4d66394d-b30d-c83f-a827-e6a517fb94d6","text":"The wound healed with elongated callus formation at the fracture site and the patient was able to straight leg raise. Two months before the patient presented in our clinic, his orthopaedic surgeon performed the resection of the callus and patella osteosynthesis. The procedure was complicated by the proximal patella necrosis and soft tissue necrosis. After proximal patella debridement, resection and reinsertion of the quadriceps muscle tendon with transoseal sutures was performed and the exposed bone was covered with a local flap. Post-operatively, the local flap used to cover the soft tissue defect became necrotic, so it was debrided and negative pressure wound therapy was applied.","title":"Single-stage quadriceps tendon reconstruction with gastrocnemius fascia and knee soft tissue defect reconstruction with medial gastrocnemius flap—A case report"}
{"_id":"4d684eb2-e4f7-ba36-8e5f-83007b8fedbc","text":"Table 2 Primary and secondary endpoints in patients with or without anticoagulation in unmatched and matched cohorts","title":"Hospitalized patients with isolated distal deep vein thrombosis: anticoagulation therapy or not?"}
{"_id":"4d6af33e-29ce-c8e6-7495-ab9449309b44","text":"We are also willing to raise awareness about this syndrome as a possible cause of DVT in children and its unfortunate possible complications.","title":"Acute osteomyelitis, thrombophlebitis, and pulmonary embolism: a case report"}
{"_id":"4d6d0daa-62a0-a8b3-d2cd-8626db2ecc77","text":"MR imaging is a highly sensitive method for the diagnosis of bone sarcoidosis, but the lesions are not specific. Moreover, the serum hypercalcemia that may be present both in sarcoidosis and in metastatic bone disease is not helpful in differential diagnosis.","title":"Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis"}
{"_id":"4d8d158f-d786-5b66-d5f6-bf2d7536eb77","text":"Conclusion: The demand for C1 Inhibitor is on the rise. The reasons for this are multiple including better awareness and understanding of HAE along with easier access through home infusion programs leading to less ED visits. Future studies assessing utilization are needed to gain a better understanding of the increasing use of this life-saving treatment.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"4da20211-a7d6-d315-e9b2-ea5810832b33","text":"The medical literature is scarce regarding the effectiveness of simultaneous treatment of PD tremors and occupational therapy with local BoNT injection and should be considered in future study designs. It seems that it is better to apply occupational therapy and local BoNT injection in the case group to determine whether it improved the effectiveness of local BoNT injection [6]. Some studies have been published on the efficacy of concomitant occupational therapy and local BoNT injection in other conditions. Recently a systematic review has measured the effectiveness of BoNT treatment for upper limb spasticity after stroke [38].","title":"Effectiveness of Botulinum Toxin on Hand Tremor Intensity and Upper Limb Function in Patients with Parkinson’s Disease: Results of a Systematic Review"}
{"_id":"4da3a458-9a84-681b-9bbb-462a01f7582c","text":"The photographs were assessed for the following parameters and were graded by 3 external surgeons, and the mean scores were determined:","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"4dace0a7-9323-9d67-f0f6-4cc7046a7e53","text":"Though age is uncertain as a risk factor, we found an increasing evidence of thrombosis with greater age. All our DVT positive patients were in the age group of 63-94. As regards known risk factors responsible for occurrence of postoperative DVT as mentioned earlier, we found that except one female diabetic patient who developed extensive proximal thrombosis following surgery, none of the other eight patients had a known risk factor for development of DVT.","title":"Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?"}
{"_id":"4dc5816d-ef86-065a-5ad4-8ae0b88ee0c5","text":"The timing of the findings noted above far exceeds the currently recognized course of post-operative fat embolism, and exertional events have not been previously reported. Although the prosthetic joint itself may be well-seated and stable, the potential disruption of the intramedullary cavity and venous sinusoids caused by the stem component may persist longer than is currently recognized, thereby allowing ongoing passage of fat globules into the venous circulation. Whilst there were no evident clinical sequelae at six months in this case, the exertional fat emboli seen here indicates the potential for a pathogenic role in patients with unexplained respiratory or neurological deterioration weeks, rather than hours to days, after orthopedic surgery.","title":"Exertional fat embolism after hip joint replacement: a case report"}
{"_id":"4dce007a-f1b7-a6c9-68f1-898c75cf31c9","text":"Evaluation of progress is a critical element for an effective ADP and can foster support and accountability. Assessment in regular intervals would be recommended since this can foster a sense of support and accountability. One potential strategy is to hold regular meetings with your mentor to revisit goals and associated tasks to assess if they have been achieved, are in progress, or have been unaddressed. The method of evaluation should be tailored to the preferences of the mentee and mentor. Meaningful feedback from faculty mentors and supervisors is strongly encouraged to facilitate student and resident development. However, faculty often are limited in time or formal assessment training, thus lowering the impact that the feedback can have on students. Therefore, we encourage more emphasis on time allocation for feedback sessions and formal assessment training for all mentors.","title":"Twelve-step Approach for Academic Development Planning in Academic Surgery Climbing the Academic Uphill With Strong and Steady Steps"}
{"_id":"4dce8c0e-f822-2d97-9fcf-b02f28f87154","text":"A significant proportion of the patients with primary free flap reconstructions after oral cancer surgery develops postoperative complications. Prolonged anaesthesia time and red cell transfusion are possible predictors for systemic complications and hospital stay respectively. These and other risk factors are relatively unchangeable, so little influence can be exerted on the patient’s outcome. Therefore preoperative screening for risk factors is advocated for patient selection and to have realistic information and expectations.","title":"Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction"}
{"_id":"4dd130e8-12df-cca2-0054-75d8ba5a85c2","text":"Lateral arm biopsy is useful in performing stereotactic biopsy in the presence of breast implants using the Eklund technique, in sampling medial, lateral, inferior and posterior lesions or in very thin breasts when there is risk of trauma to the skin. The advantage of lateral arm biopsy visualising calcification in the biopsy chamber using the 3 o’clock and 9 o’clock positions will be discussed and how this can limit the number of cores taken decreasing the risk of haematoma. Examples of failed upright stereotactic biopsy and the benefit of Lateral arm and case selection aids will be presented. Tips and tricks and a flow chart aiding selection of Lateral arm cases will be discussed.","title":"Meeting Abstracts from the British Society of Breast Radiology Annual Scientific Meeting 2022"}
{"_id":"4dd6cc7a-8fa6-96bb-cc7a-340545fbf5dc","text":"One of the possible methods of radiation therapy dose distribution in time is a continuous mode of exposure for several days. An example of this method is the brachytherapy whereby radioactive sources are implanted into the tumor or superimposed on the tumor of the skin or mucosa by means of special devices, applicators. The main advantage of this method is a sharp gradient of dose with increasing distance from the source, which allows sparing of normal tissues at adequate radiation of the tumor. The proximity of the radiation source to the object exposure is assumed here.","title":"Optimal Placement of Irradiation Sources in the Planning of Radiotherapy: Mathematical Models and Methods of Solving"}
{"_id":"4dde403a-89aa-c65c-4967-48b842d081cf","text":"In our experience soft tissue sarcomas with vascular involvement are inherently very aggressive tumors which at presentation have large size and high grade. Resection usually involves large amount of tissue resulting in much higher incidence of wound related complication. Reconstruction of the resected vessels is prone to blow outs in the immediate postoperative period and vascular insufficiency in long term. Because of these factors functional outcome can be unpredictable.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"4ddeaece-73a3-5bdf-cbfa-a051d6fcd8f1","text":"FGI can be performed in patients younger than 40 years with heavy jobs, having mylopathy and are already operated same level.","title":"Single level cervical disc herniation: A questionnaire based study on current surgical practices"}
{"_id":"4de4e3d3-db67-a719-7572-887d7deded9f","text":"As mentioned before in this article, in literature there’re not yet a clear indication when it is safe and recommendable to deviate from widen the resection margins in order to preserve as much as possible a very significant part of the body, and a frank and open discussion with the patient on pros and cons is mandatory.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"4de674df-d004-0722-3c0d-b5a9ffe54505","text":"Few studies have explored the mechanisms underlying allergy disorders triggered by venom from marine\/aquatic organisms, other than the study that identified the venoms of anemone and jellyfish from the phylum Cnidaria as causing anaphylaxis in humans.","title":"Anaphylaxis induced by Thalassophryne nattereri venom in mice is an IgE\/IgG1-mediated, IL-4-dependent phenomenon"}
{"_id":"4df2faaf-603a-ddb6-19bd-bd7af7e3a532","text":"In the post operative period following abdominal liposuction, the patients are advised to avoid prolonged sitting for 3 to 4 weeks to prevent development of skin folds and creases. Pressure garments are to be religiously worn for 3 to 6 months. While, a regular finger tip pressure massage in the indurated areas is fine with small areas of induration, an ultrasound massage works well for lumpy areas and sites with persistent pain or edema.","title":"Liposuction"}
{"_id":"4dfa0cde-de5b-82b2-9b24-a8ae7a05d72f","text":"This retrospective analysis found a positive association between the presence of ECE and the number of lymph nodes involved in the axilla.","title":"Measurement of extracapsular extension in sentinel lymph node as a possible predictor of residual axillary disease in breast cancer"}
{"_id":"4dfbb1b0-955c-d9b2-ef81-2cfe7566deae","text":"Destaining: The stained LD specimens were again placed in Sihler I solution for two hours to destain the muscle fibers and leave the stained nerves.","title":"Intramuscular Neural Arborization of the Latissimus Dorsi Muscle: Application of Botulinum Neurotoxin Injection in Flap Reconstruction"}
{"_id":"4e062533-0075-ad66-5dbf-f7a53babc095","text":"The CARRA legacy registry recruited pediatric rheumatology patients from 55 centers across North America from 2010 through 2014, including over 650 subjects with Juvenile Dermatomyositis. We compared the demographic characteristics, clinical disease features and treatment histories of those with and without calcinosis using univariate and multivariate logistic regression.","title":"Clinical phenotypes and biologic treatment use in juvenile dermatomyositis-associated calcinosis"}
{"_id":"4e0877b3-2ecd-ca39-a035-d749b25fe847","text":"The results of this trial will be presented at relevant national and international conferences and the findings will be submitted for publication in peer-reviewed journals.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"4e0d1037-c07c-a5c2-cf27-841631e75501","text":"HNSCC cell lines Detroit and FaDu were diluted in PBS and counted and seeded into 10 ml peripheral venous blood samples collected from normal healthy individuals at final concentrations of 10, 50, 100 and 500 cells per 10 ml in triplicate. A recent study by Balasubramanian et al (2009) determined that the number of circulating tumour cells in head and neck patients ranged from 0 to 214 per ml therefore the range we have chosen for these reconstruction experiments will be suitable to determine the lower limit of detection of HNSCC [26].","title":"Long term survival following the detection of circulating tumour cells in head and neck squamous cell carcinoma"}
{"_id":"4e144384-6917-41ac-7366-ba4dedcff4a6","text":"ZJ is the lead author of the paper and along with IW founded the idea for the review. Both contributed singificantly to the preparation of the manuscript. TD, AH, and KS assisted with the literature search whilst also contributing to the writing of the manuscript. All authors have reviewed and approved the final manuscript and agreed to be accountable for all aspects of the work.","title":"Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions"}
{"_id":"4e361d6a-05fb-a2eb-290b-2892c415b97b","text":"Intraoperative frozen section control extends surgery times, increases costs and requires an experience pathologist to be present at the medical center where the surgery is performed. In recurrent BCC, which has a higher recurrence rate than primary BCC, excision with frozen section control may lower the incidence of recurrence for these patients.","title":"The Importance of Frozen Section-Controlled Excision in Recurrent Basal Cell Carcinoma of the Eyelids"}
{"_id":"4e3e3e86-359a-51e4-449b-7feee89340d5","text":"This study is limited to interactions within secondary care only, where patients have an injection under radiological guidance, in an injection clinic, or in theatre. The patients included are therefore only those undergoing primary injection that is registered within this system. Our validation studies showed that the HES APC dataset includes patients undergoing intra-articular injections under radiological guidance or on a specific injection list, but will not include those being undertaken in traditional secondary care outpatient clinic settings or that had occurred previously in primary care or in interface services. This produces a selection bias in the patients included, but also indicates that patients included here are those who have been referred to secondary care. As the data does not link to primary care, we cannot fully record treatment that has gone before, and this is acknowledged as a limitation.","title":"Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis"}
{"_id":"4e4269dc-02b5-4e90-c9b7-f123f0e4e307","text":"We did not find a significant difference in inpatient stay between SIEA and DIEP flaps, largely due to the recent push within the NHS to discharge patients with abdominal drains in situ. In institutions where out-of-hours support for patients with abdominal drains is reduced or discharge with drains in situ is not possible, these patients may benefit from preferentially or deliberately carrying out DIEP flaps as opposed to SIEA to reduce the length of inpatient hospital stay.","title":"Increased Production of Abdominal Donor Site Fluid Following Microsurgical Breast Reconstruction With Superficial Inferior Epigastric Artery Versus Deep Inferior Epigastric Artery Perforator Flaps"}
{"_id":"4e43991a-6816-8ac0-2fbe-497e7af7f150","text":"We did not biopsy clinically cleared LM, only areas of suspicion. A pilot study16 showed that 5 out of 6 patients treated with LM had complete or almost complete clinical clearance despite histological persistence. If this is correct then a post-operative sample biopsy could easily miss patchy persistent disease and only complete excision of the previously affected area will be confirmatory. It is for this reason that random biopsy samples were not taken of clinically normal skin in our patients. We were unable to perform a full excision of the lesion as the recruited patients were all by definition not suitable for surgery. We do appreciate that in the absence of histological confirmations and the small numbers in the study the conclusions are softened.","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"4e4d8f3a-2746-47aa-cdde-0e2b2f8835a8","text":"Student t-test was used to compare in situ immune profiles between SLNs invaded by cancer cells and those that were cancer cell free. Log transformations were done for all immune marker values to reduce skewness.","title":"Sentinel lymph node B cells can predict disease-free survival in breast cancer patients"}
{"_id":"4e4e049a-a10d-884d-753e-ffdf468af52a","text":"In conclusion, plant photodynamic stress is considered as abiotic stress linked to ROS production as the first cause of cell death. It is still poorly studied regarding characterization of photodynamic stress determinants and outcomes especially at molecular level in plants. Besides, plant photodynamic stress has not been exploited yet, especially as valuable exogenous treatment for the purposes we mentioned above. Nevertheless, we are confident that in the near future, this approach based on PS and especially porphyrins could be relevant to respond to the Directive 2009\/128\/EC of the European Parliament plans that aim to reduce the use of pesticides while maintaining high yield as well as high quality in agricultural production. PS are photodegradable and non-toxic under dark as well as they were used at micromolar concentrations therefore they could be promising candidates to fulfill the task of European projects for environment sustainability in respect to wildlife, water sources and human health.","title":"Plant Photodynamic Stress: What's New?"}
{"_id":"4e53cf29-f6b1-97f8-5bc3-0ab55c01bba1","text":"A 29-year-old man was diagnosed with CAPV with splenomegaly and gastroesophageal varix when being treated for pancytopenia and liver dysfunction. A living donor liver transplantation was performed for him using the right lobe which had been donated by his mother. The PV was reconstructed using his own great saphenous vein (GSV) as a graft vein. The end of the GSV graft was anastomosed to the inferior mesenteric vein while the other end was anastomosed to the vein graft of the right hepatic vein from the explanted liver.","title":"Living donor liver transplantation for congenital absence of portal vein in portal venous reconstruction with a great saphenous vein graft"}
{"_id":"4e55ce74-e54f-b6a5-a101-19b176f6be3d","text":"We proposed utilizing negative pressure wound therapy effectively fulfill skin graft taking in reconstruction of extended breast skin defects and should be considered for the management of these challenging wounds.","title":"Utilizing NPWT improving skin graft taking in reconstruction for extended breast skin defects following mastectomy"}
{"_id":"4e55e19e-431b-d75b-cf97-e7d93e118f70","text":"Briefly, the preprogrammed harvest protocol from TerumoBCT was used in which the hollow fibers containing the cells were fully washed with PBS; TrypLE loaded into the fibers and held at 37°C for 8 min and then a matched volume of culture medium added and flushed out of the system into a cell harvest bag. This process was repeated twice to ensure that all cells were harvested. Harvested cells, in TrypLE and culture medium, were aliquoted into tubes before centrifugation at 400 g for 10 min to produce a cell pellet, which was reconstituted in 1 mL media.","title":"The Upscale Manufacture of Chondrocytes for Allogeneic Cartilage Therapies UPSCALE HOLLOW-FIBER BIOREACTOR CHONDROCYTE MANUFACTURE"}
{"_id":"4e57790c-0c57-d8d4-ecb3-7804e4ddce89","text":"The majority of fellowship programs focused on the attainment of clinical expertise over and above the competencies of specialty or subspecialty residency, usually in a distinct clinical area.","title":"Fellowship training: a qualitative study of scope and purpose across one department of medicine"}
{"_id":"4e63d623-42bf-b625-69f0-3d7deec6148f","text":"The study was authorized by the local ethical committee and was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki, as revised in 2000.","title":"Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection"}
{"_id":"4e653ace-3cda-4995-af63-daafe797649d","text":"This connector was finally anchored to the surrounding nerve sheath with nonabsorbable 4-0 silk threads, so as to prevent that any twisting forces applied to the electrode cable would reposition the TIME.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"4e7452c4-37c3-cb77-6e0c-e1d5d0af3d79","text":"ICG contains sodium iodide and should be used with caution in patients who have a history of allergy to iodides.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"4e7a3f54-d11f-4cd6-3076-6f9fea36aed8","text":"The NHS is trying to save money and yet provide the same quality of care. Wound management is a potential field where this could be addressed, through a wider use of NPWT.","title":"Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom"}
{"_id":"4e8211b3-1bbc-4f84-b917-89b0c38a73c1","text":"Our next procedure was to lay the gauze in the wound. In heavily exudating wounds, we apply gauze while it is still dry rather than wetting it beforehand. It is important to lightly pack the gauze into any crevices so that all parts of the wound are in contact with it.","title":"Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective"}
{"_id":"4e83ff73-a533-29a4-f45c-c50b26894605","text":"A48 Oscillometric bronchodilator response in 3 to 5 years old healthy and asthmatic Filipino children","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"4e891a14-f01e-0268-b7e1-66f658c666e7","text":"NMS are common among atypical parkinsonian disorders and may be underreported by patients unless systemically sought out in clinical practice. Evaluating NMS in atypical parkinsonian syndromes is essential to providing a holistic clinical care plan and appropriate pharmacological treatments for these patients to help with their unmet needs.","title":"Neurological update: non-motor symptoms in atypical parkinsonian syndromes"}
{"_id":"4e8ed297-d65c-83d8-8697-a9ce50b0751a","text":"The duration of the trial is 2 years. The trial will end when the last subject makes the last visit to determine the late response following the final open label follow up intradermal injection at the August 2014 time point.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"4e914d9e-e47f-99b4-7bfb-ca3dcf7e6ef3","text":"Another area in which research has led to the development of efficacious extracts is the treatment of animal allergy. The treatment of subjects with cat allergy is a revealing example of the difficulties inherent in developing useful extracts and the importance of proper investigations. Cats have long been recognized as an important cause of AR, and such AR has traditionally been ascribed to cat dander, with little insight in regard to the term \"dander.\" The assumption that the allergen was a pelt-derived protein led to the development of extracts derived from the skins of carefully cleaned animals. The subsequent recognition that the dominant cat allergen is a protein derived from skin glands led to the recognition of the paradox that the commercially available extracts were virtually devoid of Fel d I and, as such, were worthless as immunomodulating agents. Current standardized extracts, with quantifiable levels of the dominant cat allergen, have proved effective for cat allergy. The treatment of dog allergy has lagged behind that of cat allergy, but the recent characterization of the dominant dog allergens has begun to make available extracts with sufficient concentrations of these allergens to warrant investigations to document their efficacy. Rodents, either as pets or as pests, are an additional major source of animal-derived allergens. The rodent glomerulus permits the passage of small proteins, and these urinary proteins are the primary source of allergens. As in the case of cat allergy, only after the recognition that urine and not dander was the source of the dominant allergen has it become possible to develop allergy extracts that contain sufficient concentrations of relevant allergens to plausibly provide efficacy. Continuing research has defined major allergens in other mammals such as horses, cows, and rabbits, and this presumably will lead to the availability of useful extracts.","title":"Update on Allergy Immunotherapy"}
{"_id":"4e967fba-5381-c3b4-0c38-bd1887ff8d12","text":"The oral mucosa including the lips is constantly exposed to several noxious stimuli, irritants and allergens. However, oral contact pathologies are not frequently seen because of the relative resistance of the oral mucosa to irritant agents and allergens due to anatomical and physiological factors such as the high vascularization that favors absorption and prevents prolonged contact with allergens, the low density of Langerhans cells and T lymphocytes and the dilution of irritants and allergens by saliva that also buffers alkaline compounds [1].","title":"Unmet diagnostic needs in contact oral mucosal allergies"}
{"_id":"4e981008-2f03-ace2-95c3-3d80789877af","text":"Therefore, ultrasound contrast technology can effectively identify the benign and malignant nature of ovarian tumors, especially for those patients with new capillaries or slow blood flow in malignant tumors which cannot be detected by color Doppler. It can provide help for the early diagnosis of ovarian tumors and make up for the limitations of two-dimensional and color flow imaging in the detection of low-velocity blood flow and small blood vessels in ovarian tumors. The results of this study showed that ultrasound contrast was superior to color Doppler ultrasound in sensitivity, specificity and accuracy in the diagnosis of ovarian tumors, suggesting that ultrasound contrast was more effective than color Doppler ultrasound in the differential diagnosis of ovarian tumors, which is similar to the results of Kumazawa.23","title":"Application Value of Color Doppler Ultrasound and Ultrasound Contrast in the Differential Diagnosis of Ovarian tumor"}
{"_id":"4e984add-7527-794c-e04c-101b305b1edd","text":"Desmoid tumors were pathologically benign, which could extensively invade tissues around the lesions. The invasion of major vessels and nerves and quality of surgical margins are the key factors for the high postoperative recurrence rate.","title":"Postoperative recurrence of desmoid tumors: clinical and pathological perspectives"}
{"_id":"4e9d26fd-645a-4e2f-d017-78419ff9ed6b","text":"Autonomic function testing (AFT) can be beneficial when patients are presenting with autonomic symptoms and therefore may be used in addition to a skin punch biopsy to further quantify the disease. Autonomic testing is a type of electrodiagnostic medicine and clinical neurophysiology testing that can be used to assess sympathetic and parasympathetic neural pathways. Autonomic testing is designed to evaluate various clinical scenarios that may involve small-fiber autonomic dysfunction. Testing often requires the use of a tilt table and other tools that are frequently only found at tertiary medical centers. It is the position of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) that, in order to perform and interpret diagnostic studies of the autonomic nervous system appropriately and ensure quality patient care, the individual performing the studies must be a physician with special training in diagnosis and treatment of disorders of the autonomic nervous system and in application of particular neurophysiologic techniques to study these disorders. These requirements often limit the availability of AFT for routine use.","title":"Intraepidermal Nerve Fiber Density as Measured by Skin Punch Biopsy as a Marker for Small Fiber Neuropathy: Application in Patients with Fibromyalgia"}
{"_id":"4ea13686-98d1-e6b9-f871-260e7e19d985","text":"The following series shows that patients with soft tissue infection and internal hardware contamination might benefit from a one-stage debridement and soft tissue reconstruction with a musculocutaneous flap without internal hardware removal.","title":"Distally based sural fasciomusculocutaneous flap for treatment of wounds of the distal third of the leg and ankle with exposed internal hardware"}
{"_id":"4ea2d484-2943-2193-252b-96d2d0647061","text":"In patients with fracture, multifragmentary fracture of the vertebral body where the instability of the anterior column was not suitable for stabilization via the posterior approach alone was an indication for multilevel corpectomy.","title":"Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients"}
{"_id":"4ea33002-9a77-2eac-e821-8423d8ccdeff","text":"We started our in vivo study with the group I rabbits first where no graft material was used. This was to establish the osteomyelitis model before undertaking the studied on group II and group III rabbits. The wound was closed with absorbable sutures. The limbs were not splinted in any of the groups and the rabbits were left free in the cage. In group II and group III rabbits, the infected metaphyseal defect was immediately filled with a uniform size of plain DBM chips and antibiotic-impregnated DBM chips, respectively.","title":"Decal bone matrix as a local antibiotic delivery vehicle in a MRSA-infected bone model: An experimental study"}
{"_id":"4eab5d31-49d6-416a-81c3-2aa7765b9269","text":"Osteoporosis is common and femoral neck fracture due to falling is not rare in aged patients and early osteosynthesis is required to keep the patient’s quality of life. Although periprosthetic infection is not so common, it sometimes needs an emergent debridement. Thus, it is a clinically acceptable decision to perform an emergent operation on the present two patients, even if the patients were taking SERMs. Although the two patients developed or worsened existing DVT after the operation, we started anticoagulation therapy immediately, resulting in early lysis of DVT with no serious consequences. These two cases suggest that an ultrasound examination of the lower extremities after the operation may be recommended in emergent operation patients who take SERMs.","title":"Selective estrogen receptor modulators and deep venous thrombosis after an emergent operation in senior women"}
{"_id":"4eb338e2-34bf-8305-0d0c-e7a8abaea426","text":"Multidisciplinary approach by team work for treatment of TMJ ankylosis serves towards a better outcome in order to capture the richness of experience in the lives of patient and boosting the level of confidence along with normal form, function, and stability.","title":"TMJ Ankylosis: Multidisciplinary Approach of Treatment for Dentofacial Enhancement—A Case Report"}
{"_id":"4eba2270-6281-73c6-ba95-0a4ec85f2048","text":"Spear and Hess (2005) performed a literature review to identify biomechanical and functional changes in the shoulder following transfer of the LD muscle for breast reconstruction. The purpose was to search available studies to identify any clinically relevant findings for inclusion in discussions with patients considering breast reconstruction options. In spite of the methodologic differences identified, these authors found adequate evidence that some degree of weakness results from the transfer of the LD, but range of motion was not significantly affected. Based on their findings, this review suggests that patient education include expected limitations for the first 2 to 3 weeks postoperatively, with full return of function in 6 to 12 months.","title":"Functional Morbidity Following Latissimus Dorsi Flap Breast Reconstruction"}
{"_id":"4ec144fa-5cfe-5989-6770-ef94c4cdd273","text":"Rivaroxaban is a highly selective drug with a rapid onset of action that inhibits FXa by disrupting the internal and external pathways of the blood clotting cascade. In addition, it inhibits the formation of thrombin and the development of blood clots. This drug is used to prevent stroke and blood clots in patients with nonvalvular atrial fibrillation [156]. It is used together with aspirin to reduce the risk of heart attack and stroke in patients with coronary artery disease. This drug is also used to prevent VTE in some hospitalised patients who are at risk of blood clots due to reduced mobility and who do not have a high risk of bleeding. Rivaroxaban is associated with a lower frequency of severe and fatal bleeding than warfarin. However, rivaroxaban shows a higher rate of gastrointestinal bleeding [166].","title":"Factors Affecting the Formation and Treatment of Thrombosis by Natural and Synthetic Compounds"}
{"_id":"4ec5c330-0804-4b9c-e122-0522160020b9","text":"For each time point, we determined the signal unit ratio between the intracranial region of interest and blood of sagittal sinus, and between parenchyma of deep cervical lymph node and medial pterygoid muscle.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"4ec80b01-b9a9-a8bd-8176-efecc80a233f","text":"This systematic review will update the literature on best practice in pediatric osteomyelitis. A similar study was conducted in 2002 and found that shorter courses of parenteral therapy had similar cure rates to prolonged courses but the results were limited to cohort studies. We will conduct a comprehensive search reviewing an estimated 3,400 studies, compared to 284 reviewed by Le Saux et al. and, we hope that relevant randomized controlled trials will have been published in the past decade.","title":"Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol"}
{"_id":"4ecb06b4-d3cd-7505-8bec-34c6dc02381d","text":"The scientific study of the ways that makeup changes the appearance of the face has begun only recently, and there is little published research on the topic. To our knowledge there are no studies that have systematically compared the ways in which women of different racial groups use makeup. We predict that women of a particular race use makeup to modify (or should use makeup to modify) their facial contrast in the ways that facial contrasts change with age in their particular race. Here we observed some specificity according to races in the way aspects of facial contrast vary with age (i.e., luminance and yellow contrast around the mouth). Only Chinese women and Latin American women have higher luminance contrast around the mouth with age; their lips appear darker with age. These observations suggest possible reasons for cultural preferences in makeup shades used by women and that the shades of lipstick may have different effects on perceived age in women from different races and cultures. Because we observed some similarities but also some specificities in the way facial contrast varies with age according to the origin of women; this points toward a rational approach to the development of cosmetics and to the personalization of cosmetics.","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"4ecb1391-19c7-f1b5-02b6-488eb0fcc595","text":"Parotid deep lobe tumors can be benign or malignant. Parotid gland malignant tumors (whether superficial or deep lobe) require not only the excision of the main mass but also the resection of the entire parotid gland tissue as total parotidectomy. In the presented case, parotidectomy or facial nerve identification was not performed because of the presence of intact adipose tissue between the deep lobe of the parotid and the mass, and thus the mass originating from the parapharyngeal region.","title":"Parapharyngeal space carcinoma ex pleomorphic adenoma: case report and literature review"}
{"_id":"4eccb6ea-8c2d-7be9-699f-7b18ef150b3f","text":"A national study carried out for facial dystonias, included four patients of BEB and found botulinum toxin effective in its treatment. The side effects experienced by the patient of this study were similar but less in frequency to those experienced by our patients.","title":"Efficacy of botulinum toxin in benign essential Blepharospasm: Desirable & undesirable effects"}
{"_id":"4edd40e3-badc-411b-6880-d440cb64d435","text":"There are few publications documenting the imaging finding of extraosseous fat as a specific feature of acute osteomyelitis. To our knowledge, this is the only reported case confirmed with both bone biopsy and intraoperative findings documenting a cortical sinus tract with macroscopic extraosseous fat. Extraosseous fat fluid levels have been elegantly depicted on fat-suppression MRI sequences and previously described as a specific sign for acute osteomyelitis in patients presenting with a soft tissue infection. In the absence of trauma, the extraosseous fat fluid level on MRI has been proposed as a specific sign for osteomyelitis with cortical breach even when the cortical breech was not seen. In contrast to acute osteomyelitis, the penumbra sign consisting of hyperintense signal interposed between low signal abscess cavity and marrow has been previously described as highly specific for chronic, subacute, or acute on chronic osteomyelitis.","title":"Extraosseous marrow fat: an MRI sign of acute aggressive osteomyelitis"}
{"_id":"4eddd8a9-47cd-523e-92e9-e5595eed8f92","text":"Growth of surgical caseload among specialties with a large contribution margin is an important financial objective for hospitals. In this study, we examined the diversity of referral patterns to a neurosurgeon over an eight-year interval and examined practice attributes related to surgical growth.","title":"Building a Brain Tumor Practice: Objective Analysis of Referral Patterns and Implications for the Growth of a Subspecialty Surgical Program"}
{"_id":"4edf7225-3c79-9dfb-3953-2c0a949d83f6","text":"The clinical and radiological diagnosis of our case suggested calcinosis cutis of the hand following the treatment of hypocalcemic seizure with calcium gluconate infusion.","title":"Iatrogenic calcinosis cutis in 9-month-old baby boy: a case report"}
{"_id":"4ee5f9e4-69a6-728d-64cb-c7330e4455c1","text":"This study revealed a wide spectrum of neoplastic lesions of skin. Majority of cases were benign tumors and among the malignant tumors, squamous cell carcinoma was predominant followed by basal cell carcinoma. Staging of the malignant tumors in excision biopsy specimen especially for squamous cell carcinoma needs to be emphasized since it is a predictor of prognosis.","title":"Histomorphologic Profile of Skin Tumors"}
{"_id":"4eec5937-64be-b761-feb3-56521d7e283c","text":"The pigmented superficial and nodular basal cell carcinoma on his upper mid back was excised and the surgical wounds were closed with complex layered closure. Follow-up examination five months later showed excellent healing of both surgical sites and no evidence of recurrence.","title":"Red Dot Basal Cell Carcinoma: Report of Cases and Review of This Unique Presentation of Basal Cell Carcinoma"}
{"_id":"4eed95c5-838e-f27f-c73f-d6c2722eb61d","text":"Methods: Changes in the JADAS scores in consecutive visits were calculated in a dataset of 1,874 visits of JIA patients seen at the study Unit. Both parent and attending physician were asked to rate in a 5-point Likert scale if the patient was much worsened, slightly worsened, stable, slightly improved, much improved from previous visit. Those visits in which patient was subjectively rated by parents or by the physician as slightly worsened or slightly improved were retained. Subsequent visits with a time interval of more than 6 months were not retained; each patient could contribute for no more than 1 visit for improvement and 1 visit for worsening for each assessor. MCID were defined as the median changes of the JADAS scores of individual patients who had a minimal important improvement or worsening between visits.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"4ef5ba3c-ac61-c431-5d6b-6c56d1fa12ea","text":"Surgical management of such lesions with one-centimetre oncological margins in all dimensions contrary to the routine five millimetre surgical margins reduces the chance of recurrence.","title":"Occurrence of Second Oral Potentially Malignant Disorder following Excision of Primary Lesion: A Prospective Study of Cases from a Tertiary Care Centre"}
{"_id":"4efac871-7927-7506-48b5-b4b1429c1650","text":"A superficial infection or pin tract infection was defined as any sign of an infection that healed with or without antibiotics and by just wound care and dressing. Deep infection was defined as an infection that needs surgical debridement in operating theatre. Osteomyelitis was defined as deep bone infection shown clinically or radiographically and confirmed by surgical findings intra-operatively. Delayed union was defined when the union was delayed more than 23 weeks. Non-union was defined as a fracture that has not healed nine months after the operation and there is no visible progress of healing during the last three months. Mal-alignment was described as when there is more than 5° of angulation in any plane. Articular incongruency was noted when there was any articular step seen radiologically after surgical intervention. Ankle arthritis was identified when there was osteophytes formation, subchondral sclerosis with or without reduced joint space.","title":"Surgical Management of Distal Tibia Fracture: Towards An Outcome-based Treatment Algorithm"}
{"_id":"4f03ddbc-a58b-afb1-6748-3b390c9d2bd1","text":"Venous thromboembolism is a preventable cause of morbidity and mortality after surgery. To ensure that patients receive appropriate venous thromboembolism chemoprophylaxis, a nonmandatory risk-stratification tool based on patient clinical condition was implemented through the electronic health record to stratify patient risk and recommend chemoprophylaxis. We hypothesized that implementing this tool would reduce postoperative venous thromboembolism events in general surgery as well as across all surgical services.","title":"Electronic health record risk-stratification tool reduces venous thromboembolism events in surgical patients"}
{"_id":"4f08d739-896e-9e42-c95d-329e565c0d80","text":"In summary, clinically indicated SLNB can offer consequential prognostic information for melanoma patients and affect management and surveillance. Recommendation for SLNB should be done in an individualized basis, taking into consideration the patient’s comorbidities, the value of the information obtained, and the way this information would change management and surveillance. The operation has a low procedural false negative rate (< 5%) when performed by expert hands, and its morbidity is low.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"4f0fc0b9-f495-212e-dbf8-23a5f4862d27","text":"Plastic surgical reconstructive techniques do not only offer complete defect coverage of large defect zones, but also functional reconstruction with restoration of adequate range of motion. As demonstrated in our case report, this allows for successful reconstruction with a LDMF following wide tumor resection in anatomically complex regions such as the shoulder.","title":"Functional Reconstruction with Latissimus Dorsi Flap following Resection of an Extensive Basal Cell Carcinoma in the Shoulder Region: A Case Report"}
{"_id":"4f132d7b-b845-f799-5ae8-f11f2a62d7a7","text":"Our lateral subcutaneous LCP and small incision reduction is a safe and efficient procedure for distal‐third diaphyseal humerus fractures. Adequate stabilization and satisfactory functional recovery of the upper arm can be obtained. The risk of iatrogenic radial nerve injury is low if surgical techniques are appropriate. Furthermore, internal fixation devices can be easily taken out from the body without aggravating the radial nerve, greatly reducing the risk of secondary injury to the radial nerve. The optional surgical removal of implants may meet the requirement of most patients after the fracture is healed.","title":"Lateral Subcutaneous Locking Compression Plate and Small Incision Reduction for Distal‐third Diaphyseal Humerus Fractures"}
{"_id":"4f13aa45-57a9-737a-35bb-ea3e68bbd7c1","text":"Here we report the cases of two patients that underwent aesthetic procedures with large volumes of PMMA injections who developed severe hypercalcemia and advanced CKD because of such procedures.","title":"Case reports of hypercalcemia and chronic renal disease due to cosmetic injections of polymethylmethacrylate (PMMA) Relatos de casos de hipercalcemia e doença renal crônica devidas a injeções de polimetilmetacrilato (PMMA) por razões estéticas"}
{"_id":"4f153e78-a63b-792a-1af9-31379102af85","text":"In this study we found that validated medically attended local reactions were uncommon following Td vaccination, with an overall estimated risk of 3.6 events per 10,000 Td vaccinations. The risk of medically-attended local reactions varied by age, and was significantly higher in the 9 to 10 and in the 21 to 25 year old age groups compared with the risk in persons 11 to 20 years of age. In addition, among the subgroup of persons with at least five years of enrollment in the MCO prior to the Td vaccination, there was a statistically significant association between receipt of a TDCV within five years prior to the Td vaccination and a higher risk of a medically attended local reaction to Td vaccine.","title":"Frequency of medically attended adverse events following tetanus and diphtheria toxoid vaccine in adolescents and young adults: a Vaccine Safety Datalink study"}
{"_id":"4f190567-731a-be84-adcb-21581eca691b","text":"Once a biofilm has formed on an implant, drug tolerance increases and makes it difficult for most conventional pharmacological treatments to penetrate and effectively treat the infection. Non-pharmacological methods usually utilize some form of physical or chemical agitation of the biofilm to either directly cause bacterial death or to increase antibiotic access to the infected area. These methods also have the advantage of not being reliant on bacterial metabolism and to some extent, drug delivery to the infected area. Because these devices make use of physical energy to disrupt the biofilm, they are not limited by some of the toxicity liabilities that various pharmaceuticals might have. They are also not limited by the lifetime of the implant itself and so can be utilized regardless of the chronicity of the infection. A summary of extrinsic methods is available in Table 2.","title":"Physical Approaches to Prevent and Treat Bacterial Biofilm"}
{"_id":"4f1d3f7f-48d9-f59b-9b32-5e7ca1bf1e46","text":"The treatment of peri-implant lesions has long been a controversial topic. The purpose of the present case-report was to define a new surgical and regenerative protocol to restore peri-implant tissue health and esthetics in the esthetic zone. The results of the follow-up of more than 2 years showed an excellent reosteointegration of the bone around the implant affected by a combined defect similar to a crater in the most apical part and a vertical defect in the distal region.","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"4f217496-5a47-2259-85c9-0ffb15f7fb2e","text":"The diagnosis of tumoral calcinosis was retained. The therapeutic management included first measures to regulate the phosphocalcic balance and then the indication of a parathyroidectomy was justified by the secondary hyperparathyroidism and the presence of parathyroid hyperplasia on scintigraphy.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"4f220b71-4da4-49ce-74d9-f5949bff2288","text":"CONCLUSIONS It can be concluded that the focused ultrasound device used in this study is safe and effective in the treatment of soft-tissue injury by cutting inflammation factor expression and increasing pain threshold.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"4f23e96e-d684-ee4c-e603-b21444e86a0b","text":"Patients with head & neck cancers and women <50 years old with breast cancer are at increased risk of subsequent malignancies. The pattern of second cancers was similar to that of first cancers and thus the advice to minimise exposures to the 14 lifestyle and environmental factors described by Parkin [42] remains valid. Further research is needed to determine the effects of behaviour change and previous exposure on subsequent risk. The higher rate of malignant melanoma among patients with breast and prostate cancer requires further investigation. Breast and prostate cancer are socio-economically patterned and higher rates could be due to healthcare seeking behaviour which increases detection or, in the case of melanoma, to increased sun exposure in more affluent patients. Analysis of recent second primary cancer rates in other countries is needed to test these hypotheses.","title":"Second primary cancer risk - the impact of applying different definitions of multiple primaries: results from a retrospective population-based cancer registry study"}
{"_id":"4f24b4a9-0f62-0d21-b9d3-9c1159510c12","text":"Before surgery all of the patients were checked for having each of intended complications. After initial examination, the operation was performed by a single surgeon with a constant method in similar environmental conditions under general anesthesia. Patients spent the night at the hospital and were discharged the morning after the surgery. All of the patients had nasal cast for 6 days. They had adhesive tape for 3 to 4 weeks after removing the cast. The adhesive tape covered their nose to the nasofacial sulcus.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"4f2c76d0-38a2-9de2-fe22-85491dc7cde2","text":"Table 2 The diagnosis and treatment of breast cancer for reported cases","title":"Traumatic neuroma in a patient with breast cancer after mastectomy: a case report and review of the literature"}
{"_id":"4f31901f-ce81-02d6-2335-d02cd4ab6658","text":"Glottic insufficiency is a debilitating laryngeal disorder in which the loss of tissue volume prevents vocal folds from fully closing, producing a glottic gap (Fig. 1a) that results in difficulty speaking and swallowing. Patients that do not respond to conservative management with voice therapy must undergo augmentation of the vocal folds with a tissue filler to restore volume. Injectable biomaterials are desirable for vocal fold augmentation over implantation surgeries due to their minimally invasive delivery. However, injectable fillers for vocal fold augmentation have been adapted from temporary dermal fillers used in cosmetic plastic surgery that only offer a transient benefit.","title":"De novo tissue formation using custom microporous annealed particle hydrogel provides long-term vocal fold augmentation"}
{"_id":"4f33234c-a329-0326-65a5-4f8204976419","text":"The flat-based hull RG is a modification of the conical hull, where the tip of the geometry is removed by an intersecting planar cut coincident with the base of the tumor, perpendicular to the line between the focal point and the tumor centroid. The flat-based hull is generated by rotating the bone and tumor meshes about the initial coordinate space, then applying a translation in the new local coordinates. The 3D convex hull of the tumor surface and the focal point is computed, with the focal point trimmed from the geometry and replaced with a facing cut at the lowest point of the tumor surface mesh.","title":"Automated elaborate resection planning for bone tumor surgery"}
{"_id":"4f341e92-9040-5d0d-2761-c73690133ccb","text":"A cross-sectional design provides the opportunity to assess patients with different treatment times whose evaluation would be more difficult in a prospective study. However, we acknowledge that a prospective design would be more appropriate to evaluate the impact of mastectomy combined or not combined with breast reconstruction on the quality of life of patients, and this may be considered a limitation of the study. Small subgroup sample sizes in terms of tumour characteristics were also a limitation that prevented some subgroup analyses. Further studies that include more patients, utilize a prospective design, and involve multiple centres are necessary to extend our results.","title":"Sexuality, depression and body image after breast reconstruction"}
{"_id":"4f362b8d-8ae9-009e-bd71-01a371214dea","text":"This study builds on a growing body of research on the axillary assessment of breast cancer patients and the identification of criteria for patients who are more or less likely to benefit from axillary surgery (sentinel node biopsy or axillary clearance). Following the evidence presented above that ultrasound investigation of axillary lymph nodes can help to quantify axillary burden, the exploration of a scoring system for ultrasound assessment in breast cancer patients could also be an area of focus for future research and clinical practice.","title":"Non-invasive predictors of axillary lymph node burden in breast cancer: a single-institution retrospective analysis"}
{"_id":"4f406e77-88f9-8afd-395e-e047f3c5fd4e","text":"As to erythema and edema being complicated with the treatment, in our study we found that the Botulinum Toxin A-induced swelling in all subjects subsided within 48-72 hours. the intramuscular injection group showed a higher incidence than the nanomicroneedle group and the intradermal microdroplet group. The pain score of the nanomicroneedle group was lower than that of the intramuscular injection group and intradermal microdroplet group.","title":"A Comparative In Vivo Study on Three Treatment Approaches to Applying Topical Botulinum Toxin A for Crow's Feet"}
{"_id":"4f46478d-69be-e68c-cdb1-4d2747778fc8","text":"Being aware of several technical points is crucial before performing this complex surgery. With the small field of the posterior cervical spine, correct surgical steps involving PI and EOLP with miniplate fixation and bone grafting are essential factors in reducing the operation time and complication rate. Through the method we applied in this study, the advantages of these posterior procedures were combined effectively without problems. In addition, a one-stage anterior and posterior surgery for DCKS can enable achieving superior surgical outcomes through ACF, primarily to correct the kyphotic curve and sequential posterior instrumented fusion with decompression to keep the lordotic curve and decompress the spinal cord. However, placing a patient with an endangered spinal cord in a relative lordotic supine position to perform the anterior surgery would cause neurologic deterioration. Therefore, patients should be asked to extend their neck consciously before the surgery to determine whether a neurologic compromise occurs. If a neurologic compromise occurs during neck extension, then more complex posterior anterior posterior surgical steps should be considered. For patients with DCKS, continuous intraoperative neuromonitoring should be performed.","title":"Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis"}
{"_id":"4f4874b5-35aa-e164-ee97-33eb84a53760","text":"Our cost function is capable of learning an adaptive dictionary to reconstruct the underlying image but it is NP hard and non-convex even when quasi norm is relaxed to norm. Hence we use alternate minimization methods to solve this problem. Elimination of aliasing and noise is done through the adaptive patched sparsity, whereas the elimination of the artifact is done from overlapping patches.","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"4f517741-477a-86df-82da-271e39492fae","text":"Regarding the operative procedure, the same approach as the ACDF described above is used. Once the correct level is confirmed the anterior longitudinal ligament over the disc spaces above and below the level to be resected is incised; the most anterior portions of the underlying discs are then removed, as is the anterior longitudinal ligament covering the front of the vertebrae. The extent of bone to be removed is then marked, the width of bony resection is usually 18 mm, but can be decreased to 15 mm at C4 or C5 level surgery to decrease the incidence of C5 nerve root dysfunction [24]. An operating microscope is used as bony resection proceeds using a diamond burr; care is taken once the superficial portion of the body is removed as the vertebral artery lies in the middle third of the AP diameter of the vertebral body. As bony resection proceeds, the end plates of the adjacent vertebrae are also resected. The posterior longitudinal ligament is then opened taking care to lift it away from the dura, and Kerrison rongeurs are then used to resect it as far as the bony exposure. Bony reconstruction can be accomplished using an allograft, autograft, or cage system. The graft should be 2 mm longer than the length of the vertebrectomy, the AP depth is 13 mm. Distraction pins are used above and below in order to insert the construct; using a graft holder it is then hammered into place until it is flush with the anterior aspect of the adjacent vertebral bodies.","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"4f53a778-c986-040f-f9b4-5cba77a1c4f2","text":"The mean value of all measurements from the right and left side was used for statistical evaluation. The time spent for each sonographic assessment was also taken to evaluate the feasibility.","title":"Accuracy and performance of a new handheld ultrasound machine with wireless system"}
{"_id":"4f645fb2-0ad4-12d6-692e-f2f008c45334","text":"On the other hand, en face sectioning provides the opportunity to examine the entire margin using a relatively smaller number of sections. This method involves making thin sections to minimize the risk of misinterpreting the histological margin. By utilizing en face sectioning, a comprehensive assessment of the entire margin can be achieved while maintaining clarity in the histopathological evaluation. If the en face method is used, the fabric can be incorporated with the edge facing up or down. The advantage of the margin down technique is the reduced requirement for extensive levels during evaluation. However, the drawback is the increased difficulty in accurately orienting these specimens. On the other hand, margin down allows for a comprehensive section from the margin nearest to the tumor. In certain cases, en face sectioning may present challenges in obtaining smooth and complete tissue slices, leading to areas of the margin being unavailable for evaluation. If the initial section is incomplete, additional cropping may be necessary to obtain a complete image of the margins. A further problem is that en face sectioning does not allow for the determination of the distance between the tumor and the margin. Even if the margin is negative, the tumor could be negative a few micrometers away. Therefore, in cases where en face sectioning is utilized during controlled excision of frozen sections, it is important to note that even if a 4 mm margin appears clear, it is still not considered adequate. It is advisable to maintain a clear clinical margin to reduce the risk of having an insufficiently small histological margin.","title":"Recurrence of Basal Cell Carcinoma Treated with Surgical Excision and Histopathological Analysis with Frozen Section Technique with Complete Margin Control (CMC-FS): A 15-Year Experience of a Reference Center"}
{"_id":"4f6dfe30-c51b-7a5d-8916-850940c7d84a","text":"A team of five plastic surgeons and two breast surgeons performed the surgery at the public hospitals, while a team of two plastic surgeons and two breast surgeons performed the surgery at the private hospital.","title":"Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery"}
{"_id":"4f6e0c5e-3277-44eb-4a0f-dc42c2999b8d","text":"While most authors recommend this flap for reconstruction of small scrotal defects, Parkash and Gajendran10 reported good outcomes in 40 patients with defects confined to the scrotum that were treated with mobilization of scrotal skin to cover the testes. Even when the majority of the scrotum was involved, they performed mobilization of the surrounding scrotal rim with the addition of skin grafting alone when the defect extended beyond the scrotum in 3 patients. Four patients in this group experienced wound dehiscence that healed spontaneously.10","title":"Reconstruction of Defects After Fournier Gangrene: A Systematic Review Karian et al"}
{"_id":"4f6e121f-cba4-dc12-bba5-4672a6c19c27","text":"The goals of study are studying of incidence and epidemiology of anaphylaxis. Management of emergency medical assistance in prehospital stage. In accordance with the purpose and objectives of the study were studied 60 patients during the three months of 2016.","title":"37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)"}
{"_id":"4f6f3aee-58f5-470c-c1f2-bf6fb4e98209","text":"FES occurring after cosmetic procedures such as liposuction and gluteal vitamin E injections is a well-described phenomenon that has even led to fatalities. While these aesthetic procedures are relatively safe, clinicians should be aware of the possibility of FES in the postoperative period, and exercise suspicion should their patient become acutely unwell.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"4f6fce9f-0fb6-ee90-bfc8-97874d03dd68","text":"Methods: A chart review was done on patients seen from year 2006 to 2014 at the University of Santo Tomas Hospital who completed the modified regimen.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"4f70be5c-5f82-235e-c668-a0d0cbab84eb","text":"CONCLUSIONS Pulsed ultrasound pressure field was quantified by numerical acoustic holography based on a fast optical measurement using a phase contrast method in combination with a CT algorithm. Both pressure waveform and absolute pressure from the proposed method agreed well with that from hydrophone scanning. Further studies underway are applications to high pressure field at a therapeutic level and to continuous wave field such as that of HIFU (high-intensity focused ultrasound).","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"4f75718f-6c88-6dac-e5f2-00f23dac0828","text":"In total 8 patients with oropharyngeal cancer (Figure 3) and N0 necks were subjected to the added investigation as described. In all cases the sentinel node or nodes could be identified and sent for separate, more intense pathological identification. The number of sentinel lymph nodes varied from one to 5 with an average of 3. In one patient with a maxillary tumor the sentinel node was positive with a micro metastasis present.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"4f8cfa75-3abf-fe55-30bd-dd0099db49a4","text":"Moreover, we noticed a less prominence of the nasolabial fold probably due to a reduction of the underlying support of the tissue medial to the crease and descent in a similar fashion to the lateral tissue.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"4fa812d1-c7db-2239-a01e-5e8670676967","text":"To analyze changes in the thermal pattern in the skin graft receptor bed, after the use of therapeutic ultrasound through the thermographic images.","title":"Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats"}
{"_id":"4fac40dd-3546-7ffc-6fe3-f3f5abf71321","text":"The diagrams in Figure 5 summarize the techniques used for anastomosis, expanding upon various vein graft patterns used for extending pedicle length to reliable vessels for free tissue transfer.","title":"Reliability of Long Vein Grafts for Reconstruction of Massive Wounds"}
{"_id":"4fb02266-4f37-fadb-7de0-03a1feca739e","text":"Odontogenic tumours make up a complex group of maxillary lesions derived from the dental mesenchymal tissues. This pathology represents 2.8% of the biopsies carried out by the Service of Oral and Maxillofacial Surgery of the Dental Clinic of Barcelona University between January 1995 and March 2008, giving us an idea of its rarity. However, the clinical and histopathological distinctive characteristics of these tumours as well as being a specific and unique pathology of the maxillary make them an important and interesting case study.","title":"Central odontogenic fibroma: Retrospective study of 8 clinical cases"}
{"_id":"4fb06f7f-0310-7c95-ecfb-a9e96c5c097d","text":"Given the increasing use of dermal fillers and prevalence of COVID-19 vaccine use as well as the spread of COVID-19 infection, general practitioners and specialists alike should be aware of the delayed hypersensitivity reactions that may occur at the site of hyaluronic acid injections.","title":"Delayed hypersensitivity reaction to cosmetic filler following two COVID-19 vaccinations and infection"}
{"_id":"4fb07977-d44f-586c-cf62-a58b4abf88a6","text":"All fellows who completed an IGH Fellowship between August 2008 and February 2015 were identified and invited to complete an online questionnaire regarding their experience.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"4fb85fba-bf20-d95e-e11c-4f52ce738da1","text":"To validate the potential of ultrasound as a treatment for superficial cancers in tumor‐bearing mice, we initially conducted a safety study to evaluate the effect of ultrasound on normal, healthy skin. Since we aimed to evaluate the effect of ultrasound in vivo, in which the ultrasound energy needs to permeate the ultrasound gel (coupling agent) placed above the skin surface and the dense tissue rather than an aqueous medium, the energy level applied for the in vivo experiments was two orders of magnitude higher than the energy level used in the in vitro experiments, mainly due to the large attenuation of ultrasound in the ultrasonic gel evident by the gel temperature increase requiring gel replacement every 30 s as described the materials section.","title":"Cell stiffness predicts cancer cell sensitivity to ultrasound as a selective superficial cancer therapy"}
{"_id":"4fc3a864-b217-62b2-188e-284b30caa4f9","text":"From the Figure 1 and Table 1, the comparison of PSNR for both methods can be analyzed which shows that SiFo converges quickly by using norm reconstruction of difference between two successive iterations. So our algorithm is appropriately minimizing the noise and aliasing observed in the zero filled case to deliver a better reconstruction.","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"4fc5b6ff-45f9-6a8d-5aa9-a8c4197b625b","text":"Our results demonstrate that there is overall increased risk for second malignancies one year after the diagnosis of MCC. Malignant melanoma alone had two times more risk when compared to other second cancers after one year of diagnosis of MCC. The complexity of MCC involves several factors like genetic susceptibility, environmental factors, and biological factors, thereby warranting further studies with greater number of variables.","title":"Risk of Second Cancers in Merkel Cell Carcinoma: A Meta-Analysis of Population Based Cohort Studies"}
{"_id":"4fce7e1b-0bfc-98d9-8bd1-1db28c0495b2","text":"With progression in size and symptoms, a multidisciplinary decision was made to proceed to operative resection. This was done under general anaesthetic via an extensile right upper thoracic incision extending towards her right scapula. The mass was excised en bloc. She had an uneventful postoperative course and was discharged well to home.","title":"A Rare Paraspinal Desmoid Tumour following Instrumented Scoliosis Correction in an Adolescent"}
{"_id":"4fcf4a27-b985-2230-9dde-bb58b2cbf1c5","text":"Our machine learning models were trained on definitively diagnosed cases where the presence or absence of gross residual disease was known; our models can be extrapolated for the vast majority of non-clinically evident cases of gross residual disease, where there is clinical uncertainty to guide adjuvant therapy and\/or postoperative follow-up. This will be most clinically useful at the end of index operations where surgical teams believe they have removed all cancer but have missed residual disease. In these settings, our machine learning models can predict the possibility of residual disease and risk stratify patients to alter their postoperative management. Our research serves as the basis for prospective studies on patients with non-clinically evident remaining cancer who are believed to not have residual disease but have a high risk score on our model.","title":"Machine learning methods to predict presence of residual cancer following hysterectomy"}
{"_id":"4fd6b347-9def-8724-145b-d4e14021a9a5","text":"Apart from the 2 patients who had residual disease post laser excision, upon follow up, 2 more patients developed a recurrent tumor in the primary site at 13 months and 19 months post treatment while none of the other patients had residual or recurrence in the neck.","title":"Treatment of Advanced Carcinoma of the Larynx and Hypopharynx with Laser Followed by External Radiotherapy"}
{"_id":"4fd8a2c7-4e34-c691-28db-f6998d66c8e0","text":"Actinic keratosis numbers alone have been criticised for unreliability of grading because of significant differences in investigator counts and for being nonreproducible with significant count variations over time. , , , , The latter compounds the difficulties of comparing studies with varying post‐treatment assessment periods. Moreover, reductions in size or thickness of lesions as a result of treatment were not usually accounted for and may result in a false‐negative effect. Criticism of some studies has been made on the basis of limited size of test areas, low patient numbers and the arbitrary selection of test sites as it is common to choose only the most visibly damaged part of an anatomic area for scrutiny. The lack of a good field cancerisation grading scale has also likely contributed to poor assessment of the extent of solar damage prior to treatment and for consistent reappraisals after treatment.","title":"A review of actinic keratosis, skin field cancerisation and the efficacy of topical therapies R SINCLAIR et al."}
{"_id":"4fddb68d-8925-5ab1-5002-bfebc4a03b8f","text":"We retrospectively reviewed patients who underwent operation under general anaesthesia between August 2011 and December 2013. VTE in the perioperative period was identified through contrast enhanced CT which was performed from 30 days before operations until 90 days after operations. Multivariate logistic regression was conducted to assess the associated factors of developing VTE.","title":"Prevalence and associated factors of developing venous thromboembolism in the perioperative period"}
{"_id":"4fde1c2b-2eb0-bd94-d401-ff3eaa98a828","text":"Primary sternal osteomyelitis is a rare condition that is frequently caused by Staphylococcus aureus. It is often confused with other cardiac and pulmonary conditions. Early antimicrobial treatment and surgical debridement is the cornerstone of treatment.","title":"Primary sternal osteomyelitis: A case report"}
{"_id":"4fde508e-d17b-db2d-e09c-0c23ee701240","text":"Simple infection prevention strategies can help mitigate the risk of infection associated with IO access.","title":"Tibial Osteomyelitis Following Prehospital Intraosseous Access"}
{"_id":"4fe359ca-5165-3bf9-6612-a4f029fceff9","text":"Additionally, more research is required to evaluate the therapeutic potential of nanocarriers in relevant clinical models of disease. In light of the aforementioned advantages, it is anticipated that new nanotechnology-based methodologies will be created which have the potential to revolutionize important facets of clinical dermatology. There is still much to learn about the topical application of nanotechnology as a therapy option for skin illnesses, even though extensive research is ongoing and significant discoveries have been made. Future research must continue the shift from preclinical investigations to clinical trials in order to have a more accurate understanding of the true impact of these nanocarriers. Finding the optimal nanocarrier for each type of skin disorder would be a fascinating future task that would help enhance nanotechnology’s advantages. Although more research is still needed, it is reasonable to claim that nanobased carriers provide a promising alternative to traditional therapy and improve safety and efficacy in the management of skin disorders.","title":"New Insights in Topical Drug Delivery for Skin Disorders: From a Nanotechnological Perspective"}
{"_id":"4fe4490b-1ba2-950f-0579-58564baaba9b","text":"Total joint arthroplasty is associated with high blood loss that may need blood transfusions. The published studies favor the use of tranexamic acid as a safe and effective method of reducing blood loss. Our patients have no previous history of thromboembolic episodes and we used one gram of intravenous tranexamic acid thirty minutes before incision to reduce perioperative bleeding.","title":"Demography of Total Joint Replacement Surgeries Performed in a Tertiary Care Hospital: A Cross-sectional Survey"}
{"_id":"4fe481bc-6db0-87f3-7d84-1449fca6dbfd","text":"Aggressive resection of SPEN tumours results in loss of pancreatic parenchyma and may lead to pancreatic insufficiency in children. This has been a major concern of pancreatic resections and a more conservative approach has been advocated by performing enucleation of the tumour instead. Solid pseudopapillary neoplasms are surrounded by a fibrous capsule that can be excised from the adjacent parenchyma without removing pancreatic tissue. Tumour involvement of the main pancreatic duct, local invasion into the pancreas or surrounding organs and metastases are contraindications to the use of this technique. The use of intraoperative frozen section should be employed to ensure the surgical margin is free of tumour and thus confirm a complete resection. The presence of positive margins and suspicion of malignancy mandates surgical resection and removal of the distal or proximal pancreas depending on tumour location.","title":"Solid Pseudopapillary Epithelial Neoplasm of the Pancreas in the Paediatric Population: A Report of Two Cases"}
{"_id":"4fe8361e-093a-f5ba-8d7a-2f8377bd24f7","text":"All patients with clinically localized cutaneous melanoma who underwent lymphoscintigraphy and in whom SNB was intentionally not performed due to advanced age and\/or comorbidities were included.","title":"Focused Ultrasound Surveillance of Lymph Nodes Following Lymphoscintigraphy Without Sentinel Node Biopsy: A Useful and Safe Strategy in Elderly or Frail Melanoma Patients"}
{"_id":"4ff37484-6792-bba2-56ae-7eba9deacb0e","text":"Patient and flap selection are critical steps in the setting of lower limb reconstruction. The classic indication for free flap lower extremity reconstruction is an extensive wound in the distal third of the leg or any complex wound in the upper or middle third of the leg with composite tissue loss. Major vascular or nerve injury in the lower extremity, as well as a significant loss of a muscle compartment and a large composite tissue loss beyond possibility of soft tissue or bone reconstruction are the main contraindications to the surgery [20].","title":"Muscle vs. Fasciocutaneous Microvascular Free Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies"}
{"_id":"4ff43da8-b502-81e0-6a7e-711fc2fbbd4a","text":"This study shows that with the right expertise, simultaneous debridement, Ilizarov frame and free muscle flap transfer is safe and effective in treating complex limb infection. It requires organisation of services for effective delivery and careful preoperative planning. The results show that correctly performed distraction osteogenesis techniques do not adversely affect free flaps and are not associated with an increased flap failure rate, or reduced bone healing.","title":"Simultaneous debridement, Ilizarov reconstruction and free muscle flaps in the management of complex tibial infection"}
{"_id":"5006c8e3-ce1b-bab4-f9aa-a224255f7be9","text":"The sample size in our study was large enough to eliminate the natural differences in facial shape. We divided the subjects into younger and older adults to study the effect of aging on facial sexual dimorphism. The strength of this study is that factors such as age, BMI and body height are considered, which provided a clear picture of the distinctive facial gender features.","title":"Effect of aging and body characteristics on facial sexual dimorphism in the Caucasian Population"}
{"_id":"5009f847-42a3-a50f-142d-46780289a5fa","text":"They should be adjusted so that they equal the line from D to E via F.","title":"Reduction mammoplasty"}
{"_id":"500b504e-1e20-e721-9906-1ce7b7cd6b93","text":"Compared with thermal ablation, the advantages of cryoablation include the following aspects: the combination of multiple cryoablation needles can obtain larger tumor ablation volume. The ablation area is highly visible under CT scan, which makes the ablation range more accurate and effective. Patients are well tolerated due to the analgesic effect of cryoablation. Cryoablation is a safer option for lesions near blood vessels or bronchus because it preserves collagen and cellular structures in frozen tissue. One disadvantage of cryoablation is puncture bleeding. The latest cryoablation systems allow additional radiofrequency heating of the frozen probe shaft, allowing thermal solidification of the probe prior to probe removal. Another disadvantage of cryoablation compared to thermal ablation is the longer procedure time required to produce adequate tumor coverage.","title":"Cryoablation and immune synergistic effect for lung cancer: A review"}
{"_id":"500c379d-7ae0-b1a5-296a-fd7fa9bc7e78","text":"The aim of this study is to evaluate the hypothesis of whether the minimally invasive technique of Ilizarov external fixator with minimal internal fixation in tibial plateau fractures can provide a satisfactory outcome with few complications. Particular attention is paid to the functional outcome of, and the complications associated with, this treatment method.","title":"Complex Tibial Plateau Fractures: Primary Fixation Using the Ilizarov External Fixator. A Two-year Study at Civil Hospital Karachi, Pakistan"}
{"_id":"500feb7e-b610-f011-6981-f767eab298cf","text":"The following sensitivity analyses were conducted: changing the 14-day window for reoperation and start of follow-up to 7 days after primary surgery; changing the inclusion criteria from no more than 1 day difference between the recorded date of primary surgery in the DNPR and the DBCG database to no more than 14 days and no more than 31 days; changing the study population to include only patients with stage I and II disease at diagnosis; and excluding patients with previous cancers.","title":"Breast cancer recurrence after reoperation for surgical bleeding"}
{"_id":"5018e741-d1cc-c15c-3483-a0f75d7bdc99","text":"Synergism of ultrasound and laser radiations in the presence of GNPs","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"5019bffb-41bb-fa71-8e0b-244dd9e608c6","text":"We report here a case of a 78-year-old Moroccan woman presenting initially with a synchronous double malignancy, the first in her cervix and the second in her skin. Our patient was treated with radiation therapy for both tumors and remained in good control for 17 years, when she developed a metastatic disease from a neuroendocrine carcinoma of an unknown primary site.","title":"Triple malignancy in a single patient including a cervical carcinoma, a basal cell carcinoma of the skin and a neuroendocrine carcinoma from an unknown primary site: A case report and review of the literature"}
{"_id":"50265787-8fa3-9a73-cb76-40abf8e7a2e8","text":"Inadvertent intravascular injection of dermal fillers causes emboli, leading to skin necrosis and unpleasant scarring if these emboli are not treated in time. The progression of clinical skin ischemia is typically used to judge the progress of the disease in such patients, although this method is subjective and inaccurate. The use of LDI to confirm perfusion defects overcomes most of the shortcomings of visual and photographic examinations.","title":"Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review"}
{"_id":"50277a53-9c89-283b-f6af-1151da905817","text":"This paper provides details of the planned statistical analyses for this trial and will reduce the risks of outcome reporting bias and data driven results.","title":"Wound Healing In Surgery for Trauma (WHIST): statistical analysis plan for a randomised controlled trial comparing standard wound management with negative pressure wound therapy"}
{"_id":"50277b96-4b99-bc12-4dc8-466db22e5438","text":"The author has developed a grading system for assessment of the mastectomy flap vascularity described previously. Addressing this in several ways, firstly, by converting a prepectoral reconstruction to a subpectoral reconstruction, secondly, instead of using a fixed volume implant or fully inflated prosthesis one can deflate the prosthesis or use a prosthesis with minimal inflation for at least 3 wk before starting inflation so the skin flaps can vascularise and are in no undue tension or a delayed reconstruction altogether lastly, in patients with large ptotic breasts where the flaps are long and preservation of the nipple-areolar complex can be difficult perhaps, use of either, a reduction pattern or a simultaneous mastopexy with minimal underlying skin tension could reduce the subsequent risk of flap necrosis.","title":"Implant-based Prepectoral Breast Reconstruction: The Importance of Oncoplastic Plane, its Blood Supply and Assessment Methods"}
{"_id":"502fb18f-7390-16db-56a5-0f3043079933","text":"The underrepresentation of women both in ophthalmology overall and in leadership positions is a concerning trend. This suggests that women may face obstacles in entering this competitive field and encounter even more difficulties in advancing to leadership roles. Previous research has shown a higher proportion of men serving in senior faculty positions compared to women [15], underscoring the persistence of the gender gap in academic ophthalmology and the limited presence of women in leadership roles. This disparity in leadership positions may further perpetuate the unequal cycle of inequality, possibly contributing to the ongoing underrepresentation of women in the field of ophthalmology.","title":"Analysis of Publication Productivity and Academic Rank of Ophthalmology Residency Program Directors in the United States"}
{"_id":"503210b1-dc49-d8a3-2a8c-18e0cf0dd2e3","text":"Perhaps more striking than the descriptions of ongoing relationships between alumni and fellowship mentors were the descriptions of how Afya Bora alumni had become mentors themselves in the time since the fellowship. This was a recurrent theme in many of the descriptions alumni provided about their changing positions in the workplace, and is further evidence of transformative leadership. Inherent in these new mentorship roles is a promulgation of leadership qualities that alumni now embody. Additionally, the following quotes describe the process of teaching and transmitting leadership skills that are not typically taught in health workers’ training programs.","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"5033cd52-d759-3254-3ff8-cfc90b89855f","text":"Total lower lip excision defects can only be satisfactorily closed with the use of composite free flaps [4–9]. The ideal free flap should be thin and pliable in order to be shaped to reconstruct the lower lip and provide sensitivity and support in order to avoid drooling. The free flap that gathers all these properties is the free radial forearm flap, and thus it is the most commonly used free flap in the case of reconstruction of the lower lip. Flap necrosis is an unfortunate event that has to be confronted with the use of another flap. The substitute flap can be the dorsalis pedis free flap, since it resembles in its characteristics the radial forearm flap. We present our experience with the use of the dorsalis pedis flap as an alternative composite fasciocutaneous tendon flap in total lower lip reconstruction.","title":"Dorsalis Pedis Free Flap: The Salvage Option following Failure of the Radial Forearm Flap in Total Lower Lip Reconstruction"}
{"_id":"5034b3d1-e684-e7bb-512f-ff244fdbe89c","text":"Total 65 patients were included in this study from March 2005 to December 2012. These patients received surgical reconstruction of Platysma flap and Submental flap at the department of Oromaxillofacial Head and Neck surgery, School of Stomatology of China Medical University. Patients with widespread metastatic condition and inoperable cancers were excluded. The protocol of our study was approved by the institutional review board and conducted in accordance with the declaration of Helsinki. Written Informed consent was obtained from all the patients.","title":"Submental versus platysma flap for the reconstruction of complex facial defects following resection of head and neck tumors"}
{"_id":"503b0d74-1bae-f157-1a38-e120096b905b","text":"Anaphylactic reactions can occur to the benzyl benzoate component of depot preparations of testosterone undecanoate. It is potentially unrecognised or can be misdiagnosed as oil embolism and underreported. Testing for reactions to the individual components of pharmaceutical agents may prevent inappropriate exclusion of all available preparations of a particular agent if it is the vehicle rather than the active ingredient that is causative. Similarly, it will alert the patient to risk of hypersensitivity to unrelated products which may utilise the same agent. Doctors should remain aware of the potential for serious reactions to testosterone replacement therapies and should consider appropriate further investigation.","title":"Anaphylaxis Triggered by Benzyl Benzoate in a Preparation of Depot Testosterone Undecanoate"}
{"_id":"504f047b-14f1-8858-0f36-f78638888d4d","text":"A final limitation is the self-report nature of the SNA survey which may lead to biased responses. Completion of the survey will also be done in the presence of the research team which may drive idealised responses regarding who participants suggest represent leadership in their organisaitons [74]. To ensure the quality and rigour of our data, we will explore and validate the results of the SNA during the interviews and conduct crosschecks across participants working in the same organisations. During the network analysis, we will make the assumption that the networks produced for each hospital are standardised across time and will remain static for the period of longitudinal data collection. However, it is possible that individuals in the network leave the organisation or change roles. Where possible, we will seek to uncover details regarding any changes and the impact they had during the interviews. The limitations of the methods used will be taken into account in the interpretation of the study findings.","title":"Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol"}
{"_id":"505470af-0d00-4ae6-299f-1b88f98bb1c3","text":"The current trend of burn wound care has shifted to more holistic approach of improvement in the long-term form and function of the healed burn wounds and quality of life. This has demanded the emergence of various skin substitutes in the management of acute burn injury as well as post burn reconstructions. Skin substitutes have important roles in the treatment of deep dermal and full thickness wounds of various aetiologies. At present, there is no ideal substitute in the market. Skin substitutes can be divided into two main classes, namely, biological and synthetic substitutes. The biological skin substitutes have a more intact extracellular matrix structure, while the synthetic skin substitutes can be synthesised on demand and can be modulated for specific purposes. Each class has its advantages and disadvantages. The biological skin substitutes may allow the construction of a more natural new dermis and allow excellent re-epithelialisation characteristics due to the presence of a basement membrane. Synthetic skin substitutes demonstrate the advantages of increase control over scaffold composition. The ultimate goal is to achieve an ideal skin substitute that provides an effective and scar-free wound healing.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"505bf840-8125-f76f-dff1-c5d44d284ea4","text":"There is a profound variation in the facial nerve branching pattern that has not been previously reported. Awareness about differences in the anatomy of the facial nerve assisted useful information to surgeon to preserve FN during parotidectomies.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"5064db14-d651-53fd-5ddb-454746f58555","text":"The data extraction forms will be completed prospectively by a member of the pain team.","title":"Transversus abdominis plane block following abdominally based breast reconstruction: study protocol for a randomized controlled trial"}
{"_id":"506b9924-c4b7-1ca2-e739-d38e9aefc9c3","text":"Biological results demonstrate that BRAF inhibitors promote paradoxical activation of the MAPK pathway in cells that do not carry BRAF mutation leading to keratinocyte proliferation and hyperproliferative skin lesions which are the most common side effect of BRAF inhibitors [18]. A concurrent inhibition downstream of RAF with a MEK inhibitor preventing the pathway activation results in the significant reduction in cutaneous side effects [19].","title":"Cutaneous Side Effects of Targeted Therapy and Immunotherapy for Advanced Melanoma"}
{"_id":"506c60af-2662-2d0e-996f-7d75e917a141","text":"The patient then has mammography of both breasts. Ultrasound is routinely done for the breasts and to the liver. All the patients have a fine needle aspiration to examine the cytology of the breast lump at the time of their attendance or afterwards. Some of these patients have to have a core needle biopsy to confirm the suspicion of non-diagnostic fine needle aspiration or non-diagnostic radiological findings.","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"507866b0-79cd-5966-21b3-feef842ff394","text":"Another limitation of this review was the inclusion of all patients taking MTX, regardless of other regimens they were using concurrently, including other nonbiologic systemic medications, phototherapy, and biologics. We believed that including these patients was necessary to have a complete understanding of the effect of MTX on NMSC risk for patients with psoriasis and would add to the power to address the question. For this reason, however, we cannot say that the findings reported in this study represent the sole effect of MTX on NMSC development because we could not estimate the role of other therapies in the development of skin carcinomas in patients using multidrug regimens. In fact, the risk of NMSC may be higher than identified in this study in psoriasis patients treated with MTX compared with no systemic therapy, given that many systemic therapies in the comparative arm have also been associated with NMSC development.","title":"Psoriasis Patients Treated With Methotrexate Have an Increased Risk of Nonmelanoma Skin Cancer: A Systematic Review and Meta-Analysis"}
{"_id":"50820789-5787-3fd9-feee-7b6977b35e93","text":"The World Health Organization defines female genital mutilation (FGM) as any procedure involving partial or total removal of female external genitalia or other injury to genital organs for non-medical indications. Despite prohibitory legislation in the United States and significant morbidity related to FGM procedures, the practice continues throughout the globe with three million women at risk annually. Surgical care for women with FGM has historically been in the hands of obstetrician and Gynaecologists (OB GYNs), and mainly focused to help safe labor and delivery. Recent awareness of the need for improved reconstructive surgical care for FGM has developed in the plastic surgical literature. This Current Opinion article highlights the historical surgical care for FGM and the opportunity for plastic surgeons to get more involved in the multidisciplinary care of these patients.","title":"The Role of Plastic Surgeons in Female Genital Mutilation Reconstructive Surgery"}
{"_id":"5083143d-e6fa-0969-1a40-83929e67fac8","text":"CONSORT flow diagram of the study. CONSORT indicates Consolidated Standards of Reporting Trials. Group U was short for nerve block with ultrasound guidance, group N was short for nerve block with nerve stimulation guidance, group M was for nerve block with combined guidance","title":"Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial"}
{"_id":"5083351d-897b-ae6d-6096-a39b2850eaf5","text":"Due to high frequency of minor post rhinoplasty complications, lack of enough structured studies in this regard and ambiguity of the exact pathophysiological aspects and risk factors of these complications, more studies about these complications and their aggravating and resolving factors are needed. It seems that the most important issue is gaining more knowledge about the natural history of these complications.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"5089b1dd-54e9-8156-6d0c-6fc6703602e0","text":"CONCLUSIONS Our results reveal the first direct observations of acoustic streaming in a soft tissue microenvironment. We showed that although gelatin and polyacrylamide have acoustic properties suitable for ultrasound imaging and hyperthermia experiments, they are not effective in studying acoustic streaming. Instead, we recommend the use of MPPA, because it supports fluid flow through its microstructure by having interconnected pores or channels. Using this phantom material, we wereable to study acoustic streaming under different exposure parameters; finally demonstrating that pulsed ultrasound produces greater acoustic streaming with less risk ofthermal damage than with continuous wave emission using the same acoustic energies. Our future work is to study optimise ultrasound parameters to maximise acousticstreaming in this material and in in-vivo tissue for enhancing drug distribution and neurostimulation.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"508d6d9c-5b09-75e5-994f-53d59c415143","text":"The aim of this study is to report the yield of percutaneous bone biopsy in persons with diabetes with clinically suspected osteomyelitis involving the foot and the spectrum of offending pathogens recovered from these biopsies.","title":"Is fluoroscopy‐guided percutaneous bone biopsy of diabetic foot with suspected osteomyelitis worthwhile? A retrospective study 一项回顾性研究:怀疑骨髓炎的糖尿病足在透视引导下经皮骨活检是否具有价值?"}
{"_id":"509030f3-39fc-fe3c-cddf-f5c6338f5129","text":"Autologous fat grafting surgery can be performed under general anesthesia (as used here) or with local anesthesia supported by sedation and under the observation of a certified anesthesiologist. In patients presenting with severe microstomia, which may lead to a difficult intubation or in cases of respiratory or cardiac impairment due to disease progression, assessment by an experienced anesthesiologist is required to determine the safest anesthesia modality for the patient.","title":"Total Facial Autologous Fat Grafting for Treating Skin Manifestations in Scleroderma"}
{"_id":"5090a45f-f84f-9a93-49d4-8bd04823ed75","text":"Patients with tortuous iliac arteries, significant iliac vessel calcification that require limb placement in small diameter external iliac artery are at highest risk for limb occlusion. During planning and implantation, a special focus on prevention strategies of this complication should be made. While there are multiple treatment modalities for limb occlusion after EVAR open bypass surgery remains a fast, safe and durable solution used in most patients even nowadays.","title":"Abstracts DGG"}
{"_id":"50945240-01dd-e1ba-802e-827503921992","text":"In 2014, Pereira and colleagues [1] performed a prospective cohort study aimed at clinically evaluating the extent of resorption over time of corticocancellous fresh frozen allograft bone blocks used in the reconstruction of severe maxillary atrophy. They found that the use of fresh frozen allograft bone harvested from the iliac crest is a suitable alternative in atrophic maxillary reconstruction and exhibited a low resorption rate at 5 months, which allowed for proper stability of dental implants prior to fixed prosthetic rehabilitation.","title":"Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data"}
{"_id":"5095a5f0-edc3-ec7f-874f-0f9e59bff51c","text":"The main objective of the study was to outline the main esthetic-functional complaints reported by patients to be submitted to a revision rhinoplasty in our hospital and to correlate them with the internal and external objective nasal evaluation performed by the surgeon. Other epidemiological and surgical questions were also investigated, such as the number of previous surgeries and the time since they were performed, previously used surgical accesses, and the reasons why the patient did not return to the previous surgeon.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"50a1de44-469f-0674-f2fa-c48ff22d0352","text":"All patients received routine postoperative care such as infection prevention and antiosteoporosis therapy. The drainage tube was removed within 48 hours after surgery if there were no indications showing leakage of cerebrospinal fluid. On postoperative day 2, a cervical collar was used to protect the cervical spine; the patient may have been asked to sit unsupported or supported by the elevated bedhead.","title":"Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations"}
{"_id":"50ad5457-167a-57ec-7cf1-b8bda8d37523","text":"Total outdoor physical activity was calculated by summing the 5 individual outdoor activities described earlier. For correlation and regression analyses, the physical activity variables were natural log transformed because of positive skew.","title":"Parents’ Perceptions of Skin Cancer Threat and Children’s Physical Activity"}
{"_id":"50bfaa0c-dd2b-0bee-1685-9a04e1d6c529","text":"The desire to reduce the potential negative impact of surgical resections of malignant lesions of the face carries considerable value in the context of the patients satisfaction as a treatment outcome. If surgical intervention can be performed without loss of oncologic safety, but at the same time strive to reduce the size of resection, the personal impact on the patient is likely to be substantial. Facial lesions and the aesthetic consequences of the treatment of such lesions carry a social impact that hold potential for great disability. Although some degree of residual cosmetic defect is almost always going to be present in treatment of any facial lesion, if the defect can be reduced to a minimum, multiple outcomes may be enhanced. As a result, we believe that PDT may serve a valuable role as neoadjuvant therapy for malignant lesions of the face. It is clear that surgery remains the gold standard specific to treatment of skin cancers of the face, yet the ability to minimize the posttreatment consequences of surgery cannot be discounted.","title":"Neoadjuvant Use of Photodynamic Therapy in Basal Cell and Squamous Cell Carcinomas of the Face"}
{"_id":"50bfe89d-8881-6c59-1871-df027f5264e9","text":"We hope that this review provides an up-to-date overview of the optimal surgical margin for skin cancer and methods for diminishing complications associated with dermatologic surgery and that it facilitates the determination of methods in clinical practice.","title":"Evidence from Clinical Studies Related to Dermatologic Surgeries for Skin Cancer"}
{"_id":"50c4e63c-50d5-406b-4a0e-627f36413e6e","text":"A wish to get help to make the situation of nourishing the infant function in better ways is an essential longing, or to get a confirmation on a decision to terminate breastfeeding—to end the struggle—and a wish to get help to rely on themselves in a challenging and new situation.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"50c6ca45-4282-7fa6-6651-daf9cd4f427c","text":"SimCO is considered to train a dictionary having unit norm atoms from a set of signals so that signals can be better represented as the linear combination of a few atoms of the dictionary.","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"50c8a9bb-cdf8-f09f-ecb7-fa214adc7f9d","text":"Our rationale for using a definitive spacer revolved around the potential for prolonged local antibiotic exposure. Masri et al reported elution of vancomycin and tobramycin from cement spacers at levels above the breakpoint sensitivity limit for sensitive organisms at a mean of 118 days when high doses of antibiotic were used. Similarly, Fink et al found vancomycin, gentamycin, and clindamycin to be eluted in concentrations higher than their MIC from cement spacers 6 weeks after implantation. It has also been shown that antibiotics released from cement can result in local levels that are markedly higher than those reached with parenteral therapy.","title":"Antibiotic Impregnated Cement Dowel in a Tibial Stump to Salvage Infected Below-Knee Amputation in a Diabetic"}
{"_id":"50cb46d7-9592-acec-74b6-aa0c14b76adb","text":"Early antibiotic therapy before extensive destruction of bone produces the best results in patients with osteomyelitis. During treatment patients should be followed closely for signs and symptoms of worsening infection. After the completion of treatment follow-up should be based on the response to therapy and the overall health of the patient.","title":"Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report"}
{"_id":"50d5bc79-8345-8095-b70f-ffc7548b19dd","text":"Patients will be recruited through a number of primary care and secondary care anticoagulation clinics in the wider Midlands area over a two year period.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"50e00345-3a54-d956-63c4-2bb0efe37f71","text":"DF is a benign tumor but locally aggressive, with rapid growth and a tendency for local recurrence. Detecting the tumor before progression to a larger size will facilitate an easier surgical excision with increased likelihood of achieving microscopically negative margins. Surgical excision remains the preferred approach. However, more data are required in order to formulate an algorithm to approach and manage such tumor.","title":"Massive congenital cervicofacial desmoid-type fibromatosis in a 5-month-old infant"}
{"_id":"50e27e33-37f2-2b64-6a3c-c322342bf677","text":"The pathological specimen showed fibrinoid vasculitis surrounding calcinosis. It is hard to explain whether the inflammatory calcinosis is due to muscle vasculitis because there was no muscle vasculitis where no calcinosis was present. Muscle vasculitis arising from JDM should be symmetrical. We prefer to surmise that fibrinoid vasculitis was followed by the calcinosis universalis itself. Besides, no report of a direct relationship between vasculitis and calcinosis universalis has appeared in the literature.","title":"Efficacy of thalidomide in a girl with inflammatory calcinosis, a severe complication of juvenile dermatomyositis"}
{"_id":"50e49c8a-3f96-c8f7-82c8-54e2aa59c810","text":"Of the 12 patients with limb preservation, 7 required excision of the main artery en bloc with the tumour and vein in order to get clearance. Arterial reconstruction using a vein interpositional graft was performed in these patients. None of the patients had vein reconstruction as we often tried to preserve the saphenous veins in these patients with the hope that these would become the dominant venous drainage. This was determined preoperatively, and the surgery was done in collaboration with a vascular surgeon who performed the reconstruction. In the remaining 5 cases the resection included only the vein and no reconstruction was done. This was possible in case of resection of the femoral vein due to the presence of the saphenous vein which together with the collaterals compensated for the loss of the femoral vein.","title":"Leiomyosarcomas of Vascular Origin in the Extremity"}
{"_id":"50e70d35-7bf8-0dd0-d47c-e3a5414b3c19","text":"The American Joint Committee on Cancer ypT catgeory is based on the size of the largest contiguous focus of residual viable tumor, excluding areas of fibrotic tumor bed. A more comprehensive method of pathological evaluation of response after neoadjuvant chemotherapy is the residual cancer burden (RCB), which accounts for intervening fibrosis by incorporating the largest two-dimensional area of extent of residual invasive cancer and the percent of that area containing cancer cells, percentage of cancer that is in situ disease, and the extent of nodal involvement by the number of involved lymph nodes, and size of largest diameter of metastasis in the lymph nodes. I-SPY2 uses the methodology of mapping the histopathologic sections to the macroscopic findings as its standard procedure to accurately determine the extent of residual disease for ypStage and RCB, to maintain standardized pathology procedures across clinical sites and minimize the chance of missing residual disease.","title":"Surgical Standards for Management of the Axilla in Breast Cancer Clinical Trials with Pathological Complete Response Endpoint"}
{"_id":"50ecdb7b-dbcd-820d-7b52-d3352faf7c9d","text":"The proposed technique involves reconstruction of the 3D image from the 2D CTA image using the ENURBS 3D approach and planning of the surgical methods based on the 3D reconstructed liver model for precise liver resection using VSP.","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"50ee710d-130b-ed44-ce72-4c21f4ed158a","text":"There have been numerous reports of allergies with causes such as differences in the amino acid sequences between human insulin and insulin extracted from porcine and bovine pancreas. Insulin allergy leads to deterioration of blood glucose control and decrease in quality of life. However, the availability of genetically recombinant human insulin formulations has led to insulin allergy becoming uncommon [1], and such allergies also occur much more rarely when insulin analog formulations are administered.","title":"A case of type 1 diabetes mellitus with which localized insulin allergy was markedly alleviated by switching to insulin glulisine"}
{"_id":"50eea95b-4bf4-4054-d90f-477b1e7547d9","text":"Together, our advanced imaging techniques have provided a comprehensive understanding of the bacterial behaviour and tissue changes associated with bone infections.","title":"Insights into S. aureus-Induced Bone Deformation in a Mouse Model of Chronic Osteomyelitis Using Fluorescence and Raman Imaging"}
{"_id":"50fa0fcb-4600-7bcc-60ef-9e25a01f9a31","text":"A telephone survey in recently treated Squamous Cell Carcinoma patients in Italy also found skin cancer knowledge to be low [24]. We found no significant difference in knowledge from diagnosis to 8 weeks post treatment. Participants told us that information given at diagnosis was not really considered as they were so shocked at hearing the word 'cancer’ that everything went out of their head and they couldn’t think of anything else. Lack of knowledge of NMSC most likely contributed to the delay in presentation for many of the participants with some not consulting a doctor for up to 2–5 years. Our study found lack of awareness to be one of the main reasons for delay. Despite participants being aware of their skin lesion for many years, most thought it was a sign of ageing or something that would go away despite in many cases the lesion repeatedly bleeding and failing to heal and despite self-treating with various creams. A recent study [13] in patients presenting for Mohs micrographic surgery for NMSC found similar reasons for delay in presentation, however they did not look at what prompted people to eventually seek advice. We found many participants only consulted a doctor after others such as hairdressers, dentist, or friends had encouraged them to do so. Knowledge is a necessary prerequisite for anyone to be able to interpret a symptom as a signal of cancer or to judge it as serious and requiring medical attention [25].","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"51034aa7-64ee-1353-8f01-d41e1a21c14e","text":"In 2009, Contar and colleagues [7] conducted a study of 15 patients with atrophy of the maxillary ridge who required bone block grafts prior to implant placement. These patients underwent maxillary reconstructions performed with block grafts comprising fresh frozen chips harvested from allogeneic tibial bone. They concluded that block fresh frozen allografts could be used successfully in the treatment of maxillary ridge defects.","title":"Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data"}
{"_id":"5103ec83-bd73-d1ab-2c1f-b5494f311975","text":"One significant difference observed between the cuSCCs and the AKs is the percentage of their neoantigens that are highly recognized by TCRs. The cuSCCs on average had a lower percentage of binding neoantigens that are also predicted to be highly recognized by the TCRs. Thus, the presence of a greater numbers of neoantigens in cuSCCs may not directly correlate to the visibility of that lesion to the immune system. Rather, the increased percentage of neoantigens that are recognized in AKs compared to cuSCCs indicates that the TCR recognition of the neoantigens predicted to bind MHC may be an important factor in determining the success of immunosurveillance. This finding corroborates the work of Anagnostou et al. who demonstrated that, after immunotherapy, the number of neoantigens increased, but the strength of those neoantigens decreased (16).","title":"Neoantigen Fitness Model Predicts Lower Immune Recognition of Cutaneous Squamous Cell Carcinomas Than Actinic Keratoses"}
{"_id":"510e2305-0e85-c61c-0fc0-ea921b45d089","text":"In this study we give insight into the spectrum of the application of ICG angiography in plastic reconstructive surgery based on representative and selected clinical cases and demonstrate the advantages and disadvantages of this procedure in the context of the current literature.","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"510e78c3-38f8-eabf-5068-0640c6597f09","text":"Semi-structured interviews were carried out with the participants from December 2015 to January 2016. The questions addressed the meaning of the detection and diagnosis of breast cancer and the quality of cancer care provided by the national health care system. Filed notes and participant observation complemented the collected data.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"511c9bde-37be-a3b3-f821-0fed32b0ae14","text":"Open fractures of the proximal tibia often pose serious challenges to the treating orthopedic surgeon. Management of these complex injuries becomes difficult if they are associated with damage to the extensor mechanism and an exposed knee joint. The scenario becomes more difficult to manage when the soft tissue defect extends to the middle third of the leg. We report a case where we used an extended medial gastrocnemius flap in combination with a saphenous artery fasciocutaneous flap and a medial hemisoleus flap for treatment of an infected proximal tibia fracture with loss of the extensor mechanism and soft tissue defect. To the best of our knowledge, combined use of these three flaps for the management of such injuries has not been reported elsewhere to date.","title":"Knee extensor loss and proximal tibial soft tissue defect managed successfully with simultaneous medial gastrocnemius flap, saphenous fasciocutaneous flap and medial hemisoleus flap: a case report"}
{"_id":"5122b7c5-0d5a-3949-e949-f1b955132658","text":"Implant surgery is now an integral part of modern orthopaedics and the norm in orthopaedic surgery, from the management of fractures to the replacement of joints in degenerative joint disease and the substitution of bones in limb salvage surgery. The future also holds promise for several implantable (artificial intelligence) devices in orthopaedics, general surgery and other medical conditions. In the United States alone the number of joint replacements is estimated to exceed one million and the infection rate is said to be two percent, up to 20,000 infections per one million per year. The use of internal fixation is rising as the number of fractures involving high-velocity injuries increases and these often require internal fixation with implants.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"51235a15-f3a8-deef-fcb2-144afd301c96","text":"Once the cement has set and the femoral length trialed (long enough to avoid shortening of tissues in the interval before second stage revision, but not so long as to put tension on the wound or prevent reduction) distal locking is performed in a routine manner with intraoperative fluoroscopic guidance.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"51267abd-3042-f5fe-59cf-f6e942316082","text":"A retrospective case note review was performed of patients who had undergone free abdominal tissue transfer for bilateral breast reconstruction between August 2003 and February 2014. The list of patients was identified through a contemporaneous logbook of the senior author.","title":"Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients"}
{"_id":"51270f59-9107-bf93-4f9b-bb8f1078d241","text":"The review of the profile and risk factors of patients with DVT in our study setting shows predominantly young patients with female preponderance. TB and HIV are well-recognised risk factors, either alone or in conjunction. Clinicians should have a heightened awareness of VTE in patients with either condition or where both conditions occur together and appropriate thromboprophylaxis should be administered.","title":"The profile and frequency of known risk factors or comorbidities for deep vein thrombosis in an urban district hospital in KwaZulu-Natal"}
{"_id":"51298743-7656-b7b8-7f4b-0bce74e70fa6","text":"FES is both a clinical diagnosis and a diagnosis of exclusion because it is often associated with concomitant injury\/ illness. This also leads to difficulty in evaluating the severity of FES.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"5133aecc-44dd-27f3-3db8-13c37b127b5a","text":"Surgical approaches for cervical myelopathy due to cervical spondylosis can be anterior, posterior or combined. The last option is reserved for deformity correction. In most instances a lordotic or slight kyphotic cervical spine is present. The choice for an anterior or posterior approach is dependent on the main site of compression, the shape of the cervical sagittal curvature and to a lesser account on the preference of the surgeon.","title":"Design of Lamifuse: a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy"}
{"_id":"51385115-599a-85b0-a0b0-fd2af381ae12","text":"The ideal manner to compare PDT to surgery is a prospective randomized study. The main problem with such a design is to offer patients a trial where two very different techniques are going to be used, and there is no option to choose which treatment they want. In our institute, PDT is offered routinely to patients with thin oral cavity cancers as an alternative to surgery. By screening our database, we were able to identify comparable cohorts of patients who have had the same tumor work-up including measurement of the thickness of the tumor, management of the neck and follow-up schedule. Comparison of these cohorts gives an idea about the success of PDT compared to surgery of early stage oral cavity tumors.","title":"A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer"}
{"_id":"5141535f-5011-6696-3e1f-0593844d2050","text":"Mean values of all biophysical measurements were highly comparable between the right and left half cheek. Also the P values of the ANOVA showed similar probabilities.","title":"Characterizing Facial Skin Ageing in Humans: Disentangling Extrinsic from Intrinsic Biological Phenomena"}
{"_id":"5141a94c-b963-e865-d536-3bc0d399db9e","text":"The safety and quality of care during immunotherapy are also impacted by the level of communication between inpatient and outpatient providers. Feedback from inpatient providers regarding the effects experienced and required adjustments in medications is critical to preparation for the next admission. The outpatient provider can then prepare accordingly and ensure that the orders for subsequent cycles are appropriate, so side effects can be minimized. If a patient developed hives on day 1 of a dinutuximab infusion and additional antihistamines were effective, additional antihistamines should be incorporated into orders for future admissions. Consistency of care and ongoing communication are essential.","title":"Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications"}
{"_id":"51426e66-1ba9-f520-5f9d-5eef037430ff","text":"Though, now considered as a benign lesion, the exact biological behavior of AVLs is not fully established because of the limited number of cases encountered. More cases of post radiation AVLs may be encountered in the future and hence breast carcinoma patients who have received radiation therapy have to be closely monitored for development of papulonodular skin lesions. Long-term follow-up study of these patients is necessary to assess the exact behavior of the lesion and risk of progression to angiosarcoma. The pathogenetic factors have to be elucidated by studying these group of patients.","title":"Postmastectomy-Postirradiation Atypical Vascular Lesion of the Skin: Report of 2 Cases"}
{"_id":"5143ee83-85d2-af07-7ce2-e4c678f13c4c","text":"Newer and more innovative techniques need to be developed to counter these problems. The only way to do that is to first find out why and how is the microbe resistant to antimicrobials or to the host immunity.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"5145bc14-80c2-af14-ca89-4915b9f2b455","text":"Limb salvage surgery in the presence of neurovascular bundle infiltration necessitating vascular reconstruction is a well established procedure in western literature. Many major centers in India, even today, continue to offer potentially morbid amputations to these patients. Post operative morbidity, fear of oncological outcome and complexity of the procedure associated with vascular reconstruction has deterred many to undertake limb salvage in this subset of patients in India despite being reported in western literature.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"5145cf10-5a5c-678f-293b-68c619fc2855","text":"This study was a retrospective study and suffers from the limitations of all retrospective studies such as a reliance on the accuracy of the written record and dealing with missing data. This study suffers from significant selection bias as only 65 of the 612 patients presenting with complaints suspicious for an abscess were included. This decreases the clinical implications of this study but does not eliminate the finding that in some patients, US demonstrated an abscess when CT did not. It is likely that the utility of US in the majority of patients that did not receive CT was equal to the patients included in this manuscript, as US has been demonstrated to be useful in less complicated patients that rarely receive CT imaging.","title":"Comparison of computerized tomography and ultrasound for diagnosing soft tissue abscesses"}
{"_id":"5146dfed-e11e-1be8-5832-7d80cc7088f4","text":"Currently, at UTMDACC, needle placement and injection for SLNB is performed with a combined approach with the needle placed in breast imaging under mammographic or sonographic guidance and the radiopharmaceutical injected by a nuclear medicine physician through or adjacent to the localization needle in the nuclear medicine suite. This approach requires the patient to be transported from breast imaging to nuclear medicine (one floor away) with a localizing needle in the breast. An advantage of the combined approach is that the radiopharmaceuticals can remain in the nuclear medicine area throughout the procedure.","title":"Sentinel Lymph Node Evaluation: What the Radiologist Needs to Know"}
{"_id":"514f2594-cb44-a838-9a6a-8f2c10405392","text":"The reconstructive success rate following pedicled perforator flap reconstruction targeted by CDU appears to be high and the procedure provides a wide scope of applications and margin of safety. It is evident that the risk of venous congestion is 11 times greater in the lower extremities than the truncus, a finding that needs further attention in future studies.","title":"Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps—a systematic review and meta-analysis"}
{"_id":"5154b8f1-aee6-751b-456a-93c6b0bd89a1","text":"Whether this is due to the small number of patients in this study or represents a typical pediatric cohort remains to be elucidated and no generalizable conclusions should be drawn from these findings.","title":"Anaphylactic reactions in the build-up phase of rush immunotherapy for bee venom allergy in pediatric patients: a single-center experience"}
{"_id":"515ec0e3-1945-581a-3b3b-8fb771f16eb6","text":"T coefficients obtained from the multivariable model were used to set up a nomogram for practical use.","title":"The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)"}
{"_id":"515f57ec-854d-d2db-824b-af3b9116017b","text":"Our results show that in this model ibuprofen significantly reduced melanoma invasion in one out of three melanoma cell lines and showed a tendency to reduce invasion in another. It was without effect in the third, very aggressively metastatic melanoma cell line. Clearly now that this model is established it will need extending to other melanoma cell lines to establish how widespread the actions of an anti-inflammatory might be in retarding melanoma invasion. We suggest this study significantly extends our previous studies showing melanoma cells interact with skin cells in their invasion into TE skin but also shows for the first time that fibroblasts on their own tend to inhibit the invasion of melanoma cells and that ibuprofen can reduce melanoma invasion under conditions designed to model some of the key features of removal of a primary melanoma–the creation of a wound and the presence of associated inflammation. The use of a tissue engineering approach allows one to study these as separate features—something not easily possible in in vivo studies. These results held true for the two least invasive melanoma cell lines but unfortunately ibuprofen was without effect on the invasion of the very aggressive C8161 cells in this model.","title":"Use of a Tissue Engineered Human Skin Model to Investigate the Effects of Wounding and of an Anti-Inflammatory on Melanoma Cell Invasion"}
{"_id":"51630929-20c3-2f00-4235-31e8b15fec06","text":"Complication following insertion may be divided into those specific to the prosthesis and those associated with anterior cervical discectomy. No cerebrospinal fluid leak or wound hematomas in this group, but 1 case of esophageal injury occurred, though 1 week of nasogastric feeding tube and regional drainage, recoverd successfully. No no end plate of Bryan cervical disc migration, 1 case of failure to maintain motion because of spontaneous fusion in replaced segment. No cases of subsidence of device failure. 2 case of worsened cervical regional kyphosis in 9 cases of with preoperative focal kyphosis at operated segments.","title":"Clinical report of cervical arthroplasty in management of spondylotic myelopathy in Chinese"}
{"_id":"5172684b-b245-1f7a-4d58-70b539e84774","text":"Local flaps based on perforator vessels are raising interest in reconstructive surgery of the limbs. These flaps allow efficient coverage of large wounds without the need to sacrifice a major vascular axis. The operative technique does not require microvascular anastomosis and allows reconstruction of soft tissue defects using nearby similar tissues. The aim of this study was to evaluate the clinical results of local perforator flaps in the treatment of complex lower-limb defects.","title":"Perforator-based propeller flaps treating loss of substance in the lower limb"}
{"_id":"517f0028-15f5-e133-2316-dbb819e76c6f","text":"The study design for each of the 3 studies is briefly presented below:","title":"Skin rash following Administration of Apalutamide in Japanese patients with Advanced Prostate Cancer: an integrated analysis of the phase 3 SPARTAN and TITAN studies and a phase 1 open-label study"}
{"_id":"518549f9-609e-913e-bd3b-b2a49b88b139","text":"Figures 5 and 6 illustrate that the n value calculated over the full time frame and the value calculated as a mean of segments will not necessarily be the same. In the example the value will be smaller than n.","title":"Photoplethysmography for demarcation of cutaneous squamous cell carcinoma"}
{"_id":"518550e1-27b6-ad36-4343-e4c69147fd79","text":"Patent blue V is a well known cause of perioperative anaphylaxis","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"51885d09-b1b0-e0c0-a359-98a79820f15e","text":"This study suggests an increased risk for breast cancer recurrence in women receiving a delayed DIEP flap reconstruction as compared to women receiving an immediate DIEP flap reconstruction. However, these data should be interpreted carefully as a result of selection bias.","title":"The difference in local, regional and distant breast cancer recurrence between the immediate and delayed DIEP flap procedure; a retrospective cohort study"}
{"_id":"518ddc61-1a4b-801f-ca34-2a9bfa1080ff","text":"Rhinoplasty is a very common surgery nowadays. The most important expectations of patients and surgeons from this surgery are pleasing from cosmetic results and no recurrence of any deformity over the years. However, many complications may develop even after years from rhinoplasty.","title":"The Development of Dorsal Nasal Cyst Formation after Rhinoplasty and Its Reconstruction with Conchal Cartilage"}
{"_id":"519374be-405f-edae-3e34-29d98c3e296e","text":"In our case, a total parotidectomy and a sacrifice of facial nerve were preformed with adjuvant radiotherapy because surgical margins were positive.","title":"Metastatic Liposarcoma to the Parotid"}
{"_id":"519e1da1-7671-3cf2-4b02-3134ab0cd2e2","text":"Abdominal free flaps for microsurgical breast reconstruction are most commonly harvested based on the deep inferior epigastric vessels that supply skin and fat via perforators through the rectus muscle and sheath. Intact perforator anatomy and connections are vital for subsequent optimal flap perfusion and avoidance of necrosis, be it partial or total. The intraflap vessels are delicate and easily damaged and it is generally advised that patients should avoid heparin injection into the abdominal pannus preoperatively as this may compromise the vascular perforators through direct needle laceration, pressure from bruising, haematoma formation, or perforator thrombosis secondary to external compression. We report three cases of successful deep inferior epigastric perforator (DIEP) flap harvest despite patients injecting therapeutic doses of low molecular weight heparin into their abdomens for thrombosed central venous lines (portacaths™) used for administering primary chemotherapy in breast cancer.","title":"Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus"}
{"_id":"51a21b6a-9bdd-ddfc-dbbc-8d81b7387e75","text":"Our study has some unique aspects compared with previous studies. The first is that this study shows that endoscopic treatment which is common in far eastern countries like Japan and Korea can be successfully performed by endoscopists and anesthesiologists with western education in endoscopy units with the necessary equipment. The second is that this is the first study to compare general anesthesia and sedation performed completely under anesthesiologist observation. The third is that as our study was performed by the same endoscopist and the same anesthesia expert, and confounding factors such as the learning process and procedure experience were reduced to a minimum. The fourth is that because we only included ESD cases with gastric localization, the results of our research were more homogeneous.","title":"Propofol-Based Sedation Versus General Anesthesia for Endoscopic Submucosal Dissection"}
{"_id":"51ab9892-a2a6-0fcd-1435-01102103fe4f","text":"We found that using Pelnac as an overlay for minced split-thickness skin grafts accelerated wound closure and stimulated cell proliferation and tissue angiogenesis. In addition, this approach enhanced collagen synthesis and increased the formation of basement membrane and dermis as well as the expression of growth factors related to wound healing while reducing scar formation.","title":"Abstracts from the 12th Asia Pacific Burn Congress Singapore. 14-17 August 2019"}
{"_id":"51b03f13-e309-d79c-6c7f-f471bdb030a8","text":"The focus of this review is to identify themes that arise from the STF Decisions and CMPA STF Data that relate to the informed consent process and discussions between physician and patient in the specific context of STF therapy.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"51b3bbd0-159f-1732-b7c9-ab9d83876feb","text":"Four medial gastrocnemius flaps were performed. One was for a proximal tibial hemicortical allograft after neoadjuvant radiation and resection of a HG STS. This patient had an excellent outcome, but required prolonged antibiotics for cellulitis. Two were performed in conjunction with surgical debridement for infection in proximal intercalary allografts that were explanted for a cement spacer. Both cases were salvaged with an allograft or subsequent arthroplasty. One gastrocnemius flap was performed for a diaphyseal intercalary allograft with wound healing delay. This patient required an amputation for distal diaphyseal wound failure and progression of disease.","title":"Allograft Reconstruction for Sarcomas of the Tibia"}
{"_id":"51b4a8b4-600b-5efa-5b54-f04c231de308","text":"Participation is considered complete after the 30th postoperative assessment day if no implants have been used, or after the 12th postoperative month if an implant was used. Another exit point is if the dressings of group II patients get wet before the sixth postoperative day, thus requiring withdrawal from the study.","title":"Dressing wear time after breast reconstruction: study protocol for a randomized controlled trial"}
{"_id":"51b5803f-6dc0-494d-56fd-98b7a1608bab","text":"We usually used the LITA and the saphenous vein as grafts. The LITA was most frequently anastomosed to the LAD or D1, whereas the saphenous vein was used for up to three sequential anastomoses. The venous only revascularization was achieved using the saphenous vein as aortocoronary bypass anastomosed to the acending aorta as standardized.","title":"Coronary artery bypass grafting in young patients - insights into a distinct entity"}
{"_id":"51c0110a-ff67-4269-950a-f59617f92327","text":"Complex CADRs are a potentially life threatening category of eruptions that typically present with a mixture of cutaneous and visceral\/systemic involvement.","title":"The Role of Patch Testing in Evaluating Delayed Hypersensitivity Reactions to Medications"}
{"_id":"51c274d8-db95-941b-b8ed-d710fd158ec8","text":"And most important of all is to have a defined leader who acts as a leader!","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"51c37edc-48d1-72d4-65e2-20b122dd4a47","text":"Because these data are essential to guide physicians in thromboprophylaxis management following surgery, we set out to determine the size of the risk of recurrent VTE in patients with a history of VTE who undergo surgery. In addition, we identified factors associated with recurrence in these patients.","title":"Risk and Risk Factors Associated With Recurrent Venous Thromboembolism Following Surgery in Patients With History of Venous Thromboembolism Recurrent Venous Thromboembolism After Surgery in Patients With History of Venous Thromboembolism"}
{"_id":"51cc2dba-357a-9d18-a120-42a3f3ebbbb8","text":"Professional competence was a quality that many team members appreciated in a leader. The team leader had to be trustworthy to the team members. The informants emphasized that the leader must have a special interest in emergency medicine. It was also pointed out that good leadership skills can not compensate for lack of trauma care knowledge. Several informants mentioned that a leader with high professional competence makes the team members confident. Some of the team members had bad experiences with inexperienced leaders.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"51d53900-4a6b-c123-53e1-833d74ae72f6","text":"The inclusion criteria were a primary benign tumor of the parotid gland diagnosed by ultrasound and fine-needle aspiration biopsy and no previous surgery in this region.","title":"Prospective Assessment of Intraoperative Facial Nerve Monitoring in Patients Undergoing Partial Parotidectomy"}
{"_id":"51d88ab1-45fd-739d-1685-cbf33a80735c","text":"Many of the physical changes that come with age include greying of the hair which also becomes sparse, drying and wrinkling of the skin, receding gums, loss of teeth leading to a shift in facial configuration. Strength and agility reduce to a considerable extent and the sensory capacity and cognition decline.","title":"Psychiatry in India: Need to focus on geriatric psychiatry"}
{"_id":"51e05587-124e-89a7-5046-7e1f75cb5c30","text":"The woman in this report had an acquired asymptomatic subcutaneous mobile nodule. It could readily be moved from a proximal site on her leg to a more distal location and then it could be moved back to the original site of origin. An incisional biopsy not only removed the benign lesion but also established the diagnosis of a mobile subepidermal calcific nodule.","title":"Mobile Subcutaneous Calcinosis Cutis: A Case Report of a Mobile Solitary Subepidermal Calcified Nodule on a Woman’s Leg and a Review of Mobile Subcutaneous Tumors"}
{"_id":"51e181fe-bfe0-0787-6ed1-e5fa71548220","text":"At the end of each course, all of the cooperative partners were informed by email of the evaluation results and asked for their evaluations of the most recent SiGma cohort. Those at the University Hospital evaluated the collaboration with the students as very positive and beneficial. Those in key positions at the government ministries represented on the supervisory board repeatedly expressed their agreement with and support for the course concept. Furthermore, those serving as role models in the decision-making bodies concretely express their support for this course in that they are willing each year to meet with the participating students for the role interviews.","title":"Simulating the physician as healthcare manager: An innovative course to train for the manager role Simulation Gesundheitsmanagement – der Arzt als Gesundheitsmanager: Ein innovativer Kurs zur Ausbildung der Managerrolle"}
{"_id":"51e39236-63b2-2859-8c3d-beacb2840fe5","text":"Intensive physiotherapy is offered to clear chest secretions, prevent or treat respiratory infections and rapidly mobilize the patients out of bed. The patients' wheelchair needs to be assessed and modified in order to accommodate for their corrected spinal posture and seating balance after surgery. A reclining wheelchair can be used initially to provide better sitting comfort during the immediate postoperative period and while a patient who has been fused distally to the sacrum and the pelvis has difficulties to sit to 90°. No postoperative immobilization or external support is used.","title":"Development and treatment of spinal deformity in patients with cerebral palsy"}
{"_id":"51e6b206-1db5-c83e-f7ce-ac1442e76525","text":"Therefore, the present authors performed retrograde superficial sural artery flap surgery for the distal metal plate exposure, which occurred as a complication after MIPO for distal tibial fracture. The aim of this study is to suggest some surgical tips with a small cohort to improve the outcome and success rate after MIPO for distal tibia fracture.","title":"Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap"}
{"_id":"51eaa142-0192-1e01-6115-94be3c86c9fd","text":"The HNCM lymphatic drainage is extremely variable in regard both to the sites and number of involved SLNs. Our study demonstrated that it is not possible to clinically predict the lymphatic drainage of HNCM, and we highly recommend lymphoscintigraphic studies to identify all possible SLNs in order to perform an accurate staging for all patients and to avoid missing unexpected SLNs. This is important to avoid inappropriate or excessive dissections that could result in a functional or aesthetic limitation for patients. For these reasons, multidisciplinary management is essential for patients with head and neck cutaneous melanomas.","title":"The Lymphoscintigraphic Study of Unpredictable Head and Neck Cutaneous Melanoma Lymphatic Drainage"}
{"_id":"51eedad5-8b43-ef9f-5571-37b9ed1208b0","text":"The patient additionally underwent TSCPC at the time of surgery, which was planned before the time of surgery in order to maximize IOP-lowering effect in a patient with severe glaucomatous changes and highly uncontrolled IOP who was resistant to traditional glaucoma surgery.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"51f1954c-1305-c0cd-ba83-d4bd9bcad55d","text":"The cervical carcinoma was treated with radiation therapy. A whole pelvic external beam radiation dose of 40 Gy was delivered in 20 fractions with 2 Gy per fraction over four weeks, followed by 30 Gy delivered by brachytherapy. In summary, she received 70 Gy total dose radiation on the cervical cancer, and 60 Gy total dose radiation on the skin cancer.","title":"Triple malignancy in a single patient including a cervical carcinoma, a basal cell carcinoma of the skin and a neuroendocrine carcinoma from an unknown primary site: A case report and review of the literature"}
{"_id":"51f40562-8b59-9cb6-c84f-a82c8bcb29e0","text":"While risk of occupational skin cancer and the use of sun protection at work is largely neglected in Danish outdoor workers, they are still favorable towards the use of sun protection at work, especially so when provided by their employers. This indicates a great potential for introducing sun protection at work. The fact that outdoor workers protect themselves with greater care from the sun at leisure and on sun holiday and only differ from indoor workers by less use of sunscreen at leisure also suggests a singular prevention potential at work. Meanwhile, several major Danish contractors affirm that they are ready for taking part in responsibility for better sun protection at work by providing sun protection for the many thousands of Danish outdoor workers. However, currently, there is no legislation or guidelines for the use of sun protection at work to act on. Therefore, we propose the design of a commonsense operating guideline for the use of sun protection at work, as a joint effort between key stakeholders in the form of occupational medicine clinics, company health and safety organizations, worker unions, and The Danish Working Environment Authority.","title":"Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers"}
{"_id":"51fd1ef3-70a2-5cf1-4f6d-6fac3b83fd0a","text":"Acellular matrix has been used since the beginning of the 1990s to resolve some of the issues associated with insufficient sources of autologous materials and suboptimal bioactivity of synthetic materials, and it is widely used in clinical practice for filling tissue defects, trauma repair, and facial contour remodeling. Revascularization of the acellular matrix is a key issue that affects the outcome of therapeutic procedures. During preparation, the acellular matrix is completely stripped off the vascular endothelial cells, and even the walls of some fine vessels are damaged to varying degrees. The acellular matrix loses its original vascular network and requires revascularization to achieve blood perfusion after implantation in the body. However, the inflammation, hypoxic state, and lack of growth factors at the implantation site are often not conducive to revascularization, which in turn affects the effectiveness of acellular matrix repair of the defect. How to promote the angiogenic process of acellular matrix has become one of the research hotspots in regenerative medicine.","title":"Engineered nanovesicles from stromal vascular fraction promote angiogenesis and adipogenesis inside decellularized adipose tissue through encapsulating growth factors"}
{"_id":"51fe16c5-ee41-38bb-8461-3448a2aedebe","text":"Heterogeneity across studies was high, and the lack of concordance and standardization of protocol across different centers reduced direct comparability. Many of the studies measuring tolerability were doing so as a secondary outcome and used different methods of administration and anesthesia. Bias was also high throughout, partially influenced by the lack of full texts available and the nature of patient‐reported pain scores as an outcome.","title":"Interventions to improve tolerability of local anesthetic intradetrusor Botulinum toxin injections: A systematic review"}
{"_id":"5202dd56-d5b1-d36d-0c86-5502d925f359","text":"To ensure the clinical success, cranial implants must fit precisely against all surrounding borders of the bone defect in a way that subsequent movement is avoided, while also successfully restoring the patient’s natural cranial aesthetic shape. In order the cranial implant has to fulfil both functional and aesthetic aspects when used for defect reconstruction.","title":"Synthetic skull bone defects for automatic patient-specific craniofacial implant design"}
{"_id":"5202e334-cd99-6202-2bcd-f82bdea13bc0","text":"There is no strong evidence of a causal relationship between folic acid supplementation and ankyloglossia. At the current time, the known benefits of folic acid supplementation in the preconception period and during pregnancy far outweigh the potential risks, with overwhelming evidence to support supplementation before and during pregnancy. These benefits must be clearly communicated to patients by their clinicians during preconception and antenatal care.","title":"Maternal folic acid supplementation and the risk of ankyloglossia (tongue-tie) in infants; a systematic review"}
{"_id":"5206fbfd-ba77-8c21-368a-5fef8e57afbe","text":"Frank bony and disc destruction is usually seen in chronic cases when there is a lack of initiation of prompt and appropriate treatment, either due to delay in presentation or diagnosis. Reactive bony changes, such as new bone formation and sclerosis, normalization of T1 signal intensity within a previously infected vertebral body and resolution of bone marrow edema on T2 weighted images suggest bone healing in a resolving infection.","title":"Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review"}
{"_id":"520a51f0-6cd6-43e0-01e3-27d5a51caa15","text":"Available products like the dermal regeneration templates can be used in acute burn wounds as well as for scar reconstructions. Dermal templates can be easily used certainly if other options like local flaps or full-thickness skin grafts are not available for that specific scar reconstruction procedure. Engineering of fat and cartilage is relatively new but already promising for scar reconstruction. The introduction of advanced 3D bioprinters may have a significant role in tissue engineering, specifically for cartilage.","title":"Tissue engineering in burn scar reconstruction"}
{"_id":"521d2a4e-7232-f651-9f6b-9037708453d8","text":"The case was presented at a multi-disciplinary team meeting including the urologists, general surgeons, pathologists and radiologists. Surgical management option was selected by the multidisciplinary team basing on the tumor resectability assessment and the ability of the patient to tolerate the surgery. The procedure was promptly planned and an en bloc resection of the tumor was performed through a right iliac incision extended to the scrotum. The main difficulty was to guarantee clear margins sparing major vessels or adjacent organs.","title":"Giant recurrent liposarcoma of the retroperitoneum – A surgical challenge: A case report"}
{"_id":"521e6915-b343-7f68-af13-a5f4866a6260","text":"Patients who did not cooperate during the procedure and the follow-up survey","title":"Ultrasound-guided transversus thoracic muscle plane-pectoral nerve block for postoperative analgesia after modified radical mastectomy: a comparison with the thoracic paravertebral nerve block"}
{"_id":"5222d926-3754-7306-8202-2291b6a37826","text":"In general the excision margins for first surgery of suspicious pigmented lesions were 2 mm however in a number of cases where the clinician felt that the lesion was obviously a melanoma, and in discussion with the patient, wider margins were taken to reduce the need for treatment margin wider excision. These margins ranged from 5 mm to 3 cm and this was the case for 23 of the 26 patients who did not undergo secondary excision (5 nodular melanomas, 9 superficial spreading, 5 in situ, 1 lentigo maligna melanoma, 1 acral and 2 cases where the subtype was not specified). The remaining 3 patients who did not undergo treatment margin wider resection were not fit for further surgery due to comorbidities or widespread disease at the time of presentation. Three patients required more than 1 additional excision.","title":"Melanoma in Buckinghamshire: Data from the Inception of the Skin Cancer Multidisciplinary Team"}
{"_id":"522a5be7-7696-6bac-6f93-bc5d752ebecc","text":"The utilization of SI timing allows for the majority of mastectomy-related problems to occur prior to the placement of implants, likely mitigating their effects on reconstruction following NSM, regardless of ptosis grade. Although a second procedure is needed for this reconstructive timing variation, the majority of the study population achieved reconstruction completion at the time of implant placement without further revision. The findings described in this article support the utility of SI timing in DTI PP breast reconstruction following NSM.","title":"Outcomes of Nipple-Sparing Mastectomy in the Ptotic and Non-Ptotic Breast with Staged-Immediate Reconstruction Timing and Pre-Pectoral, Direct-to-Implant Technique"}
{"_id":"5232c98a-bde9-a8f1-f0e8-9923c150a3a5","text":"Photodynamic therapy combining nanotechnology has shown great potential with improved therapeutic efficacy and fewer side effects. Ideal photosensitizers for cancer treatment should both have good singlet oxygen production capability and be excitable by light illuminations with deep tissue penetration. Here we report a type of hybrid photosensitizers consisting of plasmonic silver nanoparticles and photosensitizing molecules, where strong resonance coupling between the two leads to a broadened excitation profile and exceptionally high singlet oxygen production under both visible light and infrared light excitations. Our results indicate that the hybrid photosensitizers display low cytotoxicity without light illumination yet highly enhanced photodynamic inhibition efficacy against Hela cells under a broad spectrum of light illuminations including the near-infrared light, which has great implication in photodynamic therapy of deep-tissue cancers.","title":"Plasmonic Nanoparticle-based Hybrid Photosensitizers with Broadened Excitation Profile for Photodynamic Therapy of Cancer Cells"}
{"_id":"5234d600-c61c-87b0-4e7f-ad6329203ed0","text":"The efficacy in treating laBCCs shown by Sonidegib is higher than that demonstrated in trials and similar to that reported in real-life settings. Real-life reports seem to experience a higher rate of CR than clinical trials. Conversely, dropouts due to intolerance happen to be more frequent in research settings when compared to real-life ones. Similar to what has been reported in trials, a large proportion of patients in this case series had to discontinue treatment due to the onset of unbearable AEs. Future efforts should be focused on finding successful strategies to achieve long-term results either by reducing the maintenance dosage or by adopting combined or neoadjuvant treatment approaches. The main limitations of this case series are represented by the small number of patients retrospectively included and their different treatment duration times. The latter factor could represent a confounding factor.","title":"Sonidegib in Locally Advanced Basal Cell Carcinoma: A Monocentric Retrospective Experience and a Review of Published Real-Life Data"}
{"_id":"523604a7-0901-85d5-05c1-c0680c4f207e","text":"Ultrasonography performed to train ultrasound competences was described by both novice and experienced GPs. The goal was to try new types of ultrasound examinations, to practice difficult ultrasound competences or simply train or maintain skills. These training examinations were often an extension of a focused examination of organs without clinical indication:","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"5236feb8-42df-8e52-79cd-42375cc06303","text":"From the comparison between the population with melanoma and the control group, we have identified significantly lower VDSL in the first group. This result agrees with other studies that recognize a deficiency status of vitamin D as a possible predisposing factor for the development of melanoma. The hypothesis is supported by the deficit of the known anti-proliferative and antiangiogenics effect attributable to calcitriol, which would have an antitumor action. Future perspective should investigate the possible correlation between novel pathways of vitamin D3 and 7-dehydrocholesterol metabolism initiated by CYP11A1 and the melanogenesis.","title":"Role of vitamin D serum levels in prevention of primary and recurrent melanoma"}
{"_id":"523d93a2-335e-c2d0-9b56-1130fd369754","text":"Besides electron microscopic techniques such as transmission electron microscopy, scanning electron microscopy and environmental scanning electron microscopy, modern fluorescence microscopic approaches based on fluorogenic dyes offer detailed insight into bacterial biofilms and an investigation of the genes involved in cell adhesion and biofilm formation.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"52405949-6fc0-7743-f7d8-ed3078ea39c5","text":"The most significant modification from the prior seventh edition is the introduction of cSCC from a general chapter for the entire body to a head and neck-specific cutaneous malignancies chapter, thus addressing NMSCs of the head and neck as well as those malignancies that arise from the mucosal surfaces of the upper aerodigestive tract and salivary glands.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"524536c9-cc3b-c627-3e8a-8ec930dd887a","text":"The results of the ongoing study assessing the effectiveness of TTOP are eagerly awaited and will be published after termination of the study. In addition, it will also be interesting to determine what could\/must be transferred into the daily routine clinical practice and how practical or time consuming such a transfer might be. In the long run, we aim to be able to have the key elements of the TTOP program being applied in the daily clinical routine leading hence to a significant increase of adherence and improvement of the severity grade of their chronic condition for the patients.","title":"Development of an adherence-enhancing intervention in topical treatment termed the topical treatment optimization program (TTOP)"}
{"_id":"524a6da8-496e-83e1-6fbc-dd90e4572eeb","text":"Table 3 shows the proportion of cases found in each histological grade in the three classification systems studied, obtained by the diagnostic scoring system and by the subjective reading of the digital images of DCIS.","title":"Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis"}
{"_id":"524cce67-ea65-7505-3e5d-1e442eea1b61","text":"Does laser tonsillotomy performed under local anesthesia offer comparable symptom relief but shorter functional recovery times than conventional tonsillectomy performed under general anesthesia among adults undergoing surgical tonsil removal?","title":"Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults A Randomized Clinical Trial Laser Tonsillotomy vs Conventional Tonsillectomy in Adults"}
{"_id":"524e1805-dd1f-1afe-4caf-1bbd25b136ae","text":"This trial will be conducted in a tertiary outpatient clinic specialized in the treatment of headache and facial pain. There will be three investigators performing the injections who are experienced in the treatment of headache and facial pain and trained in botulinum toxin type A injections.","title":"Botulinum neurotoxin type A in the treatment of classical Trigeminal Neuralgia (BoTN): study protocol for a randomized controlled trial"}
{"_id":"524e469b-11d3-d051-1a50-fc38752c1c1c","text":"Chronic hardware infections are not typically generated by environmental contaminants in surgical suites, nor by hematologic transfer in healthy subjects. Rather, endogenous transfer of staphylococcal biofilm during surgery from deep pores or hair follicles colonized with biofilm that cannot effectively be decontaminated is the likely cause. Preformed biofilm can immediately establish on damaged and devitalized tissue or directly on the abiotic surface of a prosthesis, carrying with it antibiotic tolerance. During the acute postoperative period, this infection typically establishes on permissive tissue or sequestra and transfers to the prosthetic joint surface as it matures, and this is important to consider when modeling infection.","title":"Improve Integration of In Vitro Biofilm Body of Knowledge to Support Clinical Breakthroughs in Surgical Site Infection"}
{"_id":"524ea7a9-fc8c-101d-c03a-bcb6458e908f","text":"Intraoperative investigation of DVT in these five patients demonstrated that DVT occupied both concomitant veins in one patient and only one concomitant vein in four patients. The patient with DVT in both concomitant veins undertook a delayed free ALTP flap transfer using veins unaffected by DVT two weeks after the first surgical intervention because continuous thrombus occupied both veins. Of the four patients with DVT in only one concomitant vein, two patients had segmental thrombus, and another two had continuous thrombus. In two patients with segmental thrombus, the vein was used as the recipient vein after simply resecting the segment containing the thrombus. For two patients with continuous thrombus, the vein was substituted with the great saphenous vein (GSV) in one patient and not used for venous anastomosis in the other patient. In the latter patient, single venous anastomosis using an unaffected concomitant vein was performed. Of the 11 patients diagnosed with DVT preoperatively, three patients with iliofemoral DVT were initially managed by administering therapeutic doses of low molecular weight heparin (LMWH). The prophylactic dose of LMWH was started in the other eight patients on the day of diagnosis.","title":"Deep vein thrombosis in donor or recipient veins encountered during lower extremity reconstruction with a free anterolateral thigh perforator flap: How do we deal with it?"}
{"_id":"524f475b-c24f-6353-23c3-c80ed0cdccda","text":"Limited information is available on whether neutralizing antibodies resolve over time and, consequently, whether attempts at reinjection should be made after a prolonged period. An investigation is underway to determine whether injections of botulinum toxin type B are useful in patients with neutralizing antibodies to type A. Using the lowest dose of toxin necessary to achieve the desired clinical effect and avoiding reinjection within one month appear prudent in an effort to keep antibody formation as low and unlikely as possible.","title":"BOTULINUM TOXIN"}
{"_id":"5258d428-ca74-a9bf-bdeb-dbac6a2973ae","text":"Average time for completion of reconstruction was less for the guided group but not statistically significant. Figure 4 shows the time for completion of each resident There is an inverse relationship between time to completion and residency training year, as expected. Average time to completion without bone plating time for freehand and guided group was 51 min and 46 min respectively with p = 0.172.","title":"In house virtual surgery and 3D complex head and neck reconstruction"}
{"_id":"5259920b-1ebf-d990-ad71-6724781ff729","text":"This study has several drawbacks, firstly it is a single central retrospective study with a high potential for bias. Secondly the sample size was relatively small and the experimental data lacked convincingness; a large prospective study would have better validated our conclusions. Also, we only performed Doppler ultrasound on patients preoperatively and on the seventh postoperative day, which may have been missed due to the fact that Doppler ultrasound was only performed on patients with DVT-related symptoms only in the postoperative follow-up of patients after discharge from hospital. In addition, Doppler ultrasound is not the gold standard for the diagnosis of lower limb venous thrombosis and the likelihood of false negatives increases. When the Gross equation method is used to estimate blood loss, the true calculated total blood loss may be compromised due to the transfer of body fluids and haemolytic reaction to transfusion.","title":"Effect of bone cement sealing of the intramedullary femoral canal on coagulation status after total knee arthroplasty: a retrospective thromboelastography study"}
{"_id":"525ba6ec-6e03-fe33-5e84-ef2872d11b52","text":"Spinal cord injuries at the cervical spine level represent the most consequential of the related injuries at all levels of the spine. They can trigger permanent unilateral or bilateral damage with conspicuous disability. Regarding unstable injuries, the gold standard approach is open reduction and osteosynthesis, which can select between anterior and posterior surgical access. Each of the aforementioned approaches demonstrates both advantages and disadvantages; thus, it is up to the surgeon to determine the optimal option concerning the patient’s safety. Diligent intraoperative control of anatomical reduction is pivotal to obtaining the best feasible postoperative outcomes. Literature data delineate copious complications following surgical intervention in the cervical spine. Indubitably, the most crucial intraoperative complication accounts for vascular injuries, with the most preponderant being the corrosion of the vertebral artery, as it is potentially life-threatening. This paper aims to provide a succinct and compendious review of the existing literature regarding cervical spinal cord injuries and to deduce many inferences concerning the incidence of iatrogenic vertebral artery injuries in relation to the surgical approach for fracture reduction.","title":"Incidence of vertebral artery injury in patients undergoing cervical spine trauma surgery in correlation with surgical approach: A review"}
{"_id":"52620b93-0bb1-cff2-9b00-768fa4eecdd8","text":"The goal of this study was to describe the treatment results of two patients with CPF using vascularized fibular periosteal flaps.","title":"Refracture, a Potential Complication of the Periosteal Flap Technique Without Bone Graft for Isolated Congenital Pseudarthrosis of the Fibula: A Report of Two Cases and Literature Review"}
{"_id":"52667db9-e5d5-222e-6fd1-2d5deafea9f1","text":"In the case of hospitalized patients who have a high risk of VTE associated with a high risk of bleeding or have contraindications for the use of anticoagulants, mechanical methods of preventing VTE, such as intermittent pneumatic compression, graduated compression stockings and venous foot pump, are recommended.6 When mechanical prophylaxis options are used, the transition to a pharmacological agent should be considered as soon as the risk of bleeding becomes low or is reversed.","title":"Bleeding risk assessment for venous thromboembolism prophylaxis"}
{"_id":"52707bbf-49da-f531-9030-ea56e3e1994a","text":"Negative pressure wound therapy is an effective way to treat deep surgical site infection of the spine without removing the implants. Even in infection with resistant organism, we found that NPWT can be used with successful outcome. Thus, the use of NPWT may improve the overall care of the patient and help reduce the hospital cost.","title":"Negative Pressure Wound Therapy in Infected Wound following Posterior Spinal Instrumentation using Simple Self-assembled System: A Case Report"}
{"_id":"52724655-afa6-d040-1268-412d2edb9f00","text":"There is some evidence in the literature that IMQ can be successfully used in the treatment of some sclerodermiform and infiltrative types of BCC and may induce partial remission of multiple BCCs in patients with Gorlin syndrome or xeroderma pigmentosum [78].","title":"Mediators of Inflammation in Topical Therapy of Skin Cancers"}
{"_id":"5275ad0f-3689-146f-19f3-0de4bd06e618","text":"At present, no study has definitely stated if a reduced vascular supply together with motor nerve fiber interruption can compromise the rectus abdominis muscle composition and function.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"528573c1-c784-8d4d-7fff-0cb252dced0e","text":"Calcinosis cutis is a condition of accumulation of calcium salts within the dermis leading to the formation of a calcified mass. This complication has been reported in acne vulgaris and other systemic metabolic disorders. This paper presents a rare case of calcinosis cutis in a 14-year-old male which was found at a routine orthodontic assessment.","title":"Calcifying Acne: An Unusual Extraoral Radiographic Finding"}
{"_id":"528b480d-c193-e0d0-d431-b4e47d6d6e20","text":"There is still no established pattern for the electrical activity of the suprahyoid muscles involved in the sucking function in infants based on lingual frenulum attachment to the tongue and the floor of the mouth. In this context, we note the importance of in-depth studies on this subject that may favor the understanding of muscle activity and aid in the identification of possible oral motor dysfunctions and feeding efficiency problems. These studies may also contribute to the planning and implementation of actions in health services that would enable breastfeeding and minimize the impact and consequences related to early weaning, which would benefit child development.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"5292b71b-d30b-03e1-7da6-545818d35485","text":"The patients included in this report had many of the above noted contributions to abnormal growth and development including a pre-existing condition, vascular compromise due to multiple surgeries, loss of muscle mass, limited use of the extremity for a defined period of time, infection and chemotherapy. Chemotherapy may temporarily reduce bone growth through systemic effects that include the direct effects of specific agents or the indirect effects resulting from systemic infections and abnormalities in metabolism and nutrition.","title":"Valgus and varus deformity after wide-local excision, brachytherapy and external beam irradiation in two children with lower extremity synovial cell sarcoma: case report"}
{"_id":"52946ee4-816f-01b1-2ec4-ce0460bdbb83","text":"The high rate of carcinomatosis observed in the study was likely related to our criteria for identifying the condition. Carcinomatosis was considered to be present if microscopic seeding of neoplastic cells was noted on any peritoneal surface, irrespective of proximity to the primary tumor. In all cats with carcinomatosis, seeding was noted on the peritoneal surface immediately adjacent to the primary tumor.","title":"Outcome and Prognostic Factors in Cats Undergoing Resection of Intestinal Adenocarcinomas: 58 Cases (2008–2020)"}
{"_id":"52950ae5-48d0-5c21-73aa-705d1501332c","text":"However, the degree to which sensitization occurs towards intact versus hydrolysed allergens remains unknown and yet such knowledge is essential if we are to gain a deeper understanding of the mechanisms of food allergy.","title":"Effect of simulated gastro-duodenal digestion on the allergenic reactivity of beta-lactoglobulin"}
{"_id":"529ba918-8a74-abe7-1f33-172c576469ba","text":"Current trends in facial plastic surgery include increased utilization of nonsurgical techniques such as fillers and neurotoxins to treat the aging face, development of new laser technologies, utilization of 3-D imaging techniques for individualized plating in maxillofacial surgery in trauma, and minimally invasive techniques such as endoscopic approaches to minimize scaring.","title":"Overview of Facial Plastic Surgery and Current Developments"}
{"_id":"52aa3dad-3096-1429-d799-209a61d9aa32","text":"Sentinel lymph node biopsy has been widely used in cancer treatment to assess lymph node metastasis at early stages. It has been reported that this procedure has an accuracy rate greater than 95% in the evaluation of lymph node metastasis in patients with stage N0 carcinoma, especially in patients with malignant melanoma or breast carcinoma. Sentinel lymph nodes are those that directly drain a primary tumor, and metastatic cells are likely to spread to and lodge in the sentinel lymph node(s) first. Therefore, precise examination of the sentinel lymph node can accurately predict the lymph node status of the entire lymph basin at early stages of cancer progression.","title":"Dual-modality imaging with 99mTc and fluorescent indocyanine green using surface-modified silica nanoparticles for biopsy of the sentinel lymph node: an animal study"}
{"_id":"52b3a121-988e-daa7-8df2-c70ea5f11efa","text":"The flap survival rate was good. There were 4 cases of flap failure in peripheral arterial vascular disease patients who had undergone lower limb reconstruction.","title":"Fibrin glue as a protective tool for microanastomoses in limb reconstructive surgery Fibrinkleber als protektives Hilfsmittel bei Mikroanastomosen in der Extremitäten erhaltenden Chirurgie"}
{"_id":"52c50236-1a27-146f-5450-4de8debee1cc","text":"Follow-up should continue for no longer than 5 years after which patients should be referred to regional general physicians or should be encouraged to undergo surveillance examinations provided as a part of health care programs in their districts or at their places of work. In that aspect, collaboration among various levels of medical facilities is needed to provide comprehensive care to gastric cancer survivors. Ultimately, there remains a need to scientifically verify the prognostic relevance of postoperative follow-up programs.","title":"Japanese gastric cancer treatment guidelines 2018 (5th edition)"}
{"_id":"52c84da5-5198-53f3-0f85-7daad28ae080","text":"Intraoperative ultrasound imaging assists surgeons who perform thoracic wall, paravertebral, and transversus abdominis plane nerve blocks.38–44 Ultrasound guidance may be used to avoid the implant at the time of breast fat grafting,36 to guide iliohypogastric nerve resection in patients with chronic pain,45 assist in cephalic vein transposition,46 and to identify digital artery perforators.47","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"52cff01c-c746-ecfb-eb5c-f84aa00a76f9","text":"Tibial and pedal artery embolism is rarely encountered, and most emboli that cause peripheral arterial disease are large and often occlude the proximal arteries. Retrograde embolectomy of tibial emboli through the pedal arteries has been reported previously. However, reports of surgical revascularization for pedal arterial occlusion due to peripheral embolism are rare. One important cause of peripheral embolism may be an aortic thrombus. Arterial thromboembolism in patients with an unknown source of embolization is still associated with significant morbidity and mortality. Furthermore, spontaneous embolization from an aortic plaque can lead to organ dysfunction and limb loss. Atherosclerosis of the abdominal aorta is considered a significant risk factor for embolism. A computed tomography (CT) angiography provides information on characteristics of the aortic wall and enables evaluation of aortic plaques that could form emboli. We report here the successful embolectomy of the plantar artery explored at ankle level and prevention of embolization recurrence with a graft replacement of the abdominal aorta, which was confirmed as the source of embolization.","title":"Successful Embolectomy of the Plantar Artery Occlusion Due to Thromboembolism"}
{"_id":"52d1ed05-1a12-bae7-8c9b-41f55e2f7c62","text":"The aim of the present study was to evaluate the use of thermal cutting instruments for lingual frenectomy as well as direct impacts on improving tongue movements and breastfeeding within 15 days after the surgical procedure. Two thermal instruments were compared: surgical cuts performed with a high-power diode laser and electrocautery.","title":"Comparison of the Effects of High-Power Diode Laser and Electrocautery for Lingual Frenectomy in Infants: A Blinded Randomized Controlled Clinical Trial"}
{"_id":"52d59c47-bdbb-c4f5-c64b-769b317a8efa","text":"Up to December 31, 2015, there were 445 patients enrolled in the CARRA Registry from 41 different CARRA centers. The clinical characteristics of the patients at enrollment are shown. With respect to cohort establishment, 105 patients were enrolled within 6 months of their diagnosis of JIA and 96 patients initiated methotrexate or biologic therapy at the time of enrollment. The numbers of patients currently using methotrexate and specific biologic agents at enrollment are shown.","title":"Proceedings of the 2016 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting Toronto, Canada. 14-17 April 2016"}
{"_id":"52dddaa1-8ac4-0012-9281-6dad852b7d47","text":"The IVC is located posterior to the peritoneum and another risk of open surgery is that it interferes with the intestinal function. The surgery was performed via the lateral right hemi-colon to the retroperitoneum without disrupting the mesenteric and intraperitoneal vessels, thus reducing the impact on the blood supply to the gastrointestinal tract and without causing internal hernia.","title":"Removal of inferior vena cava filter by open surgery after failure of endovenous retrieval"}
{"_id":"52dde604-43e3-597a-b074-1a521db30fa7","text":"In the preoperative assessment of patients for laparoscopic surgery following abdominal wall-based breast reconstruction, history and careful abdominal exam to assess abdominal wall stiffness may indicate that laparoscopy for elective procedures should be delayed until abdominal wall compliance normalizes.","title":"Failed pneumoperitoneum for laparoscopic surgery following autologous Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction: a case report"}
{"_id":"52e78e69-4638-dc5b-0141-5012814a2b2c","text":"Surgical removal of the entire infected bone has been considered in the past and even recently as the standard treatment 2 in patients with DFO because of the poor results obtained by antibiotics alone in these settings. Despite long standing discussions, surgery remains necessary in many (but not all) diabetic foot infections involving bone and joint structures 1,2. One must however keep in mind that the story does not end as soon as the operative wound is closed. Indeed, the surgical resection of the infected bone tissues cannot remove all the bacteria involved in most of the cases. This means that the surgical management of DFO necessarily includes an antibiotic therapy the choice and the duration of which will be determined by the culture results of the intraoperative samples. In other words, surgery and medical parts of the management of DFO are linked by the results of bone specimen examination. This is true even in case of major amputations since several studies have shown that bone biopsies of the margins of the amputation are positive in a non-neglectable proportion of cases 4,5.","title":"Surgical techniques for Bone Biopsy in Diabetic Foot Infection, and association between results and treatment duration"}
{"_id":"52f0bba9-b243-29a8-b49c-aa202c6087fe","text":"A vasoactive drug was administered intravenously when the mean arterial blood pressure or the heart rate was reduced by 20% as compared to the preoperative baseline values.","title":"Ultrasound-guided transversus thoracic muscle plane-pectoral nerve block for postoperative analgesia after modified radical mastectomy: a comparison with the thoracic paravertebral nerve block"}
{"_id":"52fa206d-b3cd-e21a-7ab5-f463fe804121","text":"This study’s findings suggest that a simple algorithm enables immunization of most patients with a history of allergy, while only patients defined as highly allergic should receive vaccination under medical supervision.","title":"Prevalence of Allergic Reactions After Pfizer-BioNTech COVID-19 Vaccination Among Adults With High Allergy Risk Allergic Reactions After COVID-19 Vaccination Among Adults With High Allergy Risk"}
{"_id":"52fbad6f-4cd0-d620-71cb-08a996102cd1","text":"It would be unwise to rely entirely on antimicrobials incorporated into the fluid transfer component to provide protection for the wound against infection. In at-risk wounds, interventional approaches with antibiotics and\/or effective bactericidal antibacterial delivery systems such as nanocrystalline silver may be clinically required prior to, or during NPWT use, to help control infection. In our experience, thorough debridement should always be carried out prior to NPWT to reduce bacterial load and the use of topical antimicrobials should be considered on the basis of an assessment of the pathogens most likely to be present in the wound.","title":"Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective"}
{"_id":"52fe7d1c-f7b6-50d4-57d7-cbe6fda0a887","text":"A conflict of interest in medicine exists when a physician’s ability to act in the best interests of a patient could be influenced by relationships with others. For example, a potential conflict of interest exists when the introduction of a new therapy or device coincides with higher industry payments to physicians. A conflict of interest likely exists when there is an association between the receipt of payments for nonresearch compensation purposes and increased medication prescription. Because of growing concerns that the wide-ranging financial ties between medical professionals and industry may disproportionately affect professional judgments and the goals of medicine, the Institute of Medicine, the predecessor to the National Academy of Medicine, advocated for the medical community to identify, limit, and manage potential conflicts of interest. In this study, we examined the extent of and timing for the formation of new financial relationships and potential conflicts of interest between industry and physicians who recently graduated from ACGME-accredited residency or fellowship programs in orthopedic surgery, neurosurgery, and internal medicine. There are several important observations in this study regarding potential conflicts of interest in the form of general payments from industry to newly independent physicians. First, the financial relationship between these newly independent physicians and industry began to develop in the first year after graduation from their training programs and continued to expand in the early years of independent physician practice. Second, the recent graduates in surgical specialties (orthopedic surgery and neurosurgery) accepted higher general payments compared with recent graduates in internal medicine. Third, newly independent male physicians accepted higher general payments compared with their female colleagues in all 3 specialties.","title":"Trends in Industry Payments to Physicians in the First 6 Years After Graduate Medical Training Industry Payments to Physicians in the First 6 Years After Graduate Medical Training"}
{"_id":"530cd51b-9650-cdb0-6ecb-cb2e6bcdec60","text":"In this cohort we found a high percentage of first surgery and treatment margin wider excisions where the excision margin was not documented. Ideally the excision margin should be documented for all operations so that the width of excision for the wider excision can be planned appropriately.","title":"Melanoma in Buckinghamshire: Data from the Inception of the Skin Cancer Multidisciplinary Team"}
{"_id":"53101c1e-acbd-ae74-caf0-783cdaaf00f9","text":"The visible tumor volume that can be felt by hand and can be detected by methods such as CT or MR.","title":"Use of Positron Emission Tomography\/Computed Tomography in Radiation Treatment Planning for Lung Cancer Akciğer Kanserlerinde Radyoterapi Planlamada Pozitron Emisyon Tomografi\/Bilgisayarlı Tomografi Kullanımı"}
{"_id":"5311079c-065e-61db-6891-b0293c597421","text":"Table 7 Sites of breast cancer recurrence according to the type of surgery and the presence of multifocal and multicentric breast cancers","title":"“Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases”"}
{"_id":"53227ee5-e362-236c-2663-214be2901bbc","text":"Open fractures of the proximal tibia often pose serious challenges to the treating orthopedic surgeon because of multiple issues such as the high velocity of the injury causing extensive soft tissue disruption, the intra-articular nature of the fracture and significant metaphyseal comminution with bone loss. Management of these complex injuries becomes more difficult if they are associated with damage to the extensor mechanism and an exposed knee joint. Fracture stabilization, reconstruction of the quadriceps mechanism and coverage of the knee joint and the soft tissue defect involving the proximal leg must be considered simultaneously for faster rehabilitation. There are limited treatment options, particularly when the soft tissue defect extends to the middle third of the leg.","title":"Knee extensor loss and proximal tibial soft tissue defect managed successfully with simultaneous medial gastrocnemius flap, saphenous fasciocutaneous flap and medial hemisoleus flap: a case report"}
{"_id":"53268425-6054-e3f3-6d52-4f9bc91e72b6","text":"We acknowledge a number of limitations in the current study. We did not confirm diagnosis of DVT by venography because it is difficult to perform in critically ill patients. Duplex ultrasonography is operator dependent, so to minimize bias, all studied were recorded and reviewed by a blinded radiologist. We had some inconclusive ultrasonography results because of edema in the lower extremities. The considerable number of inconclusive results could lead to underestimating the incidence. Moreover, our study did not systemically focus on pulmonary embolism except that patient developed clinically suspected pulmonary embolism. Future studies about the incidence of both DVT and pulmonary embolism will be needed.","title":"Incidence of proximal deep vein thrombosis in medical critical care patients"}
{"_id":"532d78f9-72e4-a48e-74ed-950cd5ca76c3","text":"The indolent clinical course along with the imaging findings of paravertebral abscess raises a differential diagnosis that includes atypical infections like tuberculosis and brucellosis.","title":"Q Fever Vertebral Osteomyelitis Complicating Vertebroplasty"}
{"_id":"53350d14-5dc4-442c-1c04-751a04b01ff6","text":"Effective targeted treatments and new breakthroughs in immunotherapy have been shown to improve survival and are now a part of the routine clinical care of melanoma patients. The challenge for clinicians and researchers moving forward will be to determine the optimal tools for patient selection, sequencing of therapy, and ideal combination strategies. The translation of key scientific findings into well-designed clinical studies will be critical in answering the most important questions in the future. Overall there has been much progress in the development of systemic therapy for advanced melanoma, which will hopefully benefit many patients to come.","title":"Updates in Therapy for Advanced Melanoma"}
{"_id":"533a6dc7-c1df-63c6-b9ec-9f020f69dd50","text":"This research into the response to treatment of lower limb DVT and predictive factors for DVT resolution, recurrence and PTS could inform a more tailored approach to anticoagulation therapy for the future management of DVT.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"533d7a72-4ea3-27ef-1a9c-c6489172429d","text":"Anaesthesiologists must update their knowledge regarding the drugs and methods used in the prevention and management of VTE, as well as their implications in the conduct of anaesthesia.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"533eaba4-b85c-ec4f-b99c-ba64881fe2dc","text":"In any case, at this time, guidelines conclude that there is insufficient evidence to recommend for or against internal mammary nodal treatment and leave the decision to the treating physician. I have previously advocated for individualized consideration of the risk of IMN nodal involvement, as well as patient anatomy and ability to exclude critical normal structures from the treatment fields [78]. While it does not seem prudent to treat the internal mammary region when the risk of involvement is low, such as cases of micrometastatic axillary disease, coverage of this region does seem worthwhile when axillary involvement is more substantial, particularly when the tumor is medially located or other high-risk features exist. With modern techniques, including consideration of respiratory gating, it appears possible to cover the IMNs in most patients with very low dose to the heart and its critical coronary vasculature. Given the totality of the existing evidence, it seems reasonable to encompass the internal mammary region in postmastectomy treatment in patients who have substantial risk of involvement and in whom coverage can be achieved with only low-dose scatter to the heart.","title":"Postmastectomy Radiation Therapy: An Overview for the Practicing Surgeon"}
{"_id":"533ebc98-1ecb-8bfb-25ab-1cccdd40d7aa","text":"There are conflicting data regarding the prognostic value of the lymphatic basin drainage pattern in melanoma patients and the evidence is scant in the setting of negative sentinel lymph node biopsy.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"5348a081-7bfa-1e1b-625b-e5e70f4a5dc1","text":"Data were retrospectively analyzed from prospectively populated hospital databases and patient charts. To ensure adequate follow up or to account for deaths that occurred in patients discharged prior to 180 days from admission, the social security index and Hartford Hospital databases were used to determine if there were any deaths prior to this time.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"535e0dd1-1a46-71a8-5831-dabde5e1ec68","text":"According to a modified Blair incision, the skin flap is elevated in the superficial parotid fascia layer anteriorly to expose the mass to be resected. The parotid gland with cancer is separated from the cartilaginous external auditory canal. The sternocleidomastoid muscle is detached from the mastoid process with electrocautery. When the mastoid process is removed by large rongeur bone forceps, the main trunk of the facial nerve can be observed from stylomastoid foramen (Figure 1). The length of the cancer and mastoid process was 3 mm. The working space is very narrow. Removing mastoid process extends the working space extremely. This contributes to leveling the height between the facial nerve and the surface of the tumor, facilitating the handling of surgical instruments in the narrow working space along the facial nerve, and diminishing the tension on the facial nerve by releasing the facial canal proximally.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"5361099c-5158-259a-6584-694530f170b5","text":"Morpheaform BCC is less common than superficial and nodular variants and this subtype is known to be more aggressive than other types, because of its tendency to infiltrate deep subcutis. Similarly, infiltrative BCC is considered a high-risk histopathological subtype because it is more likely to be incompletely excised or occurs especially on face where surgical margins might be conservative.","title":"Clinical and epidemiological analysis of basosquamous carcinoma: results of the multicenter study"}
{"_id":"53633369-e8b9-7693-d5e4-704a1a9ac843","text":"The surgical therapy used is initially characterized by the use of a coronally advanced flap for the treatment of multiple recessions. This allows for the avoidance of scarring in areas where release cuts might be necessary and ensures a greater blood supply to the flap.","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"536f1dd4-0ac7-91d7-786c-ca6e0c753482","text":"The research project was submitted to and approved by the Human Research Ethics Committee, and all patients who agreed to participate signed an informed consent form.","title":"Nonmelanoma Skin Cancer at Critical Facial Sites: Results and Strategies of the Surgical Treatment of 102 Patients"}
{"_id":"5375125e-7a6a-4c8a-281e-7385b83d5617","text":"Ultrasound guided parasternal block seems to be an effective, safe and easy to perform technique in patients undergoing cardiac surgery under sternotomy. Although it did not significantly affect postoperative analgesia, it showed a relevant reduction in intraoperative opioid consumption and a better postoperative performance at spirometry compared to the Control group. Further studies are expected to confirm these findings and explore the medium- and long-term impact of this technique on postoperative morbidity.","title":"Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study"}
{"_id":"5377b9b1-91e5-6dbf-1cf5-ba55ee17ad79","text":"Adipose tissue is easily obtained through liposuction and it provides a good source of stem cells which serve as a useful agent for soft tissue regeneration or repair. It has been found that fatty tissue has the highest percentage of adult stem cells of any tissue in the body with about 5000 adipose-derived stem cells per gram of fat vs 100–1000 stem cells per milliliter of bone marrow.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"537b71f6-cb96-511f-7d71-74aa86405c3f","text":"In this study, we also did not find differences in endothelial loss between the vsE and vsO groups at the time of implantation of the distal part of the vein graft. The distal portions of vein grafts harvested with the vsE method were implanted 52 min ± 19 after harvesting and with the vsO method 72 min ± 44 after harvesting; the time of implantation was not significantly different between the two groups. During this time, the venous grafts were stored in a cold heparinized solution. There was a significant loss of endothelial cells at the time of implantation of the distal part in both groups compared to the portion of the vein graft at the time of harvesting, suggesting adverse hypoxic conditions in the heparinized solution even though the solution was cooled, which reduced metabolism and consequent oxygen demand [21].","title":"Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery"}
{"_id":"5382d68c-d430-0050-e1aa-b45e03f18eb6","text":"Calcinosis remains a significant source of morbidity for many JDM patients, yet it is poorly understood and lacks uniform treatment approaches compared to other aspects of JDM. This survey describes the approach and management of calcinosis by a large number of pediatric rheumatologists.","title":"Assessment, classification and treatment of calcinosis as a complication of juvenile dermatomyositis: a survey of pediatric rheumatologists by the childhood arthritis and rheumatology research alliance (CARRA)"}
{"_id":"5384b80b-c194-9ed2-ed4a-355cb7a8af7a","text":"Our study suggests a novel 12-gene SLN signature risk score which may predict disease recurrence in cutaneous melanoma patients managed with wide excision of the primary tumor and SLN biopsy.","title":"Sentinel Lymph Node Gene Expression Signature Predicts Recurrence-Free Survival in Cutaneous Melanoma"}
{"_id":"538c441c-02d3-ea78-faff-86121dc1d18a","text":"After dividing the pedicle, the flap is transferred to the thorax for anastomosis to the internal mammary vessels with 9-0 interrupted nylon sutures under surgical microscope augmentation. The flap is deepithelialized, and a skin paddle is left in place to monitor the flap, usually where the implant was exposed to make up for the lost tissue in that area. The flap is inserted in the pocket and the wound closed in two layers with 3-0 Monocryl on top of a suction drain.","title":"Immediate implant replacement with DIEP flap: a single-stage salvage option in failed implant-based breast reconstruction"}
{"_id":"538dd836-f8ce-52ba-0f2e-4eb2505e800e","text":"Introduction The main postoperative complication of free flaps is perfusion compromise. Urgent intervention is critical to increase the chances of flap survival. Invasive flap perfusion monitoring with direct blood flow feedback through the Cook–Swartz Doppler probe could enable earlier detection of perfusion complications.","title":"Cook–Swartz Doppler Probe Surveillance for Free Flaps—Defining Pros and Cons"}
{"_id":"53956bb4-34e2-87a8-0429-4a529e1682f9","text":"After obtaining the institutional review board approval, we retrospectively reviewed the medical and radiographic records for all consecutive patients from January 2010 to August 2017 who underwent a limb salvage procedure with ACC-IMNs. Patients with follow up periods of less than 2 years were excluded from the study.","title":"Antibiotic Cement-Coated interlocking Intramedullary Nails in the Treatment of Septic Complex Lower Extremity Reconstruction; A Retrospective Analysis with Two year Minimum Follow up"}
{"_id":"53989c20-2f2e-ca43-7a4e-39f646cc1b69","text":"Case 2 demonstrated weaning from the first appointment, introducing formulas combined with breastfeeding. In addition to mentioning pain when latching, the mothers said that the infant had grown accustomed to taking supplements and could no longer be weaned from them. Case 1 stated that they weaned the infant at 2 months since the baby was hungry and could not survive solely on EBF. Case 5 reported poor milk supply at 5 months and began supplementing. All other dyads breastfed exclusively until the sixth month.","title":"Does neonatal ankyloglossia interfere in the growth of infants during the first 6 months of life? A case series nested in a cohort study"}
{"_id":"53a12118-a800-4c17-9c45-45290d6645a1","text":"Identification of risk factors is essential to define the prognosis and the most appropriate treatment approach.","title":"Localized Non-melanoma Skin Cancer: Risk Factors of Post-surgical Relapse and Role of Postoperative Radiotherapy"}
{"_id":"53a7c1ec-7c59-a82f-5338-bda80be9202b","text":"The use of tissue expansion is an option to increase the possibility of primary closure but unfortunately this option was not suitable for most of our patients for many reasons: most of the defects were too large for this technique; many patients had a lack of skin pliability and some had recurrent tumors or received radiotherapy; in addition this technique is neither free of complications nor suitable for immediate coverage [6,14].","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"53ace551-a529-2f00-91ea-59719c352d38","text":"We reported two aged patients undergoing an emergent orthopedic surgery for lower extremities while taking SERMs for osteoporosis before the operation. DVT was newly developed in one patient and worsened in the other patient after the operation. We found eight aged patients underwent the same operation while taking SERMs for recent 3 years, including the two cases and DVT did not occur in the other six patients. Thus, the incidence of DVT in our patient population was 25%.","title":"Selective estrogen receptor modulators and deep venous thrombosis after an emergent operation in senior women"}
{"_id":"53b49572-b2f0-25a5-17af-aabfe97bc4d3","text":"Table 3 Reported characteristics of the provider performing the frenotomy and the method and location of the frenotomy associated with complications","title":"Complications and misdiagnoses associated with infant frenotomy: results of a healthcare professional survey"}
{"_id":"53bae1b3-9ee9-edb8-4592-aacfaa45f4f9","text":"Conversely, maternal desire for control may be dispositional and affect breastfeeding duration. Three main findings support this. Firstly, maternal control was not associated with infant age. If maternal control develops as a consequence of feeding experience, it would be expected that levels of control would decrease within the breastfeeding group as infant age increases. Secondly, when the sample was reduced to mothers with an infant aged two weeks old or less, differences in maternal control remained between mothers who breast or formula fed at birth. It is unlikely that this short experience of milk feeding modifies level of control. Thirdly, mothers who were mixed breast and formula feeding reported higher levels of control than mothers who were exclusively breastfeeding. Experience of feeding using a bottle may increase maternal control due to greater opportunity to manipulate milk intake. However again control was not related to infant age suggesting that desire for control may drive behaviour. Mothers who wish to be able to monitor milk intake or give feeds at particular times may choose to incorporate a bottle to gain this control. Therefore, maternal control may be dispositional and instead drive decision to breast or formula feed. Mothers who desire a feeding style which allows them to exert high levels of control may choose to formula feed, or struggle with the infant led nature of breastfeeding.","title":"Breastfeeding Is Associated with a Maternal Feeding Style Low in Control from Birth"}
{"_id":"53bcfe5a-9ba3-b312-2968-2e9ff91b1013","text":"Visual inspection coupled with an accurate history can determine the presence of a chronic vascular condition. In chronic arterial insufficiency, the arterioles are maximally dilated as a compensatory response to the chronic ischemia intensifying color changes. In acute arterial occlusion, the venules empty, leading to a chalky white appearance regardless of extremity position. Partial but inadequate perfusion either from an incomplete acute or chronic occlusion allows for pooling of blood in the venules, which may be red in the cold or blue at higher temperatures.","title":"Contemporary Evaluation and Management of the Diabetic Foot"}
{"_id":"53bfca22-68dd-209c-b8f2-0bfa80f4635e","text":"Educating physicians on perceptions and behaviors that predict increased risk for future skin cancers would also allow physicians to target specific high-risk patients with strong messaging on sun protective behaviors. For example, in our study, Hispanic participants demonstrated higher sun exposure and more positive perceptions of tanning but also more sun protective behaviors. This finding suggests that this population may benefit from more targeted counseling about increasing sun protection rather than on changing tanning risk perceptions.","title":"Attitudes and Behaviors That Impact Skin Cancer Risk among Men"}
{"_id":"53c4cdca-9ac6-c481-f5b9-91f96e508250","text":"In our case, the patient was immunosuppressed following oral treatment with corticosteroids and Diclofenac. The injection administrated for the upper respiratory tract infection was decisive for NSTIs onset, because a plausible necrosis in the site of injection could have been infected by bacterial translocation inserting the needle or bacterial implantation after a transient bacteremia as an effect of respiratory phlogosis. The delayed clinical presentation could be strictly correlated to the administered therapy and to her state of immunosuppression [3, 4], since she showed up to hospital at a very late stage after the injection.","title":"Necrotizing Soft Tissue Fasciitis after Intramuscular Injection"}
{"_id":"53ce7ae6-47f4-177e-47b0-a005ca4567c5","text":"An advantage of the jejunal free flap is the avoidance of an additional suture line when reconstructing circumferential defects. The primary disadvantage of the jejunal free flap is the need for a laparotomy, which may result in postoperative ileus as well as the risks of anastomotic leakage of the repaired small intestine and potential late bowel obstruction due to adhesion formation. The ALT free flap is associated with minimal donor site morbidity but may be excessively thick in obese patients, although it usually tolerates aggressive thinning down to a thickness of around 0.5 cm, as long as the perforator and a cuff of subcutaneous tissue around it are carefully preserved. Both flaps are reliable with low rates of postoperative pharyngocutaneous fistula formation.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"53d0f475-f3cd-0bc0-9aea-3a6f6126fafb","text":"Lumbar spine surgery is being increasingly performed and imaging evaluation of the postoperative spine has evolved significantly in the past decade. Advances in CT and MRI with reduction of image degradation due to hardware-related artefacts have improved the evaluation of the postoperative spine and early detection of complications.","title":"Imaging of lumbar spinal surgery complications"}
{"_id":"53d205d4-4c4e-c92d-c5c4-4c8e6b108adc","text":"Several studies assumed the existence of a relationship between OSAS and a short lingual frenulum but the real innovation that characterized this study was the results, which demonstrated a clear correlation between a short lingual frenulum and OSAS. Surgical treatment of the condition of ankyloglossia with the use of diode laser technology in pediatric patients led to a complete or partial resolution of OSAS.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"53d473c0-31a4-013f-d931-f64ebfe2f8f9","text":"The results of this clinical study provide an initial set of in vivo MPM and OCA features of different types of dermoscopic equivocal lesions. Using MPM, we have developed a scoring system that shows potential to discriminate between benign lesions and melanomas on the basis of their autofluorescence and SHG signals. OCA has demonstrated the ability to separate melanomas in situ and invasive ones by quantitative analysis of vessels length and density. A combined use of MPM and OCA can help physicians to increase the accuracy of diagnosis of melanocytic lesions at early stage and minimize the need for biopsies.","title":"In vivo multimodal optical imaging of dermoscopic equivocal melanocytic skin lesions"}
{"_id":"53d4d0bd-982a-7a82-0c25-34514d30b417","text":"The use of vein grafts has been associated with significantly higher flap losses than those with direct microanastomosis. Although the most common scenario in which vein grafting is required is the lack of nearby or even ipsilateral healthy recipient vessels, and such conditions were generally encountered in those who had a prior failed reconstruction, a repeated cancer resection, or those who already received radical neck dissection or radiotherapy. However, in this study, there was no significant difference of vein graft use between those who had primary or recurrent cancers either before or after propensity score matching. In contrast, there was a higher rate of contralateral microanastomosis of the patients with recurrent cancers than those with primary cancers during free flap reconstruction either before or after propensity score matching. This might be contributed by the fact that the vessels nearby have already been used in a previous reconstruction surgery for the patient’s primary cancer. Since vascular microanastomosis is the critical step for a successful free flap transfer, the surgeons might have foreseen the disadvantages of using the vessels in the same side in a prior surgery or radiotherapy and also choose not to use a vein graft but rather proceed with contralateral microanastomosis instead. Accordingly, the reconstructive option seemed to be different in handling the recurrent cancers and the primary cancers.","title":"Comparison of the surgical outcomes of free flap reconstruction for primary and recurrent head and neck cancers: a case-controlled propensity score-matched study of 1,791 free flap reconstructions"}
{"_id":"53dc2414-ffda-495b-60fe-3bc70ca00ea5","text":"Five patients who have undergone head and neck reconstruction using CCP flap were included.","title":"The contralateral based Cervico-pectoral rotation flap for large neck defects"}
{"_id":"53e9d250-9162-ed33-ae26-8fa6301842c0","text":"A 58 year old lady presented with a right breast cancer and a prior history of malignant melanoma excised from the right chest wall eight years previously. An abnormal axillary lymph node resected contained features of both metastatic breast carcinoma and malignant melanoma. Following oncologic breast cancer management, the patient is well with no evidence of recurrence at three years.","title":"Breast carcinoma and malignant melanoma metastasis within a single axillary lymph node"}
{"_id":"53ed2dce-ed8b-5baa-68c6-75c74c0ff2b2","text":"This study had the limitations of being retrospective in design and having a small sample size especially in the SIEV group.","title":"Use of the superficial inferior epigastric vein in breast reconstruction with a deep inferior epigastric artery perforator flap"}
{"_id":"53f0bf26-143c-9e58-1b34-50da3280ee12","text":"This study suggests that the chondral harvest site in ACI is not associated with significant joint morbidity, at least up to 5 years postharvest. However, one should carefully consider the location for chondral harvest as this has been shown to affect knee function in the longer term.","title":"Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI) A Study of ACI-Treated Ankles and Hips with a Knee Chondral Harvest"}
{"_id":"53f7accb-699c-5e9c-cae3-62b86ab17739","text":"The use of 3D printing in pediatric patients with retroperitoneal tumors can improve the understanding of pediatric surgeons. Education with 3D printing was helpful for understanding the lesion by students and residents; it also helped guardians to comprehend better in informed consents.","title":"Application of 3D printing technology for pre-operative evaluation, education and informed consent in pediatric retroperitoneal tumors"}
{"_id":"53fb7d89-2a5d-2cc5-6899-05e7d0d26ece","text":"Although there have been important developments in microsurgery in recent years, there is no current and comprehensive bibliometric study in the literature.","title":"Global Scientific Outputs of Microsurgery Publications: A Bibliometric Approach About Yesterday, Today, and Tomorrow"}
{"_id":"53ffd83f-655a-b7df-7227-59df6a46685e","text":"SAA levels were evaluated before colchicine cessation and at 3 and 6 months following cessation. Colchicine therapy was resumed in case of FMF attacks reappeared during this period.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"5406ecf3-f619-c807-0ddd-fbbb2ee5c358","text":"To our knowledge, this study is the first of its kind in Saudi Arabia to assess the perception and knowledge of medical students about plastic surgery. Many different modalities may improve awareness of this specialty. Self-explanatory brochures about this specialty and its different disciplines have been advocated as a tool to increase awareness. We recommend that future studies asses if there are any social or cultural components to the awareness score and analyze medical students’ interest of pursuing a carrier in plastic surgery.","title":"Perception of Plastic Surgery and the Role of Media Among Medical Students: Cross-Sectional Study"}
{"_id":"540f89b1-9242-2ca0-5e61-ce8bcb7c9f02","text":"Clinical trial or prospective registries adapted for both tumor and host risk factors are awaited to accurately determine the role of adjuvant RT on outcome of localized NMSC.","title":"Localized Non-melanoma Skin Cancer: Risk Factors of Post-surgical Relapse and Role of Postoperative Radiotherapy"}
{"_id":"54133429-9560-eef8-779d-f9fafccf6f34","text":"The aim of this review is to systematically evaluate the efficacy and safety of venous coupler devices compared to hand-sewn anastomosis, appraise the quality of evidence in the relevant literature and perform meta-analysis of key outcomes to guide further surgical practice.","title":"Protocol for a systematic review of venous coupler devices versus hand-sewn anastomosis for microsurgical free flap reconstruction"}
{"_id":"5416a2d4-73ce-609d-6cd4-8843a1035d52","text":"Fellowship training results in the attainment of specialized knowledge and skills beyond those of graduates pursuing general practice. The number of residents deciding to pursue fellowship could be a benchmark of success for programs, particularly those affiliated with academic institutions where training future leaders in the specialty is valued. This has been used previously as a means of evaluating general surgery programs.22","title":"Metrics of Resident Achievement for Defining Program Aims"}
{"_id":"541b6151-8334-2538-20d1-2a988f02ea78","text":"In the clinical scenario of surveillance after mastectomy without reconstruction, the rates of clinically occult, nonpalpable cancer were considerably lower than the cancer detection rates across all imaging modalities. This observation is relevant in clinical practice because it is the nonpalpable lesions detected only with imaging that should be considered when the yield of imaging surveillance is investigated, because palpable lesions will be clinically detected without the need of imaging. Similar trends were observed in the clinical scenario of surveillance after mastectomy with reconstruction. As a result, the clinical value of imaging surveillance after mastectomy is further restricted to the low detection rates of clinically occult, nonpalpable cancer rather than the somewhat higher, but still low in terms of BI-RADS benchmarks, cancer detection rates.","title":"Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer A Systematic Review and Meta-analysis Surveillance Imaging After Mastectomy for Patients With Breast Cancer"}
{"_id":"54225667-f12c-48bf-0bf6-f1bfe9681a62","text":"In the present study, we analyse the viability of performing percutaneous Achilles tenotomy as an outpatient procedure under local anaesthesia. This analysis is based on an initial quantification of the suffering involved and of related variables.","title":"Quantification of Procedure Time and Infant Distress Produced (as Crying) When Percutaneous Achilles Tenotomy Is Performed under Topical Local Anaesthesia: A Preliminary Study"}
{"_id":"54265d28-4f4e-306b-17ba-4be829c878de","text":"Additionally, estradiol levels may be reduced after oocyte retrieval by the use of GnRH agonists to trigger ovulation instead of hCG. This has been shown to substantially reduce the risk of ovarian hyperstimulation in patients undergoing IVF by decreasing ovarian stimulation after retrieval. This has been evaluated in oocyte donors undergoing oocyte vitrification and has been shown in a retrospective study to result in similar numbers of oocytes retrieved. There was also no significant difference in the percentage of oocytes surviving thawing, oocyte fertilization, and pregnancy rates [41]. Further research is needed to determine if this will be beneficial in cancer patients undergoing oocyte or embryo banking but holds promise to further decrease any theoretical risks of breast cancer progression or recurrence as a result of ovarian stimulation.","title":"Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review"}
{"_id":"54270e46-62d7-8c80-ebc6-02957b41ef16","text":"In our prospective clinical trial, we compared autologous costal cartilage versus CCA in reconstructive and cosmetic rhinoplasties and demonstrated satisfying and reliable clinical outcomes up to 1-year evaluation. Most of our patients in the CCA group benefited from having only one surgical site, reduced time of harvesting the cartilage grafts, and decreased operating room cost. Of note, even though the cost of shipment and storage of the fresh frozen cartilage was high (between −40° and −80°C), we noticed that the full price of the surgery was still lower than using the autologous costal cartilage. In addition to the reduction in surgical fees, the observed reduction in narcotic medications also represents a significant benefit. The objective assessment in our study demonstrated long-standing structural support in the CCA group with no significant changes in the values of deviation angle, nasofrontal angle, total facial convexity, nasofacial angle, and the nasolabial angle at 6-months and 12-months follow-up. Due to the heterogenicity of our patient population and procedure types, we did not compare the anthropometric nose measurements to those of an “ideal” nose, or between pre- and postresults. Instead, the change of angles and ratios of the nose on a profile view at different postoperative time points allow the focus on the “change” during the first 12 months after recovery, despite patients’ diagnoses, ethnic groups, or surgical types. Patient satisfaction with nose and nostrils were significantly improved in the CCA group postoperatively. The rate of cartilage-related complications was also lower in the CCA group.\"","title":"Prospective Clinical Trial Evaluating the Outcomes Associated with the Use of Fresh Frozen Allograft Cartilage in Rhinoplasty"}
{"_id":"54283eae-887a-0dc1-c93d-dc8aef5ab356","text":"In the present study, we described the use of electromyographic biofeedback in a speech therapy intervention seeking to reduce signs of facial aging. We noted the beneficial effect of electromyographic biofeedback in learning the trained orofacial myofunctional patterns, and functional and aesthetic improvements, following the realization of nine speech therapy sessions, with a consensus that this technical resource represents a useful tool for therapeutic contexts.","title":"Utilization of electromyographic biofeedback in speech therapy to attenuate the signs of facial aging: a case report"}
{"_id":"54296f2d-7b0e-32e9-08ed-fea0dcc8c9e0","text":"Leadership is an area of education and training that is critical to the development of medical providers as health care professionals, yet few medical school curricula offer formal training in this area.","title":"Preparing Medical Students to Be Physician Leaders: A Leadership Training Program for Students Designed and Led by Students"}
{"_id":"5442df1d-4eb6-5f03-8f11-02dcf4034f95","text":"Assessing for intraarticular extension and secondary septic arthritis is also very important in the management of pelvic osteomyelitis. The incidence of joint involvement with acetabular osteomyelitis in pediatric patients has been reported to be as high as 66%. Although ultrasonography is the most sensitive tool for detecting an effusion in the hip, MRI is more specific and may show signal intensity alterations of the bone marrow and contrast enhancement of the adjacent soft tissue. If a hip effusion is present and there is concern for septic arthritis, a hip aspirate should be done.","title":"Pediatric Acetabular Osteomyelitis Treated With Hip Arthroscopy"}
{"_id":"544805b1-031a-c2a8-2308-b29eaded08a4","text":"The present study demonstrates normative values for anterior and posterior tongue mobility using TIP and LPS functional movements. The results in this study build on the work by Yoon et al and Marchesan. The prior studies helped establish and validate a functional approach to the assessment of ankyloglossia based on vertical extension of tongue mobility compared with mouth opening (described in this manuscript as the TRMR‐TIP assessment). TRMR‐TIP was found to be a more reliable tool for the functional assessment of tongue mobility in comparison with the traditional assessment of ankyloglossia which was based on the structural free‐tongue or frenulum length. Since that time, the TRMR‐TIP measurement has been used to demonstrate an association of restricted tongue mobility to development of the maxillary arch and elongation of the soft palate, as well as case selection in lingual frenuloplasty and myofunctional therapy for the treatment of mouth breathing, snoring, clenching and myofascial tension in appropriately selected patient candidates.","title":"Assessment of posterior tongue mobility using lingual‐palatal suction: Progress towards a functional definition of ankyloglossia"}
{"_id":"544e4307-a86f-ddba-8b1a-711e01fde2fa","text":"The essential meaning of the phenomenon, initial breastfeeding complications as they are lived and experienced by mothers and how these mothers can be supported, can be described as situated on “the fringes of life,” meaning that one is going through existential extremities. Concerns include former and present expectations of the new situation, an experience where so much is at stake that it may dislocate the situation, experiencing severe nourishment complications, and finding solutions to make the breastfeeding situation work. Experiencing existential extremities is expressed in terms of “Expectations fulfilled and expectations coming to naught” is expressed as an initial and overall great love for an infant that enters one’s life and at the same time a deep sadness and despair regarding the confrontations with oneself related to severe challenges concerning complicated nourishing situations that arise. This is an incomparable vulnerability that relates to a new and trembling openness of becoming a responsible parent that comes as an initial shock-like confrontation in a situation where so much is at stake.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"545266cb-a70c-9d69-4b95-fb28311cb3ae","text":"The research center for the project will keep the medical records of the participants, such as the CRF and MRI results, fully secured and stored. Confidentiality of the personal data gathered during the experiment will be maintained, and all data will be saved on an encrypted computer located in the research center. Access to this computer will only be granted to authorized researchers working on the project, and the data will only be used for the purposes of the project and not for any other reasons.","title":"A multi-center, single-blinded, randomized, parallel-group, superiority study to compare the efficacy of manipulation under anesthesia versus intra-articular steroid injection in the treatment of patients with frozen shoulder and a diagnosis of rotator cuff injury or tear by MRI: study protocol for a randomized controlled trial"}
{"_id":"545482a3-6729-3d55-e378-98891f43a4af","text":"Duplex ultrasonography of the operative arm was performed between 2 and 5 days after index surgery for evaluation of the incidence of DVT in all patients. The examination was performed by an experienced sonographer certificated by the American Registry for Diagnostic Medical Sonography and interpretation was performed by an experienced vascular surgeon. The patient underwent duplex ultrasonographic examination in supine and arm abduction position using a 4–14 MHz linear probe for the cephalic, basilic and brachial veins and a 3–11 MHz linear probe for the axillar and subclavian veins. The presence, location, and nature of thrombosis was assessed and recorded. Echogenic material in the lumen of the deep vein, incompressible vein walls with external transducer pressure, no detectable vein wall motion in central veins in a B-mode image, and color filling defects on color Doppler ultrasonography were regarded as positive findings of acute thrombosis.","title":"Is Routine Screening Using Duplex Ultrasonography for Deep Vein Thrombosis Necessary after Shoulder Arthroplasty?"}
{"_id":"545ae371-6ede-9a9a-8d5a-e92b503d6b1b","text":"In accordance with the design of the study in both groups, the SG and the CG, neither the health worker assigned to the intervention conducted nor the patient who underwent the treatment became aware of the double-blind assignment of the group.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"545def21-f91a-ec6f-6a46-f9df332e6b66","text":"The University of Cape Town Karl Storz Head and Neck Surgery Fellowship is the only head and neck surgery fellowship in Sub-Saharan Africa. This article briefly describes this fellowship and outlines the experience and ongoing collaborative efforts of members of the American Academy of otolaryngology-head and neck surgery with graduates of this program who are now building head and neck surgery programs in East Africa. This educational collaboration avoids many common pitfalls associated with short-term humanitarian outreach and represents a successful model for international collaborative educational efforts with head and neck surgeons in developing countries in Africa.","title":"Educational workshops with graduates of the University of Cape Town Karl Storz Head and Neck Surgery Fellowship Program: a model for collaboration in outreach to developing countries"}
{"_id":"5465eb81-901a-8b70-9bb9-3e3adf3c3197","text":"5-fluorouracil is a fluorinated pyrimidine that blocks the methylation reaction of deoxyuridylic acid to thymidylic acid and in doing so destabilises DNA. It is sometimes used to treat small, superficial BCCs and should only be used on low risk sites. It therefore is not recommended in the management of facial BCCs.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"546966e5-5a9c-e3bb-8f26-f7cfa2e03240","text":"Although vascular occlusion occurred in three cases in the AV-ETS group, we believe that these complications could have been avoided by considering these precautions. In the unlikely event that the recipient artery is damaged by the intraoperative procedure, it would be better to reconstruct the injured main artery first using a vein graft and then perform the ETS again using the implanted vein as the recipient artery.","title":"A simple free flap strategy using end-to-side anastomosis to the main vessels in injured extremity"}
{"_id":"546fc5a1-df39-18e8-9850-4c9f8ac0edae","text":"Nevertheless, we must state that one of the limitations of our study is the difference in the volume of breast tissue removed between the two groups. In particular, the group subjected to breast reduction surgery with the McKissock technique was found to have removed about 400 g less than the other group. This may be because patients who underwent operations using the Thorek technique were included in group B, but it is still a limit that must be carefully taken into account when evaluating the outcome.","title":"The McKissock's technique in reduction mammaplasty: A comparative study of outcomes and complications in 211 consecutive patients"}
{"_id":"54759288-bcfd-577d-48c0-c66396120ed2","text":"The analysis of the sites of recurrence showed that relapse at any site was significantly more frequent in patients with MF\/MC breast cancers. Table 7 reports the distribution of relapses in MF\/MC breast cancers in relation to the type of surgery performed; the incidence of locoregional and distant recurrences in MF\/MC cancers did not differ between cases treated with mastectomy or with conservative surgery.","title":"“Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases”"}
{"_id":"5478f113-7c60-6243-6913-517fdbab1793","text":"In this study, detection and assessment of periapical bone edema in clinically silent periapical disease was feasible and accurate compared to standard dental imaging. Furthermore, the extent of the bone edema as well as the PAI scores was significantly higher compared to the measurements on OPT and periapical radiographs. In all patients with periapical radiolucencies on OPT, a corresponding bone edema was detected on 3D STIR sequences, and the detected bone edema significantly exceeded the measured radiolucency.","title":"Evaluation of 3D MRI for early detection of bone edema associated with apical periodontitis"}
{"_id":"5487741a-4574-f05d-cc3b-ff5f3d110586","text":"As is well known, in dental meshes we need soft tissue to cover the mesh to prevent bacterial colonization and also to prevent osteoblastic cells from adhering. If osteoblastic adhesion, proliferation and differentiation were to occur, the mesh could become osseointegrated, and it would be difficult to remove the plaque once the bone regeneration biomaterial had succeeded in increasing the bone volume. This is why the mesh needs the formation of soft tissue that seals the dental mesh from bacterial attack and that this tissue forms quickly to avoid the formation of bone tissue that would make mesh removal difficult. The dentist himself removes it once the bone has regenerated.","title":"Optimization of Titanium Dental Mesh Surfaces for Biological Sealing and Prevention of Bacterial Colonization"}
{"_id":"549024fe-5909-49a2-c1be-ba809cd9e606","text":"Patients with near ideal Coverage Index and Conformity Index showed a trend to complete response compared to those with residual disease. However Logistic Regression Analysis showed that these trends did not graduate to statistical significance. There were no observable differences with other indices with respect to the disease response. Still, we can observe from this study that good brachytherapy technique definitely plays a role in obtaining complete response.","title":"Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa"}
{"_id":"5490ac33-e1a2-d418-211b-0d8df7c2a4d2","text":"There are several procedures for distal lower extremity reconstruction. In some cases, primary repair after debridement was the only surgery that was needed in superficial soft tissue injuries spit thickness skin grafts that were harvested preferably from intact limb as a good choice, but in some cases; combined procedures including skin grafts and some variety of flaps were necessary. Nerve damage usually can manage at the same time of soft tissue reconstruction or delayed repair and is dependent to wound condition and severity of damage.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"54949ff6-49bd-cd63-7da5-9a215684e296","text":"The purpose of this study was to evaluate the outcome of varying stenotic vascular situations, on the local and distal flap perfusion, with three established modalities in a well described rat model.","title":"A comparative analysis using flowmeter, laser-Doppler |spectrophotometry, and indocyanine green-videoangiography for detection of vascular stenosis in free flaps"}
{"_id":"549ed650-b820-3857-1a90-3392e4eff563","text":"Our experience has been highly positive, and we believe that the application of both virtual reconstruction technology and the printing of physical models in pediatric oncological cases where complex tumor resection are required is a useful tool for improving outcome and will take a relevant place in the near future for planning and surgical training in this type of complex surgeries.","title":"Three-Dimensional Printed Model and Virtual Reconstruction: An Extra Tool for Pediatric Solid Tumors Surgery"}
{"_id":"54b00bd5-e05d-108b-f2fe-df5da147ce96","text":"Leadership is not only about the leader himself; it is also about developing the personal qualities of communication and negotiation to work effectively with others. Physician leaders should become the mediators between their team and the organizational management, minimizing miscommunication and maximizing agreement and understanding.","title":"Effective medical leadership in times of emergency: a perspective"}
{"_id":"54b2ce75-bd55-ab75-9c5b-8012830e81c0","text":"Reoperation is one of the key factors affecting postoperative clinical outcomes. The reoperation rates of cervical surgeries might be different from those of lumbar surgeries due to the anatomical and biomechanical differences. However, there has been no study to compare the reoperation rate between them. The purpose is to compare reoperation rates after fusion surgeries for degenerative spinal diseases depending on the anatomic region of cervical and lumbar spines.","title":"Reoperations after fusion surgeries for degenerative spinal diseases depending on cervical and lumbar regions: a national database study"}
{"_id":"54c04a32-7d74-82ba-0c1b-98cc057c39fd","text":"Considering that rhinoplasty is ranked as the fifth most common plastic surgery in these countries, in Iran it is already the commonest facial plastic surgery taking place; therefore, rhinoplasty complications are thought to be the most popular legal claims in this category.","title":"Litigation After Nasal Plastic Surgery"}
{"_id":"54c6fdeb-0342-c31c-0b41-fdabda555dac","text":"According to our comprehensive statistical analysis findings with 2,063 articles, a significant increase was observed in the number of articles on microsurgery especially after 2005. The number of articles published ranged from 21 to 60 per year between 1980 and 2009. The number of articles exceeded 60 in 2010 and reached 122 in 2019. When the regression analysis results were evaluated, we observed that the number of articles published will continue to increase.","title":"Global Scientific Outputs of Microsurgery Publications: A Bibliometric Approach About Yesterday, Today, and Tomorrow"}
{"_id":"54ca79bc-54a7-d7fd-cfa3-72b0baf571b3","text":"Brain-wide glymphatic circulation was first visualized by MRI after intracisternal MRI contrast agent administration in rats. In a recent cohort study, we have shown the existence of glymphatic parenchymal contrast enhancement in man by applying intrathecal contrast enhanced MRI. Whether the glymphatic system drains to cervical lymph nodes in man remains to be determined.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"54d142db-1722-da2b-7ea2-b6e7d6d93a72","text":"Raising this flap at this level is technically less demanding as the surgeon will be nowhere near the distal septocutaneous perforators which are 5 to 7 cm proximal to the tip of the lateral malleolus. Compared to the soleus muscle flap in the reconstruction of the middle 3rd of the leg, it is less invasive. The complementary function of the soleus muscle to the gastrocnemius is preserved. The procedure is easier for younger surgeon compared to the soleus muscle flap. The problem of painful neuroma at the point of transection of the sural nerve is eliminated. This procedure will not eliminate the aesthetic problem of secondary defect as seen in the classical reverse sural artery flap unless this can be closed directly. However, poor cosmesis would be of less concern in relation to function when dealing with trauma.","title":"Sural nerve preservation in reverse sural artery fasciocutaneous flap-a case report"}
{"_id":"54d348a6-c22f-83ac-e9fd-1cf30ae13c99","text":"The incidence of DVT is extremely high in patients with ARDS and may be associated with adverse outcomes. The risk factors for DVT are age, serum creatinine level, and IMV in ARDS. We suspect that DVT is probably an additional risk factor for the death of ARDS in hospitalized patients. The classification and analysis of ARDS may help to provide more accurate screening for DVT and risk stratification and lead to corresponding measures to improve the clinical outcome of patients with ARDS.","title":"Prevalence, risk, and outcome of deep vein thrombosis in acute respiratory distress syndrome"}
{"_id":"54d926cd-2eea-d073-a641-d2fd1237bd38","text":"We can conclude, that the tumour localization and method of preoperative biopsy do not significantly affect the sentinel lymph node detection rate. However, performing a vacuum-assisted biopsy of a tumour in the upper outer quadrant may be a potential risk factor for a failure of SLNM after periareolar nuclide injection. Our findings should not indicate to avoid a routine SLNM with periareolar nuclide injection if the described conditions were met. But physicians should pay extended attention and consider adaptions in the clinical workflow, such as an additional peritumoural nuclide application, in time. Future studies should verify these results in larger patient populations.","title":"Impact of Tumor Localization and Method of Preoperative Biopsy on Sentinel Lymph Node Mapping After Periareolar Nuclide Injection"}
{"_id":"54dc7fab-b8ff-933b-8e12-056fce4971fa","text":"This is demonstrated by the fact that some patients spend years satisfied with their postoperative results and after several years complain again of visible aesthetic deformities. This fact results from the scar retraction, which is gradual and continues for years after the first surgical procedure.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"54ed99a7-8aed-7543-192b-d7fb68136716","text":"Facial augmentation with autologous fat injection can cause superior ophthalmic vein embolism. Surgeons should therefore perform this procedure very cautiously. Prompt ophthalmological evaluation and proper management are important for improving clinical outcomes.","title":"Superior Ophthalmic Vein Embolism Following Forehead Augmentation with Autologous Fat Injection"}
{"_id":"54f85ba2-cd95-d440-c162-56d5d7fac416","text":"Further information on study design is available in the Nature Portfolio Reporting Summary linked to this article.","title":"Bruton’s tyrosine kinase inhibition for the prevention of anaphylaxis: an open-label, phase 2 trial"}
{"_id":"55000a2b-9c5c-ac0e-80a1-435f19d9642f","text":"Furthermore, special attention should be paid also to the possible existence of a crossover between breast SLNs and ARM lymph nodes, which may make impossible to preserve the arm-draining lymph nodes. Studies investigating the SLN biopsy and ARM procedures reported that patients with concordance between the SLN and ARM nodes during SLN biopsy procedure had a higher lymphedema occurrence rate than those without node concordance [17, 21]. These results could suggest that the connection between the lymph drainage pathways of the breast and extremities would lead to lymphedema even in patients who undergo only SLN biopsy.","title":"New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery"}
{"_id":"55054994-d06a-80c6-10b1-8443afa2b340","text":"Presented the high rate of MRSA strains is alarming and calls for updating of the antibiotic therapy guidelines in the country. Good results in treatment of chronic osteomyelitis can be achieved by a single-stage protocol including radical debridement combined with systemic and topical antibiotic.","title":"Chronic Osteomyelitis - Bacterial Flora, Antibiotic Sensitivity and Treatment Challenges"}
{"_id":"550b2581-c431-b3f5-01d5-f69b07cb568d","text":"Increased understanding of the coagulation cascade has led to advancements in the development of anticoagulation agents and increased pharmacologic options. Given the high satisfaction rate and low rate of revision following total joint arthroplasty utilizing contemporary surgical technique and improved biomaterials, protection of the post-operative surgical wound and related complications are of paramount importance. Given the emerging trends of abbreviated inpatient stay following TJA and the increasing percentage of total joint arthroplasty performed in the outpatient setting, the search for reliable chemical anticoagulation agents that reduce VTE events while minimizing post-operative bleeding and wound complications is of great interest [37]. Not all new agents have been able to achieve these objectives consistently; many have been associated with an increased incidence of wound leakage and increased length of stay after total joint replacement [26]. Continued exploration of novel agents as they become commercially available is essential.","title":"Review of Therapeutic Options for the Prevention of VTE in Total Joint Arthroplasty"}
{"_id":"5514406d-e25f-4c7d-eec3-429db2e4dce3","text":"The current gold standard treatment for acute postoperative pain after major abdominal surgery is multimodal analgesia using patient controlled analgesia delivery systems. Patient controlled analgesia systems are expensive and their routine use in very low income countries is not practical. The use of ultrasound in anaesthesia has made some regional anaesthesia blocks technically easy and safe to perform. This study aimed to determine whether adding an ultrasound guided transversus abdominis plane block as an adjunct to the current parenteral opioid based regimen would result in superior pain relief after a trans abdominal hysterectomy compared to using parenteral opioids alone.","title":"Adding a transversus abdominis plane block to parenteral opioid for postoperative analgesia following trans-abdominal hysterectomy in a low resource setting: a prospective, randomised, double blind, controlled study"}
{"_id":"551890ae-a7f3-0960-a471-7f958a53e9b4","text":"Postoperative neuropathies can be minimized by careful attention to body positioning and padding during surgery. Avoiding deep dissection or sutures in the inguinal area reduces the risk of a lateral femoral cutaneous or iliohypogastric neuropathy.","title":"Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures"}
{"_id":"551f365f-b47d-6bc9-e21c-a8f627dba5d8","text":"Standard and modified techniques of plating after lengthening were safe and required only a short period of external fixation. The modified technique offered an easier way of plate insertion in a deformed bone.","title":"Submuscular Plate Stabilisation After Lengthening: Standard and Modified Techniques"}
{"_id":"55221e98-3a81-29e1-b8c8-c19b7de65776","text":"From 2007 to 2013, a total of 362 patients underwent breast reconstruction after partial or total mastectomy for breast cancer in Kyungpook National University Hospital.","title":"Natural course of fat necrosis after breast reconstruction: a 10-year follow-up study"}
{"_id":"55251fdd-b70a-9f7b-1563-bcf003dc947c","text":"Preoperative markings are performed with the patient in the standing and supine positions. The superior margin of the flap is shifted slightly above the umbilicus to include periumbilical perforators. Perforators are identified with a handheld 8 MHz Doppler. No additional image studies are routinely performed in our institution.","title":"Immediate implant replacement with DIEP flap: a single-stage salvage option in failed implant-based breast reconstruction"}
{"_id":"552b6e29-4313-756a-6e44-bd647dfe9e92","text":"All examinations were performed by a single physician with more than five-years experience in vascular sonography. The examinations were performed in the morning if possible and the patients were recommended to observe a 10-hour fasting period beforehand. The complete procedure was generally completed within approximately 30–35 minutes. All examinations were started with the patients in the supine position, in order to visualize the abdominal aorta and the origin and proximal course of the main renal artery. The patients were then kept recumbent in various different positions: the left decubitus position to explore the right renal artery, the ventral decubitus position to explore the left renal artery or the right decubitus position in a few cases.","title":"Diagnostic role of new Doppler index in assessment of renal artery stenosis"}
{"_id":"553d9b36-a32c-a18c-7e4f-51c04f5e0780","text":"The present meta-analysis found that the risk of posterior crossbite falls as the duration of breastfeeding rises. It also found that the risk of posterior crossbite was 1.52 times higher in children who had not been breastfed than in those exclusively breastfed for between one and six months, and 3.74 times higher than in children exclusively breastfed for over six months.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"553f07bf-247d-5872-88d3-41bc7d92ce7d","text":"BBF has made substantial contributions to conception of the study and interpretation of data and drafted the manuscript. LE has designed the study, performed statistical analysis, interpreted the data and helped to draft the manuscript. MK has collected the data and contributed in the conception of the study. RF has carried out the microbiological exams and contributed in data collection. MW has made substantial contribution to acquisition of data and has revised the manuscript critically. SS has performed the surgical procedures and revised the manuscript. AW has made substantial contribution in data interpretation. MB participated in the design and coordination of the study helped to draft the manuscript. All authors read and approved the final manuscript.","title":"Is switching to an oral antibiotic regimen safe after 2 weeks of intravenous treatment for primary bacterial vertebral osteomyelitis?"}
{"_id":"554046c5-b70e-fb45-f8cc-0651b92be89c","text":"According to some authors, the negative reactions of permanent fillers are produced by a low-grade bacterial infection surrounding foreign substances. The development of related fibrosis is determined by the implant’s physical attributes and inherent traits.4 Hence, management of such complications has mostly focused on general anti-inflammatory medications and sometimes surgical removal followed by a facelifting procedure to minimize any resulting deformity.","title":"Facial Contouring after Permanent Filler Removal with Combined Facelift and Fat Grafting: A Case Series"}
{"_id":"5540782c-507b-7a4b-074c-e5f3a6321d6c","text":"The present study provides novel in-vivo observations of CNS lymphatic drainage in man and demonstrates that CSF tracer uptake in neck lymph nodes is a much slower process than previously observed in animals, and that peak CSF tracer uptake in the glymphatic system and cervical lymph nodes coincides in time.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"5540f35e-9c78-8df4-cee2-5e0832e88691","text":"Clinical and demographic data of the patients are shown in Table 1.","title":"Human microRNA expression in sporadic and FAP-associated desmoid tumors and correlation with beta-catenin mutations"}
{"_id":"5543f804-ef9d-6caf-097f-9e5ffbe157b9","text":"This study was a retrospective cohort study with convenience sampling following the STROBE guideline comparing the presence or absence of Extracapsular Extension (ECE) in invasive breast cancer with positive sentinel lymph node biopsy.","title":"Measurement of extracapsular extension in sentinel lymph node as a possible predictor of residual axillary disease in breast cancer"}
{"_id":"55440920-a1b8-d4ab-3cf2-bf9e1cd67057","text":"The same analyses were also performed on the complete cohort of patients to assess the impact of the mitotic index independently of the T category of the TNM classification for malignant melanoma. Cox regressions were used to assess RFS and MSS.","title":"How does the mitotic index impact patients with T1 melanoma? Comparison between the 7th and 8th edition of the American Joint Committee on Cancer melanoma staging system"}
{"_id":"554b9b8d-c6ed-d086-91ac-ac0436d0f41d","text":"• This is the first study to specifically match study groups by the volume of RBCs transfused, which eliminates the potential confounding effect of RBC volume transfused on DVT and mortality.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"554e4c2a-3420-92c5-03b4-de347f498277","text":"Stage one: Full thickness Excision of the skin of one side of the face and replacing it immediately by a sensate free vascularized fasciocutaneous radial forearm flap harvested from her healthy donor. Part of the face is to be covered by split thickness graft again from the donor to assess any difference in performance between the fasciocutaneous flap and split thickness grafts when used as allograft to guide future procedures. The donor site is to be closed by an auotologous partial thickness skin graft.","title":"Living related hemi-face skin transplant using radial forearm free flap for a xeroderma pigmentosa patient: early outcome"}
{"_id":"55560bbf-b7bc-997e-a2db-7ec9cfaaf8f6","text":"In this case, the combination of FIN and Ilizarov fixator ensured stability for the femoral bone fragments and permitted early full weight-bearing in the immediate postoperative period. That resulted in bone union at the pseudarthrosis site within 45 days. There was no secondary torsional deformity in postoperative period. This approach represents an advantage in comparison with the use of telescopic rodding alone. With regard to the tibial deformity correction, a combination of intramedullary flexible nail, subperiosteal flexible nail and subperiosteal titanium net seems to be useful in small diameter shaft bones. The achievement of all normal radiological parameters of anteroposterior alignment of lower limbs [45] in children with severe forms of OI may be improbable, but overall realignment should be considered as crucial for the goal of better quality of life including mobility and functional independence.","title":"Use of flexible intramedullary nailing in combination with an external fixator for a postoperative defect and pseudarthrosis of femur in a girl with osteogenesis imperfecta type VIII: a case report"}
{"_id":"555d658d-0950-fe75-1b4c-59d9b1ea00ff","text":"The findings of this study suggest that melanoma patients with BRAF or NRAS mutant tumours have an increased risk compared to patients with BRAF\/NRAS wild-type tumours of developing disease recurrence following a tumour-negative SLNB. The results of this study contribute to a greater understanding of disease biology among tumours harbouring these somatic mutations and suggest that BRAF\/NRAS mutant tumours may be more potent drivers of aggressive tumour biology.","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"555ee3ff-9f64-1175-c873-27275e31569f","text":"Recent data suggests avoiding ALND in cases of positive SLN where treatment strategy includes whole breast radiotherapy alone or combined with adjuvant therapy following conservative surgery of T1-2 breast cancer.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"55603949-e56e-e960-421a-2e314550ec15","text":"Over the counter use of antibiotics and irrational empirical treatment of bacterial infections in the study settings [27] might result to the selection of resistant Staphylococcus aureus strains such as MRSA. This is further supported by the fact that in the current study the majority of patients with history of antibiotic use were using ampicillin-cloxacillin hence more likelihood of selecting MRSA strains.","title":"Methicillin resistant Staphylococcus aureus causing osteomyelitis in a tertiary hospital, Mwanza, Tanzania"}
{"_id":"5560d80a-4573-c685-1ef3-36a94ed7f5f1","text":"La fibromatosis de tipo desmoide es una rara proliferación fibroblástica monoclonal caracterizada por un curso clínico impredecible y variable.","title":"Papillary thyroid carcinoma with desmoid fibromatosis: a case report and review of literature Carcinoma papilar de tiroides con fibromatosis desmoide: reporte de caso y revisión de la literatura Carcinoma papilífero de tireoide com fibromatose desmóide: relato de caso e revisão da literatura"}
{"_id":"55672a11-0a84-db97-1949-05e1145ad641","text":"In spite of all these advances, the survival of patients with malignant gliomas is still closely correlated with the more extensive tumour resection.3,4 Even when the radical removal of a brain tumour is not possible, surgery provides the diagnosis and prevents symptoms of mass effect. Tissue obtained during surgery is critical to allow for the individualized approach in designing treatments with newer therapies that are becoming available.","title":"New developments in surgery of malignant gliomas"}
{"_id":"5573e885-91de-b89a-0de6-9ab27830fd98","text":"A series of 60 open Gustilo IIIB tibial fractures reconstructed with islanded, distally-based fasciocutaneous flaps reported a 20% complication rate including five patients with complete flap loss and four patients with chronic OM and nonunion. 54","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"557bd022-f94f-2330-1544-cd9bf1dfab40","text":"To objectify and further analyze some of our findings, we would conduct a prospective study and invite experienced plastic surgeons who perform 30 or more face lifts per year to participate. Face lift patients would be divided into 2 groups: filler-naïve patients and panfacial filler patients who have had 2 or more rounds of facial fillers performed within the 2 years prior to their facelift. The surgeons would then assess each surgery by noting exact length of the procedure; degree of bleeding; and ease of raising the facial flap. The immediate postoperative course would be assessed based on presence of compromised skin flaps, hematomas, or bunching of the facial tissues. The long-term postoperative course would be assessed by following the patients at regular intervals for a period of 2 years and noting the length of time for evidence of recurrent tissue relaxation as assessed by the surgeon and the patient. This prospective study design may help elucidate a more objective analysis of what our survey results have revealed.","title":"Potential Effects of Repetitive Panfacial Filler Injections on Facelift Surgery and Surgical Outcomes: Survey Results of the Members of The Aesthetic Society"}
{"_id":"557d9e8e-4723-8f37-0698-7acf079011b9","text":"The approach of harvesting fibula suggested by author reduces donor site morbidity and is safer than conventional approach.","title":"Harvesting the free fibular graft: A modified approach"}
{"_id":"557edaa9-b258-7668-7b1a-311098bd7a73","text":"The donor site of STSG treated with minced residual skin grafts showed a reduction in healing time and the healed scar had a significantly better appearance as compared to the donor site treated without a skin graft. Our study shows that, when applicable, this technique can be incorporated as a \"standard procedure\" following STSG to achieve optimal wound healing of the donor site.","title":"Use of Minced Residual Skin Grafts to Improve Donor Site Healing in Split-Thickness Skin Grafting"}
{"_id":"5582d8b0-4b59-4b30-afed-f9f734735bf8","text":"Conclusion: Findings suggest that there are no clinically meaningful differences in the efficacy and performance of the two most widely used NPWT devices, based on consideration of a number of wound outcomes.","title":"A Retrospective Comparison of the Performance of Two Negative Pressure Wound Therapy Systems in the Management of Wounds of Mixed Etiology"}
{"_id":"55836b19-8ac2-f68c-f564-654048ba156a","text":"When evaluating cryosurgery as a treatment option the main problem is the quality of the data presented to date. The lack of randomized clinical trials and the inexistence of a validated standard definition of failure are the most problematic.","title":"Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution"}
{"_id":"558808ef-20e1-75df-927b-107dc6e496b6","text":"This is an infection of bone where the main causative microorganisms are sessile, rendering them less sensitive to systemic antibiotic agents and making routine culture techniques unreliable. The discovery that osteoclastic and osteoblastic cells play a central role in the immune response of bone has resulted in a better understanding of osteoimmunology. The knowledge of biofilm has provided new and effective means of understanding osteomyelitis and to fine-tune and enrol newer methods for the management of bone and prosthetic joint infections.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"559202ac-c752-0de8-596d-9a6e7d386931","text":"We report a waning of the immune response following a fourth vaccine dose. After three months, a significant decay of IgG, IgA, and neutralizing antibodies was evident in both vaccines, with a further decay in IgG and neutralizing antibodies in the BNT162b2 group. We were able to show that after three months, the immunological markers tested lost much of the elevation gained following the receipt of the fourth dose and that some nearly returned to their baseline point as measured four months after the third vaccine dose. A decay of the immune response was previously reported after both the second and third vaccine doses. We previously showed similar waning of IgG and neutralizing antibodies after the third BNT162b2 dose. Therefore, the data presented here further support our previous results that a fourth vaccine dose temporarily restores antibody levels but does not change antibody dynamics. Immunologically, this suggests that periodic booster doses will be necessary to maintain high antibody levels.","title":"Immunogenicity and efficacy of fourth BNT162b2 and mRNA1273 COVID-19 vaccine doses; three months follow-up"}
{"_id":"559566fd-7921-605a-fdf3-7d23ad320a19","text":"The results of our study show that negative pressure wound therapy improves the healing process of venous ulcer by decreasing its surface area, which significantly reduces the time of wound treatment.","title":"The Application of Negative Pressure Wound Therapy in the Treatment of Chronic Venous Leg Ulceration: Authors Experience"}
{"_id":"5599b6fd-8bba-907e-49a4-b95ade2f14b4","text":"Knowledge on biofilm mechanics is of particular interests for effective design and use of applications in which biofilms are either actively or passively involved. More specifically, parameters inferred from mechanical studies enrich mechanical models and help improve the comprehension of the behavior of biofilms subjected to environmental stress or user stimulus. For instance, knowing when the biofilms loss its rigidity is an appealing outcome to better deliver drugs in the case of cleaning procedures. Furthermore, cohesive forces can be sought using mechanical models to optimize operational parameters in physical removing strategies. Hence, developing an interdisciplinary understanding of bacterial biofilms behavior seems to be relevant to prevent their formation, treat biofilm-related infections, disrupt recalcitrant biofilms or harness the metabolic properties of biofilms.","title":"Towards standardized mechanical characterization of microbial biofilms: analysis and critical review"}
{"_id":"559acf31-9530-8f56-db18-4ea0d1c6a767","text":"The main limitation of the present is the limited sample size. Further multicenter studies with larger sample sizes that allow performing multivariate analysis are needed to confirm our findings, as well as to evaluate impact of different variables on aesthetic results according to scalp reconstruction techniques and the long-term stability of the soft tissues. Due to the retrospective nature of the study, there is a selection bias since not all patients had the option of all three flaps. In some patients, flap options were limited because of contraindications for one or more of the techniques analyzed.","title":"Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps"}
{"_id":"559d1fc6-9c07-c1c6-2c86-45f7865ed5b9","text":"The frequency of limb loss in DFO increases the more proximal the initial DFO lesion occurs in the foot, with almost half of patients losing their limbs suffering from hindfoot DFO. Only hindfoot DFO was found to be an independent risk factor for DFO-related major amputation both initially and after initial partial foot amputation care.","title":"Foot Osteomyelitis Location and Rates of Primary or Secondary Major Amputations in Patients With Diabetes"}
{"_id":"559eb36f-b0e7-6355-dcda-84a9106d9e08","text":"It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled.","title":"Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis"}
{"_id":"55a0b458-9053-60da-32b6-fd3cbcc26d89","text":"Despite the fact that a plethora of modern techniques have been developed and utilized in the diagnosis of skin disease, dermatologists still rely vastly on biopsy for diagnostic purposes. As discussed in this study, there is a wide range of diseases that allow dermatologists to select skin biopsy in order to confirm their suspected diagnosis, and the histological perspective proves to be both helpful and reliable in the majority of cases. However, there are also limitations in this method and there are cases that the performance of a biopsy does not produce diagnostic results. As a consequence proper diagnosis is delayed and all imminent therapeutic decisions rely heavily upon the dermatologist's comprehension of the situation. Therefore an optimal use of the process is suggested with comprehensive descriptions and relevant diagnoses by the dermatologist along with a closer cooperation with the dermatopathologist performing clinicopathological correlation whenever possible.","title":"Skin Biopsy in the Context of Dermatological Diagnosis: A Retrospective Cohort Study"}
{"_id":"55a50493-56a5-4c3d-c4b3-213baa081d70","text":"Posterior approaches may be considered when the pathology is located at the posterior portion of the spinal canal, for example, in cases of hypertrophied ligamentum flavum. Nevertheless, posterior decompression also addresses anterior compression because it indirectly decompresses the spinal cord by enlarging the spinal canal. When compared to anterior approaches, posterior procedures offer several advantages for the treatment of CSM. Some of these factors are that they may not require fusion of that vertebral level and it enables direct visualization of the spinal canal and wide decompression of spinal cord and nerve roots.","title":"Cervical Spondylotic Myelopathy: Pathophysiology, Diagnosis, and Surgical Techniques"}
{"_id":"55a64808-fd0c-9303-37b9-0f1be32e4bb7","text":"A recent study in Kenya explored the use of BFPS in a hospital setting to support ill malnourished infants aged between one and four months [13]. Findings from the study indicate that BFPS are effective to increase the rate of exclusive breastfeeding in hospitalized infants. Qualitative data from this study indicates that BFPS work by creating an emotional bond with the mothers during the admission period. This helps to generate trust giving confidence in mothers to explore new ideas and techniques as suggested by the BFPS [14, 15]. In this way BFPS can provide the more intensive breastfeeding support which is recommended for infants admitted with an illness who are likely to experience low appetite and have little energy to breastfeed by themselves. We set out to conduct a scoping literature review to explore implementation of breastfeeding peer support strategies that have been applied for hospitalized infants globally and highlight similarities and differences in their implementation in order to guide future research and practice.","title":"A scoping review of breastfeeding peer support models applied in hospital settings"}
{"_id":"55a8c571-ce73-36f3-a85e-9abcfe446df1","text":"Our findings on intestinal and liver fat embolism strongly support the embolic nature of lipid droplets in the lungs. As the portal system drains venous blood from most abdominal fat depots to the liver, the embolic fat originated in the VAT necessarily pass through the liver to reach other organs. The unequivocal presence of lipid droplets into sinusoids and liver veins supports the fat embolic production by abdominal fat.","title":"Visceral fat inflammation and fat embolism are associated with lung’s lipidic hyaline membranes in subjects with COVID-19"}
{"_id":"55af796c-5d1a-2e27-c35c-eb6b9a1f0486","text":"Acoustic cavitation in the presence of GNPs and IPL has been introduced as a new method to enhance the therapeutic effects on tumor cells. Due to the low penetration depth of light, this method can be utilized for shallow treatment sites.","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"55b0ca9b-f05d-7a3d-c9b3-c73c12c37fd2","text":"Empirical antibiotic therapy was defined as the first antibiotic given with suspicion of infection. Targeted therapy was defined as antibiotic treatment directed against the isolated microorganisms following susceptibility testing. Adequate therapy was defined as any antibiotic treatment efficacious against the detected organism according to susceptibility testing.","title":"Surgical and Antimicrobial Treatment of Prosthetic Vascular Graft Infections at Different Surgical Sites: A Retrospective Study of Treatment Outcomes"}
{"_id":"55b0d897-11fa-5f6f-55bb-c36cc57e2b46","text":"Vulvar cancer is a rare gynecological malignancy with incidence rates steadily increasing over the past 10 years. Despite aggressive treatment, recurrent disease is common. Vulvar cancer recurrence poses a significant therapeutic challenge as most patients have been previously treated with surgery and\/or radiation limiting the options for additional treatment. There are no consensus guidelines for the treatment of recurrent disease. Current literature supports the use of salvage interstitial brachytherapy. However, the total sample size is small. The goal of this case report is to review the current literature and to provide a guide for the use of salvage interstitial brachytherapy for recurrent disease by describing, in detail, the techniques used to treat two patients with unique cases of vulvar cancer recurrences in women with advanced disease and multiple medical comorbidities.","title":"High-Dose Rate Salvage Interstitial Brachytherapy: A Case-Based Guide to the Treatment of Therapeutically Challenging Recurrent Vulvar Cancer"}
{"_id":"55b9b2ae-b791-1ac7-3688-f28fc21d3c16","text":"Osteosarcoma that has spread from the initially affected bone to one or more sites in the body, distant from the site of origin, is called metastatic. The most common site to which osteosarcoma spreads is the lungs. A CT scan of the chest was performed every 3 months in the first year, and every 6 months thereafter. A bone scan was performed every 6 months in the first year and annually thereafter for life.","title":"Evaluation of the Efficacy of Pasteurized Autograft and Intramedullary Vascularized Fibular Transfer for Osteosarcoma of the Femoral Diaphysis"}
{"_id":"55c7a671-a473-067c-7af7-b6d44b4cbd7a","text":"The aim of this study was to determine the relative efficacy and safety of PDT compared with placebo or other interventions for the treatment of skin carcinomas.","title":"Photodynamic therapy for skin carcinomas: A systematic review and meta-analysis"}
{"_id":"55c84be4-dda2-4c5d-8f24-592382825edd","text":"Conclusions: Treating patients with bone and joint infections for the first six weeks of therapy with oral antibiotics is both less costly and does not result in detectable differences in quality of life compared to treatment with intravenous antibiotics. Adopting a practice of treating bone and joint infections with oral antibiotics early in the course of therapy could potentially save the UK National Health Service over £17 million annually.","title":"Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial [version 4; peer review: 2 approved]"}
{"_id":"55cfe7a2-4ea1-0473-dce8-ec7819a74fd3","text":"Exclusive breastfeeding defined as a practice whereby the infants receive only breastmilk without mixing it with other milk or food during the first six months of life. The EBF rate was measured by the responses of participants from questionnaires, which reported by individual participant regarding their self-assessment on breastfeeding practice.","title":"Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace"}
{"_id":"55d022c7-a8a4-e8fb-cf14-37403742c08e","text":"Our study used computational approaches for identification of a community-based PAD cohort and limb outcomes over time. Using this approach, new knowledge acquired may be linked to clinical decision support, enabling a learning health care system as recommended by a recent Scientific Statement of the American Heart Association. The use of these approaches also offers the potential to rapidly evaluate quality metrics as well as promote increased adherence to guideline-recommended strategies via clinical decision support deployed to EHRs at the point of care.","title":"Association of Ankle-Brachial Indices With Limb Revascularization or Amputation in Patients With Peripheral Artery Disease Association of Ankle-Brachial Indices With Limb Revascularization or Amputation"}
{"_id":"55d9190b-1b8d-ab87-7cee-3945bb268a08","text":"Sexual dimorphism in facial characteristics greatly contributes to the variability of the human face and exists from prenatal development. Although in some cases sex could already be estimated from the infant face, the degree of sexual dimorphism changes as a function of age. The growth rate is not constant throughout ontogenetic development and differences are also apparent between the sexes, especially during adolescence, when sex hormones play a major role in facial appearance. The generally accepted view is that sexual dimorphic facial traits become more apparent after 13 years of age and result from the different growth trajectories in males and females.","title":"Three-dimensional analysis of modeled facial aging and sexual dimorphism from juvenile to elderly age"}
{"_id":"55e0fc2f-4e1f-b120-09c6-020f6cea335e","text":"The characteristics and results of the selected studies are summarized in Supplementary Table 1, and the panel analyzed the results through frontal and online discussions. Consent was obtained by using the Delphi method.","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"55e2dae4-de87-9f56-b61b-8fa518da9db5","text":"Surprisingly, the usual hyperechoic fluid accumulation noted during acute rupture of the gastrocnemius muscle was not observed by US in our patient in the prone position. Usually, a longitudinal US image of the calf area will reveal a hyperechoic fluid collection between the medial head of the gastrocnemius and soleus muscles during the acute stages of gastrocnemius muscle rupture. The hyperechoic fluid collection represents fresh blood [1]. The reasons that fluid accumulation was not observed by US in our patient in the prone position may be due to:","title":"A novel approach to sonographic examination in a patient with a calf muscle tear: a case report"}
{"_id":"55e3b363-f4f4-9676-aa5c-df54fba54576","text":"Pediatric general anesthesia poses significant considerations for parents and adds to the burden of the procedure. Compared to traditional extraocular muscle surgery, approximately half of the children in the BTA injection group could be performed with local anesthesia and a second injection could be performed. This also demonstrates that BTA injections are significantly more convenient than surgery, while reducing the demand on medical resources and improving the operability of repeat injections. Furthermore, in China, parents prefer local anesthesia for surgery. BTA not only facilitates local anesthesia injection, but also increases the possibility of local anesthesia surgery, as the binocular visual function can be preserved after BTA injection and the age of surgery can be postponed, which is more in line with the needs of Chinese parents.","title":"Comparison of Botulinum toxin type A with surgery for the treatment of intermittent exotropia in children"}
{"_id":"55e71358-d5b2-3cbe-946b-185b5407ac9b","text":"The laparoscopic approach shows minimal invasiveness and significant scar reduction. Conventional surgeries such as harvesting of latissimus dorsi flap have been associated with high morbidity of the donor region and hyperdimensional scars. With robotic assistance, these surgeries can become almost invisible.","title":"Robotic-Assisted Microsurgery and Its Future in Plastic Surgery"}
{"_id":"55e8b7b5-4e40-ef54-aef5-e85cf63ad1dd","text":"Observing a metastatic malignant melanoma and its primary lesion at the same time is rare. The histopathological detection of any unusual pigmented lesion is critical.","title":"Malignant melanoma of parotid glands from a neglected lesion: A case report"}
{"_id":"55e9b976-0540-97cf-13c6-a98cac7082f6","text":"Spores of Aspergillus are continuously inhaled and therefore fungal colonization of the upper airways is common. Despite this continuous exposure, invasive disease caused by Aspergillus in an immunocompetent host is very rare. Although some degree of immunosuppression may be present in patients with fungal SBO, often the only apparent risk factor identified is a chronic external otitis or an anatomical obstruction of the sinuses (e.g. nasal polyps or chronic inflammation of the mucosa). The extent of tissue invasion in these patients may vary depending on the underlying immune status of the host. In the present study we present six cases of skull base osteomyelitis due to Aspergillus fumigatus and Aspergillus flavus, in whom we investigated whether the innate and adaptive immune responses known to be important for antifungal host defense are defective.","title":"Th17 cytokine deficiency in patients with Aspergillus skull base osteomyelitis"}
{"_id":"55eb1d53-4ea4-bee0-e680-93e52ed1f60b","text":"Those not in formal positions of authority can take up leadership roles as part of their service delivery and\/or within the service itself. It is not uncommon for the latter to happen when an individual chooses (or is asked) to lead on a particular initiative. Responsibilities for different aspects of a particular project may be shared across a team. These are common experiences and a key element of a leadership culture within a service. Some of the heightened expectations of new entrants and those who have gained CPD doctorates can be met in this way.","title":"Leadership of education psychological services: fit for purpose?"}
{"_id":"55eb7656-2f1b-1faa-cfef-2399fe7b358a","text":"Satisfactory surgical outcomes are not just limited to cosmetic aspects and functional demands of the lower extremities must also be surgically addressed. Due to all these reconstructive difficulties and despite remarkable advancements of limb salvage procedures, in some cases amputation and use of advanced prosthetics remain a more feasible and beneficial alternative. Here, the challenges and proposed solutions regarding successful soft tissue reconstruction of the battlefield lower extremity trauma regarding to increase in terrorist attacks and increasing of civilian populations that are injured in such casualties were studied.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"55ef597a-1464-6c7f-a31d-25f241e4c973","text":"Seven mature female Welsh Mountain Sheep were used in this study with approval from from both the Animal Welfare and Ethical Review Body, University of Cambridge and the UK Home Office Project Licence number 70–7740. All methods were performed in accordance with the relevant guidelines and regulations.","title":"Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model"}
{"_id":"55f04bfd-f8e3-9b05-af27-78a5a839a354","text":"Limb-salvage surgery has become the mainstream approaches for the treatment of sarcoma in the lower extremity. In cases where the sarcoma infiltrates the primary vessel, concurrent resection of the vessels and vascular reconstruction are required to ensure sufficient resection and preservation of limb function. The objective of this study is to assess the clinical outcomes of patients who underwent vascular reconstruction utilizing synthetic grafts for limb salvage, specifically in terms of postoperative complications and limb functional status.","title":"Clinical outcomes after vascular reconstruction using synthetic grafts for limb salvage in patients with lower extremity sarcoma: a single-center retrospective experience"}
{"_id":"55f06ec8-fb1e-1121-b169-4841e2efb4cb","text":"Ultrasound has long been used by physical therapy as a modality to improve local swelling and inflammation. The application of ultrasound alone appears to have postinjury modulation and prevents inflammation in the kidney by stimulating the splenic cholinergic anti-inflammatory pathway 59. Indeed, it has been shown in mice to markedly attenuate kidney ischemia-reperfusion injury 60. While these studies were performed in mice and have not been validated in humans, the use in muscle and joints is well established in the physical therapy community and is likely to be applicable in humans.","title":"Ultrasonography in Acute Kidney Injury"}
{"_id":"55fddeca-c42d-0c1b-3f77-89d87d3c4cda","text":"None of these definitions can cover the needs of assessemnt of an elderly cancer patient, predict the response to a treatment or reduce the risk of toxicity related to a treatment. Absolutely none of these definitions is able to accurately describe the scenario in which the character represented by the oncological elder is recited","title":"Management of The Elderly Cancer Patients Complexity: The Radiation Oncology Potential"}
{"_id":"5601bdfb-6fb6-d9d9-79b7-5dc0af644539","text":"From our experience, free fibula flap is a good option for the reconstruction of hand and foot. Proper planning and meticulous flap dissection and inset can save many hand and foot from amputations.","title":"Experience of Saving Limbs With Free Fibula Osteocutaneous Flaps"}
{"_id":"560254f1-cead-ae11-69e8-282c9041556f","text":"The case presented offers a unique opportunity to explore the relationship between IV drug use and osteomyelitis with a rare pathogen. This study could be extended further by analyzing other, related infectious sources of Serratia marcescens to look for shared epidemiological features.","title":"A Complicated Case of Vertebral Osteomyelitis by Serratia Marcescens"}
{"_id":"560c6107-55d0-fa9f-859f-bebd0d7d6d7c","text":"Among the limitations of our study are a small sample, which does not allow an adequate statistical comparison between groups, and that fact that chemotherapy and radiotherapy at the time had poorer results compared to current therapies. Furthermore, the watch and wait approach for organ conservation was not as established then as it is currently, and was therefore not taken into account. Another aspect that was not considered, and that could enrich the study would be the assessments of function and the quality of life of these patients.","title":"Surgical treatment of rectal cancer: prospective cohort study about good oncologic results and low rates of abdominoperineal excision Tratamento cirúrgico do câncer retal: estudo coorte prospectivo com bons resultados oncológicos e baixas taxas de amputação abdominoperineal"}
{"_id":"560d8804-d6a0-16ca-12ce-dbc96e0848a6","text":"Dorsal rotation DAP flaps can be used to cover defects on the dorsum of the distal digit as described by Kawakatsu et al. They reported on a 15 × 12mm dorsal rotation flap based on a dorsal DAP to cover a DIP extension crease defect (Figure 2J). The flap was from the dorsum of the middle phalanx with a very narrow skin bridge over the perforator pedicle. Skin grafting the donor site may be necessary if more movement of the flap is required to cover the defect.","title":"Homodigital Pedicled Digital Artery Perforator flaps for fingertip reconstruction - a review of flap options"}
{"_id":"5610188a-eca1-d78f-a1d2-9a805bd15e58","text":"Screenshot from the website that provides the newly created questionnaire and scoring system","title":"Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis"}
{"_id":"5619d430-60e5-e9e2-9362-268cce6696f9","text":"The important surgical oncological question over the past 50 years have been to move from a concept of the most extensive demolition to the most conservative surgical approach that could guarantee the same oncological result but a higher result in quality of life.","title":"Surgical management of melanoma: an EORTC Melanoma Group survey"}
{"_id":"561a4e71-be22-1f00-1137-9e3309fe6a12","text":"The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer TD and handling Editor declared their shared affiliation.","title":"Preoperative Radiotherapy and Wide Resection for Soft Tissue Sarcomas: Achieving a Low Rate of Major Wound Complications with the Use of Flaps. Results of a Single Surgical Team"}
{"_id":"563058af-8e23-7b43-3d09-5ab2c491e929","text":"The lingual frenulum is shown to be a dynamic structure formed by a midline fold of the FOM fascia together with the overlying FOM mucosa. We have confirmed that the lingual frenulum is definitely not a discrete midline structure. There is significant individual variability in histological composition and microanatomical structure of the FOM fascia. A high proportion of Type III collagen and elastin fibers in the central FOM fascia suggests that, at least in some individuals, the FOM has a composition that allows distensibility of the fascial layer. As tongue elevation creates tension in the FOM fascia, raising the fold of the lingual frenulum, the variability in relative gliding and mobilization of the mucosal and fascial layers appear to impact frenulum morphology. Further biomechanical research is needed to define the impact of these and other variables on tongue mobility and function.","title":"Understanding the Lingual Frenulum: Histological Structure, Tissue Composition, and Implications for Tongue Tie Surgery"}
{"_id":"56318188-2114-3665-0159-79b438e761f4","text":"Desmoid tumors are histologically benign tumors that do not metastasize. However they can be locally aggressive and hence the main goal of desmoid treatment is local control. Extraabdominal tumors are not commonly associated with mortality however morbidity and disfigurement may be related to treatment or tumor progression. The literature lacks level I evidence in the form of randomized controlled trials to compare the relative efficacy various treatment modalities. A multitude of treatment options are available and choosing the appropriate method for achieving local control depends on the functional and cosmetic outcomes of each method and the associated complications [1,24].","title":"Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach"}
{"_id":"5635367f-1bed-5393-d651-324a1bf39cd0","text":"The dataset includes medical records for each patient's length of stay in hospital, and changes in their attendance are important for the treatment of spinal tuberculosis. In this paper, we analyse the inflammatory response of patients in the context of hospital infection and look for the most common inflammatory expression factors in terms of inflammatory expression.","title":"Meta-Analysis and Data Mining-Based Study on the Expression Characteristics of Inflammatory Factors and Causes of Recurrence in Spinal Tuberculosis"}
{"_id":"563da42b-74e5-f55a-c6e9-bb9353fa429c","text":"The paradigm of VTE diagnosis is to accurately identify all patients who would benefit from treatment as quickly as possible while minimizing the burden of diagnostic tests performed on patients without VTE. In recent decades, advances in diagnostic strategies have helped to reduce the number of imaging tests required in patients with suspected VTE, while missing few patients who would have benefited from treatment. These diagnostic strategies for VTE can be considered in several phases—first the patient’s history and physical examination lead the clinician to suspect VTE; second, screening tests to rule out VTE may be performed; and finally, patients in whom VTE cannot be ruled out undergo a more definitive imaging study. In this review, we describe the current approaches to diagnosis of VTE and focus on areas that require improvement.","title":"Current Challenges in Diagnosis of Venous Thromboembolism"}
{"_id":"564aa07b-ddb7-8dfe-bb61-1912e3be5c3f","text":"If studies with both a low and a high risk of bias are available for a specific outcome, the studies with a low risk of bias are primarily used to derive proof, an indication or a hint of a greater benefit of NPWT.","title":"Negative pressure wound therapy in patients with wounds healing by secondary intention: a systematic review and meta-analysis of randomised controlled trials"}
{"_id":"56562696-4eae-f9fd-616a-be8d0d2028f6","text":"Based on this study, the breast tissue below the areola that is typically excised in superior pedicle reductive mammary surgery can reliably be raised as an axial flap pedicled on both the 4th and 5th IMAPs or on the 4th perforator solely.","title":"Color Duplex Assessment of 4th and 5th Internal Mammary Artery Perforators: The Pedicles of the Medially Based Lower Pole Breast Flaps"}
{"_id":"5661f9ef-d2c4-f9a4-8be7-37e962f21d82","text":"Initial experiences with interposed SVGs for ischemic and traumatic occlusion of the internal carotid artery and intracranial aneurysm obtained encouraging results with an overall patency rate of 80% at a 12-month follow-up.98 In cases of distal vertebral artery disease, the SVG was placed either from the C2 transverse foramen to the intradural portion of the vertebral artery, or from the extradural C1 portion to the intradural artery beyond the posterior inferior cerebellar artery.99 Morgan et al100 reported 57 interposition SVG bypasses between the common carotid artery and the intracranial internal carotid artery in 55 patients, with which early graft occlusion was 5%.","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"566c8433-fb3a-ae30-6333-2b6e4847a642","text":"Funding is a perpetual challenge in academic environments, and building support for global health programming is no exception. Creative funding methods have been required in addition to ongoing departmental support. Many programs across NA are developing global health fellowships, in which (an often junior) faculty member spends part of their time earning clinical dollars and part of their time abroad; this is attractive but may prohibit the long-term presence abroad that is fundamental for building strong connections and meaningful longitudinal contributions. The importance of building the connection between the team leaders who spent their time in Kenya and their home institutional department has proved important for the team leaders’ professional development.","title":"Developing Ethical and Sustainable Global Health Educational Exchanges for Clinical Trainees: Implementation and Lessons Learned from the 30-Year Academic Model Providing Access to Healthcare (AMPATH) Partnership"}
{"_id":"5674a740-2c4a-b8c3-b13d-2797d8aad872","text":"FDG-PET staging in head and neck cancer has good positive and negative predictive values in determining lymph node status. The maximum SUV of the primary tumor is predictive of overall survival. This is the first report to find that the SUV of a lymph node is predictive for ECE and also for distant recurrence.","title":"FDG-PET staging and importance of lymph node SUV in head and neck cancer"}
{"_id":"567521a6-1af2-6d95-f087-6696898d3a2f","text":"We conducted a review of the literature using PubMed database to identify original articles that assessed the role of axillary lymph nodes’ classification in breast cancer axillary management.","title":"New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery"}
{"_id":"56774567-8e3f-dc09-becf-dcc5ba0db728","text":"In summary, lip tie is a condition that is gaining acceptance for its association with breastfeeding difficulty. These patients present with breastfeeding difficulty and an abnormal latch, which can be simply and effectively addressed with frenotomy. Patients should be carefully selected for this procedure based on physical examination and history. While a larger study population and prospective data are needed to generate stronger conclusions and guide society's recommendations, this study demonstrates a successful improvement in breastfeeding and weight gain following the correction of isolated upper lip tie.","title":"Labial Frenotomy for Symptomatic Isolated Upper Lip Tie"}
{"_id":"567bd7a7-af18-722a-c878-34cd2745f6bf","text":"The aim of this case report is to present an alternative method for managing chronic wounds of the lower limb by using nanofat grafting under an autologous split-thickness skin graft.","title":"Nanofat grafting under a split-thickness skin graft for problematic wound management"}
{"_id":"567c6de7-deae-14bd-085f-df230ac77ebd","text":"The TALD flap was successfully employed for a variety of indications including DCIS and invasive cancer and in patients who later went on to receive postoperative adjuvant irradiation of their reconstructed breasts. None of these underwent further adjustment of their reconstructed breast such as lipofilling. The main shortcoming of the TALD flap in non-obese patients is that the volume of the tissue transferred may be insufficient and therefore require lipofilling to augment the reconstructed breast volume or shape either at the time of immediate reconstruction7,9 or subsequently.19,20 There is also the additional problem of muscle atrophy that besets all LD flaps whether they are used with or without an implant. In our study after an average follow up of more than 5 years, none of the patients have required or requested adjustment or balancing surgery, further confirming that the reconstructions were adequate and the fat transferred provided sufficient tissue. From a technical standpoint, it is important to make the reconstructed breast slightly bigger than the opposite breast, as there is a small and inevitable muscle atrophy despite preserving the thoracodorsal nerve.","title":"Postmastectomy Breast Reconstruction With the Totally Autologous Latissimus Dorsi Flap in the Thin, Small-Breasted Woman: Give It More Thought! Kazzazi et al"}
{"_id":"567c708a-0ec3-d59c-8140-4d3acf25a418","text":"The delayed onset of these hypersensitivity reactions misled our team initially in both the above cases, having potentially serious health consequences. Only following failed antibiotic treatment was an allergic reaction considered. Our differential diagnosis was further misled by the fact that both patients had used chloramphenicol ointment previously without clinical adverse effects.","title":"Reaction or infection: topical chloramphenicol treatment"}
{"_id":"5680e650-aaec-1240-4ef9-359151366b6a","text":"Descriptive statistics were used to tabulate and present the study findings.","title":"Tumor associated PD-L1 expression pattern in microscopically tumor positive sentinel lymph nodes in patients with melanoma"}
{"_id":"568dfd2d-0c6b-8562-3d3c-6e009e3d4ef7","text":"Reconstructing a large cutaneous cheek defect post tumour excision poses a great challenge to the reconstructive surgeon.1 The microvascular free tissue transfer techniques used for the repair of extensive cheek defects are not routine in developing countries like Nigeria. Free tissue transfer, where available may not be feasible for high surgical risk patients who may not be able to withstand prolonged anesthsia. Hence, such patients will benefit from locoregional flaps such as cervicofacial flap that can be done over a reduced operating time and considerable postoperative recovery time. This flap technique had gone through various modifications since its introduction by Esser et al. in 1918 2 The modifications are in relation to superficial musculo-aponeurotic system (SMAS) plane dissection whether superficial or deep to it 3. It has robust random blood supply and it is usually inferiorly based. The reporting of this flap in literature is scanty especially among dark skinned people of African race. Hence, we report two cases of patients that underwent modified cervicofacial flap for reconstruction of Zone 1 cheek defects6. This technique reduced operating time and post op recovery time. The flap is reliable and with good patients’ selection, the outcome in dark skinned individual is acceptable as highlighted in these two cases.","title":"Versatility of cervicofacial flap in management of cutaneous cheek defects post tumour excision: a report of two cases"}
{"_id":"56964d71-3cb4-f367-0a7d-a136762cef6c","text":"The majority of the tree nut and especially hazelnut sensitization seen in Northern Europe is secondary to birch pollen sensitization often causing no symptoms at all or subjective or milder symptoms (13, 33). We wanted a representative group of tree nut allergic individuals, where we would expect a high degree of atopic co-morbidity (34) that includes birch pollen sensitization characteristic of the Scandinavian area. We found no significant differences in sIgE to the tree nuts and birch pollen in the patients who were recruited through the database search as compared with the newly referred patients, indicating that the study population is representative of most patients referred with a clinically relevant tree nut allergy in the capital region of Denmark.","title":"Patterns of Clinical Reactivity in a Danish Cohort of Tree Nut Allergic Children, Adolescents, and Young Adults"}
{"_id":"569bbc1a-2915-b053-95d6-97c54e5873d8","text":"A gastrocnemius muscle flap is a versatile option for covering the proximal one-third of the lower leg and around the knee. On the other hand, it is of limited use in patients with short gastrocnemius muscle or insufficient volume. The authors present a case in which a knee soft tissue defect occurred in a very thin patient and was reconstructed using a gastrocnemius myocutaneous flap and a distally based gracilis flap as a supplementary flap.","title":"Reconstruction of complex knee wounds with a distally based gracilis flap and gastrocnemius myocutaneous flap: A case report"}
{"_id":"569bf668-e54c-141f-ea65-6dc536e9b865","text":"In this study, we demonstrate a series of cases of invasive osteomyelitis in the femoral head and acetabulum treated with the Girdlestone procedure and NPWTi-d with a subsequent resolution of all infection.","title":"Combination of Girdlestone Pseudoarthroplasty and Negative Pressure Wound Therapy with Instillation and Dwell in the Treatment of Invasive Osteomyelitis of the Proximal Femur"}
{"_id":"56ac0f82-aa39-cc82-ac84-f7fa5dbd6044","text":"Our retrospective study conducted amongst paediatric inpatients in the highest referral hospital in the Gambia shows more than half of the admitted patients received at least one antibiotic and slightly more than half of these patients had microbiological cultures indicated. Antibiotic resistance was high for the most commonly used antibiotics (ampicillin and gentamicin).","title":"Antibiotic use on paediatric inpatients in a teaching hospital in the Gambia, a retrospective study"}
{"_id":"56b32d96-397c-b857-9846-162e50c7de3d","text":"Because of the absence of metastatic disease, the treatment of choice for the patient in this case was en bloc tumor resection with corrective arthroplasty using a vascularized free fibular autograft consisting of the proximal fibular head and 19 cm of the shaft.","title":"Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius"}
{"_id":"56b93d15-0668-e45b-762c-c00ffd1f3a91","text":"After each margin evaluation, the pathologist called the surgeon in the operating room by phone to communicate the diagnosis. A second sample was taken from the area where residual tumor was visible when a sample was found to have tumor cells after histopathologic analysis. Until clean margins were achieved, fresh tissue from the excision was delivered to the pathology laboratory. Only when the histopathological analysis no longer found tumor cells in any margin the oculoplastic surgeon could perform the reconstruction (Figure 3). The diagnosis of the frozen slices was then confirmed by sending all samples for long-term paraffin sections. Through this mixed approach, precise microscopic control of all margins can be achieved with more effective preservation of normal tissue and reduced sacrifice of healthy tissue.","title":"Recurrence of Basal Cell Carcinoma Treated with Surgical Excision and Histopathological Analysis with Frozen Section Technique with Complete Margin Control (CMC-FS): A 15-Year Experience of a Reference Center"}
{"_id":"56ba21b6-cde8-76f6-d66a-0d6c96820ba7","text":"In recent years, natural extracellular matrix derived scaffolds are gaining popularity owing to their natural structural composition and native microenvironment 4. Decellularization technology is used to reduce the antigenicity of xenogeneic tissues and retain all the important compositions of the extracellular matrix 5. Porcine septal cartilage is produced as a decellularized extracellular cartilage matrix that is appropriate for cartilage tissue engineering with human chondrocytes. Decellularized septal cartilage was produced using strong denaturant and base, guanidine hydrochloride 6. However, not all the decellularization technology was found to be efficient and good for the production of natural scaffolds, that can be used for tissue engineering.","title":"A novel 3D histotypic cartilage construct engineered by supercritical carbon dioxide decellularized porcine nasal cartilage graft and chondrocytes exhibited chondrogenic capability in vitro"}
{"_id":"56c0f1a3-364b-4ff8-ecc7-ce1a20372e0f","text":"The benefits that interviewees described as a result of working on an overseas quality improvement project may be broadly grouped as those relating to the experience of working within a foreign healthcare system and those relating to the opportunity of practicing leadership through taking the lead on an assignment. Leaving the UK and facing the challenge of working within a foreign healthcare system gave the fellow a new perspective on healthcare:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"56c7770f-15c3-223b-d3bf-8298b766d347","text":"The transposition of the earlobe was done to the desired level. The tissue expander was removed from its position and the portion of capsule on the undersurface of the skin flap was removed to obtain the better extensibility. Hemostasis was maintained and framework inserted into the pocket. After that, negative pressure suction catheter was inserted between framework and pocket and secured. The negative pressure suction catheter was generally removed on 5th to 6th operative day. Suture was removed on 12th operative day and patient was generally discharged after the suture removal.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"56d8f57b-932e-4a83-de94-6c9a6214251b","text":"Grades of Recommendations Assessment Development and Evaluation (GRADE) guidelines will be used to evaluate the quality of evidence through 5 factors to lower it and the quality will be graded in 4 levels.","title":"Acupuncture therapy strategy options in postoperative management after laparoscopic cholecystectomy A protocol for systematic review and Bayesian meta-analysis"}
{"_id":"56da7e3e-a7c2-ce85-256e-6fcfa82eb5c5","text":"In this preliminary study we report the incidence of positive cultures in section’s osseous slice biopsy (SOB) taken at the level of major limb amputation and compare the microbiology of positive cultures with percutaneous bone biopsy cultures performed at distal infected site. We also analyze the relationship between diabetes and microbiological culture results.","title":"Section’s osseous slice biopsy during major amputation of lower extremity: preliminary results of prospective cohort study"}
{"_id":"56e325ad-11df-0df4-295f-a6894e8bffd1","text":"Failure rates of up to 12% of saphenous vein grafts within the first week after operation have been described. Therefore alternative grafts such as bilateral internal thoracic artery or radial artery grafts are more frequently used.","title":"Coronary artery bypass grafting in young patients - insights into a distinct entity"}
{"_id":"56e51e12-b062-0f1e-b511-9604c49e8263","text":"to objectively assess the degree of patient satisfaction one year after rhinoplasty using the Rhinoplasty Outcome Evaluation questionnaire at a referral academic center.","title":"Long-Term Evaluation in Aesthetic Rhinoplasty in an Academic Referral Center"}
{"_id":"56f0d75c-5ea3-7812-b650-e2be16626e78","text":"The studies involving human participants were reviewed and approved by Ethics Committee of Zhangzhou Affiliated Hospital of Fujian Medical University. The patients\/participants provided their written informed consent to participate in this study.","title":"A Comparison of Puncture and Continuous Pump Analgesia With Two Different Approaches to Thoracic Paravertebral Block for Thoracic Surgery"}
{"_id":"56f128c6-30c2-6a26-1a3e-d60f625bd886","text":"The “off-the-shelf” CCA in this clinical trial is a novel Food & Drug Administration–regulated costal allograft that is provided sterile; the unprocessed donor tissues are pretreated with a low dose of gamma radiation if recovery cultures warrant it. The unique advanced tissue processing used during processing is a disinfecting method that yields essentially sterile allografts while preserving the natural integrity and function of the tissue.5,25,26 In addition, the fresh frozen allografts are procured and screened under strict acceptance criteria, with less than 2% of offered donors being accepted for further tissue processing. Hence, it is a safe option for use in patients who have questionable cartilage quality, while concurrently eliminating the need for the surgical harvest of autologous tissue.","title":"Prospective Clinical Trial Evaluating the Outcomes Associated with the Use of Fresh Frozen Allograft Cartilage in Rhinoplasty"}
{"_id":"56f28148-7f0e-5497-464e-383056b0d11d","text":"Thrombotic risk persists for at least a month after surgery for CS, and although studies have not consistently identified risk factors for VTE, prolonged thromboprophylaxis has been shown to decrease the risk of VTE. Therefore, it is reasonable to recommend thromboprophylaxis for at least 1 month, especially in cases of severe CS. This case report highlights the need for further research on risk factors associated with thrombosis in patients with CS and the importance of updated guidelines to address this issue.","title":"Multiple Deep Vein Thromboses After Curative Surgery for Cushing Disease: A Case Presentation and Review"}
{"_id":"56fb28f4-cf5f-d956-e1d7-61787eae1b4f","text":"Brachytherapy (BT) was the first radiotherapeutic technique used to treat human disease and remains an essential modality in radiation oncology. A decline in the utilization of BT as a treatment modality has been observed and reported, which may impact training opportunities for medical physics residents. A survey of therapeutic medical physics residency program directors was performed as part of an assessment of the current state of BT training during residency.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"56ff13ae-bab3-a756-2fc8-55e856b582fd","text":"The future of the study of skin stem cells is ultimately their in vivo regulation by means of targeted innovative therapies involving topical drug delivery strategies.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"5706d1f3-ae50-a40c-7618-f35a5b7082b7","text":"Overall, while radiation has emerged as a promising partner for immunotherapy, the identification of tumor and patient characteristics that can predict which patients should receive upfront the combination of immunotherapy with radiotherapy instead of immunotherapy alone remains unclear.","title":"Melanoma and immunotherapy bridge 2015 Naples, Italy. 1–5 December 2015"}
{"_id":"570be109-03e0-155b-eb7a-00df00761b90","text":"Existing skin substitutes currently used in burn wounds and ulcer treatment are unable to recapitulate the native complexities of the skin dynamic and structure. While 3D bioprinting holds great potential in creating functional skin equivalents, further studies have to be conducted to elucidate the choice of scaffold materials that fulfill the biocompatibility and biodegradability requirements. Additionally, a new design process is required to better represent the heterogeneity of the skin construct. Other considerations include a reduction in or no scar formation and integration of functional skin appendages similarly to the local physiological organization, while keeping the wound infection rate low. More importantly, reciprocity of signaling pathways between the scaffold, cells and the growth factors has to be established to support vascularization.","title":"Translational stem cell therapy: vascularized skin grafts in skin repair and regeneration"}
{"_id":"571044d6-ecf1-f672-a3ef-9a066627949e","text":"An analysis of variance between the subjects was conducted in order to find the difference between the various experimental conditions.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"571333a7-6173-e80f-73ff-f075a8f78574","text":"Axillary lymph nodes represent the main stay of lymphatic drainage from the breast, and the first lymph node among them to be affected is called the sentinel lymph node. Sentinel lymph node biopsy (SLNB) is the standard diagnostic procedure for patients with early-stage breast cancer to assess the status of lymph node. Identification of this node is made by injecting radioactive tracer into the breast in the vicinity of the tumour, followed by its excision, and a biopsy that reflects the histological characteristics and status of nodes in the axilla. Surgeons carry out axillary lymph node dissection (ALND) in breast cancer for cases where SLNB is positive and abandon this intervention if it is negative. Identification and assessment of sentinel lymph node metastasis dictates the right surgical approach adopted and the prognosis in patients with early breast cancer.","title":"iTRAQ proteomics of sentinel lymph nodes for identification of extracellular matrix proteins to flag metastasis in early breast cancer"}
{"_id":"57148a1b-fc8e-23b4-2878-cb0804a3abbd","text":"This study evaluated six LN features that are evaluated routinely by radiologists at the authors’ institution to detect LN metastasis in patients with melanoma. Patients with one or more of these CT characteristics in the inguinal LN had a 50 per cent chance of having positive spread of melanoma to the pelvic LN; this increased to 80 per cent in those who had concurrent RM and ECS. Both ECS and RM within the inguinal station LN was predictive of pelvic spread, and thus may be useful in identifying patients who could benefit from ilioinguinal dissection, even in the absence of suspicious CT findings in the pelvis. Absence of all six features correlated with a high likelihood of disease-free pelvic LNs and could guide clinical recommendations for inguinal dissection only.","title":"CT diagnosis of ilioinguinal lymph node metastases in melanoma using radiological characteristics beyond size and asymmetry"}
{"_id":"57152d42-f93c-3ce5-2e62-d28cfc800c3f","text":"In Plastic Surgery, the time of training to acquire all surgical techniques and assure appropriate management of the various pathologies is extensive. In Switzerland, there has been implementation of the 2005 Swiss labor law that restricts working hours to only 50 a week for the medical doctors. Research and education are to be included in this 50 a week resulting in a 42-hour on-hands work week for many.[ Although a survey accomplished in 2013 in Swiss Hospitals revealed that almost 70% of Swiss MDs worked more than the 50 hours imposed level, more than 25% said they worked over 60 hours per week. This massive decrease of time for training can be associated with a large decrease in the total number of operations performed by plastic surgery residents and this decrease in operative volume exposure has been accompanied by diminished self-reported operative confidence and expert rating of the operative ability of recent graduates (clinical observations).[ Nowadays, to be formally prepared as a plastic surgeon, it has been observed that the number of years as a resident will have to increase to have full training. This will then have certain implications for overall training in the field of plastic surgery such as lower number of positions available, as current residents occupy the posts longer to enable full overall training throughout the full program required for both the European and Swiss board examination.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"571d0516-dee9-751e-fc78-7c7051d9057c","text":"For this cohort study, data were retrieved from the pathology reports of all newly diagnosed adult DM patients in The Netherlands between 2000 and 2014. Patient with a melanoma without or unclear Breslow thickness were excluded, as well as patients presenting with stage IV disease at the moment of diagnosis. For the present study, this yielded a dataset with histologically proven invasive, primary DMs diagnosed between 2000 and 2014 in The Netherlands.","title":"Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival"}
{"_id":"5725347d-09c5-629b-082c-398fa948483b","text":"This work adds to the body of evidence supporting biodegradable alternatives to acrylic based cements. The CaP\/CaS composite clearly provides advantageous properties as it is an efficacious vehicle for delivery of vancomycin and demonstrates a balance between biomaterial resorption and bone formation. This bone substitute assists in the prevention and treatment of osteomyelitis and its associated bony defects. The biodegradable, antibiotic eluding and osteogenic capabilities of this calcium phosphate-calcium sulfate composite allow for its application in a variety of clinical scenarios.","title":"Vancomycin-laden calcium phosphate-calcium sulfate composite allows bone formation in a rat infection model"}
{"_id":"572b5cec-9ad4-8307-6657-67be7fd97759","text":"This study has several limitations including single-center retrospective design and small sample size, which restrict the ability of statistical analysis. Furthermore, the small number of flap fail in this study and the presence of several risk factors in a single patient also lead to some difficulty in determining the actual reason of flap failure. Further study with large size and is well designed is really necessary to make a power statement.","title":"What is the impact of infrapopliteal endovascular intervention on free flap survival in diabetic foot reconstruction?"}
{"_id":"572c5e82-cc12-1aa5-5015-160404c41dd0","text":"The localisation kinetics of aluminium after subcutaneous injection, based on allergy formulation, has been investigated with the rate of clearance of aluminium from the injection site calculated from a rat model. Granuloma formations are one of the most common unwanted adverse reactions when a patient receives allergy subcutaneous immunotherapy. The results presented herein support current understanding that aluminium has the propensity to form focal accumulations in the body, beginning at the site of administration.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"572d45fb-30f3-099a-6771-aab5dc4f3d27","text":"Critical limb ischemia with osteomyelitis is so difficult to treat that even appropriate revascularization and wound therapy cannot achieve limb salvage because of uncontrollable infection. It is still difficult to judge the possibility of limb salvage before revascularization.","title":"Successful limb salvage through staged bypass combined with free gracilis muscle transfer for critical limb ischemia with osteomyelitis after failed endovascular therapy"}
{"_id":"573283ec-4663-8143-8f71-09e1a136d94e","text":"Although in the UK most spinal trauma cases present initially to district general hospitals, our study shows a trend not to stock the halo device in one third of these hospitals. This would mean immobilisation of potentially unstable cervical spine injuries by other, less rigid cervical orthoses. When the halo device was available, only two thirds of the trauma surgeons were confident in applying one. Previously, this would have been considered a prerequisite trauma skill for practicing orthopaedic surgeons in hospitals providing acute services. There now appears to be a wide variation in the provision of this essential service throughout the UK, with a high proportion of trauma units having neither the resources nor clinical expertise to manage these injuries. As the management of spinal trauma becomes more specialised, this is likely to affect service delivery and training, and has important safety implications.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"5739a3b1-7a5b-536d-24ee-fde4f4404bc8","text":"DVT in our study occurred predominantly in young female patients unlike previous studies where patients were generally older. Furthermore, HIV and tuberculosis were the two most common known risk factors or comorbidities observed. Clinicians should have a heightened awareness of venous thromboembolism in patients with either condition or where both conditions occur together and appropriate thromboprophylaxis should be administered.","title":"The profile and frequency of known risk factors or comorbidities for deep vein thrombosis in an urban district hospital in KwaZulu-Natal"}
{"_id":"573b07f7-7e88-fd12-2a39-40b183a2dda2","text":"PSs usually accumulate in the tumours of mice after intravenous injection. After irradiation with a red laser beam at a specific wavelength of light, photodynamic therapy is activated by the absorption of a photon, followed by the oxidation and degradation of vital biomolecules.","title":"Chemical approaches for the enhancement of porphyrin skeleton-based photodynamic therapy"}
{"_id":"573dd624-2afb-c784-bfa9-ff0e3e65a0f9","text":"In a recent study in which authors applied topical cooling on VAT in a swine model of metabolic disease, it was reported that the cooling of VAT induced 30% loss in mesenteric fat volume, improved insulin sensitivity and blood pressure in this model. Although authors of this study did not show weight loss or check for changes in expression of adipokines and genes associated with obesity that led to improved metabolic disease profile in these swine, this study provides proof for the notion that reduction of VAT with cooling in this swine model does promote concomitant reduction in insulin resistance and metabolic syndrome risk. Our findings provide a potential new and practical method of selective and targeted reduction of viscleral fat that can lead to weight loss and improved methabolic disease profile. Unlike topical cooling, injectable slurry can make such procedures minimially invasive and less time consuming to perform.","title":"Selective reduction of visceral adipose tissue with injectable ice slurry"}
{"_id":"5745a16b-ab8c-16e9-e09a-0f099e6eeefd","text":"In order to measure the excisional margins we calculated the difference between the major and minor axes of the surgical specimen and those of the tumor. The differences between the major and minor axes of surgical specimen and tumor were calculated. These differences were subsequently divided by two, hypothesizing that the lesion had the same distance from the margins of the surgical specimen. Major and minor axes were measured in millimeters (mm).","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"574981e8-c642-9077-ef1c-42a5ec1680ce","text":"This clinical investigation confirmed the safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites. The bilayered wound dressing is thus recommended as an option for split-thickness skin donor sites or other partial thickness wounds treated in the clinic.","title":"Randomized Clinical Trial of the Innovative Bilayered Wound Dressing Made of Silk and Gelatin: Safety and Efficacy Tests Using a Split-Thickness Skin Graft Model"}
{"_id":"574c1a58-004b-e3d0-002b-1cb4b32557ba","text":"What we propose is to give the medical students teaching and practice in the basic procedural skills they may encounter while on elective. This will make for a more robust learning experience and will reduce some unease of performing procedures for the first time while abroad. Future research is needed to optimize and standardize PDT curriculum in procedural skills.","title":"Procedural skills training for Canadian medical students participating in international electives"}
{"_id":"5755eb3c-6a23-7f26-064f-e958d2db5731","text":"Tissues including bones were procured up to 48 h after death in the local sterile field at the procurement facility of the Warsaw Forensic Department by the personnel gowned in sterile clothing using sterile surgical instruments. The procured tissues were packed in uniquely labelled double sterile foil bags and transported in transport containers at temperature of 2–8 °C with the donor’s and procurement documentation to the tissue bank. After reception in the tissue bank the procured tissues initially stored in −80 °C in deep-freezers were then released from quarantine for processing after a decision was made by a responsible person from the tissue bank following a review of the donor’s screening documentation, testing results, conditions of procurement and transportation as well as examination of tissues.","title":"Long-term outcomes of the use of allogeneic, radiation-sterilised bone blocks in reconstruction of the atrophied alveolar ridge in the maxilla and mandible"}
{"_id":"5755ee2a-1a4e-4611-7e02-a85533bfe576","text":"In this paper we studied humeral head (bone) segmentation in axial PD MRI of shoulder. In the first step we applied SRAD method and homomorphic filter. SRAD is very sensitive to the estimation of SDN and normally calculated in a homogenous area [4, 9]. We estimated this parameter from area of interest where there is more tissue intensity than background to reduce Rician noise. By this way we extended use of SRAD in PD MR images. Noise reduction with SRAD makes a good contribution to the correction of inhomogeneity because the image noise is a factor that affects quantity of inhomogeneity. But noise reduction with SRAD alone is not enough for satisfactory correction of inhomogeneity in the image. Thus we supported SRAD method with homomorphic filter. This filter separates low and high frequency components in an image and enhances changes in high frequency component and suppresses changes in low frequency component to obtain more homogenous images. Moreover, the homomorphic filter is in its essences a linear filter and is quintessentially used for noise reduction or signal feature extraction if the signal (PD MR image) is distorted by additive noise.","title":"Segmentation of Bone with Region Based Active Contour Model in PD Weighted MR Images of Shoulder"}
{"_id":"575731d7-68c6-0929-9b76-ecf89c815b52","text":"The integrated literature review supported the proposition that some malocclusions are closely related to the presence of ankyloglossia and, although very few clinical trials on this topic have been published so far, there is a consensus among authors concerning the negative effects of functional imbalances over the stomatognathic system’s proper growth and development. Half of the studies found state that surgical interventions for releasing the lingual frenum are both safe and effective, concerning improvement in breastfeeding scores. Moreover, 4 out of the 14 studies included in this integrated review, report a negative influence of ankyloglossia over the orofacial muscular system.","title":"ANKYLOGLOSSIA AND ITS INFLUENCE ON GROWTH AND DEVELOPMENT OF THE STOMATOGNATHIC SYSTEM A INFLUÊNCIA DA ANQUILOGLOSSIA NO CRESCIMENTO E DESENVOLVIMENTO DO SISTEMA ESTOMATOGNÁTICO"}
{"_id":"575ccc41-6ca2-d563-d45e-80c5a0eb7120","text":"Ultrasound examination is a useful method for evaluating joint cavity effusion in cases of acute and chronic arthritis in the course of sarcoidosis, also allowing assessment of synovium, tendons and cartilage. Under ultrasound’s guidance joint fluid can be collected for examination. This modality is also useful in visualizing sarcoid changes in soft tissues and can be used to localize and biopsy the lesions.","title":"Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis"}
{"_id":"5766c505-32ad-520b-10dd-5a72b7edcccf","text":"An appropriate areolotome was used to mark the NAC, which was then excised and stored as a free graft in physiologic saline solution. A frozen section was taken for histological examination to determine if there were malignant cells in the nipple ducts.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"5768cdd5-ea8b-1a6d-80ad-d890404d993c","text":"Furthermore, it is interesting to note that immunotherapy is specifically prescribed in case of cSCC mainly by dermatologists with 10–19 years of specialization. It is not easy to interpret such data but it could be explained because younger dermatologists may be not confident in managing this therapy while older dermatologists may be less aware of this more recent therapy.","title":"Attitudes among dermatologists regarding non-melanoma skin cancer treatment options"}
{"_id":"57723285-d479-ede2-cb54-c5902742eb12","text":"A man with subungual calcinosis cutis and subsequent nail dystrophy of the same digit is described. Clinical examination revealed a split midline ridge on his right thumbnail; a biopsy of the nail matrix demonstrated calcinosis cutis. The differential diagnosis of subungual calcification is reviewed.","title":"Subungual Calcification and Nail Dystrophy: A Case of a Man With Subungual Calcinosis Cutis and an Associated Split Nail Plate"}
{"_id":"5779f96b-25f9-970f-8b22-f93f57655aff","text":"Free vascularized fibular grafts from the contralateral limb heal quickly and the chances of infection are less. Also, these grafts survive on their own and do not undergo creeping substitution. On the downside, this procedure is associated with a relatively higher morbidity to the normal limb and requires a specialized microsurgical team which may not be possible in every center. Free vascularized grafts from the opposite leg may necrose in the presence of sepsis, and even if the graft does survive, healing will take a very long time, with expectation of a poor functional outcome.","title":"The Huntington procedure: still a reasonable option for large tibial defects in paediatric patients"}
{"_id":"577c7329-fe07-67d0-8132-b5aff6f3c85c","text":"Autologous fat presents ample opportunities for clinical use and innovation, and investigation into fat graft injection location indicates that there is no statistically significant difference in neovascularization signals between the subcutaneous plane and the local fat pad in the athymic rat model [55].","title":"Modern trends in lipomodeling"}
{"_id":"578c1ce9-e45c-6b08-42dc-f6a6ed7c7e35","text":"Botulinum toxin is used in various ways such as temporarily resolving muscular problems in musculoskeletal temporomandibular disorders. It is used not only for treating these diseases but also for the cosmetic purpose to smoothen wrinkles caused by the muscle. The importance of knowledge on anatomical structures to reduce side effects is true.","title":"Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain"}
{"_id":"57922219-0f58-5198-46f8-c075a80dde1c","text":"The scientific community could highly benefit from planning future trials comparing all the available therapeutics and that compare their relative efficacy. Such collaborative efforts would aid in the formulation of guidelines that could better direct clinical practices and treatment rubrics.","title":"A Desmoid Tumor Responding to Systemic Therapy With Tamoxifen and Sulindac"}
{"_id":"5794d0ae-2061-2943-0e40-9dd3471386c0","text":"Comparison of efficacy and side effects of various vitiligo surgical modalities was not done.","title":"Split Thickness Skin Grafting in Patients with Stable Vitiligo"}
{"_id":"5797a68d-d87a-6684-880f-e018f89c6e53","text":"Since it was first described in the literature over a century ago microsurgical techniques have become an essential part of plastic surgery practice offering significant advances in soft tissue reconstruction. Microsurgery is now an essential and routine part of plastic surgical practice. The ability to perform microsurgery has thus become a necessity for both trainees and consultants alike. Microsurgery offers a number of uniquely challenging technical elements that can be attributed to the scale on which surgery is performed. Operating on vessels with a caliber of 1–2 mm in diameter under a stereoscopic vision offers little or no haptic feedback, limited dimensional perspective and a need for fine dexterity. These technical elements in combination with the often noisy and distracting theater environment are what makes microsurgery uniquely challenging.","title":"Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance"}
{"_id":"579eaa0d-0ef6-9daa-fb7a-46c4fa78e870","text":"The management for recurrence of ilioinguinal lymph node disease from anal adenocarcinomas specifically however is less clear cut and lacks guidance from society guidelines. Thus, it would seem that performing a groin dissection for recurrent lymph node disease could be a reasonable approach for anal adenocarcinoma, similar to how anal squamous cell carcinomas should be managed optimally. Primary physicians should also consider adjuvant chemoradiotherapy, especially if there has been no previous radiotherapy to the groin area.","title":"Recurrent ilioinguinal lymph node metastasis from primary anal adenocarcinoma: what should we do? – A case report and review of literature"}
{"_id":"57a5613e-6f3d-aaba-4e0b-d61ab65f239a","text":"Dermal fillers are an important tool in the armamentarium of an aesthetic dermatologist in the management of ageing skin. A surge in the use of fillers has been witnessed due to increasing awareness among people, easy availability of fillers and increased enthusiasm amongst the dermatologists and plastic surgeons to use this modality. In this era of evidence-based medicine and litigations against doctors, Dermatologists should be vigilant about different acts of omission and commission in the use of fillers. This article briefly discusses the dos and don'ts with respect to dermal fillers.","title":"Dermal Fillers: Do's and Dont's"}
{"_id":"57a86b16-63c9-d1ce-efa5-7757d0714ee4","text":"Possible differential diagnoses at this location are abdominal wall endometriosis and hematomas of the abdominal wall.","title":"Multimodality imaging features of desmoid tumors: a head-to-toe spectrum"}
{"_id":"57aa2e5e-6bc1-eea3-7275-bcd2fd5745db","text":"In conclusion, our results demonstrate that AT13387 is a potent new cancer drug and effective radiosensitizer in vitro with an excellent in vivo efficacy. AT13387 treatment has the potential to improve external beam therapy and radionuclide therapy outcomes and restore treatment efficacy in cancers that are resistant to initial therapeutic regimes.","title":"The novel HSP90 inhibitor AT13387 potentiates radiation effects in squamous cell carcinoma and adenocarcinoma cells"}
{"_id":"57b0e267-379a-1532-7956-ba491eafb092","text":"Correlation between age and higher tissue response to radiation up to now was unexpected. Older patients may be better candidates for brachytherapy than younger since their response to radiation is more pronounced. The correlation between dermoscopic response to radiation and the relapse rate of treated tumours requires further study.","title":"Basal Cell Carcinoma Treated with High Dose Rate (HDR) Brachytherapy—Early Evaluation of Clinical and Dermoscopic Patterns during Irradiation"}
{"_id":"57b42458-2197-5caa-b2a3-d9526bd26c14","text":"The Polish system of undergraduate and postgraduate medical education, including specialization courses in surgery, provided only general guidelines concerning the issue of creating a leader or preparing for leadership. The process of building the position of a leader has had a rather spontaneous character thus far; it has been based on the individual, natural predispositions of a candidate for the position of a leader. There are no formal guidelines for this in Poland. It is required that graduates of medical studies or residents should acquire the so-called professional and social skills before they complete their specialization training. In the light of the ongoing debate, it seems worthwhile to give a thought on the role of a leader and to undertake harmonized actions to work out a common stance on understanding the issue of leadership and teach leadership skills as a part of a harmonized, methodologically correct system of education, so that the best ways of preparing residents to perform the role of a leader in surgical and other medical surroundings could be realized.","title":"Surgical leadership in Poland: ideas and challenges"}
{"_id":"57b780d5-81f0-4da0-b955-1f9595a672f4","text":"In the past several decades, innovative research in cancer biology and immunology has contributed to novel therapeutics, such as targeted therapy and immunotherapy, which have transformed the management of patients with melanoma. Despite the remarkable therapeutic outcomes of targeted treatments targeting MAPK signaling and immunotherapy that suppresses immune checkpoints, some individuals acquire therapeutic resistance and disease recurrence. This review summarizes the current understanding of melanoma genetic variations and discusses individualized melanoma therapy options, particularly for advanced or metastatic melanoma, as well as potential drug resistance mechanisms. A deeper understanding of individualized treatment will assist in improving clinical outcomes for patients with cutaneous melanoma.","title":"Individualized Treatment Strategy for Cutaneous Melanoma: Where Are We Now and Where Are We Going?"}
{"_id":"57b9e0dd-a6e8-c99e-5495-fdf75ea0e6a0","text":"Topical imiquimod seems to be a good local treatment for Kaposi's sarcoma skin lesions with a good toxicity profile, regimens with daily application may offer best clinical results and should be explored and evaluated concerning the toxicity.","title":"Kaposi's sarcoma responding to topical imiquimod 5% cream: a case report"}
{"_id":"57bad7f5-2592-63fe-bcc6-c0b1d41d3254","text":"Patients were included if they had surgical management of chronic osteomyelitis or infected non-union of the tibia with simultaneous application of an Ilizarov ring fixator and a free muscle flap. All patients had major soft tissue defects which could not be closed directly, by local tissue transposition or by limb shortening.","title":"Simultaneous debridement, Ilizarov reconstruction and free muscle flaps in the management of complex tibial infection"}
{"_id":"57c28e1d-ed7d-9d0a-041b-782cc20cd859","text":"In order to detect the presence of tumor cells, a photosensitive marker is introduced into the particular area. Protoporphyrin IX is formed as a result of chemical reactions inside the body, which is absorbed by the healthy cells but gets accumulated in the tumour cells. When the resectoscope is introduced into the area, under blue illumination the accumulated pigment in the tumour cells emit red fluorescence and normal cells will be in blue. To provide contrast for photodynamic diagnosis (PDD) yellow-light filter is specially designed which enhances the red fluorescence. Skin lesions using photodynamic diagnosis are based on the fluorescent properties of an exogenous and endogenous compound in response to illumination. Stimulation of photosensitizers is made to produce the photodynamic effect when a certain wavelength of light is exposed to it.","title":"Skin cancer detection using non-invasive techniques"}
{"_id":"57d8ec04-acbf-dd19-dd6a-5c10a8e9a4c1","text":"In conclusion, the modified technique in this study is simple and effective in correcting severe congenital blepharoptosis. This modification not only retains the advantages of the conventional FM flap but also greatly reduces the incidence of serious complications. It makes use of clear anatomical landmarks, and the operation procedures are easily learned, both of which are especially suitable for beginners or hospitals lacking sling materials. Although the retrospective design of this study has some limitations, we believe that the modified FM flap advancement technique is worth comparing with brow suspension in future controlled trials for the treatment of severe congenital ptosis.","title":"Comparative evaluation of conventional and modified frontalis muscle flap advancement techniques in the treatment of severe congenital ptosis: A retrospective cohort study"}
{"_id":"57d8f64e-4420-7af9-463d-ce0f547b3ff7","text":"We assessed the effects of rapid review methods on meta-analyses results for a primary outcome only; we were not able to investigate rates of incorrect answers (as review conclusions do not typically depend on a single meta-analysis result but would be expected to depend on analysis from expert authors taking account of multiple beneficial and harmful outcomes and knowledge of the topic).","title":"Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study"}
{"_id":"57da17c2-e3f7-717d-1dae-e64291777f77","text":"Worldwide, a large number of studies have been reported pointing towards the increasing incidence of skin tumors and a similar trend is being seen in Nepal as evident from the multiple literature available in the matter.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"57ddc9a5-9669-4de7-ded8-e7987d060838","text":"Some past reports have described supercharging the thoracodorsal artery and superior gluteal artery after elevating the reverse latissimus dorsi flap,3 and others state that the procedure is safer if it is performed after a delay.4 We were also prepared to supercharge the thoracodorsal artery to the inferior epigastric artery or another artery during surgery if circulation was unstable, but bleeding from part of the humerus terminal area, which is the most distal portion of the latissimus dorsi muscle, was observed. We therefore considered that supercharging or other additional circulation to the reverse latissimus dorsi flap was not necessary even if the perforating branch of the ninth intercostal artery was transected. Watanabe et al5 reported a useful study that provides support for these results. In a 3-dimensional anatomic study using angiography, they observed 3 vascular territories anatomically in the latissimus dorsi and reported that the perforating branch of the 10th intercostal artery was directly connected to all 3 territories via choke vessels. We therefore concluded that it is possible to supply nutrients to the entire latissimus dorsi if only the perforating branch of the 10th intercostal artery is included as a nutrient vessel.","title":"Case Report Reconstruction of Exposed Ilium With Reverse Turnover Latissimus Dorsi Muscle Flap"}
{"_id":"57e04395-4b63-9491-1e12-c7df7eeb127c","text":"The present report is about a patient who showed allergic reactions to various insulin formulations, but showed only a weak allergic reaction to insulin glulisine, so the symptoms of insulin allergy ceased when treatment was switched to insulin glulisine.","title":"A case of type 1 diabetes mellitus with which localized insulin allergy was markedly alleviated by switching to insulin glulisine"}
{"_id":"57f8d438-6774-e6ad-43d8-58cb8b980d23","text":"The authors thank the patient and his family for permission to publish this case report.","title":"Clinical application of next-generation sequencing for the management of desmoid tumors A case report and literature review"}
{"_id":"580ffb4d-22e8-7190-b634-700813a69508","text":"All eligible participants will be informed about the study purpose and must consent to participate. Participants will answer questions regarding their socio-demographics and use of medication and will answer questionnaires about their health-related quality of life. Participants are allowed to be in a stable treatment phase with systemic drugs prescribed for dermatological disease.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"58112a03-e0d6-3dc1-4a41-c83baf941203","text":"In our present study, we aimed to develop and assess a novel MSI algorithm for melanoma Breslow tumor thickness prediction, and thus the determination of optimal safety margins of melanoma surgeries. Then we compared the algorithm to the performance of clinical assessment by dermatologists and dermatology residents.","title":"Multispectral Imaging Algorithm Predicts Breslow Thickness of Melanoma"}
{"_id":"58134fdd-ebd7-83e4-3307-eadc0f6e2f91","text":"The use of microvascular free flaps is a reliable and efficient method for head and neck reconstruction offering advantages such as the ability to repair complex structures and a high overall success rate of over 95% for all flaps in general. However, flap failures may still occur and have devastating consequences for the patient, such as the need for additional surgical procedures and potentially permanent disfigurement and functional impairment.","title":"Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study"}
{"_id":"581526fb-bcd4-ee49-968d-0df3596f1b35","text":"Treatment is ideally based on wide surgical which consists of carcinological removal of the tumor with sufficient safety margins followed by parietal reconstruction using prosthetic reinforcement if necessary. The combination of radiotherapy and hormonal therapy is a good alternative that provides objective answers in inoperable desmoid tumors and reduces the recurrence rate.","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"5817a104-cace-596f-1f8a-1f3ae0c7370d","text":"In the beginning, we designed those skin islands on multiple perforators, but such large skin islands are often hard to fix to the underlying surface and can be compromised by shearing off due to their own weight. Therefore, a smaller island with one singled out perforator is often more feasible, especially since the option to use such a perforator island as another flap to close secondary defects is undesirable in this constellation due to the bulk of the subcutaneous fat.","title":"Microsurgical Reconstruction of Extensive Oncological Scalp Defects"}
{"_id":"58206c8f-36d9-9407-bc37-33cf5513d293","text":"External fixation as an alternative with satisfactory short and long-term outcomes is commonly practiced in military medicine in reconstruction of the severe open ankle and foot fractures in combat zone. This technique is superior to the conventional civilian approach regarding its applicability in face of poor recourses and less surgical insult to the severely damaged soft tissues. However, some reports suggest persistent morbidity despite proper and in time use of external fixation in midfoot crush injuries. In another approach, successful use of saphenous cross-leg flap with modified Masquelet technique in reconstruction of extensive medioplantar defect was reported. Following saphenous cross-leg flap, corticocancellous iliac bone graft was used to reconstruct the medial cuneiform deformities.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"58323ed5-2067-f215-93c5-17f061011fb6","text":"Obstacles are defined as issues that required further surgery but were resolved before the frame was removed. Two patients required a second corticotomy and one patient required overdrilling to treat a pin site infection. One patient required reapplication of a ring to treat symptomatic wire site.","title":"Transverse debridement and acute shortening followed by distraction histogenesis in the treatment of open tibial fractures with bone and soft tissue loss"}
{"_id":"5836d573-5173-6606-66b5-5cad2b6f87d5","text":"AS was revealed as an effective treatment modality. The transition to AT needs to be considered for neck location and CTNNB1 S45F mutation DF. Good results can be obtained by selecting a treatment method that considers the tumor location even in cases that require intervention.","title":"Clinical results of active surveillance for extra‐abdominal desmoid‐type fibromatosis"}
{"_id":"58388175-4107-6de1-ffb9-c9aa0ca69ec2","text":"We used dot plots together with quartiles to show the differences in the distribution of DCCD values among the groups defined by the other variables.","title":"Quantitative Measurement of Melanoma Spread in Sentinel Lymph Nodes and Survival"}
{"_id":"583a7957-d2c5-c2b4-d0a7-b9cc600f4057","text":"Patient expressed a written informed consent to accept the publication of this paper.","title":"Successful laparoscopic trans-peritoneal repair of an incisional inguinal hernia, resulting from deep lymph node dissection for melanoma: A case report"}
{"_id":"583da836-58a8-f036-5efc-a29c883f981f","text":"Hence a prospective questionnaire based study was designed to evaluate the opinion of participating neurosurgeons with wide experience on operative treatment of single level cervical disc herniation to decipher their decision making criteria on their preferred operative procedure.","title":"Single level cervical disc herniation: A questionnaire based study on current surgical practices"}
{"_id":"583ebefe-2e33-49c2-9c45-bee01c13c6a1","text":"In the cases of infection, from the time of diagnosis the patients were treated according to the protocol for arthroplasty infection at our institution, which involves antibiotic therapy associated with surgical cleaning and debridement and optional removal of the implant. After the usual treatment, a NPWT device was placed on the wound as an additional measure.","title":"NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY TERAPIA COM PRESSÃO NEGATIVA EM FERIDAS NO TRATAMENTO DE LESÕES GRAVES APÓS ARTROPLASTIA TOTAL DO JOELHO"}
{"_id":"5840e32b-7651-2fbe-bd04-e7137c9e0d04","text":"Photodynamic therapy (PDT) has proven to be a promising alternative to current cancer treatments, especially if combined with conventional approaches. The technique is based on the administration of a non-toxic photosensitizing agent to the patient with subsequent localized exposure to a light source of a specific wavelength, resulting in a cytotoxic response to oxidative damage. The present study intended to evaluate in vitro the type of induced death and the genotoxic and mutagenic effects of PDT alone and associated with cisplatin.","title":"Photodynamic therapy combined to cisplatin potentiates cell death responses of cervical cancer cells"}
{"_id":"5846b466-079a-5918-5085-6eff94831c4e","text":"In this study, the majority of patients classified as probably food-allergic were not referred for further testing for an objective diagnosis of food allergy. It should be noted that there is good availability of specialist allergy care for pediatric patients in the area where this study was conducted. Infrequent or no referrals of patients to a specialist with specific expertise on allergology after an allergic reaction is in agreement with the findings in previous studies [4, 5]. One might speculate that GPs do not recognize allergic reactions or underestimate their severity, and therefore do not refer patients for further diagnosis. Implementing clear referral criteria could be beneficial to assist GPs to refer patients to a specialist with specific expertise on allergology when this is needed. In the Northern part of The Netherlands our centre and other hospitals can be reached easily by car or public transportation. All patients in The Netherlands have health insurance and all costs are covered. In our centre we have a waiting list for food challenges. However, all patients are seen within 2 weeks at the out-patient clinic. When necessary they are prescribed an EAI.","title":"Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands"}
{"_id":"584a3893-cf49-fb1a-9bc8-1e3a383b6548","text":"Pseudoallergic hypersensitivity reactions may be of relevance for chronic spontaneous urticaria with persistent symptoms. Patients can present urticarial episodes during treatments with molecules chemicaly not related. Usualy symptoms are non-reproducibles during provocation tests. We describe a case series of children with CIU and several exacerbations related to exposure to different foods and medication that had low DAO activity, high histamine plasma levels and improved after avoidance measures.","title":"PD31 - Pseudoallergic reactions to food and drugs in children with chronic idiopathic urticaria"}
{"_id":"584ecce8-03fa-d4dc-f089-f85d141ba524","text":"DTs often cause significant functional limitations, pain, and even major disabilities. It affects young patients, so their quality of life during a productive and active age is severely affected, despite the fact that DTs do not cause distant metastasis. Early referral to a sarcoma center or sarcoma specialist should be encouraged. The unpredictable course, the low incidence of the disease and the lack of knowledge about it have been limiting factors toward a more rapid advancement of the management of this complex pathology. The integration of molecular biology with the clinical and therapeutic aspects will allow us to see each case as an individual entity, as part of a spectrum of manifestations of the disease and not as one heterogeneous group encumbered by such diverse results.","title":"Desmoid-Type Fibromatosis"}
{"_id":"5858781d-8837-1d4e-784a-158a82e642f5","text":"The dissection of the lateral pelvic sidewall lymph nodes commenced with the dissection of the internal iliac vessels from the medial structures. The branches of the internal iliac vessels were identified, ligated and divided as close to their origin as possible. For the cases that the tumour was close to the iliac artery, the lateral pelvic sidewall lymphadenectomy was performed en bloc with the resected specimen including the unilateral internal iliac artery and preservation of the superior vesical artery and the obturator nerve, if possible.","title":"Extended lymphadenectomy for locally advanced and recurrent rectal cancer"}
{"_id":"585d74b1-2a59-c990-1121-05da0d47e83d","text":"The working status of the mother impacted on the household financial situation, which in turn impacted on access to food and beverages for the breastfeeding mother and how much work (paid and unpaid (housework) the mother had to undertake. Wealthier households were able to afford housemaids to assist with childcare and housework and\/or were able to stay home from paid work for longer periods of time. Women who had to return to work often left their infant in the care of housemaids, grandmothers or neighbors. Expressing breastmilk is not a common practice and consequently the infant was often fed liquids and foods other than breastmilk. One of the significant barriers identified by participants was the lack of paid maternity leave. Mothers working in government offices only receive 3 months maternity leave, making EBF for 6 months difficult.","title":"Exploring the challenges and opportunities towards optimal breastfeeding in Ethiopia: a formative qualitative study"}
{"_id":"585d8038-b39b-b352-9376-936ec27bca68","text":"It can be noted that a generalist profile is very common among physicians in small towns, while in big cities there is greater demand for specialized professionals.","title":"Plastic surgery professional misconduct: a cross-sectional study on cases between 2008 and 2017, filed before the São Paulo State Medical Board"}
{"_id":"585eadf1-d590-deb6-3676-caddc9e892aa","text":"• Mortality at 30 days is independently associated with the transfusion of RBCs of 28 or more days of storage in this study population.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"586435ec-9094-4556-daa5-0c51737f3a45","text":"Prophylaxis consists of mechanical and pharmacological measures which has been most effective for venous thromboembolism as demonstrated in several previous studies. Mechanical prophylaxis (compression stocking or sequential compression devices) after spine surgery is considered both effective and safe but chemoprophylaxis with anticoagulation therapy is not accepted to be safe as early anticoagulation chemoprophylaxis has the potential risk for bleeding complications, specifically, acute post-operative formation of epidural haematomas which has significant neurological sequalae. Timing for starting chemoprophylaxis postoperatively is also controversial as there is no conclusive evidence that exists in the literature to guide management for such patients. In our study, all the patients who underwent spinal surgeries were given mechanical prophylaxis to mitigate the risk of epidural haematoma associated with use of pharmacological prophylaxis.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"5866f13e-a5cd-46b3-5cee-c0d954807188","text":"The aim of this study was to assess the cost of treatment for patients undergoing osteomyelitis excision with free flap reconstruction and compare it to the renumeration. The tariffs are complex and variable and the focus of this article is to explain them in full. The tariffs vary within the group, but for example a very common tariff applied in this series is £3650 and the expected hospital stay is 42 days. If the hospital stay exceeds this, an additional daily rate is added to the tariff.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"5867ad74-f597-7df5-5cdd-e6e5f29d0295","text":"Table 1 Online Resources for Families and Patients in Need of Further Information about Peanut Allergy","title":"Peanut Allergy: An Overview"}
{"_id":"58693db9-f2b8-3961-9e3f-2c54d1d2996b","text":"In the clinical suspicion of a pathology affecting the acromioclavicular joint, the execution of a radiographic examination associated with the echotomographic examination represents the first steps of the diagnostic procedure.","title":"Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint A case report"}
{"_id":"586b4d06-bbfe-b379-e383-23261f675850","text":"Primary tumour resection was done with the lateral border over buccal mucosa, 1 cm above the right lower gingivo buccal sulcus, medially along the symphysis, the floor of the mouth on the right lateral aspect of lingual frenum while including the lateral border of the tongue and tongue muscles at the junction of anterior one third and posterior two-thirds of the tongue.","title":"Oral malignant melanoma of the lower jaw—a case report with immunohistochemical investigations"}
{"_id":"586f03b9-f27c-f560-c92b-0078cda3bf89","text":"Despite this very elementary approach of IORT, a large number of physical preparations and quality assurance measures are needed and must be adjusted to the workflow of each individual IORT facility. The majority of these physics issues has been discussed in three reports and guidelines by the America Association of Physicists in Medicine (AAPM) [1, 2] and the Italian Istituto Superiore di Sanità [3], and shall only briefly be enumerated here. The following article reviews publications on the assessment of physical parameters needed to assure treatment quality. A special focus is placed on the uncertainties in these parameters. The review intends to identify issues that presently remain to be solved and to address pathways to their solution, in part also pathways that have not yet been treated in literature. A number of different technologies are used for IORT delivery which are often developed and marketed by a single manufacturer. In the review, the different devices therefore are often identified by their brand names in order to characterize the underlying technology. This naming intends no preference or endorsement for any particular commercial brand and does not imply that a named brand is necessarily superior for the described application.","title":"Present state and issues in IORT Physics"}
{"_id":"5875bfc0-6183-c245-5d28-a37ca178e19c","text":"As a result of the deficiencies of FNAC, lymph node excision is required and is the recommended second line diagnostic procedure. In addition to providing a greater volume of tissue for histological evaluation subtype classification, it also provides a baseline against which the effects of chemotherapy may be judged.","title":"Does the surgeon still have a role to play in the diagnosis and management of lymphomas?"}
{"_id":"587ea6ef-f744-1305-9fb9-b3643314819a","text":"Placement of the sternal support across the lower anterior chest appears to provide optimal support for the sternum and may reduce late depression of the upper chest.12 In three patients with PE, we noted that placing the bar posterior to the costal cartilages or perichondrial sheaths before attaching it to the appropriate rib on each side elevated the anterolateral chest as well as the sternum to provide optimal cosmetic as well as physiological reconstruction. This technique is used for patients with a higher level of pectus index, who would have developed flail chest with respiratory stress after the postoperative period. It prevents paradoxical respiration, reduces pain, permits early movement, permits deeper inhalation, reduces hospitalisation time and cost, and provides very good long-term results.13","title":"Clinical experience of repair of pectus excavatum and carinatum deformities"}
{"_id":"58823d7e-1130-2b73-5a5f-d32f746d8348","text":"These appearances were highly suggestive of a fistula from the prostate into the pubic symphysis giving rise to osteomyelitis and osteonecrosis. A closer review of imaging showed the fistulous tract extended into the base of the penis with areas of enhancement within the region of the perineal body seen in T 2 weight sagittal sequence (Figure 3).","title":"Imaging findings of urosymphyseal fistulas Patel et al"}
{"_id":"5882fa36-29b3-d60b-b8a1-197fcbe56890","text":"One veterinary practitioner; sonographer 2, had 20 years of clinical experience and felt moderately experienced in ultrasound and mildly experienced in equine joint ultrasound. Sonographer 2 reported that the technique was relatively easy to perform and spent 40 min and 22 s on the first examination without stifle flexion, and 38 min and 58 s on the second examination with stifle flexion.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"5885b28f-6cb8-e45f-99cd-3edad6231ea0","text":"A significant decrease in the tumor volume was reported, eight days after treatment of the mice irradiated using ultrasound in the presence of GNPs compared to those in the control group. The same results were reported for the above mentioned treated group and the groups that received GNPs or ultrasound alone, which confirms the effect of nucleating cavitation in the presence of GNPs (47).","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"58892d2f-9ef9-47aa-de24-3a11f664d732","text":"Abdominal wall defects caused by trauma or surgery are a common surgical problem to solve. Reconstruction of complicated abdominal dehiscence is a challenging condition for both general and plastic surgeons and several techniques have been described.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"5893652c-a848-8881-a979-5810d9540e9a","text":"No Institutional Review Board approval needed for review at our institution.","title":"Rhomboid flap: Indications, applications, techniques and results. A comprehensive review"}
{"_id":"5899f5ab-47f7-a346-8d01-fe1f4c7753a2","text":"We determined to assess the nodal harvest from the axilla in these various contexts, within a single centre, with the same surgeons and pathologists all working in accordance with the same standardised protocols. Our hypothesis was that dALND might yield a lower number of lymph nodes due to increased technical difficulty and scarring compared to iALND.","title":"The Axillary Nodal Harvest in Breast Cancer Surgery Is Unchanged by Sentinel Node Biopsy or the Timing of Surgery"}
{"_id":"589e8562-af0c-42b4-d26a-8353996ca3ff","text":"Thus a combination of the color Doppler and duplex scanning may be used. But studies have shown that the clinical examination has a high specificity almost equal to that of the Duplex scanning and can reduce the load on vascular labs [10].","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"58a07859-95ff-e9c8-1268-9127835c0773","text":"As the use of the radial artery for diagnostic and therapeutic procedures continues to expand it is behest on the reconstructive surgeon to consider this potentially silent disease in planning head and neck reconstruction. To this end, we reiterate the importance of performing a detailed assessment of both ulnar and radial artery blood flow prior to RFFF harvest by performing the Allen’s test in both directions, as already described. When the ‘reverse’ Allen’s test demonstrates a complete lack of re-perfusion of the hand and digits then a lack of flow through the radial artery should be assumed. This is in contradistinction to the situation where there is reperfusion to the thumb and index finger, which is due to an incomplete arch with lack of communication with the ulnar system. In the latter situation a hand-held Doppler can be used to trace the flow in the radial artery in order to determine candidacy for a RFFF and when flow is present proximally it can aid in designing the flap more proximally over an area of skin that will be perfused by the radial artery. Alternatively, another donor site may be chosen, particularly if the injury to the radial artery extends proximally.","title":"The Allen’s test: revisiting the importance of bidirectional testing to determine candidacy and design of radial forearm free flap harvest in the era of trans radial endovascular access procedures"}
{"_id":"58a49eca-d8c4-a737-b560-6b61725eaf8d","text":"The sonography probe sends ultrasound waves and records the intensity of the pulse echo and reconstructs the 2D image. In reconstructing image procedure, the mentioned natural frequency from different parts of the skin tissue is mapped on the corresponding part of image and leads to the different echoes in the image. So by analyzing the frequency patterns of ultrasound image, a new golden biomarker to classify the different skin will be obtained. At last with extracting the special frequency features from both type of skin lesions (benign and malignant), these lesions can be classified with high precision.","title":"Early diagnosis of skin cancer by ultrasound frequency analysis"}
{"_id":"58acb70f-b059-186f-f8e3-0a60d56c55b9","text":"The majority of current and recent fellows and program directors support transitioning to a uniform application service and a uniform application deadline, as shown in Table 2.","title":"Improving Knowledge and Process for International Emergency Medicine Fellowship Applicants: A Call for a Uniform Application"}
{"_id":"58b082ab-4c1c-7994-efc6-341f26ebe0d1","text":"The patient was diagnosed with a large complex cutaneous tumor invading the calcaneus, and he was planned for surgical radial excision of the tumor and heel reconstruction surgery.","title":"Squamous Cell Carcinoma of the Heel Invading the Calcaneus Treated by Radical Excision and Reverse Sural Flap"}
{"_id":"58b08813-fd94-22d4-35e7-ba23c6dcce76","text":"In conclusion, the MR-angiographic assessment of the suitability of the saphenous vein as a bypass conduit corresponded with the sonographic evaluation in all of the patients who underwent peripheral MRA and subsequent bypass surgery. With BPCA-MRA, a reliable assessment of the venous diameter of the GSV is possible and shows no significant differences in comparison to DUS as the standard of reference. Consequently, in patients with PAOD who in the preoperative workup undergo peripheral MRA to evaluate the arterial status, the inherent MR-angiographic imaging of autogenous saphenous veins can offer additional information regarding the suitability of the veins as a bypass conduit without the need of an additive ultrasound examination.","title":"Mapping of Autogenous Saphenous Veins as an Imaging Adjunct to Peripheral MR Angiography in Patients with Peripheral Arterial Occlusive Disease and Peripheral Bypass Grafting: Prospective Comparison with Ultrasound and Intraoperative Findings"}
{"_id":"58b74653-f9e5-999e-fe97-a755f336c555","text":"There is a significant body of literature describing the syndrome and the excellent outcomes following OVE however the lack of prospective, multicentre randomized controlled trials for both investigation and management of PVCS is a significant barrier to the complete acceptance of both the existence, investigation and management of the condition.","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"58bb3433-ed48-8a4f-df8a-697b60672405","text":"Because of a perceived need to educate our residents in the business of medicine, we established a new lecture series for our chief residents as part of a comprehensive business leadership course. Its inception and evolution are the subject of this report.","title":"Evolution of a Novel Business Leadership Course for General Surgery Chief Residents"}
{"_id":"58bd37d3-7002-cf63-aa9d-fd31b4f1328e","text":"Our case highlights the importance of recognizing ovarian vein thrombosis because of the risk of fatal complications such as pulmonary embolus. The presence of large fibroids should raise our awareness for OVT in the setting of abdominal pain and fever. The absence of complications in previous pregnancies should not alter our clinical suspicion.","title":"Ovarian Vein Thrombosis Complicated by Pulmonary Embolism after Cesarean Delivery in the Presence of a Large Fibroid: Case Report and Literature Review of Contributing Factors"}
{"_id":"58c7a427-2c89-afee-4945-f0625f14b519","text":"The studies involving human participants were reviewed and approved by Institutional Review Board of Peking Union Medical College Hospital. Written informed consent for participation was not provided by the participants' legal guardians\/next of kin because this study was based on the Vaccine Adverse Event Reporting System (VAERS) database which publicly available and no potentially identifiable human image or data in the database.","title":"Allergic Reactions After the Administration of COVID-19 Vaccines"}
{"_id":"58cc83ca-9a1e-a9ad-5f20-9fdac95be3ae","text":"The case presented here demonstrates that both iNPH and cervical myelopathy may present simultaneously and result in gait disturbances and imbalance in some patients. For patients with suspected iNPH and myelopathic findings on examination, it is prudent to obtain a cervical spine MRI to assess for cervical stenosis. Moreover, cervical stenosis can mask the effect of cerebrospinal fluid diversion in patients with comorbid iNPH and cervical myelopathy. Therefore, the differential for patients who have symptomology suggestive of iNPH should include cervical spine myelopathy, with considerations for possible cervical decompression in addition to placement of a ventriculoperitoneal shunt.","title":"Clinical Reasoning: A 75-Year-Old Man With Dementia, Incontinence, and Gait Dysfunction"}
{"_id":"58d6be90-b8ee-664c-d8fb-ff20fc754cd6","text":"The aim of this review is to describe the potential clinical applications of this emerging technology in the context of cell and tissue repair, and the status of clinical trials using ultrasound for regenerative medicine.","title":"Ultrasound Therapy: Experiences and Perspectives for Regenerative Medicine"}
{"_id":"58e5c764-8842-88f1-3c8e-823fad0a1ad8","text":"The excellent aesthetic outcome was found in all cases of primary closure, single and double rotation flap. The requirement of milling of exposed bone or removal of necrotic bone was compared in post-electric contact burn and other patients as shown in Table 3.","title":"Reconstruction of Scalp and Forehead Defects: Options and Strategies"}
{"_id":"58ead1ed-c55e-a5ab-85d6-7bcaef8bafbd","text":"The limitations of this study are the small sample size and short follow-up of patients in a single center. There are no results and data on the quality of life of patients before breast reconstruction, so the comparison with quality of life after surgery is impossible. There is insufficient information in the study on the reported complications of a particular operation as one of the important factors to consider when deciding on an appropriate method of breast reconstruction. There are insufficient data on preoperative chemotherapy and radiation therapy in patients who have undergone breast reconstruction.","title":"Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients"}
{"_id":"58ec019c-fee1-a2ea-07e7-56f1d6d33a70","text":"The purpose of our paper is to add to the body of knowledge regarding the use of surface brachytherapy for the treatment of skin malignancies. We report on our institution’s experience with using 192Ir-based HDR surface mould brachytherapy for the treatment of skin malignancies.","title":"Surface Mould Brachytherapy for Skin Cancers: The British Columbia Cancer Experience"}
{"_id":"58f1791c-da6e-a347-ddd6-e92b1f34947e","text":"A 49 year old female patient presented a progressive lymphedema at the right leg refractory to conservative measures. In the medical history 4 years ago a laparoscopic hysterectomy and adnexectomy as well as a radical pelvic lymphadenectomy on the right side were performed because of a uterine cervical carcinoma. Despite conservative treatment the lymphedema exacerbated resulting in functional impairment and loss of quality of life. After inconspicuous follow up care and lymphoscintigraphy scan a microsurgically transplanted omentum majus flap containing lymph nodes and lymph vessles was planned. Using a laparoscopic approach the omentum majus flap was raised including the right gastroepiploic artery and vein. The flap was then anastomosed to the right femoral artery and vein. Figure 2 shows the ICG measurement after anastomosis. The well-perfused vessel arcades via the right gastroepiploic artery could be defined, whereas ICG angiography revealed the mal-perfused parts of the omentum majus which could not be determined by clinical signs. Especially in free flaps where no skin is included and peripheral bleeding on the wound edges is not common as well as residual perfusion is not sufficient for tissue survival, conventional clinical judgement by means of capillary refill or color change is not a reliable option. Discarding of too much or too less tissue is the possible consequence in these cases. Finally after discarding mal-perfused tissue parts the omentum majus was placed and spread out in the subcutaneous tissue to enable lymph vessels to grow in and establish a new lymph collector for the right lower extremity.","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"58fb4765-ced8-5a94-4414-3d14996b1879","text":"Doppler ultrasound of the left lower limb shows Knee strain and left femoral vein thrombosis.","title":"Acute osteomyelitis, thrombophlebitis, and pulmonary embolism: a case report"}
{"_id":"58fc6cc8-2331-59a2-3022-02a82bbc687c","text":"Objectives: To report the efficacy and safety of biological treatment in a cohort of patients with JIA under biological treatment in a single paediatric rheumatologic centre, in a prospective observational study.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"58fe260a-a31c-fe2f-3659-f29381f92189","text":"Costs and benefits of an effective approach to preventing DVT following stroke will accrue over time. An important element of the economic analysis will be a focus on longer run outcomes using a decision-analytic model that builds on the within trial findings. The key parameters for the patient level simulation model will include expected survival, quality of life, long term complications, such as post-thrombotic syndrome, and use of health services over a 6 month to 5 year time horizon. The model will be calibrated using distributions from reported systematic reviews of survival and health-related quality of life following stroke and the long term prognosis and cost burden of DVT in the community. Monte Carlo probabilistic sensitivity analysis will be used to account for uncertainty in the cost effectiveness results based on the simulation model.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"59000faf-c650-0ab3-3b21-8213b041c424","text":"We herein report a case of isolated venous occlusion from fat embolism. The patient developed acute painful proptosis and blurred vision of her right eye while undergoing an esthetic autologous fat injection into her forehead. Based on her clinical manifestations and radiologic findings, the patient was diagnosed with superior ophthalmic vein occlusion. Symptomatic and supportive treatments were given. Spontaneous clinical improvement occurred without secondary complications. Therefore, the initially planned endovascular therapy with transfemoral transvenous embolectomy of the right superior ophthalmic vein was canceled.","title":"Superior Ophthalmic Vein Embolism Following Forehead Augmentation with Autologous Fat Injection"}
{"_id":"59019ba5-ca37-7ea2-0a51-e096d912c5bc","text":"Then the lateral and inferior aspects of the cartilage were left, and the perichondrium was saturated on the gap left by the graft. Layered suture of muscles and cutaneous layers followed.","title":"Minimally Invasive Harvesting Technique for Costal Cartilage Graft: Donor Site, Morbidity and Aesthetic Outcomes"}
{"_id":"59031c01-fd95-ea39-9538-1738b565de6c","text":"The emphasis on surgery as a calling is an important aspect of the survey responses in this study. Although the concept of a career calling cannot be implanted into an individual, i.e., an individual either does or does not have a calling, enthusiasm and dedication from a role model can be contagious and may help undecided students appreciate and weigh the positive aspects of surgery. However, it is also important that interested students see that their concerns regarding training are seen and shared by surgeons, particularly by surgeons who are most involved in training. This acknowledgement of concerns may spark optimism that reflections regarding training issues may produce changes. Another important conclusion of this study is that it is important for surgeons to not underestimate or belittle the most often and most consistent concerns for not pursuing a career in surgery, including the extensive workload and the perceived incompatibility of surgery with having a family. A lack of desire to work in conditions of constant exhaustion and an interest in striving for both a fulfilled work life and family life is not indicative of a lack of dedication; instead, these traits protect against burnout, depression, and health problems. Today’s graduates may not be willing to accept the extensive workload and work-family imbalance as unchangeable components of a surgical career.","title":"The Surgeon’s Perspective: Promoting and Discouraging Factors for Choosing a Career in Surgery as Perceived by Surgeons"}
{"_id":"590332b9-7030-a399-1b82-de7a5276185f","text":"As a component of the key factors responsible for the aesthetic success of implant therapy, the prosthetic aspect is equally as important as the surgical aspect. The surgical aspect should provide a reliable hard tissue foundation for the creation of a harmonious soft tissue profile, which is completed and perfected by a well-planned and carried out prosthetic phase. It Commences with the functional loading of the implant, with an appropriately designed abutment and temporary restoration in a provisional phase of treatment, which is responsible for the soft tissue modeling, followed by the placement of the permanent restoration once the desired soft tissue form has been obtained, which effectively maintains the results achieved through long-term stabilization of the tissues. The fundamental concepts that will be discussed in this paper are the timing of the loading of the implant, the principles and techniques used for tissue modeling, and the management of the periorestorative components interface to achieve stabilization of adequate and predictable aesthetics.","title":"Soft and Hard Tissue Management in Implant Therapy—Part II: Prosthetic Concepts"}
{"_id":"590478c3-139b-109f-8d45-80324273b317","text":"P52 Diagnosis of hypersensitivity reactions to paracetamol in a large series of cases","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"59073504-d847-4257-9cb7-94cae13af3f8","text":"The present study showed that a single preoperative ultrasound-guided TPVB resulted in lower intraoperative sufentanil consumption and shorter awakening time and extubation time than the control group without nerve block, suggesting that general anesthesia combined with a single TPVB during thoracoscopic pulmonary lobectomy could provide effective intraoperative analgesia and good anesthetic awakening. The possible reasons were speculated as, TPVB is a nerve block technique in which local anesthetic is injected directly into the thoracic paravertebral space to block the thoracic spinal nerve and the branches as well as the sympathetic trunk, and the local anesthetic could spread cranially and caudally through the loose connective tissue of the thoracic paravertebral space [15], as well as laterally to the intercostal and epidural spaces [16], so it could provide analgesia comparable to that of the thoracic segmental epidural block.","title":"Ultrasound-guided single thoracic paravertebral nerve block and erector spinae plane block for perioperative analgesia in thoracoscopic pulmonary lobectomy: a randomized controlled trial"}
{"_id":"590b8ea7-8abb-c247-259a-f56f96009718","text":"TAXIS is designed to determine whether ALND may be no longer necessary for confirmed nodal disease at first diagnosis of breast cancer given the prevalence of extended regional nodal irradiation in clinically node-positive patients in the adjuvant setting or incomplete response of nodal disease in the neoadjuvant setting. In many patients undergoing ALND, the number of negative lymph nodes removed exceeds the number of tumor-affected nodes. Removing multiple unaffected lymph nodes increases morbidity with no therapeutic benefit. It is a consequence of the commitment of radical surgery to the principle of complete tissue removal within the anatomical borders of the axilla. Benefits and harms of this approach must be re-assessed. TAXIS investigates tailored axillary surgery (TAS), a tailored approach focusing on the removal of tumor-affected lymph nodes while limiting the extent of surgery to minimize the number of negative nodes removed. TAS may offer non-inferior oncological outcomes with less morbidity than ALND in patients with clinically positive nodes at first presentation and confirmed nodal disease at surgery with or without neoadjuvant therapy.","title":"Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial"}
{"_id":"590dc6f6-b7ee-48e6-46e6-cf6544cc9ba9","text":"Identifying bone and joint lesions in a sarcoidosis patient and implementing appropriate treatment is important because of possible complications such as pathological fractures of the bones and vertebral bodies. Imaging methods are used for follow-up during treatment.","title":"Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis"}
{"_id":"59127df0-9828-201d-0e91-04af206b07f7","text":"The use of surgical resection in combination with brachytherapy was demonstrated as a modality for treatment of refractory keloid scars that can be recommended to surgeons who deal with these patients.","title":"Outcomes of Surgical Excision and Brachytherapy in Intractable Keloids"}
{"_id":"5912f675-3b46-eea7-0857-5d321ab44cd9","text":"Dissection is deepened to expose the external oblique fascia and superficial inguinal ring. Local anesthesia is required at this point prior to opening the canal. Care is required to identify and avoid injury to the ilio-inguinal and ilio-hypogastric nerves. Their course usually runs deep to the external oblique, superior to the deep ring and superficial to the cord structures. Infiltration of the internal oblique muscle superior to the canal can provide anesthesia for the internal oblique and peritoneum used later in the reconstruction. If the nerves are traumatized at any point, we do not hesitate to resect the damaged segments to avoid neuropathy postoperatively. The resultant numbness after nerve resection is not usually of any clinical significance.","title":"The Shouldice technique for the treatment of inguinal hernia"}
{"_id":"592825e6-267e-3bcb-49d4-6bb267f24dc9","text":"Limitations of this study are acknowledged as the study was conducted on an animal model with the limited time frame for removal of the implants for purposes of the study which may not directly translate to the human model.","title":"Expression of NF-κB-p65 and α-SMA in the Study of Capsules formed by Surface Textured Implants Versus Foam Covered Silicone Implants in a Rat Model"}
{"_id":"5929f7c2-1b57-7c08-56c3-6c4449b6742c","text":"The primary outcome of interest was the incidence of surgical site infection after the administration of antibiotic prophylaxis within different timing intervals from the first incision in non-clean and implant surgical procedures.","title":"Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection A systematic review and meta-analysis"}
{"_id":"592d6939-f723-edb9-5cdf-3e360603ab66","text":"The relative proportions of those planning on undertaking a fellowship and those believing one to be necessary for attaining clinical competence is interesting to note and varies between specialties. Explanations for this disparity may relate to both the need to differentiate prior to consultant job applications and the relative difficulty in obtaining a consultant post. A period of additional training may be desirable in competitive jobs markets like neurosurgery and trauma and orthopedics, which have the highest overall levels of trainees intending to undertake a fellowship. Pediatric surgery on the other hand, a small specialty where training takes place in closely supervised regional centers, has the lowest overall levels of respondents intending to undertake a fellowship, potentially because of more closely aligned training needs and workforce requirements. The variation demonstrated illustrates that future approaches to quality assurance and administration of fellowships will need to reflect the needs of individual specialties rather than across surgery as a whole.","title":"Clinical Fellowships in Surgical Training: Analysis of a National Pan-specialty Workforce Survey"}
{"_id":"59306563-cfc0-222a-e516-a4a7b252221f","text":"Table 3 Patient outcomes and comparison between patients with and without VTE","title":"Point of care ultrasound screening for deep vein thrombosis in critically ill COVID-19 patients, an observational study"}
{"_id":"593853f6-0e62-4b76-8d93-891664845972","text":"TIC is highly specific with an acceptable overall sensitivity. The sensitivity increased under the period of the study and it was higher in cases with larger size of the primary tumor. There was no difference in TIC sensitivity between the different histological subtypes.","title":"Evaluation of intraoperative touch imprint cytology on axillary sentinel lymph nodes in invasive breast carcinomas, a retrospective study of 1227 patients comparing sensitivity in the different tumor subtypes"}
{"_id":"593fd878-364f-c59c-122b-89a7be3fe7a8","text":"Central cord syndrome (CCS) is a clinical syndrome of motor weakness and sensory changes that presents disproportionately greater in the upper extremities as compared to the lower extremities.1–3 While CCS is most often associated with traumatic events, there also have been a few documented cases being caused by other types of lesions such as demyelination or abscesses resulting from osteomyelitis.4 Cases of cervical osteomyelitis and the associated CCS are rare. We present a unique case of subacute CCS in a 56-year-old male with cervical vertebral osteomyelitis and discitis who recovered from his symptoms with conservative management and without any recommended surgical intervention.","title":"Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report"}
{"_id":"59418150-b2e0-eb7a-44fc-d3ac5aab98fb","text":"Having found that several aspects of facial contrast decrease with age in all groups of faces we aimed to determine whether facial contrast influences the perception of age independently of the ethnic origin of the face and the cultural origin of the observer. We tested 4 ethnic origins of faces (the same origins as in study 1) and 2 cultural origins of participants (French Caucasian and Chinese Asian). We manipulated the aspects of facial contrast that decreased with age across ethnicities, to test whether they are causally related to age perception. We considered any of the contrast which has the same change with age in at least 3 groups of faces in order to look at what was consistent in most of the groups, namely the luminance contrast around the eyes and eyebrows, the a* contrast around the eyes and mouth, and the b* contrast around the eyes. These five aspects of facial contrast were either increased or decreased to create 2 versions of each face, a high and a low contrast version. Then we used a forced-choice test design in which the two versions of each face were compared side by side by the participants.","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"594916cc-e7cb-b7c5-1092-b67ff1598788","text":"Assessment of tongue function is only one part of the feeding assessment and so the decision to divide a tongue-tie should be based on:","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"594fa5d8-c534-25ba-6c11-0f32c20f351c","text":"The underlying cause of the disease in our patient remains unclear. The degree and clinical distribution of the calcinosis, the young age of our patient as well as the very high levels of osteopontin, a major regulatory protein of calcification, suggest an autoimmune disease. The patient's differential diagnosis includes an unknown genetic disease of calcium metabolism - we are still awaiting the results of a whole exome analysis of the patient and her family members. Immunosuppressive therapy did not stop progression of calcinosis and only after starting pamidronate rapid regression of calcified lesions was noted. Whether this therapy has any long-term beneficial effect and whether the immunosuppressive therapy can be fully tapered remains to be seen.","title":"PReS-FINAL-2275: Improvement of calcinosis cutis with intravenous pamidronate in a 2-year-old girl with progressive widespread skin calcification of unknown origin"}
{"_id":"594fb5e1-0322-7304-0ddc-ef09d9f539f2","text":"Dr Russo is a resident in radiation oncology in his 4th year of training. He has an interest in breast cancer research and has published in this area as well as CNS, lung and GYN.","title":"Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction"}
{"_id":"59510fb5-942c-459f-8150-acb88e6be2be","text":"Thus any exchange of body nature oscillations that take place between the various cells in the body, can lead to detect an abnormality in that part of body.4","title":"Early diagnosis of skin cancer by ultrasound frequency analysis"}
{"_id":"59551308-63ee-f7d4-e237-c108ffea3987","text":"A retrospective study was performed from October 2012 to December 2018. Patients with invasive breast cancer who had a clinically node-positive disease at diagnosis and with a complete axillary response after neoadjuvant chemotherapy were selected. Patients included underwent SLNB and axillary lymph node dissection (ALND) after NAC. The SLN was considered positive if any residual disease was detected. Descriptive statistics were used to describe the clinicopathologic features and the results of SLNB and ALND. The DR of SLNB was defined as the number of patients with successful identification of SLN. Presence of residual disease in ALND and negative SLN was considered false negative.","title":"Accuracy and Limitations of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer Patients with Positive Nodes"}
{"_id":"59568101-2f9b-8dfe-bdb3-98355415ad53","text":"Most authors reported no postoperative complications and satisfactory or good cosmetic outcomes after surgical excision and primary closure.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"595b4cc0-9752-21b2-0a47-d80c2bbd29eb","text":"The complications of the case described are significant and can have serious implications for altering the effectiveness of radiation therapy if the dermatitis is severe enough to prevent further treatment or if the typical radiation dermatitis is worsened. Consequences of missed or delayed radiation treatments are well documented and are shown to be associated with an increased risk of cancer recurrence [13].","title":"Thermoplastic Mask-Induced Contact Dermatitis: A Case Report"}
{"_id":"595c3d8c-c2a1-f3a5-728b-2fbccea602f7","text":"These studies emphasize the importance of adjuvant radiation among patients with regional spread, either to the parotid or to the neck.","title":"The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer"}
{"_id":"595e283d-9110-921a-cb98-87c43b2b41be","text":"Some limitations include that data collection was based on maternal recall, and mothers may have difficulty remembering details such as the time they initiated breastfeeding. Therefore, there is a potential of recall bias which may overestimate or underestimate the results. Because the sample sizes for the low and medium BPI scores were small, it was not possible to run an ordinal logistic regression analysis, which may limit the strength of this study.","title":"Four in every ten infants in Northwest Ethiopia exposed to sub-optimal breastfeeding practice"}
{"_id":"59651653-4cba-b896-fb12-feb953ffc94e","text":"The recommendation of the European Stroke Organization guidelines for the diagnosis of cerebral venous thrombosis is the use of MR venography as a reliable alternative to DSA for confirmation in patients with suspected cerebral venous thrombosis [5].","title":"Imaging of Cerebral Venous Thrombosis"}
{"_id":"596693aa-a420-4b80-c44d-503ec514954b","text":"The procedures presented herein constitute a broad overview of the most commonly performed oncoplastic breast conserving procedures for optimizing tumor resection and cosmesis. This overview provides a starting point for surgeons interested in adding oncoplasty to the surgical options that they offer to their patients. While some of the procedures can be introduced without specialized training, breast and general surgeons seeking advanced training in oncoplastic surgery should participate in a breast fellowship program or an oncoplastic surgery course. Oncoplastic surgery courses are offered by several specialty societies, including the American Society of Breast Surgeons and the American Society of Breast Diseases.","title":"Oncoplastic Approaches to Breast Conservation"}
{"_id":"596b813f-330d-c7bc-1187-a498cb8f26ff","text":"Non-pharmacological methods including a variety of physical therapy agents are the cornerstone of management of chronic low back pain. Therapeutic ultrasound (US) is among the commonly used physical modalities for treating soft tissue injuries. There is some evidence that therapeutic ultrasound has a small effect on improving low-back function in the short term, but this benefit is unlikely to be clinically important. Evidence from comparisons between other treatments and therapeutic ultrasound for chronic low back pain were indeterminate and generally of low quality.14 As with many causes of musculoskeletal pain, for low back pain the combination of therapeutic US with TENS has been shown to be more effective than applications alone for pain and disability.24 There are very few studies comparing the TENS and Ultrasound combination commonly used in daily practice by physiatrists with HILT as our study does.","title":"Comparison of high-intensity laser therapy and combination of transcutaneous nerve stimulation and ultrasound treatment in patients with chronic lumbar radiculopathy: A randomized single-blind study"}
{"_id":"596d89bd-ebc5-143b-19b4-10aea06d97e4","text":"Digital artery perforator flaps provide a useful option for reconstruction of soft tissue defects of the digits, and many variations of these flaps have been described for fingertip defects. This review aims to summarize various pedicled digital artery perforator flap anatomical configurations described in literature for fingertip reconstruction and their results.","title":"Homodigital Pedicled Digital Artery Perforator flaps for fingertip reconstruction - a review of flap options"}
{"_id":"597457d7-34ed-cebb-3f31-f8bebf416291","text":"The current pilot study aims to address particular situations in which primary closure of the vulvar defect is not possible and when the use of flaps or grafts is not advisable (risk of contamination, severe tissue damage or the patient's poor clinical condition). The primary objective of this pilot study was to evaluate the feasibility and operative outcomes of leaving the surgical defect open for secondary healing with the aid of a hydrofiber 6, with the outcomes including the complication rates of the patients with locally advanced vulvar cancer who were treated first with inguinofemoral lymphadenectomy and chemoradiation and then with excision of the vulvar lesion with free margins.","title":"Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control study"}
{"_id":"5979ac91-a3e6-7353-edb2-3a30716fc311","text":"Clinical leadership is fundamental in facilitating service improvements in healthcare. Few studies have attempted to understand or model the different approaches to leadership which are used when promoting the uptake and implementation of evidence-based interventions. This research aims to uncover and explain how distributed clinical leadership can be developed and improved to enhance the use of evidence in practice. In doing so, this study examines implementation leadership in orthopaedic surgery to explain leadership as a collective endeavour which cannot be separated from the organisational context.","title":"Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol"}
{"_id":"598d6d6f-0d6d-9da4-1ab3-349fb99eae82","text":"The current goal is to highlight some of the more common techniques used to reconstruct cutaneous defects of the nose with a specific focus on decision making based on aesthetic subunit and defect size. The authors attempt to share common pitfalls and offer practical suggestions that they have found helpful in their clinical experience.","title":"Reconstruction of the Nose: Management of Nasal Cutaneous Defects According to Aesthetic Subunit and Defect Size. A Review"}
{"_id":"598f898f-4c93-d645-6b72-33a5cf01d4d0","text":"The type of antimicrobials used, and the duration of intravenous or combined oral and intravenous therapies did not associate with osteomyelitis relapse in our study. However, it should be considered that the mean duration of intravenous therapy in our series (about 4 weeks) was similar in both groups and large enough to ensure sufficient antibiotic therapy. Therefore, any possible impact of treatment duration on the outcome would be minimized. Consequently, we cannot completely exclude that shorter periods of treatment could have an influence on the relapse rate. On the other hand, the similarity between the two groups regarding the duration of antibiotic therapy contributes to exclude this potentially important interacting factor and to stress the value of the other factors associated with relapse found in our study.","title":"Factors predictive of relapse in adult bacterial osteomyelitis of long bones."}
{"_id":"59912771-4f5e-5a52-9a5f-33957c963ac7","text":"Imaging methods play a crucial role not only in establishing the diagnosis, but also in anticipating the direction of infection spread underneath the skull base.","title":"The routes of infection spread in central skull-base osteomyelitis and the diagnostic role of CT and MRI scans"}
{"_id":"599516e1-d1a6-263d-38cd-4a37e2e8bc4c","text":"There are limited number of studies exist on the cost effectiveness of radiation therapy options for the treatment of localize prostate cancer across Europe. Most studies are originated from the US Medicare payer Perspective. Further research is need that investigate the cost effectiveness of these radiation therapy options from the societal perspective in Europe. Evidence base cost effectiveness studies based on market demand for medical services remain significant for future studies especially in larger society settings.","title":"Model-based cost-effectiveness analysis of external beam radiation therapy for the treatment of localized prostate cancer: a systematic review"}
{"_id":"59a352e8-07af-f1f2-484d-5446109c9f8d","text":"In summary, our study demonstrates that the time course of recurrences is basically consistent with previous description, constructed biologic subtype is associated with interval to recurrence, and regional nodes is the most common place for recurrences in this series of patients who developed ILRRs following treatment with mastectomy and contemporary adjuvant systemic therapies but without PMRT. Prospective studies to further investigate the implications of constructed biologic subtype and its relationship to recurrence patterns following mastectomy in these women are warranted.","title":"Isolated locoregional recurrence patterns of breast cancer after mastectomy and adjuvant systemic therapies in the contemporary era"}
{"_id":"59a54c59-0979-2af1-e7d7-6fc9039c93ca","text":"In the rehabilitation of the edentulous posterior mandible with the technique of osseointegrated implants some items that should be evaluated such as the quantity and bone quality and anatomical location of the remaining mandibular canal. These are extremely important for the stabililization and subsequent success of the implant. When teeth are lost, the aveolar bone loses its function and is physiologically atrophied. This is important, particularly in the posterior region of the mandible by the presence of a noble structure, the vasculo-plexus inferior alveolar nerve. The anatomical location of this plexus in atrophic mandibles sometimes makes impossible the rehabilitation with implants. There are some techniques for reconstruction of the posterior mandible to these situations, such as bone grafts for gain in height, set of short implants and inferior alveolar nerve transposition. This is to change the way of the inferior alveolar nerve for installation of dental implants. There are two different surgical techniques: one in which the nerve is transposed without including the foramen mentoniano and another in which the foramen is included. The choice for the technique is done by the extension of the area to be rehabilitated. Some accidents and complications are inherent to the surgical procedure, and the most common is transient paresthesia. The objective of this work is to present a clinical case of surgical rehabilitation of posterior mandibular osseointegrated implants associated with inferior alveolar nerve transposition as well to discuss the indications and the contraindications, advantages and disadvantages of this technique.","title":"ABSTRACTS OF THE WORKS PRESENTED AT THE 22nd Academic Conference of the Bauru School of Dentistry “Dr. Waldyr Antonio Janson”"}
{"_id":"59a5a32b-86eb-f742-dc83-7ba4944a069a","text":"The skin acts as a thermoregulator of body temperature, modulating the activity of blood vessels and preventing the loss of water and it plays a role of synthesis and reserve of lipids and water necessary for the correct maintenance of its functions.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"59a6e99d-5260-6b0f-e852-f93a1f0d383a","text":"The DGO was first performed to avoid complications related to healing of the deep gluteal tendon, and hence, minimise post operative instability. The authors routinely perform this approach for THRs as they feel it gives improved access for femoral and acetabular reaming with improved postoperative stability.","title":"Approach to the canine coxofemoral joint using an osteotomy of the deep gluteal muscle insertion for total hip replacements"}
{"_id":"59acc2cf-1a58-14c0-f86e-3955446a7388","text":"The DM in general surgery at the Saint Augustine Campus was adapted from the program out of the Mona Campus with an identical structure and identical university examination process. It is accepted as a specialty degree that qualifies the successful candidate to be conferred on the Specialist Register of the Medical Board of Trinidad and Tobago and allows independent practice in the field of general surgery throughout the Caribbean. At Mona, postgraduate specialty training was traditionally sought in the UK and the USA, but these spaces have become quite competitive in recent times, hence the need to introduce postgraduate training in surgery at the Saint Augustine Campus. The environment in 2005 was indeed ripe at the time with the leadership of the UWI, and the recognized need was in sync with the focused goal of introducing this program. The program initially commenced with six candidates in 2005 at San Fernando General Hospital. It was expanded to Eric Williams Medical Sciences Complex, Mount Hope, in 2012 and the Port of Spain General Hospital. At each teaching site, a senior UWI surgery faculty facilitated the implementation and took charge of the leadership.","title":"Surgical training in the Caribbean: The past, the present, and the future"}
{"_id":"59ae8cdb-1ca9-9aaa-a3f2-ce182d51b45b","text":"Parotidectomy is the treatment of choice in sebaceous lymphadenoma, however in presence of synchronous squamous cell carcinoma neck dissection should also be carried out if cervical lymph nodes are involved and we feel that postoperative adjuvant radiotherapy should improve the survival.","title":"Synchronous sebaceous lymphadenoma with squamous cell carcinoma – case report"}
{"_id":"59b014ee-cf82-6a4d-f5c1-b1bfb4794df2","text":"Although deep inferior epigastric perforator flap has recently been in the limelight because of difficulty in predicting optimal results due to muscle atrophy in TRAM flap, but TRAM flap breast reconstruction is still a safe, widely used autologous breast reconstruction method. The shape of the inflammatory fold can be affected by rectus muscle in conventional TRAM flap breast reconstruction. The Island TRAM flap surgery, which was introduced to improve this shortcoming and outcomes, has come to be considered a novel TRAM technique. 3 Therefore, research on nutrient vessel on TRAM flap to increase muscle fine dissection and flap mobility has been continued and the results have been presented.","title":"Deep Inferior Epigastric Perforators Topography for “Island Transverse Rectus Abdominis Musculocutaneous Flap” in Breast Reconstruction"}
{"_id":"59b81996-7444-b193-6c5f-a05f38241222","text":"Specific IgE antibodies are present in serum as a result of sensitisation and not necessarily allergy.","title":"Ingestion of mammalian meat and alpha-gal allergy: Clinical relevance in primary care"}
{"_id":"59b889d0-b22a-fa8a-ab58-6dd59eccfd8f","text":"The use of LAOMCM flap can combine the reconstruction of the nose from both the mucosal surface and nasal skin in only one flap, which minimizes the risk of suboptimal reconstruction and makes the reconstruction much easier. It gives the best cosmetic result in case of small lesions, which require full thickness reconstruction. Another advantage of this technique that it can be easily used either unilaterally or bilaterally for larger and central defects. It gives very acceptable donor site scar result.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"59b9af95-c276-1679-cd50-10a927e5679e","text":"Both histology and Prussian Blue staining confirmed the presence of SPIOs in the fat pad and surrounding synovial fluid, where there was significant MRI signal decay. MSCs were not detected in other regions with any of these methods, specifically, at the site of the defect where MSCs were believed to hone. The investigation of this MSC and OA model suggests that MSCs do not differentiate, otherwise they would hone to the defect. If these MSCs are involved in repair, the mechanism of action would be in the recruitment of secondary cells.","title":"Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model"}
{"_id":"59bafae3-d02b-ebe2-4938-31c1413964e3","text":"For comparison with the AJCC model, the patients were originally divided into three groups according to the differences in survival predictions between the two models. For individuals in Group S1 of Table S2, the survival probability for the new model was at all times greater than the survival probability according to the AJCC model; the absolute percentage difference was greater than 13%. In Group S2 the survival probability for the new model was at all times smaller than the survival probability according to the AJCC model; the maximum absolute percentage difference was greater than 13%. For Groups S1 and S2, the maximum absolute percentage difference of 13% was chosen because it exceeds the maximum absolute percentage differences for those patients for whom the survival in one model was not always greater than the survival in the other model. The remaining patients formed Group S3.","title":"Quantitative Measurement of Melanoma Spread in Sentinel Lymph Nodes and Survival"}
{"_id":"59bbad79-5583-6902-6882-385ac1a9dddf","text":"In the teeth region, as shown in Fig. 6b, the mandibular and maxilla are the main instances showing ageing salience, which can be reflected in the ARDA map in Fig. 3 where the upper teeth and lower teeth are the main regions of the ARDA distributions. In addition, the ARDA in the lower teeth region is much more obvious than the upper teeth at age ranges from 4 to 40 years except for the ages before 10 years and after 37 years.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"59c408ab-aafd-e112-6379-7594438da31c","text":"It was done univariate analysis of demographic, base and control variables with respect to the occurrence of CR. In this case was not observed any significant influence of analyzed variables with respect to clinical response.","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"59c82519-fd78-898e-7237-bd3835e3c770","text":"The bilateral breast returned approximately to its normal size after therapy for 6 months.","title":"Bilateral breast myxedema caused by Graves’ disease and responsive to multipoint subcutaneous injection of long-acting glucocorticoid Case report"}
{"_id":"59c92398-66b2-9c2b-8e7e-2acf2af7cc30","text":"The adoption of national and international measures to prevent and to contain the spread of Covid-19 contributed to a decrease in the OHCA cases in public, a decrease in the number of patients who benefited from BLS by bystanders, and an improvement in unfavorable clinical settings for the adoption of ACLS.","title":"Abstracts of the ICARE 2023 77th SIAARTI National Congress"}
{"_id":"59ca405c-7488-e041-8909-b00987fd193f","text":"In the group subjected exclusively to ischemia-reperfusion, the distal portion of the flap exhibited minimal necrosis and loss of muscle tissue under macroscopic examination as well as microscopic ulceration and necrosis in the epidermis on day 10. Macroscopic or microscopic necrosis was not observed in the other groups (Figures 4–6). According to the histopathological examination, acute inflammation of the Botulinum A toxin group of dermis tissue was more severe than the IR group at the 24th hour and on the 10th day. The acute inflammation at the 24th hour and on the 10th day in the Botulinum A toxin group of muscle tissue was less than the IR group, but more severe than the preconditioning group.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"59ce0e0e-1ed2-3d91-0e1c-13d1fba1a45c","text":"In this study, reconstructions for the recurrent cancers were performed by surgeons with more experience than those in the primary cancers. This study also revealed that the free flap reconstruction had a higher failure rate in the recurrent group than the primary group, but this difference was not found in the matched groups of patients who had similar patient-related covariates. This result implied that the higher failure rate of the free flap reconstruction in patients with recurrent cancers than primary cancers may be mostly attributed by the different patient characteristics. The above observation may also sketch a situation that, in the reconstruction of the recurrent cancers, the experienced surgeons may choose an alternative flap other than the ALT flap for reconstruction, prefer contralateral microanastomosis, but somehow intentionally not to use the vein grafts to prevent anticipated challenges. However, such a hypothesis requires more studies for validation, seeing there are still debates regarding the successful rates of different flap types and the altitude and circumstance in doing the reconstruction for patients with primary or recurrent cancers were unknown.","title":"Comparison of the surgical outcomes of free flap reconstruction for primary and recurrent head and neck cancers: a case-controlled propensity score-matched study of 1,791 free flap reconstructions"}
{"_id":"59ce5589-2693-14e7-b5c6-986526580639","text":"The proximal humerus was approached using an extended deltopectoral approach, and an intra-articular resection of the proximal humerus was performed (Figure 2). The tendons of the rotator cuff cut at the myotendinous junction and tagged for repair. Owing to the previous nononcologic surgery, the anterior half of the deltoid and accompanying axillary nerve were resected. A FVET was harvested with the anterior tibial vessels. The articular surface of a cadaveric proximal humerus was removed with a saw, and the cancellous bone of the metaphsysis was removed with a burr to the cortical bone to allow for fitting of the fibular head, whereas the diaphysis was reamed to allow for the FVET to be intussuscepted within the humerus allograft with the articular surface of the fibula facing the glenoid at the level of the tuberosity. A window was created for the vascular pedicle on the medial aspect of the allograft. The anterior tibial artery was anastomosed to a side branch of the profunda brachii artery and vein. The distal end of the fibula was intussuscepted into the remaining host distal humerus, and the allograft was fixed with a compression plate. The remaining host rotator cuff was attached to the allograft cuff via heavy suture.","title":"Composite-Free Vascularized Fibular Epiphyseal Flap and Proximal Humeral Allograft for Proximal Humerus Reconstruction in a Pediatric Patient"}
{"_id":"59cfcb03-9dc7-085f-e113-c6ff7fd70a36","text":"The other injuries were treated as follows: proximal femoral nailing for the intertrochanteric fracture; intramedullary nailing for the left tibial fracture; and placement of a propeller flap for the calcaneal skin defect. These were performed at 2 weeks once it was declared the right side had no evidence of infection. At the end of the third week, a valgus deformity of the transferred segment of fibula was corrected by realigning the distal Schanz pins under fluoroscopy.","title":"Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture"}
{"_id":"59d22418-d5ed-12c9-40ef-60e220fbcbcd","text":"In a multicenter cohort of 41 children 22 % started with unifocal lesion with a significant diagnostic delay. A higher proportion presented with chronic persistent disease than with a recurrent form. An osteomyelitis in the pelvic region is significantly associated with other features of juvenile spondylarthritis.","title":"Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study"}
{"_id":"59d3a1db-d3d2-6639-1e06-83d48f91dbd9","text":"In conclusion, in the case of this superobese patient with difficult airway revealed by the preoperative examination, ultrasound-guided multiple peripheral nerve blocks were successfully performed following unsuccessful attempts for spinal block. Ultrasonography enables direct visualization of the nerves and reduction in the required local anesthetic doses and thus allows for multiple nerve blockade. In addition, ultrasound guidance enables the use of new peripheral nerve block approaches in obese patients. Due to these reasons, ultrasound-guided peripheral nerve blocks may be a good alternative to general anesthesia and central blocks for extremity surgeries in obese patients despite their technical difficulties. Based on our experience, the identification of more distal and superficial block points by individualized scanning instead of using common regions may be useful in the identification of physiological changes induced by obesity. Further studies are needed for the optimization of nerve block techniques and local anesthetic doses in obese patients.","title":"Ultrasound-Guided Multiple Peripheral Nerve Blocks in a Superobese Patient"}
{"_id":"59d4610b-42f5-ae96-719f-572a2c82e0cd","text":"The case was discussed at multidisciplinary meeting. Given the high risk of recurrence with desmoid tumours and likelihood of incomplete resection, active surveillance was recommended unless increasing in size or highly symptomatic.","title":"A Rare Paraspinal Desmoid Tumour following Instrumented Scoliosis Correction in an Adolescent"}
{"_id":"59d7a8d1-b22d-4f13-6977-5b773835e95f","text":"The addition of chemotherapy whether given in the neoadjuvant or adjuvant setting is an important part of the management paradigm for these patients. The optimal sequencing of surgery, radiotherapy, and delivery of chemotherapy may vary between patients and the involvement of all specialists at the multidisciplinary team is imperative for best outcomes.","title":"Breast Radiotherapy after Oncoplastic Surgery—A Multidisciplinary Approach"}
{"_id":"59dc9ff9-b513-ce05-df50-031e21a1d4e9","text":"There are no objective markers available to assess both the symptom severity and response to treatment (unlike other chronic conditions such as hypertension or diabetes). Assessment of response to treatment is based predominantly on the patient’s subjective report as the symptoms and signs of CD have generally returned by the time of the follow-up botulinum toxin appointment. Patients may be asked to recall their best response over the time period since their last injection in order to inform the injector’s treatment decisions on dosing going forward. Doses are titrated based on this feedback over the course of several treatment cycles as every patient’s response is individual. Many patients require lifelong injections of botulinum toxin from the time of diagnosis.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"59dec94a-b20e-37ab-2c6d-58942246202e","text":"The analysis showed that the majority of respondents who were trained under the HLF program have characteristics such as positive attitudes and values and an attentiveness attitude toward their health (two thirds of the respondents were doing sports). More than half of the respondents from this group participated in the scientific work and public life of the educational institution, as presented in Figure 2. Also it should be noted that one third of the respondents were married.","title":"Leadership and Emotional Intelligence: Current Trends in Public Health Professionals Training"}
{"_id":"59df4d2e-3bd6-2b9b-86bd-a98505a9039b","text":"Any participant identified as having a recurrent DVT or an existing DVT that has extended at any point during follow-up is immediately reviewed by the rapid access thrombosis clinic. A recurrent DVT is diagnosed as the presence of a new thrombus either in the ipsilateral or contralateral leg or the presence of new thrombus on old thrombus in the same venous section as the original thrombosis, all of which are confirmed on Duplex ultrasound.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"59eb868c-a64f-d465-d329-d225520718e9","text":"Little is known about optimal management of prosthetic vascular graft infections, which are a rare but serious complication associated with graft implants. The goal of this study was to compare and characterize these infections with respect to the location of the graft and to identify factors associated with outcome.","title":"Surgical and Antimicrobial Treatment of Prosthetic Vascular Graft Infections at Different Surgical Sites: A Retrospective Study of Treatment Outcomes"}
{"_id":"59f2cd58-cb9a-c55a-9c1c-d050a229a23c","text":"Some of our patients received only 3 months of follow up – this was only in the cases that were deemed uncomplicated, with patients that had been WBAT without pain for some time and without issue seen on serial radiographs.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"59f41ca1-71cb-cd51-146b-f3f95eeafa2b","text":"The aim of this study was to identify a protocol that could optimize the decellularization of human auricular cartilage. The technique was based on the success of previous methods applied in the case of tracheal and ear decellularization. Our methodology consisted of applying three different decellularization protocols to human ear cartilage consisting of both physical and chemical methods. Physical methods of decellularization such as freeze thaw can help disrupt cell membranes as well as induce apoptosis of chondrocytes. However the effect on degradation of the extracellular matrix structure has been proven to be insignificant. Szarko et al. reported no differences in glycosaminoglycan and collagen content after freeze thaw as well as reporting no change in the mean complex stiffness level. The process however initiates decellularization by inducing necrosis of cells whilst maintaining the three dimensional matrix structure. This reduces the duration of exposure to chemical methods of decellularization. Chemical methods whilst effective can impair the mechanical properties of the matrix as Elder et al. noted decreased matrix strength when the exposure time of cartilage to SDS was increased from 2 hours to 8 hours. Therefore a combination with physical decellularization techniques can help reduce the exposure time of cartilage to chemical methods. Freeze thaw action has been reported to accelerate the decellularization process in various tissues with lower nuclear content detected when combined with chemical techniques. This study is the first to compare multiple decellularization protocols for human auricular cartilage and in doing so has identified a pathway for accelerating the process whilst preserving the structure of the native matrix.","title":"Optimising the decellularization of human elastic cartilage with trypsin for future use in ear reconstruction"}
{"_id":"59fb53d1-6bbe-74c7-85cb-9fa158ca642d","text":"FU hair transplantation could be an effective method for managing scar tissue on the scalp and offers several advantages, including a high transplantation survival rate and satisfactory postoperative results.","title":"Treatment of Postsurgical Scalp Scar Deformity Using Follicular Unit Hair Transplantation"}
{"_id":"59ff7b5c-b3e4-916d-9553-6dc9e4fbaaf1","text":"In Italian context asymptomatic suspected ruptures are diagnosed by US during normal follow-up checks and radiologists address them to MRI examination and surgical visit while symptomatic patients or suffering trauma undergo MRI directly.","title":"Determinants of surgeon choice in cases of suspected implant rupture following mastectomy or aesthetic breast surgery Clinical implications"}
{"_id":"5a05f1aa-dd4f-2a03-c4f1-40222a4adedc","text":"Although medical advertising was not the subject of the majority of the complaints filed during the period of the present study, all four of the aforementioned articles involve medical advertising to some degree, as explained in a previous study. In plastic surgery, medical advertising strongly influences the mistake or misconduct identified. Profiting from the profession through marketing of medicine is considered to be unethical behavior. In this vein, physicians are not allowed to be party to any commercials or advertisements that in any way promote or profit from the profession. Regardless of the specialty, physicians should not guarantee results or treatment. Physicians must clearly inform patients of the benefits and risks of a given procedure. Advertising in which physicians publicize simple and quick treatment that is 100% effective is an invitation for lawsuits to hold physicians to the purported results. Promising results put the physician in a delicate situation, since complications may arise during treatment. Medical information should include what is scientifically correct and accepted as good medical practice, and medical professionals should base their practice on the laws that are in effect.","title":"Plastic surgery professional misconduct: a cross-sectional study on cases between 2008 and 2017, filed before the São Paulo State Medical Board"}
{"_id":"5a07f052-da73-5815-1010-b17eaceccee7","text":"Destructive per continuitatem spondylodiscitis is a rare and severe complication post-EVAR\/TEVAR. Clinical and imaging features of anterior paravertebral disease and anterior vertebral body involvement suggest direct continuous spread of the graft infection to the adjacent vertebral column. The mortality rate of these severe infections is extremely high and treatment with a permanent fistula may be one salvage procedure.","title":"Destructive per continuitatem spondylodiscitis after endovascular abdominal or thoracic aneurysm repair (EVAR\/TEVAR): rare and untreatable?"}
{"_id":"5a0ec17a-cb2e-e07d-b386-396eccb33b78","text":"Our results can support previous data about heterogeneity of SLN biopsy performed in cutaneous melanoma localized in both dorsal subscapular region and lumbar region. For these reasons, in cases of doubtful sentinel lymph nodes, there is a need to add other imaging evaluations to the preoperative lymphoscintigraphy.","title":"Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma"}
{"_id":"5a1499b2-a17a-2dfa-d80d-cd93a5367d98","text":"The extent of damage to the nerve due to IM injection depends on both the site of injection and the injected drug. The pathophysiology of injury involve the damage to the nerve fibres that may have occurred either because of the needle or because of the chemical composition of drug administered [4]. Also, the dosage of administered drug plays an important role in an intrafasicular injection. The iatrogenic injuries present poor prognosis. The patients presenting the symptoms typically presents the immediate onset of paresis and pain following the nerve course, with the numbness gradually following the complete sensory loss. The onset and presentation of symptoms immediately after an IM injection considering the severity of damage to the nerve needs an extensive keen medical management followed by the physiotherapeutic advancement for the complete recovery. However, the body follows an auto-repair mechanism which allows the lesion caused to the nerve to repair itself during the course of recovery.","title":"Fourteen (14) months follow up of traumatic sciatic neuritis due to intramuscular injection: a case report"}
{"_id":"5a16bfc5-e279-a6d2-c6ed-aa1d146b552f","text":"The results are promising, but a dedicated technical device for brushing the bones and the correct timing of the operating room and pathology process are key to performing the intraoperative procedure.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"5a1b5c7f-2865-077a-8ee6-0ef65f20842e","text":"The aim of our study was to describe outcomes after the reconstruction of sternal defects using a unilateral advancement rotational pectoralis major flap, to establish its clinical feasibility, and document the associated complications.","title":"Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap"}
{"_id":"5a2896de-e24a-351a-d980-104322d92431","text":"The downturned nasal tip followed by residual bridge hump was the main complaints reported by the patients and confirmed by the objective examination by the physicians. Such findings differ from those found in other studies, where the asymmetric tip and bridge irregularities in the middle third are the most frequent complaints and findings observed by surgeons. The presence of 37.2% of the patients with nasal obstructive complaints shows that greater attention should be paid to functional deformities during the first surgical procedure to prevent reinterventions aimed to correct these deformities. The differences observed between patients’ complaints and surgeons’ evaluations confirm the need for detailed assessment and clarification to the patients regarding their expectations and actual surgical possibilities.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"5a29df73-2327-1bed-7469-66f0f267b86c","text":"At initial diagnosis with breast cancer, prior to chemotherapy, placement of a clip at the primary tumor site at the time of diagnosis is standard for all patients treated with neoadjuvant systemic therapy. Additionally, evaluation should include documentation of the clinical nodal status by physical examination and axillary ultrasound. Cases with sonographically abnormal lymph nodes (cortex > 3 mm) should undergo percutaneous needle biopsy (fine needle aspiration or core needle biopsy) of the most abnormal lymph node, for cytologic or histologic evaluation for the presence of metastatic disease. Placement of a clip in the biopsy-proven positive node is strongly recommended, to aid identification of this node at surgery after completion of chemotherapy. Clip placement can be performed at the time of fine needle aspiration biopsy or core needle biopsy of the lymph node or at a subsequent time point if needed. If multiple nodes are biopsied, the most abnormal appearing node should be clipped. Placement of the clip in the hilum of the lymph node can avoid potential issues with clip migration during response to chemotherapy. Surgical staging of the axilla must occur after neoadjuvant chemotherapy. Axillary surgery before neoadjuvant chemotherapy loses the ability to assess response to therapy and to document the presence or absence of residual disease, therefore in trials with pCR as the primary endpoint all axillary surgery must occur after completion of neoadjuvant chemotherapy.","title":"Surgical Standards for Management of the Axilla in Breast Cancer Clinical Trials with Pathological Complete Response Endpoint"}
{"_id":"5a29e296-38db-8700-87ad-80d34fb3d431","text":"The purpose of this study was to examine the treatment courses and long-term outcomes of tibial allograft reconstruction in children and adults with sarcoma. Being able to characterize patterns of success and failure allows surgeons to effectively counsel patients and manage expectations prior to surgery.","title":"Allograft Reconstruction for Sarcomas of the Tibia"}
{"_id":"5a2fb21f-c4aa-800c-2096-70af8f1fc04f","text":"This workshop was part of a series of BNGAP modules and can also be taught as singular sessions. Modifications to this workshop should remain anchored to the exposure, role modeling, mentoring, and observation framework upon which the curriculum was based. Leadership development through engagement with the OSA can pave the way for the next generation of rising leaders for academic medicine.","title":"Office of Student Affairs: Engagement and Leadership Opportunities for Medical Students, Residents, and Fellows"}
{"_id":"5a368401-480c-1b3f-9ea9-f298e324a281","text":"Dermatofibrosarcoma of the scalp has historically shown potential for periosteum invasion. Although only a few cases of this have been reported, craniectomy is typically required for establishment of margin-free resection. Given the location of the lesion over the sagittal dural venous sinus and significant thinning of the underlying bone, a multidisciplinary decision was made to proceed with craniectomy to achieve a negative margin following Mohs micrographic surgery.","title":"Managing the positive periosteal margin after Mohs excision of scalp dermatofibrosarcoma protuberans in children with underlying calvarial bone thinning and resorption: The value of multidisciplinary treatment"}
{"_id":"5a37367e-46ba-4e65-280f-ac9097e05db2","text":"We presented our experience in wound reconstruction using FTSG in 28 patients. We selected cases with graft size equal to or more than 130 cm2. Seven patients had chronic but healthy granulating wounds and 21 patients had fresh raw areas. Sizes of FTSG used varied between 130 to 452 cm2 of outstretched skin at donor sites. We used subgluteal skin crease in most of cases, though groin, upper medial thigh and medial arm aspects were also used.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"5a3e284d-4d70-da09-61e3-3e9b96b94ef8","text":"This lack of reference values for the physiological bone marrow attenuation on VNCa images obligates each comparative study to define an individual reference cohort and furthermore impairs real-world applicability of findings from the literature. Hence, the aim of our study is to provide a large-scale reference cohort of physiological bone marrow attenuation on VNCa, as a foundation to support further investigation of pathological bone marrow alterations.","title":"Dual-Energy CT, Virtual Non-Calcium Bone Marrow Imaging of the Spine: An AI-Assisted, Volumetric Evaluation of a Reference Cohort with 500 CT Scans"}
{"_id":"5a445e85-13c9-5e3a-446f-ecc806f70bb4","text":"The difference in count rates with CrystalClearView disabled (Figures 8a and 9a) and enabled (Figures 8b and 9b) are statistically insignificant since the average background count rates of the room was 27 cps and the fact that CrystalClearView also reduces 123I at an equal ratio as 99mTc implies the CrystalClearView tool does not yield accurate quantitative results during dual isotope imaging of two nuclides with overlapping energy window as stipulated by the manufacturer. Although there is currently no technique using dual isotopes in the localization of SLN in melanoma, the need to mark the detected SLN on the patient's skin with a 57Co pen‐point marker in routine clinical practice; necessitate the investigation of the effect of CrystalClearView in dual nuclide imaging due the overlapping energy windows of the 99mTc and 57Co.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"5a446dcb-8482-168e-45cd-d94bc6a0dec8","text":"Blunt injuries, hemodynamic shock at the admission, injury to large thoracic and abdominal vessels and injury to the popliteal artery, associated injuries to vital remote organs and to the vein and the nerve in proximity are factors predictive of poor outcome of the vascular injury.","title":"A decade of civilian vascular trauma in Kosovo"}
{"_id":"5a4da2ab-f0b8-6738-a005-1fecd13338b2","text":"Open surgery to manage symptomatic patients with filter-related IVC perforations can be challenging. The need to expose the IVC involved in an inflammatory reaction, followed by clamping and sectioning of the vein are technical aspects that add to the increased morbidity of this approach.","title":"An alternative approach to treatment of inferior vena cava filter perforation Tratamento alternativo para perfuração de veia cava inferior por filtro"}
{"_id":"5a532f3e-1a00-8935-26ac-2461c5097058","text":"Additionally, adjuvant postoperative radiotherapy was a positive prognosticator for PFS if compared to radiotherapy at recurrence. The addition of radiotherapy at an earlier time point of the disease may be advisable. We looked at the fraction size under the hypothesis that as desmoid tumours are slow growing tumours originating from fibroblasts, and thus may need a higher single fraction size. The use of daily fractions ≥ 2 Gy reduced the hazard for a tumour recurrence to 60%. To our knowledge this finding concerning the fraction size for radiotherapy of aggressive fibromatosis has not been reported in the literature.","title":"The impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients. A study of the Rare Cancer Network"}
{"_id":"5a5416c1-554e-c7b1-f742-ff7bedab2722","text":"O5 Neutrophil activation in systemic anaphylaxis: results from the multicentric NASA study","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"5a5eac2a-f863-5adc-0e40-1a8a6f0c8639","text":"In a recent clinical comparison of the effectiveness of topical application of methyl aminolevulinic acid with photodynamic therapy verses diclofenac in hyaluronic acid, it was found that although the diclofenac therapy is more cost effective, it is less clinically effective in the complete remission rates for treatment of actinic keratosis [49]. The ability of DKP to enhance diclofenac retention within the epidermis may be useful as an alternative diclofenac delivery method for targeting actinic keratosis lesions.","title":"Cyclic Dipeptide Shuttles as a Novel Skin Penetration Enhancement Approach: Preliminary Evaluation with Diclofenac"}
{"_id":"5a62aabb-80bc-3822-2ee4-1ef97cb7c084","text":"Table 1 summarizes the differences between intrinsic and extrinsic aging of the skin that have been generally recognized to date. However, recent research suggests that this distinction is not as clear-cut as textbooks describe and can often be confusing. It would be more clinically appropriate to understand that middle-aged adults visiting dermatologic clinics for skin rejuvenation undergo concomitant intrinsic and extrinsic aging. Thus, the histological and molecular changes related to skin aging that have been acknowledged to date should be organized to establish an appropriate treatment plan.","title":"Skin aging from mechanisms to interventions: focusing on dermal aging 10.3389\/fphys.2023.1195272"}
{"_id":"5a736595-dacb-f9d2-854d-767809f9d105","text":"The FIGO committee stated that the stromal invasion (defined as the measurement of the tumor from the epithelial–stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion) and the extension to adjacent anatomical structures play a role in pushing the stage in a higher level with worse prognosis.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"5a7506c5-ee46-cec2-6888-3009dd532921","text":"The CD31 fluorescence content in the upper dermis showed no difference between ALA and BF-200 ALA independent of the illumination scheme used. Fig 8 shows a set of three representative composite images of the CD31 and CD144 fluorescence for control and the 4 PDT treated skin samples. The control images show colocalised or closely associated CD31 and CD144 fluorescence. For skin treated with ALA and a single illumination scheme we found less colocalisation and slightly more CD144 fluorescence outside the vasculature. After treatment with ALA and light fractionation we see more loss of CD144 fluorescence and therefore almost no colocalisation. For BF-200 ALA we see the same, i.e. a single illumination results in less colocalisation and more CD144 fluorescence away from the vessels and after light fractionation CD144 seems to be faded, although the intensity of the CD144 overall is lower after BF-200 ALA.","title":"Light Fractionation Significantly Increases the Efficacy of Photodynamic Therapy Using BF-200 ALA in Normal Mouse Skin"}
{"_id":"5a81be66-cae5-2b94-075e-05e57442a565","text":"The surgeon required the patient to remain immobile during ablation to reduce lung injury from punctures. The disappearance of this reaction may reduce the number of punctures and indirectly reduce lung injury.","title":"Single ultrasound-guided thoracic paravertebral block with a large volume of anesthetic for microwave ablation of lung tumors"}
{"_id":"5a90ed2d-6ece-cdaf-465a-30362a0eb111","text":"The risk of a medically attended local reaction to Td vaccine was compared between persons who did and who did not have a record of receipt of a TDCV within the previous five years. Prior vaccinations classified as TDCVs included Td as well as diphtheria, tetanus and pertussis vaccines administered as part of the childhood vaccination series but did not include Tdap or Menactra vaccines as those vaccines were not available during the time period of interest. In order to ensure accurate assessment of prior vaccinations from the MCO records, the analyses of TDCVs given before the Td vaccination were restricted to persons with at least five years of continuous enrollment in the MCO prior to the Td vaccination of interest. Overall and in the younger age groups there was a trend toward a higher risk of a local reaction in persons who received Td within five years of a prior TDCV but only the difference in all age groups combined was statistically significant (Table 3).","title":"Frequency of medically attended adverse events following tetanus and diphtheria toxoid vaccine in adolescents and young adults: a Vaccine Safety Datalink study"}
{"_id":"5a977516-e62a-623d-d89b-12e5c66e2fad","text":"All patients provided written informed consent to participate and to publish pictures of their wounds.","title":"The effects of intermittent negative pressure on the lower extremities' peripheral circulation and wound healing in four patients with lower limb ischemia and hard‐to‐heal leg ulcers: a case report"}
{"_id":"5a980221-008b-8963-2fd6-9f3523dd1388","text":"In summary, our results showed that the symmetry of the NAM was maintained by preventing the collapse of the nasal wing, and there was no difference in the axis of the nasal pillar between the two groups. The impact of the NAM method was mainly derived from correction of the greater nasal alar cartilage modified by the nasal stent of NAM during the first 3 months after birth. There are various confounding factors and limitations found with this observational study of two CLP surgery methods, such as the small sample size, problems with the surgical technique (such as suturing and degree of overcorrection), differences in the degree of deformity in the patients, and differences in skeletal growth. The fact that the treatment method may have been modified by the patients' families or that the surgeon's skill may have improved over the duration of the study period could also have impacted on our findings. Reliable clinical studies, such as randomized controlled trials with more cases, will be necessary to confirm the efficacy of the NAM method shown in this study. If more precise measurement methods for the NAM effect are established, it will be useful for determining the stent technique of NAM and surgical design during primary cheiloplasty to assess the final morphology of the nose after growth.","title":"Nasal molding prevents relapse of nasal deformity after primary rhinoplasty in patients with unilateral complete cleft lip: An outcomes‐based comparative study of palatal plate alone versus nasoalveolar molding"}
{"_id":"5a996729-2eb0-035e-4f66-5ebf6cfa1425","text":"Problems during pregnancy and childbirth appeared to influence the duration of breastfeeding as well. The estimated mean duration of breastfeeding was shorter and found statistically significant for women having a preterm birth, having an infant birth weight of less than 2500 g, having a cesarean birth, and having a baby hospitalized in NICU. Mothers who were able to room-in during hospitalization had a longer estimated mean duration of breastfeeding compared to mothers whose babies were admitted to the infant ward or NICU.","title":"Breastfeeding challenges and support in a high initiation population"}
{"_id":"5a9abd14-a6fd-1f98-2fca-ca7713444f8f","text":"Our analysis will enable us to understand how and why different configurations of leadership develop and under what organisational conditions they are able to flourish. In doing so, we critique existing notions of implementation leadership, which portray leadership through the behaviours and attributes of individual champions working within distinct clinical communities. We adopt a DL approach as the conceptual and theoretical framework guiding our study, to explain leadership as a collective endeavour which cannot be separated from context. The study findings will, we hope, guide the development of interventions that are grounded in the data and aimed at advancing leadership for service improvement and innovation which we will implement and test in future research.","title":"Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol"}
{"_id":"5aa968c0-0db6-dea7-d5bf-99ca1ec44769","text":"The aim for these guidelines is to minimize clinical risk for patients and demonstrate competence for practitioners. As with all new procedures, formal training must be undertaken and should have the following components:","title":"Modern trends in lipomodeling"}
{"_id":"5aa9f872-7cc6-ac49-61f1-7d7d7a8ae4ba","text":"A combined serratus anterior and latissimus dorsi myocutaneous free flap was applied to cover the raw surface and reinforce the abdominal wall and to fashion a new colostomy, as well as successfully filling the pelvic cavity with a large muscle body and long vascular pedicle. This is the optimal method for reconstructing severe abdominal wall defects that have many complications.","title":"Combined serratus anterior and latissimus dorsi myocutaneous flap for obliteration of an irradiated pelvic exenteration defect and simultaneous site for colostomy revision"}
{"_id":"5aaeac4c-5685-2fe3-6b43-9e26066d1ad2","text":"In this retrospective cohort study, all patients who underwent BCS or mastectomy to treat breast cancer between January 2009 and December 2010 were included. Both patients with contralateral breast cancer and those undergoing surgery because of local recurrence were included. Patients with distant metastasis at surgery or within 3 months from surgery and those having other cancer at pathological anatomical diagnosis were excluded.","title":"Association of postoperative infection and oncological outcome after breast cancer surgery"}
{"_id":"5ab1cf0c-615c-61ad-3c94-3da60e76683f","text":"The right latissimusdorsi muscle of 8 rats in the ischemia reperfusion group which were raised as musculocutaneous flaps were returned to their places after they were subjected to ischemia reperfusion procedures described above. MPO and NO levels were measured in blood and tissue samples of 4 rats at the 24th hour and 4 rats on the 10th day of ischemia reperfusion. Thus, the effect of ischemia reperfusion injury on the parameters used was determined. The data of the other two experimental groups were compared with the data of this group and their protective effects were evaluated.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"5aba3dcd-91fa-6eaf-b977-4defcfbe8526","text":"All patients were closely monitored monthly by personal interview after treatment for up to 6 months after the Botox injection. Any adverse events considered possibly related to Botox treatment were recorded.","title":"Factors Associated with Therapeutic Efficacy of Intravesical OnabotulinumtoxinA Injection for Overactive Bladder Syndrome"}
{"_id":"5abaae76-23b7-d2b6-2370-83952d8f727b","text":"Understanding the time course of this immune regulation is significant to guide clinical management. Our nonlinear regression model based on cross-sectional data from the first cycle of our longitudinal study implies a phase of progressive downregulation of T cell responses, a trough around 90 days ARE, and a phase of returning toward the baseline. Although a trend of both phases was seen in the second cycle of the longitudinal cohort, the trough was not determined in the present study, which was unfortunately not completed due to the lockdown for the COVID-19 pandemic.","title":"B cells modulate mouse allergen-specific T cells in nonallergic laboratory animal-care workers"}
{"_id":"5abedb1d-7491-b231-c00d-df19d1360b0f","text":"The skin, subcutaneous tissue, and the underlying fascia are respected en-mass while exercising such a lesion. In conditions where the bone has involved the periosteum or even a part of the underlying bone needs to be excised to acquire a negative margin. On excision of a large tumor with adequate margin, the closure of the defect is often a challenge. The functional deformity is an issue when a large defect needs to be made while excising such tumors with adequate margin, cosmetic distortion is also a problem that needs to be addressed at times, depending on the location of the tumor. The Mohs micrographic surgery is advocated these days as an initial modality of treatment provided the disease is limited to a small area.","title":"Recurrent Dermatofibrosarcoma Protuberance: A Case Report"}
{"_id":"5ac75b9a-b9ec-b2ad-ff81-428a80c51351","text":"Our objective of this study was to assess the incidence of Deep Venous Thrombosis in patients including those with sickle cell disease who underwent spine surgery, and also to determine the association of Sickle Cell Disease as a clinical predictor for Deep Venous Thrombosis in spinal surgery patients.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"5ac8992f-39bf-c061-4626-6d46cf8cb45e","text":"There is unanimous consensus that to help the diagnostic workup for suspected recurrent VTE a baseline imaging of leg veins and\/or pulmonary arteries at the moment anticoagulant therapy is completed would be highly recommended, especially in those patients with an unprovoked VTE, who are at higher risk of recurrence. A recent clinical study confirmed that available baseline imaging was of substantial help in interpreting diagnostic tests in cases of suspected recurrent VTE [31].","title":"Recurrent Venous Thromboembolism: What Is the Risk and How to Prevent It"}
{"_id":"5ac95b60-efaa-7571-c77c-afc02b3f18c1","text":"Skin melanoma localization was correlated to the topographical localization of the sentinel lymph node in the axilla.","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"5acb2097-aa65-e1d2-e5f1-1876170e9519","text":"Two patients had a Charcot neuroarthropathy. In all patients osteomyelitis was confirmed and microbiology showed various microorganisms in nine patients. Seven patients were treated by sequestrectomy and in six patients an ulcerectomy was performed. In one case the bone fragments were stabilized by an external hybrid fixator and in three cases a dermal substitute was used for wound care. In another three cases a partial calcanectomy was performed.","title":"Multidisciplinary Approach for the Management and Treatment of Diabetic Foot Infections with a Resorbable, Gentamicin-Loaded Bone Graft Substitute"}
{"_id":"5acbd515-8ca6-9641-0aa0-858a40417aca","text":"As far as we know, this study is one of the maximum number of cases in the treatment of complex intracranial aneurysms with saphenous vein bypass.","title":"Safety and effectiveness of high flow extracranial to intracranial saphenous vein bypass grafting in the treatment of complex intracranial aneurysms: a single-centre long-term retrospective study"}
{"_id":"5acf9689-83e8-c119-4127-53f31a30d4d2","text":"In this review, contamination of tissues following recovery was found to be quite variable despite attempts to reduce bioburden prior to recovery, such as the method used to disinfect the skin. Processes to disinfect tissues with a combination of antibiotics and antifungals, irradiation or PAA treatment were found to be effective in reducing positive culture results and have minimal, if any effect on tissue integrity. Preservation of samples with 10 or 20 % glycerol compared to other methods of cryopreservation was shown to have an antimicrobial effect.","title":"Disinfection of human skin allografts in tissue banking: a systematic review report"}
{"_id":"5ad391ff-f1da-e737-1e72-5552cafd96dd","text":"In the last years, we put emphasis on the quality control of our work and look for more sustainability. Camp registration and documentation became obligation for the team insurance and financial acceptance. In the new established INTERPLAST Academy, experienced plastic surgeons train our own team members in the special pathology of the developing countries and explain the basic plastic surgical technics suitable for the simple local facilities in the foreign environment. So, it will be much easier to perform teaching of the local doctors during the camp in order to enable them to help their own patients better.","title":"INTERPLAST-Germany—adapting to global plastic surgery"}
{"_id":"5ad4a5e9-f8d4-b553-200a-2e5e2bb9906c","text":"There were some limitations in our study; first there is no defined time duration from surgery to measure quality of life outcomes and needs further research. The outcome of cancer free state outweighs the patient satisfaction and quality of life measures although the age of the patient can be a potential bias here, where the patients that are younger tend to be more conscious about their physical appearance and outcome comparing to women of older age and that could lead a new path for further exploration where age adjusted quality of life measures can have impact on patients satisfaction with breast, physical, psychosocial and sexual health of patients. Despite all these, this is the first study reporting quality of life domains especially sexual health of breast cancer survivors in our oriental population. This can play a role in preoperative counselling of patients for better procedure selection.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"5ad5491c-ff74-e56b-095d-63d39dd6330f","text":"During the time period of the study the typical practice at our trauma center did not include the frequent early use of plasma, platelets and cryoprecipitate as is described in Table 1 and there was no use at all of rFVIIa. Despite the low frequency of the use of these blood products the amount of cryoprecipitate was independently associated with in-hospital mortality. A potential explanation for these findings is that the use of cryoprecipitate was used very late in the resuscitation of patients when the patient was already in a state of irreversible shock and high risk of death secondary to hemorrhage. These findings are in contrast to recently published US military data indicating that the early use of procoagulant blood components to include cryoprecipitate and plasma are independently associated with improved survival [44-46]. As we are unable to determine when specifically cryoprecipitate was transfused in our study, we cannot easily explain these results.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"5ae57d28-8284-7f9e-7dd5-33e66270c3fa","text":"A number of approaches have been used to grade levels of evidence and the strength of recommendations. The use of many different approaches detracts from one of the main reasons for having explicit approaches: to concisely characterise and communicate this information so that it can easily be understood and thereby help people make well-informed decisions. Our objective was to critically appraise six prominent systems for grading levels of evidence and the strength of recommendations as a basis for agreeing on characteristics of a common, sensible approach to grading levels of evidence and the strength of recommendations.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"5ae9086a-e7c9-8d23-a88a-d5afea516b38","text":"Bone scintigraphy is a high sensitive method for determining the focus of tumoral calcinosis. The diagnostic radiological modality for tumoral calcinosis is generally direct radiography. In our case direct radiography had failed to detect the calcific deposit in the left iliac wing. In addition, it also helped us to determine the unknown foci, as it gave information about the whole body. It should be kept in mind as a differential diagnosis in patients with a mass seen in the soft tissue with dense calcification.","title":"Tc-MDP bone scintigraphy in a case with sporodical tumoral calcinosis"}
{"_id":"5aec7625-1acc-94f9-514c-5b8e912600f5","text":"In general, the standard treatment procedures for OM include thorough surgical debridement and systemic antibiotic administration. Although surgical treatment is indispensable, the antibiotics used to fight infections and inhibit biofilm should be chosen carefully because they can have a significant impact on the outcomes.","title":"Comparing the efficacy of different antibiotic regimens on osteomyelitis: A network meta-analysis of animal studies"}
{"_id":"5af77a56-6d1f-4b08-6955-1f7fbab95c67","text":"All participants were tested individually in a room with normal interior lighting.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"5afbc855-64b3-0ffb-9793-e7d3d8ce6dd4","text":"Sentinel lymph node biopsy in prophylactic mastectomy is controversial. It avoids lymphadenectomy in occult carcinoma but is associated with increased morbidity. Women with BRCA mutations have a higher incidence of occult carcinoma and our objective was to assess the clinical utility of sentinel lymph node biopsy when these women undergo prophylactic mastectomy.","title":"The Use of Sentinel Lymph Node Biopsy in BRCA1\/2 Mutation Carriers Undergoing Prophylactic Mastectomy: A Retrospective Consecutive Case-Series Study"}
{"_id":"5b04d4ab-b04c-fc2f-1565-3343b941cff0","text":"The pigmentation of hair appeared preserved even in the skin areas affected by vitiligo, a fact that denotes the presence of a reserve of melanocytes attributable to the structures of the hair follicle in the compromised areas.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"5b0afd60-0a38-4ebc-5db6-d3eaa830caaa","text":"He again underwent a sequestrectomy with extraction of 4 teeth with ectopic aspects and curettage of the surrounding bone which appeared to be necrotic, then the 3 skin fistulas were removed and an attempt was made to cover the mandibular bone. The patient was put on ciprofloxacin (1g per day in two doses) intravenously for 5 days and then relayed orally.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"5b15208f-1918-288e-b0bd-1983396e7b75","text":"2) Omalizumab should only be administered by a physician or registered nurse who is trained in the recognition and treatment of anaphylaxis; and","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"5b19856f-4045-eda7-842d-bd5841fbf438","text":"For proper preoperative planning, evaluation of possible autologous vascular grafts for vascular reconstruction is essential. Ultrasound of the venous system of the lower extremities, especially the greater saphenous vein on both sides including measuring of their diameters, should be performed as well as an ultrasound of external and internal jugular veins.","title":"Vascular surgery in liver resection"}
{"_id":"5b238b88-44a6-3243-6d7a-9be522e8f3cd","text":"9 October – WHO 2018 Symposium on health financing for UHC","title":"Public health round-up"}
{"_id":"5b29554a-92e1-5610-2766-b4d3ac7ccc8a","text":"Our experience in treating this condition and evaluating limitations of previously described techniques for management of sternoclavicular joint osteomyelitis has led to the development of a novel surgical strategy for treatment. We propose initial incision and debridement of the infected sternoclavicular joint followed by delayed resection and pectoralis major muscle flap advancement as the optimal treatment for patients diagnosed with sternoclavicular joint osteomyelitis requiring surgery.","title":"Treatment of Sternoclavicular Joint Osteomyelitis with Debridement and Delayed Resection with Muscle Flap Coverage Improves Outcomes"}
{"_id":"5b2aae4b-4158-cd6f-a47f-80bd4a62d41f","text":"Lower body lifts may be safely performed in the outpatient setting with attention to safe anesthesia, limited blood loss, and efficient use of operating room time. Preservation of a midline posterior skin bridge avoids elongation of the gluteal cleft. Superwet infusions assist with regional anesthesia and hemostasis and facilitate both liposuction and the dissections. Buttock fat injection is a safe adjunctive procedure to restore volume. Secondary surgery may be needed in some patients to treat persistent skin laxity.","title":"Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures"}
{"_id":"5b2fd72b-da24-0480-8edd-27ae42105873","text":"A386 Risk Factors for Systemic and Local Reactions to Subcutaneous Allergen Immunotherapy","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"5b3d6944-6818-4b5c-307f-793d2d8988ac","text":"Autoaugmentation does not improve lateral gluteal deficiency, which is desired by many women to enhance an hourglass figure. Fat injection is simple and quick and provides a net increase in volume. It is imperative to stay subcutaneous when performing the injections to avoid fat emboli. The author has evaluated the level of fat injection using ultrasound in surgery to visualize the tissue planes; the cannula remains well above the muscle fascia.","title":"Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures"}
{"_id":"5b40afd5-66d1-6c5a-117f-c05ffc5d763a","text":"Combinations of endovascular procedures and open surgery are increasingly important for treatment of complex cases in patients with severe vascular disease involving several arterial levels and for complications of open surgery.1-7 The case described here illustrates the importance of a hybrid approach in a patient with critical lower limb ischemia, a failed initial endovascular procedure, and serious complications of the open surgery employed as an alternative.","title":"Hybrid treatment for lower limb revascularization in a patient with vascular graft infection: a case report"}
{"_id":"5b4ec84e-77d0-9b0a-f793-3185d1f680bc","text":"In this first evaluation, we employ a VR prototype for surgical planning to two real cases of patients with liver tumors who were scheduled for surgery. Four surgeons used the prototype as a sophisticated pilot study before the surgery to plan the procedure in addition to their regular planning process. We used individual and group interviews with the surgeons before and after the surgery to explore the benefits and pitfalls of VR surgical planning. We found that all surgeons valued that the tool provides easy and immediate access to the patient's individual anatomy and, therefore, enables them to understand the spatial anatomy and identify surgical relevant anatomical variants faster. They described the tool as easy to use and directly wanted to integrate it into their standard workflow. By conducting evaluations of the prototype under real conditions, we gain insights on how VR as a technology and related concepts of embodiment, natural and spatial interaction benefit surgeons in their daily work, how it possibly improves the safety of surgeries, and how this technology could be integrated into medical applications.","title":"Virtual Reality for Surgical Planning – Evaluation Based on Two Liver Tumor Resections"}
{"_id":"5b53cd1e-033e-0e61-fc3d-8b16a8c21581","text":"A small number of key informants also commented that some clinicians were wary of the Australian guidelines owing to what some perceived to be conflicts of interest amongst those involved in the guideline development process (Guideline Factors – Source of Recommendation).","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"5b62aeb8-25b4-df60-5859-e73cfbb51d07","text":"More, a reconstructive procedure of a single ray of the hand or a part of the foot may be not compensated by a concrete advantage in term of functional recovery and better outcome, so a frank discussion with patient about realistic pros and cons appears mandatory.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"5b62d36a-d52d-ef5c-ff43-096de5b59be2","text":"This reflects the frustration that was expressed by some of the interviewees in regards to the rigid and traditional clinical roles within the NHS. Some interviewees expressed new aspirations for their careers:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"5b65575d-758b-41bb-b494-384828e4aca2","text":"According to our experience, disc decompression using the Coblation technique has proved to be one of the best MISS, but it is essential to strictly adhere to his indications and to choose the best therapeutic approach for each patient.","title":"Percutaneous cervical coblation as therapeutic technique in the treatment of algo-dysfunctional pain of discal herniation"}
{"_id":"5b674ed7-ab21-8911-2425-2a2524a8f0c5","text":"Previous retrospective analyses have been done on patients with CSSTIs, concentrating on the infection located in the potential spaces or fascial planes of the anterior neck. No recent information on the situation in the incidence, severity, causes, and occurrence of complications in CPCSSTIs is available which may have their special characteristic. The main purpose of the present study was to present our own experience of the clinical course of CPCSSTIs to identify clinical features and emphasize the importance of appropriate treatment selection in those patients.","title":"Complicated Posterior Cervical Skin and Soft Tissue Infections at a Single Referral Center"}
{"_id":"5b74e151-d478-d8b3-5172-0162a46fe0c8","text":"There was no information on tumor size for the two step ablation.","title":"Cryotherapy in extra-abdominal desmoid tumors: A systematic review and meta-analysis"}
{"_id":"5b833f86-269e-859a-7da1-d3bc95fb0e7a","text":"The findings of the present study point to the need for further research and actions, especially regarding information on breast cancer, strategies for early detection, and actions to minimize the delay in care and in the resolution of other problems within the cancer care network.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"5b8a1fa2-ca7c-e15c-463e-6b7a9000ef71","text":"Desmoid tumors associated with familial adenomatous polyposis (FAP) are classified as benign, but clinically considered to be a disease similar to malignancies because of their tendency to occur as multiple lesions in the abdominal wall or mesentery. Surgical therapy is the first choice of treatment, but repeated procedures for recurrent tumors may cause gastrointestinal stenosis or dysfunction. Although hormone therapy and chemotherapy for desmoid tumors have been described in the literature, no established treatment is available other than surgical resection. We report a case of inoperable growing desmoid tumor in the abdominal wall that shrank in response to heavy ion radiotherapy and has remained stable and free of effects on the adjacent intestinal tract for 3 years. No cases like this have been reported anywhere in the world. We believe that heavy-ion radiotherapy has the potential to become an effective treatment option for patients with desmoid tumors.","title":"Carbon ion radiotherapy for desmoid tumor of the abdominal wall: a case report"}
{"_id":"5b8c2745-3059-b92d-1b42-68681f85e8b2","text":"In the biopsy taken from the Botulinum A toxin group at 24 h, more vascularization was observed in the dermis layer compared to the control group. The vascularization of the muscle tissue was similar to the control group at the 24th hour, but vascularity in the Botulinum A toxin group was higher than the control group on the 10th day.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"5b8e8a3e-35af-9c60-eec6-2ea6d124b217","text":"Our results suggest that switching to an oral antibiotic regimen after two weeks of intravenous therapy is safe in immunocompetent patients for primary non-implant vertebral osteomyelitis if epidural or paravertebral abscesses have been drained and if an oral antibiotic therapy with documented susceptibility, high bio-availability and bactericidal activity is available. Our results should be confirmed by a prospective randomized controlled trial.","title":"Is switching to an oral antibiotic regimen safe after 2 weeks of intravenous treatment for primary bacterial vertebral osteomyelitis?"}
{"_id":"5b91879d-05ed-46d4-98c1-a272fdd1f2e2","text":"This is the first study to date to classify the extent of sciatic nerve involvement in STS and to suggest a surgical treatment algorithm. In our study, the extent of nerve resection had no significant impact on disease recurrence or overall survival. Hence, precise classification of nerve involvement is useful in selecting the appropriate degree of nerve resection, without compromising oncological outcome or unnecessarily sacrificing leg function. Additional studies are necessary to validate and optimize this classification.","title":"Limb-Salvage Surgery of Soft Tissue Sarcoma with Sciatic Nerve Involvement"}
{"_id":"5b961ba7-ed86-b482-857e-31b1b1b52821","text":"Figure 1 shows the evolutive timeline of the events described above.","title":"From Grafts to Human Bioengineered Vascularized Skin Substitutes"}
{"_id":"5b9ef4db-41c4-397d-4f50-9b1154d115bb","text":"The most frequently cited criteria for the diagnosis of paradoxical embolism are:","title":"Paradoxical embolism, deep vein thrombosis, pulmonary embolism in a patient with patent foramen ovale: a case report"}
{"_id":"5bb7bb64-52e4-4d29-9017-3737e19af6bc","text":"Objective: This study aimed to describe the implementation of ultrasound teaching program in medical school in the Faculdades Integradas Pitágoras of Montes Claros.","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"5bbdb829-95a3-c598-962c-af8bc4a73712","text":"This descriptive study presents an overview of resident’s views towards complex, interrelated aspects of residency training including strains and concerns regarding training experience, interest in subspecialty training as well as motivation for the choice of surgical career. Educational debt appears to play in integral role in the choices that are made by residents and thus counseling as well as financial planning programs may aid in preventing bright minds from shying away from pursuing fellowship training as well as an academic career. Furthermore our study highlights that at least 6 months of training in individual subspecialties is necessary in order for residents to get comfortable with the specialty. Findings of our study maybe used to target areas of deficiencies and to design a comprehensive curriculum to improve upon areas of weaknesses. Future analysis should explore ways to improve aesthetic and microsurgery training experience for residents using longitudinal data. We hope that findings of our study will assist programs in improving the quality of plastic and reconstructive surgery training.","title":"A survey of current state of training of plastic surgery residents"}
{"_id":"5bc29a7c-2642-6721-2156-c784ffd62964","text":"In 2 patients the spacer was exchanged before definitive cancellous bone graft in order to get bacterial biopsy confirmation that infection was eradicated.","title":"Infected tibia defect fractures treated with the Masquelet technique"}
{"_id":"5bc88a85-4a1e-3174-44cf-6fb70355c22a","text":"The major modifiable risk factor for the development of skin cancer is reduction of ultraviolet radiation exposure. This has been well established and includes both sun exposure and indoor tanning. Sun exposure has been implicated in approximately 90% of nonmelanoma skin cancers, and sunburns have been shown to increase the risk of melanoma. Given the association, indoor tanning has been deemed a carcinogen by the United States Food and Drug Administration and the World Health Organization International Agency for Research on Cancer. Furthermore, in the case of melanoma, studies have demonstrated association of advanced disease presentation with low socioeconomic status and lack of access to health care services, among other factors. These findings serve to support an overall multidisciplinary approach to increasing general patient awareness and provider training for early skin cancer detection as it stands to make a significant public health impact.","title":"A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence"}
{"_id":"5bce8477-18c5-359e-dace-d65f3441f446","text":"Necroptosis differs from apoptosis and autophagy in both its specific mechanism of action and physiological significance. In the morphological picture, necroptosis is manifested by swelling of cells and organelles, mainly mitochondria and early rupture of the cell membrane. The mechanism by which CAPE affects ovarian cancer cells is still under our investigation. Another experiment will allow us to assess which pathway regulating cell elimination is the target of the ester.","title":"Caffeic Acid Phenethyl Ester (CAPE) Induced Apoptosis in Serous Ovarian Cancer OV7 Cells by Deregulation of BCL2\/BAX Genes"}
{"_id":"5bd01234-aa7b-57ce-6f6f-86cfcbea63f3","text":"Overcoming resistance to BRAF inhibitors in melanoma is a complex challenge, but researchers have been investigating various strategies to address this issue.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"5bd51f82-a905-24e3-cee6-cf6e03ed0833","text":"All amendments and changes to the study protocol as well as changes in investigators will be reported to the local ethical committee right away. For trial specific communication with the local ethical committee, there is a two-step verification guarded online application available. Participants will be informed of changes by phone. Changes in time schedule that change the course of funding will be reported to the German Research Foundation.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"5bdd520d-0142-5e44-01ca-a9a599a5eafe","text":"Artificial dermal covering combined with fascial sleeve flap transplantation can effectively avoid wound dehiscence or sinus formation caused by foreign body retention, infection and flap contracture. It has good effect in repairing chronic wounds with bone plate exposure after severe trauma of lower limbs.","title":"Analysis of the therapeutic effect of artificial leather embedding combined with fascial sleeve flap transplantation on chronic wounds of lower limbs with bone and plate exposure"}
{"_id":"5be25733-d321-7d0f-d270-d7fe07f90570","text":"On the day of surgery, the pedicle location is confirmed using Doppler ultrasound. A suture can be fixated at the pivot point and the radius of rotation and skin paddle length can be estimated and marked out with a surgical marker. An elliptical skin paddle is then designed according to the defect and also includes an additional 2 to 3 cm of skin medial to the pedicle origin. The skin paddle may be up to 6 to 8 cm wide and still be closed primarily in some patients, depending on the skin laxity of the shoulder area. Lengthwise, the flap can extend up to 3 cm distal to the acromion. The length of the SCAIF skin island can be increased by delaying the flap, elevating it but returning it to its original position without rotation for a period of about 7 days.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"5be4abd4-ba28-3ab8-28ed-2d5f8059d595","text":"It is concluded that nurses working in these environments are able to maintain careful and astute observation of their vulnerable patients, and concern arises when they may be unable to do so.","title":"37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)"}
{"_id":"5be7adbf-bb03-9563-7b6d-072448fde9eb","text":"Clinical knowledge transmission was found to be a more important goal in journal clubs in orthopedic fellowship programs over residency programs. This was found in a survey of 57 hand surgery fellowship directors, where the current literature was reviewed for the fellows and faculty as a primary goal.15 These fellowship directors felt this journal club was very important for fellowship training.","title":"Planning and executing orthopedic journal clubs"}
{"_id":"5befa35b-df03-e58a-108b-4dccdce4ea7a","text":"Pediatric rheumatologists and nephrologists agree on treatment of severe cases of proliferative LN refractory to induction therapy or LN flare after remission. However, there were differences in choice of therapies in the milder cases, specifically in the use of rituximab. Further investigation will be necessary to delineate the reasons behind this finding. This study highlights the importance of collaborative effort in developing CTPs for pediatric LN.","title":"Proceedings of the 2016 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting Toronto, Canada. 14-17 April 2016"}
{"_id":"5bf52e4a-915d-7c69-542b-3b6a5d0784a8","text":"Hence, the present studies recommend the use of propeller perforator flaps as they allow reconstruction of even complex wound with local tissues in a single stage, accelerating recovery with minimal post-operative discomfort and frequently, a better aesthetic result than traditional methods of reconstruction. It was also observed that this surgery is easy and quick which is designed after marking the median sural artery and perforators with Doppler and the average operation time of elevating the flap was 30 minutes.","title":"The Clinical Outcome of Perforator Based Sural Artery and Propeller Flaps in Reconstruction of Soft Tissue of Extremities"}
{"_id":"5bfb6d5a-b31f-e6a8-9ada-e09fc887d5ee","text":"The aim of the present study was to analyze the clinical and functional outcomes of intercalary reconstruction using a composite graft comprising a devitalized autograft and a vascularized fibula graft after wide resection of malignant bone tumor of the lower extremity and compare the results with those reported previously for other reconstruction methods. In addition, we investigated the applicability of a novel surgical technique using a frozen autograft and a vascularized fibula graft composite and compared it with pasteurized autograft group.","title":"Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized Autograft and a Vascularized Fibula"}
{"_id":"5bfe0808-81b6-90f7-31b0-de703b73284b","text":"Recent clinical testing has revealed that hypericin was not tumoricidal in a patient with mesothelioma who was exposed to 632 nm red laser light, but clear evidence of phototoxicity was seen in two subjects after intradermal drug injection when activated by green laser emissions at 514 nm rather than by 632 or 670 nm red light.18 , 19","title":"Does hypericin boost the efficacy of high-power laser? A preliminary experimental study on rats A hipericina aumenta a eficácia do laser de alta potência? Um estudo preliminar e experimental em ratos"}
{"_id":"5c069acc-b5f0-c803-192c-1facbc4a5f1f","text":"The overlay image was also not considered to yield any advantages regarding the diagnostic value and image quality as a stand-alone image. The readers rated the overlay image with a lower score than the bone-equivalence image and even lower than the conventional radiograph image in all five categories.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"5c129ece-024f-8061-0b02-d1980e093ba0","text":"The current study also confirms findings from a prior report1 that the Biodesign Innovation Fellows are effective in inventing technologies during their training. However, a key objective of the fellowship is to teach a repeatable process for health technology innovation that alumni can continue to apply in their careers. The fact that more companies have been started (and more patients reached) by fellowship alumni based on work after their time at Stanford Biodesign compared to during their time in the fellowship suggests that the fellows are applying what they have learned beyond the scope of the program.","title":"The Impact of Postgraduate Health Technology Innovation Training: Outcomes of the Stanford Biodesign Fellowship"}
{"_id":"5c180218-80c1-bc2d-01ec-6be4048593ea","text":"The results of these 2 trials suggested that it is safe to omit axillary dissection in women with early breast cancer who have only 1 or 2 positive sentinel nodes. It should be noted, however, that all of the women in the Z0011 trial received whole breast irradiation, and a large proportion of the women in the IBCSG 23-01 trial also underwent radiation therapy. Given that level I and part of level II of the axilla are included in the treatment field with whole breast irradiation, women who received irradiation in the 2 trials probably experienced a therapeutic effect from radiation therapy sterilizing residual tumor, but it is not clear how much of a role this played in the trial outcomes.","title":"Controversial Indications for Sentinel Lymph Node Biopsy in Breast Cancer Patients"}
{"_id":"5c18a489-5bdb-2b04-6002-706302dc50d3","text":"Radiation monotherapy appears effective for the curative treatment of MCC and should be used, especially in situations where extensive surgery is not favored.","title":"Complete remission of Merkel cell carcinoma on the upper lip treated with radiation monotherapy and a literature review of Japanese cases"}
{"_id":"5c1d24a4-354c-b499-554e-b9d067cc2b45","text":"All DT cells included in this study were created in the Sarcoma Research Lab at the Ohio State University and the MD Anderson Cancer Center. This study was conducted with approval from both the Ohio State University and the MD Anderson Cancer Center institutional review board (IRB) with written informed consent of patients. All cell lines and corresponding tumors were genotyped for CTNNB1 by Sanger sequencing to confirm that the cell lines were truly desmoid tumor cells. Iterion Therapeutics (formerly BetaCat Pharmaceuticals) provided BC2059.","title":"Preclinical efficacy of the Wnt\/β-catenin pathway inhibitor BC2059 for the treatment of desmoid tumors"}
{"_id":"5c237ec8-3a9d-650e-de7e-e3b7d47580ab","text":"Their clinical and immunological features are summarized in Tables 1 and 2.","title":"The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults"}
{"_id":"5c252bb9-c617-8df5-d333-3dd3fdb4a58a","text":"Due to the fact that tumors of the salivary glands in childhood and adolescence are a rare disease, it is in our opinion not very easy to make a comparison with a similar adult population. On the one hand, it is not possible to get significant information especially due to the high variety of different tumors. On the other hand, the problem of a retrospective clinical investigation is sometimes a lack of specific information, which makes it hard to determine a really similar adult population.","title":"Diseases of the salivary glands in infants and adolescents"}
{"_id":"5c25fd9e-f82c-ef5b-10c0-6452a4145624","text":"Anterior decompression through a linear transvertebral midline approach for a ventrally located cervical SEA is a safe and pragmatic surgical procedure to achieve spinal cord decompression and collect bacteria culture without destabilizing the cervical spine.","title":"Case report: Anterior midline decompression of a cervical epidural abscess: Technical note and case series of seven patients"}
{"_id":"5c27251d-29af-e9b3-727e-84a90d3b9b57","text":"The combined treatment was generally well tolerated (Table 1). The most common side effects attributable to radiation were fatigue and dermatitis, and imatinib was associated with nausea and fatigue. One patient with a left axillary desmoid tumor developed ipsilateral breast edema 4 months after radiation therapy that resolved with physical therapy. Another patient with an axillary desmoid tumor was noted to have radiographic features of avascular necrosis and adhesive capsulitis of the humeral head on MRI 4 months after radiation therapy. Imatinib was stopped, and the patient has been managed medically.","title":"Concurrent Imatinib and Radiation Therapy for Unresectable and Symptomatic Desmoid Tumors"}
{"_id":"5c2c4b3c-9cb3-3e2a-dcbe-37c75184425a","text":"In the era of microsurgery, the gastrocnemius myocutaneous flap for reconstruction of defect involving the upper and middle third of the leg is very attractive and versatile option for plastic surgeon. It is a simple technique allowing rapid, durable and reliable coverage of these defects without sacrificing a nerve or a major vessel to the foot. No donor site morbidity as functional deformity was noted in any patient.","title":"Gastrocnemius Myocutaneous Flap: A Versatile Option to Cover the Defect of Upper and Middle Third Leg"}
{"_id":"5c2f9de8-6ef5-580d-62e4-41b077345548","text":"Graphs in Figure 5a,b are shown for a noisy case with 4 fold Cartesian under sampling for reconstruction of a phantom image.","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"5c3053d9-98f6-9d97-c64a-54033a5ae83c","text":"Approximately 5% of patients with thin melanoma will harbor nodal disease. Regression is associated with nodal recurrence after a negative SLNB in this population. Therefore, patients with thin melanoma and regression may need more intensive surveillance after a negative SLNB. Further studies are needed to evaluate the indications for SLNB in thin melanoma patients and to investigate whether the same immune mechanisms that lead to regression in the primary also do so in the lymph nodes, potentially affecting the ability to detect lymph node metastases.","title":"Regression in thin melanoma is associated with nodal recurrence after a negative sentinel node biopsy"}
{"_id":"5c306c85-14f7-a94e-0890-09e3a23fce06","text":"Recent advancements in synthetic chemistry and material science have resulted in the development of programable systems that respond to physiological changes due to diseases. PACT has followed a similar trend with the fabrication of systems that are stimuli-responsive to target bacteria. This section will focus on the advancement of porphyrin-based PACT systems for targeting bacteria and bacterial infection sites.","title":"Photodynamic Antimicrobial Chemotherapy: Advancements in Porphyrin-Based Photosensitize Development PACT: Advancements in Porphyrin-Based Photosensitizers"}
{"_id":"5c3084ae-9d94-c3a0-78cd-64003dbb6489","text":"Parotid salivary gland lesions were managed using a parotidectomy approach. Diom performed a total parotidectomy as the lesion was located between the deep lobe of parotid gland and the parapharyngeal space. The integrity of the facial nerve was not mentioned. Battaglia performed a superficial parotidectomy as the lesion was entirely within the superficial lobe. The facial nerve was fully preserved.","title":"Osteolipoma of head and neck – a review"}
{"_id":"5c309e59-3f14-8760-4d70-d01da5250fcb","text":"The minimum time to assure a complete healing of the surgical site is 2 months. Our second laser resection was a revision of the surgical bed of the previous surgery.","title":"Impact of resection margin status and revision transoral laser microsurgery in early glottic cancer: analysis of organ preservation and local disease control on a cohort of 153 patients"}
{"_id":"5c37dd55-4032-275d-83c1-3ffac849e452","text":"This procedure has been used in multiple patients with promising results which was published in literature. Literature shows that it provides relief of medically intractable pain, without the need for destructive procedures or more central modulation approaches with a preferable safety profile compared to other invasive procedures.","title":"Supraorbital Nerve Stimulation for Facial Pain"}
{"_id":"5c38e3d8-851e-7f4b-a9f4-ffb07881af91","text":"A stepwise approach describing the incorporation of Hyper Accuracy 3D imaging technology into the preoperative surgical planning and intraoperative guidance of a patient with multiple myomas undergoing multiple myomectomy.","title":"Incorporating 3D reconstruction in preoperative surgical planning of Multiple Myomectomy"}
{"_id":"5c5c8eb6-bd94-7117-2b0f-ccf08077d549","text":"We recommend future clinical trials investigating biologics implement more complete reporting of injection site reactions in terms of type, number of events, and changes in occurrence over time to facilitate a better understanding of its epidemiology and how it impacts patients who receive biologic medications.","title":"A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections"}
{"_id":"5c60cb7c-4293-d90e-5c75-049777f1a9eb","text":"Although we cannot definitively confirm a true association between non-skin cancers and MM, we believe that there are sufficient links for further investigation in order to identify new aetiological factors and therapeutic targets for these cancers.","title":"Appearance of malignant melanoma after a non-cutaneous cancer diagnosis"}
{"_id":"5c76ac71-7566-ee8b-1024-fcd49fdc7c23","text":"Harassment can also be a barrier to progression in academic rank and leadership and is not unique to any particular specialty in medicine. Recent surveys of female French intensivists and female American anesthesiologists report high levels of harassment at work [8, 9]. A recent survey of the Women in Otolaryngology section of the American Academy of Otolaryngology noted that 41% of respondents had experienced at least a subtle level of harassment during their residency training [7]. In our study we were able to show that women report a higher level of harassment both in residency and as an attending physician. Female respondents also endorsed more harassment from patients and colleagues than their male peers. This correlated with a lower rate of female identified surgeons in leadership positions. There is a significant amount of literature that shows that women are less likely to pursue an academic medical or surgical career [5, 10]. While this study was not powered to link levels of harassment with academic progression, one can surmise that this could be one of many reasons that female surgeons are less likely to hold leadership positions in their academic institutions.","title":"Canadian Women in Otolaryngology—Head and Neck Surgery part 1: the relationship of gender identity to career trajectory and experiences of harassment"}
{"_id":"5c8c59b0-6594-15be-c0af-122e652da1e8","text":"Venous drainage of the lower abdomen skin and subcutaneous tissue occurs primarily through the superficial venous system and secondarily through the deep venous system, with perforating veins interconnecting the 2 systems. When congestion occurs, assessed by the presence of an engorged and tense SIEV, a second anastomosis can be performed to ensure proper venous draining. An algorithm has been designed for choosing this second anastomosis.3 Anastomosis can be achieved by either connecting the SIEV to the deep inferior epigastric vein (DIEV) or by anastomosing the SIEV or DIEV to the distal retrograde IMV stump. The latter technique has been successful in relieving multiple cases of venous congestion. The relative lack of valves in the internal mammary system and alternative drainage through the proximal intercostal system may explain its success.","title":"Utilizing the Retrograde Descending Internal Mammary Vein in DIEP Flap Anastomosis"}
{"_id":"5c98e006-bba5-1873-d3cb-75818750841c","text":"Although VSD has many advantages in the treatment of chronic osteomyelitis, it is not the ultimate means to treat chronic osteomyelitis as a physical method. The complete removal of bacteria ultimately requires the action of antibiotics. Due to the extremely poor local blood supply in chronic osteomyelitis, the hardening of the cavity wall left after bone destruction, and the resistance of the biofilm on the bacterial surface, it is difficult for simple intravenous antibiotics to enter the bone cavity; antibiotics are added through lavage, even if the lavage rate does not guarantee sufficient time for antibiotics to exert their bactericidal effects. Therefore, the key step in the treatment of chronic osteomyelitis is how to ensure and maximize the bactericidal effect of antibiotics after debridement and drainage. A large number of clinical data have proved that the local application of implanted antibiotic beads to the lesion can achieve an effective bactericidal concentration at the lesion and avoid the side effects of systemic antibiotics.","title":"MRI Manifestations and Diagnostic Value of Chronic Osteomyelitis"}
{"_id":"5c9b9188-7ca8-08aa-04af-16fa2a51410b","text":"Patients who had undergone breast reconstruction after mastectomy reported better sexual function, better body image, and fewer depressive symptoms than patients who had undergone mastectomy alone. The results also showed that sexual dysfunction was associated with the absence of a marital partner and a higher level of education and was more frequent in the mastectomy group.","title":"Sexuality, depression and body image after breast reconstruction"}
{"_id":"5c9d1bce-84d0-7ed7-8f16-a307eca236a5","text":"Reasons for the variation in response of deep vein thrombosis (DVT) to anticoagulation treatment are not known. Some patients develop complications such as post-thrombotic syndrome or recurrent DVT but others make a full recovery. The aim of the study is to identify the level of variation in response to anticoagulation treatment and provide more precise and quantitative disease characterisation in response to treatment.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"5c9e7b77-885b-bf17-df94-91d56d7370d3","text":"Despite the proposal of BR, there still remains a group of women with breast cancer who prefer ablative surgery without any kind of reconstruction.","title":"Patient’s Education Before Mastectomy Influences the Rate of Reconstructive Surgery"}
{"_id":"5ca488ce-ad64-5171-10b5-2b20ddd693b6","text":"In conclusion, scalp reconstruction is a complex field with numerous surgical options and different approaches available. The successful reconstruction of the scalp requires an accurate and individualized approach with attention to both the functional and esthetic goals.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"5ca56216-5431-4be8-4ecf-996e68ab0204","text":"The time frame of treatment in most our patients was only for 6 weeks, 1 patient had two 6 week treatment courses. Other studies have used treatment times of up to 12 weeks. It seems that it is the inflammatory response that is important and the time taken to achieve that in most cases was a 6 weeks course.","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"5ca97842-0c82-b306-0b81-2bb1d8a67a14","text":"Conclusion: Islanded gastrocnemius musculocutaneous flap is an effective simple alternative for coverage of large soft tissue defects from the knee to half of the leg distally with minimal donor site morbidity. Aggressive debridement of unhealthy tissue is necessary to prevent infection following wound coverage with this flap.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"5cabc7e4-dd8f-0ece-392d-8caeb5cdaf9a","text":"We will define adverse events and withdrawals for any reason stated in the included studies.","title":"Therapeutic effect of photodynamic therapy for nonresectable cholangiocarcinoma Protocol for a meta-analysis and systematic review"}
{"_id":"5cb07c9d-18b3-7e7e-5d88-5e7475cfaedb","text":"The addition of biologic agents to the graft materials did not have a significant effect on the amount of horizontal bone gain or successful implant placement; however, it marginally enhanced the bone density of the grafted area.","title":"Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study"}
{"_id":"5cb4f331-28b8-e130-db21-70d149a283ee","text":"The study findings show that the management of patients presenting with an acute allergic reaction at the A&E department should be optimised with the guidelines in order to provide better care. Recommended areas of improvement in the management of these patients include more regular monitoring of the vital signs and increased patient education regarding avoidance of the causative allergen, for instance through the introduction of educational leaflets. Possible ways to improve management of patients presenting to A&E with acute allergic reactions include the implementation of a pro-forma sheet, establishment of a referral criteria, continuous medical education to the emergency staff and the updating of hospital guidelines according to the latest studies.","title":"37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)"}
{"_id":"5cbad7e3-fa1e-8d2b-1203-cadc6ee9e9d2","text":"A retrospective review of all limb salvage surgeries done in our department between 2005 and 2008 was done and four cases of extremity sarcoma of lower limb involving femoral vessels analyzed. Interpretation of data from these cases, along with review of literature, is done.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"5cc09b08-1eeb-494d-8b07-317a088e94cb","text":"Periocular botulinum toxin injection should be thus used with caution in patients with narrow angles or angle-closure glaucoma because it decreases the iridocorneal angle. If applied in these patients, the intraocular pressure should be monitored closely after the procedure because of a potential acute rise in intraocular pressure.","title":"Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm"}
{"_id":"5cc1d6a4-5a22-bb75-4271-bfe1d157b448","text":"The authors are grateful to Jennifer Dandrea Palethorpe for assistance in preparing this manuscript, and to all medical and paramedical staff of the various MTFs who took part in the treatment of the patients.","title":"Soft tissue coverage using pedicled flap in combat zone: a case series"}
{"_id":"5cc53d2c-1277-11af-2b8d-e5c216194dd2","text":"Secondary cicatricial alopecia occurs as a result of destruction of hair follicles by scar tissue formed in the scalp and eyebrows. It is a permanent condition and regrowth of hairs in the area is not expected. The purpose of the study was to select the appropriate method for treating cicatricial alopecia. 24 patients were admitted to our hospital during the period from June 2006 to July 2007. They were suffering from acquired cicatricial alopecia affecting the scalp and the eyebrow. Their ages ranged from 6-48 years with mean age 26-25 years. They were treated surgically by total excision of the lesions with direct closure of the defect in ten cases, excision of alopecia with advancement flaps with the aid of scalp expanders in seven cases, scalp reduction through serial excision of alopecia in three cases and excision of alopecia and reconstruction of the defect by strip composite hair-bearing scalp grafts in four cases. Our results suggest there are three key factors that decide the surgical methods for treating alopecia: size, location and shape. We also discuss and evaluate the various techniques of reconstruction. Good results were obtained in 18 patients.","title":"Surgical treatment of secondary cicatricial alopecia of scalp and eyebrow"}
{"_id":"5ccf6f15-2d7f-acb7-51b5-7c21ab3c683e","text":"Flow diagram of male cancer patients who presented to Sichuan Human Sperm Bank from 2010 to 2019 for sperm cryopreservation","title":"Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience"}
{"_id":"5cdaa66a-f733-2bdc-73f9-0e6f3ed719e6","text":"The FACE-Q rhinoplasty Module is a rigorously developed PRO instrument to evaluate QoL and that complies with the requirements of international guidelines. This tool is designed to specifically evaluate cosmetic and psychosocial aspects associated with rhinoplasty, and it has been suggested to be the most suitable instrument to evaluate aesthetic outcome.","title":"Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients"}
{"_id":"5cdb4d43-0151-6ee9-7b2b-b22e073d3ce7","text":"The posterolateral dissection of the popliteal fossa has the common peroneal nerve at its distal margin approximately 6-8 cm proximal to the fibular head and usually posterior to the biceps femoris tendon. Dissection through the area of fat directly posterior to the biceps femoris usually reveals the common peroneal nerve which is located posterior and lateral to the popliteal vessels. Protecting the peroneal nerve, the biceps femoris can be fractionally lengthened with partial tenotomies or step--cuts at several levels. The tibial nerve should be identified adjacent and lateral to the popliteal artery in the popliteal fossa.","title":"Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty"}
{"_id":"5ce6b219-915b-a4a7-a9f3-4efd457ce7bf","text":"In wide healthy granulating chronic wounds we successfully applied the FTSG, after meticulous wound debridement, with removal of all debris and securing heamostasis. Graft take was complete for all cases except in three cases in which there were small islands of graft loss due to small subcutaneous hematomas. In those three patients, bed-side wound debridement and regular dressing changes ended with epithelialization and complete healing within two weeks. There were no differences in graft take between acute and chronic wounds, provided that meticulous debridement and absolute heamostasis was done. Whatever the site and size of the grafts; early postoperative erythema or hyperpigmentation were observed in donor site scar. It was improved by time until regaining its original skin color almost within three to six months.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"5ce94c9a-ccb1-06e8-df16-8da5b9b7131f","text":"The patients with elder age, malignant tumor, cardiovascular comorbidity or large postoperative hemostatics dose should be paid high attention to and the minimally invasive surgery are optimal treatment in preventing DVT.","title":"Analysis of deep venous thrombosis after Gynecological surgery: A clinical study of 498 cases"}
{"_id":"5ceea362-948d-51a7-9a70-caa099a8fb47","text":"In this single institutional study, we found a high prevalence of DVT on ultrasound scans and an association between DVT and SIRS score, serum creatinine level and IMV in these patients.","title":"Deep vein thrombosis in acute respiratory distress syndrome caused by bacterial pneumonia"}
{"_id":"5cf29ec0-c2e7-d8c7-eb8d-a346d0eb8c86","text":"As shown in Table 3, candidates for chemoprophylaxis were chosen on the basis of the size of the erythema response following TST during the contact investigation and by examining the difference in erythema that occurred following TST administration at the regular school-entry checkup and following TST administration during the contact investigation. No students who developed a large erythema response during the contact investigation but in whom the difference from the regular school-entry checkup was small developed tuberculosis. Five such students in groups 2 and 3 developed 30+ mm of erythema during the contact investigation, but had only an increase of 19 mm or smaller in erythema from the previous TST, while six such students in group 4 developed 50-59 mm of erythema during the contact investigation but only had an increase of 29 mm or smaller in erythema from the previous TST.","title":"Validity of Using Tuberculin Skin Test Erythema Measurement for Contact Investigation during a Tuberculosis Outbreak in Schoolchildren Previously Vaccinated with BCG"}
{"_id":"5d05f53f-549a-d52e-d62b-585c84409fb2","text":"A prior history of mastectomy may not be an absolute contraindication to sentinel lymph node biopsy.","title":"Axillary sentinel lymph node biopsy after mastectomy: a case report"}
{"_id":"5d0816ae-9a08-9677-997e-2bf8106dd3db","text":"Despite its favorable safety profile, research showed that multiple BTA injections might induce BTA-related immunoreaction in some individuals, hence invoking a delayed-type hypersensitive reaction, which can lead to serious consequences if early allergic symptoms are not taken seriously or even ignored.","title":"Mild Allergic Reactions after Botulinum Toxin Injection: A Case Series and Literature Review"}
{"_id":"5d0972d7-bad9-c151-ed6d-6b18e2d731b6","text":"Conclusions: Our study found distinct vaccine-elicited immune responses between adults and teenagers when both were repeatedly vaccinated in consecutive years. An interactive effect of age and BMI on the HAI composite scores were identified in the overall population and the adults.","title":"Longitudinal Assessment of Immune Responses to Repeated Annual Influenza Vaccination in a Human Cohort of Adults and Teenagers"}
{"_id":"5d098814-269e-18ee-4a0a-83b9673af17f","text":"Carious tissues should only be removed when there is no feasible alternative management such as cleaning cavities regularly with brush and fluoride toothpaste, a method particularly suitable in primary teeth. The guiding principles behind that process of removal are to:","title":"Contemporary operative caries management: consensus recommendations on minimally invasive caries removal"}
{"_id":"5d19e4f6-46ea-79d7-729d-3be18794934b","text":"In the diagnosis and management of patients, diagnostic labels are important since they drive investigation and treatment strategies. The misunderstanding of diseases’ concepts is likely to hamper the indication of diagnostic method procedures as well as can induce inappropriate management. For example, using the term wheezy bronchitis to describe asthma steers people towards prescribing antibiotics for exacerbations. Some physicians and health care professionals consider wheezy bronchitis to be attributable to bacteria without appreciation that often viruses such are responsible for symptoms.","title":"Dissemination of definitions and concepts of allergic and hypersensitivity conditions"}
{"_id":"5d1d4484-eed6-7f6a-58ae-1f9927d0fcca","text":"This data implies that orthopedic leadership often comes from programs with an increased reputation. This trend can be due to a variety of reasons. Often programs with a higher reputation also produce a significant amount of research, which has been shown to be associated with those found in leadership in orthopedics [4]. Also, academic institutions may want to pursue physicians with training at higher ranking residency programs to improve their own reputation further. While many factors go into deciding which programs to rank when matching into a residency program, program reputation may play a role in those hoping to pursue an academic leadership position eventually.","title":"Trends in Medical Training and Leadership at Academic Orthopedic Programs"}
{"_id":"5d2008b5-a98d-4e1f-49de-6891ab896983","text":"The purpose of this trial is to evaluate the efficacy and oncological safety of iNPWT for the prevention of the clinically relevant morbidities after ILND. In addition, this study is an advancement of trial methodology for assessment of postoperative outcomes after lymph node excisions. The study is expected to generate valuable new information in the possible prevention of postoperative complications and improve recovery following cancer treatment.","title":"Prevention of seroma following inguinal lymph node dissection with prophylactic, incisional, negative-pressure wound therapy (SEROMA trial): study protocol for a randomized controlled trial"}
{"_id":"5d202b8d-8be1-fca3-0b39-b1d0645ce80c","text":"One aspect that needs to be explored soon is the possibility that some forms of PDT might exert a negative action on the immune system and on immunosurveillance.","title":"Oxidative Stress and Photodynamic Therapy of Skin Cancers: Mechanisms, Challenges and Promising Developments"}
{"_id":"5d206913-f276-88c8-fa4c-4bafdbade294","text":"BTA is as effective as surgery in the treatment of IXT in children, but the recovery of the fusion is lower than surgery.","title":"Comparison of Botulinum toxin type A with surgery for the treatment of intermittent exotropia in children"}
{"_id":"5d25867e-40bf-275b-2067-976626a8d88d","text":"In conclusion, our study suggests that the development of melanoma recurrence following a negative SLNB might be related to tumour mutation status. If these findings are validated in larger, prospective studies, a role for mutation testing amongst patients with earlier stage disease to guide more intensive surveillance for SLNB-negative patients may be considered, particularly if additional biological parameters combined with BRAF\/NRAS mutation status allow further enrichment of patients with a high risk of relapse. The findings of our study also confirm the importance of continued surveillance to monitor for melanoma recurrence in SLNB-negative patients, particularly in older patients and patients with thicker primary tumours. In the context of the rapidly evolving landscape of melanoma treatment and the more intensive follow-up of high risk patients, it is important to understand the clinicopathological and mutation predictors of disease recurrence following a negative SLNB.","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"5d2c0510-b90d-bc49-2d21-2228debd0f10","text":"The current study has several limitations that should be considered. Firstly, the CFD images did not come with actual ages, and all selected images used were limited to between 20 and 40 years old based on the subjective age ratings provided, meaning that the findings may not generalise to other age groups. Additionally, the chromatic information used in the images did not isolate surface-based cues, as shading caused by facial topography may have influenced chromatic content. Even though the facial bones almost stop growing after the age of 20, increasing age leads to a dissipation of the soft tissue in the face resulting in the bony appearance of the face in older adults. Nose shape and the thickness of the soft-tissue change significantly with age. Such changes in facial topography may cause differential shading that influences the chromatic content of facial images. Therefore, while the current study sheds light on the role of colour and chromatic contrast in facial age perception, it is important to recognise the limitations associated with the age range of face stimuli and the complexity of chromatic information in facial images.","title":"Colour information biases facial age estimation and reduces inter-observer variability"}
{"_id":"5d3a7fd2-83da-92b8-a01c-0bd6c50db2d9","text":"Serious AEs are defined as any untoward and unexpected medical occurrence that:","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"5d43ce4b-a59d-9811-4629-119ab7c6afbd","text":"For curves with 2‐phase decay, we repeated this calculation for both the rapidly and slowly progressing subpopulations. We then calculated the proportion of all remaining patients who would be from the rapidly vs slowly progressing subpopulation at various time points of interest.","title":"Optimal frequency of scans for patients on cancer therapies: A population kinetics assessment"}
{"_id":"5d448a24-60c0-87dd-507b-1d04510cda03","text":"Compared with the anterior lateral thigh flap, the posterior tibial flap is particularly suitable for resurfacing defects of the hypopharyngeal mucosa with optimal functional and aesthetic outcomes, although the anterior lateral thigh flap does not require skin graft on the leg donor site for almost all cases. Lastly, since these flaps provide a long pedicle and large vessels, the microvascular anastomosis is presumably safe and the choice of recipient vessels in the neck is flexible, which is especially important for patients with a history of previous surgery or radiotherapy.","title":"Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma"}
{"_id":"5d6620f3-60ae-b66c-cac5-f00f82200840","text":"Lymphadenitis due to parasitic and reactive causes was clearly more in children as shown in Figure 1. All these benign causes were treated accordingly.","title":"Peripheral Lymph Node Excisional Biopsy: Yield, Relevance, and Outcomes in a Remote Surgical Setup"}
{"_id":"5d7373c2-0454-3d32-ca14-4d7e7b93e403","text":"The reconstruction of lower third of the leg is one of the most challenging problems for plastic and reconstructive surgeons and current approaches are still disappointing. We show an easy option to obtain a coverage of traumatic pretibial defects with good aesthetic and functional results: the association of negative pressure wound therapy, acellular dermal matrix, and skin graft. The choice of this combined therapy avoids other surgical procedures such as local perforator flaps and free flaps that require more operating time, special equipment, and adequate training.","title":"Reconstruction of Traumatic Defect of the Lower Third of the Leg Using a Combined Therapy: Negative Pressure Wound Therapy, Acellular Dermal Matrix, and Skin Graft"}
{"_id":"5d75c69e-159d-56f1-bb42-f78c7a9fbe05","text":"The success of radioimmunoscintigraphy in identifying small cancers, local involvement of normal sized lymph nodes and recurrent cancers that spread in sheets or ribbons or recur as plaques, is that the technique is essentially one of identification or characterisation of a tissue type. It is making use of the subtle differences between the cancer cell and the normal cell. A radioactive pinhead is identifiable if it has enough radioactivity on it, although it may appear over a centimetre across on the gamma camera image because of that imaging system's inherently poor resolution. It is the number of molecules that contain a radioactive signal that bind to each cancer cell that is the crucial determinant. Where tumour associated antigens are concerned there are between 5000 and 50 000 accessible antigens per cell. It has been calculated that there are up to 10 000 HMFG1 epitopes accessible for binding on a typical malignant breast cancer cell surface. This in principle gives a considerable amplification factor, which helps to overcome the poor photon yield of radiopharmaceuticals with gamma camera imaging. The order of magnitude greater detection sensitivity over single photon agents of PET equipment for Positron Emitting F-18 of FDG helps to account for its success. However the amplification of the Glucose Transporter protein 1 because of its upregulation in malignancy as compared to normal tissue appears to be only five to 10-fold.","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"5d78334d-1170-7ad9-6f57-49635fa1b0c9","text":"The objective of treatment should be to treat these patients in a manner that kyphosis does not progress on treatment. The case should be evaluated by imaging adequately to rule out concomitant posterior column involvement along with vertebral body disease. Such cases should be surgically stabilized. The kyphosis which is likely to progress on treatment needs to be kept under observation and for need to be corrected\/ stabilized in active stages of the disease.","title":"Kyphosis in spinal tuberculosis – Prevention and correction"}
{"_id":"5d7b9308-5fda-018c-a7cd-4037d022350a","text":"Referring to the small number of patients in this study, it was not possible to perform subgroup analysis of all the studied angiosomes with respect to initial vascular status and the location of arterial occlusion or stenosis. This will be an important issue for coming studies because vascular anatomy varies widely in PAD, from short stenosis that limits blood flow to complete arterial occlusion. Furthermore, collateralization, which varies as well with respect to duration of PAD, physical activity of the patient and other factors also affect tissue oxygenation saturation. Formation of the collateral arteries due to ischemia-induced neoangiogenesis does not respect the borders of defined angiosomes and affects local tissue perfusion as well. In turn, microcirculation assessed by means of HSI in an angiosome can be normal although the corresponding artery is stenosed or even occluded.","title":"Evaluation of Hyperspectral Imaging for Follow-Up Assessment after Revascularization in Peripheral Artery Disease"}
{"_id":"5d7cc11f-3a78-f331-294e-1b43c646260a","text":"This work adds to the growing body of evidence of high treatment success in early intravenous to oral switch antibiotic therapy in S. aureus prosthetic bone and joint or orthopedic metalware-associated infection. It is now important to clearly define the optimal oral antibiotic regimens and its duration for patient management, and to communicate the international guideline to avoid unnecessary use of intravenous therapy.","title":"Effectiveness of early switching from intravenous to oral antibiotic therapy in Staphylococcus aureus prosthetic bone and joint or orthopedic metalware-associated infections"}
{"_id":"5d7e65bb-e94b-5768-52ca-3469e6efb261","text":"We describe a 19-year-old female patient who presented with acute respiratory failure and diffuse pulmonary opacities on chest radiographic image shortly after liposuction and fat grafting. Bronchoalveolar lavage was performed and lipid content in alveolar cells contribute to the diagnosis of the fat embolism syndrome. The patient was successfully treated with noninvasive mechanical ventilation and a short course of glucocorticoids.","title":"Rare case of pulmonary fat embolism and acute respiratory distress syndrome after liposuction and fat grafting: a case report"}
{"_id":"5d86cd79-1f6d-2cc4-3b1c-d67c5883c397","text":"Sensitivity analyses including all studies regardless of quality included the same studies.","title":"Diagnostic accuracy of three ultrasonography strategies for deep vein thrombosis of the lower extremity: A systematic review and meta-analysis"}
{"_id":"5d898a09-d2e4-92f2-098f-7ac150b70fc3","text":"The method is very simple and except for the equipment investment relatively cheap to run due to the relative small cost of the ICG compound. No pre planning needed as with conventional Technesium 99 labelled sulfur colloid and one can start with the sentinel node identification within seconds after injection. Few adverse reactions to ICG have been reported, however care should be taken in patients sensitive to iodide.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"5d8eb615-907a-e1e0-45ed-575f64007df5","text":"Medicare Australia is a universal health insurance scheme that reimburses patients for medical fees incurred. Benefits are paid according to the Medicare Benefits Schedule (MBS) with respect to each individual Medicare item number. The item number for treatment of 10 or more solar keratosis by cryosurgery is 30192. There is no item number for treatment of fewer than 10 AK and therefore no reimbursement for cryotherapy treatment of less than 10 AK.","title":"Cost for the treatment of actinic keratosis on the rise in Australia v2; ref status: indexed"}
{"_id":"5d919369-4307-a8d5-ceda-608b50232354","text":"Obtained data were statistically processed using Microsoft Excel and Prism 8 software.","title":"FOXP3 in Melanoma with Regression: Between Tumoral Expression and Regulatory T Cell Upregulation"}
{"_id":"5d95b24f-8107-46bb-bc12-1726902a436a","text":"It is worthwhile to consider that the omitted dissection of the third nodal level does not imply an augmented risk of recurrence.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"5d9ad0a8-3cec-27cd-c255-88c667340002","text":"The difficulty of the methods described demonstrates the necessity of having an experienced pathologist to evaluate extemporaneously micro metastases or isolated metastasis cells. As proposed by the American Society of Breast Surgeons, accreditation should be given to surgeons practicing sentinel node examination in breast cancer after teaching and evaluating their technique.","title":"The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management"}
{"_id":"5d9b4c15-71f9-d6a0-edd1-ae8225307db9","text":"Studies have conferred that there is a strong genetic association between HLA alleles and susceptible drugs leading to hypersensitivity. Patients with HIV have the highest risk of developing active Tuberculosis. So here we studied the genetic predisposition to anti-tuberculosis drugs as a model to study the pathological role of HLA alleles in drug hypersensitivity.","title":"Risk assessment studies on HLA association with drug induced hypersensitivity caused by anti tuberculosis drugs – an in silico approach"}
{"_id":"5d9dab2d-224a-93cc-b760-185152ed2112","text":"Although the significant difference in the number of lymph nodes in the surgery and pathology groups suggests that there will be a difference in the pathology result, the result is not significant. This result shows that pathological dissections are also sufficient and the surgeon-pathologist harmony is excellent.","title":"N1 lymph node detection in lymph node harvesting in non-small cell lung cancer: Formaldehyde exposure is a drawback?"}
{"_id":"5da588e7-c545-ab90-8a9b-f3d85dc56337","text":"Hematoma represents a less frequent periprosthetic finding, for which an MRI can provide information on the time of onset, with a hyperintense signal in the T1 sequences in the acute forms tending to decrease progressively in the subacute and chronic forms.","title":"Medical Imaging of Inflammations and Infections of Breast Implants"}
{"_id":"5da8e297-c121-1ac8-f628-a9ab93833d93","text":"Not required as data is not individualized and primary data was not collected. Not required as data is not individualized and primary data was not collected.","title":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis"}
{"_id":"5db91eb4-6397-e5cb-f7b8-f7157cfe05e9","text":"The excision orientation should take into account the local lines of tension, as it can be seen in Fig. 1, in order to decrease the necessity of skin grafting or extensive reconstructive procedures. A personal approach consists in a round excision with the proposed margins and subsequently the excision of the tegument extensions needed for a linear closure, that reveal themselves clearly under the local tissue tensions.","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"5dbf6348-6898-1c4a-6dca-87a0fab143d7","text":"Micropigmentation used for permanent makeup along with needles should not be toxic to the human body, and pigments of various colors deposited in the skin after the procedure should retain their color for a long time. The injection of inorganic pigments into the skin can cause chronic and systemic diseases.","title":"Analysis of microstructural characteristics and components of red and yellow ink pigments used in permanent makeup"}
{"_id":"5dca390b-8eb5-2e57-6c02-2fda0380e503","text":"The present report is the first to highlight the important role of radiation therapy in the management of patients with aggressive cutaneous scc and a history of cll. We describe 4 patients seen in our multidisciplinary non-melanoma skin cancer clinic who had local recurrence following surgical excision of a cutaneous scc in the head-and-neck region, where further surgery was not recommended, and the treatment modality of choice was local radiotherapy. Although the final outcome for all patients was not total eradication of local disease, radiation was able to provide local control for several months.","title":"Treating recurrent cases of squamous cell carcinoma with radiotherapy"}
{"_id":"5dccaf6e-b5f7-fe32-0c05-92c9520199bf","text":"The deterioration of facial nerve function or hearing, rapid tumor growth, or impending labyrinthine erosion or other complications require the consideration of conducting more aggressive treatment strategies. Irradiation or fallopian canal decompression of tumors is often employed for facial nerve function with an HB grade between II and IV. Microsurgical excision and facial nerve repair is generally delayed until the facial nerve function deteriorates to HB grades IV–VI. This is due to the consideration that postoperative facial nerve paralysis is expected to last for six to 18 months, which may be followed by an improvement to an HB grade III at best. In conclusion, the present case identified that enhancement of the geniculate ganglion is an important characteristic to identify when evaluating the MRI appearance of cerebellopontine angle masses. In addition, a more conservative treatment modality may allow a greater number of patients to experience improved long-term facial nerve function in the management of facial nerve tumors.","title":"Facial nerve schwannoma: A case report and review of the literature"}
{"_id":"5dd0aeba-d12a-a7f1-9753-f0aad34eb1b0","text":"These reported studies exhibit how PAI can be exploited to pre-operatively map the skin cancers to aid the surgeons in planning their excision surgery to save time and increase the accuracy of lesion margin removal. However, the challenges for PAI in skin cancer detection remain as the system’s detection limit of the imaging depth is only about 10 mm [82,83] and thus the technical design of the handheld probes have to be modified to address this pitfall. Furthermore, 3D mapping of the skin lesions are sensitive to motion so acquisition with artefacts have to be discarded. Future studies to validate the use of PAI in delineating skin cancer lesions would be using the pre-operatively determined tumor dimensions in the surgical planning process and judging the extent of cancer clearance.","title":"A review of clinical photoacoustic imaging: Current and future trends"}
{"_id":"5dd17a1b-2eb6-e2c2-536c-fa9281762d29","text":"Autologous bone grafting within induced granulation tissue membranes, otherwise known as the Masquelet technique described in 1986,[ is a relatively simple method of treating segmental bone defects in the upper and lower extremities. Thorough debridements are needed to remove all dead and infected tissue and an antibiotic cement spacer is temporarily implanted in this well prepared environment. Soft tissue coverage of the defect is another prerequisite to induce a biomembrane. Repeated superficial debridements may take place during the time of the implanted spacer in situ. The induced membrane is made of a type 1 collagen-heavy matrix with fibroblastic cells and contains high concentrations of growth and osteogenic factors.[ The best timing of the spacer explantation remains under debate as well as the use of additional growth factors.[ During cement spacer removal the membrane is opened for insertion of bone graft and the membrane is then closed. The membrane is supposed to protect against autograft bone resorption by supplying it with growth factors and vascularization and preventing soft-tissue interposition. It serves as a barrier to outward diffusion of growth and osteoinductive factors throughout bone healing. The definitive fixation can be obtained either with a nail or plate.","title":"Infected tibia defect fractures treated with the Masquelet technique"}
{"_id":"5ddb7d8d-4aea-4c0f-10b2-1b92c2df30b0","text":"Emerging from the lateral surface of the peroneal nerve, we can identify the lateral sural cutaneous nerve (Figure 3). This nerve is responsible for the sensory innervation to the posterolateral surface of the leg. The sural nerve is formed from the fusion between a communicating ramus of the lateral sural cutaneous nerve and the medial sural cutaneous nerve in the middle of the leg. If possible, this superficial communicating ramus should be preserved during the dissection over the lateral head of the gastrocnemius. In case of tumor involvement of the lateral cutaneous sural nerve or its communicating ramus, their sacrifice does not cause significant sensory deficit, if the medial cutaneous sural nerve is preserved. The medial cutaneous sural nerve has its origin from the tibial nerve and emerges from the popliteal space to run superficially in the groove between the two heads of the gastrocnemius muscle near to the small saphena vein in the middle of the back of the leg. Division of the medial cutaneous sural nerve results in cutaneous anesthesia.","title":"Popliteal lymph node dissection for metastases of cutaneous malignant melanoma"}
{"_id":"5de13a14-0f4b-0996-e5bf-2a330dc2eb90","text":"Tumor arthroplasty or allografts remain the reconstruction mode of choice if the epiphysis reveals tumor infiltration and neither a wide resection of the primary tumor nor a sufficient fixation of the interposition can be realized although there have been efforts even to implement biological reconstruction methods for osteoarticular defects [43].","title":"Bilateral Fibular Graft: Biological Reconstruction after Resection of Primary Malignant Bone Tumors of the Lower Limb"}
{"_id":"5de5054f-f356-5cdd-f5be-dbc24f942841","text":"Breast reduction mammaplasty is one of the most common procedures performed by plastic surgeons in the United States. Despite many surgical options, most plastic surgeons use the reliable and easy to learn Wise pattern technique. However, other techniques such as liposuction reduction are also available to select patient populations. Given the rise of obesity in the American population, complications related to breast reduction in cases of severe macromastia will continue to be a concern for plastic surgeons. This prevalence of massive gigantomastia has led to innovations in reduction mammaplasty and the implementation of newer techniques such as modifications to the traditional Wise pattern technique and the use of intraoperative laser angiography techniques to assess nipple viability.","title":"Breast Reduction Mammaplasty"}
{"_id":"5de8140d-d61e-70d3-cfd3-d161b6cfdc32","text":"Breast ultrasonography is a cost-effective and widely available screening tool, which detects tumors by bouncing acoustic waves off breast tissue. To identify the structure of the human breast, an ultrasound transducer is generally applied to measure the acoustic waves reflected from the breast. Breast ultrasonography increases the cancer detection rates for subjects with high breast cancer risk and it helps to identify cysts and solid masses, but less efficient compared to mammography.","title":"Early Diagnosis of Breast Cancer"}
{"_id":"5dea586e-d972-a358-cfb0-115e4ffbc276","text":"Nasal reconstruction is deeply founded on the nasal subunit principle, and the physician must bear in mind the various tissue quality among the subunits when outlining a reconstructive strategy. Primary targets of nasal reconstruction are complete tumor resection along with a satisfactory cosmetic and functional result. Reconstructive surgeons should treat each patient as a distinct individual with a peculiar defect, and the procedure should be customized according to the clinical conditions and the demands and wishes of our patients.","title":"Reconstruction of the Nose: Management of Nasal Cutaneous Defects According to Aesthetic Subunit and Defect Size. A Review"}
{"_id":"5dfa1a29-947d-4c36-09d5-7ff0a860c7af","text":"Telemedicine can be an important tool for educating the medical practitioners at remote areas. Teleeducation of the doctors at remote areas about the spectrum of plastic surgery will also result in more accurate and direct referrals for our specialty.","title":"Awareness and Perception of Plastic Surgery among Healthcare Professionals in Pune, India: Do They Really Know What We Do?"}
{"_id":"5dfae9b0-deea-9bbf-fe7c-9a3069059375","text":"Second purpose of the trial was to examine, if sevoflurane preconditioning of the lower limb would probably be effective in patients with occlusive arterial disease. Effective sevoflurane preconditioning was defined as a significant effect of sevoflurane preconditioning on rSO2 measured by NIRS during IPC and on rSO2 measured by NIRS during postoperative reperfusion.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"5e0e2ad7-4d75-0d38-b08b-373d844dc536","text":"Our research showed that almost half of the respondents are convinced that hydrolysis removes the immunoreactive properties of soy. Most of the interviewed medics claimed that patients allergic to soy may consume products with added soy preparations. While not questioning the lower allergenicity of hydrolysates compared to raw materials and considering their small amount in products, it must be remembered that allergic reactions can happen after contact with even a minimal amount of the allergenic content. Research on immunoreactive properties of soy preparations indicate the necessity to control individual additives and products. It is the only way to properly evaluate their antigenic properties and correctly label products, which, in turn, will increase the safety of allergic people.","title":"Soy Preparations Are Potentially Dangerous Factors in the Course of a Food Allergy"}
{"_id":"5e1f358f-820c-22a2-d75f-d926288c89c4","text":"All procedures were performed with the patient under general endotracheal anesthesia. The technique that is normally used for a standard inguinal lymph node dissection was used in the present study patients. The aim of this approach was to remove all of the lymph nodes that were in the most probable location for first-line lymphatic invasion. The technique used for the selection of the incision sites and the creation of space was based on the technique described by Xu et al (13).","title":"Preliminary experience of performing a video endoscopic inguinal lymphadenectomy using a hypogastric subcutaneous approach in patients with vulvar cancer"}
{"_id":"5e1f9366-6a7e-622a-d192-71e2e9dd02e1","text":"No better substitute for scalp tissue exists than scalp tissue itself. Tailoring the right procedure for the right patient is necessary for scalp coverage either with flap or skin expansion techniques.","title":"Surgical treatment of secondary cicatricial alopecia of scalp and eyebrow"}
{"_id":"5e27255f-92a2-fe32-702b-72221d071fcc","text":"We conclude that, at the time of implantation, the endothelial layer of saphenous veins harvested endoscopically is more preserved than the endothelium of saphenous veins harvested using the open method. However, none of our patients showed clinical signs of arterial or venous graft failure following the endoscopic or open harvesting 1 to 2 years after surgery.","title":"Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery"}
{"_id":"5e28d39a-35e7-fe20-1e8c-a5bac248ae5d","text":"Patients with a long duration of anamnesis and refractory to former treatments could be enrolled. The use of analgesics before and after enrolment was not limited. Patients having undergone surgery or shock wave therapy after randomization were excluded.","title":"Randomized multicenter follow-up trial on the effect of radiotherapy on painful heel spur (plantar fasciitis) comparing two fractionation schedules with uniform total dose: first results after three months’ follow-up"}
{"_id":"5e29db0f-465a-51ec-191e-2cadcbcbca49","text":"The decision to perform an SIEA or DIEP flap takes into account many factors, particularly the intraoperative availability and reliability of the vascular pedicle. Increased abdominal fluid output following SIEA dissection is another factor for surgeons to consider when deciding what flap to raise, given the increased risks of infection and reduced mobility with prolonged time with drains and, in some centers, a potential for a longer hospital stay.","title":"Increased Production of Abdominal Donor Site Fluid Following Microsurgical Breast Reconstruction With Superficial Inferior Epigastric Artery Versus Deep Inferior Epigastric Artery Perforator Flaps"}
{"_id":"5e31875d-851f-aa2e-f3e6-034cc303133d","text":"First, we performed an analysis on the patients. Patients were considered with concordant results when the same lymphatic sites were found in both the Auckland database and our lymphoscintigraphy; patients were considered with no concordance results when our lymphoscintigraphy differed from the Auckland database in at least one of the lymph node levels. Cohen’s kappa was performed to evaluate the agreement.","title":"The Lymphoscintigraphic Study of Unpredictable Head and Neck Cutaneous Melanoma Lymphatic Drainage"}
{"_id":"5e55dc58-75a2-dcdd-a061-a23223b2de64","text":"Minimalistic approaches are no longer viable for women with breast cancer, and the aim of the contemporary surgeon is to team up with all available specialists, and to coordinate efforts to reach the goal of local control.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"5e5bad98-06aa-cc69-c24a-724e19a39edd","text":"Benign plexiform neurofibromas may grow rapidly in children and adolescents (Figure3). Children and young adults with rapidly growing tumours or large total body tumour burden may be at especially high risk for developing an MPNST in the future, but longitudinal whole body MRI studies with longer follow up are needed to determine whether this is so. We note with some concern that whole body tumour burdens greater than 1000 mL are distinctly unusual in the patients we studied over 40 years of age.","title":"Growth dynamics of plexiform neurofibromas: a retrospective cohort study of 201 patients with neurofibromatosis 1"}
{"_id":"5e5c88cc-e4d0-a9c4-acd7-fd8347494282","text":"Intradural fat graft packing is unnecessary in the endoscopic endonasal pituitary adenoma resection. The outcome of our graded sellar floor reconstruction strategy is satisfactory.","title":"Intradural fat graft packing is not indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries"}
{"_id":"5e5e778f-22c7-5acb-bfbe-8e8c62601bb4","text":"CONCLUSIONS Based on the result that FUS treatment with high MI and very short duration can enhance therapeutic effects of DC treatment, it is assumed that mechanical effects of FUS might be the main mechanism for enhanced treatment effects of DC therapy. In order to investigate the detail of FUS effects on different therapeutic outcome and to improve the treatment protocol for enhanced therapeutic effects of the combined treatment further study will be followed.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"5e5f05e8-5f38-ef28-9ad1-3ebc6e8f633f","text":"Intradermal and subcutaneous injections of UCA in the mammary areola region may have clinical application value for the identification and localization of SLNs in breast cancer patients. The identification rate is higher than that of blue dye method, which can be used as a new tracer of sentinel lymph node biopsy and complement other staining methods to improve the success rate.","title":"The value of contrast‐enhanced ultrasound in determining the location of sentinel lymph nodes in breast cancer"}
{"_id":"5e68a148-00c0-4afe-c81a-d7366db814ec","text":"Finally, the predictions of trends in sperm cryopreservation incidence given by the two models (the Poisson regression model and the Verhulst model) were compared with the true sperm cryopreservation incidence rate observed in the CECOS network of French regional sperm banks.","title":"Sperm cryopreservation incidence in men with testicular cancer: towards a stabilization in testicular cancer incidence? Results from the CECOS network"}
{"_id":"5e68ccee-1e2d-ad54-4b55-0e2bf3229d43","text":"The use of WB-MRI within 6 months of disease suspicion may serve as a benchmark to support early diagnosis of CRMO. Quantitative MRI features such as T2 SI ratios correlate with clinical outcome. They are suitable for response assessment and can be used as prognostic markers for the prediction of clinical response.","title":"Early diagnosis and response assessment in chronic recurrent multifocal osteomyelitis: changes in lesion volume and signal intensity assessed by whole-body MRI Kieninger et al"}
{"_id":"5e6c9c16-8142-4a53-36de-c4e87055f04c","text":"The results confirm that comparable margins and reconstruction options are achievable when excising keratinocyte cancers under LA by surgical trainees. This is fundamental in cost and timesaving, as well as reducing risk of aerosolisation of virus during GA, in a pandemic.","title":"Keratinocyte Skin Cancers in General Surgery: The Impact of Anaesthesia, Trainee Supervision, and Choice of Reconstruction"}
{"_id":"5e70def9-6daa-32ce-f3a4-4ee1b8874c34","text":"Immediate repair and reconstruction after tumor resection were performed in all cases by two operating teams, one performing jaw resection and a second harvesting the flap. Before tumor resection and achievement of clear margins, a titanium reconstruction plate was temporarily fixed to the lower margin of the mandible in the location of anticipated mandibular segments. An aluminum template of the reconstruction plate was placed. It guided the reconstruction plate to be bent according to the mandibular curvature. A reconstruction plate was given to second team to shape the new mandible donor site before division of flap to minimize the ischemia time. The holes for the recon-plate and those of screws on the mandible were noted with markings to ensure that they were replaced in the exact position after resection and during flap in setting. The tumor was subsequently resected with safe margins, and the remaining mandibular segments were secured by mandibular maxillary fixation. A previously shaped transparent sheet of plastic was utilized to produce an outline and shape of the defect on lateral cephalogram (1:1). It was also used as a stencil to shape the harvested flap. Measurements were taken with help of a calibrated scale, which was also used for orientation of bony wedge to be removed between osteotomies (Figure 1a,b).","title":"Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study"}
{"_id":"5e766ed6-067c-401d-cd7c-14082c73ee8e","text":"Complete diagnostic ultrasound assessment of the proximal and distal lower limb veins using a combination of colour and spectral Doppler and compression ultrasound is undertaken on initial presentation. The diagnostic ultrasound is undertaken by Clinical Vascular Scientists from the Vascular Studies Unit, UHBristol who are trained locally under the standards of the National School of Healthcare Science NHS Scientist Training Program. The unit performs between 2000 and 2400 diagnostic ultrasound assessments for DVT annually and has a detection rate of 20–24 %. The following details are recorded: thrombosis location and extent, if the thrombosis is occlusive or partially occlusive and if adherence to the vessel wall is complete or partial. Any relevant clinical history is recorded at initial presentation including the nature and duration of any clinical symptoms.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"5e7e6de1-5743-a864-f492-261300a6bd8b","text":"Injuries to upper limb has been on the increase and is invariably associated with significant soft tissue loss requiring a flap cover. Local tissue may not be available for cover in a majority of situations, necessitating import of tissue from a distant source. We have utilized the thoraco-umbilical flap taken from the trunk for this purpose. This flap is based on the perforators of the deep inferior epigastric artery that are maximally centred on the periumbilical region. This flap was used in 83 patients. The patients were observed for at least 3 weeks and any flap or donor site complications were recorded. The patients were again followed up at 3 months interval and the donor site scar was assessed. The flaps survived in 81 patients; there was marginal flap necrosis in five patients and partial flap necrosis in two patients. None of these patients required any additional procedure for coverage. The flap is technically easy to plan, almost effortless to drape around upper limb defects, with no significant donor site morbidity and also the post operative immobilization was fairly comfortable. The thoraco-umbilical flap thus is a very useful technique for coverage of the upper limb and is recommended as a first line flap for this purpose.","title":"The pedicled thoraco-umbilical flap: A versatile technique for upper limb coverage"}
{"_id":"5e7ef10b-268a-a57e-1bd0-0f86d247c9a8","text":"Another important characteristic of desmoid-type fibromatosis is their expression or not of S100 protein. Most DTs are negative for S100 protein but a small percentage of cases can demonstrate S100 protein immunopositivity. This is an important diagnostic criterion that must be taken into consideration when confronting this type of tumor.","title":"An unusual finding in a desmoid-type fibromatosis of the pancreas: a case report and review of the literature"}
{"_id":"5e85c2f8-5b6e-6524-c189-572c1ca74b61","text":"IgE-dependent and immune complex reactions and vesiculobullous diseases are immunopathogenic reactions usually developing when the medication has been used for some time and resolves when it is withdrawn or may be triggered rather than being induced by medication, in which case the disease runs a persistent clinical course despite the withdrawal of the offending drug.","title":"Adverse Immunologically Mediated Oral Mucosal Reactions to Systemic Medication: Lichenoid Tissue Reaction\/Interface Dermatitis-Stomatitis, Autoimmune Vesiculobullous Disease, and IgE-Dependent and Immune Complex Reactions"}
{"_id":"5e89051d-8378-9c1a-ccf5-229f417731e6","text":"The SCIP flap is one of the most advantageous flaps because it enables the reconstruction of multiple lesions with one source vessel. It can be designed with a lobulated appearance in order to repair two or more wounds simultaneously by anastomosing one group of blood vessels.","title":"Free superficial circumflex iliac artery perforator flap with a single-pedicle bilobed design for pediatric multi-digit defect reconstruction"}
{"_id":"5e8b2601-52f6-08a9-ab71-2b9f7eed7477","text":"Preoperative vein mapping facilitates rapid and accurate location of the vein, thus reducing soft tissue injury and the creation of tissue flaps. It also helps to predetermine the best segment of the vein for grafting.","title":"Surgical Aspects of No-Touch Saphenous Vein Graft Harvesting in CABG: Clinical and Angiographic Follow-Up at 3 Months"}
{"_id":"5e94bd23-48ba-67c5-2ca5-21997831b3e9","text":"The reasons for the incomplete removal of tumors destroyed after photodestruction should apparently be associated with the topography of the subcutaneously located vessels, the distribution of the photosensitizer and its dose, the parameters of the laser irradiation, and the distribution of the photodynamic exposure energy in the biological tissue.","title":"On the Pathomorphological Pattern of the Efficiency of Photodynamic Therapy of Murine Melanoma B16 Using a New Photosensitizer Based on Chlorin e6 Conjugate with a Prostate-Specific Membrane Antigen"}
{"_id":"5e974643-1c84-d0c7-3036-a8ef97c08917","text":"During routine neck dissection, a horizontal skin incision was first made 2 cm below the mandible and carried down through the subcutaneous tissue and platysma. The submandibular gland was then dissected free of the surrounding structures cranially and caudally, up to the horizontal branch of the mandible and down to the level of the hyoid bone. During the preparation of the submandibular gland flap, the capsule of the submandibular gland was well-protected.","title":"Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers"}
{"_id":"5ea09715-d685-3d6c-0bc3-fd72cc1148e3","text":"There are no definite study results on this topic so far. But an animal study on rabbits has shown miscarriage and other side effects. Botulinum toxins are classified into Pregnancy category C drug, and there is a report that a woman who underwent botulinum toxin treatment gave normal birth to a child. There is no report of teratogenicity up to date; however, the use of botulinum toxin during pregnancy is generally not recommended.","title":"Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain"}
{"_id":"5ebe3da8-a404-681d-517e-68a418ea7080","text":"This case demonstrate the feasibility of minimal invasive procedure of harvest an omental flap laparasopically, and the use of large omental flap to cover the entire scalp of a child skull the probably even latissimus dorsi flap may not provide similar coverage and pliability.","title":"The use of an omental flap for the reconstruction of a burn injury to the scalp: A case report"}
{"_id":"5ec21952-f0ad-53a6-795b-57181651fe8c","text":"The study findings suggest that NPWT applied to the healing process of flap closed-incisions after 3D prosthesis implantation in patients with COSTD can reduce the occurrence of postoperative major complications and promote the recovery of lower limb function and daily activities, which should be recommended for clinical practice.","title":"Negative pressure wound therapy for flap closed-incisions after 3D-printed prosthesis implantation in patients with chronic osteomyelitis with soft tissue defects"}
{"_id":"5ec9286c-4fb5-5051-b067-2e7a9b98244e","text":"The study also shows that when compromised flaps are salvaged quickly there is not a significantly higher price to pay, although the necessary theatre time is expensive (£1000 an hour). The 5 patients who had early flap salvage did not have a significantly greater mean cost in the study group. On the other hand, in the one case where the free flap was not salvaged there was an extremely high cost. The patient had three further operations, including the second free flap and the associated 90 day stay. Although the additional hospital stay did result in an extra nightly payment this was much less than the actual cost and this was by far the most underfunded case.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"5ecbb0cf-d999-688d-8360-42a06c146a68","text":"The rheological characteristics influence the integration between the HA filler and the surrounding soft tissue and determine the HA filler capacity to modify the volume of the injected anatomical layer. It is mandatory for clinicians to be able to select the filler with appropriate characteristics to achieve the desired final clinical results. The filler selection is based on the anatomy of the injected area, on tissue consistency, on tissue thickness, on the tightening of the retaining areas, on the intensity and strength of mimetic muscle activity, and lastly, on external forces acting on the facial zone and on the anatomical layer selected by the injector. In each facial area, all these variables change and the selection of filler necessitates an accurate assessment. Other considerations that may come into play when selecting fillers include the presence or absence of local anesthetic. Since this has become standard practice in filler manufacturing, future studies may explore the effects of lidocaine on the physicochemical properties of fillers upon integration in soft tissue.","title":"The Rheology and Physicochemical Characteristics of Hyaluronic Acid Fillers: Their Clinical Implications"}
{"_id":"5ed2e01d-c593-e21d-aa75-46cdcafdbd6b","text":"According to a famous Canadian marijuana activist who established his method of extracting oil from cannabis for promoting its homeopathic uses in various types of skin cancers such as melanoma cancer and Basal Cell Cancer and the oil is extracted from potent sedative Indica strains that consist of about 90% of THC level. However, it is illegal to produce oil from cannabis, and there are no clinical trials conducted for its efficacy and safety in humans [326].","title":"Skin cancer: understanding the journey of transformation from conventional to advanced treatment approaches"}
{"_id":"5ede56a1-c508-f3a1-8cfc-c1cb36a22c6e","text":"Remodeling of the nose can be one of the most challenging components of facial plastic surgery. Typically, it is taught and performed in a seemingly artistic manner without an empiric base. With all the elements of the nose and intricacies of wound healing, the entire notion of rhinoplasty can be overwhelming. Most rely on surgeon experience to determine which technique to employ, or in our case, how much cartilage to resect in order to achieve a certain outcome. Our aim was to provide an element of predictability to less experienced and perhaps even seasoned rhinoplasty surgeons.","title":"Nasal Sculpting: Calculated and Predictable Tip Elevation With Cephalic Trim Redstone et al"}
{"_id":"5ee43e86-b3cc-4747-587b-9ec6b99b26fd","text":"Epidural anaesthesia has shown decreased incidence of deep venous thrombosis in these patients. All of our patients of hip and knee replacement were done under epidural anaesthesia followed by subcutaneous injection of low molecular weight heparin 40mg for 5 days from the first postoperative day to prevent deep venous thrombosis.","title":"Demography of Total Joint Replacement Surgeries Performed in a Tertiary Care Hospital: A Cross-sectional Survey"}
{"_id":"5ee484bc-2654-a55a-50aa-d01b52426704","text":"Retrospective data on the omental biopsies was collected and the histopathology reports were reviewed.","title":"Ultrasound-guided omental biopsy: Review of 173 patients"}
{"_id":"5ee4eca5-710e-23f1-0747-63c088f29f8f","text":"Subcutaneous injection of the isotope is strongly recommended to trace SLNs distributed at level 2 because of the possibility of skipping metastasis. Intradermal injection of blue dye are superior methods for tracing SLNs located at the latissimus dorsi lateral margin; however, whether such SLNs should be removed still needs to be determined by further large multicentered clinical studies.","title":"Retrospective observational study about reducing the false negative rate of the sentinel lymph node biopsy Never underestimate the effect of subjective factors"}
{"_id":"5ee7aed5-4ada-3504-5815-3178a6b192ff","text":"A comparative descriptive and statistical analysis between parascapular and latissimus dorsi flap is shown in Table 2. Nine patients received a parascapular free flap for scalp reconstruction. Herein, necrosis of the flap occurred in one patient after several attempts to salvage the flap such as a conversion to the facial vein with a vein graft and interim recovery after venous congestion. Secondary reconstruction of the defect was done with a microvascular latissimus dorsi flap with a STSG.","title":"A Standard Algorithm for Reconstruction of Scalp Defects With Simultaneous Free Flaps in an Interdisciplinary Two-Team Approach"}
{"_id":"5eecdca3-7659-65a1-a847-a421dfc54151","text":"As with the removal of any lesion, the goal of the surgeon in dealing with GCTTS is to excise the tumor with minimal disruption to adjacent structures. However, adequate excision may be compromised in an effort to fully preserve anatomical structures. Because recurrence is thought to be due to incomplete excision of the tumor or satellite lesions, a balance must be maintained between salvaging tissue and adequately removing tumor margins. Increased recurrence has been associated with distal joint location of the tumor4 and direct involvement of the tumor with the extensor tendon, flexor tendon, or joint capsule.22 This is likely due to more difficult excision of such tumors. In light of these findings, it has been suggested that the surgeon be more aggressive in removing tumors that are directly involved with these structures.22 The reported recurrence rates of GCTTS appear to be decreasing over time but remain variable between studies. This variation may be due to publication bias, but could also be ascribed to different surgical techniques, with inadequate tumor removal resulting in an increased risk of recurrence. To minimize recurrence, complete marginal excision should be performed.","title":"Giant Cell Tumor of the Tendon Sheath: Experience With 65 Cases"}
{"_id":"5ef1d21e-c83f-65de-d02c-d76d4a5994a0","text":"The presence of lymphadenopathy requires further investigation. Often its presence is explained by a simple viral illness or trauma. Rarer causes are often made apparent by thorough history taking and examination. The need for a biopsy is controversial. We report a case where the answer may have been staring us in the face if we knew where to look. The fact that a tattoo causes lymphadenopathy is well known in the acute phase. This is thought to be due to local inflammation from the initial insult. However, to our knowledge there have been no reports of a palpable node after time delay this long.","title":"Tattoo pigment in an axillary lymph node simulating metastatic malignant melanoma"}
{"_id":"5f016afe-8082-2049-8451-48d890ee8f53","text":"The treatment of chronic tibial osteomyelitis is a thorny problem in orthopedic surgery. Patients determined to accept limb salvage treatment usually undergo multiple previous surgical interventions, causing soft tissue compromise and bone defects. In the last few years, Ilizarov technique of distraction osteogenesis has gradually became a main method to treat tibial chronic osteomyelitis. Comparing with other methods, Ilizarov bone transport could solve not only the segmental defect but also the coexisting problems. However, limb salvage option with conventional Ilizarov technique is time-consuming for both the surgeon and the patient and is associated with many complications due to the prolonged treatment time. The main aim of the present study was to investigate a modified technique to obtain elimination of infection and to substantiate that this technique can diminish the EFI and reduce the risk of complications.","title":"L-shaped corticotomy with bone flap sliding in the management of chronic tibial osteomyelitis: surgical technique and clinical results"}
{"_id":"5f0dd64b-40cc-b70e-0fe8-08c9edbd4945","text":"The purpose of this study was to evaluate the antitumor efficacy of PDT with this photosensitizer against transplanted murine B16 melanoma according to the histological and immunohistochemical pattern observed in the area of laser radiation exposure on the 21st day after PDT.","title":"On the Pathomorphological Pattern of the Efficiency of Photodynamic Therapy of Murine Melanoma B16 Using a New Photosensitizer Based on Chlorin e6 Conjugate with a Prostate-Specific Membrane Antigen"}
{"_id":"5f1f7650-d642-071a-83d2-67e69761dbbb","text":"A further potential benefit of targeted oral therapy includes a reduction in use of broad-spectrum antibiotics and the consequent risk for emerging antibiotic resistance.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"5f210191-baa4-ada2-5992-a1bf51a0aef6","text":"The primary tumors have underwent an complete excisional biopsy (margin of less than 3 mm as recommended of the NCCN guidelines) before the radical surgery, or an immediate radical excision if melanoma was strongly suspected. The excision margin was recorded in the operative note as the surgical distance from the edge of the tumor or the center of the scar (minus 3 mm) in cases of complete lesion excision for biopsy to the closest peripheral cutaneous edge, which was measured and photographed before making an incision. The skin incision was continued vertically down to the deep fascia. Patients underwent direct primary closure or reconstructive surgery with a local flap or a skin graft according to the specific condition of the wound.","title":"Surgical resection margin for T3–T4 primary acral melanoma: a multicenter retrospective cohort study"}
{"_id":"5f24ff6b-bcc8-b609-2dd5-f7192c9d3222","text":"The age group of patients ranged from 45 days to 90 years of age and the maximum number of patients were in the age group of 31-40 years.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"5f2cac2b-0403-fc55-4481-79e182ab9bcf","text":"To the best of our knowledge this is the first study comparing the flap characteristics and functional outcomes of the two commonly performed flap techniques and shows significant differences between the two flaps. However due to technical difficulties and contraindications of either flaps in specific circumstances randomization was not possible. This could be the reason of lack of clinical and randomized controlled trials comparing the two techniques. During the seven year study period, the five year follow up for tumor free survival was not possible in all patients. We also recommend future studies with randomization among patients in selected cases where both the flap techniques can be used safely with longer follow up.","title":"Submental versus platysma flap for the reconstruction of complex facial defects following resection of head and neck tumors"}
{"_id":"5f2e6aac-8251-a46a-8f1e-c9f405bff177","text":"Taking into account the great number of skin malignances that occur in the head and neck regions, problems related to their surgical treatment represent a constant concern for plastic surgeons. They have to deal with the difficulties of radical excision and also with reconstructive possibilities. More than 2\/3 of these malignances are basal cell carcinomas, which, if left untreated might become very invasive, surgical treatment being more difficult in such cases. Recurrent carcinomas combined with radiation injuries represent a serious challenge even for experienced surgeons regarding the size of the defect and anatomical structures involved.","title":"Surgical treatment of a case of recurrent irradiated basal cell carcinoma of the head with a large soft tissue and bone defect"}
{"_id":"5f30e12f-ae5b-b18f-99d2-6e840e23d246","text":"The number of lumbar spinal surgery complications is proportional to the extent of surgery, lowest with minimally invasive degenerative disk procedures and greatest for scoliosis and dysraphism repairs. Complications can occur at any time in the postoperative period. Immediate postoperative complications are related to improper hardware placement, most commonly an intracanalicular pedicular screw course, resulting in vascular or neural injury. Complications that occur in the scale of days and weeks post hardware placement are seroma\/haematoma and infection within the postoperative site, including the hardware or superinfection of postoperative collections. Hardware loosening usually occurs over a period of months to years post surgery and is associated with hardware failure.","title":"Imaging of lumbar spinal surgery complications"}
{"_id":"5f3649d3-74d0-1b3c-3a5d-cbd1a60adfa4","text":"The technique of two triangular flaps allows achieving all therapeutic goals, formation of symmetric lips and commissures of the mouth, reconstruction of the orbicularis muscle of mouth to restore labial function, and reconstruction of the commissure of the mouth with a natural looking contour. The advantage of this technique is that the position of the commissure of the mouth can be adjusted intraoperatively according to the extent of macrostomia. All these methods emphasize the importance of restoration of the integrity of cheek and lip muscles.","title":"Bilateral Transverse Facial Cleft as an Isolated and Asyndromic Deformity"}
{"_id":"5f36647e-6331-210d-d333-c24798822693","text":"The safety of the procedure was always a concern, and there has been a continuous improvement in the way injectable fillers are delivered to the nose. There are several complications that can happen following nasal injections with fillers—these range from mild ones such as bruising and swelling to very serious ones having a long-term negative impact on the patient’s such as like skin necrosis and vision loss. Based on the latter, nonsurgical rhinoplasty is considered by physicians as not only a quick and simple but also a delicate office procedure.","title":"Ethnicity and Nonsurgical Rhinoplasty"}
{"_id":"5f3a2b32-9a63-840a-fffa-bbe0a0fd700f","text":"Surgical debridement must be aggressive to halt progression of infection. Cultures of infected fluid and tissues should be obtained during the initial surgical debridement and the results used to tailor specific antibiotic management.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"5f47793b-e9a7-2ac6-e7da-3bfe08d796df","text":"In this study, hypervascularity was more persuasively related to reported sun exposure than periorbital wrinkles. It was positively correlated with average daily and weekday sun exposure, and was also associated with MC1R variants, known to be associated with sun sensitivity.4 Smoking and increased age were also associated with cutaneous hypervascularity and published data suggest that these associations probably result from relative cutaneous hypoxia.41,42 Decreased density but increased length of cutaneous capillaries were reported in elderly individuals compared with younger subjects.43 Heavy smoking is said to compromise the peripheral microvasculature,44 leading to chronic ischaemia of the dermis and the consequent development of telangiectasia as a compensatory mechanism. We also showed an association between increased BMI and periorbital hypervascularity. Obesity may conceivably increase vascularity as a result of poorer temperature control-induced persistent vasodilation, but secreted products of fat cells (adipokines) and macrophages in fat are also postulated to induce new blood vessel formation.45 The severity of vascular damage in the periorbital area was strongly predicted by sex in our population. Males were consistently more prone to develop hypervascularity even when controlling for all the potential confounders. As previously reported,46 telangiectasia may be a weaker marker of skin ageing in women due to the protective effect of oestrogens on skin microvasculature. Skin capillary blood flow was shown to increase with the oestrogen level47 and to decrease significantly with menopause.48 A protective role of physiological concentrations of oestrogens was also reported in a mouse model of skin ischaemia.49","title":"The determinants of periorbital skin ageing in participants of a melanoma case–control study in the U.K."}
{"_id":"5f4aba7f-f517-3835-c0b6-be5a8b94d414","text":"The etiology of actinic keratoses involves both individual and environmental factors.","title":"Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects"}
{"_id":"5f4e0a79-8e1e-7611-9f13-6f30e47ea894","text":"Inclusion criteria were patients older than 18 years who underwent MMS for treatment of BCC previously biopsied by 3 or 4 mm punch. Only cases in which it was possible to assess the preoperative biopsy slide were included. These cases were selected from two private dermatopathology laboratories and from the Pathological Anatomy Laboratory at Hospital de Clínicas, Universidade Federal do Paraná. Cases which had a preoperative biopsy performed at other laboratories were excluded, due to the difficulty in accessing histopathological slides, as the biopsy had often been performed in other cities. Patients whose preoperative biopsy was performed using a method other than punch biopsy and patients whose tumor was not identified at MMS were also excluded. This can occur when the margins were clear in the first stage and debulking was not performed, or when no tumor was observed in the examined histological sections.","title":"Comparison of basal cell carcinoma subtypes observed in preoperative biopsy and Mohs micrographic surgery"}
{"_id":"5f5440d6-e399-05b7-a66a-46391a8e288c","text":"The differences in the accuracy of sonography between the RH and the UH in our study can be explained by the fact that sonography is operator dependent and requires dedication and experience: at the RH an experienced physician performed all examinations, while at the UH the majority of ultrasounds were performed by ER residents or radiology fellows with different levels of experience. Thus sonography has great weight in decision making related to the diagnosis of acute abdominal pain at the RH. At the RH, the diagnostic possibilities are limited but the attending surgeon could, due to his great clinical experience and the long time collaboration with the sonographer, place more trust in the results of the sonography.","title":"Decision making in patients with acute abdominal pain at a university and at a rural hospital: does the value of abdominal sonography differ?"}
{"_id":"5f5feae8-4294-d7f3-13dc-41d7d751951d","text":"The goal of the program was not to internationalize anatomy teaching or the anatomy course content. The anatomy courses rather served as a vehicle and binding element to help improve global healthcare by preparing future medical and dental leaders via early international networking, international collaboration and exchange, and intercultural experience.","title":"An International Partnership of 12 Anatomy Departments – Improving Global Health through Internationalization of Medical Education"}
{"_id":"5f8982bc-d174-0c97-17dc-77454dcc51aa","text":"The antibiotic gentamicin seems to be an appropriate and active agent to support tissue healing burdened by infection processes. To be able to provide concise judgment of the post-operative change of the bone tissue, it is very important to assess the operated structures from different views and eventually different scanning methods. Otherwise, details can be missed out or tubular structures may only turn out as solid forms.","title":"Treatment of a chronic recurrent fistulized tibial osteomyelitis: administration of a novel antibiotic-loaded bone substitute combined with a pedicular muscle flap sealing"}
{"_id":"5f95574e-f093-a0da-1e51-a606b5ee6f2d","text":"At least 30 orthopaedic research fellowships in the United States are available to students who are looking to acquire more research experience and strengthen their application for orthopaedic residency. These fellowships can help medical students increase their probability of matching into orthopaedics through publications, networking, and clinical exposure.","title":"Gap Year Research Fellowship Opportunities for Medical Students Interested in Orthopaedic Surgery"}
{"_id":"5f9733e1-9515-b22d-00bb-8470c0495138","text":"Sample size: No a priori sample size calculation was performed for this study for two reasons. The expected number of patients in the chosen time interval was high enough for detection of any clinically relevant difference without having the risk of being under powered. There was no primary endpoint for a sample size calculation, since this is an exploratory trial with several different endpoints.","title":"Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study"}
{"_id":"5f99b98d-fe30-ae8a-8b16-ef550b222b7b","text":"Approximately 10% of breast cancer patients are expected to experience an ipsilateral recurrence 10 to 15 years after their initial treatment.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"5f9fcc94-0dcd-6e3a-60d0-fdc70b3bf95e","text":"where μ is the mean and σ denotes the standard deviation.","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"5fa0925b-73a7-73ec-0a6b-3da33e33c3b1","text":"Sentinel lymph node biopsy is increasingly being used as a staging procedure for various malignancies. The sentinel node can be defined as the lymph node on the direct drainage pathway from the primary tumor [1]. Therefore, this particular node is likely to be the first node to harbor metastasis and can be used to provide information about the rest of the nodal basin. Based on the hypothesis of sequential tumor spread, sentinel node mapping can be used for nodal staging, being more precise than imaging procedures and less invasive than regional prophylactic nodal dissection. In melanoma, the sentinel node status has proven to provide relevant prognostic information and is widely performed to accurately stage melanoma patients [2]. The procedure has evolved to a routine staging method for patients with clinically localized breast cancer and is nowadays used to stage patients with other solid tumors as well. The role of sentinel node biopsy has not been clearly defined for head and neck squamous cell carcinoma. Positive sentinel nodes have shown to be a negative prognostic factor in oral cancer [3] and several authors have published good results regarding staging accuracy of the sentinel node biopsy in oral cancer patients [4–6]. It can be used to select patients for subsequent neck dissection and can reduce morbidity in many sentinel node negative patients who can be spared this operation.","title":"Sentinel Node Detection in Head and Neck Malignancies: Innovations in Radioguided Surgery"}
{"_id":"5fa34690-d84d-ba72-3a40-31a93bdde29c","text":"Postoperative computed tomographic angiography showed patent anastomoses and a vascularized fibula graft. Six weeks postoperatively, a cerebrospinal fluid leak and associated dorsal midline defect were closed successfully with a previously described sensate medial dorsal intercostal artery perforator (MDICAP) flap.","title":"Free Vascularized Fibula Graft as Primary Salvage Procedure for Acute Cervical Osteomyelitis Caused by Epidural Abscess"}
{"_id":"5fb33add-da73-d747-4ade-f2f3218b56ff","text":"We collected data on 194 patients suffering from CM in order to analyse the clinical characteristics of CM and to define the frequency, site, and type of second primary cancers in CM patients.","title":"Clinical Characteristics of Cutaneous Melanoma and Second Primary Malignancies in a Dutch Hospital-Based Cohort of Cutaneous Melanoma Patients"}
{"_id":"5fb42aaf-56a4-f8cd-39fd-e52e813b07f7","text":"Iatrogenic vertebral artery injury during cervical spine surgery is an infrequent but potentially pernicious complication that can be fatal. Meticulously reviewing the literature, comparing anterior and posterior surgical access promotes the anterior as safer regarding the incidence of vascular injuries. Nonetheless, selecting the approach where the attending surgeon is best trained is considered more expedient. Apposite preoperative preparation with imaging anatomical variations of the vertebral artery is of paramount significance to diminish the rates of intraoperative vascular complications.","title":"Incidence of vertebral artery injury in patients undergoing cervical spine trauma surgery in correlation with surgical approach: A review"}
{"_id":"5fb8c7bb-85db-48d1-b730-15671e920c5b","text":"Regarding the increase in the volume of the mass and the aesthetic problem, the patient was planned for a parotidectomy. the first step of this surgery consisted of a conventional incision to access to the parotid region, liberation of the posterior part of the gland, and identification of the trunk of the facial nerve. Resection of the superficial lobe was started finding the tumor extension of the inferior branch of division of the facial nerve. The tumor was resected with the sacrifice of the inferior branch of the facial nerve and respect of the continuity of the trunk and the superior branch of the nerve. Nerve reconstruction by anastomosis or transplantation of another nerve was not performed in the same surgical procedure.","title":"Intraparotid facial nerve plexiform neurofibroma in a child (case report)"}
{"_id":"5fb9c33d-b5c3-ea01-d57c-23b4071f2c05","text":"Moreover, our findings support the importance of advanced planning and preparation in the healthcare sector for large-scale sporting events. Establishing a special task force and implementing a crisis plan allowed the Orthopaedic Surgery section to effectively manage the surge in demand for its services during the World Cup. These efforts also ensured the uninterrupted continuation of the residency and fellowship training programs, which are critical for developing the next generation of orthopaedic surgeons.","title":"Trauma and orthopaedic surgery response at the world’s largest sporting event: an analysis of the FIFA World Cup Qatar 2022"}
{"_id":"5fbba4b4-7763-aaec-d7ad-c0feab3ca0ef","text":"Do you experience or have you experienced coughing prior to the admission?","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"5fbe0678-d75a-cc95-1278-c7f33c80497e","text":"The first image processing step is importation of DICOM data to a 3D modeling software. The region of interest (ROI) must be digitally partitioned from the surrounding tissue via a process known as segmentation. The goal of segmentation is to identify and separate the ROIs into individual components that are easier to identify and manipulate digitally.","title":"Virtual surgical planning and 3D printing: Methodology and applications in veterinary oromaxillofacial surgery"}
{"_id":"5fc21823-d1d5-7c76-3a7e-91a037cf5e5d","text":"Ultrasound has been used to study the integrity and rotation of breast implants.12–20 Ultrasound is an important tool in the management of Breast Implant-Associated Anaplastic Large-Cell Lymphoma.21 This device is essential for the evaluation of breast masses, including those that occur after autologous fat grafting.22","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"5fc92780-1259-0bae-a676-4ca20ddbdca3","text":"Fuzzy entropy values were calculated for each movement for the patient group before and after rehabilitation. Fuzzy entropy values smaller than 0.01 were removed to clean the muscle resting state; subsequently, the mean values of fuzzy entropy measures were calculated for each channel to evaluate the effects of the rehabilitation sessions. The results are given for primary facial movements and simple facial expressions.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"5fd0e125-f287-0a4a-cd17-9ea80cf8f523","text":"Calcinosis cutis refers to the deposition of insoluble calcium salts in the skin and subcutaneous tissue. There are five different subtypes: dystrophic, metastatic, iatrogenic, calciphylaxis, and idiopathic. Dystrophic calcinosis cutis, the most common form, is caused by tissue damage and commonly associated with autoimmune connective tissue diseases, such as systemic sclerosis, dermatomyositis, and systemic lupus erythematosus.","title":"Idiopathic Calcinosis Cutis of the Hand"}
{"_id":"5fd725e6-b434-95e8-332c-4161507c1e27","text":"Simultaneous diagnosis and treatment of superficial NMSCs is a successful way of improving efficiency and patient satisfaction.","title":"Same Day Biopsy and Treatment of Non-Melanoma Skin Cancer in Patients with Field Cancerization: A Retrospective Chart Study"}
{"_id":"5fd7cc2f-5f97-ecc7-ad5d-ac70a918a3d4","text":"Perhaps the least expected result was the emphasis on public lack of awareness of the benefits of microsurgery as a critical challenge. This was not previously reported in literature but was the leading response in the unguided segment of the study questionnaire. Many shared the view that unawareness primarily among the medical fraternity was at fault, extending to members of the general public and leaders. This implies that many people in the region may simply be unaware that life-changing microsurgical procedures such as extremity replantation can be performed by local plastic surgeons with support provided. In a similar manner, participants felt the necessary support from members of other surgical specialties was lacking, leading to poor coordination in patient management. Increased advocacy was proposed to correct this lack of knowledge as well as the negative perceptions of microsurgery.","title":"Challenges in global reconstructive microsurgery: The sub-Saharan african surgeons’ perspective"}
{"_id":"5fd9bb53-92b9-391a-13b8-7fab0ac2dae2","text":"Although this is a single-center retrospective review of the application of regional anesthesia techniques in patients undergoing MICS, it represents a continuous series of patients who had surgery in a contemporary time span. Furthermore, this study is one of the most recent reports with a large control group and a comparatively larger sample size that examines both intraoperative and postoperative parameters.","title":"Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery"}
{"_id":"5fdd7414-e827-64d3-b6ce-290d07c4cd68","text":"As for now, external beam radiation and brachytherapy remain as the core treatment for most stages of cervical carcinoma. Of late, the results obtained with radiation were improved by adding concurrent chemoradiation which has been widely adopted as the newer standard of management around the world. However, in many developing countries cervical cancer patients may go untreated or receive a suboptimal therapy due to lack or poor radiation resources. In this situation, it makes sense to study the here called \"radiation sparing managements\" such as the total mesometrial resection thal could make unnecessary the use of adjuvant radiation; the use of neoadjuvant chemotherapy that could avoid the use of adjuvant radiation in around 85% of patients as well as preoperative chemoradiation that could make brachytherapy dispensable. Nevertheless, these alternatives for management of cervical cancer that decrease or avoid the use of radiation are far from solving the problem. Access not only to radiation but to cancer treatments is one of the areas of greatest need in the developing word, particularly for the countries with the lowest-revenue such as those in the sub-Saharan Africa. If neoadjuvant chemotherapy or preoperative chemoradiation is contemplated, in most low and middle-income countries the cost of drugs is usually covered by patients who may found it prohibitive. A similar situation can be encountered regarding the availability of local or regional cancer centers equiped with surgical rooms and intensive care units required for radical surgical procedures. In both cases, qualified medical and surgical oncologists may also be insufficient or unavailable at all.","title":"Radiation-sparing managements for cervical cancer: a developing countries perspective"}
{"_id":"5fe129f5-2b34-86a3-ae02-754eda900570","text":"Four of the 18 patients received treatment at the level of two distinct discs, of which three during the same session and one in two separate moments.","title":"Percutaneous cervical coblation as therapeutic technique in the treatment of algo-dysfunctional pain of discal herniation"}
{"_id":"5ff04acf-5a6b-0b70-9697-60c759916b7e","text":"Special attention should be paid to the physical examination of the entire skin surface to look for satellites or in-transit metastases but also for a second primary melanoma. Physical examination of the regional lymph node basin should be included.","title":"Melanoma: Staging and Follow-Up"}
{"_id":"5ff3259d-22d5-1acf-e3bf-f6f3ecdd63c9","text":"Table 2 shows the incidence of tuberculosis by exposure group based on whether the student had a positive TST in the contact investigation and was eligible for chemoprophylaxis. Eleven cases were identified before or during the contact investigation; five cases occurred in 144 students who were referred for chemoprophylaxis; and eight cases occurred in 411 students that were not required to receive chemoprophylaxis.","title":"Validity of Using Tuberculin Skin Test Erythema Measurement for Contact Investigation during a Tuberculosis Outbreak in Schoolchildren Previously Vaccinated with BCG"}
{"_id":"5ff67db2-c93d-e04a-da56-4ce00ea960f7","text":"In patients with UCLP, our main indication is to facilitate eruption of the lateral incisor and the canine in the cleft area. Augmentation of the alar base of the nose is not recorded as a major indication.","title":"Alveolar bone grafting"}
{"_id":"5ff8c6ab-2cb1-1f59-307f-782020c78f7e","text":"Clinically, the observations of the health care staff looking after these patients postoperatively suggested that patients who received PVC-based regional anesthesia were the most comfortable in the cardiac surgery intensive care unit. Even so, the magnitude of the differences in outcomes between the PVC group and the control group was surprising to us and is perhaps a strong indication of the importance of pain control in recovery from MICS.","title":"Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery"}
{"_id":"60040325-1182-2393-11c9-b441c665cd12","text":"Potential participants were explained the purpose of the study and the procedure of participation. Informed consent was obtained from all subjects.","title":"The appropriate and sequential value of standard radiograph, computed tomography and magnetic resonance imaging to characterize a bone tumor"}
{"_id":"60088f0c-89f0-085a-b36c-b8832679d964","text":"Programs may also wish to carefully consider how their definition of excellence is used during the selection of residents to ensure they are meeting their goals while also seeking out residents who can push the program in new directions.60 While programs may impact the likelihood that a resident pursues scholarship or advocacy, selecting students who already have a track record of success in these areas may mean they are likely to continue to excel in this area during residency. Table 2 shows how four example residencies might use the definitions described in this manuscript to define measurable aims for themselves, using vastly different metrics depending on their local goals. It is also important to note that developed program aims can, and should, evolve over time to meet the current needs of the program and its graduates. For example, a program previously focusing on metrics associated with resident scholarship may require shifting focus to the creation of aims surrounding metrics of resident wellness in response to the COVID-19 pandemic and the emotional burden it placed on trainees.","title":"Metrics of Resident Achievement for Defining Program Aims"}
{"_id":"6009ad2c-a058-dcf5-d917-2c3feb36a681","text":"Dissection is continued between the pectoralis major and minor muscles to create a tunnel through which the flap can pass to the neck. A cut is made through the attachment of the pectoralis major to the clavicle to connect the neck and chest tunnel. Once the vascular branches of the flap and muscular attachments are released, the flap can be passed through this opening as depicted in Figure 5.","title":"Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: contrasting shoulder morbidities across mysofascial flaps"}
{"_id":"600b6dd9-d267-9edb-91b0-0eaa0e8d5dc8","text":"Randomisation began in February 2013 and the final participant will complete the trial protocol in August 2014.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"60233790-c0c4-72f3-a13f-cab40ed763ee","text":"Breastfeeding by HIV-infected mothers remains a complicated dilemma for health professionals. Exclusive artificial breastfeeding remains the most reliable and safe way to prevent transmission in developed countries. Few studies discuss the consequences of breastfeeding on children when mothers are infected with HIV in industrialized countries. The current recommendations advise on supporting the decision of HIV-infected mothers who really want to breastfeed but remain vague about the strategies that should be implemented. There is a clear unmet need to clarify these issues in order to best accompany HIV-infected women in their choice to breastfeed while ensuring the safety of their infants.","title":"HIV-Infected Mothers Who Decide to Breastfeed Their Infants Under Close Supervision in Belgium: About Two Cases"}
{"_id":"6024be17-b12a-120a-7108-0bec1a92adb0","text":"All residents have individual training programmes that comply with the requirements in the description of objectives.","title":"Factors related to the role of programme directors in association with quality in postgraduate medical education – a cross-sectional study"}
{"_id":"6025784e-db6a-051f-1fcc-3d73475f16e6","text":"This study presents 10 patients in whom a fasciocutaneous perforator flap combined with the Masquelet technique was used to restore soft tissue and bone defects of the lower extremity, and were admitted in two level 1 trauma centers in Shanghai. The first stage included debridement of necrotic bone and infected tissues, implantation of a polymethylmethacrylate cement spacer to cover the void; bridging fixation of the osseous defect using external or internal fixators, and soft-tissue reconstruction with a fasciocutaneous perforator flap. The second stage included cement spacer removal with membrane preservation, refreshing bone edges, and grafting the cavity with bone morphogenetic proteins and autologous iliac bone graft.","title":"Simultaneous reconstruction of septic composite defects in lower extremities: Combination of fasciocutaneous perforator flap and Masquelet technique"}
{"_id":"60261e58-3f00-a635-e7b9-a41ff30064f6","text":"All studies comparing the use of anastomotic coupler devices for venous anastomosis in free flap tissue transfer to hand-sewn venous anastomosis will be eligible for inclusion in the final review.","title":"Protocol for a systematic review of venous coupler devices versus hand-sewn anastomosis for microsurgical free flap reconstruction"}
{"_id":"602f4cc1-d8f2-41ed-5753-baa145e9982f","text":"A residency program should offer work-based training opportunities with annual progression toward achieving microsurgical competency. With respect to standardized environmental conditions and risk stratification, we hope that our innovative model of microsurgical training in the operation theater will be helpful for young microsurgeons worldwide and will strengthen their microsurgical skills. The high level of expertise of the teacher, the resident’s experience and the proper institutional infrastructure is mandatory. We recommend this innovative procedure as an adequate teaching method during residency to promote the future of our specialty, and we hope that our students will become even better than their teachers. Giving motivations to young microsurgeons to operate during this safe training method, will reboost the microsurgery specialty and keep it in top and alive.","title":"The Anterolateral Thigh Perforator Flap in an Innovative Microsurgery Training Method"}
{"_id":"603ede24-c7b3-81dc-d899-51f1406cbfd7","text":"This study aimed to describe the results of a preliminary experience with 3DVT and 3DIN application to complex liver resections in a single center of hepatobiliary surgery.","title":"Hyper accuracy three-dimensional (HA3D™) technology for planning complex liver resections: a preliminary single center experience"}
{"_id":"604008b4-58a9-0a30-6ae7-074b71ff73a2","text":"We conducted a retrospective analysis of CFRs conducted at a tertiary oncology hospital from May 2009 through December 2018.","title":"Short-term survival in extensive craniofacial resections"}
{"_id":"6042b548-88b7-b853-1f50-8989788c2970","text":"The ideal free flap is the latissimus dorsi muscle because of its large surface area and rather thin thickness.","title":"36-year Follow-up on Scalp Reconstruction Using Free Latissimus Dorsi Muscle Flap, Skin Grafting, and Scalp Expansion"}
{"_id":"60444e62-a1f8-3a60-818b-38583af75af1","text":"The primary objective of our study was to characterize the use of temporal bone CT in the acute emergency setting and investigate the clinical utility of this imaging modality in diagnosis and management of acute infectious and traumatic pathology of the temporal bone in the pediatric population. Our goal was to identify patient characteristics and common indications for temporal bone CT at our institution and to determine the subsequent clinical and\/or operative management for these patients. Recognizing the appropriate scenarios to order temporal bone CT may prevent unnecessary radiation exposure in children presenting with such pathologies.","title":"Utility of Temporal Bone Computed Tomography in Pediatric Emergency Medicine"}
{"_id":"604cbf33-62de-85aa-d64b-d5388cd330fe","text":"Due to the variation in perforator vessels and the occurrence of false-positive in the perforator localization examination, if either the perforator could not be found or the diameter of the skin flap did not meet the design during the operation, it was necessary to alter the design of the flap. In addition, in some patients, the tissue in the donor area needed to be clipped when it was closed and sutured. Both of these types of cases were recorded as cases of donor site invalid trauma.","title":"Application of an L-shaped anterolateral thigh flap in reconstruction after hemiglossectomy"}
{"_id":"605a9790-246c-b5a6-12d7-cbaff89d2cae","text":"Clinical evaluation was performed every 3 months during the first year after surgery, every 6 months for the subsequent 2 years, and yearly thereafter for 2 more years. Rectal examination and serum CEA measurement were carried out whenever the patient visited the outpatient clinic. Contrast-enhanced helical CT was performed every 6 months during the follow-up period and MRI was performed if needed. Local recurrence was defined as evidence of tumor within the lesser pelvis or the perineum and distant metastasis was defined as evidence of tumor in any other area. Local and distant recurrences were confirmed radiologically or histologically by qualified radiation oncologists and pathologists.","title":"Oncologic Impact of Fewer Than 12 Lymph Nodes in Patients Who Underwent Neoadjuvant Chemoradiation Followed by Total Mesorectal Excision for Locally Advanced Rectal Cancer"}
{"_id":"605cc761-029e-c8e3-d5e9-f5dcc496c874","text":"The margins differed based on the anatomic location and on the growth pattern based on clinical history. The mean surgical margin was 3 to 5 mm on the facial area and 5 to 10 mm on the other areas. The wider excision in cases of incomplete eradication of a MTC was 5 mm around the entire scar of the previous surgery (Table 2).","title":"Metatypical basal cell carcinoma: a clinical review"}
{"_id":"605d9aea-2ad9-50ce-17e8-ff776b7e0130","text":"Paravertebral block is a unilateral analgesic technique that can provide adequate surgical anesthesia and great advantages in many types of surgery with a low side-effect profile. In this case we present combination of bilateral thoracic paravertebral block under ultrasound guidance with sedation which provides complete anesthesia and postoperative analgesia in a myasthenic patient undergoing cosmetic breast surgery. In myasthenic patients paravertebral blocks may be a better option for breast surgery with avoiding the need for muscle relaxants and opioids and risk of respiratory failure in postoperative period.","title":"Paravertebral Block Combined with Sedation for a Myasthenic Patient Undergoing Breast Augmentation"}
{"_id":"605f5dca-093c-a739-4912-c530d90936be","text":"Vascularized pedicle bone grafts usually based upon vessels supplying fibula in the form of microvascular pedicles have been found to have undergone minimal creeping substitution and are expected to live on their own vessels to enable quick healing.5 There are two types of vascularized grafts (a) free fibular graft using microvascular techniques for harvesting and reimplantation and (b) vascularized iliac crest graft with lesser morbidity, lesser time used as well as technically less demanding surgery.","title":"Management of avascular necrosis of femoral head at pre-collapse stage"}
{"_id":"60702965-67c5-3acb-653e-923bcacc1741","text":"To determine the incidence and pattern of cervical lymphatic drainage in patients with melanomas located on the upper limb or trunk, and to evaluate our current neck dissection protocol for those patients with a N+ neck.","title":"Lymphatic Drainage Patterns from Melanomas on the Shoulder or Upper Trunk to Cervical Lymph Nodes and Implications for the Extent of Neck Dissection"}
{"_id":"60730cd1-7e2c-3031-f7df-4d3288fee70b","text":"HA is a substrate for the enzyme hyaluronidase: the enzyme cleaves HA molecular strands into smaller oligosaccharides, making them susceptible to metabolism and clearance from the body. Increasing the degree of crosslinking is expected to reduce the propensity to enzymatic degradation and achieve longer residence.","title":"Evaluating hyaluronic acid dermal fillers: A critique of current characterization methods"}
{"_id":"6074c2e2-0d39-377b-0607-170c8ff8e2f8","text":"Logistic regression models are used to analyze the effect of various predictors on the presence or absence of positive lymph nodes. Given that women with bilateral breast tumor appear twice in the data set, generalized estimating equations (GEE) are used to account for the association between the two responses from the same person.","title":"Is the sentinel lymph node biopsy more sensitive for the identification of positive lymph nodes in breast cancer than the axillary lymph node dissection?"}
{"_id":"6075dc07-a26e-5321-4e5e-cabaafeb755e","text":"This study aims to compare the postoperative outcomes of the Limberg flap reconstruction technique with wide-open excision and healing by secondary intention in the surgical management of PNS.","title":"Comparative Study of Limberg Flap Reconstruction With Wide-Open Excision and Healing by Secondary Intention in the Management of Pilonidal Sinus: Our Experience at a Tertiary Care Center in India"}
{"_id":"608e1719-b01a-5ce5-3195-abd1b302b1de","text":"This study represents the largest report of patients with locally advanced and metastatic GISTs treated with radiation therapy. Radiation was largely effective at achieving palliation for symptomatic tumors, and radiographic response is possible in some patients, providing evidence that GIST is not universally radioresistant. Toxicities were mild, and concurrent use of TKI therapy did not portend an increased risk of side effects. Further study to establish the role of radiation therapy in the management of gastrointestinal stromal tumors is needed and supported by the findings of this report.","title":"External beam radiation therapy for locally advanced and metastatic gastrointestinal stromal tumors"}
{"_id":"609daa7e-ba4d-f799-a21b-134e0efc369b","text":"The purpose of our study was to assess the efficacy of the Illizarov method in addressing both bone and soft tissue defect in patients with a history of open fracture or dead and infected bone segment and severe soft tissue injury who had undergone multiple surgeries.","title":"The efficacy of ilizarov method for management of long tibial bone and soft tissue defect"}
{"_id":"609dda77-cfc6-ceb8-5995-128303bccba1","text":"Mean age of patients at surgery date was about 27 years; although most of them were aged 25 to 30, a remarkable number of them were aged over 35. According to data obtained from this study, those patients whose complaints were limited only to cosmetics had a lower mean age, meaning that younger patients are more concerned about the cosmetic outcomes while older patients would rather focus on functional outcomes along with cosmetics.","title":"Litigation After Nasal Plastic Surgery"}
{"_id":"60a10ec9-f284-2a19-f601-825179f3cbb7","text":"In view of the limited number of publications on this topic, our results should be of interest to clinicians in the field. Our observations show that more than half of the patients admitted in ICU received antibiotics during their stay, half of them on an empiric basis. Half of these treatments may not be justified on the basis of negative microbiologic cultures. In ICUs with written protocols for empiric AT, treatments might be initiated more rapidly at the time of suspicion of infection and out-of-hours. These observations should encourage the establishment of local AT protocols to initiate AT without delay and to stop the abuse of AT. Since pulmonary infections are the most frequent type of infection and as septic shock and MOF are the most life-threatening infections, local guidelines should start by addressing these issues.","title":"Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units"}
{"_id":"60a30589-8daa-5184-7186-b9e7e4065a53","text":"There was not agreement that any of the systems are likely to discriminate successfully, although everyone thought that the ACCP, SIGN and USPSTF systems are somewhat to highly likely to discriminate. Lastly, we largely agreed that we were not sure how reproducible assessments are using any of the systems, although half of us considered that assessments using the ANHMRC system are unlikely to be reproducible and about 1\/3 considered that assessments using the OCEBM and ACCP systems are likely to be reproducible.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"60aa1b0a-eac6-c2cf-3077-d969d1c9c1a3","text":"FTSG exploited for tip reconstruction should be thinned minimally due to the characteristics of caudal nose skin","title":"Reconstruction of the Nose: Management of Nasal Cutaneous Defects According to Aesthetic Subunit and Defect Size. A Review"}
{"_id":"60ad2caf-4414-6c41-f790-d10b004440ea","text":"Despite the emotional distress from losing the breasts by mastectomy, some of the participants tried to accept and cope with their new situation by using different coping strategies, while others were unable to do so.","title":"Beyond the scars: a qualitative study on the experiences of mastectomy among young women with breast cancer in a country with crisis"}
{"_id":"60b035f2-da61-4ce8-a822-9267cd917a37","text":"More recently an American systematic review was published that identified five distinctive MRI image patterns through the three phases of cerebral fat embolism: scattered cytotoxic oedema occurred in the acute stage, while confluent cytotoxic oedema or vasogenic oedema occurred in the subacute stage, in the long-term brain atrophy and demyelination was identified. Petechial haemorrhages in a confluent shape were seen in all stages of cerebral FES. Early recognition of these patterns may help identify the appropriate management.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"60b88751-acd7-bfb7-2261-fab426ade9ff","text":"Our results show that expandable titanium cages are a safe and useful tool in anterior cervical corpectomies for providing adequate anterior column support and stability. Pain and functional score improvement in most of the patients with different indications recommends the use of an expandable cage. Our initial experience and patient outcomes require careful interpretation due to the variety of indications for surgery. There is a need for prospective studies which assess the advantages and disadvantages of the use of expandable titanium cages for specific indications due to the fact that the different quality of the bone substance in patients with degenerative spine disease, tumor, fracture and infection probably substantially influences the outcome. Single-level surgery showed more favorable clinical outcomes. Due to possible occurrence of adjacent segment disease in patients with high risk, indications should be thoroughly reviewed and a continuous postoperative follow-up is recommended.","title":"Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients"}
{"_id":"60bd0d38-851d-5aa9-5897-2743e08d0c24","text":"Knowing which institutions enable medical students to participate in meaningful research and produce first-author publications can help medical students pursue the best option when considering a mid-medical school research year and help premedical students pursue the medical school that most fit their career interests if they are lucky enough to have a choice. Thus, we aimed to provide objective data on the topic of medical student academic productivity in plastic surgery by quantifying the number of medical student first-author publications that have been published during five years from 2016 to 2020. We also further compared this number of publications for each program\/department by department size, geographical region, and medical school ranking.","title":"A Review of Medical Student First-Author Publications in Plastic Surgery"}
{"_id":"60bfc353-f7cb-02a8-dd5a-01d9a20fcd40","text":"A similar flap design was described by Gupta and Devendra [22] but without preoperative or intraoperative perforator detection which makes the flap a random one and with a possible risk of postoperative flap necrosis, especially if used on a large number of patients.","title":"Freestyle perforator flap in earlobe reconstruction"}
{"_id":"60c356d1-4faf-c824-12fe-e2924a855cdc","text":"Procedures that involve injectable nonmedical materials as filler modeling substances for aesthetic purposes can expose the patient to the development of infectious processes. The possible source of late infections in these patients may be the result of environmental contamination at the time of the cosmetic procedure or the use of potentially contaminated filler material. It is important to recognize the danger of such illegal procedures and to increase the awareness of the public to minimize these adverse events, as this has evolved into a significant public health issue.","title":"Infections in patients with adverse reactions to the use of unknown modeling substances for soft tissue enhancement in Cali, Colombia"}
{"_id":"60cdee51-45f4-ba5c-b80f-6991ea5352ad","text":"All breast reconstructive surgeries were done by single plastic surgeon using same surgical technique for each surgical procedure. Major complication where considered when there was secondary surgical intervention such as, partial flap necrosis needed debridement or hematoma that need evacuation.","title":"Patient-reported outcomes after breast reconstructive surgery: A prospective cross-sectional study"}
{"_id":"60cf5065-6518-bd50-247e-7a1ed652b858","text":"Rhinoplasty using diced cartilage fascia graft simultaneously with ORIF is a breakthrough in Maxillary Le Fort II reconstruction. It brings off the incorporation of aesthetic surgery concept into reconstruction, annihilating post-op complaint from patients and preventing secondary rhinoplasty due to previous trauma.","title":"A breakthrough in Maxillary LeFort II fracture reconstruction: Case series of rhinoplasty using diced cartilage fascia graft simultaneously with ORIF"}
{"_id":"60d3849c-1947-dc27-7762-148d1d9e623a","text":"Open surgical repair of aneurysms of the popliteal artery is a safe procedure with low rates of perioperative complications and excellent long term rates of both graft patency and limb salvage, particularly in asymptomatic cases.21 In the present case, there were no intercurrent conditions during the first 10 first months of follow-up.","title":"Treatment of bilateral popliteal artery aneurysms"}
{"_id":"60d3b6e5-2838-7ec2-62a4-d98a675fe7ce","text":"The use and benefit of alternative imaging modalities such as breast MRI to further evaluate suspicious clinical findings with normal mammography and breast ultrasound was not explored in our study. Breast MRI is particularly useful in the assessment of focal suspicious palpable areas of concern [8].","title":"Clinically guided core biopsy and cutaneous punch biopsy in the evaluation of breast lesions: a necessary test or an obsolete skill?"}
{"_id":"60d411fe-20a1-5617-3498-2a911530a435","text":"Older people were more likely to believe that sunburn in childhood and having moles were risk factors for skin cancer.","title":"SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample"}
{"_id":"60d4a453-c8b8-cb46-d091-888587fce809","text":"The inclusion of surgical simulation in the ophthalmology clerkship led to increased confidence in the microsurgical skills of medical students. Offering surgical simulation training prior to residency can help to expose students to surgical fields, identify those that have particular talent and aptitude for surgery, and assist them in deciding which specialty to pursue.","title":"Implementation of microsurgery simulation in an ophthalmology clerkship in Germany: a prospective, exploratory study"}
{"_id":"60f3eabe-de70-02e9-08ea-76357c3a5739","text":"Overall, this animal model feasibility study demonstrates the practicality of using ICG and intraoperative NIR fluorescence for mapping of sentinel lymph nodes in the VX2 rabbit model. Our study is focused on a combination of CBCT and ICG. Micro CT gave superior soft tissue detail to CBCT, however they had comparable sensitivity in lymph node identification. The combination of CBCT and INR intraoperatively might offer added value to visualize lymph node metastasis in addition to the value received from the Preop CT. This work further demonstrates the potential utility of intraoperative ICG and NIR fluorescence as a method of localizing sentinel lymph nodes in a reliable, safe and cost efficient manner.","title":"Sentinel lymph node mapping using ICG fluorescence and cone beam CT – a feasibility study in a rabbit model of oral cancer"}
{"_id":"60f848a1-db16-001e-9a59-0085040dfa8d","text":"• Very large pigmented tumors whose complete excision would result in unreasonably high skin defects in the absence of a clear diagnosis","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"6100df57-e88b-7c04-a68f-08f91b263bd0","text":"Pleomorphic adenomas are benign tumors generally seen in the superficial lobe of the parotid gland.","title":"Clinico-histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10-year retrospective study—a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma"}
{"_id":"610348a4-f383-4e05-60e9-512fd2ae318b","text":"To the best of our knowledge, this is the first case reporting the clinical application of NGS and aggressive treatment based on the genotyping results for the management of a desmoid tumor. Our case highlights the need to consider desmoid tumors among the differential diagnoses when a pleural mass is encountered at a previous thoracotomy site. More importantly, molecular profiling using NGS can be useful for the establishment of a treatment strategy for this tumor, although further investigations are required.","title":"Clinical application of next-generation sequencing for the management of desmoid tumors A case report and literature review"}
{"_id":"610353ac-32c5-b8c7-787f-bf9844d131ce","text":"At a cost of modest decrease in regional nodal recurrences, CLND did not provide survival benefit and increased the rate of lymphedema (6 vs. 24% in MSLT-2). No subgroups of patients were identified who would benefit from a CLND. The reported rate of non-sentinel lymph nodes (further positive lymph nodes present in a CLND after a positive SLNB) is ~ 20% [42]; therefore, this change of practice entails that there is further nodal melanoma involvement in 1 out of every 5 SLNB-positive patients observed. However, patients with non-sentinel lymph node involvement have a higher risk of distant recurrence [42, 43]; thus, addressing the regional nodal basin surgically with CLND will be unlikely to improve distant metastatic recurrence. An important caveat about these studies is that they took place before modern systemic immunotherapy was available, the size of the lymph node metastases in the sentinel lymph nodes was relatively small, and the published studies still have short median follow ups. A retrospective cohort study of patients in which the principles outlined in the randomized trials were utilized, however, suggests that the real-world application of the study results leads to similar results with differences noted in nodal recurrence-free survival, but no difference in disease-free survival [44].","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"6105167f-86ee-b874-d242-2d4958cc87d0","text":"Table 2 shows the breakdown of all the physicians without a specialty title in plastic surgery who were accused of medical misconduct, namely: physicians with a medical specialty other than physical surgery; and physicians bearing no record of any medical specialty.","title":"Plastic surgery professional misconduct: a cross-sectional study on cases between 2008 and 2017, filed before the São Paulo State Medical Board"}
{"_id":"6108dc3e-e26c-31a7-6597-8721ff615060","text":"Therefore, the goal of this study was to characterize the various clinicopathological features of patients with invasive breast cancer in order to identify the risk factors that might help in predicting positive NSLN, particularly in cases of SLN metastasis in 1 to 2 nodes, hereby exploring the feasibility of avoiding ALND.","title":"Positive non-sentinel axillary lymph nodes in breast cancer with 1-2 sentinel lymph node metastases"}
{"_id":"610a9c7a-3d0e-5246-8fc8-c01bf65df19e","text":"ALBC embedding spinal instrumentation procedure can be a viable treatment for curing SSI in complex cases, such as patients with RA who undergo high cervical fusion surgeries without implant removal.","title":"Deep surgical site infection after posterior instrumented fusion for rheumatoid upper cervical subluxation treated with antibiotic-loaded bone cement Three case reports"}
{"_id":"610d2b49-3462-e284-d9c3-cb60ee62c926","text":"The aim of the study was to describe the authors’ experience in auricular reconstruction after MMS and to evaluate the most frequently used repair methods.","title":"Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases"}
{"_id":"6110e095-ed78-02e6-7efc-4451fb127169","text":"Neurosurgical procedures are extremely delicate and require a collaborative effort to ensure safety and success. Technologically fueled interventional neuroradiology is particularly challenging for anesthesiologists to practice in new settings and demandingly complex procedures [2]. The development of functional and minimally invasive procedures has also accelerated the demand for anesthesiology in the neurosurgical sphere. Such increasing emphasis and expectations for optimal operative conditions prompt anesthesiologists to increase their skills and knowledge to expert levels.","title":"Value of Neuroanesthesiology Fellowship Training"}
{"_id":"611422ae-a844-323b-e2d4-cfd5ce9971e0","text":"Therefore, the aim of this review is to illustrate several general and specific considerations in patients undergoing microsurgical reconstruction of large oncological scalp defects.","title":"Microsurgical Reconstruction of Extensive Oncological Scalp Defects"}
{"_id":"61173ec8-af26-836d-67fb-5bfbe51db948","text":"Analysis of PFS was not calculated due to the small number of events.","title":"Head and Neck Non-Melanoma Skin Cancer Treated By Superficial X-Ray Therapy: An Analysis of 1021 Cases"}
{"_id":"61214a53-1dee-0475-921f-9bc4b58a51c9","text":"Flow process chart: the reconstructive approach is dependent on the defect components, size as well as the quality of the surrounding soft tissue","title":"Reconstruction of composite defects of the scalp and neurocranium—a treatment algorithm from local flaps to combined AV loop free flap reconstruction"}
{"_id":"61237c87-b0b5-8bb7-3d1a-e3e428070020","text":"Escherichia coli is a rare cause of vertebral osteomyelitis. Our patient was not immunocompromised and did not have other risk factors associated with the development of osteomyelitis. However, the history of a urologic procedure immediately prior to the development of systemic symptoms and ultimately neurologic symptoms should alert the clinician to the possibility of vertebral osteomyelitis. Aggressive surgical debridement, spinal stabilization, and appropriate antimicrobial therapy can result in successful patient outcomes.","title":"Surgical Management of Thoracic Osteomyelitis due to Escherichia Coli Sepsis"}
{"_id":"612df095-8710-1fa8-2379-57b3ff6e9978","text":"Radiotherapy is an effective nonsurgical therapy available to patients with NMSC.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"6135af03-9087-9a38-4640-2fec50278ed9","text":"When investigating the non-lactating breast for abnormalities the patient is often placed in the posterior oblique position with the breast to be examined raised. The objective of this position is to flatten the breast and bring the internal structures more parallel to the ultrasound beam. Thus the degree of obliquity depends on the size and shape of the breast and may vary during scanning. Upright positions are used occasionally to determine if there is either floating debris or dependent levels within cystic lesions. For the lactating breast it may be necessary to use a combination of oblique and upright positions to adequately examine the entire breast, particularly in women with very large breasts. Warm ultrasonic gel is used for scanning to enhance the transmission of sound through the skin into the breast and maintain good contact [3, 18, 19].","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"6135c9d5-723a-2be8-539b-f4f4e99d4da5","text":"He was referred from a rural hospital at the age of 11 months for further evaluation due to poor weight gain despite adequate breastfeeding. He was exclusively breastfed for 3 months and started formula feeds supplementation at 4 months without significant improvement in weight. There was no associated vomiting or diarrhea. He had multiple admissions for nutritional rehabilitation due to undernutrition with minimal weight gain. On weaning, he fed mainly on cow’s milk and hardly took any solid feeds from the family diet.","title":"Fanconi–Bickel syndrome in a Ugandan child – diagnostic challenges in resource-limited settings: a case report"}
{"_id":"61373a94-9dd3-9849-62d5-77dc227c376b","text":"We retrospectively reviewed patients who underwent USG-guided omental biopsies in our institution between April 2006 and March 2010. All patients who had a thickened omentum and no other accessible site for a biopsy were included in the study. The main exclusion criterion was the presence of uncorrectable bleeding parameters.","title":"Ultrasound-guided omental biopsy: Review of 173 patients"}
{"_id":"613dae5f-9a58-122a-7da9-2b83ebb4025c","text":"At first instance the general health status of the patient is optimised and the initial primary and secondary survey will lead the management plan. In all acute traumatic injuries, the goal is to reduce the bacterial load by thorough lavage of the wound and immediate debridement with bone fixation and coverage where possible. If the wound is not ready for coverage or closure it is wise to apply a negative pressure dressing which will reduce the exudate and edema of primary insult and till the patient's general health is optimised. The wound is assessed after an average of 72 hours of continuous negative pressures at our unit. Initial studies advise the use of intermittent negative pressure dressing [9]. There are studies which suggest that change of dressing may be delayed for six to seven days [10].","title":"Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing"}
{"_id":"61423333-4c93-7dff-cb35-85568d708adf","text":"The significance of the lived experience in nourishing an infant having severe breastfeeding complications can be further understood by its constituents as described in the following.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"61429d4c-01f8-f2c8-e75d-34a7e81856b6","text":"The most common complications of external fixation are pin loosening and pin tract infection. Pin tract infection was observed in nine rats and all healed after local daily application of antibiotic ointment. Two rats developed deep tissue infection, one of which necessitated euthanasia. Pin loosening was observed in nine rats. Most of the cases were corrected by adjustment of the external fixator and did not affect the overall stability of the device. Only two of the external fixators failed, both of these failures occurred at 7 weeks post operation. One rat died 4 weeks post operation of unknown causes; however, it did have deep infection found on necropsy. One rat developed a femur fracture at the proximal pin site at 3 weeks, which was likely iatrogenic during the insertion of pins.","title":"External fixation of femoral defects in athymic rats: Applications for human stem cell implantation and bone regeneration"}
{"_id":"6146c145-0ab8-5031-32da-3aee159f338d","text":"Between January 2016 and January 2018, data from 7 consecutive patients who underwent partial breast mastectomy with lateral thoracodorsal flap were enrolled. A wedge shaped flap was designed using the pinch test using the index finger and the thumb in small defects, while larger defects required a convex shaped incision with curved superior and inferior borders. Incision was made along the marked margins of the proposed flap and deepened to the underlying serratus anterior and latissimus dorsii muscle. The flap was transposed in the defect and the symmetry of mound between the two breasts confirmed in sitting and supine position.","title":"Lateral Thoracodorsal Flap Revisited: An Underappreciated Workhorse"}
{"_id":"614711e6-f5d7-adb9-36fa-8a014c92b35e","text":"A strength of this study is that it assessed CuSCC only of the head and neck. Establishing treatment recommendations specific to the head and neck is important as a high proportion of skin cancers develop on the head and neck, and the anatomy and lymphatic drainage of the head and neck is unique. Also, given the functional and aesthetic importance of the head and neck, appropriate margin distance is paramount to minimizing the morbidity of resection.","title":"Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck"}
{"_id":"6149dda5-3f1b-2bb9-a790-f32fa2ea7077","text":"These findings could be beneficial in informed preventive of DVT and optimized management of hip fracture in specific group of young and mid-aged patients.","title":"Incidence and risk factors associated with preoperative deep venous thrombosis in the young and middle-aged patients after hip fracture"}
{"_id":"6160c445-b6af-1a7a-3689-a36e0219b47e","text":"We presented 14 successful elimination of back rolls and aesthetic back contouring using UAL and helium-activated RF treatments that are less invasive than a traditional upper body lift. All patients treated demonstrated aesthetic improvement of back contour and elimination of back rolls. Patients were followed up at 6 months with postoperative documentation of back roll elimination and subjective satisfaction of their results. In summary, we present an effective alternative to prior contouring procedures that benefit from avoidance of surgical incision lines, unsightly scars, and more invasive maneuvers.","title":"Successful Back Contouring With Elimination of Back Rolls Using Ultrasound-Assisted Liposuction and Helium-Activated Radiofrequency"}
{"_id":"616359ff-19f8-49d3-fc46-06829e1aa888","text":"The patient was continued on levofloxacin for his previous infection and started on IV vancomycin for a total of 7.5 weeks followed by doxycycline and continued levofloxacin suppressive therapy, which at this time has no specific end point. The patient had improvement in his inflammatory markers with marked improvement in his neck pain and gradual improvement in his neurological complaints.","title":"Cervical spine spondylodiscitis: Review of literature on current treatment strategies"}
{"_id":"61636ee7-8f5f-e057-a58d-4c388009e308","text":"Panoramic view of the popliteal fossa and identification of the major anatomic structures after removal of the surgical specimen.","title":"Popliteal lymph node dissection for metastases of cutaneous malignant melanoma"}
{"_id":"6167a6e8-4a16-7523-920e-56697b6e0c7e","text":"Technesium 99 labelled sulfur colloid (99 mTcSC) alone or in combination with methylene blue is probably the most widely used as it allows one to quantify the radioactivity picked up on the gamma probe and further to have a pre operative picture of the identified SLN. Injection of 99 mTcSC around the primary tumor site is performed at least 2 hours before or even the afternoon before surgery the next morning. The injection is reported to be painful as local anesthesia in the vicinity should be avoided. Another advantage is the possibility to perform a scintigraphy beforehand to identify and localize the SLN before surgery. This may be of great help where the SLN isolated in an unexpected area.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"616c32de-2b91-78e3-f10a-c217edaa4b64","text":"Limitations of our analysis include confounding by indication (IDDVT patients were often treated for shorter periods and with lower anticoagulant doses 19 ) and wide confidence intervals of the estimates. Moreover, the classification of patients according to baseline risk factors was done retrospectively. Finally, the relatively low count of events recorded in this study did not allow us to adjust for other important variables which may confound the association between DVT location and outcomes.","title":"Recurrence Risk after First Symptomatic Distal versus Proximal Deep Vein Thrombosis According to Baseline Risk Factors"}
{"_id":"61701ef1-099b-ebd7-d0e6-4db9f236c895","text":"Desmoid tumors are benign neoplasms that most often arise from muscle aponeurosis and have been associated with both trauma and pregnancy. The etiology of desmoids has not been determined. We report the case of anterior abdominal wall desmoid tumor in a female patient with previous history of cesarean section. Preoperative ultrasound and computed tomography demonstrated a large mass mimicking a large hematoma or an intraabdominal mass. The tumor was removed by wide excision with safe margins. The abdominal wall defect was reconstructed with polypropylene mesh. Subsequent histology revealed a desmoid tumor. Desmoid tumors in females are often associated with pregnancy or occur post-partum. The reasons behind this association are unclear. The most common sites are in the abdominal muscles.","title":"Huge desmoid tumor of the anterior abdominal wall mimicking an intraabdominal mass in a postpartum woman: a case report"}
{"_id":"61791557-1823-4e9b-0938-b7ee97256611","text":"There are five different subtypes: dystrophic, metastatic, iatrogenic, calciphylaxis, and idiopathic. Dystrophic calcinosis cutis, the most common form, is caused by tissue damage and commonly associated with autoimmune connective tissue diseases, such as systemic sclerosis, dermatomyositis, and systemic lupus erythematosus. Metastatic calcinosis cutis results from defective metabolism of calcium and phosphate. Iatrogenic calcinosis cutis occurs from treatment with intravenous calcium compounds and calcium chloride electrode paste used in electroencephalography. Calciphylaxis is characterized by the calcification of small- and medium-sized blood vessels in the dermis or subcutaneous fat, leading to ischemia, necrosis, and ulceration of the skin.\n\nIdiopathic calcinosis cutis is a rarer form of this disease process. It occurs without any underlying tissue damage or defects in metabolism and can present as papules, nodules, or plaques that may be ulcerated or with white chalky discharge.","title":"Idiopathic Calcinosis Cutis of the Hand"}
{"_id":"617f94ab-d987-2910-d793-51f19ef0b645","text":"Clinical diagnosis of most adnexal skin carcinomas is difficult not only between them but also with adnexal benign tumours.","title":"Adnexal carcinomas of the head and neck"}
{"_id":"6181d415-a271-9543-fdca-09ce206b61d1","text":"In our case, the patient was of older age and had restricted lung function due to the previous lobectomy. Given these factors, after well discussion and consent, we chose to use a transposition flap with skin grafting for her scalp reconstruction rather than other more complicated and time-consuming techniques. The reason why we selected the occipital scalp as the donor site was to hide the alopecia area on the rear of her head. However, the donor site wound ended up with subsequent graft loss, probably related to compression during rest or sleep resulting in loss of blood flow to the STSG.","title":"Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft"}
{"_id":"61855f27-9631-4149-2254-c75979ed9088","text":"In osteonecrosis the vascular supply of the bone is interrupted and the living cells die. The inorganic mineral network remains intact until ingrowing blood vessels invade the graft. Accompanying osteoclasts start to resorb the bone trabeculae and gradually replace the bone. If the osteonecrosis occurs in mechanically loaded parts, like in the subchondral bone of a loaded joint, the remodelling might lead to a weakening of the bone and, in consequence to a joint collapse. Systemic bisphosphonate treatment can reduce the resorption of necrotic bone. In the present study we investigate if zoledronate, the most potent of the commercially available bisphosphonates, can be used to reduce the amount or speed of bone graft remodeling.","title":"Systemic zoledronate treatment both prevents resorption of allograft bone and increases the retention of new formed bone during revascularization and remodelling. A bone chamber study in rats"}
{"_id":"6186d164-043e-d889-dee6-1eec492b74b8","text":"The presence of a short lingual frenulum, in fact, limits the possibility of a lingual upward movement. This consequently leads to the onset of abnormal swallowing and an anterior open bite, which perpetuates the incorrect swallowing pattern with a continuous forward thrust of the tongue with a modification of the dental occlusion. This defect can be solved with an orthodontic approach.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"619442f7-5fd1-3208-2a81-a74fb8876d32","text":"Paravertebral blocks are becoming increasingly utilized for breast surgery with studies showing improved postoperative pain control, decreased need for opioids, and less nausea and vomiting. We describe the anesthetic management of an otherwise healthy woman who was 12 weeks pregnant presenting for treatment of her breast cancer. For patients undergoing breast mastectomy and reconstruction with tissue expanders, paravertebral blocks offer an anesthetic alternative when general anesthesia is not desired.","title":"Right Breast Mastectomy and Reconstruction with Tissue Expander under Thoracic Paravertebral Blocks in a 12-Week Parturient"}
{"_id":"61965bc5-b48c-769f-f327-76edfd9ee631","text":"In susceptible individuals chloramphenicol has been shown to exhibit a delayed type hypersensitivity reaction. This type of reaction is the same as the reaction first demonstrated by Robert Koch in 1882 with his tubercle bacillus. The nature of the delayed type hypersensitivity reaction is that it has a postponed onset of 24–72 hours. This time lapse makes clinical differentiation from an infective origin all the more challenging.","title":"Reaction or infection: topical chloramphenicol treatment"}
{"_id":"619cb54f-f598-909e-b025-b5f9ea3a6a08","text":"We analyzed 59 consecutive patients 44 receiving IA and 15 receiving TAP block as regional analgesia. Population baseline characteristics are summarized in Table 1.","title":"Abstracts of the ICARE 2023 77th SIAARTI National Congress"}
{"_id":"61a0a281-583a-d890-4fda-5bbd5f0e0037","text":"This study was not without limitations; the first being the selection bias of only including orthopaedic surgeons employed by the top 10 institutions. While highly ranked institutions tend to conduct and publish more research, this still represents a limitation in the utility of subspecialty references at other institutions. It was not feasible to collect data for the orthopaedic faculty at every academic centre, so we chose to focus on these institutions where we predicted this type of data would be of greatest utility to department chairs. The other main limitation of this study was that not every journal lists the date of acceptance along with the date of publication, so publication date had to be used when the acceptance date was not available. With the time from initial submission to publication estimated to be 36 weeks, the significant correlations seen between sequential stages in training, such as residency and fellowship, may be influenced by a lag in publication times [6]. Lastly, while the number of publications has been widely used as a measure of academic productivity, the quality and impact of each publication should also be considered. While we did not assess the quality of each individual publication, the use of PubMed helped to ensure only peer-reviewed articles within the field of biomedical sciences and life sciences were counted.","title":"Does Publication History Predict Future Publication Output in Orthopaedics?"}
{"_id":"61a172ef-eb28-94cb-abb3-c69fc40706ba","text":"• Mortality at 30 days was increased with 1 to 2 units of RBCs of 28 or more days of storage in this study population.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"61a535cd-ea6d-c946-d5f3-f69bb5e6f51f","text":"DTF is a rare, benign tumor of myofibroblast origin. While they most commonly arise in the extremities or abdominal wall we present a rare occurrence in the ileocolic mesentery. Long term recurrence in mesenteric desmoid tumors remains undetermined given its rarity and variable presentation. Recent guidelines recommend more conservative approaches and watchful observation, but our case emphasized the need for immediate surgical intervention considering location and size. Our case emphasized the importance of a multidisciplinary approach in establishing an accurate diagnosis and in providing the proper treatment with the necessary perioperative considerations. This case presented a rare presentation of ileocolic mesentery desmoid tumor and demonstrated the complexities in managing patients with large intra-abdominal desmoid tumors.","title":"A Large Sporadic Intra-abdominal Desmoid-Type Fibromatosis in a Young Male: A Case Report"}
{"_id":"61a562df-a049-fcc2-30a4-5edf24bf36e9","text":"This was a retrospective observational study including rare skin tumors and less common variants of basal cell carcinoma and squamous cell carcinoma treated using Mohs micrographic surgery, between October 2008 and April 2021.","title":"Mohs micrographic surgery in rare cutaneous tumors: a retrospective study at a Brazilian tertiary university hospital"}
{"_id":"61ab6898-32fe-f6d6-b8cb-bc5f49e1be5c","text":"Facelift surgery has some potential complications. Probably the most important one is damage to the facial nerve causing partial or complete facial palsy. Parotid duct injury may also occur. Flap necrosis and compromised wound healing causing scar tissue on the face are also important complications especially for smokers and vegetarian patients. Using an inert suture material to suspend the malar tissues above the nasolabial sulcus solves the problem in a simple and less complicated way. Softening of the nasolabial fold and lifting the malar fat pad can be achieved by these sutures.","title":"Suture midface suspension"}
{"_id":"61b0eff5-bf65-1b65-71be-efd5f6183c45","text":"The use of flaps in vulvar cancer-related reconstruction has been increasing, but few studies have evaluated the outcome and quality of life of patients after this surgery. The purpose of this study was to evaluate the outcomes of vulvar reconstruction using musculocutaneous\/skin flaps in patients with advanced and recurrent vulvar malignancies.","title":"Outcome of vulvar reconstruction in patients with advanced and recurrent vulvar malignancies"}
{"_id":"61b99b73-3940-0b17-36d6-8a84aa2bc3dd","text":"patients who presented T3 staging are the ones who most presented positive SLN.","title":"Evaluation of tumor load in sentinel lymph node in patients with cutaneous melanoma Avaliação da carga do tumor em linfonodo sentinela nos doentes portadores de melanoma cutâneo"}
{"_id":"61bbe8c9-6bc3-42dc-e4a8-99f33c5b351e","text":"Today, the best solution for vascular damage is to categorically avoid dermal fillers treatments with non-medical and untrained personnel. This report aims to offer present a protocol for the early treatment of vascular damage after dermal fillers. Our early-implementation protocol has been compared with results presented in the literature and allowed us to avoid complications such as skin necrosis with permanent damage .","title":"Early hyaluronidase use in preventing skin necrosis after treatment with dermal fillers: Report of two cases [version 2; peer review: 2 approved"}
{"_id":"61c081a2-47a3-35a2-4eb2-f580ee5f86d2","text":"One of the strengths of this study is the systematic methodology that was followed to formulate recommendations. The PICO framework was used to guide the literature search, and then the GRADE method was followed to assess the evidence. Moreover, the Delphi method enabled a systematic approach to finding consensus while maintaining the anonymity of responders and achieved a high level of participation from experts in clinical nutrition. Another strength of this study is the evaluation of the usefulness and feasibility of nutritional assessment tools as separate concepts. Most healthcare professionals involved in the routine care of patients with malnutrition or at risk of malnutrition are not generally as specialized in this topic as the experts who participated in this study. However, the group of Delphi respondents was heterogeneous in the type of healthcare professional represented, the hospital setting where they practiced, and their geographical location (representing 16 of the 17 autonomous regions of Spain), which increased the external validity of our findings. Additionally, the experts evaluated the feasibility of each tool and test considered here, which ensures that the recommendations are grounded in real-world clinical practice and do not merely reflect the literature.","title":"Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study"}
{"_id":"61c13e86-1202-ea25-1263-388375b36faa","text":"The overall objective of this SLR was to summarize and gain insight into the latest pretrained and federated learning techniques for the detection of melanoma and nonmelanoma skin cancer. The ROs of conducting this SLR were:","title":"Federated and Transfer Learning Methods for the Classification of Melanoma and Nonmelanoma Skin Cancers: A Prospective Study"}
{"_id":"61c157df-f5b7-f93d-6a2c-671a7325d0c9","text":"ICU residents with no or limited experience could detect DVT with ultrasound in critically ill COVID-19 patients following a short education. VTE was associated with kidney dysfunction and features of hyperinflammation and hypercoagulation.","title":"Point of care ultrasound screening for deep vein thrombosis in critically ill COVID-19 patients, an observational study"}
{"_id":"61c41f88-52c9-049c-1e62-914be41b4969","text":"To provide physicians with practical information, the following treatment algorithm was built from the available data and expert opinion. The algorithm proposes a baseline treatment followed by additional suggestions according to symptom severity.","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"61c60182-bc83-5d20-3a13-a0a9cbcb43d6","text":"The pathogenesis is complicated and currently is not fully known but it responds well to immunosuppressant therapy which means there is an autoimmunne response at the core of the disease.","title":"Dermatomyositis post vaccine against SARS-COV2"}
{"_id":"61d0e661-873f-be54-025c-1cbf7be95d24","text":"In our department, the treatment protocol had been formulated as follows: when a patient with the suspicion of CPCSSTIs was admitted, we performed thorough physical examination and peripheral blood laboratory tests. Imaging studies such as neck soft tissue radiography or neck CT scan were used selectively. A paired swab and tissue culture had been obtained for the identification of underlying microorganisms. Initial empirical intravenous antibiotics were immediately administered before the culture results were available. Thereafter, the treatment regimen and dosage of antibiotic agents were later modified based on the bacterial culture and sensitivity report.","title":"Complicated Posterior Cervical Skin and Soft Tissue Infections at a Single Referral Center"}
{"_id":"61d87237-43da-280b-dc73-318be31a0954","text":"These are either acquired or inherited hypercoagulable states associated with a high incidence of DVT and PE.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"61da1a1f-25e3-1556-fc65-3e891d113b7b","text":"Although there are many different surgical techniques to reconstruct a breast after mastectomy, there is still no specific surgical method that is perfect or well-suited for all patients undergoing breast reconstruction surgery. In our study, we found that there was no significant difference in satisfaction between the ABR and IBR group.","title":"Patient-reported outcomes after breast reconstructive surgery: A prospective cross-sectional study"}
{"_id":"61dcbe29-42a3-2eb8-4153-26ac772d8e0e","text":"The distinction between T1a and T1b is no loger based on mitotic index, as it was in the 7th edition. This alteration impacts mainly when considering candidates for SLNB, since some patients with thin melanoma have undergone sentinel lymph node surgery based only on the mitotic index. Now, even though the new consensus no longer uses mitotic index as a criterion for SLNB, some surgeons may question whether they should really change their practice.","title":"How does the mitotic index impact patients with T1 melanoma? Comparison between the 7th and 8th edition of the American Joint Committee on Cancer melanoma staging system"}
{"_id":"61dd34aa-6df5-86ff-a0fd-d2f21c458f6b","text":"Decreased mobility and bedridden status in critically ill elderly patients predispose an increased incidence of pressure ulcers which are major causes of morbidity and mortality and significant financial burden. The best management approach is to alleviate the risk factors particularly minimizing the prolonged pressure, and keeping the skin clean and dry. However, once a pressure ulcer occurs careful evaluation and staging should be performed. For microbiological documentation, which will be necessary in patients with persistent infection, swab cultures should be avoided and only tissue samples should be cultured. Systemic antibiotic therapy is required for sellulitis and in patients with signs of systemic infections in addition to bed sores. Presence of osteomyelitis would also necessitate parenteral antibiotic therapy along with effective devitalized tissue debridement. Local antiseptics should be applied only in the short term since they may interfere with wound healing. Topical antibiotics have no role for the treatment. Several dressings and topical agents are available and can be effectively used, but none of them have been shown superiority than others. Similarly, negative pressure wound therapy with application of a foam dressing inserted into the wound which is then covered with a film and a vacuum is created by a suction device showed an advantage over the other types of dressings. An extensive review has recently been published about management of pressure ulcers (17).","title":"Infections in the Elderly Critically-Ill Patients"}
{"_id":"61dedf23-29ea-f66d-b246-6516417dfd53","text":"Despite the evolution of microsurgery, supermicrosurgery and the technical refinements proposed by experienced microsurgeons (95–100), there will probably always be cases in which an unexpected error and an inadvertent injury of the perforator vessels will occur. Our solution to reconstruct the perforator with a SIEV graft using a microsurgical coupler device adds to the diverse solutions made possible by the SIEV and gives weight to the idea of preserving the SIEV while harvesting the DIEP flap.","title":"Use of the superficial inferior epigastric vein in breast reconstruction with a deep inferior epigastric artery perforator flap"}
{"_id":"61e0fe75-0973-aa1b-47e5-4f8297785e19","text":"Fillers are commonly used in several aesthetic indications. Though considered safe, several side effects have been reported. The role of biofilms in the causation of some of these side effects has been elucidated only recently and this article presents a short review of the subject.","title":"Biofilms: Their Role in Dermal Fillers"}
{"_id":"61e3bfa5-e384-a9a3-1d14-f6e9bb0d2002","text":"After necessary preoperative evaluation and counselling he underwent a sub total excision of the tumour by median labio-mandibular glossotomy approach. Reconstruction was carried out using a vascularised fibula osteocutaneous flap. The fibular strut was used to reconstruct the vertebral column. It was wedged between healthy bone of the lower clivus and the C3 vertebral body, and held in place with a small mini-plate at the lower end of the graft. The skin paddle was used to reconstruct the posterior pharyngeal wall which was largely scarred from the previous surgeries and was excised with the tumour. The artery was anastomosed to the lingual artery and the vein to one of the tributaries of internal jugular vein in the neck. The recipient vessels in the neck were in close proximity to the donor vessels and so the length of the vascular pedicle was adequate. Figure 3 shows the three-dimensional CT image after surgery. The skin paddle was periodically monitored directly in the oropharynx. Since the manoeuvre of depressing the tongue and visualizing the flap was stressful to the patient due to the presence of the wounds and mandibulotomy, this was done less frequently than the usual hourly observation. Postoperatively, tracheostomy could be removed and satisfactory oral swallowing could be initiated by six weeks. He was treated with adjuvant intensity modulated radiotherapy with 6 MV photons with a dose of 60Gy in 30 fractions, which was tolerated well. After 18 months of follow-up he is symptomatically well, though imaging studies revealed residual disease.","title":"Vascularised fibula osteocutaneous flap for cervical spinal and posterior pharyngeal wall reconstruction"}
{"_id":"61f320aa-c3a7-9176-bbeb-e3c49b91095b","text":"In our patient, there was a composite defect of the skin, cartilage and lining and the tissue requirement was large. In an acute setting of trauma, expanding the forehead would be time consuming. There was open wound with exposed bone over the left supraorbital region which would increase the chances of infection in case that an expander was used. Other options for lining like the bipedicle vestibular skin flaps, septal mucoperichondrial flaps and turbinate flaps were not an option considering the enormously large mucosal defect and smaller donor area. We therefore, felt that lining for mucosa with a prefabricated flap by skin grafting was a better and considered a prefabricated forehead flap for nasal reconstruction.","title":"Complex Nasal and Periorbital Reconstruction Using Locoregional Flaps: A Case Report"}
{"_id":"61f5d0f8-86c3-2c90-c721-52089d975c4a","text":"We conclude that in management of locally malignant tumorsone should not be lenient and planning in reverse is very importantand we shouldnever compromise to excise in fear of residual defect size and always consult your colleague for any help.","title":"Recurrent Dermatofibrosarcoma Protuberance and its Management with Radical Excision and Interval Skin Grafting: A Case Report"}
{"_id":"61f807c9-512c-0cf7-b93b-c9e14e42512a","text":"Alternatives to anterior cervical discectomy and fusion have been developed that attempt to address some of the kinematic and biomechanical issues associated with fusing two spinal levels. It has been shown that twenty-five percent of patients undergoing cervical fusion will have new onset symptoms within ten years of that fusion due to degenerative changes at adjacent levels [23]. Total intervertebral disc replacement was introduced to preserve motion and restore disc height after removing the pathology. The Bryan cervical disc prosthesis was first introduced in the USA in 2002. It was used for the treatment of both radiculopathy and myelopathy, and in recent studies comparing the two for single-level disease and comparing artificial disc versus fusion have shown both groups to have comparable improvement in all outcome measures [24].","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"61fa7b7f-4c32-7e61-f312-f191d8e2a2b6","text":"Reconstruction after mastectomy is increasingly becoming the mainstream approach for younger women who are diagnosed with breast cancer. Mastectomy defects can cause significant psychological trauma, making breast reconstruction become the most valuable and challenging procedure performed by breast oncology surgeons in our institute. The increasingly significant demand of Chinese patients for breast reconstruction has promoted the development of a myriad of acceptable procedures.","title":"Patient-Reported Outcomes and Complications Following Breast Reconstruction: A Comparison Between Biological Matrix-Assisted Direct-to-Implant and Latissimus Dorsi Flap"}
{"_id":"61fd00df-9e18-3861-97ae-2c8bb2a2d64d","text":"This study will be presented at the 2010 Annual Meeting of the American Society for Therapeutic Radiology and Oncology in San Diego, CA.","title":"The initial experience of electronic brachytherapy for the treatment of non-melanoma skin cancer"}
{"_id":"620c7ded-6753-ab0d-1e50-a85b3b09f490","text":"Burn care and reconstruction surgery have been a core area of plastic surgery and represent a fundamental competency in plastic surgery residency training. The knowledge of tissue handling and scar revision procedures from burn care also can inform new methods for treating complications after FGM. While plastic surgeons’ well practiced techniques of labiaplasty and certain cosmetic genital procedures can also inform improved methods of FGM reconstruction, the essentials of plastic surgery training: tissue handling, wound care, reconstruction play a critical role as well.","title":"The Role of Plastic Surgeons in Female Genital Mutilation Reconstructive Surgery"}
{"_id":"6213ec21-86e3-96c9-6369-8ce22d401c73","text":"All kyphosis cases which report for the first time with moderate to severe kyphosis of 50° of more, may be taken up for kyphosis correction surgery. Lots of studies are available where outcome of kyphosis is described. However, only few studies cover the broad principles of kyphosis correction in spinal tuberculosis.18–21 Most of the studies describe one stage or two stage surgery to decompress the spinal cord and stabilize the spine with the objective to prevent post treatment deterioration of kyphosis.","title":"Kyphosis in spinal tuberculosis – Prevention and correction"}
{"_id":"6216d879-d075-c43b-5107-a3a52d4cc126","text":"Thus, the present study aims to analyze the use of vascular ultrasonography to map the saphenous vein in the preoperative period of myocardial revascularization surgery to define viability and the best site for venous graft dissection, and its impact on the reduction of unnecessary incisions and complications.","title":"Use of Doppler Ultrasound for Saphenous Vein Mapping to Obtain Grafts for Coronary Artery Bypass Grafting"}
{"_id":"62179b60-2862-9539-1bb8-4205c10c79d0","text":"Micronodular BCC is composed of dispersed micronodules of tumor cells. These tumor nests extend into the deeper dermis, and sometimes into the subcutaneous tissues. Satellite like arrangement of punctate nodules with irregular contours can be seen. Those are separated by normal dermal collagen and lined by a thin margin of stroma.","title":"Molecular Mechanisms and Targeted Therapies of Advanced Basal Cell Carcinoma"}
{"_id":"62198d01-5e7f-16f5-201d-c47177bff014","text":"A full thickness skin graft involves a skin graft taken from a donor site such as the pre-auricular area, the donor site closed primarily and the graft inset over the defect. The limitation of this option is that is does not reconstruct the cartilage.","title":"Malignant epithelioid hemangioendothelioma of the ear"}
{"_id":"621c246a-6d0b-f8bc-148a-0e715a1a5b7b","text":"There are many surgical methods for haemorrhoids, but each has its own advantages and disadvantages. Therefore, it is particularly necessary to explore a surgical method that not only does not damage anal sphincter function but can also restore the normal shape of the anus.","title":"Modified ultrasound scalpel haemorrhoidectomy versus conventional haemorrhoidectomy for mixed haemorrhoids: a study protocol for a single-blind randomised controlled trial"}
{"_id":"6222a71d-9fe7-edb4-cd91-2bbbf248ab5d","text":"An 84-year-old patient in good general condition with an extensive surgical breach in the scalp comes to our observation where a sessile squamous cell carcinoma was removed 2 months ago in another hospital; The surgeon had removed the aponeurotic galea with bone exposure.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"6224048b-7dde-afc1-0a9c-c0f9fa927d84","text":"Materials and methods: Up to ten melanoma cell lines bearing different mutations in the BRAF gene were exposed to BRAFi and\/or MEKi from 2 to 72 h and harvested for protein and RNA extraction. Drug resistant melanoma cell populations were selected using increasing drug concentrations over a 2 months period. Activation of RTKs and intracellular signaling was assesses by RTK arrays and western blotting. ErbB3 receptor was inhibited by monoclonal antibodies A3 and A4. Changes in miRNA levels were detected by Nanostring technology or by RT-PCR. Tumor biopsies were obtained from patients before KI therapy or after relapse and used for RNA extraction.","title":"Melanoma and immunotherapy bridge 2015 Naples, Italy. 1–5 December 2015"}
{"_id":"6228d11f-501b-f680-eed4-d03ddd336479","text":"Among them, autologous costal cartilage has the advantages of sufficient material and strong support. It can make various fine adjustments to the nasal tip support according to the needs and can effectively resist the contraction of the skin and obtain a more stable long-term effect. Moreover, since the nasal cartilage of East Asians is generally weak and the nasal septal cartilage is short, the nose tip shaping of autologous costal cartilage came into being and became popular among Asians. Especially in the case of secondary nasal surgery for secondary deformity of cleft lip, the scar contracture of alar cartilage makes autologous costal cartilage almost the only choice.","title":"3D Printing Technique Assisted Autologous Costal Cartilage Augmentation Rhinoplasty for Patients with Radix Augmentation Needs and Nasal Deformity after Cleft Lip Repair"}
{"_id":"62303da3-115d-3080-24d6-e5a31f4da789","text":"A total of 55 reports were analyzed from ultrasound examinations of the lower limb venous system that met the inclusion criteria. A total of 132 patients had undergone ultrasound mapping prior to surgical procedures. Seventy-seven of these patients were excluded because of absence of saphenous vein reflux and the final sample comprised 55 subjects, as illustrated in Figure 1.","title":"Patterns of flow drainage from varicose veins originating in the incompetent great saphenous vein Padrões de drenagem do fluxo das varizes oriundas da veia safena magna incompetente"}
{"_id":"6231472f-203a-6547-8dd3-293fd1a89332","text":"In the face of the above facts, there are critical questions whether our pregnant women are treated in euthyroidism and whether the treatment of the euthyroid pregnant women has a negative effect on pregnancy course and foetus.","title":"Abstracts and short papers from the 5th Congress of the Polish Thyroid Association, Poznan, 3-5 September, 2015"}
{"_id":"6233fb7a-2623-e120-4749-d3fceec1931e","text":"The face and the neck in a MWL patient are usually tackled at the end. Due to sudden and massive weight loss following bariatric surgery, the volume loss often gives the face an emaciated and gaunt appearance. Excessive facial fat atrophy coupled with redundant skin and SMAS leads to loss of facial contours and elasticity. The goal in facial rejuvenation in MWL patient is to restore the facial and neck contours. Multiplaner rhytidectomy addresses both volume and skin laxity. Secondary procedures are often performed to correct the residual deformities.","title":"Body contouring surgery in a massive weight loss patient: An overview"}
{"_id":"6234023b-9689-f3be-3486-6e586d48100e","text":"MRI currently represents the technique with a greater sensitivity and specificity for the evaluation of silicone breast implant integrity and the identification of inflammatory complications. Its diagnostic value is higher in symptomatic than asymptomatic patients and when contrast media is administered.","title":"Medical Imaging of Inflammations and Infections of Breast Implants"}
{"_id":"62441434-7d9d-1cd8-4d2d-5e489376f61d","text":"In this cross-sectional study, results suggest that the majority of specialties in academic medicine saw no improvement in racial diversity despite the greater diversity of the pool of available faculty members to choose from; meanwhile, several specialties did experience significant increases in gender diversity among their leadership. However, all of the specialties analyzed continued to have lower leadership diversity when compared with their own faculty members, with many of the surgical specialties having lower than average racial and gender diversity in their leadership. In conclusion, persistent monitoring of diversity in leadership allows us to accurately assess the trends of diversity in medicine and determine the potential to promote a diverse physician workforce.","title":"Racial, Ethnic, and Sex Diversity in Academic Medical Leadership Racial, Ethnic, and Sex Diversity in Academic Medical Leadership"}
{"_id":"62451d70-e3ab-f0e1-bd15-7d23ad3d154b","text":"We can define composite tissue allotransplantation as transplanting a graft composed of a variety of heterogeneous antigenic tissues across a genetic mismatch. It is a challenge with many barriers and complexities in comparison to a more homogenous organ such liver or kidney.","title":"Transplantation of composite tissue allografts. Scientific bases and clinical applications"}
{"_id":"62481227-2b27-5772-b5d8-0078386098cf","text":"SLN detection was first used in other anatomical areas like the breast and soon skin cancer as well as gastric cancers followed. In many centers SLN detection has become standard clinical practice.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"62498793-5fb8-d001-cea0-751bb0b0fd09","text":"Because of the above findings, a free vascularized osteocutaneous fibular flap for the reconstruction of the right elbow was selected. The procedure was performed 4 days later as patient's resuscitation was optimized to allow reoperation and elbow wound was free of infection or excessive drainage. The flap was harvested using the standard technique as previously described by Chen and Yan.6 Following ulnar nerve anterior submuscular transposition, a 6-cm fibular graft was inserted into the medial column defect and subsequently stabilized with a new 3.5-mm reconstruction plate. Microvascular anastomoses of the donor peroneal artery and its accompanying veins were carried out on the corresponding radial artery and venae comitantes after passage of the pedicle through brachialis muscle. On completion of the anastomoses, there was brisk arterial bleeding from the muscle sleeve with satisfactory venous return along venae comitantes. The donor site was closed using a thigh skin graft by the same plastic surgeons' team. Under the same anesthesia and after completion of elbow reconstruction, sacroiliac screw insertion for fixation of pelvic fracture was done. No intraoperative complications were encountered during the 2 surgical procedures.","title":"Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft"}
{"_id":"624ac1d7-a1bd-7ab4-def9-dc0390fb079c","text":"In the UK all surgeons need to have leadership skills as, despite the increasing importance of team management, the consultant surgeon still has overall responsibility for the patient under their care. Poor care is evident when clinical leadership fails. The UK hospital system is non-hierarchical within the consultant body. The clinical surgical manager in a hospital may not be the most senior clinician and the role will often rotate. The manager may or may not have the characteristics of a leader, and very often surgical leaders in a hospital may have no formal role. They are, however, essential to the functioning of the service. Nationally the roles in which professional leadership may reside are numerous. The country has multiple Surgical Royal Colleges and innumerable specialty associations and sub specialty associations all of which have councils and presidents and the multiple specialty and sub-specialty associations normally will have an annual meeting. In the long term this is probably unsustainable and although consolidation is desirable it is hard to achieve. In summary, good surgical leadership is found in many settings in the UK, some in formal roles within hospitals, some in the colleges and specialty associations and sometimes in individuals with no formal role but the capacity to make things happen.","title":"Surgical leadership: the British concept"}
{"_id":"624b08a4-ea6d-a877-8c0f-77c0c100c976","text":"Breast cancer management has undergone many changes in recent years, particularly where treatment is concerned, with the objective of improving the effectiveness and tolerance of treatment. Axillary status is an important prognostic factor in breast cancer and may be a determinant indicating whether systemic adjuvant therapy should be administered 12. Axillary management in patients with breast cancer has improved significantly over recent decades, with SLNB having become the standard procedure for axillary staging in patients without clinically detectable lymph nodes (cN0) 11.","title":"Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy"}
{"_id":"62573b4f-387b-7d12-e541-4643dfd43606","text":"Nonetheless, the current review findings are essential for the clinicians and surgeons involved in the management of patients with periprosthetic joint infection. PET\/CT is a good enough diagnostic method and can be applied in patients suspected of having periprosthetic infection of the hip. To the already existing advantages in terms of time and cost reduction, the evidence of high level of accuracy can be added as another major advantage to be included in the standard protocol of these patients. Utilizing this imaging modality will help to start the treatment early leading to better patient outcomes. More prospective studies can be performed to check whether this can be used as confirmatory test, as it has not reached such levels as per the current review findings. Further large-scale research can help to find answers for such questions and provide final conclusive evidence on the inclusion of the imaging modality into the routine clinical practice guidelines for suspected periprosthetic joint infection patients.","title":"Diagnostic accuracy of positron emission tomography\/computerized tomography for periprosthetic joint infection of hip: systematic review and meta-analysis"}
{"_id":"6259e01c-ee51-0475-f8a1-241d46ad5791","text":"The purpose of this study was to demonstrate the incidence of venous thromboembolism in patients including those with sickle cell disease who underwent spine surgery and to formulate a protocol to provide prophylaxis to patients undergoing spine surgery in the future if the incidence was found to be significant with positive association between these two variables.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"625a8f8d-501c-d44a-b9c2-f4295a43e78a","text":"Limb salvage surgery has become the standard of care in managing extremity sarcomas.1–5 With recent advances in radiotherapy and chemotherapy, 95% of patients with extremity sarcomas will have limb conservation surgery but five per cent of these patients will still require amputation. Common indications for amputation are major neurovascular involvement and large primary tumor where resection would leave a functionally useless limb.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"62623b72-1eb6-2cb6-0b04-0456356f1f56","text":"Despite sampling a limited number of patients, our experience suggests that the modern surgeon approaching such areas should rely upon all available instrumentation to accurately study anatomy and define a personalized treatment strategy. Virtual examination of such anatomical regions not just aids the preoperative study of patients but also provides guidance also during surgery thanks to surgical navigation and virtual endoscopy. Especially for malignancies, in which resection extends to remove the macroscopic residual of disease, the prompt identification of structures contributes to operate more safely and with an increased awareness.","title":"Anatomical Computerized Exploration to Excise Malignancies in Deep Facial Compartments: An Advanced Virtual Reality Protocol for a Tailored Surgical Approach"}
{"_id":"626309f9-4890-4745-3791-a7af8ecb1fb1","text":"The patient was then referred to our department. He presented a wound of 30 × 12 cm on the anterior surface of right leg with exposed fracture of tibia and ischemic sufferance of the distal bone segment.","title":"Cross-Leg as Salvage Procedure after Free Flaps Transfer Failure: A Case Report"}
{"_id":"627d6ddd-2a83-4870-b7e3-060ed09a8db2","text":"The first successful experiment of PDT was carried out on animals in 1975 at Roswell Park Cancer Institute in Buffalo. From this successful experiment, PDT gained some importance and was used by scientists in experimental models.","title":"Reactive Oxygen Species Produced by 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Cancer"}
{"_id":"62825cb3-45c0-bff9-a8d4-8840183bf61f","text":"The occurrence of VAD following FVFG is a well-known donor site complication in skeletally immature patients. In contrast, adults with stable congruent ankle joints are not expected to suffer from this complication at all. This case report demonstrates the possibility of severe VAD following FVFG in an adult patient population with generalized joint hypermobility. Not unexpectedly, the syndesmotic ligament in adults with EDS may lack the robust nature required to support the ankle after the removal of the fibular shaft. Without the ligamentous support of the proximal fibula at the knee, all of the force that is transmitted through the fibula during ambulation is dispersed to just the distal remnant and syndesmotic ligaments, causing it to displace.","title":"Donor-Site Complication of Severe Valgus Ankle Deformity in an Adult With Ehlers-Danlos Syndrome Following Free Vascularized Fibular Grafting"}
{"_id":"6283e03e-4aaa-72fc-1303-51107173756f","text":"In this study, radiation pneumonia SD rats were established, and we identified for the first time that the radiological manifestations of RILI after interstitial brachytherapy are less severe, with a slight impact on lung function and lung volume. This study provides novel insights for patients with malignant tumors treated with interstitial brachytherapy.","title":"The occurrence and development of radiation-induced lung injury after interstitial brachytherapy and stereotactic radiotherapy in SD rats"}
{"_id":"62995f4a-a6c8-6e85-e388-f347c96af519","text":"In summary, we provide evidence that quantification of lymphatic cancer cell dissemination is feasible and can be combined with other quantitative and qualitative characteristics of the primary tumor for accurate individual outcome prediction, probably not only for melanoma but also for other types of solid cancer [34]. It will be important to validate the findings in an independent study before the assay and the prediction model are used clinically.","title":"Quantitative Measurement of Melanoma Spread in Sentinel Lymph Nodes and Survival"}
{"_id":"629cd52f-7eb9-dc91-c048-fada7bd6a6da","text":"For ex vivo robust real time sentinel lymph node analysis, further research should initial focus on the accuracy of photoacoustic imaging for small lymph node metastases.","title":"Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging"}
{"_id":"629f0f6c-299c-201a-274b-0feb3dec75c3","text":"Eighty patients were excluded from analysis in this study because no allergic symptoms were recorded in the patients’ medical records. In the records of four of these patients, it was remarked that they presented to the primary care practice with anaphylactic symptoms after eating food possibly containing peanuts or tree nuts. According to the risk factor assessment used for this study these patients were also considered high risk patients and candidates for an EAI. Importantly, one of them had not been prescribed an EAI. Descriptive characteristics are shown in Table 1.","title":"Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands"}
{"_id":"62a2969b-92ca-4be3-175b-8f8088cdc572","text":"Recent studies highlighted potential therapeutic uses of stem cells of different origins in the treatment of psoriasis, even if the underlying mechanisms remaining are not clear and are elusive. For example, a recent clinical communication describes the positive effects of mesenchymal stem cells infusions, capable of decreasing the severity and extension of psoriasis. It is assumed that the mechanisms at the basis of this activity are the downregulation of the expression of proinflammatory cytokines and the inhibition of the infiltration of cells involved in the immune response to the structures of the skin [36].","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"62a38796-ed9b-73a6-138d-1c80583fac39","text":"Out of the 167 patients, 55 had isolated distal vein thrombosis and 112 had either proximal or proximal and concomitant distal vein thrombosis. The latter patients will be further referred to as having proximal DVT, because of the similar risk of pulmonary embolism affiliated with the two joined conditions.","title":"Systemic and Local Factors’ Influence on the Topological Differences in Deep Vein Thrombosis"}
{"_id":"62a7b2f4-1fc1-6cca-f488-141b559639ff","text":"Existing literature indicates that benign adverse events following manual treatments to the spine are common, while serious adverse events are rare. The incidence and causal relationships with serious adverse events are challenging to establish, with gaps in the literature and inherent methodological limitations of studies. Clinicians should ensure that patients are informed of risks during the consent process. Since serious adverse events could result from pre-existing pathologies, assessment for signs or symptoms of these is important. Clinicians may also contribute to furthering understanding by utilising patient safety incident reporting and learning systems where adverse events have occurred.","title":"What are the risks of manual treatment of the spine? A scoping review for clinicians"}
{"_id":"62ab2094-b670-232c-c353-d8e9a9b569fa","text":"What can be done to reduce the incidence of unplanned positive margins?","title":"Positive Margins Following Excision of Primary Bone & Soft Tissue Tumours in a Tertiary Centre and the Impact on Patient Outcomes"}
{"_id":"62ad7728-4f3c-576d-a527-8144126f4102","text":"The SCIP flap is crucial for hand reconstruction not only in adult patients but also in pediatric patients. Previous relevant studies have mainly focused on adults, and few studies have reported the use of perforator flaps in pediatric patients. To be certain, vascular anastomosis in pediatric patients certainly poses a unique clinical challenge.","title":"Free superficial circumflex iliac artery perforator flap with a single-pedicle bilobed design for pediatric multi-digit defect reconstruction"}
{"_id":"62c28b2b-efd6-2bdb-eea0-7cc01937fd03","text":"All 4 nodal recurrences presented within 1 year of completing RT.","title":"Efficacy of elective nodal irradiation in skin squamous cell carcinoma of the face, ears, and scalp"}
{"_id":"62c394ab-5eed-2258-65b7-6176776aab13","text":"In our study all patients had clinical and radiological features of chronic osteomyelitis by the time they were referred for definitive treatment. The mixed organism growth from bacterial cultures of nosocomial origin required repeated hospitalisations and expensive antibiotics for infection control. Despite being advised about proper pin site care, very few patients strictly adhered to the instructions. Two patients with septic arthritis of the knee who required arthrotomy and drainage were not co-operative and this directly correlated with the educational status of the patient. The pre-existing bone infection and insufficient pin care probably account for the higher incidence of pin tract infections in our study. We feel these patients are monitored under close medical supervision for optimal results.","title":"Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study"}
{"_id":"62c3eaa1-b955-d471-bb1f-698fd8934540","text":"Limitations of this study are mainly the retrospective nature of the study design and the small number of cases. This caused a lack of traceability in some of our cases about the used materials and techniques. Nevertheless, this study can help clinicians to overview different types of filler materials, possible complications and conservative and particularly surgical techniques to resolve these rare complications.","title":"Complications and Disasters After Minimally Invasive Tissue Augmentation with Different Types of Fillers: A Retrospective Analysis"}
{"_id":"62c5bac6-48e1-8f71-9015-a3750d48cd02","text":"The early outcomes of electronic brachytherapy for the treatment of NMSC show acceptable acute toxicity and favorable early cosmesis. The hypofractionated approach provides patient convenience with effective early outcomes. Long-term follow up is in progress to further assess efficacy and cosmesis.","title":"The initial experience of electronic brachytherapy for the treatment of non-melanoma skin cancer"}
{"_id":"62c9a70a-531e-1fbe-6455-1010c40abf16","text":"Proper vascularization is definitely the key element to be addressed for successful grafting. During the initial phase, a well-developed vessel bed is especially important for essential nutrients to reach the metabolically demanding cells to prevent tissue necrosis. In the future, smart scaffolds with tailored biological properties that directs the formation and maintenance of the hierarchal vasculature network through biochemical cues could be the next breakthrough in skin tissue regeneration.","title":"Translational stem cell therapy: vascularized skin grafts in skin repair and regeneration"}
{"_id":"62d395cf-bbbe-871e-3556-8652d0c30405","text":"Island flaps involve a slightly more complex procedure, care must be taken when preparing the tunnel under the skin as it must accommodate the pedicle with minimal or no compression.","title":"The First Dorsal Metacarpal Artery Flap Family: A Review"}
{"_id":"62dba2d1-3c42-c8ba-3a4c-cbcfa0e14d15","text":"There may be an increased risk of preterm birth and associated neonatal complications for female cancer survivors, but the outcomes of the majority of pregnancies appear similar to noncancer patients. It is not clear whether the increased risks in pregnancy are related to the malignancy itself or the result of treatments such as radiation or chemotherapy. Also, the risk of disease recurrence will depend on several factors, but for most cancers the risk of recurrence is not increased secondary to pregnancy. Overall, pregnancy appears safe for most patients after cancer treatment but will depend on individual patient characteristics.","title":"Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review"}
{"_id":"62dee978-c799-8676-2377-65a773ab31a8","text":"The last possible drawback was that the specific degree of ISR and the overall degree of stenosis when stent compression presents with ISR was not assessed. Measuring diameter stenosis by DUS and MDCTV is problematic because of the irregular shape of neoplasms and the elliptical shape of the post-stented lumen. The optimal assessment would be to use IVUS to directly delineate the area encompassed by the stent perimeter and then calculate the percentage stenosis with the lumen area within the ISR [16].","title":"Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting"}
{"_id":"62e0b218-8d47-d1dc-d793-fb7ad5cd96a9","text":"Second, we will extend the literature on leadership in implementation research by revealing the configurations of leadership which appear to be effective in getting evidence into practice. Throughout our study, we position leadership as the contextually situated process of a collective group, not the actions of the person who attends leadership development programmes. The leadership networks mapped in this study will be illuminated and enriched through the narratives of participants to understand the leadership configurations that exist in practice and those which appear more effective for improving implementation of evidence-based practice. Thereby answering the questions, how do you get leadership for improvement? Which actors are best placed to perform leadership to improve implementation? What do these actors need? And what are the organisational conditions that allow it to happen?","title":"Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol"}
{"_id":"62e169b1-b18b-1b6d-ef59-3e44fcd21b19","text":"With the current techniques like Inferior pedicle with an Inverted T skin resection, there is no role for free nipple graft procedure except in selected cases of gigantomastia with ptosis where the pedicle length necessary to translocate the nipple-areola may be enormous.","title":"Reduction mammoplasty"}
{"_id":"62e40569-a9db-2e82-3832-2d4462bf8a80","text":"Traumatic events in the Achilles region require free-tissue transfer. A study performed by Vaienti et al.13 reported that flaps using these vessels are safe and their perforators enable surgeons to extract more tissue to use in the reconstruction of the Achilles region. Furthermore, recent studies have reported that flaps from the lateral calcaneal artery (which is normally a branch of the FA, although it can sometimes arise from the PTA) is a good option for small injuries in the calcaneal region, but this is contraindicated in cases in which the lateral calcaneal artery provides the supply for the whole foot.25 In the present case, we would advise not to use the distal portion of the PTA or the FA for vascular flaps, since any type of iatrogenic injury during surgery could cause massive bleeding and hemostasis would be difficult, leading to limb ischemia or death because of the anastomosis in an unusual pattern.","title":"Clinical features of a rare anatomical variation of the posterior tibial and fibular arteries Aspectos clínicos de uma variação anatômica rara das artérias tibial posterior e fibular"}
{"_id":"62e5cead-06f1-7405-6371-0c4538b2d5bb","text":"Our proposal is based on the observation that serum specific IgE levels, triggering dose of allergenic food and severity of reactions seem to greatly vary even into the same group of termed highly allergic children.","title":"Oral desensitization to milk: how to choose the starting dose!"}
{"_id":"62e8941d-9ebc-35c7-37be-48a4e24b7e40","text":"In this study, we aimed to identify the risk factors associated with the development of DVT in neurosurgical patients, with the objective of being able to identify types of patients with the highest risks in our given cohort and therefore, to assist the neurosurgeon in deciding on patients who would benefit from more aggressive coverage with anticoagulants. We had also included Well’s scoring to determine its validity in an inpatient neurosurgical setting as it was not a routine tool used for our patient assessment. We further looked at D-dimer values to compare with the limits that had been suggested in other studies.","title":"Deep Vein Thrombosis and the Neurosurgical Patient"}
{"_id":"62f192a7-b5e6-c934-04a1-327b386c4fb1","text":"The global SARS-CoV2 pandemic has been a challenge to the health authorities and medical science worldwide and it has made us create new protocols to study possible therapies and vaccines.","title":"Dermatomyositis post vaccine against SARS-COV2"}
{"_id":"62f33a7b-c923-4d9f-bb35-171aab690781","text":"One patient had a residual T3N0M0 adenoid cystic carcinoma instead of squameus cell carcinoma. Patient was treated with PDT and surgery. Patient had a partial response and has been symptom free for 22 months.","title":"Photodynamic therapy in the therapy for recurrent\/persistent nasopharyngeal cancer"}
{"_id":"62f41591-6f69-f38d-7cb7-04518b21750e","text":"All patients underwent surgery under general or regional anesthesia with tourniquet control. First, we debrided the recipient area for the preparation of recipient vessels. We extended the skin incision to the out of the zone of injury, dissected digital artery or common digital artery which did not affect the finger survival and got the veins in the dorsal aspect of finger. At this time we dissected enough to perform the vascular anastomosis out of injury zone. We made a template with surgical glove, which included the site of artery, vein, and contour of defect. The tourniquet was inflated to 100 mm Hg, which allowed the veins to engorge. The veins were marked on the forearm distal volar aspect with a skin marker. To make the center of the flap placed on the area where the vein distribution was most abundant, we applied the already manufactured template on the forearm and drew the flap more larger than the recipient site to prevent postoperative swelling, edema, and tension. At this time the relatively smaller vein was planned to be used as the afferent vein and the larger vein as the efferent vein.","title":"The clinical result of arterialized venous free flaps for the treatment of soft tissue defect of the fingers"}
{"_id":"62f5405a-d184-fc9f-49f5-433323f9a114","text":"Nonsurgical rhinoplasty is a procedure that is gaining popularity in aesthetic clinics particularly because of its minimally invasive nature compared with surgery. It is recognized that there are ethnic variations in nose injection techniques and planned aesthetic outcomes.","title":"Ethnicity and Nonsurgical Rhinoplasty"}
{"_id":"62f6bdd8-d6fc-193a-2888-2ae99dd03497","text":"In terms of an omental free flap for use in reconstruction of complex scalp defects, Losken et al showcase the versatility and high success rate of omental free flaps. The omentum is pliable and has the ability to fill the irregular borders that are sometimes present in scalp reconstruction procedures. Furthermore, patients who receive an omental free flap are better equipped to fight infections at the wound site due to the abundant vascularity and unique immunologic properties of the omentum. The omental free flap has also proven to be a good alternative to the traditional free flaps when they are either too hard to harvest or not big enough to cover the defect. One unique disadvantages of using omental free flaps is the need to enter the abdominal cavity. Intra-abdominal complications of omental free flap harvest include volvulus, intestinal obstruction, or enterotomies, and special caution should be taken when the patient has peritonitis or adhesions due to prior intra-abdominal surgeries.21","title":"Scalp Reconstruction: A Review of the Literature and a Unique Case of Total Craniectomy in an Adult With Osteomyelitis of the Skull Tutela et al"}
{"_id":"62fbfe6e-a87e-3731-0142-229c78d18523","text":"Postoperative topical psoralens with UVA was seen to produce better colour intensity and spread of pigment, thus hastening the complete response stage. Postoperative steroids were found to enhance the pigmentation and shorten the stage to complete response in patients who showed no pigment at the end of 6 weeks.","title":"Split Thickness Skin Grafting in Patients with Stable Vitiligo"}
{"_id":"6300338b-bdd4-6006-0bc1-4904c55320b0","text":"The patient was subsequently taken to the operating room at to The Arthur G. James Cancer Hospital and underwent an ultrasound directed wide local excision of the inferior portion of her right breast in the 7 o'clock axis within the mid to peripheral breast field.","title":"Fibromatosis (desmoid tumor) of the breast mimicking a case of ipsilateral metachronous breast cancer"}
{"_id":"630840ec-8fab-0c6a-520b-a804d2145e23","text":"Ventral skin deficiency is frequently seen in patients with hypospadias. Skin coverage of the penile shaft at the end of a hypospadias repair can be challenging and the skin deficiency may become more prominent following correction of ventral curvature and\/or the use of ventral skin flaps during urethroplasty. Byars described a multistage repair for hypospadias in 1951 using flaps created from the dorsal preputial skin.[5] The skin is incised longitudinally and then translocated to the ventral aspect of the penile shaft for use in creating a neourethra at a subsequent stage. These same Byar’s flaps have come into routine use for resurfacing the ventral penile shaft in most hypospadias repairs.","title":"The role of flaps and grafts in modern hypospadiology"}
{"_id":"630ec865-6197-0ab0-7e90-f97973447faa","text":"Despite negative results of skin tests with for food and inhaled allergens one could suspect type I hypersensitivity reaction due to the time of reaction, elevated serum levels of IgE and positive result of the intradermal test with calcium citrate. In this case, calcium citrate should be accounted as haptene. Type I hypersensitivity reaction is a result of stimulation by allergen IgE sensitized mast cell. Mast cells release mediators that cause inflammatory reactions typical for Type I hypersensitivity. It is also known that mast cells release a number of cytokines.[","title":"Allergic reaction to platelet-rich plasma (PRP) Case report"}
{"_id":"631f22da-18c8-5569-98ce-249970c08f78","text":"In summary, this is the first comprehensive planning study to evaluate VMAT, IMRT and 3DCRT planning techniques for unresectable chest wall desmoid tumours. Our findings show that both VMAT and IMRT provided superior PTV coverage and improved OAR sparing compared to 3DCRT. VMAT was associated with reduced MUs with a trend towards lower ipsilateral breast dose compared to IMRT. Further prospective studies are required to assess whether VMAT would translate to clinical benefits especially reduced incidence of late effects compared to IMRT, however this is challenging due to the low incidence of desmoid tumour and the long follow-up that would be required.","title":"Chest wall desmoid tumours treated with definitive radiotherapy: a plan comparison of 3D conformal radiotherapy, intensity-modulated radiotherapy and volumetric-modulated arc radiotherapy"}
{"_id":"6322d6b1-cf43-b853-fbdd-355cf249e375","text":"So what might the true future of surgery and surgical training be like in the Caribbean? Or a better question, what would we like to see as the future of surgical training in the Caribbean? Over the next few years, the number of general surgeons will gradually be reduced, and we will have superspecialists for all areas. This growth rate will be a bit slower than that in the USA, but there will always be a role for the general surgeon, especially in rural areas. It is hoped that the many “toys” that exist in the first world today will also be available in the Caribbean. However, there must be a balance between conventional traditional approaches and highly specialized approaches such as robotics. Our feeling is that this balance will be preserved based on the costs associated with these at least for the next few decades. Better yet, the Caribbean exposure may be of interest to the first world with regard to the potential for rotations for residents who may not be used to seeing traditional open surgery.","title":"Surgical training in the Caribbean: The past, the present, and the future"}
{"_id":"6325a32c-f10d-df4f-1c49-d2df39932700","text":"The findings of this study suggest an association between anosognosia and decreased perfusion in the frontal, temporal, and anterior cingulate cortices. Brain perfusion SPECT with automated BA analysis and comparison with a normal database would serve as a neuroimaging biomarker to provide insight into the mechanism of anosognosia in dementia, as well as in other neurological diseases. The understanding of anosognosia neural substrates is of great clinical interest and would aid in the disease prognostication.","title":"Anosognosia in Dementia: Evaluation of Perfusion Correlates Using 99mTc-HMPAO SPECT and Automated Brodmann Areas Analysis"}
{"_id":"63275c0b-63d0-44da-2ce8-8a5ada1e11fb","text":"Advantages of punch biopsy include ease of performance and obtaining uniformly shaped tissue. Disadvantages are that the material obtained may be inadequate and often biopsy may not include deeper tissue.","title":"Techniques of Skin Biopsy and Practical Considerations"}
{"_id":"6328256c-2ba8-f9ca-5e36-975a7614c1fe","text":"Maintaining the blood supply is crucial and is particularly vulnerable during the first weeks after microsurgery. If a perfusing or draining vessel is occluded by thrombosis, wound healing, and integration of the graft in the recipient area can be compromised and lead to the loss of all or part of the transplant in up to 20% of cases. Regardless of the type of tissue adhesive, vascular occlusions, and thromboembolic material were detected more frequently due to the use of adhesives during microvascular anastomosis. Intraluminal devices such as stents, on the other hand, serve as intraluminal connection devices and can secure the opening of the vessels during the bonding process and prevent the penetration of adhesives into the vessel lumen.","title":"Mechanical strength and hydrostatic testing of VIVO adhesive in sutureless microsurgical anastomoses: an ex vivo study"}
{"_id":"6329784d-d114-fbd1-0f26-af6ede15b954","text":"Table 2 Characteristic of the health care facilities and providers for the study sample","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"632a5c21-61a7-bddd-8587-436549cb411f","text":"OBJECTIVES Ashi ultrasonic therapeutic instrument can effectively alleviate the chronic soft tissue injury pain, the EFT immunity influences the therapeutic effect ofthe equipment. In order to diminish the randomness in the EFT immunity test, it is essential to adopt statistical analysis for research on EFT immunity of Ashi ultrasonic therapeutic apparatus.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"633a3c0e-9a23-916f-a907-4aa09f7f471e","text":"The patient was able to stand and work with an aide or walker and without pain. The range of motion in the hip and knee joints was not restricted. Bisphosphonate treatment had been resumed at that moment.","title":"Use of flexible intramedullary nailing in combination with an external fixator for a postoperative defect and pseudarthrosis of femur in a girl with osteogenesis imperfecta type VIII: a case report"}
{"_id":"634ae83e-e9be-d95d-bd51-ac44165deafb","text":"Given the above, this study primarily aimed to highlight the early assessment of breast pathology by ultrasound and its importance. The secondary aim was to evaluate breast characteristics throughout the course of ageing.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"634db31d-1859-fb94-7faf-4870029702b7","text":"Being compromised meant that participants were dependent on others to act on their behalf until they felt well enough to consent for themselves. In this acute period they invested a high degree of trust in the team, for clinical decisions as well as research, but also in relation to hope for their future recovery. They wished to be involved in trial decisions but were aware that they were compromised by the impact of injury and treatment diminishing their ability to function normally. Wound dressings were considered a minor aspect of their care in relation to the enormity of other therapeutic treatments. Being grateful for their care, altruism based on helping others and the minimal trial requirements were facilitators of trial participation. In making sense of the study they were hampered by their lack of understanding and experience of the two treatments but showed a preference for NPWT once experienced.","title":"Participation in a trial in the emergency situation: a qualitative study of patient experience in the UK WOLLF trial"}
{"_id":"63530c84-f6dd-901b-0516-fe8622d1145f","text":"From the insights gathered from the survey responses, it is clear that IMGs face many challenges from the time they decide to explore the options for training in the UK to the time they actually join the UK NHS. In an attempt to help address these challenges effectively, we recommend a number of actions or plans. These relate to the different levels of governance.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"6355b27f-8ac7-e1de-b11c-0a8dc611173e","text":"We advocate a low threshold for using free flaps in the lower limb.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"63566edb-b8a9-b103-cf66-8bc17d4ac335","text":"CONCLUSIONS This study showed the feasibility of LIPUS for stimulating the proliferation of hair follicle cells. Further in depth study may assess mechanisms of thestimulation and optimize ultrasound parameters.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"6356fb5c-606e-d089-fdf7-8123e17ee9ae","text":"Breast cancer survivors are increasing followed for new breast cancers \/ recurrences by mammography screening only. We aimed at assessing how often breast cancer survivors get a false positive or false negative result at mammography screening.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"6359018a-30ce-3e17-fe6c-17a94fca0785","text":"In summary, although previous studies have shown that some high risk food-allergic patients do not seek medical care, this study shows with data recorded by GPs themselves that those that do visit their GPs are often not prescribed an EAI, even to those with a previous severe anaphylactic reaction. This shows that previously identified low rates of EAI ownership may be partly due to GPs not prescribing this medication to patients for whom it would be appropriate to do so. These data suggest that there is a need for improvement of the quality of care for high risk food-allergic patients in primary care.","title":"Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands"}
{"_id":"635d58d9-a072-3f9f-8186-191c8af2e1bb","text":"The clinicopathologic data of 46 tongue carcinoma cases hospitalized from December 2009 to April 2014 were obtained from Nangjing Stomatological Hospital, Medical School of Nanjing University. All the subjects were evaluated for the articulation and the swallowing function 3 months after the surgery.","title":"Functional assessment: Free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects"}
{"_id":"63604c5f-fe25-fcf2-ff23-9c7b7d4552cd","text":"We believe that our experience at the VCU Massey Cancer Center supports the use of HDR brachytherapy for cases of recurrent vulvar cancer. This technique is particularly useful for patients who have previously undergone surgery or radiation and\/or for those that are not optimal surgical candidates. The patients discussed here had very unique cases that involved multiple recurrences and\/or extensive disease both of which are extremely difficult to treat. This required a creative approach including atypical implant devices and a modified template. Ultimately, our experience could be adapted to other patients with difficult recurrent vulvar cancer and, in some cases, may serve as a guide to other providers. Because of our implementation of interstitial brachytherapy, we were able to increase and prolong patient comfort, and our approach ultimately allowed for preservation of a rectum in one patient preventing the need for colostomy. This technique is both safe and effective allowing for adequate disease control with improved quality of life for patients.","title":"High-Dose Rate Salvage Interstitial Brachytherapy: A Case-Based Guide to the Treatment of Therapeutically Challenging Recurrent Vulvar Cancer"}
{"_id":"6363506f-6b41-762d-731d-1490a640f04e","text":"There were 9385 patients identified with CM as the index cancer with 56 195 person-years of follow-up. There were 3465 males and the median age at diagnosis was 57.3 years. The total number of observed and expected cases of CLL and NHL developing within this group is shown in Tables 1","title":"Evidence for an association between cutaneous malignant melanoma and lymphoid malignancy: a population-based retrospective cohort study in Scotland"}
{"_id":"6366fd68-cf24-309c-811b-b478ce66c933","text":"All the captured hemodynamic patterns, associated with the arterial and venous occlusion, by the optical monitoring system are clear evidence of the great potential of the proposed approach, providing a reliable and effective indicator for the detection of arterial ischemia and venous ischemia in flaps, which can be used for handheld readings or continuous monitoring.","title":"Design and testing of an optical instrument for skin flap monitoring"}
{"_id":"63675ec9-1e57-798b-5c95-7b5974fbb7c5","text":"Surgical treatment of patients in our series closely followed these principles. Our approach to ORN treatment is summarized in Figure 1. The majority of patients with stage 1 ORN were treated conservatively and with local debridement. Surgical care escalated to sequestrectomy and marginal resection with reconstruction in stage 2 patients. Most patients with stage 3 disease underwent radical excision of ORN with free tissue reconstruction. Of note, several patients with stage 3 disease required a second flap, which in 2 cases was a simultaneously performed two free flap procedures. Expectedly, the number of free flaps used increased corresponding to disease stage.","title":"Osteoradionecrosis of the mandible: a case series at a single institution"}
{"_id":"637d5121-eb9e-c02f-5825-14a7f44c9a05","text":"The introduction of target therapy and advancement of chemotherapeutic treatments have brought an increase in pCR rates, but BCS rates following NACT stay relatively unaffected [11], partly because an increase number of patients may opt for mastectomy treatments due to a lack of consensus on adequate margin in BCS after NACT. These findings may reflect discrepancies in practice among clinicians and guidelines with the consequence of re-excision to gain wider margins.","title":"Association of surgical margins with local recurrence in patients undergoing breast-conserving surgery after neoadjuvant chemotherapy"}
{"_id":"6388d2eb-18e5-c1c3-0138-8752ca0f75c6","text":"This is a case series of twelve patients who underwent islanded GMCF surgery in our hospital from 2004 until 2018 based on our registry. Their medical records were retrospectively reviewed and the data were collected for analysis. The surgical technique was based on the concept of the musculocutaneous perforators at the leg.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"6388dfc8-db16-d0be-c601-298a0c32fa7a","text":"Healthcare professionals often opt out of leadership roles, leaving others to make important decisions about how the services should be run. This important role was recognised by those who participated in the study. There is a need to reinforce leadership training, and careful thought needs to be given as to how it could be strengthened in the registrar training, a key role of the FP is to participate in clinical governance activities within the district health system.","title":"Perceptions of specialists in the public sector, on the role and value of family medicine"}
{"_id":"638c122a-7ce6-b552-93fc-408f6304b17d","text":"Current NCCN guidelines [7] recommend 1 cm margins for melanomas with a thickness of less than 2 mm and 2 cm margins for those greater than 2 mm. However, the appropriate extent of resection margins in the head and neck area is subject to debate. The use of the recommended standard margins can be difficult to obtain in this region, as it could result in severe functional and cosmetic defects or is sometimes not technically feasible at all.","title":"Challenges in the Complex Management of Neglected Cutaneous Melanomas in the Head and Neck Area: A Single Center Experience"}
{"_id":"63959fd2-f07c-c31f-e621-451dd5d6d77a","text":"Another limitation of stents is that they must be manufactured with desired geometries and dimensions, which do not allow their application when using anastomoses of unequal vascular lumina, which are common in reconstructive procedures. It is common for the vessel lumina to be interindividual and also differ between the graft vessel and the recipient vessel in reconstructive surgery. As with many studies, one limitation of this research is the lack of a stent design and architecture that addresses the success and improvement in different vessel diameters.","title":"Mechanical strength and hydrostatic testing of VIVO adhesive in sutureless microsurgical anastomoses: an ex vivo study"}
{"_id":"6399184d-77d5-b00d-cb3f-77f5a341b433","text":"Four patients received excision with a safety margin that included 3 mm of normal skin around the NS lesion, and 5 patients received surgery with the just the NS margin of NS and no normal safety margin.","title":"Malignant transformation of nevus sebaceous to basal-cell carcinoma: Case series, literature review, and management algorithm"}
{"_id":"63999e12-bb5c-9458-559d-f23d6c2d7287","text":"Periorificial face cancers are challenging because it is important to balance the local control of the disease with a satisfactory cosmetic outcome. Interstitial HDR IRT could be an effective therapeutic option providing adequate disease control and preventing potentially disfiguring surgical approaches. More numerous and standardized studies are warranted to confirm the available evidence.","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"63a9023d-a5db-ec7a-37fc-062d401d2d60","text":"It is the author's preference to monitor the flap with a skin paddle. In all patients who underwent DIEP flap reconstructions in this study a small elliptical skin paddle was externalized to be later incorporated into a nipple areola reconstruction. For PAP flap cases a vertically oriented skin paddle was externalized within the vertical limb of the Wise pattern (Figure 3). In cases where no Doppler signal is captured over the externalized portion of the flap, an implantable Doppler is used to monitor the arterial portion of the flap, and the flap skin paddle color is monitored to assess the venous outflow. This is preferred to leaving an excessively large or poorly positioned skin paddle in order to capture a skin perforator signal. Following completion of nipple areola reconstruction in DIEP flap patients the skin paddle should fall entirely within the area of the tattooed areola (Figure 1, Figure 2). For PAP flap patients the skin paddle is simply excised.","title":"Optimizing aesthetic outcomes for breast reconstruction in patients with significant macromastia or ptosis"}
{"_id":"63adf0e0-67c4-04e9-9faa-779bcacf25fa","text":"Huge advances in genotyping technology in recent years has not yet been translated into clinical utility, but this is probably only a matter of time. In order to be in a position to take advantage of these advances, the international scientific community needs to continue in, and accelerate, joint efforts to collect and store clinically well characterized biological samples which could be used to identify or confirm DNA variants useful in predicting adverse drug reactions. In addition, research into the functional mechanisms of genetic associations found with hypersensitivity reactions should be considered in order to identify causal variants, strengthen the basis of associations, and ultimately allow for the development of diagnostic tests, and in the future, lessons for safer drug design.","title":"Drug Induced Hypersensitivity and the HLA Complex"}
{"_id":"63b29b15-0a88-bb46-c45b-b1bd58d5f096","text":"Assessment of preoperative values for satisfaction with the nasal appearance and preexisting adverse effects enables surgeons to identify patients who will potentially be less satisfied with the surgical outcome, as individuals who have very low or higher\/above normal scores are predicted to be less satisfied after surgery. Another strength of the current study lies in its anonymous design, which reduces bias and makes data more reliable. Patients do not feel coerced into stressing preoperative adverse events regarding the nose to warrant surgery.","title":"Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients"}
{"_id":"63b544c7-4913-a5b7-79a8-ee9d158445b4","text":"All women should have the option of breast reconstruction following mastectomy.","title":"Breast cancer treatment in clinical practice compared to best evidence and practice guidelines"}
{"_id":"63b7bf03-af66-9fd5-06f1-3abf2b173d6e","text":"The PVC group had a PVC inserted on the side of surgery before the induction of anesthesia. PVC placement was performed in the operating room prior to induction of anesthesia by an anesthesiologist trained in ultrasound or landmark-based placement with the patient in the sitting position. A linear ultrasound probe was placed in the parasagittal plane to find the transverse process at the fourth thoracic vertebrae. Local anesthetic was administered in the skin, and a 17 gauge Tuohy needle was inserted into the paravertebral space under ultrasound guidance. The desired endpoint of needle insertion was either direct needle visualization deep to the costotransverse ligament in the paravertebral space and\/or depression of the parietal pleura upon injection of saline.","title":"Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery"}
{"_id":"63b89c6c-d22b-ba84-b79e-2f9d79fc91b5","text":"Cryotherapy is a safe and effective treatment modality for extra-abdominal desmoid tumors with efficacy similar to those treated with traditional strategies in the short to medium term.","title":"Cryotherapy in extra-abdominal desmoid tumors: A systematic review and meta-analysis"}
{"_id":"63b9a8f0-db05-e904-de57-3556a9a583bb","text":"In parallel with their clinical tolerance, patients’ highest negative skin test dilution of peanut also increased several logs. However, acalabrutinib treatment did not completely suppress skin tests as was observed for basophil activation, which was abolished by acalabrutinib treatment. This is in line with prior studies showing that BTK inhibitor doses that can suppress ex vivo basophil activation responses do not completely inhibit skin tests. The reasons for this disparate activity of BTK inhibitors on identical FcεRI pathways in mast cells versus basophils are as yet unknown. In vitro data suggest that the inhibitory concentrations of BTK inhibitors are similar in human mast cells and basophils. In a previous trial assessing ibrutinib’s effects on skin tests, seven days of ibrutinib did not suppress skin tests further compared to two days. Therefore, one could speculate that longer duration of BTK inhibitor therapy would not offer additional protection against anaphylaxis, and that skin mast cell inhibition in vivo is incomplete at the doses of irreversible BTK inhibitors that are FDA-approved for malignant indications. The dose of acalabrutinib utilized in this trial, which is the FDA-approved dose for treating B cell malignancies, has been shown to result in 100% drug occupancy of BTK in peripheral blood mononuclear cells. However, the penetrance of BTK inhibitors into organs such as the skin has not been studied. Full inhibition of tissue-resident mast cells may require different BTK inhibitor dosing than what is used for treating cancers. Interestingly, the 3 patients who did not achieve full protection with acalabrutinib treatment did not demonstrate any symptoms of the skin or mucosa while on acalabrutinib as they had during their baseline OFC.","title":"Bruton’s tyrosine kinase inhibition for the prevention of anaphylaxis: an open-label, phase 2 trial"}
{"_id":"63ba625d-c6eb-f530-9a7c-e5ea972af4ab","text":"Table 5 Feeding practices among mothers returning to work or school at KIBS1 and KIBS2","title":"Are we doing enough? Improved breastfeeding practices at 14 weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa"}
{"_id":"63bb736d-92aa-2b44-193d-439e05b19039","text":"Patients were categorized into two groups based on their surgery dates: 291 cases underwent lymphadenectomy along the left RLN using the ESLR method, while 102 cases underwent lymphadenectomy along the left RLN using the conventional method.","title":"A novel technique for lymphadenectomy along the left recurrent laryngeal nerve during minimally invasive esophagectomy: a retrospective cohort study"}
{"_id":"63bb9430-6966-ac2a-3507-c2aea8118df4","text":"Although the hierarchy of evidence favours quantitative methods, mixed research approaches are becoming increasingly acceptable in assembling evidence. There is a place for rigorous qualitative research or case series that include in-depth analyses of few patients in their natural clinical setting.","title":"Perinatal psychological interventions to promote breastfeeding: a narrative review"}
{"_id":"63bbb4b0-d877-8616-fd22-fb32c00a57ac","text":"Patient 1 received 60 Gy radiation over 30 fractions for treatment of a T3N2b adenosquamous carcinoma in the left parietal scalp. The patient had experienced grade 2 dysgeusia and grade 2 radiation dermatitis on the posterior scalp and left neck by the end of the treatment. There was no evidence of disease at 8 months post treatment.","title":"3D printed integrated bolus\/headrest for radiation therapy for malignancies involving the posterior scalp and neck"}
{"_id":"63c1ee19-0737-cab1-713c-6f405e5c314e","text":"Clinical practice is determined as much by what a clinician knows as by the norms within their community of practice, and by the meaning that an innovation holds for clinicians. This meaning differs depending on professional group affiliation or community of practice and evolves with time, changing with the emergence of new evidence and new opinion leaders. Adoption of SN biopsy in Australia over the past 20 years has involved a process of assessing continually evolving evidence from clinical trials followed by review and reframing by clinicians from different specialty areas involved in the management of primary melanoma of the evidence for SN biopsy. It is anticipated that we will continue to see change in the uptake of SN biopsy as knowledge of the role of adjuvant therapies in melanoma management diffuses, or is actively disseminated, amongst these communities of practice by these emerging opinion leaders. Any intervention aimed at improving uptake or adherence to SN biopsy recommendations would benefit from a co-design approach to ensure appropriate engagement of key existing and emerging opinion leaders who are familiar with the evidence on which those recommendations are based.","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"63c531a6-b14b-a699-5f87-4a1305cb7b5b","text":"The history of application of skin substitutes dates back to the first written report on the skin xenograft in the 15th century BC as mentioned in the Papyrus of Ebers. The clinical use of human skin allograft was first described in the manuscript of Branca of Sicily in 1503. Various skin substitutes that were tested over time, such as human skin allograft, xenograft and amnion, are still being used at various burn centres all over the world. With the advent and progress of biotechnology and tissue engineering, a wide array of skin substitutes is now available in the market for the treatment of burn injury.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"63c92e63-59ac-74ac-fd97-d8a8c714455c","text":"Generally women reported high satisfaction with alternative follow-up regimes. These studies did not report any consideration of age in the design or interpretation of the trials or details of how alternative follow-up was presented to the women and whether survival was discussed. It is likely that when survival and well-being are in conflict, such as in making decisions about stressful tests or preventive treatment which has side effects, patients may make different choices [66] so that some inequalities will not depend on service availability. More research is needed into how well patients understand risk, how much they are prepared to allow their treating doctors to make medical decisions on their behalf and the social differences and circumstances associated with these choices.","title":"Options for early breast cancer follow-up in primary and secondary care - a systematic review"}
{"_id":"63d9f1d5-6eeb-bf3a-e1d0-8f4ade533f25","text":"The classification proposed by Oeslner was also compared with the classification proposed by Li et al. This comparison showed the following data:","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"63dc3a64-a365-8a4f-a356-cfcb9575f876","text":"This case illustrates a previously underreported phenomenon of surgical scar recurrence of breast cancer metastases after surgical intervention to the femur. We believe this information can be useful in guiding radiation oncologists in the determination of treatment volumes in cases of post-operative radiotherapy for non-spinal bone metastases.","title":"Surgical Scar Recurrence of Bone Metastases to the Femur: A Case Report"}
{"_id":"63e2be25-eaf6-4477-5c11-53f7a00037fd","text":"Dental rehabilitation may be achieved by the use of fixed or removal prostheses that are retained by osseointegrated dental implants. The efficacy of this technique has been demonstrated in the noncancer edentulous population. Use of osseointegrated dental implants requires adequate bone stock and a well-vascularized recipient tissue bed with stable soft tissue coverage. Placement of osseointegrated implants into the remaining edentulous native mandible or free vascularized bone flaps has been very successful in carefully selected patients [56]. Implants must be surrounded by a minimum of 1 mm of healthy bone. The fibula and iliac crest free flaps offer the best bone stock for osseointegration, while the scapula and radial forearm do so less reliably. Implant failure is increased in patients who smoke or have had radiation therapy or poor oral hygiene with dental infections.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"63ed2bd6-0d9f-c3a8-147c-48924e739be2","text":"Figure 4c and 4d illustrate the temperature and electric field distributions when 2000 V is applied after 90 seconds of thawing. The temperature distribution is similar to that seen in Figure 3c (when 1 V is applied). However, the temperature rises to a higher value over a shorter distance when 2000 V is applied due to Joule heating. The lowest temperature is 275 K in the 2000 V case rather than 274 K as in the 1 V case. The electric field in the 2000 V case has a similar distribution to the 1 V case, except the highest electric field reached in this case is 75,000 V\/m. It is important to note that changing the voltage magnitude has a very small effect on the temperature distribution. This is because the energy content in an electroporation pulse is very small relative to the enthalpy of phase transition.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"63ee1cc6-8288-798b-e3a8-2b59510b53a0","text":"Finally, the four cases in which the EM residents missed an isolated SFV thrombus bring us back to the point that two-point compression ultrasound may not be sufficient for diagnosis of lower extremity DVT.","title":"Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis"}
{"_id":"640140fe-17fd-a7c6-d635-0fab66c02def","text":"In summary, it appears that it is generally safe to place titanium or PEEK hardware in the setting of a cervical spine infection as the rate of fusion in the above studies is higher with hardware and the rate of recurrent infection is low.","title":"Cervical spine spondylodiscitis: Review of literature on current treatment strategies"}
{"_id":"6401504b-1cf3-f316-8628-d6abf9ac75e2","text":"Cheek defect reconstruction with cervicofacial flap is simple, reliable and with similar favourable aesthetic outcome when compared with free flap procedure. It should be an important part of a reconstructive surgeon armamentarium.","title":"Versatility of cervicofacial flap in management of cutaneous cheek defects post tumour excision: a report of two cases"}
{"_id":"6412f513-a8d8-6645-60e1-f17543194037","text":"The majority of cases occur in population-dense developing countries like Africa or India, however due to globalization and travelling it is no longer a disease limited to developing nations. Most cases in the western world of spinal tuberculosis are seen primarily in immigrants form endemic countries. While in endemic countries, Pott´s disease is more common in children and younger adults, in developed Western and Middle East countries adults are affected. The upper lumbar and lower thoracic region of vertebral column is most frequently affected. Characteristically for spinal tuberculosis is destruction of the intervertebral disk space and the adjacent vertebral bodies. Collapse of the spinal elements and anterior wedging leading to the characteristic angulation and gibbus formation. Surgical treatment is considered in cases of severe spinal instability or progressive neurological symptoms with evidence of cord compression or deformation.","title":"Surgical management and clinical outcome of cervical, thoracic and thoracolumbar spinal tuberculosis in a middle-European adult population"}
{"_id":"6413676c-84f4-3859-1603-6e202d7f58b6","text":"Open type III tibial fractures are often complicated by soft tissue and bone defects and are commonly associated with infection including osteomyelitis. To properly manage these clinical complications, various techniques including the VBG and MT have been proposed (Table 4). However, the two techniques have not been compared to date. In the present study, there was no statistical difference between the VBG and MT groups regarding union time, total treatment time, and subsequent osteomyelitis. In the VBG group, the union time was relatively constant regardless of the defect length, whereas in the MT group, the union rate was significantly better in the patients with bone defects less than 60 mm than in the patients with bone defects greater than 60 mm. Thus, we propose a 60 mm cut-off point for the two reconstruction methods. VBG may serve as the more reliable technique in cases where the bone defect length is greater than 60 mm, while MT may be applied in cases where bone defects are less than 60 mm or in cases with severe surgical site infection or osteomyelitis. We speculate that the reason VBG presented with better outcomes for larger defects might be due to the blood supply being completely and immediately transplanted to the fracture site, while the blood supply of MT relies on the angiogenesis process and therefore the bone healing process may potentially be limited by the bone defect length.","title":"Comparison of the clinical outcomes between vascularized bone graft and the Masquelet technique for the reconstruction of Gustilo type III open tibial fractures"}
{"_id":"64169855-ba01-22d1-be41-771b2cc27172","text":"Despite the mentioned and manageable drawbacks, this approach should be included in the repertoire of soft tissue intraoral and mandibular reconstruction with a free flap next to chimeric FFF and muscular intraoral lining with the FFF. These motioned approaches represent new reconstructive solutions for patients with a history of radiotherapy in the head and neck region, neck dissections, and consecutive clinical situations of a radiogenic dermatofibrosis or with a vessel-depleted neck, which would traditionally indicate a double flap reconstruction.","title":"Superficial Temporal Artery and Vein as Alternative Recipient Vessels for Intraoral Reconstruction With Free Flaps to Avoid the Cervical Approach With the Resulting Need for Double Flap Transfer in Previously Treated Necks"}
{"_id":"6418fca2-ba83-4e70-9073-bc6c33914bc0","text":"To our knowledge, this is the largest case series of stroke from large vessel occlusion caused by fat embolism. We illustrate two cases of stroke from large vessel occlusions as a complication from orthopaedic surgery due to paradoxical cerebral fat embolism from PFO, and one case from cardiac sternotomy. In our first case, we were able to obtain histological confirmation by demonstrating the combination of adipocytes, bone marrow constituents and thrombus.","title":"Cerebral Large Vessel Occlusion Caused by Fat Embolism—A Case Series and Review of the Literature"}
{"_id":"6419a313-a652-ba67-922f-9d794f171b4b","text":"The findings for this are presented in Additional file 1: Table 2 and Table 3. Local recurrence is defined as recurrence in the same breast or lymph nodes which is normally a recurrence of the same cancer as the primary. This is potentially curable with conventional therapies currently in use.","title":"Options for early breast cancer follow-up in primary and secondary care - a systematic review"}
{"_id":"641bca77-f1e7-08e8-0d87-692414db3af8","text":"We present a unique case of acetabular osteomyelitis with secondary septic arthritis, treated successfully with hip arthroscopy and antibiotic therapy. This surgical technique should be considered for the experienced hip arthroscopist for management of this relatively rare condition because it provides an excellent view and access to the joint and joint surfaces and allows for excellent débridement of pathological tissues and irrigation of the joint.","title":"Pediatric Acetabular Osteomyelitis Treated With Hip Arthroscopy"}
{"_id":"641fe6ee-a08a-4536-240b-246793a07714","text":"The main issue of this article is the regional control in patients of 50 years and older with T1–2 cN0 breast cancer treated with breast conserving therapy and regional radiotherapy compared to an axillary lymph node dissection. The low regional recurrence rates in our study show that RT is a safe alternative for an ALND.","title":"Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up"}
{"_id":"642476d1-f48c-2eb5-f727-590f38acc052","text":"In conclusion, we believe that a subfascial vessel should be considered as a recipient vessel for a second free flap procedure, as well as for the first, when the surgical approach and dissection are complicated by the location of the major recipient vessel being deep within the target tissue or when there is an increased risk of damage due to repeated recipient vessel dissection. Furthermore, we recommend that the subfascial vessel beneath the deep fascia be used as the recipient vessel, for easy vascular anastomosis.","title":"Validity of the use of a subfascial vessel as the recipient vessel in a second free flap transfer A retrospective clinical review"}
{"_id":"642677fd-94d3-6e4c-4a3e-b0aa9678ff64","text":"When applied to the health institutions that alumni work in, the transformative leadership skills mentioned here are likely to improve organizational capacity and efficiency, particularly as alumni advance in the workplace to become higher in leadership structure. As promotions occur, alumni acting as change agents within institutions will have larger effects on the growing areas they oversee.","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"642bae5f-be9a-1738-f2e7-1f3fc9958563","text":"We too did not encounter any serious complications in our study, moreover in none of our patients a pain raise was noticed also. Three patients complained pain soon after the procedure, while other two developed a little hematoma in the puncture site.","title":"Percutaneous cervical coblation as therapeutic technique in the treatment of algo-dysfunctional pain of discal herniation"}
{"_id":"6433d981-61c0-e1d7-12e8-2e5622f1b53d","text":"The lack of clear guidelines might contribute to patients not getting the correct VTE prophylaxis. Also, the prescribing behavior is mostly based on personal experience and case reports instead of international guidelines based research. The difference between different specialties was expected, but the low prescribing rate for the emergency physicians identifies a clear point of focus for education and training and the need for specialty based guidelines.","title":"37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)"}
{"_id":"643bebcd-d279-ae74-1160-54f229ef5299","text":"All patients underwent immediate reconstruction after ascertaining that that there is a 1 cm safety margin by frozen section. Neurosurgical attendance was required in six patients. Three of these patents had clavarial skull bony involvement while the other three patients had an infiltrated deep safety margin by frozen section. Excision of part of the outer table of the skull was done in three cases and full thickness excision was done in the remaining cases with no CSF leak.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"6443a20d-46bb-67fc-7fb7-f7fa828e7676","text":"Gustilo and Anderson type IIIB open tibia fractures are associated with high rates of surgical site infection, wound complications, and flap failure. Controversy surrounds the optimal timing and method of wound management prior to flap coverage. No studies to date have investigated the use of negative pressure wound therapy with instillation and dwell for open type IIIB tibia fractures. We present a single case of an open type IIIB tibia fracture that was managed with 21 days of circumferentially applied negative pressure wound therapy with instillation and dwell prior to flap coverage. Our results suggest that negative pressure wound therapy with instillation and dwell may minimize infection risk, decrease wound size, and allow for delayed soft tissue coverage.","title":"Circumferential Negative Pressure Wound Therapy with Instillation and Dwell Prior to Delayed Flap Coverage for a Type IIIB Open Tibia Fracture"}
{"_id":"6452aae3-dd21-55d4-8089-036ab7040953","text":"We had a very interesting case of a Gustilo–Anderson IIIB open tibiofibular fracture. The patient suffered a severe comminuted tibia fracture and a segmented fibula fracture with large soft tissue defects. Fortunately, all the vessels of the lower extremity including the peroneal vessels were intact and the tibial cortical bone defect was almost the same size as the fibula fracture segment. Hence, we used an ipsilateral vascularized fibula graft for tibia reconstruction. We also employed a thoracodorsal artery perforator free flap for resurfacing the soft tissue using the distal end of the peroneal vessels for the sequential chimeric flap.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"645409eb-e0c9-5358-4b2d-e3ef44af8ff8","text":"Informed consent was obtained from all patients or their caregivers before the study according to the Hospital Ethics Committee guidelines based on the ethical guidelines of the Helsinki Declaration of 1975, as revised in 2000. All patients and caregivers received written directions on radioprotection before the study.","title":"Anosognosia in Dementia: Evaluation of Perfusion Correlates Using 99mTc-HMPAO SPECT and Automated Brodmann Areas Analysis"}
{"_id":"64685970-d2ff-ce66-3545-7e6bdbc7c7ee","text":"This is the first report in the literature of an aborted laparoscopic procedure for failed pneumoperitoneum following autologous flap-based breast reconstruction. Given the frequency of laparoscopy and abdominal-based breast cancer reconstruction in current surgical practice, this case provides some insight into an important aspect of surgical disease management that has not been recognized or discussed in the literature.","title":"Failed pneumoperitoneum for laparoscopic surgery following autologous Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction: a case report"}
{"_id":"64688c2f-17c6-aa4a-9294-5a4d3b75fd4b","text":"To what extent and by what processes do trainee doctors’ perceptions of the stereotype of the surgeon influence their professional identification with surgical specialties?","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"6471c2e9-d8c4-bb9a-7f81-9abaf75140b3","text":"This result leads us to hypothesize how osmolarity of the contrast agent is one of the main factors that affects the release of cell mediators and, therefore, the appearance of an adverse reaction. Thus, the osmolarity of a contrast agent may be considered an important factor to be taken into account in those patients who present an immediate reaction to CM and with negative SPTs and IDTs for that particular CM.","title":"The involvement of osmolarity in the safety of contrast media"}
{"_id":"647284c5-3aff-c5eb-5d73-36f543674cd2","text":"In conclusion, the diagnostic accuracy of PJI is high when the MARS MRI of patients with suspected PJI shows signs of bone destruction, lamellar synovitis and extracapsular soft-tissue edema. We can accurately determine that the infection has been controlled when MARS MRI shows no lamellar synovitis and extracapsular soft-tissue edema prior to stage II reimplantation surgery. The diagnostic efficacy of MARS MRI for PJI preoperatively is not inferior to that of conventional diagnostic indices. It improves the efficiency of debridement by providing a visual reference for surgical planning preoperatively, which will make debridement more thorough and avoid overlooking occult infectious lesions.","title":"Metal Artifact Reduction Sequences MRI: A Useful Reference for Preoperative Diagnosis and Debridement Planning of Periprosthetic Joint Infection"}
{"_id":"6479fee4-f355-f93e-647e-595e52636069","text":"The greatest logistical challenge we faced was adding a series of new activities to an already crowded medical curriculum. The longitudinal integration of leadership training across a medical school curriculum has been promoted as a solution to the problem of competing demands. We took a longitudinal design into account when planning the LI by looking to assimilate offerings in the existing social and health system science course (SHS), which threads through the SOM curriculum. The first-year offerings were required courses in the SHS1 and 2 curricula which would account for the high rate of participation. The lower participation rate in the fourth-year reflects pilot work of these courses with a lesser number of students.","title":"Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy"}
{"_id":"64841eaa-c12b-9ec0-c711-dc833a12c009","text":"The patient was anticoagulated with intravenous unfractionated heparin with eventual conversion to long term oral anticoagulation with warfarin. Broad spectrum antibiotics were initiated and continued for 6 weeks. After 6 weeks of treatment, our patient had near complete resolution of cervical pain and headache with no significant neurologic deficits. Blood cultures remained negative throughout hospitalization.","title":"Pyogenic Odontoid Osteomyelitis with Sinus Thrombosis"}
{"_id":"64882bd3-fe81-7f63-a51e-5b8ccf53a824","text":"Step 2: To address the posteromedial tibial plateau fracture site, a gentle S‐shaped curvilinear incision was placed on the posteromedial aspect of the knee. After sharp dissection of the subcutaneous tissue, the popliteal fascia was incised, preserving the small saphenous vein as well as the medial sural cunateous nerve. The medial head of the gastrocnemius muscle was then mobilized and retracted laterally. The oblique tendinous expansion of the semimembranosus tendon was identified and retracted medially. The superior border of the popliteal muscle was identified and the muscle was dissected subperiostally to allow for posteromedial fracture site visualization. An arthrotomy was performed to assess the reduction of the articular surface at the level of the main fracture.","title":"Modified Anatomic Locking Plate for the Treatment of Posteromedial Tibial Plateau Fractures"}
{"_id":"648c7100-f125-8f77-54c3-706b78d2e966","text":"The objective of this study was to assess the degree of recanalization and the time taken for recanalization by analysis of color Doppler ultrasonography (CDU) reports from patients with DVT treated either with rivaroxaban monotherapy or with parenteral heparin followed by oral warfarin.","title":"Analysis of recanalization of deep venous thrombosis: a comparative study of patients treated with warfarin vs. rivaroxaban"}
{"_id":"6498f5d9-8b7d-f03d-7916-25b57fd46161","text":"Surgery when it's possible is still the treatment of choice, whether in primary or recurrent abdominal wall desmoid tumor. The quality of resection is a main prognosis factor. Radical surgery results in significant loss of substance in abdominal wall which can be managed using many reconstruction techniques. Repair by a double layer mesh covered by a pedicled fascial flap seems to be simple and efficient method.","title":"Recurrent desmoid tumor of the abdominal wall"}
{"_id":"649a0d7b-8f5c-babc-11c0-bd17347e0cf9","text":"Probably, the many arborising branches of the intercostal and lumbar vessels can support the blood supply regardless of the contribution of the two main epigastric vessels.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"649beab5-6288-8f20-6fe3-43929357a8c0","text":"Understanding the sociodemographic factors that may influence breastfeeding initiation and duration in Latinas is important as this population continues to grow in the U.S. The ability to appropriately target interventions so that Latina mothers initiate breastfeeding and continue to breastfeed as recommended by the AAP, despite length of time in the U.S., is important in assuring optimal future health of both Latino children and mothers. Specific interventions should target new mothers, as initial feeding decisions will likely be carried over to subsequent children. Additionally, mothers with children at home have specific challenges and need to be targeted for intervention to ensure that breastfeeding continues until 6 and 12 months of age. The IIFAS scale may be a useful tool in predicting breastfeeding outcomes for Latina mothers but further studies are needed to assess the validity of this instrument with this specific population.","title":"Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study"}
{"_id":"64a0f4f9-da2c-7e48-c065-f7960b49e26e","text":"The type of reconstructive procedure utilized for a tumor defect is dependent upon numerous factors. For any particular defect there will be multiple methods of reconstruction. The challenge for the reconstructive surgeon is finding what best suits the needs of the patient.","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"64ad8b85-7331-6bc9-00da-13096eef76c8","text":"The LENI myocutaneous flap is a reliable technique for reconstruction of the cutaneous defects of the nose with excellent aesthetic outcomes. We believe that it should serve as a workhorse alternative for reconstruction of nasal defects of up to 1.8 cm.","title":"Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction"}
{"_id":"64af2bff-aaa3-d548-9eae-05c29d6aa76d","text":"Another way of achieving dose escalation for the treatment of UIR and HR disease with SBRT is to combine conventional EBRT to the prostate +\/− pelvis with a SBRT boost to the prostate mimicking the combination of EBRT plus BT boost.","title":"Stereotactic Radiation Therapy versus Brachytherapy: Relative Strengths of Two Highly Efficient Options for the Treatment of Localized Prostate Cancer"}
{"_id":"64b0e792-a42b-63c1-c39b-a63d39a244c7","text":"Neoadjuvant therapy is an under-utilized regimen for the treatment of metastatic melanoma. The use of this approach has been increasing in other tumor types. Neoadjuvant therapy may reduce occult circulating tumor cell burden in the face of bulky disease and afford a real time evaluation of treatment effectiveness. Neoadjuvant approach can also provide preoperative histologic and molecular analysis of treated tissue that may guide the postoperative treatment planning in patients with resectable metastatic melanoma lesions. The putative benefits of better margin control and clearance of occult systemic disease would theoretically improve surgical outcome. With the advent of effective agents against metastatic melanoma, this common approach to the treatment of rectal cancer, metastatic colon cancer, and breast cancer should also be evaluated as a viable treatment strategy for advanced stage melanoma.","title":"Neoadjuvant treatment of melanoma: case reports and review"}
{"_id":"64b2610c-fc97-f3ee-a31a-1c62ab4152e7","text":"Finding out that the infant has physical disorders that complicated the breastfeeding situation gave confirmation to the suspicions or notions that something was wrong.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"64b3b5d3-37c2-ebbd-b2df-b7adc942f1fb","text":"How this report contributes to current knowledge: Patients with HSR to etoposide, in which this drug is the most adequate chemotherapeutic option for such a severe disease, the desensitization protocol is a treatment that proved to be effective in order to administer the treatment.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"64baa0f7-eb2d-1e09-0956-d25d54ed0f92","text":"We retrospectively reviewed all omental biopsies performed under USG guidance from April 2006 to March 2010 in a tertiary care hospital.","title":"Ultrasound-guided omental biopsy: Review of 173 patients"}
{"_id":"64bb61d6-02dd-e641-e3cf-1070b1ee3ce2","text":"A source of criticism of previous studies is the inclusion of patients who received non-leukocyte reduced RBCs. A recent study by Weinberg and colleagues only included patients who received prestorage leukoreduced RBCs and their results still demonstrated an increased risk of death with the use of RBCs more than 14 days of storage for patients transfused 6 or more units of RBCs [32]. In addition, while our study groups received a mixture and similar proportions of both non-leukoreduced and leukoreduced RBCs, the percentage of leukoreduced RBC units was not associated with survival on univariate or multivariate logistic regression analysis.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"64bcd522-420f-c90c-82e4-dada8fea2292","text":"Extensive scalp wounds and avulsions with exposed periosteum are treated with skin grafts or left to heal by secondary intention when wounds are smaller. Those wounds with exposed calvarium are typically treated with dermal substitutes due to the extended interval to contracture, infection risk, and difficulty with dressing changes.1","title":"A Novel Use of Integra™ Bilayer Matrix Wound Dressing on a Pediatric Scalp Avulsion: A Case Report Singer et al"}
{"_id":"64c1b9a3-b1b0-f79c-7789-391a9871ff85","text":"This survey received a response rate of 14% but involved only a small sample of 206 people. This sample cannot be considered representative of the population of practitioners and residents practicing oral surgery. Further research is needed to refine these results for the dental surgeon and oral and maxillofacial surgeon populations. Regarding the distinction between private and hospital or academic practice, a statement of bias exists because of the common oral surgeon’s dual private and public activity, except for residents and assistant professors.","title":"Social Media’s Use and Impact on Oral Surgeons and Oral Surgery Residents"}
{"_id":"64c304dc-586b-2e3a-af1a-da5e8a1a613e","text":"The types of surgical techniques that are currently available are conventional scalpel surgery and laser surgery.","title":"Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review"}
{"_id":"64cef7da-5d81-a53e-f6ed-643cdfe9c4ec","text":"The second is the intervention of a third party who carries out an active process designed to accelerate or modify the natural healing process in case of major injuries such as extensive burns or non-healing ulcers. The third party intervention is commonly known as surgical intervention which will produce the conditions that will lead to spontaneous wound healing. It can also be the application of biological or biocompatible materials which will act to close the wound and reach a stable and acceptable endpoint to the healing process [7]. The common surgical treatment for major skin loss is the split skin graft (SSG) where a layer of skin is removed from a healthy part of the body (donor site) and grafted onto the wound. Although this is an effective treatment for burn and trauma cases, there are certain disadvantages including the limited availability of graftable skin and the increase risk of infection for patients with massive skin loss. Moreover, the process is painful and may result in scarring, and is not suitable for diabetic individuals with compromised healing abilities. These limitations lead to the use of skin substitutes for the treatment of skin loss caused by major injuries or diseases.","title":"Shelf-Life Evaluation of Bilayered Human Skin Equivalent, MyDerm™"}
{"_id":"64d5b26c-1328-df78-d3db-4f0dab61e202","text":"Ultrasound is an excellent imaging modality used in the assessment of the cervical lymph nodes. The ultrasound probe contains a transducer which sends ultrasound waves into the neck tissues. Any sound waves that are 'reflected back' are picked up by the same transducer and used to create an image on the screen. A coupling gel is placed between the probe and the skin surface to ensure a good contact. This is required so the sound waves will propagate into the tissues.","title":"Imaging patients with cancer of the oral cavity"}
{"_id":"64df807c-b8c9-6730-c968-0177bd2979b2","text":"Ultrasound is one of the most used tools for acquiring medical images for screening and diagnosis in the field of obstetrics and gynecology. Ultrasound scanners capture reflections at the boundaries between and within tissues using the principle of pulse-echo imaging. Pulsed acoustic waves are transmitted and received by a transducer with frequencies for diagnostics ranging between 1 and 20 MHz. In general, higher frequencies produce better resolutions but penetration of the investigated tissues is lower, while lower frequencies produce greater depth of penetration but lower resolution.","title":"A New Approach in Detectability of Microcalcifications in the Placenta during Pregnancy Using Textural Features and K-Nearest Neighbors Algorithm"}
{"_id":"64e54818-86c0-b1b2-a524-e377d76c92f9","text":"In our series we have treated six cases with a second salvage treatment. It is worth noting that 4 of them are included in the first cases treated. Cases 1, 2, and 12 were made before the rectal Onik manoeuvre was well established. As described in the literature, the highest incidence of complications and the worst results occur in the series published prior to the development of this maneuver. An increase in complications rates has not been appreciated after salvage treatments and all cases are free of biochemical relapse with a maximum followup (132 months) in the first and second cases of the study.","title":"Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution"}
{"_id":"64e839cd-36dc-7631-3127-63ada5f3592e","text":"Iliac crest bone graft and anatomic locking plate fixation allow for a safe and adequate stabilization and radiographical bony union in non- and malunions of the clavicle with a high degree of patient satisfaction. However, secondary fractures of the anterior superior iliac spine constitute relevant complications and the time of hardware removal should be considered carefully.","title":"Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft"}
{"_id":"64ee10ef-29cf-e8f3-acc7-2e2c309a7dc9","text":"After being clinically rechecked about 30 minutes after the end of the treatment, the patient was discharged with the following indications: absolute functional rest for the first 3 days; relative functional rest for further 15 days, taking care to avoid elevation and abduction movements of the joint above 90°, and avoid the use of the left upper limb to move heavy loads; ultrasound clinical examination after 3 weeks from the treatment; and application of ice packs during the first 3 hours after the intervention and intake of analgesic drugs only if needed.","title":"Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint A case report"}
{"_id":"64ef5598-b54a-81b3-b361-55afc82bfecf","text":"In summary, the overall outcome of patients with unresectable HCC complicated by PVTT remains pessimistic. The best therapeutic approach is still to be determined. Although sorafenib is now the only recommended treatment, additional radiotherapy combined with locoregional therapy such as TACE might be a promising alternative for HCC patients with PVTT. Moreover, a good response to radiotherapy for PVTT and the control of intrahepatic HCC by additional locoregional therapy could perhaps offer patients a favorable outcome as well as a cure with subsequent surgical management.","title":"Efficacy of External Beam Radiation-Based Treatment plus Locoregional Therapy for Hepatocellular Carcinoma Associated with Portal Vein Tumor Thrombosis"}
{"_id":"64eff777-a5b8-b91d-7e75-65a51e67dafc","text":"Treatment of osteomyelitis requires the combination of antimicrobial therapy and surgery. Despite surgical and chemotherapeutic advances, it is a difficult condition to treat and there is no universally accepted protocol for treatment.","title":"Facial trauma followed by osteomyelitis - Case report"}
{"_id":"64f52c7e-6c40-2f4f-8d31-39b4f5858ef3","text":"Materials and methods: Retrospective review of charts of oncology patients desensitized in the Immunoallergology Department of CHUC in the last 5 years.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"64ffc1bf-2d19-43e5-533a-5d6764c01e2a","text":"The patients in this manuscript have given written informed consent to publication of their case details.","title":"Herpes zoster and alopecia areata following mRNA BNT162b2 COVID ‐19 vaccine: Controversial immune effects"}
{"_id":"6508893e-a911-48ac-ec39-9d69be0fc603","text":"The efficiency of the CO2 laser allows sealing lymphatic and blood vessels using a caliber beam under 0.5 mm that renders a bloodless surgical field. This may account for the minimal fluid extravasation observed, with a bloodless surgery and a minimal inflammatory response around the tissues under surgery management.","title":"Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser"}
{"_id":"6512d7a4-2f6f-4a13-3e4a-c3d35bb5f8cf","text":"Pulmonary embolism is a life-threatening complication of deep venous thrombosis. The risk of incidence is increased by major surgery. A summary and meta-analysis of contemporary cohort studies reporting its incidence, determinants and case fatality rate in patients undergoing major surgery will be invaluable in assessing its true impact in the perioperative period, and informing health authorities on major determinants of PE for which control interventions can be geared to curb this burden.","title":"Global incidence and case fatality rate of pulmonary embolism following major surgery: a protocol for a systematic review and meta-analysis of cohort studies"}
{"_id":"65192385-2d62-5d18-c663-78d04572f4e1","text":"According to the results of this study, rehabilitation of patients with edentulous atrophic maxillae with fixed prostheses supported by zygomatic implants combined with anterior implants in the premaxilla resulted in patients reporting a better quality of life and greater satisfaction with treatment than patients treated with fixed prostheses supported by four anterior implants following the all-on-four concept.","title":"Evaluation of Quality of Life and Satisfaction in Patients with Fixed Prostheses on Zygomatic Implants Compared with the All-on-Four Concept: A Prospective Randomized Clinical Study"}
{"_id":"651a8def-6e34-c4e2-88be-b24dc75dc7ff","text":"Currently, we have not been able to find a statistically significant correlation between the site of the melanoma and the area of lymphatic drainage in the axilla.","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"651cf2a9-1526-c79c-dfbe-ae8cae0b3666","text":"Primary melanomas of the uterine cervix are rare tumors with no more than 60 cases reported in the world literature. Poor prognosis is considered for the neoplasia itself as well as for diagnostic tardiness. There is no standard treatment; however, radical surgery is the treatment cornerstone. Our aim was to present the case of a 34-year-old woman with a primary malignant melanoma in the uterine cervix with affectation of the posterior face of the vagina without metastasis. Total infraelevator pelvic exenteration and adjuvant radiotherapy was performed. The patient was under surveillance for 8 years of followup without evidence of local or distant disease. The majority of case reports found suggests radical hysterectomy as the treatment indicated for these patients. Notwithstanding this, survival is very short when patients are treated in this manner. Based on our results and on those reported in the literature, we propose initial treatment with total pelvic exenteration as optimal management for this neoplasia in its initial form.","title":"Primary Malignant Melanoma of the Uterine Cervix Treated with Ultraradical Surgery: A Case Report"}
{"_id":"652609ef-d1c3-3768-cc19-623b84ee5b75","text":"Following laser excision, 18 (90%) patients had no evidence of a gross tumor and continued to be disease free at the 3 month post radiotherapy follow up and at their last follow up which ranged from 4 months to 9 years 10 months post therapy, with a mean of 3 years and 81 days. The duration of the follow up was more than 5 years in 6 patients and more than 1 year in 5 patients.","title":"Treatment of Advanced Carcinoma of the Larynx and Hypopharynx with Laser Followed by External Radiotherapy"}
{"_id":"652daef9-38d5-8d47-3fd0-14ddb6fc450a","text":"While permanent sensory disturbances can occur with GAN transection, the otolaryngology literature documents that even when the GAN is intentionally sacrificed during parotidectomy, the majority of patients regain normal sensation within 1 year. Furthermore, residual sensory disturbances do not significantly affect the quality of life. Dysesthesias or neuroma of the GAN is more debilitating and may require surgical exploration for debulking or excision.","title":"How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications"}
{"_id":"652dbcea-c4cb-c7e5-025a-0a4424245d3b","text":"Satisfaction and dissatisfaction patterns between male and female rhinoplasty patients","title":"Ethnic Rhinoplasty: A Middle East-Centered Patient Satisfaction Survey Using the FACE-Q Questionnaire"}
{"_id":"6538766d-a4b7-c864-16fa-105974fd0bae","text":"The main objective of this study was to identify prognostic factors for thin melanoma and predictive factors associated with SLN involvement in a large multicenter cohort of patients with melanoma.","title":"Survival analysis and sentinel lymph node status in thin cutaneous melanoma: A multicenter observational study"}
{"_id":"653db52f-b7b4-e646-84a7-44105e29528b","text":"The decision to administer adjuvant treatment was discussed with our multidisciplinary team. All patients were appointed to our outpatient department for weekly assessment in the first month and then monthly until 6 months postoperatively, then every 3 months for 2 years and 6 months for 5 years. Patients with follow-up times less than 6 months were excluded from the study.","title":"Comparisons of complications between extended latissimus dorsi flap and latissimus dorsi flap in total breast reconstruction: A prospective cohort study"}
{"_id":"653fb9f1-3b37-63d8-6993-9391c5d7dfac","text":"With such little data about the intracellular effectiveness of fusidic acid, no conclusions can be drawn for the treatment of osteomyelitis and further studies are needed.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"65401378-79b3-7c4a-9d0e-26263bce82e3","text":"Whenever a seemingly primary melanoma is detected in an atypical location such as the colon, it is prudent to conduct a thorough clinical investigation to consider the possibility of metastatic disease.","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"65432d47-1bf0-b63a-0d0d-ddc07adac03a","text":"For a better planning of which solution would be the best choice to adopt, in other fields of tumor surgery the plastic surgeon is a component of the team that evaluates preoperatively the patient.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"65439483-55ce-b52c-c0d5-1da5db9f5dc3","text":"The aim of this study is to analyze management approaches and outcomes for patients with sporadic abdominal wall desmoid tumors treated at two large institutions affiliated with the University of São Paulo, Brazil.","title":"Sporadic Abdominal Wall Desmoid type Fibromatosis: treatment paradigm after thirty two years"}
{"_id":"65460d9c-4a36-99fa-5b84-c8529dab4d6f","text":"The risk of infection would be substantially increased for elderly patients with continuous femoral nerve block time of over 48 h as the femoral nerve puncture catheter was near the perineum, with potential risk of infection, and the patients were often associated with diabetes preoperatively.20 In addition, TKA patients were often prescribed with low molecular weight heparin and other anticoagulants before and after surgery to prevent the occurrence of deep vein thrombosis, so there is a potential risk of bleeding at the puncture site, and catheterization may increase the risk of local hematoma formation. It is difficult to fix the femoral nerve catheterization, and especially the postoperative early activities of patients increase the risk of catheter detachment. Based on the above considerations, this study used sFNB, without carrying out control study on the postoperative analgesic evaluation of cFNB and sFNB.","title":"Clinical effects of single femoral nerve block in combination with general anesthesia on geriatric patients receiving total knee arthroplasty"}
{"_id":"65495e0b-b459-a2b8-19ad-51de7481f8bd","text":"A final explanation for more aggressive tumors lies with the interventions themselves. When disease has been present for a long period or there is repeat treatment\/trauma to the site, this can increase the potential to develop skip lesions and multicentricity.17 Multicentricity provides the most plausible route for recurrence, but it is often difficult to know whether it was not a de novo lesion instead. True multifocal dermal sebaceous carcinoma is rare, reported to range from 2% to 12%, and only occurs in advanced presentations.17 Consider also that the basis for the literature defined margins when excising these tumors was a retrospective study of 14 patients by Dogru which demonstrated recurrence with a surgical margin of 1 to 3 mm, but no recurrence if 5 mm or greater.18 Ignoring for a moment that it is possible that margins were left positive at the time of the initial excision, local recurrence is even associated with wide surgical excision and Mohs Micrographic Surgery with acceptable margins. 9% to 36% of sebaceous carcinoma patients have local recurrence within 5 years after wide local excision and as early as 3 to 35 months after Mohs.3","title":"Locally Aggressive and Multicentric Recurrent Extraocular Sebaceous Carcinoma: Case Report and Literature Review Bongu et al"}
{"_id":"654f2013-caf4-162d-eb49-428ffd16e779","text":"The patient was admitted to the Neurosurgical ward after surgery. Lumbar drain was removed on postoperative day 3, while the anterior nasal packing was removed on postoperative day 4. During hospitalization, neurological examination and clinical evaluation to check postoperative CSF leak were performed daily. Patient was discharged on postoperative day 7 after an outpatient rhinoscopy. Further ORL outpatient rhinoscopies were performed at 30 and 90 days after surgery with evidence of good healing of nasal mucosa e no signs or symptoms of CSF leakage.","title":"Ipsilateral Nasoseptal Flap Pedicle for Transpterygoid Approach: Technical Note"}
{"_id":"65513468-bf33-eeea-bc98-0cb7837d61f1","text":"This survey represents the opinions of those SLTs who were selected randomly and who were willing to respond to the survey. It is possible that those SLTs who received the survey and did not respond, did not feel that additional training in this area was a need or concern. Another limitation is the lack of verification of the actual training in CLP and CFD by the universities, to justify whether the perceptions are valid or not, which could raise a whole new set of questions.","title":"South African speech-language therapists’ opinion of their training in cleft lip and palate and craniofacial deformities"}
{"_id":"655976de-2c4d-d65a-8ee7-0d3c0804415d","text":"When imaging shows an osteolytic lesion with a central nidus surrounded by a sclerotic margin in a patient with a typical history of night pain relieved by use of NSAIDs, one should consider the diagnosis of osteoid osteoma.","title":"Childhood osteomyelitis: imaging characteristics"}
{"_id":"655b3cf6-993d-b580-0cca-9b1cd11711cc","text":"The aim of our study was to determine patient satisfaction in regard to nose appearance and function with the use of a validated questionnaire, before and after rhinoplasty surgery.","title":"Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study Avaliação dos desfechos estéticos e funcionais em cirurgia de rinoplastia: um estudo prospectivo"}
{"_id":"6560ee1c-51ec-9f21-2df4-848f428bdb5b","text":"In conclusion, our study provided evidence suggesting the unsaturation degree of circulating fatty acids as the predominant trait that is involved in the development of facial skin aging. Further studies are needed to investigate the role of long-term supplementation of unsaturated fatty acids in facial skin aging.","title":"Relationships between circulating metabolites and facial skin aging: a Mendelian randomization study"}
{"_id":"65614a27-88d2-33f5-3e1c-082965cce295","text":"Six donors were processed with a uniform protocol at Cambridge university where solid tissues were cut into small pieces, then homogenised with enzymatic digestion for 2x 15 minute heating\/mixing steps at 37°C. The remaining six donors were subjected to a tissue adapted protocol with the aim of improving immune cell recovery, and this protocol was harmonised as closely as possible between the two collection sites.","title":"Cross-tissue immune cell analysis reveals tissue-specific features in humans"}
{"_id":"6566aeac-0a30-b031-fd2a-fcc2a81d438c","text":"The authors acknowledge that a predominantly remote fellowship designed to accommodate and be tailored to the diverse and unique interests of each fellow comes with limitations. Namely, with a primacy placed on a nimble and adaptive learning environment, assessment of participant outcomes is limited due to the high degree of variation in participant area of focus. Despite this limitation, future fellowship cohorts will benefit from a more robust set of evaluation methods designed to capture their mastery of the competencies described in Table 1.","title":"Creating climate-informed physician leaders: The evolution of a physician fellowship in climate and health science policy"}
{"_id":"657248fe-0d67-4ffd-d1b2-8553a819148a","text":"The repeat BCG stimulation of PBMC obtained from BCG vaccinated individuals shows enhanced immune activation with respect to increased anti-BCG titre, IFN-γ and ADA activity without concomitant increase in CD4 and CD8 cells. This study provides some basic data in future experiments in animal models with respect to repeat BCG vaccination.","title":"Assessment of immune response to repeat stimulation with BCG vaccine using in vitro PBMC model"}
{"_id":"6573255a-37ae-a43d-ccef-0c572c250779","text":"PDT is one of the best nonconventional treatment options for CRC, playing a major role in the progression of immune response that helps in the defense mechanism against cancer. In CRC, the rectum opening is commonly used to access the colorectal cancer site. Colonoscopy endoscopes are used to administer the PS and specific wavelength to the target area to activate PS drug.","title":"Reactive Oxygen Species Produced by 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Cancer"}
{"_id":"6576bd4e-b554-295e-3a39-7f3531f08c5b","text":"Desmoid tumours are challenging with unpredictable natural history. Current management involves a multidisciplinary approach. Wide margin surgical resection remains the main treatment modality for local control of the tumour in all age groups. Amputation should not be a primary treatment and should be reserved for refractory cases or for those in whom the disease or its treatment have resulted in a non-functional or chronically painful extremity. Function and structure-preserving procedures should be the primary treatment goal.","title":"Current trends in the management of extra-abdominal desmoid tumours"}
{"_id":"6577ac1f-1177-f3e6-4625-eb0dd8265599","text":"A 5 mm Ø punch biopsy of the cutis and subcutis was conducted on the left thigh at the interface of the necrotic core and the macroscopically intact cutis. The biopsy specimen was fixed in a 10% neutral formalin solution. Macroscopic examination revealed dark skin pigmentation along with a 1 mm brownish nodular lesion without any other relevant features.","title":"Severe Fatal Mucormycosis in a Patient with Chronic Lymphocytic Leukaemia Treated with Zanubrutinib: A Case Report and Review of the Literature"}
{"_id":"6578ab2e-7a91-0597-be96-22a87da80c65","text":"All patients underwent surgical therapy for the tumors. The parotid lesions were excised by superficial or complete parotidectomy with dissection and preservation of the facial nerve.","title":"Lymphadenoma of the salivary gland: Report of 10 cases"}
{"_id":"65827117-1e9e-d536-d78e-e4caf132021a","text":"Mammography and ultrasound are the gold standard imaging techniques for preoperative assessment and for monitoring the efficacy of neoadjuvant chemotherapy in breast cancer. Maximum accuracy in predicting pathological tumor size non-invasively is critical for individualized therapy and surgical planning. We therefore aimed to assess the accuracy of tumor size measurement by ultrasound and mammography in a multicentered health services research study.","title":"The impact of breast cancer biological subtyping on tumor size assessment by ultrasound and mammography - a retrospective multicenter cohort study of 6543 primary breast cancer patients"}
{"_id":"6587523d-fda0-fcc3-32c1-19ba179598f5","text":"Observations: Limitations of synthetic implants for nasal and auricular reconstruction, such as silicone and porous polyethylene, have meant that autologous cartilage tissue for such cases remains the current gold standard. Similarly, tissue engineering approaches using unrelated cells and synthetic scaffolds have shown limited in vivo success. There is increasing recognition that both the intrinsic and extrinsic microenvironment are important for tissue engineering and synthetic scaffolds fail to provide the necessary cues for cartilage matrix secretion.","title":"Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions"}
{"_id":"65893003-0c43-4855-99a9-ff56e78458ef","text":"While institutions may not intend for their cultures or policies to inhibit the career development of women, we have found that time-honored traditions and unexamined biases strongly affected the experiences of female surgeons. Institutions must proactively identify policies that may be prohibiting promotion and could be making advancement particularly tricky for female surgeons. Proper organizational guidance, career support, and careful professional navigation could make advancement for women in surgery much more beneficial for the institution and the individual. The development of educational programs that augment leadership skillsets may provide women with the necessary skills to navigate institutional challenges and further equitable sex representation at the leadership level. At Michigan Medicine, more women are taking part in initiatives like the Leadership Development Program, a yearlong program that prepares faculty for institutional and professional society leadership, team building, and business acumen.","title":"Defining Barriers and Facilitators to Advancement for Women in Academic Surgery Defining Barriers and Facilitators to Advancement for Women in Academic Surgery"}
{"_id":"6595a53c-e5c0-7ffe-f54c-685242fb367d","text":"Release of the posterior margin of the vastus medialis in the popliteal fossa is challenging due to the proximity of the femoral artery at the “adductor hiatus”, approximately 12-14 cm from the knee joint. A sterile doppler probe is used to help locate the popliteal artery before deep fascial release in that location. In this revision setting, there is usually a thick posterior pseudocapsule typically 1-2 cm thick. The popliteal artery is the most anterior of the neurovascular structures in the posterior knee. At the level of the knee joint, it is located in the posterior midline coursing into the posterior calf. More proximally, approximately 8-10 cm above the patella in an adult, the femoral artery dives posterior to the posteromedial intermuscular septum and through the adductor hiatus. It lies directly posterior to a thin layer of adductor hiatus tissue and typically courses posterior to the femur, immediately posterior to the fascial attachment of the compartment posterior to the medial femoral diaphysis. The most distal perforating branch of the deep femoral artery perforates the lateral intermuscular septum at this level as well. If the patient had a prior distal femoral replacement, the distal adductor magnus insertion has already been released from the femur. The doppler is used to find the vessel which may be in an atypical location due to scarring. Placing the probe through the posteromedial release allows one to auscultate the vessel behind the thick posterior pseudocapsule. Locating the popliteal artery with a doppler before deep dissection in this location is important in order to minimize the risk of incidental laceration of popliteal vessels.","title":"Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty"}
{"_id":"659b260f-bb65-4dee-dfe0-0249dacb5fd0","text":"Additionally, following implementation of the infections conferences, it was noticeable that they were an efficient tool to accelerate the process of multimodal decision making, which both the patient and the staff benefitted from. Especially complex medical decisions which rely on fundamental knowledge in various fields can be quite time consuming for hospital staff. Consulting physicians might not be readily available and it can be an administrative challenge to gather all information and implement the expert opinions of various people. With all fields of expertise gathered at the weekly conferences, complex decisions could be efficiently and profoundly made.","title":"Implementation of a multidisciplinary infections conference improves the treatment of spondylodiscitis"}
{"_id":"659c89ae-4f90-e12c-d9ec-2d449b30a7a9","text":"As there is a familial tendency to melanoma, all first-degree relatives of a patient diagnosed with melanoma should be encouraged to go for a full skin examination to identify a previously unsuspected melanoma and to assess risk of future development of melanoma. Relatives assessed to be at high risk should be offered a surveillance program.","title":"Malignant Melanoma"}
{"_id":"65a586ed-cf90-5493-14bd-98905220d8e2","text":"Assessment of the percent of AK lesion clearance in each treated area was performed 12 weeks after PDT completion.","title":"Topical Photodynamic Therapy with Different Forms of 5-Aminolevulinic Acid in the Treatment of Actinic Keratosis"}
{"_id":"65af95f0-5426-20e6-59dd-6037494e2ba7","text":"Biological mesh is a new frontier in treating complicated open abdomen wounds and clinical evidences are progressively increasing in clinical practice.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"65c0e60f-7a16-a2bc-7320-54930768c092","text":"The pedicled TRAM flap has been a workhorse of autologous breast reconstruction for decades. However, there has been a rising concern about the abdominal wall donor site morbidity with the use of conventional TRAM flap. This has generally been cited as one of the main reasons for resorting to “abdominal wall friendly” techniques. This study has been undertaken to assess the abdominal wall function in patients with pedicled TRAM flap breast reconstruction. The entire width of the muscle and the overlying wide disk of anterior rectus sheath were harvested with the TRAM flap in all our patients and the anterior rectus sheath defect was repaired by a Proline mesh.","title":"Assessment of the abdominal wall function after pedicled TRAM flap surgery for breast reconstruction: Use of modified mesh repair for the donor defect"}
{"_id":"65c17d17-1ec1-6202-0303-0e187ed341a9","text":"Differentiated union rates with and without previous surgery are presented in Table 1.","title":"Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union"}
{"_id":"65c809c1-1e8a-442e-0732-8f26ad850f42","text":"Skin flap, musculocutaneous flap, and osteo-myocutaneous flap are conventional methods of postoperative reconstruction in patients with oral cavity and oropharyngeal cancers. However, older aged patients with oral cavity and oropharyngeal cancers tend to have comorbid conditions. Older aged patients with this complex medical condition have poor surgical tolerance and thus cannot undergo a lengthy and potentially risky surgical operation. Our combined reconstruction technique with submandibular gland flap and sternocleidomastoid myocutaneous flap has the advantages of being easier to perform, causing less surgical injury and only minor impact on contour, and greatly reducing operation time and surgical risk. This technique can facilitate the restoration of oral function and facial aesthetics and greatly improve the quality of life of older aged patients. Hence, this technique can provide a new and safe reconstruction option for older aged cancer patients with complex medical conditions. If we can verify at the molecular level the absence of intraglandular lymph nodes and that there is no lymphatic metastasis to the submandibular glands, this combined reconstruction technique may gain popularity.","title":"Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers"}
{"_id":"65d503e5-7498-f22f-6d4d-13d451b46de2","text":"Assessment of scar quality and the aesthetic outcome was done by an experienced occupational therapist and a burn surgeon at the trial site using two different reliable and validated tools; The Patient and Observer Scar Assessment Scale (POSAS) and the Cutometer Dual MPA 580. The recipient and donor sites were assessed separately.","title":"A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft"}
{"_id":"65da75f5-bfb8-5773-09ad-bf3d1e61c414","text":"In anatomic locations where tissue conservation is of the greatest concern, such as the face, the surgeon may utilize frozen section or staged surgical excision techniques. Frozen section techniques are beneficial as they conserve tissue and allow for immediate reconstruction once the margins are clear.28 Although staged surgical excision is a more precise technique with lower recurrence rates, it is more expensive and requires patients to undergo multiple operations over the course of several days.29,30","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"65dd4e53-add7-de98-b026-4268d469b65b","text":"The microsurgical ALT flap was chosen because it is considered the best option for lower limb reconstruction in children being reliable, having a relatively thick dermis and the advantage that the donor site can be hidden. Local flaps from weight‐bearing surfaces of the same foot were not considered necessary in this case because the patient was not ambulatory, and were avoided to preserve the area in case of new or recurrent PIs.","title":"Surgical treatment of pressure injuries in children: A multicentre experience"}
{"_id":"65e93cb4-2b9d-0b59-f22c-d4a2d8e39f7a","text":"Our two cases developed local recurrence within 1 year after surgery. In case 2 of our study, we performed mastectomy with extensive skin resection, including the pectoralis fascia, but the margin tested positive for tumor cells because of the deep stump of the tumor, resulting in early local recurrence at 40 days after surgery. Although we retrospectively reviewed the images from the ultrasound and MRI after the surgery, it was difficult to make a diagnosis for the surgical margin. We were aware of the difficulty of preoperative diagnosis for the safety surgical margin.","title":"Two cases of breast angiosarcoma after breast conserving surgery"}
{"_id":"65f6d7e3-ac75-a33a-b7a7-dc128d790a42","text":"Osteomyelitis of the maxilla is now a rare event with the advent of antibiotics. The two predominant causes are odontogenic infections and sinusitis. Immunocompromised states such as diabetes, HIV, and malnutrition increase the risk of osteomyelitis. It is important to recognize this early as it is a difficult entity to treat with potentially serious consequences. We report an unusual case of right sided maxillary osteomyelitis in a lady with poorly controlled diabetes in rural Lincolnshire. Biopsy of the right maxillary bone showed features of acute osteomyelitis. This responded well to a prolonged course of oral antibiotics.","title":"Maxillary Osteomyelitis: A Rare Entity"}
{"_id":"65fc2117-070f-62a6-5f19-2c75d2c05a13","text":"Generalisation of the tumour process remains the most common cause of treatment failure in pancreatic cancer.","title":"Radiotherapy in Pancreatic Cancer: To Whom, When, and How?"}
{"_id":"6605678a-a266-8a71-8c92-7debe2a52f7d","text":"Our findings provide evidence of an increased risk of cancer, particularly melanoma and NMSC, in patients living with CLL in Australia. Chronic lymphocytic leukaemia patients also had an increased risk of death due to melanoma and NMSC, suggesting these skin cancers may be more aggressive in CLL patients. We speculate that a shared risk factor, such as general immune suppression, modulated by UVR exposure may explain the increased risk of melanoma and NMSC in CLL patients. Australia is an area of high solar radiation that makes this particular relationship extremely important (Siskind et al, 2002). Information from this study could be used to develop surveillance recommendations for doctors and patients in order to prevent morbidity and mortality. Further research in this area is necessary to understand the true risk of skin cancers and all other second cancers following CLL in Australia. An accurate understanding of the risk of second cancer may lead to changes in clinical practise with regard to the follow-up of CLL patients, such as specific protocols for early detection and treatment of cancers.","title":"Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study"}
{"_id":"66094bef-eb6c-213a-44c1-d5f986b7250b","text":"For these and other reasons the TRAM flap remains a popular flap for reconstruction, especially of the breast and chest wall. Multiple modifications on the original design have been proposed to increase the flap perfusion and reliability, decrease donor site morbidity, and widen the demographic for which the flap is appropriate. Grotting’s introduction of the free TRAM in 1989increased the versatility of the flap dramatically, allowing its use beyond the arc of its pedicle and for other applications beyond breast reconstruction.","title":"Comparative Perfusion Analysis of Free Muscle-Sparing Versus Pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps in Vivo in the Peri-Operative and Late Post-Operative Periods"}
{"_id":"66141107-4443-c34c-7fe1-35e2d2399c6b","text":"Tumor size is an important prognostic factor and it is used to classify tumors in the TNM staging system.","title":"Localized Non-melanoma Skin Cancer: Risk Factors of Post-surgical Relapse and Role of Postoperative Radiotherapy"}
{"_id":"6616a71c-867e-1b52-eef1-4b4067c6c2bb","text":"Fibromatosis or desmoid tumor is a rare soft tissue tumor that lacks a metastatic potential, but is characterized by a locally aggressive and infiltrating growth pattern and a high propensity toward local recurrence if incompletely excised.","title":"Management of a patient with multiple recurrences of fibromatosis (desmoid tumor) of the breast involving the chest wall musculature"}
{"_id":"66254b9a-1a55-2913-faa9-bfaa3cb04ba1","text":"Our second patient had very few options, to begin with, given her age and multiple other comorbidities. When her disease recurred, interstitial brachytherapy was truly the only option that we had to obtain any control of her disease. Her extensive disease and obliteration of perineum and vaginal canal made the treatment approach fairly difficult and required a decent amount of creativity. The modified Syed template and transrectal ultrasound guided needle placement were unique to this patient.","title":"High-Dose Rate Salvage Interstitial Brachytherapy: A Case-Based Guide to the Treatment of Therapeutically Challenging Recurrent Vulvar Cancer"}
{"_id":"66259dd9-4b87-5a9e-0fe6-874f6bb9804e","text":"In vivo imaging fluorescence values were significantly higher in the no treatment group, whereas interleukin-6 and tumor necrosis factor-α levels were significantly higher in the treatment group at 18 h after injury. Histologic examination results revealed that the treatment group had less bleeding and more degeneration repair processes than the no treatment group at 24 h and 1 week after muscle injury.","title":"Effect of photodynamic therapy on local muscle treatment in a rat muscle injury model: a controlled trial"}
{"_id":"663811b0-1a30-517c-2ffe-93226dc197d5","text":"This article reviewed our experience of Chinese nasal reconstruction over 12 years and evaluated the effect of expanded forehead flap both aesthetically and functionally. The special skin type and other anatomic features of Chinese patients was understood thoroughly during the treatment. This article thus catered for the need of multiracial nasal reconstruction. We analyzed existing clinical data and demonstrated a typical case in detail. The postoperative result supported our strategy which advocated the extensive application of expanded forehead flap, together with flip scar flap as the internal lining. The features of Chinese patients also prompted the use of costal and auricular cartilage. Emerging technology like 3D-printing would benefit nasal reconstruction from more aspects.","title":"Expanded forehead flap in Asian nasal reconstruction"}
{"_id":"6642ab8a-e138-b36c-96d8-7a2571712ca7","text":"The fibula was harvested with the proximal fibular head intact. The fibular collateral ligament was identified and a z-plasty was performed to allow a component of the ligament to remain attached to the fibular head for soft tissue ligament reconstruction in the wrist and the remainder used to stabilize the knee following flap removal.","title":"Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius"}
{"_id":"66438f76-a9b0-d479-f0cf-f2453b7e49c3","text":"The radiotherapy fields used for the treatment of recurrent disease were designed to encompass the entire chest wall and the regional lymphatics. Several techniques were used to accomplish this goal. Treatment to the chest wall was delivered using either photon tangential fields or appositional electrons. The supraclavicular fossa and axillary apex were treated with an anterior photon field. A separate appositional electron field was commonly used to treat the medial chest wall and internal mammary nodes. Although omitted by some institutions, in our practice a boost was consistently delivered to the chest wall flaps including the scar with generous margin and any additional sites of disease.","title":"Radiation dose escalation for loco-regional recurrence of breast cancer after mastectomy"}
{"_id":"66478136-c67d-47a0-3712-be7aff932004","text":"Finally, some indicators are likely to be more important than others and the uniformly poor achievement of a minimum acceptable diet may have compromised all the children in our sample. Or perhaps the burden of exposure to intestinal pathogens and other infections overrides the effect of feeding. It is also possible that the effects of IYCF are not manifest as contemporaneous somatic growth, or may not manifest until children are older. Some of the indicators are assessed over narrow windows and it may be unreasonable to look for short-term benefit. For example, introduction of solids is assessed for children at 6–9 months of age and its effects on growth may not appear until later.","title":"Malnutrition and infant and young child feeding in informal settlements in Mumbai, India: findings from a census"}
{"_id":"664d17a2-aa9d-6a24-5f8d-07086362c848","text":"Some craniofacial morphology capabilities and characteristics are precise to some age brackets and are altered through the aging process. Changes in skin pigmentation are predominant in growth noticeable from birth to adulthood, while skin texture modification can be seen at some stage in adulthood.","title":"A novel genetic-artificial neural network based age estimation system"}
{"_id":"664ebb3c-d643-6027-f715-42fb000416b0","text":"We aim to conduct a feasibility trial of NPWT versus standard dressing following hip fracture surgery. It is intended to obtain a reliable estimate of the rate of SSIs in the target population. In addition, feasibility will be considered in terms of other aspects of the trial such as recruiting and randomising large numbers from individual sites within a relatively short time frame.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"6650093c-e737-ca0f-6de4-e1c05f2e50d2","text":"Some authors have expressed concerns regarding the cost of using botulinum type A injections to treat muscle spasms [28]. This concern is relevant for patients who suffer from neurological conditions that cause chronic muscle spasms as they would likely require continuous, periodic botulinum treatments. However, none of the patients in this study had flexion contractures associated with a neurological disorder and would ideally require only one treatment. While the authors await long-term results to see if the initial botulinum treatment is sufficient, the mean follow-up of 20 months for this study suggests that a single dose botulinum injection can provide desirable results beyond the ten to twelve weeks in which botulinum is most effective as a neuromuscular transmission inhibitor. No formal physical therapy was required beyond six weeks to maintain these results.","title":"Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series"}
{"_id":"66638f8e-03d3-8373-b6e5-281171c95ff2","text":"Each of the participants participated in two separate measurement sessions. The interval between the sessions was 45 min. During both the first and the second sessions, the examination was performed independently by Examiner number 1 and Examiner number 2. Examiner 1 was an experienced examiner and a tutor for sonographic skills university tutorials. Examiner 2 was an inexperienced examiner with basic sonographic skills gained in university tutorials. Before starting the measurements, a training session was held to practice the measurement technique and correct handling of the ultrasound probe. For maximum standardization, both investigators underwent training by the study director regarding the measurement technique.","title":"A Pilot Study on the Reliability of Ultrasound-Based Assessment of Patella Diameter and Sulcus Angle"}
{"_id":"6664c8e1-6ae1-65d3-b2c0-cbacaf76735b","text":"Our hospital is a reference center in the treatment of Pierre Robin Syndrome patients, and that could explain the increased number of glossoptosis found in our population.","title":"Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil Traqueostomia em crianças: uma experiência de dez anos em um centro terciário do sul do Brasil"}
{"_id":"667a146b-3764-b1f8-5c70-4b6ea7fa634a","text":"Any clinically palpable or radiologically suspicious lymph node should be biopsied via fine-needle aspiration (FNA) [25] or core-needle biopsy (CNB). If needle biopsy cannot be obtained, or the clinical suspicion remains high after a non-diagnostic biopsy, excisional lymph node biopsy should be considered with technical awareness about potential future lymphadenectomy in planning the incision.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"667a4f15-2bc2-7610-4242-3fd1cebdd91a","text":"The inability of individual series to demonstrate significant overall advantages with the addition of RT is skewed by the inherent selection bias each retrospective analysis, in which patients with more extensive disease were often treated more aggressively. Postoperative RT may therefore potentially benefit patients, despite retrospective series paradoxically reporting better outcomes in patients treated with surgery alone. Our data suggests that the addition of conventionally delivered RT leads to improved local control, as all three patients who recurred locally had not received postoperative RT to the tumor bed.","title":"Mucosal Melanomas of the Head and Neck: The Role of Postoperative Radiation Therapy"}
{"_id":"667d6def-1039-1fdc-ef9c-1d93d917f353","text":"Preoperative mechanical thromboprophylaxis may confer an additional benefit by preventing postoperative VTE without adding more risk of perioperative bleeding in elderly patients with hip fracture.","title":"Does preoperative mechanical prophylaxis have additional effectiveness in preventing postoperative venous thromboembolism in elderly patients with hip fracture?—Retrospective case-control study"}
{"_id":"6682f558-5ed1-2331-4097-d606e0ab24be","text":"These findings are also in agreement with those from Silva, who reported excellent correlation between TEOAEs and the ENT examination to differentiate conduction diseases from their cochlear counterparts. That conductive hearing disorders also influence OAE results.","title":"The influence of the type of breastfeeding on middle ear conditions in infants"}
{"_id":"6684d1de-1a39-e5c5-ae40-19b87d6ec6bb","text":"The patient we present herein was a young female who had no personal or family history of FAP or Gardner syndrome, no history of trauma or abdominal surgeries and was not on any hormonal treatment.","title":"A Sporadic Giant Mesenteric Desmoid-Type Fibromatosis in a Teenage Female: A Report of a Rare Case"}
{"_id":"6691714a-3779-7335-452c-69b1069bc726","text":"Our study has limitations related to the small sample size and consequent lack of statistical power. Larger prospective cohort studies would be needed to reach statistical significance. Moreover, even though we do not believe that a matched cohort of patients undergoing biological arthrodesis with Mg-hydroxyapatite bone graft without antibiotics could have resulted in a different rate of SSI, if compared with patients undergoing arthrodesis with autologous bone, the use of the same bone substitute would have been preferable form a methodological point of view. However, given the retrospective nature of this study, we did not have a comparison cohort of patients who underwent biological arthrodesis with Mg-hydroxyapatite bone graft without antibiotics.","title":"The benefit of antibiotic-combined Mg-hydroxyapatite bone graft substitute over autologous bone for surgical site infection prevention in posterolateral spinal fusion: a retrospective cohort study"}
{"_id":"6691e0e4-5e3d-a426-4fdb-e86ce46dee86","text":"A comprehensive evaluation of the ASGE grading system, as recommended by the working party itself, has yet to take place. The use of this classification system in TEESAT, a broadly recommended and used tool, seems to make an examination of this score all the more interesting. Our study therefore aimed to assess the recommended grading system on the basis of the data collected by the ÖGGH regarding success and AE rate and to adjust the metrics to create a novel scoring system.","title":"SASE, S uccess and A dverse event S core in E ndoscopic Retrograde Cholangiopancreatography: a Novel Grading System"}
{"_id":"669f1180-72c4-5c16-5f24-7732cda08626","text":"The edge of a separated muscle flap loses blood flow easily. In MC flaps, the vascular structure is different from that in the jejunum or omentum. Our study showed a significant decrease of blood flow in the edge of MC flaps compared with jejunal and omental flaps. It is thought that the blood flow to the edge decreases still further when the flap is sewn in completely. In our preliminary experience, the low blood flow region presents as a blue area in which the flow level is approximately less than 80% of normal, indicating potentially necrotic tissue. The case is presented in Figure 6. When MC flap was collected, it was noticed that the blood flow of the flap was bad in laser speckle flowgraphy. MC flap on the other side was collected without the MC flap separating. In two days after the operation, the blood flow worsened and the edge of the flap got the sphacelation. The ratios of blood flow at the edge of flap to that in the center were 80%.","title":"Free Flap Blood Flow Evaluated Using Two-Dimensional Laser Speckle Flowgraphy"}
{"_id":"66a3004f-7046-5c07-9ccc-1c35111339a4","text":"It has been declared by many and mentioned in number of ways that our achievements and impacts in life are significantly dependent on the type of journey that we choose to take and how further and better we travel on that chosen journey. Likewise, there is an Ethiopian quote which says “When you go further on a life journey, you will encounter with thousands of opportunities.” In the same spirit as the above quote, a plastic and reconstructive surgery fellowship at Asan Medical Center allowed me to travel further on the fascinating journey of reconstructive surgery. A journey which is very much unique and unattempted by many plastic surgeons living in the part of the world where I come from, Africa. On this expedition I happen to encounter with several opportunities to be exposed to a variety of knowledge, skills, and attitudes regarding reconstructive surgery. An opportunity to challenge myself into acquiring of new sets of skills and practices in plastic and reconstructive surgery in general and reconstructive microsurgery in particular. An opportunity to meet and create network with several prominent figures in the field of reconstructive surgery. An opportunity to get exposed to new language, culture, and weather conditions. All the opportunities that I encountered by going further on the highway of reconstructive surgery is made possible due to this fellowship. This opportunity and the associated exposure that I run into due to the fellowship, have already made me to be a much better plastic and reconstructive surgeon with several added values in terms of knowledge, skills, and attitude. I should also admit that the fellowship has also created the opportunity for me to broaden my view toward new cultures and the untaken roads.","title":"Fellowship Away from Home: A Journey toward Advancing the Current Practice of Reconstructive Surgery in Ethiopia"}
{"_id":"66ae8822-1341-b7e3-3403-174fadd06b8a","text":"A consensus has been reached regarding the treatment of deep using active anticoagulation. Anticoagulant therapy can reduce the possibility of intramuscular venous thrombosis progressing to deep venous thrombosis near the heart and can significantly improve the recanalization rate of the intermuscular vein.","title":"Safety and effectiveness of rehabilitation training for stroke complicated with muscular call vein thrombosis: An observational study"}
{"_id":"66b6e83b-bf65-cbfd-2b05-cc1957889de9","text":"Scrotal skin has unique cosmetic and functional features that make reconstruction difficult. Ruggal nature and thinness of the testicular covering is important for temperature control and optimal spermatogenesis. Mesh skin graft provide a thin covering and a design similar to ruggal skin. Skin flap from the groin or medial circumflex femoral perforator flap can provide thin and mobile cover for scrotal reconstruction. Demir and coworkers using Johnsen score for spermatogenesis found that use of graft in animal for scrotal reconstruction diminishes testicular function whereas use of flaps resulted in testicular function similar to control group [15]. More human study needs to be carried out on the best option for scrotal reconstruction.","title":"Scrotal Calcinosis: A Case Report and Review of Pathogenesis and Surgical Management"}
{"_id":"66b77396-7ec8-8a8a-aa32-e9ec3ec8d8e1","text":"A written informed consent was obtained from all the participants. They were informed about the option of undergoing mastectomy or breast conserving surgery and also that the latter would necessitate RT. The patients were then offered to select operation method based on their preference, followed by a uniform and standard treatment protocol for RT and CT.","title":"Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India"}
{"_id":"66baf746-e1f9-2c15-5aef-c5d535d33b51","text":"this study was undertaken to evaluate the results of immunotherapy to Mites upon allergic reactions to shrimp allergen in a 40 years old female suffering from combined allergy to mites and shrimp. The patient had a 10 years history of severe allergic reactions after eating shrimp; for which she was hospitalized several times to receive intravenous steroids and antihistamines. Despite avoiding consumption of shrimp for several years she continued to have allergic rhinitis symptoms. The last episode of allergic reactions to shrimp occurred while cooking shrimp not eating it.","title":"Life threatening shrimp allergy cross reacting with mite allergy : a case report"}
{"_id":"66be046a-b1cf-6ca5-c17f-0365e6ded368","text":"Any further wound dressing after the initial dressing will be recorded and will follow the allocated treatment unless otherwise clinically indicated.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"66c04799-652d-a6fd-8ee5-398ce9c94249","text":"Desmoid tumors are slow growing deep fibromatoses with aggressive infiltration of adjacent tissue but without any metastatic potential.","title":"Desmoid tumors of the abdominal wall: A case report"}
{"_id":"66c0f826-afc6-855a-42e9-658d00b2ced3","text":"The endothelial cells had reacted with the anti-vWF antibody, and the blood vessels located in the dermal layer were stained brown. The morphological structure of the vessels and the consistency of the tunica intima remained intact in both the fresh and cryopreserved groups, which indicated that HHP treatment and cryopreservation had not damaged the structure of the blood vessels.","title":"Inactivated Nevus Tissue with High Hydrostatic Pressure Treatment Used as a Dermal Substitute after a 28-Day Cryopreservation Period"}
{"_id":"66c554e2-cf0a-633b-9207-0d39b786c595","text":"Immediate breast reconstruction is widely accepted following oncologic mastectomy. This study aimed to build a novel nomogram predicting the survival outcome for Chinese patients undergoing immediate reconstruction following mastectomy for invasive breast cancer.","title":"Novel nomograms for predicting survival for immediate breast reconstruction patients diagnosed with invasive breast cancer—a single-center 15-year experience"}
{"_id":"66ca9c56-6cf4-6cc8-7c81-961c3cc31d92","text":"Radical resection with adjuvant RT offers the best form of management.","title":"Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines SALIVARY GLAND TUMOURS: UK GUIDELINES"}
{"_id":"66cc537c-0072-cdec-c7bf-754992ccea02","text":"Correlation with the clinical presentation of the tumor is usually extremely helpful in narrowing the differential diagnosis, specifically the size and depth of the lesion. A histological confirmation obtained via a core needle or incisional biopsy is necessary for accurate diagnosis.","title":"Desmoid Tumors: A Clear Perspective or a Persisting Enigma? A Case Report and Review of Literature"}
{"_id":"66d18703-5823-1020-c7b0-0a75b3802c27","text":"Last but not least, US can be very useful for diagnosis and staging of melanoma skin cancer, which is still one of the deadliest types of cancer. A very precise DOI should be measured because the staging and the treatment change from a difference of just 1 mm. The treatment of both melanoma and non-melanoma skin cancer is difficult in the head and neck region due to the multiple anatomical vital elements, and the large excisions recommended for other anatomical regions are frequently not applicable. Comparative studies between these two pathologies could be further directions for skin cancer research.","title":"High-Frequency Ultrasound in Diagnosis and Treatment of Non-Melanoma Skin Cancer in the Head and Neck Region"}
{"_id":"66d239e7-1ceb-87b6-0a10-057bc534737a","text":"However, several gaps in the management of acute osteoarticular infections remain. There are relatively few studies of the diagnostic methods that should be performed for the identification of the different pathogens and the most appropriate parameters to be used in children to switch from parenteral to oral antibiotic therapy in relation to the etiology. Consequently, further research should focus on these issues to optimize the duration of intravenous and oral anti-infectives. Moreover, further studies of the quantitative impact of MRSA and S. aureus PVL-producing strains in these infections as well as on the optimal treatment in terms of the molecule of choice and the duration of antibiotic administration are mandatory. In addition, limited data on the efficacy and safety of corticosteroids in patients with acute osteoarticular infection are available, and further studies on this issue should be useful. Furthermore, the role of biofilm in treatment failures in pediatric patients should be evaluated. Finally, the emergence of bacterial strains resistant to antibiotics makes it imperative to focus the research on the search for new molecules that are capable of adequately penetrating bones and joints to overcome this problem.","title":"Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis"}
{"_id":"66d3c0d9-08e6-9215-5b79-b107afb00fd1","text":"The diagnostic trajectory of primary colonic melanomas maybe more protracted as compared to their metastatic counterparts owing to the absence of a history of melanoma.","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"66d9c08f-f56b-60e9-5b77-af8b52cc0e28","text":"In PDT, a nontoxic photosensitizing agent such as photofrin is given intravenously 48 hours before transpapillary or percutaneous radiation with light of a specific wave length. Due to the accumulation in the neoplastic tissue, the reactive oxygen free radicals produced by photosensitizers cause the destruction of the light absorption on the target cancer cells. The effect of PDT on survival benefit in NCC has been evaluated in numerous pioneer studies. In 1991, McCaughan reported the first experience of a woman with histologically proven adenocarcinoma of the common bile duct that was successfully treated with 6 injections of dihematoporphyrin ether followed by 7 photodynamic therapy treatments. The patient lived for 4 years after the PDT treatment.[ Since then, various controlled trials have revealed that PDT has a promising future in nonresectable cholangiocarcinoma.[","title":"Therapeutic effect of photodynamic therapy for nonresectable cholangiocarcinoma Protocol for a meta-analysis and systematic review"}
{"_id":"66deccb4-afe6-5ec2-68cf-be7f4fc577d3","text":"Conclusions: Early PN introduction in atopic infants was safe in the majority of high risk infants as per NIAID. Time from assessment to challenge appears to influence outcome of PN tolerance. Challenging infants less than a week from their initial assessment decreased the risk of allergic response. Skin test size did not appear to differentiate between allergic and tolerant infants.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"66e8d809-2078-12a6-4ae3-b7a207090a19","text":"The areas previously marked during the exam identifies the areas of injection, which are prepped with alcohol. The pectoralis major muscle is palpated under the skin and confirmed with muscle activation. The skin and muscle at the site of the injection is pinched between fingers and the implant is displaced away from the injection site. The injection is performed using the entire length of the 30G ¼ inch needle into the tissue isolated between the fingers. Awareness of the injection location and length of the injecting needle, as well as displacement of the implant was performed to avoid injury to the underlying implant. Of note, the use of BTX-A for these purposes is off-label and not yet approved by the FDA.","title":"Diagnostic and Therapeutic Use of Botox for Breast Reconstruction"}
{"_id":"66fa6bc7-018d-b317-52f2-45f67d66bc9d","text":"To demonstrate the importance of an adequate oncological follow-up algorithm in patients with fatty liver with special focus in oncologic patients who underwent chemotherapy treatments.","title":"The Proceedings of the 19th International Cancer Imaging Society Meeting and Annual Teaching Course"}
{"_id":"67100ca3-05c5-53d3-36cc-e1c3daf6ff9e","text":"The presence of Mycobacterium chelonae in skin and oral masses of the farmed specimens of Acipenser gueldenstaedtii reported in this study was considered as a secondary event subsequent to a dystrophic calcinosis occurred in previously damaged tissues. In fact, the absence of typical granulomas in all organs of the fish examined lead us to exclude a primary role of the piscine mycobacteriosis. Finally, experimental in vivo studies will be helpful to clarify the role of M. chelonae as a potential pathogen (or opportunistic agent) causing skin and subcutaneous tumor-like masses with calcinosis in sturgeon.","title":"Mycobacterium chelonae associated with tumor-like skin and oral masses in farmed Russian sturgeons (Acipenser gueldenstaedtii)"}
{"_id":"67246544-397b-dcee-4daf-57359dc812b4","text":"For there to be significant gains for DO medical students successfully matching into surgical subspecialty residencies, there need to be viable DO organizations. Organizations are viable when there is a strong membership, and the members are active. DO societies need to offer many reasons for membership, including advocacy and the continuation of the profession. Advocacy is the primary means to continue promoting the value of the holistic osteopathic profession in any specialty and in medicine. Without advocacy, the concerns of osteopathic physicians would largely go unheard, and DO physicians would have to rely on other organizations that do not fully comprehend the challenges of the inherent bias. Furthermore, osteopathic organizations at the local, state, and national levels can work collaboratively and create opportunities for students to establish thriving mentor relationships that can lead to successful careers within all specialties and lead to higher success rates within the match for each specialty.","title":"Comparison of Osteopathic (DO) and Allopathic (MD) Candidates Matching Into Selected Surgical Subspecialties"}
{"_id":"6727ef43-0be1-964e-ca1d-eb874a37eafa","text":"Written informed consent was obtained from the patients for the publication of this case report and any associated images.","title":"Early hyaluronidase use in preventing skin necrosis after treatment with dermal fillers: Report of two cases [version 2; peer review: 2 approved"}
{"_id":"67331d39-eada-aad2-4e67-9d56d27ccf72","text":"Patients with missing values for main explicative variables were compared with other patients for the main demographic and clinical characteristics.","title":"Post-traumatic osteomyelitis in Middle East war-wounded civilians: resistance to first-line antibiotics in selected bacteria over the decade 2006–2016"}
{"_id":"673acd1f-ba3a-8449-fb2e-9ee46e4c6c91","text":"The period of active surveillance should include close monitoring of patients with MRI or computed tomography every month for the first two months, then every three months for the first year followed by every six months until the fifth year, and yearly after. The intensity of the surveillance regimen, especially during the first years serves for early identification of rapidly progressive cases. Patients who have tumors in life-threatening locations as well as those with severe pain may avoid the surveillance period.","title":"Desmoid-Type Fibromatosis"}
{"_id":"673c12b6-9aea-2f71-4f9c-8ee182fcd165","text":"Survey responses were entered into an Excel spread sheet in a deidentified manner. For those questions that employed the Likert Scale, the 2 highest rankings (very good and highly valuable) were combined and then divided by the respective response count. This pooled the 2 highest rankings for each question into a single percentage format and allowed the top 2 participant preferences to be considered equally.","title":"Establishing Priorities for the International Confederation of Plastic Surgery Societies"}
{"_id":"67443b64-1132-2fcb-e752-799450c972fc","text":"We considered the seven cases with tumor recurrence as failures. However, this is not altogether accurate since in six of these patients, treated with re-resection and bone grafting, bone incorporation was complete. Even two patients with deep infections retained and incorporated their grafts. In two cases results with allograft bone were not adequate. The first patient was an elderly man with a lymphoma who underwent chemotherapy and radiotherapy to the acetabulum. He subsequently developed avascular necrosis and a protrusio deformity of the proximal femur. Despite the appearance of graft consolidation after total hip arthroplasty, the patient subsequently developed a fracture of the medial wall requiring revision surgery with a structural allograft and a cage. Although a number of successful grafting procedures using allograft particulate bone have been performed in patients with deficient medial acetabular walls, radiotherapy in this patient more than likely inhibited bone remodeling. Although the patient with fibrous dysplasia underwent internal fixation to augment the proximal femur after curetting and allograft packing, he continued to have pain that may have been more related to his disease than to structural insufficiency. When the oncologic results are separated from the reconstructive results, the later two cases and the two deep infections represent the only true failures of the use of the microparticulate bone allograft in the 97 patients included in this series.","title":"Microparticulate Cortical Allograft: An Alternative to Autograft in the Treatment of Osseous Defects"}
{"_id":"67459113-7e1a-3dfa-7416-413a915dd640","text":"Our findings provide strong evidence that the effect of breastfeeding on early child development may be mediated by an initial selective effect on gross motor development, facilitating more active, exploratory, independent activities as reflected in items such as running or climbing upstairs alone during the first 18 months of life. According to Piaget, during this initial sensorimotor stage of cognitive development from birth to approximately 2 years of age, infants derive their understanding of the world through active adaptation to their environment.","title":"Late weaning and maternal closeness, associated with advanced motor and visual maturation, reinforce autonomy in healthy, 2-year-old children"}
{"_id":"675037c6-2e1b-6cfc-2bf4-e21d6fefe0c9","text":"He underwent left posterior neck dissection with sacrifice of the trapezius, wide local excision of posterior scalp malignancy, right posterior lateral neck dissection with adjacent tissue transfer closure. Resection of the posterior scalp and right retroauricular and suboccipital region was consistent with pleomorphic dermal sarcoma, positive for lymphovascular and perineural invasion. There were also 14 lymph nodes containing metastatic pleomorphic dermal sarcoma out of 55 examined lymph nodes. The tumor was staged as T3N2c.","title":"3D printed integrated bolus\/headrest for radiation therapy for malignancies involving the posterior scalp and neck"}
{"_id":"675961fe-0cc5-e41b-f93a-1f915569eee6","text":"A pitfall with regard to differential diagnosis of a supposedly benign squamous keratosis is when encountering a specimen of a superficial shave. Histologically, attention should be turned away from the hyperkeratotic superficial horn to the underlying lesional epithelium, which may be limited in amount in the specimen (Figure 3). The presence of significant atypia or abnormal maturation would raise the possibility of actinic keratosis or Bowen disease or even the superficial aspect of an invasive SCC.","title":"Simulators of Squamous Cell Carcinoma of the Skin: Diagnostic Challenges on Small Biopsies and Clinicopathological Correlation"}
{"_id":"6766a2b1-39dc-8e3e-d531-408b4c824622","text":"The previous experience of using a strict and isolated dermal component in the STSG technique was first introduced by Hynes already in 1954, as an alternative to the direct or tubed flap. After this attempt, two publications described a modified technique by which the dermal graft was applied upside down at the recipient site. The graft was thereafter left to vascularise and as it did not epithelialise at the surface, a second STSG was applied on top after 2 weeks. It needs to be stressed that the STSG taken at the donor site at the time of the dermal graft was returned to its original position in our study. In the publication by Querings et al. in 2002, it was emphasised that both the functional and cosmetic results at the recipient site were favourable.","title":"A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft"}
{"_id":"676b28a1-8063-633a-9234-cffe17a46560","text":"The aim was to achieve anatomical reduction of articular fragment. Sequence of fixation in most of the cases was by indirect reduction and temporary fixation of the articular fracture then alignment of the articular fracture to the diaphysis and fixation with the plate.","title":"Evaluation of Radiological and Functional Outcome of Intra-articular Proximal Tibia Plateau Fracture Treated with Plating"}
{"_id":"677292d7-4d40-e8ad-641c-02785a768d7d","text":"We propose to focus on the indispensable essentials, which account for the observed departure from adherence to the current NCCN standards for the surgical management of malignant melanoma. This selective approach could lead to decreased variation in the observed national practice patterns and improve outcomes. We fully underscore the importance of all of the NCCN guidelines but also recognize that the contemporary data suggests that they are not widely adopted. This adjunct to best practice patterns is amenable for use in academic and non-academic centers alike. This subset of the NCCN guidelines addresses the primary elements of melanoma diagnosis and treatment, which although notably deficient in the reported national studies, is employed by trained surgical and medical oncologists expert in the field. Focusing our attention on these streamlined guidelines may avert departures from NCCN best practice patterns. They address the following essential elements:","title":"Adjunct primer for the use of national comprehensive cancer network guidelines for the surgical management of cutaneous malignant melanoma patients"}
{"_id":"6773c27e-a68a-b16b-a401-49ec9a6010c1","text":"Satisfied neurological improvement was obtained by ADF and PDF for patients with KCSM. Cervical kyphotic correction caused significant improvement of AS, and was more favorable with ADF than with PDF. Surgeons should pay full consideration of the merits and shortcomings of each approach when deciding on a surgical plan. ADF is more suitable for the KCSM patients who have less than 3 levels of spinal cord compression which need to be intervened. Nevertheless, PDF is more suitable for the KCSM patients who have 3 or more levels of spinal cord decompression.","title":"Cervical alignment and clinical outcome of anterior decompression with fusion vs. posterior decompression with fixation in kyphotic cervical spondylotic myelopathy"}
{"_id":"67761d91-2b79-927c-6e10-33d06fbfa2b8","text":"The lines had a mean duration of insertion of 156 days.","title":"The Proceedings of the 19th International Cancer Imaging Society Meeting and Annual Teaching Course"}
{"_id":"677ef5d5-3ca0-6ca4-b76a-fc2e3cf9ae2b","text":"Additionally, to simulate the different blood vessels that irrigate the lower limb, endovenous tracts have been incorporated in different areas of the lower limb taking into account the real location of the blood vessels. After the design of all these parts, they are implemented altogether in the prototype shown in Figure 3.","title":"Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study"}
{"_id":"6780a9c4-c2ee-6811-b139-51c56f3780c0","text":"The patient was managed in a public hospital, a provincial reference center of the Piedmontese oncological network for skin cancer. All services and hospitalization were taken care of by the National Health Service.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"678b4d7c-955a-8a0c-fb05-15e406ad2432","text":"The purpose of this study is to determine the correlation between non-technical risk factors and the perioperative flap survival rate and to evaluate the choice of skin flap for the reconstruction of foot and ankle. In this study, the perioperative period was defined as within 2 weeks after flap transfer.","title":"Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis"}
{"_id":"678b9263-2a6b-4814-b664-b70a069965b6","text":"Screw migration following anterior cervical discectomy and fusion is a very rare complication and it is often related to device failure. Even more exceptional is the extrusion of an intervertebral graft.","title":"Oral extrusion of a vertebral body replacement device after chordoma tumor growth and radiation: case report and review"}
{"_id":"678f4baa-afc0-81ae-2e4b-20d94d9a39db","text":"Knowledge of the countless variants of the pelvic venous anatomy is just as important as prior assessment of anatomic variants of the IVC for reducing iatrogenic potential and for deciding on access strategies for interventional radiology procedures.10","title":"Endovascular treatment of pelvic venous congestion syndrome in a patient with duplication of the inferior vena cava and unusual pelvic venous anatomy: literature review"}
{"_id":"67986721-3d09-4ed7-1d5a-19105a535f57","text":"Bilateral TPVB can be provided for pain relief to the participants who suffer from moderate to severe pain after upper laparotomy in the PACU.","title":"Bilateral thoracic Paravertebral block for immediate postoperative pain relief in the PACU: a prospective, observational study"}
{"_id":"67996ea8-d027-fcdb-7d5d-0705a453b532","text":"As plastic surgeons are involved in both elective and emergency surgery, they figure significantly in treating major trauma patients, who often suffer from fractured facial bones, injuries of bodily soft tissue, and injuries to the hand or neurovascular injuries. Our previous study statistically explored the contribution of plastic surgeons to trauma patient management. The study found that approximately 5% of all emergency room patients were treated by plastic surgeons, while the proportion rose to roughly 15% for trauma patients.[ Due to their approach to reconstruction and rehabilitation, plastic surgeons are uniquely positioned to play a vital role in a subspecialty for trauma reconstruction. The improvement in outcomes when coordinated care is provided from the resuscitation to rehabilitation stage is exemplified in open lower limb fractures. A combined effort from orthopedic and plastic surgeons for early soft tissue reconstruction in such fractures is established as the gold standard of care in the United Kingdom, as described in the national guidelines set out in February 2016 by the National Institute for Health and Care Excellence. This underscores the importance of clinicians and multidisciplinary health care professionals collaborating for the patient’s journey extending beyond immediate treatment of injury. Plastic surgeons also play a crucial role in such cases, in addition to dealing with nonfatal disease.[","title":"Association between the participation of the plastic surgery department and qualitative prognoses in severe trauma patients: A retrospective observational study"}
{"_id":"6799fded-cc73-6950-d344-b7e0df28c9eb","text":"Axillary reverse mapping procedure, especially using blue dye, is an easy to reproduce technique in any surgical center, although the blue dye technique produces a relatively low detection rate. ARM node detection is difficult in patients with a high BMI, so the technique might not be feasible for these patients. There is a preferred anatomical pathway of drainage for the lymph of the arm (superior to the intercostobrachial nerve, inferior to the axillary vein and lateral to the thoracodorsal bundle). The rate of metastatic involvement of ARM nodes is significant and cannot be predicted by any preoperative factor; this shows that we cannot stratify breast cancer patients in order to identify the ones that might benefit from this procedure. However, we observed a correlation between ARM node metastases and the metastatic involvement of the other axillary lymph nodes, which might show that the drainage of the arm and breast have multiple connections that are not independent.","title":"Preventing Breast Cancer-Related Lymphedema: Feasibility of Axillary Reverse Mapping Technique"}
{"_id":"679c6a6f-158f-f3f0-c1fe-70b8852505d9","text":"Table 1 Classification of evidence for allergen-specific immunotherapy used in the manuscript","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"67a02cf2-acea-680b-24df-9926fed816cd","text":"In one study 3 weeks and one year after open rhinoplasty the sensibility of various parts of the external nasal skin was evaluated and it was shown that altered sensibility following open rhinoplasty occurs in the early postoperative period (3 weeks post operatively) in the area of skin supplied by the external nasal nerve (nasal tip and adjacent upper columella); but sensation became normal after one year; the nerve is probably injured during the subcutaneous dissection as the nerve passes between the nasal bone and the upper lateral cartilage to supply the skin [8].","title":"Comparing the Alteration of Nasal Tip Sensibility and Sensory Recovery Time following Open Rhinoplasty with and without Soft Tissue Removal"}
{"_id":"67a09a39-ecd6-75b0-50d2-dd57eff1c9fb","text":"We used the criteria of the Brighton Collaboration case definition of anaphylaxis [11] with the aim of obtaining an estimation of the patients with a possible anaphylactic reaction in our cohort, assigning the Brighton Collaboration classification level of certainty for each reaction.","title":"The Prevalence of Immediate Hypersensitivity Reactions to the BNT162b2 mRNA Vaccine against SARS-CoV-2: Data from the Vaccination Campaign in a Large Academic Hospital"}
{"_id":"67a47594-70c5-0fb6-79d7-49499e112241","text":"Other disadvantages of FNAC are lack of material for an accurate typing of lymphoma due to lack of tissue for immunohistochemistry [5]. Low grade lymphomas are difficult to diagnose even on excisional biopsies and special staining techniques are required to differentiate between a florid follicular hyperplasia and a follicular lymphoma.","title":"Does the surgeon still have a role to play in the diagnosis and management of lymphomas?"}
{"_id":"67ab9be9-3e00-478b-ab4f-92663db373c6","text":"Reconstruction of mandibular defects represents a challenge to the head and neck reconstructive surgeon. Autogenous bone grafting produce the most successful and predictable results when selected from the available reconstruction options for mandibular bone defects. At the present time, autogenous bone grafting is the gold standard by which all techniques of osseous reconstruction of the mandible must be judged, and amongst the other available options, is the most reliable and predictable modality to restore form and function of the missing mandibular segments. The free vascularized fibular flap has the least resorption and failure rate as proven in our study hence it should be the first choice for most cases, particularly those with anterior or large bony defects requiring multiple osteotomies.","title":"Reconstruction of mandibular defects - clinical retrospective research over a 10-year period -"}
{"_id":"67ad1e57-fa05-cd96-428d-754a8509a00c","text":"Increased attention to the essential elements of current NCCN management guidelines for the surgical treatment of patients with cutaneous malignant melanoma can improve the care of most of these patients who present with early disease and improve outcomes. Variations in practice patterns resulting from the disuse of this subset of the guidelines account for most of the reported departure from best practice patterns. Additional recommendations to curb these practice variations, such as the inclusion of all melanoma patients in discussions at multi-disciplinary tumor boards, should already be in place. Yet, the sheer numbers of patients with early or favorable presentation does not permit the review of all of these cases, even in academic specialty centers. Another option is regionalization of care for malignant melanoma as has been done for complicated tumors, such as pancreatic or esophageal cancers. However, 1 in 74 Americans is diagnosed with cutaneous melanoma [17] and in the majority their management does not incur the potential morbidity and mortality inherent to the surgical management of pancreatic or esophageal cancer patients, which has resulted in the regionalization of their care. Therefore, regionalization would probably be impractical and costly.","title":"Adjunct primer for the use of national comprehensive cancer network guidelines for the surgical management of cutaneous malignant melanoma patients"}
{"_id":"67b3290f-967f-4e25-7be2-7f0c987cd9d3","text":"While many of our residents continue to pursue general surgery practice after graduation, confidence appears to play a major role in the decision to pursue fellowship. This suggests that our residents are overall confident in their ability to practice broad based general surgery independently at graduation. We looked at factors that may contribute to this level of confidence through an anonymous survey of active attending surgeons and current residents.","title":"Early Autonomy May Contribute to an Increase in the General Surgical Workforce"}
{"_id":"67b5731e-0f19-1948-0133-4a850294e7fc","text":"Alternative feeding methods were coded based on whether recommendations for use prioritized breastmilk options. Recommendations regarding the use of expressed breastmilk were coded as in alignment with the WHO recommendations where guidance was unambiguously supportive if mothers were not directly breastfeeding. If use of expressed breastmilk was conditionally supported, it was coded as not in alignment with the WHO recommendations with a notation on reasons. Recommendations regarding donor human milk were coded as in alignment with the WHO recommendations where guidance supported use when maternal breastfeeding or expressed breastmilk were unavailable. If donor human milk was specified as only available for premature infants this was coded as contrary to the WHO recommendations. Recommendations regarding use of breastmilk substitutes were coded as in alignment with the WHO recommendations when they specified that use was supported if maternal expressed breastmilk was unavailable. Conversely if breastmilk substitutes were prioritized over, or equal to breastmilk, this was coded as contrary to the WHO recommendations.","title":"First do no harm overlooked: Analysis of COVID-19 clinical guidance for maternal and newborn care from 101 countries shows breastfeeding widely undermined"}
{"_id":"67b9a653-f973-653e-e1ed-01836e54d40e","text":"Patients who did not undergo a preoperative CT scan or refused physiatrist examination were excluded from the study.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"67badbed-ab79-5ae4-dfae-86d3f3a8d08e","text":"One unique pollen count station recorded grass pollen counts at each site. The start of the GPS for each site was defined as the first 3 consecutive days with a pollen count of 10 grains\/m3\/day or greater, and the end of the GPS for each site was defined as the last day of the last occurrence of 3 consecutive days with a pollen count of 10 grains\/m3\/day or greater. The peak of the GPS was defined as the period of 15 consecutive recorded days with the highest average among all possible 15 consecutive-day averages across the GPS.","title":"A phase 3 trial assessing the efficacy and safety of grass allergy immunotherapy tablet in subjects with grass pollen-induced allergic rhinitis with or without conjunctivitis, with or without asthma"}
{"_id":"67c44da4-b0c8-0730-4ee4-d7460e2bf8fc","text":"The choice of leg is based on the anticipated side of the recipient blood vessels and expected need for extra- or intraoral lining. The author usually prefers to use the leg that is contralateral to the side of the recipient blood vessels when intraoral lining is needed based on the location of the septocutaneous perforators that travel along the posterior-lateral border of the fibula in its native position on the leg. The flap is oriented so that the pedicle is on the lingual side, to minimize external compression and allow plate placement on the lateral aspect of the fibula and, for posterior defects, is usually placed posteriorly close to the branches of the external carotid artery and the internal jugular vein.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"67ca7615-1ae3-4f58-9fec-5e5e3cb0d1cc","text":"Surgical excision has been the historical treatment of choice in OSSN, although since 1986 topical pharmacotherapeutic agents such as 5-FU, MMC and IFN have been increasingly used in the treatment of OSSN both as an alternative of the surgery and in combination.","title":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis"}
{"_id":"67d6c429-4232-5faf-0fed-bd6ca01b255b","text":"We searched for eligible participants among outpatients and newly referred patients.","title":"Patterns of Clinical Reactivity in a Danish Cohort of Tree Nut Allergic Children, Adolescents, and Young Adults"}
{"_id":"67d8db1e-2f12-360d-f7a0-8995d21c02e6","text":"The economic size and development levels of the countries were an important factor in academic productivity in microsurgery. Undeveloped countries should be encouraged by performing multidisciplinary studies in this regard.","title":"Global Scientific Outputs of Microsurgery Publications: A Bibliometric Approach About Yesterday, Today, and Tomorrow"}
{"_id":"67dd81ad-fd81-943e-23af-0374284605be","text":"The Caribbean surgeon prior to the start of our own residency programs generally would have done undergraduate medical education at the UWI and then to the USA or more commonly the UK to train in surgery and then return to practice. This still happens in a limited manner, but by far the majority of surgeons who remain in the West Indies are trained in the Caribbean (some with a fellowship training of 1–2 years externally during or after residency). The advantage of the external experience is tremendous and extremely important for the establishment of new procedures and standards (7), even if the differences in resources in being trained in a developed world university and working in a resource-restricted environment provided by most Caribbean hospitals can be challenging. Notwithstanding this fact, the future of surgery in the Caribbean is bright. The success of the DM program has resulted in adequate numbers of surgeons distributed throughout the region, even though other countries were affected by inequality of the rural–urban distribution. The prospects for surgery in the region are demonstrated by the number of UWI DM graduates who have gone on to do fellowships in the subdivision of general surgery and have returned to work in and train the next generation of Caribbean surgeons. This is facilitating a gradual move away from a multispecialist surgeon to a superspecialist surgeon. At most of our teaching hospitals, the colorectal surgeon now performs procedures in the treatment of rectal cancer, and our hepatopancreaticobiliary team performs the Whipples procedure or major hepatic resections. While most of our graduates are equipped to perform everyday laparoscopic resections, such as for cholecystitis, appendicitis, and right hemicolectomy, our more advanced procedures such as bariatric surgery are confined to a few surgical teams distributed across the region.","title":"Surgical training in the Caribbean: The past, the present, and the future"}
{"_id":"67debcf3-5723-a4b0-a64a-bff003122bde","text":"The most important finding of the present work was that it comprehensively analysed the quantitative anatomy of the PLT and presents a systematic classification of the PPM origin based on anatomical dissection and that it includes new categories.","title":"A proposal for a new morphological classification of the popliteus muscle tendon with potential clinical and biomechanical significance"}
{"_id":"67ded69f-e60d-8c1d-a7d7-5d3e0ac77a1b","text":"In this time interval patient needs to replace daily dressings that are very painful, besides in this period patient would have no social function.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"67e17193-4463-9b01-ee9c-fa885d9f3a63","text":"To measure the effectiveness of each of three interventions designed to increase the duration of breastfeeding among new parents in urban areas.","title":"A study to prolong breastfeeding duration: design and rationale of the Parent Infant Feeding Initiative (PIFI) randomised controlled trial"}
{"_id":"67e2528f-c8d7-a228-4f03-107b938623d3","text":"Participants who participate in the study are covered by the Danish Health Authorities via the Danish Act on Complaints and Compensation.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"67e58933-fff1-cbc6-68b9-c03c9400b7c6","text":"One of the most important contributions that the treating surgeon can make to the care of patients is to take time to closely listen to their unique concerns and those of their family members about the surgery, its outcome and their experience living with disfigurement.[49]","title":"Psychological issues in acquired facial trauma"}
{"_id":"67e9bd45-0cb2-2e76-aea7-5521b6c9911b","text":"N1 lymph node dissection was similarly performed in the pathology group by the pathologist. While the parenchyma was dissected towards the periphery over the most central bronchus, unlike in the surgical group, the bronchus was cut and the lymph nodes were dissected by moving distally over the bronchial tree. However, the specimens of the patients in this group were exposed to formaldehyde solution before dissection.","title":"N1 lymph node detection in lymph node harvesting in non-small cell lung cancer: Formaldehyde exposure is a drawback?"}
{"_id":"67ee20fb-9348-87a4-c43e-d6e8587dc915","text":"Although our data reveal that the risk of recurrence is significantly reduced after one year, a rigorous followup should be performed over a longer period of the child's development. The prospect of local reconstruction has been planned, and maxillary functional orthopedic treatment will likely be required to stimulate adequate facial growth as fibrous healing is a considerable local issue.","title":"Melanotic Neuroectodermal Tumor of Infancy in the Maxilla"}
{"_id":"67f67406-38b4-1161-93ea-64f7aac97f96","text":"English and colleagues demonstrated that the retraction of excitatory glumatergic synaptic inputs onto axotomized lumbosacral motoneurons could be prevented by sex-specific exercise programs of continuous and interval training for 2 weeks [117,118]. Such retention of synaptic inputs on facial motoneurons may very well be the explanation for the positive effects of the sensory input from Mstim of the whisker pad in restoring normal whisking.","title":"Trigeminal Sensory Supply Is Essential for Motor Recovery after Facial Nerve Injury"}
{"_id":"67f995f5-140d-5ea2-e0bb-11b9dda34c1c","text":"Differential diagnosis includes other spindle cell tumors and tumor lesions such as bronchial carcinoid of the large spindle cell variant, pleural fibrous mesothelioma, metastatic malignant melanoma, metastatic synovial sarcoma and occasionally plasma cell granuloma.819 To discriminate these lesions, immunohistochemical studies can be of great help in which both benign and malignant smooth muscle neoplasms show muscle markers like actin and desmim.19 Immunohistochemical staining for desmin and myogenin was performed here to find the exact nature of the tumor which confirmed the diagnosis of leiomyoma.","title":"Endobronchial leiomyoma; report of a case successfully treated by bronchoscopic resection"}
{"_id":"67fcc9a7-43cf-788a-724e-6a7656738698","text":"Neurological damage during surgery is thought to be the source of postoperative chronic pain. Rib resection and suturing techniques increase the risk of nerve damage. In the study of Maguire et al., it was determined that patients who did not undergo rib resection were exposed to more intercostal nerve damage during rib resection. Although the effect of rib resection on the development of postoperative chronic pain is controversial, there are studies with different results. In a study that retrospectively investigated the risk factors affecting the development of chronic pain after thoracotomy and included 208 patients, it was found that the risk of developing chronic pain increased by 9.8 times in patients who underwent rib resection. In our study, rib resection increased the risk of chronic pain after surgery by 11.8 times.","title":"Retrospective Analysis of Factors Affecting Chronic Postoperative Pain After Thoracotomy: Single Center Experience"}
{"_id":"6803feb9-b6c3-4291-ffa3-9b985edb7704","text":"The incidence of DVT was determined by reviewing ultrasound results for DVT screening tests that are routinely performed on days 2 to 3 of admission for all trauma patients in the ICU. In addition to these empiric screens, if a DVT was diagnosed later in the admission due to clinical suspicion it was also included in our analysis. A DVT was defined as a thrombus that was detected by ultrasound in a deep vein. Superficial venous thrombi were not included. All forms of DVT prophylaxis were recorded including intravenous and subcutaneous heparin, subcutaneous enoxaparin, and pneumatic compression devices. The frequency of DVT prophylaxis was then compared between RBC storage age study groups. The ISS was calculated by trained staff within the Hartford Hospital Trauma Program according to the methods described by the Association for the Advancement of Automotive Medicine Abbreviated Injury Scale, 1998 Revision. Cause of death was determined by chart review and was categorized as either death due to hemorrhage, primary central nervous system (CNS) injury, or MOF. MOF was defined as two or more organ failures at the time of death. Organ failure at time of death was defined as follows: cardiac failure as requiring vasoactive agents, pulmonary failure as requiring mechanical ventilation with radiographic evidence of lung pathology, CNS failure as GCS less than 6, and renal failure as requiring dialysis or serum creatinine more than 3 mg\/dl. Patients with traumatic brain injuries who remained intubated at time of death without evidence of lung injury or who were on minimal mechanical ventilator settings were determined to have died secondary to primary CNS injury and not MOF. The cause of death and organ failure at time of death was determined by chart review by a single reviewer (PCS) who was blinded to patient RBC age category and all other variables recorded for the study patients. This was accomplished by this reviewer being blinded to the database and just reviewing death certificates and patient charts. Organ failure scores such as the Sequential Organ Failure Assessment or Marshall Multi Organ Dysfunction Score were not able to be calculated from our database.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"6803ffff-f68a-6583-50fd-21d86f505816","text":"Acute osteomyelitis was defined as a history of relevant symptoms of less than 14 days and subacute osteomyelitis as a history of symptoms of 14 days or more.","title":"Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study"}
{"_id":"680bd0c8-a93b-3588-18dd-2d97c3dc9c53","text":"We present a case of successful management of an intracoronary thrombus, which was accomplished combining IVUS data and a distal protection device.","title":"Intravascular ultrasound to guide the management of intracoronary thrombus: a Case Report"}
{"_id":"680d40f5-aa04-2f81-b8b4-7fb155892c5a","text":"Skin transplantation is one of the main methods to treat skin defects such as extensive burns and refractory skin ulcers. However, the source of skin grafts is limited and there is a greater damage to the donor area. In recent years, with the rise of tissue engineering, tissue engineered skin is considered to have the unique advantage of repairing damaged tissue and possibly exercising part of the skin function.","title":"Endowing iPSC-Derived MSCs with Angiogenic and Keratinogenic Differentiation Potential: A Promising Cell Source for Skin Tissue Engineering"}
{"_id":"680ebd68-48f5-6295-72da-d90fb858f33d","text":"The flap was sutured in its new position and the donor area was covered by split skin graft. While suturing the flap, due care was taken that flexor aspect of the joint was covered by the flap. The initial two sutures were placed on the side of the perforators so as to prevent torsion and stretch on the perforator. Stretching and drying are the most common causes of perforator thrombosis during the operation and must be prevented. Twisting of the pedicle occurred more commonly in perforator flaps than in conventional flaps. Paying special attention to the course of the vessels during the inset, were vital maneuvers. Light dressings coverred the flap, which could be monitored easily for any change in color.","title":"Use of Local Perforator Flaps for Post Burn Reconstruction"}
{"_id":"6819a21c-9042-b931-01d0-d7f994521b8b","text":"The diagnosis of recurrent DVT is challenging because a history of DVT increases the pretest probability in patients with suspected DVT and reduces the specificity of D-dimer. However, it appears that a low pretest probability and a normal D-dimer level safely exclude recurrent DVT in patients not taking anticoagulants . Prior DVT reduces the diagnostic specificity of ultrasonography because residual ultrasound abnormalities are found in at least 50% of patients 1 year after their index event. Consequently, compression ultrasonography is useful only if comparison with a previous examination shows involvement of a new venous segment.","title":"Recent advances in understanding, diagnosing and treating venous thrombosis [version 1; peer review: 2 approved]"}
{"_id":"681a6272-9570-de11-334a-3a76e60756b2","text":"Osteomyelitis is an infection of the bone that can arise via direct inoculation or hematogenous seeding. Treatment often requires operative debridement and prolonged antimicrobial therapy.","title":"Tibial Osteomyelitis Following Prehospital Intraosseous Access"}
{"_id":"681f8cd8-2e2a-b9f9-c3df-cf7bc54cca66","text":"Such overt expressions of sexism were rare. More common was a feeling of just not fitting in with the dominant surgical culture, or not matching up to the expected personality type. While some male participants also reported this, the gendered character of the surgeon stereotype made it harder for women to match up to these assumptions:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"682bb577-da06-c973-9ea2-e444ba016538","text":"In summary, our study did not evidence any clear symptomatic or disease-modifying effects of monthly bee venom injections over an 11 month period compared to placebo using a standard bee venom allergy desensitization protocol in PD patients. Of note, bee venom administration appeared safe in non-allergic patients. Given the increasingly strong preclinical rationale that SK channel blockade may be beneficial in treating PD short and long term, we believe that a larger study with less stringent exclusion criteria regarding IgE levels and ST is warranted. In particular, we feel that higher administration frequency and possibly higher individual doses of bee venom may reveal its potency in treating PD.","title":"Bee Venom for the Treatment of Parkinson Disease – A Randomized Controlled Clinical Trial"}
{"_id":"682e88fc-6167-8dd2-643c-cf87b8d00cd0","text":"Theoretically, interposition vein grafting offers benefits of increased vascular pedicle length to overcome problems of tension and gaps between free flaps and recipient vessels. However, vein grafting techniques in microsurgery are far more difficult than primary anastomosis of free flap vessels because the vessel caliber of the graft may vary, and more vascular anastomoses are required.","title":"The role of vein grafts in reconstructive head and neck microsurgery"}
{"_id":"6830731a-31fc-d4ec-7bc2-da58683397ef","text":"Endovascular treatment in 17 legs of 17 patients comprised eight recanalizations of complete occlusions of the superficial femoral artery and nine revascularizations of highly stenosed superficial femoral arteries.","title":"Evaluation of Hyperspectral Imaging for Follow-Up Assessment after Revascularization in Peripheral Artery Disease"}
{"_id":"68349eac-98fe-cc49-740e-d33e56b0a714","text":"A review of literature on primary melanoma of the colon did not reveal any specific criteria that authors have used to assign specific surgical modalities to patients. Since the patients were managed by different surgeons, each management approach was individualized according to the judgment and discernment of the surgeon. However, in general, it is easy to appreciate the general trend that patients with limited, controlled disease were managed with curative surgical therapy.","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"6838ff98-5b7b-41c3-52a0-de1e182cf471","text":"We believe that the positive experience that we achieved in the use of composite grafts for the reconstruction of large areas of the nose could be interesting for others surgeons.","title":"Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose"}
{"_id":"684dc594-117d-592f-df34-982ffc2304c6","text":"The ASCENDE-RT team acknowledged that there were major flaws in the technique used for the implantation of the radioactive seeds that could explain the unexpected high level of urethral strictures. Notably, the protocol specified a too generous inferior margin in defining the BT target volume because of uncertainty regarding the location of the prostatic apex on previous generation transrectal ultrasound imaging. It was then stated that technological advances may reduce adverse events while maintaining the gain in bRFS. Other authors had already demonstrated that improving the quality of the implant could drastically influence BT toxicity [177].","title":"Stereotactic Radiation Therapy versus Brachytherapy: Relative Strengths of Two Highly Efficient Options for the Treatment of Localized Prostate Cancer"}
{"_id":"68511b2e-8549-8f5a-f0d3-ecfc325a059e","text":"The researchers will be able to get ideas for new studies on this subject by evaluating the development of the topics studied by year, the trending topics, and the topics that received more citations. Hence, this study will be a useful guide for clinicians and scientists on the global outcomes of studies on microsurgery.","title":"Global Scientific Outputs of Microsurgery Publications: A Bibliometric Approach About Yesterday, Today, and Tomorrow"}
{"_id":"68544f4b-a9b1-b8af-d9d3-b5e83f8beb15","text":"Adverse events were evaluated by using CTCAE v4.0 and the electronic medical records. The most severe grades that occurred during the period were tabulated. Statistical analysis using the χ2 test was performed to determine if there was a significant difference in the proportions of Grade 3 or higher patients in each group.","title":"A comparative study of high-dose-rate brachytherapy boost combined with external beam radiation therapy versus external beam radiation therapy alone for high-risk prostate cancer"}
{"_id":"6860f899-ef78-46a9-1c77-4e025c4c12f6","text":"The anatomical study showed that the IGAP flap is thicker than the gluteal thigh flap in both its proximal and distal portions. This fact can be explained by the distribution of the fat in the body. While in the gluteal region the subcutaneous tissue is thick, in the posterior thigh region, the thickness decreases from proximal to distal. The indication of the IGAP flap as the first option to cover ischiatic pressure sores can be done based on the like with like concept. When selecting the gluteal thigh flap, the thickness can be increased through deepitelialization and folding of the distal portion of the flap [17].","title":"Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps"}
{"_id":"6869edc9-b517-eb35-225a-73c489abf160","text":"The chest wall can be involved in both primary and secondary tumors, and even today, their management and treatment continue to be a challenge for surgeons. Primary chest-wall tumors are relatively rare and include a large group of neoplasms that can arise from not only bone or cartilage of the chest wall but also from associated subcutaneous tissue from muscle and blood vessels. Secondary tumors refer to a direct invasion of the chest wall by neoplasms located elsewhere in the body, mainly metastases from breast cancer and lung cancer. En-bloc surgical excision of the lesion should ensure adequate negative margins to avoid local recurrence, and a full thickness surgical resection is often required, and it can result in important chest-wall defects such as skeletal instability or impaired breathing dynamics. The reconstruction of large defects of the chest wall can be complex and often requires the use of prosthetic and biologic mesh materials. This article aims to review the literature on these tumor entities, focusing on the main surgical techniques and the most recent advances in chest-wall resection and reconstruction. We also report on the institutional experience our center.","title":"Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience"}
{"_id":"687566e1-8aaf-6994-f122-95ade7985adc","text":"Fillers have been classified by many over the years, and it is beyond the scope of this manuscript to get into debates and discussions on the various classifications with regard to which group of fillers in these classification systems is better than the other. What is important for the discussion at hand is that there are fillers that can be classified as non-permanent and those that are considered permanent.[3] Non-permanent fillers are the most popular at this time and we continue to see an increase in their use and in the number of these fillers reaching the market. These fillers usually last upto one to two years for some products. Permanent fillers may have a role for certain patients and in the hands of skilled injectors.","title":"Soft Tissue Augmentation in Dermatology – 2009 Update"}
{"_id":"68785eda-4f82-8285-949e-16200f25e99c","text":"All patients underwent sensory testing by the same examiner at least 3 months after surgery. Sensory function was assessed in the center of the flaps and on the contralateral side cheek as a control group. The tests were performed with the patient blinded. Patients were asked to acknowledge sensation by holding up their fingers depending on the sensation tested.","title":"Sensory Recovery with Innervated and Noninnervated Flaps after Total Lower Lip Reconstruction: A Comparative Study"}
{"_id":"687979ee-9e21-f487-eb68-a6930f475352","text":"Autologous fluid cartilage obtained from the shaving procedure of the cartilage septum provides an autologous source of filler, and it has been demonstrated to be effective in the treatment of nose defects in the dorsum of the nose and alar cartilage defects, or the correction of sovratip imperfections; moreover, the incomparable biocompatibility enabled shaving cartilage to be a promising autologous biotechnology for tissue engineering and aesthetical purposes [3]. Other donor sites can be the rib cartilage and the chonca ear auricular cartilage, but with different peculiarities than those of the nasal cartilage.","title":"Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage"}
{"_id":"688336d3-9235-0927-63c8-1dadb845a2fa","text":"Early termination of the planned 6-week period of oral or IV antibiotic therapy because of adverse events, patient preference or any other reason","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"6885d274-d475-94f6-dbb2-9ef9c56db680","text":"Therefore, the future will be that local general surgeons or plastic surgeons will present their difficult cases in Zoom conferences and experts in Europe will prepare and discuss their surgery proposals. If we have left them dermatomes and skin mesher and they have performed some skin grafts with it, then they will be able to treat their burn patients optimally themselves with our virtual help in the future.","title":"INTERPLAST-Germany—adapting to global plastic surgery"}
{"_id":"688cf12b-bef3-fb9b-ffe9-f80ef02b1ad6","text":"External beam therapy is the irradiation of a tumor with charged particles such as proton and helium ion beams or with stereotactic methods. This modality can be used to treat tumors up to 14 mm thick with a basal diameter up to 28 mm.","title":"Uveal Melanoma: Current Trends in Diagnosis and Management"}
{"_id":"68903bc8-32e1-318d-d5b1-e56b5ced5a41","text":"Conclusion: Canakinumab is a safe biologic agent to maintain disease control in children with HIDS even in renal transplantation course. We think that canakinumab can be successfully and safety used in renal transplant patients.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"68a66d34-9110-24a6-fd39-ff970679ad28","text":"To sum up, cleft lip patients generally have serious nasal deformities accompanied by the distortion of nasal septum and nasal bone. If 3D printing can be used to assist autologous costal cartilage augmentation rhinoplasty, the deflection of costal cartilage can well correct and achieve satisfied results.","title":"3D Printing Technique Assisted Autologous Costal Cartilage Augmentation Rhinoplasty for Patients with Radix Augmentation Needs and Nasal Deformity after Cleft Lip Repair"}
{"_id":"68aee20d-2042-6a4f-ccbb-0482c0500571","text":"There have been documented incidences of cervical epidural abscesses in literature, but very scant presentations with the subacute nature of this case of CCS (Table). Trombly and Guest documented a CCS secondary to an underlying vertebral osteomyelitis and epidural abscess, but the patient had the abrupt onset of symptoms secondary to minor trauma.11 Schimmer et al retrospectively studied 15 patients with osteomyelitis of the cervical spine and of the nine patients presenting with neurological symptoms, only one had been experiencing neurologic symptoms for at least two days – the remaining eight had sought medical attention within 24 hours of onset of neurological deficit.3 However, over a third of the patients had been experiencing worsening neck pain over several weeks with one of them experiencing pain for as long as four months, although these were present without coinciding neurological symptoms.3 Similarly, Khalid et al reviewed cases of upper cervical epidural abscesses, and few were associated with neurological symptoms that were subacute in onset.12 Of the cases that had at least two weeks of neurological symptoms prior to presentation, only one presented with CCS similar to the patient described above.12","title":"Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report"}
{"_id":"68c655b4-1526-c20b-f772-a08b2d3707f5","text":"Our results show that the neurosurgeon’s increase in surgical caseload was not a function of a small number of physicians referring many patients but rather from many physicians each referring a few patients. The vast majority of physicians only referred zero or one patient who had had surgery within the previous 365 days. Our finding implies that few physicians could have had a sufficient sample to use their own patients’ surgical outcomes to influence their decision to refer patients to the neurosurgeon.","title":"Building a Brain Tumor Practice: Objective Analysis of Referral Patterns and Implications for the Growth of a Subspecialty Surgical Program"}
{"_id":"68c6c1ad-cba2-c42f-4196-914c8537ead7","text":"Mohs micrographic surgery is a tissue-sparing technique that allows for excision of cutaneous tumors under complete microscopic margins control. Mohs surgery boasts high cure rates and maximum tissue conservation. We introduce the double-blade scalpel in Mohs surgery as a timesaving and easy way to harvest tissue strips of uniform width and therefore increase the intraoperative efficiency of the procedure.","title":"Double-Bladed Scalpel in Mohs Micrographic Surgery"}
{"_id":"68c871b1-af84-3ba8-92f5-c33f0e79f07b","text":"Many studies have shown that the decrease in NAD due to aging is correlated with the functional decline of tissues and the development of age-related diseases and cancer. In the epidermis, UV irradiation, the most important extrinsic factor of skin aging, causes NAD depletion as well as chronological aging. Since the skin is constantly exposed to UV irradiation in daily life, the topical application of NAD-boosting agents seems to be a reasonable approach for preventing NAD reduction and protecting the skin from UV damage. Indeed, enhancing NAD in the skin has been shown to prevent UV-induced skin cancer and immunosuppression in mice. Jacobson et al. reported that topical nicotinic acid derivatives increased skin NAD content and improved barrier function. In addition, several clinical studies have shown that topical application of the NAD precursor NAM reduces signs of skin aging. These in vivo and clinical data support the possibility that elevated NAD levels prevent skin damage and delay aging. We have also previously reported that maintaining adequate NAD levels is essential for the protection of human epidermal cells from UV stress. In this study, we demonstrated that PPE enhances intracellular NAD levels in keratinocytes. We also found that its active ingredients have LMW of less than 3 kDa, which are effective for both monolayer and 3-dimensional epidermis culture models. These findings suggest that the active ingredients of PPE could be transdermally absorbed and therefore highlight its potential application as a topical agent for boosting skin NAD levels.","title":"Porcine placental extract increase the cellular NAD levels in human epidermal keratinocytes"}
{"_id":"68c95272-21b7-638f-f02b-37c227db0b4d","text":"Given this shift towards localism and clinician led services it would appear that leadership will have significant a role in both medicine and dentistry. However, there will be a number of challenges and opportunities. In medicine, the Academy of Medical Royal Colleges and NHS Institute for Innovation and Improvement developed the medical leadership competency framework and the medical leadership curriculum and this now forms the NHS Leadership Academy (Table 2). Although the GDC has placed more emphasis on leadership in education and training for dental professionals,26,27 there is a need to define and scope the leadership traits and behaviours that are required for developing leaders within the specific context of dentistry.","title":"What is clinical leadership and why might it be important in dentistry?"}
{"_id":"68caf933-77ae-984d-a709-3b40d0c446e3","text":"Others discussed the motivation and enthusiasm they gained from the programme:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"68d0d8bc-9d23-8bd0-986d-d73b098d1bcf","text":"Proper flap selection for axial based flaps also includes choosing flap harvest on a pedicle or performing a free tissue transfer. An adequately perfused flap is often the only thing that stands between a patient and exposed hardware or important visceral structures. Therefore, knowing what autologous options will provide the most robust blood supply can decrease potential complications related to flap loss. This study capitalized on a unique reconstructive opportunity to directly compare the perfusion of a free muscle-sparing and pedicled TRAM flap side by side in the setting of long term follow up. We hypothesized that through the operative and post-operative period, the free muscle-sparing flap would show earlier and increased perfusion as compared to the matched pedicle flap.","title":"Comparative Perfusion Analysis of Free Muscle-Sparing Versus Pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps in Vivo in the Peri-Operative and Late Post-Operative Periods"}
{"_id":"68dc1781-4ab2-a357-7a75-07714606456a","text":"Moreover, this case raises the important question of the systematic histopathologic analysis of resected specimens. Indeed, a current and controversial debate exists about the usefulness systematic histopathologic examination in routine tonsillectomy specimens. Some authors state that routine histologic examination is important because it allows the detection of unexpected malignant findings while other suggest that this should only be indicated in case of malignancy suspicion and when risk factors are present.9 This case report strengthens the arguments of physicians who support the importance of a pathology review even in normal‐appearing specimens. They support this systematic analysis according to the multiple malignancy cases discovered incidentally without significant risk factors.12 Our findings further support the latter statement in favor of the systematic histologic examination. Should some of the palatine tonsillar specimens not be submitted to the laboratory of pathology or only be grossly examined, some malignancies may not be diagnosed in both adult and pediatric patients,12 which might lead to delayed management of malignancy and complex medicolegal implications.","title":"An unusual cause of obstructive sleep apnea syndrome"}
{"_id":"68e08fb8-3195-0fbe-b336-47bb3a583e4c","text":"Despite the reported problems facing trainees during the training process; overall, the participants confirmed that they are satisfied that they will make excellent surgeons and clinicians after completion of their training. Nevertheless, they were concerned about their teaching and research skills. Most of trainees stated that they will look for fellowship position abroad before taking a consultant post and commit themselves to training other doctors. Quotations by participants from the focus group discussion rounds were demonstrated in Table 1.","title":"Needs assessment study of postgraduate surgical education in Sudan: Trainees perspective"}
{"_id":"68e3413c-c168-e660-7331-52ec54ce4887","text":"Decreased masticatory muscle thickness also seemed to have direct effects on bone density of the ramus and coronoid process of the mandible. Most studies about the association between BTX induced masticatory muscle atrophy and mandibular bone loss have been animal studies and sparse well-designed human studies have been carried out due to difficulties in analyzing craniofacial bone qualities in humans. Owing to advances of 3D-modeling technology, evaluating the cortical bone density and the thickness of craniofacial structures using CT images has become possible in routine clinics. Therefore, in the present study, we aimed to reveal the influences of the BTX-induced masticatory muscle atrophy on the cortical bone thickness and density of the mandibular structures using CT imaging based on 3D modeling technology.","title":"Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults"}
{"_id":"68f0b327-4e03-abca-59b2-880d94ec3b4d","text":"This case report offers an adjunct to the conventional management of diabetic stump infections. The addition of an antibiotic spacer could offer an alternative to a higher level of amputation and improve the survival rates of below-knee amputation in this difficult population.","title":"Antibiotic Impregnated Cement Dowel in a Tibial Stump to Salvage Infected Below-Knee Amputation in a Diabetic"}
{"_id":"68f3c3c9-a739-0526-e352-f3256a9a3e5b","text":"Of interest is to note that the volume of the fused atlas proposal was on average smaller than the single atlas proposal. The pearl editing tool was regarded by the radiation oncologist as somewhat easier to use when starting with a small volume where the borders are pushed outwards to the desired position rather than the opposite, which would mean that smaller proposals would be preferred over larger.","title":"Clinical evaluation of multi-atlas based segmentation of lymph node regions in head and neck and prostate cancer patients"}
{"_id":"68fb65ac-2efa-2cd5-3b45-231a2ea97264","text":"For patients with traumatic injuries transfused 5 or more units of RBCs and alive on ICU admission:","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"68fca472-6ef2-5487-71b9-228eb6a90147","text":"In the setting of tumor excision surgeries, there exist 2 possibilities: cases where surgeons definitively have been able to identify or rule out the postoperative presence of gross residual disease via visual inspection and\/or pathology scans and cases where there exists a medical uncertainty as to whether there is any remaining disease left in the patient. The latter possibility constitutes a serious clinical problem for physicians, who then must decide how to proceed with postoperative patient management and weigh the risk between preventing possible residual disease with adjuvant chemotherapy, at the cost of harming the patient’s health.","title":"Machine learning methods to predict presence of residual cancer following hysterectomy"}
{"_id":"690fd08a-7732-6564-c6de-0e61f0e65be7","text":"All the surgical procedures were conducted by the same team, and all the patients acquired preventative cephalosporin antibiotics perioperatively. Radical debridement and irrigation were performed before the installation of the HEF in the open fractures. Four patients with Type I wound and 9 patients with Type II wound were closed primarily within 8 h, while the other 3 Type II wound had delayed primary closure. Eight patients with Type IIIA wound had split-thickness skin grafting, and the other 3 with Type IIIB wound had a rotational flap. The patient with closed fracture suffered compartment syndrome underwent fasciotomy followed by skin grafting. The other patients who failed closed reduction underwent the definitive management of the TSF. The associated fractures in 9 patients were managed simultaneously or another subsequent surgical procedure considering the specifics. According to the treating surgeon’s discretion, all the procedures were performed between 1 and 12 days after injury.","title":"Management of high-energy tibial shaft fractures using the hexapod circular external fixator"}
{"_id":"6913d178-4965-7eb7-1be5-1a9c275eaf4c","text":"The dissemination of suspLN is shown in Table 2. Overall or in any analysed lymph node station the distribution of suspicious lymph nodes showed to be significantly influence resectability.","title":"Relevance of suspicious lymph nodes in preoperative imaging for resectability, recurrence and survival of intrahepatic cholangiocarcinoma"}
{"_id":"69147ddd-b582-9f10-7035-ef27b5fe07b3","text":"The incidence proportion of proximal lower limb DVT among Asian medical critical care patients without thromboprophylaxis was slightly lower than reported for Caucasian populations. Patients at higher risks for development of proximal DVT were those with increased age, female gender, receiving a femoral venous catheter, and the absence of platelet transfusion. Patients with DVT stayed longer in hospital but did not show increased mortality. Based on our results, we would suggest routinely pharmacologic VTE prophylaxis in critically ill patients particularly a patient who is an elderly female and has a femoral venous catheter because the probability for development of DVT is more than 50%.","title":"Incidence of proximal deep vein thrombosis in medical critical care patients"}
{"_id":"69165c0b-8fda-a1e8-5b03-7fe6cba699f2","text":"It is important to conduct a comprehensive examination of the body before starting treatment. Some injuries will be fatal if left untreated such as pleural effusion, pneumothorax, and intracranial hemorrhages. Hypovolemic shock may be seen in such injuries and must be detected and managed early by both blood and fluid administration.","title":"Successful management of scalp avulsion with full‐thickness graft"}
{"_id":"6917c3a1-4e03-b998-67aa-614af0f3de54","text":"The undergraduate medical curriculum has been overcrowded with core learning outcomes with no formal exposure to plastic surgery. The aim of this study was to compare medical students from two educational settings for the basic understanding, preferred learning method, and factors influencing a career choice in plastic surgery.","title":"Plastic Surgery Inclusion in the Undergraduate Medical Curriculum: Perception, Challenges, and Career Choice—A Comparative Study"}
{"_id":"69210b20-68fa-b0ff-10a5-0b9a9480f773","text":"In 15 of 20 cases, the frequency we identified was either at or below the lower end or else at or above the upper end of the range recommended by NCCN, despite the NCCN recommended ranges being very wide, and for several examples, NCCN does not offer guidelines. The benefits of the NCCN guidelines would depend on the costs arising as a result of following them as opposed to using more or less frequent scans, and we have not specifically calculated these costs in this paper.","title":"Optimal frequency of scans for patients on cancer therapies: A population kinetics assessment"}
{"_id":"69339ca7-cc81-0260-5ffa-1e614791569c","text":"Thrombosis risk factors are summarized and the mechanism of thrombus formation and the symptoms accompanying this process are described.","title":"Factors Affecting the Formation and Treatment of Thrombosis by Natural and Synthetic Compounds"}
{"_id":"693436ee-b39c-c767-4496-865ae5071346","text":"Seven studies contributed to the descriptive subtheme of Hospital Routines. In these studies, participants described hospital routines that were often inconsistent and unpredictable, which hindered their ability to engage with their infants. Some of these routines included nursing assessments, specimen collections, and medication administration. Mothers who use substances also explained how nurses entering and exiting the room interfered with their ability to relax when caring for their infant. Mothers who use substances also reported that the frequent and strict NAS scoring schedule would interrupt their abilities to feed, comfort, and nurture their infants. The mothers who use substances believed that the NAS scoring of their infants was disruptive and made their infants irritable, which increased the appearance that the infants were experiencing more severe NAS symptoms. Nurses in these studies reiterated about the disruptive nature of having to disturb the infants to perform NAS scoring.","title":"Factors Associated with Maternal Engagement in Infant Care When Mothers Use Substances"}
{"_id":"6935dc3e-b604-c4e3-82ea-b15f02794906","text":"This option offers two advantages: there is no need for donor site cartilage and there is reduced risk of the collapse of the nasal valve with graft displacement.","title":"Functional results in airflow improvement using a “flip-flap” alar technique: our experience Resultados funcionais na melhora do fluxo de ar utilizando uma técnica alar em flip-flap: nossa experiência"}
{"_id":"6936c816-4d71-ef05-41b1-0a7110e536bf","text":"On intraoral examination mixed dentition period with normal occlusion with several decayed primary teeth was noted. His oral hygiene was average and his dental history was found to be insignificant. These clinical features were typical of chronic suppurative osteomyelitis and a clinical diagnosis of CSO of the mandible was made.","title":"Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report"}
{"_id":"693faa54-3df6-e20d-8450-d79949c872e9","text":"Firstly, to exclude the venous anomaly by dividing the single IMV cranial to the ring would leave the length of recipient vessel prohibitively short for the coupler mechanism for the anastomosis, potentially risking its integrity and avulsion of the repair or IMV with excessive tension. Conversely, completely preserving the ring by dividing caudal to the bifurcation would require rib sacrifice in order to adequately expose the caudal end of the divided vein; this therefore increases the risk of the adverse outcomes associated with this method – particularly pertinent to a bilateral reconstruction case where symmetry is important and by having differing methods of vessel exposure on each side this would potentially risk asymmetrical chest wall contour [11].","title":"An unusual “venous circle” of the internal mammary vein encountered during microvascular anastomosis and implications for practice"}
{"_id":"6948deae-762d-3a9c-1f43-a1ba0aae10d7","text":"For scanning PBT to the reconstructed breast, the most commonly reported adverse outcome was removal of prosthetic implant, which occurred in 19% of patients assessed. This may be higher than expected in current clinical practice using photon radiotherapy where estimates are around 9%. However, estimates of the prevalence of reconstruction outcomes after radiotherapy vary considerably and without information on the timing of reconstruction outcomes comparison between studies is difficult. Published data only include reconstruction outcomes of 348 breast reconstructions irradiated with scanning PBT for early breast cancer after a median follow up less than three years, so further data are needed.","title":"Proton Beam Therapy for Early Breast Cancer: A Systematic Review and Meta-analysis of Clinical Outcomes"}
{"_id":"694a6a81-4b9c-a53f-52c5-57887eb7d1b2","text":"The American Society for Reproductive Medicine (ASRM) Ethics Committee published guidelines in 2005 on fertility preservation and reproduction in cancer patients. These guidelines state that the only established method of female fertility preservation is embryo cryopreservation and that experimental procedures such as oocyte or ovarian tissue cryopreservation should be offered only in a research setting with IRB oversight [27]. However, these recommendations may be revised with improvements in oocyte preservation technology and increasing numbers of live birth reported in the past several years.","title":"Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review"}
{"_id":"694ff8c2-419c-41a8-2be6-026e7e7b2bf0","text":"From 1192 unselected melanoma patients who underwent sentinel node biopsy at the Netherlands Cancer Institute or the University Medical Centre Groningen between December 1991 and July 2010 a total of 631 patients with a primary melanoma on the upper limb or trunk were identified. The anterior trunk melanomas were located on the trunk from the umbilicus up to the clavicle and on the anterior side of the shoulder, which is divided by an imaginary line over the deltoid region. The posterior trunk melanomas were located on the trunk from the level of the umbilicus up to vertebra C7 and on the posterior side of the shoulder posterior from the imaginary line. Sentinel node biopsy was carried out if the primary tumor had a Breslow thickness of at least 1 mm or a Clark level IV.","title":"Lymphatic Drainage Patterns from Melanomas on the Shoulder or Upper Trunk to Cervical Lymph Nodes and Implications for the Extent of Neck Dissection"}
{"_id":"69535af2-7e00-5158-960e-eb7d2e2892b1","text":"Although the MLCF and LI competencies are comparable, the development process for each respective competency set was different. The MLCF process involved a comprehensive literature review of medical leadership, comparative analysis of leadership competency frameworks, and iterative consultations and input from medical practice and education stakeholders in the UK. In contrast, the development process for the LI competencies utilized resources and collaboration from business and management education, which may provide a more expedited approach that can be individualized to existing educational environments and curricula. Although strategies for implementing the MLCF have not been systematically described and evaluated, a qualitative study reported that medical students had conflicting views about when to introduce the content but felt that they had to have some clinical experience in order to appreciate the importance of leadership.","title":"Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy"}
{"_id":"695f40f7-9935-c5e4-100e-6eb09524ed2c","text":"Few risk factors have been identified for the development of calcinosis among patients with Juvenile Dermatomyositis, and currently no clinical phenotype has been associated with its development. We analyzed a large database of patients to further elucidate any relationships among patients with and without calcinosis.","title":"Clinical phenotypes and biologic treatment use in juvenile dermatomyositis-associated calcinosis"}
{"_id":"696414c0-821b-30ff-d7f5-7b7969975e73","text":"Although a number of multidisciplinary, design-oriented educational programs in biomedical technology innovation have been launched in universities in the US and abroad,2 the impact of this type of training remains difficult to quantify.3,5 The present study reports the results of a detailed survey of 114 alumni of the Stanford Biodesign Innovation Fellowship, who at the time of the study were between one and 14 years into their careers. The data indicate that the fellowship alumni have been productive in inventing new technologies that have translated into patient care; they have progressed into leadership roles in health technology; they self-report that they value the training they received in the Biodesign approach; and they are actively involved in mentoring others in the this approach. This study also compares the career metrics of the alumni with candidates who were finalists in applying to the program but were not selected to be fellows. Many more alumni than finalists continue to work in the healthcare field generally, although this could be due, at least in part, to a much higher percentage of individuals with MDs in the alumni group than in the finalist group. The more striking difference is the higher proportion of fellowship alumni who continue in careers in health technology innovation compared to the finalist pool. This suggests (but, of course, does not prove) that there is a positive impact of the program on career trajectory, which aligns with the report of the alumni that their training in Biodesign had a major impact on their choice of career.","title":"The Impact of Postgraduate Health Technology Innovation Training: Outcomes of the Stanford Biodesign Fellowship"}
{"_id":"6964cff1-60eb-ec68-9eaa-a639469acd57","text":"Skin type was assessed by questions from the well-established Fitzpatrick scale [16] about how their skin responds to the sun and if their skin tans. A skin type score was created by assigning each question a range of 0 to 4, where 0 represents a person who never burns and always tans, and a 4 is a person who always burns and never tans; the two skin type questions were then summed to create a score ranging from 0 to 8.","title":"Attitudes and Behaviors That Impact Skin Cancer Risk among Men"}
{"_id":"6972c8d6-1356-32fb-ddaa-b07b94c13555","text":"Improving the diversity of leadership teams is in an important component of improving health equity, as diverse leaders can help reduce the cultural gap. Different backgrounds benefit patients and improve recruitment of future physicians underrepresented in medicine. There are immediate strategies that can be used to improve diversity, including acknowledging that systemic bias is prevalent and investigating the hiring process to see where it lies. Widely promoting open positions and implementing blinded screening policies for new hires can help diversify the hiring pool and avoid the pitfalls of implicit bias during the hiring process. Implicit bias training, diversifying search committees, and implementation of holistic review in the hiring process are also all positive steps to diversify leadership. Additionally, making diversity and health equity a stated goal of the entire health system can focus priorities across the campus on making clear and concrete steps toward improvement. This requires structural change to eliminate barriers toward advancement that many women and individuals from racial and ethnic minority groups have faced, including inadequacy of mentoring, lack of protected time for academic scholarship, and bias in promotion to midlevel leadership positions (eg, department head, chair, or vice chair). The baseline information provided by this study could serve as a comparison for the future to measure how successful diversity initiatives have been.","title":"Racial, Ethnic, and Gender Representation in Leadership Positions at National Cancer Institute–Designated Cancer Centers Racial, Ethnic, and Gender Representation in Leadership Positions at NCI-Designated Cancer Centers"}
{"_id":"697715ca-a5a8-8df5-342a-e90c25ed171c","text":"The principle of delayed consent is an established principle in trials that include critically ill patients and has been considered acceptable from research participants’ perspectives [16]. Due to the nature of the study setting, patients will be transported from the emergency room to the operating room for emergency surgery, often without full consciousness. The emergency circumstances require prompt action and generally provide insufficient time and opportunity to locate and obtain consent from each patient’s legally authorized representative. Therefore we cannot practically carry out the research without the use of delayed consent. Patients who have acute surgery enter the study under presumed consent. Patients are then informed and written consent for continuation in the trial is collected at the fist appropriate time in the postoperative period.","title":"Negative-Pressure Wound Therapy Versus Standard Treatment of Adult Patients With Conflict-Related Extremity Wounds: Protocol for a Randomized Controlled Trial"}
{"_id":"697869cb-2f43-5aab-f031-60a0980e9561","text":"The University of Cape Town does not have the capacity to provide meaningful ongoing academic support to the fellows upon their return to their home countries. This has created a window of opportunity for members of the AAO-HNS to step in and provide ongoing support for these head and neck surgeons to establish and grow their head and neck programs.","title":"Educational workshops with graduates of the University of Cape Town Karl Storz Head and Neck Surgery Fellowship Program: a model for collaboration in outreach to developing countries"}
{"_id":"6979b724-c247-2a28-f102-eaeafad24ab3","text":"Conflict of Interest:The author of the critical review personally believes that tongue tie is extremely rare and very seldom causes breast feeding problems. His belief could have subconsciously influenced the selection of this paper for critical analysis and opinions expressed therein.","title":"Release of Tongue-Tie in Neonates"}
{"_id":"697e383c-310e-347c-7d2a-e870e80cdee7","text":"When performed in a multidisciplinary team to ensure the oncologic safety, breast reconstruction represents an important stage in the treatment of breast cancer.","title":"Prediction factors for breast reconstruction postoperative complications"}
{"_id":"6988b00b-a9ed-c891-4051-a63debf471b8","text":"Dynamic VAS scores at rest and on cough showed that bilateral TPVB provided effective analgesia with a rapid onset, supporting the use of bilateral TPVB in the PACU as an effective rescue analgesic technique. The rapid onset could be explained by the spinal nerve in the thoracic paravertebral space lacking both an epineurium and part of the perineurium, and with only a thin membranous root sheath. All these could enhance rapid local anaesthetic penetration, providing effect and rapid analgesia [20]. A mild decrease of systolic pressure without further treatment at 10 min after block and no changes of heart rate and SPO2 indicated that bilateral TPVB has minimal inhibitory effects on cardiorespiratory system.","title":"Bilateral thoracic Paravertebral block for immediate postoperative pain relief in the PACU: a prospective, observational study"}
{"_id":"6990320e-1c5b-39d9-2fc1-9d34b69b1fba","text":"Future perspectives in this topic concern investigation of the educational value for residents and junior surgeons in the learning of surgical skills.","title":"Exoscope and operative microscope for training in microneurosurgery: A laboratory investigation on a model of cranial approach"}
{"_id":"6991523e-1422-f41a-b16f-657fe6e269db","text":"There are limitations to this study. We did not compare this new approach for identification of SLNs directly with the current gold standard of using radioactive isotope. There were small numbers of animals in the study making firm conclusions difficult to make. Furthermore we do not have longitudinal data to provide information on the dynamic changes in fluorescence of the primary tumour size.","title":"Sentinel lymph node mapping using ICG fluorescence and cone beam CT – a feasibility study in a rabbit model of oral cancer"}
{"_id":"6995053c-8831-ef74-7933-d569586732fc","text":"Finally, cutometric measurements of skin elasticity and hydration were also performed before the treatment and at 21 and 150 days after the treatment using Courage + Khazaka Multi Skin Test Center MC 1000.","title":"HA PEGylated Filler in Association with an Infrared Energy Device for the Treatment of Facial Skin Aging: 150 Day Follow-Up Data Report"}
{"_id":"69994372-660e-9e04-4d3e-7aac7161ba21","text":"Surgery and\/or systemic chemotherapy for metastatic lesions could increase the survival of patients with distant metastases who underwent surgical resection of the primary tumour. Complete surgical excision of the primary tumour with negative margins remains the only proven curative treatment. We recommend a multidisciplinary treatment for patients with MPNST with aggressive features to maximise a good prognosis.","title":"Clinical Outcomes and Prognostic Factors for Patients with Malignant Peripheral Nerve Sheath Tumour"}
{"_id":"699e4a25-ffaa-9842-d1f3-a37541ae2599","text":"The single most important step that plastic surgeons can make to ensure that their patients attain the highest level of psychosocial rehabilitation is to develop a consistent and trusting relationship with a mental health professional whom one can confidently and enthusiastically refer your patients.","title":"Psychological issues in acquired facial trauma"}
{"_id":"69a402dc-41ab-9214-6d33-cbaca578389e","text":"In general, an association between skin cancer and a second primary cancer could reflect shared aetiologic factors or biased ascertainment of new primaries as a result of increased surveillance (Schottenberg 1996). It should also be noted that individuals who are at a high risk of skin cancer may have other risk-taking behaviours related to their increase in risk of a second primary cancer such as smoking, dietary intake and physical activity levels.","title":"Second primary cancers in patients with skin cancer: a population-based study in Northern Ireland"}
{"_id":"69b09f3e-b496-093a-3e2f-d208f8f3e96e","text":"When analyzing total scores, the variables that contributed to intellectual functioning and behavioral changes were associated with general anosognosia. The findings differ in this regard from the general pattern observed in pAD patients where mainly behavioral changes contributed to general anosognosia.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"69b0bd3f-e0de-5f9a-cbdd-b3c57b494d14","text":"Another interesting and new consequence of a positive SLNB is that it recently has become the gateway to adjuvant immunotherapy for melanoma patients.34 The role of immunotherapy in DM was investigated by Eroglu et al., who conducted a retrospective analysis that showed that patients with advanced DM appeared to have higher response rates and favorable clinical outcomes to adjuvant immunotherapy compared to patients with other advanced melanomas, possibly due to a higher mutational load in DM.35 One of the proposed criteria to consider adjuvant therapy in melanoma in general is a positive SLNB.36 The question remains whether a positive SLNB is a relevant criterion in DM patients for the indication of adjuvant therapy too.","title":"Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival"}
{"_id":"69c364b1-77da-b385-bee2-87013d60c284","text":"The graft material could be introduced without vigorous force through 14 to 18 gauge needles or blunted tip lipofilling cannulas with 1.3-1.7 mm internal diameters, and the process of injection was incremental and cautious. Repeated visual and tactile evaluation was performed until adequate volume was injected. Final molding of the injected material could be done with gentle massage of the overlying skin if it was not injected into a tight pocket.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"69c8a297-30d2-b0c4-21b6-bc700acba243","text":"It is important to underline that the removal of the crown allows from a clinical point of view a better access to the pocket and to the surface to be decontaminated.","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"69cfa665-8bd3-9283-edb4-b49614caf0e8","text":"Our study demonstrates a positive correlation between female members and women on the Board of Directors in regional and state orthopaedic societies. Twelve societies had female presidents within the past 10 years. Female representation in leadership positions may help with the recruitment of female orthopaedic surgeons and improve diversity in orthopaedics. Future studies should evaluate different methods of increasing female membership and leadership positions in state and regional orthopaedic societies.","title":"Women in Leadership in State and Regional Orthopaedic Societies"}
{"_id":"69d0a884-be5a-65b8-325b-2334f6692bc1","text":"The combined treatment with radiotherapy showed a significantly longer progression-free survival than surgical resection alone (p smaller than 0.001). Extremities could be preserved in all patients treated with combined surgery and radiotherapy for tumours located in the limb, whereas amputation was necessary for 23% of patients treated with surgery alone. A comparison of PFS for tumour locations proved the abdominal wall to be a positive prognostic factor and a localization in the extremities to be a negative prognostic factor. Additional irradiation, a fraction size larger than or equal to 2 Gy and a total dose larger than 50 Gy to the tumour were found to be positive prognostic factors with a significantly lower risk for a recurrence in the univariate analysis. This analysis revealed radiotherapy at recurrence as a significantly worse prognostic factor compared with adjuvant radiotherapy. The addition of radiotherapy to the treatment concept was a positive prognostic factor in the multivariate analysis.","title":"The impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients. A study of the Rare Cancer Network"}
{"_id":"69d54b85-a9a6-b519-7c8f-7f95b1045426","text":"3D-navigation is accurate in the preclinical setting for guiding saw planes and is more accurate than unnavigated cutting when executing a computerized virtual surgical plan. The distance from the intended resection margin that 3D-navigated osteotomies should be planned using the present navigation system is certainly within 5 mm and may be a distance of 3 mm. For osteotomies virtually planned at a distance of 10 mm from the edge of the bone tumour, the present navigation system would produce a negative (5 mm) bone margin in greater than 99% of cases.","title":"Accuracy and reproducibility of virtual cutting guides and 3D-navigation for osteotomies of the mandible and maxilla"}
{"_id":"69d86b6e-4830-21c2-59f8-ca3089316a0c","text":"Do you have any suggestions for changes of the trauma team?","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"69de8f10-214b-aef8-6c4f-35b77d642a89","text":"A major assumption of symbolic interactionism is that meaning arises out of the process of interaction between people, resulting in possible ways of acting. That is, the search for possibilities for an interactive care in the field of breast health should take place in the first opportunity, and the health service should evaluate the potentialities of this encounter and the perceptions\/impressions caused.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"69ef50d8-210e-b875-6e69-c8e0fb68c468","text":"All rats were observed for signs of ill health or overt toxicity. The injection sites were examined approximately 1 to 2 h after dosing for any signs of inflammatory skin reactions.","title":"Preclinical studies on the toxicology, pharmacokinetics and safety of K1-70TM a human monoclonal autoantibody to the TSH receptor with TSH antagonist activity"}
{"_id":"69f54bd9-92be-bc06-4ae3-544903c9f581","text":"There are two requirements for emergent leadership: a culture generated by those in formal positions of authority that views leadership as adaptive, distributed and not restricted to their roles alone, and an enabling and confidence in staff across the service to exercise leadership. This might require a rehearsal of what leadership means in different contexts as well as explicit permission and clarity regarding accountability. This particularly applies to services where an entrepreneural approach is developing in the context of traded services. Within the service there will then be a unique discourse on leadership with which all staff can identify.","title":"Leadership of education psychological services: fit for purpose?"}
{"_id":"6a0a7fad-ba69-1a7c-35cd-aa597df65c7e","text":"The main goal of this study was to elucidate the profiles of IMGs who have successfully matched into US plastic surgery programs, and key findings include the extensive research experience of integrated IMGs and the strong USMLE examination performances of independent IMGs.","title":"International Medical Graduates in the US Plastic Surgery Residency: Characteristics of Successful Applicants Kokosis et al"}
{"_id":"6a0c17db-eb19-f2b5-5a7a-48ee16bd5ce1","text":"First, this is a systematic review specifically focused on correlation between XP and skin cancers that was never been conducted before.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"6a16d3aa-9535-7144-a2a6-05b3d80c916b","text":"The testing for hypercoagulable states in an individual after a single episode of thrombosis is a costly, yet routine procedure in many centers. The common assumption that an identified presence of a thrombophilic abnormality increases the risk of recurrence, and justifies prolonged therapy is without clear supportive evidence. A review of the current literature concerning the treatment of individuals with coagulation deficits concludes that there is no clear evidence that modifying treatment because of an identified hypercoaguable state alters the outcome, or that more intensive therapy is required in patients with laboratory evidence of thrombophillia [3].","title":"Traumatic deep vein thrombosis in a soccer player: A case study"}
{"_id":"6a244488-26cd-749c-8e37-869c913605c9","text":"Patients have been followed up for six months. The morning after the surgery, dressings were removed and the surgical site was cleansed gently with saline solution. Most patients healed and shed the scabs in 7-14 days. In group 5, there was an initial false growth of hair for approximately three to four weeks, subsequently those hairs shed and there was no growth of hair up to two to three months. Thereafter the hairs reappeared and significant growth of hair was noted at six month after surgery. In group 1 widening of suture line after total excision with direct closure was noted in one case and accepted by the patient.","title":"Surgical treatment of secondary cicatricial alopecia of scalp and eyebrow"}
{"_id":"6a287b83-5c93-a87b-76ee-097df0673a00","text":"Red dots represent individual planktonic cells while green dots represent biofilm embedded bacteria with blue dots showing protective microstructures","title":"Physical Approaches to Prevent and Treat Bacterial Biofilm"}
{"_id":"6a29701e-35d7-54b0-f4f7-1a1c269f4035","text":"Liposuction surgery is defined as a surgical procedure applied to remove fat from subcutaneous tissues by using metal cannulas that are placed through small incisions. Liposuction can secondarily worsen the degree of cellulite by reducing the amount of subcutaneous fat [8].","title":"Comparison of Extracorporeal Shock Wave Therapy versus Manual Lymphatic Drainage on Cellulite after Liposuction: A Randomized Clinical Trial"}
{"_id":"6a2b0449-5d52-ce63-974f-c14bb542509f","text":"One patient in group A and one patient in group B complained of dizziness after the procedure, but the symptoms improved within a week without any particular treatment.","title":"Lumbar Sympathetic Block with Botulinum Toxin Type A and Type B for the Complex Regional Pain Syndrome"}
{"_id":"6a2b713c-d402-e8cc-7b25-58485b1cacd5","text":"We experienced a case of cervical spine osteomyelitis and epidural abscess after CCRT for head and neck carcinoma. Cervical spine osteomyelitis after CCRT for head and neck carcinoma is a complication to guard against, since it can lead to a fatal outcome if the condition worsens. Our results suggested that posttreatment necrosis of the posterior pharyngeal wall mucosa can develop into cervical spine osteomyelitis. If the risk associated with surgical treatment is high, HBO is thought to be an effective alternative treatment method.","title":"Cervical Spine Osteomyelitis and Epidural Abscess after Chemoradiotherapy for Hypopharyngeal Carcinoma: A Case Report"}
{"_id":"6a2bb347-f50c-4c6e-3a5d-a4418c65afa8","text":"Removal of all six levels is not always required due to the lymphatic pathway of head and face drainage.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"6a2d6d8a-6d7e-76e2-401c-a5bb0573b6d5","text":"The revolution in various forms of media and social networking channels has made the conditions treated by plastic surgeons more recognizable. Medically themed series such as Grey’s Anatomy and House seem to be significantly associated with better awareness of plastic surgery among the students in our study. The internet and social media are considered a rich source of information for plastic surgery, as the majority of students identified them as their sources of information. Considering new trends in social media and the advertisements that serve to educate students about cosmetic surgery, the use of the internet and social media tools to promote a more accurate and realistic portrayal of medicine should be strongly advocated.","title":"Perception of Plastic Surgery and the Role of Media Among Medical Students: Cross-Sectional Study"}
{"_id":"6a32658d-c205-3b44-dc79-3698699cc90e","text":"It is essential to involve clinicians in the decision-making involving education and training and workforce planning. Clinicians are best placed to know what courses and training are required for specific postgraduate programmes as well as advising on appropriate quality assurance. Taking into account the views of doctors and other professionals in local plans is important for getting the content of such education and training right. Involvement will improve clinician confidence in the new arrangements [20]. Although amendments to the Care Bill now require that the boards of LETBs include persons with clinical expertise, the majority of board members with clinical backgrounds are in management roles, primarily representing providers, rather than the training and education needs of doctors. With only four surgeons currently involved at LETB board level, it is also a concern that in many LETBs the surgical voice may be lost amongst other competing disciplines. It is therefore important that surgeons, if not represented at board level, are willing engage with the LETB advisory groups in order to promote the needs of surgical training locally.","title":"Health Education England, Local Education and Training Boards (LETBs) and reform of healthcare education: implications for surgical training"}
{"_id":"6a377208-2efc-2000-a88f-724f9ee27448","text":"A fifty seven year old male presented with suspected allergy. He gave a nine month history of three episodes of lip and tongue swelling which were not associated with any other swelling or rashes. The attacks always occurred during the night and there was no temporal association with food or drugs. The patient also suffered from hypertension for which he had been taking lisinopril for two years. The lisinopril was stopped, the patient commenced on alternative anti-hypertensive medication and the angioedema resolved, consistent with a diagnosis of ACE inhibitor sensitivity. The patient was advised to avoid ACE inhibitors in future.","title":"Complexity of case mix in a regional allergy service"}
{"_id":"6a46c98b-21a0-6ca1-362b-12b5d240042f","text":"Given the previous points and the wide clinical use of BTK inhibitors, physicians should be aware of the risk to develop severe invasive mycosis.","title":"Severe Fatal Mucormycosis in a Patient with Chronic Lymphocytic Leukaemia Treated with Zanubrutinib: A Case Report and Review of the Literature"}
{"_id":"6a4b132c-e1ae-6d01-612e-5cef536477ab","text":"The major limitation of our study was small sample size which limits power to detect associations reflecting relative rarity of this condition in clinical practice. Furthermore, the biochemistry profile presented was limited to at the time of diagnosis and within 6 months after and did not address daily changes which may have occurred in the course of followup of the subjects. Nonuniformity of treatment of calciphylaxis also makes it hard to conclude outcome as poor as reported. Furthermore, contribution of other risk factors of ischemic heart disease was not assessed in spite of myocardial infarction being one of the common causes of death in the study population. Lastly, it is important to note that there is a limitation to retrospective studies in general. Observations derived from such studies may contain some missing information and thus may serve as a stimulus to further prospective work to clarify findings. The present work must be interpreted in the knowledge of the defects inherent in such studies. Despite these, our result is consistent with other reports [2, 10]. The study has further suggested calciphylaxis, a syndrome with high mortality irrespective of mode of care.","title":"Calcific Uremic Arteriolopathy on Multimodal Combination Therapy: Still Unmet Goal"}
{"_id":"6a4df8b0-8b30-811b-8281-54994edfc536","text":"Due to poor initial experiences with the trans-cutaneous visualization a sub-platysmal flap was raised and the sternocleidomastoid muscle was retracted before the Infra red camera was directed to the area. Time from injection to identification was more than 30 minutesinitially, but brought down to 5 minutes or less in the latter cases where the lymphatic drainage pattern could be seen in real time on the video screen.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"6a5024c7-1969-e6a0-5c8d-445432cf1e9d","text":"In conclusion, routine preoperative carotid and femoral duplex scans are easy and feasible investigations that can influence the decision making of revascularization and conduit planning. They can help reduce the risk of postoperative complications including cerebrovascular accidents, peripheral limb ischemia, and delayed leg wound healing by performing CEA preoperatively if needed or by adopting bypass strategies to avoid brain hypoperfusion on bypass. LL arterial duplex can also help plan for the most suitable site for IABP insertion whenever needed.","title":"Assessment of carotid artery stenosis and lower limb peripheral ischemia before coronary artery bypass grafting operations: a non-randomized clinical trial"}
{"_id":"6a5029b2-8340-943c-b7b2-6df8fdefc889","text":"Infectious diseases continue to be a significant cause of morbidity and mortality, and although efficacious vaccines are available for many diseases, some parenteral vaccines elicit little or no mucosal antibodies which can be a significant problem since mucosal tissue is the point of entry for 90% of pathogens. In order to provide protection for both serum and mucosal areas, we have tested a combinatorial approach of both parenteral and oral administration of antigens for diseases caused by a viral pathogen, Hepatitis B, and a fungal pathogen, Coccidioides. We demonstrate that co-administration by the parenteral and oral routes is a useful tool to increase the overall immune response. This can include achieving an immune response in tissues that are not elicited when using only one route of administration, providing a higher level of response that can lead to fewer required doses or possibly providing a better response for individuals that are considered poor or non-responders.","title":"Co-Administration of Injected and Oral Vaccine Candidates Elicits Improved Immune Responses over Either Route Alone"}
{"_id":"6a52f4d6-6915-7122-2524-caaa7a6d29f6","text":"Treatment with thalidomide produced a sustained major clinical improvement in a case of JDM with inflammatory calcinosis refractory to the conventional corticosteroids and immunosuppressants and even to etanercept.","title":"Efficacy of thalidomide in a girl with inflammatory calcinosis, a severe complication of juvenile dermatomyositis"}
{"_id":"6a5503a6-04db-1322-1715-e86661639122","text":"The study was completed in 19 subjects, as one subject withdrew during the study due to syncope associated with hearing their blood flow through the ultrasound machine. The characteristics of the participants are shown in Table 1.","title":"Efficacy of Micromobile Foot Compression Device in Increasing Lower Limb Venous Blood Flow"}
{"_id":"6a5cda48-4b96-ef70-b578-8d8a535540c0","text":"Delayed reconstruction had a significantly higher incidence of infection and wound dehiscence when compared to immediate reconstruction in the sarcoma limb salvage patient population. Immediate reconstruction may reduce the morbidity associated with this complex reconstruction.","title":"Immediate versus Delayed Sarcoma Reconstruction: Impact on Outcomes"}
{"_id":"6a5efdca-c1ea-d975-be60-3a29ecad7236","text":"This national multicenter trial prospectively enrolled clinically node-negative breast cancer patients planned for NAST at 13 recruiting Swedish hospitals between October 2010 and December 2015. SLNB before NAST was followed by ALND after NAST in all individuals. Repeat SLNB after NAST was encouraged but not mandatory.","title":"Swedish prospective multicenter trial on the accuracy and clinical relevance of sentinel lymph node biopsy before neoadjuvant systemic therapy in breast cancer"}
{"_id":"6a6dce2d-4d18-93d2-035e-dcefda90d382","text":"The results of this study demonstrate that both CT and US accurately identify superficial soft tissue abscesses, but US demonstrated a superior sensitivity and CT demonstrated a superior specificity. The question of how to integrate CT and US into the care of patients with suspected superficial soft tissue infections is a matter of debate, but the role of an imaging modality in these patients is not dictated solely by the sensitivity and specificity of the diagnostic modality. CT provides details concerning distant structures such as underlying bone, muscle and organs that may not be visualized during sonographic imaging due to the limited depth imaged by ultrasound. In contrast, US is a dynamic imaging modality that provides information not available by CT, such as streaming of abscess purulence with manual pressure or the ability to dynamically guide surgical drainage. Other aspects of US such as the use of Doppler imaging have also been shown to be useful in diagnosing superficial abscesses [7]. It is not clear why ultrasound was more sensitive than CT for soft tissue ultrasound, but we speculate that this is due to the ability of ultrasound to provide greater submillimeter detail combined with the ability of ultrasound to provide dynamic imaging. The higher sensitivity of US relative to CT supports the use of US as the initial imaging modality. CT can be reserved for cases where either the US images are unclear or the abscess cavity extends into deeper tissue planes.","title":"Comparison of computerized tomography and ultrasound for diagnosing soft tissue abscesses"}
{"_id":"6a6dddda-8629-5c2b-148e-fe4ce00b1e0a","text":"The primary outcome of this study will give a more decisive answer to the question of whether a dangling protocol is necessary after a free flap reconstruction of the lower leg. The secondary outcomes of this study will provide a better insight into the physical functions, infection rates, and union rates in these patients.","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"6a71e3ee-90e7-cbdf-8768-535fd1620e7d","text":"These morphological changes of the lips become an obvious sign of aging. Repetitive and underlying action of the orbicularis oris muscle leads to the formation of visible fine vertical rhytides surrounding the lips. The effects of gravity coupled with loss of lip volume and support cause the upper lip to lengthen and the lip to fall vertically. As collagen production diminishes, the Cupid's bow and vermilion border lose their distinction,1 and the inability to conceal these signs of aging may be correlated with increased anxiety and depression.2","title":"A prospective, open-label, multicenter, observational, postmarket study of the use of a 15 mg\/mL hyaluronic acid dermal filler in the lips"}
{"_id":"6a7281ef-28de-31f7-c17b-4e3bfc048b25","text":"These patients should undergo speech therapy and oropharyngeal exercises prior to any surgical procedure, in order to avoid glossoptosis and improve their quality of life and sleep apnea results.","title":"Does Frenotomy Modify Upper Airway Collapse in OSA Adult Patients? Case Report and Systematic Review"}
{"_id":"6a754a87-defe-f8ba-cd82-b0945f9a4e3c","text":"When the draining lymph node basins are clinically unaffected (clinical stage I or II), sentinel lymph node biopsy (SLNB) procedure should be considered.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"6a78d7d9-f1cd-9fbb-bade-89bb314f2601","text":"The details of the initial treatment method and the number and type of operations performed prior to the tibialization of fibula were recorded. Patients were subjected to routine investigations for surgery, and X-rays were obtained of the affected leg. A segmental bony defect was defined when there was no radiographic evidence of contact between the bone ends on either side of the nonunion on two orthogonal views. If a gap was present, it was measured from the point at which at least 50 % of the diameter of the bone was present in the proximal fragment to the corresponding point on the distal fragment on a radiograph. In patients with chronic osteomyelitis, initially active infection was managed with serial debridements followed by intravenous antibiotics. Before starting treatment, the patient’s guardians were made to understand the real situation as well as possible future outcomes. Informed consent was obtained from all families.","title":"The Huntington procedure: still a reasonable option for large tibial defects in paediatric patients"}
{"_id":"6a7b1701-7a7b-a215-a004-10a47848fd35","text":"The surgeon is often confronted with an intraoperative dilemma of how much to remove because there is a poor delineation between normal bone and necrotic bone.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"6a853bd1-385a-c725-7e8f-a10654e13340","text":"3D reconstruction of the 2D CTA liver image taken from the dataset was performed using the ENURBS algorithm, and then, preoperative planning of the surgical method was done using VSP. This section deals with the simulation results and their detailed explanation. The influence of our approach on liver resection was evaluated based on the performance metrics such as accuracy and prediction time. Simulation graphs were obtained using MATLAB. Figure 2 shows the sample of a 3D reconstructed liver tumor model of a 2D CTA image considered from the dataset.","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"6a8b8b74-dd57-85ed-ef4f-7deacd8e8844","text":"This study showed that the skin manifestations related to melanoma cancer therapies varied widely. The therapies showed an acceptable skin toxicity profile compared to the survival benefits in particular the target therapy showed no serious toxicities and in limited numbers. In a recent retrospective study it was shown that with low doses of cortisone it is possible to control cutaneous adverse events without significant associations with survival outcomes.","title":"Cutaneous side effects and types of dermatological reactions in metastatic melanoma patients treated by immunotherapies or targeted therapies: A retrospective single center study"}
{"_id":"6a8d266f-4554-6afd-7804-dc7c02771c9b","text":"Consistent with a review summarizing the prognosis of skin lesions at 12 to 16 weeks, this cohort study identified an increasingly favorable prognosis for all 3 therapies as the follow-up duration increased until a year. The finding highlights the importance of enhancing patient adherence to therapies, especially for those who might not respond in a month after treatment initiation. Since the increase from a favorable prognosis was greater than that from an unfavorable prognosis, improved patient adherence may lead to better patient satisfaction. Nevertheless, a considerable number of patients with moderate skin lesions did not respond to any of the 3 therapies after a year of treatment, a finding suggesting that more dynamic biologic therapy strategies for patients with less severe skin lesions are needed to improve patient satisfaction.","title":"Modeling Posttreatment Prognosis of Skin Lesions in Patients With Psoriasis in China Modeling Posttreatment Prognosis of Skin Lesions in Patients With Psoriasis in China"}
{"_id":"6a94f6ca-462c-0c4c-3d43-2c4091f0cd12","text":"TMJ ankylosis is a challenging condition that requires individualized treatment approaches. Orthomorphic correction is a viable surgical option for patients with adequate mouth opening but persistent facial deformity. The utilization of an STL model for surgical planning enhances precision and allows for better visualization of the corrective procedure. Harvesting cancellous bone graft from the anterior iliac crest offers a reliable source for reconstructing the bone defect caused by the orthomorphic rotation of the lower jaw. The satisfactory postoperative healing and favorable outcomes observed in this case highlight the effectiveness of orthomorphic correction in addressing facial asymmetry resulting from long-standing TMJ ankylosis.","title":"Orthomorphic Correction for Facial Asymmetry in a Patient With Long-Standing Temporomandibular Joint Ankylosis: A Case Report"}
{"_id":"6a9f8a87-c081-adf3-3ef9-4219a6d3f52e","text":"The ability to radiate confidence and calmness was highlighted by several team members. One nurse said that if the leader seems confident she feels confident too. A young surgeon recalled a situation where he experienced a leader who remained calm in a stressful situation and emphasized that this had made a big impression on him.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"6a9f99fe-9164-0c2f-b967-4945bb32ddfc","text":"Laparoscopic abdominal surgery may prove difficult in patients who have undergone previous abdominal procedures. No reports in the medical literature have presented an aborted laparoscopic procedure for failed pneumoperitoneum following autologous flap-based breast reconstruction.","title":"Failed pneumoperitoneum for laparoscopic surgery following autologous Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction: a case report"}
{"_id":"6aa2c500-e324-d10c-b28f-b6c6fafda04f","text":"The introduction of laparoscopic simulated training program may increase the number and complexity of total and laparoscopic procedures in a three-year General Surgery Residency.","title":"IMPACT OF A SIMULATED LAPAROSCOPIC TRAINING PROGRAM IN A THREE-YEAR GENERAL SURGERY RESIDENCY IMPACTO DE UM PROGRAMA DE TREINAMENTO LAPAROSCÓPICO SIMULADO EM RESIDÊNCIA DE CIRURGIA GERAL DE TRÊS ANOS"}
{"_id":"6aaaebe4-2aa3-ddf0-578c-61cce6e82916","text":"Although the fibula osteocutaneous flap is a reliable choice for maxillofacial reconstruction, flap harvesting is fairly difficult. Accordingly, surgeons must be aware of anatomical variations of the flap and have a suitable case selection to minimize the risk of surgical complications.","title":"Evaluation of Anatomic Variations of Fibula Free Flap in Human Fresh Cadavers"}
{"_id":"6ab5986c-1d46-0475-9c5c-d4ec2cc1e8d3","text":"A significant proportion of the patients with primary free flap reconstructions after oral cancer surgery develops postoperative complications. Prolonged anaesthesia time and red cell transfusion are possible predictors for systemic complications and hospital stay respectively. Preoperative screening for risk factors is advocated for patient selection and to have realistic information and expectations.","title":"Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction"}
{"_id":"6ab7cabe-2dfc-498f-2f27-73e6f7b9a7cc","text":"Color flow imaging was used to interrogate the luminal stenosis or occlusion. The color scale and color gain were adjusted to make sure the flow was shown in the lumen without saturating the stent walls and the surrounding tissues.","title":"Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting"}
{"_id":"6ac0b4b4-f7ff-1c3b-05ee-c498763e48cc","text":"This Swedish multicenter trial evaluates the accuracy of SLNB in the neoadjuvant setting. In the present part of the trial, SLNB was attempted after NAST together with concomitant ALND in 195 T1–4d breast cancer patients with biopsy-proven lymph node metastasis at diagnosis. The results of the other part of the same trial regarding cN0 patients in whom SLNB was performed before and ALND after NAST are reported separately.","title":"Swedish prospective multicenter trial evaluating sentinel lymph node biopsy after neoadjuvant systemic therapy in clinically node-positive breast cancer"}
{"_id":"6acc141c-0273-ece6-fff7-0a46fc6aae86","text":"Older age was also associated with worse RFS and MSS whereas it was not associated with SLN positivity. In a recently reported multi‐institutional study of 1524 patients with cutaneous melanoma greater than 1 mm in thickness also showed a similar result; older age was not associated with SLN positivity but was associated with worse DFS and OS 33.","title":"Clinical impact of ulceration width, lymphovascular invasion, microscopic satellitosis, perineural invasion, and mitotic rate in patients undergoing sentinel lymph node biopsy for cutaneous melanoma: a retrospective observational study at a comprehensive cancer center"}
{"_id":"6ad26ff8-a3c3-3ae6-9094-e4f44b04b035","text":"Table 2 Antimicrobial therapy characteristics according to the timing and level of microbiologic results","title":"Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units"}
{"_id":"6ad36d9b-d797-6611-df28-026efebcf511","text":"In this presentation we share our experience with a patient whom we managed with an island latissimus dorsi muscle and a perforator flap, thus obviating the need for the use of fascial graft and laminectomy.","title":"Island Latissimus Dorsi Muscle Flap and a Perforator Flap in Repairing Post-Gunshot Thoracic Spine CSF Fistula: Case Presentation"}
{"_id":"6ad52e82-2f5e-87ea-97a0-5f2c65e64d15","text":"Topical NPWT was applied with the VISTA system, as EZCARE was not available then in the United Kingdom. NPWT was applied for 10 days to prepare the wounds for skin grafting.","title":"Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective"}
{"_id":"6ad9ed32-b179-b8b5-2300-0a01be0ab04b","text":"Merkel cell carcinoma is a rare and aggressive neuroendocrine-derived skin cancer arising most commonly on the sun-exposed head and neck skin of elderly and immunocompromised patients. Although a combination of wide excision and adjuvant radiotherapy is the optimal therapeutic approach for Merkel cell carcinoma, radiation monotherapy has recently been recommended for unresectable tumors. We report here a case of Merkel cell carcinoma treated with radiation monotherapy and reviewed Merkel cell carcinoma cases treated with radiotherapy alone in Japan. A 75-year-old man was referred for treatment of a tumor on the upper lip with a swollen submental lymph node. The histopathological diagnosis from biopsied material was Merkel cell carcinoma (T3N1bM0, stage IIIB). The submental lymph node was extirpated and radiation monotherapy was applied according to the 2014 National Comprehensive Cancer Network Guidelines because the Eastern Cooperative Oncology Group Performance Status of the patient was grade 3 and the patient and his family did not desire surgery. The primary site and bilateral upper neck regions were irradiated with 45 Gy followed by 20 Gy irradiation for the primary site alone. Three months after radiotherapy, the tumor seemed to have completely remitted. Approximately 1 year after radiotherapy, no evidence of local recurrence or late metastasis has been noted. Radiation monotherapy should be considered as a curative treatment for Merkel cell carcinoma, particularly in situations where extensive surgery is not favored.","title":"Complete remission of Merkel cell carcinoma on the upper lip treated with radiation monotherapy and a literature review of Japanese cases"}
{"_id":"6adcda26-e877-0895-2a58-c9d764949b72","text":"The reconstruction itself can be divided into primary wound closure and functional reconstruction. Primary closure attempts should only be performed when a tension free closure can be guaranteed and after an evaluation of aggravating factors for wound healing such as irradiation. In all other cases, defect reconstruction is indicated, to prevent complications due to insufficient skin closure. In our study, 6\/21 patients developed complications after primary wound closure and five out of those six patients needed secondary flap reconstruction after the primary wound turned out to be insufficient.","title":"Interdisciplinary Surgical Therapy of Extremity Soft-Tissue Sarcomas: A Personalized Resection and Reconstruction Algorithm"}
{"_id":"6ae126a1-1336-f6f7-4a6e-418fa9ddf1af","text":"16 of 22 patients did not present any signs of local recurrence or metastases. There were three patients that manifested local recurrence and underwent supplementary ongectomy or mastectomy and are free of recurrence ever since. One patient with metastatic CP died.","title":"Phylloides tumor of the breast: a rare neoplasm, though not that innocent"}
{"_id":"6ae4fba0-80a4-5440-80dd-85a287204269","text":"In multivariate analyses, sociodemographic factors were not associated with breastfeeding at one year. Confidence intervals throughout the multivariate models were large, suggesting a low level of precision and the need for a larger sample size. Data were missing at the one year time point that could not be collected through chart review, which may have provided a more robust set of data for analysis. We did not use any instrument to assess acculturation [44] but rather used proxies of acculturation status such as language use and years in the United States; future studies might use these indicators in addition to validated instruments to assess maternal acculturation.","title":"Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study"}
{"_id":"6ae6fe2e-4310-4215-4128-8156f874b77f","text":"It is interestingly to note that patient has presented pain and irritation of the perianal skin during the period of Imiquimod application and the inflammatory process completely improved after the first 45 days with remaining residual local pruritus.","title":"Rare perianal extramammary Paget disease successfully treated using topical Imiquimod therapy"}
{"_id":"6af3b748-f82c-b581-8881-acaf2a38d8c7","text":"Therefore, since a key factor for the development of respiratory allergy is the exposure to airborne allergens, many avoidance strategies have carried out to reduce allergens exposure to avoid the elicitation of symptoms.","title":"Allergen Avoidance in Allergic Asthma"}
{"_id":"6b01b7f8-1ff4-5cbb-d0e8-037f87738b00","text":"Although there is considerable literature on why students do not choose to specialise in FM, and on what FPs think of their career choices, little local literature is available on the perceptions of other specialists on the role of FM in SA and whether or not they perceive it as an attractive specialisation. The aim of this study was therefore to assess the perceptions of other specialists working in the public sector on the role and value of FM. It is hoped that this research will improve the understanding of and working relationships between FM and other specialists, which are often strained. It is important to understand why the role and place of FM still remains unclear to other specialists, despite the presence of FM training in the country since 2007.","title":"Perceptions of specialists in the public sector, on the role and value of family medicine"}
{"_id":"6b01e5e3-e1cd-4fd4-ac31-4f1e24277208","text":"We conclude that there was no significant difference seen between the efficacy and safety profile of enoxaparin and rivaroxaban in our cancer patient population. While rivaroxaban has recently become popular in cancer associated VTE due to its ease in utilization and comparable results with LMWH in preventing recurrent VTE. Attention also needs to be paid on patient’s disease specific details and demographics before favoring DOACs over LMWH.","title":"Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre"}
{"_id":"6b079db1-ea2a-dcc3-51fd-398e8d0ea72e","text":"We also noted that children aged 6-12 years and adolescents aged 13-18 years showed satisfactory outcomes of surgical procedures as compared to adults aged more than 18 years. In children contractures released were better resurfaced with full thickness skin grafts due to reduced secondary contraction compared with split thickness skin grafts. There are certain limitations of full thickness graft like providing insufficient graft for bigger wounds, hairy grafts and lower graft take rates. Whereas literature showed that the split thickness grafts have early take rate, reduced infection rates and used to resurface larger areas but has some disadvantages such as increased count of secondary contractures and cosmetically less pleasant.17 Full thickness skin graft take is also influenced by infection due to its reduced rate of graft take.18","title":"Surgical Management of Post Burn Hand Deformities"}
{"_id":"6b080760-f889-b53e-3ed5-9a52b2c353ba","text":"The solid‐state detector handheld gamma camera was unable to localize a higher‐echelon node in the head and neck region and only 5 in the groin compared to the 5 and 29 higher‐echelon nodes detected by planar imaging in the head and neck region and groin respectively.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"6b08287c-7894-ef1a-565a-d1ab4dfc1e53","text":"In this paper, we presented a contrast-free ultrasound imaging technique for monitoring the hemodynamic response to pressure cuff induced occlusion in the lower extremity of PAD patients. Metrics were defined to analyze and quantify the variations in blood flow in a baseline state, and after pressure release. These quantification metrics can be utilized to differentiate between affected and unaffected legs and potentially help with more accurate diagnosis of PAD patients before the need for more costly cross-sectional imaging approaches arises. In our future studies, we plan to recruit larger numbers of patients and perform statistical analyses on the proposed metrics to evaluate their discriminatory potential.","title":"Contrast-free ultrasound imaging for blood flow assessment of the lower limb in patients with peripheral arterial disease: a feasibility study"}
{"_id":"6b096d65-0e13-585c-52bf-888e47745ffc","text":"One potential drawback to consider when using the thoracoacromial axis for recipient vessels is that the pectoral branch supplies the pectoralis major muscle, a traditional lifeboat in head and neck cancer patients, however the blood vessels to the pectoralis major flap can be avoided by utilising one of the other branches of the thoracoacromial axis. Consideration needs to be given to the best reconstructive options for the salvage head and neck cancer patient, their general medical conditions and prior reconstructive attempts before planning any further reconstruction operations. The use of the thoracoacromial vessels for microvascular anastomosis following ipsilateral pedicled pectoralis major flap is also safe and has been well documented in the literature [9]. The pedicled pectoralis major flap has its own drawbacks, having limited reach and it is often bulky, which can be an issue when reconstructing a tracheoesophageal or pharyngolaryngectomy fistulae. However, the pedicled pectoralis major flap does retain utility in its reliability and ability to cover larger blood vessels especially post-radiation. With the advent of microsurgery, tailored free tissue transfer offers a wide variety of tissues options and ultimately leads to a superior reconstruction.","title":"The thoracoacromial axis in salvage head and neck reconstructive surgery, a case series"}
{"_id":"6b1768c9-bc13-9e33-7db8-5dd8e088c489","text":"While the efficacy of these agents in producing a variety of different downstream positive effects is clear, these elements largely have not been evaluated against each other for liver ablations. The present study specifically investigates regional peripheral nerve blocks and whether a unilateral or bilateral paravertebral block is more effective in decreasing post-procedural opioid requirements, utilization of general anesthesia, and decreasing rates of admission to the hospital.","title":"Evaluation of paravertebral blocks in improving post-procedural pain and decreasing hospital admission after microwave ablation of liver tumors"}
{"_id":"6b179993-6940-6671-2f6b-62690feb3681","text":"Resident patient satisfaction scores may be another useful tool by which to benchmark program excellence. While this metric is similar to what attending physicians are measured on, it is controversial whether patient satisfaction scores are appropriate markers for quality of care received and physician performance,38–40 and it may be difficult to separate scores about the residents from perceptions of their attendings.37 Despite these significant limitations, training programs have begun to experiment with collecting data on resident-specific patient satisfaction scores and these could be used as one metric for defining excellence for a program.37","title":"Metrics of Resident Achievement for Defining Program Aims"}
{"_id":"6b186148-9bfb-3530-ecdf-bc2477ef350f","text":"Another limitation is the limited number of patients that was possible to include in the study, which does not guarantee a sufficient sample to consider the result obtained valid on a large scale. It would be necessary to conduct a similar study involving a greater number of patients in order to confirm that the results obtained are valid even in presence of a greater number of variables.","title":"Clinical Comparison of Diode Laser Assisted “v-Shape Frenectomy” and Conventional Surgical Method as Treatment of Ankyloglossia"}
{"_id":"6b1c4c4d-f9f2-ad4e-50a5-0dceb009464a","text":"Advantage of gastrocnemius myocutaneous flap is that the flap can cover the defect up to middle third of leg successfully without any complications. In our study, functional loss was not seen in any patient and the contour deformity was acceptable. This result is similar to that found in the study of Kroll et al. who have concluded that functional and aesthetic outcome is acceptable when only one flap is raised. Scar can be avoided by tunneling of the flap beneath skin-bridge.","title":"Gastrocnemius Myocutaneous Flap: A Versatile Option to Cover the Defect of Upper and Middle Third Leg"}
{"_id":"6b1e327f-095b-14cd-b948-b6b63afb0007","text":"Patients with scalp sarcoma have high risk of LR, particularly in cases with positive margins. Adjuvant radiation was not associated with improved local control for close or positive margins. Complete surgical excision to establish negative margins remains the primary standard treatment for patients with this rare disease.","title":"Local Relapse and Survival Outcomes in Patients with Scalp Sarcoma: A Retrospective Study of 95 Patients Treated in a Provincial Cancer Care Institution Over 25 Years"}
{"_id":"6b22b5a0-8528-1118-da4b-de24ff781bfc","text":"The present study based on the patch skin test with TCE and its metabolites in 19 subjects with THS suggested that exposure to TCE is the main cause of THS, and that the category of immune reaction of THS is mainly type IV hypersensitivity. THS is potentially mediated through its metabolite CH. The CH patch test could be potentially useful for the diagnosis of THS and identification of subjects at risk of THS.","title":"Trichloroethylene Hypersensitivity Syndrome Is Potentially Mediated through Its Metabolite Chloral Hydrate"}
{"_id":"6b2ce6d7-9a13-04f8-33fd-1be27ed7ac2d","text":"Additionally, they discussed that the reason for this is that the deep lobe of the parotid gland is adjacent to the parapharyngeal space and is rich in lymphatic vessels, making it easy to recur after cervical neck dissection, and the lymph nodes in the deep lobe may have remained after superficial parotid lobectomy, resulting in recurrence.","title":"Role of Intra-Parotid Lymph Node Metastasis in Primary Parotid Carcinoma"}
{"_id":"6b2de208-b4bd-7a73-c5ef-a2712ecd7ce0","text":"The onset of posttraumatic vascular disease occurs 1 week after the trauma and sometimes up to 12 cm above the lesion. As it is associated with perivascular fibrosis, spasms, and decreased thromboresistance, some authors do not recommend anastomosis of a free flap to a vessel after 1 week or at a distance of less than 10 cm from the traumatic lesion.10","title":"Omentum Free Flap Anastomosed to Arterial Bypass in Open Knee Dislocation: Case Report and Discussion Pauchot et al"}
{"_id":"6b2e0e14-bdc9-3308-b878-b4fa344e8d02","text":"Pelvic varicosities and CPP are typical findings of PVC, although women diagnosed with pelvic varicose veins may be asymptomatic, constituting a diagnostic challenge for gynecologists investigating CPP.6 , 8 Multiparity is a constant in patients with PVC, with complaints of dysmenorrhea and exacerbation of symptoms during or after coitus and when standing for long periods. The origin of PVC is very probably multifactorial and two factors appear to play an important role in genesis of cases. The first is valve incompetence caused by congenital absence of valves or presence of dysfunctional valves and the second is the around 60 times increase in pelvic venous capacity during pregnancy, due to mechanical compression by the gravid uterus and the vasodilatory action of progesterone, which can cause incompetence of venous valves, with subsequent venous hypertension and retrograde flow.2 , 9","title":"Endovascular treatment of pelvic venous congestion syndrome in a patient with duplication of the inferior vena cava and unusual pelvic venous anatomy: literature review"}
{"_id":"6b339d41-e203-0e86-29f5-6412aff582b9","text":"Cervical spondylosis is a common and disabling condition. The initial management should be nonoperative for the first 3 months. Surgery should be reserved for moderate to severe myelopathy patients who have failed a period of conservative treatment and patients whose symptoms are not adequately controlled by nonoperative means. Nonoperative treatment is labour intensive, requiring regular review and careful selection of medications and physical therapy on a case by case basis. More invasive treatments such as epidurals may be of benefit in a select group of patients that do not respond to simpler measures.","title":"Nonoperative Modalities to Treat Symptomatic Cervical Spondylosis"}
{"_id":"6b38ce8b-8bb4-fac1-faa1-1263b733ebb8","text":"Today, axillary lymphadenectomy has remained an essential component of breast cancer surgery. The complete axillary lymphadenectomy is necessary for cases in which mastectomy is performed without postoperative irradiation. A full axillary lymphadenectomy is mandatory for cases with 3 or more positive nodes, for diagnosis and local control of the disease. In less advanced stages of breast cancer, sentinel node biopsy can be considered sufficient to provide a fair picture of the entire lymphatic basin status and can establish the indication for selective lymphadenectomy. By excluding the axillary surgery for breast cancer, conclusions from the currently ongoing clinical trials to evaluate the safety and benefit\/ risk of such a decision are required. The results of this study confirmed the data reported in the field from highly experienced centers.","title":"Modulating the extension of axillary lymphadenectomy for early stage breast cancer"}
{"_id":"6b435125-cd85-29b2-d723-fb862377eaff","text":"Patients with infected metalwork are a heterogeneous group, and often suffer high morbidity and mortality. The modified NPWT technique shows potential as an adjunct in the treatment of complex orthopaedic patients with infected metalwork.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"6b4d43f3-f542-3bfa-7610-08486c68fbad","text":"The study statistician is Lars Lindhagen at Uppsala Clinical Research Center.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"6b512e8d-7d6f-9d29-be03-b11b63f4ff36","text":"The aim of this study was to determine whether the use of antibiotic-impregnated PMMA spacers followed by bone transport with circular external fixation is effective in achieving remission of infection following segmental resection in chronic tibial osteomyelitis. A secondary objective was to determine the external fixation index of these cases and to compare it to those of other authors using traditional Ilizarov methods.","title":"Bone transport through an induced membrane in the management of tibial bone defects resulting from chronic osteomyelitis"}
{"_id":"6b5907aa-096e-a5db-f6b9-3bf410e393be","text":"The initial decision to remove the flexed stifle for the additional observers was the perception that imaging the flexed stifle in a yearling would be difficult and time consuming. The observers did not perceive the flexed stifle as a more difficult component of the examination, and the visualisation of the more caudodistal aspects of the femoral condyles would be important in the search for osteochondral disease. Both observers noted that imaging the tarsus was more challenging reflecting the more complex anatomy. However, confidence improved with practice, and both observers acquired diagnostic images. Both practioners highlighted the importance of having reference images to emulate ensuring the images acquired were consistent and repeatable.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"6b5bc0b5-3cc8-0a4f-4171-928ca4bb01ec","text":"Section’s osseous slice biopsy (SOB) is rarely performed in routine amputations, partially due to additional cost and the threat of increased risk of adverse events. However, the belief that the proximal amputation site distant from the site necessitating the limb amputation is unlikely to be involved in the infectious process, is still frequent and this may explain why SOB is regularly omitted from the amputation site selection process. Data about the probability of the extension of the infectious process affecting the distal site responsible for the amputation, prognostic value are lacking and findings present have only been established by taking superficial microbiology cultures.","title":"Section’s osseous slice biopsy during major amputation of lower extremity: preliminary results of prospective cohort study"}
{"_id":"6b6102f2-5532-e58b-25e8-9078289b005c","text":"The second step is the reduction of the posterior wall. Throughout the procedure, care must be taken to preserve the capsular attachment to all posterior wall fragments to avoid excessive devascularization. A suture can be placed in the capsule to facilitate retraction and visualization of the posterior column reduction. The traction should be released and the femoral head is used as a template for the reduction of the posterior wall fracture. Marginal impaction, when present, requires elevation of the articular surface by a curved chisel or osteotome with additional support obtained by bone grafting the void left following elevation of the impacted segment. The autologous bone graft can be obtained from the greater trochanter. Free pieces of articular surface should then be relocated in appropriate position utilizing the femoral head as a guide. The main wall fragments can then be correctly reduced with the ball spike pusher, followed by provisional fixation with K-wires. Fixation should consist of buttress plating with the adjunctive lag screw fixation when fragment size is sufficient. Lag screws alone do not provide sufficient stabilization. A 3.5 mm reconstruction plate, or acetabluar specialty plates are the traditional implants of choice for buttress fixation. If the fragments are comminuted, small or very peripheral then a spring plate can be applied (Figure 2). This is achieved by cutting a one-third tubular plate through the end hole and placing it over the fragment. The spring plate is slightly over-contoured so that when the reconstruction plate is applied over the spring plate, the captured fragments are held firmly in position. Application of the buttress plate requires the distal portion of the plate to extend low enough on the ischium to permit the most distal screw to be placed into the ischiopubic ramus. Screw placement in the central area of the posterior column is avoided to prevent intra-articular placement. Generally, 2 distal screws and 2 proximal screws are sufficient for adequate buttress fixation. Visualization of the proximal part of the plate by muscle retraction may be obtained by careful placement of a Hohmann retractor hammered into the intact ilium. However, the superior gluteal neurovascular structures can be injured from excessive retraction of the abductor muscle mass. It is recommended to not use a very long plate and to keep the hip abducted. At the end of the operation, it is advisable to check for intra-articular screws by both moving the hip while listening for audible crepitance and by using fluoroscopy.","title":"Safe surgical technique for associated acetabular fractures"}
{"_id":"6b633dbf-20fd-fc44-507d-74f2e7522ba5","text":"We investigated the correlations between echocardiographic parameters and the changes in hepatic venous flow parameters. Changes of serum creatinine, bilirubin, and transaminase levels from their baseline values were also correlated with changes of the VTI ratios. Fluid overload and the amount of vasoactive support were analyzed both as continuous parameters and comparison between groups who had growth in the VTI ratio compared to those without growth.","title":"Association between Hepatic Venous Congestion and Adverse Outcomes after Cardiac Surgery †"}
{"_id":"6b6fbd3f-2d06-568d-4616-87444c1fb5e1","text":"We cannot reliably speculate as to the origins of the lymphatic channels by which this recurrent cancer reached the axilla. It is possible that original lymphatic channels maintained in the superior flap of the mastectomy remained, that new collateralization of lymph channels had occurred, or perhaps that because of dermal involvement, that this recurrent cancer utilized sub-dermal lymphatics similar to that of a cutaneous malignancy. Whatever the pathway, it seems reasonable to assume that if lymph node metastases are to occur in cases of recurrent breast cancer, they will use the same pathway as that taken by sulfur colloid injection near the tumor. Peri-tumoral injection of radiocolloid therefore seems advisable when normal lymphatic anatomy has been profoundly disrupted. If preoperative lymphoscintigraphy maps to a nodal basin there is no reason to believe that SLN biopsy will not be successful.","title":"Axillary sentinel lymph node biopsy after mastectomy: a case report"}
{"_id":"6b716779-a01c-40aa-280a-d04deca2e4ff","text":"Due to the ineffectiveness of current treatment and the inferior prognosis, fat embolism, a severe complication of autologous fat graft, should draw the attention of both plastic surgeons and neurologists so that actions may be taken for both its prevention and treatment.","title":"Case report and literature review: fatal cerebral fat embolism following facial autologous fat graft"}
{"_id":"6b76bc79-1e80-050c-2fb1-049e5ea1d1ab","text":"Detailed information on the baseline characteristics of patients with pathological findings can be found in Table 4.","title":"Occult Pathologic Findings in Reduction Mammaplasty in 5781 Patients—An International Multicenter Study"}
{"_id":"6b7ed094-0eaa-d43c-4d7b-06a56d5e784d","text":"The fundoscopy and ultrasound were used to localize the tumor. Transillumination was used to locate tumor margins. The implant location enclosed the tumor and the safety margin was marked at first with a pen on the sclera. The Plaque was sewed to the marked position. Uncertainties in positioning were taking into account by using the 2 mm safety margin around the GTV. To ensure that a safety margin of at least 2 mm was added on all margins of the GTV, the chosen plaque diameter was 4 mm more than the largest tumor diameter.","title":"106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma"}
{"_id":"6b7f6f16-3f79-bf40-370a-9b4dcf650cd1","text":"This study aimed to determine the risk factors for progression of neurological symptoms after anterior fusion for cervical spine trauma with no or incomplete spinal cord injury.","title":"Risk factors for spinal cord injury progression after anterior fusion for cervical spine trauma: a retrospective case-control study"}
{"_id":"6b81709a-25f9-d586-5819-20e79b5d2126","text":"Our data support the use of topical imiquimod cream as a safe, effective alternative to surgical reexcision in selected individuals with positive MIS margins after initial surgical resection of melanoma or MIS. Although our series shows promising results, larger studies need to be performed with longer follow-up periods to confirm the utility of imiquimod in such cases.","title":"Using topical imiquimod for the management of positive in situ margins after melanoma resection"}
{"_id":"6b91002f-665c-f7be-4f67-14d6581118d1","text":"We reviewed three cases of scalp injury patients, with representative clinical information, and used these cases to outline feedback on scalp trauma treatment based on the specialty knowledge of general and emergency surgeon.","title":"Scalp injury management by a maxillofacial surgeon in a low-resource hospital"}
{"_id":"6b9c3d2d-c5ba-27f8-819f-bb34711f6a2b","text":"This report describes how good results were obtained from the reconstruction of soft tissue and bone after an osteomyelitis of the calcaneus. A radial forearm free flap reconstruction was followed by an endoscopic subtalar arthrodesis. We recommend multidisciplinary management of significant tissue defects of the hindfoot. Soft tissue coverage is a challenge for the reconstructive microsurgeon. Experience in arthroscopic surgery helps the surgeon to perform further surgery and bone reconstruction without having to compromise the soft tissues once again.","title":"Arthroscopic Subtalar Arthrodesis after a Calcaneus Fracture Covered with a Forearm Flap"}
{"_id":"6b9c3e39-7cc5-087f-daba-3f36d1c0e36e","text":"Extensive scalp defect with exposed bone is best reconstructed with flaps. Majority of these wounds are now routinely reconstructed with free flaps in many centers. Free flaps however require lengthy operative time and may not be available to all patients, where possible less extensive options should thus be encouraged. A sixty-eight-year-old patient presented to us with a Marjolin's ulcer on the vertex of the scalp. After wide local excision a defect of about 17 cm and 12 cm was left. The defect was successfully covered with a combination of an ipsilateral pedicle temporalis fascial flap and an axial supraorbital scalp flap with good outcome. In conclusion wide defects of the scalp can be fully covered with a combination of local flaps. The axial scalp flap and the pedicle temporalis fascial flap where applicable provide an easy and less demanding option in covering such wounds. These flaps are reliable with good blood supply and have got less donor side morbidity.","title":"Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound"}
{"_id":"6b9cbef0-a315-e4f0-ed73-2ef36310b4a5","text":"Patients had not been taking any antihistamines or other drugs that could affect skin tests or drug provocations. Patients on beta-blockers were requested to ask their cardiologist if they could stop taking the drug for 2 days.","title":"Comprehensive allergy work-up is mandatory in cystic fibrosis patients who report a history suggestive of drug allergy to beta-lactam antibiotics"}
{"_id":"6b9ffced-e3cd-e747-975e-ea52ab0f4b80","text":"The objective of this study was to examine the reported histologic margin distance following WLE of advanced CuSCC and its association with recurrence and survival.","title":"Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck"}
{"_id":"6ba47fbd-82f5-ffbf-0b7a-758e0d6b5b8d","text":"When the heart stopped, the right atrium was opened through the usual oblique incision, beginning at the base of the right atrial appendage and extending toward the inferior vena cava cannula. After the stay sutures were secured, a pump suction was introduced into the left atrium across the atrial septal defect. On examination of the interior of the right atrium, there was an enormously enlarged coronary sinus ostium. The left hepatic vein on the left of the inferior vena cava was also draining into the coronary sinus. A large sinus venous inferior vena cava of type atrial septal defect was present. One right superior and one right inferior pulmonary vein orifice were visible in the left atrium. An additional anomalous opening was also visible at the junction of the inferior vena cava and right atrium, almost inside the lumen of the inferior vena cava. This was an anomalous or accessorized right inferior pulmonary vein draining into the inferior vena cava close to the inferior vena cava-right atrial junction (scimitar vein).","title":"Successful Surgical Management of Incidentally Diagnosed Scimitar Syndrome With Anomalous Connection of the Left Hepatic Vein to Coronary Sinus and Persistent Left Superior Vena Cava"}
{"_id":"6ba5bb88-8b8e-b3ce-f4d1-754d9aaa64e7","text":"Complicated skin and subcutaneous abscesses are typically well circumscribed and respond to incision and drainage with adjuvant antibiotic therapy.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"6ba8fe23-e84c-6209-6d9d-3b39e154cb3c","text":"Previous studies investigating the analgesic efficacy of ESPB only concentrated on a single endpoint for postoperative pain evaluation, while studies focusing on the direct comparison between ESPB and TPVB in urological surgery are still lacking. Our study is the first trial in non-inferiority design of comparing ESPB and TPVB in patient undergoing laparoscopic nephroureterectomy, and the primary outcome is the joint endpoint of opioid consumption and pain NRS score.","title":"Ultrasound-guided erector spinae plane block versus thoracic paravertebral block on postoperative analgesia after laparoscopic nephroureterectomy: study protocol of a randomized, double-blinded, non-inferiority design trial"}
{"_id":"6bab7312-9025-64c1-d4cd-d0940b7466e2","text":"An ABC is a highly destructive benign bone tumor with an unfavorable prognosis if not treated early, despite surgical treatment. Proper follow-up should be scheduled at least every three months for the first two years of treatment. In our patient, we surgically treated the tumor first by sclerotherapy after which we curetted and filled it with autogenous bone graft followed by chemical cauterization in order to restrict the aggressive tumor from causing a pathological fracture. The patient responded well to the treatment and is under follow-up.","title":"A 5-Year-Old Female With an Aneurysmal Bone Cyst of the Proximal Humerus"}
{"_id":"6bb33e8c-f243-c0e5-d334-a1126664a3dd","text":"When reviewing the published literature on desmoid tumors, we found that many studies did not report specific point mutations of the APC gene. Instead, several studies grouped patients together into ranges of codon mutations. These ranges were often based on the results of protein truncation tests commonly used to identify mutations in the APC gene prior to sequencing. The largest of the ranges was from a study by Bertario et al and this was used as the basis for our statistical analysis [4]. Given the rarity of both desmoid tumors and FAP, the decision was made to include these patients into the database in order to have as many published cases as possible. While this would limit our ability to analyze specific codon mutations, we are able to increase the statistical significance for the codon mutation ranges. One codon was able to be fully analyzed as a point mutation, 1309, and the results of that analysis are included below.","title":"Desmoid tumors complicating Familial Adenomatous Polyposis: a meta-analysis mutation spectrum of affected individuals"}
{"_id":"6bbe48eb-9d30-69c3-5c85-36a194b306ee","text":"The classification of physicians against whom plastic surgery medical misconduct cases were filed before the São Paulo State Medical Board (CREMESP) that was presented in this study was similar to what has been shown elsewhere in the medical literature. Physicians of all medical specialties, including plastic surgeons, are aware that medical practice nowadays is replete with many ethical assumptions and bioethical dilemmas stemming from new technologies and procedures. This demands deeper ethical reflection before making medical decisions. Medical misconduct due to negligence has become more rigorously punished on ethical grounds, both in Brazil and internationally.","title":"Plastic surgery professional misconduct: a cross-sectional study on cases between 2008 and 2017, filed before the São Paulo State Medical Board"}
{"_id":"6bc10839-7194-109b-6824-cd469706d953","text":"On operation table cautery test was performed to check the alignment of the lower limb and assess the correction of deformity.","title":"Correction of lower limb deformities with fixator assisted nailing"}
{"_id":"6bc31579-aeff-ecef-14ce-fb70cc53a22a","text":"Given the new interests regarding the pharmacokinetic profile of AA, the attention of researchers and clinicians has also focused on the pharmacodynamic aspects of the molecule.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"6bd66628-274e-fb8c-4ed8-eebb09efec81","text":"Intercommunicating plexuses from visceral branches of the internal iliac vein include:","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"6bdd1fd0-612c-7916-0752-7bce4258d181","text":"If the flap supplying the vessels was ipsilateral to the donor lymph tissue, it was only necessary to anastomose the flap vessels to the recipient vessels. However, if the flap supplying the vessels and donor lymph tissue was on a different side, both the flap supplying the vessels and the lymph tissue supplying vessels needed to be anastomosed to the recipient vessels. This situation occurred for 1 patient with lymphatic DIEP. For this patient, when we first harvested lymph tissue from the inguinal region on the left side, we found that the ipsilateral deep inferior epigastric perforator vessels were not sufficient to supply the flap, so we decided to use the contralateral deep inferior epigastric perforator vessels to supply the flap. In this case, we anastomosed the right side deep inferior epigastric perforator vessels to the subscapular vessels and the left side superficial circumflex iliac vessels in the donor lymph tissue to the branch of the superficial circumflex iliac vessels. After the recipient and donor vessels were anastomosed, the lymph tissue from the iliac region was covering the surface of the axillary vessels.","title":"A retrospective study of lymphatic transverse rectus abdominis myocutaneous\/deep inferior epigastric perforator flaps for breast cancer treatment-induced upper-limb lymphoedema"}
{"_id":"6bdf354d-118c-7208-eeae-2cf4cedbcdf2","text":"With an abdominal wall desmoid tumor in our minds, a wide surgical resection was performed with a peripheral healthy margin of about 3 cm. The defect in the anterior abdominal wall due to resection of the rectus muscle was repaired with polypropylene mesh. On cut section, the mass looked gritty and glistening with trabeculations similar to that seen in the scar tissue. On histopathological study, the tissue consisted of elongated spindle cells resembling fibroblasts embedded in collagenous matrix. The tumor cells seemed to invade the skeletal matrix distorting its architecture. The above histopathology strongly suggested towards a diagnosis of desmoid tumor which was again supported by immunohistochemistry study. The patient had an uneventful postoperative period.","title":"Desmoid Tumors: A Clear Perspective or a Persisting Enigma? A Case Report and Review of Literature"}
{"_id":"6be7de95-a927-6c4b-78e8-7258bc17f465","text":"Furthermore, the skin is usually free of hair and has an excellent blood supply from the branches of the facial artery.","title":"Reconstruction of Nasal Skin Cancer Defects with Local Flaps"}
{"_id":"6bed83f6-6111-56a9-dc63-6445520be981","text":"This goes along with the perceptions of the staff members that these team sessions are not appreciated enough. An occupational therapist from another facility with a lower level of patient success states in a group discussion:","title":"Cooperative leadership as a condition for patient-reported rehabilitation success"}
{"_id":"6bf2df83-7ec8-0428-53a6-0d18dc98fe64","text":"The incidence of complications from STF is low. However, the increased utilization of STF for cosmetic services is associated with the heightened frequency of the known consequences of treatments. In addition to the direct adverse event, there is a possibility that patients may experience unsatisfactory results or unmet expectations. Physicians who inject STF for cosmetic corrections may be involved in medical-legal disputes or receive complaints to regulatory authorities from patients who perceive that they have experienced harm as a direct result of their treatment","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"6bf5d7e2-bb24-0644-7d2d-4e53dc410002","text":"In our case, distraction osteogenesis with the Ilizarov technique was combined with autologous iliac crest grafting in order to achieve bone healing, while a sural fasciocutaneous flap was used in order to restore the soft tissue loss. The mosaicplasty technique can be an alternative in iliac autograft harvesting with low complication rates and good clinical results. A multidisciplinary approach may be required for the treatment of complex distal tibial fractures with both bone and soft tissue loss in order to ensure not only limb salvage but a good clinical outcome as well.","title":"A Case of Reconstruction of an Open Tibial Fracture (Gustilo-Anderson Type IIIB) With Severe Skin and Bone Loss Using Corticocancellous Bone Plugs From the Iliac Crest and an Ilizarov Frame"}
{"_id":"6c01bb90-7e1d-c0da-a424-19b76231f2d9","text":"Breastfeeding or pregnant patients or fertile women who do not use reliable contraception","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"6c027c88-feb0-258b-ca5e-deddb18346db","text":"Facial nerve damage can lead to partial or total facial nerve palsy. Photobiomodulation has been reported to improve and accelerate functional recovery following peripheral nerve lesion, depending on the type of lesion and the light exposure parameters used. The aim of this study was to investigate the effects of infrared exposure on functional and axonal regeneration after section-suture of the distal branches of the facial nerve: the buccal and marginal mandibular branches and the distal pes. The animals underwent surgery and were irradiated with infrared light at 850 nm twice daily from day 1 to day 16. The recovery of facial function was then studied at both the behavioral and morphological levels. Behavioral analyses were performed by videoscoring with a high-speed camera and using various devices to assess the recovery of whisker movement on the lesioned side from day 1 to day 30. We also assessed nasal deviation toward the intact side and the ability to close the ipsilateral eyelid completely from day 1 to day 38 and from day 1 to day 50, respectively. For morphological analyses, we assessed the re-establishment of facial motoneuron labeling with Fluorogold®, an immunofluorescent retrograde marker of axonal transport injected into the vibrissae, on D10, D14 and D30. We found that whisker movements recovery was significantly faster in treated than in control mice. A complete disappearance of nasal deviation was observed at 2 weeks in infrared-treated lesioned mice and at 5 weeks in controls. Complete eyelid closure was observed 3 weeks after surgery in treated animals and 6 weeks after surgery in controls. Finally, normal fluorogold labeling of the facial nuclei complex was restored 30 days after surgery in the treated animals, but no such restoration was ever observed in control animals. In conclusion, our data show that IR treatment at a distal site has a significant positive effect on facial nerve recovery. These findings pave the way for the clinical use of infrared photobiomodulation in patients with nerve lesions.","title":"Efficacy of LED Photobiomodulation for Functional and Axonal Regeneration After Facial Nerve Section-Suture"}
{"_id":"6c04669c-53ca-7cd3-9d18-cf3386cda8cf","text":"The presence of women surgeons challenges the gendered stereotype and opens up the possibility of a career in surgery. Women surgeons could also provide support and encouragement to trainees who were considering a career in surgery:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"6c06cde0-17f0-d913-bee2-3f8ae80f3b01","text":"The most robust studies on NPWT have been conducted in the acute trauma setting. In the analysis of the FLOW (fluid lavage of open wounds) trial, NPWT was associated with a significantly increased rate of infection in all types of open fracture wounds. 48 The recent WOLLF (wound management of open lower limb fractures) multicenter randomized clinical trial of 460 patients comparing standard care wound management versus NPWT after debridement in adult patients with an open fracture of the lower limb demonstrated no benefit of NPWT. 49 Furthermore, the latest Cochrane systematic review found that, based on 7 randomized controlled trials, there is moderate-certainty evidence for no clear difference between NPWT and standard care on wound healing. 50 Based on a separate comprehensive systematic review, the UK National Institute for Health and Care Excellence guidance recommends soft tissue coverage within 72 hours of open fracture. 51","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"6c0d3fa9-6412-a2de-6837-23a15e3fe4a6","text":"Diagnostic tests for delayed drug hypersensitivity are scarce. In vivo tests like epicutaneous patches are the most readily available. These patches must be prepared with the suspected drug involved in the reactions (based on a very detailed allergy clinical history) with an appropriate concentration and vehicle in order to yield accurate results. A positive result confirms the involvement of the drug, but the predictive value of a negative test is unknown. Therefore, a drug challenge is still considered the gold standard for diagnosing a drug allergy. In most delayed reactions, this option is not possible due to the patient’s risk of reaction and the lack of standardization of the challenged drugs, as a complete single dose of a drug may rule out an immediate IgE-mediated reaction but not a delayed reaction that may occur after consecutive doses in a longer treatment.","title":"Value of the Lymphocyte Transformation Test for the Diagnosis of Drug-Induced Hypersensitivity Reactions in Hospitalized Patients with Severe COVID-19"}
{"_id":"6c0f7ff4-09c9-89d8-ad4f-962ef57c180a","text":"Specialists in the acupuncture & moxibustion department with at least three years of clinical experience and a license from the Ministry of Health of the People’s Republic of China will administer the treatments strictly following the detailed procedures. Any acupuncture or physiotherapy that can impact the results will be prohibited during the treatment and the follow-up period. Drugs prescribed for the participants four weeks before the trial will be allowed depending on their effect on outcomes. Information regarding medications administered to the participants will be recorded in the case report form (CRF).","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"6c11400f-ef7f-0b32-068d-9f8c5e4048f7","text":"Even when at baseline no diagnostic tool indicated AK; areas of concern promptly showed clinical signs of inflammation during imiquimod therapy. Biopsies taken at this stage featured some signs of premalignant alterations in the histology. The response of atypical keratinocytes to imiquimod in these nonsuspicious areas should not be interpreted as imiquimod-induced alterations but rather as imiquimod-detected altered cells. Clearly AK may exist but may not be evident clinically in their early development as shown in Figure 3.","title":"Visualization and Treatment of Subclinical Actinic Keratoses with Topical Imiquimod 5% Cream: An Observational Study"}
{"_id":"6c14e206-705a-709b-51f1-81e8ffee9483","text":"Some infants cannot be classified by the HATLFF scoring system,40,42 so infants who are experiencing breastfeeding difficulty should also undergo division, as our meta-analysis has shown that division is associated with breastfeeding improvement.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"6c1c49cb-7170-f8e3-6d1f-a5614f97a4a1","text":"Several fibrous hyperplastic lesions are similar both clinically and histologically, requiring biopsy for definitive diagnosis. Pedodontist should be familiar with the different types of fibrous hyperplasias they may encounter during patient treatment and should note such lesions for further evaluation by Oral and Maxillofacial Pathologist.","title":"Giant Cell Fibroma in a Paediatric Patient: A Rare Case Report"}
{"_id":"6c269ecd-019f-bd02-76ad-65e99c80cdd4","text":"Therefore, in the setting of clinical trials evaluating response to systemic therapy, given the importance of accurate staging of the axillary lymph nodes along with optimizing the clinical management of patient care and avoiding over-treatment and invasive axillary surgery, there is a need to standardize the optimal surgical management of the axilla for patients treated with neoadjuvant chemotherapy on prospective clinical trials evaluating pCR as a primary endpoint. The multidisciplinary team from the I-SPY2 clinical trial leadership along with their principal investigators including surgeons, medical oncologist, and pathologist across sites have developed a recommended minimum standard, as follows, for surgical management of the axilla in patients with clinically node positive disease treated with neoadjuvant chemotherapy. The goal of these guidelines is to set a standard that surgeons adhere to when treating patients on a clinical trial with a pCR primary endpoint and can also be used to inform management outside of a clinical trial.","title":"Surgical Standards for Management of the Axilla in Breast Cancer Clinical Trials with Pathological Complete Response Endpoint"}
{"_id":"6c2a0c86-f177-1a10-9938-95bc53a5f8a3","text":"Facial nerve injury can be a devastating injury resulting in functional deficits and psychological distress although the nerve is anatomically intact or the injury is limited to the medial portion of a peripheral branch.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"6c2b91b7-cc56-ca21-1bf6-ab5ac8c6d5fe","text":"In our study, we aimed to investigate the impact of the complexity of wounds on the success of Matriderm®-augmented split-thickness skin grafts as well as the role of NPWT in the preconditioning of the defects with a focus on its impact on the development of the bacterial load during the course of the treatment.","title":"Long-term experience with a collagen-elastin scaffold in combination with split-thickness skin grafts for the treatment of full-thickness soft tissue defects: improvements in outcome—a retrospective cohort study and case report"}
{"_id":"6c3b5c96-ce31-1e5f-c17a-78915cdf0627","text":"The main concern of researchers on increasing the therapeutic efficiency of ultrasound is to provide target tissue selectivity and to reduce the ultrasound intensity, needed for the occurrence of inertial cavitation.","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"6c43b91b-4af4-da96-9c95-c082c5020376","text":"Our case shows that a cognitive decline with impaired verbal and visual memory can be the leading symptom of an IgLON5 disease. The so far reported typical symptoms are sleep disorder and gait abnormalities or bulbar dysfunction, and cognitive symptoms show a broad variety from visuoconstructive dysfunction to hallucinations. This combination of symptoms is highly unspecific, making the diagnosis of IgLON5 disease based on the clinical symptoms difficult. The so-far described cases showed very different results after treatment, and the greater part of patients suffered a progression or remaining deficits. An early treatment in the course of the disease and timely escalation to plasmapheresis or B-cell-depleting antibodies seems to be recommendable.","title":"Case Report: Neuropsychological Findings in IgLON5 Antibody Disorder"}
{"_id":"6c4ca5ae-bb79-1b49-bf97-d08f76abde28","text":"The study setting is a single-site study at the outpatient clinic at the Department of Dermatology at Odense University hospital in Denmark. Psoriasis patients who are either already patients at the clinic or newly referred to the clinic will be considered for inclusion.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"6c54c0e1-eb03-4696-b01b-582533a12036","text":"In conclusion, the combination of imiquimod and cryosurgery within the frame of immunocryosurgery is a potent and efficacious treatment for keratinocytic skin cancers that enables a lasting therapeutic result combined with maximal healthy tissue preservation. BCC remains the main domain of immunocryosurgery application. However, the spectrum of diagnoses that are amenable to treatment with immunocryosurgery is currently actively explored, as well as the impact of possible adjuvants.","title":"A Review of Immunocryosurgery and a Practical Guide to Its Applications"}
{"_id":"6c5bf958-be65-7395-ef3e-11de656818a3","text":"This study is only a preliminary exploration of the tissue response and tissue remodeling mechanism of novel injectable cosmetic fillers from the fields of histology and immunology, but further research needs to be done combining other methods such as molecular, imaging, and so on to establish a quality evaluation method and research system on the tissue remodeling mechanism, to solve the bottleneck of the critical technical deficiency in the evaluation of this type of products, and to improve the overall competitiveness and level of absorbable regenerative medical device industry in China.","title":"Mechanism of remodeling and local effects in vivo of a new injectable cosmetic filler"}
{"_id":"6c5f789f-e481-dfdf-f0c8-b40bf1010076","text":"The dominant mammary branch of the IMA can be located by positioning the transducer in a transverse plane alongside the sternum and making a sweep scan from the second to the sixth intercostal space. Colour Doppler imaging is essential to locate the IMA, which appears as a circular hypoechoic area between the rib spaces deep to the pectoral muscle. The probe is then rotated until the long axis of the branch of the IMA is imaged passing through the rib spaces towards the mammary gland (Figure 11) [34,35]. Doppler flow measurements are advised to be taken near the origin of the branch both distal to the pectoral muscle and removed from the parenchyma of the mammary gland. The mammary branch of the LTA can be located laterally and superiorly to the breast near the axilla. Generally settings for Colour Doppler are those typically used for low flow vessels, for example the velocity range can be as low as 4.5 cm\/s. Steering of the Colour beam will facilitate detection and interrogation of vessels that are oriented almost parallel to the beam.","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"6c5ff1b2-43cf-8e5d-d3f5-61a19cf57dc8","text":"In this study, there was significantly different use of flap types for reconstruction in patients with primary and recurrent cancers either before or after propensity score matching. Notably, less ALT flaps were used for patients with recurrent cancers than patients with primary cancers. This may be attributed to the fact that the ALT flap has generally been the first choice and is used for reconstruction in prior surgery, leaving the surgeons to no longer choose an anterolateral thigh flap, even from the contralateral thigh, for further free flap reconstruction following repeated cancer resection. This is also reflected by the more frequently used AMT flap and that the freestyle flap was used in patients with recurrent cancers compared to those with primary cancers.","title":"Comparison of the surgical outcomes of free flap reconstruction for primary and recurrent head and neck cancers: a case-controlled propensity score-matched study of 1,791 free flap reconstructions"}
{"_id":"6c70085e-af8c-8fbe-7b7d-7a0d1ce4de30","text":"Patients with inguinal LN metastasis from rectal or anal canal adenocarcinoma who underwent inguinal LN dissection with curative intent at the National Cancer Center Hospital from September 1986 to August 2017 were included in this study. Patients who had incomplete medical records and those who underwent only biopsy of inguinal LNs for diagnosis were excluded. Patients with inguinal LN metastasis from colon adenocarcinoma and patients with other histological types were also excluded.","title":"Long-term outcomes after surgical dissection of inguinal lymph node metastasis from rectal or anal canal adenocarcinoma"}
{"_id":"6c71f28f-4b44-05f4-1a9d-d16384200d7f","text":"Due to the large size of the mass and the symptoms caused by mass pressure on adjacent organs, a decision was made with the patient and her family to perform surgical exploration with resection.","title":"A Sporadic Giant Mesenteric Desmoid-Type Fibromatosis in a Teenage Female: A Report of a Rare Case"}
{"_id":"6c7d783d-f404-0ecc-90b4-f26b9770338c","text":"In addition to the clinical CLI of uveal melanoma patients, experimental CLI of ruthenium-106 plaques placed in a water-filled container was performed to optimize instrumentation performances and to visualize the pattern of Cherenkov radiation generated in the water adjacent to the plaque.","title":"Cherenkov Luminescence Imaging for Assessment of Radioactive Plaque Position in Brachytherapy of Uveal Melanoma: An In Vivo Feasibility Study CLI in Brachytherapy of Uveal Melanoma"}
{"_id":"6c8047f7-c597-b55e-4614-4963cec2a481","text":"Frequently, the plastic surgeon must individualize therapy to the patient. A fixed procedure does not always apply to every clinical scenario. Adhering to principles of techniques and knowledge of anatomy frequently serves as a foundation for the reconstructive surgeon when planning procedures. This study can aid the novice and experienced surgeons in obtaining quality outcomes in terms of not only aesthetics but also function.","title":"Plastic Surgery of the Breast: Keeping the Nipple Sensitive Riccio et al"}
{"_id":"6c8984e6-037f-52a1-ac5c-f8b8966425e5","text":"Genetic alterations in the TERT gene have been extensively studied in melanoma.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"6c89ba3a-2a3d-ba65-79b6-139960afeb14","text":"The most common risk factor for DVT among these patients was age over 65 years. It was observed from the results obtained that there are divergences between clinical practice and the recommendations for diagnostic assessment of patients with suspected DVT, due to inappropriate use of diagnostic tests and examinations.","title":"Evaluation of the diagnostic management of deep vein thrombosis in the emergency department of a tertiary hospital in Santa Catarina, Brazil: a cross-sectional study"}
{"_id":"6c8d5aa0-d65c-2328-a965-bef1bedcf70d","text":"The presence of large variations in the cartilage matrix productivity of cultured auricular chondrocytes is a major issue in the manufacture of regenerated cartilage because it may contribute to the contamination of auricular chondrocytes with low cartilage productivity. Therefore, we need to develop a simple method to evaluate the cartilage matrix productivity of auricular chondrocytes to facilitate the realization of treatment with regenerated cartilage. One candidate method to evaluate the characteristics of cultured cells is real-time PCR or ELISA with cell lysate samples. However, the findings of real-time PCR are presented as relative values and their standardization is difficult. In contrast, ELISA is more appropriate for standardization because measurement results are presented as absolute values. ELISA is clinically employed in biochemistry tests and applied to the diagnosis and judgment of treatment. Thus, we considered a search for a protein index of auricular chondrocytes to be reasonable.","title":"Glial Fibrillary Acidic Protein as Biomarker Indicates Purity and Property of Auricular Chondrocytes"}
{"_id":"6c8eb897-67ca-798c-2da0-1e52cc1fc3ce","text":"Treatment of tibial OM is intensive and demanding on patients, staff, and resources, as is evidenced by the large number of previously unsuccessful interventions and the duration of OM in our patient population. The importance of a successful outcome in the treatment of chronic OM of the lower limb is further highlighted by Lerner et al,26 who found that patients with chronic refractory OM scored lowest in quality of life parameters compared with patients with long bone fracture nonunion and those who had undergone posttraumatic amputation. Future developments, such as the use of bone morphogenic protein in lieu of bone grafts, may further improve the treatment of this condition.27","title":"Aggressive Management of Tibial Osteomyelitis Shows Good Functional Outcomes"}
{"_id":"6c917850-a4bc-b192-94c6-b8d73d49968a","text":"There were no palpable cervical lymph nodes. The patient underwent right radical parotidectomy and sacrifice of the facial nerve. The tumor was found intraoperatively to be arising mainly from the deep lobe of the parotid gland involving the anteroinferior part of ear canal extending medially into infratemporal fossa and para pharyngeal space, sparing the posterior canal wall and middle ear. The facial nerve was surrounded by a tumor. Microscopically, the malignant squamous epithelial cells showed pleomorphic vesicular nuclei with prominent nucleoli and bizarre mitotic figures.","title":"Parotid Gland Carcinoma Masquerading as an Aural Polyp"}
{"_id":"6c920976-ab33-2ff6-70b5-98f3fdc849bb","text":"TD branches of similar size to the DIEP pedicle were prioritized in anastomosis. The descending branch and the branch to the serratus anterior muscle are expected to be good candidates as recipients in breast reconstruction with DIEP free flap. Moreover, supercharged anastomosis of DIEP pedicles can be achieved within TD branches.","title":"Diametric Comparison between the Thoracodorsal Vessel and Deep Inferior Epigastric Vessel in Breast Reconstruction"}
{"_id":"6c9733bf-0767-e463-f824-f45872bbb4c4","text":"The pedicle was dissected toward its origin from the external iliac vessels aiming beyond the confluence of the venae commitantes. This was repeated on the opposite side.","title":"Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification"}
{"_id":"6c9785ff-8bb8-881c-3486-4ad20dfa1067","text":"It was therefore the objective of this investigation to evaluate a single surgeon SIEA flap series over 15 years comparing various aspects of donor site seroma formation in SIEA and DIEP abdominal flaps used for breast reconstruction. We tested the hypothesis that in general more abdominal donor site fluid is produced following SIEA flap harvest than DIEP flap dissection.","title":"Increased Production of Abdominal Donor Site Fluid Following Microsurgical Breast Reconstruction With Superficial Inferior Epigastric Artery Versus Deep Inferior Epigastric Artery Perforator Flaps"}
{"_id":"6c98411d-1498-7457-1e03-49612ccc20c7","text":"It is not just men who perpetuate the belief that surgery might not be a wise career choice for a woman. Even when offering support and encouragement, female trainee surgeons could still reproduce the belief that a career in surgery may not fit with traditionally female childcare duties:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"6ca86b83-8972-d2f1-e989-c2a6ae2c9124","text":"The presentation of skin symptoms was variable depending on the immunosuppressive treatment. A significant improvement was seen after the start of intravenous immunoglobulin therapy with slight fluctuations depending on the weeks elapsed after the last treatment. The patient received IVIG every 5–6 weeks and slight worsening was seen 1–2 weeks before each treatment in the number of blisters.","title":"Sporadic late onset nemaline myopathy with concurrent dermatological symptoms responding to immunosuppressive treatment"}
{"_id":"6caba230-64df-3865-f2c6-d1870601ae1c","text":"Flap type and postoperative wound infection were both independent risk factors influencing the flap survival rate in the foot and ankle. However, postoperative wound infection was a risk factor for the pedicled flap but not for the free flap. In addition, pedicled flap necrosis may be associated with flap-related factors. Microvascular anastomosis is a major cause of free flap necrosis. Preoperative wound bed inflammation was found to be a risk factor associated with postoperative wound infection. To increase the perioperative flap survival rate, multiple thorough debridements should be performed before flap transfer. For the reconstruction of complex or wide soft tissue defects of the foot or ankle, free flaps are safer and more reliable than pedicled flaps and should thus be the primary choice.","title":"Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis"}
{"_id":"6cadbc35-79bd-4d93-42ec-fb052edeb907","text":"Audience exposure and engagement in social media have been the focus of study for many researchers in the medical field. Plastic surgeons have pioneered the use of social media in practice given the consumer-driven nature of surgical procedures and the visually driven aesthetic outcomes throughout the specialty. Although the proper use of social media has been debated, no definitive guidelines are provided to direct specific usage of the platforms in terms of content to be shared and methods to increase interested patient exposure. Additionally, proper use commentary among plastic surgeons tends to focus on the sharing of patient information and photography that may be viewed as indecent or obscene by the general public. When scrolling through their feed, most individuals are not wanting to view graphic, post-surgical pictures, even if they demonstrate superior outcomes in comparison to other surgeons. Few studies have explored the content of social media posts and their effects on audience engagement. Dorfman et al study demonstrates that a strong social media following correlates with website ranking on the Google search results page. This finding emphasizes the importance of a social media presence and the value of strategic sharing of content. Personal posts, which provide less practice information, can improve a surgeons social media footprint which can increase exposure of marketing posts. Practice marketing posts, which receive less overall engagement on their own, may still provide information for potential new patients to the practice.","title":"Content and Engagement Among Plastic Surgeons on Instagram"}
{"_id":"6caf712e-0dae-ddf3-15a5-018d7e6ebdce","text":"The maintenance of an adequate blood supply of the peri-implant tissues is an important factor both during the surgical phase by preventing the undesired effects such as the loss of tissues following the surgical procedures and for the nutritional requirements of the tissues during the tissue conditioning stage of the prosthetic phase, either by the healing abutment or by the provisional restoration [13]. A reduced blood supply may be the result of the conventional surgical implant placement protocol or may be caused by increased pressure of the prosthetic components, which may lead to ischemia of the tissues resulting in necrosis or recession of the gingival tissues.","title":"Soft and Hard Tissue Management in Implant Therapy—Part II: Prosthetic Concepts"}
{"_id":"6cafc636-4978-ca4b-1255-84fff0de1ffe","text":"Our group of breast cancer survivors is older than the group of women with no previous breast cancer diagnoses. As younger women are more likely to have dense breasts and mammography works best in fatty breasts, the found difference in sensitivity between these two groups is probably underestimated.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"6cbb8f16-60ef-2082-951b-b5d7cd7aa914","text":"Due to the location and extent of these tumors in the head and neck region, a wide surgical resection is sometimes not possible without leaving the patient with significant functional or cosmetic deficits. For these reasons, definitive RT has been considered for mucosal melanomas of the head and neck.","title":"Mucosal Melanomas of the Head and Neck: The Role of Postoperative Radiation Therapy"}
{"_id":"6cbe257e-3ef1-3da8-b035-25e78b92dd02","text":"A retrospective analysis was done of the clinical files of all patients receiving electron radiation treatment in a radiation oncology centre. The patients were referred from different surgical centres to receive adjuvant radiotherapy during the years 2006–2013.","title":"Postoperative radiotherapy in the management of keloids"}
{"_id":"6cc0c606-dc80-e216-53e6-c2300418c060","text":"Doppler ultrasound of deep veins of the legs is a diagnostic test for the presence of VTE. Ventilation-perfusion lung scan is a proven diagnostic test for suspected PE with low sensitivity.","title":"Venous Thromboembolism – Current Diagnostic and Treatment Modalities"}
{"_id":"6cc30f10-1db6-1778-e46e-8b389b53cf93","text":"The purpose of this study was to describe the use and the patient outcomes of botulinum toxin injections in conjunction with intensive manual joint mobilizations and stretching programs to treat patients with persistent contractures who were recalcitrant to traditional rehabilitation efforts following total hip arthroplasty.","title":"Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series"}
{"_id":"6cc78580-65de-93dc-5263-f071f4024b2d","text":"Aim: This study aimed to define the costs of surgical management of chronic osteomyelitis where free tissue transfer was required in addition to debridement of bone, particularly the increased costs incurred by a return to theatre. We hypothesised that there would be a significantly greater cost when patients required re-exploration for vascular compromise.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"6cc8993c-519d-2f1e-609c-98ad1b6a85fd","text":"This is the ideal indication to start with for a novice injector. Stretch and compress the skin to visualize the fold. Inject into a site medial to the fold to avoid further cheek ptosis. Overcorrection is common here and this leads to change in animation, lumpiness, and bumpiness. Remember that nasolabial folds always display a degree of natural asymmetry which should be discussed with the patient prior to injection. Usually a linear threading or a fern technique is chosen to treat this area.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"6cc926fe-d07c-2434-971d-01021c5ec054","text":"When the bony defect extends more laterally or posteriorly on one side than another, that side is usually preferred for the microvascular anastomosis due to closer proximity to the recipient blood vessels. Alternately, the side with better recipient blood vessels, if any, is selected. The leg that is ipsilateral to the side of the planned microvascular anastomosis is chosen as the fibula osteocutaneous free flap donor side so that the skin paddle can be used to restore the palate with tension on the cutaneous perforators. Vein grafts are used when pedicle length is inadequate to reach the recipient vessels. The facial blood vessels are usually preferred as recipients when available, due to their proximity to the defect and their good size match to the peroneal blood vessels.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"6cd4a650-1478-4112-2d34-98c3fe6b6b91","text":"Methods: We conducted a retrospective data analysis included in the Register of sJIA cases, for the period from 2002 to 2015","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"6cdf1dc0-8ea4-ae55-4359-ca4b689bc249","text":"The routine use of SLNB for the evaluation of residual lymph node metastasis after neoadjuvant chemotherapy has not been recommended for patients who initially tested positive for malignancy. In these cases, axillary management after neoadjuvant chemotherapy should be individualized in accordance with the clinical subtype of the tumor, with SLNB being performed in selected patients whenever possible 25.","title":"Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy"}
{"_id":"6ce64282-76ac-a0af-71e8-7d5e2692dc07","text":"Figure 1 shows different patterns in annual incidence rates of first and second primaries where first primary malignancies showed multiphasic pattern and second primary malignancies showed a steady increase. The potential causes for first primary malignancies were discussed elsewhere [32]. Our paper presents a new pattern in second ocular and its adnexal malignancies that may not be influenced by the same factors. Such point is a potential for future further research for investigating the underlying molecular and genetic differences between the cancers especially in non-Hodgkin’s lymphoma and melanoma.","title":"Second primary malignancies of eye and ocular adnexa after a first primary elsewhere in the body"}
{"_id":"6cea938e-7b5f-4ede-ed0f-c7490fcf772a","text":"The measurements were performed during a breathing pause while patients were in a sitting position. The nosepiece used in the measurements was 5 cm in length and was anatomically sculptured. To ensure a tight connection between the nosepiece and tip of the nose, a small amount of ultrasound transmission gel was applied to the edge of the nosepiece. Care was taken not to obstruct the nasal vestibule with gel or deform the nose during testing. The angle of the incident acoustic impulse was about 45° with respect to a line joining the base of the piriform aperture of the nose to the tragus. Measurement performed in either of two conditions of without a decongestant and with a decongestant, respectively.","title":"Does Cosmetic Rhinoplasty Affect Nose Function?"}
{"_id":"6ceeca7a-051b-df80-1180-dc3ab56f9359","text":"A high index of suspicion is needed to diagnose FES. A combination of clinical criteria and MRI brain will enable early and accurate diagnosis of FES.","title":"Emergency management of fat embolism syndrome"}
{"_id":"6cf4cfda-f4ca-7c25-2b6a-69b451e71d3a","text":"Table 1 Summary of tumour characteristics for the five cases of extrascleral extension.","title":"Extrascleral extension of choroidal melanoma after iodine-125 brachytherapy treatment: a case series"}
{"_id":"6cf5df6c-ede3-43a4-339f-a66115256d1f","text":"The number of changes in the antibiotic treatment in relation to the injury type also showed clear differences. Patients with open fractures received a mean of 3.2 different antibiotic substances compared to 3 in the fracture group and 2.7 in the soft tissue group.","title":"Long-term experience with a collagen-elastin scaffold in combination with split-thickness skin grafts for the treatment of full-thickness soft tissue defects: improvements in outcome—a retrospective cohort study and case report"}
{"_id":"6d0194f3-7850-7420-f2c7-66476e4fc793","text":"This study uses molecular methods to assess whether SLNB can be reliably used in patients treated with NAC before they undergo SLN mapping and surgery. Our findings for SLNB were also correlated with those for axillary lymphadenectomy. The total tumor load (TTL) of the sentinel lymph node results was also evaluated as a predictive factor of positive ALD status in NAC settings.","title":"Total Tumor Load of mRNA Cytokeratin 19 in the Sentinel Lymph Node as a Predictive Value of Axillary Lymphadenectomy in Patients with Neoadjuvant Breast Cancer"}
{"_id":"6d0284a8-58bf-9474-b5a7-00f291284eac","text":"Surgical tumor therapy with curative intent is based on the achievement of tumor-free margins wherever possible. If clear margins seem achievable preoperatively, the surgical procedures including reconstructive strategies should integrate oncological and functional considerations to obtain an optimal outcome in terms of survival and postoperative quality of life. Extensive tumor resections in the head and neck area including full-thickness resections are feasible, and free flap reconstruction offers a versatile tool to restore function and aesthetics while providing good local disease control rates.","title":"Full-Thickness Tumor Resection of Oral Cancer Involving the Facial Skin—Microsurgical Reconstruction of Extensive Defects after Radical Treatment of Advanced Squamous Cell Carcinoma"}
{"_id":"6d07b546-9d6e-92ed-1987-5ca9a84ade02","text":"Homogeneous surgical standards of pelvic lymph node dissection in prostate cancer cannot be found in the current literature. Therefore, the percentage of pN+-stages distinctly varies depending on the treated patients and the extent and technique of lymphadenectomy. The minimal lymph node dissection only considers lymph nodes in the obturator fossa, whereas the standard lymphadenectomy also includes lymph nodes along the external iliac vessels. The extended lymph node dissection is a complete lymph node dissection along the external iliac vein, the internal iliac artery up to the common iliac vessels including presacral lymph nodes and lymph nodes in the obturator fossa. With the extended lymph node dissection more lymph nodes are removed and more lymph node metastases are detected. But, this technique requires much more time and has a higher complication rate than standard lymphadenectomy. Sentinel lymph node dissection could be a way out of this dilemma.","title":"Radioguided surgery in urological malignancies"}
{"_id":"6d0a7edd-7d23-19e5-1a28-aac387e01f8c","text":"Finally, regarding our findings and the results in the literature, we recommend that sentinel lymph node biopsy should be offered to a selected group of patients, including women with a synchronous or previous breast cancer diagnosis and those who cannot be evaluated using MRI in the short interval before surgery.","title":"The Use of Sentinel Lymph Node Biopsy in BRCA1\/2 Mutation Carriers Undergoing Prophylactic Mastectomy: A Retrospective Consecutive Case-Series Study"}
{"_id":"6d0bf4f4-17f4-ef5a-bd9c-ef80f206d34b","text":"Wound dehiscence: Wound dehiscence was defined as the opening of the skin including exposure of the underlying tissue prior to wound healing.","title":"Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial"}
{"_id":"6d0c47eb-eff9-756b-8ae5-130e388621f4","text":"Use of MarginProbe, as depicted in this study, is not the complete solution to the complex problem of lumpectomy margins. This device provides incremental improvement in reducing reexcision procedures, which is meaningful because these additional unanticipated procedures burden patients and the health care system. Although this device adds some additional cost, it is offset by the cost of reexcision procedures and costs related to positive margins. More work is needed to understand the relationship between various margin distances and in-breast recurrence rates. Additional evaluation of the new margins of cavity shaving specimens would also provide important intraoperative information. The use of MarginProbe or other technology to interrogate the lumpectomy cavity might provide additional data regarding the adequacy of resection. Novel methods for preoperative breast imaging might also provide a more accurate roadmap for surgical planning. The number of patients opting for mastectomy procedures is on the rise. It is possible that the frequent need for multiple excisions to achieve adequate lumpectomy margins contributes to this trend.","title":"A Randomized Prospective Study of Lumpectomy Margin Assessment with Use of MarginProbe in Patients with Nonpalpable Breast Malignancies"}
{"_id":"6d10ee4d-b0dd-ae48-786c-d2bb6574ed17","text":"To further decrease the risk of seroma in patients receiving an ADM patch, the drain was left in situ until the daily amount of aspirate was about 10 to 20 mL (in patients who did not receive an ADM patch, the drain was removed when the daily volume of aspirate was 50 mL).","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"6d12c7b9-6c3f-0843-946f-2b0052faaaef","text":"The patient's IOP was initially controlled through postoperative month 18, at which time IOP became persistently elevated to 27–31 mmHg on multiple visits despite use of 4 classes of glaucoma medications. At this time the patient underwent Xen 45 Gel Stent implantation and has since had well controlled IOP without medications through postoperative month 1 with a best corrected VA of 20\/30.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"6d178e11-3574-7e79-c5e4-f5f0f243a9e4","text":"Our data suggest that M and FC free flaps are both safe and effective approaches to lower extremity microvascular reconstruction after trauma, infection, or oncological excision, although FC free flaps offer significantly less donor site morbidity and seem to provide both greater aesthetic satisfaction and better environment-reducing susceptibility to postoperative infection. However, the results of this meta-analysis should be interpreted with caution because it only includes retrospective studies, and therefore larger randomized investigations should be performed to verify these data. Both reconstructive options must be included in the armamentarium of the plastic surgeon who must be able to select the best option according to individual needs.","title":"Muscle vs. Fasciocutaneous Microvascular Free Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies"}
{"_id":"6d20b10a-77ce-4a0c-c790-ba0c8270bb63","text":"Two hundred forty-four adult patients from the dermatology clinics at University of Oklahoma and Loyola University Chicago were surveyed using digital images and questions regarding personal and family history of skin cancer, sun protection practices and sun protection knowledge.","title":"Assessing individual patients’ knowledge of benign versus malignant skin lesions in the dermatology clinic population"}
{"_id":"6d25198a-d275-41ae-7beb-c5b668c5b008","text":"The preoperative US of regional lymph nodes spares some patients with melanoma from undergoing a SNB. Patients with regional metastases and a negative preoperative US have a significantly lower tumour burden in comparison to those with clinically negative lymph nodes, which is also reflected in a better OS.","title":"Lower tumour burden and better overall survival in melanoma patients with regional lymph node metastases and negative preoperative ultrasound"}
{"_id":"6d275619-dceb-241d-f532-2cdb6cf5bbff","text":"Although a number of nipple reconstruction procedures are described in the literature, few clinical trials have been conducted to reach a consensus on a favoured method in terms of long-term cosmesis and ease of the technique. In practice, the chosen method is usually dependent on the experience of the individual surgeon and patient choice. Nipple reconstruction with or without areola tattooing is the finishing touch and the defining feature of the female breast.7 Some studies have shown that timely reconstruction leads to improved psychological wellbeing in the patient and improved patient and partner satisfaction.,","title":"Nipple Reconstruction Using the C-V Flap Technique: Long-Term Outcomes and Patient Satisfaction"}
{"_id":"6d2b861c-dd6f-fdcb-bfef-096a58a1ea27","text":"This study shows that breast cancers survivors have a smaller amount of their new breast cancers detected at mammography screening, when compare to the amount of new breast cancers detected at mammography screening among women without previous breast cancer. The lower sensitivity does not seem to be due to different behavior among breast cancer survivors.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"6d331d65-aedc-fc0f-8d95-0cf02a2ba337","text":"Since the morbidity of upper trapezius palsy following neck dissection with spinal accessory nerve sacrifice is well known, we sought a functional restoration of the upper trapezius by means of an innervated gracilis free flap [7,14]. Adequate muscle tensioning and precise technique enabled us to restore most of the trapezius strength minimizing postoperative morbidity. The outcome of surgical treatment was excellent, suggesting that when adequate reconstructive techniques to restore function are available, the threshold to consider surgical treatment of DT can be lowered. As described by Ihara et al., another optimal donor site suitable for reconstruction of the trapezius muscle can be the latissimus dorsi [15]. We believe that the gracilis is the best reconstructive option for small and medium-size defects mostly because of the minimal morbidity of the donor site and its use in reconstructions of the head and neck district is well established. In addition, it has the advantage that it can be comfortably harvested by a second surgical team while the first one takes care of the resection. The latissimus dorsi is a broad and flat trunk muscle that is closer in features to the trapezius and has been described as a pedicled flap for its reconstruction. Its shape and dimensions make it a valid option for the reconstructions of larger defects","title":"“Functional trapezius muscle reconstruction after resection of a desmoid tumor using an innervated gracilis free flap”"}
{"_id":"6d331f02-fca5-ea2f-5857-5476baf95fbe","text":"The enzymatic degradation was monitored following the increase in the soluble fraction during the incubation time.","title":"New Directions in Aesthetic Medicine: A Novel and Hybrid Filler Based on Hyaluronic Acid and Lactose Modified Chitosan"}
{"_id":"6d333600-5480-bbd7-3a2b-fc7b24fbf6a5","text":"Thumb pulp defects are commonly due to avulsion injuries. It is very important to reconstruct these defects using sensate flaps as the thumb pulp needs to be sensate for implementing the various functions of the thumb. A very good option for coverage of these defects is the islanded first dorsal metacarpal artery flap. Our study was done over a period of 2 years and involved 9 consecutive cases of thumb pulp defects treated at our institution. The patients included 8 males and 1 female, ranging in age from 16 to 51 years old. The flap size ranged from 2 × 1.5 cm to 5 × 3 cm. We had only one complication in the form of partial flap necrosis, which fortunately healed following debridement without the need for a secondary procedure. All our cases were done under local anesthesia with tourniquet control. All the patients had good fine touch and average two-point discrimination of 6 mm, which was satisfactory. Our good results further reinforce the islanded first dorsal metacarpal artery flap as one the best flaps for sensate reconstruction of thumb pulp defects. It replaces the soft tissue loss at the thumb pulp with minimal donor site morbidity and with good return of thumb pulp sensation.","title":"First dorsal metacarpal artery islanded flap: A useful flap for reconstruction of thumb pulp defects"}
{"_id":"6d35ab9d-1d8b-c55c-4c6f-1386d845706a","text":"Paravertebral block is currently the gold standard for management of chronic thoracic pain. Unfortunately, contraindications such as coagulopathies or anticoagulant therapies and the difficulty in performing the block may determine the exclusion of many patients from this treatment.","title":"Ultrasound‐guided Erector Spinae Plane Block (US‐ESPB)—Anesthetic block: Case report"}
{"_id":"6d45ac74-afb4-1dfe-d89e-ee03e339f7f4","text":"The conclusion of our study is that AF is commonly found among children below 15 years of age, affecting males more as compared to females. Positive margins after surgery indicate a high risk for disease recurrence therefore; primary surgery with negative margins is the treatment choice for children with AF. However, radiation may assist in maintaining local control of these tumors in patients with positive margins or residual disease therefore use of adjuvant therapy in children with AF may be a reasonable alternative. However, multicenter prospective (randomized) trials will be necessary to clarify the role of adjuvant treatment for patients with pediatric AF.","title":"Aggressive fibromatosis in pediatric population—A case series"}
{"_id":"6d48c2fb-9cd7-fb1c-c4d0-6a75b54c4b7f","text":"A better understanding of leadership implementation efforts, as well as how and why leadership is effective and in what contexts, will help to facilitate more successful efforts to identify and advance clinical leadership in surgery. Filling this knowledge gap will identify the contextual influences and the mechanisms of evidence-based implementation which will be crucial to the development of targeted implementation interventions in the surgical specialties [28]. To achieve this depth of understanding, our study will examine surgical leadership across a range of hospital contexts to answer the following research question: How can clinical leadership be improved to enhance the use of evidence in orthopaedic surgical practice?","title":"Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol"}
{"_id":"6d4d544f-9f0e-54fd-e181-aad2e81387f6","text":"Doppler ultrasound has also been used on cadavers to explore the anatomical feasibility of harvesting an artery for sural artery perforator flap. It is a reliable tool for mapping the arteries of the lower leg for harvesting of the medial and lateral sural artery perforator flap [26].","title":"A Comprehensive Review of Medical Imaging Equipment Used in Cadaveric Studies"}
{"_id":"6d53a411-9b9a-85e7-5fb0-8b4457a34436","text":"Although there is evidence that breastfeeding can assist children with a history of relational trauma to heal, breastfeeding is not a panacea and will not solve every difficulty. Thus, while breastfeeding may comfort children and assist in the development of the attachment relationship, this does not mean that every adopted child who breastfeeds will develop a secure attachment with their mother. Building a trusting relationship with a child who has been abused or neglected can be extremely difficult and developing a secure attachment may be impossible for some children. In some cases, day-to-day life can be so difficult for children with histories of relational trauma and their families that assistance from mental health professional will be required. In addition, even where children with a history of relational trauma are able to form secure attachments with their caregivers, early abuse or neglect may have a permanent impact on brain functioning [107, 151]. However, children who have formed secure attachments with their adoptive parents will be best able to function in spite of deficits. Thus, breastfeeding is one tool that mothers can use to provide nurturing as they seek to develop trust and attachment with their child and should be used with other parenting strategies that will promote attachment. Nonetheless, though families still face many challenges as a result of their child's history, mothers who have initiated breastfeeding with their child have universally expressed that breastfeeding was helpful to them and their child.","title":"Mental health, attachment and breastfeeding: implications for adopted children and their mothers"}
{"_id":"6d57a42c-0842-5f3a-f63e-606d7b717e98","text":"In 5 of 14 enrolled patients elective implant removal was performed by the patients’ explicit request because of complaints such as pain if carrying a heavy backpack or sensitivity to weather changes. In the current literature, routine removal of metal implants remains a controversial issue with a lack of evident guidelines in the surgical treatment of acute clavicle fractures as well as of clavicle non- or malunions. Due to the typical surgical risks and complications, implant removal should only be performed in symptomatic patients after a detailed discussion of potentially available treatment options. Compared to other bony sites of the upper limb, removal of metal implants is most commonly performed in the clavicle [24], most likely because of the prominent subcutaneous position of the implant especially in athletes with poor soft tissue coverage. In our collective, in 5 patients removal of implants was performed at the earliest time point two years after surgery and only after integration of the bone graft and bony union had been proven by CT. However, one patient presented five weeks after elective implant removal with a re-fracture of the clavicle. She reported a sudden onset of pain in her shoulder during swimming. Although swimming constitutes a questionable adequate trauma we recommend to restrain from sport activities for at least 8 weeks after implant removal. However, evidence for a reasonable recommendation is lacking and benefit as well as risks of implant removal have to be investigated in further studies.","title":"Mid-term outcome following revision surgery of clavicular non- and malunion using anatomic locking compression plate and iliac crest bone graft"}
{"_id":"6d5987c6-8678-7b1f-f6cf-67b1db9d0ec3","text":"High rates of loss-to-follow-up of patients have made it difficult to implement treatment protocols effectively. Medications that should be administered every 3 weeks can sometimes be administered every 6 weeks because that is when patients show up. Sometimes patients get lost completely preferring to get medication from herbalists and faith healers. We are engaging community health workers to solve this problem. We are also encouraging our patients to enrol in the National Hospital Insurance Fund because insurance will reduce the number of patients lost to follow-up due to lack of funds.","title":"Developing medical oncology in Africa"}
{"_id":"6d5f3e85-48c6-ea81-ad13-66b9938cc63b","text":"The histopathologic differentiation between aggressive fibromatosis and other closely related spindle cell lesions like fibrosarcoma, neurofibroma, nodular fascitis, fibrous histiocytoma and infantile myofibromatosis are a challenge to the pathologists as it requires expertise to differentiate the finer details. But the major challenge in dealing with the lesions of fibromatosis is to avoid an overdiagnosis of fibrosarcoma and an underdiagnosis of reactive fibrosis. Fibromatosis has a more uniform growth pattern, more mature cells and a paucity of mitosis compared with fibrosarcoma. Reactive fibrosis such as that following injury or trauma has a more variable growth pattern than fibromatosis and may show areas of focal hemorrhage or hemosiderin deposition.[1]","title":"Aggressive fibromatosis of anterior maxilla"}
{"_id":"6d65ccd0-c976-b62a-e0f3-75b369f0d425","text":"With regard to local recurrence we prefer to monitor the site by regular patient self-exams and physician exams of the surgical site at routine intervals. If there is a concern based upon the physical examination or if the patient is felt to be at particularly high risk of local recurrence then an MRI with and without gadolinium enhancement is warranted to evaluate for a potential local recurrence.","title":"Multidisciplinary Management of Soft Tissue Sarcoma"}
{"_id":"6d664226-f3d1-01f2-546a-003707d40dfe","text":"The rationale of this procedure of vascularized pedicle bone grafting is based on the following three points:","title":"Osteonecrosis of femoral head: Treatment by core decompression and vascular pedicle grafting"}
{"_id":"6d716e8f-730c-dd21-69e6-5ac729930572","text":"In cases where the sentinel lymph node is negative, adjuvant radiation therapy is used to reduce the probability of local recurrence of the tumor.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"6d7767ed-b476-1a8d-c1c9-0871c157454c","text":"There were no differences in sunburn prevalence between intervention and control groups. Protection routine 1 and 2 both increased the overall protection score compared to non-users. Protection routine 1 increased the reported use of shade and decreased time exposed in the sun. Protection routine 2 increased the use of hat and sunscreen amount.","title":"Novel sunprotection interventions to prevent skin cancer: A randomized study targeting Danes going on vacation to destinations with high UV index"}
{"_id":"6d7b48d3-8545-b87a-d015-e92460ce00bf","text":"Photodynamic therapy is a medical procedure based on the activation of the molecules of various exogenous or endogenous chemical substances called photosensitizers by a light source emitting radiation of an adequate wavelength, usually situated in the visible spectrum; the photosensitizers are chemical compounds with the property of being able to selectively concentrate in the neoplastic cells. The energy captured by the molecules of the substances captured within the tumor cells is subsequently discharged in the surrounding tissue, triggering certain photodynamic reactions that result in the destruction of the tumor [6].","title":"Photodynamic therapy in the treatment of basal cell carcinoma"}
{"_id":"6d7dac50-65f3-b99b-fec6-5ef43421b6c3","text":"The season as well as the temperature were used for cohort selection. All patients who underwent surgery from 1 November 2018 to 30 April 2019 were assigned to the winter group. All patients who underwent surgery between 1 May 2019 and 31 October 2019 were assigned to the summer group.","title":"Seasonal Impact on Free Flap Surgery in Terms of Flap Loss and Wound Healing Disorders: A Retrospective Cohort Study of 158 Free Flaps"}
{"_id":"6d8261a9-70d6-32b6-c548-421e8c70ea24","text":"Postoperative radiotherapy significantly improved the PFS compared to surgery alone. Therefore it should always be considered after a non-radical tumour resection and should be given preferably in an adjuvant setting. It is effective in limb preservation and for preserving the function of joints in situations where surgery alone would result in deficits, which is especially important in young patients.","title":"The impact of radiotherapy in the treatment of desmoid tumours. An international survey of 110 patients. A study of the Rare Cancer Network"}
{"_id":"6d8435fb-e0e4-2d04-7513-7cbfbb140b28","text":"Six cases had a dry tap and in 26 cases less than 0.5 ml synovial fluid was aspirated, which was sent for microbiological analysis and returned negative. Analysis of further synovial fluid parameters such as WBC count and others was not performed due to the limited amount of synovial fluid.","title":"Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery"}
{"_id":"6d90bea3-8942-4165-3fc3-f689bdae1e5a","text":"In the RSA groups, the early designs of fasciocutaneous flaps extending along the vertical axis of the leg with a proximal pedicle have been modified by the use of transverse flaps with a lateral or medial pedicle, and lastly with a distal pedicle. Present studies also took note of the fact that the blood supply to the fasciocutaneous flap was provided by the perforators from underlying muscle, septocutaneous perforators, and axial vessels. Perforators system in the lower extremity are the clinical bases of designing fasciocutaneous flap.","title":"The Clinical Outcome of Perforator Based Sural Artery and Propeller Flaps in Reconstruction of Soft Tissue of Extremities"}
{"_id":"6d94d1b6-b862-82c4-4148-e6f9545c876d","text":"In the head and neck, TLND includes dissection of all regional lymph node basins affected. Clinically involved parotid gland lymph node requires superficial parotidectomy with preservation of the facial nerve and modified radical neck dissection of the ipsilateral lymph nodes. Total parotidectomy is associated with a higher risk of facial nerve injury. If the posterior neck triangle lymph nodes are pathologically involved, dissection of these is required with preservation of the spinal accessory nerve. Intraoperative US may aid in the identification of additional abnormal lymph nodes in the neck.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"6d96f161-9d30-dc02-5f2a-6f782bdca71b","text":"Once the treatment options have been explained, the patient has the radiolabelled monoclonal antibody imaging explained and informed signed consent is obtained. The patient is asked about any allergies to inoculations. If positive the patient would be excluded from the test but no such patient was found so none were excluded. The breast surgery is usually undertaken within a month of the histological diagnosis and the imaging with Tc-99m hHMFG1 within 2 weeks before surgery.","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"6d98e6b7-5ccb-18eb-eade-73590e22fd4a","text":"Rhinoplasty is one of the most common plastic surgical procedures performed among Iranians. Performance of such surgeries on Iranians with the existing ethnic variety encourages the need for an analysis of this particular population.","title":"Structural Characteristics of the Iranians Nose: An Anatomical Analysis"}
{"_id":"6da5f555-dfd5-bb79-4f49-b4fa44efcfb7","text":"There are no good randomized clinical trials of treatment for desmoid tumors and most studies are based on small case series. The effects of treatment are further compounded by the variable natural history of the disease with some tumors apparently regressing or remaining stable even without treatment [1].","title":"A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report"}
{"_id":"6db5f8a1-c487-7569-f610-1cd8b4c5e2f0","text":"Both treatment methods (NPWT and conventional dressings) are well established and used in the treatment of acute and chronic wounds. As it is unknown whether there is any difference in outcome between the two treatment modalities, neither patient group may be regarded as receiving preferential treatment. In this study, we will allocate treatment at the end of the first surgery so there is no difference between the groups in terms of surgical risks.","title":"Negative-Pressure Wound Therapy Versus Standard Treatment of Adult Patients With Conflict-Related Extremity Wounds: Protocol for a Randomized Controlled Trial"}
{"_id":"6dc208d1-8873-2b91-6c35-1e3430c47538","text":"If prolonged blanching and pain occurs while injecting the filler, there is a possibility that cutaneous arteriolar occlusion has occurred. The immediate administration of heat, massage of the area and application of the nitroglycerin paste should be performed while the patient is still in the office and at home by the patient until the symptoms subside. If a hyaluronic acid-based filler was used, hyaluronidase can be injected in the blanched, painful area and around the vessels involved and in order to disrupt the product and decompress the vessel in the hypoxic area.","title":"Fillers: Contraindications, Side Effects and Precautions"}
{"_id":"6dcb91c0-b104-4c63-e44c-88b4cdd809cb","text":"Allergy and hypersensitivity can affect people of any age and manifest with problems in a range of organ systems. Moreover, they can have a significant impact on the quality of life of patients and their families. Although once rare, there is presently an epidemic of allergic disorders with associated considerable societal consequences.","title":"Dissemination of definitions and concepts of allergic and hypersensitivity conditions"}
{"_id":"6dcbce47-c40f-ae48-8f84-7462d1ff8597","text":"In conclusion, we demonstrate for the first time that S45F mutation of CTNNB1 may serve as a prognostic marker in patients with sporadic desmoid tumors treated with conservative treatment with meloxicam. Given the current shift in the treatment modality for patients with desmoid to conservative treatment, the identification of prognosticators for conservative treatment is more important than ever. Mutation status of CTNNB1 may be a promising tool to predict the efficacy of conservative treatment including meloxicam.","title":"CTNNB1 S45F Mutation Predicts Poor Efficacy of Meloxicam Treatment for Desmoid Tumors: A Pilot Study"}
{"_id":"6dcfd1e4-f89b-cb1a-7539-a4eda859f383","text":"These procedures are among the modality of maxillofacial surgery that have developed most in recent years because of faster techniques that decrease morbidity.","title":"Service Profile of Orthognathic Surgery of a Medical School"}
{"_id":"6dd1a055-12a1-65c5-8853-690934070efc","text":"There are several inherent limitations to the survey. Given the lower response rate from the survey, it is possible that the results may not represent the predominant surgical practices and experiences of facial aesthetic surgeons. It is also possible that the survey was sent to a large number of The Aesthetic Society members who do not perform a significant number of facelifts, which may have led to a dilutional effect and the low response rate. Since the survey was sent only to The Aesthetic Society members, there are surgeons outside the society who do not have their perspectives reflected in these results. Additionally, questions related to the respondents' opinions regarding potential facelift complications related to fillers or speculation on their patients' history of filler injections are subjective and therefore, open to bias.","title":"Potential Effects of Repetitive Panfacial Filler Injections on Facelift Surgery and Surgical Outcomes: Survey Results of the Members of The Aesthetic Society"}
{"_id":"6dd87e40-c795-7813-3978-322b0f8ac09f","text":"Clinical core and cutaneous punch biopsies remain a valuable tool in the diagnosis of breast cancer particularly in the management of clinically suspicious radiographically occult malignancies.","title":"Clinically guided core biopsy and cutaneous punch biopsy in the evaluation of breast lesions: a necessary test or an obsolete skill?"}
{"_id":"6de1ed82-b1fd-96d5-f5aa-45de4e15dc4b","text":"Tissue match for more complex defects is somewhat limited. Generally, only fat and skin can be carried with this flap. While vascularized clavicle can in theory be transferred, the bone does not have enough reach to be useful for almost all defects in the head and neck. The lack of muscle also makes it less ideal for sealing oral or pharyngeal defects following chemoradiation. The color and texture match of the supraclavicular flap for facial defects is generally superior to distant free donor sites and regional pedicled donor sites on the torso.","title":"Regional pedicled flap salvage options for large head and neck defects: The old, the new, and the forgotten"}
{"_id":"6df9d84e-504e-018a-a544-cc1669ac24af","text":"Breastfeeding practice was universal but exclusive breastfeeding was lower and discontinued earlier with early initiation of complementary feeding. Lack of time due to work was the most common reason stated behind not exclusively breastfeeding and starting complementary food early. Thus, supportive environment should be provided to encourage women to exclusively breastfeed and continue breastfeeding for longer duration.","title":"Practice of Breastfeeding and its Barriers among Women Working in Tertiary Level Hospitals"}
{"_id":"6e043364-886a-ad26-1132-464347cdc8fe","text":"The clinical and atypical histopathologic features of this case series are summarized below in Table 1 and Figure 12 and Figure 13, respectively.","title":"COVID-19 Vaccine-Induced Lichenoid Eruptions—Clinical and Histopathologic Spectrum in a Case Series of Fifteen Patients with Review of the Literature"}
{"_id":"6e059e81-5989-39b3-49f6-591bb09fc0ec","text":"Despite the fact that injectable filler usage in the gluteal region has not been recommended in formal medical institutions, illegal procedures are performed in many clinics and beauty centers across Egypt. This case report illustrates the illegal practice culminating in a fatal complication.","title":"Fatal pulmonary embolism following injectable gluteal filler usage: a case report"}
{"_id":"6e15f101-784c-f414-234c-90ea3a06ed25","text":"Choosing great vessels as one side of anastomosis is safe and can be done as a primary approach due to technical demand or as a final resort when there is shortage of side branches.","title":"Anastomosis of Free Flap Pedicle to Great Vessels"}
{"_id":"6e18a3dc-47c9-6745-ccae-ac288f17c3b2","text":"Participants in the FGDs spent considerable amount of time discussing the problems of their training programme. In addition, they tried to analyse the factors contributing to these problems and to giving suggestions for solutions in order to improve the quality of training.","title":"Needs assessment study of postgraduate surgical education in Sudan: Trainees perspective"}
{"_id":"6e19e9ee-cae6-d9af-c883-e9ef933d24c3","text":"Knowledge seems to make team leaders confident. Therefore it is not surprising that this is mentioned as important by several team members. Professional competence gives the leader authority. It will also give the leader a sense of confidence that might make it easier to live up to the expectations resting upon him. A study of pediatric residents showed that improving technical skills made the residents more confident in their leadership [17]. A confident leader with little medical competence is even more dangerous to the team work and for the patient's wellbeing.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"6e20a42d-001f-b177-75f5-37b07cd545db","text":"Identify the site and nature of lesions resulting in the determinations of Progression Free Survival per RECIST 1.1 guidelines","title":"The Proceedings of the 19th International Cancer Imaging Society Meeting and Annual Teaching Course"}
{"_id":"6e2f1f17-ef03-a336-d430-f28748f12053","text":"These results imply that necrosis of a cutaneous perforator angiosome territory can occur after sacrificing its supplying perforator if the territory is located far from another territory which still supplied by its intact perforators. Accordingly, the leading cause of our partial flap necrosis cases may be that the distance between the proximal flap portion and the perforators from DB-LCFA was too far for the blood circulation to be maintained after sacrificing the perforators from TB-LCFA. However, determining the proximal limitation of a wide ALTP flap within a safe distance from the perforators of DB-LCFA is technically impossible due to anatomical variations and the lack of evaluation methods. Thus, preoperative flap size or design adjustment to avoid proximal flap necrosis is also impossible.","title":"The turbocharged wide anterolateral thigh perforator flap to reconstruct massive soft tissue defects in traumatized lower extremities: A case series"}
{"_id":"6e411875-4290-2a87-157a-254df50c885b","text":"Direct elliptical closure undermining the supraperichondrial or supraperiosteal plane was usually used for defects up to 1 cm in diameter. Upper nonsebaceous nasal areas were most amenable to direct closure.","title":"Reconstruction of Nasal Skin Cancer Defects with Local Flaps"}
{"_id":"6e41ac85-74d2-f91f-d0ad-5454ab0e40df","text":"We hope this article will reach out to the junior hand surgeons so that this useful flap can be utilized more effectively. This is the primary aim of this article.","title":"First dorsal metacarpal artery islanded flap: A useful flap for reconstruction of thumb pulp defects"}
{"_id":"6e43d4cd-0233-4438-6965-0b14bdc5039e","text":"The vascularised free chondrocutaneous flap allows reconstruction of the three layers of the nasal ala: the inner lining, cartilaginous framework and outer skin, in one procedure. Due to similar sun exposure, the auricular skin also provides a good match to nasal skin in terms of colour and texture. The natural curvature of the helical rim at the root is similar to that of the nasal ala. The resulting ear defect with be reconstructed at a later stage using a cartilaginous graft from the costal margin and skin grafting.","title":"Reconstruction of a full thickness nasal alar defect following resection of a BCC with a vascularised chondrocutaneous helical rim flap: a case report"}
{"_id":"6e49a559-a894-4ec7-4fcd-cc250918b8f3","text":"Cutaneous metastasis following colorectal cancer resection is a well-recognised entity though rare. Any unusual skin lesions especially on the abdominal wall skin, previous incision scars or near the stoma should be biopsied early to rule out metastatic disease and systematic work-up should be carried out to rule out any metachronous tumour or metastasis elsewhere in the body.","title":"Late recurrence of large peri-stomal metastasis following abdomino-perineal resection of rectal cancer"}
{"_id":"6e58f9e7-4195-d436-486a-16804d8e5e07","text":"The analysis of Adverse Events Following Immunization (AEFI) is important in a balanced epidemiological evaluation of vaccines and in the issues related to vaccine injury compensation programs. The majority of adverse reactions to vaccines occur as excessive or biased inflammatory and immune responses. These unwanted phenomena, occasionally severe, are associated with many different endogenous and exogenous factors, which often interact in complex ways. The confirmation or denial of the causal link between an AEFI and vaccination is determined pursuant to WHO guidelines, which propose a four-step analysis and algorithmic diagramming. The evaluation process from the onset considers all possible “other causes” that might explain the AEFI and thus exclude the role of the vaccine. Subsequently, even if there was biological plausibility and temporal compatibility for a causal association between the vaccine and the AEFI, the guidelines ask to look for any possible evidence that the vaccine could not have caused that event. Such an algorithmic method presents several concerns that are discussed here, in the light of the multifactorial nature of the inflammatory and immune pathologies induced by vaccines, including emerging knowledge of genetic susceptibility to adverse effects. It is proposed that the causality assessment could exclude a consistent association of the adverse event with the vaccine only when the presumed \"other cause\" is independent of an interaction with the vaccine. Furthermore, the scientific literature should be viewed not as an exclusion criterion but as a comprehensive analysis of all the evidence for or against the role of the vaccine in causing an adverse reaction. Given these inadequacies in the evaluation of multifactorial diseases, the WHO guidelines need to be reevaluated and revised. These issues are discussed in relation to the laws that, in some countries, regulate the mandatory vaccinations and the compensation for those who have suffered serious adverse effects.","title":"Causality assessment of adverse events following immunization: the problem of multifactorial pathology [version 2; peer review: 3 approved"}
{"_id":"6e60ffc8-8368-b50f-0773-1d81c8a31d87","text":"The management of non-unions of the tibia with a skeletal defect is a big challenge for the orthopaedic surgeons. Distraction osteogenesis has been used effectively to resolve this problem. This technique involves a corticotomy above or below the defect followed by progressive transport of the normal bone segment into the bone defect. The gap created at the corticotomy site is filled with new bone called regenerate. The junction of the healthy bone segment and the end segment is called the docking site. Defects of the tibia measuring less than 3cms are treated with acute docking and lengthening wherein the bone defect is acutely closed and length achieved by distraction at the corticotomy site.","title":"Role of Primary Autologous Bone Graft at Docking Site in the Treatment of Infected Non-union Tibia Using Rail Fixation System"}
{"_id":"6e644df4-671e-3f73-b295-c75877f723c4","text":"We did not found changes in B lymphocytes and ERα levels because it may be more appropriate to search for plasmatic cells. B cells did not change because their production may also not be affected by BPA, with its differentiation to plasmatic cells potentially being the key. We are currently working to elucidate this effect of BPA. As for the ERα, the binding of BPA probably does not affect its expression and thus, there will be no changes despite the mechanism of action occurring through that pathway. To block ER using tamoxifen or ICI-250 would help to dilucidate if the BPA mechanism of action only occurs by binding to ERα. Otherwise, it is possible that other steroid hormone receptors are involved in the BPA effect, such as PR or even ERα.","title":"Neonatal Bisphenol A Exposure Affects the IgM Humoral Immune Response to 4T1 Breast Carcinoma Cells in Mice"}
{"_id":"6e650068-34bc-83fa-d697-d38221c9810c","text":"A rare complication after lower limb revascularization using a saphenous vein bypass graft in a crush injury patient where the saphenous vein graft was the sole supplying vessel to the leg is described; a pseudoaneurysm developed in the saphenous vein graft and caused active profuse bleeding through the surgical wound. The aetiology of this condition is uncertain but it could occur owing to slippage of ligature from one of the tributaries of the saphenous vein. The diagnosis was made by digital subtraction angiography. The pseudoaneurysm was successfully obliterated by glue embolization, which stopped the bleeding immediately, with preservation of distal flow, thereby salvaging the limb.","title":"Leaking pseudoaneurysm of lower limb saphenous vein graft: a rare complication and its successful treatment by endovascular embolization"}
{"_id":"6e67289f-78dc-065f-8c68-cdbc2f1b0f8c","text":"Conclusion: CNO diagnosis is often delayed due to lack of suspicion of the disease. This series suggests that biological therapy may represent an effective alternative in refractory cases. Further research into the disease is needed to ascertain the precise role of biological therapy in its management.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"6e6a1c36-124d-73fc-69ce-09da4857b2e7","text":"The complexity of surgical care can be summarized by the use of free tissue transfers per patient with the specific stage of ORN (Table 6). None of the patients with stage 1 disease required free tissue transfers. There were a total of 2 free flap procedures in 3 patients with stage 2 disease. On the contrary, there were 6 free tissue transfers in 6 patients with stage 3 disease, including 2 cases, where two simultaneous free flaps were utilized during a single procedure in either primary or secondary ORN reconstruction. One flap was required for external skin cover due to markedly contracted soft tissue envelope. The second flap was provided with either a pectoralis major myocutaneous flap or additional fasciocutaneous flap based on recipient vessel availability. There were no flap failures encountered in this series.","title":"Osteoradionecrosis of the mandible: a case series at a single institution"}
{"_id":"6e730f33-88cc-9ce9-0090-46afddc7c842","text":"Calcinosis refers to the deposition of calcium in the skin and subcutaneous tissues and can either be localised in the form of calcinosis circumscripta or diffuse, calcinosis universalis.","title":"Calcinosis circumscripta of the breasts: The deeper meaning"}
{"_id":"6e7ad7d0-d952-7e40-6939-ef19c8a157ea","text":"All data concerning participant information will be stored in REDCap and will only be accessible for staff members. All collected data will only be traceable by a code.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"6e7ddf11-9c21-de0c-1365-57e3510611e9","text":"As there was virtually no further soft tissue at the medial side of the flap, a wound healing disorder occurred postoperatively in this region. It took months of regular, daily wound cleaning and dry bandages until granulation tissue led to secondary wound healing.","title":"Late radiation sequelae as a consequence of breast-conserving therapy with cobalt irradiation aggravated by various risk factors RM Herman et al"}
{"_id":"6e82d98f-9830-5a03-acd1-3e1f649aea95","text":"The 3 patients in our case series developed local recurrence at the site of microvascular anastomosis within 10 months of their DBR, despite being disease-free for a long time following their mastectomy. In fact, one of the patients was disease-free for 10 years prior to her DBR and then presented shortly (4 months) after her reconstruction with local intercostal space recurrence. This temporal relationship between the DBRs and the recurrences therefore raises the question whether an aspect of the DBR such as the IMV dissection or general immunosuppression may have in some way stimulated the local breast cancer recurrence. Could it have activated dormant tumor cells present in the lymph nodes at the internal mammary dissection site present for instance in the IMLNs? It has previously been documented that surgical trauma and other stress factors can “activate dormant micrometastases” and this may be a potential explanation for the local recurrence in our patients.11 It is also conceivable that breast cancer cells which had metastasized to the IMLNs and lymphatics might have been inactive prior to the reconstructive surgery but were reactivated following the reconstruction. The patient who had incidental lymph nodes harvested during vessel exposure was found not to have metastatic malignancy at the time of DBR, thus suggesting that there was no evidence of locoregional metastases at the time of DBR. This finding would suggest that surgical trauma or other stress factors during the DBR may have “re-activated dormant micrometastases,” which months later caused the patient to present with local chest wall recurrence.","title":"Internal Mammary Recipient Site Breast Cancer Recurrence Following Delayed Microvascular Breast Reconstruction"}
{"_id":"6e8c93ac-c453-3b08-8635-a38794be7ac3","text":"The BTA allergic symptoms reported so far all occurred around the injection sites or primarily occurred in the injection sites before spreading to other sites. We have noticed several patients in our clinical practice who experienced inconspicuous and nonpruritic erythema on the chest after BTA injection into the upper face, but the injection sites showed no anomaly.","title":"Mild Allergic Reactions after Botulinum Toxin Injection: A Case Series and Literature Review"}
{"_id":"6e8e7e22-a763-af39-518c-3389533d1878","text":"The main inclusion criterion for the nucleoplasty treatment was discogenic pain without motor and sensory deficits not responsive to at least three months of medical treatment and physiotherapy. CT or MRI images should show a discal protrusion, bulging or a little migrated soft herniations.","title":"Percutaneous cervical coblation as therapeutic technique in the treatment of algo-dysfunctional pain of discal herniation"}
{"_id":"6e90172f-a82b-ef2a-b470-65e279570c56","text":"This antibiotic produced by Streptomyces venezuelae contains a nitrobenzene ring linked to propanol, with an amide group binding to a derivative of dichloroacetamide acid. Chloramphenicol is bacteriostatic against Gram positive anaerobic and Gram negative aerobic and anaerobic bacteria. Presently it is uncommonly used due to the risk of hematologic adverse effects.","title":"Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy"}
{"_id":"6e905824-749f-d9e1-7663-6416e7ce0a73","text":"The establishment of scholarly global health education and research tracks has afforded our medical students an active role in international SSS through participation in academic global surgery research. We propose that these complementary programs can serve as a model for disseminated education and training of the future global systems-aware surgeon workforce with bidirectional growth in south and north regions with traditionally under-resourced SSS training programs.","title":"A longitudinal surgical systems strengthening research program for medical students: the exploration of a model for global health education"}
{"_id":"6e93116c-4404-bc63-77ca-a0cdad52873e","text":"The zinc oxide powder was a 1:1 mixture of zinc oxide and potato starch. Figure 1 shows the general topical application procedure for the zinc oxide powder. Figure 2 shows topical application of zinc oxide powder for lesions that are difficult to treat, such as those close to the nasal cavity or the oral cavity.","title":"Clinical Usefulness of a Modified Mohs' Technique and Topical Application of Zinc Oxide Powder for Treating Skin Infiltration Caused by Unresectable Malignant Tumors"}
{"_id":"6e94d793-545a-0dc1-7a02-871164828aab","text":"Most of the systems were assessed to require subjective decisions at least to some extent. The OCEBM system again stood out as being assessed more favourably, although it may be related to omission of dimensions that require more subjective decisions. Judgement is clearly needed with any system. The aim should be to make judgements transparent and to try to protect against bias in the judgements that are made by being systematic and explicit.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"6e984b0b-e3ff-22d0-f737-d2987c7e6034","text":"Fertility preservation is a rapidly evolving field that includes medical and surgical treatments to decrease the impact of cancer treatments on future fertility. Ongoing trials will address the effectiveness of GnRH agonists in protecting ovarian reserve. Several technologies exist to help preserve future fertility including embryo cryopreservation, oocyte, and ovarian tissue cryopreservation. Embryo cryopreservation is currently the only recommended method of gamete preservation, but recent advances in oocyte vitrification may increase the utility of this treatment for cancer patients. Additionally, PGD may decrease the risk of disease transmission of hereditary cancer syndromes. The risk to the patient of IVF may also be decreased with recent advances in IVF stimulation protocols.","title":"Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review"}
{"_id":"6ead334e-5ca3-596e-2832-784fd680524f","text":"The combined use of bilateral FVFG and lower limb revascularization with a GSV graft is a somewhat heroic measure, but it can be a permanent and durable limb salvage solution for complex femoral defects. The functional and cosmetic advantages of this method are of great significance in the young population.","title":"Simultaneous reconstruction of the bone and vessels for complex femoral defect"}
{"_id":"6eadb86d-2192-967f-cf4c-fbef428902e4","text":"Ensuring that the randomisation forms, radiology report forms and discharge forms are completed and either entered on line or sent to the coordinating centre promptly and that copies are kept in a site file and patient notes.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"6eb84fe9-d37a-4918-0d77-92cad51236d4","text":"We developed a novel pedicled DIEP flap model in rat to explore the possible remedy for the distal necrosis of the flap.","title":"What’s the remedy for the distal necrosis of DIEP flap, better venous drain or more arterial supply?"}
{"_id":"6ebad80e-489b-8c9b-0721-62f801ea48bc","text":"The anatomical landmarks for standard ILND template are the inguinal ligament superiorly, the adductor longus muscle medially, sartorius muscle laterally, and the apex of the femoral triangle inferiorly. The dissection sometimes involves ligation and excision of the proximal greater saphenous vein and complete dissection of the femoral vessels within the femoral triangle. Sartorius muscle can be mobilized for coverage of the femoral vessels.","title":"Utility of Minimally Invasive Technology for Inguinal Lymph Node Dissection in Penile Cancer"}
{"_id":"6ec5d6f8-e794-be3c-5550-d094b3c08aa3","text":"The expression of glucose transporters GLUT1 through GLUT12 was evaluated in the RNA-seq dataset, and their proportionate expression was calculated by dividing the CPM for each transporter by the total GLUT mRNA expression and conveyed as a percentage.","title":"Novel Expression of GLUT3, GLUT6 and GLUT10 in Equine Gluteal Muscle Following Glycogen-Depleting Exercise: Impact of Dietary Starch and Fat"}
{"_id":"6ec6b09b-40a0-34e2-afd0-ac9f475a727b","text":"An argument might be made to perform staged surgery and look at the possible parameters on the formal histology of the resected tumour. Tables 1 shows that in this study, none of the parameters was able to reliably indicate a group of patients with a low level (under 5%) of axillary node involvement with the exception of grade 1 tumours less than or equal to 15 mm or grade 2 tumours under 11 mm, both without lymphovascular invasion.","title":"Sentinel node biopsy should be supplemented by axillary sampling in patients with small breast cancers"}
{"_id":"6ec7a357-c456-41d5-fcb9-163bf7a30f76","text":"Excluding CMA by DBPCFC successfully stopped unnecessary elimination diets in the long term in most children. The MEDs form potential useful information for offering dietary advice to patients and their caretakers.","title":"Double-blind placebo-controlled food challenges in children with alleged cow’s milk allergy: prevention of unnecessary elimination diets and determination of eliciting doses"}
{"_id":"6ecb1aaf-bfe5-9a63-986d-e05d483470d7","text":"A relatively long mean predicted survivorship of 11.2 years has been reported in children and adolescents with severe spastic CP and neuromuscular scoliosis who underwent surgical correction.31 In the same study, the most accurate determinant for survival rates was the number of days the patient stayed postoperatively in ICU, which is primarily related to pulmonary complications and reflects the preoperative general medical condition of each patient.","title":"Development and treatment of spinal deformity in patients with cerebral palsy"}
{"_id":"6ed00b1f-79ce-41bf-abc2-824e3bef55f4","text":"Plastic surgery training is undergoing major changes however there is paucity of data detailing the current state of training as perceived by plastic surgical trainees. Our aim was to determine the quality of training as perceived by the current trainee pool and their future plans.","title":"A survey of current state of training of plastic surgery residents"}
{"_id":"6ee17e3f-17c4-7e7e-1407-45f64f928785","text":"In the next set of operations, we utilized the layer compositing functions to specify material assignments. If the vessels are intramuscular and causing a subtraction in the rectus abdominis muscle, determined in the step above, a color channel based additive arithmetic composting operation is performed to modify that portion of the corresponding voxels associated to the intra-muscular vessels by color only, leaving the morphology unaltered. The resulting material differentiation specifying intra and extra-muscular vessels are exported as STL files by creating closed isosurface meshes at the midpoint of the material gradient between the rectus abdominis muscle and the intramuscular vessels.","title":"Hybrid modeling techniques for 3D printed deep inferior epigastric perforator flap models"}
{"_id":"6ee200e5-79c1-6d24-2222-42819dfc04ca","text":"We found this hierarchical order also expressed in the seating arrangements in team meetings.","title":"Cooperative leadership as a condition for patient-reported rehabilitation success"}
{"_id":"6ee6b433-eda1-7f64-64b5-b74fab1623e2","text":"Often after rhinoplasty, the minor irregularities are generally given little thought or attention, but they must be treated as precisely as possible to achieve the perfect profile. Our information obviously highlights the constructive effects of fluid cartilage filling on minimal irregularities of the nasal surface and the absence of major side effects. Fluid cartilage may fill in as a safe and effective treatment alternative to hyaluronic acid or traditional cartilage graft; more broad controlled examinations are required.","title":"Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage"}
{"_id":"6ee7c692-7373-9e1e-694c-2a6fbc93049e","text":"One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Le Saux’s review, over 10 years ago, suggested that shorter therapies could be efficacious and safe but emphasized the need for higher quality evidence. We hypothesize that new evidence has been published over this time period. Our study aims to now review the currently available evidence from randomized trials regarding duration of both parenteral and oral therapy for pediatric acute osteomyelitis.","title":"Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol"}
{"_id":"6ee83904-7735-afba-4741-a984e00ac6dc","text":"Acute transfer of the ipsilateral fibula with its vascular pedicle intact should be considered an option for the management of large tibial defects when techniques of bone transport or acute shortening\/lengthening are deemed too risky or entail an excessively prolonged treatment period.","title":"Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture"}
{"_id":"6f017894-9240-038e-add8-a2c78b73ddec","text":"Also, the site of the anastomosis itself needs to be protected from any pressure. If the anastomosis is in the area of the lateral face and neck, a modified cervical spine collar with sufficient space over the area of the anastomosis can aid in protecting it.","title":"Microsurgical Reconstruction of Extensive Oncological Scalp Defects"}
{"_id":"6f06fcc7-56db-98da-c121-bc022ec8b61e","text":"This study uses light and electron microscopes to gain a better knowledge of the interactions of calcium hydroxylapatite filler with the connective tissue of the skin and the modifications of the human deep dermis, after 2 months of treatment. Some morphological evidences of this observational study of filler treated tissue support-specific mechanism involved in the structural modifications of both filler microspherules and cells of the connective tissue. They demonstrate the absence of any immunological reaction and show that the used filler is modified very slowly over time by the action of cells of the connective tissue closely related to the filler without any activity of phagocytosis. Furthermore, associated with the modifications of the filler, evidences of stimulatory effects on dermal fibroblasts are reported.","title":"Microscopic and ultrastructural evidences in human skin following calcium hydroxylapatite filler treatment"}
{"_id":"6f0f343f-1837-672c-41b0-b55b467c78e0","text":"The mean number of positive nodes harvested was higher, although not significantly so, in patients undergoing primary axillary clearance compared to those having an axillary clearance following SLNB. This tendency may reflect bias due to preoperative selection of patients with clinically or radiologically positive nodes in the primary axillary clearance cohort.","title":"The Axillary Nodal Harvest in Breast Cancer Surgery Is Unchanged by Sentinel Node Biopsy or the Timing of Surgery"}
{"_id":"6f202b75-13c0-dde5-0f2e-1f270eccc1c0","text":"We report cases of two North African white patients with operated scrotal calcinosis. We describe the clinical and histological aspects as well as a pathogenic hypothesis and surgical management principles.","title":"Scrotal calcinosis: two case reports"}
{"_id":"6f23d427-3ced-c63d-b1e9-68c4fdca235d","text":"Limitations of this study include both its retrospective nature and a limited number of cases overall. Of the 112 procedures analyzed in this study, only 28 were unilateral block placements. This discrepancy between the number of recipients who received a bilateral block compared to those that received a unilateral block reduces the power of the study. Therefore, findings that were not statistically significant, such as the decreased MME among patients receiving bilateral blocks, may still be clinically significant. However, although the results of the study favor the use of bilateral paravertebral blocks, each case must be considered individually, and the interventionist must adapt to a variety of situations in which local anesthesia may be preferred over regional or general anesthesia. Further inquiry with a larger sample size in a prospective study design is necessary to elucidate and bolster the findings in this report.","title":"Evaluation of paravertebral blocks in improving post-procedural pain and decreasing hospital admission after microwave ablation of liver tumors"}
{"_id":"6f249d20-6e2e-c133-6aaa-b23b4b085ccf","text":"To evaluate the association of performing a SLNB with overall survival in intermediate thickness melanoma patients in a Dutch population-based daily clinical setting.","title":"Survival of sentinel node biopsy versus observation in intermediate-thickness melanoma: A Dutch population-based study"}
{"_id":"6f2843e7-c908-3de6-bc1b-c734cdf35056","text":"Usually the skin changes seen in Frey's syndrome are initially observed around the time of introduction of first solid food particularly following ingestion of citrus fruits and skin erythema is the most common change and it usually lasts for 30–60 minutes and resolves spontaneously.","title":"Recurring Facial Erythema in an Infant"}
{"_id":"6f340fe5-f411-1502-fc12-8dfb2f199f7b","text":"The present study aimed to identify mastectomized women’s perception of the quality of care provided by the cancer care network for the early detection and diagnosis of breast cancer in a large city in Northeastern Brazil.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"6f449a64-4ac2-59da-aa1e-d96f4da57ad2","text":"Once discharged from the hospital, patients were followed up weekly by the clinical occupational therapist and by nephrologists 3 times a week at the renal dialysis session looking for relapse of the calciphylaxis. Results were presented in tabular form for all the patients. Comparison of biochemical profile was made at and within 6 months after the diagnosis of CUA with overall results depicted as mean ± standard deviation, where applicable.","title":"Calcific Uremic Arteriolopathy on Multimodal Combination Therapy: Still Unmet Goal"}
{"_id":"6f475d2b-fca4-9e11-9241-08c30843882b","text":"Even a perfectly designed and executed reconstructive surgery needs appropriate postoperative care and followup to optimize the final outcome. Informing patients that their cooperation with postoperative instructions will contribute to optimal cosmetic results tends to increase patient compliance.","title":"Reconstruction of Nasal Skin Cancer Defects with Local Flaps"}
{"_id":"6f4f77be-05f2-c558-c4b1-0165abde8aba","text":"NIRS and SpO2 allow continuous monitoring, but the attachment of sensors limits their application to different body parts. Our sensor probe is expected to have good conformity to the tissue transplant on any body part because flexible devices can be attached to the skin much more securely than previous devices. Furthermore, existing NIRS and SpO2 monitoring devices are designed to measure only one point. Compromised circulation can occur partially in a flap. In many cases, partial circulatory failure in the flap can result in total flap loss. Therefore, multipoint mapping is required to detect partially compromised circulation as early as possible.","title":"Multipoint Tissue Circulation Monitoring with a Flexible Optical Probe"}
{"_id":"6f53773b-1838-bf85-fc8b-df44181a0c86","text":"A191 Current Practice of Infants and Children with Acute Urticaria at a Single Wide Regional Emergency Medical Center","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"6f539df4-2b16-fbb5-6a15-a58c99860d7d","text":"Careful and meticulous surgical dissection with a good safety margin around the lesion is required for adequate wide local excision to reduce the incidence of postoperative recurrence. It is interesting to note that the nerves and tendons are rarely involved in mycetoma [4], and extra care must be observed in dissecting these structures to avoid postoperative neurological and locomotor complications.","title":"The Surgical Treatment of Mycetoma"}
{"_id":"6f5b74eb-6452-66af-0dbf-537f279558d7","text":"Given the controversial results, we retrospectively evaluated a case series of trunk melanomas with negative SLNB. Melanomas of the trunk were choiced since they are responsible for the majority of multiple-LBD and we selected a sole anatomical area to gather a more homogeneous cohort of patients.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"6f5ce6fa-fe4b-b9c1-815f-810a89611f24","text":"Although there were lots of reports about brucellar infection involving the vertebral body or intervertebral disk, there were few previous reports about brucellar infection involving epidural space. Cervical spinal epidural abscess due to brucellosis is a rare condition, difficult to diagnose and can be complicated by disastrous neurological and vascular complications if left untreated. Hence, early diagnosis and initiation of appropriate medical and surgical treatment are lifesaving.","title":"Cervical spine epidural abscess caused by brucellosis: A case report and literature review"}
{"_id":"6f6083f4-31c6-6056-ec2e-1437d58f011a","text":"Breast reconstruction with a DIEP flap in the lithotomy position is useful for teaching institutions with additional operators. It provides sufficient working space and allows simultaneous procedures to be performed.","title":"Immediate Breast Reconstruction with a Deep Inferior Epigastric Perforator Flap in the Lithotomy Position"}
{"_id":"6f658ad1-2a7b-d857-91d5-034590a5e046","text":"Rising popularity of skin sparing mastectomy is due to better understanding of tumor biology and pattern of recurrence. Data showed that most of patients with local recurrence would progress to distant metastasis and the local recurrence could not be considered as an isolated event resulting from inadequate resections. As with all other types of mastectomy, SSM leaves some residual breast tissue behind but it has been proved that the stage of the primary tumor is the dominant predictor of local recurrence rather than the amount of tissue remains under skin flap.","title":"Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR) for early breast cancer: Eight years single institution experience"}
{"_id":"6f661370-39db-eea9-ac92-740899ff608e","text":"Autologous cartilage is used in our in respect of the first fundamental principle of nasal reconstruction. Use of an autologous graft is important to avoid rejection and helps to obtain a natural result, especially on skin nose tip that is very thin. Our technique does not require the use of cartilaginous graft reinforcement to improve the internal nasal valve degree, unlike other techniques that have been proposed.13, 14","title":"Functional results in airflow improvement using a “flip-flap” alar technique: our experience Resultados funcionais na melhora do fluxo de ar utilizando uma técnica alar em flip-flap: nossa experiência"}
{"_id":"6f70467b-9242-82c1-3a28-64209e93435a","text":"There are many classifications used for the subdivision of the axillary lymph nodes.","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"6f7133e4-b560-7d83-4185-531d46144776","text":"Postoperative care and monitoring were done for first 5 postoperative days. Anticoagulation with heparin sodium was initiated intraoperatively and continued until the 4th postoperative day. Patients were ambulated on the 10th postoperative day but were advised against any strenuous exercise for a period of 3 weeks. All skin sutures were removed 2 weeks after operation, following which cautious active hand movements were encouraged, except in cases where internal fixation was performed. K-wires were removed 4 to 6 weeks after surgery followed by functional rehabilitation program.","title":"Neo-digit functional reconstruction of mutilating hand injury using transplantation of multiple composite tissue flaps"}
{"_id":"6f721677-27a0-2d35-b318-971f108a62be","text":"It would also evaluate whether there is correlation between nodal status and margin positivity in relation to prognosis and overall outcome, to determine how these results apply as guide on re-excision policy.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"6f7375ee-316c-5589-5cd5-320fb48bff6c","text":"Chronic wounds with skin and soft tissue defects of lower extremities and exposure of bone and steel plate, the blood vessels of lower limbs were unobstructed, there are enough donor sites of skin flap at the back of the leg, and all patients are in good condition and can tolerate the operation and anesthesia.","title":"Analysis of the therapeutic effect of artificial leather embedding combined with fascial sleeve flap transplantation on chronic wounds of lower limbs with bone and plate exposure"}
{"_id":"6f7ac202-0df1-d094-72a4-8f47119e19bc","text":"In conclusion our procedure allows to be more confident with each single child when starting oral desensitization and it offered a better standardized approach to force tolerance avoiding individual variability.","title":"Oral desensitization to milk: how to choose the starting dose!"}
{"_id":"6f7d4f20-6417-130e-38d7-e72e1d1f9580","text":"The difference in the duration of analgesia after various blocks is due to different planes of drug deposition and the nerves anaesthetised. The differences observed in the duration of analgesia even after administration of standardised weight-based volume and concentration of local anaesthetic in a block can be attributed to the variation in structure and function of deep fascia and interfascial journey of somatic and sympathetic nerves. The time to request of the first rescue analgesia found in this study was comparable with previous studies.","title":"Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block Versus Erector Spinae Plane Block for Postoperative Analgesia After Modified Radical Mastectomy: A Randomised Controlled Trial"}
{"_id":"6f811d6d-2159-9d4c-ec57-c8f8a3debf77","text":"The number of subspecialty fellowship programs and approved positions has increased dramatically in the last 8 years. Many of the new programs were at community hospitals. The change in RRC rules has been associated with increased availability of fellowship programs in the university and community hospital setting for subspecialty training.","title":"Sponsorship of Internal Medicine Subspecialty Fellowships Since 2000: Trends and Community Hospital Involvement"}
{"_id":"6f85c206-fd15-a84d-8eac-e384bc0be4d6","text":"Fellowship directors may be reluctant to include off-cycle residents because they may present scheduling and orientation challenges. Other specialties have recognized problems with the July 1 timing of transition from residency to fellowship and have adopted delayed fellowship orientation and start dates. Orthopedic surgery fellowships agreed on an August 1 start in the 1990s, and in 2014, the American Board of Surgery moved all fellowships to a uniform start date of August 1. Delayed starts allow residents to complete all clinical requirements without taking vacation or other methods to move and begin fellowship orientation on time.","title":"A Nationwide Cross-Sectional Survey of Anesthesiology Fellowship Program Directors: Attitudes on Parental Leave in Residency and Fellowship Training"}
{"_id":"6f89ecd0-3277-aaf0-0908-38e28975351f","text":"The participant may be enrolled only if he or she meets each of the following criteria:","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"6f8c1fce-058b-e793-95d9-6b4f0237d212","text":"Therefore, the use of thermography in these cases is a tool to assist in the assessment of repair after a surgical procedure, as well as in the diagnosis of neovascularization in the surgical bed after the use of regenerative therapies.","title":"Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats"}
{"_id":"6f8fd630-fd5f-8cb5-4556-91a75ec258f5","text":"The purpose of this study was to further evaluate the safety and efficacy of fresh frozen, aseptically processed, and nonterminally sterilized CCSAs in complex primary and secondary rhinoplasty cases performed in Canada. All donor tissue was sourced from the United States and used in Canada. We did not experience any difficulty with obtaining the CCSAs from the United States for use in Canada. Our early experience has been favorable, with CCSAs providing stable structural support and predictable results at short\/mid-term follow-up. Although this is a small clinical series, complications were rare with no evidence of infection or warping of the CCSA, and resorption was not clinically appreciable when the CCSA was carved into sheets. However, 1 patient experienced resorption when the CCSA was diced and wrapped in autologous temporal fascia for dorsal augmentation. Two patients underwent revision surgery for further aesthetic refinement, but this was not attributed to a failure of the CCSA; these aesthetic issues were not secondary to warping or resorption of the CCSA. These findings offer further support for the use of CCSA in managing patients who lack sufficient native nasal cartilage to create a structurally stable nasal osseocartilaginous framework.","title":"A Canadian Experience With Off-the-Shelf, Aseptically Processed, Costal Cartilage Segment Allografts in Complex Rhinoplasty"}
{"_id":"6f902cc6-c596-4f36-9f35-7e6cef3d7146","text":"Surgery for resection of the breast primary and staging of the axillary nodes should be performed no earlier than 3 weeks after last dose of cytotoxic chemotherapy and no later than 12 weeks after the last dose of cytotoxic chemotherapy. All patients must undergo resection of the site of primary disease in the breast by either breast conservation or mastectomy. In cases with complete imaging response, surgical resection is still required to assess for residual disease at the site of the index tumor as this is a critical component of response assessment for evaluation of new drugs. The resection is guided by the residual tumor seen on imaging in relation to the clip placed at diagnosis. If the tumor is no longer present on imaging, the entire surgical bed does not need to be removed, and thus placement of multiple clips to map out the extent of a single tumor at presentation is discouraged. The area of the tumor must be sampled to confirm pCR, and the clip serves as guidance for such a resection. When the original tumor is diffuse and hormone receptor positive, it is more likely that scattered disease may be present over the area of the tumor bed, and this may impact the approach to surgical resection.","title":"Surgical Standards for Management of the Axilla in Breast Cancer Clinical Trials with Pathological Complete Response Endpoint"}
{"_id":"6f905c5a-9fb4-e35d-0384-8bc71e338275","text":"Concealment mechanism is provided by the REDcap software that allows the user to perform randomization without the possibility of knowing the outcome beforehand. The statistician that created the randomization file that was imported to the REDcap randomization module is a separate statistician, not the same as the study statistician, and is otherwise not involved in the study.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"6f9c80ad-9c64-92a2-6803-86463c2b1807","text":"One patient from group 1 with a contralateral RRM developed implant rupture 5 years later and the implant was replaced. Three patients in group 1 developed visible skin rippling and underwent 7 sessions of lipo-filling.","title":"Immediate and Long-term Complications of Direct-to-implant Breast Reconstruction after Nipple- or Skin-sparing Mastectomy"}
{"_id":"6f9d5d09-ffea-ba28-61ea-c3739addab63","text":"In conclusion, although there is some variability in the fellowships offered in the UK they are generally of high quality and prepare the fellow for progression into a consultant post. They help increase surgical confidence and provide opportunity to complete academic work. Fellowships without VR on-calls can be improved by incorporating this. Finally, COVID-19 impacted exposure to elective cases for some fellows. A similar system of fellowship regulation and endorsement such as that provided by AUPO in the US could be adopted by the Royal College of Ophthalmologists in partnership with BEAVRS. This can also include a yearly compulsory exit survey to ensure standards remain high.","title":"Experience gained during vitreoretinal fellowships in the United Kingdom"}
{"_id":"6fa0ca89-c0e2-0be7-d613-696df3b3610f","text":"To respect the anonymity of the institution in which we have conducted our research all we can mention is that it has been serving the higher education sector in Egypt for 50 years today and offers more than 18 specializations from diplomas, to master to doctoral degrees, in both the professional and academic arena.","title":"Students' perceptions of online learning in higher education during COVID-19: an empirical study of MBA and DBA students in Egypt"}
{"_id":"6fa3fe66-1e7c-b560-e2c7-12bb35ce6b92","text":"We applied specially formed TMC interbody bone graft technology designed specifically for a single one-stage posterior surgery. The design of the TMCs (usually two) is made appropriate to the size of the anterior column defect space after debridement; then, the TMCs are implanted in the anterior column through the channel after debridement; this reduces the difficulty during TMC implantation and also ensures the strength of the bone graft. The TMC design not only includes the transverse section design according to the particular shape for the bone graft but also includes the coronal and sagittal section designs according to the length of the bone defect.","title":"Debridement, internal fixation, and reconstruction using titanium mesh for the surgical treatment of thoracic and lumbar spinal tuberculosis via a posterior-only approach: a 4-year follow-up of 28 patients"}
{"_id":"6fb12218-1845-abbb-482f-765c0f8ef137","text":"This paper aims to review the published literature to determine the optimal timing and type of patient follow up and the nature of investigations to be performed.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"6fb7ab92-47ac-2650-764e-0d6985f1dec7","text":"An fine needle aspiration cytology of the tumor was done before planning for surgery which revealed the finding consistent with a tumor of the mesenchymal origin. All these findings were consistent with the recurrence of the previous lesion and the patient was prepared for surgery. Pre-anesthetic consultations were done and proper consent was taken from the patient. The patient underwent local excision of the tumor with a 3cm peripheral margin and the tissue defect that was created post-operatively was closed with a split-thickness skin graft taken from the left gluteal region. Mass of 8 × 5cm was excised and sent for HPE (Figure 3). Special effort was taken to avoid dissection beyond the midline over to the right side to prevent injury to the perforators. Wound dressing was inspected daily to look for any wound soakage and the graft was opened on the fifth postoperative day, the graft take was satisfactory on inspection. Subsequently, the drains were removed and the patient is doing well.","title":"Recurrent Dermatofibrosarcoma Protuberance: A Case Report"}
{"_id":"6fb997f5-d817-06c9-46c5-3625fcde0ea8","text":"The content analyses resulted in three main categories for promoting surgery and two main categories for discouraging surgery as a career. Tables 2 and 3 show the descriptions of the categories, subcategories, and representative examples of the statements for each subcategory.","title":"The Surgeon’s Perspective: Promoting and Discouraging Factors for Choosing a Career in Surgery as Perceived by Surgeons"}
{"_id":"6fb9a92d-a4c2-ac2f-aaa7-90d54458167e","text":"From a broader perspective, intraoperative identification of flap compromise, as opposed to postoperative identification, generally yields a better prognosis with reduced flap complications. The prognosis is also improved with fewer salvage attempts. In the case presented here, the existence of two adequately sized right IMVCs allowed us to use this unique salvage option. If there is only one adequately sized IMVC, as is often the case, other potential recipient vessels may include the lateral thoracic vein, thoracodorsal vein, and cephalic vein turn-down, among others.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"6fbb896c-6770-1ac6-be6a-df30c5fdb049","text":"Despite improvements to exclusive breastfeeding, failure to initiate and sustain breastfeeding is a challenge to achieving optimal breastfeeding practices. Interventions are required to address these challenges and support breastfeeding particularly among working mothers and HIV positive mothers.","title":"Are we doing enough? Improved breastfeeding practices at 14 weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa"}
{"_id":"6fc1e6ae-25b2-434c-944c-fda00dd9c750","text":"Additional prospective multicenter studies are needed to confirm these findings and identify predictors of LAA thrombus incidence and resolution\/persistence while treated with different anticoagulant regimens.","title":"Prevalence and Rate of Resolution of Left Atrial Thrombus in Patients with Non-Valvular Atrial Fibrillation: A Two-Center Retrospective Real-World Study"}
{"_id":"6fc3857a-6786-57c2-3421-1580fa0e6f9d","text":"The volume of fat graft injected and of the mixture of PRP + HA varies for every patient. Must be taken into account the quantity of available fat donor sites, the tolerance of the skin and the mucosa while injecting. We advice not to inject more than 30 cc of fat graft because of the increase risk of fat necrosis and infection in this area.","title":"Novel technique of vulvo-vaginal rejuvenation by lipofilling and injection of combined platelet-rich-plasma and hyaluronic acid: a case-report"}
{"_id":"6fcf1942-8968-2220-6953-102de2bd51b1","text":"The incision was commenced just above the medial malleolus. The vein was identified and cleared of all adventitia and connective tissue using sharp and blunt dissection. The skin was incised over the whole length of the vein to the required length and careful dissection was used to isolate the vein in situ, with attention given to avoid unnecessary trauma to the vein or its tributaries. Side branches were ligated with 4\/0 ethibond ligatures on the vein side and metal clips on the patient side. The leg wound was closed in layers and a full length pressure dressing was applied.","title":"Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest"}
{"_id":"6fd21a12-e1fa-a466-3147-838571b2173d","text":"An early correct diagnosis will thus allow for better management and a possibility to delay or even prevent the onset of asthma in children with eczema and the avoidance of further deterioration of lung function in children with asthma [16, 25].","title":"Phadiatop Infant in the Diagnosis of Atopy in Children with Allergy-Like Symptoms"}
{"_id":"6fd41024-fe01-2748-f084-d1795dcabdd2","text":"This fellowship has facilitated increased opportunities and new experiences for the Fellows with extended networks and visibility on a national and international level. This is evidenced by feedback from senior colleagues who credited the positive influence that the CPhOGH Fellows exhibited within their own departments to motivate others and act as role models. Workplace-based leadership training has been shown to increase willingness to lead [32]. These qualities and skills were challenged during the COVID-19 pandemic and it was acknowledged that the CPhOGH Fellows responded positively and were able to adapt to new ways of working.","title":"Assessing the Impact of a Global Health Fellowship on Pharmacists’ Leadership Skills and Consideration of Benefits to the National Health Service (NHS) in the United Kingdom"}
{"_id":"6fd63dec-9a65-2cb5-f28c-b329b3f0ef27","text":"There appears to be no consensus in terms of recommended skin biopsy techniques for definitive diagnosis, as well as the role of sentinel lymph node biopsy. Though sentinel lymph node biopsy is warranted in cases of palpable lymphadenopathy, current data on regional lymph node dissection are sparse and more research is needed for any recommendation.","title":"Updates on the Management of Non-Melanoma Skin Cancer (NMSC)"}
{"_id":"6fd6ef76-2615-1f5a-ad0d-4705d7b3fe6a","text":"In our case, emergent bilateral thoracostomy was performed using two 24-ch chest drains, one on each side. The clinical state of the patient allowed us to perform thoracostomy in the emergency room rather than needle decompression. Other colleagues confronted with intraoperative tension pneumothorax and the need for intraoperative resuscitation first carried out needle decompression and secondarily inserted chest drains. In such cases, the lack of time favors emergent needle decompression. We preferred to insert a medium-diameter chest drain in the seventh intercostal space at the mid-axillary line rather than in the second intercostal space at the mid-clavicular line to achieve a better postoperative aesthetic result. We do not believe that a chest tube of a smaller or larger diameter or another tube insertion location would have changed the outcome or would have had an effect on the total duration of the hospital stay. The chest drains were not directly placed on suction to avoid pulmonary expansion edema. No persistent air leakage from the thoracic drains was observed, so no further radiological examination or surgical procedure was necessary. The pneumothoraces resolved uneventfully over the next several days.","title":"Bilateral pneumothoraces complicating reduction mammoplasty: a case report"}
{"_id":"6fe05013-b54a-130e-48b2-4eafe3af7c0b","text":"Most studies reported a higher risk of subsequent primary melanoma in the first 2 years after the first primary melanoma and remains higher in the first 5 years. However, several studies reported the occurrence of second primary melanoma 2 or 3 decades after the first melanoma.[ Scheibner et al[ reported the occurrence of subsequent primary melanoma 41 years after the first diagnosis, which might indicate that the risk remains stable and does not diminish with time.","title":"Multiple primary melanomas: A literature review"}
{"_id":"6ff5ac66-e12f-b714-a433-7e8e53ed28e3","text":"It is only through open rhinoplasty that the author was able to manage and reconstruct 458 post-rhinoplasty deformities, an experience I wish to share in this article. I met the same satisfaction of improved results in 1200 of my other primary rhinoplasty cases.","title":"Secondary rhinoplasty"}
{"_id":"6ff5dd44-c0b2-813f-3037-09e74de38b58","text":"Gentle manipulation of vessels during micro-anastomosis is crucial to prevent damage to the endothelium and minimize the risk of thrombosis. In our institute, we use a meticulous technique that involves the use of stay sutures placed at 180 degrees along the vessel circumference, with anterior suturing performed first. To assist with optimal exposure, a cottonoid or similar gauze material with adequate frictional force is placed under the blood vessel and used to carefully rotate the vessel by 180 degrees. Hydrostatic dilation is achieved by squirting heparinized saline solution into the vessel lumen under pressure, which provides adequate exposure of the posterior wall while continuously monitoring the correct positioning of the stitches. This method avoids the need for an Ikuta approximator, which further minimizes the risk of injury to the delicate vascular tissue.","title":"Safe and effective thrombolysis in free flap salvage: Intra-arterial urokinase infusion"}
{"_id":"6ff8d1b3-37e8-7c01-1f93-3bf4ba2632ac","text":"Tracheotomy may generate anaerobic bacteraemia and related osteomyelitis in the specific setting of severe trauma patients. Clinicians should consider anaerobic vertebral osteomyelitis when they are confronted with a febrile tetraplegia after tracheotomy.","title":"Cervical anaerobic vertebral osteomyelitis following surgical tracheotomy: a case report"}
{"_id":"6ffb4c58-dbbe-96d1-5dbc-4e8dab8f726c","text":"Approval of the ethical committee of the National Cancer Institute of Cairo University was obtained to publish this data.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"6fff0d9c-81e1-7172-d137-3b8d5f874108","text":"The VEGF expression in primary cutaneous melanomas and their stromal microenvironment is not considered to be a reliable predictor of metastasis in the sentinel lymph nodes. The density of intratumoral and peritumoral lymphatic vessels was not able to predict the potential of metastasis in the sentinel lymph node. On the other hand, the presence of the ulceration and the lymphatic invasion can predict the poor prognosis, suggesting a high probability of the metastases in regional lymph node.","title":"Lymphangiogenesis and Its Correlation with the VEGF Expression and the Sentinel Lymph Node in Cutaneous Melanomas"}
{"_id":"70065d8e-ea1e-7508-05a3-470495c71590","text":"Parents were asked to video the case during feeding and it was also observed during the time of doing the US scan while feeding. It showed development of erythema on the right check extending to the right ear few minutes after starting solid food which was reported more with citric fruits and disappeared fully an hour after feeding ceased.","title":"Recurring Facial Erythema in an Infant"}
{"_id":"7009d75f-5dd6-4b14-3d30-12033aac3925","text":"The results of this study have shown that 18 MHz frequency sonography can be utilized as an uncomplicated and effective noninvasive technique for assessing acral melanoma prior to surgery. There exists a positive correlation between the thickness measurements obtained through 18 MHz ultrasound and histological analysis.","title":"The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients"}
{"_id":"700bdb88-0c72-a8e5-983b-37421c67a684","text":"The interaction between brachytherapy and senescence is potentially of paramount importance clinically. We presented strong evidence that brachytherapy provides significant survival benefit to patients with moderate to high senescence. Therefore, patients with moderate to high senescence should be treated with brachytherapy to achieve the best outcome. It will be important to reassess whether brachytherapy should be given to patients who have low senescence because no significant benefit was seen for these patients. This could be an even more critical decision in resource-limited countries so that brachytherapy can be delivered to high senescence patients. Our results also raised an interesting possibility that the benefit of brachytherapy is primarily through killing senescent cells while external radiation therapy may not be efficient at eliminating senescent cells. This hypothesis is worth further investigation.","title":"Senescence-Associated Secretory Phenotype Determines Survival and Therapeutic Response in Cervical Cancer"}
{"_id":"700d93d0-0fec-2707-9dc7-667e84a33e2a","text":"There was no difference of rSO2 between groups during surgery, but there was a significant effect of sevoflurane on the time course of postoperative reperfusion with higher rSO2 in the sevoflurane group at the end of reperfusion.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"70130d94-2989-3223-e1a6-96d179d6bbf5","text":"We recognise that our study has significant limitations. This was a retrospective audit, and all data relied on accurate recording of clinical details. We validated the cases where there was a suspicion of inaccuracy and crosschecked the information with community databases whenever possible.","title":"Prevalence of venous thromboembolism in patients undergoing diagnostic venous ultrasound during the first SARS-CoV-2 pandemic: A personal history of VTE and a positive COVID-19 test are associated with the diagnosis of DVT"}
{"_id":"7021a244-5a2e-8e53-abee-9c7664062127","text":"• Discontinuation of postoperative prophylactic Antibiotic within 24 hours after surgery Preoperative Antibiotic Administration timing within 60 minutes","title":"Sixth Annual Mediclinic Middle East Research Conference"}
{"_id":"702cd927-1f24-e6b9-3eb1-24a00aba27a4","text":"Although there is an increasing appetite in the plastic surgery community for expert peer-reviewed literature on the applications of artificial intelligence in surgery, it is important to note that the democratization of access to AI resources currently makes it possible for plastic surgery innovation to come from within our community. Surgical skills and clinical intuition are necessary but insufficient conditions to implementing such powerful technological advances as AI in the field of plastic surgery. The authors are optimistic that, equipped with the basic tools contained herein, plastic surgeons will be able to navigate technical conversations with peers, trainees, patients, and technical partners for collaboration and to usher in a new era of technology in plastic surgery. Most importantly, they will be able to think critically about study design involving AI and plastic surgery. For now, we will continue to identify and explore opportunities related to AI that can benefit plastic surgeons and we encourage our peers to publish their work about AI as it relates to aesthetic surgery to raise awareness about the potential applications in our field.","title":"A Practical Approach to Artificial Intelligence in Plastic Surgery"}
{"_id":"70443fcd-58d7-1804-018a-ea74b6838816","text":"People in today's world are more health conscious and are aware of the different medical specialties. Despite the tremendous advancements in the field of plastic surgery, there seems to be a limited knowledge among the general public and also among medical professionals regarding the spectrum of plastic surgery. As a medical specialty, plastic surgery is poorly understood by both the general public and some medical professionals as well.","title":"Awareness and Perception of Plastic Surgery among Healthcare Professionals in Pune, India: Do They Really Know What We Do?"}
{"_id":"704752e4-146f-97c8-ef16-6da07fe53baf","text":"The clavicular end of the sternocleidomastoid was dissected to produce a sternocleidomastoid myocutaneous flap, and the clavicular end of sternocleidomastoid was then sutured to the anterior belly of the digastric muscle and mylohyoid muscle to reconstruct the floor of the mouth (Figure 2).","title":"Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers"}
{"_id":"7048da19-8bcb-e6e4-1ec3-75f0c41de15b","text":"In the recent years, more and more clinical studies build evidence that electrical stimulation is a suitable clinical treatment in the acute phase of acute facial or recurrent nerve lesion. We aim to review the positive effects of the latest advances in electrical stimulation during the early phase of a facial or recurrent nerve lesion on muscle atrophy prevention and preservation of specific muscle function. Hereby, we want to pay attention to the common features of electrical stimulation to restore facial and recurrent nerve function in the phase from onset of denervation to regeneration of the target muscles. The focus will be on this efferent function, being aware that the peripheral facial nerve is distal to its exit of the stylomastoid foramen a pure motor nerve whereas the recurrent nerve is a mixed nerve. This review will focus on efferent electrical stimulation. This review will not touch upon electrical stimulation of chronic, long-term denervated facial or laryngeal muscles.","title":"Selective Electrical Surface Stimulation to Support Functional Recovery in the Early Phase After Unilateral Acute Facial Nerve or Vocal Fold Paralysis"}
{"_id":"704e7c24-6898-4d0c-950e-41d990fb96b0","text":"Eradication of chronic tibial osteomyelitis necessitates aggressive debridement is often followed by soft tissue reconstruction. Muscular flaps are said to be more effective than non-muscular flaps for infection treatment, while fasciocutaneous and perforator flaps are considered to be less invasive and offering a better aesthetic result.","title":"Muscular Versus Non-Muscular Free Flaps for Soft Tissue Coverage of Chronic Tibial Osteomyelitis"}
{"_id":"7058ffd0-0406-e595-7d09-29fde8e7e9f7","text":"The primary role of imaging examination is to define the extension and potential resectability of the lesion.","title":"Multimodality imaging features of desmoid tumors: a head-to-toe spectrum"}
{"_id":"705a0707-ccb6-5a07-2696-9e270419effa","text":"Table 4 shows a summary of the mean pre- and intraoperative radiation exposure for the clinical staff as has been measured or estimated above for penile carcinoma SLNB, in comparison with the mean dose values that apply in malignant melanoma or breast cancer SLNB procedures.","title":"10-Year experience regarding the reliability and morbidity of radio guided lymph node biopsy in penile cancer patients and the associated radiation exposure of medical staff in this procedure"}
{"_id":"705a83d0-8f4d-9b84-78d9-4f7779e49e5c","text":"Conclusion The Island TRAM flap includes 10 perforators to get the vigorous blood flow. The periumbilical to upper medial perforators become more dominant in the perfusion of the flap after deep inferior epigastric artery division. Well preserved perforators will guarantee the satisfactory breast reconstruction with the least complication.","title":"Deep Inferior Epigastric Perforators Topography for “Island Transverse Rectus Abdominis Musculocutaneous Flap” in Breast Reconstruction"}
{"_id":"705bf5c8-6eae-0e7d-1d34-25083370f253","text":"No statistically significant difference was found in the rate of LAA thrombus resolution between the different anticoagulant drugs. Although this observation may be limited by the relatively small sample size of patients with LAA thrombus, to our knowledge, our sample population included the largest number of patients with LAA thrombus.","title":"Prevalence and Rate of Resolution of Left Atrial Thrombus in Patients with Non-Valvular Atrial Fibrillation: A Two-Center Retrospective Real-World Study"}
{"_id":"70657ed6-be5e-7fb4-9411-7a5e46cc291e","text":"While this study confirmed the wide use of clinical examination and dermoscopy in NMSC treatment monitoring, our results suggest that RCM best identifies BCC lesions with persistent disease following medical treatment. However, the OCT is in evolution, and more data are needed to confirm the noninvasive skin imaging diagnostic accuracy. Due to the high sensitivity of the RCM and specificity of OCT, studies reporting an integrated approach with the two techniques are encouraged.","title":"Non-Melanoma Skin Cancer Clearance after Medical Treatment Detected with Noninvasive Skin Imaging: A Systematic Review and Meta-Analysis"}
{"_id":"707300f4-fb36-7f98-ecf2-44580d4791ef","text":"Excisional biopsies of the lip mass and a skin lesion of the abdomen were taken.","title":"Oral and maxillofacial non-Hodgkin lymphomas Case report with review of literature"}
{"_id":"70732cc8-54c8-4a31-79e4-e307c8e6f836","text":"The reconstruction with free flaps is a feasible method to restore the functional outcomes in speech and deglutition among patients who undergo total glossectomy with laryngeal preservation.","title":"Ablation of advanced tongue cancer and mobile tongue reconstruction by using a sensitive anterolateral thigh and vastus lateralis muscle free flap"}
{"_id":"7074613c-90b2-8757-6323-3fb2ae79cb4a","text":"Problems are defined as issues that required treatment but not surgery and were fully resolved before frame removal. Pin site infection requiring oral antibiotics occurred in eight patients, of whom one also required intravenous antibiotics.","title":"Transverse debridement and acute shortening followed by distraction histogenesis in the treatment of open tibial fractures with bone and soft tissue loss"}
{"_id":"7075f213-2a40-9ce8-8907-fe74d2451480","text":"Local flaps have an architecture similar to the recipient site, and low donor site morbidity results in an aesthetically more pleasant outcome. In our experience, scalp defects up to 50 cm2 were covered with the local scalp flaps with primary closure of the donor area. Defects ranging from 50 to 200 cm2 required local scalp flap with skin grafting at the donor area. Free tissue transfers are usually needed when the defect is very large, devoid of the periosteum, or with the calvarial defect.","title":"Reconstruction of Scalp and Forehead Defects: Options and Strategies"}
{"_id":"70787444-3788-0777-2d45-a0325dc37544","text":"Chinese herbal medicine is a popular method of alternative medical therapy. The literature is sparse regarding the effectiveness of Chinese medicine for any condition, and what little literature does exist is in Chinese and is not easy to search. There is one meta-analysis that investigated the effectiveness of Chinese herbal medicine, finding only 4 studies (two of which were unpublished). This study concluded that there was weak evidence to suggest that Compound Qishe Tablet was superior to placebo and that topical Compound Extractum Nucis Vomicae was more effective than topical diclofenac gel.","title":"Nonoperative Modalities to Treat Symptomatic Cervical Spondylosis"}
{"_id":"707a2773-e9c0-8846-f479-17afa393e670","text":"In conclusion, ilioinguinal lymph node metastasis from a primary anal adenocarcinoma can be expected given the anatomy of the lymphatic drainage from the anal canal. Surgical treatment should be the treatment of choice given the survival outcomes as reported by prior studies, with consideration for adjuvant chemoradiotherapy as well.","title":"Recurrent ilioinguinal lymph node metastasis from primary anal adenocarcinoma: what should we do? – A case report and review of literature"}
{"_id":"707e166f-fb14-e4d0-be3a-e1c9bae00494","text":"The term radiotherapy was defined as external beam radiation therapy (EBRT) targeting the involved primary tumor field or areas of local lymph node metastasis. Patients who received radiotherapy with surgery were differentiated from those who were treated with definitive radiotherapy without surgical tumor resection.","title":"Biliary Rhabdomyosarcoma in Pediatric Patients: A Systematic Review and Meta-Analysis of Individual Patient Data"}
{"_id":"707fbd54-08fb-529a-cdd3-ad28de600cbc","text":"The results indicated that the two treatments did not differ significantly in preventing local recurrence.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"7083d4f0-0723-3c7f-fbc0-a9094e7f900e","text":"This paper documents the largest number of complications and misdiagnoses reported by a survey of physicians and dentists that were associated with the performance of infant frenotomy. The data is from international sites. This is the first report that associates complication with the method and site of frenotomy. This is particularly important with the increase in number of frenotomies being performed. This was a survey of physicians and dentists with an interest in care of the breastfeeding infant, so they may be more likely to care for breastfeeding infants with complications or misdiagnoses associated with frenotomy.","title":"Complications and misdiagnoses associated with infant frenotomy: results of a healthcare professional survey"}
{"_id":"70851d47-2c46-ef28-6c18-8b8314d2651f","text":"This randomized clinical trial evaluated the possibility of not draining the axilla following axillary dissection.","title":"Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial"}
{"_id":"70866e69-dec8-9db0-6370-b228a3026a4e","text":"The purpose of this cohort study was to assess the incidence of positive cultures in section’s osseous slice biopsy (SOB) taken at the level of major limb amputation. In case of positive cultures we sought whether the microorganisms present in SOB could take origin from the primary infection site necessitating the amputation. The impact of diabetes on culture results was also investigated.","title":"Section’s osseous slice biopsy during major amputation of lower extremity: preliminary results of prospective cohort study"}
{"_id":"7089f831-fa35-32d8-d11e-112a279f0093","text":"Patients will be screened from the emergency department at the trial centres. All patients with an open fracture of the lower limb will be screened for eligibility by a research associate.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"7092fe75-85f5-aa5f-8e58-5bf81d1275c4","text":"Benefits for the patients are the more selective removal of the first drainage lymph nodes from a particular anatomical site with lower morbidity and by closer histological examination of the nodes a higher detection rate of micro metastasis is possible.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"70952211-a873-3090-f618-c316ebdfc7d2","text":"Although several retrospective studies have reported specific outcomes resulting from M or FC microvascular free flaps in a comparative view, there are no sustained results on the overall overperformance of one flap typology in terms of clinical outcomes. Given the lack of comprehensive data on comparative studies that evaluate this issue, we performed a meta-analysis to critically evaluate the spectrum of reported outcomes associated with M versus FC free flap coverage in lower extremity microvascular reconstruction.","title":"Muscle vs. Fasciocutaneous Microvascular Free Flaps for Lower Limb Reconstruction: A Meta-Analysis of Comparative Studies"}
{"_id":"7096cf89-47ee-479c-6926-2105c01168b1","text":"Directors and division heads described an enhancement in the scholarly environment of the division as a result of the presence of this group of advanced learners. They identified improvements in both the formal and informal academic curriculum as well as benefits in the interactions with other learners in the system.","title":"Fellowship training: a qualitative study of scope and purpose across one department of medicine"}
{"_id":"7097c3e8-494f-4cf1-a7d1-1cedb8a311ac","text":"The ultimate goal of any microsurgical trainee is to attain a level of proficiency whereby they progress from being a novice trainee to an expert. Consultant or expert surgeons interact with stress and cognitive distraction differently when compared to trainees. More experienced surgeons have been shown to be less affected by distractions when performing a surgical skill (17). The concept of automaticity has been attributed as the explanation for this ability to deal with adverse external distraction and stress with little or no affect on performance. Automaticity is where experience in performance of a particular technical skill is thought to lead to a state of automatic performance, requiring less conscious effort or cognitive capacity (17). This in turn allows for increased cognitive capacity to deal with other tasks, not necessarily related to the primary task at hand. Gaining automaticity thus reduces the effect of a distracting or a stressful event (17). The ability to cope with cognitive distraction and stress to the point that it does not hinder or affect a trainee's surgical proficiency reflecting gained automaticity could potentially be used as an objective measure of progress as well as experience. The results herein reiterate the concept of gained automaticity specifically in microsurgery and illustrate that the effect of cognitive distraction and stress among the consultant cohort lead to increased efficiency with a negligible impact on accuracy. The consultant cohort TTC improved by almost 30 s with the introduction of stress and cognitive distraction while their mean ALI only increased by 1 point. These results were a truly differentiating outcome measure between the consultant cohort and the other study participants (trainees and novices).","title":"Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance"}
{"_id":"709ea4b0-981f-40e6-1018-ef63ecdb9356","text":"If upper limb lymphedema is caused by interruption of the corresponding axillary lymphatics and\/or removal of the lymph nodes, the possibility to identify and preserve them might prevent upper limb lymphedema during axillary surgery.","title":"New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery"}
{"_id":"70a71ea7-e96b-9834-d616-5e2a6a198d6e","text":"We compared demographic and clinical characteristics between patients in the radiotherapy and nonradiotherapy treatment cohorts using χ2 tests for categorical variables and Wilcoxon rank sum tests for continuous variables. We assessed unadjusted survival in each treatment group using a life table. We used Cox regression analysis to estimate the association between radiotherapy and the risk of a second primary cancer, adjusted for all covariates of interest. To test the proportional hazard assumption, we included an interaction term between treatment and time. The interaction was statistically significant, suggesting the treatment effect changed over time; therefore, we calculated a piecewise model with radiotherapy effect assessed at 5-year intervals. Time to event was defined as time from the diagnosis of prostate cancer to the diagnosis of a second primary cancer. Patients without a second primary cancer were censored at the date of their last VA visit or the date of death through December 31, 2020.","title":"Assessment of Second Primary Cancer Risk Among Men Receiving Primary Radiotherapy vs Surgery for the Treatment of Prostate Cancer Second Primary Cancer After Radiotherapy vs Surgery for Prostate Cancer"}
{"_id":"70a9a1e4-af90-0d5a-dbf0-ddc4dba1c53c","text":"Therefore, it is entirely reasonable that a program should be developed to allow and facilitate young general surgeons wishing to expand their knowledge and experience in abdominal wall surgery. But practicing general surgeons with a special interest in hernia surgery can also extend their knowledge by participating in clinical work shadowing in hernia centers, workshops and congresses.","title":"The reality of general surgery training and increased complexity of abdominal wall hernia surgery"}
{"_id":"70adf0c1-3eef-5af0-3dfd-982bd2976d56","text":"Acute lower extremity proximal DVT is a common clinical entity frequently found in differential diagnosis in outpatient and inpatient settings that requires urgent evaluation. POCUS, which is widely used in the ED and ICU, has also been gaining popularity in primary care and hospital medicine due to increased training opportunities and reduced cost of equipment. POCUS has a well-demonstrated role in the rapid evaluation of suspected DVT in the emergency department and in critically ill patients, and thus there is increased interest in using POCUS to diagnose DVT on the medical\/surgical wards as well as ambulatory clinics.","title":"The Use of Point-of-Care Ultrasound (POCUS) in the Diagnosis of Deep Vein Thrombosis"}
{"_id":"70aec1a9-be84-47f6-59ab-c853afead31c","text":"She went to the operating room two days later. During takedown of the LIMA a six cm length of dense adhesions was noted and presumed to be related to her prior history of radiation for breast cancer. The LIMA proved to be encased in scar tissue and was deemed unsuitable as a conduit, and a saphenous vein graft was bypassed to the left anterior descending artery in its place. Due to the dense nature of the scar tissue on the mammary wall a specimen was sent to pathology.","title":"Case report: recurrent metastatic breast cancer in internal mammary dissection bed discovered at the time of coronary bypass"}
{"_id":"70afb188-c0d2-0dc7-5990-ae785b2e0db6","text":"A 38 year old male was diagnosed to have chronic phase chronic myelocytic leukemia 5 years back.","title":"EXTENSIVE CUTANEOUS MANIFESTATIONS: PRESENTING FEATURE OF CHRONIC MYELOCYTIC LEUKEMIA IN SECOND BLAST CRISIS"}
{"_id":"70b2049a-a3fd-c714-d01b-ee62bba09693","text":"In the standard dose cohort, the primary radiation fields were treated to 50 Gy followed by a 10 Gy boost to the chest wall flaps and any additional sites of recurrence. The dose escalated cohort had the primary radiation fields treated to 54 Gy followed by a 12 Gy boost (Table 2).","title":"Radiation dose escalation for loco-regional recurrence of breast cancer after mastectomy"}
{"_id":"70b55118-8a4c-2f24-d9fe-c59f5ee72049","text":"We strongly recommend operative intervention where there is no need for NAC. The preferred timing for operative intervention is in the second trimester, to allow for completion of organogenesis in the first trimester.","title":"Guidelines for breast cancer management in Bosnia and Herzegovina"}
{"_id":"70b6326b-f79c-1807-d757-3cbcba88dfdb","text":"We report overall good results for all breast reconstruction procedures, but with more reserved scores for LD reconstruction. Interpretation of the relatively high satisfaction rate of IBR should take into account the particularly low rate of adjuvant radiotherapy in this group compared to autologous reconstructions. DIEP reconstruction appears to be the most satisfactory and best experienced reconstruction method from the patient perspective, despite the complexity of the intervention. Clinicians should be encouraged to consider DIEP as a principal choice for breast reconstruction.","title":"Defining the Ideal Breast Reconstruction Procedure After Mastectomy From the Patient Perspective: A Retrospective Analysis"}
{"_id":"70bf3fdc-660b-db25-c7d5-cb7427bbe0a7","text":"supports, Patients referred to physical therapy Department for appointment waited a minimum of three weeks. The physical therapy staff found this frustrating as patient’s conditions often became more chronic during the wait and they often needed to take prolonged periods of sick leave. Physical therapists felt that in order to provide a better quality service they should reduce the waiting time of the patients.","title":"Sixth Annual Mediclinic Middle East Research Conference"}
{"_id":"70cad00d-e5de-b5da-d553-7974599c47ea","text":"The vascular supply of the hand is derived from the superficial and deep palmar arches, which receive their arterial inflow from the radial and ulnar arteries. The ulnar artery is usually the dominant contributor to the superficial arch, anastomosing with the superficial branch of the radial artery over the thenar eminence [10]. Palmar digital arteries run distally from this arch to supply the fingers. A complete superficial arch is present in 84–90 % of patients, with considerable variation occurring. In contrast, the radial artery predominantly supplies the deep arch. It almost invariably forms a complete arch through anastomosis with the deep branch of the ulnar artery. The palmar metacarpal arteries arise from the deep arch and anastomose with the palmar digital arteries from the superficial arch. Hence the hand is supplied by an anastomosing network of arteries arising from both superficial and deep palmar arches, which in turn are supplied from a combination of the radial and ulnar arteries. These extensive anastomotic connections usually prevent the hand from ischemic damage in the face of injury to a single component of the network.","title":"The Allen’s test: revisiting the importance of bidirectional testing to determine candidacy and design of radial forearm free flap harvest in the era of trans radial endovascular access procedures"}
{"_id":"70cd4d3e-67ec-6603-7a0d-fdd1df65afbc","text":"Preparation for the surgery included catheterization of the bladder to maintain an empty bladder during surgery, and bowel preparation using an enema. The surgeries were performed under general anesthesia with the patient in the lateral position, and were covered by prophylactic broad-spectrum antibiotics including metronidazole. Meticulous preoperative planning was done to achieve wide resection of the tumor in all patients using available investigations knowing very well that intraoperative decisions may vary because of the difficult anatomy and unexpected tumor invasion. Preoperative counseling about the need to eradicate the tumor was given to all the patients and were warned that it might be impossible technically to preserve the limb; they all consented to amputation in such conditions.","title":"Surgical management of pelvic Ewing’s sarcoma"}
{"_id":"70d56986-c1b7-a3a3-a7a9-f296820351c9","text":"Out of the three cases two underwent postoperative radiotherapy for which doses varied depending on type of lesion and previos radiotherapy.","title":"Clinical outcome in Giant cell tumor of cervico-thoracic spine: Our experience with three cases"}
{"_id":"70de7ba7-8734-8c7d-275f-f733ff0f6539","text":"Trained and certified sonographers performed lower limb venous Doppler ultrasound examinations on patients before and 1 to 2 days after surgery for screening of CMVT using a standardized method. We recorded the CMVT scores in gastrocnemius and soleus veins.","title":"The Risk Factors for New-Onset Calf Muscle Venous Thrombosis after Hip Fracture Surgery"}
{"_id":"70e2d8d9-94a6-d1b4-4e48-59ff2924a3a6","text":"However posterior tibial flap reconstruction has its limitations. A major tributary of the lower limb is sacrificed which might jeopardize circulation and subsequently induce ischemia. Although the distal leg is supplied with redundant blood flow and multiple arterial-arterial connections that provide a rich vascular network even after removal of the posterior tibial artery [13], strict selection criteria should be used to exclude patients with insufficient distal leg circulation. By following such criteria, we ensured that no worsening of peripheral vascular disease or distal limb ischemia occurred in the present study during the postoperative period.","title":"Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma"}
{"_id":"70eb0240-2761-c14a-0732-5fadcc9186e4","text":"None of the studies in which contrast venography was the reference standard assessed serial limited CUS.","title":"Diagnostic accuracy of three ultrasonography strategies for deep vein thrombosis of the lower extremity: A systematic review and meta-analysis"}
{"_id":"70ec6fb9-25ed-5d0c-186b-e15973a5854d","text":"There is yet to be investigated if the far more invasive fusion surgery is necessary to prevent the progression of deformity after decompression of the spinal cord or if the risk of DJK, pseudarthrosis, and implant failure after fusion surgery is more dangerous for these elderly and often frail patient group with CSM.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"70f1572a-e9ef-3c1e-82a6-5e5b2ab10e71","text":"Our current study results regarding the efficacy and side effects of botulinum toxin for BEB are consistent with studies carried out at other centers.,","title":"Efficacy of botulinum toxin in benign essential Blepharospasm: Desirable & undesirable effects"}
{"_id":"70f1e873-53fb-e84e-f8b5-76a0fcc5e508","text":"Resistance to daptomycin is rare but emerging with its increased use. Mechanisms of resistance thus far characterized are cell wall adaptations that lead to reduced binding of daptomycin by either diversion from the binding site or electrostatic repulsion.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"70f5fb33-51c3-a63c-fd0f-1e9baed5edb9","text":"The radiomics classification model was used to differentiate malignant from benign lesions. The workflow of the study is shown in Figure 4, and the general structure of the radiomics model is shown in Figure 5.","title":"Radiomic Analysis of Contrast-Enhanced Mammography With Different Image Types: Classification of Breast Lesions"}
{"_id":"70fdc84c-d74b-ba2a-6b77-87289376c5f6","text":"The most important issue for used graft materials on the nasal dorsum is causing the irregularities that can be seen from the outside. Therefore, graft material should be carefully selected and placed properly.","title":"The Development of Dorsal Nasal Cyst Formation after Rhinoplasty and Its Reconstruction with Conchal Cartilage"}
{"_id":"7100012f-4974-cf2c-451a-db7af6a43c5c","text":"In this chapter the importance of surgical margins will be discussed as well as the concept of what a good margin might\/should be.","title":"Soft tissue sarcoma of the extremities: pending questions on surgery and radiotherapy"}
{"_id":"7101186a-c708-9570-d009-b2e957cb1f1f","text":"JPS: performed the patient chart review, literature review, and wrote the manuscript under the guidance and recommendations of the following coauthors and principal investigator. CL: provided expert consultation in regard to understanding the role of reconstruction and fat grafting following breast surgery. AM: provided the patient consent information and administrative support in retrieving additional patient information for use in the clinical history that was otherwise unavailable in the accessible electronic medical record. WEC: developed the original concept for the manuscript and provided the most significant contributions regarding revisions and critical review of the manuscript. All of the authors were provided manuscript drafts throughout the writing process in order to aid the development of the final submission.","title":"Unusual recurrence of breast cancer in a BRCA‐variant patient after fat grafting SKENDELAS et al."}
{"_id":"710175d2-dc5a-208d-637b-6539c63e3c97","text":"For palpable lesions, direct peritumoral injection of the radiopharmaceutical is performed in the nuclear medicine suite. Four to six injections are performed with divided doses around the tumor. For nonpalpable lesions, mammographic and sonographic techniques for localization have been modified to accommodate the administration of the radiopharmaceutical. Imaging guidance allows for accurate localization of nonpalpable lesions as well as peritumoral injections of the radiopharmaceutical.","title":"Sentinel Lymph Node Evaluation: What the Radiologist Needs to Know"}
{"_id":"7103fdd9-2a54-5650-3253-8b88088ea51e","text":"The color Doppler is considered as a better investigation to identify the perforators objectively, which excludes the subjective variation among the assessor [1]. An important disadvantage of the color Doppler investigation is that it leads to a significant number of negative explorations as the specificity is low causing a considerable cosmetic disfigurement due to the scar.","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"7106a887-c866-7ad7-eaf6-50fa717039af","text":"In this work, we analyze the effect of the neonatal administration of BPA on the immune response of the B cell population. We did not find significant changes in the percentage of the B cell population when the peripheral lymph nodes and the spleen were analyzed in mice treated with BPA. This may be explained by previous studies, which demonstrated that the inoculation of 4T1 cells tends to immunosuppress the mice that receive these cells [14,15]. We observed this phenomenon when the B cells in the spleen are analyzed as shown in Figure 2. It is likely that the non-observance of some effect of BPA on the average population of B cells is due to the fact that this immunosuppression is greater than the measured effect, which subsequently masks it. It is possible that the use of another murine model of breast cancer will be required to accurately assess the effect of BPA on the percentage of the B cell population.","title":"Neonatal Bisphenol A Exposure Affects the IgM Humoral Immune Response to 4T1 Breast Carcinoma Cells in Mice"}
{"_id":"710e2bba-84cc-c21f-360e-1340cb11b319","text":"The frequency and importance of AEs associated with the inhibition of the Hh pathway may be a limiting factor in the continuity of treatment. Dose adjustment or temporary interruption of treatment are advisable to increase patient compliance. During the BOLT trial [11], it will be verified that temporary interruptions or dose reductions did not have a negative impact on the efficacy of sonidegib. So, although patients currently starting treatment with Hh pathway inhibitors receive important health education, which can minimize the expression of some side effects, their collection in real practice clinical series is not usually as exhaustive as in the case of clinical trials.","title":"Multicenter Retrospective Andalusian Study of the Use of Sonidegib for the Treatment of Local Advanced Basal Cell Carcinoma in Real Clinical Practice"}
{"_id":"710e6e45-2e96-b679-eee9-0198ede405e0","text":"In December 2021, in the Clinic of Otolaryngology CMKP in Warsaw, the first Polish single-stage procedure involving the placement of Vistafix 3 system titanium implants was successfully performed. The procedure led to effective fixation of a nasal prosthesis in a patient after the total amputation of the external nose and the anterior wall of the frontal sinus caused by squamous cell carcinoma of the maxilloethmoidal massif.","title":"The Latest Craniofacial Reconstructive Techniques Using Anchored Implants after Surgical Treatment of Nasal and Paranasal Sinuses Tumors"}
{"_id":"710f69af-8d11-150d-e5bf-9c4662af34ad","text":"Currently, surgical resection has the highest probability of improving the prognosis of patients when used as initial treatment for Stage I disease. By combining treatment with sentinel lymph node biopsy, we were able to accurately determine the stage of disease and thus avoid systematic lymph node dissection and further surgical treatments.","title":"Concomitant sentinel lymph node biopsy leading to abbreviated systematic lymphadenectomy in a patient with primary malignant melanoma of the vagina"}
{"_id":"71135df8-73da-0a96-70f9-f682c09db853","text":"We performed a retrospective chart review of patients treated with topical 5% imiquimod cream for MIS that had persisted after initial surgical excision of melanoma or melanoma in situ. All patients included in the review had undergone diagnostic biopsy at their initial presentation, followed by standard excision with 1-cm margins for Breslow depth ≤1 mm, 2-cm margins for Breslow depth of 2 mm and above, and a minimum of 5-mm margins for MIS. These patients were then found to have varying degrees of residual MIS at the excision margins through histologic analysis of the surgical specimens. Patients with residual MIS were offered topical application of 5% imiquimod cream over the involved area of skin or reresection. Patients who preferred imiquimod application over reresection were evaluated for application of imiquimod. The study was approved by the Yale University Human Investigation Committee. Informed consent was obtained from all the patients undergoing treatment after a discussion of the risks and benefits of treatment with imiquimod.","title":"Using topical imiquimod for the management of positive in situ margins after melanoma resection"}
{"_id":"711541ad-623d-5094-4aa2-75e202e68785","text":"The environment where tumor cells end up entangled varies from that of the primary location. A hypothesis through which DTCs adjust to the actual environment hypothesizes that tumor cells produce a premetastatic niche by altering the environment to better fit their needs.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"71184a2d-8ab3-e2a0-3a81-56e011e83a49","text":"Recruitment and retention rates will be reported through a consort diagram and so will inform the planning of a definitive trial with respects to sample size and the time points of measurements.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"711a7c11-4e65-48ae-f031-b1cec7ec6517","text":"Almost one third of outdoor workers rarely or never use any kind of sun protection. This applies to both at work and at leisure and reflects a sun protection behavior in line with their perception of occupational skin cancer risk and sun protection importance and contrary to the fact that most Danish outdoor workers agree that use of sun protection can reduce their risk of skin cancer.","title":"Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers"}
{"_id":"711a89e6-98b2-ea42-c3cf-70b04ba77fef","text":"In addition to personal experience and beliefs, breastfeeding attitudes may be shaped by cultural or personal experiences, although there is limited evidence regarding differences in attitudes between urban and rural areas of developed countries. In a study of factors associated with breastfeeding initiation and duration in rural USA, the lack of role models and a perception that breastfeeding was not the normal infant feeding method for women of particular cultural backgrounds were identified as potentially contributing factors [29]. Other evidence suggests that economic factors in rural communities such as the need for women to return to work and limited community facilities to support continued breastfeeding are also significant barriers [30].","title":"The influence of infant feeding attitudes on breastfeeding duration: evidence from a cohort study in rural Western Australia"}
{"_id":"711ed5d9-8ca3-c001-a608-e2a2ed40b359","text":"Conclusion: Pharmachild showed that MTX and biologics increase the risk of infection in JIA patients. This risk is significantly enhanced by the addition of steroids to immunosuppressive therapy. We recommend monitoring for infections in JIA patients on immunosuppressive therapy","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"712d8803-c93a-1af8-2c1a-a0f8fa94aec9","text":"The small sample size in our study was one of its limitations. A bigger sample size might reveal possible interactions between the variables that can influence the study results. The clinical outcome after skin grafting or flap reconstructing surgery is good if it is done in time after an adequate number of patients and wound preparation. The success of flap surgery depends upon its availability in nearby of the defect; it should not be short enough to cover the defect, while transposition of flap venous insufficiency has to be taken care of. Thus, resurfacing techniques are needed to preserve the basic function of the limb while healing wounds in a timely and abnormal fashion.","title":"Various Modalities of the Resurfacing of the Lower Limb and Its Outcome"}
{"_id":"71331461-ec4b-a9de-ef32-b9f10c93d233","text":"At the end of the bone transport, there was no need for frame modification or adaptation of bone ends because in the first stage a square osteotomy of bone ends was done. This allowed maximum bone contact at the end of transport. Moreover, the transport was done guided by a temporary intramedullary K-wire in cases of large defect to facilitate the process of transport without deflection of the transported segment. This temporary guide was not fixed to the distal ring due to the fear of the occurrence of impingement during the transport and it was bent at its end and not buried under the skin as it was removed once the transported segment was approaching the docking site at an early stage. Furthermore, the induced membrane—in addition to its biological significance—may represent a guiding chamber during bone transport.","title":"Masquelet–Ilizarov technique for the management of bone loss post debridement of infected tibial nonunion"}
{"_id":"7136665a-1add-c22c-f330-71613a5e336e","text":"The main limitation of the current study is that many cancer cases that were referred to main oncology centers were not included in the current study. This may contribute to the relatively low number of cases. The lack of precancerous lesions and benign lesions is also another limitation of the current study.","title":"The Burden of Skin Cancers in Saudi Arabia Through 2011-2022"}
{"_id":"713b3537-360b-6db1-2b3a-b89250f20621","text":"The pattern of sensory recovery found in this series of patients of innervated and noninnervated flaps used for total lower lip reconstruction is quite different from others reported in the literature.","title":"Sensory Recovery with Innervated and Noninnervated Flaps after Total Lower Lip Reconstruction: A Comparative Study"}
{"_id":"713eefd4-e6df-7614-3b58-85ef5190af7e","text":"Soft Tissue Filler (STF) Therapy for cosmetic facial rejuvenation is associated with known complications. The manifestation of these known complications can lead to patients commencing civil litigation actions or making complaints to provincial regulatory authorities and alleging that the practitioner failed to obtain the patient’s informed consent to the therapy. Data provided by the Canadian Medical Protective Association (CMPA) on medical-legal cases arising from the provision of STF therapy between 2005 and 2019 are presented. Select reported case law decisions from Canadian courts and regulatory bodies addressing the concept of informed consent are reviewed. Insights about the risk factors pertaining to the process of obtaining informed consent for STF therapy are presented to increase an understanding of the elements of communication and documentation needed to ensure patients are aware of the consequences of this treatment.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"713f384e-02a3-3e12-0029-ca4aeba1fb8a","text":"The fractures of tibia type 3a and 3b Gustilo are devastating injuries requiring several operations. Several combinations of RLD-Serratus have already been reported but a rib-LD muscle with “picket fence” design has not been reported .The RLD transfer with two ribs divided into four struts for bone coverage and muscle to cover all the upper tibia soft tissue defect can be a useful tool in the armamentarium of the surgeon treating combined defects in a single stage.","title":"Combined Rib-Latissimus Flap; the “Picket Fence” Concept for Reconstruction of Upper Tibia Defects"}
{"_id":"71411173-dcab-b02e-773c-109a7309d212","text":"These findings suggest that there are modest differences in risk between the 3 types of skin cancer. The risks associated with hair color and susceptibility to burn were similar across the 3 cancers. Risk prediction algorithms and clinicians should weigh the risk factors differentially, particularly family history of melanoma and nevus counts. A better understanding of the different risk profiles of these cancers will permit more accurate identification of susceptible populations and help target prevention strategies.","title":"Heterogeneity in Host Risk Factors for Incident Melanoma and Non-Melanoma Skin Cancer in a Cohort of US Women"}
{"_id":"71464f00-2b81-56a5-dc07-e11036c839c5","text":"Table 1 Patients with open tibial fractures in Sweden during 1998-2010","title":"Lower extremity soft tissue reconstruction and amputation rates in patients with open tibial fractures in Sweden during 1998–2010"}
{"_id":"714e4195-f54e-d1f2-c2a3-60bc5d3eec41","text":"Wider excision has been demonstrated to reduce the risk of local persistence\/recurrence of the tumor and local metastasis but there is no evidence that a margin greater than 1 cm offers additional benefit in terms of patient survival.","title":"Malignant Melanoma"}
{"_id":"714f32aa-eb8a-6f9a-9434-62952e5d6bc8","text":"Cardiovascular and cerebrovascular diseases Cardiovascular and cerebrovascular diseases refer to the manifestations of general vascular diseases or systemic vascular diseases in the heart and brain. Like hypertension, it involves the changes of hemodynamics and hemorheology as well as the damage of blood vessel wall, so it will increase the risk of DVT to some extent. K ö nigsbr ü GGE o reports that patients with congestive heart failure are three times more likely to develop DVT than patients without congestive heart failure [24, 25].","title":"Epidemiological status and risk factors of deep vein thrombosis in patients with femoral neck fracture"}
{"_id":"715a931d-f6bc-aed6-1423-74c8a060f451","text":"Increased awareness of tumoral calcinosis is essential. Complete surgical resection is the treatment of choice in most idiopathic cases. Alternative treatments using radiotherapy and systemic steroids have been unsuccessful.7 Finally, the role of the surgeon consists not only in the proper excision of the mass but also in reconstruction of any resulting tissue defect or functional deficit. With the additional help of early hand therapy, complete functional return of the affected digits should be expected.","title":"Idiopathic Tumoral Calcinosis in Hand: A Case Report Xu et al"}
{"_id":"715d2f08-dcd5-eb72-9da3-662de4ceb723","text":"Our institution rarely performs preoperative radiologically guided biopsy, but it can be helpful in patients who are unfit for surgery and in whom microbiological specimens can be used to guide suppressive antibiotic regimes.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"715ec3d2-9e31-e396-4cef-05b6ef82a232","text":"As described above, after the anaphylactic reaction and subsequent protocol eligibility criteria modification to exclude participants with preexisting allergies to contrast agents, no other anaphylactic reactions were observed in this study. This was the only serious adverse event determined to be related to the study drug in more than 342 patients who received a pegulicianine injection in our published and unpublished feasibility studies. The pegulicianine safety profile compares favorably with isosulfan blue, routinely used in BCS for sentinel lymph node mapping, which has an allergic reaction rate of 1% to 3%.","title":"Clinical Impact of Intraoperative Margin Assessment in Breast-Conserving Surgery With a Novel Pegulicianine Fluorescence–Guided System A Nonrandomized Controlled Trial Clinical Impact of Intraoperative Margin Assessment in Breast-Conserving Surgery Using a Novel Fluorescence–Guided System"}
{"_id":"716c1ae1-25c9-cb4b-e4d1-cf98c69eee62","text":"3D Ultrasound is an effective tool in evaluating the morphology of breast masses and plays a significant and supplementary role to mammography, especially in dense mammary tissue. This new technique, based on a specific scoring system, gives reliable information and characterizes the breast tumors. It gives more comprehensive information on anatomical details and pathological structures and offers a new diagnostic aspect for the differentiation between benign and malignant breast lesions. The Power Doppler findings should be regarded as additional diagnostic features to the sonographic evaluation of breast lesions, besides the already established criteria, with the potential to improve differential diagnosis. However, in view of the small number of patients with breast tumors in our study, these observations should be considered as preliminary. Further studies are needed to establish the role of 3D ultrasound in tumor detection and differential diagnosis and to determine treatment options.","title":"The Contribution of Three-Dimensional Power Doppler Imaging in the Preoperative Assessment of Breast Tumors: A Preliminary Report"}
{"_id":"71716f94-bf63-d162-4d9e-76e97858ab8b","text":"An alternative to decellularised allograft is washed bone. Studies have found that allograft bone that undergoes a washing process to remove bone marrow possesses similar mechanical properties to fresh-frozen allografts and the removal of immunogenic material could minimise immune reaction and increase bone regeneration.23 Washed bone products have been provided by NHS Blood and Transplant, Tissue and Eye Services and used by orthopaedic surgeons since 2000.24 As there have been no reports of negative outcomes with these products, it can be assumed that they perform well, and their continued use suggests that washed bone has clinical benefits over traditional fresh-frozen allograft bone. The cost-effectiveness of washed bone has yet to be systematically evaluated and compared with fresh-frozen or decellularised allograft bone.","title":"Cost-effectiveness of decellularised bone allograft compared with fresh-frozen bone allograft for acetabular impaction bone grafting during a revision hip arthroplasty in the UK"}
{"_id":"7174c130-e043-81a1-fc2b-7544a7aaf654","text":"The procedure of Masquelet is technically simple and has the advantage that the soft tissues and the infection can subside during the time of the spacer in situ. This is important, especially in those polytrauma patients with massive damage of the soft tissue. This can be seen in the large number of reoperations needed (median of 12) until the Masquelet phase could be started.","title":"Infected tibia defect fractures treated with the Masquelet technique"}
{"_id":"717f1ed6-9327-734c-8b3a-715351f16b53","text":"Despite our successes with the patients described previously, our experience with the patient in Case 8 was mixed. As the patient was a child, it was difficult to persuade him to cooperate with the axillary nerve block and the procedure could not be completed. When he calmed down, a supraclavicular block was performed to complete the anesthesia. Despite the full cutaneous anesthesia that followed, he reported pain during the subsequent forearm reduction. His high level of anxiety during the regional block and the reduction process itself made it difficult to gauge how much he benefited from the procedure.","title":"Ultrasound-guided nerve blocks in the emergency department"}
{"_id":"7186a04a-8742-b2fb-2556-a7137bfbfe18","text":"In contrast to the number of athletes concerned with their vitamin D status, a greater number were concerned about skin cancer as the result of sun exposure (66%), this possibly reflects the strongly promoted sun safety messages and the high prevalence of skin cancer in New Zealand [29,30]. The high rate of concern for skin cancer may be the reason for the high proportion of athletes who report sunscreen use. This suggests an awareness of sunscreen use to attenuate the risk of skin cancer. However, the lower proportion who use sunscreen all the time and the even smaller amount who regularly reapply sunscreen is of concern especially given the higher risk of skin cancer in New Zealand [29,30]. The data suggest that even those who are concerned about skin cancer risk are not fully aware of the optimal application of sunscreen. In order to promote a more effective use of sunscreen ie frequent reapplication, the reasons for not using sunscreen need to be addressed. Factors such as ensuring sunscreen is available at the training location and that the athletes are provided with training breaks in order to reapply sunscreen along with towels to wipe excess cream off their hands therefore minimizing the impact on training could help promote sunscreen use and attenuate the risk of skin cancer. Factors such as seeking shade and the wearing of sunglasses maybe more difficult to address in some sports due to the training venue or sporting regulations, however, in such cases education about attenuating the risk of skin cancer whilst away from training may be beneficial.","title":"Knowledge and attitudes to vitamin D and sun exposure in elite New Zealand athletes: a cross-sectional study"}
{"_id":"7189a895-52b9-77a4-3ae8-c6e07e5c309e","text":"One patient developed an acute respiratory failure and died before starting any treatment.","title":"The Management of Desmoid Tumors: A Retrospective Study of 30 Cases"}
{"_id":"718eb066-d2a1-0ed6-0730-bfda4f40f62f","text":"Patients should be advised not to be alarmed by the aspect that the wound may develop in the event that a white exudate showed up during the second-intention-healing of the wound.","title":"Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser"}
{"_id":"7193b457-2eb4-da11-199e-2fd7e6c87780","text":"An understanding of the biology of bone and soft-tissue sarcomas, knowledge of adjuvant therapies and refinement in techniques of reconstructive surgery have allowed limb-sparing and limb salvage surgery to become a reality in the management of malignant tumors of the extremities. Functional limb salvage following radical resection has become a possibility in many resectable tumors by the use of alloplastic prostheses, homograft or autogenous bone for skeletal reconstitution combined with vascularized soft tissue coverage. Although the free fibula flap has been well described for reconstructions of the mandible and oral cavity, it has not been widely presented as an ideal tool to preserve extremities and to circumvent amputation.","title":"The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection"}
{"_id":"7196af9e-9a56-e0eb-643e-d2d49282770f","text":"FRI treatment failure was defined by infection recurrence or amputation. Infection recurrence was defined as the unscheduled return to operating theatre for further debridement or implant revision due to new clinical indications of infection, followed by a new course of antibiotic therapy.","title":"Fracture Related Infections and Their Risk Factors for Treatment Failure—A Major Trauma Centre Perspective"}
{"_id":"7197d0bf-74fc-b457-72ee-f6134a635164","text":"Microvascular replacement of bone is preferred to bridging mandibular plates for reconstruction of defects when segmental mandibulectomy is performed to treat mandibular BRONJ. Vascularized bone graft reconstruction with a fibular free flap is feasible and has a high success rate in terms of bony union and fistula closure in advanced cases. Detailed preoperative planning is important, and the first step should be resection of the damaged tissue with an adequate margin. The fibular bone needs to be reshaped to match the original shape of the mandible on a case-by-case basis. Adequate resection and a well-designed reshaped fibular free flap are essential.","title":"Refinements in the reconstruction of bisphosphonate-related osteonecrosis of the jaw"}
{"_id":"719b33e0-84da-0974-ef2c-d8812cc633e5","text":"The mean number of risk factors observed in patients in all of the different study population strata confirms the ACCP’s VTE prevention statement that almost all hospitalized patients have at least one risk factor for VTE. 5 The low prevalence of patients with contraindications against chemoprophylaxis is also similar to other authors’ results 17 and shows that administration is safe.","title":"Evaluation of deep vein thrombosis prophylaxis in a general hospital"}
{"_id":"71b09d60-9a47-73e4-2caf-04b5250da446","text":"We present a case of IVC perforation that was identified during a laparotomy and treated without filter removal. The technique described avoided a procedure involving greater morbidity requiring vein clamping, cavotomy and filter removal.","title":"An alternative approach to treatment of inferior vena cava filter perforation Tratamento alternativo para perfuração de veia cava inferior por filtro"}
{"_id":"71b73d4a-7806-a9aa-4452-2ab2032107b8","text":"Written informed consent was obtained from all patients for presentation of the paper and accompanying images.","title":"Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma"}
{"_id":"71b84ce6-de50-35c9-63f5-a814f4ecc399","text":"A total of 237 Danish outdoor workers were asked to complete surveys in 2016\/17 and in 2020. Multicomponent interventions, between surveys, included information on skin cancer risk and use of sun protection, personal dosimetry and skin examination for signs of photodamage and skin cancer. Survey items on awareness of occupational skin cancer risk and perceived importance of sun protection as well as availability and use of sun protection at work were compared and analyzed in relation to the multicomponent intervention.","title":"Sun Protection Behavior in Danish Outdoor Workers Following a Multicomponent Intervention"}
{"_id":"71bbfb99-1e35-cc90-c048-1aed1bb7ee3d","text":"It would appear that in KLA the vast majority of hepatic vein septic thromboses resolve spontaneously without anticoagulation. The thromboses improved as the abscess resolved, suggesting management should be targeted at the underlying abscess. Although too few to draw any real conclusions it is worth noting that the 3 portal vein thromboses in this series resolved spontaneously, which is in keeping with the recent observation of high rates of spontaneous recanalization of portal vein thromboses in KLA [8].","title":"Impact of Regional Vein Thrombosis in Patients with Klebsiella pneumoniae Liver Abscess"}
{"_id":"71bc2129-cce4-929c-083a-f9f5fbe45477","text":"The upper pole can be augmented using the pectoralis major muscle flap in breast reconstruction using the PAP flap, which expands its indications. The patient satisfaction rate at 12 months after the reconstruction was statistically higher in the patient group with the pectoralis major muscle flap augmentation than in the patient group without the augmentation.","title":"Filling the Upper Pole with the Pectoralis Major Muscle Flap in Profunda Femoris Artery Perforator Flap Breast Reconstruction"}
{"_id":"71bc8ba1-e030-af1d-c1ed-e5b26afe2b73","text":"This study included 128 patients who underwent arthroscopic PCL reconstruction. Venography was performed on the operated leg 3 days postoperatively. The patients were divided into 2 groups based on whether they had DVT. A correlation analysis was performed to determine the factors associated with DVT.","title":"Incidence and risk factors of deep venous thrombosis following arthroscopic posterior cruciate ligament reconstruction"}
{"_id":"71c7fbf6-ea00-007a-7c7b-6a80232f7cb4","text":"In this study, it is possible that when the baby still had their tongue movement restricted by ankyloglossia, the participation of the masseter was overloaded at the first moment to adapt the jaw movements.","title":"Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles Efeito da frenotomia lingual na amamentação e na atividade elétrica dos músculos masseter e supra-hióideos"}
{"_id":"71cf7f23-013f-ecba-ba34-21001b3b1b35","text":"Fraser and Purves (1960) stated that the elaborate plexus investing the air sac system was “apparently entirely subservient to the proper functioning of the latter.” Given the intimate association of the accessory sinus system with the aforementioned venous plexuses, this seems like a reasonable conclusion. We suggest that the large venous investment of the air sinuses may provide an alternate mode of nitrogen absorption or elimination during the course of a dive. Such gas kinetics may be beneficial during normal diving, but may pose a threat of DCS or venous gas embolism when diving conditions are artificially or inappropriately altered. During descent, the increasing pressure could drive nitrogen out of the sinus and into the surrounding venous plexus, as happens in the lungs. Admittedly, whether such diffusion across the venous wall is possible will likely depend on the thickness of the venous wall and the nitrogen partial pressure differential between the venous blood and sinus air.","title":"Vascularization of Air Sinuses and Fat Bodies in the Head of the Bottlenose Dolphin (Tursiops truncatus): Morphological Implications on Physiology"}
{"_id":"71d7c9df-1645-7bcd-a569-9faa9e6a3408","text":"The nodal areas we treated in this study are listed in Table 4. As this study was limited to patients who received ENI, the data does not inform the question of indications for elective treatment of the regional nodes, how an approach using ENI compares to elective neck dissection, or observation with treatment reserved for salvage of nodal recurrence.","title":"Efficacy of elective nodal irradiation in skin squamous cell carcinoma of the face, ears, and scalp"}
{"_id":"71e2f0e7-2a37-e553-04e2-82550086f2fc","text":"When performed properly, standard surgical excision and margin assessment results in 5-year cure rates, ranging from 90% to 99%.22–27","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"71e5806a-9bfb-befd-8987-d2f8152055d0","text":"Our study was designed to attempt to replicate the results of the above-named study. We aimed to test the accuracy of the two-point compression technique for diagnosis of lower extremity proximal DVT as performed by EM residents with no prior formal training in this technique compared to the gold standard performed by ultrasound technologists and interpreted by radiologists. We also performed an analysis of our EM residents’ ultrasound videos to determine if the ultrasound images were adequate and to assess for common errors that might be made when performing two-point compression ultrasound. Finally, we sought to characterize the potential impact on ED length of stay (LOS) if EPs were to make disposition decisions based on their bedside DVT ultrasound.","title":"Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis"}
{"_id":"71e82bc0-454a-c101-a351-8d8158b5ba3e","text":"The waiting period for patients in our series was between 18 to 273 days. The range of the waiting period differed because we waited for the healing of the pin tract before inserting the plate. During lengthening, the pin tracts were usually unhealthy due to skin necrosis and healing times varied with the different grades of infection, where Grade III and Grade II pin tract infections significantly delayed plate insertion. Endo et al suggested postponing the conversion from external fixation to internal fixation if blood test and clinical findings indicated an active infection.","title":"Submuscular Plate Stabilisation After Lengthening: Standard and Modified Techniques"}
{"_id":"71eb006d-ce8c-7b5c-9d68-fb9f62874649","text":"Primary wound healing is of major importance in the outcome of regenerative therapy. In the current study, primary healing was evaluated using the Early Wound Healing Index, where the margin of the wound is evaluated using a five-point score. This revealed all of the patients except two showed complete closure of the flap without the formation of a fibrin line in the interproximal area at two weeks after surgery. This helps to achieve faster revascularization and facilitates primary intention healing. Those two patients in the SFA group had a score of 2, indicating complete closure of flap with the fibrin line in the interproximal area, which is in agreement with Retzepi in 2007 [21]","title":"The Efficacy of Low-Level Laser Therapy Combined with Single Flap Periodontal Surgery in the Management of Intrabony Periodontal Defects: A Randomized Controlled Trial"}
{"_id":"71fe3f3e-0f89-7daa-c5eb-efee6234ab65","text":"Oil Red O stained slides of the lung reveal extensive intravascular fat emboli within the peribronchiolar and alveolar vessels, as well as a perivascular fat globule and the presence of small lipid vesicles within alveolar macrophages","title":"Cerebral fat embolism after traumatic bone fractures: a structured literature review and analysis of published case reports"}
{"_id":"720079af-4af3-49b7-c764-f416b99a87be","text":"Despite the aforementioned advances in diagnostic tools, the diagnosis of AF poses remaining challenges to the treating physicians. Although the rising incidence is most likely biased by diagnostic modalities and improved registration, the presented results showed an increasing number of patients being treated for AF.","title":"Time Trends in the Incidence and Treatment of Extra-Abdominal and Abdominal Aggressive Fibromatosis: A Population-Based Study"}
{"_id":"720b6da1-e4e0-bddd-7f4e-2f152f961aef","text":"One hundred and two women with early breast cancer were investigated in this study. Patients were selected for axillary sentinel lymph node biopsy and then surgery .Then the rates of false negative and true positive, and diagnostic accuracy of sentinel lymph nodes biopsy were evaluated. In addition, the hormone receptors status of the tumor was determined through IHC and data was analyzed in SPSS21.","title":"Sentinel Node Biopsy in Early Breast Cancer Patients with Palpable Axillary Node"}
{"_id":"720c779d-6c36-7e27-1805-68e648895e0b","text":"In our patient this was achieved by using a segment of the latissimus dorsi muscle as well as a perforator fasciocutaneous flap. The muscle was mobilized on one of the paravertebral blood vessels as an island flap. Due to its bulk it was able to fill the gunshot wound adequately, completely obliterating any dead space and also acting as a biological barrier to the continuous leakage of the CSF. Further theoretical advantages of the muscle included drainage of the CSF back to the circulation through its rich capillary network. The fasciocutaneous flap on the other hand was able to provide adequate skin and fascia over the wound, allowing for good soft tissue padding over the muscle. It also enabled the defect to be covered with tissues away from the zone of injury with better vascularity and minimal chances of contamination.","title":"Island Latissimus Dorsi Muscle Flap and a Perforator Flap in Repairing Post-Gunshot Thoracic Spine CSF Fistula: Case Presentation"}
{"_id":"720d134b-23a0-fd0e-7d5c-d52a561d7e3d","text":"The skin flap thickness is a critical factor for the aesthetic outcome and the complication rate in immediate implant-based reconstruction, so its measurement can be used for establishing appropriate candidates for this type of surgery. Surgeons can also be aware of the presence of sections of the breast where the dissection might be difficult because of the breast parenchyma coming too close to the skin envelope. Of course, the mammary gland is replaced with fatty tissue in elderly patients and the breast parenchyma is supposed to be far from the skin, but for young patients, where the breast is very dense, determining the distance to the skin might be of great importance.","title":"Assessment of Mastectomy Skin Flaps for Immediate Implant-Based Breast Reconstruction"}
{"_id":"720ed859-1a6b-0059-c96a-1a6902eed689","text":"The patient was checked every week for the first month then every 2 weeks for 3 months.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"72119a95-6992-a43f-72a6-b75596e107b5","text":"Our decision to use a long course of clindamycin to treat this multi-sensitive pathogen was primarily based upon a concern regarding the possibility of an incomplete excision. Oral clindamycin has good bone penetrance and good activity against anaerobic bacteria. Concerns about pseudomembranous colitis are less immediate in a young, otherwise healthy man. Co-amoxiclav or metronidazole could have been suitable alternatives but the poor bone penetrance of oral beta lactams plus the side effect profile of metronidazole make these less favourable choices for a long term antibiotic course.","title":"Clostridium cadaveris Osteomyelitis: an Unusual Pathogen which Highlights the Importance of Deep Tissue Sampling in Chronic Osteomyelitis"}
{"_id":"7215fff7-be7d-ee60-f4c9-3543ca616e85","text":"The use of fresh tissue micrographic surgery offers distinct advantages over other currently available forms of treatment in the management of primary and recurrent periocular basal cell epitheliomas. The technique is described and the results of a prospective study of 22 patients are presented. The advantages in terms of both surety of tumour excision and tissue preservation are discussed. We conclude that micrographic surgery has a definite role to play in the management of certain periocular basal cell epitheliomas.","title":"Micrographic (MOHS') surgery in the management of periocular basal cell epitheliomas"}
{"_id":"72169981-a2c6-61a3-8a04-da16b5acb25d","text":"All parents of child patients or the adult patients themselves were asked to sign a written informed consent form before starting the allergy work-up. All patients had been off antihistamines or oral corticosteroids for 10 days before drug evaluation.","title":"The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults"}
{"_id":"7216dc18-0e2e-cc08-635c-336bae2a6db4","text":"Neither the mites nor their debris can be seen under normal circumstances, therefore education of patients regarding dust mites avoidance may be difficult.","title":"Allergen Avoidance in Allergic Asthma"}
{"_id":"72177ef4-a692-8315-af41-806e61d1ce81","text":"In our series four patients had undergone vascularized fibula as an adjunct in the primary procedure to expedite biological reconstruction. One patient had delayed union in which 24 cm of ipsilateral vascularized fibula was used along with nonvascularized contralateral fibula, to fill the diaphyseal defect of tibia. Initial fixation device was removed and limb was put in cast for 2 months following healing. Full weight bearing is not yet allowed as the tibialization of fibulas is not complete in this case. In the rest of the cases vascularized fibula was used as onlay graft; thus good healing was evident with return to previous weight bearing status in an average of 11 months.","title":"Complex Biological Reconstruction after Wide Excision of Osteogenic Sarcoma in Lower Extremities"}
{"_id":"721947db-aac2-a6e9-2ec0-84e55ab2763a","text":"Under simulated surgical teaching, we must emphasize the importance of an objective evaluation during and at the end of the whole teaching and learning process of each proposed surgical skill in order to measure the level of acquisition of the taught skills [75].","title":"Basic Plastic Surgery Skills Training Program on Inanimate Bench Models during Medical Graduation"}
{"_id":"721d259a-a548-da9c-3235-ff3856055382","text":"In the present study we reviewed four patients who had undergone rotationplasty with vascular reconstruction for revision of tumor prosthetic knee joints after long-term infections and summarize the relevant literature to guide management of such cases.","title":"Rotationplasty with Vascular Reconstruction for Prosthetic Knee Joint Infection"}
{"_id":"7224bdf5-b35b-1e69-cc93-20c68722b818","text":"Literature on decellularization of human auricular cartilage is currently in-sufficient. Utomo et al. have provided a protocol however it didn’t specify the number of decellularization cycles required to produce an optimized scaffold. Similarly in the study by Gong et al., they have not clarified details of experimental steps. In addition the cartilage is of a porcine source only. This study is the first to compare multiple protocols for decellularization of human auricular cartilage with the detergent\/enzymatic method proposed in protocol B having shown to have been the most effective. The steps for protocols A to C were chosen based on the success of methods from previous study groups. The process of freeze thaw has shown to accelerate decellularization when applied to different tissues and this can minimize the duration of exposure to chemical forms. Adding a wet freeze thaw cycle in PBS allowed for cellular remnants to be washed away from the scaffold after thawing at room temperature as well as exerting greater mechanical pressure on the cartilage in physically decellularizing it. Detergent\/enzymatic methods can damage the structure of the ECM if prolonged and so physical techniques can shorten the exposure time. The use of EDTA in protocol C was adapted from Utomo et al. who had used it successfully in their decelullarization process. In addition the use of DNAse as well as SDC amongst the different protocols has been reported to effectively decellularize cartilage in the literature. Trypsin was used in protocol B as it has shown to accelerate decellularization in the case of hyaline cartilage of the trachea as reported by Gomez et al..","title":"Optimising the decellularization of human elastic cartilage with trypsin for future use in ear reconstruction"}
{"_id":"72264589-4b8c-660e-eedd-b878f8b17af5","text":"Eight of the studies used patient assessment as at least one measure. This is relevant in a clinical setting, as the patient's perceived benefit would be a huge influence on their satisfaction and potential repeat business. It is however fraught with potential bias where the patient is aware of the desired outcome and also potentially the influence of cost and access where treatment intervals are concerned.","title":"A review of the longevity of effect of botulinum toxin in wrinkle treatments"}
{"_id":"72328d04-32b9-2751-0b7a-2f9f261cff0c","text":"The frequency of the specific vein recipient used is shown in Figure 3.","title":"Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team’s Experience"}
{"_id":"7233e97f-703b-6a25-2b93-32b1af44eda2","text":"We created a standardized patient for this cost-analysis model based on 76 patients that were referred to hospital for a suspected DVT. Travel distance to the health care centre and hospital was calculated based on the home address. Hospital costs were acquired from the hospital price list and Finnish legislation. Time spent in the hospital was retrieved from hospital statistics. Time spent in the health care centre and travelling were estimated and monetized based on average salary. The cost of participating physicians attending a US training course was estimated based on the national average salary of a general practitioner as well as the course participation fee. A cost-minimization modeling was performed for this standardized patient comparing the total costs, including private and public costs, of standard and LCUS strategies.","title":"Cost-minimization modeling of venous thromboembolism diagnostics: performing limited compression ultrasound in primary health care reduces costs compared to referring patients to a hospital"}
{"_id":"723f4455-511e-6a84-5db7-8ce9f574d071","text":"This study showed that microlaryngeal surgery under general anesthesia is feasible for patients with severe obese elite vocal performers if proper simulations are conducted beforehand and the position of the patient and anesthesia is considered.","title":"Microlaryngeal surgery in severely obese elite vocal performers"}
{"_id":"7240776a-8913-9098-ea28-b642cc21029c","text":"Connective tissue and muscle are essentially unaffected by this process as they are more dense but an accumulation of secondary thermal energy and micromechanical trauma on sustained application of ultrasound after complete emulsification by microcavitation may result in damage. Thus direct micromechanical trauma and secondary thermal effects of persistent ultrasound energy is the mechanism of action for external UAL.","title":"Liposuction"}
{"_id":"72449980-2959-16d5-71c3-b3d87e342479","text":"The aim of this study was to document the difference in diameter between the TD vessel as a recipient and the DIEP pedicle in each patient who underwent microsurgical breast reconstruction. This information allows the appropriate recipient site of the TD vessels to be predicted and a supercharging site also to be selected before surgery. To the best of our knowledge, this is the first clinical study to compare the diameter of TD branches with that of the DIEP pedicle in patients undergoing microvascular breast reconstruction.","title":"Diametric Comparison between the Thoracodorsal Vessel and Deep Inferior Epigastric Vessel in Breast Reconstruction"}
{"_id":"72452261-899e-6804-2f02-bf5076651131","text":"The time required to reach the maximum degree of swelling or Q was analyzed by continuous measurements over 48 h, as shown in Figure 3. The results show that equilibrium swelling was achieved after 24 h of water submersion for all hydrogels. In this sense, with the objective of analyzing the thermal sensitivity of the hydrogels, a swelling analysis at different temperatures was also performed.","title":"Poly(N-vinylcaprolactam)–Gold Nanorods–5 Fluorouracil Hydrogels: In the Quest of a Material for Topical Therapies against Melanoma Skin Cancer"}
{"_id":"72503868-51f5-fd1d-6a66-b0a119cff111","text":"The present study was conducted to define the lymphedema rate at our institution in patients undergoing axillary or inguinal lymph node dissection for melanoma. It also aimed to examine potential risk factors predisposing patients to a higher rate of lymphedema, highlighting which patients could be triaged to ILR.","title":"Higher Rate of Lymphedema with Inguinal versus Axillary Complete Lymph Node Dissection for Melanoma: A Potential Target for Immediate Lymphatic Reconstruction?"}
{"_id":"7250cb0f-1a31-453c-6632-64b2ece4c8c5","text":"All flaps did well without any recontracture and need of splintage.","title":"Use of Local Perforator Flaps for Post Burn Reconstruction"}
{"_id":"72598d75-3380-a426-ebab-f6e8e0027885","text":"Do you get enough education for your tasks in the trauma team?","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"725d534e-38fb-6b9d-7584-6c612d62517d","text":"Physical examination clues for DVT include a swollen extremity that is tender to palpation. Erythema of the skin may or may not be present but is a feature of venous engorgement. Venous ultrasound is the standard imaging test for patients suspected of having acute DVT, and the Society of Radiologists in Ultrasound recommends a comprehensive duplex ultrasound protocol from thigh to ankle with Doppler at selected sites rather than a limited or complete compression-only examination [5].","title":"The Role of Serial Ultrasounds in Diagnosing Suspected Deep Venous Thrombosis"}
{"_id":"725ed72d-6e72-4509-4d15-0ae60280e6d8","text":"Some of these stereotypical attitudes were seen as being necessary for the job:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"726354cc-40dd-0a70-c315-45b62f1aecc3","text":"Family history of melanoma is associated with a high risk of melanoma, independent of other phenotypic characteristics. Those with multiple primary melanomas tend to have a higher positive family history rate. There are few data on the risk of SCC and BCC in people with a positive family history of melanoma. However, a history of previous melanoma is associated with an increased risk of developing SCC and BCC, and individuals with prior SCC or BCC are at higher risk of developing melanoma.","title":"Heterogeneity in Host Risk Factors for Incident Melanoma and Non-Melanoma Skin Cancer in a Cohort of US Women"}
{"_id":"72672ae4-3a06-6cbb-cacc-6e93e70935ce","text":"There was one case of second primary invasive cancer of the opposite breast after two years elapsed of the primary cancer, which was treated by the same SSM technique. One smoker patient developed metachronous metastatic lung cancer five years after treatment for her breast carcinoma. The patient died during last follow up. Three patients died because of cardiac events.","title":"Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR) for early breast cancer: Eight years single institution experience"}
{"_id":"726c5be3-05cf-fc92-67ac-8c6d4ee27afe","text":"Table 2 summarizes and reviews the DTH reactions associated with the main antineoplastic agents used today, organized by mechanism of action.","title":"Evaluation of Delayed-Type Hypersensitivity to Antineoplastic Drugs—An Overview"}
{"_id":"726edab9-2e96-d80a-49a3-c15a5cf86a05","text":"We found the thoracoacromial axis particularly useful in reconstructing tracheoesophageal fistulae due to the proximity to the defect. In these situations, local flaps have high rates of breakdown and it is imperative to recruit well-vascularised tissue from outside of the previous surgical site and radiotherapy field.","title":"The thoracoacromial axis in salvage head and neck reconstructive surgery, a case series"}
{"_id":"727dded0-ddc7-773c-27e8-2510d8ed3a09","text":"P14 Electrothermal bipolar vessel sealing system dissection reduces seroma output or time to drain removal following axillary and ilio-inguinal node dissection in melanoma patients: a pilot study","title":"Melanoma and immunotherapy bridge 2015 Naples, Italy. 1–5 December 2015"}
{"_id":"727f3c58-ac2e-8b8f-7476-261ed9afa1e6","text":"The deep inferior epigastric perforator (DIEP) flap has become a mainstay for autologous reconstruction with generally low complications and risk of flap failure. The internal mammary vessels, which are a popular recipient vessel choice, can occasionally be found to be suboptimal intraoperatively. A common reason for recipient vessel concern is related to size mismatch resulting in turbulent flow.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"72815704-e5f1-a720-c8f0-5b59f13bc256","text":"Radical resection with free margins is the standard treatment for primitive malignant melanoma.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"72822454-d58f-f143-9af3-51483fbab788","text":"Based on the responses of the program directors, it was identified that the residency programs might benefit from additional resources such as virtual BT training, interinstitutional collaborations as well as resident fellowships. Programs might also benefit from additional guidance related to BT‐specific training requirements to help program directors attest Authorized Medical Physicist eligibility for graduating residents.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"72838877-f8f0-eea6-e5a9-6fa56c57b544","text":"Subsidence was considered to have occurred if either the anterior or posterior height of the intervertebral space decreased by more than 1 mm from that measured on the postoperative radiograph due to sintering of the implant in the endplates of the adjacent vertebra [9,10].","title":"Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients"}
{"_id":"72866667-d269-bc3b-c77c-ae8202ae986d","text":"The neurovascular bundle of the leg was identified and dissected in a fashion consistent with conventional rotationplasty. The remaining posterior thigh musculature was transected and a large thigh skin flap along with the sciatic nerve was maintained. Prior surgeries and chronic infection had resulted in excessive scar tissue formation, encasing the femoral and popliteal vessels, as shown in Figure 2. Preserving these vessels was an unfeasible option.","title":"Modified Rotationplasty as a Composite Free Flap for Femur and Thigh Reconstruction"}
{"_id":"7287f011-5221-5af2-ee41-8c7a4ee0d311","text":"This indicated that only after a long time do low antigen doses accumulate in a sufficient quantity not only at the sites of the antigen administration but also in regional lymph nodes. Another possibility is that the antigen reached the lymph nodes during the first week of administration, but certain specific but unidentified niche factors suppressed early B-cell IgE and IgG1 switching in secondary lymphoid organs (SLOs).","title":"Early IgE Production Is Linked with Extrafollicular B- and T-Cell Activation in Low-Dose Allergy Model"}
{"_id":"728c68a5-4407-77c8-7be8-e4dee911452d","text":"The goal of this study was to evaluate the diagnostic yield of B-mode ultrasound and ultrasound elastography used alone and in combination for differentiating breast lesions into benign and malignant.","title":"Characterization of Breast Lesions Using a Novel Combined Approach of Ultrasonography and Elastography Prior to Invasive Procedures: Are New Age Modalities Set to Replace the Diagnostic Giant?"}
{"_id":"728e0821-e8d6-d538-5641-0dc38acf762f","text":"The main aims of this work were to emphasize the variety of immunological side effects in oncological treatment and to outline the need for future research. In the future, researchers should focus on ways to prevent side effects and treat the symptoms that have already arisen with methods that would not involve discontinuation of therapy.","title":"Immune Reactions in Major Types of Oncological Treatment"}
{"_id":"728f0371-7eb8-07f4-5c99-80cd0ecc049f","text":"Patients are eligible for enrollment in the study if they meet all the following inclusion criteria:","title":"Efficacy and safety of different antimicrobial DURATions for the treatment of Infections associated with Osteosynthesis Material implanted after long bone fractures (DURATIOM): Protocol for a randomized, pragmatic trial"}
{"_id":"7293c832-cf9a-390d-e6e7-e87585e01157","text":"Others have shown considerable benefits from the use of negative pressure wound therapy (NPWT) compared with conventional wound care, and a few studies have even reported success with treating sternal dehiscence using it solely. In our study most patients were treated with both NPWT and several sternal revisions prior to flap surgery. Our results may be of importance in the assessment of guidelines regarding the treatment of deep sternal wound infections.","title":"Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap"}
{"_id":"7293d25f-3b92-70d2-b9f1-24d2c8255a23","text":"The analysis of the application of PEF during cryosurgery requires the simultaneous solution of the Laplace equation and the Pennes Bioheat equation. The Laplace equation solves for the electrical potential distribution associated with an electric pulse, and the Pennes Bioheat equation solves for the temperature distribution. The form of the Laplace equation utilized in this study is shown below:where σ is electrical conductivity, and is the electrical potential. The electrical potential is subject to voltage boundary conditions applied at the outer edges of the analyzed domain, and the temperature distribution achieved from the solution of the Bioheat equation.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"729456ed-66ba-d75b-4e05-0422717919fd","text":"Tables 3 and 4 represent the dosimetric parameters for bladder and rectum, respectively, with HDR_BT and IMRT plans. The dose to 5 cc of bladder and rectum, respectively, was significantly lower with HDR_BT as compared to IMRT. Statistically significant differences between the two techniques were seen for doses to 1 cc and 2 cc of the volumes of rectum, while the difference in the doses to 1 cc and 2 cc of bladder between HDR_BT and IMRT plans was not statistically significant. It can be seen from Table 5 that the volume of the normal tissue receiving 10% of the prescription dose was lower with HDR_BT as compared to IMRT plans. The integral doses to the target and nontarget structures are tabulated in Table 6. The integral doses to the nontarget critical structures are smaller with HDR_BT as compared to IMRT (sliding window and static) due to the rapid fall-off in dose beyond point A.","title":"Dosimetric comparison of high dose rate brachytherapy and intensity-modulated radiation therapy for cervical carcinoma"}
{"_id":"72954d6b-0da0-0cc3-b8f9-a20e0b699794","text":"Practice inspections have already been covered above and are also implied in the tenth ordinance, where the announcement of the location of the practice and agreement to payment of a retention fee is mandatory; 'it is Ordained that no person of the Fellowship, after he has been admitted and sworn Freeman of this City before the Chamberlain, presume to open his Shop Windows before he has presented himself to the Masters or Governors of the Mistery for the time being, and with them has agreed in paying his due.'12","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"72957153-d370-42bc-42ca-ea43c1d6abf4","text":"This study investigates characteristics of cutaneous malignancies in the head and neck region that ultimately result in microsurgical, free vascularized tissue reconstruction. Moreover, we aim to create awareness for aggressive skin cancer dissemination mechanisms and to indicate possible pitfalls in patients’ treatment pathways by sharing our personal experience and approach in this work.","title":"Resection of Skin Cancer Resulting in Free Vascularized Tissue Reconstruction: Always a Therapeutic Failure?"}
{"_id":"7297db34-aaa4-1ac9-fd49-10531953edcc","text":"Minimum complications were reported in use of Medpor implants as dorsal and spreader grafts. Especially in spreader grafts the infectious complication rate was lower. However, most of infectious complications and extrusion were seen after implanting Medpor as strut and rim grafts in our stydy Some complication and extrusion were seen in long term follow up in Medpor dorsal graft in other study and because treatment of infectious complications and skin diseases is complicated, we recommend use of Medpor implants only as spreader graft safely.","title":"Use of porous high-density polyethylene grafts in open rhinoplasty: no infectious complication seen in spreader and dorsal grafts"}
{"_id":"729bb83d-7606-27ad-6a9b-f48bc9c31662","text":"The purpose of this study was to compare treatment outcomes of DFO patients treated with antibiotherapy alone and those who underwent concurrent bone debridement.","title":"Antibiotherapy with and without bone debridement in diabetic foot osteomyelitis: A retrospective cohort study"}
{"_id":"729c598e-0bc0-f1c7-414a-9716fefb437a","text":"We describe a case report of PG following bilateral breast reconstruction with a deep inferior epigastric perforator (DIEP) flap. The case highlights how important the early diagnosis and treatment of this condition is to avoid unnecessary debridement that can cause significant morbidity to the patient.","title":"Pyoderma gangrenosum after deep inferior epigastric perforator flap: How prompt diagnosis and treatment can avoid surgical debridement and further morbidity"}
{"_id":"72a1607c-367f-413b-c4fc-2e90bc61bed1","text":"Patients should undergo an initial postoperative check within four weeks of discharge to rule out any immediate wound complications, discuss pathology results and any further treatment if required, to identify nutritional problems and discuss any unresolved issues. The rest of the follow up should be focused on nutritional and psychosocial support and identifying any concerning symptoms - all of these issues tending to arise within the first two years after resection. Any patient developing recurrence can have their symptoms palliated efficiently and appropriate support offered.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"72a67aac-8a1b-0809-ea21-869e2aa81b4d","text":"Many interviewees reported that they had established new ideas about roles that they would like to work in and empowered them to pursue their career choices. For many, it enabled them to understand how they would be able to achieve such a goal:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"72a917aa-207f-46e0-64a2-ffd3f948fdee","text":"Study drug accountability will be assessed and documented by Guy’s Hospital Pharmacy. Study vials that have been reconstituted in saline for injection and used will be stored separately at room temperature after use for return to pharmacy for drug accountability to be assessed.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"72b37e7a-f633-c06f-6793-18500c029a82","text":"Such similarities have led to the hypothesis that tympanosclerosis, which is initiated by local inflammation following trauma or acute and chronic infection of the middle ear mucous membrane, might arise regardless of any association with other diseases. On the other hand tympanosclerosis could be influenced by the typical dysmetabolism of CRF patients, in which the prevalence of tympanosclerosis would be increased.","title":"Myringosclerosis in patients with chronic renal failure: comparative analysis with a control group"}
{"_id":"72b3db73-c645-2bf1-178f-2f4b884acf43","text":"In all cases, breast mound creation with free tissue from the abdominal donor site was performed in the standard manner, utilizing the deep inferior epigastric pedicle as donor vessels and the internal mammary pedicle as recipients for microvascular anastomosis. Poorly perfused regions of the flaps were assessed by clinical examination or fluorescent angiography and resected. Flap inset (unilateral and bilateral breast reconstructions) was to the contralateral chest with the flap apex placed in the superior position in a vertical inset pattern to provide ideal pedicle and microvascular construct positioning and to maximize the position of well-perfused flap segments.","title":"The Lateral Breast Flap Sling: A Novel Technique for the Revision of Autologous Breast Reconstructions"}
{"_id":"72b771c0-ee22-9aaa-6f8b-f3c62c51dad5","text":"Even though there are numerous blood vessels that originate as transverse rectus muscle flaps, there has been no previously reported location of the perforator vessels that provide vigorous blood flow to their flaps. Therefore, in this study, the perforator that enables the maintenance of the healthy state of Island TRAM flap was identified during the surgery and topographic mapping of their location was created, which is considered very important and significant. The complication rate in this surgery was checked together to confirm and suggest the appropriate method of preserving the perforator as much as possible in breast reconstruction using TRAM flap.","title":"Deep Inferior Epigastric Perforators Topography for “Island Transverse Rectus Abdominis Musculocutaneous Flap” in Breast Reconstruction"}
{"_id":"72b8f0f7-7380-25cc-fa77-0c2049d20b42","text":"Patients understood the need to continue to check for further skin lesions although most were not sure what they were looking for. Many participants continued to spread the word about skin cancer advising others to seek medical advice regarding suspicious lesions.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"72bb21f2-2858-5430-c26a-1373c0f015cc","text":"In summary, we conclude that the early detection and assessment of edematous bone changes of AP using 3D STIR imaging was feasible, while the extent of bone edema measured on MRI exceeded the radiolucencies measured on OPT. In clinical routine, dental MRI might be useful for early detection and assessment of AP before irreversible bone loss can be detected by conventional panoramic and periapical radiographs.","title":"Evaluation of 3D MRI for early detection of bone edema associated with apical periodontitis"}
{"_id":"72c6537b-343f-8bf2-e28c-6eecd968cbaf","text":"Conclusions: Untreated UPE in oncology patients does not always progress in the immediate term, with the majority in this cohort remaining static. Resolution and variable vascular distribution suggests that pulmonary thrombus can develop locally rather than as the consequence of a thromboembolic event.","title":"Proceedings of the International Cancer Imaging Society (ICIS) 16th Annual Teaching Course"}
{"_id":"72caba81-d53a-7c60-f126-aabd6025f2e3","text":"With increasing evidence that neuraxial blocks such as epidural or paravertebral anesthesia may influence the degree of dissemination of metastatic disease [3, 6, 7, 12, 16, 17] anesthesiologists should no longer consider these techniques as rare methods performed in highly specialized centers. Even if the scientific evidence regarding the precise role of these techniques on cancer recurrence is still questioned by some experts [18], there is no known effect where these methods would in any way promote the spread of cancer cells. Hence the potential benefits in reducing postoperative pain alone appear to outweigh the risks of the method; hence anesthesiologists today find themselves in a situation where they need to discuss why they are not liberally employing these techniques. One obvious reason, particularly in breast cancer surgery, is the requirement of a high cervical level block which can be technically challenging and usually only few anesthesiologists would have had previous exposure to these techniques since they are usually restricted to selected centers. With breast cancer surgery being performed in many hospitals this gives rise to a significant discrepancy between the demand for cervical epidurals and the ability of the staff to perform these techniques.","title":"Feasibility of Cervical Epidural Anesthesia for Breast Cancer Surgery"}
{"_id":"72cc2cf8-113d-78dd-12d8-1ade14723c66","text":"The present study has shown that the analgesic efficacy of ultrasound-guided paravertebral block is linked with a higher success rate, better postoperative analgesia, and comparatively less complications than the landmark technique in patients undergoing laparoscopic cholecystectomy. We thus recommend that ultrasound-guided PVB is a useful and safer approach than the conventional landmark technique for pain management during elective laparoscopic cholecystectomy. Hence, the USG-guided thoracic PVB technique should be considered a safe and effective alternative treatment to conventional methods for postoperative pain management. Further studies with a greater number of patients to ascertain success rates and complications related to paravertebral techniques can be done in the future.","title":"Comparative Study Between Conventional Landmark Versus Ultrasound-Guided Paravertebral Block in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Study"}
{"_id":"72d1cfda-ac5e-dce9-c394-42c4efb6212d","text":"Treatment of ankyloglossia with frenotomy (incisional release of frenum), frenectomy\/frenulectomy (excision of frenum tissue; the 2 terms describe the same procedure), or frenuloplasty (release and repositioning of frenum tissue to lengthen lingual sulcus) may be associated with improvements in breastfeeding, speech articulation, and dentofacial development.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"72d80489-6918-5a40-1907-aeacee6f55cc","text":"Local ethical agreement and informed consent of the patient were obtained.","title":"Timing between Breast Reconstruction and Oncologic Mastectomy—One Center Experience"}
{"_id":"72dcde96-49d2-b1b3-b8d4-4468eb745751","text":"• A very wide excision requiring skin grafts or rotation flaps for skin closure; either of these two techniques could applying of either of these two techniques could alter lymphatic drainage","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"72de43c2-dfd2-adc2-27f0-663c99fd6eb9","text":"Patient characteristic data were presented as the mean with standard deviation or frequency with percentage.","title":"Stereoscopic virtual reality models for planning tumor resection in the sellar region"}
{"_id":"72e50ef7-f9b4-5563-47e7-195da50523c2","text":"Sebaceous gland carcinoma has the highest occurrence rate in Bangladesh. The gold standard for treatment modality is surgical excision with microscopic margin clearance under frozen section control. Metastasis and recurrences are usually found in cases of SGC rather than basal cell carcinoma and squamous cell carcinoma. Melanoma is rarely occurred eyelid malignancy. This finding differs from the Western reports and is similar to those from Asian regions.","title":"Clinicopathological Analysis and Surgical Outcome of Eyelid Malignancies: A Study of 332 Cases"}
{"_id":"72e7eeb4-3304-dfa5-2b30-15de447d49f5","text":"In contrast, prognosis of patients with loco-regional skin metastases has not been analyzed in detail and the concurrent presence or absence of lymph node metastasis represents the only established prognostic factor thus far.","title":"Prognostic Factors of Melanoma Patients with Satellite or In-Transit Metastasis at the Time of Stage III Diagnosis"}
{"_id":"72e99e9a-fd56-f1c1-0eec-57d81d3351b7","text":"No laboratory test or biological materials are collected during this trial.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"72ec349b-2766-9f31-5edd-27bd7593c7b2","text":"Microtia reconstruction using tissue expander and autologous costal cartilage is a standard method of ear reconstruction with good satisfaction rate for surgeons and patients. Although the complication rate was high in our study, most of the cases were managed with acceptable results. Therefore, a standard protocol should be developed regarding the timing of the surgery for microtia reconstruction, considering pre-operative radiological analysis of the costal cartilage development along with age and weight of the patient.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"72f0ac50-c394-8187-e1d4-ca7a65cefd3e","text":"After the second series of autologous fat transplantation, the patient developed irritative rash of the skin which had been in contact with the Brava system; the irritation of the skin persisted and increased in intensity with the continued use of Brava. After the fourth series of treatment, the evolvement of blisters resulted in sleepless nights due to pain and itching, which required prescription of sedatives and antihistamines (Figure 1). Furthermore Mildison a hydrocortisone based ointment and Comfeel Plus were applied to the skin. Due to these skin lesions, multiple additional consultations were necessary at our wound clinic. The blisters subsided only after discontinuation of Brava. A silicon allergy test was performed and found negative. Due to the pain and itching, the use of Brava was reduced with approximately 2 hours daily during the final 5 series of treatments. Aesthetic analysis was performed using preoperative and postoperative photographs. Both patient and surgeon evaluated the reconstruction of the breast as optimal with a soft and natural appearing breast after 7 series of treatment.","title":"Delayed Total Breast Reconstruction with Brava"}
{"_id":"72fb9631-9151-59b3-8ff8-e4453f7089b8","text":"Giant Cell Tumour of the cervico-thoracic spine is a rare entity which has not been previously extensively reported. Early diagnosis and proper surgical excision using extralesional\/en bloc resection is required but due to the fear of injury to the extremely close neurovascular structures Marginal resection is done which leads to higher chances of recurrence as the total resection is not feasible. A close follow-up and monitoring for signs and symptoms with periodic imaging are excellent tools to identify the recurrent lesion and plan out the necessary treatment. Also radiotherapy plays a pivotal role to prevent recurrence in cases where extralesional\/en bloc excision is not feasible if used in controlled dosage.","title":"Clinical outcome in Giant cell tumor of cervico-thoracic spine: Our experience with three cases"}
{"_id":"73018aa9-5474-d096-f4f1-d9bd64fb902f","text":"Computer tomography of the thorax and abdomen showed no evidence of distant metastasis. The patient was optimised for general anaesthesia after consultation with a Consultant Respiratory Physician who managed to improve her respiratory function with medical therapy. Subsequent right sided mastectomy was performed under general anaesthesia in January 1999. As the spread of extraskeletal osteosarcoma is haematogenous rather via lymph, axillary lymphadenectomy was not perfomed. Histology of the mastectomy specimen showed no evidence of residual tumour involvement.","title":"Primary osteogenic sarcoma of the breast: A case report"}
{"_id":"730c861e-5a48-294c-d1e9-b53f86906a24","text":"The anterolateral thigh (ALT) or rectus abdominis myocutaneous (RAM) free flaps are usually well suited to provide the appropriate amount of tissue for posterior palatomaxillary reconstruction (Figure 1). These flaps tend to be thicker in Western patients and will partially obliterate the maxillary sinus. Both flaps can be dissected such that their muscular components can be minimized and the flaps can be safely defatted in patients with more subcutaneous adipose tissue than desired. By utilizing distal perforators, the pedicle length is usually satisfactory in both flaps to reach the neck blood vessels without need for interposition vein grafting. Suturing to the palatal mucosa should take place over the bony palatal remnant to avoid an oronasal fistula, or holes can be drilled in the bony palate and a deep layer of sutures can be placed through them for an extra degree of wound closure stability.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"730f6597-448a-0721-3dce-ab79b87e721c","text":"The use of adjacent tissue in reconstruction of the cheek should be given a good consideration with respect to aesthetic and functionality. A simple primary closure could not be considered in our index cases because the defects were more than 4cm in sizes and attempting to close such in Zone 1 will lead to anatomic distortion and ectropion. Skin grafting which appears as a simple option is fraught with texture and colour mismatch and only reserve as an option when patient cannot undergo prolonged surgery due to severe co-morbidities. Camouflaging the scars of other pedicle flaps is usually very difficult. Free flaps are limited to patients that can undergo prolonged surgery and it requires expertise which is not readily available. Free flaps are usually bulky and require multiple stages for refining. Furthermore, free flaps do not provide colour and texture match. Modified cervicofacial flaps provide an excellent colour and texture match because it is adjacent to the defect, its s easier to elevate as a flap with good learning curve, less distortion of anatomic land mark, reduce operative time and surgical complications. Modified cervicofacial flaps can be carried out in patients with high surgical risk as it can be performed under local anaethesia with little or no donor site morbidity. The modified cervicofacial flaps was used by Kaplan in 1978 for coverage of defects following removal of cancers of the head and neck.2 This flap had undergone modifications based on the plane of dissection either superficial or deep to SMAS 3. The supra- SMAS flaps depend on the rich subdermal plexus of vessels, and the infra- SMAS flaps rely upon more reliable large perforator branches from facial and transverse facial arteries. The infra-SMAS flaps are believed to reduce post op complications including distal flap necrosis, epidermolysis because of its improved vascularity and provide thick skin flap. 8 However, we performed a supra-SMAS modified cervicofacial flaps for both of our patients which was much easier, with reduced operative time under general anaesthesia. 9 our patients did not have the potential complications of flap necrosis, lower eye lid ectropion nor epidermolysis. We were also able to avoid the potential facial nerve injury that could be associated with deep dissection technique.2,10 The scars were well camouflaged as we saw in the follow up after 4 years (Fig. 7a & b)","title":"Versatility of cervicofacial flap in management of cutaneous cheek defects post tumour excision: a report of two cases"}
{"_id":"731d5f57-f766-c801-3e12-08f961300839","text":"Evolution and function of the immune system in mammals are driven by the need for protection against pathogenic infection. The balance between the conflicting requirements for capacity to recognize a universe of continually evolving microorganisms while avoiding deleterious responses to self poses a challenge. Hypersensitivity responses are defined as disorders that are caused by the immune response and include autoimmune responses. Three of the four classically described types of hypersensitivity involve antibodies. Type I hypersensitivity involves IgE antibodies and atopy and will not be discussed further. Types II and III hypersensitivity involve IgG antibodies and are implicated in immune pathology, especially the Type II hypersensitivity response, which explicitly involves autospecific antibodies. Type IV hypersensitivity involves T cell response, particularly CD4 T cell responses.","title":"Hypersensitivity Responses in the Central Nervous System"}
{"_id":"73203f90-7c03-409e-2f59-00e6db17e53e","text":"Diltiazem was tried in 8 patients for either the treatment of or prevention of calcinosis. In 2 of these 5 children with pre-existing calcinosis there was improvement with resolution in some areas, but 2 of the 3 to whom it was given prophylactically developed calcinosis. Chloroquine was prescribed in 4 patients for severe skin disease.","title":"Juvenile dermatomyositis in South African children is characterised by frequent dystropic calcification: a cross sectional study"}
{"_id":"7322a4c4-317d-e5d4-9397-fe7d86f56df1","text":"Identifying the number of abnormal lymph nodes on axillary ultrasound can play a role in quantifying axillary nodal burden in breast cancer patients. In particular, it may be useful in identifying patients with a high axillary burden of more than two macrometastases, to consider receiving ANC upfront or primary systemic therapy. However, the accuracy of axillary ultrasound alone is not sufficient to replace SNB for all patients. Further research comparing the role of a wider range of ultrasound features and imaging modalities in staging the axilla could inform future management of the axilla with reduced surgical morbidity.","title":"Non-invasive predictors of axillary lymph node burden in breast cancer: a single-institution retrospective analysis"}
{"_id":"7323380c-8b06-5d4a-3f49-fdb1d8586166","text":"In cases of postoperative deep wound infection after interbody fusion with cages, it is often difficult to decide whether to preserve or remove the cages, and there is no consensus on the optimal approach for removing cages. The aim of this study was to investigate the surgical management of cage infection after lumbar interbody fusion.","title":"The comparison between anterior and posterior approaches for removal of infected lumbar interbody cages and a proposal regarding the use of endoscope-assisted technique"}
{"_id":"7323587e-905f-9946-3799-a4bba716415b","text":"The follow up was defined as time between the end of treatment to either the event or the most recently dated medical record.","title":"Head and Neck Non-Melanoma Skin Cancer Treated By Superficial X-Ray Therapy: An Analysis of 1021 Cases"}
{"_id":"73259290-74f7-ab8e-8591-a9ecfc5f7199","text":"We observed that the percentages of different plasmablast subpopulations in the regional lymph nodes and the withers tissue started to increase at the same time points. This meant that the antigen, even at low doses, was rapidly delivered to the regional lymph nodes. Thus, one could suppose that extrafollicular plasmablast accumulation per se is necessary but not sufficient for IgE production. The impact of different types of T helpers on these cells in the withers adipose tissue on the one hand and the regional lymph nodes and in the visceral fat on the other could result in delayed IgE switching in regional lymph nodes and visceral fat tissue.","title":"Early IgE Production Is Linked with Extrafollicular B- and T-Cell Activation in Low-Dose Allergy Model"}
{"_id":"732e6250-a85e-1500-30c2-36d95b3b0c72","text":"Arthroscopic surgery is minimally invasive and avoids significant skin scars and greater risk of damage to the facial nerve. We commend it to surgeons interested in TMJ surgery.","title":"A Modified Technique of Temporomandibular Joint Arthroscopic Operative Surgery of the Superior and Inferior Joint Spaces"}
{"_id":"7333eacd-a611-6df2-662e-85187e1ecd37","text":"For example, the use of an intramedullary CTS offers different advantages, especially in cases with a combined severe bone loss and large soft tissue defect in the pilon region. The use of an intramedullary CTS promotes soft tissue healing and especially free flap healing due to the absence of external soft tissue cutting rods, pins or cables, which are needed for the classic transport method. Second, intramedullary CTS allows targeted transport with axially aligned regenerated bone, which is particularly important in bone transport for ankle arthrodesis since the tibia has a small diameter and needs to be moved into the right position with respect to the talus, which becomes more difficult as the defect size increases. This is supported by the fact, that axial misdirected transport only occurred in the classic transport group (Table 3). At first glance, the additional docking operation that is required to remove the flexible cable of the CTS seems disadvantageous with respect to classic bone transport. However, since autologous bone grafting at the docking site is the current “gold standard” and delayed bone healing is often observed at the docking site, we performed both cancellous bone grafting at the docking site and removal of the flexible cable. This combined procedure may lead to significantly lower rates of delayed union at the docking site than those reported in the current literature. However, a specific problem of the CTS group that had to be mentioned was a cable breakage that occurred in three cases, necessitating a renewed attachment of the flexible cable.","title":"Analysis of bone transport for ankle arthrodesis as a limb salvage procedure for the treatment of septic pilon fracture nonunion"}
{"_id":"73358c0f-c149-6ef0-8a2e-1e60dd8a6b40","text":"Poor and short-term results may not be the only risks of this noninvasive facial rejuvenation procedure. Permanent insertion of a foreign body can cause unexpected reactions with considerable morbidity and negative esthetic effects, and even the most stable alloplastic material may fail and break down under repeated stress and flexion, such as occurs in the moving face. Reports on side effects of a wide variety of alloplastic materials applied to the face for this purpose have increased, and a more stringent monitoring of these effects is necessary.19, 25 Although immunological or chemical reactions to an inert implant are very unlikely, such foreign bodies can infect or fragment Because these procedures are commonly performed on relatively young patients and complete surgical suture removal is virtually impossible, residual fragments can remain for decades, worsening symptoms over time.","title":"Facial thread lifting with suture suspension Rejuvenescimento facial com fios de sustentação"}
{"_id":"73360f2b-1707-dd37-6e63-ec8478d9d13a","text":"Interviewees described how they developed their interests and aspirations as a result of their experiences on placement. Common areas that evolved included interest in leadership roles, developing the service, improving patient care and global health. Interviewees reported that the development of these interests and values influenced their subsequent choices in careers. One interviewee stated how the programme equipped her to pursue the career of her choice:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"733614a5-3a41-1586-b09e-e03c92a0deb3","text":"Often the pathologist's report of a diagnostic biopsy of melanoma will include a statement regarding the presence or absence of tumor at the biopsy margins. This information is of no significance and can mislead many primary care physicians into not seeking additional surgical consultation. Therapeutic margins for melanoma are a function of the micro-staging thickness of the melanoma. Clear radial margins of 1 cm are required for all thin melanoma while 2 cm radial margins are recommended for all intermediate thickness lesions. These evidence-based recommendations have been designed to avoid a local recurrence, which is accompanied by a dismal five-year survival. Thick melanoma can be managed with 2 cm radial margins or greater if the lesion is associated with clinically evident satellitosis [7]. Melanoma in situ which has no metastatic potential should be excised with a 5 mm radial margin designed to remove all of the pre-malignant tissue to avoid a potential local invasive recurrence.","title":"Adjunct primer for the use of national comprehensive cancer network guidelines for the surgical management of cutaneous malignant melanoma patients"}
{"_id":"733e6daa-5caf-082f-4419-5d5c93cefb38","text":"Most of the informants emphasised that a good leader needs to have an overview and see the totality of the situation. He has to help the process move forward and intervene if the process is going in the wrong direction. He needs to take responsibility and make decisions. The team members expect that the leader remain focused on what is important. Indecisive leaders were mentioned as the reason for unsuccessful trauma situations. An example was mentioned where the leader did not guide the team. The team leader became focused on single procedures and not the overall wellbeing of the patient.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"7341c389-b1db-f564-fd6e-5cb75f26cd0c","text":"Table 4 Pre- and intraoperative mean radiation exposure of the clinical staff by SLNB in different tumour entities","title":"10-Year experience regarding the reliability and morbidity of radio guided lymph node biopsy in penile cancer patients and the associated radiation exposure of medical staff in this procedure"}
{"_id":"7346cd19-db8b-fa9d-9bbd-1005da4c4954","text":"Both junior and senior sonographers were involved in this project and performed the ultrasound examinations. Training sessions were organized and reliability exercises preceding the actual study demonstrated that US is a reliable exam even in the hands of junior sonographers after a short but intensive training session.","title":"Structural ultrasound of joints and tendons in healthy children: development of normative data"}
{"_id":"734de4a0-d538-f43d-8890-6bdcdc13c686","text":"Advantages of dorsal surgery include less surgical effort and time to decompress multiple levels and less frequent need for instrumentation and fusion, thereby helping decrease the chance of adjacent level disease, and it also affords direct visualisation of nerve roots when decompressing, and there is little risk to anterior neck structures such as the recurrent laryngeal nerve and the oesophagus.","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"73527094-b5bd-447f-a072-b865956f6e12","text":"Thus, to validate and illustrate this theory and to evaluate the efficacy and safety of our approach for repairing lower extremity defects, utilizing the scalp as a donor site and employing the DermaBlade as the cutting tool, we conducted a clinical prospective study, including patients with surgical defects and leg ulcers who received treatment at our center. The main objective was to assess the potential advantages offered by the innovative aspects of the proposed method.","title":"Enhancing Lower Extremity Defect Coverage: High Viability Ultra-Thin Split-Thickness Skin Grafts Obtained from the Scalp"}
{"_id":"7358d60a-251f-0a72-a78d-20eebcc0dadb","text":"The above stated studies all suggest that earlier weight-bearing and motion would allow patients earlier return to function without any compelling disadvantage. Our findings show that patients can fully weight-bear as tolerated during the immediate postoperative period similar to patients with stable ankle fractures. Our patient group had one case of loss of reduction and fixation failure. This occurred as a result of a missed syndesmotic injury. This reaffirms the importance of identifying syndesmotic disruptions.","title":"Immediate Weight-Bearing after Ankle Fracture Fixation"}
{"_id":"7367fd84-85fb-da49-ab87-9d41b816626c","text":"This retrospective non-randomised case control study has demonstrated the safe use of a novel application of negative pressure wound therapy that substantially improves the incidence of seroma formation and postoperative complication rate for inguinal lymphadenectomy for melanoma. This data could possibly be extrapolated for other disease indications requiring inguinal lymphadenectomy, though we would advise caution. However, given the encouraging data we would recommend that a prospective phase III RCT is undertaken to validate our findings. Similarly, we would also encourage the commercial sector to invest in product design to improve the facility for applying and changing the dressings in both the hospital and primary care settings.","title":"Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma"}
{"_id":"73750a40-adfa-3fc2-fe88-34792698142b","text":"'And where by custom each year on the Sunday after the Feast of St. Bartholomew the ApostleFootnote 2 a dinner is held for the Livery of the Company at the Barber's Hall, and on the Saints Day of Cosmas and DamianFootnote 3 (unless it is a Saturday) a dinner for those of the Company not in Livery, it is ordained that every man who has been the Master or Upper Governor of the Company shall pay at and for the dinner twelve pence for himself, and eight pence for his wife if she comes.","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"737e64d7-0664-6940-b355-189c48363407","text":"All participants reported re-using their own syringes at varying frequency and typically dependent on sterile syringe availability to the individual. Most described cleaning the needle after each use with either tap or bottled water, some noted that there were still visible blood products within the syringe prior to next use.","title":"Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage"}
{"_id":"73805986-0eb2-550f-fee2-0025060188f8","text":"Thus, the aim of this study was to evaluate the impact of breast reconstruction after mastectomy on specific aspects of patient quality of life, including sexual function, body image, and depression. If the study shows that breast reconstruction after mastectomy leads to improved quality of life in the breast cancer population, the findings may contribute to the inclusion of breast reconstruction procedures in the routine treatment of patients with breast cancer in the Brazilian public health system.","title":"Sexuality, depression and body image after breast reconstruction"}
{"_id":"73945ac0-6b12-85a7-b2bd-880e3ac0c6cc","text":"Quantitative CT can be used to measure volumetric trabecular BMD, which is more sensitive and precise than DXA for detecting bone mineral loss by avoiding the superimposition of cortical bone and other soft tissues [28]. However, quantitative CT is rarely used in clinical practice because it requires specialized equipment and measurement software. In contrast, lumbar CT is routinely performed for the preoperative assessment of patients with low back pain. Opportunistic osteoporosis screening from lumbar CT imaging data can provide valuable preoperative information for spine surgeons since osteoporosis is a major cause of instrumentation failure after spinal fusion surgery [3]. Our predictive model with high discriminative power provides the possibility of opportunistic osteoporosis screening in non-dedicated lumbar CT scans. Based on the performance in our study, it can be expected that quantitative CT radiomic features can be regarded as a reliable substitute for DXA in the preoperative setting","title":"Using radiomic features of lumbar spine CT images to differentiate osteoporosis from normal bone density"}
{"_id":"73966f53-206f-8b9b-982f-3908c41f4361","text":"Conclusion Aspirin is an effective and safe prophylactic against deep vein thrombosis following major elective lower limb arthroplasty surgery.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"73aeaf24-f8c6-2257-4a29-f189279192e4","text":"This statement is based on a number of studies in favor of the superiority of MCS respect standard excision in accuracy and less rate of false negative margins.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"73b2fc23-ce3d-3019-7809-74c6e4704550","text":"The ESP block has provoked the curiosity and interest of clinicians as the paravertebral distribution associated with the block has been established and the method is relatively easier and safer to apply compared to the paravertebral block. Thus, the publication of data on the successful management of postoperative analgesia by the application of the ESP technique at the level of T5 after the thoracic and breast surgeries has been followed currently by reports on the use of that method at various levels for a range of indications from acute herpes zoster treatment at low thoracic levels to abdominal and hip surgeries [13-15].","title":"Ultrasound-guided Low Thoracic Erector Spinae Plane Block for Effective Postoperative Analgesia after Lumbar Surgery: Report of Five Cases"}
{"_id":"73b3846b-068e-933f-f6fa-68ec2c846ead","text":"Fifth, majority of graduating plastic surgery trainees’ complete residency with inadequate business skills as evidenced by this survey. The ever increasing complexity of the United States healthcare system in conjunction with the competitiveness of the plastic surgery marketplace, demand that residencies begin to address practice development in their training of residents.","title":"A survey of current state of training of plastic surgery residents"}
{"_id":"73ba8970-3405-5288-68c1-7fc7622cf86f","text":"The ratio of bound\/released GAG per spheroid was calculated by dividing the amount of GAGs bound within a respective spheroid and the amount of GAGs secreted by the same spheroid. A ratio of >1 indicated more GAGs bound into the spheroid than released into the medium by the respective sample.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"73bf6864-5775-5511-0885-2dd555613548","text":"In Korea, nearly all hospital follows the requirements of surgical treatments of the Korean National Health Insurance Corporation for reimbursement. In the case of anterior cervical decompression combined with fusion for cervical radiculopathy, these regulations require intractable pain despite non-surgical treatment for at least 6 weeks and associated neurologic deficit. The regulations for fusion surgeries combined with decompression for cervical myelopathy are neurologic deficits attributed to this diagnosis. The surgical standard of care for patients with lumbar disc herniation in Korea is lumbar discectomy in case of the patients with intractable pain or neurologic deficits despite non-surgical treatment that lasted for at least 12 weeks. Regarding lumbar fusion for lumbar disc herniation, these regulations additionally require recurrent lumbar disc herniation, foraminal lumbar disc herniation, or lumbar instability combined with lumbar radiculopathy. The surgical standard of care for patients with degenerative spondylolisthesis or spinal stenosis in Korea is posterior lumbar decompression in the case of the patients with no improvement of symptoms despite non-surgical treatment that lasts for at least 12 weeks. Concerning lumbar fusion for degenerative spondylolisthesis or spinal stenosis, these regulations additionally require findings of foraminal stenosis or lumbar instability combined with degenerative spondylolisthesis or spinal stenosis. Therefore, the requirements of the Korean National Health Insurance Corporation were considered as the surgical indications for patients in this cohort.","title":"Reoperations after fusion surgeries for degenerative spinal diseases depending on cervical and lumbar regions: a national database study"}
{"_id":"73cb25b2-e749-3b32-f8fd-978c9951f7d5","text":"Hence the surgeon must be well-versed with the techniques of cartilage grafting. We also performed nasal tip reshaping by using the sutures techniques to alter the shape of the lower lateral cartilages. So dorsal hump reduction can be recommended with accuracy and safety without compromising the nasal airway.","title":"Component Rhinoplasty"}
{"_id":"73ccc1e0-7c8e-656c-0ce4-9ebe4c5cb33d","text":"Access to the healthcare system can present a significant barrier to care in general, with WHO estimates indicating that more than 40% of the population of some countries does not have effective access to healthcare for reasons ranging from language barriers and a lack of education to a lack of health infrastructure and lack of access to other public services, including electricity and sanitation, which thus impairs adequate provision of healthcare 73. Where access to the healthcare system is available, one of the major barriers to appropriate anticoagulation in Latin America is economic; the high pharmacy cost of outpatient anticoagulation treatment can make it inaccessible to patients who must pay drug costs out of pocket 73 and when funded publicly, the use of more expensive drugs may be restricted or controlled centrally 13. Consequently, ambulatory patients who would be suitable for outpatient treatment with new oral anticoagulants may be admitted to the hospital to receive the first few days of treatment as inpatients. In some institutions, patients may be admitted to receive unfractionated heparin via continuous infusion pump to avoid the high cost of LMWH 13,26, despite the greater overall cost to the healthcare system of doing so 74,75. Thus, while it may be theoretically possible for 80% of patients with DVT to be managed on an outpatient basis 76,77, the actual rate of outpatient care is much lower and both institutional and healthcare system costs are increased.","title":"Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care"}
{"_id":"73d1c2cf-6335-6a43-0fc3-c4f86e009bc9","text":"The statistical data were completed with the analysis of variance being used to test if the number of Mohs stages needed to clear the defect was associated with the different repair options; a P value was determined based on the association of nasal defect locations and closure options selected.","title":"Nasal Reconstruction of Post-Mohs Defects >1.5 cm in a Single Cosmetic Subunit Under Local Anesthesia by a Combination of Plastic Surgeon and Mohs Surgeon Team: A Cross-sectional Study and Review of Algorithmic Nasal Defect Closures"}
{"_id":"73de9e00-1dc9-725d-9a17-e3f1c4b59c05","text":"This study relied on several different software programs and modalities for planning. Preoperative CT imaging is an important part of presurgical planning in patients with primary cranial tumors. The characteristics of the tumor on advanced imaging allow for determination of the invasiveness of the tumor and whether a patient is a surgical candidate or not [16]. The tumor margins were identified based on the CT scan in a DICOM viewer prior to transfer to CAD software for creation of the virtual defect. To identify the tumor margins, ROI points were marked on the CT with the radiologist and surgical oncologist and this method was the most easily translatable for communicating the exact location and extent of the tumor in the design phase. Creation and export of the tumor ROI allowed the design engineer to accurately create a defect with surgical margins that mimicked the surgical procedure and allowed for design of the implant. The surgical margin communicated to the design engineer directly related to the invasiveness of the tumor and extent of bone affected as seen in previous cases [17].","title":"Schedule feasibility and workflow for additive manufacturing of titanium plates for ranioplasty in canine skull tumors"}
{"_id":"73def974-6bdb-ea6d-37db-7c2e72f2c113","text":"The ultrasound-guided preoperative single TPVB and ESPB for thoracoscopic pulmonary lobectomy could both reduce the postoperative pain VAS score and reduce the dose of perioperative sufentanil and postoperative remedial analgesics.","title":"Ultrasound-guided single thoracic paravertebral nerve block and erector spinae plane block for perioperative analgesia in thoracoscopic pulmonary lobectomy: a randomized controlled trial"}
{"_id":"73eff3dd-bb23-433e-d624-b13fc0a040cd","text":"Table 2 Reports of nipple pain in women who received peppermint water and expressed breast milk","title":"Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial"}
{"_id":"73f4e44f-dcf2-1028-3718-d5db86c98f85","text":"We extracted data of individual patients from each study and summarized the outcomes of all evaluated treatment modalities with the descriptive statistics. We reported medians with ranges for continuous variables and frequencies for categorical variables. Missing data were managed by mean imputation.","title":"Local, non-systemic, and minimally invasive therapies for calcinosis cutis: a systematic review"}
{"_id":"73f96956-30d9-2888-c62e-e65bb6fc552a","text":"This combined iPDT-APC injection strategy would both directly destroy portions of the tumor and additionally induce in situ APC activation which enhances antigen acquisition and processing as well as migration of the APCs to draining lymph nodes. This in vivo produced vaccine would potentially enhance the primary PDT effect and prevent tumor regrowth. It would also obviate the time consuming and costly necessity of priming APCs in vitro.","title":"Photodynamic therapy mediated immune therapy of brain tumors"}
{"_id":"73ffebdd-cf18-d1b3-d162-e7b388280f77","text":"The aim of this study is comparison of reactions of allergy shots in adults and children.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"74001676-145b-cdad-0628-bb4cda7050c4","text":"Breast reconstruction surgery should not be avoided simply because of advanced age. Various factors may influence the decision to offer or deny an elderly patient a particular procedure. More studies and longer follow-up periods will be required in the future, but the case presented here demonstrates the usefulness of DIEP flap reconstruction for elderly patients.","title":"Immediate one-stage breast reconstruction for an 85-year-old breast cancer patient using deep inferior epigastric perforator flap surgery"}
{"_id":"7401a75e-a41d-466e-305e-0fa9202bae33","text":"Wound debridement was repeated and dressings changed three times over the course of hospital stay. Scalp swelling and inflammation gradually subsided.","title":"Alopecia and pet: a case report"}
{"_id":"7404896b-f2c4-ce3d-0c4b-f920e5a1e72e","text":"This study was conducted while the Covid-19 pandemic was ongoing, which was a period during which normal ambulatory care for patients with peripheral arterial occlusive disease was greatly restricted, which had a negative impact on recruitment of patients for the study.","title":"Correlations between ultrasound, tomographic, and intraoperative measurements of the great saphenous vein used as an arterial graft"}
{"_id":"7408720b-e35e-4a67-6ae8-34bb9f65d76d","text":"Patients were recruited from the Johns Hopkins University Allergy and Clinical Immunology outpatient clinic and through IRB-approved advertising on social media. Patients who responded to advertisements were initially screened by telephone to determine eligibility. Patients who were taking proton pump inhibitors were instructed to stop these medications 7 days prior to enrollment. If determined eligible, patients were remote consented prior to Visit 1 by teleconference in compliance with FDA 21 CFR Part11.","title":"Bruton’s tyrosine kinase inhibition for the prevention of anaphylaxis: an open-label, phase 2 trial"}
{"_id":"740cece2-b6ce-8164-b1af-97fb554c742a","text":"Fibromatosis or desmoid tumor of the breast is an extremely rare entity. While it lacks a metastatic potential, it can grow aggressively in a locally infiltrating pattern. The failure to recognize this as a finite entity within the breast can lead to local recurrence after incomplete excision.","title":"Fibromatosis (desmoid tumor) of the breast mimicking a case of ipsilateral metachronous breast cancer"}
{"_id":"74107eae-770b-a2cf-41e5-d99a2159571a","text":"Online sessions were held over the course of three days from Monday 28 June to Wednesday 30 June 2021 covering:","title":"Bone Research Society 2021 Abstracts"}
{"_id":"7417ad33-65a2-20e0-a0a6-849156b2981b","text":"Proximal tibial skeletal traction was performed immediately after all patients with closed fractures were admitted to the hospital. Patients with Gustilo I and Gustilo II open fractures first underwent debridement and suturing, after which they received proximal tibial skeletal traction. In two patients with a Gustilo III fracture, limited internal fixation combined with external fixation was implemented following debridement. All patients with open fractures received postoperative intravenous antibiotics for 24 to 48 h. X-ray and CT examinations were used to visualize fracture displacement and the presence of fragments when determining the surgical strategy for each patient. All patients underwent surgical treatment as soon as their condition had stabilized.","title":"Application of Cortical Bone Plate Allografts Combined with Less Invasive Stabilization System (LISS) Plates in Fixation of Comminuted Distal Femur Fractures"}
{"_id":"7417dd30-8fe2-8488-83a3-290e1e6b2720","text":"In the axilla region, CrystalCam and planar imaging statistically exhibit an almost perfect agreement with CrystalCam missing only 1 SLN that was localized by planar imaging. The unidentified SLN can be associated with the small FOV of the handheld gamma camera compared to conventional gamma camera. Planar imaging and the handheld camera show a moderate agreement in localizing SLNs in the groin.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"7419b716-1299-7785-6a81-c1c8abfc6248","text":"Reconstruction choices of these cutaneous malignancies are dependent on multiple factors such as type of the tumor, risk factors of the lesion, and general health status of the patient. Moreover, the reconstruction ladder should not be forgotten in case of insufficient excision or recurrence of the tumor. We reviewed our 3 years series of 148 consecutive patients with NMSCs and reported the demographic features, risk factors, reconstruction choices, long term results as well as comorbities of the patients. We hope that this limited report could be a pioneer to a multicentric study that contains the features of NMSCs in our country.","title":"Non-metastatic Non-melanoma Skin Cancers: Our 3 Years of Clinical Experiences"}
{"_id":"741a3d9e-1124-4b0a-2793-a7d0864cd69f","text":"To guarantee sufficient exposure, a progressive dissection, initiated by the confection of the lateral flap, was continued throughout removal of all soft tissue. The subsequent surgical steps are followed according to the same principle of removing all fibrous and fatty tissue around, beneath, and alongside the popliteal vessels and nerves. After retraction of the flaps, an easy identification of the peroneal nerve and its ascending dissection until its origin in the sciatic nerve offers prompt identification of the tibial nerve. Subsequent recognition of the sural cutaneous nerves and their branches makes the dissection secure. The next crucial step involves the resection of all fat pad tissue close to the popliteal vessels. Meticulous inspection and palpation of the popliteal fossa must be performed not to leave any lymph node undetected.","title":"Popliteal lymph node dissection for metastases of cutaneous malignant melanoma"}
{"_id":"742af827-16ac-0090-9d92-aa95ed8f5b63","text":"Chronic osteomyelitis often presents a chronic draining fistula although rest of the features are similar to acute counterparts.","title":"Mucormycotic Osteomyelitis Involving the Maxilla: A Rare Case Report and Review of the Literature"}
{"_id":"7432f299-f9a1-0a24-b77a-bd12e5a7a8e6","text":"Most scholars agree that popliteal cyst is a distention of the bursa located between the medial head of the gastrocnemius muscle and semimembranosus. The bursa space is communicated with knee cavity through one-way valvular mechanism covered by posteromedial capsular fold. Synovitis and chronical joint effusion in knee osteoarthritis will increase articular cavity pressure and can cause continuous unidirectional flow of synovial fluid from articular cavity to popliteal cyst because of low pressure in popliteal cyst. The synovial fluid in popliteal cyst could not return to knee articular cavity. So the popliteal cyst will be enlarged gradually.","title":"Arthroscopic internal drainage and cystectomy of popliteal cyst in knee osteoarthritis"}
{"_id":"7439bb04-f259-ac77-2b42-6fb3c3ea4483","text":"The trapezius muscle compared with other muscles for the coverage of the posterior defect such as latissimus dorsi, has a low donor site morbidity and allows early rehabilitation. Glenohumeral function is preserved in lower trapezius flap in contrast with latissimus dorsi which result in weakness of the shoulder extension and adduction.","title":"Trapezius Rotational Flap for Cervico-thoracic Wound Breakdown in Post-radiotherapy Necrosis : A Case Report"}
{"_id":"743d2ecb-0f33-3b00-66ee-71df9b0f36c7","text":"Bell's palsy is a common neurological problem that leads to peripheral palsy of the facial nerve. Most patients have a favorable response with or without treatment while some are left with significant facial deformity. Identification of factors which influence the outcome in patients with Bell's palsy may help clinicians counsel better.","title":"Evaluation of prognostic factors in patients with Bell's palsy"}
{"_id":"743d4df2-42c4-9dea-b341-090d7bdc1919","text":"IMGs can help improve existing training programs and develop new specialty residency and fellowship training opportunities in developing countries by using the Internet or through on-site visits. For example, in the developing world, many medical training institutes lack opportunities for specialty training in such disciplines as child and adolescent psychiatry, bone marrow transplants, and palliative care. With the help of international physicians trained in these specialties, the alumni of different medical schools can arrange lectures on sub-specialty subjects for medical students, residents and fellows across the globe. International physicians can teach these subjects from a distance via regular webinars or as visiting faculty members and by helping to develop specialty centers to train local doctors. They can also collaborate with local training programs to improve curriculum with local adjustments according to the needs of a particular country. These measures can provide opportunities for top quality professional training for the next generation of medical graduates.","title":"International medical graduates: from brain drain to potential gain"}
{"_id":"74401e2f-3368-4d1d-63a4-5a93a1bb4519","text":"Ankylosis can be defined as a stiffness of a joint due to abnormal adhesion and rigidity in bones of the joint.","title":"True bony TMJ ankylosis in children: Case report"}
{"_id":"74416e14-c1f6-b7f4-c9cf-7dcbd948b6b3","text":"We demonstrate that administering bilateral TPVB is a safe and useful procedure for performing cosmetic breast augmentation for patients when general anesthesia is not desirable. The procedure is advantageous in that the use of muscle relaxants, volatile anesthetic agents can be avoided. The risk of perioperative respiratory depression caused by high dose opioid usage can be minimized. Performing the block with ultrasound guidance by an anesthesiologist who is experienced in this technique, the chance of pneumothorax will be extremely low.","title":"Paravertebral Block Combined with Sedation for a Myasthenic Patient Undergoing Breast Augmentation"}
{"_id":"7444faa6-6c35-d788-989a-b2fd8bef34b7","text":"The present study found that promoting early initiation of breastfeeding reduces the pre-lacteal feeding practices suggesting that a stringent focus on enhancing levels of early initiation of breastfeeding may yield reductions in levels of pre-lacteal feeding among the newborn babies. The study findings further indicate that the breastfeeding advice during pregnancy and breastfeeding observation by the health service provider after the birth significantly improve breastfeeding and pre-lacteal feeding practices. This supports that increased focus on these practices by the grass root level heath workers at the time of visits can help accelerate reductions in neonatal mortality. However, there is a gap in the program implementation as it lacks universal adherence, more specifically in the private health facilities. Thus, it is of utmost importance that the future programs make concerted efforts and pay greater attention to ensure that the expectant mothers are duly advised on early initiation of breastfeeding and that the service providers observe the early initiation to ensure adherence. For example, it may be helpful to create the awareness and greater commitments among the service provides about the importance of early initiation and its adherence and how this can bring about positive changes in the health outcomes among newborn babies including reduced mortality. Additionally, supporting new mothers with proper guidance and resources may facilitate establishing successful breastfeeding routines.","title":"First 72-hours after birth: Newborn feeding practices and neonatal mortality in India"}
{"_id":"744591fe-7661-df72-7e9c-0ce7a78ba885","text":"Having fellows in multiple specialties has meant being thoughtful about mentorship on how fellows can integrate climate and health education, advocacy and leadership into their respective fields and careers. Recognizing that climate-informed healthcare is a novel, but burgeoning field in many specialties, there has been particular focus among fellowship faculty to provide meaningful mentorship on this front. As a fellowship that is not tied to a certificate or degree, fellows must consider factors that will facilitate their marketability beyond the fellowship. Fellows meet with faculty on a monthly basis to discuss professional development, as well as to track progress on deliverables to ensure they are all well positioned to pursue leadership positions post-fellowship.","title":"Creating climate-informed physician leaders: The evolution of a physician fellowship in climate and health science policy"}
{"_id":"745245b7-28fd-3c6b-93a4-86bb23e80801","text":"The aim of this analysis is to bolster the existing but highly limited literatures on malignant melanoma of Asian people by documenting the clinical presentation as well as outcome after active treatment of a relatively large group of Chinese patients with pathologically confirmed malignant melanoma recently treated in our tertiary referral center specialized for the management of this disease.","title":"Clinical presentation, histology, and prognoses of malignant melanoma in ethnic Chinese: A study of 522 consecutive cases"}
{"_id":"7453fcdb-993c-8f8f-888e-be955a417b39","text":"The calculation of the Odds Ratio also demonstrated a moderate negative association between sufficient and desirable values of vitamin D and neoplasm, allowing us to hypothesize that an optimal state of vitamin D may play a protective role towards melanoma. The observed data are aligned with the results of studies that identified low VDSL as a risk factor for melanoma development. The comparison of our results to the Cattaruzza and Nurnberg studies are summarized in Table 4 (Fisher's Exact Test).","title":"Role of vitamin D serum levels in prevention of primary and recurrent melanoma"}
{"_id":"7458f649-b9a7-5680-5c8b-64647a046ba4","text":"Injection sites in the cortex and corresponding FG injection sites in the lumbar cord (L1\/L2) for each rat are shown in Fig 2A and 2B. Injection sites were focussed within the primary and secondary motor cortex and the adjacent primary sensory cortex as described above for LCIN experiments. FG injections were within L1\/L2 segments. Spread of FG was observed within the grey matter ipsilateral to each injection but there was no spread to the contralateral grey matter. Fig 2C and 2D show injection sites within the MLF and corresponding FG injection sites in the lumbar cord. The micropipette was placed in the right side of the MLF but CTb labelling was visualised bilaterally. The FG injections into the lumbar spinal cord were found within L1\/L2, with the injection site centred in the intermediate grey matter.","title":"Corticospinal and Reticulospinal Contacts on Cervical Commissural and Long Descending Propriospinal Neurons in the Adult Rat Spinal Cord; Evidence for Powerful Reticulospinal Connections"}
{"_id":"745a9961-e6bc-c522-a0eb-7bc6e2f714d8","text":"GDPs are at the same time both business people and health professionals.28 While entrepreneurship and leadership does have some theoretical overlap,29 they can also be mutually exclusive.30 Kempster and Cope argue that the complex process of 'becoming' a leader happens through naturalistic learning.30 Environments and contextual experiences, which provide opportunities to participate in and observe leadership, are the dominant process in which emerging leaders develop their understanding and practice of leadership. To this extent GDPs are at a disadvantage given the limited scope for observation within the relative isolation of the practice environment. Surgeries are not easily shared and the one-to-one relationship between dentist and patient means it is difficult to observe other clinicians28 and providing clinical leadership at a systems level is quite different from leading a practice team. If the model for medicine is adopted, the GDPs that will form part of the LPN will need to be given support and encouragement to look beyond their practice population in order to drive local commissioning.","title":"What is clinical leadership and why might it be important in dentistry?"}
{"_id":"745b4b38-afd7-93ad-067d-124170be7126","text":"This study concludes the prevalence of septorhinoplasty is low which may be due to the COVID-19 pandemic during the study period. The results of the study suggest that septorhinoplasty has high satisfaction rates concerning the final aesthetic result. The grade of satisfaction remains high in both genders postoperatively. The most important factor that influences success is probably your choice of the rhinoplasty surgeon. People are pleased with the results of cosmetic nose surgery if undertaken with realistic expectations. The goal of the surgery is to create harmony and a natural shape.","title":"Septorhinoplasty among Patients who Visited the Outpatient Department of Otolaryngology-Head and Neck Surgery of a Tertiary Care Center: A Descriptive Cross-sectional Study"}
{"_id":"745cf31c-ef62-6ca3-8d42-1d2be12020de","text":"Table 1 and Figure 1 show a summary of the statistics of the MCK variables. The MCK pattern in the histological bone sections can be seen in Figure 2 and Figure 3.","title":"Osteonal Microcracking Pattern: A Potential Vitality Marker in Human Bone Trauma"}
{"_id":"7467fa08-166a-1dc2-a609-686879bb43de","text":"The treatment of COF involves conservative surgery through enucleation of the lesion and the use of a curette to heal the remaining cavity. The clinical cases and the series of published cases to date have contributed to knowledge about clinical and histological characteristics of COF. Despite this, certain gaps in knowledge remain with regards to the definition and etiology of this entity such as reasons for COF recurrence following surgical treatment since some cases have been recorded. For this reason, we decided to carry out a study using 8 new COF cases analyzing the clinical, radiological and histopathological characteristics of this tumour.","title":"Central odontogenic fibroma: Retrospective study of 8 clinical cases"}
{"_id":"747111f1-1ae6-5302-be07-15e2317df563","text":"Since 2002, market studies have predicted a physician shortage with an increasing need for future subspecialists. A Residency Review Committee (RRC) rule that restricted sponsorship of fellowships was eliminated in 2005, but the influence of this change on the number of fellowships is not known. We believed that the rules change might make it possible for community hospitals to offer fellowships. Our objectives were to determine the extent of change in the number of fellowships in university and community hospitals from 2000 through 2008, both before and after the RRC regulation change in 2005, and to determine whether community hospitals contributed substantially to the number of new fellowships available to internal medicine graduates.","title":"Sponsorship of Internal Medicine Subspecialty Fellowships Since 2000: Trends and Community Hospital Involvement"}
{"_id":"7472c8fa-5881-49f0-8357-91915083a718","text":"18F NaF PET scan has been also shown to be useful in the detection of a variety of skeletal abnormalities in young patients with back pain with higher resolution and similar radiation dosimetry but a higher cost relative to Tc99m-MDP [5].","title":"SPECT\/CT bone scintigraphy to evaluate low back pain in young athletes: common and uncommon etiologies"}
{"_id":"7473c892-568c-e72a-a85c-1461419fb7da","text":"MJG has been involved in revising critically for important intellectual content, has given final approval of the version to be published and has written part of the discussion and conclusions.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"7474159a-f807-6f00-9437-34cdc2c6cde0","text":"SRA activity focused on process development and tissue supply by MTF and in vitro measurements at MIZZOU. Successful completion of the SRA has resulted in initiation of an approved patient assessment study and limited distribution of the allograft tissue to select sites to create journal publications that will describe the health care and patient efficacy benefits of the technology.","title":"A One Health overview, facilitating advances in comparative medicine and translational research"}
{"_id":"74750436-fa54-d5c5-cd33-8854537b91bc","text":"Breast surgeries conducted under regional anaesthesia leads to early ambulation therefore early discharge of patient hence can reduce hospital stay cost as recently a study demonstrated an approximately 75% cost reduction in patients undergoing ambulatory breast surgery as opposed to surgery followed by two to three days hospitalization [14].","title":"Use of Paravertebral Block as an Alternative to General Anesthesia for Breast Surgeries: A Randomized Control Study"}
{"_id":"74754d0c-79a6-239d-394e-3b1a8de3547d","text":"The Karapandzic flap is an advancement-rotation flap that maintains lip mobility and sensation provides excellent oral competence. The original technique involved extending the incisions parallel to the upper lip toward the nasal ala, medial to the nasolabial fold. It is more commonly used for lower lip defects but can also be applied to defects of the upper lip (Figure 5). Sensation and mobility are maintained through meticulous dissection of the neurovascular structures entering the flap between the orbicularis oris musculature and surrounding facial musculature and soft tissue.","title":"Lip Reconstruction after Tumor Ablation"}
{"_id":"747a2a00-f9d7-8ec8-d4fa-1e543ba7f734","text":"Using inductively coupled plasma-mass spectrometry, we previously demonstrated that saliva from a patient with manic disorder contained a high concentration of one of the components of a drug, lithium carbonate, that the patient had been administered on a regular basis. The patient developed oral lichenoid drug reaction, but did not have any other lesions on the skin or in other areas of the body. We performed a drug-induced lymphocyte stimulation test and demonstrated that the patient was allergic to lithium carbonate. This finding suggested that the oral lesion was caused by lithium that was excreted with saliva and acted directly on the oral mucosa. Although many studies demonstrated that drugs are excreted into the saliva in addition to the blood and urine, few have examined the effect of drugs in saliva on the oral mucosa. Therefore, we performed a study to recognize the direct influence of a drug on the oral mucosa by showing the amount of 5-FU excreted from saliva as a numerical value.","title":"A pilot study of the clinical evidence for the methodology for prevention of oral mucositis during cancer chemotherapy by measuring salivary excretion of 5-fluorouracil"}
{"_id":"7480e55e-aea7-914a-92ac-16817bc2b11e","text":"Photodynamic therapy (PDT) is an effective treatment for a number of solid malignancies. In this work, the antitumor efficacy of photodynamic therapy for murine B16 melanoma with intravenous administration of a new photosensitizer (PS) based on the chlorin e6 conjugate with a prostate-specific membrane antigen (PSMA) was studied in vivo. We have previously published the data obtained in the first part of the study: the dynamics of PS accumulation in the tumor and surrounding tissues and the antitumor efficacy of the photodynamic therapy, which was evaluated by the regression parameters and morphological characteristics of the tumors—including by the complete regression of the tumors, the absolute growth rate of the tumors among the mice with continued tumor growth, and an increase in life expectancy compared to the control. The criterion for a complete cure was the absence of signs of tumor recurrence within 90 days after therapy. The conducted studies demonstrated the high efficiency of the new photosensitizer for the photodynamic therapy of B16 melanoma. This article presents a continuation of this work, including histological studies of the zones exposed to laser irradiation on the 21st day after treatment and an assessment of the therapeutic potential of photodynamic therapy for the destruction of tumor cells. Pathological studies in the zones of photodynamic exposure revealed that the effectiveness of the PDT depended on the PS dose and the laser irradiation parameters.","title":"On the Pathomorphological Pattern of the Efficiency of Photodynamic Therapy of Murine Melanoma B16 Using a New Photosensitizer Based on Chlorin e6 Conjugate with a Prostate-Specific Membrane Antigen"}
{"_id":"74831c04-5cb1-c6b8-8700-6adfad2a55ab","text":"Craniofacial development is a complex and irreversible process, involving age-related changes in bone and soft tissue. The developmental process that can be quantified allows researchers to have a clearer picture of the development of craniofacial bones and teeth. Previous related ageing and developmental studies attempted to characterize ageing changes in tissues from the perspective of geometric measurements, which include measuring changes in head circumference and skull volume, and measuring sutural growth displacement of the maxilla, etc. The ageing-significant regions revealed by the proposed ARDA map corresponding developmental period are basically consistent with the developing regions of craniofacial and teeth proven in previous related ageing studies.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"748888f8-4cef-234a-2355-fb394f4a5353","text":"The adverse events are reported by the senior spine surgeon to the steering committee.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"7488a6c3-3e67-e8de-092b-f399f2dfda5a","text":"Most venous thrombi originate in the valve pockets of the calf veins where there is stasis and hypoxia. Consistent with slow blood flow, contrast dye lingers in the valve pockets after venography . Hypoxia occurs because the valve leaflets are avascular and the oxygen tension in the valve pockets rapidly decreases when blood flow stops . Endothelial cells lining the valve pockets express antithrombotic proteins such as thrombomodulin and endothelial protein C receptor . Such expression is downregulated by local hypoxia or inflammation and by the loss of oscillatory shear-dependent transcription factors that endow perivalvular venous endothelial cells with an antithrombotic phenotype . Therefore, stasis and hypoxia in venous valve pockets promote a hypercoagulable microenvironment, which explains why DVT starts in this site.","title":"Recent advances in understanding, diagnosing and treating venous thrombosis [version 1; peer review: 2 approved]"}
{"_id":"7490bbff-2221-6e17-a140-1caddf71b6c1","text":"The derivation of all these classification systems was based upon small numbers of infants the overwhelming majority of whom had difficulties breast-feeding. Moreover, recent anatomic studies have demonstrated that the lingual frenulum is not a fibrous band or cord, but rather, a fold of fascia that is in continuity from the floor of the mouth to the bottom of the tongue. The fold varies as the tongue moves. The frenulum is visually more prominent when the mucosa and fascia attach higher on the ventral tongue surface, closer to the tip, and the frenulum appears much thicker when some of the genioglossus is pulled up between the folds. These studies also identified branches of the lingual nerve extending from the frenulum onto the superficial ventral surface of the tongue that have direct connections to the motor end plates of intrinsic tongue muscles and thus likely have a direct role in shaping the contour of the tongue in response to sensory input (8, 17). These authors also point out that the lingual frenulum is not a band or string of fibrous tissue and so there is no anatomic basis for “posterior tongue tie”. They also point out the frenulum is sensate, and pain severe enough to require analgesia has been reported for as long as a week after frenulotomy in older children and adults.","title":"What is tongue-tie and does it interfere with breast-feeding? – a brief review"}
{"_id":"74936e93-0da7-40b9-629b-afb0d5750e30","text":"Conclusions: Our study showed that our residents appear to have earlier levels of autonomy than that experienced by our practicing surgeons when they were residents. Confidence continues to play a role in the decision to pursue fellowship and overall our residents are confident in technical skills at graduation. Our unique program continues to graduate the majority of our surgical residents into successful general surgery practice.","title":"Early Autonomy May Contribute to an Increase in the General Surgical Workforce"}
{"_id":"7493fdea-7e78-9f75-69bc-a9743a601cd8","text":"Rationally, conventional drug delivery routes have many inherent limitations that could potentially be overcome by advanced drug delivery methodologies such as transdermal delivery.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"7497df46-032e-90c7-12af-b0f2753a2860","text":"Limited data is available regarding the optimal surveillance strategy for patients diagnosed with early stage melanoma. With over 11,000 patients, this study represents one of the largest cohorts reported to our knowledge. By using a hazard rate analysis, we sought to identify the highest risk period for recurrence in order to define a window where patients are most likely to benefit from surveillance.","title":"Hazard-Rate Analysis and Patterns of Recurrence in Early Stage Melanoma: Moving towards a Rationally Designed Surveillance Strategy"}
{"_id":"74989e25-5354-85c0-f942-d3b48e0f53e3","text":"The major limitations of this study are the small sample size and relatively short follow‐up. In addition, further study is needed to determine if the association between regression and a false‐negative SLNB observed in this study holds in a larger cohort of thin melanoma patients and on multivariable analysis, particularly since nodal recurrence may also be associated with other factors such as Breslow thickness, ulceration status, and presence of LVI. It may be necessary to distinguish between different mechanisms and phases of regression in order to draw clinically meaningful conclusions 37. Furthermore, while there are many studies investigating the impact of regression in the primary tumor, we are unaware of any such studies evaluating for the presence of regression in the nodal basin. If additional investigation reveals that the same immune mechanisms driving regression in the primary tumor are also at play in the lymph nodes, it is possible that regression of metastatic deposits in lymph nodes may make it more difficult to detect these regressed metastatic deposits by SLNB. Thus, it may be that thin melanoma patients who display regression merit more intensive surveillance after a negative SLNB.","title":"Regression in thin melanoma is associated with nodal recurrence after a negative sentinel node biopsy"}
{"_id":"749a1bda-8e4a-0ed5-1781-45c1c8b9630d","text":"The use of free flaps in lower extremity reconstructive surgery has seen growing adoption for treating tissue loss in patients with diabetes mellitus and peripheral artery disease as a means for limb preservation. The superficial circumflex iliac perforator artery (SCIP) flap is one of the most commonly utilized flaps in foot reconstruction and has demonstrated benefits over amputation. Patients with impaired vascular and neurologic function are predisposed to complications following lower extremity reconstructive surgery, particularly ischemia in the angiosomes of the arteries used for flap anastomosis. We present the case of a patient who underwent successful SCIP flap reconstruction of the calcaneus but developed gangrene in the forefoot region supplied by a hypoplastic posterior tibial artery in subsequent months. The changes in tissue oxygenation and hemoglobin distribution of the foot are shown using spatial frequency domain imaging throughout the flap healing process and eventual tissue necrosis.","title":"Steal syndrome from a superficial circumflex iliac perforator artery flap in a patient with a hypoplastic posterior tibial artery and severe diabetic peripheral artery disease"}
{"_id":"749db73b-2908-6fc8-a047-f3cd20731cc8","text":"Please describe the composition of the trauma team at this hospital?","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"74a69e47-2980-a619-c5ea-75acfdef3e3b","text":"In our study, TAP group patients had excellent pain relief in 30 minutes postoperative assessment than the non-TAP group. However, as time progressed, better pain relief was noted in the non-TAP group as compared to the TAP group. This may be due to inadequate drug instillation in the TAP region (which is between the internal oblique muscle and transversus abdominis muscle of the anterior abdominal wall) where cutaneous nerves needed to be blocked, but instillation of drug mainly in the transversus abdominis muscle region would not result in the desired effect. Laparoscopic TAP block with a visualization of the bulge as a marker for installation of the drug in transversus abdominis muscle pain in patients undergoing laparoscopic cholecystectomy surgery is an alternative mode of pain management in the absence of ultrasound-guided TAP block.","title":"Efficacy and Cost-Effectiveness of Laparoscopic Transversus Abdominis Plane (TAP) Block in Laparoscopic Cholecystectomy: A Comparison With the Non-TAP Group"}
{"_id":"74a6e700-f3c3-f7ef-eaa4-ca1cc6797430","text":"Dental composite materials should be used for the direct restoration of damaged dental hard tissues and as restorative and bonding materials for reconstructing damaged tissues using indirect adhesive techniques. The possibility of modifying the composition of both the basic polymer matrix as well as additional components and fillers causes these materials, compared to those previously used, to be distinguished by much better performance properties.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"74aa7415-fd06-6d41-5cd3-3977769bd694","text":"Arteriography displayed patency of the vascular axis and viability of the posterior tibial artery to the ankle. The size of the defect precluded the use of a local flap, while the depth of the wound and the existence of internal hardware made the sural fasciomusculocutaneous flap preferable to the fasciocutaneous flaps.","title":"Distally based sural fasciomusculocutaneous flap for treatment of wounds of the distal third of the leg and ankle with exposed internal hardware"}
{"_id":"74ad67c8-43a3-6fe9-993f-24c327431489","text":"Passing each stage and entering the next stage was the criterion for wound healing.","title":"Therapeutic Effects of Successful Angioplasty on the Aorta and Lower Limb Arteries on the Healing of Chronic Ischemic Wounds"}
{"_id":"74bb472b-f5c6-968f-804b-49abbf7e4c59","text":"Basic participant identification of program and gender only was required, the remaining participant identifications were kept anonymous hence it does not add or deduct the value of the survey.","title":"Students' perceptions of online learning in higher education during COVID-19: an empirical study of MBA and DBA students in Egypt"}
{"_id":"74c1088f-51f7-a5ae-0d3b-de0bc51ba99c","text":"A good outcome in terms of donor site morbidity is seen in our study with scar quality complaints being the commonest complication of the flap. This could be attributed to the patient population characteristics of our study and designing the flap with primary closure of the donor site being the best method of minimizing poor scarring. Skin grafts and delayed wound closure methods, as known from their increased inflammation and poor quality of scar formation, were indeed associated with a greater rate of poor quality scarring and possibly altered sensation as well. ALT flaps also result in a relatively concealed scar but sacrificing the lateral cutaneous nerve of the thigh during harvest may result in discomfort to the patient.[17] The use of an ALT for a small defect in our cases would be an underutilization of the ALT flap where it could be used to reconstruct larger resections in the future if the tumor should recur. Free radial forearm flaps have an unsightly scar at the donor site where skin grafts are most likely required for the flap volume required for a subtotal glossectomy reconstruction. The disruption of the conjoint tendon during harvest may also result in unsightly bowstringing of wrist flexors which may not be favorable in certain patients. Lastly, if disruption to the paratenon covering the tendons during harvest occurs, poor skin graft take may result and may require subsequent revision surgery.[18]","title":"Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction – An outcome study"}
{"_id":"74cb5390-1a29-db8d-64da-6b9399e9f2b3","text":"All of the goats tolerated the surgeries very well, with the exception that one died from anesthesia complications. The general anesthesia provided a good condition for surgeries. Because of the structure of the gastrointestinal system of goats, it is very important for the animals to undergo fasting for 24 hours before the surgery and to limit the food uptake 24 hours after the surgery to avoid the risk of aspiration and asphyxia during the surgery and intestinal tympanites after the surgery. Several different surgical techniques using the anterior approach have been developed to relieve the symptoms of pain. The anterior approach to remove herniated discs is safe and efficient in decompressing both the spinal cord and cervical nerve roots. Therefore, we chose to implant the ACVC using the anterior approach.","title":"Artificial Cervical Vertebra and Intervertebral Complex Replacement through the Anterior Approach in Animal Model: A Biomechanical and In Vivo Evaluation of a Successful Goat Model"}
{"_id":"74ce3739-877e-3895-66b3-f2a9d806ead3","text":"In retrospection, we could have avoided ALND in 95 micrometastatic SLNs and in 125 macrometastatic nonmultiple SLNs with concomitant breast conservative treatment.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"74d68298-b560-ec4c-4d45-d566580cab5d","text":"Dermal matrices cannot be used on bone as they still need blood support to facilitate the repair process. Local flaps could not be used as the skin was seriously photodamaged and treatment of this would further delay the repair. In our case the solutions adopted with other patients were not applicable, therefore we evaluated the literature to determine which solution could be adopted. We had experience with tissue perforation in large ulcers and position punch grafting to facilitate re-epithelialization therefore we also drew inspiration from this method.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"74d6b746-686b-5f08-2c18-dbd07a46ce9b","text":"Pectoralis major muscle flap has adequate bulk, and it easily adheres to irregular 3 dimensional defects. It can be used to wrap around metal recon plate to avoid plate extrusion and reconstruct the floor of the mouth. We have used it for coverage of chin defect, reconstructing the floor of mouth and enfolding the reconstruction plates. It provided as filling dead space and reliable soft tissue coverage.","title":"Taking a step down on the reconstruction ladder for head and neck reconstruction during the COVID-19 pandemic"}
{"_id":"74d8d338-801a-b5ef-809c-69ba1b135c84","text":"Leadership in professional surgical organizations is one modality for advancement in academic surgery. In addition to scholarly activity, leadership within organizations provides networking opportunities and exposure to potential referees when applying for academic advancement. Given this relationship, gender parity within surgical organizational leadership is important for women to continue to advance in academic surgery. This data should be revisited to identify trends of advancement if in leadership roles held by women, closing the gender equity gap in leadership amongst surgical organizations.","title":"Leadership Amongst Regional and National Surgical Organizations: The Tides Are Changing"}
{"_id":"74dc1cbd-1393-7b3f-36c4-a6be88b062da","text":"Rhinoplasty undoubtedly represents one of the most difficult cosmetic surgeries. Quantification of PRO satisfaction would enable the surgeon to assess the success for each technique from a patient perspective and determine the technique with the best outcome.","title":"Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients"}
{"_id":"74ed5759-1979-e2bf-5494-7d00c16f02bd","text":"Axillary ultrasound is the main imaging tool for the assessment of lymph nodes, which are divided into three levels in relation with pectoralis minor muscle: level I axillary lymph nodes are lateral to the lateral border of the pectoralis minor muscle; level II axillary lymph nodes are between the medial and lateral borders of the pectoralis minor muscle; level III axillary lymph nodes are medial to the medial margin of the pectoralis minor muscle and inferior to the clavicle.","title":"Bilateral lymphadenopathies on mammograms: a case of mixed connective tissue disease and psoriatic arthropathy Giambersio et al"}
{"_id":"74ef48db-cad8-a321-6687-1745c1311f02","text":"We report the results of 40 patients affected by PFC and treated by HDR interstitial IRT.","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"74f83f25-6525-4c1c-d01a-2179d95b9b7b","text":"Ankyloglossia can be divided into partial or complete ankyloglossia. The academy of Breastfeeding Medicine Protocol defines partial ankyloglossia as the presence of a sublingual frenulum which changes the appearance and\/or function of the infant's tongue because of its decreased length, lack of elasticity or attachment too distal beneath the tongue or too close to or onto the gingival ridge. Complete ankyloglossia is a condition in which there is extensive fusion of the tongue to the floor of the mouth which is extremely rare [16].","title":"Clinical Guidelines and Management of Ankyloglossia with 1-Year Followup: Report of 3 Cases"}
{"_id":"74f9ac2a-75a5-9554-2e2d-5296f6c03e4d","text":"The same concept was adapted by Chow et al. for the reconstruction of the tibial condyle after en bloc resection of giant cell tumours, with preservation of the blood supply as a pedicled vascularized graft in 1982. A vascularized graft does not undergo resorption and creeping substitution. It rather progresses to rapid fusion and adapts to physiological load.","title":"Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: long-term result"}
{"_id":"7501a46a-bf58-b99c-196c-29a602141e1c","text":"Subsequently, the popliteal fossa is entered by opening the popliteal fascia vertically in the midline. The first structure to appear is the Tibial nerve, which crosses vertically and disappears between the 2 heads of Gastrocnemius. Lateral to it is the Peroneal nerve, which courses laterally along the biceps femoris tendon and then turns obliquely towards the fibula. Both nerves should be retracted laterally with vessel loops to allow adequate and safe exposure of the vessels and the LNs. Dissection deep to the Tibial nerve will reveal the popliteal vein. The popliteal artery passes deep and slightly medial to the vein. It is the deepest structure in the popliteal fossa and lies on the femur and capsule of the knee joint. The LNs are contained within the fatty tissue that is found superficial, alongside and deep to the popliteal vessels. LN dissection should include, therefore, all the fatty tissue in the popliteal fossa till reaching the posterior aspect of the knee joint. It should be noted that the popliteal fossa is wider in the deeper part than in the superficial part. Adequate retraction of the Gastrocnemius muscle heads, therefore, is essential to ensure adequate exposure and dissection of all the LNs.","title":"Popliteal lymph node dissection for metastatic squamous cell carcinoma: a case report of an uncommon procedure for an uncommon presentation"}
{"_id":"750533c5-8ef8-7117-235d-e5497ee09494","text":"The parascapular flap has found popularity as the workhorse solution for free flap reconstruction in patients with facial volume loss, particularly in those without associated skin deficits. It is widely accepted as the first choice for volume restoration in patients with Parry-Romberg disease3 and is increasingly finding use following tumor ablation.4 The advantages of the parascapular flap include reliable vascular anatomy, ease of dissection, and the availability of multiple tissue types. However, flap harvest may require an intraoperative position change and the resultant scar is located in a relatively conspicuous area.","title":"Superficial Inferior Epigastric Artery Flap for a Total Parotidectomy Defect Alkureishi et al"}
{"_id":"75074ca8-e843-ac76-cd2e-507cb02100b1","text":"In this context, imaging play a major role in the initial diagnostic of bone tumor. In February 2018, the work group of Musculoskeletal Tumor Society and American Academy of Orthopedic recommended plain radiographs as the initial evaluation for a possible bone tumor.","title":"The appropriate and sequential value of standard radiograph, computed tomography and magnetic resonance imaging to characterize a bone tumor"}
{"_id":"750b37fc-682c-611a-c34d-2e0e1fb4ef69","text":"Approaching the canine coxofemoral joint using an osteotomy of the insertion of the deep gluteal muscle, rather than deep gluteal tendon partial tenotomy, ensures the deep gluteal tendon strength is maintained to aid in postoperative hip stability. The authors also propose that this approach minimizes muscle damage related to retraction for THR reaming likely due to improved access.","title":"Approach to the canine coxofemoral joint using an osteotomy of the deep gluteal muscle insertion for total hip replacements"}
{"_id":"75189bd8-5149-09b3-4bd2-92718b291878","text":"The above reasons have precluded a robust statistical data analysis, and further randomized trials are strongly recommended before drawing any definitive conclusion.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"751f9663-d222-1b45-53c4-d8665b503ace","text":"Ethical approval was given by the Aleppo University Hospital and the parent's patient has given their parental consent for this study.","title":"Successful management of scalp avulsion with full‐thickness graft"}
{"_id":"75240928-bcf1-80a8-a724-ea162d519b59","text":"The BOOG 2013-08 trial is a Dutch prospective non-inferiority randomized multicenter trial invesitgating whether the sentinel lymph node biopsy can be safely omitted in clincially node negative breast cancer patients treated with breast conserving therpay. If the sentinel lymph node biopsy can be safely omitted in clinically node negative breast cancer patients undergoing breast conserving therapy, this study will costeffectively lead to a decreased axillary morbidity rate and thereby improved quality of life with non-inferior regional control, distant-disease free survival and overall survival.","title":"Clinically node negative breast cancer patients undergoing breast conserving therapy, sentinel lymph node procedure versus follow-up: a Dutch randomized controlled multicentre trial (BOOG 2013-08)"}
{"_id":"752be612-9017-9a0e-d343-85dd52d610ce","text":"We did not use Doppler on regular basis. The surgeon stands on the ipsilateral side and performs the excision taking into consideration the oncological principles. Axilla dissection is performed through the same incision in small breasts or through a different incision in larger breasts. Incision is made along the marked margins of the proposed flap and deepened to the underlying serratus anterior and latissimus dorsii muscle, elevating the flap subfascially. The flap is based on the lateral intercostal perforator artery and hence skin and subcutaneous tissue are dissected away from the muscles in a lateral to medial manner.","title":"Lateral Thoracodorsal Flap Revisited: An Underappreciated Workhorse"}
{"_id":"752bee75-3b84-a3df-8855-4a52afe52137","text":"This study demonstrated that the PoCUS compression technique for the diagnosis of TR-CVCd in the IJV is reliable and accurate when performed by expert physicians in comparison to the Color Doppler venous examination. Despite the small sample of students in this study, it is possible to conclude that a training program to teach the compression technique to non-expert students and form new operators is feasible, but needs to be optimized and more detailed to reach a sufficient level of efficiency. Finally, our study demonstrated that the TR-CVCd of the IJV has a high prevalence in our traditional dialysis center. This high prevalence maybe expected also in other centers and should be carefully investigated. An efficient training of nephrologists to the use of PoCUS would allow a more diffuse early diagnosis of this complication, which is crucial to avoid all the possible deleterious consequences of the misdiagnoses.","title":"Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients"}
{"_id":"752f5e2c-c3d0-0e8d-5107-169413d55525","text":"Management and histological assessment of cases in specialist centres for sarcomas is recommended. , The increased absolute risk of distant metastatic disease in patients with local recurrence, and the increased risk of local recurrence in patients with narrowly or incompletely excised primary tumours suggests that aggressive and expedient surgical management to achieve tumour clearance and local control should be the primary treatment objective. , , We can make no statistically significant recommendations about the optimal surgical approach due to the sample size and the absence of a comparison group treated with Mohs micrographic surgery. No tumours were noted to recur in n = 4 patients that had a second WLE procedure which was offered due to histologic involved or narrow (<1 mm) deep margins. Achieving increased tumour clearance from the deep margin is a major challenge for managing PDS considering the typical anatomical locations. Wide Local Excision with a 20 mm margin has been recently reported to be associated with a superior progression free survival in a multi‐centre cohort review by Persa et al. The efficacy of adjuvant treatments such as radiotherapy requires further definition. The role of sentinel‐lymph node biopsy has also not been established. The optimal adjuvant and metastatic disease management is also not yet clear, but complete remission following anti‐PD‐1 immune checkpoint inhibitor Pembrolizumab treatment has been recently reported.","title":"Pleomorphic dermal sarcoma: Clinicopathological features and outcomes from a 5‐year tertiary referral centre experience"}
{"_id":"7533a0fd-768e-ac7a-8e90-14c2ce5cb18c","text":"There were three major limitations of the study. The data set did not include data on cryotherapy item numbers charged to the Department of Veterans affairs; the data did not include treatment of less than ten lesions; the Medicare item numbers could have included lesions that were treated multiple times; in addition the 30192 item number may include other premalignant conditions of the skin, however we have assumed that AK are the predominant skin lesion. Some AK may clinically resemble SCC and be treated surgically. We have not calculated the costs of skin surgery of AK. Our calculations did not include any patient co-payments costs incurred or the cost of the consultation. Estimates of the number of treatments for other treatment modalities were not available.","title":"Cost for the treatment of actinic keratosis on the rise in Australia v2; ref status: indexed"}
{"_id":"75342c9b-a235-341b-5af7-c5bb115ff02d","text":"Few cases of nerve injury following MOWHTO have been reported. Shin et al reported a case of tibial nerve neuropathy during MOWHTO, which was caused by placement of an excessively long screw through the screw hole just below the osteotomy site.7 Tibial nerve and popliteal vessels are located only 0.5‐1 cm behind the tibia, at the tibial osteotomy level. Since both the popliteus and tibialis posterior muscles are located between the tibia and neurovascular structure, the tibial nerve and popliteal vessels are at risk of injury during tibial osteotomy, unless retractors are correctly placed in the space between the popliteus muscle and tibia.9 Neurovascular injury can occur during osteotomy and screw fixation. In the study by Shin et al, the plate was anteriorly positioned, posing a risk for the screw to penetrate the tibial nerve.7 It is recommended to medially position the locking plates as much as possible to maximize fixation strength and avoid the risk of injury to the popliteal vessels and tibial nerve.10, 11 However, the risk of DPN injury by drilling of the distal locking screws has not been recognized. We also underestimated the situation of this patient and considered EHL dysfunction as temporal and mild. This was the reason that we performed nerve conduction studies remarkably late, four months postoperatively.","title":"Deep peroneal nerve injury during plate fixation for medial open‐wedge high tibial osteotomy: A case report and cadaveric study"}
{"_id":"7534822e-ddb4-9cfd-e237-14077ea5ce63","text":"The prevalence of vascular surgery for peripheral vascular trauma among vascular surgeries operated in our study was similar to other studies done in similar settings. The vascular injury needs an urgent intervention so as to save limb as well as life. If properly managed in coordination with the vascular surgical team, surgical intervention for vascular injury has a very high chance of limb survival.","title":"Peripheral Vascular Trauma among Vascular Surgery Cases Operated in a Tertiary Care Hospital: A Descriptive Cross-sectional Study"}
{"_id":"7535b75c-42d8-6433-d22d-f7e7ba6da947","text":"The superior gluteal artery exits the pelvis through the greater sciatic foramen above the piriformis and then divides into a superficial and a deep branch (Figure 7). The superficial branch supplies the gluteus maximus, while the deep branch divides into superior and inferior divisions deep to the gluteus medius. The superior division courses superiorly to the anterior superior iliac spine, while the inferior division dives down toward the greater trochanter. The anatomic position can vary between patients. The superior gluteal artery and its branches must be visualized and avoided in extended posterior approaches to the hip. While visualization of these branches is necessary in posterior approaches to the hip, exposing the vessels during routine femoral nailing is unnecessary.","title":"Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation"}
{"_id":"75361fa1-e031-f009-4958-77cfaf073c67","text":"Our study is limited as we assessed the efficacy of bilateral TPVB as a rescue technique for inadequate analgesia from our standard intravenous regimen, rather than comparing the efficacy of bilateral TPVB prior to surgery. A different study is required to test that research question. Furthermore, our study is observational without epidural block and or intravenous analgesic as the control groups and therefore we couldn’t conclude if bilateral TPVB gives better pain relief and has less side effects. Lastly, only a single shot was conducted and therefore, it is not known how the picture of bilateral TPVB with continuous infusions by catheter insertion is when compared with a single shot injection. Anyhow, our study showed that bilateral TPVB under the aid of ultrasound guide at the T8 level in the PACU provides immediate and good analgesia for patients suffering moderate or severe pain after laparotomy without significant side effects. However, due to the nature of the observatory study reported here, clinical trials are needed to further confirm its clinical safety and effectiveness.","title":"Bilateral thoracic Paravertebral block for immediate postoperative pain relief in the PACU: a prospective, observational study"}
{"_id":"7537d8fb-01b9-78ec-b7c9-773ac371ae28","text":"A 42-year-old Indian woman first noticed an itch at the top of her left ear 10 days after receiving her second COVID-19 vaccination. The itch was followed by the appearance of small papules that flattened over time and left a residual dark pigmentation. Over the next several weeks, she noticed brown macules and small patches appearing at the anterior and inferior aspects of the left side of her neck. This distal area of involvement gradually extended proximally up the neck over the next 4 weeks to meet and join the initially involved area on the ear.","title":"COVID-19 Vaccine-Induced Lichenoid Eruptions—Clinical and Histopathologic Spectrum in a Case Series of Fifteen Patients with Review of the Literature"}
{"_id":"7543abd4-0dbe-f4bc-8623-5c2b04e22086","text":"We present the preliminary results of our first experience (from October 2017 to January 2020) on the use of this technique in a population of patients affected by NMSCs. The main goal was to assess the clinical efficacy and safety of a single application of a standardized high dose brachytherapy using a nonsealed 188Re source in the treatment of NMSCs.","title":"High dose brachytherapy with non sealed 188Re (rhenium) resin in patients with non-melanoma skin cancers (NMSCs): single center preliminary results."}
{"_id":"7546bbfd-5715-0d55-5e6d-1a77e15eb367","text":"It should be noted that projections of future burden of neoplastic disease have historically been underestimations; in 2001, the projection for 2020 based on similar data sources was 15 million new cases, now thought to be an underestimation of more than 46% compared with the true increase over that interval, although the projected number of deaths appears to have been more accurate. The underestimated prediction of future cancer incidence may be due at least in part to a low penetrance of cancer registration in LMICs, along with systematic weaknesses in cancer registration that lead to incompleteness in the data, as well as issues related to impaired access to care and low utilization of care such that the formal healthcare sector in LMICs is not encountering the true population incidence. This is consistent with the major increase in cancer incidence occurring within the geography that is least equipped to measure it. Moreover, the increase in cancer incidence and mortality within LMICs is diverse and uneven, with rates of increase often most rapid in the lowest income settings, and heterogeneity across regions regarding the histologic makeup of the cancer burden. In some regions, a significant portion of the cancer burden continues to be secondary to infectious diseases such as hepatitis viruses, human papillomavirus, human herpesvirus 8, and human immunodeficiency virus (HIV).","title":"A Review of the Current State of Global Surgical Oncology and the Role of Surgeons Who Treat Cancer: Our Profession’s Imperative to Act Upon a Worldwide Crisis in Evolution"}
{"_id":"754ab78e-16c7-4fa4-a2af-2e492c006038","text":"If an investigator becomes aware of an unexpected SAE during the trial, he or she contacts the CI, who clarifies clinical details and reports the SAE to the sponsor. If, in the opinion of the CI or the sponsor, an unexpected SAE may be relevant to participant safety, a detailed report including an assessment of causality and severity is forwarded to the DMC, which in turn makes a recommendation regarding the safety of the trial in the light of this report.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"754e32cd-cc1f-4e8a-afa2-76125a425165","text":"This report highlights that a single isolated blunt trauma can cause distal ulnar artery thrombosis and that it can be treated effectively by resection of the thrombosed distal ulnar arterial segment.","title":"Traumatic Distal Ulnar Artery Thrombosis"}
{"_id":"754ed97a-d61f-1a55-ec65-9735bd0c8513","text":"We retrospectively reviewed records of 14 patients who underwent surgery for gap nonunion tibia with ipsilateral tibialization of fibula. Fibula is transferred to tibia as pedicle graft in two-staged procedure. Due to retained blood supply to one end of the transplant, the graft easily takes up and hypertrophies upon weight bearing over a period of time.","title":"The Huntington procedure: still a reasonable option for large tibial defects in paediatric patients"}
{"_id":"755c53b4-8d27-0434-5944-2e46cb85884f","text":"We evaluate the procedure and application of preoperative CTLG in the superficial localization of SLNs and lymphatics, which may lead to a decreased incidence of cutting off the lymphatics of SLNs and consequently more rapid and accurate SLN detection. This method promotes personalized SLN mapping, providing detailed information about the number and anatomical location of SLNs and lymphatics for adequate surgical planning for breast cancer patients.","title":"Application of preoperative computed tomographic lymphography for precise sentinel lymph node biopsy in breast cancer patients"}
{"_id":"755f0336-7e5b-03c4-5cda-335204186042","text":"Permanent (not degradable), semipermanent, and temporary (degradable) materials can all be categorized as filler materials. Hyaluronic acid and collagen, which are used as temporary fillers, are entirely broken down by the surrounding tissue after a few months. Permanent fillers, such those made of silicon oil and minerals, are not biodegradable and can have negative side effects that are severe and irreversible. Because they are biodegradable, they stay in place, making them a viable choice for deep wrinkles and acne scars.7 Because they have a high degree of permanence, patients mostly need several injections to achieve the desired volume. Temporary fillers invariably cause temporary side effects, whereas those of permanent fillers may last forever.8","title":"Facial Contouring after Permanent Filler Removal with Combined Facelift and Fat Grafting: A Case Series"}
{"_id":"7561298d-942a-2997-71c8-496ceb233788","text":"The coding system is not affected by the success or failure of a procedure, so many patients who have undergone procedures previously will have already cost the NHS significant monetary and clinical resources but still require definitive treatment. This means it is possible for a hospital to make a profit on simpler unsuccessful surgery, while losing money on more complex, definitive and curative surgery.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"756c570f-4b52-e2d8-99ef-27f9a0f3ddc5","text":"The prevalence of incidentally detected peripheral vascular disease was significant. Three of 31 knees had severe arterial stenosis and two knees had DVT. All patients with vascular pathologies had one or more risk factors related to vascular disease. Out of those patients, age was the most important risk factor. Understanding the prevalence of vascular pathology and related risk factors in TKA candidates may be important for successful TKA.","title":"Asymptomatic peripheral vascular disease in total knee arthroplasty: preoperative prevalence and risk factors"}
{"_id":"7576a005-930f-b4ff-0a73-0e3e65fb5085","text":"The study population consisted of patients aged 12–23 years who consulted their GP for allergic symptoms due to food from 2001 to 2012. Access to the patient’s medical history was a prerequisite. Patients were excluded from analyses if they did not have allergic symptoms to food or if no allergic symptoms were reported in medical record.","title":"Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands"}
{"_id":"757f649c-03dc-8421-e74c-4419c97ccc57","text":"Since there is no evidence to show that routine screening of popliteal arteries will detect asymptomatic aneurysms [8] and in addition the pick up rate is low, the majority of the patients with popliteal artery aneurysms present with limb threatening complications including thrombosis and distal embolisation. Venous occlusion has been documented [9] but our case shows that DVT and PE is another poorly documented presentation. A high index of suspicion is needed in a patient presenting with signs and symptoms of deep vein thrombosis or a massively swollen leg with impending compartment syndrome or anaemia with out any clear diagnosis. Inappropriate management of patients with deep venous thrombosis from unrecognised arterial aneurysms is associated with unacceptable morbidity and mortality.","title":"Deep vein thrombosis and pulmonary embolus associated with a ruptured popliteal aneurysm – a cautionary note"}
{"_id":"7582b1e0-4dbb-3e19-5d9d-1bd9654f1d41","text":"Drug allergy to BLs in CF patients is of importance since many patients report clinical presentations suggestive of a drug allergy. However, most of these presentations are not a true drug allergy and a full drug allergy work-up is recommended. Otherwise there will be a loss of chance for these patients who often require BLs, and for whom the control of the infection is a major factor of their life expectancy.","title":"Comprehensive allergy work-up is mandatory in cystic fibrosis patients who report a history suggestive of drug allergy to beta-lactam antibiotics"}
{"_id":"758398d3-7af4-8a32-b300-5aec4e364e72","text":"Combined usage of stage I latissimus dorsi myocutaneous flap and stage II iliac bone flap grafting is an efficacious and safe surgical technique in clinical practice.","title":"Combined application of latissimus dorsi myocutaneous flap and iliac bone flap in the treatment of chronic osteomyelitis of the lower extremity"}
{"_id":"7586f12e-7c0e-c82a-1e9d-8e9e19865959","text":"OBJECTIVES Several studies have shown the promising results of drug delivery across the BBB using MRgFUS in combination with microbubbles. However, more studies are required to evaluate this treatment technique prior to apply in clinic. This study was designed to evaluate the therapeutic effects of chemo-agent for brain metastasis cancer by delivering drug across the BBB using MRgFUS andmicrobubbles.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"758ee683-655c-45a0-0ea0-ab577d1ce444","text":"Spinal rigidity, either due to DISH, anterior multilevel osteophytes, or previous spinal fusion in elderly patients can be associated with osteoporotic spinal fractures and localized instability. Findings of increasing vacuum signal change on either CT or MRI scans, regarded as a clear radiologic indication of osteonecrosis and instability, concurrent with worsening and localized pain, can be an indication of clinical symptomatic segmental instability. Multilevel fusion and instrumentation to stabilize these difficult fractures have been the recommended treatments, but in certain cases, percutaneous vertebral augmentation may be a reasonable alternative approach to treatment. When there are large radiologic vertebral clefts, it is critical to get the cement into the cleft to get symptomatic relief and prevent further fracture progression. This has been shown to be an effective treatment with osteoporotic fractures as well as in cases with instability due to loose pedicle screws and poorly incorporated interbody grafts. In this case, when contrast injected into the involved disc space documented the communication with the adjacent avulsion fracture, the unstable segment was able to be treated with percutaneous multi-site injections of bone cement with lasting symptomatic pain relief.","title":"An Unusual Vertical T12 Fracture Extending into the T12-L1 Disc in a Patient with Diffuse Idiopathic Spondylotic Hyperostosis: A Case Study Using Vertebroplasty to Stabilize the Fracture"}
{"_id":"75929c5e-bd06-374a-62b9-c9c31499ae28","text":"The recommended management of masses caused by tumoral calcinosis is surgical excision.9 Complete removal of abnormal tissue is required to prevent recurrence.10 Medical therapies using agents to decrease serum phosphate levels have limited usefulness in the management of tumoral calcinosis.11 Alternative treatment strategies using steroid and radiation therapy have also been proposed but do not consistently prevent lesion recurrence.2 Therefore, surgical management appears to be the only curative approach.","title":"CASE REPORT Idiopathic Tumoral Calcinosis of the Nontraumatic Thumb"}
{"_id":"759a491c-b3a8-b37f-af00-03e62e2354a4","text":"Pigs allocated to the control group underwent sternotomy and were exsanguinated as described above, but fluid resuscitation was administered through intravenous catheters inserted bilaterally in large ear veins.","title":"Intraosseous fluid resuscitation causes systemic fat emboli in a porcine hemorrhagic shock model"}
{"_id":"759b1711-48cc-2280-8f97-cf73594bae7c","text":"All cases with histologically proven desmoid tumors in the Tumor Registry of our institution from 1980 through August 2011 were initially identified. There were 56 total cases of which there were 24 males and 32 females. Among the females 10 fit our criteria for pregnancy associated desmoid: arising in pregnancy, growth of a previously identified desmoid during pregnancy or development in 36 months after parturition. We used this definition since these are slowly growing tumors and it is likely that they were present at the time of pregnancy. Thus in our series 18% of all patients seen here during this time period had a pregnancy associated desmoid. Perhaps more striking is the fact that of all females with desmoids in our registry 31% were pregnancy associated. Details of these patients are shown in Table 1. Four of these were included in a prior paper [2]. In the current series the patients ranged in age from 22 to 39 years with a mean age of 32 and a median age of 33 years. Nine of the 10 cases developed the tumor after completion of pregnancy at an average of 12 months postpartum. One was found in the last month of pregnancy. The most common site was the right rectus abdominus muscle in 6 cases; two were in the left rectus abdominus, one in the mesentery and one on the back in a patient with Gardner’s Syndrome. Surgical resection was the method of primary treatment in 10 patients. The tumors ranged in size from 2 to 16 cm with an average size of 4.5 cm. Two of these had microscopically positive margins, but none of the patients who had surgical resection; even with positive surgical margins have had local or systemic recurrence at a mean follow-up of 3.4 years. No patient received further therapy after surgery. One patient was treated with tamoxifen followed by gleevec prior to surgery with minimal benefit. Two patients subsequently had full term pregnancies without complications or desmoid recurrence. Two patients have active tumors not thought to be amenable to surgical resection and are currently being treated with tamoxifen and clinoril. Except for the patient with Gardner’s Syndrome no patient had a family history of desmoids tumors.","title":"Desmoid Tumors in Pregnant and Postpartum Women"}
{"_id":"759ebad7-b391-715b-1f93-4822f907f09e","text":"The most common preoperative risk factor for skin necrosis is active tobacco smoking. Rees et al’s retrospective review of 1186 consecutive facelifts documented that active smokers were 12.46 times more likely than nonsmokers to suffer skin slough postoperatively. A more recent histologic study of skin resected at the time of facelift confirmed these findings. The study demonstrated increased cutaneous occlusive vascular disease in all patients, with specimens from smokers exhibiting significantly more disease than nonsmokers at any given age. Furthermore, the severity of occlusive vascular disease was positively correlated with the incidence of skin slough.","title":"How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications"}
{"_id":"759f9beb-b1e6-841b-36c6-1b5f91e87085","text":"This observation is supported by the clinical practice, in presence of a large and invasive tumor a microscopically controlled surgery would take several hours to be accomplished, given the size of the specimen and the number of margins to be processed.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"75a2a890-9793-918a-9e79-e03a75eee545","text":"Regarding the remaining variables, no significant relationships were found. This may be because the sample was small or because there were some inconsistencies in the collection of data through the questionnaires.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"75a2e347-dd2f-2d22-3c75-77023daa4f85","text":"Research evidence to date suggests that there is variability in the response to treatment in terms of thrombosis resolution and residual venous function. Some thromboses may resolve before the course of anticoagulation treatment is completed and some may not be resolved upon completion of the treatment cycle. Some patients may recover fully from having had a DVT and others may be left with on-going problems associated with chronic venous hypertension. However, clinical ultrasound imaging is not routinely used on completion of the course of anticoagulation treatment to establish the status of the thrombosis or residual venous function. The length of treatment or the decision to stop or continue treatment is therefore not informed by either the degree of resolution of the DVT (i.e. the presence of residual thrombus) or the residual venous function. There is debate whether prolonged anticoagulation could benefit certain patient groups in terms of reducing the risk of recurrence and the development of PTS.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"75a43eef-4ef2-4420-8980-26f016a07201","text":"Despite the fact that there is no previously published study proposing surgical removal of distant malignant metastatic melanocytic masses, surgical excision of the tumour located at the thoracic musculature was elected as the treatment of choice. Surgical margins were determined based on gross appearance of the surrounding tissue and not on histological examination. The mass was well demarcated and at least 2cm of the surrounding tissue was additionally removed. No cisplatin‐impregnated beads were implanted into the tumour bed, as complete excision of the mass was possible.","title":"Surgical excision of a malignant metastatic melanoma located in a skeletal muscle of the lateral thorax of a horse"}
{"_id":"75a466c6-89bf-80c3-b64f-81978aa6341d","text":"Additionally, although lymph node cryoablation might effectively manage individual low-lying axillary nodes, cryoablation of multiple axillary nodes or cryoablation of lymph nodes in the upper axilla can increase the risk of lymphedema due to collateral disruption of arm draining lymphatic structures. Furthermore, attempted ablation of nodes near the large vessels in the upper axilla has a greater risk of incomplete ablation due to the high volume of warm blood flow through the axillary artery and veins that prevents the iceball from reaching an extremely cold temperature. Lastly, the presence of a grossly abnormal lymph node suggests that nearby normal-appearing nodes might be microscopically positive. Consequently, these patients would benefit from radiation therapy to reduce the risk of recurrence in the breast and lymph nodes.","title":"Breast Cancer Cryoablation in the Multidisciplinary Setting: Practical Guidelines for Patients and Physicians"}
{"_id":"75ad41bb-cf6c-8eb7-9ca1-f0095ac93e9e","text":"The use of TXA as a preventative medication for post-tonsillectomy hemorrhage has been studied with little reported benefit but did show an overall reduction in mean blood loss and mean duration of bleeding intraoperatively.8 Systemic administration of TXA has been shown to have minor side effects ranging from nausea and vomiting to more severe side effects such as seizures and renal toxicity in those patients with already decreased function.7–9 Most of these side effects have only been described in adult patients, and seizures seem to be related to high-dose administration, especially in cardiac surgery.9 Maeda et al found that prolonging drug delivery time during the early postoperative period may lead to a reduction in seizure events.7 Other studies have found that administration of TXA during tonsillectomy has side effects such as nausea, headache, vomiting, and dizziness.12 It appears that these side effects may be dose related, but due to lack of standardized dosing for its various uses this is difficult to extrapolate.7","title":"Nebulized Tranexamic Acid for Pediatric Post-tonsillectomy Hemorrhage: A Report of Two Cases"}
{"_id":"75b2bd92-1c6e-3470-7d71-fe3e6d67e017","text":"As for the cases of facial nerve neuroapraxia, they were treated by massage of affected muscles, physiotherapies in the form of galvanic stimulation, corticosteroids, and vitamin B12 injection for 8 weeks until complete recovery, which was usually achieved between 3 weeks and 3 months.","title":"Facial Contouring after Permanent Filler Removal with Combined Facelift and Fat Grafting: A Case Series"}
{"_id":"75b81f89-12d5-99c7-76a8-d99472b7a61b","text":"Femoral deformity was present in one patient. This patient also had an associated femoral length discrepancy as well as having an intramedullary nail in place. Two other patients required bone transports following motor vehicle accidents. One of these patients had a leg length discrepancy with significant sciatic and femoral nerve injuries. The other patient had an infected tibial fracture without length discrepancy of the lower extremities. Two other patients had leg length discrepancies due to bone defects present in the femora.","title":"Femoral Reconstruction Using External Fixation"}
{"_id":"75bbcfba-7798-c464-2ce7-f09a6c2d1b4f","text":"The key documents also identify a managerial role for the FPs. The strategy refers to the FP as a leader, or a decision-maker and where possible a change agent in hospital administration and resource management within his area of work. The managerial role became more evident from the interviews with those FPs who were posted as medical superintendents:","title":"What challenges hamper Kenyan family physicians in pursuing their family medicine mandate? A qualitative study among family physicians and their colleagues"}
{"_id":"75bff843-cfff-a29b-b3d5-8e8be9fd9f85","text":"In Appendix 1 antimicrobial regimens for necrotizing soft tissue infections are listed.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"75c61370-84bf-407e-0806-9ef22ee97934","text":"The tragal cartilage is used as graft in this technique. The perichondrium over both surfaces of the cartilage is protected during graft harvesting. The perichondrium is elevated from the cartilage on one surface during graft preparation. The perichondrium on the other surface is kept non-elevated. The adjacent cartilage and the non-evelated perichondrium are protected and the cartilage is properly re-sized. The cartilage is thinned to a 0.5 mm thickness using a scalpel. The part of the cartilage block that corresponds to the proximal aspect of the manibrium mallei and lateral process of the malleus projection is partially resected by protecting the perichondrium underneath. Six palisades of approximately 1 mm size are formed on the cartilage block that are adjacent to the underlying perichondrium (Figure 1, Figure 2) and the cartilage graft is placed in such a position that the non-elevated intact perichondrium would face the external acoustic meatus. The graft is placed with the underlay technique according to the tympanomeatal flap, fibrous anulus and membrane remnant, and the overlay technique according to the malleus (Fig. 3). The graft was held in place supported by absorbable haemostatic gelfoam placed in the middle ear cavity. The control group included 43 patients in whom the island cartilage graft technique without cartilage thinning was used. The tragal cartilage was used as graft in this group. Mastoid dressings were removed on postoperative day 1 in the both groups. Oral antibiotic therapy was continued until postoperative day 7 and local treatment was begun with ofloxacine and corticosteroid drops onto the external auditory canal tract packing. External auditory canal tract packing was removed on postoperative day 10. Local treatment was continued at the same dose for two more weeks and gelfoam was cleared under otomicroscopy if it remained at the end of this duration.","title":"Rates of success in hearing and grafting in the perichondrium-preserved palisade island graft technique"}
{"_id":"75ead9f8-0df6-6e04-efb2-3f102e7980e7","text":"Whereas injected doses did not elicit detectable IgA titers when used as the sole route of administration, when followed by two oral doses, the IgA titers were higher than that obtained with two oral doses co-administered with the injected dose. This may indicate that while the injected dose does not elicit a mucosal response, it may prime the immune system to be more receptive to the oral dosing.","title":"Co-Administration of Injected and Oral Vaccine Candidates Elicits Improved Immune Responses over Either Route Alone"}
{"_id":"75eb75d1-44f6-e0a3-4300-baff29e890c2","text":"In cases of PAD IV and infection of large wounds with exposed bone or tendons, a combined management of improving blood supply and vacuum therapy can establish granulation tissue to cover the whole defect. After split skin transplantation with complete wound healing amputations can be avoided in many cases.","title":"Abstracts DGG"}
{"_id":"75ed4bf2-13c1-de32-b3b1-4665c80b1b50","text":"The patient who was a known case of Netherton syndrome wasn't following any routine skin cancer surveillance and was ignorant towards the growths on his skin that later appeared to be cSCC which had already metastasized to his lung, maxillary sinus, and skull bones. He was started on Pembrolizumab for his recurrent and metastatic cSCC.","title":"Significant response to Pembrolizumab for metastatic cutaneous squamous cell carcinoma in patient with Netherton syndrome"}
{"_id":"75f8bc46-753f-b8cf-d0a5-5bd6ba3629fc","text":"Clinical presentation in toddlers and small infants is usually hematuria and abdominal pain, whereas in children and teenagers it more frequently entails colic lumbar pain and symptoms that are secondary to urinary tract obstruction.","title":"Extracorporeal Shock Wave Lithotripsy and Combined Therapy in Children: Efficacy and Long-Term Results"}
{"_id":"75fc39a6-ae5d-da75-5af4-ccf82ee0bf54","text":"The aim of our study was to examine the management of large, locally advanced primary head and neck cutaneous melanomas treated at our institute in the context of current clinical standards. We were also interested in the functional and esthetic outcomes and the reasons for neglecting such apparent tumors.","title":"Challenges in the Complex Management of Neglected Cutaneous Melanomas in the Head and Neck Area: A Single Center Experience"}
{"_id":"76026f6d-6d65-aa67-b567-057a1cf698c0","text":"A major limitation of the present study was the inadequate access to all patients referring to health centers and some cases of inaccurate data in patient records, resulting in exclusion from the study.","title":"Prevalence of Head and Neck Tumors in Children under 12 Years of Age Referred to the Pathology Department of Children’s Hospital in Tabriz during a 10-year Period"}
{"_id":"76060594-2658-ab2f-4c32-0915cc064ccf","text":"This is the first instance that the carbon ion radiotherapy has been effective for the unresected desmoid tumor, and it is believed that this will become the one effective option for the treatment of desmoid tumors.","title":"Carbon ion radiotherapy for desmoid tumor of the abdominal wall: a case report"}
{"_id":"760b4c8b-45d0-54dc-c004-e535387e26cf","text":"In trauma patients transfused 5 or more units of RBCs, DVT, and in-hospital mortality was increased with the transfusion of old RBCs when compared with a group of patients of similar severity of injury who were transfused RBCs of decreased storage age. After adjustment for other variables associated with mortality there was an independent association with the transfusion of older RBCs with in-hospital mortality. The increased risk of mortality was associated with the transfusion of just 1 to 2 units of RBCs greater than 28 days of storage and could be accounted for by increased MOF. As there is no evidence that RBCs of increased storage age improve microvascular delivery of oxygen and consumption for patients in a shock state and there is a substantial amount of evidence that indicates they may increase injury in critically ill patients, the preferential use of fresh RBCs can be appropriate if local inventory allows for this without substantially increasing RBC waste. Prospective randomized study in this population is needed.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"7613557e-f081-0349-a761-d311ec1ac8bd","text":"A Simplified Algorithm for reconstruction of Large Scalp Defects after Tumor Resection.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"7617069e-a48c-365f-306a-5bf7548964ae","text":"In our series the forearm was rested on a board across the chest. This position allowed easier inspection of reduction and fixation of both the radius and ulna at the same time. In the supine position with a side arm board it is difficult to inspect both the radius and ulna at the same time and exposure of the ulna is difficult and usually the surgeons flex the elbow with the forearm away from the side board.","title":"Exposure of both the radius and ulna through a single posterior incision: a technical note"}
{"_id":"761e2094-fa44-dc94-be45-978608f44478","text":"69 patients operated in the otorhinolaryngology service were selected. The patients were operated upon by third year residents during the period from January to December 2007 and answered the questionnaire translated by the authors of this study.","title":"Long-Term Evaluation in Aesthetic Rhinoplasty in an Academic Referral Center"}
{"_id":"76224e1c-e14d-f47d-67cf-899f7563fd55","text":"After 6 months of anticoagulant therapy and elastic compression stockings the patient remains asymptomatic.","title":"A rare cause of deep vein thrombosis: inferior vena cava agenesis Agenesia da veia cava inferior: uma causa rara de trombose venosa profunda"}
{"_id":"76276f06-9423-7e42-c5e9-11cf2774d12d","text":"The outcomes of the present study indicate that an intact contralateral perforator can provide sufficient supercharging to the zone IV of a rat DIEP flap. Ligation of the perforator venae comitante does not significantly weaken the supercharging effect, while ligation of the perforator artery will significantly endanger the survival of the distal flap.","title":"What’s the remedy for the distal necrosis of DIEP flap, better venous drain or more arterial supply?"}
{"_id":"76283bee-e030-3ee2-0027-79d52406c930","text":"We highlight the importance of radical surgical excision to avoid desmoid tumor complications and to minimize the recurrence risk.","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"762b2fa7-14e6-0e98-753a-08bfc30b4094","text":"The advantages of the laser speckle flowgraphy used currently are as follows.","title":"Free Flap Blood Flow Evaluated Using Two-Dimensional Laser Speckle Flowgraphy"}
{"_id":"762f24a3-2ae5-fc7b-f40b-2e73724e7de2","text":"Upper cervical cord or brainstem compression occurs when the subarachnoid space is obstructed which is evident when the cerebrospinal fluid disappears in both the anterior and posterior subarachnoid spaces on T2-weighted images. A deformity of the spinal cord or brainstem appears on MRI imaging as decreased cord diameter at the level of subarachnoid space obstruction compared with the cord diameter superior or inferior to the stenotic level. Sub-axial spinal cord compression is present in cases of obstruction of the subarachnoid space and deformity of the medulla.","title":"Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis"}
{"_id":"7632b7c8-60df-97f5-b374-b4ef6d6e80ce","text":"The head and neck area is by far the most common location for primary cSCC.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"76339640-880d-cdd9-5c65-d1e863407e82","text":"Although pruritus may sometimes be a consequential situation to neoplasms, it more frequently emerges after commencing chemotherapy. In this review, we present our analysis of the chemotherapy treatments that most often induce skin changes and itching. After discussing conventional chemotherapies capable of inducing pruritus, we present our evaluation of new drugs such as immunological checkpoint inhibitors (ICIs), tyrosine kinase inhibitors, and monoclonal antibodies. Although ICIs and targeted therapy are thought to damage tumor cells, these therapies can modify homeostatic events of the epidermis and dermis, causing the occurrence of cutaneous toxicities in treated subjects. In the face of greater efficacy, greater skin toxicity has been reported for most of these drugs. A remarkable aspect of some reports is the presence of a probable correlation between cutaneous toxicity and treatment effectiveness in tumor patients who were treated with novel drugs such as nivolumab or pembrolizumab. Findings from these experiments demonstrate that the occurrence of any grade of skin side effects can be considered as a predictor of a better outcome. In the near future, studies on the relationship between the onset of skin alterations and outcomes could open new perspectives on the treatment of neoplasms through specific target therapy.","title":"The Impact of Immunological Checkpoint Inhibitors and Targeted Therapy on Chronic Pruritus in Cancer Patients"}
{"_id":"763f0a17-f0d4-33bd-1de0-7ec331c1c811","text":"Barriers to robotic training and exposure in the UK and Ireland may be due to cost, access and training. We believe that with the emergence of robotic competitors the cost will decline. Further, as more hospitals buy or rent more robotic platforms, the individual operative cost is likely to significantly reduce as seen with a thirty-year history of laparoscopy. Access to a robotic theatre will therefore also improve as robotics becomes more and more standardised in some centres. A surgeon should have access to a robotic theatre and\/or simulation at least once a week for continued professional development and maintenance of technical skills. With heavy investment into robotics in the UK and Ireland we would hope this to be the case in the majority of hospitals in the future. We expect the UK and Ireland to follow the USA over the next decade, with more surgical trainees exposed to robotic surgery and training as standard. However, developing UK and Ireland robotic training centres and implementing robotics into national training programs, before current more senior surgeons are through their initial learning curve, will significantly reduce this time-lag and ensure a safer execution of robotic surgery for patients.","title":"The Atlantic divide: contrasting surgical robotics training in the USA, UK and Ireland"}
{"_id":"764184a0-a002-eaf0-7fdd-195680daae25","text":"Skin tumor diagnosis can be difficult due to the variable clinical presentation of skin lesions. In order to correctly identify melanoma at its earliest stage, the use of dermoscopy has been shown to significantly increase the sensitivity and specificity of diagnosis when compared to traditional naked-eye examination . In equivocal cases benign lesions may be excised when further cytological information is required to rule out malignancy. Recently reflectance confocal microscopy (RCM) use in clinical practice has been shown to further improve early melanoma diagnosis non-invasively by providing an in-vivo optical biopsy at histologic resolution down to a depth of 200 µm of skin tissue . Moreover RCM has been shown to significantly reduce the number of unnecessary excisions in different settings .","title":"Case Report: melanoma and melanocytic nevus differentiation with reflectance confocal microscopy. v1; ref status: indexed"}
{"_id":"764f1c60-feb0-fc02-62e2-dc6bacb384cc","text":"Successful subintimal recanalization and angioplasty was performed of the right distal posterior tibial artery occlusion as well as the proximal peroneal artery occlusion.","title":"Psychiatric sequelae of thromboangiitis obliterans: a case report and review of the literature"}
{"_id":"76705690-c98b-575e-7187-df35f23e6dc1","text":"The limitations of this study were hard work conditions for keeping the rabbits. Because of this, 3 rabbits died during the process and our sample size was approximately low. Strength points of it were study on effect of the human amniotic membrane on the cartilage itself, different types of cartilage, and different shapes in each of the cartilage types. On the other hand, the clinical use of various types and shapes of cartilage in the aesthetic and restorative nasal surgeries is very high, as plastic surgeons often deal with this issue daily. Cellular therapy has emerged as a new solution with considerable effects in many plastic surgery procedures.","title":"Effects of the Human Amniotic Membrane on the Cartilage Graft: Prognosis and Absorption in White Rabbits"}
{"_id":"7675c3ba-0c36-753d-242c-98e64e7b8350","text":"Sarcoidosis is a systemic disease characterized by the formation of noncaseating granulomas in various tissues. Cutaneous involvement occurs in 20 to 35 percent of the patients and may be the initial manifestation of the disease. Our study was performed to discriminate the clinical, laboratory, and prognostic differences between patients with specific and nonspecific cutaneous involvement. The second aim was to asses the diagnostic usefulness of punch biopsy in sarcoidosis.","title":"Diagnosis of cutaneous sarcoidosis; clinical and the prognostic significance of skin lesions"}
{"_id":"76767738-f72b-5503-d05d-2516b49665e3","text":"The mesh was rapidly integrated within the abdominal wall, restoring abdominal wall continence. Our clinical case shows that NPWT use is not contraindicated if a biological mesh is present and exposed; on the contrary NPWT could reduce hospitalization time with a decreased rate of complications.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"767fcc18-7e20-24d1-b61b-8253e6684f4c","text":"In cancer patients, a recent randomized study compared the use of LMWH (tinzaparin) and warfarin for the treatment of 900 cancer patients with DVT during the first 6 months. The study demonstrated that LMWH is more effective than warfarin, without alterations in death rates and major bleeding. Other studies have also shown that the reduction of the risk of recurrence of VTE in cancer patients is higher with the use of LMWH compared to warfarin.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"76831dd7-74a3-eccc-72bb-4424d3f1b265","text":"To date, a consensus on which method is better indicated for open tibial fractures with bone defects is still under debate. In the present study, we aim to analyze the outcomes of VBG and the MT used for the reconstruction of the bone defect of Gustilo III open tibial fractures by reviewing two decades of cases treated in a single tertiary trauma center and to determine the most suitable reconstructive methods.","title":"Comparison of the clinical outcomes between vascularized bone graft and the Masquelet technique for the reconstruction of Gustilo type III open tibial fractures"}
{"_id":"76923541-1178-078c-644e-d0e0fed96830","text":"In this study we enrolled 20 volunteer subjects who had undergone coronary artery bypass surgery and who had excess saphenous vein grafts. Perivascular cyanoacrylate was administered to one of two saphenous vein grafts explanted from each patient. The other saphenous vein graft from each patient was not treated and was used as the control. A model of the arterial system was created using a saphenous vein cardiopulmonary bypass system. Circulation was maintained at 120 mmHg for 45 minutes. Afterwards, the grafts were subjected to histopathological examination.","title":"Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model"}
{"_id":"7694de98-8f15-c8b8-db23-1b9f14fd0b0d","text":"The Danish Board of Health recommends a 6‐week smoking cessation prior to surgical removal of HS. However, our patient continued smoking and was withheld surgical excision while her HS severely worsened, to a point where surgery was not possible anymore. It is an ethical dilemma, whether surgery should be postponed until smoking cessation in every case. In a former study by Losanoff,6 surgery is the only known treatment method that provides a real chance for a cure for both HS and a complicating carcinoma. Patients that do not initially undergo surgery for severe HS can potentially develop cancerous degeneration as in the present case report. This is why complete excision in severe cases of HS is also indicated to avoid chronic progression of the disease. Retrospectively, less strict smoking policy could have allowed surgery and perhaps avoided cancer transformation and death. It is important to consider the socioeconomic situation of the patient in the treatment as well. Our patient only had one distant relative for support, lived alone and could not take care of herself, so she failed to seek medical attention even though her disease severely worsened. Support for the patients with low socioeconomic status including smoking cessation and weight loss should be considered for optimal wound healing7 and adherence to therapy.","title":"Fatal outcome of malignant transformation of hidradenitis suppurativa: A case report and literature review"}
{"_id":"769bbeaa-43f7-07a6-d8a7-054d7747e81b","text":"It is necessary to emphasize the importance of myofunctional therapy associated with orthodontic therapy to ensure the stabilization of the effects of orthodontic treatment and to restore the correct nasal respiratory process.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"76afd689-7a10-2162-a805-63f620f516e6","text":"The authors followed the guiding principles from the Declaration of Helsinki.","title":"Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients"}
{"_id":"76b12ea3-ec44-e8ce-8eb8-cba0d8fbb9f8","text":"All patients received steroids and more than one DMARD before starting rituximab and were continued thereafter, follow up after rituximab was 3 to 5 years.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"76b80a4a-84a1-8339-3537-db00b33672bc","text":"The color and temperature of the flaps were routinely monitored postoperatively. Anticoagulant and antispasmodic medications were administered intravenously for 7 days postoperatively.","title":"Simultaneous reconstruction of septic composite defects in lower extremities: Combination of fasciocutaneous perforator flap and Masquelet technique"}
{"_id":"76bc4b4e-746f-c60d-5237-ef280b319f0e","text":"In the axilla, it is reasonable to remove level I and II lymph nodes within the boundaries of the chest wall\/serratus anterior muscle, the axillary vein, and the latissimus dorsi muscle, with careful identification and preservation of the thoracodorsal neurovascular bundle and the long thoracic nerve. Most practitioners include level III infraclavicular lymph nodes, especially if they are grossly involved\/palpable. Level III axillary lymphadenectomy does increase the risk of upper extremity lymphedema. It is suggested the level III involvement is highly unlikely in SLNB-positive patients, but more likely with gross bulky nodal axillary disease [45, 46].","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"76c42578-6086-b705-2496-f0d6526257c7","text":"Material decomposition methods yield the possibility to filter the conventional X-ray images in order to obtain a bone-equivalence image showing only the attenuation caused by bony-material and excluding the effects caused by soft tissue, which are overlaying in conventional radiography, promising a potentially higher image quality and an increased level of diagnostic confidence and hence a prospectively improved approach to the limitations faced in the musculoskeletal diagnostics with conventional radiographies.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"76c5a0d6-a23b-6813-ee67-c26bbb6f2e22","text":"The primary conclusion to be drawn from our study is that the women surveyed simply do not want to be surgeons: None of the sample group had experienced surgery (and could not, therefore, have been put off the idea) and only two out of nearly 200 women expressed concerns about lifestyle, contrary to convincing evidence gathered from women at later stages in their careers. One can only guess as to why this should be but it is perhaps the case that views held prior to entering medical school have lead some women to believe that surgery is an unsuitable option for them.","title":"Who wants to be a surgeon? A study of 300 first year medical students"}
{"_id":"76c947ce-49a2-2016-d4c8-4ce25530307b","text":"In contrast to other studies which have evaluated this learning curve in the context of experienced arthroplasty surgeons transitioning to DA, our study evaluated the learning curve among newly trained fellowship surgeons. Only two previous studies to our knowledge have looked at the learning curve of new surgeons. Burnham et al evaluated 286 patients between four different fellowship-trained arthroplasty surgeons and found a learning curve of approximately 40 to 50 cases when looking at medical and surgical complications. Garbarino et al examined outcomes in a surgeon with postfellowship specialty training THA. This study reported lower rates of complications of the DA approach compared with the existing literature. Our findings are in agreement with the above studies which suggest with appropriate training, there is no notable increase in complications with the DA versus other approaches. Of note, although we found no differences in learning curve among surgical approaches, we did report a notable decrease in revision surgeries, total and surgical complications when comparing the first 50 with last 50 cases with the combined surgical approach cohorts and within each approach group. In contrast to the previous studies, our study focused on comparing fellowship-trained surgeons during their first year of practice performing two different approaches. The lack of difference between the two groups may be explained by the inherent learning curve accompanied in all surgical trainees and junior attendings rather than a true steeper learning curve among the DA approach.","title":"Total Hip Arthroplasty Learning Curves Based on Approach for New Fellowship-trained Surgeons"}
{"_id":"76cb3090-df6c-d3b6-63b7-e542ccc238ca","text":"Table 2 summarizes the screening modalities to be undertaken in the medical follow up of patients with NF1.","title":"Neurofibromatosis 1 French national guidelines based on an extensive literature review since 1966"}
{"_id":"76cdbb8f-ecad-8aaa-0a7e-32819174c6d0","text":"Disadvantages of these flaps are that they have a limited role in larger defects, degloving injuries, and variable location of the perforators away from the soft tissue defect can sometimes be a hurdle. The main drawback of the perforator flaps however is the higher risk of venous congestion. Because the perforator venous wall is much thinner than the perforator arterial wall, it has a greater chance of venous congestion when rotated up to 180 degrees. The proximal part of the flap which is used for defect coverage sometimes suffers from partial skin necrosis due to venous congestion. The problem of venous congestion can often be prevented with adequate dissection, loose suturing, post operative dependent drainage and massage.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"76d9f574-6ad8-faaf-9ad9-946c8cf1dc16","text":"All patients had preoperative full-length radiographs of the affected leg for assessment of the level and type of fracture nonunion, plane of deformity, bone quality and presence of sequestrum. All patients were counseled about the procedure to be performed, and the expected outcome of treatment. All patients were optimised preoperatively for the proposed operation. Physiotherapy within comfort with specific reference to joint mobilisation and oedema control was attempted in all patients. Culture swabs from draining sinuses and open wounds were carried out in all patients and appropriate antibiotic therapy was initiated. This was repeated whenever necessary throughout the duration of treatment.","title":"Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study"}
{"_id":"76e04d6d-611c-3d36-1712-35ae6877fbdb","text":"It is clear that the average and range of walking age of children with idiopathic club feet treated with the Ponseti method was the same in our children as in the published studies. This may question the influence of the length FAB of use during the first year of life on the initiation of independent ambulation. Parents’ concern as to the inhibitory effect the FAB might have on the development of their child are not supported by our experience and the above-cited studies, and they should be addressed during the clinic visits, where parents should be provided periodic assessment and reassurance.","title":"Prolonged use of foot abduction brace reduces the rate of surgery in Ponseti-treated idiopathic club feet"}
{"_id":"76edda57-1dcf-991a-0d17-a139bac55a2c","text":"In view of the rapid growth of MNTIs, their malignant potential, and their high rate of recurrence, it is essential to diagnose this type of tumor at an early stage. Pediatricians and pediatric dentists should be aware of this disease and direct patients to prompt oral surgery treatment to minimize mutilating surgeries.","title":"Melanotic Neuroectodermal Tumor of Infancy in the Maxilla"}
{"_id":"76f56643-0087-03a9-216d-626fe2ef435c","text":"Higher surgical training lasts six years and during this time all trainees are expected to develop competence in all aspects of the specialty. Trainees should take their Intercollegiate Exam from ST6 onwards. In the final two years trainees should spend more time in their area of special interest including advanced fellowship training. The SAC must prospectively approve these posts for training.","title":"Education of trainees, training and fellowships for head and neck oncologic and surgical training in the UK: United Kingdom National Multidisciplinary Guidelines EDUCATION OF TRAINEES, TRAINING AND FELLOWSHIPS: UK GUIDELINES"}
{"_id":"76f8911e-2de7-95fc-e187-d8c5e291bbfc","text":"By studying the hospital records of patients and their clinical records data were collected and entered into the questionnaire.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"76f9e1ce-a610-800b-e865-6fcfb8abdd83","text":"Patients who already have swelling or other signs of an existing DVT. Such patients may be recruited once a DVT has been excluded by normal D Dimers or CDU. There is a concern that if one applied IPC to patients who may already have a DVT it may displace the thrombus and increase the risk of PE. However, this potential risk has not been documented in the RCTs so far. And we have not identified any case reports where there is convincing evidence that this has occurred.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"770408cc-fb8a-3859-59e1-dc5471add78c","text":"Data on survival with mucosal melanoma and on prognostic factors of are scarce. It is still unclear if the disease course allows for mucosal melanoma to be treated as primary cutaneous melanoma or if differences in overall survival patterns require adapted therapeutic approaches. Furthermore, this investigation is the first to present 10-year survival rates for mucosal melanomas of different anatomical localizations.","title":"Primary Localization and Tumor Thickness as Prognostic Factors of Survival in Patients with Mucosal Melanoma"}
{"_id":"770579a0-5212-086d-5755-6a53bb77267c","text":"A 49 years-old female came to our attention complaining of an intraoral burning sensation with a later appearance of erythematous and bullous-like lesions on the tongue and the mouth floor, arising 24 h after the second dose of BNT162b2 vaccine administration.","title":"Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases"}
{"_id":"770e6b1b-a2f7-7a3d-0c7d-d2e603024602","text":"The gist of the scene refers to the perceptual information that an observer receives from a momentary glimpse of an image. It is a remarkable characteristic of the human visual system, which helps us to intelligently allocate attention and access stored knowledge about elements of a new environment even if a complex scene is presented for only 20 milliseconds. In the context of medical image interpretation, the gist response refers to instantaneous perception of features relating to an abnormality in an image. These might be ignored or overruled following more detailed image evaluation because the gist signal appears to be a global signal, spread across the image, and not merely a lucky glimpse of a localized lesion. It has been previously hypothesized that radiological visual search starts with a global or “holistic” response that establishes context, identifies gross deviations from known normal pattern, and initiates a sequence of foveal checking fixations.","title":"Radiologists can detect the ‘gist’ of breast cancer before any overt signs of cancer appear"}
{"_id":"7716ea49-8573-ea26-2104-b9b78a95e86e","text":"For shear high strain rates we defined as the integral of the ratio of area of the vein wall experiencing pathologically low shear strain rates multiplied by the shear rate over those areas:where the normalization factor is =3000 s, and is the regions of the vein walls over which by the shear strain rates of s were predicted. Note that the length of the vein both proximal and distal to the anastamosis were set in all simulations to be sufficiently long to ensure fully developed flow fields both before and after the graft. While having too short of a vein could affect the measures of flow pathology, having too long of a vein did not, as the region over which pathological flow fields occurred was not expanded by extension of the vein beyond a critical length.","title":"Tailoring of arteriovenous graft-to-vein anastomosis angle to attenuate pathological flow fields"}
{"_id":"771a35ac-dd83-2b59-8590-9fae2daa86cb","text":"Empiric antibiotic treatment consists of a short intravenous cycle based on anti-staphylococcal penicillin or a cephalosporin in children aged over 3 months with the addition of gentamicin in infants aged under 3 months. An oral regimen may be an option depending on the bioavailability of the antibiotic chosen and clinical and laboratory data. Further studies on the optimal therapeutic approach are needed in order to understand the best first-line regimen, the utility of biomarkers for the definition of therapy duration and treatment of complications.","title":"Update on Acute Bone and Joint Infections in Paediatrics: A Narrative Review on the Most Recent Evidence-Based Recommendations and Appropriate Antinfective Therapy"}
{"_id":"771b60a0-033e-0524-28ba-a98f29abc3f3","text":"While less invasive than surgical excision, EDC produces an unsightly hypopigmented scar and often results in post-procedural alopecia.8,31 Because of this, patients with non-melanoma skin cancers of the face and scalp may elect to undergo another form of treatment. Despite the 91%−99% 5-year cure rates seen in patients treated with EDC, histologic margin assessment is not possible in these patients, given the destructive nature of the procedure.8,31–33 Because of this, patients and providers should pay close attention to the treatment area for signs of recurrence.","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"771cf1f9-c41a-215b-a53e-4d67b6876fa7","text":"Access to a DICOM viewer should be readily available to most veterinary specialists who would be performing a surgery of this nature and it is important that the individuals involved in patient clinical care determine the tumor extent and planned surgical margins. Following identification of tumor extent and planned surgical margins, the rendering of the 3D skull, defect and plate design can be outsourced to an applications engineer or may be performed as part of a design and printing package with a 3D metal printing medical solution centre, when available. While we selected software that we are most comfortable using, the steps to create the 3D skull with the defect could be performed in many software programs that have ROI, segmentation and CAD capabilities.","title":"Schedule feasibility and workflow for additive manufacturing of titanium plates for ranioplasty in canine skull tumors"}
{"_id":"77228409-427f-8ba2-ad45-a9a60894b306","text":"The patient was extubated without any difficulty at the day of surgery. Due to pericardial effusion, we placed a pericardial drainage for 2 days. An early mobilisation was performed and anticoagulation with warfarin was started for a period of 3 months. The postoperative echocardiography showed a good function without any evidence of obstruction of the atrial baffle. We performed a postoperative MRI which revealed the superior vena cava draining into the right atrium. The upper and middle pulmonary veins as well as the scimitar vein were redirected with a baffle into the left atrium (Figure 4).","title":"Unique technique of surgery in an unusual variety of Scimitar syndrome: A Case Report"}
{"_id":"7724acca-509e-12c1-68c4-ca97813b8038","text":"The effects of PACT on the treatment of skin infections have mostly been demonstrated in in vitro studies. What is still lacking is a complete in vivo evaluation of the feasibility of PACT in treating skin and soft-tissue infections. Many researchers have in recent times discouraged the over-reliance on in vitro studies results in PACT because of the variations of outcomes encountered when carrying out the complementary in vivo studies. This means that conducting in vivo follow-up studies, right after an in vitro study, is key in establishing the overall efficacy of PACT.","title":"Photodynamic Antimicrobial Chemotherapy: Advancements in Porphyrin-Based Photosensitize Development PACT: Advancements in Porphyrin-Based Photosensitizers"}
{"_id":"772f4fbb-14f2-2500-2749-76724905eaf4","text":"All patients in the present study were children and had extra-abdominal type PDT. We evaluated the clinical characteristics and analyzed the risk factors for prognosis. The study could provide helpful advice to doctors who are formulating a therapeutic strategy for PDT patients.","title":"Clinical prognostic factors for pediatric extra-abdominal desmoid tumor: analyses of 66 patients at a single institution"}
{"_id":"772f8f00-ecc9-1431-ca94-93722ce61172","text":"Although herpes reactivation is more commonly associated with immunosuppressive therapies, few cases of herpes zoster and herpes simplex following Botox injection have been reported. The pathogenesis of herpes reactivation following Botox injection is unclear; however, it has been hypothesized that the Botox protein is a potent antigen that may activate the cellular immune system, making it easier for the virus to reactivate. Healthcare providers should be aware of this potential complication and consider it when evaluating patients who present with painful rashes following Botox injections. In addition, individuals who want to receive Botox injections should be informed of this complication. The diagnosis of herpetic infection should be made promptly, and antiviral therapy should be initiated to minimize the risk of complications. Further research is needed to better understand the pathogenesis and risk factors for herpes following Botox injection and to develop strategies for preventing and managing this complication.","title":"Unusual herpetic reactivation in a young female following botox injection: a case report study"}
{"_id":"77300733-6efc-0049-3d86-375acaf5bc15","text":"Using biocides in antibiofilm strategies is sometimes inappropriate for biofilms outside the body or unsuccessful due to increasing resilience of biofilms to antibiotics and remaining biological substrates susceptible to be reused by bacteria. Repeated applications of cleaning cycles on industrial setup or on medical devices as endoscopes, tracheostomy tube have been shown to be a failure or to enhance the opposite effect and promote the resistance of bacteria. Mechanical force is another management approach in order to weaken and clear biofilms while bacteria show rising antibiotic resistance. Unlike the chemical strategy, mechanical removal is not a species-specific way to eliminate the biofilms. Biofilm management involves removing biofilms by imposing a flow or a mechanical load to overcome forces which keep the biofilm together and bonded to the surface. The detachment can be partial—cohesion loss—or complete—adhesion loss. The EPS matrix supports the mechanical stability of the biofilm through physico-chemical interactions. The aim is to disassemble EPS matrix or to detach biofilm clusters by weakening the cohesive forces. Measuring the ability of biofilms to withstand stress provides information and indicates future directions for the design of biofilm-cleaning tools. Mechanical studies measure parameters which enrich mechanical models and then improve the comprehension of the behavior of biofilms subjected to forces. Many studies have accordingly sought to determine at what point a biofilm fails or disperses when exposed to loading, in particular under the influence of hydrodynamics stress. In medical devices, surfaces are often cleaned using a pressurized water brush, in the same way that cariogenic biofilms are commonly removed mechanically with a toothbrush, but a more drastic method consists in generating a fluid stress in the form of high-velocity water droplets, microsprays, water jets, or air bubbles. Actually, fluid jet lavage is used to remove infected bacteria from tissue or abiotic surface. Moreover, it is now well known that the biofilm life-cycle includes dispersal of planktonic bacteria that enables biofilms to spread. The detachment of biofilm fragments driven by the flow can also lead to the transmission of pathogens to drinkable water. To limit contamination, microbiologists have to know precisely when detachment of biofilm fragments under flow stress occurs. Particularly interesting is then the study of biofilms behavior under fluid solicitation. The latter can cause biofilm to flow across surfaces in ripple and wrinkle structures. Another problem is the management of channel clogging by filamentous streamers. For instance, the tolerance of Streptococcus mutans to shear stress has been extensively studied to improve the mechanical removal of dental plaque. Reclamation and reuse is problematic in terms of microirrigation issues. Actually, biofilm formation provokes pipes clogging and industry has to process mechanical blockages. The use of adapted flow rate of water is based on the knowledge of the shear strength of the biofilm which cover pipes. Food and engineering industries need physical biofilm cleaning with strong shear flow. In addition to being reliable, the mechanical cleaning solutions should be eco-friendly. Furthermore, mechanics can be used as a mean to deliver more efficaciously antibiotics. Mechanical action is a possible way to increase the antibiotic susceptibility by enhancing chemical diffusion or the action of antibiotics which are more efficacious on planktonic bacteria.","title":"Towards standardized mechanical characterization of microbial biofilms: analysis and critical review"}
{"_id":"77381f66-55c3-cfcc-2b9f-aa1ab17f275f","text":"Epidermoid cysts always remain asymptomatic for a relatively long period until the lesions infringe the nerves or spinal cord, along with cyst rupture which is another vital trigger. Pain and neurologic deficits such as numbness, weakness, and paralysis with long duration are the most common symptoms which are nonspecific.[ The typical imaging findings of intraspinal epidermoid cyst are hypointense on T1-weighted images and hyperintense on T2-weighted images which are consistent with the signal of the cerebrospinal fluid.[ Almost all the intraspinal epidermoid cysts in the literature were intradural and enlarged in the type of swelling growth, but the recurrent case was located in the centrum and increased in invasive growth which was a signal for possible malignant transformation. Imaging studies of the patient showed that lytic imaging of bone and the content of the cyst with solid change seemed to be abnormal.","title":"Repeated recurrent epidermoid cyst with atypical hyperplasia A case report and literature review"}
{"_id":"77391992-c099-5ab8-0a99-137374732e4d","text":"Orthopedic shoulder and elbow fellowship directors have differing opinions in regard to ranking fellowship applicants, but consistently ranked interviews, letters of recommendation and personal connection to applicant\/letter writer higher than factors such as strength of shoulder\/elbow experience in residency, ties to geographical area and comments made regarding technical competence. This provides both PDs as well as applicants with additional information to consider when navigating the shoulder and elbow fellowship application process.","title":"Factors considered in ranking orthopedic shoulder and elbow fellowship applicants: a survey of program directors"}
{"_id":"7739fcfe-a41a-429b-7277-f386bbae8b76","text":"The main limitation of this study is its retrospective character, which precluded proper randomization of the two study groups. The number of patients in the two groups was nevertheless significant for a rare disease like DSWI. The cautious deployment of both negative pressure therapy techniques ensured","title":"The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study"}
{"_id":"773a3659-201e-2861-5e14-34da0de90302","text":"It is increasingly noted that venous thrombosis is associated with an inflammatory response which plays an essential role in both formation and resolution. This could explain why ICU patients are at higher risk of thrombosis. Thrombus generation is dependent on adhesion molecules such as the selectin family. These molecules are critical for recruitment and attachment of inflammatory cells and fibrin deposition within the thrombus. The mechanism of delivery of the components necessary for thrombus formation is via microparticles shed from the plasma membrane of various cells. Leukocytes and cytokines associated with inflammation are also essential to angiogenesis and fibrinolysis of thrombus resolution. Outlining the inflammatory mechanisms involved in the genesis and resolution response may lead to potential treatments for venous thromboembolism. Current anticoagulation therapies primarily that prevent thrombus propagation are associated with bleeding risk, and do not directly modulate the associated inflammation [41–46].","title":"Sonographic and Clinical Features of Upper Extremity Deep Venous Thrombosis in Critical Care Patients"}
{"_id":"773aaeca-eaeb-ebc0-792c-a13be1faec12","text":"Measured parameters and patterns of associations were similar on the left and right cheek skin. This indicates that despite possible asymmetrical sun exposures skin ageing related changes are highly comparable on both body sites. The similarity of our findings between the left and right cheek skin supports the internal validity of the study results.","title":"Characterizing Facial Skin Ageing in Humans: Disentangling Extrinsic from Intrinsic Biological Phenomena"}
{"_id":"773b5c83-d588-be68-f03e-da998fabe829","text":"About one in seven women in lifetime suffered from breast cancer making it the most common invasive cancer in this sex worldwide with higher incidence in developed world1,2. In a low middle income country like Pakistan, it accounts for the most frequently diagnosed and leading cause of cancer deaths in female population having an estimated 5-year prevalence between 34 038 and 90 000 newly diagnosed cases and 16 232 deaths in 2017 which is an alarming situation3. Therefore, newer innovative treatment strategies are continuously being introduced with the primary aim of improving quality of life and patient’s satisfaction with their cosmetic outcome following breast surgery.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"77418caa-707e-86fc-b090-1967ea63a429","text":"This study aims to describe the histological composition and architecture of the layers forming the lingual frenulum. Using adult human cadavers, we assess the variability in these features between individuals, including an understanding of the frenulum's relationship to genioglossus and FOM structures and the relative mobility and gliding of these layers\/structures when tongue elevation is utilized to form the frenulum. We aim to verify if the FOM fascia is consistently present as a histologically identifiable layer, to clarify the connective tissue composition of the FOM fascia, and to establish any variability between individuals.","title":"Understanding the Lingual Frenulum: Histological Structure, Tissue Composition, and Implications for Tongue Tie Surgery"}
{"_id":"77445e0b-29a5-c37f-0bda-3c633a6bfec4","text":"However, compared with thoracic and lumbar regions, acute cervical spinal infection with osteomyelitis is a formidable adversary with potentially ruinous results. Reconstruction of the infected cervical column challenges the reconstructive surgeon with compact anatomy, building biomechanical stability, and operating in a field with complicated infectious dissemination. There is also a higher risk for more severe neurological complications compared with thoracic and lumbar regions. The number of reports for cervical reconstruction due to cervical spinal infection is limited.","title":"Free Vascularized Fibula Graft as Primary Salvage Procedure for Acute Cervical Osteomyelitis Caused by Epidural Abscess"}
{"_id":"7744e6a2-2396-60c5-0603-fe4ffd321d30","text":"In recent years an earlier step down to oral antibiotic therapy has been advocated for numerous infections. Trained infectious disease specialists regularly consulting their colleagues may speed up the implementation of such recommendations into clinical practice and thus may improve treatment.","title":"Impact of a pediatric infectious disease consultation service on timely step-down to oral antibiotic treatment for bone and joint infections"}
{"_id":"77450a92-4924-d10e-320f-c9b1ca092727","text":"Patients who smoke, have high body mass index or have had previous radiotherapy to the breast will not be excluded for participation in the trial but surgeons will be encouraged to offer mesh-assisted IBBR in line with updated joint Association of Breast Surgery and British Association of Plastic, Reconstructive and Aesthetic Surgeons’ guidelines for the use of mesh in reconstructive procedures.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"7746037c-6e8d-3b67-e206-a643663258bb","text":"Fibroblasts are the main functional cells in the dermis, and injection of autologous fibroblasts is regarded to be more beneficial and more persistent than other therapies, such as the various dermal fillers. This type of therapy has been effectively used for dermal and subcutaneous deficiencies since 1995 18, 35, and clinical research into for autologous fibroblast therapy has been undertaken since 2001. Research has also shown this approach to be safe and well tolerated 36.","title":"Global Gene Expression of Cultured Human Dermal Fibroblasts: Focus on Cell Cycle and Proliferation Status in Improving the Condition of Face Skin"}
{"_id":"77516b8d-42a3-bd19-cca5-ad560a685627","text":"Therefore, in each case the decision to perform or withhold lymphadenectomy in patients with melanoma and a positive sentinel node, should be considered individually and taken after profound discussion with the patient. The observational approach to the melanoma patients with positive sentinel node biopsy is associated with comparable or even slightly improved survival. Patients with low perioperative risk could be still considered for surgical approach, particularly if no strict clinical follow-up is available to them.","title":"Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis"}
{"_id":"7753b9bd-6ebf-8828-af4e-bea96adc1293","text":"The primary objective of this study was to demonstrate the incidence of total venous occlusion using 1,470 nm endolaser to treat venous segments, as confirmed with Doppler ultrasonography, at 30 days and 1 year postoperative. An additional objective was to describe the side effects and their incidence during the postoperative period and report rates of reintervention or supplementary treatment.","title":"Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser"}
{"_id":"77541f72-0aa0-f4a2-a197-286d61a0d08d","text":"Ischemic or volatile anesthetic preconditioning is defined as tissue protection from impending ischemic cell damage by repetitive short periods of tissue exposure to ischemia or volatile anesthetics. Objective of this study was to elucidate, if ischemic preconditioning and pharmacological preconditioning with sevoflurane have effects on muscle tissue oxygen saturation in patients undergoing surgical revascularization of the lower limb.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"77571abb-d844-49b1-1af8-c5598e066923","text":"Step by step description of the endoscopic double flap technique (nasoseptal and pericranial vascularized flaps and fascia lata free graft) as used and illustrated in two patients with an olfactory groove meningioma who underwent an endoscopic approach.","title":"Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note Técnica endoscópica endonasal utilizando duplo retalho para reconstrução de grandes defeitos da base anterior do crânio: nota técnica"}
{"_id":"775cb50b-d260-ddf0-c8f6-e00d0596cc68","text":"Finally, like the comparison study that we sought to validate, we conducted a retrospective analysis of ultrasound studies using the sequential compression technique. We visualized the location of the thrombi in the various portions of the proximal leg and extrapolated that the presence of an isolated thrombus in the femoral vein would result in a missed DVT using the two-point compression technique. While this is likely true when performing a limited DVT ultrasound in the ED using compression as the method to identify thrombi, it does not account for flow alterations that may be visualized with Doppler proximal to the site of a thrombus. Since routine use of Doppler is not typically performed in ED ultrasound, this was not assessed in our study. For these reasons, further analysis in a prospective manner would be warranted.","title":"Two-point Compression Ultrasound Technique Risks Missing Isolated Femoral Vein DVTs"}
{"_id":"7762b983-a500-52da-f969-eb9a013b890f","text":"The data management is fully compliant with the Data Protection Act and ICH GCP. The trial is registered with Legal Services at the University of Birmingham who are responsible for ensuring that the purposes for which the University processes personal data is registered with the Information Commissioners office.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"77694d4b-0dd2-0608-b9f4-4a67ddbb3e58","text":"Radiotherapy is the main therapeutic modality in the management of primary or recurrent vaginal cancer. Brachytherapy remains integral part of definitive radiation therapy for these patients [2-9]. The preponderance of the published literature on brachytherapy in this setting demonstrates a wide variation on techniques and dose utilized for LDRB. Although HDRB is widely available and used for a variety of gynecologic malignancies, the published data on this technique for vaginal cancer treatment are limited. The HDR planning software offers the ability to optimize the dwell time and position of the radioisotope source (Ir-192) in order to create conformal radiation treatment to a specified target. This improvement in dose uniformity and ratios between tumor and normal tissue is important advantage of HDR brachytherapy. These advantages of HDRB over LDRB have to be weighed against the need to use a larger number of HDR fractions and the inconvenience of multiple implantations.","title":"High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina"}
{"_id":"776e825d-9017-a442-3a91-aa497f69f885","text":"Lipofilling is very promising as an adjunct procedure to implant based reconstruction. It can be used for implant salvage in cases of implant exposure without infection.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"7771cd02-673f-8a4e-e0d8-2e5515cfb5e0","text":"Lower body lift surgery has increased in popularity. A circumferential body lift or belt lipectomy is often recommended to treat skin redundancy. A drawback for this procedure is the midline scar bridging the lower back causing elongation of the gluteal cleft. Autoaugmentation methods have not been shown to provide a net increase in buttock volume.","title":"Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures"}
{"_id":"777228b0-2b78-8ed4-ff00-3392fcffd4a5","text":"Another important indication for CT in the elective field is the planning of corrective osteotomies in cases of remaining deformities or post-traumatic growth disorders.","title":"Rational Usage of Fracture Imaging in Children and Adolescents"}
{"_id":"7774f8a6-084b-2190-7055-8211b4a3d14f","text":"An understanding of the natural progression of the tumor is vital in this case because limb-salvage surgery is possible with minimal reconstruction and a good overall prognosis. These decisions are not just limited to malignant tumors as benign tumors can progress to the point of requiring a determination about amputation versus limb-salvage surgery. In areas with poor access to health care, benign and benign aggressive tumors are more likely to have advanced in severity before presentation. This case again illustrates the importance of consultation with the operating surgeon, as resection of the biopsy tract is needed to prevent local recurrence, and a poorly performed biopsy can result in the need for amputation. If the biopsy contaminated the popliteal vessels, limb salvage would not have been possible as the risk of performing a vascular reconstruction was unacceptable.","title":"Limb Salvage for Musculoskeletal Tumors in the Austere Environment: Review of the Literature With Illustrative Cases Regarding Considerations and Pitfalls"}
{"_id":"77755fb5-0a8d-07cf-a4f1-556fe15ccdc4","text":"An FVFG combined with posterior stabilization could be a promising primary salvage procedure in cases with progressive myelopathy caused by acute cervical osteomyelitis due to spinal infection. The FVFG contributes to blood circulation, delivery of antibiotics, and an immunological response to the infected wound bed and can stimulate rapid fusion and hypertrophy over time.","title":"Free Vascularized Fibula Graft as Primary Salvage Procedure for Acute Cervical Osteomyelitis Caused by Epidural Abscess"}
{"_id":"77800824-36c6-0e77-956c-c41cf6efa95f","text":"By virtue of their high frequency and low mortality, non melanoma skin cancers offer an excellent opportunity to study the factors that put some individuals at increased risk of multiple malignancies. We had the opportunity to elucidate the risk of multiple malignancies using a large population-based series of SCC and BCC cases and controls with individual risk factors collected through a detailed personal interview. In addition, we aimed to assess whether the excess risk of cancer after NMSC could be explained by known cancer risk factors.","title":"Non Melanoma Skin Cancer and Subsequent Cancer Risk"}
{"_id":"7783531f-2718-f41e-4f85-80048aa33e7c","text":"Giant phyllodes tumors are rare, and mastectomy is preferred for complete tumor excision. Latissimus dorsi myocutaneous flap can be successfully used to reconstruct the breast after the removal of very large tumors and can provide excellent aesthetic results with a low risk of flap necrosis or donor-site morbidity, and can also be used for high-risk patients who may be unsuitable for TRAM or DIEP flaps.","title":"Immediate latissimus dorsi pedicle flap reconstruction following the removal of an eight kilogram giant phyllodes tumour of the breast: a case report"}
{"_id":"7785fa3a-0738-77bb-412d-0d84669970d7","text":"Additional attempts now include a rolled cylinder of collagen derived from the submucosa of porcine small intestine being used in conjunction with a skate flap in a human based study.41 The outcome at the time of surgery ranged from 6 to 7 mm nipple projection, with a 30–50% loss at 6 months.","title":"Breast Reconstruction with a Tissue Engineering and Regenerative Medicine Approach (Systematic Review)"}
{"_id":"778b9447-daf8-3251-3556-a4eb7571ad26","text":"Cases of chronic osteomyelitis in humans are relatively common, due to the increasing elderly population, the high prevalence of underlying diseases such as diabetes mellitus and the increased frequency of joint replacement surgery.","title":"Microbiological aspects of osteomyelitis in veterinary medicine: drawing parallels to the infection in human medicine Veterinary Quarterly"}
{"_id":"778c8691-dd17-9105-35a8-24d4ea218ed6","text":"Genetics of complex traits such as allergy and immunity to helminths are matters of study worldwide, but it acquires special interest in the Tropics because of the great number of shared aspects between the allergic reaction and the immune response to helminths. There is no unique genetic background for people living in the Tropics. Depending on their historical past, countries in this zone are the results of diverse population admixtures from most of the current world populations. African ancestry is an important component of the genetic admixture in several tropical regions and some studies suggest that this component predisposes to high levels of total IgE and asthma, which could be the only known risk at the population level; however, there are not enough data supporting that this ancestry component exerts influence in all genetic backgrounds. An advantageous condition for studying the genetics of IgE responses in the Tropics is that extreme phenotypes such as IgE hyperresponsiveness to allergens and helminth components allow a better dissection of the genetic and environmental influences. Epidemiological studies revealed that in addition to exposure from the household, genetic factors account for an important proportion of the variation in worm loads [457–460]. A summary of genes associated with the susceptibility to helminth infections in humans [461–474] is presented in Table 6.","title":"Particularities of allergy in the Tropics"}
{"_id":"779af5eb-a790-b9ce-6c25-c9cdf09e6b45","text":"The round ligament was transected using a Hatt spoon, the femoral head luxated and a femoral head ostectomy was performed as described for the Zurich Cementless total hip replacement (15). This ostectomy involves removing the ridge of bone between the greater trochanter and the femoral head to a level just distal to the femoral head, whilst preserving the calcar. An oscillating saw is then utilized to perform the femoral head ostectomy.","title":"Approach to the canine coxofemoral joint using an osteotomy of the deep gluteal muscle insertion for total hip replacements"}
{"_id":"779f0707-c58d-2d40-15cb-ad06e07b98af","text":"The analysis of the patterns of recurrence suggests that breast conservation can be safely performed in MF cancers, provided that an adequate excision is warranted, and that more aggressive surgical approaches do not result in a better locoregional control or in reduction of distant recurrences.","title":"“Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases”"}
{"_id":"77a6fb3f-0c8c-1757-2d23-9f8c3ad5702b","text":"A comprehensive review of the epidemiology and diagnostic work-up of 550 patients referred to our lymph node diagnostic clinic was undertaken. Patients were assessed in a timely fashion with a median time of 6 days between receipt of the referral letter and the first clinic visit, and all patients were offered an appointment within 2 weeks. Malignancies were diagnosed with a median time of 15 days from the patients' initial visits, and those with potentially curable cancers such as Hodgkin's disease and diffuse large B-cell lymphoma completed their staging investigations and commenced their definitive treatment in just over 2 weeks after diagnosis.","title":"Rapid access multidisciplinary lymph node diagnostic clinic: analysis of 550 patients"}
{"_id":"77b5f3fe-652d-553d-b6cc-4780d427a498","text":"The first dorsal metacarpal artery is a constant vessel arising from the radial artery just distal to the tendon of the extensor pollicis longus and proximal to the point at which the radial artery pierces between the radial and ulnar heads of the first dorsal interosseous muscle. The artery runs over the fascial layer of the first dorsal interosseous muscle and divides into the radial branch to the thumb, the intermediate branch to the first web space, and the ulnar branch to the index finger.[8]","title":"First dorsal metacarpal artery islanded flap: A useful flap for reconstruction of thumb pulp defects"}
{"_id":"77b6c8f6-bfa5-d7fc-1659-7ba8ce26f6f1","text":"In this review we will refer to the most commonly used methods to cover defects on dorsum, on palm of the hand and on forearm.","title":"Upper limb traumatic injuries: A concise overview of reconstructive options"}
{"_id":"77bc9477-9959-7e6c-54c9-8ec69da80b09","text":"At the day of surgery, the allografts are removed from their sterile boxes in the freezer and immersed into 4 L of sterile isotonic saline at a maximum temperature of 40 °C. Samples for cultures and resistance are collected, then 300 mg rifampicin is added to the saline according to the procedures for procurement from Belgium. The grafts are soaked in this solution for a minimum of 30 min. The surgeon prepares the graft before rinsing it with sterile saline and then implanting it.","title":"Clinical outcome after knee ligament reconstruction with tendon allografts"}
{"_id":"77c408de-5dfb-a839-87b3-1ddf3e500ef8","text":"The first reported application of using a radioisotope to treat a malignancy intraoperatively is credited to Robert Abbe in the year 1910. This technique in time evolved into the discipline of Brachytherapy and it has established itself as an important treatment modality over the last century. Brachytherapy using iridium interstitial implants has been practised in head and neck cancers. It has also been combined with surgical resection of tumors with treatments delivered either intraoperatively or perioperatively. Perioperative high dose rate brachytherapy (PHDRB) is a technique which involves intraoperative insertions of brachytherapy catheters in the tumor bed at time of surgical resection followed by a fractionated brachytherapy treatment in the perioperative period. It combines the advantages of a highly conformal radiation dose delivery with a clear visualization and demarcation of the tumor bed at the time of surgical dissection. This coupled with incorporation of CT-based treatment planning gives it a high level of treatment delivery precision. Perioperative brachytherapy is an established technique of delivering radiotherapy treatments in sarcomas and its application has been reported in pancreatic cancers. Its use in head and neck cancers has been infrequent due to the complex regional anatomy, surrounding vascular and nervous tissues, multitude of organs at risk and the invasive nature of the procedure. PHDRB can be used in head and neck cancers to primarily irradiate the tumor bed to a very high dose of radiation as a single modality or combined with external beam radiotherapy in both the primary treatment and for reirradiation of recurrent cancers. We report here two cases highlighting the applications of perioperative brachytherapy in these clinical situations.","title":"Perioperative high dose rate brachytherapy in head and neck cancers: case report and review of clinical application Bahl et al"}
{"_id":"77cb9275-d4c8-5ca0-a186-3a254c1f0313","text":"The aim of this review is to retrospectively analyze the surgical management of patients with pleomorphic adenoma of the parotid gland performed at the Department of Otorhinolaryngology (Department of Sense Organs of “Azienda Policlinico Umberto I” in Rome), from 2010 to 2020, with a focus on the percentage of recurrence and on the complication related to surgery to suggest an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma. The analysis of the complications observed in case of different surgical approaches was performed using the X2 test.","title":"Clinico-histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10-year retrospective study—a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma"}
{"_id":"77dd14dc-86ea-4d66-c8a4-5e38b07eedc5","text":"Also, this study aim was to confirm ultrasound as a screening test to raise awareness of its importance and the importance of breast assessment.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"77e0810f-cd11-f512-be5e-ff7f74018e59","text":"The objective of depositing a therapeutic radiation dose to the tumor while minimizing damage to nearby healthy structures requires imaging modalities for accurate target localization during radiation treatment. Modern external beam radiation therapy uses collimated high energy photon beams in the form of either intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT) to deliver radiation doses. Contrary to megavoltage photon beams, ion beams can provide an even higher dose to the tumor region while further reducing dose to healthy tissues beyond the tumor. Based on this premise, there has been an exponential increase in demand for systems employing the use of protons within clinical care in the last two decades. Heavy particles have a higher relative biological effectiveness (RBE) than protons, which may provide a better therapeutic ratio and therefore a clinical advantage. Globally, 12 centers are currently using carbon ion beams and many facilities are investing large amounts of funding to investigate the use of other particles for therapeutic purposes.","title":"Neutron activation of gadolinium for ion therapy: a Monte Carlo study of charged particle beams"}
{"_id":"77e170cf-6432-482f-49fd-f9b85ee4f9d1","text":"Obtained images were observed and evaluated by two independent reviewers. Reviewer A is an expert and certified as a specialist in diagnostic radiology and nuclear medicine. Reviewer B was training to be a specialist in diagnostic radiology. Final interpretation as determined by mutual agreement. Images were viewed on a liquid crystal display color monitor, and reviewers could freely change the window level and width.","title":"Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities"}
{"_id":"77e633fe-16f0-b4e9-442a-2e858136fff9","text":"A problem that other users have noted in several reports is the ingrowth of granulation tissue into the cells of PU foam, causing severe pain at dressing changes and disturbance of the reepithelialization process.10–16","title":"Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective"}
{"_id":"77e66862-3bc7-f016-c07a-d1ae7862716d","text":"VTE, which includes DVT and PE, is associated with significant morbidity and is a leading cause of cardiovascular death worldwide 28. DVT is a common complication of and the most common cause of rehospitalization following any major surgery. Although less common than DVT, PE is a serious complication that can occur after surgery or in association with cancer, other chronic illnesses and pregnancy 28. Various risk scores have been developed to estimate VTE risk in specific patient populations, such as the Khorana score in patients with cancer 29 and the Caprini score in surgical patients 30.","title":"Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care"}
{"_id":"77e6a886-160f-35e0-a3e6-c250cac4f037","text":"Drawbacks of this study includes the limited available sample size and the lack of advanced investigations like high performance liquid chromatography (HPLC) and electrophoretic study which would have helped in finding out the type of sickle cell disease (trait or disease) and its association with the incidence of Deep Vein Thrombosis.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"77ec7491-985e-b9a9-a64c-65f18860a30b","text":"The literature search was expanded to include trials concerning follow up of common cancers such as breast, lung and colorectal. There are several randomised controlled trials examining the effects of intensive versus non intensive follow up for these common cancers. The American Society of Clinical Oncology breast cancer follow up guidelines have shown no significant survival advantage with an intensive surveillance protocol instead of a clinically based protocol [21]. There is no consensus regarding the follow up of patients after curative resection for colorectal cancer. The British Society of Gastroenterology guidelines suggest there is no evidence that frequent follow up visits carry significant survival advantages or benefits to patients whereas other meta-analyses have shown some survival benefit as metachronous tumours can be diagnosed earlier [22,23]. However these tumours have completely different biology and treatment options compared with oesophagogastric tumours, so recommendations regarding the follow up of these cancers while providing a useful framework may not be transferable to oesophagogastric cancer patients.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"77ef3121-b772-9c74-4d45-4d472f64854b","text":"Trauma patients are at an increased risk of developing venous thrombosis early in the hospital course due to comorbidities associated with trauma. Whereas, venous thrombosis in trauma patients diagnosed after the first 48 hours of hospitalization appears to be associated with prolonged patient immobility.","title":"Early Detection of Deep Venous Thrombosis in Trauma Patients"}
{"_id":"77f9459b-47ab-3d36-1b97-2ec4e4cc284e","text":"Caution is to be exercised in the learning curve when shifting to the UAL, or by the beginner aesthetic plastic surgeon to minimize concurrent damage to the vital structures and damage to the overlying skin.","title":"Liposuction"}
{"_id":"780821aa-95c1-aaad-f360-cc0081d50e66","text":"Ideally, the patients should be followed up for 4 to 6 weeks to determine the maximum effect of the injection and the need for further sessions. The patients are asked about focal weakness or checked with a hand dynamometer.","title":"Effectiveness of Botulinum Toxin on Hand Tremor Intensity and Upper Limb Function in Patients with Parkinson’s Disease: Results of a Systematic Review"}
{"_id":"780f2463-7030-5209-6a76-76857fa7575e","text":"After planning of the flap, the hatched area of the pedicle is de-epithelized so that it may heal in under the skin. The pedicle should be sufficiently large in order to secure good supply to the flap. The graft is dimensioned so that it covers the inferior surface of the cranially pedicled mucosal flap and the donor defect at the posterior tracheal wall without tension. Both flaps are fixed together with fibrin glue. In order to avoid pressure on the pedicle, the anterior part of the second tracheal ring is resected. A slight tamponade stabilizes the position of the graft. It is recommended that a bigger tracheostoma be created and the skin be sutured with the skin-platysma fascia graft with slight tension at the superior circumference of the tracheostoma. The same applies for the suture of the other parts of the tracheostoma between skin and tracheal mucosa. Generally, the insertion of a cannula after extubation is not necessary.","title":"Position paper of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the German Society of Phoniatrics and Pediatric Audiology – Current state of clinical and endoscopic diagnostics, evaluation, and therapy of swallowing disorders in children"}
{"_id":"78126cfd-a39e-7335-6aa7-a5b27a77c334","text":"The current case demonstrates the successful management of secondary chronic osteomyelitis using intravenous high-dose pamidronate over a short period. Since this is the second case reported in international literature, firm recommendations can only be proposed. The treatment with bisphosphonate might be a new approach in refractory cases and needs to be further investigated in clinical studies.","title":"Bisphosphonate-treatment of secondary chronic osteomyelitis of the jaw – a case report"}
{"_id":"78193a3f-1e25-eed8-c70e-f7b43bd2c478","text":"Written consent for publication by both parents of the patient was obtained.","title":"Juvenile dermatomyositis‐associated calcinosis successfully treated with combined immunosuppressive, bisphosphonate, oral baricitinib and physical therapy"}
{"_id":"781af578-2f58-2fef-3841-8730a0e88850","text":"Treatment decisions for SSTI depend on numerous factors including the severity and depth of infection and the clinical setting.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"781ce9de-6ab0-495f-0ee9-164868613af6","text":"Patients with cOM can be chronically unwell and suffer considerable pain and disability with persistent wounds that discharge malodorous pus. The infection may have been present for months and even decades and is associated with reduced life expectancy. 1 Treatment of cOM typically includes a combination of surgical intervention and a prolonged course of antibiotic therapy. Failure to effectively eradicate the infection results in prolonged hospital stays, multiple surgical procedures, and may promote the selection of antibiotic resistant microorganisms. Occasionally, such infected limbs are considered unsalvageable and amputation may become the only treatment option. Failure of treatment results in loss of mobility, unemployment, requirement for significant long-term support but rarely, uncontrolled infection and death. The economic impact of OM is substantial 2 3 and its incidence is rising largely due to the increased prevalence of risk factors, including diabetes and orthopaedic surgery, as well as life expectancy. 4 5","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"781d529f-ca63-379b-8364-edea1093fdac","text":"In comparison with cases of benign tumor, a statistically significantly greater number of repeated biopsies were taken in cases diagnosed as malignant tumors to confirm the pathological diagnosis. Therefore, when there is clinical suspicion, even if there are no findings of malignancy on the first biopsy, it can be recommended that the biopsy should be repeated without any loss of time.","title":"The role of nasopharyngeal examination and biopsy in the diagnosis of malignant diseases O papel do exame clínico e da biópsia de nasofaringe no diagnóstico de doenças malignas"}
{"_id":"781fb591-693b-7752-a9e0-048aa371c0fa","text":"A retrospective review was carried out on all patients treated by a single orthopaedic consultant with the modified NPWT as part of their surgical treatment for infection between 2008 and 2010. As the aim of this study was to review the use of the modified technique in patients with metal work in situ only, patients were excluded from review if there was no metalwork in situ, if it was removed prior to the NPWT commencing or if they had an arthroplasty or hemiarthroplasty (as different treatment protocols exist in patients who have undergone arthroplasty-type procedures). Patients were also excluded if they did not tolerate the NPWT, if they were transferred to another hospital during treatment or if they were not fit enough to complete the treatment.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"7820fc51-a2b2-9819-2631-4b7d5f34d669","text":"Surgical biopsies are commonly obtained by a wide local incision under ideal anaesthesia and surgical conditions. Occasionally a tru-cut needle biopsy under local anaesthesia is performed in massive lesions with wide local spread.","title":"The Surgical Treatment of Mycetoma"}
{"_id":"78211633-34f9-09e0-b726-4d2a0bc9f5c0","text":"Finally, we combined Groups S1 and S3 from Table S2 to form two groups. Group 1 now comprised patients for whom the novel model predicted better survival than the AJCC model and patients for whom the predictions of both models concurred. Patients for whom the novel model predicted a worse survival than the AJCC model formed Group 2.","title":"Quantitative Measurement of Melanoma Spread in Sentinel Lymph Nodes and Survival"}
{"_id":"783a08ac-3262-2ddf-261a-8dda0344f80f","text":"A strategy that can be useful to increase dermal delivery is to exploit the combination of different approaches. In some cases synergistic systems employing combinations of different penetration enhancers operating through different mechanisms, are more efficient in overcoming the protective barrier of the skin if compared to single methods from both the point of view of the extent of absorption and of the efficacy and safety of the drug [73,74].","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"7846f663-2321-bc4f-6036-c9fe0a86ce1e","text":"Using inductively coupled plasma-mass spectrometry, we previously demonstrated that saliva from a patient with manic disorder contained a high concentration of one of the components of a drug, lithium carbonate, that the patient had been administered on a regular basis.2 The patient developed oral lichenoid drug reaction, but did not have any other lesions on the skin or in other areas of the body. We performed a drug-induced lymphocyte stimulation test and demonstrated that the patient was allergic to lithium carbonate. This finding suggested that the oral lesion was caused by lithium that was excreted with saliva and acted directly on the oral mucosa. Although many studies demonstrated that drugs are excreted into the saliva in addition to the blood and urine, few have examined the effect of drugs in saliva on the oral mucosa. Therefore, we performed a study to recognize the direct influence of a drug on the oral mucosa by showing the amount of 5-FU excreted from saliva as a numerical value.","title":"A pilot study of the clinical evidence for the methodology for prevention of oral mucositis during cancer chemotherapy by measuring salivary excretion of 5-fluorouracil"}
{"_id":"7849bd48-ef5f-3f95-9d86-1d7972248056","text":"The majority of patients with breast cancer who undergo mastectomy do not proceed with breast reconstruction. The decision involves multiple factors, some biological and socio-demographic, as well as personal choice. Almost two-thirds of patients were unsatisfied with the information they received. We believe efforts must be made to improve the type and timing of delivering information in order to ensure that patients receive the information they require. By better understanding the factors that the patient takes into consideration in making her decision, we can adapt the information to serve the patient’s personal needs and to support the patient in making an informed personal choice on approaches to reconstruction following mastectomy. Future studies must be directed with patients themselves to improve the type and timing of delivering information on different ways of reconstruction.","title":"Reasons of not having breast reconstruction: a historical cohort of 1937 breast cancer patients undergoing mastectomy"}
{"_id":"784bdc92-21ee-e26d-c576-3bba5df32181","text":"A number of professional societies convened consensus panels in the United States after the publication of the Danish and Canadian trials, as well as the early retrospective series described previously. These panels generally concluded that the evidence to support PMRT was only strong enough to sustain a recommendation for patients with 4 or more lymph nodes involved; for patients with 1–3 lymph nodes involved, the general consensus of these panels convened a decade ago was that there was insufficient evidence to make suggestions or recommendations for the routine use of PMRT.","title":"Postmastectomy Radiation Therapy: An Overview for the Practicing Surgeon"}
{"_id":"784c4c7d-6f30-23a3-34a5-1584567b2709","text":"The treatment of FES is mainly supportive. The initial presentation in terms of hypoxemia and respiratory rate of 35\/min at the time of ICU admission mandated endotracheal intubation and mechanical ventilation with application of PEEP in our patient. However, with worsening hypoxemia requiring FiO2 of more than 0.8 within few hours of ICU admission made us to employ prone positioning in our patient.","title":"Prone Positioning for Management of Fat Embolism Syndrome in a Patient with Spine Fracture; An Unusual Scenario and Review of Literature"}
{"_id":"784ce285-73fc-0698-691e-fd28909474f4","text":"Based on our results, residents who wish to subspecialize in orthopaedic trauma should build a relationship with orthopaedic trauma surgeons during their residency as this may assist them in securing a fellowship position as the surgeon may make a personal recommendation on their behalf. Overall, we believe that trainees may use this study to assist with compiling a strong application to optimize their chances of matching at the program of their choice in the increasingly competitive field of orthopaedic trauma.","title":"The Competitive Orthopaedic Trauma Fellowship Applicant: A Program Director's Perspective"}
{"_id":"786a23ec-538a-ae70-87d9-353f1ee674db","text":"AA tends to oxidize easily in light and in the presence of oxygen, so its use is limited by these conditions.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"786ed1c6-843c-79b8-14c5-46d114d93af6","text":"Brachytherapy is a feasible therapeutic option for cN0 cSCCs in cases of contraindications to surgery for poor clinical conditions or cosmetic issues. However, the specific skills required and the limited availability of this peculiar type of radiotherapy in RT departments may explain the greater use of EBRT.","title":"Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: The Current and Future Role of Radiation Therapy in the Era of Immunotherapy"}
{"_id":"7876581b-41c4-54c0-aada-d2c68fec980b","text":"Virus-neutralizing antibody and B cell responses to influenza A viruses were measured in 35 aged and 28 middle-aged individuals following vaccination with the 2012 and 2013 trivalent inactivated influenza vaccines. Antibody responses to the vaccine strains were lower in the aged. An analysis of B cell subsets by flow cytometry with stains for immunoregulators showed that B cells of multiple subsets from the aged as compared to younger human subjects showed differences in the expression of the co-inhibitor B and T lymphocyte attenuator (BTLA). Expression of BTLA inversely correlated with age and appears to be linked to shifting the nature of the response from IgM to IgG. High BTLA expression on mature B cells was linked to higher IgG responses to the H1N1 virus. Finally, high BTLA expression on isotype switched memory B cells was linked to better preservation of virus neutralizing antibody titers and improved recall responses to vaccination given the following year.","title":"BTLA expression declines on B cells of the aged and is associated with low responsiveness to the trivalent influenza vaccine"}
{"_id":"78775fb4-6b2a-540a-7f86-944b07246505","text":"A thin split thickness graft is harvested from either the medical aspect of the upper arm or lateral aspect of the thigh, by using a sterile blade. The grafts are kept moist in saline-soaked gauzes. The recipient site is cleaned and similarly a flap of the epidermis is raised using a sterile blade. One end of the epidermis is left in contact with the dermis and the flap is turned to expose the dermis. The graft is placed with the dermal side of the graft in contact with the dermis and the flap is put back in position to cover the graft. Cyanoacrylate glue is used to secure the graft and the flap. Both the donor and recipient areas are dressed.","title":"TISSUE GRAFTS IN VITILIGO SURGERY – PAST, PRESENT, AND FUTURE"}
{"_id":"787c21aa-1091-281d-f43c-a07c26e2e08f","text":"The ceramic interconnect of the electrode was directly anchored by suturing to the nerve as shown in Fig. 2, as this would not induce any compression and it would avoid any problem for the interface of the electrode embedded into the connective tissue from detaching from the nerve.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"7886fa57-5466-ae3b-cca7-05e81c6ab0fa","text":"Patient's occupation was the second important factor that had a bearing on decision making for 87% of surgeons. Heavy jobs can have a negative effect on stability of the cervical spine.2391016 With recurrent micro-trauma the chances of spine dysfunction and instability is higher. Involvement in heavier occupations also seem to exacerbate the imaging findings of degenerative disc disease on plain X-ray and MRI of the cervical spine.1 Many cases of cervical disc herniation occur during heavy manual labor and unusual activity231016 hence for patients who have undergone a cervical discectomy the risk of delayed instablility is higher. In patients with myelopathy, 66 surgeons believed that it is better to consider FGI but for those with radiculopathy this was not the case. In those patients with spinal cord injury due to a herniated disc the neurological deficit has a negative effect on spine stability.78910","title":"Single level cervical disc herniation: A questionnaire based study on current surgical practices"}
{"_id":"78885123-7c07-539b-aa99-78275ac35f65","text":"There is evidence to suggest that most PG I and II MCTs that are smaller than 4 cm in size can be excised completely with 2 cm margins despite the fact that the overall quality of published evidence is classified as low. However, this review should encourage further study in this area, as use of smaller surgical margins can positively influence patient morbidity, owner satisfaction, and reduction in financial burden.","title":"A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs"}
{"_id":"789446d1-9406-ac64-5e49-425a8aea4d96","text":"Taking into account the still scant number of publications specifically about EVLA using different operating techniques and considering that it is a relatively new and evolving method, especially in the Brazilian context, this research output article will present the clinical results achieved with the methodology, contributing to the attempt to perfect the treatment, achieving the greatest efficacy and least invasivity.","title":"Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser"}
{"_id":"789599a9-daba-9e8f-9bff-56449622cfad","text":"The worst pattern of invasion (WPOI) is cited to be of a good prognostic value. Highest percentage of disease progression on follow-up has been seen in patients with the WPOI 4 followed by WPOI-5 while the least in patients with WPOI 1.22 Current study evaluated the association between worst pattern of invasion score and pathological and clinical tumor staging. The highest WPOI score was seen in Primary Tumor stage IV followed by stage III and the least in Stage-I. This identifies WPOI 4 & 5 as possible predictors of poor survival where they reflect advance stage disease also in cohesion with Mishra A et al where WPOI is identified as independent prognostic factor for OSCC.23 They also reported association of WPOI 4 with surgical margins, poor disease free survival and overall survival however our study did not include survival analysis but is in cohesion in terms of surgical marginas involvement thereupon surgeons may involve larger healthy margin especially in cases with initial histological assessment reporting Invasive pattern in order to avoid loco-regional recurrence and improve survival.23","title":"Oral Squamous Cell Carcinoma Clinico-pathological features in relation to Tumor Stage; AJCC 2018 perspective"}
{"_id":"7897e5a6-97a3-c4a9-c89c-c1cbb58a282e","text":"The right technique of administration has to be used for the filler being injected and for the site where it is being deposited.","title":"Dermal Fillers: Do's and Dont's"}
{"_id":"789b1c19-be43-7631-3a01-429a4ab77b32","text":"The final diagnosis was severe apostematous myositis of the left neck region with extension of infection into the cervical vertebral column, resulting in severe focal osteomyelitis of the left part of the arch of C5 and marked compression of the spinal cord with moderate Wallerian degeneration. The heifer also had gastrointestinal parasitism. The poor condition of the heifer at initial presentation was thought to be due to parasitism and ringworm. No other diseases were detected at post-mortem examination.","title":"Abscess of the cervical spine secondary to injection site infection in a heifer"}
{"_id":"789e1739-d763-ebe6-6b7f-6c82c9a9cf0e","text":"Methods: Circulating levels of biomarkers were measured by Luminex assay in 57 samples obtained, from 24 patients with active sJIA and in 37 samples from 20 patients with MAS at sampling at variable severity and treatments.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"78a541e7-8a4e-92f5-b99e-ef809f7e2a9d","text":"Our study confirmed that altered sensibility following open rhinoplasty occurs 3 weeks after surgery in the same area previously reported by Bafaqeeh and Al-Qattan [8]; these areas (nasal tip and adjacent upper columella) are supplied by the external nasal nerve; the nerve is most probably injured during the subcutaneous dissection as the nerve passed between the nasal bone and the upper lateral cartilage to supply the skin; the external nasal nerve injury could also occur during intercartilaginous and cartilaginous splitting incisions of the endonasal rhinoplasty; it is also mentioned in study [8] that they checked nasal sensation one year after operation that showed complete recovery, but we performed nasal sensory testing 6 month after operation and we found that normal sensation and complete recovery is taking place as soon as 6 months postoperatively in nasal skin and there was no difference between two groups, so our study showed that subdermal soft tissue removal did not make any difference in sensory recovery time between two groups 3 weeks and 6 months after surgery.","title":"Comparing the Alteration of Nasal Tip Sensibility and Sensory Recovery Time following Open Rhinoplasty with and without Soft Tissue Removal"}
{"_id":"78a681c3-f905-3994-1154-1be68e3d0398","text":"The DFSP of her right shoulder region was first diagnosed in 1991. Following several incomplete tumour resections and local progressive tumour growth she was transferred to our hospital in 2001. Tumour resection was carried out and radiation therapy was suggested but refused by the patient. Despite clear resection margins the tumour recurred locally 10 months later and, at this stage, the tumour had infiltrated the brachial plexus. Since then, additional surgical interventions for local recurrences of the DFSP were required every 5 to 9 months. Fifteen years after the initial diagnosis of the DFSP, at readmission for a local recurrence, the tumour extended from the axilla along the thoracic wall to the lateral aspect of the ipsilateral scapular and an additional small (less than 2 cm) reddish blue subcutaneous nodular lesion was observed at the dorsal aspect of the right elbow.","title":"Merkel cell carcinoma metastasis and dermatofibrosarcoma protuberans presenting as a collision tumour: a case report and review of the literature"}
{"_id":"78ac536d-a5de-26c7-aba2-d9eb42ae9c24","text":"The primary objective of this study is to evaluate the adequacy ratios of the surgical margin with our proposed algorithm in selecting the safe margin in patients undergoing standard surgical treatment and to evaluate the distribution ratios of tumors that are re-excised after standard surgical treatment. Our secondary objective is to determine the predictive risk factors that cause recurrence in recurrent BCC cases and to review the clinical features, histopathological findings, and treatment protocols of metastatic BCC cases. In addition, the authors aim to analyze the epidemiological, clinical, and histopathological features of BCC and compare them with previously published reports.","title":"Adequacy of surgical margins, re-excision, and evaluation of factors associated with recurrence: a retrospective study of 769 basal cell carcinomas"}
{"_id":"78acdfb8-5d08-2d72-2850-f53c05b1a8db","text":"This study was a retrospective review of patients with bedside US for a suspected skin abscess presenting to an urban academic emergency department over an 18-month period. Patients were eligible for enrollment if they had localized swelling, pain, induration, and warmth suspicious for a soft tissue abscess and underwent both US and CT scan of the affected area. Patient care was provided by emergency medicine residents working with emergency medicine attending faculty. Patients were excluded if the image sets for either US or CT were incomplete. US imaging was performed prior to CT imaging in 91% of patients. This study was approved by our institutional review board with waiver of informed consent.","title":"Comparison of computerized tomography and ultrasound for diagnosing soft tissue abscesses"}
{"_id":"78b55a3b-3b1b-d048-249b-840af38ddbe8","text":"Diagnosis is often delayed as in the acute phase, as plain radiographs offer no aid as signs of osteomyelitis do not appear until 10 to 14 days after onset of symptoms 4. Certain radiographic features associated with salmonella osteomyelitis such as nonspecific osteolytic foci with sclerotic margins may mimic bony tumours 4.","title":"Salmonella Osteomyelitis in a one year old Child without Sickle Cell Disease: A Case Report"}
{"_id":"78b861fa-f6cd-6a0a-75d7-c70ee9abe80d","text":"In summary, simultaneous ultrasound assisted liposuction and helium activated radiofrequency provide an effective treatment for patients desiring improvements in upper and middle back contour and elimination of back rolls while avoiding more invasive excisional surgeries.","title":"Successful Back Contouring With Elimination of Back Rolls Using Ultrasound-Assisted Liposuction and Helium-Activated Radiofrequency"}
{"_id":"78bd6551-e73b-3e8e-87f3-18731ada4d5c","text":"Table 1 Australian Clinical Practice Guidelines for the diagnosis and management of melanoma","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"78c4271f-d844-3f38-1a6b-dd605a995cc5","text":"The flapless surgical approach was introduced in the late 1970s by Ledermann [1] to overcome the bone resorption process. Studies comparing the crestal bone height using the flapless and the flap surgical techniques are minimal. The purpose of this study is to compare the clinical advantages of flapless implant surgery over conventional flap technique of implant placement.","title":"Clinical Evaluation of Placement of Implant by Flapless Technique Over Conventional Flap Technique"}
{"_id":"78c5c2a7-3851-6f67-c7d5-75e116142d2b","text":"When local tissue transfer is used, only outer skin and subcutaneous tissue are involved; the facial musculature will remain intact. Cutaneous lower lip can be reconstructed with a variety of flaps from the chin and submandibular area. Because the chin is a very visible aesthetic unit, incisions should be planned where there is minimal chin distortion. Larger lower lip defects reconstruction can be done using an inferiorly based or bilateral inferiorly based melolabial flaps.","title":"Lip Reconstruction after Tumor Ablation"}
{"_id":"78c94cb4-d7dc-0e6d-0ee4-fa51bf4b71bc","text":"In a final study, 25 healthy term infants with ankyloglossia who had been referred to a lactation clinic because mother was experiencing pain with nursing were randomized to frenulotomy followed by a sham procedure or vice versa (31). Ankyloglossia was diagnosed by visual inspection. Feeding effectiveness and pain were determined during the first feeding immediately after the sham procedure or frenulotomy. Mothers were blinded as to the order of procedures, and observers watched to make sure nobody examined the infant's mouth immediately after the procedure. Frenulotomy was associated with small but statistically significant improvements in maternal pain and feeding effectiveness however the authors do not report data following sham procedures nor do they provide any other follow-up information.","title":"What is tongue-tie and does it interfere with breast-feeding? – a brief review"}
{"_id":"78cb89f0-ff9e-7e2e-a6ed-54f1a54c9591","text":"Looking at the studies assessing surgical management of CS involvement in patients with RA, we found a total of 17 studies which assessed postoperative outcomes and seven studies that evaluated the potential rise in the incidence of postoperative subluxation compared to the preoperative ones. There were studies that evaluated both outcomes and were therefore reported twice in each individual table.","title":"Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis"}
{"_id":"78d37360-3b9c-9a23-762d-1cff7b4aacfc","text":"The number of cases of atopic allergies has increased in industrialized countries. There is increasing evidence that house dust belongs to the inhalant allergens that most commonly provoke allergic diseases in humans. Exposure to house dust allergens is an important cause of allergic reactions in sensitized asthmatic patients. The main allergenic part of house dust is domestic mites, whose density depends on various indoor environmental factors, both biotic and abiotic.","title":"Abundance of domestic mites in dwellings of children and adolescents with asthma in relation to environmental factors and allergy symptoms"}
{"_id":"78e31726-c8b2-00ec-8e79-b933ed71fafc","text":"Current forms of cancer treatment may successfully destroy cancer cells; however, are ineffective at eradicating resistant cancer cell populations and their stem cells. It is imperative to find therapies that can eliminate cancer stem cells that are the helm for cancer recurrence and metastasis. Metastasized melanomas are more difficult to reach with laser light. Furthermore, their melanin pigment responds poorly to photodynamic therapy. It is not only vital, but also beneficial to utilize photodynamic therapy components that maximize the level of photosensitizer absorption. Absorption can be achieved through targeting tumor cells and administering precise laser wavelengths and effective exposure times to achieve the highest excitation of effective photosensitizers. Although melanoma exosomes possess distinct qualities, numerous cancer types share the same tumor growth and metastasis promoting mechanisms, the effects of PDT-induced exosomes utilizing various photosensitizers in targeting melanoma cells and their stem cell population as well as their tumor microenvironment need further research. An approach directed at expanding the knowledge of photodynamic therapy effects of the tumor microenvironment and improving it as a cancer treatment through conducting more in vitro and in vivo experiments will create a better understanding.","title":"The Role of Melanoma Cell-Derived Exosomes (MTEX) and Photodynamic Therapy (PDT) within a Tumor Microenvironment"}
{"_id":"78e5c1c8-7e73-c5b7-1bcf-5985b72bbcd3","text":"Medical students' perceptions about the different surgical disciplines may increase as they progress through their clinical years. Students in their final year in this study had significantly more knowledge about plastic surgery than their younger peers. Although medicine and surgery were considered essential in shaping the educational foundation of the students, their lack of knowledge about plastic surgery may have a negative impact on their chances of obtaining a residency in this field. Plastic surgery is an extremely competitive specialty, and it is mandatory for students who wish to pursue a residency position in this field to be involved in extracurricular activities that include electives and related research.","title":"Perception of Plastic Surgery and the Role of Media Among Medical Students: Cross-Sectional Study"}
{"_id":"78ef0822-d9a1-1516-870a-f61ef76cdf11","text":"This study investigated the ability of cryoablation to create a robust antitumor response in combination with immunologic agents. The current study hypothesized that this combination would result in a synergistic effect against cancer cells. To the best of our knowledge, this is the first study to examine the combination of cryotherapy and immunologic agents in different cancer types as lymphatic nodules, small cell lung cancer in females and males, lung cancer with bone metastases, bilateral lung metastasis, and mediastinal lymph nodes.","title":"Cryoablation and Immunotherapy: An Enthralling Synergy for Cancer Treatment"}
{"_id":"78f1b014-f0df-ef91-ae3c-511ac71cbc31","text":"One patient deserves a special mention. This patient was originally treated with 45 Gy external beam radiation for primary synovial sarcoma of the lower leg, and the tumor was excised and closed primarily. The patient developed a local recurrence 2 years later and underwent wide-local excision with 35 Gy brachytherapy over the open wound. The defect was reconstructed with a STSG that initially healed, but was lost after receiving a 20-Gy course of additional postoperative external beam radiation therapy to the operated site. At that point, the wound was managed with VAC® therapy for 16 days until it filled with granulation tissue and then was successfully skin grafted after a cumulative radiation dose of 100 Gy.","title":"Outcomes of skin graft reconstructions with the use of Vacuum Assisted Closure (VAC®) dressing for irradiated extremity sarcoma defects"}
{"_id":"78f1ce63-3fd9-2d3a-fb64-d452d999986b","text":"Post procedural discomfort and pain are managed with appropriate analgesia. Use of NSAIDs may alleviate some of the local discomfort which arises from phlebitis.","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"78f73036-d7dd-ff3d-1a46-42be7713a941","text":"To date, no consensus exists regarding parotid treatment and the indication for or required extent of neck dissection in reCSCC and laCSCC; the identification of the risk factors for parotid metastasis in reCSCC and laCSCC can allow for selection of the proper treatment approach for the parotid gland and neck dissection.","title":"Parotidectomy and neck dissection in locally advanced and relapsed cutaneous squamous cell carcinoma of the head and neck region"}
{"_id":"79003c3c-4a99-32e5-bfbd-cb417148533d","text":"An important technical point is not to undermine more than 50% of the surface of the KDPF while exploring the perforator vessels.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"7902c08c-527e-f18e-e984-696ffd5464e7","text":"AA-based treatment could be used in addition to established therapies or could represent an additional therapeutic option. Topical treatments used for these cancers are mainly encouraged due to the high incidence of NMSC, especially in the elderly population. The high costs associated with the management of this category of patients related to hospitalizations and surgery mean that there is interest in the search for simpler and cheaper treatments.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"7908cad5-d6f4-8cc7-3855-3d4824bdb9b8","text":"The continuous cumulative exposure variable was further categorized based on tertiles of the distribution among controls with participants never exposed to workplace UV radiation defined as the reference category. Frequency distributions of exposures and demographic characteristics were characterized and compared by case status using chi-square tests.","title":"Occupational Exposure to Ultraviolet Radiation and Risk of Non-Melanoma Skin Cancer in a Multinational European Study"}
{"_id":"7908f4d3-8f83-a307-dd7d-498233b9043b","text":"The frequency of all 12 complications were higher in under 25 year old age group. Because most of the admitted patients for rhinoplasty were in this age category, it’s obvious that the cumulative frequency of complications would be higher in this age group.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"790bf752-012c-c19f-b753-9768c3d36a35","text":"In conclusion, the key to LDLT in patients with CAPV is PV reconstruction. The present findings proved that using the GSV to reconstruct the PV in CAPV patients is an effective method.","title":"Living donor liver transplantation for congenital absence of portal vein in portal venous reconstruction with a great saphenous vein graft"}
{"_id":"790bf761-d27f-aa8f-361c-ec8c3027cbba","text":"The postoperative course was uneventful and the patient was discharged at the 8th postoperative day.","title":"Desmoid tumors of the abdominal wall: A case report"}
{"_id":"79145686-7e0b-4633-21d8-639b800a35f7","text":"This is the first systematic review on the outcome and salvage strategies after free flap failure in post-traumatic lower extremity reconstruction. Flap failure is as common as 10% of microsurgical lower extremity reconstructions in patients treated over the past 40 years across the world. The predominant post-free flap failure strategy in lower extremity trauma is a second free flap, a strategy that is successful in the majority of cases but also proves the chance of flap survival after previous complications are less than in a primary reconstruction. The amputation rate after free flap failure overall is 12%, the risk of which increases between a primary and a secondary free flap.","title":"Strategies Following Free Flap Failure in Lower Extremity Trauma: A Systematic Review"}
{"_id":"79149585-0d4b-0414-4349-8c1751eb145e","text":"Previous implementation research in general practice has focused on exploring GP behaviours in relation to an externally imposed guideline or intervention [17]. By exploring the implementation of ultrasonography in general practice as an intervention introduced by GPs themselves, we may gain new insights into what motivates GPs towards changing their behaviours.","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"79157969-4605-ea61-b02d-1cf8a427ab4a","text":"Flap thickness is not the only parameter responsible for the skin or nipple areola necrosis.","title":"Assessment of Mastectomy Skin Flaps for Immediate Implant-Based Breast Reconstruction"}
{"_id":"791ecef2-a162-4c98-c419-285da4fc9237","text":"SV grafting has even been useful when remodeled into a cylinder configuration for a size-match purpose for the construction of either jugular or portal veins. Urayama et al4 and Sakamoto et al5 respectively utilized such remodeled SVGs where the saphenous vein was split longitudinally and sutured side-to-side (Figure 5) with good results. SV grafting added its versatility as catheter conduit for arterial infusion chemotherapy to treat hepatocellular carcinomas and metastatic liver cancer after hepatectomy or in unresectable patients with satisfactory perfusion.59","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"7925f59c-8cc6-90fd-1831-df2d1832b2c6","text":"However, one possible drawback of our technique might be its limited role in repairing wounds with soft tissue defect. There were two patients combining soft tissue defects which might well be cured with conventional Ilizarov method; based upon our experience, it turned out that the wounds were only downsized when the docking was achieved with our method. The wounds healed after dressing change for 42 and 28 days respectively. On the bright side, the relatively limited range of soft tissue transport might be beneficial to avoiding the invagination of the soft tissue in the docking site. In our study, only minimal soft tissue invagination was observed between the bone ends in patients with intact soft tissue coverage.","title":"L-shaped corticotomy with bone flap sliding in the management of chronic tibial osteomyelitis: surgical technique and clinical results"}
{"_id":"792dd947-041a-2472-1b3c-3d5e02b27be7","text":"The present review was performed to evaluate the clinical evidence of osteomyelitis treatment with anti-infective bone graft substitutes. The first results of the included studies imply that treatment of osteomyelitis with antibacterial bone graft substitutes could be a good option. The results on eradication of infection, bone growth, and degradation of bone graft substitute are worth mentioning with the high success rates. Although the included studies showed some good results, the generalizability of the results caution must be applied because of the low levels of evidence and the significant risks of bias. Taken together, these results are inconclusive and no conclusions regarding the clinical outcomes of osteomyelitis treatment with these bone graft substitutes can be drawn.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"792e7322-4d70-f8f4-46f2-590b16ef426e","text":"Complete lymph node dissection (CLND) has been a cornerstone in the management of melanoma patients with a positive SNB for many years. The underlying idea behind performing CLND is to prevent the melanoma disease from systemic spreading and attain accurate staging.","title":"Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection for Melanoma"}
{"_id":"793ae794-2ab0-4691-a62f-7e478ff48f43","text":"Eighty-five percent of the respondents classified themselves as generalists meaning their practice was classified as a general orthopaedic practice where they did not discriminate their patients. They diagnosed and managed a general orthopaedic practice regardless of the fellowship training they received. Most of these surgeons indicated that they completed fellowship training in areas to augment their skill sets to develop into better generalists. Fifteen percent of the respondents considered themselves to be sub-specialists, thus managing specific orthopaedic conditions with a specific area of expertise","title":"What orthopaedic surgery residents need to know about the hand and wrist?"}
{"_id":"79513a98-f14c-bdf1-40de-70e098861f46","text":"Anatomical abnormalities in the lower limb vessels are uncommon. However, the preoperative evaluation of the anatomical variations is very important for planning the operation procedure to prevent jeopardizing the donor leg.","title":"Assessment of vascularized free fibula transplantation revealing a congenital aplastic posterior tibial artery: a case report"}
{"_id":"7951d392-7be8-dfc9-0102-cb615e588f18","text":"All women were followed for interval cancer 24 months after the screening unless they died or emigrated in this period. Given that breast cancer survivors have a higher risk of dying than women without a previous breast cancer diagnosis the follow‐up time for breast cancer survivors is slightly lower than that of the follow‐up time for women without a previous breast cancer diagnosis. The difference in sensitivity between the two groups is therefore slightly underestimated.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"7952f07d-53d1-4370-c3af-d42dcacdd44e","text":"Gingival displacement methods can be broadly categorized into two main groups:","title":"A Comparative Analysis of Post-Retraction Changes in Gingival Height after Conventional and Surgical Gingival Displacement: Rotary Curettage, Diode and Er:YAG Laser Troughing"}
{"_id":"79571823-6713-77f2-4540-2d58805ac962","text":"To ensure clear margins preoperative imaging such as mammography or MRI is used to guide the surgeon during BCS, but they are often not sufficient to guarantee radical tumor resection. After surgery, the ultimate margin status is determined by histopathological analysis. Results of this investigation become available several days after the surgical procedure, which means that in case of tumor positive resection margins additional treatment is necessary by either reoperation or additional boost radiotherapy.– There is a clear need for a development of a new tool for direct evaluation of surgical resection margins during the surgery. In case of a tumor positive resection margin, such tool allows immediate surgical intervention during the initial surgical procedure, preventing additional treatments afterward.","title":"Nonlinear multispectral imaging for tumor delineation"}
{"_id":"7958d364-3874-56c6-55b5-36ef9e7017ff","text":"Total pancreatectomy is performed for chronic pancreatitis, tumors involving the entire pancreas or remnant pancreas after pancreatectomy. Gastric venous congestion and bleeding may be associated with total pancreatectomy. We report the case of a patient who underwent left gastric vein to splenic vein bypass to relieve gastric venous congestion during total pancreatectomy for remnant pancreatic cancer.","title":"Surgical treatment of gastric venous congestion in association with extended resection of pancreas: a case report"}
{"_id":"795e576f-616a-3e63-f668-0840dd86644f","text":"Discomfort associated with administration of local anaesthetics can be due to the prick by the needle, sudden stretching of tissue due to local anaesthetic or due to the local anaesthetic agent itself. Following measures reduce the pain associated with local anaesthetic administration:","title":"Techniques of Skin Biopsy and Practical Considerations"}
{"_id":"7973aa8a-df2b-86a4-c7ff-9e22b8526518","text":"The patient’s previous medical history included recurrent erysipelas of the lower limbs and ultrasound guided dense foam sclerotherapy of the left great saphenous vein around 2 years previously.","title":"Dystrophic calcinosis cutis in chronic venous disease of the lower limbs"}
{"_id":"797461b4-aa3f-41fa-a5ee-b7f7a79947c2","text":"This cross-sectional, descriptive study was conducted between 2014 and 2016 and included female patients of any age with a diagnosis of breast cancer and a report of the SLN status. All patients included in this study had undergone complete neoadjuvant chemotherapy at the National Cancer Institute and had been examined by intraoperative imprint cytology. Lymph nodes were identified during surgery using dual mapping agents with radiolabeled colloid and patent blue dye.","title":"Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy"}
{"_id":"797baa81-c927-e5a1-7067-34092b877eac","text":"An explicit map of LNM in patients with cervical cancer was presented in this study. Obturator lymph nodes tended to be involved. The prognosis of patients with inguinal lymph node involvement was poor in contrast to that with obturator LNM. In patients with inguinal lymph node metastases, clinical staging needs to be reconsidered and extended radiotherapy to the inguinal region needs to be strengthened.","title":"The distribution pattern of pelvic lymph nodal metastases in cervical cancer"}
{"_id":"797e61df-0ec1-b144-a3e5-b55b18f7a876","text":"Through our database search between 2015 and 2018, we identified 12 patients with humeral shaft atrophic, gap nonunions with failed surgical fixation underwent open reduction and internal fixation using LCP with autologous fibula graft and iliac crest cancellous bone graft.","title":"Autologous Nonvascularized Fibula Graft and Locking Compression Plating for Failed Fixation of Humeral Shaft With Atrophic Gap Nonunion"}
{"_id":"79827de5-1863-5f8e-09ba-030761540bc8","text":"The animals were divided into the following four groups for the experiment.","title":"Metronomic photodynamic therapy using an implantable LED device and orally administered 5-aminolevulinic acid"}
{"_id":"79831e97-47d0-2769-e86f-dd5d564c1955","text":"One of the article deals with the classification of skin lesion using Raman spectra by a non-linear neural classifier. The classification model is highly probabilistic and automated. This model involves the feature extraction for Raman spectra and a fully adaptive robust feed-forward neural classifier. The component analysis of Fourier transform Raman spectra of ex vivo basal carcinoma can be diagnosed by using the Nd:Yag laser at the wavelength of 1064 nm acting as an excited source in FT Raman RFS100\/s spectrometer. Thirty-nine set of human skin samples were collected. Among the 39 samples, 18 samples were found to be histopathologically diagnosed as non-diseased and 21 samples were found to be BCC. Raman microspectroscopy is mostly done on in vivo method. It is a non-invasive, automated and real-time application to diagnosis the non-melanoma skin cancer which includes both BCC and SCC which can calibrate the sample within less than 1 second. By using the confocal Raman system with a handheld probe, the Raman spectra of 21 suspected non-melanoma skin cancers in 19 subjects with matched normal skin spectra were collected to analyse the pathological condition. Small distinctive bands corresponding to specified Raman spectra of lipids and proteins are used to distinguish the skin lesions. Raman Spectra of various compounds can be analysed by using the partial least regression and discriminate analysis. Raman spectroscopy plays a major role in the study of static and dynamic properties of the biologically significant molecule in solution, living cells and cell culture etc. The contribution of various bio-compounds such as lipids and proteins in the tissue can be estimated by providing a linear least square fitting model, to analysis the skin cancer in the tissue regions. Raman spectroscopy can also be used as a developmental tool in medical diagnosis. By shifting the excitation energy of Raman spectroscopy from the visible to NIR regions, the fluorescence components present within the normal cells can be minimized. The software tools have been developed to interpret the spectra of the tissue to diagnose the affected areas of the tissues regions. Cluster analysis plays a significant role in the classification of Raman spectra of malignant tumours from normal cells. Latest updates on Raman spectroscopy techniques for skin cancer diagnosis are summed in Table 5.","title":"Skin cancer detection using non-invasive techniques"}
{"_id":"798c452b-5084-616f-9a1f-c97fb1ebf19b","text":"The deep brachial artery was identified in all specimens between the long head and the lateral head of the triceps brachii muscle as the first branch of the brachial artery. In all specimens, it continued along the radial sulcus, which is a groove for the radial nerve. Along this path, the artery was covered by the lateral head of the triceps brachii until it reached the lateral side of the arm. At that point, it passed through the lateral intermuscular septum and descended further between the brachioradialis and the brachialis, eventually arriving at the front of the lateral epicondyle of the humerus. Finally, the artery terminated by joining with the radial recurrent artery via anastomosis. In all specimens, the first portion of the deep brachial artery ran along the radial nerve.","title":"The Use of the Deep Brachial Artery as the Recipient Artery for Free Perforator Flap Transfer: An Anatomic Study and Clinical Applications"}
{"_id":"7992a5ad-37a3-cd6f-cad0-adb93da0d358","text":"To summarize injection site reaction data in phase 3 trials of all biologic agents.","title":"A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections"}
{"_id":"7994e5db-d75b-ae05-7746-2b7f2b6f9185","text":"The gold standard to identify true bacterial persistence would include genotyping of organisms identified at both episodes. To carry out such a study on a large scale would require at least prospective collection from an enormous number of patients, as recurrence only affects a minority, and can occur years later. The present cohort spans 14 years, and prospective organisms isolated from orthopaedic infection were not prospectively stored in our centres, so genomic analysis was not possible in the present study. Well-constructed prospective biobanks of orthopaedic infection would provide a valuable study tool to improve our understanding of recurrent infection.","title":"Microbial Persistence, Replacement and Local Antimicrobial Therapy in Recurrent Bone and Joint Infection"}
{"_id":"799d323a-8175-8778-7175-27c1f2ee2cad","text":"Melanoma affects millions of people worldwide [1–4] and its incidence is increasing every year. While surgical treatment is successful for thin and superficial melanoma which are detected at an early stage, for melanoma thicker than 1mm at presentation the prognosis remains poor due to the aggressive invasion of these transformed melanocytes. The treatments available are essentially the surgical removal of the primary tumour and melanoma in the lymph nodes followed by chemotherapy. Historically metastatic melanoma has been one of the most difficult cancers to treat showing little response to conventional chemotherapy drugs. However recent years have seen improvements in survival time with drugs targeted to BRAF and MEK gene mutations in these cancers and with the use of newer immunomodulatory therapies targeted to checkpoint inhibitors.","title":"Use of a Tissue Engineered Human Skin Model to Investigate the Effects of Wounding and of an Anti-Inflammatory on Melanoma Cell Invasion"}
{"_id":"79a378f6-26fd-db8f-3fc7-5379ecfd9715","text":"Local erythema and edema 3 days after the second dose of the mRNA-1273 vaccine","title":"Delayed skin reaction after mRNA-1273 vaccine against SARS-CoV-2: a rare clinical reaction"}
{"_id":"79b666a8-6538-5edd-da95-38d4f4f9f821","text":"We hypothesized that improvement in spasticity in the upper extremities of hemiplegic patients by BTx injection would improve postural balance and gait function. In order to establish a clear relationship, we investigate the correlation between changes in quantitative evaluation of postural balance and gait function and changes in upper limb spasticity before and after botulinum toxin injection.","title":"Efficiency of botulinum toxin injection into the arm on postural balance and gait after stroke"}
{"_id":"79b78f83-7c1e-4e84-fdb8-c41ecc1222ff","text":"Pulmonary fat emboli were ubiquitous during intraosseous infusion and systemic passage of fat emboli frequently occurred, but did not cause major respiratory or cardiovascular deterioration. Open chest conditions did not increase the risk of systemic passage of fat emboli.","title":"Intraosseous fluid resuscitation causes systemic fat emboli in a porcine hemorrhagic shock model"}
{"_id":"79b9ae4c-6e4c-40ca-90d6-591d7961cdd2","text":"The ENT team did a right neck exploration to explore the neck vessels as a backup in case the right superficial temporal artery was not suitable.","title":"The use of an omental flap for the reconstruction of a burn injury to the scalp: A case report"}
{"_id":"79bf6111-bd29-adc0-753f-9459b9834ab3","text":"We present a case of a patient with a malignant melanoma on his left heel, who had positive popliteal node metastasis and negative inguinal node. Only popliteal lymph node dissection was performed, and there was no recurrence or complication until long-term followup. This case study illustrates the importance of more detailed individual investigation of lymphatic drainage patterns from the foot to the inguinal and popliteal lymph nodes.","title":"Long-Term Treatment Outcome after Only Popliteal Lymph Node Dissection for Nodal Metastasis in Malignant Melanoma of the Heel: The Only “Interval Node” Dissection Can Be an Adequate Surgical Treatment"}
{"_id":"79c0d3e9-e833-63cf-feb3-f926d5e4b8ac","text":"Non-delayers experienced far less ambiguity about the implications of their symptom discovery and expressed more concern that the change they found might represent a serious health threat.","title":"Women’s Perspective of Breast Self-examination"}
{"_id":"79c55624-ab5f-f34d-0cae-833f93b8cf6e","text":"The association between the dependent variable MEA and the other independent variables was tested by Student’s t-test, which allows for the comparison of two samples using their means for statistical inference in order to verify if there is a statistically significant difference.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"79d018b9-1612-3391-eabd-b73300de45a9","text":"The lack of significant benefit of anticoagulation in patients with DDVT","title":"A Comprehensive Literature Review on the Management of Distal Deep Vein Thrombosis"}
{"_id":"79d63031-50fa-1dc6-4dc0-6681d6a5056b","text":"The marked increase in the 1990s in the use of radiotherapy and\/or tamoxifen for DCIS patients treated with BCS suggests dissemination of findings from randomized trials into community practice. In our settings, treatment of DCIS in the late 1990s was associated with a five-year risk of recurrence of only 8% when BCS was used. If use of adjuvant radiotherapy and tamoxifen increased further after the late 1990s and early 2000s, as is likely given that adjuvant tamoxifen was only approved for DCIS patients in 2000, the five-year risk of recurrence may be even lower for DCIS patients diagnosed and treated more recently in the community setting. Further improvements in complete surgical excision and histologic assessment of DCIS lesions may also help to decrease recurrence rates.","title":"Declining recurrence among ductal carcinoma in situ patients treated with breast-conserving surgery in the community setting"}
{"_id":"79d828a8-40f9-8faf-77d3-f3ff6b63de44","text":"However the biological and clinical implications that may be associated with the presence of circulating malignant cells during the follow-up of melanoma patients are not clear. To address the prognostic implications of the presence of late circulating melanoma cells, we decided to investigate the presence of tyrosinase mRNA by RT–PCR in the peripheral blood of stage IIB and III melanoma patients on high-dose adjuvant interferon a-2β at multiple sequential time points from initiation of treatment.","title":"Prognostic significance of the sequential detection of circulating melanoma cells by RT–PCR in high-risk melanoma patients receiving adjuvant interferon"}
{"_id":"79e2aa8d-a6e1-c2a6-3b14-f1fb73cdc6ab","text":"At his initial consultation appointment in February 2009, physical exam revealed a healing incision in the left auricular area consistent with his recent parotidectomy with no lymphadenopathy. After a careful review of the available literature regarding this rare malignancy, he was offered adjuvant radiation therapy to the left parotid tumor bed based on the findings of positive surgical margins and perineural invasion.","title":"Postoperative Radiation Therapy for Parotid Mucoepidermoid Carcinoma"}
{"_id":"79e508aa-d2f4-3a0e-0197-920da78114a2","text":"The above patients are two recent cases among many seen previously in our practice presenting with delayed onset dermatitis in the setting of previously uncomplicated chloramphenicol use.","title":"Reaction or infection: topical chloramphenicol treatment"}
{"_id":"79eb0648-a6f2-5a20-2154-c3e45c8b63b5","text":"In the current study, the presence of a breast implant during postmastectomy radiotherapy was not associated with increased doses to ipsilateral lung and heart.","title":"No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction"}
{"_id":"79ef2d86-c0e2-12b0-dd62-e602fb792820","text":"We perform the Achilles tenotomy in the outpatient clinic with local anesthesia. Only in cases of repeated tenotomy or in older children do we prefer to use general anesthesia and to perform open tenotomy rather than the percutaneous approach. We believe that tenotomy is a mandatory part of correcting the foot and only in a very few cases do we choose not to perform Achilles tenotomy. Only in cases where the heel pad was not empty and there was more than 20° of dorsiflexion did we choose not to perform Achilles tenotomy.","title":"Prolonged use of foot abduction brace reduces the rate of surgery in Ponseti-treated idiopathic club feet"}
{"_id":"79f256d5-8f7c-61c0-4889-20ca32d1d308","text":"This study also discovered 25 models using RT3 patients who are stage 3 and did not receive brachytherapy. All 25 top models were validated by 1000 iterations of bootstrapping and by the independent RTBT2 dataset. Furthermore, 22 of the 25 models were also validated in the independent RTBT3 dataset. These results suggest that these models are highly robust.","title":"Senescence-Associated Secretory Phenotype Determines Survival and Therapeutic Response in Cervical Cancer"}
{"_id":"79f27d58-466d-16c6-10d7-1146726200e6","text":"The evidence to support dressing standards for breast surgery wounds is empiric and scarce. CDC recommends protecting, with a sterile dressing for 24 to 48 hours postoperatively, a primarily closed incision, but there is no recommendation to cover this kind of incision beyond 48 hours, or on the appropriate time to shower or bathe with an uncovered incision. The results of the ongoing trial may support standard recommendations regarding dressing wear time after breast reconstruction.","title":"Dressing wear time after breast reconstruction: study protocol for a randomized controlled trial"}
{"_id":"79fa15e7-6561-4d1a-8dc9-0f032223093b","text":"In the current study a large difference in the prevalence of food sensitization between the Italian and Spanish groups was found probably due to that the children in the Italian group were much younger than the corresponding Spanish group; 6.1 vs 9.1 years of age.","title":"Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation"}
{"_id":"7a097463-d1ad-7569-50f4-6e048ca4e106","text":"The major popular aesthetic surgery in Iran is rhinoplasty as Iran is named the capital of rhinoplasty in the world. It accounts for the highest rate of surgery in women due to the prominence of their nose in Islamic dress code in our country. By improving the beauty of the face, quality of life in patients would be raised. Previous studies showed improving quality of life in patients after 6 months of rhinoplasty. We assigned that it happens even one month after rhinoplasty, as well. Patient satisfaction and quality of life are literally the most important outcomes of rhinoplasty in not only women, but also men.","title":"The Persian Version of Utrecht Questionnaire for Evaluation of Aesthetic Rhinoplasty Outcomes: Translation and Validation"}
{"_id":"7a0c4eae-b592-63a9-879f-7a07036b935f","text":"This research reports on the efficacy in terms of oncological radicality of upper-third, facial basal cell carcinomas treated with excision with the frozen section technique with complete margin control, comparing the recurrence rate to the gold standard Mohs micrographic surgery. Our observations revealed that the implementation of the complete margin control frozen section technique exhibited an eradication rate and subsequent recurrence rate comparable to that of the conventional Mohs micrographic surgery technique, widely regarded as the gold standard in the existing literature. This intriguing finding highlights the paradox that a faster and more expeditious technique can demonstrate a non-inferior profile when compared to the established benchmark in the field.","title":"Recurrence of Basal Cell Carcinoma Treated with Surgical Excision and Histopathological Analysis with Frozen Section Technique with Complete Margin Control (CMC-FS): A 15-Year Experience of a Reference Center"}
{"_id":"7a15a5f7-5ac4-0507-15f1-6f9dcd68c2f4","text":"Table 1 provides basic information on the chemical composition of the materials used in the comparative tests.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"7a169b70-0800-2ded-c38a-f9edeeafdfde","text":"One hundred and ninety-six primiparous breastfeeding women who gave birth between February and May 2005 in a teaching hospital in Tabriz, Iran, were randomized to receive either peppermint water or EBM. Each woman was followed for up to three visits or telephone calls within 14 days and then by telephone call at week six postpartum.","title":"Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial"}
{"_id":"7a19ef3f-ba68-06b2-4cd4-20d3c1bd6d29","text":"In the described case, it can be postulated that buccal and zygomatic branches of the facial nerve were entrapped into scar tissue and the release determined by fat grafting has determined a correction of nerve function loss.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"7a1ad3b0-2955-558f-aa01-1c5f872dfae3","text":"Our data shows that only 1% of cases achieved an overall compliance with the international guidelines. Although this percentage is not high, numerical data shows that also in cases where the Delta was not sufficient, its average value was close to the recommended value. Moreover must be underlined that adherence to guide lines was appropriate in high risk SCC. This suggests that surgeons respect the recommended excisional margins and in the more risky cases and in general attempted to comply with the existing guidelines.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"7a2080de-cf0a-dbc7-c14b-9622c94fb9b3","text":"The major acute complication from STF treatment is vascular occlusion. If the occlusion is not one that is recognized or able to be reversed, the result is permanent tissue loss and scarring. The anatomical location of the sites of greatest frequency of vascular occlusion are well described; filler can traverse anastomotic arterial pathways causing obstruction at sites that are distant from the injection site. The patient who is about to undergo cosmetic therapy should be aware of the possibility of vascular occlusion, the options for management and the consequence of this adverse event if left untreated.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"7a2d4ffa-ca4b-2aad-b2d2-fd08102fccaf","text":"Advanced N stage independently affects both OS and DFS. Partial parotidectomy with facial nerve preservation could be a less invasive standard surgical procedure for parotid gland SDC in the early T stage without facial nerve palsy. Effective systemic therapy is imperative to improve DFS of SDC.","title":"Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients"}
{"_id":"7a2ffdd5-8b30-24be-c356-778bc245c2ec","text":"Free nasal septum mucosa flap can be harvested in the surgery area. If we used the middle turbinate mucosa flap, it needs to be peeled off from the removed middle turbinate before use, as shown in Figure 1, paying attention to maintaining the integrity of the mucosa flap and avoiding damage as much as possible when we peel off the flap. No need to remove the bone of the middle turbinate. The free middle turbinate mucosa flap usually has a side length of approximately 2–3 cm, which is generally sufficient to repair the sellar floor defect after pituitary adenoma surgery, as shown in Figure 1. However, when encountering pituitary adenomas with significant enlargement of the sellar floor and patients with small middle turbinates, the free middle turbinate mucosal flap may not cover the dural gap of the sellar floor fully. Lay the free nasal mucosal flap flat on the dura defect of the skull base, completely covering it all around so that its edges come into contact with the surrounding bone, as shown in Figure 2.","title":"Intradural fat graft packing is not indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries"}
{"_id":"7a313394-40fc-45d3-49dc-42e10de061f8","text":"Further follow-up studies are needed to confirm these hypotheses and to investigate whether the individual MED remains constant over time. At this point, the cumulative distribution of the MED in a population can only be used for population risk assessment purposes.","title":"Double-blind placebo-controlled food challenges in children with alleged cow’s milk allergy: prevention of unnecessary elimination diets and determination of eliciting doses"}
{"_id":"7a36b2d8-312e-46a8-a198-2fb6a76f66c1","text":"Although many studies reported that the calcification of costal cartilage and costa played a key role in the outcome of grafted surgery, only a few studies have provided information on the characteristics of costal cartilage calcification and there are no studies about the calcification of costa. Moreover most studies only have displayed the degree of costal cartilage calcification but with no accurate value about the calcium content. This is because to date all the studies used computed tomographic (CT) scans to analysis the costal cartilage. Whether there is a better instrument to evaluate characteristics of both costal cartilage and costa and provide more information on them can contribute to make better decision before the surgery. In recent years, Dual-Energy CT(DECT) plays an increasing role in the clinical fields due to its quantitative density measurement and monochromatic spectral images. This is because DE imaging allows tissue characterization and functional analysis at energy levels ranging from 40 to 140 keV compared with conventional CT. The aim of our study was to assess characteristics of Chinese costal cartilage and costa calcification using DECT. In general, the sixth, seventh, or eighth costal cartilage and costa are the most often harvested in the clinic, so in the present study we only assessed these three costal cartilage and costa.","title":"Characteristics of Chinese Costal Cartilage and Costa Calcification Using Dual-Energy Computed Tomography Imaging"}
{"_id":"7a3af9f0-3e61-8e14-5a51-0f3728eca3e7","text":"Although injection site reactions are usually mild and rarely classified as severe adverse events, they may have an important impact on patient satisfaction with treatment and contribute to reasons for treatment discontinuation. A patient survey in 2015 of reasons for biologic discontinuation reported that the most common reason after lack of effectiveness was negative feelings about the injection experience. There are efforts being made to improve the experience for patients; notably, a new citrate-free formulation of Ixekizumab has shown a significant reduction in injection site pain in phase 1 trials. Thus, we may see improvements in injection site reaction prevalence in Ixekizumab or others that adopt similar solutions in the future.","title":"A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections"}
{"_id":"7a3b3da3-446c-b7d0-3622-db1d99c4908d","text":"Massive tibial defect caused by osteomyelitis can be successfully treated first stage using induced membrane followed by second stage using trifocal bone transport technique, which is an effective method in terms of radical elimination of osteomyelitis with expected clinical outcomes.","title":"Reconstruction of massive tibial defect caused by osteomyelitis using induced membrane followed by trifocal bone transport technique: a retrospective study and our experience"}
{"_id":"7a3e2e96-5ab6-8eef-fb94-10a9c5b4881e","text":"The authors wish to thank all of the Afya Bora mentors and their associated attachment site organizations for their hard work and dedication to training tomorrow’s leaders in health care.","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"7a403e4b-77b4-2be3-a4c3-e4ab5a98da35","text":"Design and setting: A retrospective study of data obtained from medicare Australia for AK treated by cryotherapy between 1 January 1994 and 31 December 2012, by year and by state or territory.","title":"Cost for the treatment of actinic keratosis on the rise in Australia v2; ref status: indexed"}
{"_id":"7a42475b-7b34-78cc-f143-210164cb5140","text":"The patient with open patellar fracture had a 10-degree extension lag because of patellectomy. One patient who was treated with Ilizarov circular fixation had a 10-degree flexion contracture of the knee and another had a 10-degree flexion contracture of the ankle. The patient with the knee contracture underwent manipulation under anaesthesia and release of the origin of the medial gastrocnemius muscle. She did not have much improvement in the range of motion but was able to continue working as a parking attendant with the local authority. The patient with ankle contracture underwent percutaneous Achilles tendon lengthening during removal of the Ilizarov circular external fixator. She had full range of motion of her ankle and was able to ambulate without support.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"7a43a7db-7170-7a04-8eec-cb33c49f8513","text":"Patients are required to return to the hospital every 3 months in the first 2 years after the surgery and every 6 months in the third year, and thereafter once a year for patients who have no signs of recurrence. Telephone calls were conducted for follow-ups to obtain the treatment information and living status if patients did not visit our hospital on schedule. The primary endpoint was OS, which was determined as the duration from the operation to death or the last follow-up.","title":"Prognostic Value of the Albumin-to-γ-glutamyltransferase Ratio for Gallbladder Cancer Patients and Establishing a Nomogram for Overall Survival"}
{"_id":"7a44340b-f779-9f4d-70e2-dba309ef18a6","text":"Skin and soft tissue defect of leg after trauma is commonly encountered for which early and precise management of the patients may improve the overall outcome aesthetically and functionally. There are many options for upper and middle third of leg defect separately, but the large defect involving area between upper and middle third or transition zone between two has very limited options like cross leg flap, gastrocnemius flap and free flap. Cross leg flap is rarely used now since it leads to long term morbidity and discomfort to the patients due their cumbersome position.","title":"Gastrocnemius Myocutaneous Flap: A Versatile Option to Cover the Defect of Upper and Middle Third Leg"}
{"_id":"7a498c60-355a-56dc-0118-0385dbc4b3b1","text":"The Hydrus Microstent combined with OMNI Surgical System ab interno canaloplasty can safely and successfully reduce intraocular pressure in phakic patients with open-angle glaucoma with uncontrolled intraocular pressure on maximum tolerable medical therapy with a low complication rate and rapid visual recovery.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"7a4c84a0-7086-3244-01c4-95764b0a3c89","text":"It is important to design the double opposing Dufourmentel flaps so that imaginary lines DF and BF’ are as parallel as possible to the line of greatest extensibility. For this reason, there are only two ideal Dufourmentel flaps surrounding a circular defect. There cannot be an unlimited number of flaps available.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"7a5058b1-32c9-eaae-8240-022ad150589e","text":"After receiving information about the research and giving their authorization by signing the free and informed consent form, 43 patients with surgical indication of revision rhinoplasty were submitted to an interview prior to the surgery by the main investigator to fill out the questionnaire.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"7a509308-baf7-82df-14d8-ca1b5aeec5b0","text":"The upper third of the trapezius was resected en-bloc with the overlying skin including the scar from the previous biopsy. The spinal accessory nerve was prepared as close to the muscle hilum as possible and so were the transverse cervical vessels. The right transverse musculocutaneous gracilis free flap was transferred to the defect. The vascular anastomosis was performed end to end between the transverse cervical artery and vein and the gracilis pedicle. Neurorraphy was performed end to end between the spinal accessory nerve and the obturator nerve. The flap survived completely and the post-operative period was uneventful.","title":"“Functional trapezius muscle reconstruction after resection of a desmoid tumor using an innervated gracilis free flap”"}
{"_id":"7a561b44-3977-1134-3709-02b17e219ee4","text":"We handled this situation by clamping the ITA and pressure-filling the arterial system with contrast fluid while recording the findings using a three-dimensional computer tomography (CT) scan. This showed that the subcostal arteries and the muscle perforating branches are filled retrogradely. However, due to reduced pressure, we could not show an alternative perfusion of the sternum via this collateral circulation. A regular circulation pressure could not be imitated and thereby a filling of the tiny branches could not be established. A filling of the vessels by arterial mass according to Thiel was also limited by the pore size and the diameter of the passages, and could only represent the large stem vessels. By infiltration of liquid contrast medium the inflow to the sternum by the subcostal arteries and by collaterals of the A. thoraco-arcomialis could be shown using CT morphology. A complete flooding of the sternum was not observed. The reason was also the very low pressure with which the contrast agent was applied. This low pressure did not allow a complete stream of contrast of the vessels with the representation of collateral circuits in our experiments.","title":"Anatomic study of the vascular perfusion of the sternum and its clinical relevance in deep sternal wound infection Anatomische Untersuchung der sternalen Gefäßversorgung und ihre klinische Relevanz bei tiefen sternalen Wundheilungsstörungen"}
{"_id":"7a5fd68b-8efb-6e0a-53ae-5b79d1f9ee8b","text":"In general, external beam radiotherapy is used for symptom control of patients with advanced HCC as a palliative treatment or for local disease control of patients with liver-confined HCC that are not eligible for other therapies such as liver resection and locoregional therapies. Meanwhile, external beam radiotherapy is also used as an extra treatment combined with other modalities to achieve a better therapeutic response.","title":"Efficacy of External Beam Radiation-Based Treatment plus Locoregional Therapy for Hepatocellular Carcinoma Associated with Portal Vein Tumor Thrombosis"}
{"_id":"7a653442-b807-05c9-0f44-cd30d0b1bfd5","text":"Specimen taken for initial biopsy consisting of 3 tan-white irregular tissue pieces from right ramus of the mandible","title":"Unraveling the challenges in the diagnosis and management of desmoplastic fibroma of the mandible–a case report"}
{"_id":"7a6ecadc-725c-45b0-ecc7-890e25574a94","text":"The study results do not provide support for an increased risk of NMSC in association with workplace exposure to natural or artificial UV radiation. These findings are consistent with weak, null or inverse associations previously reported in epidemiologic studies, particularly for BCC. Our results might be attributed to the low level of UV exposure among participants, and to exposure misclassification. The protective effect we observed among participants with light skin complexion suggests that they are using adequate personal sun-protection measures. These results add to the evidence that moderate sunlight exposure might decrease the risk of some types of cancer, likely in association with sun-protection behaviors. Further investigation focusing on individual genetic susceptibility and potential interactions with other exposures at work and with low-level environmental exposures will be conducted in order to achieve a more complete knowledge of the etiology and effective prevention methods for human skin malignancies.","title":"Occupational Exposure to Ultraviolet Radiation and Risk of Non-Melanoma Skin Cancer in a Multinational European Study"}
{"_id":"7a7b28a0-b93b-5a40-f892-7dd7ae516fd8","text":"The patient and referring physician or health care professional need to accept the possibility that a serious cutaneous reaction that requires oral or intravenous corticosteroids could occur during or after the graded challenge. If the possibility of future systemic corticosteroids is refused, the graded challenge should not be undertaken. Fortunately, most graded challenges with isoniazid would be expected to be carried out safely and with a favorable benefit-risk ratio.","title":"Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy"}
{"_id":"7a7c01c3-e9ec-74b5-e135-d03d709cd97b","text":"Utilization of DO in head and neck cancer is extremely appealing; patients could undergo large composite tissue resection and immediate soft tissue reconstruction with local flaps or microvascular free tissue transfer. Flaps could be chosen on soft tissue coverage needs alone, without the need to incorporate bone. Postoperative radiation therapy would proceed sooner as the wound healing period would be truncated. Replacement of bone through transport DO could be performed on an elective basis after completion of XRT. For elderly patients or patients in whom microvascular free tissue transfer would pose an extreme health risk, DO alone might provide a less invasive alternative. DO could also provide an additional reconstructive option after flap failure, bone resorption or osteoradionecrosis.","title":"The effects of high dose and highly fractionated radiation on distraction osteogenesis in the murine mandible"}
{"_id":"7a80584e-7dd5-1989-6f78-6be1ade37d96","text":"The results of this present study show that there is a significant decrease in the VAS score of flapless group when compared with conventional flap with the difference being highest in the second postoperative day. Also the results of this present study show that the number of patients who felt no pain was also higher in the flapless group. These results are concurrent with studies by Shamsan et al. [10] who reported statistically significant higher mean pain severity and duration in conventional technique of implant placement compared to the flapless procedure.","title":"Clinical Evaluation of Placement of Implant by Flapless Technique Over Conventional Flap Technique"}
{"_id":"7a81fe1a-6b89-7b98-5d2c-32e00d49a8c1","text":"There is no standard curative treatment for calcinosis but different agents were used with variable efficacy.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"7a913f3f-076b-28fb-ccfe-2cc2bb6cbbc0","text":"In the treatment of cutaneous and subcutaneous melanoma lesions, since there are many local therapies alternative to radiotherapy and patients are often undergoing systemic therapy, treatment should be individualized after discussion with a multidisciplinary team of experts.","title":"Radiotherapy in the Treatment of Subcutaneous Melanoma"}
{"_id":"7a99cbc5-eab9-2799-9c2b-b499e7b31fdc","text":"In summary, ICG is advantageous in ARM, enabling a higher identification rate than that achieved with MB with fewer complications in the prospective randomized study. FNAC is safe and efficient to assess the metastasis of ARM‐identified node in this setting and is recommended to target nodes for removal during ALND. The ARM with ICG may provide an approach suitable to preserve the nodes identified for patients with clinically positive nodes. However, one limitation of this study is unable to evaluate the effect of ARM in preventing lymphedema because all ARM‐identified nodes were removed during ALND. Therefore, additional prospective study is needed to evaluate whether ARM could help to curtail lymphedema effectively based on the feasibility and oncologic safety of ARM by ICG.","title":"Comparison of indocyanine green and methylene blue use for axillary reverse mapping during axillary lymph node dissection"}
{"_id":"7a9a2b10-47c9-b53d-60b3-bb7f68867854","text":"Biofilm cells change their nucleic composition, by transfer of nucleic material which can rapidly produce phenotypes to combat any adverse condition. This genetic material is transferred from cell to cell using F pilus, which are tubes that can contract and draw DNA material and transfer from one cell to another up to about 12 μm and can occur within seconds.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"7a9fe90d-b86d-5ed1-cf82-882b0a26fcbb","text":"Randomized controlled trials have shown that z-frenuloplasty and 4-flap frenuloplasty are superior to simple frenotomy across multiple metrics but must be performed under general anesthesia.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"7aa3ffa8-3341-318e-b566-415f33af12b6","text":"In older women with tumours small enough to be appropriately treated by BCS and postoperative RT, there are few arguments left to recommend mastectomy without RT. Considering the significantly increased risk of both major surgical and major medical POCs, and adding the well-documented benefit of less extensive and less traumatic surgery from a patient perspective, as well as the growing body of evidence for a survival benefit of BCS + RT over mastectomy – RT, the first recommendation of breast cancer surgery for older and often more frail individuals should be breast conservation.","title":"Medical and surgical postoperative complications after breast conservation versus mastectomy in older women with breast cancer: Swedish population-based register study of 34 139 women"}
{"_id":"7aa89b5e-8ccd-b30d-e901-630ee2629fc9","text":"Awareness of sun-safe behaviours was higher among those with educational qualifications. Women were more likely to know that people should use high factor sunscreen and stay in the shade to protect against skin cancer. Knowledge of staying in the shade, covering up and using high factor sunscreen was higher among older age groups. Having skin that burns easily was only associated with greater awareness of the need to cover up.","title":"SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample"}
{"_id":"7aa9087c-d45a-f8f2-a91e-723aee671800","text":"The average fading time of the second lymph nodes in the isosulfan blue group was significantly shorter than that in the fluorescein sodium group. Moreover, the detection rates of SLNs were higher in the fluorescein sodium group than in the isosulfan blue group. No significant differences between the fluorescein sodium group and isosulfan blue group were observed regarding the distances between the detected sentinel lymph nodes and second pair of mammary areolas, the distances between the second lymph nodes and second pair of mammary areolas, the number of detected sentinel lymph nodes and second lymph nodes, the average dyeing time of the sentinel and the second lymph nodes, and the average fading time of the second lymph nodes.","title":"10 % fluorescein sodium vs 1 % isosulfan blue in breast sentinel lymph node biopsy"}
{"_id":"7ab7590c-1ed9-c135-db42-ae99300ea238","text":"We recommend our grated cartilage technique and grating device as a fast, easy and reliable method for cartilage molding and producing autogenous material to use as a natural filler for slight soft tissue defects in primary and secondary rhinoplasty. It can be accomplished both in an outpatient session and intraoperatively with a high degree of confidence. We persuade studies with longer periods of follow up and appreciate any expert commentary and criticism. According to the very low revision rate (less than 5%), we strongly recommend our grated cartilage graft for use in primary and secondary rhinoplasty. Our study showed that patient and surgeon`s satisfaction can be achieved with a high degree of confidence.","title":"Evidence-Based Efficacy of Autologous Grated Cartilage in Primary and Secondary Rhinoplasty"}
{"_id":"7ab79d8e-458a-5940-ea3c-94729c1f899a","text":"Tumoral calcinosis is a rare and benign condition characterized by massive subcutaneous soft tissue deposits of calcium phosphate predominantly around large joints.","title":"Familial tumoral calcinosis in two Chinese patients: a case series"}
{"_id":"7abb0737-791d-2e4c-fb1f-96a6535cbe8e","text":"Diced cartilage graft is another alternative for smoothing out dorsal irregularities and filling defects. Its use was first introduced in 1943 and has been popularized since 2000. It was shown that diced cartilage grafts were viable and spaces between the small cubes of cartilage were filled by connective tissue.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"7abd7949-0493-b9df-23e0-dbdba1ec963a","text":"Imiquimod may be an alternative to surgery for patients with primary facial superficial BCCs, but long-term clearance is not as good as some of the other treatment modalities. It is not recommended for recurrent disease but is a good treatment option for elderly frail patients and patients who are not keen on surgical treatment.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"7ac33480-6902-d8f8-eb81-b9e0de8f8798","text":"In this clinical case, the multidisciplinary treatment has been a decisive factor that has resulted in the satisfactory evolution of our patient.","title":"Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn: Breastfeeding Sessions, Myofunctional Therapy, and Frenotomy"}
{"_id":"7ac4cbe9-5a27-1734-ea8d-620fc2c69018","text":"In order to identify the risks and benefits of cosmetic surgery, it is necessary to promote the public education and to correct the society attitude. For any procedures that are done for juveniles, “realistic expectations” should always be considered in all aspects of cosmetic and reconstructive surgery procedures in this age group. It is essential to justify the policies governing the relations between patient and physician in order to dampen the demand and the impact of interventions to achieve the desired objective. It must always be kept in mind that the plastic surgeons, in addition to cosmetic surgery procedures, often are as a healer and moral obligation protects the patient health as a priority. Finally, a reminder that promotes professionalism training in plastic surgery is mandatory, also the ethical aspects must be considered in any plastic surgery and it is necessary to draw special attention to pundits professionalism guidelines required for plastic surgery.","title":"Medical Ethics in Plastic Surgery: A Mini Review"}
{"_id":"7ac7972a-64c9-0122-5569-a90118f17141","text":"It is widely believed that prolonged breastfeeding and delaying the introduction of solid foods have benefits with regard to atopic dermatitis. Nevertheless, parental eczema is reportedly a major risk factor, and a longer breastfeeding duration may increase the risk of eczema in infants born to mothers with asthma. However, in this study, after the adjustment for a parental history of atopy, exclusive and partial breastfeeding for longer than 6 months were found to be still significantly related to a reduced prevalence of milk sensitization and provided protection against the development of eczema in early life. Our findings suggest the need for health-policy strategies to promote both exclusive breastfeeding and continued partial breastfeeding for preferably 6 months to not only reduce the prevalence of milk sensitization as well as reduce the development of eczema in early childhood.","title":"Exclusive or Partial Breastfeeding for 6 Months Is Associated With Reduced Milk Sensitization and Risk of Eczema in Early Childhood The PATCH Birth Cohort Study"}
{"_id":"7ac8c23c-4c91-011a-cee6-d9bbf40c5d5c","text":"In addition, the FVFG introduces blood circulation to the involved area and therewith an immunological response and delivery of antibiotics at the site of infection. Although the above-mentioned qualities are important, drawbacks of the free microvascular fibula graft are that it requires microsurgical skills, longer operation times, and multidisciplinary collaboration.","title":"Free Vascularized Fibula Graft as Primary Salvage Procedure for Acute Cervical Osteomyelitis Caused by Epidural Abscess"}
{"_id":"7ae3cd43-061d-97c1-1f77-06772e788b15","text":"Besides the benefit of meeting anticipated workforce needs, additional fellowships meet the requirements of internal medicine graduates who are increasingly demanding the option to subspecialize. The lack of subspecialty training after residency may adversely affect a hospital's residency programs. The change in rules has allowed the rapid expansion of solo fellowships, which is a benefit to the hospitals sponsoring them and also to the graduates filling the positions.","title":"Sponsorship of Internal Medicine Subspecialty Fellowships Since 2000: Trends and Community Hospital Involvement"}
{"_id":"7ae65fb1-7091-432e-b6df-3e00590ea21d","text":"This study specifically only considered the costs of IBR after unilateral mastectomy for breast cancer and women undergoing bilateral procedures were excluded. This was because the bilateral group was small, precluding meaningful comparative analysis. While the cost of the index bilateral reconstruction would be higher, women undergoing bilateral surgery may require fewer revisions and\/or contralateral procedures over time to address asymmetry. The impact on the overall costs is unknown and further work is required to explore the costs of reconstruction in this specific patient group, especially as mainstream genetic testing is increasingly available.","title":"Secondary healthcare costs after mastectomy and immediate breast reconstruction for women with breast cancer in England: population-based cohort study"}
{"_id":"7aed4017-554e-769b-3706-2d476ae0203e","text":"We recommend for patients to seek care in the United States or at a facility that is associated with a clinic in the United States for postoperative care. In the case of complications or poor results, patients should seek a plastic surgeon for assistance.","title":"Abdominal Flap Necrosis and Wound Dehiscence following a Medical Tourist Tummy Tuck"}
{"_id":"7aee65dd-0191-7f75-79dd-8e49aec93389","text":"Most common complications in our study included hematoma after stage I surgery, infection after stage II surgery and cartilage exposure after stage II surgery. Hematoma after implantation of tissue expander happened due to various factors like incomplete hemostasis during surgery, excessive crying due to pain post surgery, etc. We suggest meticulous hemostasis before the placement of tissue expander and proper pain medication to comfort the child after surgery. Other complications can be reduced by proper dressing and prophylactic antibiotic use.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"7af78f47-72a7-ca88-8f01-043611dc3428","text":"Enlarging breast masses in children and adolescents can be of great concern to young patients, and fibroadenomas should be included in the differential diagnosis. Generally, the management of breast disease in children and adolescents is different from that in adults. Special surgical consideration needs to be placed on maintaining lactation ability, preserving the developing breast parenchyma through minimal injury of the breast, and achieving good cosmetic results because of the patients’ young age. A further consultation with a plastic surgery specialist may also be required, especially in those cases when breast symmetry is not easily achieved after a standard lump excision. Patients need to receive appropriate counseling and to be closely followed up for future breast masses or abnormalities that may form as they progress through adolescence and adulthood. In summary and based on our review, the authors conclude that ultrasonography is the most common method of evaluation and total lump excision is the most common treatment option. Therefore, ultrasonography is recommended as an initial diagnostic tool. However, the currently available data do not suffice for the purpose of proposing standard recommendations for adolescent patients presenting with such breast lesions.","title":"Giant Juvenile Fibroadenoma: Case Report and Review of the Literature"}
{"_id":"7afb6487-0af5-8053-82c2-ee4e1f518141","text":"There are several limitations to this analysis. For one, as randomized clinical trials exploring this therapeutic approach are lacking, the majority of included studies were retrospective in nature and of varying levels of quality. There were also inconsistencies among studies with respect to the standards used for patient inclusion, and parameters such as PSA levels or age cannot be controlled for in our pooled analyses. Moreover, one of the included literature focused on patients that had undergone cryosurgery, in contrast to open or robotic surgical approaches [30]. Cryosurgery is well tolerated as it is associated with reduced intraoperative blood loss and decreased trauma and has an impact on the overall survival benefits of patients. Our results are inevitably impacted by the short follow-up duration and the limited numbers of patients in the included studies. There was also substantial heterogeneity among these studies with respect to the stage of metastatic prostate cancer patients included in the corresponding analyses, further complicating the interpretation of these results and underscoring directions for further research.","title":"Cytoreductive prostatectomy improves survival outcomes in patients with oligometastases: a systematic meta-analysis"}
{"_id":"7b022ce4-53f7-ab13-3a54-6cd067b4cc93","text":"Both devices were tested to assess the amount of distal embolization generated during a simulated thrombectomy conducted in the flow circuit described above. A piece of tubing filled with the simulated thrombus described above was attached to the 3D printed housing in the flow circuit. A catheter was inserted into the flow setup as described above.","title":"Multimodal thrombectomy device for treatment of acute deep venous thrombosis"}
{"_id":"7b044b0d-8fd9-9629-2b89-01098e701099","text":"Popliteal artery is the main artery which supplies the leg and foot by its branches—anterior and posterior tibial arteries. Anterior tibial artery enters anterior compartment through the upper opening in the interosseous membrane and supplies anterior compartment and dorsum of foot. Posterior tibial artery descends down in the posterior compartment and supplies both posterior and lateral compartments of leg and sole of foot. Dorsalis pedis artery begins in front of the ankle joint midway between the malleoli as a continuation of the anterior tibial artery. It runs on the dorsum of foot anteriorly over the dorsal aspect of the talus, navicular and intermediate cuneiform bones till the proximal end of the first dorsal intermetatarsal space and passes inferiorly as the deep plantar artery between the heads of the first dorsal interosseous muscle to complete the plantar arch in the sole of foot with the lateral plantar branch of posterior tibial artery.","title":"Variations in the origin, course and branching pattern of dorsalis pedis artery with clinical significance"}
{"_id":"7b090b5f-2780-fc71-7291-be912524c018","text":"Sometimes a commissuroplasty is needed to correct the asymmetry which resulted from oral commissure reconstruction. Care must be taken during commissuroplasty to avoid excessive disruption of the orbicularis musculature that could result in oral incompetence.","title":"Lip Reconstruction after Tumor Ablation"}
{"_id":"7b0d9a99-0eee-f3ba-d610-914ad578ee2f","text":"A biodegradable drug delivery system would have the merit of avoiding the removal of drug carrier which normally involves a secondary surgery. Furthermore, the discharge rate of antibiotics can be fine-tuned in a biodegradable system, which can be attributed to the properties of the material. The solubilizing property of the carrier does not prevent new bone from growing into the defective site, and the calcium component of the beads serves to replace the bone mineral.","title":"In vivo efficacy of tobramycin-loaded synthetic calcium phosphate beads in a rabbit model of staphylococcal osteomyelitis"}
{"_id":"7b1054bb-d018-9c3d-297f-c34414d2e5af","text":"All patients were clinically followed up for 6 months postoperatively to monitor for symptoms of delayed or recurrent VTE. No delayed VTE was diagnosed after discharge, nor were any other complications related to the use of chemoprophylaxis.","title":"Short-duration chemoprophylaxis might reduce incidence of deep vein thrombosis in Asian patients undergoing total knee arthroplasty"}
{"_id":"7b1f459c-66a2-5d7b-85c8-6d8bccf75c14","text":"Despite the fact that the publications described above all favored adjuvant radiotherapy for PNI, the addition of radiation treatment is not consensual and the NCCN guideline only recommend a multidisciplinary consultation and the consideration of adjuvant radiotherapy in the case of PNI involving large or named nerves [10].","title":"The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer"}
{"_id":"7b214d8c-39d9-5b50-b8f1-c76b39a6e552","text":"Sentinel lymph node biopsy is controversial in the prophylactic mastectomy setting because of the expected advantage of avoiding axillary lymphadenectomy versus the low number of cases it will benefit [26]. Studies addressing this question have included a heterogeneous population of high-risk women. In addition to including only BRCA1\/2 mutation carriers, other notable characteristics of our study included the facts that an MRI evaluation before surgery is part of our standard protocol and that whole specimens of the breast parenchyma were entirely processed and the slides reviewed to confirm histologic findings. Our study population is the result of a systematized assessment by both a Breast Cancer Risk Evaluation Clinic and a Breast Cancer Committee.","title":"The Use of Sentinel Lymph Node Biopsy in BRCA1\/2 Mutation Carriers Undergoing Prophylactic Mastectomy: A Retrospective Consecutive Case-Series Study"}
{"_id":"7b2162b0-4762-2f57-80ba-ebb1439f8d25","text":"Articular chondrocytes have got a long lifespan but rarely divides after maturity. Thus, an articular cartilage has a limited capacity for repair. Periosteal grafts have chondrogenic potential and have been used to repair defects in the articular cartilage. The purpose of the present study is to investigate the differentiation of free periosteal grafts in the patellofemoral joint where the cambium layer faces the subchondral bone and to investigate the applicability of periosteal grafts in the reconstruction of articular surfaces.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"7b2354bb-da41-e1db-6930-1e04e8c324f0","text":"Although there are several limitations including an unknown response rate (due to the secondary dissemination of the survey by national ICOPLAST delegates) and the potential for selection bias based on the distribution method, the diverse demographic data provide some reassurance that we have sourced representative information from ICOPLAST member societies. Although there was an unequal spread of respondents geographically, the fact that all major regions were represented to a varying degree suggests that the findings can be generalized to the growing ICOPLAST community.","title":"Establishing Priorities for the International Confederation of Plastic Surgery Societies"}
{"_id":"7b29c9ff-c4be-d596-714c-929439f7014f","text":"A study of women from Sergipe (a city in Northeastern Brazil) demonstrated that they paid for imaging tests for breast lump detection and diagnostic confirmation [45]. They chose to pay for consultations and imaging tests as they realized it would be difficult to have access to tests through SUS and because they were aware of the delay in testing and results.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"7b2ea52f-cd59-475e-472a-a56dee80a7ce","text":"This randomized clinical trial found similar efficacy and reoperation rates for arthroplasty and fusion 5 years after surgical treatment for cervical radiculopathy. The improvements in all PROMs were sustained at 5 years for both interventions.","title":"Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy A Randomized Clinical Trial Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy"}
{"_id":"7b31afa0-dbc5-dc45-9c73-cb456401e119","text":"The dosage of ALA needs to be reconsidered for clinical use.","title":"Metronomic photodynamic therapy using an implantable LED device and orally administered 5-aminolevulinic acid"}
{"_id":"7b36a381-d078-8527-18b7-4e44bd6924db","text":"Two months later at a follow-up visit she presented with pelvic discomfort and dark brown discharge from her vagina. Clinical examination revealed a stricture at the surgical site resulting in stenosis of the vagina. This stricture was then dilated under anesthesia. The margins of the stricture were surgically resected and the vaginal epithelium was approximated. She was discharged home on postoperative day two. She was again extensively counseled regarding the use of manual vaginal dilation methods in order to prevent recurrent stenosis.","title":"Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision"}
{"_id":"7b3d361d-0c1f-c158-f1cc-98e3e8ec95fc","text":"Embryo banking has several advantages for patients interested in preserving fertility. It provides reassurance to a patient that she will have some potential to conceive if the cancer treatments result in permanent amenorrhea. There is also over 20 years of outcome data for cryopreserved embryos showing no effect on miscarriage, implantation rates, or live birth [26]. A disadvantage of embryo banking is the need to administer ovarian stimulation medications to obtain oocytes for fertilization. Ovarian stimulation is a particular concern for patients with hormonal sensitive tumors such as breast cancer and will be addressed further in this review.","title":"Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review"}
{"_id":"7b3e482f-329c-ea63-0f9e-4f220d1d54c5","text":"The corpse was used for a surgical-anatomical study on the superficial and subfascial vascularity of the gluteal region. When dissecting the right side and detaching the gluteus maximus muscle to display the gluteal arteries and veins no piriformis muscle could be found.","title":"Case report: absence of the right piriformis muscle in a woman"}
{"_id":"7b462bb0-5005-9396-5b64-56acb12205c5","text":"Symptomatic recurrent lesions can be surgically treated once more but tumor excision becomes harder by formation of scar tissue resulting from the previous interventions. Even so, surgery is the most effective and curable method to remove oppression and relieve symptom for the spinal lesions. Radiotherapy once used for a repeatedly recurrent epidermoid cyst in the spine and received a relatively good result of controlling tumor growth and alleviating pain, while chemotherapy was considered useless and had never been used.[ Given that the patient had received 3 surgeries and relapsed for 3 times, we decided to adopt extended excision of the lesion with adjuvant therapies of intraoperative local chemotherapy and postoperative radiotherapy. The results were inspiring that complications of chemotherapy and radiotherapy did not appear, pain and neurologic deficit recovered well, and no recurrence has been found until now.","title":"Repeated recurrent epidermoid cyst with atypical hyperplasia A case report and literature review"}
{"_id":"7b4e73f0-1200-f465-f942-24baaafdfd68","text":"The presence of hematoma had a toxic effect which lead to flap necrosis and infection. So all the suspected cases of hematoma were well evaluated and transferred to operating room for evacuation. In our study, only one case needed removal of tissue expander because of uncontrolled bleeding within 24 hours of surgery, rest of the cases were managed without much difficulty. Additionally, 2 cases in our study had a severe infection on operated site, 3 weeks after stage I surgery. Infection was not controlled by antibiotic and dressing which lead to the exposure of the tissue expander.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"7b5088e1-5ea4-3c21-7885-ca074fc4eb17","text":"Hematogenous spread of tumor cells from a primary tumor can be considered as a crucial step in the metastasis cascade that can lead eventually to the formation of clinically manifest metastases [2]. Although it is likely that only a small percentage of the tumour cells that are shed into the peripheral blood will successfully lodge and continue to proliferate in distant sites, the presence of these cells within the circulation indicates that the disease has progressed to a stage where metastasis is possible. Indeed, the clinical relevance of the use of methods for the detection of tumour cells disseminated via peripheral blood has already been demonstrated by several studies of samples from patients with solid epithelial cancers including breast, prostate and colorectal [3,4]. The use of methods for the detection of haematogenous spread of tumour cells from head and neck squamous cell carcinomas (HNSCCs) may also prove to be of clinical relevance for patient prognosis, staging and monitoring of therapy.","title":"Long term survival following the detection of circulating tumour cells in head and neck squamous cell carcinoma"}
{"_id":"7b5af233-f07d-c28b-38fd-93fc34af8f26","text":"There was no majority support for a fellowship match among program directors and recent fellows and less support among recent fellows. Recent fellows appear more satisfied with the current selection and application process than program directors.","title":"The Radiology Fellowship Application and Selection Process in the United States: Experiences and Perceptions from Both Sides"}
{"_id":"7b5b3fa8-e2e4-6f49-63bf-679534c589a5","text":"It is also important to highlight that even though local tomography is associated with image distortion and small perturbations in the image intensity, such artefacts are particularly a matter of concern in regions close to the boundary of the field of view and thus have been avoidable in our study. Furthermore, SR CT presents some advantages when compared with desktop X-ray sources; for instance, beam hardening effects are not present in SR CT since the radiation is monochromatic, in addition the fast acquisitions minimise artefacts related to sample movement or thermal stability.","title":"Simultaneous visualisation of calcified bone microstructure and intracortical vasculature using synchrotron X-ray phase contrast-enhanced tomography"}
{"_id":"7b5d3af3-2811-60bb-46c1-d3eb893e14f4","text":"In conclusion, preoperative ultrasound-guided single TPVB and ESPB for thoracoscopic pulmonary lobectomy could reduce the VAS of postoperative pain in patients and decrease the perioperative sufentanil and postoperative remedial analgesic medications.","title":"Ultrasound-guided single thoracic paravertebral nerve block and erector spinae plane block for perioperative analgesia in thoracoscopic pulmonary lobectomy: a randomized controlled trial"}
{"_id":"7b5e7327-b4e7-949c-6fce-e56b96b5edab","text":"The goal of this retrospective study was to compare and characterize these infections with respect to the location of the grafts and to find treatment factors associated with a beneficial clinical outcome. The overall goal of the study was achieved in terms of establishing, that the location of a graft does influence the characteristics and treatment outcomes for PVGI, and that rifampicin-based antimicrobial regimens might be independently associated with a higher cure rate.","title":"Surgical and Antimicrobial Treatment of Prosthetic Vascular Graft Infections at Different Surgical Sites: A Retrospective Study of Treatment Outcomes"}
{"_id":"7b65128c-8fa2-b6f6-7186-467984d65b3f","text":"PRISMA flow chart of search results showing sources of records and exclusions at each stage of the review","title":"What are the risks of manual treatment of the spine? A scoping review for clinicians"}
{"_id":"7b680add-ac40-9048-8b21-b7d006f438ae","text":"Saphenous vein or its branches are commonly used as vein grafts because of its accessibility. It is placed in a reversed position to allow free blood flow via the venous valves when used as vessel graft. Although vein grafts are often seen as a savior, the use of vein grafts also has disadvantages, requiring surgery in another healthy part of the body. On the other hand, one of the main problems with the use of saphenous vein grafting is the size discrepancy. The diameter of the saphenous vein is considerably larger than the medial and lateral digital proper arteries, and primary anastomosis of the great saphenous vein to the lateral proper digital artery is very difficult because of this size discrepancy. This can lead to thrombosis in the anastomosis. The muscular layer of veins is weaker than arteries and is more sensitive to hemodynamic instability. In cases where long vein graft use is required, hypotension may result in collapse and thrombosis in the vein due to weak bending resistance of vein graft [15–17].","title":"A new method for second toe flap revascularization in plantar dominant artery pattern - dorsal metatarsal artery interpositional graft"}
{"_id":"7b683ad8-17af-6664-1c88-0fb663782734","text":"Not all plastic surgeons have the chance to be trained at a center with a high volume of microsurgical operations and breast reconstructions. As a result, some or many of them may never begin or give up quickly after the first complications occur.","title":"Breast Reconstruction with DIEP Flap: The Learning Curve at a Breast Reconstruction Center and a Single-Surgeon Study"}
{"_id":"7b711de4-ec41-6f91-f551-8064023321d6","text":"Having knowledge about minor complications of rhinoplasty will help us to know which of these complications needs prompt medical intervention and which of them will resolve with time and just needs giving reassurance to the patient.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"7b72e876-5915-a3c1-0937-44a917431e47","text":"The lymphoscintigraphic image available before surgery is of great value as it allows the detection of the location and the presence of one or more lymph nodes to direct the surgeon before surgery.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"7b765e97-d5e7-7822-71e2-300050d995d9","text":"Carpue found a description of this Indian technique, giving rise to the modern era of nasal resurfacing with the use of a pedicelled forehead flap. Kazanjian advanced the development of the forehead flap by advocating primary closure of the forehead donor site. In the current case study, the ultimate deformity was smaller than the original defect and reconstruction with a midline forehead flap was successful.","title":"Use of Forehead Flap for Nasal Tip Reconstruction after Traumatic Nasal Amputation"}
{"_id":"7b7a9c62-f47f-9e54-1ea0-8b5e61eb8ddb","text":"Increased total treatment time is associated with an increased risk of local relapse.72 80If external beam radiotherapy and brachytherapy are carried out at different centers, the external beam radiotherapy center should ensure that the patient is referred sufficiently early in the treatment process (preferably before the start of external beam radiotherapy) so that the total overall treatment time is not prolonged. If such a process is not feasible, it is recommended that the patient is referred for her whole treatment in the center with the brachytherapy facility. Maximum tumor regression is achieved after the patient receives an external beam radiotherapy dose >36 Gy. Ideally, brachytherapy should be performed after the patient receives a minimum dose of ≥40 Gy but for logistic purposes, it is acceptable to schedule brachytherapy after the patient has received a total external beam radiotherapy dose >36 Gy. Such organization may help in keeping the overall treatment time as short as possible in patients with low volume or well responding tumors. For patients with advanced disease, the maximum external beam radiotherapy dose should be delivered (45 Gy) to take advantage of tumor regression at the time of brachytherapy.","title":"ESGO\/ESTRO quality indicators for radiation therapy of cervical cancer"}
{"_id":"7b7ae2e4-31fe-c55e-f304-ffc388077261","text":"Correlation between the lymphocytic peritumoral infiltrate and the sentinel lymph node status","title":"Immunological aspects predicting metastatic sentinel lymph node in early breast cancer patients"}
{"_id":"7b82d5ce-ad56-85ee-8e99-b76b82f4e4b1","text":"The strength of our study relies on the selection of cases for sonographic evaluation within 14 days of delivery, with the majority performed up to 7 days before delivery. Additionally, sonographic evaluation was undertaken by highly experienced ultrasound technicians or physicians who were ultrasound specialists.","title":"The Accuracy of Sonographically Estimated Fetal Weight and Prediction of Small for Gestational Age in Twin Pregnancy—Comparison of the First and Second Twins"}
{"_id":"7b915fb5-f62c-d03f-b7aa-5cea0c01efda","text":"The antibiotics used in the treatment of implant-related infection have been studied extensively over many years. The main target for these studies has been S aureus owing to it being the most common infective organism although the most important factor when deciding on the choice of antibiotics is the microbiological cultures. Rifampicin has been shown to be one of the most effective antibiotics, especially when used in combination with daptomycin.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"7ba386bb-2dfd-b471-9e06-0de5e7a31b96","text":"Although venous and arterial thrombotic disease have been historically regarded as distinct diseases with differing etiologies, these two classes of thrombotic events share common characteristics. Both hypercoagulability and inflammation contribute to the development of arterial and venous thrombi, and risk factors for the two diseases are not altogether dissimilar. However, the magnitude of arterial risk associated with a previous arterial thrombosis is not as high as that associated with a previous venous thrombosis and vice versa, so that the etiology of these two thrombotic diseases may be distinct.","title":"Hydroxyurea prevents arterial and late venous thrombotic recurrences in patients with myeloproliferative neoplasms but fails in the splanchnic venous district. Pooled analysis of 1500 cases"}
{"_id":"7babd915-c92d-1da7-3cb7-bbf5ba2b7f83","text":"In this study, we employed a hematogenous osteomyelitis mouse model to investigate this condition on different imaging length scales. Alterations in the behaviour and movement patterns of the mouse mirrored the complications seen in humans with osteomyelitis. An in-depth analysis explained the cause of the movement restrictions with a deformed bone architecture seen in an X-ray analysis and extensive lesions observed on a microscopic level.","title":"Insights into S. aureus-Induced Bone Deformation in a Mouse Model of Chronic Osteomyelitis Using Fluorescence and Raman Imaging"}
{"_id":"7bacf31e-71ee-2d96-03a7-7d124641217d","text":"In patients with suspected VTE with a low pre-test probability, the application of an AADD appears to safely increase the proportion of patients in which VTE can be excluded without the need for reference standard imaging.","title":"The application of an age adjusted D-dimer threshold to rule out suspected venous thromboembolism (VTE) in an emergency department setting: a retrospective diagnostic cohort study"}
{"_id":"7bb212d4-bad5-e379-f10a-068278eead89","text":"The procedure is similar to that with the radioactive tracer but only in the operative phase. A volume of about 5 mL, consisting of 2 mL of magnetic tracer and 3 mL of saline solution, is injected in the periareolar or perilesional area and for 5 min the inoculation area is massaged in order to speed up the lymphatic drainage. After about 20 min (in the case of elderly or overweight patients, the migration of particles requires more time), the search for the sentinel lymph node is initiated by passing the magnetometer probe along the axillary cord. Once a discrete signal is detected, an incision is made and the search for signal is continued from the inside; access can also be made by exploiting a previous surgical breach.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"7bb62ffd-1b8c-9d43-d1e5-b96b6cd4a6bf","text":"This patient was diagnosed with a middle thoracic oesophageal squamous cell carcinoma by both a gastroscopy and a biopsy. We routinely perform radical resections of oesophageal carcinomas with an intrathoracic oesophagogastrostomy. In this case, the superior edge of the tumour was located at the back of the azygos arch and adhered tightly to it. The dilated gastric tube could have put pressure on the azygos vein and the azygos arch, which may have caused a blockage of the venous return from the lower limbs, pelvic area and abdomen. In addition, the enlarged azygos arch could have put pressure on the anastomotic stoma, which may have resulted in an anastomotic fistula. Therefore, a McKeown oesophagectomy was performed for this patient, and the gastric tube was pulled from the back of the sternum to the neck to perform the anastomosis.","title":"Oesophagectomy in a patient with azygos vein continuation of the inferior vena cava: report of a case"}
{"_id":"7bb95808-491b-84a8-55ae-29f33cb0684c","text":"Patient were asked to contact the physician if a reactions occurred in the days following the provocation test in order to identify delayed reactions.","title":"Comprehensive allergy work-up is mandatory in cystic fibrosis patients who report a history suggestive of drug allergy to beta-lactam antibiotics"}
{"_id":"7bbeaa1c-4f60-1a4e-bf87-0f7589427e3f","text":"We have shown in our case series that free vascularized fibula transfer has gained an important place in the field of skeletal reconstruction and is a reliable method for various bone reconstructions.","title":"The Use of Free Fibula Flap in Different Extremities and Our Clinical Results"}
{"_id":"7bbeb75e-860d-ade2-442d-fc906b4f9688","text":"The combined action of these enzymes contributes to an efficient removal of peroxide from the blood and this does not allow to reach systemic doses of H2O2 that could be effective against cancer cells.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"7bc85f88-b495-97a0-d5f4-66808ef74b48","text":"The Ordinances were not created from new and the preamble shows that in accordance with the 1503 Act, the Masters and Governors of the Fellowship of Barber-Surgeons had submitted their old ordinances for review. Leaving these lines in the original form gives an idea of the phrasing of the whole document;","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"7bc9d160-71e2-2297-5b07-4ae503d4ac16","text":"Therefore, mitochondrial targeting and preventing the quenching of photosensitizers are the main solutions to solve the problem of short singlet oxygen lifetime and short diffusion distance of ROS in PDT. Good dispersion of photosensitizers is a useful way to solve their photophysical quenching issue, which can maximize the application of photosensitizers in the cancer treatment.","title":"Solutions to the Drawbacks of Photothermal and Photodynamic Cancer Therapy"}
{"_id":"7bcaa31c-6d44-e278-d002-51414d737570","text":"We have transferred the complete LD muscle with a suitable skin paddle to the dorsal forearm through a gutter at the lateral border of the arm in 5 patients. The transfer is bipolar and muscle insertion is sutured to the dorsal upper arm muscles and deep fascia. The TFL tendon is harvested and passed through a slit in the muscle and fixed to the extensors of the wrist and fingers at a separate incision. All the previous authors have tried to lengthen the LD muscle by gluteal fascia, but we think adding a tendon graft between the LD muscle and the extensors is stronger because proper tension can be applied to the muscle without fear of ischemia to the muscle and suture disruption at the extensor-muscle junction. An external fixator holds the elbow in flexion and the wrist and fingers in extension. A literature review revealed no similar technique. Total muscle transfer with added tendon graft has far superior activity than the partial muscle transfer sutured directly to the extensors. The results have been uniformly good, with less revisional reefing of muscle and satisfactory extensor action on joints, and a good range of motion is obtained.","title":"Case Report: Modified Latissimus Dorsi Muscle Transfer for Radial Palsy, Presentation of a New Technique"}
{"_id":"7bcc7891-d5e6-450c-f806-2299b1c73a06","text":"On the morning of the surgery 4 ml of Tc99 sulfur colloid was injected peritumorily and scintigraphic images were taken 4 hours later. The scintigraphic image showed one sentinel node in axilla and other in supra clavicular fossa (figure 2). At surgery 4 ml of isosulfan blue was injected peritumorilly and sentinel node identification was carried out by combined method. On exploration of axilla the blue and hot sentinel node was identified and removed. However, hand held probe failed to pick a hot spot in supra clavicular fossa axillary dissection was completed.","title":"Fallacies of preoperative lymphoscintigraphy in detecting sentinel node in breast cancer"}
{"_id":"7bdc0561-ac72-cb3e-1b6d-df416be90391","text":"The primary aim of this study is to determine the incidence of postoperative VTE following TKA in our local population with and without additional chemoprophylaxis in addition to routine mechanical prophylaxis in all patients. The secondary aims are to assess possible risk factors associated with VTE and to compare the 2 year functional outcomes of patients with and without postoperative VTE. We hypothesize that the rate of VTE in TKA patients is comparable to that of Western populations, and that there would be no differences in terms of functional outcomes between patients with and without postoperative VTE.","title":"Chemoprophylaxis in addition to mechanical prophylaxis after total knee arthroplasty surgery does not reduce the incidence of venous thromboembolism"}
{"_id":"7bebbc6e-c124-d8ec-c80e-283840ec0b3f","text":"The results of the present study revealed that a single preoperative ultrasound-guided ESPB also reduced the intraoperative sufentanil consumption and shortened the awakening and extubation time compared with the control group without nerve block, suggesting that general anesthesia combined with a single ESPB could provide effective intraoperative analgesia and good awakening in patients undergoing thoracoscopic pulmonary lobectomy. It was assumed that the possible reasons were, after the preoperative administration of a single ESPB, local anesthetics injected into the interstices of the erector spinae and transverse spinal processes could spread cranially and caudally along with the deep layers of the thoracolumbar fascia, blocking the ventral and dorsal branches of the thoracic spinal nerves and the traffic branches of the adjacent segments, and some drugs could also block the sympathetic nerves and result in suppression of visceral pain [17].","title":"Ultrasound-guided single thoracic paravertebral nerve block and erector spinae plane block for perioperative analgesia in thoracoscopic pulmonary lobectomy: a randomized controlled trial"}
{"_id":"7bf2e0d5-b471-020d-dfa6-3252596ee633","text":"In our study, the use of an autologous bone graft harvested from the distal radius bone decreased the complication ratio as well as the duration of hospitalization when compared with that harvested from the iliac crest bone. We preferred to use an autograft harvested from the distal radius bone in patients with a tumor size of approximately <1 cm² and female patients with cosmetic concerns. These patients were operated under regional anesthesia and were discharged on the same day. In addition, donor site pain in the iliac crest or related thigh numbness and wound infection were not observed in these patients who had grafts harvested from the distal radius bone.","title":"Surgical Treatment of Solitary Enchondromas of the Hand"}
{"_id":"7bfadef3-6daf-7603-0ab8-d7cdd8a293d1","text":"There are no clinical or laboratory features to plead for the pre-malignant or malignant character of a lower lip tumor, consequently histopathology examination is used for the diagnosis of the lesion, especially because often, the clinical appearance of a premalignant lesion corresponds to the appearance of a histopathology confirmed squamous cell carcinoma. Due to the high percentage of the malignant transformation of precancerous lesions, particularly in the form of squamous cell carcinoma, the surgical attitude should be the excision of the lower lip tumor in oncological safety margins followed by the reconstruction of the lip.","title":"Surgical attitude in premalignant lesions and malignant tumors of the lower lip"}
{"_id":"7c044460-b935-c022-5c45-de4955c45b22","text":"We feel that one of the important reasons for poor knowledge and perception of plastic surgery in our survey is inadequate training and exposure of plastic surgery at undergraduate level. There has been much discussion in the western literature regarding if there is a place for plastic surgery in the undergraduate curriculum. As outlined by Wade et al. [6] many undergraduates are in favor of having plastic surgery teaching even though many may not necessarily want to pursue a career in the specialty. The portrayal of plastic surgery in the media is frequently that of purely elective cosmetic operations and this is often the understanding that undergraduates have of the Specialty until they do further research and discover the main workload carried out by a plastic surgeon. Undergraduate exposure is the single most influential factor for subsequent career interest in plastic surgery [7] with the duration of specialty exposure directly proportional to subsequent career intentions [8]. Given the inherent difficulties of changing our university curriculum, a simple but effective solution to increase plastic surgery exposure to all our medical students is required. A career in plastic surgery day has been held at the Royal College of Surgeons in London with talks from surgeons in different subspecialties and on careers in the profession, in addition to surgical skills practical sessions under the supervision of trainees in the profession [9]. An attempt to introduce a similar module can be made at other places as well. These conferences can give students a good insight into the specialty. Teaching undergraduate plastic surgery has potential benefits to all future doctors and ultimately patients, irrespective of career intentions. Exposure to plastic surgery may not lead to the development of a career interest in plastic surgery [9]. However, this is still an important reason to encourage undergraduate teaching, as a negative decision allows students to choose more suitable career paths. Given the multidisciplinary nature of plastic surgery and the abundant team working with other medical and surgical specialties, it is important that nonplastic surgery colleagues are aware of the work carried out by plastic surgeons. Referrals will therefore be more accurate, resulting in a more efficient and higher quality of service delivered to patients [9].","title":"Awareness and Perception of Plastic Surgery among Healthcare Professionals in Pune, India: Do They Really Know What We Do?"}
{"_id":"7c044c2c-3516-bd04-25eb-4730bdc5dab5","text":"Low molecular weight heparin (LMWH) which is currently recommended to be one of the preferred drugs for thromboprophylaxis has many potential disadvantages like increase in the total cost of treatment and bleeding complications. McNally et al.,22 have also stated that increased incidence of bleeding complications like excessive bruising around the wound and increased wound bleeding or hematomas with the use of LMWH has prevented their routine use in joint replacement, as was the case with unfractionated heparin in the past. We, therefore, wonder how far we are justified in subjecting all the patients undergoing arthroplasty or fracture surgery in the lower limb to routine chemoprophylaxis which could increase the risk of hematoma formation, infection, a re-operation and a prolonged hospital stay and put more burdens on the already stretched financial resources of the patient.","title":"Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?"}
{"_id":"7c12edb1-c067-cb57-433e-7b5207a353ff","text":"Additional areas for improvement come within the intrinsic structuring of departments. It has been found that within these selected surgical subspecialties having specific subspecialty members on medical school faculty improves match rates for candidates applying from their institutions [19]. This was studied within NSGY where it was found that schools with higher numbers of NSGY faculty in their medical schools have better match rates in neurosurgery [19]. This is theorized to be due to the increased early exposure, research projects, mentorship, and education within that surgical subspecialty allowing for improved success in audition rotations, interviews, and for candidates creating successful applications. A direct benefit would be creating a Surgical Chair position at every osteopathic medical school to be the liaison for students pursuing surgical training. This Chair would be able to help students make connections to surgeons in their chosen field to fortify the previously discussed aspects of ensuring a successful match.","title":"Comparison of Osteopathic (DO) and Allopathic (MD) Candidates Matching Into Selected Surgical Subspecialties"}
{"_id":"7c137310-1817-f93e-e85d-f4fe9dc3c889","text":"A current matter of debate relates to extension of chemoprophylaxis after discharge. During the study period, we did not routinely utilize extended chemoprophylaxis. Guidelines from CHEST released in 2012 suggested extending chemoprophylaxis for 30 days after surgery in cancer patients who are high risk for forming VTE and for whom there is no contraindication to anticoagulation, but there is no recommendation for patients undergoing abdominal surgery for reasons other than malignancy. There is still a paucity of evidence regarding extended chemoprophylaxis for VTE prevention in noncancer patients.","title":"The Pathway to Low Outlier Status in Venous Thromboembolism Events: An Analysis of Pancreatic Surgery in the National Surgical Quality Improvement Program"}
{"_id":"7c1556e9-6bc0-c298-b53a-26a641efd300","text":"Retrograde anatomy searches for the musculocutaneous perforator in the plane of the external oblique aponeurosis and then cuts the obliquus externus abdominis according to the course of it, thus avoiding serious injury of the external oblique muscle caused by traditional anterograde anatomy. In addition, retrograde anatomy only needs to ligate the musculocutaneous artery from the inner side of the vessels, while the branches from the outer side of the vessels that enter the inner plate to nourish the iliac bone are not interfered, so that intraoperative bleeding can be minimized. The whole procedure of retrograde anatomy is required to be carried out using microscissors and mosquitoclamp under microscope. In this way, the precision of surgical manipulation can be improved and the intraoperative bleeding, lateral femoral cutaneous nerve injury, and ectopic ossification can be effectively reduced. During the operation process, the suitable separation plane of the deep circumflex iliac artery can be selected according to the diameter of the vessels in the recipient area so as to improve the success rate of iliac bone flap transplantation. The cutting method of retrograde iliac bone flap is similar to the idea of \"retrograde anatomical\" perforator flap. In both cases, the main vessels of the graft are dissected after confirming the reliability of the perforator vessels of the graft (suitable for the required length and corresponding vessel diameter of the donor area) [46, 47]. For the above advantages, it can be considered that retrograde anatomical iliac bone flap transplantation technology is worthy of further exploration and promotion.","title":"Comparison of retrograde anatomy iliac bone flap grafting versus anterograde anatomy iliac bone flap grafting for treatment of osteonecrosis of the femoral head"}
{"_id":"7c15eb98-8c7e-e09e-d4d5-6b1c33fd66bd","text":"Our observations suggest that hedgehog pathway inhibitors may be an additional therapeutic strategy against B-RAF mutant melanoma. As activated RAS\/MAPK signaling has been shown to induce hedgehog pathway activity via translocation of GLI1 and GLI2 into the nucleus, it is possible that B-RAF mutation is augmenting hedgehog pathway activity in our melanoma cell lines and that inhibiting both B-RAF and the hedgehog pathway may result in an enhanced therapeutic effect. Our data demonstrate a modest but significant effect of combining B-RAF and hedgehog inhibitors, but additional studies of the dosage and sequence of administration in vivo are necessary to better define a clinically useful regimen. Whether SMO inhibition might be effective in vemurafenib resistant B-RAF mutant tumors is currently under investigation in our laboratory.","title":"Hedgehog Pathway Blockade Inhibits Melanoma Cell Growth in Vitro and in Vivo"}
{"_id":"7c17e701-509e-98d8-be0d-eb8be7ddf6ba","text":"Antimicrobial therapy was considered empirical in the absence of previous microbiological documentation. It was considered appropriate when all pathogens highlighted by gold-standard sample cultures were targeted by at least one molecule.","title":"Osteocutaneous-flap-related osteomyelitis following mandibular reconstruction: a cohort study of an emerging and complex bone infection"}
{"_id":"7c1a0124-3fe4-f8f2-05ec-b151e60b3ebf","text":"Several lines of experimental research in animals have provided evidence of lymphatic drainage from CNS to the cervical lymph nodes along cranial nerves and through the cribriform plate. However, the existence of functional, classic lymphatic vessels within the CNS has been disputed. A recent breakthrough was the demonstration of functional dural lymphatic vessels. It has been proposed that these dural lymphatic vessels may represent the anatomical continuation of the glymphatic system, though it has not been established how the glymphatic system communicates with meningeal lymphatic vessels. It has previously also been suggested that interstitial solutes are drained from the glymphatic system into CSF before resorption into meningeal lymphatics. The present observations, demonstrating that lymph node enhancement coincides with glymphatic, rather than CSF enhancement, favors resorption into lymphatic pathways directly from the glymphatic perivenous space. We therefore hypothesize that the perivenous compartments of the brain and lymphatic vessels are interconnected rather than that subarachnoid CSF and substances drain directly to the meningeal lymphatic pathways.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"7c1bd59a-9c05-0ff4-3a63-b9523c6d5b5d","text":"History of antibiotic consumption in the previous year, particularly quinolones or macrolides","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"7c1d41b7-1f3f-5e85-ed62-5fad70cb9a5f","text":"Fifthly, performing frenotomy in the experimental group without any anesthesia could possibly be unethical. Authors might have influenced IRB to do away with anesthesia as it may unmask blinding in the experimental group. Despite this precaution, the blinding methodology could still be imperfect. It may not be impossible for an intuitive mother to suspect frenotomy from the painful cry of neonates of the experimental group as compared to calm newborns of sham group. Further, the blinding is only ultra short-lived until the first feeding. Lack of long-term evaluation is certainly the biggest demerit of the study. The issue is made murkier by the crossing over of the two groups when most of the mothers of the sham group opted for frenotomy within first few weeks of the study.","title":"Release of Tongue-Tie in Neonates"}
{"_id":"7c1e03e2-f471-3e24-1c05-f99836e37e73","text":"Other limits are the sampling or interpretation errors of the specimen.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"7c21ffd0-9dd6-3650-feb7-cf9c871b9c94","text":"It is known that ankylosing spondylitis involves fibrocartilagenous structures such as the symphysis pubis and the intervertebral discs, the hallmark being enthesopathy with a tendency to bony ankylosis in the affected joint.","title":"Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis"}
{"_id":"7c272db3-52eb-c7bc-7e91-c19e27ce26d6","text":"The artery may be larger than the normal to compensate small lateral plantar artery. It may be absent. Sometimes an enlarged perforating branch of peroneal artery continues as dorsalis pedis artery. There are reports of lateral deviation and bifurcation of the dorsalis pedis artery. The dorsalis pedis artery is best for pedal revascularization since it is the largest artery distal to the ankle joint. The dorsalis pedis flap is one of the most commonly used foot flaps in traffic accidents, electrical burns, industrial injury, ulcer etc. Fasciocutaneous flaps are used for covering defects of the hand.First dorsal metatarsal artery is the most widely used arterial pedicle in toe to finger transplants. More recently dorsalis pedis fasciocutaneous flaps are used in the reconstruction of oral cavity defects in cases of oral cancers patients. Osteomyocutaneous peroneal artery perforator flap is being used for reconstruction of the skull base after craniofacial resection in the treatment of malignant cancers which results in the defects of the skull base. In diabetic patients, critical limb ischemia due to occlusions of the lower limb vessels is becoming more common, therefore knowledge of these arteries is needed in order to avoid amputations. Aneurysms and pseudoaneurysms of the dorsalis pedis artery are rare vascular complications usually caused by traumatic injury or iatrogenic intervention especially after ankle arthroscopy.","title":"Variations in the origin, course and branching pattern of dorsalis pedis artery with clinical significance"}
{"_id":"7c282217-e6e0-002c-a22a-c76185b1e34d","text":"Different types of calcifications may occur in the head and neck region, and they need to be distinguished from dystrophic calcification by thorough history taking, clinical examination together with blood testing and radiographic examinations.","title":"Dystrophic Calcification in the Oral Cavity Resulting in Mechanical Dysphagia: A Case Report and Review of Calcification in the Head and Neck Region"}
{"_id":"7c2a5ea3-8e40-ca75-a215-bd8c0d1c2753","text":"A diagrammatic representation of the methodology used in the study is given in Figure 1.","title":"A Simple In-Vivo Method for Evaluation of Antibiofilm and Wound Healing Activity Using Excision Wound Model in Diabetic Swiss Albino Mice"}
{"_id":"7c2d6aab-fcee-0a49-49f2-786c5ab6cd96","text":"The complete excision of the BCC allows disease control and reduction of relapse considered and is an appropriate surgical treatment which must focalize on the peripheral margin.","title":"Basal Cell Carcinoma: 10 Years of Experience"}
{"_id":"7c30965a-de23-45ac-cff7-6322bfe8bec2","text":"The early recognition of cervical myelopathy in the setting of odontoid pseudo tumor along with prompt surgical evaluation can reduce morbidity and improve spinal cord compression outcomes. In addition, early intervention is crucial in helping patients preserve their baseline functional status.","title":"Retro-Odontoid Pseudotumor with Cervical Medullary Compression: A Case Report"}
{"_id":"7c36b8b0-d843-d222-89fc-4731c9ba524d","text":"The high cost of such a procedure is offset by reduction in time spent in hospital. The spacer also helps to allow mobilization by partial weight bearing on a stable femoral component and provide pain control which improves quality of life as compared to prolonged intravenous antimicrobial therapy.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"7c3ef8aa-e7ef-2831-08df-e2f4f6bbb607","text":"Although the patient is still undergoing treatment for his recurrent DTF, precluding statement about the long-term outcome, the present report is important for raising awareness of an extremely rare condition and highlighting recent management options for PTC-DTF that shows aggressive features with local recurrence of the mesenchymal tumor component. Patients with this unusual tumor should be carefully monitored after thyroidectomy for both recurrent PTC and local recurrence of the fibrous component of the tumor. In patients with recurrent DTF, a multidisciplinary approach is essential.","title":"Papillary thyroid cancer with extrathyroidal extension of desmoid-type fibromatosis. A case report of an aggressive presentation of an uncommon pathologic entity"}
{"_id":"7c4047c8-6fdf-2763-664a-0f07a781eab1","text":"Various methods are introduced to crush the cartilage into desired consistency including cartilage morselizer, and cottle cartilage crusher. Crushed cartilage can be molded more easily and will have less palpable edges beneath the skin. It is easy to prepare and it is not time consuming. But the major problem is that crushing will cause a structural damage to the lacuna of the cartilage and will lead to loss of chondrocyte viability. Cackmack has well described a classification for the extent of crushing and has also evaluated the long term viability and permanence of each class in experimental studies. It is now evident that the more we crush a cartilage, the shorter it will survive as a graft. If a surgeon tends to crush the cartilage to an extent that becomes injectable, this will pose a great chance of future resorption and recurrence of the deformity.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"7c409eb1-ff82-703c-e1f8-2c2a3db9a5f8","text":"Gendered stereotypes about surgical roles persist, and for some this can hinder professional identification with the role. Positive role models and mentoring can encourage and support women who are interested a surgical career to identify with the role, but there is a need for a broader debate encompassing job redesign and surgical identities.","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"7c447b02-57c1-92d9-ffe9-96232d7f5eaf","text":"Costal Cartilage or costa grafts are widely used in the clinical fields because of their good biological compatibility, no rejection and easy survival characters compared with other materials. Autologous costal cartilages can be grafted and carved into the shapes of nasal dorsum or auricula, which are quite common in rhinoplasty and ear reconstruction. Besides costochondral grafts are also considered to be ideal donor tissues for temporomandibular joint reconstruction as there is a low incidence of complications at the donor site, good adaptability to the mandibular ramus and incorporation of the head of cartilage tissue. These advatanges promote the morphological and functional adaptations to the temporomandibular joint.","title":"Characteristics of Chinese Costal Cartilage and Costa Calcification Using Dual-Energy Computed Tomography Imaging"}
{"_id":"7c50b523-aced-afca-b799-75a66db0887a","text":"Since the chemical agent could affect the flap in the opposite, only one side of the rats was used. The other side was not assigned into the control group. The control ears in vascular delay groups were considered as the control group of vascular delay combined with chemical delay.","title":"The creation of new rotation arc to the rat latissimus dorsi musculo-cutaneous flap with delay procedures"}
{"_id":"7c5a404e-f716-7535-21c7-bce8e45f6815","text":"To estimate the validity of CNB in the context of suspected LPD seen in a primary care institution, the following parameters were analysed:","title":"Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital"}
{"_id":"7c5ad963-061a-3157-d066-0d8e7efaea43","text":"Our results confirm that amputation is rarely indicated for the treatment of chronic tibial OM, where there is an option of aggressive limb salvage surgery performed by a specialized multidisciplinary team with experience in aggressive debridement, skeletal reconstruction, and vascularized tissue transfer.","title":"Aggressive Management of Tibial Osteomyelitis Shows Good Functional Outcomes"}
{"_id":"7c62fec8-1581-4f2b-bf94-b0fcd27582da","text":"In the case of invasive ovarian tumors, pelvic and paraaortic LN dissection is part of the standard procedure aiming at complete surgical staging for early stages and at cytoreduction in advanced disease. The role of lymphadenectomy in SBOT remains debated and the prognostic significance of LNI is currently uncertain.","title":"Lymph Node Involvement in Recurrent Serous Borderline Ovarian Tumors: Current Evidence, Controversies, and a Review of the Literature"}
{"_id":"7c670e35-b4a3-ff96-90f2-2b16f2c839be","text":"The first endonasal endoscopic technique used in our study is described as a single mucosal flap technique, where a lateral wall mucosal flap is elevated to expose the lacrimal sac by removing the lacrimal bone. With the ophthalmologist passing the DCR tube, the lacrimal sac is opened longitudinally without creating a flap within the lacrimal wall.","title":"Endoscopic dacryocystorhinostomy: A comparison of double-flap and single-flap techniques"}
{"_id":"7c69e0c1-784c-7e52-dcb8-bfac9db01c59","text":"Assessing the digestibility of a protein is not by itself a sufficient measure of the allergenic potential of a protein and hence we also investigated the effects of digestion on various measures of the allergenic activity of blg and compared the properties of digested and undigested extracts as elicitors of allergic reactions. Indeed, there are some intriguing indications that the inherent stability of proteins and the characteristics of peptide antigens displayed to antigen presenting cells have an impact in various and sometimes contradictory ways on the type of induced immune responses which has clinical indications [43-46]. Due to the diversity of immune mechanisms leading to food allergy, a variety of procedures for predicting allergenic reactivity of food antigens has been developed.","title":"Effect of simulated gastro-duodenal digestion on the allergenic reactivity of beta-lactoglobulin"}
{"_id":"7c6bf56e-e314-b0ba-2caf-0abfca239766","text":"Reconstruction of the facial hard- and soft tissues is of special concern for the rehabilitation of patients especially after ablative tumor surgery has been performed. Impaired soft and hard tissue conditions as a sequelae of extensive surgical resection and\/or radiotherapy may impede common reconstruction methodes. Even free flaps may not be used without interposition of a vein graft as recipient vessels are not available as a consequence of radical neck dissection.","title":"Ateriovenous subclavia-shunt for head and neck reconstruction"}
{"_id":"7c78ddc4-d8d8-a792-4f2a-9e1481d8117c","text":"This article aims to report the challenges encountered in making an accurate diagnosis and surgical management of desmoplastic fibroma of the mandible in a young boy since the clinical appearance and radiologic features were more indicative of a more aggressive tumor. This impression affected the surgical approach to the tumor, and several treatment regimens with various results were used. The treatment was performed at the Oral and Maxillofacial Surgery Department of Aga Khan University Hospital, Karachi, Pakistan.","title":"Unraveling the challenges in the diagnosis and management of desmoplastic fibroma of the mandible–a case report"}
{"_id":"7c7a3f5f-9696-44cd-348a-d38db32bccf0","text":"The aim of this study is to assess the clinical results of bifocal or trifocal bone transport using unilateral rail system in the treatment of large tibial defects caused by infection.","title":"Bifocal or Trifocal (Double‐Level) Bone Transport Using Unilateral Rail System in the Treatment of Large Tibial Defects Caused by Infection: A Retrospective Study"}
{"_id":"7c7d2692-1894-ca22-43b5-762f0468a9f3","text":"This can be explained by preserving the function of the motor unit by choosing the row of medial perforators while harvesting the flap.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"7c86a359-30da-d044-f4e1-de46accac633","text":"Allergic asthma is the most frequent disease among the chronic respiratory disorders in pediatric age with an important social impact. In the last years, many efforts have been made to identify effective preventive approaches to get a better control of symptoms and to obtain the best future outcomes for the patients. In patients with allergic asthma triggered by the exposure to indoor allergens, the avoidance is the first intervention to prevent the appearance or the worsening of bronchial symptoms. This review article summarized the most recent evidence from literature about the efficacy of specific control interventions for the most important allergens. Even if a wide spectrum of interventions has been suggested and may help to reduce exposure to trigger allergy for sensitized patients suffering from respiratory allergy, evidence supporting the efficacy of these approaches is still weak and subject of controversy. However, the exposure control to specific airborne allergens is still widely recommended and may be effective as part of a holistic approach to reduce the severity of allergic respiratory symptoms in sensitized individuals.","title":"Allergen Avoidance in Allergic Asthma"}
{"_id":"7c87fa1d-7fbd-1dda-733f-b5b066a94492","text":"The aim of this paper is to describe the surgical technique and to look at the outcomes related to the use of GMCF in orthopaedic surgery.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"7c8d2e45-4565-8b83-e639-222fc9fc78d3","text":"Future research should focus on the integrated genomic and molecular characterization of DTF samples and include appropriate control tissues to further delineate and understand the biological mechanisms and epigenetic changes involved in the pathogenesis of DTF. The functional significance of the observed differential gene body methylation of CCDC6 in T41A and S45F DTF should be further validated and investigated. Exploration of the dynamic changes in DNA methylation patterns and their consequences for gene expression from tumor onset to tumor progression and\/or regression is of interest too and may provide an explanation for the different clinical behaviors of DTF tumors.","title":"Differentially Methylated Regions in Desmoid-Type Fibromatosis: A Comparison Between CTNNB1 S45F and T41A Tumors"}
{"_id":"7c92065d-73e4-4cde-ab82-0e03b2c36526","text":"The objectives of the study were to determine bacterial flora and antibiotic sensitivity, and to evaluate the outcome of an aggressive surgical approach to chronic osteomyelitis.","title":"Chronic Osteomyelitis - Bacterial Flora, Antibiotic Sensitivity and Treatment Challenges"}
{"_id":"7c9fb1da-eee2-358b-0375-c8af5508f5d4","text":"There are limited data on the long-term effects of cancer therapy on dental growth in pediatric patients in Turkey. The aim of this study is to determine the frequency of DAs in pediatric patients who were treated for cancer and to compare these patients with their siblings with regard to the frequency of DAs.","title":"Long-term Dental Anomalies after Pediatric Cancer Treatment in Children Kanser Tedavisi Gören Çocuklarda Uzun Süre Sonra Görülen Diş Anomalileri"}
{"_id":"7ca012c1-ee81-e871-03e5-25bc2acad5f2","text":"The most effective treatment of malignant melanoma is thought to be a surgical excision of primary tumor and metastatic lesion. The extent of excision should be necessary and sufficient from the perspective of tumor recurrence and postoperative complications, and the determination of indication for lymph node dissection is sometimes difficult.","title":"Long-Term Treatment Outcome after Only Popliteal Lymph Node Dissection for Nodal Metastasis in Malignant Melanoma of the Heel: The Only “Interval Node” Dissection Can Be an Adequate Surgical Treatment"}
{"_id":"7ca898b6-d096-6d53-d863-7b86c1994adc","text":"Comparison of anatomic distribution in primary and metastatic melanoma of colon.","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"7cab1f61-e13b-5d41-af95-558660381560","text":"The movement of dye through the lymph channels forms the basis of sentinel node biopsy. Complications of lymph node biopsy are reported as scaring, blood loss, infection and more rarely nerve damage and lymphoedema. The question remains whether it was necessary to biopsy this lymph node or was the presence of the tattoo enough to give reason for the enlarged node. In this instance the co factor of the weight loss meant that leaving the node would not be reasonable.","title":"Tattoo pigment in an axillary lymph node simulating metastatic malignant melanoma"}
{"_id":"7cae06e8-b533-ddfd-04b3-8b2d6ab09a6b","text":"Back pain can occur after any surgical procedure, and it is mostly attributed to other causes or not taken seriously. It is important to recognize pyogenic spondylodiscitis as one of the possible causes of postoperative lower back pain after cesarean sections or genitourinary interventions, even in patients who do not receive spinal anesthesia.","title":"Pyogenic Spondylodiscitis Following Nonspinal Cesarean Section"}
{"_id":"7cb56fb4-c9ca-d742-0d99-073874301fe4","text":"In the vast majority of the patients in this study diagnosed with malignant and benign lesions, the determination of the lesion on the pre-diagnostic endoscopic nasopharyngoscopy image was seen to be the first finding without radiological examination and findings of disease outside the nasopharynx. Routine endoscopic examination of all ENT patients can be considered necessary.","title":"The role of nasopharyngeal examination and biopsy in the diagnosis of malignant diseases O papel do exame clínico e da biópsia de nasofaringe no diagnóstico de doenças malignas"}
{"_id":"7cb64f4d-38ce-7778-1122-79caca3af98d","text":"Table 3 Outcomes for women using peppermint water and expressed breast milk: objective evidence of nipple and areola cracks, reported pain in the first two weeks, and breastfeeding at six weeks postpartum","title":"Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial"}
{"_id":"7cb8261d-c166-d31b-2090-cf6fb80a21ad","text":"Although some issues concerning the ARM technique have been raised, it remains a useful method to distinguish upper extremity lymph nodes from those of the breast lymphatic drainage system. In this study, to explore the mechanism of lymphedema and identify patients at high risk for lymphedema, we applied the ARM technique in patients who underwent axillary surgery to analyse the correlation between postoperative residual ARM nodes and the incidence of lymphedema as well as the oncologic safety of ARM nodes.","title":"Using the axillary reverse mapping technique to screen breast cancer patients with a high risk of lymphedema"}
{"_id":"7cb88559-38d9-c879-3d93-d621634d7201","text":"The national quality register AuriculA was matched with the NPR at the Swedish national board of health and welfare using personal identity numbers and a common database was created which was anonymised. From this database patients treated with warfarin due to VTE between January 1´st 2006 and December 31´th 2011 with available information about background characteristics in the NPR were extracted.","title":"Venous thromboembolism and cancer risk"}
{"_id":"7cb9de74-a24d-8523-1900-66859c20ee5f","text":"One clear consensus in the literature is that delayed flap compromise portends a very low risk of flap salvage. Largo et al14 reported a series of 10 patients with autologous breast reconstruction presenting with flap compromise after discharge from the hospital, and none of these flaps were successfully salvaged despite reoperation procedures. Of the 47 takebacks in the Mirzabeigi et al15 series, none of the flaps were salvaged beyond 96 hours. In the Chen et al18 series of 1142 free flaps, the lowest rates of flap salvage were reported for those flaps presenting with vascular compromise 1 or more weeks after the initial free tissue transfer procedure. In our case of successful salvage of a recurrently venous-compromised flap presenting as late as 5 weeks postoperatively, expediency of intervention was paramount. Had we not intervened in a timely fashion, it is not unreasonable to suppose that pedicle thrombosis would have resulted. The importance of skilled inpatient monitoring of free flaps cannot be overstated. In practices where patients travel long distances for surgery or in centers abiding by enhanced recovery pathways aimed at minimizing duration of hospital stays, early detection of flap compromise and expedient operative exploration may be problematic.","title":"Successful Salvage of Delayed Venous Congestion After DIEP Flap Breast Reconstruction Katira et al"}
{"_id":"7cba306a-acb1-f08f-550c-01b61e5e7aa3","text":"This study did not account for other possible confounding variables such as microorganism typification or clinical complexity. Furthermore, possible malnutrition and immune compromise can play an important role in a host's ability to clear an infection, and no analysis related to these variables was conducted. It is theoretically possible that inpatient treatment may have had an effect not only in optimizing IV antibiotic administration but also to reduce the exposure to tobacco and improve nutritional status.","title":"Outcomes of Orthopaedic Infections in Recreational Intravenous Drug Users Requiring Long-term Antibiotic Treatment"}
{"_id":"7cbb6a68-32a3-e330-01a7-4a24bf10b774","text":"CTCLs are a unique dermatological malignancy with potential to have favorable prognosis if staged and treated accurately. The case presented of a CD30+ CTCL in a 3-year-old male is a rare event where treatment was altered by a diagnostic procedure well established for other cutaneous malignancies, but not frequently used for CTCL. Although this paper highlights only one case it should bring attention to the utility of a low-risk, high-yield diagnostic procedure such as lymphoscintigraphy with sentinel node biopsy for the accurate staging and management of CTCLs. Further research is certainly indicated to evaluate the rates of asymptomatic, nonradiographic evident node positive cutaneous malignancies. Furthermore the benefit of identifying and treating microscopic disease in nodes and the effect on prognosis should be addressed if trends in sentinel node biopsy as a staging procedure increase.","title":"Radiographically Negative, Asymptomatic, Sentinel Lymph Node Positive Cutaneous T-Cell Lymphoma in a 3-Year-Old Male: A Case Report"}
{"_id":"7cbb967d-b460-b0bb-e6a4-ea8ea86e54c8","text":"In the follow-up checks that occur every 6 months for the first 3 years after cryosurgery and then every 12 months, no local or distant metastatic repetitions have been highlighted and the patient appears to be in an apparent state of good health.","title":"Cryoablation and Immunotherapy: An Enthralling Synergy for Cancer Treatment"}
{"_id":"7ccc6707-50fa-869f-22e8-83bfaae62198","text":"We found that total serum IgE levels and Api m3 sensitization levels were significantly higher in patients showing an adverse reaction to bee venom immunotherapy compared to those who did not experience any complications.","title":"Anaphylactic reactions in the build-up phase of rush immunotherapy for bee venom allergy in pediatric patients: a single-center experience"}
{"_id":"7ccf82d0-c18d-344e-d283-1014cea6dad5","text":"Permanent fillers are fillers that remain for longer than two years in the tissyue. Side effects with permanent fillers tend to be more permanent, and complication is the main issue with any permanent filler. Commonly used permanent fillers available are shown in Table 3.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"7cd23cf3-1928-31d7-4ca7-4e1175a10275","text":"Irrespective of the surgical approach, the success of surgery relies on the complete excision of the diseased tissues. In most cancers, including head and neck cancer, surgery is often the first choice of treatment, depending on the prognostic factors of the patient, the tumor classification, and the potential morbidity associated with acquiring complete resection with negative surgical margins. Frozen section biopsy is the most commonly employed technique for rapid margin assessment. Positive margins with disease present at the periphery of the resected specimen are associated with worse disease specific survival in many tumors. Preventing positive margins is a key surgical objective and is now recognized as a quality metric for surgeons in many fields. While standard pre-operative imaging can provide tumor location, surgeons still rely on visual and\/or tactile guidance to determine the interface between normal and abnormal tissue and histology to confirm microscopic clearance of abnormal disease. In robotic surgery the lack of tactile feedback limits the surgeon to visual assessment through the robot camera, thus increasing the possibility of positive margins and residual diseased tissue.","title":"Autofluorescence lifetime augmented reality as a means for real-time robotic surgery guidance in human patients"}
{"_id":"7cd7e65f-103f-eeee-5193-9e746a9f1770","text":"All surgeries were performed by the same surgical team under a tourniquet. Patients were anaesthetised generally with a medial parapatellar approach. In one group of patients, the femoral medullary canal was sealed with a bone plug made from an autologous osteotomy, while in the other group, the femoral medullary canal was sealed with bone cement on top of a bone plug made from an autologous osteotomy. The prosthesis was coated with bone cement, the prosthesis was placed, the canal was drained, and the incision was closed layer by layer with a cotton pad and pressure dressing. The drainage tube was completely clamped for 2 h after the operation, and the drainage flow was regularly observed and the degree of drainage tube closure was adjusted according to the amount of drainage flow. All patients with TKA were given oral rivaroxaban 10 mg 6 h after surgery, once daily until discharge. After discharge, in the absence of bleeding events, rivaroxaban 10 mg\/d was given for 4 weeks to prevent DVT and was discontinued in patients who developed postoperative ecchymosis. Erythropoietin was not used to improve anaemia during hospitalisation. All patients had a venous ultrasound of the lower limbs performed by the same experienced ultrasonographer on the seventh postoperative day, and those with venous thrombosis of the lower limbs were promptly referred to the vascular surgery department for appropriate management.","title":"Effect of bone cement sealing of the intramedullary femoral canal on coagulation status after total knee arthroplasty: a retrospective thromboelastography study"}
{"_id":"7ce2a6f8-bdc0-c6cd-7860-b409cda4aa7c","text":"The final diagnosis was acute post-streptococcal glomerulonephritis with esthetic filler implants microembolization into small vessels. Esthetic filler implant microembolization is here described for the first time. We conclude that esthetic filler implants may cause microembolization into small vessels. Recognition of the characteristic morphology may expedite diagnosis and avoid unnecessary further testing.","title":"Small vessel microembolization and acute glomerulonephritis following infection of aesthetic filler implants"}
{"_id":"7ce2c56d-9e0e-8abb-7601-301c200a3a6a","text":"A 78-year-old Caucasian male was diagnosed with a well differentiated squamous cell carcinoma (SCC) of the skin over the left ear. This was initially excised and treated with adjuvant radiation treatment using 12 MeV electrons between January and March 2008. An initial dose of 50 Gy was delivered to the external ear and the adjacent lymph node region, followed by a 10 Gy boost to the expanded GTV, and completed with an additional 6 Gy to a residual nodular area on the posterior surface of the ear. He later underwent excision of this nodular area with placement of a skin graft derived from the left supraclavicular area.","title":"Lack of Cetuximab induced skin toxicity in a previously irradiated field: case report and review of the literature"}
{"_id":"7ce61cee-3ebb-f204-c27c-ab3a58a1e795","text":"Both patients in our study underwent two surgical procedures and were treated with brachytherapy and external beam irradiation. Brachytherapy was used to confine the highest doses to the region at risk and minimize the dose received by normal tissues. The use of brachytherapy shortens the overall treatment time and increases the rate of local control in the setting of involved margins of resection. CT-based treatment planning was used to define the volume of irradiation and to spare normal tissue structures. By reducing the amount of radiation dose delivered to normal tissues, the probability of growth deformity, radio-chemotherapy interactions, and even the hypothetical risk of second tumor formation may be lowered. No effort was made to symmetrically irradiate the physes, which would hypothetically lead to symmetrically diminished growth without the added effect of angular deformity. Because of concerns about the effects of total joint irradiation and its possible effects on functional outcome, the inhomogeneous and asymmetric approach was taken. Despite the valgus and varus deformity experienced by these children and the need for intervention, both children and parents were completely satisfied with their functional outcome and indicated that they would chose the same course of treatment if presented again with the same options.","title":"Valgus and varus deformity after wide-local excision, brachytherapy and external beam irradiation in two children with lower extremity synovial cell sarcoma: case report"}
{"_id":"7cf6acd6-8264-8922-7db1-4ebf9233ad1c","text":"The aim of this review is to show the role of IOUS in contemporary breast cancer surgery and its changes over time.","title":"Intraoperative ultrasound in breast cancer surgery—from localization of non-palpable tumors to objectively measurable excision"}
{"_id":"7cfa0890-b1dd-40ea-c351-7b483b6c748f","text":"Several participants reported no prior knowledge regarding hand and skin hygiene prior to injection.","title":"Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage"}
{"_id":"7cfcca1e-c5e8-ac47-498e-790defb85f36","text":"DVT is a serious surgical complication that can lead to fatal pulmonary embolism.55","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"7cfeb8eb-d7c5-16e0-4f73-ad4acfe78c46","text":"Tigecycline 100 mg IV as a single dose; then 50 mg IV q12h","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"7d00f9be-bb18-dd17-a38b-2821eb02e49c","text":"On exam, the patient was an athletic appearing male with normal pulses in dorsalis pedis and posterior tibial vessels. He was tender to pressure applied immediately posterior to the tibia overlying the distal deep posterior compartment. He had no tenderness to percussion of the tibia itself or to palpation of the tibial edge. He was not tender in the midline of the posterior calf over the proximal tibial nerve [10]. His gastrocnemius muscle was slightly tender. He did have a Tinel sign over both tarsal tunnels with radiation to the sole of his feet.","title":"Non-invasive neurosensory testing used to diagnose and confirm successful surgical management of lower extremity deep distal posterior compartment syndrome"}
{"_id":"7d01808c-4358-72c7-3d8e-412ccdffcd6d","text":"All participants will receive TEA or STEA treatment once a week and concurrent acupuncture treatment twice a week for eight weeks. One of the two acupuncture treatments will be given on the same day and another one will be administered 2-3 days after the first one.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"7d161322-0177-7288-0fe7-4ceac3f004dc","text":"Based on the aforementioned points outcome evaluation of partial thickness skin graft from the scalp for scalp defect was being evaluated in the present study.","title":"Outcome of Comparison between Partial Thickness Skin Graft Harvesting from Scalp and Lower Limb for Scalp Defect: A Clinical Trial Study"}
{"_id":"7d1949b5-f94e-9f62-7229-3adcfa9cbdb3","text":"Our study found that practicing female orthopaedic surgeons are markedly underrepresented in state and regional orthopaedic societies. In addition, our study demonstrated that few women comprise the Board of Directors of state and regional orthopaedic societies. However, we found a positive relationship between the number of female members in a society and the presence of female orthopaedic surgeons on the Board of Directors. Our study suggests that female leaders proportionately represent female orthopaedic members of state and regional societies. Although, female orthopaedic surgeons are overall underrepresented relative to the number of practicing orthopaedic surgeons in the general population that these societies represent. This finding is consistent with those of Saxena et al, who found that the presence of female leaders in orthopaedic specialty societies correlates with the number of female members.","title":"Women in Leadership in State and Regional Orthopaedic Societies"}
{"_id":"7d1bf8f4-8e69-2ecf-fdc0-4a4c81d6ed7a","text":"Patient characteristics according to AT during their ICU stay were analyzed. Characteristics of AT were assessed and their relationships with death were determined.","title":"Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units"}
{"_id":"7d1f3675-8698-10f6-9b93-b82c86781210","text":"It has long been suggested that appropriate prescribing patterns and proper adherence to thromboembolism prophylaxis reduce the rate of VTE. Multimodal prophylaxis has been studied extensively in orthopedics and other surgical fields, although to our knowledge no study in pancreatic surgery has previously shown an independent effect of a prophylactic pathway on rates of symptomatic VTE. Understanding the potential reasons underlying national low outliers in VTE rates has great potential for informing patient care and improving hospital practice.","title":"The Pathway to Low Outlier Status in Venous Thromboembolism Events: An Analysis of Pancreatic Surgery in the National Surgical Quality Improvement Program"}
{"_id":"7d229ab1-3fb4-60dd-df04-2fac5b367a8e","text":"This study has identified a successful process for producing an acellular elastic cartilage ECM for ear reconstruction. Further work will involve cell seeding on to the scaffold to understand biocompatibility.","title":"Optimising the decellularization of human elastic cartilage with trypsin for future use in ear reconstruction"}
{"_id":"7d23a963-7b5a-577c-1161-17d6a5d71684","text":"The skin paddle is incised and the deep fascia is cut around the flap except at the lower border of the flap near the pedicle. An additional 3-cm incision is made at the upper border of the flap toward the popliteal fossa. Through this incision, the lesser saphenous vein is dissected superiorly and clamped to include approximately 5 cm of the saphenous vein. At the upper border of the flap, the medial sural nerve located deep into the deep fascia is also sectioned. Subfascial dissection proceeds from proximal to distal maintaining a cuff of connective tissue around the medial sural nerve and its accompanying pedicle connected to the flap's deep fascia. The pedicle is exposed along a straight line after infiltrating a 10 mL of 1% xylocaine with epinephrine in the deep dermis away from the pedicle where the skin then reflects laterally above the subcutaneous tissue.","title":"Super-Drained Distally Based Neurofasciocutaneous Sural Flap: A Case Series and Review of Literature El-Diwany et al"}
{"_id":"7d297427-66d7-63df-4093-dc56818ccb2e","text":"Our follow-up showed a reasonable cheek elevation and patient satisfaction. The results were more dramatic with moderate nasolabial folds and less dramatic in older patients with heavy nasolabial folds. This is as a result of inadequate suspension of the fat pad superiorly. We found this technique to be a useful adjunctive procedure in young patients who were undergoing surgery for facial rejuvenation and also in older patients who had previously undergone facelift surgeries. Further studies are warranties to evaluate the long term effect of suture midface suspension.","title":"Suture midface suspension"}
{"_id":"7d3170d2-d736-0eff-4eed-a21a5c510979","text":"A retrospective analysis of anatomopathological reports on patients between 1 and 18 years old issued by the oral and maxillofacial pathology laboratory between 1997 and 2021 was performed for demographic data, lesion site, type of biopsy, diagnostic hypothesis and final diagnosis.","title":"Paediatric head and neck malignant neoplasms: A brazilian retrospective study"}
{"_id":"7d35ff8a-f5c0-50a5-3e7a-1a5382b458b5","text":"There is no standard therapy for calcinosis cutis, but several treatments have been shown to be beneficial to varying degrees. These include diltiazem, warfarin, bisphosphonates, minocycline, ceftriaxone, intravenous immunoglobulin, surgical excision, carbon dioxide laser, extracorporeal shock wave lithotripsy, curettage, and probenecid.","title":"Idiopathic Calcinosis Cutis of the Hand"}
{"_id":"7d372489-1c83-e19f-5e79-55cda1020ee5","text":"After informed consent was taken, the patients were requested to lie supine on the couch. The treatment field points were reproduced with the aid of the patients' case notes and the presence of permanent tattoos which had been marked in the central treatment plane during the treatment. Nine points for ultrasonic measurements within the medial, central and the lateral areas of the treatment field as well as the corresponding points in the contra-lateral non-irradiated breast were marked as shown in Figure 2 and Figure 3.","title":"An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy"}
{"_id":"7d4a3a55-10b6-a6cc-45a6-e5e48852baff","text":"The current retrospective multicenter study aimed to determine whether narrow-margin excision is warranted for thick acral melanoma and to investigate the clinicopathologic factors associated with better local control and longer survival in thick acral melanoma. A cutaneous melanoma group was set as the control group.","title":"Surgical resection margin for T3–T4 primary acral melanoma: a multicenter retrospective cohort study"}
{"_id":"7d5273a2-1ce4-0a94-ed25-c143c4f64158","text":"The development of in vitro models to predict drug-mediated DTH is the result of international initiatives to reduce the use of research animals. An enhancement in safety and maybe a decreased probability of market removal would result from the development of in vitro assays to identify the sensitization potential during the drug development period [133].","title":"Evaluation of Delayed-Type Hypersensitivity to Antineoplastic Drugs—An Overview"}
{"_id":"7d5d6e10-086d-a33f-fadd-713bb1d37b7c","text":"If there is a need to resect additional bone, or if the preoperative plan includes placing “blind” screws through the construct, it will often be useful to also design cutting jigs and drill guides to facilitate the actual procedure. When the current position of the region of interest is acceptably aligned, cutting jigs and drill guides can be configured and positioned based on the current implant or local anatomical features. If there is a plate already in place, the jigs and guides may be designed to rest in screw holes in the current implant when possible. The jigs and guides can be screwed to the current implant and will be very rigidly oriented with regard to the skeletal pathology. This will allow the jigs and guides to be fixed in space and will aid the surgeon to accurately cut or drill the bone. When the current position of the region of interest is not in acceptable alignment, these cutting jigs and drill guides should be configured and positioned based on local anatomical features, taking into consideration the planned change in position with respect to local anatomy. The possibilities are almost limitless when conducting virtual planning.","title":"Putting 3D modelling and 3D printing into practice: virtual surgery and preoperative planning to reconstruct complex post-traumatic skeletal deformities and defects"}
{"_id":"7d5eacaf-e4e6-3de8-3932-83b5a31ea459","text":"Similar to our inference extensive study of the literature showed Giant cell tumors of the spine including sacrum should be managed with en bloc resections whenever possible as this provides the greatest chance for cure but When the risk of post-operative neurologic deficit after en bloc excision is high they should undergo intra lesional marginal resection followed by controlled local radiotherapy [12,37].","title":"Clinical outcome in Giant cell tumor of cervico-thoracic spine: Our experience with three cases"}
{"_id":"7d6339b2-8afa-2524-6920-224baf6d375a","text":"Larger defects over the forefoot sole region have no availability of local tissue. Cross leg flaps cause increased morbidity in the form of stiffness of joints and potential for formation of bedsore. A Chopart or a Lisfranc amputation[8] can be an option but not many patients are willing for an amputation and cannot be recommended on a routine basis with availability of other options. Free tissue transfer can effectively manage these defects.","title":"Free tissue transfer for trophic ulcer complicating leprosy"}
{"_id":"7d65f4a6-f1e4-467d-b31e-03bb50af2b79","text":"The purpose of this intraoperative transformation was to find a surgical alternative that would allow us a safe and technically accessible bailout in the cases where we are confronted with a poor-quality perforator vessel.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"7d691751-c04f-7c7a-267d-2e0fbbe8fe96","text":"Hereby, we report our experience of using Medpor® in some aspects of facial reconstruction especially in frontal reconstruction and rhinoplasty which were not paid enough attention in other studies, . Also to understand the probable complications of this recent material, the patients were followed for a long period. Previous studies were performed with small sample sizes and this study was designed to make some new organized evidences for adding to previous experiences.","title":"Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study"}
{"_id":"7d6ee2dc-bb7b-e457-541e-e25b86e7f280","text":"Screenshot from the website that allows subjective diagnosis, without help of the questionnaire","title":"Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis"}
{"_id":"7d736c48-92fb-d1ed-468e-a5551eec6a6e","text":"The patient was ultimately discharged home on oral antibiotics to complete the course of treatment for osteomyelitis. Figure 9 shows the healing one year later.","title":"Treating Fasciotomy Wounds with Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTi-d)"}
{"_id":"7d7681b2-3666-1b3f-285a-25f97acf449d","text":"The pelvic lymphadenectomy started developing the right paravesical and pararectal spaces. The round ligament was coagulated and transected and the peritoneal layers of the broad ligament were opened.","title":"Left External Iliac Vein Injury During Laparoscopic Pelvic Lymphadenectomy for Early-Stage Ovarian Cancer: Our Experience and Review of Literature"}
{"_id":"7d873426-6989-9b3b-3daf-a40bbc30905d","text":"Postoperative pain was rated on a numerical scale ranging from 0 (no pain) to 10 (worst imaginable pain) at 1-hr intervals until a patient requested analgesics due to the regression of the block. The type and dose of analgesic agent and its route of administration were at the discretion of the orthopedic surgeon. The duration of surgical anesthesia and postoperative analgesia was defined as the time between the end of the local anesthetic injection for brachial plexus block and the postoperative administration of analgesic agents.","title":"Comparison Between Ultrasound-Guided Supraclavicular and Interscalene Brachial Plexus Blocks in Patients Undergoing Arthroscopic Shoulder Surgery A Prospective, Randomized, Parallel Study"}
{"_id":"7d88e3d1-14a8-7397-3b53-57acba3f6c90","text":"The scientific literature review revealed heterogeneous data on the empiric antibiotic therapy of AHOM.","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"7d8c42cb-2371-75e7-d05b-186a739fb884","text":"Some of these limitations are a consequence of the current catalogue of devices offered by the 3 major device companies. While the options for textured integrated port expanders are abundant, the choices for remote port tissue expanders are much more limited. Invariably only one option exists: a round smooth tissue expander.","title":"Two-Stage Prosthetic Breast Reconstruction With Integrated Versus Remote Port Expanders: A Comparison of Complication Rates Choo et al"}
{"_id":"7d9433c5-8eab-6290-62f0-6c2148f39001","text":"There is no question that AR is a very common and often very burdensome disease. It can be classified as seasonal or perennial, which has the attraction of directing attention to the relevant aeroallergen, or as intermittent and persistent and mild or moderate\/severe that reflects more the burden of the disease on the patient. It is important not to confuse NAR with AR but also not to miss LAR if indeed it is as common as reports indicate. There is a need for more effective forms of symptomatic therapy . There also is a need for new approaches to AIT that overcome the factors of safety and inconvenience with SCIT but also the limited number of allergens with established dosing with SLIT. Both of these forms of AIT involve several years of treatment to produce lasting results and in many patients this leads to poor adherence with the treatment program . Forms of AIT that require far fewer treatments over shorter periods of time are sorely needed.","title":"Recent advances in allergic rhinitis [version 1; referees: 2 approved]"}
{"_id":"7da0f543-16d3-3b10-5017-e261b8b7ac32","text":"The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function and restored facial appearance. This approach has now been adopted routinely in the unit and it is hoped that a cases series will be presented in due course with more detailed patient outcomes. Further work on the long-term results of the ZIP flap procedure is required together with an ongoing appreciation of the important case selection factors for this treatment protocol.","title":"The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy"}
{"_id":"7da1a021-938c-62f7-b886-2b6ca9c6dbbf","text":"A database was prospectively established for the purpose of this analysis. The elements of the database included basic demographic data of patients and prognosticators previously reported in literature, as well as follow-up data including clinical outcome after treatment. Medical record of all patients with pathologically diagnosed malignant melanoma consulted in our center since 2006 were retrieved and reviewed. No patient was excluded in this study. Statistical analyses including survival and multivariate analyses of factors associated with survival were respectively performed by Kaplan-Meier method and Cox proportional hazard model.","title":"Clinical presentation, histology, and prognoses of malignant melanoma in ethnic Chinese: A study of 522 consecutive cases"}
{"_id":"7da906cf-f346-00bd-7926-0fbde641b25c","text":"Patient 3 received 60 Gy radiation over 30 fractions followed by a 6 Gy sequential boost, for the presence of close margins, for treatment of a T3N0 MPNST in the left posterior scalp. Grade 3 radiation dermatitis on the posterior scalp was observed by the end of the treatment, indicated by the broad presence of moist desquamation. The moist desquamation was managed using Aquaphor and Xeroform gauze. There was no evidence of disease at 3 months post treatment.","title":"3D printed integrated bolus\/headrest for radiation therapy for malignancies involving the posterior scalp and neck"}
{"_id":"7daad7ea-9544-d03d-0205-d69b36516132","text":"History of hematological or primary solid tumor malignancy, unless in remission for at least 5 years from pre-registration with the exception of adequately treated cervical carcinoma in situ or localized non-melanoma skin cancer","title":"Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial"}
{"_id":"7db99ccc-8c96-2f8b-89fe-6d7d87844efc","text":"Relapsing or far advanced rectal and anal cancers remain difficult to treat and require interdisciplinary approaches. Due to modern standard protocols all patients receive irradiation and neoadjuvant chemotherapy—and in case of a relapse a second irradiation—rendering the surgical site prone to surgical site infections and oftentimes long lasting sinus and septic complications after exenteration in the pelvis. Despite an improved overall survival rate in these patients the downside of radical tumor surgery in the pelvis is a major loss of quality of life, especially in women when parts of the vagina need to be resected. Derived from our experince with over 300 patients receiving pelvic and perineal reconstruciton with a transpelvic vertical rectus abdominis myocutaneous (tpVRAM) flap we studied the impact of this surgical technique on the outcomes of female patients with or without vaginal reconstruction following pelvic exenteration. We found out that the tpVRAM flap is reliably perfused and helps to reduce long term wound healing desasters in the irradiated perineal\/vaginal\/gluteal region.","title":"Interdisciplinary Surgical Approaches in Vaginal and Perineal Reconstruction of Advanced Rectal and Anal Female Cancer Patients"}
{"_id":"7dcb3679-72af-99b9-857d-9412ea59f69b","text":"Of the different methods used to evaluate SLNs, imprint cytology is the most commonly used. The initial route of breast cancer dissemination follows the axillary lymph nodes, and metastatic involvement of the axilla generally progresses from the first to the second and then third level of axillary nodes. Metastases that fail to adhere to this sequence are rare, making up 2% of cases, and are referred to as skip metastases. Therefore, an intraoperative analysis of SLNs that is fast and precise is of vital importance for minimizing the need for repeat surgery in patients with sentinel lymph nodes affected by metastases 10.","title":"Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy"}
{"_id":"7dcd5748-e087-5569-0846-0ab1283de9df","text":"The setup of this study did not include a technical validation to evaluate the accuracy of the visualized arteries through AR. A follow-up study is planned to check the accurate positioning of the visualized arterial course by AR using ultrasound. This study will not only provide an answer to whether or not the AR visualization is accurate enough and can be trusted during filler injections, but also if the change in patient positioning—the patient is lying down during the MRI and is sitting up during the AR visualization and filler injection—may (slightly) affect the position of the facial arteries.","title":"The Usefulness of Magnetic Resonance Angiography to Analyze the Variable Arterial Facial Anatomy in an Effort to Reduce Filler-Associated Blindness: Anatomical Study and Visualization Through an Augmented Reality Application"}
{"_id":"7dda484e-0947-127d-0fd9-ebe3affde58e","text":"In this study, we developed and tested a personalized multichannel FES rehabilitation technique for the rehabilitation of facial expressions after full-face transplantation. The rehabilitation method was individualized based on the muscle activity locations of each patient when they performed different facial movements. During rehabilitation sessions, a healthy individual synchronously performed the same facial expression movements with each patient to develop a cognitive connection between their facial expressions and their social interactions. Complexity analysis of sEMG was used to assess motor and functional improvements during the personalized rehabilitation method, and it demonstrated that the symmetry of facial muscle activity and similarity in the pattern of fuzzy entropy for emotional motions between the patient group and healthy individuals increased. Additionally, the rehabilitation method could be used for functional movement rehabilitation of patients with partial face transplantation, arm transplantation and replantation, and stroke survivors.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"7ddfa671-c43d-f75c-65e9-81ba109bb164","text":"LIPUS is a noninvasive and effective adjuvant therapy to enhance callus maturation during DO. It enhances callus consolidation and may have a positive effect on the appropriate callus shape and type.","title":"Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure"}
{"_id":"7dfaf33e-a411-96a6-b6b2-6413b4f1f9e6","text":"Our research is constrained by the retrospective data collection and the small number of patients with DVT that were identified during free ALTP flap transfer. However, in this study, we found that the ALTP flap could be safely transferred to traumatic lower extremities even in cases where the donor or recipient veins are obstructed by DVT. Besides, based on our experience, we developed a treatment algorithm. In the future, we plan to conduct a more extensive study on more patients with DVT prospectively to verify the usefulness of our algorithm. With further research, we will refine our algorithmic approach and produce a reliable guideline for dealing with DVT in lower extremity reconstruction using free ALTP flap transfer.","title":"Deep vein thrombosis in donor or recipient veins encountered during lower extremity reconstruction with a free anterolateral thigh perforator flap: How do we deal with it?"}
{"_id":"7dfdfc0b-d5a9-55fe-53b9-509f1bf9f81a","text":"Thirteen GPs were included in the study between August 2016 and March 2017. Their characteristics are shown in Table 1. The GPs reflected a large variation in the use of ultrasonography regarding organs scanned, clinical conditions examined for and decisions made based on the ultrasound examination. The GPs had between a few months and more than 10 years of experience with ultrasonography, and all had participated in some ultrasound training. The extent of the training varied from supervised training during residency to extensive formalised education in line with specialists’ training.","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"7e034f67-0be6-94ba-fd7f-e1a144f1323d","text":"Our patients represent a small series and oral health was examined retrospectively. However, the presence of bacteria of an oral source obtained from intraoperative tissue samples and blood, collected from 4 patients with infected aortic grafts and confirmed periodontal disease, suggests revisiting the role of odontogenic bacteria in endovascular infection. Unfortunately, patient 1 died quite soon after the primary sampling and not all investigations were done in his case. Quantitative analysis of bacterial DNA was unavailable and the oral health status was not obtained. In this case, a sample of oral bacteria from either saliva or supra- or subgingival plaque in order to confirm the oral origin of these microorganisms may have been helpful. This may also be a helpful addition to any further studies going forward. In view of the catastrophic consequences of infection, it may be reasonable to recommend a simple presurgical oral assessment for all patients undergoing complex elective aortic graft surgery. In this way, any underlying periodontal disease can be addressed before surgery, the need for good oral hygiene postoperatively can be reinforced, and bacterium of oral origin can be covered when choosing antimicrobial prophylaxis.","title":"Periodontal Disease and Late-Onset Aortic Prosthetic Vascular Graft Infection"}
{"_id":"7e048394-6501-6e81-71d6-f084013f196e","text":"We were unable to detect an influence of preoperative antibiotic therapy and its duration, the overall duration of postoperative antibiotic therapy, and intravenous postoperative antibiotic therapy and its duration on major amputations. Similar to our findings, both administration route and duration of antibiotics have been investigated as potential risk factors for therapy failure in diabetic foot infections in general, failing to demonstrate any influence. Duration and administration route of antibiotic therapy in DFO remain a much-debated topic with uncertainty regarding the need of intravenous administration and optimal length of antibiotic therapy even in the most recent IWGDF guidelines.","title":"Foot Osteomyelitis Location and Rates of Primary or Secondary Major Amputations in Patients With Diabetes"}
{"_id":"7e06c164-f197-0cc6-e88d-942106ea2de8","text":"Five laboratory studies and one clinical study opted to test the efficacy of the BioCleanse™ Tissue Sterilization Process. The use of this system was extremely effective in reducing the bioburden, and did not have any reported adverse effects on the tissue integrity or transplantation outcomes. The product and process is patented, and therefore does not allow for programs to adopt without licensing the technology.","title":"Disinfection of human musculoskeletal allografts in tissue banking: a systematic review"}
{"_id":"7e076c80-0abc-2822-e2e9-de09581bea76","text":"The relatively high recurrence rate of bone infection despite appropriate therapy suggests that improvements in antibiotic delivery to the infection site are required. Antibiotic carriers currently applied in clinics possess suboptimal properties such as non-biodegradability, incomplete antibiotic release, or excessive burst release of antibiotic load. The ZOI of antibiotic loaded PMMA bone cements and collagen sheets have been reported in our previous work, showing that PMMA cements release antibiotics over 7 days while collagen materials could only establish a ZOI for 3 days [18]. However, these frequently utilized antibiotic carriers come in bulky dimensions, necessitating invasive surgeries while preventing antibiotic release directly at the interface of the bone. In this work we introduced an antibiotic microsphere carrier system that could efficiently bind to calcified materials and release its antibiotic payload in close vicinity to infected bone mimics.","title":"Poly(Aspartic Acid) Functionalized Poly(ϵ-Caprolactone) Microspheres with Enhanced Hydroxyapatite Affinity as Bone Targeting Antibiotic Carriers"}
{"_id":"7e0e9c2d-918c-112a-d617-a7e9c3b2d789","text":"Despite the acute DVT and in agreement with the oncology surgical team, the patient decided not to delay the proposed aggressive surgical intervention. Given the need for surgical intervention in the setting of an acute proximal DVT, we indicated implantation of a removable vena cava filter.","title":"An alternative approach to treatment of inferior vena cava filter perforation Tratamento alternativo para perfuração de veia cava inferior por filtro"}
{"_id":"7e100d46-c238-e16a-d209-c87c0ab59986","text":"The patient is currently nine months out from her wide local excision of fibromatosis of her right breast and she remains disease free.","title":"Fibromatosis (desmoid tumor) of the breast mimicking a case of ipsilateral metachronous breast cancer"}
{"_id":"7e12f07f-4671-4966-d573-b662040d199d","text":"The degree of severity of each symptom was assessed in scores from 0 to 3 before the start of therapy and after 6 months of treatment:","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"7e139103-64db-44c9-4ff3-0ba3bf82dec2","text":"Calcinosis cutis is a rare presentation and not many cases have been reported especially of idiopathic type. We are reporting a case of idiopathic calcinosis cutis of lower limbs in a 33-year old female who presented to our clinic for multiple painless swellings over her lower limbs for the past six months, without any history of trauma or infection. We have decided to observe her condition on regular follow-up and conservative management.","title":"Multiple Scattered and Small Lesions of Lower Limbs: Idiopathic Calcinosis Cutis: A Case Report"}
{"_id":"7e141e07-a6fc-a811-881f-d62efa283b2d","text":"A combination of these two flaps can thus be utilized to cover extensive scalp defect involving the frontal, temporal, and vertex aspect of the scalp. One however has to be careful when raising the scalp flap so as not to damage the temporal fascial or the superficial temporal blood vessels. Injury to this vessel may make the temporoparietal fascial flap unreliable and it may thus not survive. The pericranium and the temporalis muscle must also be left intact while raising the temporoparietal fascial flap so as to allow for skin grafting of the donor site.","title":"Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound"}
{"_id":"7e20ad64-9edd-8c66-a81b-3cd82bbb73a5","text":"Satisfaction in the absence of complications appears to be quite high, 6 care must be taken with aesthetics in female patients and patients with special concerns.","title":"The First Dorsal Metacarpal Artery Flap Family: A Review"}
{"_id":"7e2daf42-8a4b-ddcb-5d95-72dbfef799c6","text":"Objective: We compared the efficacy of a modified Mohs' technique and topical application of a starch powder containing zinc oxide as palliative treatments for skin lesions caused by unresectable tumors in our hospital.","title":"Clinical Usefulness of a Modified Mohs' Technique and Topical Application of Zinc Oxide Powder for Treating Skin Infiltration Caused by Unresectable Malignant Tumors"}
{"_id":"7e3b3337-99c5-823a-370d-5571c56e0055","text":"We hypothesized that intraoperative US would confer upon the surgeon a greater ability to discern the precise margins of the tumor. This would enable a more fitting initial excisional diameter and fewer close positive margins, thereby reducing the need for subsequent interventions. Furthermore, we hypothesized that other benefits accrued by use of intraoperative US include minimization of normal breast parenchyma resection and improved cosmetic results due to optimal initial breast incision placement.","title":"Intraoperative ultrasound reduces the need for re-excision in breast-conserving surgery"}
{"_id":"7e4399b2-c892-12af-e7e0-87a4109ed5aa","text":"Many older procedures have been abandoned in recent years because of the high number of complications such as skin\/nipple necrosis and loss of sensibility of the NAC.","title":"The McKissock's technique in reduction mammaplasty: A comparative study of outcomes and complications in 211 consecutive patients"}
{"_id":"7e528bb2-792e-0ff2-b628-954ec6c17ccd","text":"With the arm in full elevation, a second L-shaped incision of approximately 20 cm is performed just over the anterior border of latissimus dorsi muscle belly in the axilla. The latissimus dorsi muscle lies anterior to the teres major, and the interval between these two muscles is dissected. The long and broad but very thin tendon of the latissimus dorsi is then sharply released from the humerus and reinforced with two high-strength sutures. A passage between the posterior deltoid and the teres minor is established for the tendon transfer. The latissimus tendon is transferred through the passage and secured at the anterior portion of the greater tuberosity with the arm in 45° of abduction and 45° of external rotation. The middle deltoid is repaired to the lateral acromion using transosseous techniques.","title":"Surgical Management of Massive Irreparable Cuff Tears: Latissimus Dorsi Transfer for Posterosuperior Tears"}
{"_id":"7e58ebbd-005e-656e-37db-05093ace1562","text":"However, it must emphasize that our study was an exploratory study and a limited number of target genes was considered although there are many additional target genes that warrant further investigation.","title":"Human microRNA expression in sporadic and FAP-associated desmoid tumors and correlation with beta-catenin mutations"}
{"_id":"7e5c05c4-fcf3-594c-6077-224605b62ada","text":"Studies in the literature have shown very low rates of locoregional recurrence after omitting ALND in sentinel node negative patients.14 The results of recent trials showed that ALND can be safely omitted in early breast cancer patients with micrometastases in their sentinel nodes (SN).15 The aim of this study was to look in to the pattern of cancer recurrence after SLNB procedure at our centre.","title":"Breast cancer recurrence after sentinel lymph node biopsy"}
{"_id":"7e5fce64-7e29-301f-f5e0-dc52fa50e300","text":"Subtelny [22] first documented the downward and forward growth of the nose with maturity. The vertical dimension of the nose experiences more growth than the anteroposterior projection in both males and females. There was a spurt seen in male's nasal growth from 10 to 16 years with a peak around 13-14 years. Class II patients exhibited a more pronounced elevation of the bridge of the nose than Class I. Class I cases tended to have straighter noses. Females did not show such a spurt in growth like males but had a more steady increase in nose growth. This is of importance because an orthodontist treating a Class II girl aged 12 yrs could expect only minimal increases in nasal projection over the next few years. However, in a male of a similar age any treatment that causes upper lip retraction in combination with several mm of nose growth might produce a less than optimal final relationship between the lips and nose. When the nose is included in the profile appraisal, the soft tissue profile is seen to be increasing in convexity with progressive growth. This happens because the nose grows in a forward direction to a proportionately greater degree than the other soft tissues of the facial profile.","title":"Age Changes of Jaws and Soft Tissue Profile"}
{"_id":"7e5ff962-8f8f-14fe-ae93-976a5d48cecc","text":"The aims of this retrospective analysis were to evaluate the effect of combined superficial and deep groin dissection on disease-free and melanoma-specific survival, and to identify the most important factors for predicting the involvement of deep nodes according to clinically or microscopically detected nodal metastases.","title":"Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors"}
{"_id":"7e640f3c-3db4-4879-7f42-75332510b2b1","text":"Indications for multilevel corpectomy in patients with degenerative spine disease included severe spinal canal stenosis with myelopathy due to herniated discs and osteophyte compression on the spinal cord from the posterior aspect of the vertebra in more than one level, where we did not expect that the posterior decompression alone, with or without instrumentation, would provide sufficient decompression of the spinal cord. In multilevel spinal canal stenosis with a significant amount of compression on the spinal cord due to posterior vertebral body osteophytes, corpectomy was chosen over multilevel anterior cervical discectomy and fusion. Multilevel anterior cervical discectomy and fusion, with or without the posterior approach, was discussed with patients as a less invasive therapy alternative. In cases of metastases, we performed multilevel corpectomy of vertebral bodies which were infiltrated by the tumor at an extent of more than 50%. In spondylodiscitis, multilevel corpectomy was performed in cases of profound involvement of more than one vertebral body and adjacent discs, as well as in cases of the presence of epidural empyema along the posterior aspect of the vertebral body. In patients with fracture, multifragmentary fracture of two adjacent vertebral bodies where the instability of the anterior column was not suitable for stabilization via the posterior approach alone was an indication for multilevel corpectomy.","title":"Application of an Expandable Cage for Reconstruction of the Cervical Spine in a Consecutive Series of Eighty-Six Patients"}
{"_id":"7e654fb1-cf8e-a645-e85a-e41e52a8fc21","text":"The history of painless abdominal mass, the age and sex of the patient, the location of the mass within the anterior abdominal wall, and the imaging features make desmoid tumor a strong primary diagnostic consideration even if it is a rare entity. Aggressive, wide surgical resection with negative margin is the best surgical option. Complete surgical excision of desmoid tumors is the most effective method of cure, sometimes necessitating removal of most of an involved anterior abdominal wall in such a giant desmoid tumor with immediate repair of resultant huge defect and reconstruction using prosthetic mesh for better functional results.","title":"Giant Desmoid Tumor of the Anterior Abdominal Wall in a Young Female: A Case Report"}
{"_id":"7e6569e2-d408-32d9-2d4f-e81c4849f232","text":"Since there was a history of several recurrences due to incomplete removal of the lesion in the past, complete removal and thorough curettage of the underlying bone were necessary for treatment success.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"7e713e1f-cf0b-fff3-ab25-07a35bb3cb44","text":"The trial is planned as a monocentric study in the University hospital Mainz, Germany in the Department for General, Visceral and Transplant surgery. The department is among others specialized in hepatobiliary surgery with a case load of more than 300 liver resections each year.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"7e745cc4-66c6-42da-bb49-50c53e31fe6e","text":"In conclusion, although our study has limitations due to the retrospective nature, this series of 1500 MPN patients with incident index thrombosis is the largest ever reported, so that statistical power is adequate. The different effects of HU on the protection of arterial or venous vessels likely mirror the different pathogenetic mechanisms involved in thrombosis of different districts. The results obtained by VKA for secondary prophylaxis of recurrent VTE although significant are not entirely satisfactory. Overall, we conclude that our therapy armamentarium to prevent arterial and particularly venous recurrences in MPN is suboptimal, and future studies to optimize and personalize the secondary pharmacological prophylaxis are urgently warranted.","title":"Hydroxyurea prevents arterial and late venous thrombotic recurrences in patients with myeloproliferative neoplasms but fails in the splanchnic venous district. Pooled analysis of 1500 cases"}
{"_id":"7e788b84-d457-f0b8-8d35-bb5fff770793","text":"This survey suggested that the perceptions of plastic surgery in our society were limited and underestimated the versatility of the specialty. Therefore, we recommend improved liaison with general practitioners and the institutions of public awareness programs. Public awareness programs should be instituted through the print media and on TV and should be done judiciously and with dignity. The limitations of our study may be that the students sample was obtained from the same geographical area and this might underestimate the true nature of the awareness level. Despite the rapid growth of plastic surgery in the last two decades, a large portion of population remains unaware of the spatiality. It is essential to institute programs to educate health care consumers and providers about the plastic surgery.","title":"Views of College Students on Plastic Surgery"}
{"_id":"7e7f8d21-7ced-59d6-fd16-edb518a724c4","text":"We identified 22 additional organisations that have produced 10 or more practice guidelines using an explicit approach to grade the level of evidence or strength of recommendations. Another 29 have produced between two and nine guidelines using an explicit approach. These systems include a number of minor variations of the six systems that we appraised in detail.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"7e859120-8eef-9ec6-5ba0-1bef77e3b4b9","text":"Lorenz makes a stock prosthesis with similar components to the TMJ concepts prosthesis.","title":"Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis"}
{"_id":"7e8d067c-ea8d-0753-21fc-5a49b9fd4831","text":"A recent retrospective review that included patients with acute traumatic injuries ( n = 238) as well as chronic traumatic sequelae ( n = 280) compared muscle versus fasciocutaneous free flaps. 60 The authors found similar rates of limb salvage and functional recovery in both the acute and chronic subgroups with no significant differences in functional recovery or complication rate. However, in patients with grade IIIB injuries and\/or exposed defect hardware, fasciocutaneous flaps were more likely to be re-elevated for orthopaedic procedures, including staged primary bone grafting, hardware manipulation, and bone grafting for nonunion. This was the case in both the acute and chronic subgroups. The design of this study unfortunately precludes analysis to determine whether this difference is due to the biological effect of flap type or other confounders such as patient selection. In our series of 76 osteomyelitic limbs, 91% were muscle based (gracilis or latissimus dorsi). 47","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"7e9845cd-8858-f3d7-ba19-3a52f604d798","text":"Our study shows that basis material decomposition and particularly bone-equivalence images have a high potential of improving the diagnostic outcome of radiograph examinations of musculoskeletal disorders, suggesting considerably better image quality and diagnostic detail of bony structures and a higher overall image quality and diagnostic acceptability than conventional radiography.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"7e9d6b89-85a2-94a2-d627-1692037aab0d","text":"Definitive radiation therapy of cervical cancer is one of the most challenging treatment situations in radiation oncology requiring application of high radiation doses to achieve tumor control. However, the geometrical distribution of target volumes in the pelvis with a central tumor positioned directly between radiosensitive organs (bladder, rectum, sigmoid and small bowel) and involved or at risk lymph nodes neighboring small bowel are challenging for external beam therapy. High radiation doses can therefore typically not be delivered by external beam radiotherapy alone and necessitate an additional brachytherapy boost.","title":"A practical review of magnetic resonance imaging for the evaluation and management of cervical cancer"}
{"_id":"7ea52477-3fb6-cbcc-fdff-14e536adf6dd","text":"The current study supports laser frenotomy as an effective and safe treatment for newborns with ankyloglossia. Laser frenotomy caused low pain and very few complications both intra- and postoperatively with all wounds healed within thirty days with no recurrence of ankyloglossia. A significant improvement in breastfeeding and growth in newborns with a reduction of maternal nipple pain has also been shown.","title":"Lingual laser frenotomy in newborns with ankyloglossia: a prospective cohort study"}
{"_id":"7ea728c9-54bb-3a97-2f31-b5f648f86edd","text":"Here we report the detection of a somatic mosaic APC mutation in a patient who was diagnosed with desmoid type fibromatosis in childhood. FAP was eventually suggested after she developed extensive extra-abdominal fibromatosis.","title":"APC mosaicism in a young woman with desmoid type fibromatosis and familial adenomatous polyposis"}
{"_id":"7eb1ce86-98e5-b2bc-be52-4b4abac51f3c","text":"Ultrasound offers obvious advantages, but the operator needs to recognize the potential for pitfalls during clinical use related to difficulties with needle visualization and incorrect identification of structures. Even small involuntary movements may lead to insertion into a vascular structure and subsequent local anesthetic toxicity. Visualization of deeper structures may require more pressure to be applied to the probe in order to visualize the target nerve, causing the collapse of blood vessels leading to a false-negative aspiration test.","title":"Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review"}
{"_id":"7eb73f80-3ffb-d4c2-2a41-1ddb05492f31","text":"To create the lateral gastrocnemius muscle flap, a straight incision down to the subcutaneous tissue level was made on the posterolateral side of the leg. The lateral edge of the muscle flap was cut to locate the peroneal nerve. The space between the lateral head of the gastrocnemius and the soleus muscle was located at the posterior edge of the leg, which was bluntly separated. The incision was then extended up to the popliteal fossa. Following this, the origin of the lateral head of the gastrocnemius on the femoral condyle was dissected. The vascular pedicle of the lateral head of gastrocnemius was dissected to protect it. After that, the medial margin of the muscle flap was dissected in the internal and external space of the gastrocnemius muscle and the distal gastrocnemius was then severed.","title":"Gastrocnemius muscle flap with vancomycin\/gentamicin-calcium sulfate and autogenous iliac bone graft for the phase I treatment of localized osteomyelitis after tibial plateau fracture surgery"}
{"_id":"7eb86a20-5dc8-671b-5e02-ac470800d1c3","text":"It could also be that a previous skin cancer was accidentally injured by the chemical burn. However, the patient insisted that there was no previous skin lesion on her left lower leg. Furthermore, pathologic analysis of the specimen from the first operation revealed that the tumor size was not that small and that the margin was infiltrated by the squamous cell carcinoma. It is more likely that the burn wound changed to the malignancy rather than that a previous skin cancer existed.","title":"Rapidly developed squamous cell carcinoma after laser therapy used to treat chemical burn wound: a case report"}
{"_id":"7eba392e-0507-793d-e9b6-bd01a050b8bc","text":"When considering the placement of an AVF on a calcified radial artery, the presence and patency of the ulnar artery as well as the adequacy of its Doppler signal should be confirmed. The presence of calcifications in the ulnar artery, which are always present in the case of radial artery calcifications, should not be considered a contraindication by itself.","title":"The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini Review"}
{"_id":"7ebc1ddb-8eda-303f-27b1-000275a30363","text":"The use of SLNB reliably identifies melanoma patients with nodal micrometastases, enabling clinicians to identify patients with occult nodal metastases that would otherwise take months or years to become clinically palpable—it has been confirmed by the MSLT-1 trial data that cumulative rates of nodal involvement in patients undergoing SLN biopsy or not are similar. Currently, the positive result of SLN biopsy is a major manifestation of stage III melanomas. The results of the current study confirmed our previous data, as well as data from the AJCC staging database, demonstrating that in a group of patients with micrometastases both primary tumor features as well as nodal characteristics have independent prognostic value for OS assessment [17, 18]. Our results indicate also the heterogeneity of patients undergoing CLND due to positive SLN, which is strictly related to tumor load. The number of nodal metastases is still a very powerful independent predictor of survival among all patients with micrometastatic stage III disease, but microanatomic features of SLN metastases should also be taken into account when the patient’s prognosis is discussed.","title":"The long-term results and prognostic significance of cutaneous melanoma surgery using sentinel node biopsy with triple technique"}
{"_id":"7ebfbdd7-a9cb-11ed-96e6-fa9af084fd41","text":"We have identified subsets of patients who appear to be at greater risk of VTE following varicose vein surgery: those undergoing general anaesthesia and either EVLT combined with phlebectomy or bilateral surgery. There are no universal guidelines on the use of peri-operative thromboprophylaxis for these cohorts and it cannot be determined from HES whether VTE prophylaxis was used for individual cases. Our data support the use of VTE prophylaxis in all patients undergoing general anaesthetic varicose vein surgery, but in particular for these seemingly higher risk groups.","title":"The incidence of post operative venous thromboembolism in patients undergoing varicose vein surgery recorded in Hospital Episode Statistics"}
{"_id":"7ebfd5fa-e678-8e6e-e55c-27ba9e47fe69","text":"This is the first study in the age perception research field in which large samples of faces from diverse races taken around the world are tested with participants of different racial and cultural origins. We have shown that several aspects of facial contrast decrease with age in all racial groups, though some other aspects of facial contrast vary with age in racially-specific ways. Globally, older faces have less facial contrast than younger faces. We have also found that artificially increasing those aspects of facial contrast that decrease with age in diverse races and ethnicities makes the faces look younger, independent of the ethnic origin of the face and the cultural origin of the observers. These findings are consistent with the idea that facial contrast is a cross-culturally valid cue for perceiving age.","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"7ec312da-141b-a722-70cc-70ca0d22ab3f","text":"Hence the other patients who their follow up data was incomplete were omitted from the study.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"7eca1026-5971-5c0a-96e9-ab67f9fcb3b6","text":"Another key aspect highlighted by the survey is the need to increase trainees' awareness of the challenges they will face when applying to the UK NHS. By providing comprehensive information and guidance, trainees can be better prepared for the difficulties they may face and navigate the system more effectively.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"7ed23811-2f9d-27b1-7ebb-27ba9b53bb1b","text":"The versatility and minimum sacrifice associated with these flaps extended the scope.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"7ed89470-50d3-1f4f-1360-e4ab7ddd8674","text":"Many factors determine the propensity of a tumor to disseminate its cells to spread via the anatomical lymphatic system. Tumor cell motility as well as lymphatic vessel density is factors that may contribute to the enhanced spread along lymphatic pathways [8].","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"7ed98c4a-6d50-558f-610e-e65cf5476aeb","text":"We have been using the gracilis muscle regularly for small soft tissue defect reconstruction, coverage of small areas of osteomyelitic bone and functional transfer to the palsied hand, with a success rate of 100%. The benefits of gracilis as a donor muscle and its reliable vascular supply have encouraged us to be more liberal in its use in high-velocity trauma of the lower limb for covering vital structures as well as filling soft tissue defects after surgical excision of dead and traumatised tissue. With growing confidence, we are now increasingly using the split gracilis twin free flaps for smaller areas of tissue defects (in lower limb trauma) with gratifying results. It has ensured quick healing and superior results in lower limb trauma and a decreased “down-time” for the patients along with the added benefits of a single donor area and no functional deficit.","title":"The transversely split gracilis twin free flaps"}
{"_id":"7edc7a86-271a-7ace-356e-3f62241d8a60","text":"What about patients who do have metastatic disease in an internal mammary sentinel node? Radiotherapists and medical oncologists should modify their consensus protocols for radiotherapy and adjuvant systemic treatment to include these patients. Incorporating the tumour-status of sentinel nodes outside the axilla in the management may lead to better patient selection and improved regional control and survival. One would like to examine these issues in randomised trials but such trials will be difficult to conduct. For instance, an informed patient with a tumour-positive internal mammary sentinel node might be hesitant to accept the risk of being excluded from adjuvant radiotherapy and systemic treatment.","title":"Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients"}
{"_id":"7ede1868-5cb7-95a0-756d-d8b50f125df9","text":"Ilizarov method addresses all the above problems simultaneously and offers a panacea for infected non-unions. The stability of the fixation allows weight bearing ambulation and joint mobilisation. Progressive bone histogenesis following corticotomy and bone transport helps in filling bone gaps eradicating infection and promoting fracture union. Infection control is achieved by radical debridement of the infected tissues including bone and followed by bone transport to reconstruct the residual bone defects.","title":"Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study"}
{"_id":"7ee1f2ea-d677-f681-d324-32033bc9d4ad","text":"This retrospective non-randomised case control study has demonstrated the safe use of a novel application of negative pressure wound therapy that significantly reduced the incidence of seroma formation and postoperative complication rate for inguinal lymphadenectomy for melanoma.","title":"Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma"}
{"_id":"7ee5f938-c125-9f70-489d-e206e55078ce","text":"In a study by Aroen et al.12 in rabbits, 16 of 23 periosteal flaps became detached within 2 weeks, with no difference in the retention rate with respect to the mobilization regime or established access to bone marrow elements in the defect. The periosteum still served as a cover of the defect in 10 of 12 knees on day 4. This figure decreased to 7 of 23 knees on day 14. However in our study, we observed that there was complete graft retention at the grafted side in all the rabbits. We believe that stitching the periosteum with the adjacent muscles gives good anchoring and retains the graft in situ.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"7ee79107-f048-0f48-0e64-c8007caaf211","text":"The partial latissimus dorsi muscle flap was rotated so that it covered the anterior and inferior portions of the implant via the lateral subcutaneous tunnel of the breast and was sutured with the surrounding tissue. The flap was sutured along the inframammary fold, and the whole exposed implant was covered and left intact. A negative pressure drainage system was applied, and the wound was sutured.","title":"A Retrospective Study of Latissimus Dorsi Flap in Immediate Breast Reconstruction"}
{"_id":"7eea8b8c-4a71-d104-a36a-26612c6e2ba4","text":"laminectomy is a valuable surgical treatment for some patients with a cervical radiculomyelopathy due to cervical spinal stenosis. More recently attention has been given to motion of the spinal cord over spondylotic spurs as a cause of myelopathic changes. Immobilisation by fusion could have a positive effect on the recovery of myelopathic signs or changes. This has never been investigated in a prospective, randomised trial. Lamifuse is an acronyme for laminectomy and fusion.","title":"Design of Lamifuse: a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy"}
{"_id":"7efec892-c07e-4134-5b4d-bfa5cd3423e3","text":"Although desmoid tumors of the sternum have been described in a few case reports, they are still rare entities. Radical en bloc resection of desmoid tumor of the sternum with a negative margin and sternal reconstruction with autogenous rib grafts is safe, effective and feasible.","title":"A rare desmoid tumor arising from the manubrium"}
{"_id":"7f021152-8373-3f05-143f-76fcee1ed24c","text":"For the lid tightening movement, synkinesis in the lower face of patient A was eliminated with rehabilitation. Similarity in the pattern of fuzzy entropy for this primary motion between patient A and healthy individuals increased after the rehabilitation process. Fuzzy entropy data for the lid tightening facial movement in all subjects are illustrated in Figure 1. Fuzzy entropy data for the lid tightening facial movement in all subjects are illustrated on a 3D face model in Figure 2.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"7f0c2d99-2fb8-c60a-9c00-2a34991e2578","text":"The primary composite endpoint was ATE defined as ischemic stroke, MI or peripheral arterial thromboembolic event. Stroke was diagnosed based on persistence of typical symptoms for more than 24 h confirmed on magnetic resonance imaging or computed tomography. The diagnosis of MI was established based on typical symptoms, changes on the electrocardiogram and increased myocardial necrosis biomarkers. Peripheral arterial thromboembolic event was defined as acute peripheral artery occlusion. ATE episodes related to invasive procedures were excluded. The secondary endpoint of the study was symptomatic VTE diagnosed based on positive findings of color duplex sonography. Recurrent DVT in the same leg as the index event was diagnosed when new no-compressibility of venous segment was observed or when there was an increase of at least 4 mm in the residual diameter. Anticoagulation treatment was prescribed again in patients with recurrent VTE.","title":"Accelerated fibrin clot degradation is associated with arterial thromboembolism in patients following venous thrombosis: a cohort study"}
{"_id":"7f14d140-c00a-228f-2e75-1c539b09f36c","text":"Hyaluronic acid has an increased demand in the Asian market because of its convenience and short recovery period. However, vascular complications have always been a serious concern of this procedure. Intravascular injection or the compressive effect of the filler on local vessels might lead to extensive skin necrosis.","title":"Design and Application of a Novel Silicone Nasal Implant"}
{"_id":"7f14da2b-e759-59c7-8a52-23a5bec7ecf7","text":"Specific studies would be needed to appreciate the individual impact of each social media platform or to precise the most influential type of content on the medical or surgical experience of surgeons and residents. It would be relevant to investigate the sources of professional content consulted by the respondents. Indeed, medical content can come from official sources such as institutions or official scientific societies using social networks or from practitioners publishing on their own behalf. These contents could be prioritized according to their official or unofficial source. The credibility given to the different contents could be the objective of another investigation.","title":"Social Media’s Use and Impact on Oral Surgeons and Oral Surgery Residents"}
{"_id":"7f1869da-9067-8b3d-8f40-e2ec9c4cd2a3","text":"The purpose of this study was to evaluate the outcome of rectal cancer surgery, with a focus on the local recurrence rate, at a unit that adopts the principles of TME with a high restorative procedure rate and a low APE rate.","title":"Surgical treatment of rectal cancer: prospective cohort study about good oncologic results and low rates of abdominoperineal excision Tratamento cirúrgico do câncer retal: estudo coorte prospectivo com bons resultados oncológicos e baixas taxas de amputação abdominoperineal"}
{"_id":"7f18dac0-fb60-7fb6-8c02-0b164bb833fb","text":"Ultrasound-guided percutaneous muscle biopsy has been demonstrated to provide diagnostic rates comparable with open biopsy in the assessment of acute muscle disease but less successfully for chronic disease [8]. Furthermore, this technique conveys further practical benefits: the modified Bergström needle and suction technique is best utilized for difficult to access muscle groups that cannot be targeted using an open approach as it requires a smaller incision and reduces use of surgical theatre time. The procedure is also rapid and can be performed in an outpatient setting under local anaesthesia. Visualization of key structures minimizes the risk of post procedural bleeding and other complications, while also aiding the identification of viable muscle for biopsy. Additionally, the procedure is better tolerated by patients in comparison with surgical methods.","title":"Ultrasound-guided muscle biopsy: a practical alternative for investigation of myopathy"}
{"_id":"7f1c3ac4-9950-e3b1-7b05-b872290cac61","text":"The marked increase in the 1990s in the use of adjuvant therapy for ductal carcinoma in situ patients treated with breast-conserving surgery in the community setting only partially explains the 50% decline in risk of recurrence. Changes in pathology factors have likely also contributed to this decline.","title":"Declining recurrence among ductal carcinoma in situ patients treated with breast-conserving surgery in the community setting"}
{"_id":"7f2d11e8-0c0f-4652-457b-565533ea91db","text":"Microssurgical free tissue transfer also plays an important role in scalp reconstruction because large defects with bone exposure as well as the need for adjuvant therapy are frequent. Previous studies recommended latissimus dorsi flap, anterolateral thigh flap, and radial forearm flap. In the present case, free tissue transfer was not used because it would demand a more complex surgery as well as the reduced capability for clinical surveillance for local tumor relapse.","title":"Multifocal cutaneous angiosarcoma of the scalp—A challenging reconstructive case managed with skin substitutes"}
{"_id":"7f304557-b2de-0faa-451c-3f56eb8e1c38","text":"Many patients tolerate the harvest quite well and are ambulatory as soon as they are mobilized, which is generally postoperative day 2. To minimize any functional deficit in the quadriceps muscle group, we prefer to harvest a predominantly fasciocutaneous flap and limit the inclusion of vastus musculature unless required to preserve perforators. Using objective kinetic analyses, Kuo et al. have demonstrated a statistically significant difference in functional morbidity favoring a vascularized fascia ALT flap over a myocutaneous ALT flap [8]. Furthermore, excessive muscle harvest is unlikely to offer a significant increase in flap bulk given the inevitable atrophy that will ensue secondary to denervation. When motor nerves are sacrificed because of aberrant perforator anatomy, we prefer to reconstruct them with primary coaptation or nerve graft. The most commonly seen postoperative complication is seroma of the thigh, typically encountered several weeks after surgery once the patient has become increasingly ambulatory. This is a minor morbidity causing minimal patient discomfort that is easily treated with needle drainage in the office.","title":"Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction"}
{"_id":"7f35175b-1b1f-418c-173a-431a92a3effd","text":"The spectrum of vascular lesions developing in breast or chest wall skin following lumpectomy or mastectomy and radiation is wide and ranges from atypical vascular lesions with a benign clinical behaviour to frankly malignant, angiosarcoma ranging histologically from well to poorly differentiated variety. Postmastectomy-postirradiation atypical vascular lesions (AVLs) are rare and develop in the skin adjacent to the mastectomy scar. About hundred cases have been reported in the literature so far. AVLs have also been reported in patients after breast conservation surgery within the breast parenchyma or in the skin around the scar. The incidence appears to be rising. The exact reason for this is not known. The newer modalities of radiation therapy may be contributory to the pathogenesis. More studies have to be done in this area to prove the causal relationship. We are reporting the cases of 2 patients with carcinoma of breast who developed postmastectomy-postirradiation atypical vascular lesions. The cases were received in our department within a 6-month period.","title":"Postmastectomy-Postirradiation Atypical Vascular Lesion of the Skin: Report of 2 Cases"}
{"_id":"7f36158e-2650-8f9e-9aae-55d6d99d5222","text":"We report a case study of fat embolism seen on ultrasound at right internal jugular vein during central venous cannulation in a patient diagnosed with fat embolism syndrome. This case demonstrates the importance of ultrasound for evaluation of trauma cases with suspicion of fat embolism.","title":"Fat embolism in right internal jugular vein: incidental ultrasound finding during internal jugular vein cannulation"}
{"_id":"7f394337-37db-8fc1-97cc-ea47227f5773","text":"The aim of this paper is to describe a prospective, single blinded, multicenter study to examine patients with clinically suspicious moles or lentigo maligna to determine whether confocal microscopy can both reduce the number of unnecessary biopsies of moles and more accurately guide the surgical excision margins of lentigo maligna.","title":"Evaluating the Diagnostic Accuracy of Reflectance Confocal Microscopy to Diagnose Skin Cancer: Protocol for a Prospective, Multicenter Study"}
{"_id":"7f3f3c10-ee32-aebb-3572-c3b08c4a89af","text":"Despite this evidence for the presence of bacteria around filler material and support for a primary role in the development of LIRs, some authors postulate that these findings are not enough to conclude LIRs have an infectious aetiopathology [46]. They state that the proof of such a conclusion cannot be based on the visualization of a few bacteria on histologic slides or by genetically identifying them, but to demonstrate the presence of a biofilm formation with hundreds of bacteria.","title":"The Aetiopathogenesis of Late Inflammatory Reactions (LIRs) After Soft Tissue Filler Use: A Systematic Review of the Literature"}
{"_id":"7f555dab-7db9-9901-09e1-b84d698ea85a","text":"The lack of traditional surgical instruments and the hemostatic effect of the laser resulted in bloodless surgery and in the lack of need for affixing sutures, which are annoying in the postoperative course especially when performing myofunctional exercises.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"7f58d207-0786-59c2-4451-332a242ba63b","text":"Both the American Heart Association and American Stroke Association and the European Stroke Organisation guidelines recommend thrombophilia screening at least in certain circumstances after confirming CVT by imaging study to prevent recurrent venous thrombotic events.. On the other hand, although hyperhomocysteinemia is a well-known risk factor for CVT, there is a gap in thrombosis management guidelines not including Hcy measurements. We think measurement of plasma Hcy along with thrombophilia screening will enhance the diagnostic pick up of an underlying cause of unprovoked CVT or any large vessels thrombosis and propose modification of the current guideline as per Figure 2. In brief, clinical characteristics suggestive of HCU in patients with VTE; VTE in conjunction with weak provoking factors at a young age, often considered to be less than 40 years of age; VTE in an unusual site such as the central nervous system; recurrent VTE events, and eye glass requirement at young age or history of lens dislocation.","title":"A case series of cerebral venous thrombosis as the first manifestation of homocystinuria"}
{"_id":"7f5925f2-8bea-2860-8e95-501e890b9974","text":"Sentinel node biopsy (SNB) was performed using the dye technique only without the adjunct of radioisotope labelling and gamma probe. Five mls of patent blue dye was infiltrated peritumorally or subcutaneously in palpable cancers, around the guide wire tip in impalpable cancers or into the cavity wall when performed as a secondary procedure to initial tumour excision.","title":"Sentinel node biopsy should be supplemented by axillary sampling in patients with small breast cancers"}
{"_id":"7f607e47-2419-d0e0-f64f-99f2ee5c7ee7","text":"The quality of life in both physical and mental categories generally increased with follow-up periods. At 6 weeks, all domains in physical health and mental health of the patients were significantly greater than the baseline values before surgery excepting only physical function, vitality and social function which did not differ significantly from the baseline values. At 12 weeks and 24 weeks, the data demonstrated that both the physical health and mental health of patients after surgery significantly improved in all domains compared to the baseline values as shown in Table 5.","title":"Efficacy and Safety of Antibiotic Impregnated Microporous Nanohydroxyapatite Beads for Chronic Osteomyelitis Treatment: A Multicenter, Open-Label, Prospective Cohort Study"}
{"_id":"7f680e21-1ea5-2193-5a82-54dcffd684af","text":"Inguinal RLND was initiated with a lazy S incision extending from the anterior superior iliac spine to the apex of the femoral triangle. Skin flaps were raised using electrocautery medially to the pubic tubercle and to the adductor longus muscle, and laterally to the apex of the femoral triangle. The fatty, node-bearing tissue of the triangle was removed, skeletonising the femoral bundle in a subadventitial plane and transecting the saphenous vein at the confluence. Access to the iliac fossa was obtained via a transverse incision through the external oblique aponeurosis, 4 cm above the inguinal ligament, lifting up the peritoneum. RLND was performed around the external iliac vessels up to the level of the ureter and down in the pelvis to the obturator nerve. Finally, the muscular and aponeurosis edges were sutured, and the wound closed over a closed suction drain in the femoral triangle.","title":"Collagen sealant patch to reduce lymphatic drainage after lymph node dissection"}
{"_id":"7f6ea589-28cc-8140-41d7-a9e3bfa7e06e","text":"Intratumoral inoculation is not recommended because inflammation is often created around the lesion and the 99mTc nanocolloid tracer is unable to pass through this layer of inflamed tissue.","title":"Sentinel Lymph Node Detection in Breast Cancer: An Innovative Technique"}
{"_id":"7f8b1fc9-36b4-1a31-5f4d-7b4382ee1df9","text":"In the present study, the authors compared the long-term clinical outcomes in a cohort of 492 patients who underwent PMRT with and without prior immediate TRAM flap reconstruction at a single cancer center in Asia. The cosmetic outcome and complication rates were not the study endpoints. Recurrence and survival were the focus. The authors found no significant DFS or OS difference, and no significantly different local recurrence or distant metastases rates between patients with and without TRAM flap reconstruction.","title":"Comparison of Long-Term Outcomes of Postmastectomy Radiotherapy between Breast Cancer Patients with and without Immediate Flap Reconstruction"}
{"_id":"7f908f81-b649-ea81-c1ea-038fe4cff5e5","text":"Furthermore, it is a sensitive area when friends and relatives elaborate on the breastfeeding situation and the nourishment problems. When telling about their complications, the mothers feel that their concerns are diminished, like suspicions of suckling positions, sleeping disorders, feeding frequencies, and vomiting in terms of volume and frequencies. When explaining their concerns about the infant having different ways of gripping the nipple that would cause severe pain and create soreness and bruises, they felt that health care personnel tried to normalize these problems. Sometimes they had to return 2 or 3 times over a period of 6 weeks before being confirmed that the infant was suffering from pyloric stenosis or a too tight lingual frenum that needed to be operated on or cut in order for them to get a better grip. This period is a burdensome time because so much is at stake for the mothers.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"7f9e8b13-6a5d-97fd-34ee-cfee10d8bf1a","text":"NPWT is an old technique but it is time tested and it has a key role in converting a complex three-dimensional wound into a two-dimensional wound to progress towards the definitive management. In the developing countries, NPWT stays as the first line of treatment in management of complex wounds after debridement.","title":"Negative Pressure Wound Therapy (NPWT): Our Experience in Pakistan With Locally Made Dressing"}
{"_id":"7fa34753-4604-857e-9e0e-b245daf56bde","text":"We do not want to support persons who are only looking for their own profit while organizing a camp. We do not do cosmetic surgery and never take money for our operations in the foreign countries. The skills and risks of every operation should absolutely fit to the experience and quality of the surgeon; we do not do experimental surgery and do not use the trip only as training camp for our team members. There is no place for heroes and big adventure.","title":"INTERPLAST-Germany—adapting to global plastic surgery"}
{"_id":"7fa729e0-34ff-d1e9-7fb6-f4bcad02d527","text":"Emergency-care givers and radiologists should be informed about this infrequent complication in order to make early diagnosis and initiate adequate antibiotic therapy.","title":"Acute Tibial osteomyelitis caused by intraosseous access during initial resuscitation: a case report and literature review"}
{"_id":"7fa8fc5d-487c-13d9-04d6-062f45b37063","text":"With the majority of included studies being small scale observational studies, there is a lack of high quality studies that assess the use of iVR for preoperative planning within larger patient and surgeon populations over an extended follow-up period. This may help to elucidate the effects of improved surgeon preparedness and confidence on the longer-term patient specific outcomes. Moreover, there is substantial heterogeneity in the outcomes and outcome measures used to assess the effectiveness of the technology as an intervention. There is a need for the use of standardized outcomes and validated instruments within high quality randomized trials to investigate the efficacy iVR on preoperative planning before implementation into practice. There is also value in further exploring facilitators and barriers to implementation using robust qualitative methodology.","title":"Immersive Virtual Reality for Patient-Specific Preoperative Planning: A Systematic Review"}
{"_id":"7fa9d0f9-d0eb-3f4f-cda7-0fc69a25530a","text":"Our data are consistent with others and indicate that not all of the patients who have metastasis in LNs detected by US guided needle biopsy should undergo ALND, because there is a sub-group of patients among them who fulfil the Z0011 criteria, meaning that SLNB is safe and sufficient for them.","title":"Could axillary clearance be avoided in clinically node-negative breast cancer patients with positive nodes diagnosed by ultrasound guided biopsy in the post-ACOSOG Z0011 era?"}
{"_id":"7fad8321-d8ce-d1d7-55f9-c35a09c86c97","text":"Soft tissue fillers are a mainstay in contemporary, minimally invasive facial rejuvenation procedures owing to timely results and minimal recovery period. Although associated with a low complication rate, soft tissue fillers are not without risk. Complications range from mild superficial skin irregularities to granuloma formation to vascular occlusion leading to skin necrosis or even blindness. Fillers vary in composition, elasticity, hydrophilicity and duration of effect that is tailored to specific cosmetic indications. Selecting the right product for the desired effect can cut down on unwanted outcomes. Severe adverse events can be avoided with safe injection technique, early recognition of symptoms and a thorough knowledge of the local anatomy. This review outlines several complications all providers should recognize and discusses strategies for their prevention and management.","title":"Complications after cosmetic periocular filler: prevention and management"}
{"_id":"7fae0624-86a7-067a-ffcf-a82c2884f0d7","text":"Based on data reported in the literature and obtained in the present case report, cryosurgery is a safe and extremely effective procedure in the treatment of lesions occurring in the oral and maxillofacial region. Nevertheless, despite the scientifically proven efficacy and routine application of cryosurgery across many medical specialties, this treatment modality is still rarely used in dentistry.","title":"Cryosurgery as an Option for the Treatment of Vascular Lesions of the Oral Cavity"}
{"_id":"7fb75080-d909-d8f8-c915-8774543b4f2e","text":"The first patient was recruited in June 2017 and as of April 2020, almost 500 patients had been included at 19 centers in Sweden.","title":"TRIM study protocol - a prospective randomized multicenter Trial to assess the Role of Imaging during follow-up after radical surgery of stage IIB-C and III cutaneous malignant Melanoma"}
{"_id":"7fb7cf02-e700-5fac-f9e8-698f85e1bd9f","text":"Secondary analyses explored the separate risk of proximal DVT and of PE, as well as the risk of major VTE stratified by the presence or absence of VTE screening tests and by anticoagulation regimen.","title":"Proximal deep vein thrombosis and pulmonary embolism in COVID-19 patients: a systematic review and meta-analysis"}
{"_id":"7fb89988-1c83-7a43-8cae-b46d5ac32b37","text":"Our results showed that the 13 patients in whom the pectoralis major flap and gastric pull-up were used to restore intestinal continuity had a shorter mean swallowing function recovery time than did the ten patients whose defects were reconstructed using gastric pull-up and covered by a pectoralis major flap, but this finding was inconclusive due to the small number of patients in each group. However, we did observe that these 13 patients had a smooth postoperative recovery without anastomotic leakage. This finding suggests that the combined use of pectoralis major flap and the gastric pull-up to restore intestinal continuity is a safe reconstructive method for patients with extensive hypopharyngeal cancer after uncompromised resection. Furthermore, it is probable that using this combined flap technique to restore intestinal continuity contributes to a quick postoperative recovery without severe complications and thus leads to a shorter swallowing function recovery time after surgery. However, future studies with large sample sizes are needed to verify our findings.","title":"Combined use of gastric pull-up and pectoralis major flaps for massive defects after total laryngopharyngoesophagectomy in patients with advanced hypopharyngeal carcinoma"}
{"_id":"7fc4bfd1-c5dd-6cde-0333-868412c5a8cd","text":"As the tumour to background ratio is usually low and as scattering and attenuation of photons within the patient is another problem, so statistical probability mapping, SPM, with a change detection algorithm has been investigated to see if it provides an acceptable solution.","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"7fcdae44-c781-06bf-f415-2e24e8aafc60","text":"Bone resection and minor even major amputations are unlikely to remove all the bacteria involved and it seems therefore important to obtain data on the persistence of infected tissues including bone. Most but not all the studies have reported a negative effect of residual osteomyelitis on the outcome of patients operated for DFO. A lot of questions about the examination of the bone specimens (e.g., culture or\/and histology, the interpretation of the results) have not yet been solved. Some studies have pointed out the discrepancies between culture and histology of bone margin biopsies. These studies suggest that some of the positive cultures of bone margin biopsies are in fact in relation with contaminated specimens. Histology may help interpret the results of bone margin biopsies but the delay for obtaining the results in the daily practice appears to be a serious limitation in its routine implementation. In addition, the reliability of histology in these settings is an issue as suggested in some studies. The type and duration of the antibiotic treatment to consider in patients with a persistent osteomyelitis on the bone margins are currently unknown.","title":"Surgical techniques for Bone Biopsy in Diabetic Foot Infection, and association between results and treatment duration"}
{"_id":"7fce2658-f90b-14af-f008-3a284409ba5b","text":"This study evaluates the effectiveness of immediate postoperative application of NPWT following fasciocutaneous or muscle flap coverage for lower leg reconstruction. It also describes our own standard practice of NPWT application in a case series.","title":"Immediate application of negative pressure wound therapy following lower extremity flap reconstruction in sixteen patients"}
{"_id":"7fd15ac0-7e53-ad52-b9c1-ec978097890e","text":"Our results indicate that VR is helpful for planning sellar area surgery and performing operations in the sellar area. Among 11 surgeons who used VR and completed a survey questionnaire, 10 surgeons perceived that there were some differences between the model and the actual anatomy observed during surgery, but that the model does help with understanding the anatomy, and 9 surgeons thought the VR images were superior to two-dimensional images but there was still a need for other images to be used in combination with the VR images.","title":"Stereoscopic virtual reality models for planning tumor resection in the sellar region"}
{"_id":"7fd419f9-44e6-21fc-5575-a2410ef49727","text":"This case also highlights important considerations when treating ALS patients with head and neck cancer. First, the surgeon must carefully weigh the donor site morbidity when considering free flap reconstruction as there may be a discrepancy in function between the upper and lower extremities depending on the patient's neurologic status. In this case, given that the patient had no residual function in her lower extremities, a fibula free flap posed minimal donor site morbidity.","title":"Immediate postoperative non‐invasive positive pressure ventilation following midface microvascular free flap reconstruction"}
{"_id":"7fdc3f78-38ac-82ea-6d11-af5007628fab","text":"The main goals of any reconstruction of the scalp are the protection of the intracranial contents, while maintaining the contour of the head and providing an optimal esthetic restoration.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"7fe62428-caaf-6947-8099-8bdee0d1979b","text":"The findings from our study show the increasing prevalence of skin tumors, and the results were comparable to other similar studies conducted in various parts of Nepal.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"7fe9d8f9-bfe2-65f5-788a-0a0824a77481","text":"The intraoperative complications like transection of facial nerve or rupture capsule of parotid tumor or incomplete resection of parotid tumor were not reported.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"7fefbbe2-ff5e-ca60-36d7-b9b207f5c017","text":"This is a prospective comparative study that was conducted between June 2009 and July 2010 on forty patients with breast carcinoma scheduled for modified radical mastectomy. Axillary lymphadenectomy, extending from the lower border of the axillary vein superiorly, from the medial border of the pectoralis minor muscle medially, as far as the fourth intercostobrachial nerve inferiorly and to the edge of the latissimus dorsi muscle laterally.","title":"The value of mastectomy flap fixation in reducing fluid drainage and seroma formation in breast cancer patients"}
{"_id":"7ff1d73b-815c-f125-8994-10f493c5caa2","text":"Ethical approval is not necessary for case report in our locality.","title":"Giant recurrent liposarcoma of the retroperitoneum – A surgical challenge: A case report"}
{"_id":"7ff22b6e-6367-fcd7-2143-183f0563d1a3","text":"Apart from understanding the genetic basis of skin cancer, being able to modify environmental factors, such as vitamin D intake or sun exposure, is extremely important for the prevention and prognosis of this pathology. This is why we designed a study in which we assessed the relationship between NMSC and serum vitamin D levels. The objective of our study was to evaluate whether vitamin D levels have a differential effect in patients with NMSC versus healthy subjects and to determine the possible risk of NMSC for the variables sex, age and vitamin D levels and their model fit. Our study aims to provide knowledge so that in future research, it could be possible to propose new measures regarding optimal levels of vitamin D that could help prevent or improve the prognosis of NMSC.","title":"Vitamin D serum levels and non-melanoma skin cancer risk"}
{"_id":"7ff22f0e-0715-3f6e-e19b-5f081829504b","text":"As a part of the diagnostic accuracy studies POCUS of the heart, lungs and deep veins was performed within one hour after the primary clinical assessment. All three types of sonography were performed in all of the included patients. The sonographic examinations were performed according to the following protocols:","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"7ff463e4-6c9d-8936-9838-63296078217a","text":"Ulceration of a reconstructed nipple occurred in a woman in her 50s who had undergone mastectomy, axillary lymph node dissection, and deep inferior epigastric artery perforator flap reconstruction for right breast cancer. The implanted cartilage was removed on suspicion of infection and the ulcer was biopsied. Local recurrence was identified on histopathological examination. Local recurrence near a reconstructed nipple can cause ulceration because of the fragility of the reconstructed nipple tissue. If erosion or ulceration develops in the reconstructed nipple relatively long after surgery, pathological examination is warranted.","title":"A Case of Breast Cancer With Ulceration of a Reconstructed Nipple Due to Local Recurrence"}
{"_id":"80022101-af62-6dc2-045c-80b36e47c15e","text":"How do these findings in our animal model affect the concept of OIT, in which increasing amounts of offending allergens are continuously ingested by food-allergic patients? While our results suggested that continuous allergen exposure could result in persistent neuroinflammation, we cannot assume that our observations in mice with experimentally induced allergic sensitization directly apply to human patients with idiopathic food allergies. OIT aims to develop immune tolerance in severely symptomatic patients to prevent life-threatening reactions upon accidental exposure. The immunological process of tolerance established by this methodology is also likely distinct from that of tolerance in asymptomatically sensitized individuals. Importantly, the benefit of OIT to prevent deadly reactions outweighs the potential risk of developing neurological diseases later in life. Thus, additional in-depth investigations for different types of allergic patients are necessary before any clinical recommendation may be proposed.","title":"Asymptomatic sensitization to a cow’s milk protein induces sustained neuroinflammation and behavioral changes with chronic allergen exposure"}
{"_id":"800d47f0-23f5-896d-fa01-159f262c1568","text":"A well-designed fibular flap is an optimistic method for the reconstruction of a type C composite oral maxillofacial defect. Anatomical studies have shown that cutaneous perforators can normally be identified along the posterior border in the middle or lower third of the fibula. The average number of cutaneous perforators was approximately 4 branches. Our experiences demonstrated that designing two skin paddles was safe, and the flap could be stably dissected. Locating muscular perforators to the soleus was crucial for harvesting a chimeric fibular flap with blocks of muscle. A cadaveric study showed that two sizable muscular perforators to the soleus consistently branched from the proximal part of the peroneal artery. After locating the main trunk of the peroneal artery, meticulous exploration should be performed to identify muscular branches to the posterior soleus muscle. In addition, a well-designed fibular flap is also a very good way to reconstruct a type C defect combined with the upper maxilla, as shown in this study. Virtual surgical planning could be used in this setting to achieve satisfactory positioning of the flap. Microvascular anastomosis of the short peroneal artery to the recipient vessel was another challenge in this case.","title":"Reconstruction of composite oral and maxillofacial defects by free flaps based on a new classification"}
{"_id":"800d7e43-9620-2bdd-6177-3eb9fa413fc4","text":"In a subset of 46 patients with evaluable conventional and 3D photography, the localization of melanoma lesions was systematically correlated to anatomically determined lymphatic drainage pathways (7). Our results show that the localization of primary melanoma on the lower leg indicates areas at risk which should be examined more closely during follow-up. In contrast, a full match between ITM and lymphatic drainage was present in only 20% of the patients with melanoma of the foot. This discrepancy may be caused by altered lymphatic drainage pathways due to surgery of the toes and sole of the foot. The fact that 9 of our 46 analyzed patients developed ITM distally of the primary melanoma indicates a significant surgical alteration of the lymphatic vessels including the draining nodal basin by prior sentinel node biopsy or lymphadenectomy.","title":"Conventional and three-dimensional photography as a tool to map distribution patterns of in-transit melanoma metastases on the lower extremity"}
{"_id":"800f2573-a55f-4143-a65d-78af3ae1dca8","text":"We retrospectively reviewed four patients diagnosed with midface huge basal cell carcinoma through biopsy between 2014 and 2016. Both the eyelid and nose were involved in all the patients. All the patients underwent the studied surgical method and were followed up from 12 to 36 months.","title":"Frontal axial pattern flap combined with hard palate mucosa transplant in the reconstruction of midfacial defects after the excision of huge basal cell carcinoma"}
{"_id":"8011d6ec-626a-b33f-4951-9f68062c3dbf","text":"In all the 15 patients of group II external fixation was applied as a major stabilizing element in unstable torsional injuries. Four were treated with an Ilizarov external fixator and 11 with a hinged unilateral external fixator.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"8014c91e-39f4-f2e1-a097-bd95e3d951e2","text":"The trial follows the pathway as shown in Figure 1 below:","title":"LIHNCS - Lugol’s iodine in head and neck cancer surgery: a multicentre, randomised controlled trial assessing the effectiveness of Lugol’s iodine to assist excision of moderate dysplasia, severe dysplasia and carcinoma in situ at mucosal resection margins of oral and oropharyngeal squamous cell carcinoma: study protocol for a randomised controlled trial"}
{"_id":"8016f116-0e69-8d56-596f-68a5fc658274","text":"PPI members sit on the trial oversight committees and members of Independent Cancer Patients Voice have provided additional PPI input into all aspects of the study. PPI representatives have been actively involved in all stages of study design including the development of patient information leaflets and planning and refining recruitment strategies. Specifically, they have advised on how and when to approach women undergoing IBBR to minimise the burden of participation and on the selection of outcome measures. PPI involvement will ensure that the patients’ perspective is considered and remains the focus of the study. The PPI members will also assist in writing lay summaries and sharing findings of the study with a wider audience. They will advise on methods and content of communication with participants including newsletters and social media.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"80188c0b-9479-07ec-144f-8379565f775d","text":"We report a case of an elderly female patient with chronic Q fever vertebral osteomyelitis at the site of her previous cement vertebroplasty.","title":"Q Fever Vertebral Osteomyelitis Complicating Vertebroplasty"}
{"_id":"801ad06d-8a59-f9ad-e4f0-19ef753636fd","text":"In conclusion, patients responding to carboplatin chemotherapy might be good candidates for carboplatin chemotherapy even when a CHR occurs. Carboplatin has proven efficacy and a low toxicity profile; termination of the therapy at the first episode of CHR does not seem justified; a desensitization protocol should be considered for patients sensitive to treatment with carboplatin in order to avoid the discontinuation of an effective chemotherapy and improve their chances of cure.","title":"Rechallenge to Carboplatin in Children with Low Grade Glioma and Carboplatin Hypersensitivity Reactions"}
{"_id":"801c11de-d201-b83b-0eab-0e5c44012a5f","text":"For head and neck reconstructive procedures, free flap survival depends on microsurgical and anatomical choices besides multimodal clinical management. The aim of the present study is to identify relevant variables for flap survival in our initial consecutive series.","title":"Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team’s Experience"}
{"_id":"801cc713-5bc1-3d87-62f8-1def439c4d42","text":"The etiology of idiopathic CC has not been explained and examples of this condition include scrotal calcification in young men and calcifed nodules in the head or extremities of healthy individuals, without any type of calcium metabolism disorder or damage to underlying tissues.2,5,6","title":"Dystrophic calcinosis cutis in chronic venous disease of the lower limbs"}
{"_id":"801e29d8-2809-9790-07ad-81390a9789c2","text":"Bridging across three of four cortices in biplanar radiographs was considered evidence of consolidation.","title":"Evaluation of the Efficacy of Pasteurized Autograft and Intramedullary Vascularized Fibular Transfer for Osteosarcoma of the Femoral Diaphysis"}
{"_id":"802054fb-33a1-a2e2-2574-fb0bdc38c89e","text":"The prevalence of DVT in patients with CSM before spinal surgery is also not known. It is of interest to identify risk factors for DVT in patients with CSM so that patients bearing these risk factors can be screened preoperatively for asymptomatic DVT. The present retrospective cross-sectional study was performed to determine the preoperative prevalence of DVT in patients with CSM who were scheduled to undergo spinal surgery to treat their CSM symptoms. The risk factors for DVT in this patient population were also assessed.","title":"Preoperative deep vein thrombosis in patients with cervical spondylotic myelopathy scheduled for spinal surgery"}
{"_id":"8020946f-797d-232e-e3d6-eb80377d9236","text":"Regardless of the therapeutic regimen adopted, the duration of treatment should be based primarily on complete healing of the lesions. In the event that scarring does not occur within six weeks, lesion biopsy must be performed to exclude the possibility of malignant transformation, particularly to squamous cell carcinoma. There is no relationship between the size of the lesions and response to treatment. In the rare cases in which relapse occurs after apparent clinical cure, treatment should preferably be repeated with a drug with an antimicrobial spectrum different from that used for primary infection and for a longer period than the first time. After treatment and complete healing of the lesions, the patient must be followed-up for at least one year, every two or three months.","title":"Donovanosis"}
{"_id":"8021736f-6bdf-2595-7ae7-738662934cc7","text":"In our study, we performed a single bilateral inguinal lymph node dissection, the dissection was negative right and left we found a single node metastases <3 cm without capsular which did not require a pelvic lymphadenectomy ipsilateral metastasis is recommended if there are more than two nodes or metastasized to a lymph node capsular.","title":"Penile cancer: about ten cases at the University Hospital of Rabat, review of the literature"}
{"_id":"802524f3-4ace-d9b6-5cc1-f1c512bf1059","text":"Our constructed risk score reflects an individual’s combined risk for skin cancer by weighing in all measured risk factors in 1 variable. Indeed, we found lower odds of sunbathing and higher odds of using sunscreen while sunbathing in the group with the highest risk score for skin cancer, but we found no association with going on sunny holidays. However, differences in the risk score groups were not impressive and a high proportion of people with a high-risk score still had suboptimal sun exposure behavior.","title":"Difference in Sun Exposure Habits Between Individuals with High and Low Risk of Skin Cancer"}
{"_id":"80255b99-03ab-515f-7f78-2a53ceb5e3dd","text":"Even though CM is a rare disease, the potential mortality makes accurate diagnosis and appropriate treatment imperative. The literature data consists mostly of a limited number of studies due to the rarity of the disease. Currently there is an almost uniform approach for initial treatment of limited, focal disease, consisting of excisional surgery and cryotherapy, although approaches to more advanced disease or adjuvant treatment differ between centers. Even with adjuvant treatment, mortality rates can only be reduced to a certain extent. Further classification of CM is still needed for individual prognostic and survival prediction. Genetic and molecular alterations common to CM and cutaneous melanoma make it amenable to studies on targeted molecular therapy. Multi-center and prospective trials would improve our understanding of the biological behavior of this potentially deadly tumor by providing more information about the molecular alterations implicated in the development of the disease and the corresponding targeted therapy.","title":"Current Management of Conjunctival Melanoma Part 2: Treatment and Future Directions"}
{"_id":"802d3958-24ba-c5ef-8d52-2eb53932f9fe","text":"Patients not experiencing an event will be censored at the date of the last available assessment.","title":"Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial"}
{"_id":"802f5994-2fac-4432-70d9-435acb9c7edc","text":"We believe that the sural fasciomusculocutaneous flap is a valuable reconstructive option for wounds of the lower leg and the distal third of the foot with exposure of internal hardware, although larger case series are necessary to precisely define the indications and limits of this versatile reconstructive choice.","title":"Distally based sural fasciomusculocutaneous flap for treatment of wounds of the distal third of the leg and ankle with exposed internal hardware"}
{"_id":"80358194-006b-4e4d-5542-93dc6f2ca95f","text":"The patient described the episodes beginning as a tingling around her face and mouth similar to a bee sting, swelling of her mouth and finally, a complete inability to breathe. There were no inciting episodes that the patient could point to that caused this to occur.","title":"A patient with chronic lymphocytic leukemia and acquired angioedema: correlation of clinical and biochemical response to CLL therapy"}
{"_id":"803b4162-9fed-c8df-0cca-a1f3f75cc002","text":"There are several reports in the literature on the therapeutic results after the use of pectoralis major flap4, 5, 12 and its advantages are numerous, but when it is not indicated or cannot be used as in our case because we already used it in the first surgery and now it was invaded, lattisimus dorsi myocutaneous flap or a trapezious one are in our opinion the second best choice. We used the lower island of the trapezious flap as it offers enough skin and muscle to enable large head and neck defects9, 5 and it's easy to raise. The esthetical result is acceptable concerning the skin colors, and it can be improve by skin tattooing.","title":"Cancer patients with large defects. Reconstructional options: A case study"}
{"_id":"803c1141-197b-3cdc-c156-fe5aa2a3fab4","text":"In clinical cases, partial blood flow impairment in the transferred LNs was observed by ultrasonography at 2 weeks after surgery in 11.9% of the cases despite having no abnormal findings in the anastomotic vessel monitoring for 72 h after surgery and no clinical symptoms for 2 weeks. In these cases, the amount of volume reduction was smaller than the others, and lymphatic vessel recanalization was not observed 6 months after surgery. As VLNT is a surgery performed to reconstruct the lymphatic function, the significantly reduced therapeutic effect observed in this study is critical. The loss of blood flow in LNs based on ultrasound findings should be regarded as treatment failure. In future studies, more detailed investigations of the timing and cause of blood flow disruption in LNs in the acute postoperative phase would be needed, and examining the effect of the microenvironment of VLNT on good or bad blood flow in the LN would be significant. The next issue was the histological changes in LNs when partial ischemia or congestion occurred in the flaps. As it was difficult to evaluate the transferred tissues histologically in clinical cases, a mouse model simulating VLNT was developed. With this model, the features of partial ischemic and congestive flaps could be observed. The area of necrosis was wider in the congestive flaps than in the ischemic flaps. In addition, intercellular hemorrhage was observed even in surviving areas in the congestive flap.","title":"Clinical and Histological Effects of Partial Blood Flow Impairment in Vascularized Lymph Node Transfer"}
{"_id":"80459b8c-740e-7559-87c6-de274a6dc684","text":"McGill University in Canada offered a more formal inclusion of plastic surgery in their curriculum with compulsory lectures and out-patients clinics in plastic surgery during the initial 2 years of medical studies. During 4th and 5th years, students were offered four clinical elective rotations lasting for 4 weeks each in plastic surgery. Overall, McGill students were more likely to be taught plastic surgery during their undergraduate studies compared to Birmingham students. The effect of the increased exposure to plastic surgery was explored in detail as part of this study.","title":"Plastic Surgery Inclusion in the Undergraduate Medical Curriculum: Perception, Challenges, and Career Choice—A Comparative Study"}
{"_id":"8046831c-9d4b-26aa-d6da-ebbccbfad924","text":"Levels of unawareness of behavioral changes were associated with higher scores on the IQCODE. These findings suggested that pAD patients with impaired insight were described by their caregivers and family members as having more cognitive changes over the last 10 years.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"805f6d82-487f-80e4-9bb8-74e45cf1d1a5","text":"The infants whose results showed interference of the lingual frenulum in the tongue movements and\/or those with reduced activity of the suprahyoid muscles were referred to basic health units with a speech-language pathology report of the lingual frenulum. The infant was referred to the pediatric dentistry service for assessment and the definition of future conduct.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"806543f4-8453-18e2-46c2-c39a11b1333f","text":"Almost every death in young patients with an advanced skin tumor is caused by melanoma. Today, with the help of modern treatments, these patients survive longer or can even achieve a cure. Advanced stage melanoma is frequently related with poor prognosis and physicians still find this disease difficult to manage due to the absence of a lasting response to initial treatment regimens and the lack of randomized clinical trials in post immunotherapy\/targeted molecular therapy settings. New therapeutic targets are emerging from preclinical data on the genetic profile of melanocytes and from the identification of molecular factors involved in the pathogenesis of malignant transformation. In the current paper, we present the diagnostic challenges, molecular biology and genetics of malignant melanoma, as well as the current therapeutic options for patients with this diagnosis.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"80665df5-e824-4487-6ac6-151b376ee484","text":"The initial management of melanoma includes the clinical assessment of the locoregional draining lymph node basin and the lymphatic pathways in search of in-transit disease. When the physical exam is equivocal (obesity, previous surgery, etc.), imaging modalities can be considered such as lymph node basin ultrasound (US). Attention must be paid to the epitrochlear and popliteal areas in distal extremity melanomas. In head and neck melanomas, a full lymph node exam should be performed due to significant anatomical variations in lymphatic drainage. Truncal melanomas can drain to bilateral axillary, cervical, and\/or inguinal basins.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"80830a3d-c3ad-1103-7edd-a5478f43cdd7","text":"Several possible mechanisms whereby viral genome copy number might influence reactivation from the latent state can be envisioned. Many viral genome copies could effectively overwhelm factors silencing viral gene transcription, leading to an increased probability of reactivation.","title":"Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases"}
{"_id":"808fd5cf-f856-8c8a-40b1-546c71ee8ee0","text":"One informant described a situation where an ambulance delivered a patient suffering from a ruptured abdominal aortic aneurysm.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"809653e0-ff16-1c76-5d03-a980b43f5cee","text":"After anaesthetizing the skin, a stab incision in a V or a triangular shape is performed with scalpel blade 11 or 21–25 so as to extract a cone of tissue. Most often the lesion is left to heal by secondary intention.","title":"Techniques of Skin Biopsy and Practical Considerations"}
{"_id":"80971ff2-9f3d-5574-40b8-e26030e89f8e","text":"The SiFo performs better to capture the image of brain and phantom with fast convergence than DLMRI. This can be easily observed from Figure 1 and Figure 2, where our method showed better edges and sufficient features of reconstruction images.","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"809a6de6-b216-6b70-b8ae-e19669b65d9b","text":"A limitation of this study is that it does not allow one to examine the extent to which funding from other agencies or research organizations affects those that do and do not receive NRSA F32 funding. However, if individuals were able to receive support from other sources in early career and then develop their federally funded research, we would expect this to bias our estimates downwards. Thus, our results may be considered a lower-bound on the impact of fellowships on subsequent funding and an independent research career.","title":"Advancing biomedical science through investments in elite training"}
{"_id":"80a3cb26-a95f-65c1-5a9c-8c51183fcab9","text":"The following limitations were encountered in the study. The response rate of patients in the study was relatively low. Patients who are less satisfied with the outcome are potentially more willing to respond to the questionnaire to diminish scores and assure their grievance about the outcome.This might bias the results toward a poorer outcome.","title":"Assessment of Rhinoplasty Outcomes with FACE-Q Rhinoplasty Module: Norwegian Linguistic Validation and Clinical Application in 243 Patients"}
{"_id":"80a43d2c-60d4-9b59-9acb-12965fecea45","text":"Therefore, the aim of this work is to investigate the seasonal effects on the occurrence of complications after free flap surgery.","title":"Seasonal Impact on Free Flap Surgery in Terms of Flap Loss and Wound Healing Disorders: A Retrospective Cohort Study of 158 Free Flaps"}
{"_id":"80a5abea-9a3f-6427-9457-721512c9da18","text":"The 2013 updated guidelines on management of severe acute malnutrition in infants and children recommends the support of exclusive breastfeeding. These guidelines are inconsistently applied in low and middle income countries (LMICs) due to barriers including unclear implementation guides, technical support and epidemiological factors. Peer support strategies have been used to offer psychological support to families with infants in NICU and improve mental health outcomes. Breastfeeding peer supporters (BFPS) have been shown to be effective in improving breastfeeding outcomes in community settings however, their success within hospital settings in LMICs is unknown. We conducted a scoping review to explore implementation of breastfeeding peer support strategies as have been applied to hospitalized infants globally and highlight their implementation strategies in order to guide future research and practice.","title":"A scoping review of breastfeeding peer support models applied in hospital settings"}
{"_id":"80a6ec45-2a7b-dcc4-f0a6-b8261eab8c7f","text":"Instead, the surgical repair with a flap becomes necessary when the local conditions of the wound bed after resection will not allow direct or delayed grafting.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"80ab46bd-09a3-1a55-65b6-44e2e8cb6948","text":"Conclusion: The availability of additional laboratory data over the course of MAS led the experts to change their diagnosis for a number of patients. Our analysis confirms that the change in laboratory values over time may be more relevant for making a timely diagnosis of MAS than the absolute values at a single point in time.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"80b196ae-b519-3afe-8ca4-7b4a099ddeb6","text":"A diagnosis of Gorlin-Goltz syndrome was made. Both maxillary and mandibular right cystic lesions of the jaws were enucleated surgically. Marsupialization was done for the mandibular left lesion and a biopsy was performed. The histopathological examination of the tissues showed KCOT of the right and left mandibular lesions and a dentigerous cyst of the maxillary right-side lesion. The patient was followed up every week after the surgery in the first month. The patient will then be followed-up once each month for six months. The tube will be removed after six months and then the patient will be followed up every six months.","title":"Gorlin-Goltz Syndrome: A Case Report and Literature Review"}
{"_id":"80b1d2a2-b917-fd88-ea84-0a1970fe06f9","text":"Ischemic preconditioning by clamping of the femoral artery and sevoflurane preconditioning of lower limb muscle tissue during surgical revascularization have significant effects on rSO2 in patients with occlusive arterial disease of the lower limb. The results suggest that a large scale prospective randomized trial including an IPC group, a group with sevoflurane preconditioning and a control group on the effect of IPC and sevoflurane preconditioning on outcome after surgical repair of peripheral vascular disease with major morbidity as clinical endpoint should be performed.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"80bd4b97-4ded-60e6-9b66-b0bdf5ccba77","text":"Patients with facial lesions whose treatment required some type of reconstruction with a flap or graft were included in the study. The second-intention wound healing technique was not used in any case.","title":"Nonmelanoma Skin Cancer at Critical Facial Sites: Results and Strategies of the Surgical Treatment of 102 Patients"}
{"_id":"80bd84eb-0b6e-9e69-92c3-7015b555569e","text":"Particularly in oncologic patients is a very common scenario after chemotherapy treatments.","title":"The Proceedings of the 19th International Cancer Imaging Society Meeting and Annual Teaching Course"}
{"_id":"80bf6b42-e233-7d93-b45b-e23e1b9dc8f6","text":"Patients with oropharyngeal cancer and N0 neck who were scheduled for primary tumor ablation as well as a neck dissection were selected. One milliliter of Indocyanin green was injected around the tumor and the sentinel node detection was performed by aiming the infra red video camera on the cervical area. When no detection was possible transcutaneously, a cervical incision was made, a sub-platysmal flap raised and further detection was done to visualize the fluorescing lymph nodes.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"80c0840e-d010-c4df-b3d2-e0a441212230","text":"Calcinosis circumscripta and calcinosis universalis are well-established terms, used in order to refer to cutaneous and subcutaneous calcifications that occur in the absence of an underlying metabolic disorder and are typically associated with connective tissue diseases.","title":"Soft tissue calcifications: a pictorial essay Calcificações de partes moles: ensaio iconográfico"}
{"_id":"80c8091f-c5ec-b787-fd82-c06d2bc1decc","text":"Olfactory ensheathing cells can promote the facial nerve regeneration. Compared with olfactory bulb olfactory ensheathing cells, olfactory mucosa olfactory ensheathing cells were more effective in promoting facial nerve regeneration, and this difference was more significant 8 weeks after the transplantation than 4 weeks.","title":"Olfactory ensheathing cells in facial nerve regeneration Células embainhantes olfatórias na regeneração do nervo facial"}
{"_id":"80cf5ab1-d9b1-89f0-7b1f-e8c2f795d4eb","text":"2- Rotation flaps were used with 7 patients whose defects were ranging from 50 cm2 to100 cm2 with satisfactory skin pliability and satisfactory anesthetic tolerance.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"80d44780-e019-e0de-4684-9a0e04ccb1d9","text":"Inclusion criteria comprised patients diagnosed with localized prostate cancer at clinical stage T1c-T2c and negative extension studies were carried out whether value of PSA at diagnosis was above 20 ng\/mL, with the exception of two patients treated in clinical stage T3aN0 M0 as described later.","title":"Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution"}
{"_id":"80d68636-19a6-d633-46d7-473c47a79ad1","text":"In daily practice almost all midline laparotomies are closed with slowly absorbable running sutures. This technique seems ample for low risk patients. Despite the high incidence of incisional hernia, this technique is still used in high risk patients. These patients are known to have altered collagen synthesis in wound repair or increased abdominal wall stress, leading to insufficient repair of the midline after operation.","title":"A double blind randomized controlled trial comparing primary suture closure with mesh augmented closure to reduce incisional hernia incidence"}
{"_id":"80d7369f-8481-b790-6d3a-0b439fc7491e","text":"These different treatment modalities have been used with the aim of removing pigmentations for esthetic reasons and all of them have some advantages and disadvantages. Recurrent lesions are the most important concerns in all these treatment modalities. In this case no recurrent lesions were observed after one year.","title":"Management of Physiological Hyperpigmentation of Oral Mucosa by Cryosurgical Treatment: A Case Report"}
{"_id":"80d75120-f228-9037-8b72-66b50d41e9bc","text":"This review also did not include studies that did not report on the presence nor absence of injection site reactions in any capacity, as it would be impossible to determine whether patients did not have any injection site reactions or there were not enough reactions to be reported in the study results. This resulted in certain biologics such as Bimekizumab being excluded from the review entirely. For example, the BE RADIANT trial by Reich et al. 2021 was excluded from the review as they reported only the top 5% most common adverse events and selected adverse events of interest, which did not include injection site reactions. This may have also biased the estimates of prevalence to be higher than the true prevalence.","title":"A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections"}
{"_id":"80d8b2f2-f77a-7f19-ff6b-54435187fc0e","text":"The authors will perform a systematic review based on PRISMA guidelines in order to evaluate the literature, looking for evidence to support the optimal duration of parenteral and enteral therapy. The main goals are to see if literature supports shorter durations of either parenteral antibiotics and\/or enteral antibiotics.","title":"Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol"}
{"_id":"80d93bdb-ac5c-9bb3-c242-e248cc133f69","text":"Virtual surgical planning and multilayer anatomical reconstruction are valuable methods to implement for surgeries in deep facial compartments, providing the surgeon with improved understanding of the preoperative condition and intraoperative guidance in critical phases for both open and endoscopic phases. Such techniques allow to tailor each surgical access, limiting morbidity to strictly necessary approaches to reach the disease target.","title":"Anatomical Computerized Exploration to Excise Malignancies in Deep Facial Compartments: An Advanced Virtual Reality Protocol for a Tailored Surgical Approach"}
{"_id":"80da15bd-2d55-8ad1-e9d2-31cf5e955dbd","text":"Approaches to intrinsic biofilm prevention can be grouped into a number of strategies that make use of implant modification to prevent or limit biofilm formation. These strategies include co-implantation of an antibiotic reservoir, nanolayer coating of the implant and varying the implant material. These approaches can further be combined such as by varying both material and nanocoating of an implant or by incorporating antibiotics within or in combination with a nanocoating.","title":"Physical Approaches to Prevent and Treat Bacterial Biofilm"}
{"_id":"80e66c1d-a6eb-b763-c48a-787b10a8c573","text":"Table 2 Number of misdiagnoses and complications reported on infants who were referred for or had a frenotomy performed","title":"Complications and misdiagnoses associated with infant frenotomy: results of a healthcare professional survey"}
{"_id":"80e75e57-02ba-a3a6-fce0-8e76748a99dd","text":"Though a procedure of expertise free vascularised fibular grafting should always be borne in mind while treating gap non unions of forearm to give satisfactory movement and function to the patient's affected limb.","title":"Vascularised fibular graft in the management of non-union of fracture shaft of radius: a less ventured entity"}
{"_id":"80edac25-f4f0-90a3-c3ad-93673f176a2b","text":"The prolonged survival of this patient following detection of the choroidal tumour and the absence of metastatic disease at other sites further indicates that the ocular lesion was unlikely to be a metastasis, and was in fact a primary malignant melanoma whose growth had been arrested by radiotherapy. In addition the intrinsic or \"double\" circulation seen on fluorescein angiography in this case would be very atypical for a metastasis (Figure 3).","title":"Concomitant primary breast carcinoma and primary choroidal melanoma: a case report"}
{"_id":"80ef30a8-bf86-c2c8-3b76-6ebf60982c52","text":"We consider the depth at which the tumor-incision distances were measured in histology and RCM as another limitation of the study. Despite our best efforts to match this depth, due to the curving of the tissue during processing we believe this to be a serious challenge, and one which could introduce bias. The steps we took to mitigate this were to firstly note the depth of the block used to measure the distance on RCM and the carefully match this depth on calibrated histological photomicrographs.","title":"Preoperative Evaluation through Dermoscopy and Reflectance Confocal Microscopy of the Lateral Excision Margins for Primary Basal Cell Carcinoma"}
{"_id":"80f58daf-2a8f-379a-787e-e4d77ef5f533","text":"Our reconstruction method used the rotational transfer of the latissimus dorsi muscle. Close attention was paid to the following four points during the surgical procedure.","title":"Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports"}
{"_id":"80fd0bb8-5936-d717-fb31-9f3f3b68bc53","text":"It is known that thromboses in the microvascular anastomosis lead to failure in free tissue flap transfers. Technical and pharmacological advances have decreased the thrombogenic effect of abnormalities in blood vessels and endothelial lining and have helped decrease the coagulating propensity of blood during surgery. Equally important to patency of the microvascular anastomosis is blood flow, which is inversely proportional to the total resistance provided by the microcirculatory beds downstream. In this regard, we plan to characterize the vascular resistance, weight, volume and surface area of flaps available for transfer, and to identify favorable tissues for reconstruction from the standpoint of outflow resistance. Thus, laser speckle flowmetry is a highly useful, practical, and reliable tool for assessing cutaneous blood flow and is expected to be applicable to several clinical fields such as studying changes in blood flow during radiation therapy and changes in blood flow after surgery to the head and neck.","title":"Free Flap Blood Flow Evaluated Using Two-Dimensional Laser Speckle Flowgraphy"}
{"_id":"810b17b9-6fbb-efdd-b0fa-4878f4e556f3","text":"We selected patients with histologically confirmed first CM or metastasis of melanoma with unknown primary localization, diagnosed in the period between January 2002 and December 2006. These patients were included when visiting the Department of Dermatology.","title":"Clinical Characteristics of Cutaneous Melanoma and Second Primary Malignancies in a Dutch Hospital-Based Cohort of Cutaneous Melanoma Patients"}
{"_id":"81107b93-ee8f-c92b-751f-e21c8aafcac9","text":"The patient was placed on an examination bed in a supine position with the left upper limb in a neutral position.","title":"Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint A case report"}
{"_id":"811af1d4-e3a8-4b77-0f03-bfcf651b3677","text":"After surgery, the patient developed mild palsy of the temporal branch of the facial nerve and was treated with oral prednisolone with a dose tapered from 30 mg for one week. The cause of the paralysis was thought to be nerve extension due to the detachment procedure during the surgery. This facial palsy was completely healed two weeks after the surgery. The patient was followed with an ultrasound examination every three months for the first year and then every six months for two years. A plain MRI examination at six months and two years after the surgery confirmed no evidence of recurrence. At the time of the final checkup, both oral and written consent were obtained from the patient, and the Wakayama Medical University Institutional Review Board approved publication of this case report (protocol code 3814, approved on 17 March 2023).","title":"Chondroma Arising from the Temporomandibular Joint: A Case Report"}
{"_id":"8121a2ee-170d-59e9-e656-bd703b65972e","text":"CT examinations were performed at presentation using a Brilliance 64 slice CT scanner (Phillips Healthcare, Andover, MA, USA). Images were obtained following the institutional protocol for soft tissue imaging, including intravenous contrast for patients with appropriate renal function. CT images were acquired centered on the body area of interest with a slice thickness between 2 and 4 mm. The direct multiplanar reformation function was used to generate coronal and sagittal reformations with a slice thickness between 2 and 4 mm. The attending physician interpreting the CT images was not blinded to the US results but is not routinely given this information. Interpretation of the presence or absence of an abscess on CT imaging was determined using the final interpretation in the patient record. No patients in this study had a change in the interpretation of the CT findings.","title":"Comparison of computerized tomography and ultrasound for diagnosing soft tissue abscesses"}
{"_id":"812421fc-f8f1-832e-4883-c63242474947","text":"Despite minor differences in incidence of surgical complications between different fellowship trained orthopaedists, there is no major difference in overall risk of surgical complications for hip fracture patients based on fellowship status of early orthopaedic surgeons. However, case volume does significantly decrease the risk of surgical complications among these patients and may stand as a proxy for fellowship training. Fellows required to take hip fracture call as part of their training regardless of fellowship status exhibited decreased complication risk for hip fracture patients, thus highlighting the importance of additional training.","title":"The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database"}
{"_id":"8125891f-0aac-135c-b23d-ec4951ff0778","text":"Drug-induced hypersensitivity reactions are of major concern and present a burden for national healthcare systems due to their often severe nature, high rate of hospital admissions and high mortality. They manifest with a wide range of symptoms and signs, and can be initiated by a wide range of structurally diverse chemical compounds. The pathophysiological mechanisms underlying hypersensitivity reactions are not well understood, but it is thought that they are immune mediated. MHC region on Chromosome 6 contains many genes with immune function. Classical MHC molecules are highly polymorphic cell surface glycoproteins whose function is to present peptide antigens to T cells. In addition to conferring protection from some diseases, HLA alleles are also associated with an increased risk of other diseases, including drug-induced hypersensitivity. Pharmacogenetic approach to predict the risk of drug-induced hypersensitivity has been established for several drugs. We will discuss the progress of hypersensitivity pharmacogenetics over the last few years and focus on current efforts of the international community to develop consortia which aim to standardize disease phenotypes and to identify affected individuals through international collaborations. In addition, we will discuss the clinical utility of HLA typing as predictive or diagnostic testing for drug-induced hypersensitivity.","title":"Drug Induced Hypersensitivity and the HLA Complex"}
{"_id":"81309f44-0453-a1e5-4470-6bbc126308ea","text":"In this national cohort study of 323 patients in Denmark diagnosed with retinoblastoma, the incidence and mortality of second primary cancer were significantly higher in patients with heritable retinoblastoma vs patients with nonheritable retinoblastoma. The data did not show an increased risk in patients with heritable disease who were treated with external radiotherapy.","title":"Incidence and Mortality of Second Primary Cancers in Danish Patients With Retinoblastoma, 1943-2013 Incidence and Mortality of Second Primary Cancers in Danish Patients With Retinoblastoma"}
{"_id":"81313e57-e164-afe2-a9d1-b09366bac553","text":"Notwithstanding, despite the fact that this surgical approach may lead to a satisfactory result in our patient further studies with a larger patient cohort will be needed to determine its efficiency for these patients.","title":"Calciphylaxis – a challenging & solvable task for plastic surgery? A case report"}
{"_id":"8135efd7-5fb6-b234-abff-007429f5b05e","text":"Future directions will be to evaluate and stratify a large cohort of patients without infection before surgery for immune risk and use preoperative interventions to optimize their outcomes. Based upon these results, we recommend a serologic profile in addition to the history and physical to accurately stratify patients into their proper host status according to the Cierny–Mader classification of orthopedic infection.","title":"Immunological evaluation of patients with orthopedic infections: taking the Cierny–Mader classification to the next level"}
{"_id":"813741e9-278a-d3bc-2fde-e49d4069703c","text":"All 7 patients recovered following the reconstruction of the defect by FFF. Four patients experienced infections after surgery and pus cultures were performed. All were well healed without flap damage after changing the antibiotics by consultation with infectious medicine experts.","title":"Reconstruction of mandibular defects in osteoradionecrosis and medication-related osteonecrosis of the jaw using fibula free flap and management of postoperative wound infections"}
{"_id":"8138611b-76b0-3277-fe96-8b55032ff969","text":"Controversy exists on the impact of impending versus complete pathological fractures on outcomes of surgery. Some studies show impending fractures have better outcomes compared with surgery over actual pathological fractures. The current study found no significant survival difference between impending and actual proximal femoral fractures, justifying the inclusion of impending fractures in the analysis.","title":"The Importance of Awaiting Biopsy Results in Solitary Pathological Proximal Femoral Fractures Do We Need to Biopsy Solitary Pathological Fractures?"}
{"_id":"813a5ae1-8a2e-9c12-8b90-deaed7a9e499","text":"This case report highlights the risk of UEDVT as a complication following surgical fixation of a proximal humerus fracture. Knowledge of this complication along with close vigilance of post-operative symptoms and clinical course should trigger a diagnostic work up of UEDVT followed by appropriate therapy.","title":"Upper-Extremity Deep Venous Thrombosis following a Fracture of the Proximal Humerus: An Orthopaedic Case Report"}
{"_id":"813c5a78-3413-fdb9-0f96-ede4abff4082","text":"Sevety two surgeons believed that in the presence of mild degenerative change in the cervical spine it is better to consider FGI, whereas, 28 neurosurgeons did not think so and 14 had no opinion on this criterion. The other six neurosurgeons did not answer to this criteria. Signal changes on MRI, were considered to be important by 62 surgeons and 48 preferred FGI in the presence of mild to moderate signal change in spine and disc space. When signal change was detected in the spinal cord on MRI including hypersignal gliosis on T1 and T2 weighted, 51 surgeons preferred the technique of FGI;. 18 surgeons didn't answer this query or this criterion was not important for them. 72 surgeons had done FGI if any previous operation was done earlier at the same vertebral or disc level the rest didn't have any idea or experience with such a situation. Sex of the patient had no bearing on decision making for any of the respondants.","title":"Single level cervical disc herniation: A questionnaire based study on current surgical practices"}
{"_id":"813d4553-bfa7-0ee9-6323-83083dc717e9","text":"There were no adverse events that occurred in this group as a result of implementing this program among patients with asymptomatic VTE.","title":"Impact of a clinical pharmacist on ultrasound-guided venous thromboembolism screening in hospitalized COVID-19 patients: a pilot prospective study"}
{"_id":"81432c31-8912-dbf7-a6c7-9b200cc4a684","text":"Histologic assessments of surgical margins were performed at 3 sites within each resected specimen: at the 2 intestinal transection sites and at the intestinal wall at the site of the primary tumor (the mural margin). When slides containing the intestinal transection sites were not available for review, evaluation of transection sites was based on the original histopathologic report at the participating institution. Slides containing the primary tumor were reviewed by the pathologist (NMP) for bowel wall integrity, and an incomplete mural margin was diagnosed when penetration of tumor cells through bowel wall serosa was identified. Carcinomatosis was defined as microscopic evidence of seeding of neoplastic epithelial cells on any visceral or parietal peritoneal surface regardless of proximity to the intestinal tumor.","title":"Outcome and Prognostic Factors in Cats Undergoing Resection of Intestinal Adenocarcinomas: 58 Cases (2008–2020)"}
{"_id":"814aabea-4361-7905-7b7e-108460c15eb4","text":"Regarding the difference between the health care system in the UK and the country of origin, overseas trainees highlighted many differences. It can be summarised for the following domains in Table 1.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"8153c594-eed2-f9f8-8172-5607637d1319","text":"Other specific drugs not established in the protocol for these patients were prohibited. In the study were indicated dipyrone or paracetamol associated to the difenhidramine for the relief of the adverse events. Six patients maintained during all the treatment time, the specific drugs for the control of the concurrent illnesses.","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"815cc535-302f-46e5-edb5-a54c3dc6f427","text":"This study showed that administering 20 mg atorvastatin daily was cheaper compared to 10 mg rivaroxaban daily for 3 months as thromboprophylaxis of DVT events in cancer patients at high risk of thrombosis undergoing chemotherapy.","title":"The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy"}
{"_id":"815da50e-7db6-3c8a-f78e-bb936806467f","text":"Could we validate previous findings that the two-point technique misses an unacceptable rate of thrombi isolated in the femoral vein in a similar patient cohort?","title":"Two-point Compression Ultrasound Technique Risks Missing Isolated Femoral Vein DVTs"}
{"_id":"8163f3ce-80ed-1e88-dcb5-19ab2c63cd75","text":"Patients were followed up for 4 weeks after BT treatment, every 3 months during the first 3 years and then every 6 months until death. Locoregional recurrence was defined as identification of recurrence within the primary site with or without regional involvement during the follow-up period. All events from the date of the end of BT to the date of recurrence or death were recorded. The late toxicities were graded according to the toxicity criteria of the Radiation Therapy Oncology Group (RTOG).","title":"Long-Term Outcomes of Three-Dimensional High-Dose-Rate Brachytherapy for Locally Recurrent Early T-Stage Nasopharyngeal Carcinoma"}
{"_id":"8166eded-58da-1f87-f355-115a5577575a","text":"CR is a 3D rendering algorithm that simulates the propagation and interaction of light rays as they pass through the volumetric data, producing a photorealistic representation of 3D images. CR works by using advanced algorithms and mathematical models to simulate the physical properties of light and matter, creating highly realistic images and videos. The process typically begins by creating a 3D model of the object or scene that is to be rendered. This model is then lit and shaded using various techniques such as global illumination which simulate the way that light bounces and reflects off surfaces, and ambient occlusion, which adds depth and realism to shadows.","title":"Exploring the Potential of Three-Dimensional Imaging, Printing, and Modeling in Pediatric Surgical Oncology: A New Era of Precision Surgery"}
{"_id":"81715852-37de-06b8-7dd5-331bc70a0d37","text":"Controversy exists about the routine need of deep pelvic ilio-inguinal dissection to include the external iliac and obturator nodes. However, deep dissection is still standard for clinically involved ilio-inguinal\/obturator lymphadenopathy on PET-CT or pelvic CT, or in certain cases with melanoma involvement of the Cloquet’s node on intraoperative frozen examination (the last inguino-femoral lymph node present in the femoral canal, posterior to the inguinal ligament). Other practitioners routinely perform a deep pelvic dissection for grossly and apparently involved superficial groin disease. With the advent of modern systemic treatments, the routine need for clinically uninvolved deep ilio-inguinal dissections has been questioned.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"8171b749-d3ea-8be6-d9b3-e810a015a275","text":"A brief summary of the four types of hypersensitivity reactions is provided in Table 3.","title":"An introduction to immunology and immunopathology"}
{"_id":"8173e7bc-b978-8e48-22f5-1cfec42acabb","text":"Although we strive to blind the radiographer to the treatment allocation, our primary outcome may be prone to observer bias. For example, if a patient presents clinical signs of DVT, the ward staff may push harder to obtain the routine compression Duplex ultrasound scan. We will therefore repeat the primary analysis but exclude patients with a primary outcome in whom a DVT was suspected before the ultrasound scan.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: statistical analysis plan"}
{"_id":"8175ed3a-abc9-b07d-2477-08379c161fe4","text":"The definition of healing time in this study has not been used often but it was used as a way to standardise the measurement of healing time in the present study. Antibiotic treatment was stopped after clinical examination of the patient at follow up together with an infectious disease specialist, if no signs of infection were evident. Regarding antibiotic treatment we found that more different antibiotics per patient were associated with failure of the flap (Table 4).","title":"Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap"}
{"_id":"81841e4f-7686-bddd-7d64-52361bf9bbec","text":"The addition of anticoagulation therapy reduced VTE incidence although not significantly, perhaps because of the low incidence of distal DVT or because of the relatively low number of patients recruited. Perioperative anticoagulant prophylaxis with laparoscopic surgery should be carefully considered in patients of Asian descent with CRC.","title":"Efficacy and safety of anticoagulant prophylaxis for prevention of postoperative venous thromboembolism in Japanese patients undergoing laparoscopic colorectal cancer surgery"}
{"_id":"8184c1bb-cc2a-2878-6129-a075a989fb9c","text":"The accurate and optimal assessment of the axilla during breast cancer surgery requires persistence and diligence for attempting to identify all potential SLN candidates in order to avoid failing to recognize a positive SLN. The scenario in which only a single negative SLN candidate is intraoperatively identified is one that should raise some concern to the operating surgeon.","title":"Re-emphasizing the concept of adequacy of intraoperative assessment of the axillary sentinel lymph nodes for identifying nodal positivity during breast cancer surgery"}
{"_id":"818cdf9d-3621-a916-053c-9198ddf59c86","text":"The incidence of apalutamide-related skin rash was higher in Japanese patients with PC compared to patients from the rest of the world. Although there is a potential correlation between incidence of skin rash and plasma exposure to apalutamide, it did not significantly impact the grade of skin rash. Moreover, no clinical risk factors associated with skin rash were identified. Most skin rash is observed within 120 days of treatment initiation and close monitoring of the skin rash, dose reductions\/interruptions and treatment with oral antihistamines and topical and systemic corticosteroids led to resolution of the majority of skin rash observed in Japanese patients within 30 days.","title":"Skin rash following Administration of Apalutamide in Japanese patients with Advanced Prostate Cancer: an integrated analysis of the phase 3 SPARTAN and TITAN studies and a phase 1 open-label study"}
{"_id":"81a3fe5b-68d0-93e5-a09c-6d3685ec4d62","text":"Orthognathic surgery cases have been increasing in the last years and maxillary advancement alone comprised the highest number of surgical treatments.","title":"Service Profile of Orthognathic Surgery of a Medical School"}
{"_id":"81a5acfa-bdd7-3504-b057-2f16fb8aefb4","text":"Idiopathic scrotal calcinosis is an uncommon benign disorder of the scrotal skin which is characterized by multiple calcified intradermal nodules. We report a 33-year old with asymptomatic multiple calcified scrotal skin nodules. He had wide excision of the lesions and direct closure of the scrotum. We review the pathogenesis and surgical treatment options for this rare disease of the scrotum.","title":"Scrotal Calcinosis: A Case Report and Review of Pathogenesis and Surgical Management"}
{"_id":"81a6c902-0741-ae40-a6e2-921cc638e4de","text":"Since PPIX is also a fluorescent substance, accumulation of PPIX in the tumor can be determined indirectly by fluorescence measurement, in which the relative intensity of fluorescence of PPIX from tumors can be evaluated.","title":"Metronomic photodynamic therapy using an implantable LED device and orally administered 5-aminolevulinic acid"}
{"_id":"81a7e2cb-25ef-9510-95ba-25ff6c09715c","text":"Second, we did not perform a follow-up examination of patient after ICU discharge. This prevented us from detecting recurrent DVTs after the resolution of the first episode and those DVTs that would occur later in the clinical course of this illness.","title":"Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients"}
{"_id":"81a957c1-be06-8d19-3696-d75cd576503e","text":"This study was conducted in an otolaryngology department of a central public hospital composed of senior specialists and residents. One limitation of the study is the fact of rhinoplasty being performed by different surgeons with different levels of experience in the aesthetic area. Therefore, both expectations created in the pre-operative consultation and the post-operative satisfaction survey may be affected by these conditions.","title":"Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study Avaliação dos desfechos estéticos e funcionais em cirurgia de rinoplastia: um estudo prospectivo"}
{"_id":"81aabd7b-7441-0ac3-6135-fff3e7ddcb93","text":"Future genetic investigations are needed to further understand the biological course of this tumor, which would eventually help clinicians better manage this condition in both the short and long terms.","title":"A Sporadic Giant Mesenteric Desmoid-Type Fibromatosis in a Teenage Female: A Report of a Rare Case"}
{"_id":"81b2a76b-46e8-f15b-bfb0-0fbb71dc0cad","text":"Screening of gene mutations in endometrioid carcinoma was performed using the TCGA. The results showed that there are 130 mutations of CTNNB1 in 399 cases of endometrioid adenocarcinoma, including 2 cases with mutation of D32A.","title":"CTNNB1 p.D32A (c.95A > C) somatic mutation in stage I grade 1 endometrioid endometrial carcinoma with lung metastasis: a case report"}
{"_id":"81b2b43a-8c5a-6105-8a8b-87abc863d0eb","text":"The trauma surgery service then scrubbed back in and excised a long segment of the greater saphenous vein from the anteromedial left thigh. A reversed saphenous vein interposition graft was inserted into the defect in the distal right popliteal artery using 6–0 polypropylene sutures on both end-to-end anastomoses. Right pedal pulses were immediately palpable through the plastic bag over the right foot after the vascular clamps were removed. A non-reversed saphenous vein interposition graft was then inserted into the defect in the proximal popliteal vein in the same fashion. Fasciotomies of the anterior and peroneal muscle compartments of the right leg were performed through a 30 cm long skin incision two fingerbreadths superior to the right fibula laterally. Finally, contused and devascularized muscle in the right posterior calf muscle compartments was debrided back to bleeding tissue. Dry mesh gauze was then packed into the open wound in the right posterior popliteal area. Operative time for this first salvage procedure was 9 hours, and 12 units of packed red blood cells and two units of fresh frozen plasma were administered.","title":"Dangerous parking deck"}
{"_id":"81b94bd4-a164-a680-c004-10393344a874","text":"Improvements in primary facial movements and facial expressions are not possible without reinnervation. Our method basically evaluates improvements based on reinnervation. Thus, although the reinnervation occurs we showed deficiencies of expressing facial emotions and we suggested rehabilitation methods which have cognitive aspects for this problem. Sole effects of reinnervation without rehabilitation could be assessed with control cases but with very few cases it was impossible to recognize and that issue is our limit and weakness of this study.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"81c0ae02-9959-2bc1-0450-70bedffea564","text":"In this study, it was possible to verify that breast alterations can occur in any age group and that there are several external factors that can act as risk or safeguard factors. Therefore, it is important to use breast ultrasound from an early age and not from a certain age.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"81cbdfee-5fb6-1737-7f58-2f4896b244b8","text":"En-bloc surgical excision of the lesion should ensure adequate margins of healthy tissue around the tumor mass to avoid local recurrence.","title":"Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience"}
{"_id":"81d80b44-d8d6-ba5c-9aff-456bf58019ed","text":"Similar to multidisciplinary cancer conferences our results show that performing these discussions led to a significant alteration in the treatment plan, displayed by a different surgical and antibiotic regimen. Patients in the infections conference group received a significantly shorter duration of antibiotic treatment, which was furthermore strengthened by a multivariate analysis emphasizing the impact of the conferences. The results are in accordance to the recent opinion that a shorter period of antibiotic treatment (mostly 6 weeks) is not inferior to a longer application duration (mostly 12 weeks) and reflects the current guidelines of the Infections Disease Society of America. Establishing these conferences could therefore be a useful instrument to secure adherence to guidelines, as numerous studies have demonstrated improved guideline adherence due to the implementation of multidisciplinary cancer conferences. Limiting the duration of antibiotic therapy to a shorter but equally effective course may further the goal of reducing side effects in the individual patient and reducing overall antibiotic consumption, thus reducing the development and selection of drug resistant bacteria. Interestingly, the intravenous treatment duration was significantly increased in the infections conference group, which could be explained by the prolonged intensive care unit stay and higher ASA Scores of patients in this group. However, compared to most other studies the duration of intravenous therapy in both groups of this study is comparatively low. Furthermore, potentially improved bioavailability might influence the slight increase of duration as well, especially when taking the limited bone penetration of most antibiotics and the prolonged bone revascularization after surgery into consideration. Moreover, the increased rate of S. aureus in the conference group could be another explanation since S. aureus infections are thought to be associated with higher complications so that prolonged intravenous therapy could be essential. Still, it needs to be considered that there is a lack of data supporting its efficacy and recent research questions the superiority of intravenous compared to oral antibiotic treatment but not in the specific context of spondylodiscitis. Even though several surgical and instrumentation techniques to treat spondylodiscitis have been described, valid recommendations are few and there is no consensus about the optimal surgical strategy. The multidisciplinary conference is a tool to strengthen a standardized approach while also respecting the heterogeneous and individual nature of this disease. Even though we could detect significant alterations regarding the surgical management, multivariate analysis revealed that only certain aspects can be attributed to the conference. It has to be considered, that surgical strategies as well as implants have changed over the years, so that it is to be expected that the recorded differences cannot just be ascribed to the conference discussion. In this study, the alterations in the surgical strategy which can be associated to the conference by multivariate analysis were the type of screw placement as well as an almost significant trend towards one-stage procedures. Whereas the type of anterior spinal fusion could not be attributed to the implemented conference.","title":"Implementation of a multidisciplinary infections conference improves the treatment of spondylodiscitis"}
{"_id":"81d8d29b-8b86-7080-b145-12ec6c091a0d","text":"A retrospective analysis of the presence and activity of European Plastic Surgery Societies on Facebook, Twitter and Instagram was conducted between December 12th 2018 and December 12th 2019. The results have been compared to the American Society of Plastic Surgeons.","title":"Analysis of social media use by European plastic surgery societies: A missing link for #PlasticSurgery"}
{"_id":"81d98a92-4a74-4148-9ecd-b43680158a74","text":"The plots of the mean count rates per SDD measured with CrystalCam and the decay‐corrected sphere activities at the specific SDD for spheres of Group A and Group B are shown in Figures 4 and 5 respectively. In Figure 4, the sphere activities increase with sphere volumes while spheres in Figure 5 have constant activities irrespective of their volumes thus confirming the accuracy of the activity preparation and filling of spheres. For any given sphere volume and SDD, the mean count rates increase with the sphere's activity.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"81e1c5b0-01c0-6085-5e26-75db55fe0073","text":"Manual compression of the RIJ or other venous access route following catheter removal is followed by 2 hours bed rest post procedure. The patient is rested in the semi-recumbent position at 45 degrees following an IJV puncture.","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"81e2d0c7-ac9e-e2bb-e446-078126da22a5","text":"In conclusion, both authors suggest that the treatment with PEMFs by now represents one of the conservative therapies used in the first stages of avascular necrosis of the femoral head at Ficat 0, I, II or Steinberg II and III but require from patients time of treatment, care, and precision to ensure the success expected by physicians and patients. The stimulation with PEMFs may be a good opportunity to resolve the disease or at least to delay the time until joint replacement becomes necessary.","title":"Biophysical stimulation in osteonecrosis of the femoral head"}
{"_id":"81f99474-a5dd-b207-3fe8-244934a48c68","text":"In this paper a method of breast cancer treatment planning using virtual simulation implemented at the Department of Human Oncology at the University of Wisconsin is described. All patients in this procedure are placed in a custom vacuum mold in treatment position with both arms up to avoid collision with the CT scanner aperture. For all patients a CT scan of 5‐mm‐slice thickness is acquired. The ipsilateral and contralateral breast, the ipsilateral lung and the heart are delineated and a three‐dimensional plan is generated that tries to minimize the dose to the ipsilateral lung and heart while ensuring adequate coverage of the affected breast. Digitally reconstructed radiographs are used to verify the patient setup on the treatment machine. © 2000 American College of Medical Physics.","title":"On the use of virtual simulation in radiotherapy of the intact breast"}
{"_id":"81f9cbe3-234d-75c5-b5ef-721c3d6583c2","text":"Dicing the cartilage block into small pieces with sharp blades is less harmful to the structure of the cartilage and its long term viability has been observed in multiple experimental and clinical studies. Diced cartilage if wrapped in fascia is a good material to augment the dorsum but it is usually more voluminous to be applied for correction of minor irregularities. If it is used without a cover of fascia, it is applicable as small volumes but it must be applied during the course of a rhinoplasty procedure, while there is no tight pocket of surrounding tissues to prevent its displacement.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"82086b05-544b-68c3-7fb9-1c40daed626d","text":"One of the solutions to overcome the graft wrap is the use of chimeric autologous rib cartilage which is obtained by the combination of bone and cartilage in the graft to get a relatively stable a single dorsal onlay graft. We showed that autologous rib cartilage is a good graft in nasal septoplasty especially if wrapped with rectus fascia, even the limitations of our study were small sample size and a relatively short follow up.","title":"Autologous Diced Cartilage in Nasal Septoplasty"}
{"_id":"820c9c67-a440-d458-7bc1-6048484e8764","text":"We report a case of massive acute tibial osteomyelitis in an adult male three months after an IO catheter insertion for emergency drug infusion. We review the literature on association between IO access and acute osteomyelitis in children and adults.","title":"Acute Tibial osteomyelitis caused by intraosseous access during initial resuscitation: a case report and literature review"}
{"_id":"82102c25-3365-f8f8-8d08-0c3634cf6696","text":"The role of ultrasound elastography has now been extended into identifying breast lesions. It uses ultrasound waves to generate tissue displacement or deformation images in response to external mechanical compression or vibration. These images are then analysed to assess the stiffness or elasticity of the breast tissue. Using a shear wave or strain wave pattern, one can differentiate a benign lesion from a malignant one. These techniques complement each other and work on the basic principle that focal breast malignant lesions are stiffer than benign lesions [8].","title":"Innovations and Challenges in Breast Cancer Care: A Review"}
{"_id":"8210f896-873d-3dfc-508d-d6f41152b4f5","text":"The results were analyzed using Microsoft Excel and SPSS Version 25.","title":"Peripheral Lymph Node Excisional Biopsy: Yield, Relevance, and Outcomes in a Remote Surgical Setup"}
{"_id":"82184550-bab5-52b4-b6ac-4e50e3ac3830","text":"The approach generates elaborate resection plans by rotating and translating 3D bone and tumor data about Cartesian coordinate space, then generating a geometry (comparable to a ruled surface) based on the features and position of the bone and tumor surface mesh.","title":"Automated elaborate resection planning for bone tumor surgery"}
{"_id":"821eec40-6232-9304-204a-a6862f01b685","text":"The hospital notes relating to the potential endpoint are redacted for both personal identifiable information and specifics of antibiotic treatment or IV line insertion, which could indicate the route of administration of antibiotics. The redacted notes are forwarded to the ERC, who determine whether an endpoint has been met, either by consensus or by a vote called by the chair if consensus cannot be reached.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"822031cf-af56-c86e-9a10-f054479c2a4e","text":"Introduction: Microsurgery is an essential element of Plastic Surgery practice. There is a paucity of studies assessing the impact of stress and cognitive distraction on technical microsurgical performance. The ability to complete cognitive and technical skills in parallel has not been assessed in a microsurgical setting.","title":"Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance"}
{"_id":"8220cbad-dbe6-ae92-f003-3ce80356fbc8","text":"Fig 2 depicts the three most commonly held leadership positions prior to appointment as Dean of Medicine according to gender.","title":"Common pathways to Dean of Medicine at U.S. medical schools"}
{"_id":"822503ae-87ba-4f19-3cbd-1825eff456ab","text":"We preferred anterior tibial over the posterior tibial as the recipient vessel because:","title":"Free tissue transfer for trophic ulcer complicating leprosy"}
{"_id":"823035a7-9d90-95f2-815a-21a7b673c386","text":"We first seek a general conceptual framework that will allow us to interpret existing data, make predictions, and so better understand how controls within a BMU may be arranged to maintain bone balance.","title":"Bone Balance within a Cortical BMU: Local Controls of Bone Resorption and Formation"}
{"_id":"82330a77-da60-ecda-63c1-45b7c1ae0c1f","text":"Surgical resection of the oral cavity squamous cell carcinoma with clear surgical margins is the key to preventing local recurrence and avoiding the need for adjuvant treatment or margin re-resection. There is often a discrepancy observed between the clinically determined margins of the tumor when it is being resected and the histopathological result after the specimen has been processed.","title":"An Analysis of Tumor Margin Shrinkage in the Surgical Resection of Squamous Cell Carcinoma of the Oral Cavity"}
{"_id":"823d593a-3a35-a739-c1f4-642d27148598","text":"In fractures caused by torsional forces the articular surface is usually easier to reconstruct by internal fixation. In this case, ankle instability, which is the major problem, induces postoperatively pain, while osteoarthitic lesions may appear later. Major concern in these fractures should be the restoration of the stability of the ankle joint by repair of the ligamentous elements. Essential goal is to restore all structures needed in order to achieve optimal talus movement in relation to the tibia. It is known that the body of the talus has the shape of a trapezoid and is wider anteriorly. When the foot dorsiflexes, the mortise is widened by a simultaneous posterolateral displacement and external rotation of the fibula. This synchronized motion performed by certain muscle activity, is controlled by mechanisms of proprioception through receptors of the ligaments and of the articular capsule and requires continuity of the ligaments and anatomical reduction of the articular surface [2].","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"823de1a7-65de-0eed-38e5-17be5fb0c020","text":"In conclusion, preoperative simulation including the cerebellar tentorium is useful for determining the optimum and safe side and required extent of the tentorial incision necessary for tumor resection with the OTA.","title":"Simulation of the occipital transtentorial approach incorporating visualization of the cerebellar tentorium using three-dimensional computed tomography angiography and gadolinium-enhanced T1-weighted magnetic resonance imaging: technical note"}
{"_id":"823f73ad-2955-a344-7c0c-20bb8c12befd","text":"Fifteen minutes later the situation improved and a good pulsation and outflow allowed us to consider this recipient vessel reliable for a free flap. The cephalic vein was then dissected and prepared.","title":"Salvage of Upper Limb following a Severe Crushing Trauma: Immediate Reconstruction with a Free Flap and Subsequent Hyperbaric Oxygen Therapy"}
{"_id":"823fa9d6-5591-b3e1-af59-fe8726c8ec9a","text":"It is well known that poorer prognosis prevails in head and neck cancer patients that develop metastatic lymph nodes and even more so if there is evidence of extra capsular spread. This is one of the reasons why elective neck dissections are frequently performed even in patients with N0 necks [1].","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"8242501f-569a-3f55-f382-adb25c01add4","text":"It may thus be difficult to manage such injuries with the conventional management strategies as mentioned above. Effective management of such defect will demand addressing the extensive soft tissue loss as well as providing well-vascularised tissue that can integrate with the surrounding tissues and thus assist in closing the fistula.","title":"Island Latissimus Dorsi Muscle Flap and a Perforator Flap in Repairing Post-Gunshot Thoracic Spine CSF Fistula: Case Presentation"}
{"_id":"82475c26-2776-d332-94e6-66bf6a32776d","text":"We conducted a retrospective audit of all patients who underwent ST and specific IgE testing (SpIgE) for investigation of a perioperative allergic event. We sought the proportion of patients who had a likely agent detected and the prevalence of likely causative agents in our cohort.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"824a8254-97f1-ec9f-bf8a-ee9b8d3e6069","text":"This retrospective study involved 78 patients with pelvic and acetabulum fractures requiring surgical intervention from January 2015 until December 2019. Patients who underwent surgical interventions were screened pre-operatively with Doppler ultrasound to detect lower limb DVT and later compared with the incidence of lower limb DVT post-operatively. Descriptive statistical analysis was performed using IBM SPSS Statistics Version 24.","title":"Study of Deep Vein Thrombosis Screening by using Ultrasound Doppler in Patients with Pelvic and Acetabulum Fractures Requiring Operative Intervention"}
{"_id":"824b0f27-bec5-6521-e089-9e1ab9f5601a","text":"Nowadays, it is thought that surgical procedures should comprise not only resection but also reconstruction of lost tissues. Depending on the conditions and anticipated prosthetic rehabilitation, the reconstruction can be done parallel to the resection or as a separate procedure. The reconstruction should be targeted at restoring the continuity of removed tissues followed by the rehabilitation of the stomatognathic system. The reconstruction of the mandibular bone continuity is of a particular importance to the prosthetic treatment [19]. The comparative studies of the mastication in patients with and without reconstruction of the mandibular bone continuity evidently show that the function of the stomatognathic system is much better in the patients after reconstruction [20].","title":"The Management of Patients after Surgical Treatment of Maxillofacial Tumors"}
{"_id":"824eaca6-fef2-9e20-51d1-3471c76fb5dd","text":"We designed this study to determine whether ultrasound guidance deep nerve blocks would decrease the incidence of LAST compare with nerve stimulation guidance and to identify associated risk factors of LAST.","title":"Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial"}
{"_id":"824fa338-b8d7-fec5-a4c7-4f703516c954","text":"The upward mobility described in these different types of career changes demonstrates the success of the fellowship in training a cadre of professionals on track to become influential leaders in their respective arenas. In their ascent into positions of leadership, fellows were able not only to utilize skills and competencies learned in the fellowship, but also started to incorporate these strengths into the institutional framework of the organizations in which they work, as described below.","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"82521da1-af93-29e3-50da-63a920fe4dc8","text":"This study confirms the value of preoperative colour Doppler sonography for ALT flap reconstruction. The proposed mathematical model provides a highly accurate method of preoperatively assessing the length of the vascular pedicle, which may be of value in head and neck surgery.","title":"Colour Doppler sonography in the preoperative assessment of the vascular pedicle from the anterolateral thigh flap: proposal for a mathematical formula to predict pedicle length"}
{"_id":"8252c7c2-0c0d-b892-c3ab-340fd4c0d250","text":"The pathophysiology of osteomyelitis varies between animal species. The aim of this review is to analyse microbiological aspects of this infection in humans and veterinary cases.","title":"Microbiological aspects of osteomyelitis in veterinary medicine: drawing parallels to the infection in human medicine Veterinary Quarterly"}
{"_id":"825b68b6-7d38-2be4-17cf-979ca9836c98","text":"This retrospective chart review study considered all women who underwent breast surgery in our center between January 2002 and January 2012. This study was conducted according to the Declaration of Helsinki. It followed the dictates of the general authorization to process personal data for scientific research purposes by the Italian Data Protection Authority. All consecutive women treated by breast surgery during this period were included in the present study. All male cases treated by breast surgery were excluded. Information was gathered from the clinical files of our center by medical doctor experts in breast surgery supervised by a specialist in thrombosis and hemostasis.","title":"Incidence and Risk Factors for Venous Thromboembolism in Female Patients Undergoing Breast Surgery"}
{"_id":"825c55c0-816d-c16f-101c-cc0cd2887d1b","text":"The goal of periodontal treatment is to eliminate bacterial deposits by removing the supra and subgingival biofilm, and consequently reducing the excessive inflammatory response. The procedures involve diagnostic steps, followed by biofilm removal and biofilm associated calculation followed by control and maintenance, with the control of etiological agents and risk factors, based on clinical outcomes with non-surgical treatment approaches with the scraping and straightening of the corono-root with manual and ultrasonic instruments, which in addition to the removal of biofilm deposits, contributes to the reduction and modification of biofilm colonizing periodontopathogens. It is noteworthy that patient compliance and contribution is extremely important in the control of health stability in periodontal tissues. Assuming that when biofilm is controlled, it does not accumulate and colonize with more periodontopathogenic species, thus not inducing an inflammatory response related to periodontal disease. The use of lasers for periodontal treatment in noninvasive therapies presents a review of the current state of evidence for the efficacy of these approaches as an adjunctive treatment to mechanical biofilm deposition removal therapy.[","title":"Antimicrobial photodynamic chemotherapy mediated by PapaMBlue on chronic periodontal disease Study protocol for a randomized, blind, controlled trial"}
{"_id":"826588ab-b8e9-cd2f-e47e-810c0acf9834","text":"Millions of these procedures are performed annually without any adverse effects. These procedures can be safe and effective when performed by a licensed practitioner. Since most of these techniques require use of toxic substances and disruption of healthy tissue, short-term damage may follow; however, limited literature is available on the long-term effects of these procedures. It is crucial for clinicians to understand the potential adverse effects of these cosmetic enhancements given the damage they can inflict to the ocular surface and how they can impact visual outcomes. Continued research is warranted due to the rise in popularity of these cosmetic enhancements and the potential consequences associated with each of them.","title":"Eyelid Cosmetic Enhancements and Their Associated Ocular Adverse Effects"}
{"_id":"826ad4a8-cc4a-4728-1b20-7bfe0a74faf2","text":"In this study, we found additional evidence to support the competency and academic excellence of IMG applicants. We found that both integrated and independent IMGs perform well on their USMLE examinations, excel on their clinical rotations, and have strong research backgrounds. The emerging trends in this study indicate that independent IMGs in plastics have stronger USMLE examination scores while integrated IMGs have stronger research backgrounds and additional degrees. Although it is difficult to discern why these differences exist between the 2 tracks, one explanation is that integrated students may commit to plastics earlier on, focus on garnering years of research in the field, and ultimately score lower on the USMLE tests because they have an extended research-focused hiatus between the exposure to the material in medical school and the examinations. Independent students, on the contrary, may be undecided on a particular specialty and therefore opt to take the USMLE examinations immediately after graduating from medical school, forgo extensive research experiences, and enter directly into general surgery residencies.","title":"International Medical Graduates in the US Plastic Surgery Residency: Characteristics of Successful Applicants Kokosis et al"}
{"_id":"8280a618-6f69-8ff9-dded-dd33441d415e","text":"One of the first studies on the relationship between waiting time for radiotherapy and clinical outcomes was conducted in 1985 at the Institut Gustave Roussy in France by Clarke et al [23]. They reviewed 436 patients with T1 and small T2 breast carcinoma, finding a significant increase in local relapse in the group that received radiotherapy more than 7 weeks after surgery. These results were not confirmed on multivariate analysis.","title":"Waiting time for radiation therapy after breast-conserving surgery in early breast cancer: a retrospective analysis of local relapse and distant metastases in 615 patients"}
{"_id":"8289b82e-3ac7-eb92-2d1e-a1b047f3e924","text":"In view of the high sensitization rates in the general population and the manifold pathomechanisms underlying skin reactions, the importance and feasibility of allergy diagnostics may be limited. It is currently unknown if diagnostic tests would be able to reliably discriminate between “normal” reactors and those with exaggerated skin hypersensitivity reactions or risk of anaphylaxis. Moreover, it is not known how many and which particular insect species have to be considered for diagnostics since the range of locally relevant insects varies significantly.","title":"Insect hypersensitivity beyond bee and wasp venom allergy"}
{"_id":"8293d9f3-d91b-9802-66d9-1ab17cb85c7c","text":"Host optimization is crucial to ensure proper eradication of infection. Patients with abnormal immunological values would benefit most from a referral to a specialist to monitor immune status and replenish IgG if indicated. For our patients who were diagnosed with primary immunodeficiencies, we developed certain recommendations. These included referral to an immunologist or a hematologist, boosting nutrition status by vitamins and protein supplementation, and additional prophylactic antibiotic use following any subsequent clean surgical procedures.","title":"Immunological evaluation of patients with orthopedic infections: taking the Cierny–Mader classification to the next level"}
{"_id":"82a122d1-3854-e748-a822-b3d98f019db4","text":"Preoperative halo-traction followed by surgery is superior in kyphosis correction and is associated with less complication when used in the treatment of patients with cervical infections with refractory kyphosis deformity compared to surgery alone.","title":"The pre-surgical role of halo-traction in patients with cervical infection associated with refractory kyphosis: a retrospective study"}
{"_id":"82a8d648-7744-a5f3-afb5-2056a528c3a3","text":"The right breast had a scar in the upper inner quadrant of the breast from her previous lumpectomy. She had loss of volume and concavity beneath the lumpectomy scar. The patient had scars in the inframammary fold and circumareolar mastopexy scars bilaterally. The implants were in the retropectoral position.","title":"Preoperative MRI to Improve Aesthetic Outcomes in Secondary Mastopexy Augmentation: A Step-by-Step Approach"}
{"_id":"82b6d987-ecb4-a596-4f84-ed9d5c83e34f","text":"Based on the findings, the leaders of specialists had to master specialist work in the field, and a sufficiently strong medical background was deemed necessary, as leaders were otherwise felt to be disadvantaged in their leadership work and lacking credibility in the eyes of their subordinates.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"82b93fdb-a5b3-318f-99d2-ac264740eb11","text":"Al Mandhari will serve a term of five years and eight months, completing that of the previous Regional Director for Dr Mahmoud M Fikri, who took office in February of last year and died in October.","title":"Public health round-up"}
{"_id":"82ba5b99-d2dc-2f36-ff56-15d9eb50c14e","text":"The growing demand for autologous fat transplant (AFT) beginning at the end of the 80 s is linked to the advent of liposuction. The current methods of fat transfer were popularised and extensively described by Sydney Coleman who in 1986 began to transplant fat in iatrogenic deformities from liposuction and subsequently in the face. AFT is today a widely tested procedure, appreciated by patients and very widespread among plastic surgeons even for reconstructive surgery despite no consensus has been reached regarding the best technique or its success rate.","title":"Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases"}
{"_id":"82bb038a-845f-7018-01d9-19a93273a4ce","text":"A literature review revealed worldwide humanitarian actions of INTERPLAST teams, whose annual effectiveness is comparable to the operation numbers of large plastic surgery departments. Six patients with complex facial deformities requiring multiple surgical interventions were selected for temporary stay and operations in Germany.","title":"INTERPLAST-Germany—adapting to global plastic surgery"}
{"_id":"82bc0421-4fc3-51ed-8dda-73daec48f232","text":"A detailed clinical history review and a comprehensive physical assessment of the patient are mandatory prior to any difficult surgery.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"82bd94cb-785e-33d2-95d9-6f29aaaf7297","text":"The purpose of this study was to evaluate the blood supplying vessels of the sternum, show the morphometry of the ITA as well as its branches, and work out the compensating blood supply routes in the event that the internal mammary artery is no longer available after use as a bypass vessel.","title":"Anatomic study of the vascular perfusion of the sternum and its clinical relevance in deep sternal wound infection Anatomische Untersuchung der sternalen Gefäßversorgung und ihre klinische Relevanz bei tiefen sternalen Wundheilungsstörungen"}
{"_id":"82c3ded1-9551-e628-5ed8-27b3aa31cbdc","text":"Fellowships were organized into eight categories: hand surgery, craniofacial surgery, microsurgery, aesthetic surgery, burn surgery, international fellowships, multiple fellowships, and not otherwise specified fellowships (NOS). An international fellowship was defined as a clinical fellowship completed abroad after residency in any subspecialty, as indicated on surgeon websites. NOS fellowships were designated as those fellowships not commonly pursued by plastic surgeons. Given the overlap with facial plastic surgery and\/or craniofacial surgery, it was also recorded if plastic surgeons had previous otolaryngology or oral and maxillofacial surgery (OMFS) training. To account for the impact of advanced degrees in business administration, MBA degrees were also recorded. Additionally, to account for the impact of time spent on independent practice, board certification year was recorded as the following categorical variables: 10–15 years (n = 943), 16–20 years (n = 887), and greater than 20 years (n = 360).","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"82cbd3d9-83bb-42fb-de85-b59835dee757","text":"Future research work would aim at determining the exact molecular mechanism of such synergistic action.","title":"Synergistic Cytotoxic Effect of Gold Nanoparticles and 5-Aminolevulinic Acid-Mediated Photodynamic Therapy against Skin Cancer Cells"}
{"_id":"82cd1d9a-6a53-c304-7b3c-7024df6815ca","text":"Infantile digital fibromatosis is a rare childhood disease of benign myofibroblast tumors occurring on both upper and lower digits. Nodules that are asymptomatic should be watched over time for spontaneous regression or may be treated with chemotherapeutic agents, steroids if they become large or unwieldy. Surgical treatments should be reserved for cases with structural or functional compromise to minimize trauma and the associated risk of recurrence.","title":"An Algorithmic Approach to the Management of Infantile Digital Fibromatosis: Review of Literature and a Case Report Eypper et al"}
{"_id":"82ceb65d-d051-cf96-d6cb-2eae33b38649","text":"We investigated changes in treatments including switching and discontinuation. The data showed that both treatment switching and discontinuation were common in the study population. Switching was lowest in patients treated with topical therapies even though the highest proportion of those on topical therapies reported that they did not perceive their topical treatment to be effective. One potential explanation is that, even though topical therapies may only be modestly effective, patients continue on them due to perception of these therapies being safer. This explanation is supported by results from Armstrong and colleagues [19] indicating that a high proportion of psoriasis patients participating in National Psoriasis Foundation (NPF) Surveys with all spectrum of disease severity chose to receive topical treatment alone due to “fewer adverse events than other treatments”. Another potential explanation is that certain providers may have a higher threshold for what may trigger a therapeutic escalation from topical medications alone to initiating systemic therapies.","title":"Real-world health outcomes in adults with moderate-to-severe psoriasis in the United States: a population study using electronic health records to examine patient-perceived treatment effectiveness, medication use, and healthcare resource utilization"}
{"_id":"82d4ef00-f07f-2ccc-60c8-e84b12bde450","text":"Based on the acceptable prognosis of patients who underwent inguinal LN dissection with curative intent, the presence of inguinal metastasis in patients with lower rectal and anal canal adenocarcinoma can be considered regional LN metastasis. If R0 resection can be achieved, inguinal LN dissection may be indicated in patients with inguinal LN metastasis from both rectal and anal canal adenocarcinoma.","title":"Long-term outcomes after surgical dissection of inguinal lymph node metastasis from rectal or anal canal adenocarcinoma"}
{"_id":"82d5c9dd-c1d0-b1f1-08ba-3ee2df7b9bfb","text":"The study aimed to evaluate the efficacy of routine carotid and lower extremity arterial screening in asymptomatic patients undergoing CABG.","title":"Assessment of carotid artery stenosis and lower limb peripheral ischemia before coronary artery bypass grafting operations: a non-randomized clinical trial"}
{"_id":"82d7713a-0158-fda1-22a7-c16513d8ad20","text":"Song et al reported a case[ of a child with a ring finger flexion deformity after closed reduction and intramedullary nail fixation in whom they utilized conventional image intensifier monitoring. Postoperative ultrasound confirmed soft tissue interposition in the fracture gap, and then open reduction was performed. Thus, monitoring soft tissue is another advantage of ultrasound when compared to the roentgen ray images, avoiding soft tissue becoming entrapped in the fracture site.","title":"Can intraoperative ultrasound visualize the closed reduction and elastic intramedullary nail fixation processes of double forearm fractures in children?"}
{"_id":"82fdde8f-58a1-3f8f-57b5-bfa72c3d88c1","text":"Of the 20 patients 16 showed G1 toxicity and 4 G2 toxicity during radiation therapy. Measurement of hydration showed a value of moisture of the skin with a slight decrease during the therapy and at the first follow up.","title":"Preventing the acute skin side effects in patients treated with radiotherapy for breast cancer: the use of corneometry in order to evaluate the protective effect of moisturizing creams"}
{"_id":"82fded1d-203d-1a6d-fe91-6ae9f2fcd3f2","text":"Risks and advantages for patients undergoing such extreme procedures should be carefully discussed within a multidisciplinary tumor board for better defining patient selection and treatment. In metastatic cSCC and in non-responsive to chemoradiotherapy patients the surgical approach may still play a role in better local control of disease and a salvage procedure.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"83016850-dc9f-8811-5939-a27a1d99dd75","text":"All the first allergic reactions occurred into the hospital and a physician wrote them down in a case history. When necessary a therapy with antihistamines, corticosteroids and bronchodilators was performed according to the severity of the reactions. Only one patient required a treatment with adrenalin.","title":"Oral desensitization to milk: how to choose the starting dose!"}
{"_id":"83071957-188a-eb11-1eef-170e766606c2","text":"Successful hepatic venous outflow is universally accepted as a pivotal factor in the success of liver transplantation. However, venous anomalies and the potential for hepatic venous congestion continue to be major concerns for ensuring the viability of transplanted livers and maximizing regenerative capacity. The need for adequate perfusion while mitigating possible venous congestion in complicated outflow anomalies has been established in the literature previously. In this case, we discuss a plan for anesthetic management and intraoperative care used to mitigate such complications. The use of diuretics like mannitol and unique surgical procedures that included anastomosing adjacent recurring outflow tracts into single conduits are discussed. The patient provided written consent to publish this case with appropriate Health Insurance Portability and Accountability Act authorization.","title":"An Approach to Anesthetic Management of Venous Anomalies and Outflow Reconstruction in Liver Transplants"}
{"_id":"83096f97-c091-f310-a981-483c0aa9cd01","text":"Another variable that can potentially affect the detection rate of SLN in patients with surgical scars is the time elapsed between primary tumor treatment and lymphadenectomy. In women with breast cancers, available data are conflicting, with one study suggesting no impact of timing between lumpectomy and SLNB [43] and another investigation demonstrating a four times higher risk of failure when SLNB is attempted before 36 days after lumpectomy [33]. In the present study, the time between primary tumor excision and SLNB was extremely variable, ranging between 17 and 110 days. Again, the influence of timing on the detection rate was not statistically evaluated in this study due to the low number of unsuccessful procedures and consequent low power of statistical tests. In the present study, all procedures performed before 50 days after primary tumor excision were successful, and it seemed that a shorter timelapse does not negatively impact the accuracy of the technique. This observation is supported by a recent experimental study on healthy beagles, in which SLN mapping was successful in all included cases at 18 days after excision of a small skin area [19]. Further studies should elucidate the impact of timing between primary tumor excision and SLNB on the SLN detection rate in dogs","title":"Sentinel Lymph Node Biopsy Is Feasible in Dogs with Scars from Prior Local Excision of Solid Malignancies"}
{"_id":"8311c5e0-2d74-1f10-7763-c62531cf0422","text":"Ear reconstruction is one of the most challenging surgeries faced by reconstructive surgeons because of its complex three-dimensional structure. Various surgical methods and materials have been used over the years. The process of microtia reconstruction using tissue expander is performed in three stages of first that is implantation of tissue expander, second stage involves framework fabrication using autologous costal cartilage and implantation in the pocket and third stage involves tragus and concha reconstruction.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"8317c8c9-c264-d8a1-e051-a3e8415d9a0a","text":"We analyzed a retrospective database of a consecutive series of microsurgical free flaps of head and neck reconstructive procedures from July 2011 to February 2020 at Galliera Hospital in Genoa. The study was carried out in accordance with the Helsinki declaration of 1975 as revised in 1996.","title":"Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team’s Experience"}
{"_id":"8318a86d-5416-18ea-cb27-7c2fdb9369cc","text":"In 11 of the 29 cases in the series, there was a delayed corticotomy. The corticotomy was not performed at the index circular frame application if it was felt that two insults to the limb in quick succession may compromise overall union. Furthermore, the corticotomy site is above the level at which a salvage amputation would be performed. Hence, the delay was to ensure the treating surgeon was happy that the fracture was progressing to heal. The corticotomy could then be offered to the patient if they felt they had a symptomatic leg length discrepancy and without prejudice to a salvage amputation.","title":"Transverse debridement and acute shortening followed by distraction histogenesis in the treatment of open tibial fractures with bone and soft tissue loss"}
{"_id":"831d65ab-6904-a375-72db-b50ed596ca93","text":"Furthermore, only a few studies have considered the phenotypic adaptation of S. aureus to SCVs, which seems to be an important factor in intracellular persistence and could be a major reason for antibiotic treatment failure. Only one study evaluated the effectiveness of treatments against SCVs compared to that against the corresponding WT strain, and only four took the induction of SCV formation by antibiotic treatments into account.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"831e37b4-90a9-9ef9-e866-1e75b4915a30","text":"Our review included 18 articles describing inpatient breastfeeding peer support strategies, whereby 13 were publications from peer reviewed journals. Our results indicate that breastfeeding peer supporters have been used in different hospital settings to support breastfeeding of both healthy and unhealthy infants. However, most of the articles found have reported breastfeeding peer support in high income settings such as the United States and Europe. Only two study reports were from LMICs.","title":"A scoping review of breastfeeding peer support models applied in hospital settings"}
{"_id":"8329722e-7b75-1ead-4b5a-29e97983b8d9","text":"Further animal studies are needed to assess the efficacy of commercially available grafts soaked in various antibiotic solutions, against infections after sequental bacterial seeding for up 7 days. Additionally, these results have to be compared with the real situation of an implanted graft in a living human being. It should not be forgotten that antibiotic\/antiseptic impregnation is not the only way of protecting synthetic grafts. Modifying the surface characteristics of prosthetic graft to minimise bacterial adherence needs to be investigated further.","title":"Systemic and local antibiotic prophylaxis in the prevention of Staphylococcus epidermidis graft infection"}
{"_id":"83325f3d-951e-c9c0-0f47-e4bc1b18805b","text":"The sonographic examinations could not be performed within one hour after the primary assessment","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"8332908b-66bf-ed90-3429-ea5612430e4a","text":"In our Case, CT and MRI scans were used to determine the exact location and relationship of the tumor which was the rectus abdominis and the flat muscles of the abdomen.","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"83355fa7-f847-f376-720d-2486f5b3db07","text":"Heart rate variability has been used for help to the diagnosis of several illnesses. It has been recently used for the detection of allergic reactions. We explore the use of a heart rate variability monitoring device to detect in real time the allergic reactions in patients undergoing a CT.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"834038c1-d2ad-348d-22f3-b382e53bf4b2","text":"Total pelvic exenteration for primary malignant melanoma of the cervix offers a feasible initial treatment for these unusual cases. It is necessary initiate collaborative studies and followup of patients to be able to achieve establishing a therapeutic approach that may offer the best results to these unfortunate patients.","title":"Primary Malignant Melanoma of the Uterine Cervix Treated with Ultraradical Surgery: A Case Report"}
{"_id":"8341dd6b-cb41-fdc4-9189-9ac592839232","text":"Participants with autoimmune conditions and conditions associated with steroid\/immunosuppressant use were less likely to develop systemic reactions compared with other participants. The second dose might represent a more vigorous response from crossing T cells or antibodies against antigens or anaphylaxis after a sensitization process. Therefore, healthcare providers should carefully collect information on reactions to the first dose so as to be prepared for adverse reactions after the second dose. This information may also help individuals to make informed decisions about vaccinations and help with the use of antihistamines, steroids, and other anti-allergy medications prior to vaccination.","title":"Association between Adverse Reactions to the First and Second Doses of COVID-19 Vaccine"}
{"_id":"834c0010-e95a-04a0-ed2b-e51d82052ea6","text":"The aim of this study is to present the experience of a reference oncology center in the use of PMFF for nose reconstructions in the treatment of NMSC. This case series aims to reinforce the role of this technique in the management of complex nasal defects, demonstrating its safety and alerting to the pitfalls that can negatively impact results.","title":"Paramedian forehead flap in the treatment of nasal, non-melanoma skin cancer: a cross-sectional study Retalho frontal paramediano no tratamento do câncer de pele não-melanoma de nariz: um estudo transversal"}
{"_id":"83500d94-b8d2-7b5e-9c81-27a7db61766e","text":"Always choose patients with a positive glabella test. Inject small boluses relatively superficially, using only moderate pressure while injecting. Always watch for erythema and stop injecting when you see blanching as this will reduce the incidence of ischaemic necrosis which is common in this area. Techniques used in this area are usually a combination of linear threading and serial puncture techniques.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"836be5df-dcfe-6999-b28a-89447b1af569","text":"CONCLUSIONS HMI can successfully map the relative stiffness at variable depths on post-surgical human breast mastectomy specimens with or without the skin. The tumor on the HMI appeared slightly larger than the one delineated on the B-mode. This study laid the foundation for future clinical study on HMI guided focused ultrasound treatment.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"836e4f7c-18d3-4029-4495-93a9206fc382","text":"To our knowledge, this is the first study that reports the wide application of FGS in NMSC and MSC for both surgical intervention and re‐intervention. ALA was applied 2 cm beyond the macroscopic clinical boundaries to include the specific resection margins indicated by the guidelines.","title":"Fluorescence‐guided surgery for non‐melanoma and melanoma skin cancer: Case series and a brief review of the literature"}
{"_id":"836f6f91-947c-aeaf-3b96-94250b94d892","text":"While there are studies that have shown changes in trends of aesthetic surgery procedures, no study has examined the changing interest in aesthetic procedures for men, especially from the start of the 21st century. It is understood that Google Trends may not always translate to surgical volume; however, it is a powerful tool to analyze public interest in particular topics by tracking live search query information where ASPS, ASAPS, and ISAPS data collection are lacking. Therefore, we utilized Google Trends to analyze overall trends in aesthetic nonsurgical and surgical procedures in men from 2004 to 2021 with focus on the last decade.","title":"Changing Aesthetic Surgery Interest in Men: An 18-Year Analysis"}
{"_id":"8372f1d8-803b-1d20-f68c-78e244f9944d","text":"The complete resection of SCC relies on palpation and visual inspection. To ensure safety margins of the tissue removed, histological examination is performed. Positive resection margins are at high risk for developing recurrent disease and are associated with poor prognosis in other head and neck cancers.","title":"Photoplethysmography for demarcation of cutaneous squamous cell carcinoma"}
{"_id":"83759b97-35ad-0801-0713-9a893c99af5e","text":"Responses were divided into the following main domains regarding the challenges of getting a national training number. Multiple challenges were highlighted by trainees in Table 2.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"837fc7a1-6cb8-45e9-dbbd-813e85e5130c","text":"The duration of time between referral for assessment and transplant is disputed and may differ between centres13,14 and according to the type of transplant. As guidelines suggest that the oral environment is stabilised and extractions be carried out a minimum of ten days before chemotherapy begins,8 the length of this interval is key to determining management.13,14 Extensive treatment need may necessitate either compromise within the dental treatment plan or the delay of HSCT. To optimise outcome and to select the most appropriate environment for treatment, the patient's medical management, the complexity of dental treatment and the accessibility and flexibility of the dental service in question should be considered.14","title":"Dental assessment prior to stem cell transplant: treatment need and barriers to care"}
{"_id":"838e7edb-47fe-1ec3-b670-0701c9304c65","text":"A second limitation is that the SEER database does not specify whether a patient underwent SLND alone or ALND. We therefore used surrogates; patients with 5 or fewer lymph nodes removed were categorized as having undergone SLND alone, whereas patients with >5 lymph nodes removed were categorized as having undergone ALND. There may be a concern that using 5 or fewer nodes removed as a surrogate for SLND may potentially lead to poorer prognosis due to insufficient axillary node dissection. In contrast, using 6 and more nodes removed as a surrogate for ALND may potentially lead to better prognosis. Nevertheless, the analyses from the SEER database showed no difference in OS or DSS in the SLND and ALND groups using the above surrogates, despite the potential survival difference caused by arbitrary subgrouping, indicating that it may be safe to perform SLND in early stage (clinical T1 and T2, N0) ILC. These surrogates are consistent with the AJCC definition of an ALND and were used in the above referenced study of the National Cancer Data Base dataset.","title":"Outcomes of Sentinel Lymph Node Dissection Alone vs. Axillary Lymph Node Dissection in Early Stage Invasive Lobular Carcinoma: A Retrospective Study of the Surveillance, Epidemiology and End Results (SEER) Database"}
{"_id":"8396740d-9686-b514-9af3-71574ea11114","text":"The first photosensitiser prodrug to gain worldwide clinical approval was a hematoporphyrin derivative called Porfimer sodium (Photofrin®) in 1993. Modern photodynamic diagnostic approaches, such as those used for the tumour resection of bladder and brain cancers, now rely on the distinctive fluorescence of malignant and premalignant lesions induced by the exogenous administration of a photosensitiser or its precursor. Successful treatment of cancers including skin and lung cancers alongside more than 50 ongoing clinical trials using 11 different photosensitisers illustrates how promising this therapy is in the future detection and treatment of cancer.","title":"In order for the light to shine so brightly, the darkness must be present—why do cancers fluoresce with 5-aminolaevulinic acid?"}
{"_id":"8397753a-854f-4639-1474-d45749034533","text":"The introduction of NPWT has revolutionized the treatment of DSWI. The high mortality of this dreadful complication could be reduced from around 50% before the NPWT down to around 10% nowadays. , The impact on NPWT can be explained on one hand through the drainage of secretions, promotion of vascularity and granulation and on the other hand by the mechanical stabilization of the open thorax and sealing of the open mediastinal wound. The procedure has also greatly reduced the need for bedside dressing changes, which classically lead to pain, further wound contamination, and possible major organ injury. Although some authors propose to use of NPWT as a means of wound closure, we believe that the swift and effective flap closure ensures better results with less stress to the patient and better survival rates.","title":"The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study"}
{"_id":"839aab66-6b25-b3a9-98cb-5fe8816278fc","text":"The most common primary bone tumors of the chest wall are shown in Table 1.","title":"Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience"}
{"_id":"839d4760-8fff-eaa2-6747-0f955fd1e428","text":"This survey of Canadian thrombosis experts shows that there is an agreement in the use of pharmacological thromboprophylaxis post major abdominal surgery. It also shows that majority of the experts would use thromboprophylaxis during hospitalization only. It also confirms that there is clinical equipoise and uncertainty around the use of thromboprophylaxis post discharge (up to 7 to 10 days) in high-risk adult patients post major abdominal surgery and that a clinical trial is desirable.","title":"A survey of thrombosis experts evaluating practices and opinions regarding venous thromboprophylaxis in patients post major abdominal surgery"}
{"_id":"83a0dedb-99d7-5687-ca99-3d59eb8e8eaa","text":"The average gray scale of regions A and B is","title":"Evaluation of Incision Margin and Radiotherapy Adjustment in Breast Cancer-Conserving Surgery Based on VR Pathology 3D Reconstruction"}
{"_id":"83a46f42-475f-9530-c53a-c0b40fcf0ec6","text":"The results of this survey shed light on the many challenges that surgical IMGs face when they enter the UK healthcare system when they apply for a national training programme, or when they progress in their surgical careers. These challenges add to the already demanding nature of the surgical profession itself. This survey highlights the need for support for overseas surgical trainees.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"83a4eb8f-f949-98c7-4b81-94f949faad4d","text":"The patient showed allergy provocation many times during the treatment at the variable doses (Figure 2). Emergency care was done and treatment was restarted after a week. The treatment was repeated for the same dose until allergy provocation was not occurred at the same dose according to the principle of overcome of the dose of allergy provocation. The treatment was finished after 4 months days with 90 times of treatment.","title":"Specific Oral Tolerance Induction Using IFN-Gamma in 2 Cases of Food-Dependent Exercise-Induced Anaphylaxis"}
{"_id":"83a64a64-13b8-f226-33ec-466330653988","text":"The goal of an IME should be mutual and reciprocal benefit between the sending institution and receiving institution. While the student’s objective for IME should focus on learning rather than helping, we argue that spending some extra time in PDT to teach basic procedural skills will improve IME outcomes for both students and hosts. We want to minimize the burden of training for host communities, especially those in resource poor environments. Host communities face the problem of having to spend time, money and resources training students who are unlikely to return as practicing physicians to the exact setting of their international elective.","title":"Procedural skills training for Canadian medical students participating in international electives"}
{"_id":"83a7aafa-4f74-e9ad-dc39-2af05aeb56ec","text":"An online search was performed to identify year-long orthopaedic research fellowship programs available for medical students and recent medical school graduates. The number of positions per program and average number of publications of recent program graduates were also obtained.","title":"Gap Year Research Fellowship Opportunities for Medical Students Interested in Orthopaedic Surgery"}
{"_id":"83aa1453-7f80-27eb-f7d8-b870996572ad","text":"Although the ultrasound examination should be performed between 24 and 48 h after muscle trauma, it is acceptable to wait a period of 48 to 72 h for the lesion to organize and the tissue to show histological changes easily detected by ultrasound [16].","title":"Isolated partial tear of extensor digitorum longus tendon with overlying muscle herniation in acute ankle sports injury: role of high resolution musculoskeletal ultrasound"}
{"_id":"83b1a810-8c19-c859-051e-729c58bd2cf6","text":"There were two main aims of this study. The first aim was to examine the influence of worry about sun exposure and young adults' perceptions of parent beliefs about the importance of sun exposure on their sun protection behaviors. It was hypothesized that greater worry about sun exposure would be related to reports of higher levels of sun protection behaviors. Additionally, it was anticipated that greater parents' perceived importance about sun exposure would be related to higher levels of sun protection behaviors. The second aim was to examine the influence of family history of skin cancer on worry about sun exposure and perceptions of parental beliefs about the importance of sun exposure. It was hypothesized that having a family history of skin cancer would be related to greater worry and higher levels of perceived parental beliefs about sun exposure.","title":"College Students' Perceptions of Worry and Parent Beliefs: Associations with Behaviors to Prevent Sun Exposure"}
{"_id":"83b70824-9dc0-95fe-bca9-0a52f68c6b8c","text":"Our preference for complete, meticulous excision of the mass might help avoid further recurrence of the ossifying mass. The long-term follow-up of the two cases described in this study showed no clinical or radiological recurrence of the deposits. Although the surgical approach may have been the trigger event inducing the chondrometaplasia, we have not enough data to support this speculative hypothesis, nor can we rule out that the ossification and cartilaginous metaplasia could be the natural evolution of the case. The surgical findings described in this study led us to consider with caution arthroscopic excision of calcium deposits and to be meticulous during the subacromial debridement of calcific foci to minimize the risk of recurrence. We do believe that the description of these two rare cases of OT will be useful to include this condition as a further complication of CT and also to consider the shoulder as an additional potential site of OT.","title":"Ossifying tendinitis of the rotator cuff after arthroscopic excision of calcium deposits: report of two cases and literature review"}
{"_id":"83bd06fa-519e-9d94-a21f-d5acc27029bf","text":"In this cohort study of 143 886 patients with localized prostate cancer, receipt of radiotherapy was associated with a small but statistically significant increase in the risk of developing a second primary cancer.","title":"Assessment of Second Primary Cancer Risk Among Men Receiving Primary Radiotherapy vs Surgery for the Treatment of Prostate Cancer Second Primary Cancer After Radiotherapy vs Surgery for Prostate Cancer"}
{"_id":"83c1da23-71dd-dfa3-e89f-d5c6fd32173d","text":"Our study showed that our residents appear to have earlier levels of autonomy suggesting a role in greater confidence of residents on completion of general surgery training. Our program continues to graduate the majority of our surgical residents straight into practice, contributing to the general surgical workforce.","title":"Early Autonomy May Contribute to an Increase in the General Surgical Workforce"}
{"_id":"83c2a8d6-90b7-be46-6374-fabbb579c2db","text":"Reasons for pain during administration of local anaesthesia include needle prick, acidic medium of the medication and improper technique. Addition of sodium bicarbonate reduced the stinging sensation related to the acidic nature of adrenaline containing LA. Similarly various topical applications prior to prick also helped patients to tolerate the prick pain better. Apprehension is always a big problem in any surgical procedure. Conscious sedation utilizes a combination of sedatives, analgesics and tranquilizers to induce a state of amnesia, anxiolysis and analgesia. This places the patient in a quiescent state so that LA and nerve blocks may be comfortably administered.","title":"How to Make Local Anesthesia Less Painful"}
{"_id":"83c85bfb-f4bc-1dcd-2044-39d4444245d0","text":"Microvascular free fibular graft shows a predictable result although it is a technically demanding procedure and experience plays a vital role in reconstructing jaw defects with this method.","title":"A Long-Standing Giant Mandibular Ameloblastoma and its Management with Microvascular Free Fibular Graft: a Case Report"}
{"_id":"83ca0139-de1f-7ed4-c321-3ea3dccbcc75","text":"Since the patient did not present with evidence of lymph node involvement on either physical examination or imaging, the decision was made to proceed with close surveillance of the neck following surgery. In addition, the patient was once again presented at the tumor board to discuss the indication of adjuvant treatment. Since pathology demonstrated clear margins with no adverse tumor features, there was no strong indication to proceed with adjuvant radiation. The decision was made to continue with close surveillance of the primary site and neck with clinical examination and neck ultrasounds. Ultimately, the selection of the best treatment path for this patient was aided by consultation with the institutional tumor board, which provided expert multidisciplinary advice.","title":"Exophytic Squamous Cell Carcinoma of the Scalp: A Case Report"}
{"_id":"83ce8596-63f0-18cc-f65c-05f0ad8f5388","text":"VExUS scans can be used to monitor the efficacy of decongestive therapy in heart failure patients. As demonstrated in this case, portal vein waveform typically improves the other waveforms as well as the IVC distension likely because of the ‘partial’ transmission of CVP to hepatic sinusoids due to the resistance offered by hepatic venous sphincters 2.","title":"Evaluation of Venous Congestion Using Beside Ultrasonography by the Nephrology Consultant: The VExUS Nexus"}
{"_id":"83d18752-a682-7066-ff6f-d41824840e2a","text":"The administration of 20 mg atorvastatin daily was less expensive than 10 mg rivaroxaban daily for 3 months, for thromboprophylaxis of DVT events in cancer patients at high risk of thrombosis undergoing chemotherapy.","title":"The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy"}
{"_id":"83db8930-0c65-39fc-ca36-05bde57cab28","text":"OVE has superseded surgical and medical management of PVCS however the lack of robust multicentre RCTs regarding diagnosis, treatment and outcomes has hindered the complete acceptance by relevant specialists of the existence and significance of this condition. The adoption of the SVP grading system will encourage consistency of terminology, the documentation of all relevant clinical data and the standardization of reporting of outcomes. It is incumbent on all specialists undertaking OVE to engage in collaborative prospective research to enable this group of women to receive the best possible care for their condition.","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"83e010f7-40ab-2cba-dcf5-5689c0e5e50d","text":"Fillers have become a common aesthetic treatment for several cosmetic problems. Several types of fillers are available from different sources and of different longevities. It is important that the treating physician be aware of the different techniques of administration and their possible side effects. This article reviews the available literature on the subject.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"83e603c5-b88c-6adc-819b-e8c50232efd2","text":"As mentioned above, inflammation not only plays an important role in tumoral growth but also can be used to fight against neoplastic processes.","title":"Mediators of Inflammation in Topical Therapy of Skin Cancers"}
{"_id":"83f056f1-48a2-d79c-c6be-45135d45ba1e","text":"There were 6 studies that included patients who had undergone mastectomy with reconstruction, 8 that included patients with mastectomy without reconstruction, and 2 that included patients with mastectomy with or without reconstruction.","title":"Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer A Systematic Review and Meta-analysis Surveillance Imaging After Mastectomy for Patients With Breast Cancer"}
{"_id":"83f45a2a-dc7f-57c4-d121-88f1c72a9c9e","text":"Our additional safety measure was applying subsequent injections in 30 min pauses because this is the time when serious allergic reaction is usually present. Severe influenza vaccine adverse events also usually occur within 30 min post-injection.","title":"Simultaneous Influenza Vaccination and Hymenoptera Venom Immunotherapy Is Safe"}
{"_id":"83f72b9b-e311-2f00-9052-2fffe9fe89ca","text":"The one patient who had complete failure of the flap, followed by three additional surgical procedures required an in patient stay of ninety days. The first operation was attempted re-vascularisation of the flap, the next procedure: debridement of the flap and the last, a further free flap. The total cost for the episode was £74158.This was nearly four times the amount of money the hospital received for that episode and more than double the cost of any of the other 59 patient episodes. Both the hospital stay and the cost of operating time contributed significantly to the increased cost. Although this patient also attracted the greatest total funding as a result of the complication and hence longer hospital stay, it was not nearly sufficient to cover the actual excess cost. A table shows a break down of the costs for this patient.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"83fe4f3a-63e2-5c9d-aca4-bca78b1ca133","text":"The MFLPF flap was also used as a free flap in 2 cases of limb reconstruction.","title":"Medial fascia lata perforator flap: Anatomical basis and clinical application as a pedicled or free flap"}
{"_id":"84061ecd-65c1-8d56-d205-6edd71fc3f0c","text":"Much scientific work has been conducted to develop and investigate vesicular drug carrier structures in the past two decades. These are of great interest, particularly colloidal lipid aggregates. However, the mode of action of lipid vesicles in topical drug delivery gives some promising findings indicating that vesicular nanosystems remain suitable carriers for topical drug delivery.","title":"New Insights in Topical Drug Delivery for Skin Disorders: From a Nanotechnological Perspective"}
{"_id":"8409316d-7a82-a8ba-9e91-d0c577725446","text":"Clinical endpoints were not included in this study, since the patient number was too small to expect significant differences between groups. However, length of hospital stay, major cardiac events and length of follow up period have been obtained from the patients charts. There were no significant differences between the groups regarding these parameters. Due to the large variability of occlusive arterial disease and outcome after surgical revascularization, possibly a substantially higher patient number is needed to measure an effect of preconditioning on clinical endpoints.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"840bc664-3ee4-2df9-7225-f28cb1b1001d","text":"The initial stages of the disease are dominated by the ischemic and inflammatory component; the latter is responsible for the joint pain, edema, and degradation of the cartilage. In 2002, some authors have demonstrated that the positive strong antiinflammatory effects of PEMFs causes an increase of adenylyl cyclase activity and a reduction of superoxide anion production, as a result of upregulation of the A2A receptors located on the neutrophil surface.30 Recently, this antiinflammatory action has been demonstrated on the sinoviocytes and chondrocytes.31 The binding plays a fundamental role on the inflammatory response and promotes new vessel formation and limits the extension of the necrotic area, resulting from ischemia. This effect is of extreme importance because of the role of the synovial membrane on the revascularization and resorption of necrotic bone. Moreover, biophysical stimulation is able to inhibit the catabolic effects of the inflammatory cytokines on the joint cartilage32 and to stimulate the synthesis of proteoglycans and the local production of BMPs, TGF-α, and IGF-I;33 PEMFs exert a chondroprotective effect in vivo on osteoarthritis,34 which may play a fundamental role in the treatment of early stages of osteonecrosis of the femoral head by limiting the damage induced by inflammation and preserving cartilage and subchondral bone exerting a short term effects.","title":"Biophysical stimulation in osteonecrosis of the femoral head"}
{"_id":"840cf32e-9b0e-955f-4a96-d65b1dd9a7db","text":"Given the burden of HIV and TB amongst the patients seen in our study setting, we were interested in exploring the possible impact of these infections on the profile of patients presenting with DVT in our hospital. Therefore, the aim of the study was to describe the profile and frequency of risk factors of medical patients admitted with non-invasive ultrasound-diagnosed DVT.","title":"The profile and frequency of known risk factors or comorbidities for deep vein thrombosis in an urban district hospital in KwaZulu-Natal"}
{"_id":"8414608f-6283-e260-30d7-3f1922e4aa1b","text":"With respect to the data on thromboembolic disease, only one patient (receiving imatinib as TKI) presented a venous thrombotic event in the form of deep vein thrombosis in the lower limb, arising in the postoperative context of a major abdominal surgery. A patient with a history of antiphospholipid syndrome and deep vein thrombosis prior to the diagnosis of CML received imatinib without new thrombotic events after the start of this drug. No patient treated with second generation TKI or ponatinib developed venous thrombotic events.","title":"Multidisciplinary management in chronic myeloid leukemia improves cardiovascular risk measured by SCORE 10.3389\/fphar.2023.1206893"}
{"_id":"8423dbd0-d43a-737d-30ce-ca29b93418f8","text":"Although the numbers are still low in comparison to other specialties, female orthopaedic residents have increased from 0.6% of all orthopaedic residents in 1981 to 2001 to 14% in recent years. Because female orthopaedic surgery residents are young in their profession, they do not have the qualifications to be considered for leadership roles in state and local orthopaedic societies. Saxena et al noted that having seniority in an orthopaedic specialty society may play a role when becoming a member of that society's Board of Directors. In addition, Poon et al studied the presence of women in leadership positions of the Pediatric Orthopaedic Society of North America and found that there were less women in higher ranks of Pediatric Orthopaedic Society of North America, which they proposed was due to the time lag to advancement.","title":"Women in Leadership in State and Regional Orthopaedic Societies"}
{"_id":"84242999-21a4-9a47-89e6-3536438a256f","text":"In summary, our study supports the idea that cell wall Mtb antigens released by bacterial lysis induce ICs and systemic vasculitis by triggering type III hypersensitivity reactions. These harmful mechanisms might be involved in the development of neurological complications of pulmonary TB. Finally, we provided a novel animal model that could be useful to study new therapeutic strategies to counteract the consequences of ICs in TB and other disorders mediated by type III hypersensitivity responses.","title":"Mycobacterium tuberculosis Cell Wall Antigens Induce the Formation of Immune Complexes and the Development of Vasculitis in an Experimental Murine Model"}
{"_id":"8428d6ca-a313-394f-69fb-fec22ee6f000","text":"According to the designed flap, the skin and platysma muscle was incised; and the marginal mandibular branch of the facial nerve was dissected and protected. The anterior belly of the digastric muscle of the affected side was detached at the chin to avoid separation of the anterior belly of the digastric muscle from the submental flap. The submental artery was found between the upper margin of the submandibular gland and the lower margin of the mandible, and the artery was protected at the submental flap side. According to the prediction based on preoperative CT, the refluxing vein was confirmed and then preserved in the submental flap. According to the relationship between the submandibular gland and the submental artery and reflux vein, the submandibular gland was either removed or retained at the base of the submental flap as appropriate. The flap was prefabricated for later use (Figure 3).","title":"Reconstruction of nasopharyngeal defect with submental flap during surgery for nasopharyngeal malignant tumors"}
{"_id":"842ae997-6562-26c4-35d3-60aebe1c956a","text":"Regarding the method of using the FM to correct severe ptosis, there are variations between those applied in China and those applied in Europe and the United States. In Europe and the United States, it is popular to use the brow suspension operation to indirectly transmit the force of the FM to the upper eyelid through various materials. In China, it is popular to use the FM flap advancement operation, which requires the creation of an FM flap and fixation of the flap to the upper tarsal plate to produce direct traction [11].","title":"Comparative evaluation of conventional and modified frontalis muscle flap advancement techniques in the treatment of severe congenital ptosis: A retrospective cohort study"}
{"_id":"84360cd5-c96c-5f8c-498c-4ee0010e430f","text":"Stem cells, due to their great capacity to perpetuate their undifferentiated state and, at the same time, to generate differentiated progeny, are at the centre of many research projects in regenerative medicine. This therapeutic field seems to offer promising opportunities for the treatment of currently incurable diseases. The predominant strategy adopted so far in regenerative medicine is to treat patients through the transplantation of exogenous stem cells, or their differentiated derivatives, directly at the target site. A complementary alternative to cell transplantation is to regulate stem cells in vivo, for example, by renewing them or accelerating their proliferation so that the tissue is restored or positively influenced by the patient’s cells without the need to remove the tissue beforehand, to cultivate and preserve the cells ex vivo and to perform grafts. Topical delivery strategies find potential uses also in the modulation of the microenvironment surrounding cutaneous stem cells known as the niche, which plays a fundamental role in the management of the correct renewal and turnover of the skin structures and skin appendages operated by the stem cells. More specifically, the aims of accessing skin stem cells can be divided into signaling, metabolic programming and gene therapy approach.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"84413fb5-a879-d98d-a2d2-cf010c7d4e1b","text":"The progression of anatomical studies on the soft tissue vascular supply has led to the development of skin flaps based on a single vessel coming from the underlying layer, the so-called perforator flaps.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"84444d54-5517-7743-b3cd-b10e19e372bd","text":"Nose appearance and length can affect self-perception in both genders because the nose is located in the center of the face.","title":"Perception and Attitude of College Students toward Cosmetic Rhinoplasty"}
{"_id":"844fc318-4ff1-38c5-aa67-8e6bc300639c","text":"Free flap monitoring through EVM can reveal changes in perfusion without physical contact with the flap or change in patient management and with negligible added expense. With access to the free EVM software online, any person using a video camera can perform free flap monitoring. A member of the team which created the algorithm stated that a real-time version, which can potentially be downloaded as an application on a smartphone, is under development. This would allow instantaneous assessment of flap perfusion or continuous free flap monitoring with a bedside video camera.","title":"Noninvasive Free Flap Monitoring Using Eulerian Video Magnification"}
{"_id":"8455f029-8f32-cf4d-26f4-79cb15036102","text":"The case series herein reported raises the question whether there may be a causal link between DBR and local recurrence following microsurgical breast reconstruction or whether our findings were coincidental. If there was a causal link, this would have important implications for the use of the internal mammary recipient site for microsurgery. For the reconstructive microvascular surgeon, this would create a dilemma whether to preferentially use this site which has multiple advantages over the subscapular-thoracodorsal vascular axis or avoid it for fear of “reactivating” recurrence.17","title":"Internal Mammary Recipient Site Breast Cancer Recurrence Following Delayed Microvascular Breast Reconstruction"}
{"_id":"84569cc1-dc09-6d19-ad8c-345d109c23e2","text":"GF is currently in private practice as a Paediatric rheumatologist at the Wits Donald Gordon Medical Centre in Johannesburg.","title":"Juvenile dermatomyositis in South African children is characterised by frequent dystropic calcification: a cross sectional study"}
{"_id":"8456c506-8019-0b82-6f74-4d7c1926aaa2","text":"The aim of this study was to retrospectively analyze the clinical outcome, prognostic factors and changes in surgical treatment in a group of melanoma patients with positive SLNB (stage III) in the context of recently published studies and the growing importance of adjuvant systemic treatment.","title":"The Current Treatment Trends and Survival Patterns in Melanoma Patients with Positive Sentinel Lymph Node Biopsy (SLNB): A Multicenter Nationwide Study"}
{"_id":"845ac028-1ea7-1476-39f2-ad6205c6cc63","text":"For patients presenting with de novo stage IV breast cancer, cryotherapy could be considered as the preferred local ablation treatment for the primary tumor, as it avoids invasive surgical intervention and may induce a systemic immune response against the tumor elsewhere in the body. Cryotherapy also holds potential for eradicating oligometastatic disease in organs such as the liver, providing an alternative to complex invasive liver resection surgery.","title":"The Evolving Role of Cryosurgery in Breast Cancer Management: A Comprehensive Review"}
{"_id":"84671eca-aba7-5436-6d7b-7cae81ba2246","text":"A87 Increased basal activation status was noted in adult anaphylaxis patients","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"846d7179-b8cc-0f83-ca13-a629bb22308c","text":"We included studies only if the diagnostic accuracy of FDG PET\/CT was compared with that of an intraoperative positive culture, regardless of whether it was combined with histopathological evidence concerning periprosthetic tissue acute inflammation caused by surgical debridement or prosthesis removal and\/or the presence of the sinus tract that communicates with the prosthesis.","title":"A Systematic Review and Meta-Analysis on the Accuracy of Fluorodeoxyglucose Positron Emission Tomography\/ Computerized Tomography for Diagnosing Periprosthetic Joint Infections"}
{"_id":"84707b4c-1c83-c119-7acd-9250990303b9","text":"Knowledge of the normal anatomy of the lymphatic system is very important to predict the location of lymph node metastases following primary cancer in the previously mentioned sites.","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"847b7b06-141f-ad50-53db-49cd1df15d77","text":"In three patients a transpelvic rectus abdominis muscle only (RAM) flap was deemed sufficient and suitable to occlude the pelvic entrance and close the pevlic floor when no skin was resected or no skin defect resulted after radical tumor surgery.","title":"Interdisciplinary Surgical Approaches in Vaginal and Perineal Reconstruction of Advanced Rectal and Anal Female Cancer Patients"}
{"_id":"848502cb-2a18-e7bb-c32b-7294405685b6","text":"Patients who present with spinal pain, but no neurological compromise should have an MRI scan performed with STIR and T1 weighted images to detect any spinal fractures. The T1 weighted images may be better than the STIR images in highlighting the fracture line in vertebrae infiltrated with a myelomatous deposit. If one has concerns about the spinal stability because of a posterior wall defect or pedicle\/facet joint\/pars involvement, then a CT scan with sagittal and coronal reconstructions can be very helpful. Patients can have quite significant bony defects but still be structurally stable in an orthotic brace80. A brace may be all that is needed in patients with a spinal fracture if they can mobilise without significant pain. The external orthosis will also keep the patients in the upright posture (and potentially prevent the development of a kyphotic deformity) while their fractures heal. Patients who present with spinal pain and have a new diagnosis of myeloma may need, depending on systemic symptoms, to have their disease controlled with chemotherapy prior to any consideration for cement augmentation. The chemotherapy immune-compromises the patients and therefore the correct timing of cement augmentation should be a multi-disciplinary decision. Antibiotic prophylaxis in the peri-operative period is strongly advised to avoid infection. The orthotic brace can be a very useful tool to control the pain to an acceptable level while the disease is being treated with the first couple of cycles of chemotherapy.","title":"The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG)"}
{"_id":"8488c09c-ae30-cd34-b33a-09b89837e664","text":"Management has 2 goals: diminution of the risk of recurrence and an improved cosmetic appearance. Several detailed reviews have demonstrated the application of the full spectrum of treatment options of which the standard is thought to be excision and primary closure.3 Advantages of surgery include a single treatment session and the lesion in its entirety is sent for pathologic examination.8 The patient described in this case had a complete elliptical excision and meticulous closure with 5\/0 vicryl suture. The result of surgical excision is esthetically pleasing to her (Fig 2). She was followed up for 1 year after excision and no recurrence was noted. Nonsurgical treatment includes cryotherapy and laser. Cryotherapy in the form of either a liquid nitrogen spray or a cryoprobe is safe and easy technique, which is suitable for the setting of a plastic surgery out patient's clinic.1 Lasers have also proved to be a successful alternative. Carbon dioxide laser and flash lamp pulsed dye laser have all been used for the treatment of pyogenic granuloma with the advantages of minimal invasiveness and pain. In addition, it obviates the need of suturing.1 Other treatment modalities include chemical or electric cauterization and microembolization.8 An acceptable outcome with sclerotherapy using ethanolamine oleate has also been reported.5","title":"Nodular Swelling on the Lower Lip; Pyogenic Granuloma"}
{"_id":"84a95aa6-46a2-b298-f128-05692ded2307","text":"We identified patients based on an International Classification of Diseases (ICD) query of the electronic health record. Adult patients ages ≥18 years were included if they had received imaging for suspected lower extremity DVT and were diagnosed in the ED with an acute lower extremity DVT. We also included patients identified in outpatient clinics and sent to the ED for same-day initial management of DVT. Acute lower extremity DVT was defined as a thrombus at or proximal to the popliteal vein and had not been reasonably previously identified.","title":"Two-point Compression Ultrasound Technique Risks Missing Isolated Femoral Vein DVTs"}
{"_id":"84b2084f-aa65-204a-f84e-e4d4555e4590","text":"The advances in laparoscopic procedures in the 1980s were at first received with criticism but represented a big leap in decreasing the invasiveness of surgeries.","title":"Robotic-Assisted Microsurgery and Its Future in Plastic Surgery"}
{"_id":"84b34337-1cdb-1cca-ff67-51d678f1af90","text":"In conclusion, we believe that skin grafting should not be applied to G–A type IIIB fractures while early flap coverage should be the preferred option. Antibiotic treatment duration had a significant impact not only on deep infection rates but also on the presence of drug-resistant bacteria. These data suggest that prolonged antibiotic use should be avoided in cases of open fractures.","title":"Retrospective analysis of risk factors for deep infection in lower limb Gustilo–Anderson type III fractures"}
{"_id":"84bc7b9e-5c83-0dbb-f373-90d38cc509a8","text":"The rash was described by dermatology as a confluent scaly red rash in the distribution of the radiation mask that resembled the patient's previous cutaneous skin rash from lupus but was not responsive to the topical steroid treatment. A shave biopsy of skin measuring 0.4 x 0.3 x 0.1 cm was taken. Histopathological findings of the specimen were described as spongiotic psoriasiform hyperplasia accompanied by superficial perivascular infiltrate of lymphocytes and eosinophils. Diagnosis from the pathology sample indicated allergic contact dermatitis.","title":"Thermoplastic Mask-Induced Contact Dermatitis: A Case Report"}
{"_id":"84bf9acc-04ab-a67f-93f4-5706afad4ecb","text":"This systematic review revealed that there is limited research specific to chest wall reconstruction following breast cancer resection in males. Postmastectomy chest reconstruction should be regularly considered and discussed with men who have breast cancer. Larger studies are warranted to further shed light on this patient population.","title":"Postmastectomy Reconstruction in Male Breast Cancer"}
{"_id":"84c2316c-600d-ba25-faec-803a1f529269","text":"During the meeting, the literature concerning different cutaneous toxicities related to targeted therapy and chemotherapy as well as to quality of life was reviewed. The working group discussed appropriate dermatological products for each cutaneous symptom according to the available literature, and completed their recommendations with current practices in France and Germany and personal experience.","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"84c4b9ac-3e88-37c5-2c0e-7d32622f82a7","text":"As part of a quality assurance process a central pathology review of all samples will be undertaken, performed by the trial pathologist. All external samples will be re-reported according to the Royal College of Pathologists minimum dataset for head and neck carcinoma histopathology.","title":"LIHNCS - Lugol’s iodine in head and neck cancer surgery: a multicentre, randomised controlled trial assessing the effectiveness of Lugol’s iodine to assist excision of moderate dysplasia, severe dysplasia and carcinoma in situ at mucosal resection margins of oral and oropharyngeal squamous cell carcinoma: study protocol for a randomised controlled trial"}
{"_id":"84c6e106-efe4-cb72-bbf2-640c54abc2d5","text":"Cartilage grafting is mandatory in the case of the structural framework being impaired by oncological excision; it can also be used to support the soft tissues and prevent a contour deformity due to wound healing forces [14]. Alar defects should be always grafted in order to provide structural support and prevent any functional or aesthetic drawbacks.","title":"Reconstruction of the Nose: Management of Nasal Cutaneous Defects According to Aesthetic Subunit and Defect Size. A Review"}
{"_id":"84c9e054-0216-a9ac-0068-22ec1d528a72","text":"The reconstructive options were discussed with the patient. She expressed a wish for implant based reconstruction preferably with no autologous flaps.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"84ca8f27-8b50-e44c-a5ba-66efb5ba67a6","text":"A tomography was not requested because the cost was too high for the family and sedation would be required. Difficulty was also encountered in taking periapical X-rays because of the patient's age. Therefore, clinical monitoring of the case was chosen, with simultaneous orientation toward the prevention of dental caries and malocclusion. Clinical followup was performed every 2 months to verify the position of the lateral frenum insertion. Because no improvement in the insertion was observed and to maintain the segmentation of the alveolar crest, surgery was performed at 11 months of age before the eruption of the upper incisors to avoid alveolar bone loss and the persistence of morphological gingival border alterations. The clinical followup after surgery showed improvement of the insertion of the lateral frenum, better morphology of the arch, and eruption of the upper left canine and left first primary molar in their correct locations.","title":"Surgery Management of Rare Hypertrophic Frenum in an Infant"}
{"_id":"84cc2c72-1c3d-74aa-635d-64d6c46ccbb7","text":"The characteristics of the patients and renal lesions are summarized in Table 1 and Table 2.","title":"Percutaneous CT-Guided Renal Cryoablation: Technical Aspects, Safety, and Long-Term Oncological Outcomes in a Single Center"}
{"_id":"84d9faf2-2bc5-84a8-9132-458474c7d9ff","text":"The search and selection process can be summarised in the PRISMA Diagram displayed in Table 1. From a total of 50 papers in the search, 9 were deemed appropriate for inclusion in the synthesis.","title":"Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review"}
{"_id":"84dd9da6-6248-7a23-c260-1f171967f44d","text":"These findings support the practice of pre-treatment curettage as an effective intervention for tumour thickness reduction before the use of PDT in thick BCC.","title":"Pre-Treatment Deep Curettage Can Significantly Reduce Tumour Thickness in Thick Basal Cell Carcinoma While Maintaining a Favourable Cosmetic Outcome When Used in Combination with Topical Photodynamic Therapy"}
{"_id":"84dfe005-861c-7149-a0fb-095bc805d365","text":"In the current study, the presence of breast implants during postmastectomy radiotherapy was not associated with increased doses to ipsilateral lung and heart, but CTV definition and its dosimetric characteristics urge further evaluation.","title":"No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction"}
{"_id":"84e28b5c-bcf7-6097-df89-43c9ef039cd4","text":"This study showed that completion of ALND did not improve overall survival or locoregional recurrence in patients with invasive breast cancer and sentinel node metastasis. The similar overall survival between the two groups provides evidence that ALND is unnecessary in patients with up to two metastatic SLNs treated with conservative surgery and radiotherapy. This finding suggests that even in countries such as Brazil, where the overall survival in patients with breast cancer is lower than that in patients in developed nations, conservative surgical treatment of the axilla, in patients who meet Z0011 criteria, is possible. This result corroborates the data from the ACOSOG Z0011 trial.","title":"Survival and recurrence with or without axillary dissection in patients with invasive breast cancer and sentinel node metastasis"}
{"_id":"84ee0ed0-4e2b-5ad9-213e-09f1f76b5800","text":"Cervical spine injuries can have serious neurological consequences. Patients with these injuries require adequate immobilisation to prevent or limit neurological deterioration during transfer to tertiary spine centres and definitive surgical fixation.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"84f99687-babe-399c-644f-110690decd88","text":"Certain dental treatments that involve a risk of haemorrhage may require temporal interruption of apixaban administration. It is thus of great importance to plan invasive dental treatments entailing a risk of haemorrhage ahead. When dealing with a patient receiving oral anticoagulants, it is necessary to judge the risk of haemorrhage in the dental procedure and the risk of thrombosis arising from the patient’s underlying pathology.","title":"Implications of apixaban for dental treatments"}
{"_id":"8500ac7b-f3ea-13c0-b08b-71d8683ed106","text":"5 or below suggests that there is impairment of tongue function: this may or may not be having an effect on breastfeeding.","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"85038dd4-5bf0-fbbc-46f7-bfd61ea36530","text":"DVT or PE was not observed clinically in any patient in all three groups according to clinical examination and symptoms.","title":"Comparison of Enoxaparin and Rivaroxaban in the Prophylaxis of Deep Venous Thrombosis in Arthroplasty"}
{"_id":"851238d4-e3a4-6cbb-42c6-ea1f63a94213","text":"Facial IDFs may become infected following a dental infection. The mechanism could be attributed to the bacterial contamination from the mouth through the bloodstream after a dental procedure adjacent to the filler injection that can be activated by the bacterial adherence to the material biofilms. It is essential to raise awareness about the importance of completing dental treatment prior to filler placement, to avoid all risks of complications related to oral conditions. A detailed history of dermal fillers with complete information about the used materials should be known by the patient and declared to the practitioner.","title":"Infected Facial Tissue Fillers Caused by Dental Infection"}
{"_id":"8512846a-1cfb-3a18-0198-a830567c5957","text":"The aim of this study was to identify reasons for the low rate of breast reconstructions and to understand the motivations of women who refuse breast reconstruction after mastectomy.","title":"Patient’s Education Before Mastectomy Influences the Rate of Reconstructive Surgery"}
{"_id":"8516ea67-7d92-9a64-28ba-25d59a513b27","text":"We believe that the positive experience that we achieved in the use of composite grafts for the reconstruction of large areas of the nose could be interesting for others surgeons and will stimulate wider application of the technique described in this report.","title":"Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose"}
{"_id":"8517a6c7-fa8a-3b71-b869-4fb7df60efe1","text":"People with germline retinoblastoma are also at risk of developing other tumours later in life. These second tumours are most commonly osteosarcomas, soft tissue sarcomas or melanomas. The risk is increased if the child was treated with external beam radiotherapy. These second tumours most commonly occur between 10 and 50 years of age and can occur anywhere in the body. There is no effective screening for second tumours, so it is important for the patient and their medical team to be aware that they may occur. Sun protection is important, as is regular checking of the skin for melanomas.","title":"Germline retinoblastoma: estimating risk and counselling the family"}
{"_id":"851de650-0fee-c12d-877f-50e65fe0241c","text":"Theoretically, HDR involves a greater probability of late effects for a given level of tumor control; however, the fractionation of HDR intracavitary brachytherapy appears to offset this difference in tumor and normal tissue effects caused by an increase in dose rate.","title":"Brachytherapy for cervix cancer: low-dose rate or high-dose rate brachytherapy – a meta-analysis of clinical trials"}
{"_id":"8523fb31-472a-6e20-529a-e2857e158871","text":"Osteoradionecrosis of the sub-axial cervical spine is rare. Presence of cervical kyphosis makes it a difficult challenge to the surgeon not only to correct kyphosis but also to achieve wound healing, prevent infection and achieve union in an irradiated bed. Anterior cervical discectomy with bilateral uncovertebrectomy provided good decompression, anterior release and bed for fusion with a resultant correction and maintenance of cervical lordosis with resultant of a stable and painless cervical spine. Finally, hyperbaric oxygen therapy provides an excellent adjunct to prevent wound complications.","title":"Osteoradionecrosis in Subaxial Cervical Spine - a Rare and Devastating Complication: A Case Report"}
{"_id":"852603c2-d73d-b695-edc3-9be74def03f1","text":"The database software was based on Microsoft Office Access and was written in Microsoft Visual C++. OpenGL was used to realize the visualization of the 3D data. Multiple nasal shape classifications were integrated to develop the database so that nasal models could be imported into the database accompanied by their morphological features, and the proper models for certain needs could also be easily found.","title":"Development and application of a rapid rehabilitation system for reconstruction of maxillofacial soft-tissue defects related to war and traumatic injuries"}
{"_id":"852ec03a-5db6-0342-f8d7-6c19defa675d","text":"This study is limited by the inclusion of a small number of manuscripts reporting small cohorts with different study designs and therapeutic approaches employed. Clinical evaluation and dermoscopy were employed more often than RCM and OCT; therefore, the features of these first techniques are much more consolidated than those of OCT in particular. The data obtained in this study could not be compared to other data, as there are no studies reporting the diagnostic proportional estimates or diagnostic accuracy available in the literature. However, our results underline the overall previously unreported impact of RCM and OCT techniques in BCC treatment monitoring, but the data should be interpreted with caution due to the significantly large to extreme heterogeneity among the included studies.","title":"Non-Melanoma Skin Cancer Clearance after Medical Treatment Detected with Noninvasive Skin Imaging: A Systematic Review and Meta-Analysis"}
{"_id":"8532f875-4e13-0576-f3e4-9ee4bf466257","text":"Percutaneous trigeminal ganglion stimulation or trigeminal branch stimulation is an evolving modality that offers a reliable management approach with low possible morbidities for patients with severe refractory facial pain. It acts as an effective alternative to opioid medications and can be used to reduce the prescribed opioids to help in solving this ongoing health care problem that is reflected on the society with a great burden on people’s lives [5].","title":"Supraorbital Nerve Stimulation for Facial Pain"}
{"_id":"853393e0-a59d-c5ef-c41d-5c89543f8e0e","text":"The combination of features, such as the history of previous surgery, the age and sex of the patient, the location of the mass within the anterior abdominal wall and the imaging features, make desmoid tumor a strong primary diagnostic consideration even if it is a rare entity and especially in men. The treatment approach remains aggressive and includes complete surgical resection. Repair of abdominal wall defects can be sufficiently achieved with prosthetic mesh reconstruction with excellent functional results.","title":"Desmoid tumor of the abdominal wall: a case report"}
{"_id":"853918d0-e8b2-f50a-33f9-2d7a64f38e38","text":"A modern breast reconstruction center is required to offer comprehensive options for breast reconstruction. One of these options is the microsurgical free flap reconstruction with the DIEP flap as the gold standard. The successful performance of this complex operation requires a certain amount of training and experience.","title":"Breast Reconstruction with DIEP Flap: The Learning Curve at a Breast Reconstruction Center and a Single-Surgeon Study"}
{"_id":"853d93de-30af-7071-3979-6d93c1d2a217","text":"The aim of the present study was to investigate the in vivo efficacy of local and systemic antibiotic prophylaxis in the prevention of S. epidermidis graft infection in a rat model and to evaluate the bacterial adherence to frequently used prosthetic graft materials.","title":"Systemic and local antibiotic prophylaxis in the prevention of Staphylococcus epidermidis graft infection"}
{"_id":"853db314-268e-e7b2-46d1-c25b506bd124","text":"The study involved a non-invasive and painless ultrasound examination in addition to usual care and was approved by the local ethics committee; the study followed the rules of the Declaration of Helsinki. Patients gave their informed consent to be in the study.","title":"The role of ultrasound quantitative parameters in the assessment of acute radiodermatitis after breast-conserving surgery"}
{"_id":"85424b80-4311-5969-48e0-3133c5b4eba2","text":"Treatment will be ended if participants meet any of the following conditions:","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"854775cd-439c-7bf0-47ee-6fecbb3e3ea5","text":"Regarding travel, there is no clear guidance regarding the safety of plane travel immediately after a blood clot. It may be best to avoid flying in the first 4 weeks, but this is not an absolute recommendation. It is important to discuss the risks and benefits with your doctor. Massage of the extremity with the DVT is best avoided in the first few weeks of a DVT due to concerns that a clot might break off and become a PE with deep massage. Massages at a later date and while taking a blood thinner are not prohibited, but more forceful deep tissue massage that could cause bruising or bleeding should be avoided on blood thinners.","title":"Vascular Disease Patient Information Page: A guide for patients with newly diagnosed deep vein thrombosis or pulmonary embolism"}
{"_id":"85491e25-2f0a-74d7-1f9f-902f424ce8c0","text":"Patient had rapid and dramatic relief of her symptoms of pain. Treatment with sodium thiosulfate was well tolerated without any side effects, accompanied by significant symptomatic relief but without any effect on disease progression. So the role of sodium thiosulfate in calciphylaxis is unknown and need further studies.","title":"Non-healing painful ulcers in a patient with chronic kidney disease and role of sodium thiosulfate: a case report"}
{"_id":"854e212a-81a2-8688-0d26-b0929dee84c1","text":"In this study it was found that the pediatric patients who received cancer treatment before the age of 7 years constituted a high-risk group for DAs. The frequencies of microdontia and hypodontia were increased even more when the patient was treated for cancer before 5 years of age.","title":"Long-term Dental Anomalies after Pediatric Cancer Treatment in Children Kanser Tedavisi Gören Çocuklarda Uzun Süre Sonra Görülen Diş Anomalileri"}
{"_id":"85528578-9483-f973-8360-cdbe8c101751","text":"The patient was scheduled for a Lisfranc amputation and endoscopic inguinal lymph node dissection. A disarticulation at the tarsometatarsal level was performed using an arciform incision at the plantar and dorsal aspects of the right foot over the metatarsus and was completed without any complications. However, the lymphadenectomy discovered various darkened lymph nodes in the groin basin.","title":"Video-Assisted Endoscopic Inguinal Lymph Node Dissection for Acral Melanoma"}
{"_id":"85567838-b42d-b8c8-5143-8ef3a034283a","text":"The major challenges of anticoagulation management in the perioperative period are the interruption of anticoagulation, which temporarily increases the risk of thromboembolism and its maintenance during invasive procedures, which may increase the risk of hemorrhagic complications. Both challenges increase the risk of death.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"85578e4c-5be7-184e-422b-b5f1817446ba","text":"On the other hand, the screening is associated to an increased number of US examinations and a prolonged duration of stay in ICU, contributing to an increased cost for the hospitalization. A longer stay in ICU could be also due to a higher survival rate, although this result was not statistically significant in our study.","title":"Ultrasound screening for asymptomatic deep vein thrombosis in critically ill patients: a pilot trial"}
{"_id":"8559ad60-9a07-acc7-3eb3-f674813df221","text":"The authors have obtained written informed consent for written and electronic distribution of the report from the patients.","title":"Free Vascularized Fibular Graft Transfer in the Reconstruction of Defects for Premalignant and Malignant Musculoskeletal Conditions of the Femur in a Tertiary Care Setting in Pakistan: A Series of Six Cases"}
{"_id":"855a2246-a043-3a36-c46e-c93479bb5e34","text":"There are a few issues related to this case which should be addressed.","title":"Severe Fatal Mucormycosis in a Patient with Chronic Lymphocytic Leukaemia Treated with Zanubrutinib: A Case Report and Review of the Literature"}
{"_id":"855dc8d9-8c71-9d7e-6bc9-deb33fd046cd","text":"The review article discusses the advances in the diagnosis of the VTE. The recent updates in the clinical algorithms for excluding the VTE and avoiding the unnecessary testing, evaluating the probability for the VTE, D-dimer for the ruling out VTE, the advances in the imaging studies for VTE evaluation and approach in distinct clinic condition like pregnancy and malignancy. The diagnostic approach differs in patients with prior malignancy and has been discussed in the concluding section of the article.","title":"Advances in the Diagnosis of Venous Thromboembolism: A Literature Review"}
{"_id":"8561b4cc-e37f-e762-d04b-5efe12d09cc4","text":"We looked for the blue-stained lymphatic vessels and SLN along the intersection of the lateral margin of the pectoralis major and the lower edge of the mane according to the mark presented of the SLN on the body surface, and then removed 2–5 SLNs for rapid frozen pathological examination.","title":"Three-dimensional visual technique based on CT lymphography data combined with methylene blue in endoscopic sentinel lymph node biopsy for breast cancer"}
{"_id":"856c6cc4-37c7-4778-d8e7-9035b6a09c1e","text":"A preoperative core biopsy should be avoided because the resulting hematoma could affect the US visualization, and tumor damage could affect stability and firmness when anchoring the marking needle. We therefore did the frozen section procedure in all cases.","title":"Optimization of breast cancer excision by intraoperative ultrasound and marking needle - technique description and feasibility"}
{"_id":"85726b0d-499f-820f-b63a-2af462937ffc","text":"Clinical data on race and sex were available for most patients. Tumor stage information was available for a limited number of subjects.","title":"Somatic mutations in CDH1 and CTNNB1 in primary carcinomas at 13 anatomic sites"}
{"_id":"85734496-d18d-22a9-7ed2-2725e4a33ee3","text":"Using NPWT expedites the healing process of extremity wounds. It is more economical and can be considered as a substitute for the treatment of extremity wounds.","title":"Comparison of negative pressure wound therapy (NPWT) &conventional wound dressings in the open fracture wounds"}
{"_id":"857cff57-3a88-8e53-88b8-e97b05451648","text":"This report describes the effects of cryotherapy on physiologic pigmentation of oral mucosa and it is hoped that the results will be used to suggest an effective method for treatment of similar oral mucosal lesions.","title":"Management of Physiological Hyperpigmentation of Oral Mucosa by Cryosurgical Treatment: A Case Report"}
{"_id":"857edafb-a7e4-5966-8fda-8226bc7f8f2f","text":"The patients who are most likely to benefit form the ALT flap are those in whom soft tissue defect including skin is massive after extensive resection of lateral skull base tumours. This flap should be also considered in patients with comorbidities increasing the risk of donor-site complications.","title":"Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection"}
{"_id":"8587acd3-3105-53aa-57eb-ddcdfe9616c4","text":"We developed the exposure group-specific chemoprophylaxis eligibility criteria based on the erythema measurement with reference to a document issued by the Japanese Ministry of Health and Welfare in 1989. For convenience, we categorized the criteria into 5 mm intervals. The criteria also considered the increase in erythema size between that which occurred at the regular school-entry checkup and that which occurred during the contact investigation. Details of the criteria are presented in our previous report and Table 3 of the present report.","title":"Validity of Using Tuberculin Skin Test Erythema Measurement for Contact Investigation during a Tuberculosis Outbreak in Schoolchildren Previously Vaccinated with BCG"}
{"_id":"8587fa77-e9ab-910d-99c4-4bf85d5f5372","text":"Finally, another concern regarding the acceptance of non-US citizen IMG applicants is the difficulties IMGs may have in attaining visa sponsorship. J1 visas represent the most common visa category offered to newly matched IMGs due to the ease and rapidity of processing, as well as its low cost compared with other visa categories such as H1B and O1 visas. J1 visas, however, have the major drawback of requiring the IMG physicians to return to their home countries for 2 years at the end of training or to serve in an underserved area for 3 years. Furthermore, in recent years, additional restrictions have been placed on visas and have impeded the ability of many IMGs to obtain visas. Legal action regarding the restrictions on J1 and H1B visas may lower these obstacles in the upcoming years, but in the meantime, obtaining visa status for IMGs may present a challenge to US institutions.12 In summary, while concerns over diminished clinical, surgical, and ACGME competencies appear to be unfounded reasons to deny acceptance of IMGs into US plastics residencies, the visa status of IMG applicants may represent a significant hurdle to some US programs.","title":"International Medical Graduates in the US Plastic Surgery Residency: Characteristics of Successful Applicants Kokosis et al"}
{"_id":"859c9e1a-0883-f464-d995-b3bf1dd10fd8","text":"We present a case of successful prevention of macroscopic distal embolism in a young patient with ACS obtained combining IVUS and distal filter protection.","title":"Intravascular ultrasound to guide the management of intracoronary thrombus: a Case Report"}
{"_id":"85adb7a3-6306-ed09-419f-a654067847eb","text":"Although we only examined endothelial function in a sample of the harvested veins, we found no evidence that the manipulation of the vein, consequent upon using the Mayo stripper, affected endothelial function any more than the traditional open harvest method. In order to eliminate the effect of surgical expertise, we used 2 very experienced surgeons who were equally comfortable with either technique to carry out all of the vein harvesting. However, we see no reason why the less invasive technique cannot be taught to surgical trainees and surgical assistants, or why they should not be able to carry it out to an equally high standard.","title":"Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest"}
{"_id":"85b266c4-009d-f1f1-f2d3-8a958d866f59","text":"We suggest the application of NPWT to large breast wounds after LD flap and skin graft reconstruction may be a reliable method. This study suggests it to be particularly effective in the treatment of complex breast wounds.","title":"Utilizing NPWT improving skin graft taking in reconstruction for extended breast skin defects following mastectomy"}
{"_id":"85b903fe-d6f6-0bf8-5df8-c05e1fd83586","text":"We observed neither immediate local nor systemic allergic reactions after the administration of insect venom vaccine in the study group. Within the first 30 min after the administration of the influenza vaccine, no other adverse reactions occurred in the group vaccinated with both allergen and influenza. No delayed local reactions were reported by patients during the first 24 h after both injections.","title":"Simultaneous Influenza Vaccination and Hymenoptera Venom Immunotherapy Is Safe"}
{"_id":"85bda57c-0c05-e6f3-a8db-ec18689ae51d","text":"The process of osseointegration of the cells on the surface of the titanium implant is central to the success of the implant and prosthetic surgery.","title":"The Latest Craniofacial Reconstructive Techniques Using Anchored Implants after Surgical Treatment of Nasal and Paranasal Sinuses Tumors"}
{"_id":"85c0e08d-851d-7591-ccae-5f1225bc0ee4","text":"Many researchers have speculated that the progressive loss of follicular melanocytes during aging could result from follicular apoptosis of melanocytes and from defects or depletion of melanocyte stem cells.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"85c152e8-678a-0e29-ac3b-dacff9d3c427","text":"There is evidence that cancer survivors are at increased risk of second primary cancers. Changes in the prevalence of risk factors and diagnostic techniques may have affected more recent risks.","title":"Second primary cancer risk - the impact of applying different definitions of multiple primaries: results from a retrospective population-based cancer registry study"}
{"_id":"85c617b7-ea65-08b2-c937-3be8f9ddfa69","text":"The diagnosis of desmoid tumor should be strongly considered even in male patients with an abdominal mass and a history of previous abdominal surgery. The goal of its treatment is complete tumor excision and avoidance of the development of complications such as hernia.","title":"Desmoid tumor of the abdominal wall: a case report"}
{"_id":"85c65a76-7d5b-0518-ba44-b2ae7507893b","text":"Four studies included in this systematic review described successful reconstruction of scrotal defects with local scrotal advancement flaps, for a total pool of 68 patients.3,8-10 Chen et al8 described success using the scrotal advancement flap for 11 patients with scrotal defects smaller than half the surface area of the scrotum. Complications included partial flap loss in 1 patient and wound edge necrosis in 2 patients. The authors advised caution with use of this flap for defects larger than half the scrotum because the closure should be tension free.8 Ferreira et al9 included muscle in the advancement flap, with 10 patients undergoing scrotal musculocutaneous flaps for small scrotal defects.","title":"Reconstruction of Defects After Fournier Gangrene: A Systematic Review Karian et al"}
{"_id":"85c80bb0-b6ac-eead-8a81-43272b88ee77","text":"The surgical planning is based on MRI or CT images which represent the 3D anatomical structures as a stack of 2D gray scale images. Interpreting these images to determine where tumors are located and how they are positioned in relation to other anatomical structures requires years of experience and an inherent uncertainty still remains. In addition, reconstructing the 3D representation that is required to understand the anatomical structures and their relations from the stack of 2D images is done by the surgeons in their minds. This process requires extensive training and is often challenging even for experienced surgeons. Furthermore, as each surgeon builds a 3D representation in their own mind, agreements between surgeons are mostly discussed without a shared visual image of the 3D structures.","title":"Virtual Reality for Surgical Planning – Evaluation Based on Two Liver Tumor Resections"}
{"_id":"85cd827b-2e40-fb0e-76c7-170a2fabecc5","text":"We report the second case of migration and extrusion through the oral cavity of a cervical vertebral body replacement system after hypopharynx perforation in a patient that had undergone cervical corpectomy due to a vertebral chordoma. Neurological deficit was avoided thanks to the presence of a posterior cervical fusion. The antecedent of radiation therapy, as well as progressive tumor re-growth, may have favored the development of a decubitus ulcer in the pharynx and the migration of the interbody device respectively.","title":"Oral extrusion of a vertebral body replacement device after chordoma tumor growth and radiation: case report and review"}
{"_id":"85d186f7-5083-792e-79a4-6031fc24c6b5","text":"Unfortunately, 4 months later the patient had a biopsy confirmed recurrence at a site on the perineum outside of our treatment field. She received one cycle of chemotherapy with cisplatin and mitomycin-C before passing away from her disease. Survival was 21 months from the initial diagnosis and 6 months from the time of salvage therapy.","title":"High-Dose Rate Salvage Interstitial Brachytherapy: A Case-Based Guide to the Treatment of Therapeutically Challenging Recurrent Vulvar Cancer"}
{"_id":"85d2b7e3-d4d5-9598-0b63-3582ddafd5a5","text":"Data were collected from patients’ medical records. All patients were screened for the presence of VTE and depending on the clinical suspicion thoracic angiotomography for PE and\/or lower limb venous Doppler ultrasound for DVT were performed according to usual clinical practice.","title":"Predictive Value for Increased Red Blood Cell Distribution Width in Unprovoked Acute Venous Thromboembolism at the Emergency Department"}
{"_id":"85d63d54-dfe4-20e6-48dd-44fc1ab37980","text":"It is our opinion that skin is placed at risk not when the prosthesis presence generate high tension on cutaneous surface but when there is vascular damage after a poorly performed mastectomy, carried out too much superficial exposing the dermis.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"85d6bff0-ce0a-35ac-5850-5bf04cbb9f42","text":"We report two cases where examination has revealed unexpected results that have changed patient management and treatment.","title":"Should all excised surgical specimens be examined microscopically? A case report"}
{"_id":"85d8c04f-e0fd-5235-06a0-8ddd7250bceb","text":"Ethical review and approval was not required for the animal study because these were clinical patients and only standard procedures\/equipment were used and all had full client consent for the procedures performed. Written informed consent was obtained from the owners for the participation of their animals in this study.","title":"Intraoperative Ultrasound Applications in Intracranial Surgery"}
{"_id":"85de40a7-072f-eb11-061c-62d44e7d1b62","text":"Transbronchial needle aspiration (TBNA) is a new technique that involves inserting a special puncture needle with a flexible catheter into the airway through the bronchoscopy biopsy channel. The puncture needle penetrates the airway wall, attracts any tracheal and bronchial lesions outside the lumen, such as nodules and enlarged lymph nodes, and obtains relevant specimens for cytology and histopathological examination (15). Inspired by the TBNA technique, we modified the traditional FNAC method by increasing the negative needle suction pressure to 20 ml and the thickness of the needle to 18 G. The effect of our modified needle aspiration biopsy method in the diagnosis of superficial lymph nodes was compared to that of CNB in view of assessing the diagnostic value and safety of the new method in terms of superficial lymphadenectasis. Overall, the modified needle aspiration biopsy method demonstrated a similarly high diagnostic rate as CNB.","title":"The diagnostic value and safety of modified needle aspiration biopsy for superficial lymphadenectasis"}
{"_id":"85df8028-2a57-e0e8-6a84-849a19b495e9","text":"Expected SAEs that do not undergo expedited reporting are defined as:","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"85e59189-7be9-63ee-66c1-2a7ff42fc15a","text":"Aging of the skin is characterized by loss of hydration and consequent dermis and epidermis atrophy and structural and functional integrity, with altered skin barrier function and reduced immunological response especially due to components of the extracellular matrix vascular impairment and the resulting metabolic disturbance and oxidative stress [55].","title":"Allergy and Aging: An Old\/New Emerging Health Issue"}
{"_id":"85e65702-bca8-ebc7-35af-88f05518fb34","text":"Slide tracheoplasty is an effective surgical method for congenital tracheal stenosis associated with congenital heart disease. With the continuous improvement of surgical technique, the mortality has been reduced and the incidence of granulation tissue and mucosa varus also has been reduced. The period of 10 to 24 months of age is the optimal cure time.","title":"Slide tracheoplasty in 81 children: Improved outcomes with modified surgical technique and optimal surgical age"}
{"_id":"85e801b0-117a-711f-942d-392651032ec3","text":"Before initiating a surgery, it is extremely vital for the whole surgical team to collaborate for an effective surgery, the fundamental of those are that there should be comprehensive understanding of the condition of the patient and how to apply the surgical knowledge in the right manner. Surgical planning has achieved a lot of improvement with the ongoing progress of the imaging procedures that give the surgeons better visualization and better understanding for the anatomy and pathology of the patient.7 While the current practice might be adequate for surgical planning in some cases, other complex cases required better understanding that will lead to better results, decreased incidence of complications, and decreased time of surgical procedures. 3D printing possesses the ability to produce similar type of models of body organs and structures. This has generated a lot of interest in the field of surgical planning among different surgical specialties. Different centers around the world present cases in which a fabricated model was created from the imaging modalities using computer-aided design, which was then printed with a 3D printer, followed by the planning procedure by the treating team.8-10","title":"Three-Dimensional Printing Surgical Applications AlAli et al"}
{"_id":"85f8d723-4915-aab6-f00c-33736f20a88e","text":"The antibiotic treatment should ideally be initiated after obtaining sufficient samples from bone for microbiological assay 5. Most of the studies stated that the most effective therapy of a confirmed salmonella osteomyelitis is a combination of radical operative intervention and targeted intravenous antibiotics as in our case 5.","title":"Salmonella Osteomyelitis in a one year old Child without Sickle Cell Disease: A Case Report"}
{"_id":"85fcfbdd-8927-0813-bcc4-61c9c7eaa1d9","text":"Anosognosia in dementia is a highly disruptive symptom and the exploration of its neuroanatomical correlates is of particular interest. The purpose of this study was the evaluation of the perfusion correlates of anosognosia in a population with various types of neurodegenerative dementias to reveal specific BAs implicated in the symptom across disparate dementia etiologies. Moreover, we examined the whole brain cortex using a voxel-based method to avoid overlooking certain regions.","title":"Anosognosia in Dementia: Evaluation of Perfusion Correlates Using 99mTc-HMPAO SPECT and Automated Brodmann Areas Analysis"}
{"_id":"8605ef19-2b27-9894-12aa-65454128a008","text":"This report presents a rare case of cutaneous angiosarcoma in a pediatric patient with XP initially referred for frozen section biopsy and MMS for presumed nonmelanoma skin cancer. To the best of our knowledge, this is the twelfth case report of a pediatric patient with XP diagnosed with cutaneous angiosarcoma. Although not as common as nonmelanoma and melanoma skin cancers, angiosarcoma should be considered in patients with XP. Angiosarcoma tumors arise in sites of chronic UV exposure or prior irradiation, and patients with XP have an intrinsic defect in the DNA damage repair process. Clinical presentation of angiosarcoma varies, and it can present as a benign lesion or other malignant lesion, as seen in this case. Given the link between UV and radiation exposure and angiosarcoma, it is important to consider angiosarcoma in the differential for cutaneous tumors in patients with XP.","title":"Cutaneous angiosarcoma of the scalp in a pediatric patient with xeroderma pigmentosum"}
{"_id":"86083b1a-7d6d-2ad3-431f-651644691e1c","text":"Rhinoplasty is among the most common surgeries performed by facial plastic surgeons worldwide.","title":"Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study Avaliação dos desfechos estéticos e funcionais em cirurgia de rinoplastia: um estudo prospectivo"}
{"_id":"8608e4b8-7347-92d5-889e-f04da7fd7bc5","text":"Skin cancer characteristics were analyzed with specific focus on the number of cutaneous neoplasms diagnosed, the timing of the first and subsequent tumor, as well as the location and the prevalence of subtypes skin cancer. Moreover, these features among patients with each type of multiple KCs were compared to those of patients with single skin cancer. Table 1 presents the clinical variables of the patients with single and multiple KCs.","title":"Risk Factors and Clinicopathological Features for Developing a Subsequent Primary Cutaneous Squamous and Basal Cell Carcinomas"}
{"_id":"86147d5a-d064-0d8e-5c55-236b556d6e02","text":"Patients were not selected based on the tumor location in the parotid gland as it could result in the exclusion of more difficult cases, adversely affecting the study objectivity. This enabled the use of monitoring in patients with tumors in the deep lobe to be assessed. In such cases, we performed a partial parotidectomy, which included both the superficial lobe and the portion of the deep lobe of the parotid gland. The surgeon decided the extent of surgery. The primary goal was facial nerve preservation while sufficiently performing radical surgery.","title":"Prospective Assessment of Intraoperative Facial Nerve Monitoring in Patients Undergoing Partial Parotidectomy"}
{"_id":"861cd9af-780b-6733-6720-e6004341a540","text":"An atypical vascular pattern on dermoscopy is associated with thickness >1 mm, helping with the choice of the optimal site to perform an incisional biopsy when an excisional biopsy is not feasible.","title":"Predictive factors of melanoma thickness"}
{"_id":"8620a132-39fe-8574-6066-4ff624f3b81b","text":"Ultimately, the use of hyaluronic acid filler is a simple and effective method of improving nipple projection after nipple sparing mastectomy and after nipple reconstruction using flap or 3D tattoo. Its result can last at least 6 months with a single injection. In our pilot series of patients, there were no complications following this procedure. We were limited in our assessment of long-term results of a single hyaluronic acid filler injection by our duration of follow-up. The degradable nature of this type of filler mitigates the risk of potential complications observed in other similar studies, but potentially also limits the duration of response of therapy. Additional studies are needed to characterize the duration of effect of hyaluronic acid fillers to the nipple.","title":"Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique"}
{"_id":"86210a18-2f13-04ea-91a7-ceddfb3ad1dd","text":"This case serves to describe a straight-forward approach to removing a portion of an exposed titanium reconstruction plate when other methods have either failed or not acceptable. The approach used in the following patient was selected because of extensive post-radiation changes to the skin of her chin and neck. The high likelihood of skin necrosis and poor wound healing made removing the plate directly without damaging the surrounding soft tissue desirable. Several previously employed methods of plate removal, in various settings as well as their inherent strengths and weaknesses will also be discussed.","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"86233d2d-a061-8262-c3c4-0f87dc7ba6cd","text":"A possible explanation for the correlation of axillary coverage and expander volume in bilaterally reconstructed patients is that the expander was used as a surrogate for the pre-mastectomy breast tissue because there is no contralateral native breast to use as a template. Thus, if larger volume expanders are placed, then the tangents would be designed to completely encompass these larger expanders and the amount of axillary volume incidentally included in the tangents would increase. Conversely, if smaller volume expanders were placed, then the tangents would conform to the size of the expander and the amount of axillary volume incidentally included in the tangents would decrease.","title":"Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction"}
{"_id":"862707dd-707c-bf63-40b7-66b70bdfc034","text":"A proximal vein compression ultrasonography with Doppler of the common femoral and popliteal veins is proposed in the event of any unexplained clinical worsening, or in the case of a sudden increase in D-dimer levels.","title":"Prevention of thrombotic risk in hospitalized patients with COVID-19 and hemostasis monitoring"}
{"_id":"862f0a14-757c-988f-7c86-55272eedb9db","text":"All 3 patients were treated using ALBC placed on and around the instrumentation to cover them and occupy the dead space after radical open debridement.","title":"Deep surgical site infection after posterior instrumented fusion for rheumatoid upper cervical subluxation treated with antibiotic-loaded bone cement Three case reports"}
{"_id":"862f3a74-c258-a58d-5c58-fb3320ac85d9","text":"Functional deficit from this donor site is also minimal, as there is no disruption of the shoulder musculature. Tightness in the immediate postoperative period from wide flaps usually resolves fairly quickly.","title":"Regional pedicled flap salvage options for large head and neck defects: The old, the new, and the forgotten"}
{"_id":"8635a96b-727b-9627-d8d0-f0d235548d03","text":"A striking example for the difficulty of comparing these studies is the lack of reporting outcome data and the absence of an intervention protocol in most studies. Most authors discussed their results and outcome, but the additional data and probable statistical analysis or significance are not mentioned in most cases.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"8637adbb-e5bb-4d27-ae3d-9b2d98dbd964","text":"Examination of how satellite physicians perceive and balance these priorities may help determine the best environment in which they can deliver excellent clinical care, produce scholarly material, and educate trainees while maintaining high job satisfaction, which is important for faculty retention. Clinically focused faculty may lack time for scholarly endeavors, which can lead to lower job satisfaction and disadvantage their career advancement. Studies also suggest clinical faculty are less likely to be satisfied with their academic promotion, less likely to be in higher academic ranks, and more likely to leave their academic institution.","title":"Satellite Faculty in an Academic Ophthalmology Department: Junior, Clinical, and Female"}
{"_id":"86470dbb-4954-028d-7079-8e564701fd9e","text":"We collected information on all surgical procedures and operations for which patients were hospitalized for 1 or more days. We defined major surgical procedures (in terms of VTE risk) as those with an estimated duration longer than 30 minutes and minor surgical procedures as those with an estimated duration shorter than 30 minutes. The association of cancer-related surgery with recurrence risk was also studied.","title":"Risk and Risk Factors Associated With Recurrent Venous Thromboembolism Following Surgery in Patients With History of Venous Thromboembolism Recurrent Venous Thromboembolism After Surgery in Patients With History of Venous Thromboembolism"}
{"_id":"864d200d-fbec-5fc9-3674-58db1ac19c2f","text":"Quantification of an in vivo biofilm by researchers is increasing in frequency but remains unstandardized. We recommend focusing efforts on quantifying the specific phase of biofilm under investigation. Attached CFU enumeration is a clear measurement of the attachment phase. Confounders such as purulent deposits that can harbor planktonic CFUs must be rinsed off and enumerated separately. Attachment data are typically collected by disruption of the cells with sonication and manual colony counting, assuming that all viable cells are separated, and each isolated cell grows to form a visible colony. Accumulation can be measured using total biofilm coverage area, but these methods remain subject to confounding if local acute infection cannot be separated from the data. The 3DA in the biofilm coverage area indicates the extent to which maturation is underway and, taken with attachment and accumulation data, can provide strong quantitative evidence of biofilm infection. Practically, performing both 3DA and CFU enumeration on the same implant is difficult because most imaging methods require destructive processing or time-consuming imaging that affects subsequent bacterial viability. In large animal models, having separate or separable implants in one subject for different measures of biofilm burden can ameliorate this problem, but this is more difficult in smaller animals.","title":"Improve Integration of In Vitro Biofilm Body of Knowledge to Support Clinical Breakthroughs in Surgical Site Infection"}
{"_id":"864dee9b-c63f-072b-ff2d-1eb03bf75f19","text":"A number of factors should be borne in mind when selecting an appropriate patient.","title":"Conversion of open tibial IIIb to IIIa fractures using intentional temporary deformation and the Taylor Spatial Frame"}
{"_id":"864eae24-d1b2-47f0-6d55-adf9182a7b43","text":"Our data indicate that the combination of blocks targeting the pectoral girdle musculature and the PVB reduced sedative and analgesic requirements during MRM and provided more effective postoperative analgesia. Patients in the PECS 1 group had a longer duration of tolerable pain level before requesting analgesics, in addition to having a lower number of total analgesic doses.","title":"Paravertebral Block Plus Thoracic Wall Block versus Paravertebral Block Alone for Analgesia of Modified Radical Mastectomy: A Retrospective Cohort Study"}
{"_id":"865617d2-feea-2cf0-67a8-9c07069b456c","text":"From the present study we can infer that HDR Interstitial brachytherapy alone is a viable option for management of small localized buccal mucosal cancers. Five patients with T1N0 tumors were treated with HDR brachytherapy alone to a dose of 38.50 Gy and all of them had complete response at the end of treatment and continued progression free throughout the follow up period.","title":"Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa"}
{"_id":"865ab4ec-0dbd-7be4-a5a2-1913851a7c3c","text":"Intra-operative frozen sections are a useful tool if appropriately used, especially for the assessment of surgical excision margins when there is clinical doubt as to their possible involvement [15]. It should be noted that the quality of frozen sections is not as good as that of paraffin sections and that critical information may be lost, especially if disoriented and small pieces of tissue are submitted for examination or in the case of tumours with complex histopathological pattern. In addition, frozen section diagnosis requires pathologists with experience of integrating surgical and pathology findings and the capacity to make quick and accurate decisions.","title":"Qualitative and Quantitative Diagnosis in Head and Neck Cancer"}
{"_id":"866b667b-db69-fa70-5c51-082f156fb3fc","text":"We were further educating parents about the ways to reduce infection after stage II surgery. Our study had some limitations which included failure to access the complications related to the donor site. Although more costal cartilage tissues were harvested from the donor site in younger group, we cannot guarantee the higher complications in that group. The other limitation included failure to track the minor complications, where patients might have undergone treatment in the local hospital. The cases of minor cartilage absorption might not be reported to the hospital.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"8673c8ca-3d13-fed8-7daf-be32ce1881ce","text":"I managed to remain positive throughout the process mostly because I felt that I needed to be strong for my wife. I experienced anxiety for nearly 3 weeks because an accurate diagnosis did not appear until 3 weeks after initial discovery. The rarity of my tumor caused many doctors to visit my room at once which initially was not a problem until my wife and I would be asked questions about a diagnosis we hadn't gotten yet. Although the staff at the hospital were kind and caring, I felt completely in the dark about my situation. I first arrived with the thought of emergency surgery but for 4 days my wife and I were never given a straight answer. Attendings, residents, interns would shuffle into the room. I didn't mind the attentiveness but the question about surgery was never answered. Instead we were asked about cancer centers without ever being told it was cancer. After several days I received a biopsy and MRI only to be told that the general surgery team would not operate due to the foreknown size of the tumor. I was quickly referred to a nearby cancer center. Our surgeon and nurse were a breath of fresh air. The surgeon was clear, concise, and informative. During every visit he answered all of our asked and unasked questions. He would provide us with hope and reassurance and his confidence was contagious. I feel that the decision of treatment was beyond us. We simply wanted the best outcome no matter what and our surgeon, with all his confidence and experience, gave us just that. From initial discovery to removal of my tumor was 3 weeks. Things moved too quickly for us to have an opinion for my treatment. My surgeon gave us the confidence to leave the treatment decisions to the experts. I was one of the lucky ones. I did not have metastatic cancer. Surgery removed the entirety of my tumor with negative margins. My genetic testing was negative and all follow-up MRIs have been negative as well. I want to extend a thank you to all who treated me with kindness. I will strive to be just as kind, attentive, and caring as those who helped me when I most needed it.","title":"A Large Sporadic Intra-abdominal Desmoid-Type Fibromatosis in a Young Male: A Case Report"}
{"_id":"8678464c-35fd-6f20-232f-9f250e96e1f5","text":"3) Muscle flaps have the added advantage of filling in the dead spaces of the wounds and bone with vascularised tissue.","title":"The Gracilis Muscle Flap: A “Work Horse” Free Flap in Diabetic Foot Reconstruction"}
{"_id":"867a7b43-2327-b70a-7ebf-406d10667450","text":"To establish the performance characteristics of D-dimer testing whilst still on treatment as a prediction tool for recurrence of VTE in patients with first unprovoked proximal DVT or PE.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"867c7c02-e240-d684-8f9f-8f54fb7f7eac","text":"The presented trial compares three different modes of demonstration of a 3D reconstruction of CT scans of the liver, which are 3D print, a demonstration on a regular computer screen or using a head-mounted virtual reality headset, with the current gold standard of viewing the CT scan on a computer screen. The group size was calculated with n=25 each. Patients with major liver resections in a laparoscopic or open fashion are eligible for inclusion. Main endpoint is the comparison of the quotient between planned resection volume and actual resection volume between these groups. Secondary endpoints include usability for the surgical team as well as patient specifics and perioperative outcome measures and teaching issues.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"867f2b09-6799-3f76-38ab-39aa2b51953d","text":"Chest wall resection including the 1st rib requires an ingenious approach due to the complex anatomical characteristics. Cosmetic management is also necessary for young women. We herein report a case of desmoid fibromatosis of the chest wall in a young woman suspected of invasion to the 1st, 2nd and 3rd ribs.","title":"Resection and postoperative radiation therapy for desmoid fibromatosis of the chest wall in a young woman"}
{"_id":"86810d66-1646-4137-3e31-15035cedd3f7","text":"The density of lymphatic vessels was selected in a hot spot and then counted in one high power field (40x). The distribution of these vessels was divided into intratumoral and peritumoral. The peritumoral lymphatic vessels were defined as the area confined within one microscopic field of the tumor border at 40x magnification.","title":"Lymphangiogenesis and Its Correlation with the VEGF Expression and the Sentinel Lymph Node in Cutaneous Melanomas"}
{"_id":"86818341-6dac-8a45-7010-fb5b0a772c4b","text":"Free transfer of the turbocharged wide ALTP flap can be a reliable and effective reconstructive method to obtain complete coverage of extensive traumatic soft tissue defects in the lower extremities and achieve successful limb salvage.","title":"The turbocharged wide anterolateral thigh perforator flap to reconstruct massive soft tissue defects in traumatized lower extremities: A case series"}
{"_id":"8681ac39-b4d2-0db4-7518-485d331d05d6","text":"Two independent reviewers (SW and SG) screened titles and abstracts of retrieved references for potentially relevant studies. Any disagreements were solved through discussion or, when necessary, after consultation of the senior author (MB). The full text of all potentially eligible articles was obtained and reviewed for eligibility based on predefined inclusion criteria. All clinical studies comparing the outcome of surgical site infection with different timing intervals of preoperative antibiotic prophylaxis in indicated procedures were considered for eligibility. This comprised all clean contaminated, contaminated and implant surgery in all surgical fields. Duplicates, congress abstracts, experimental studies, studies with insufficient data for comparison and studies without clear description of the compared timing intervals where excluded from the analysis. This included studies that did not differentiate agents with a prolonged infusion time such as vancomycin or fluroquinolones from fast infusion antibiotics like cephalosporins as timing is generally measured form the moment of administration and a delay to full infusion is anticipated in these drugs. When full text was not available or presented results were incomplete the corresponding author was contacted. When all relevant full text papers were gathered each reference list was reviewed for any omitted studies","title":"Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection A systematic review and meta-analysis"}
{"_id":"8686df41-c706-054b-24df-d6ecd508a57c","text":"Revisions were defined as any ipsilateral procedure performed to the index breast reconstruction to improve the appearance of the reconstruction and\/or correct complications after the patient had been discharged after their index procedure. A list of procedure codes was developed and refined iteratively in collaboration with expert breast and plastic surgeons and the existing literature (Table S2). Procedures performed during the initial inpatient stay were considered to address immediate postoperative complications. These increased the length of stay and cost of the index admission, but were not categorized as revision procedures in the analysis.","title":"Secondary healthcare costs after mastectomy and immediate breast reconstruction for women with breast cancer in England: population-based cohort study"}
{"_id":"86885aa6-8534-0f37-bcd8-5d2f85a797cd","text":"To the author’s knowledge, no study in the veterinary literature has documented the role of intraoperative ultrasonography for visualizing and removing plant material from iliopsoas abscesses using a ventral midline laparotomy. Therefore, we sought to report a method to routinely investigate and treat dogs with iliopsoas myositis due to migrating plant material.","title":"Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs"}
{"_id":"868cf71a-974a-acd2-3a6d-ba1fa2c3cac4","text":"The diagnostic yield of CNB for lymphoma typing is the ratio of the number of cases for which a precise diagnosis of lymphoma was made on CNB, divided by the number of the entire cohort of lymphomas.","title":"Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital"}
{"_id":"868ed129-4af9-eaa0-ee6d-ad55e0033a0f","text":"The development and introduction of these targeted drugs will require further observational studies to provide more information about the risk of skin cancer with these newest therapies.","title":"Psoriasis Therapy and Skin Cancer: A Review"}
{"_id":"868ff7d3-9936-5ca2-6e11-b218c1685121","text":"Careful and meticulous dissection was done in a blunt way isolating the perforator. Usually the perforator had to be dissected for several centimeters to allow easier rotation or advancement. Pedicle traction during flap harvesting and positioning was avoided. Adequate release of all fascial strands around the perforator and dissection around the perforator in intermuscular or intramuscular plane to gain additional length were then carried out. This facilitates rotation of flap without kinking the perforator. After deflation of the tourniquet, hemostasis was performed and viability of flap was evaluated. Perfusion was checked before flap rotation by waiting a few minutes and irrigating with lukewarm saline solution in order to promote microcirculation recovery.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"8694abdc-b183-3ec6-95a0-c275d676c311","text":"To describe a simple and effective facelift technique useful as an adjunct to other oculoplastic procedures","title":"Suture midface suspension"}
{"_id":"8695f07e-e03a-e65b-f48e-1eff17a996cd","text":"In the present study, only one surgeon manually fixed each bone segment, drilled, and inserted the screws simultaneously; therefore, there could have been error during the process of drilling and fixing each segment on the miniplate or in the manual holding of segments. However, this should not have induced a large experimental error because such errors can also be induced in the actual surgery. The outcomes of an actual surgery are presumed to be similar to that of this study if the condyle head is well fixed on the fossa and is not displaced significantly.","title":"Precision of fibula positioning guide in mandibular reconstruction with a fibula graft"}
{"_id":"869cf113-57f6-d067-4c60-ac32add09a4b","text":"Cultural awareness is important for global leaders and should be part of the medical curriculum [53]. The cultural introduction within the large student conferences of this program helped the students to familiarize themselves with cultural differences. Unlike programs which focus on differences with LMIC, phase 1 elected to focus on countries that are of similar economic backgrounds, to ease young students into awareness of cultural differences in a more subtle way.","title":"An International Partnership of 12 Anatomy Departments – Improving Global Health through Internationalization of Medical Education"}
{"_id":"869e768f-e18f-a95a-4a7d-66cc5c808215","text":"We report here a review of the current medical literature on pregnancy associated desmoids, including 10 cases of our own. The pertinent findings are that a large percentage of desmoids in females arise in and around pregnancy. Most occur in the abdominal muscles, particularly the right rectus abdominus, perhaps related to trauma from abdominal stretching and fetal movement. While these tumors may regress spontaneously after delivery most can be surgically resected with low recurrence rates even with R1 resections and this is clearly the treatment of choice. Subsequent pregnancies do not appear to result in recurrence in either FAP or non FAP patients. It is not clear from currently available data whether pregnancy associated desmoids are molecularly distinct from other desmoids.","title":"Desmoid Tumors in Pregnant and Postpartum Women"}
{"_id":"86a185e5-0e08-68e3-8f29-9b920fa4a91d","text":"Once the new section has been built in the ICD-11 to address allergic and hypersensitivity conditions, we have been moving actions to try to support awareness by disseminating updated concepts in the field. Aligned with the ICD and the WAO philosophy of being global, this document presents fundamental and broad allergy concepts to strengthen the understanding by different health professionals worldwide, besides to support the formation of in training students.","title":"Dissemination of definitions and concepts of allergic and hypersensitivity conditions"}
{"_id":"86a25773-ce3c-7d3f-a58b-3659c217a460","text":"The sample size is based on the primary endpoint OS at 5 years.","title":"TRIM study protocol - a prospective randomized multicenter Trial to assess the Role of Imaging during follow-up after radical surgery of stage IIB-C and III cutaneous malignant Melanoma"}
{"_id":"86a2d425-495c-32bf-d378-8ce59db853e9","text":"Besides, on admission of patients in our hospital it goes through review of the surgeon and the radiation oncologist; the choice of treatment is based on multidisciplinary decision and assessment of curative and cosmetic effects of different treatments. This can cause a selection bias inherent in the study design.","title":"Head and Neck Non-Melanoma Skin Cancer Treated By Superficial X-Ray Therapy: An Analysis of 1021 Cases"}
{"_id":"86a3115b-1d05-345b-b7b9-16ca89cdc0b0","text":"Children born with a small or absent ear undergo surgical reconstruction to create a suitable replacement using rib cartilage. To overcome the donor site morbidity and long-term pain of harvesting rib cartilage, synthetic materials can be a useful alternative. Medpor, is the currently used synthetic polyethylene material to replace missing facial cartilage but unfortunately it has high levels of surgical complications including infection and extrusion, making it an unsuitable replacement. New materials for facial cartilage reconstruction are required to improve the outcomes of surgical reconstruction. This study has developed a new nanomaterial with argon surface modification for auricular cartilage replacement to overcome the complications with Medpor.","title":"Argon plasma modified nanocomposite polyurethane scaffolds provide an alternative strategy for cartilage tissue engineering"}
{"_id":"86a5e85f-5479-70de-a165-5661c0a2389e","text":"As bilateral carpal injury is common, it is understandable that lesions were commonly identified within the contralateral carpus on CT. We identified an incomplete frontal Fx of the RaF of the contralateral limb in several horses (2 of 15 horses in Part 1 and in 1 of 26 horses in Part 2), and a range of other bone lesions including OF and SCBL that occurred in addition to sclerosis, minor DCL and\/or minor modelling, osteophytosis or entheseal new bone in approximately 60% horses. Accurate diagnosis of the presence and extent of bone injury in both limbs is important for surgical planning and prognostication and the current study underscores the value of CT imaging of both carpi in horses with C3 Fx.","title":"Comparison of Radiography and Computed Tomography for Evaluation of Third Carpal Bone Fractures in Horses"}
{"_id":"86a8c347-b634-92ca-e267-f22728917685","text":"The subjective cosmetic complaints for each portion of the nose among those considering revision rhinoplasty are summarized in Table 2.","title":"Prevalence of considering revision rhinoplasty in Saudi patients and its associated factors"}
{"_id":"86ac5a8b-4f66-d2ab-a701-1c4852e93cc8","text":"Splitting a muscle flap is not a new concept and has been described for other muscle flaps, which have been split including the latissimus dorsi and the pectoralis major muscle flap. The concept is based on the intermuscular vascular anatomy. The reach of the tibialis anterior muscle flap based on a proximal pedicle to cover the defects in the distal third of the leg is limited due to segmental short vascular pedicles. Extending the reach by the complete interruption of the musculotendinous unit leaves a considerable functional deficit and therefore is not recommended in ambulatory patients.14","title":"Split Hemianterior Tibialis Turndown Muscle Flap for Coverage of Distal Leg Wounds With Preservation of Function Gundlapalli et al"}
{"_id":"86b0c527-10f9-cef1-16f5-6ae24b3b69d0","text":"Skin grafting was performed as previously described3132. Briefly, Split-thickness skin grafts were made from the full thickness skin pieces surgically collected from pigs after anesthesia. The hair on the back of anesthetized recipient mice of FVBN strain was shaved off, and a 1 × 1 cm2 wound was made on the back by shaving off the dorsal skin carefully while leaving the subcutaneous vasculature intact. Porcine skin graft with the size of 1 × 1cm2 was planted into the wound and sutured with the host skin. To fasten the touch of skin graft with the wound, the porcine skin grafts were covered with a dressing of several layers of gauze pieces and secured with a transparent medical film dressing to provide a sustainable pressure. The survival of skin grafts was observed every other day, and the survival time was defined as the first day on which more than 90% area of skin grafts was necrotic as described by Wang et al.32.","title":"Efficient generation of B2m-null pigs via injection of zygote with TALENs"}
{"_id":"86bab73f-c6d6-6c96-4a86-a7e28752ec1a","text":"Advanced wound management of complex surgical wounds remains a significant challenge as more patients are being hospitalized with infected wounds. Reducing recurrent infections and promoting granulation tissue formation is essential to overall wound healing. Wounds with acute infection and critical colonization require advanced multimodal approaches including systemic antibiotics, surgical debridement, and primary wound care. The goal in surgical wound management is to optimize clinical outcomes such as time to wound closure and functional recovery. A review of current literature suggests that negative pressure wound therapy with instillation (NPWT-i) is a viable adjunct therapy in the management of infected wounds especially in patients with medical comorbidities. The aim of this case series is to highlight the ability of NPWT-i as adjunct to prepare the wound bed for closure on infected surgical wounds that would normally require multiple operations to obtain source control.","title":"The Use of NPWT-i Technology in Complex Surgical Wounds"}
{"_id":"86bf9cf9-a9bb-f96a-36e4-24094ce8a689","text":"We acknowledge there are a number of limitations of this study. There was potential for bias in assessment of the degree of muscular damage with each technique, however it would have been difficult to blind an observer as the osteotomy is in the field of view. There is a need for biomechanical studies to compare the strength of DGO to DGT and greater trochanter osteotomy repairs. This study specifically assessed the approach and its application for Kyon THR implants and did not assess relative benefits for different types of THR implant systems. In dogs, it is not known if a failed deep gluteal tendon repair influences hip stability and clinical outcomes postoperatively. In vivo muscle tissue may behave differently to cadaver preparations and a prospective clinical study is warranted. The population size is small in this study, however it is comparable to those used in human studies assessing exposure of various approaches. The variation in cadaver sizes may also be considered a limitation and the study does not directly assess ease of acetabular or femoral reaming for each approach.","title":"Approach to the canine coxofemoral joint using an osteotomy of the deep gluteal muscle insertion for total hip replacements"}
{"_id":"86cf4621-173e-e86a-7e69-36db56de1666","text":"The dye spread observed between the costal pleura and the internal intercostal membrane, proximal to the TTP and close to the costochondral junction, could occur through the endothoracic fascia present between these structures. Similarly, the presence of staining into the mediastinum could be produced through the endothoracic fascia present between the TT muscle and the costal pleura. This fascia penetrates into the mediastinum through the costomediastinal recess. This potential pathway could correlate the staining observed between the pleura costalis and the TT muscle, within the mediastinal cavity as well as between the costal pleura and the internal intercostal membrane after all injections. The endothoracic fascia has already been suggested as a potential pathway for the distribution of an injectable solution into the thoracic paravertebral space during quadratus lumborum plane block [24].","title":"Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers"}
{"_id":"86d12654-5b65-4696-3377-0277723cc17c","text":"Our results revealed that CTLG is a feasible method for the preoperative localization of SLNs in breast cancer patients with nearly no exposure to radiation, no need for facility approval, and low cost, which could help to select the precise injection site and time of massage during SLNB and improve the identification rate of SLNs. Moreover, SLNB could be performed well for a doctor with little experience in SLNB with the help of CTLG. The use of CTLG would be a valuable complimentary tool for identifying SLNs in institutions that cannot use the radioisotope method.","title":"Application of preoperative computed tomographic lymphography for precise sentinel lymph node biopsy in breast cancer patients"}
{"_id":"86e276e5-2cdd-ed02-4c99-beda95914aa8","text":"The aim of this study was to examine the individual risk factors associated with the development of subsequent cancers after non melanoma skin cancer.","title":"Non Melanoma Skin Cancer and Subsequent Cancer Risk"}
{"_id":"86e2a505-b0e6-4ec7-fa71-f6b77dbab57a","text":"Tumor thickness at the time of surgical treatment remains the most widely accepted and accurate predictor of prognosis in patients with cutaneous melanoma. It also defines the size of the surgical margin and helps determine which patients should undergo sentile lymph node biopsy. For these reasons, much effort is being directed at obtaining reliable information regarding tumor thickness prior to the operation, as thick tumors have to be excised with a larger surgical margin.","title":"Computer-aided clinical image analysis for non-invasive assessment of tumor thickness in cutaneous melanoma"}
{"_id":"86e90d0f-20b3-de77-3192-d84958e0b27d","text":"The total number of patients in our study was relatively low with a short follow-up period compared to preceding studies. Moreover, we did not perform the bilateral paravertebral block, so the comparison between unilateral and bilateral paravertebral blocks could not be done with respect to their effectiveness and complication rates. Our study involved only patients of elective cholecystectomy due to cholelithiasis; we will not be able to generalize our results to all those having cholecystectomy due to any other reasons. Another limitation is that an experienced anesthetist performed all the USG paravertebral blocks, which may have contributed to a higher success rate for the USG-guided technique. Future studies with a larger number of patients are necessary, including patients with thoracic and abdominal pathologies.","title":"Comparative Study Between Conventional Landmark Versus Ultrasound-Guided Paravertebral Block in Patients Undergoing Laparoscopic Cholecystectomy: A Randomized Controlled Study"}
{"_id":"86ecfe21-fee0-27f7-cb55-d23a218eeac1","text":"The axis of the flap is marked preoperatively by drawing a vertical line at the pivot point located 5 cm above the lateral malleolus toward the popliteal fossa (Fig 2) while the patient is standing. The patient is placed in the prone position for surgery. The skin paddle of the sural flap is designed on the posterior calf once the defect size has been measured. The distance from the lateral malleolus to the lower aspect of the flap represents the length of the pedicle and varies according to the height of the individual and the size and location of the flap on the posterior aspect of the leg. The length of the pedicle should allow a flap transfer without tension.","title":"Super-Drained Distally Based Neurofasciocutaneous Sural Flap: A Case Series and Review of Literature El-Diwany et al"}
{"_id":"86efaa61-204a-ee7f-36b1-3c3622634fa1","text":"The role of an academic surgeon can be defined as one who serves as an innovator, educator, and expert in addressing complex clinical problems while disseminating knowledge and providing training for future generations of surgeon scientists. Future academic surgeons should understand the specifics of the career they are pursuing. The proposed 12 steps have the potential to serve as the initial building blocks for a rising surgeon’s development of emotional intelligence, a critical trait among surgeons. In fact, training programs are placing increased emphasis on emotional intelligence cultivation as the resident progresses through training via workshops, didactics, and mentorship. Surgeon mentors should support the recruitment and retainment of academic surgeons through effective academic career support and strategic planning. Intentional career development can serve as an essential tool as both mentors and mentee navigate different career choices, and we strongly encourage all to consider completing their own ADP as a significant step toward achieving a successful academic career advancement.","title":"Twelve-step Approach for Academic Development Planning in Academic Surgery Climbing the Academic Uphill With Strong and Steady Steps"}
{"_id":"86f273df-97ba-8d9b-fd11-5864fc733f6f","text":"After branching into the inferior alar branch and lateral nasal artery, the angular artery continues towards the medial canthus and connects to the dorsal nasal arterial system. The nasal dorsum contains a larger arterial and venous system superficial to nasal musculature in the subcutaneous plane. Sparse vascular networks are located within the areolar layer, including a marginal artery, which courses over the lower lateral cartilage caudal border, and the dorsal nasal artery, a terminal branch of the ophthalmic artery that courses above the muscular layer. Both of these arteries course superficially towards the nasal tip. Each of the arteries listed above have a connection with the ophthalmic and central retinal arteries so injection in each of these areas carries the risk of blindness.","title":"Complications after cosmetic periocular filler: prevention and management"}
{"_id":"86f3c972-9fad-16eb-af5c-8aba293a3951","text":"The overall results demonstrate that open incisional biopsy is of limited predictive value to diagnose PJI prior to revision THA in this problematic patient population.","title":"Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery"}
{"_id":"86f6e84e-66d3-ad75-5e5d-7cd4b4f85346","text":"From this review, it is evident that a prompt treatment represents an essential condition to improve the overall prognosis and mortality. Patients with NSTIs occurred after intramuscular injections have a worse clinical outcome than patients with different entry routes. In immunosuppressed patients or receiving corticosteroids or NSAIDs, an appropriate injection technique is a crucial approach to prevent NSTIs. As a final point, particular attention should be paid to sharp pain onset in the injection site as an early sign.","title":"Necrotizing Soft Tissue Fasciitis after Intramuscular Injection"}
{"_id":"86f9af6f-6386-e693-1355-e105cc6a953c","text":"MR imaging is considered as a second level imaging technique especially for preoperative evaluation of mesenteric masses in selected cases.","title":"Multimodality imaging features of desmoid tumors: a head-to-toe spectrum"}
{"_id":"86fa214b-6a2e-9e04-f70a-fe6a6079b1c2","text":"Monitoring and analysis of the reactive hyperemic response in the lower limb to externally induced occlusion can have diagnostic significance. It is known that a reduction in peak muscle perfusion capacity occurs in response to ischemic provocation tests, such as thigh-cuff occlusion . We hypothesize that by evaluating the blood flow variations of the lower extremity in response to thigh-cuff occlusion, we can identify PAD-affected legs. In this paper, a novel pressure-based method is proposed for flow imaging that can assess microvascular reactivity using ultrasound. The method measures the changes in microvascular blood flow in the calf muscles in response to a mechanical stimulus, which can be used to assess the function of the microvasculature in the lower extremities. We demonstrate how the measured metrics can provide potential diagnostic information about the conditions of patients in comparison to their ABI evaluations.","title":"Contrast-free ultrasound imaging for blood flow assessment of the lower limb in patients with peripheral arterial disease: a feasibility study"}
{"_id":"87030301-5696-e3a2-ccc5-48a3b4438fd6","text":"The NAVI-LARRC inclusion criteria comprised any LARC or LRRC at risk of incomplete resection where navigation was likely to improve the probability for R0 resection, but only patients with tumours involving the posterior and lateral compartments were included after MDT discussion. In these compartments, surgery carries the highest risk of incomplete tumour resection and damage to vital structures. Also, tumours deep in these compartments lie in contact with the pelvic bone, ligaments and lumbosacral nerves. They will therefore retain their spatial position relative to the bone until resected, which permits preservation of navigation accuracy during dissection. Navigation was therefore expected to be of most benefit in these patients. In contrast, navigation was considered to be less useful in the other compartments where the potentially involved anatomical structures are mobile and at risk of being displaced from their original position relative to pelvic bone during surgery. Since the technology does not provide correction for such displacement, navigation could not be performed with similar accuracy for mobile structures. Accordingly, tumours located in the posterior and lateral compartment were deemed most relevant for navigation, with the sacrum with neuroforamina, the sacral nerves and the sciatic spine being the most commonly navigated anatomical landmarks.","title":"Navigation-Assisted Surgery for Locally Advanced Primary and Recurrent Rectal Cancer"}
{"_id":"8705979a-cc95-7888-882a-1c36bfe413f8","text":"The skin performs several important functions for the homeostasis of the organism and one of its main roles is represented by its function as an anatomical barrier against potential pathogens.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"870e4eef-1bcc-42d5-296e-c2b066761f33","text":"Vascular anastomoses were performed between the distal ends of the posterior tibial vessels and the branches of the perforating or proximal anterior tibial vessels. According to the surgical plan, 2 or 3 proximal branches that had been well marked and protected were chosen for the anastomosis. Similar diameters and sufficient lengths of the proximal vessels were recommended. The whole tumor and peritumoral tissues were taken H&E staining and IHC to confirm the type of tumor and resecting boundary.","title":"Plastic lengthening amputation with vascularized bone grafts in children with bone sarcoma: a preliminary report"}
{"_id":"872253d4-2a3e-3b31-22ec-7c0345331fa5","text":"The patient's resultant defect consisted of a 5.5 cm radial epiphysis loss with an intact radial head and neck at the level of the elbow, a 20 × 15 cm overlying soft tissue defect, nearly circumferential, of the forearm involving her antecubital fossa. A repeat angiogram demonstrated flow through the ulnar artery with profuse flow to the midupper palmar arch and retrograde flow to the distal radius via the superficial palmar arch. She also had occlusion of the interosseous artery from its origin into the mid forearm with reconstitution in the distal forearm via collaterals.","title":"Use of Osteofasciocutaneous Fibular Free Flap and Radial Head Arthroplasty in Trauma for Limb Salvage and Continued Elbow Function"}
{"_id":"8726265f-6db4-33ae-98b8-9b2e07b2a368","text":"Implementation of oncoplastic breast surgery into daily clinical practice will undoubtedly take time [1, 2]. Our team of plastic and reconstructive surgeons and breast surgeons continues to develop and perfect surgical techniques since routine oncoplastic breast surgery was introduced at our practice. Successful implementation also involves learning to determine which patients are suitable for oncoplastic breast surgery and to find the most suitable technique of oncoplastic breast surgery in each patient.","title":"Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery"}
{"_id":"87295656-2c0b-845d-427a-26c135826b9a","text":"Our experience could be explained supposing a regenerative effect also on peripheral nerve function hypothesizing that its entrapment into scar tissue can determine a partial loss of function.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"872ba86a-31d6-04cb-1ddc-95d01dc3f338","text":"Although the literature has supported the use of pedicled fibula for tibial defect reconstruction in the years to follow, no further reports of lateral tibial condyle reconstruction with the vascularized pedicled fibular head graft have been cited so far.","title":"Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: long-term result"}
{"_id":"872c1067-c9dd-1014-f02b-ac18c341ba94","text":"The aim of this study was to evaluate the surgical outcome of slide tracheoplasty.","title":"Slide tracheoplasty in 81 children: Improved outcomes with modified surgical technique and optimal surgical age"}
{"_id":"872cea8c-b120-906c-fe95-b50613ce9547","text":"Here, we report successful limb salvage in a case of major tissue loss with severe infection, in which we had difficulty in judging whether limb salvage was possible. Limb salvage was achieved by staged surgical revascularization combined with free gracilis muscle transfer to cover an exposed tibial bone that was affected by osteomyelitis.","title":"Successful limb salvage through staged bypass combined with free gracilis muscle transfer for critical limb ischemia with osteomyelitis after failed endovascular therapy"}
{"_id":"8739d3bd-0fde-ef5b-eaa0-16e866d19c7d","text":"*Conduct a study aimed to compare treatment costs of two methods of primary and delayed graft until the proper recovery time.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"873d8fc1-2ff7-2827-a9d7-d9ae51d260a8","text":"Conclusions: The higher percentage of parents who gave epinephrine in the prehospital setting than previously reported may be attributed to the high level of education of most parents and the high number of anaphylactic reactions children in our study. Based on preliminary data, parents are better able to identify the symptoms of anaphylaxis in isolation than when presented with “real world” scenarios. We hope to use these data to guide the creation of an e-module for parents that focuses on anaphylaxis recognition and treatment.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"873dfed0-3c96-dc50-bc30-0b6187897ce1","text":"Aesthetic rhinoplasty is considered as one of the most common surgeries in Iran. Cosmetic nose surgery or nasal beautification is still the most common surgical operation of the authors. Secondary rhinoplasty comprises about 40% of these operations. Many of these secondary cases were shown to have radical alar base resection which may compromise external nasal valve function.","title":"Can We Add Auricular Composite Graft to Our Rhinoplasty Armamentarium?"}
{"_id":"873eb71b-9898-219b-58b4-59e13a959535","text":"Ideally, the debridement can be carried out through a window in the weakest area of the involucrum to maximize structural integrity. Sinus tracts and any adjacent scar tissue are resected during the initial skin exposure. Injection of contrast material (sinogram) or methylene blue preoperatively may help to better define the anatomy of a sinus. Although the extraperiosteal exposure may be wide, the subperiosteal exposure should be limited to the area of bone to be removed to preserve the local blood supply. All sequestra should be removed and any devitalized tissue should be curetted. The extent of debridement may be defined by the presence of punctate bleeding from the exposed bony surface referred to as the ‘paprika sign’.Once all abnormal tissue has been removed the wound should be thoroughly irrigated with sterile saline with or without an antibiotic solution. Boiled or distilled water is also an effective irrigant. The wound should be closed loosely to allow for drainage. There should be no tension on the skin edges. The bone edges are sculpted to facilitate soft tissue coverage. If possible muscle may be mobilized to cover the exposed bony surfaces. A drain should be placed after debridement with excision of bone to obliterate the dead space created by the removal of tissue. Dead space management includes local myoplasty, free-tissue transfers and the use of antibiotic impregnated beads. Soft tissue procedures have been developed to improve local blood flow and antibiotic delivery.","title":"Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report"}
{"_id":"87480ea3-54e5-b328-ee7f-71234326e546","text":"The data were described in the form of the resultant narrative review.","title":"A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs"}
{"_id":"8755870d-c997-61e9-2f4a-f78460fd4be3","text":"The objective of the present study was to compare imprint cytology with paraffin section histology for the detection of SLNs in women with breast cancer treated with neoadjuvant chemotherapy.","title":"Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy"}
{"_id":"87568df2-e201-566e-4f53-aef8727c866b","text":"This survey was only a snapshot of trainees in each of these countries. The authors acknowledge that due to distribution over multiple networking platforms we are not able to give the true participant reposnse rate. We suspect that those more likely to complete the survey may be robotic enthusiasts. However, we feel that the discrepancy between training in the USA and in the UK and Ireland has been highlighted.","title":"The Atlantic divide: contrasting surgical robotics training in the USA, UK and Ireland"}
{"_id":"8756d49a-2b35-b6e8-e86b-3eeced909733","text":"Pulse oximeter waveform and value measurement test during arterial occlusion and venous congestion","title":"Simple and Easily Interpretable Flap Monitoring Method Using a Commercial Pulse Oximeter and a Widely Used Bedside Patient Monitor"}
{"_id":"876354a9-a88c-866a-14be-4d64e8e9643c","text":"IPC should be removed completely before the patient leaves the ward to have the CDU to ensure optimal blinding of the primary outcome measure. The CDU operator is asked to guess which treatment group the patient is in prior to the examination to estimate the effectiveness of blinding. In those patients allocated IPC it should immediately be re-applied on return to the ward after the screening CDU.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"8765a83b-de12-3d4e-1003-bc5186028b8a","text":"Indeed, we did not expect to observe more patients with deficiency of vitamin D in the three subgroups, but it is especially striking that, considering the supposed protective role of vitamin D in skin cancer, we found a greater number of patients with deficit that did not present tumours than even the sum of patients in deficit with either of the two types of tumours (Table 1). In fact, there was a significant difference between the levels of vitamin D and whether the subject suffered from skin cancer: the lowest levels of vitamin D were related to a lower incidence of NMSC in our sample.","title":"Vitamin D serum levels and non-melanoma skin cancer risk"}
{"_id":"876c2526-6b97-7f3c-b77d-a66cbbaf4cbe","text":"The duration of dialysis was counted from the first recorded session in the patient file until the day in which otoscopy was done.","title":"Myringosclerosis in patients with chronic renal failure: comparative analysis with a control group"}
{"_id":"876cdd20-54c7-3660-8d84-27bf2208ecf0","text":"True flap loss was defined as flap blood supply deficiency due to arterial or venous anastomosis dysfunction or thrombosis that leads to complete loss of the transplanted flap. Other flap complications were defined as any of the following: hematoma (without interfering with flap blood supply), flap wound infection, secondary or incomplete flap wound healing, and partial flap loss. Partial flap loss was defined as the presence of distal marginal flap necrosis with no anastomosis dysfunction. Any flap complication was defined as the presence of either true flap loss or any other flap complication. ICU length of stay was the timing between admission to the ICU and discharge from the ICU to the ward. Hospital length of stay was the timing between admission to the hospital and discharge from the hospital.","title":"The Controlling Nutritional Status (CONUT) Score for Prediction of Microvascular Flap Complications in Reconstructive Surgery"}
{"_id":"8776ddb5-3e39-f76b-c0f7-3110d95dbb5f","text":"Although prompt treatment with epinephrine is deemed to be critically important for survival in anaphylaxis, we have huge gap between theoretical knowledge about epinephrine concentration and site of administration of epinephrine and fundamental practice among pediatrics trainees. Analysis of these data necessitates the urgent need of a concrete program for teaching the trainees, especially the pediatrics fellows to solidify their knowledge about anaphylaxis. More important practical guidelines about the site of administration, what concentration and how to act fast when faced with anaphylaxis is needed to be taught to current and future trainees.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"878efbe5-ba6b-1ddd-b539-1bf1e73db6cd","text":"Surgical methods for TB spondylitis with marked abscess formation and bone destruction have been thought to require direct pus drainage, focal resection, and spinal reconstruction by bone graft. However, for patients with no advanced motor palsy before surgery, and no severe kyphotic deformity associated with vertebral body destruction or severe spinal instability, the method described herein can be expected to be effective not only for pyogenic spondylitis but also for TB spondylitis.","title":"Percutaneous Discectomy—Continuous Irrigation and Drainage for Tuberculous Lumbar Spondylitis: A Report of Two Cases"}
{"_id":"878f8352-5a0d-abe5-e327-7dc29035c514","text":"A treatment algorithm for mandibular reconstructions on the basis of our results is presented.","title":"Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study"}
{"_id":"87901e35-4ec9-e696-392e-daf8e23f02aa","text":"We have encountered a patient with a combination of venous and lymphatic stasis in whom lymphatic function was improved after surgical treatment for varicose veins.","title":"Lymphatic flow restoration after stripping surgery for varicose veins: A case report"}
{"_id":"8795a125-3f03-6d86-3721-a1d59eab21c6","text":"Under normal circumstances, a certain number of pathogenic bacteria can exist in the human body, but only under certain conditions can cause disease. This depends on the relationship between the pathogenic bacteria and the body, mainly including patient resistance. The incidence of acute osteomyelitis mainly depends on the relationship between the body's resistance and the virulence of pathogenic bacteria. The human body's resistance includes systemic resistance and local resistance and has the function of preventing pathogenic bacteria from entering the human body and eliminating pathogenic bacteria. The overwhelming majority of chronic osteomyelitis is caused by delayed or improper treatment of acute osteomyelitis and delayed development of the disease. The onset of the disease can also be subacute or chronic. If the patient's resistance is strong, the pathogenic bacteria of acute osteomyelitis are low in virulence and the number is small; it can be manifested as subacute osteomyelitis or chronic at the beginning of the disease osteomyelitis and no obvious acute symptoms. The diagnosis diagram of chronic osteomyelitis is shown in Figure 1.","title":"MRI Manifestations and Diagnostic Value of Chronic Osteomyelitis"}
{"_id":"879bbf35-3754-e954-e028-6f9697fbfea2","text":"One group received both above mentioned interventions and will reveal potential dose response effects from level of protection. The control group will receive a minimal intervention with the current sun protection messages from the Danish Sun Safety Campaign. Intervention materials are available in supplementary materials.","title":"Novel sunprotection interventions to prevent skin cancer: A randomized study targeting Danes going on vacation to destinations with high UV index"}
{"_id":"87a00d3e-a131-c0c8-72b3-ed23e8c0e307","text":"Flap monitoring to detect arterial insufficiency should be meticulous and prolonged over 1 week.","title":"Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team’s Experience"}
{"_id":"87a0d130-7bbb-de87-df5e-5a3f000e4221","text":"In this paper, we present a novel surgical technique to treat a cervical SEA by anterior decompression through a linear transvertebral midline approach. This technique has the advantage of effectively draining the ventrally located SEA and obtaining material for bacteria culture while maintaining spinal stability without additional instrumentation.","title":"Case report: Anterior midline decompression of a cervical epidural abscess: Technical note and case series of seven patients"}
{"_id":"87af077f-ec2e-5667-2dd6-1a847dc4a1da","text":"In the context of cancer care, multidisciplinary conferences are already a fundamental practice and these conferences can be linked to a change in treatment plan as well as improved patient outcome and survival. Therefore, the here reported infections conference was established in a similar manner with weekly frequency, as reported in the majority of the reported studies in the literature. Due to the attendance of at least a spinal surgeon, a microbiologist, an infectious disease specialist and a pathologist as well as the additional discussion with a radiologist, the key specialties needed in the management of spondylodiscitis are all closely involved in the treatment plan.","title":"Implementation of a multidisciplinary infections conference improves the treatment of spondylodiscitis"}
{"_id":"87b4da83-37f7-1c1e-138a-716cab915587","text":"Although the correlation and similarity index show a slight improvement in the reconstruction of the brain and phantom images in the noisy case, sharpness indicates noticeable improvement as shown in Table 2 and Table 3. Brightness or sharpness of an MRI scan depends on the relaxation time of the specific molecules.","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"87b9dd1e-e28a-2864-91f1-c1fae2e23eba","text":"Radiographic analysis was performed to support the broad characterization of the healing process. The correct position of the implants was verified in all animal groups with X-ray images immediately after surgery. The X-ray analysis performed 6 months later revealed no shift of the implants and demonstrated a stable bone bond between the HA ceramics and the host bones. The interface of the HA cylinders and HA plates and the surrounding cortical and trabecular bone tissue were free of inflammatory changes and no irritation of the surrounding tissue was noted. In accordance with the histological results, CT analysis indicated new bone formation in the defect area and around the nonresorbed biomaterials. In all samples, complete cortical bone bridging of the defect site was observed. The bone tissue reached the surface of the implants, with no apparent gap between implants and the new bone tissue. Neither fibrous encapsulation nor focal osteolytic and osteosclerotic changes were detected in the surrounding tissue (Figure 8).","title":"Long-Bone-Regeneration Process in a Sheep Animal Model, Using Hydroxyapatite Ceramics Prepared by Tape-Casting Method"}
{"_id":"87bc0a69-2cae-9e54-0c8a-185852b75f65","text":"Histologically, epidermoid cysts consist of lined stratified squamous epithelium supported by an outer layer of collagenous tissue. Desquamation of keratin from the epithelial lining produces soft white material rich in cholesterol crystals. The content of the cyst contains considerable fat and little cholesterol which may produce a vigorous inflammatory reaction when the cysts rupture.[ In the treatment history of the patient, psoas abscess and catavertebral lump once occurred and were thought to be the result of cyst rupture and response of surrounding tissue to the cyst content. The difference was that psoas abscess might be the result of spontaneous rupture, while a catavertebral lump was more likely caused by intraoperative spillage of the cyst content.","title":"Repeated recurrent epidermoid cyst with atypical hyperplasia A case report and literature review"}
{"_id":"87d1390f-f19b-88ae-dd4e-ec11ffa9b2e2","text":"Heel ulceration associated with calcaneal osteomyelitis is a very difficult pathology to treat and often results in below knee amputation. Surgical excision of the infected bone and ulcer via calcanectomy has been shown to reduce amputation and mortality rates. The purpose of the study was to review our experience with this procedure and examine factors that might influence outcome.","title":"Results of calcanectomy in the surgical management of heel ulceration with osteomyelitis in the high risk patient"}
{"_id":"87d420e9-c906-696a-c310-e09e0725832c","text":"We will investigate whether there is a difference in the length of hospital stay between the two groups and perform a costs analysis.","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"87d6e327-c77e-c697-98e2-ff1c77ff7f74","text":"Despite advances in surgery, the treatment of chronic osteomyelitis remains complex and is often associated with a significant financial burden to healthcare systems. The aim of this systematic review was to identify the different single-stage procedures that have been used to treat adult chronic osteomyelitis and to evaluate their effectiveness.","title":"A systematic review of the single-stage treatment of chronic osteomyelitis"}
{"_id":"87d7dcf0-b116-eb93-f06f-ff88ceec7f86","text":"A key challenge for facial age estimation research is the fact that faces are complex stimuli, and the space of possible variables driving age perception is large. A common approach is to manipulate specific facial features and observe changes in age ratings to identify relevant features. While this approach is valid, it relies on the researcher first identifying candidate facial features, leaving open the possibility that more complex or subtle features are missed. To circumvent this limitation, we proposed to manipulate the colour contrast of entire face images using the three dimensions of Lab space, as opposed to manipulating specific facial features. We hypothesised that faces would be perceived as younger while increasing both the level of redness and yellowness. Yellowness is associated with skin health and health is a highly associated with age. Whether colour rather than grey scale presentation influences the perception of age is unknown.","title":"Colour information biases facial age estimation and reduces inter-observer variability"}
{"_id":"87d9507e-ba54-56b4-2ad1-3c7e2509504f","text":"Possible immunization to blood group or other antigens and subsequent inhibition of remodeling or incorporation after use of untreated human bone allograft was described previously. This study presents the immunological, clinical and radiological results of 30 patients with acetabular revisions using fresh frozen non-irradiated bone allograft.","title":"No red cell alloimmunization or change of clinical outcome after using fresh frozen cancellous allograft bone for acetabular reconstruction in revision hip arthroplasty: a follow up study"}
{"_id":"87dd1bb6-eff4-698c-6d35-0ee53d722a6a","text":"A 60-year-old Tunisian man with recurrent abdominopelvic DFS for which he had undergone multiple excisions presented with an extensive DFS that invaded the external genitals. He underwent a large excision with emasculation and thin cutaneous graft of the abdominal wall and local skin flap in the pelvis.","title":"Giant Darier–Ferrand dermatofibrosarcoma protuberans of the abdomen and pelvis: a case report"}
{"_id":"87e31d7b-3706-d8d4-8454-66622e77b79b","text":"In the second scenario, the same principle applies as discussed above and one should aim at complete clearance in the pelvis and offer chemotherapy in node positive patients.","title":"Treatment of locally advanced and metastatic bladder cancer"}
{"_id":"87e99393-9275-5905-966f-9ac93f930a3e","text":"The only relevant scan available in hospital records for comparison was an ultrasound of the chest wall carried out 2 months after reconstruction to assess the emergence of a soft and mobile subcutaneous mass that was eventually found to be a lipoma. This ultrasound scan had been taken only 4 months before the CT scan and careful review showed a complete absence of the calcified mass now apparent in the breast. A freeze frame of the ultrasound appearance of the right chest wall is shown in Figure 3 where the white arrow points to the lipoma. The approximate time frame revealed by the ultrasound scan for the emergence of the calcified mass raised further suspicion of a rapidly growing tumour.","title":"The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan Case report: The appearance of cartilage in breast reconstruction as a mass on CT"}
{"_id":"87efe8ed-4516-7869-39e2-dd21829aa48f","text":"We identified 18 studies evaluating cervical spine involvement in patients with rheumatoid arthritis with plain radiographs that met our inclusion and exclusion criteria.","title":"Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis"}
{"_id":"87f03ce2-37b7-7d87-304c-3342e0093697","text":"In this prospective study of US women, we have shown that host factors are not associated with identical risks of incident melanoma, SCC, and BCC. By identifying women with only 1 type of incident skin cancer and comparing their risk with that of other women with only first SCC or first BCC in a single cohort, we removed the variability in populations and data quality that complicates comparisons of separate case-control studies of the 3 cancer types. To evaluate phenotypic differences among women who developed melanoma versus those who developed SCC or BCC, we excluded women who developed more than 1 type of skin cancer and studied women who had only 1 type of skin cancer. It is likely that women with more than 1 type of skin cancer were susceptible to all forms of skin cancer or had heavier sun exposure. The principal goal of this study was to evaluate differences in phenotypic risk between the 3 skin cancers rather than susceptibility to all 3 cancers or environmental exposure. We were then able to use PLR to test for differences in the impact of the different phenotypes on the risk of melanoma, SCC, and BCC.","title":"Heterogeneity in Host Risk Factors for Incident Melanoma and Non-Melanoma Skin Cancer in a Cohort of US Women"}
{"_id":"87f2970c-c717-d02d-a77e-904ba76d956c","text":"Literature searching and study selection were done in parallel for two HTA reports, one on NPWT in patients with wounds healing by primary intention and one on NPWT in patients with wounds healing by secondary intention. The results of the HTA report on wounds healing by primary intention will be reported separately.","title":"Negative pressure wound therapy in patients with wounds healing by secondary intention: a systematic review and meta-analysis of randomised controlled trials"}
{"_id":"87feda6a-56a4-d9fb-193d-7fe6e42c87f3","text":"From the results of sequential changes of skin defects, SIH can be recommended as an alternative treatment method for restoration with more careful dressing for initial two weeks.","title":"Sequential Change of Wound Calculated by Image Analysis Using a Color Patch Method during a Secondary Intention Healing"}
{"_id":"87ff2487-567f-fa5a-c6c3-9fb9a618b536","text":"This study focused on the differences between the endoscopic and open surgical techniques with respect to endothelial loss that occurs in the period from harvesting to implantation.","title":"Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery"}
{"_id":"88098a65-887f-34d0-3c0e-fba860ceaa92","text":"Patient 5 suffered from infection of the osteosynthesis site with synchronous nonunion between the bilateral fibular graft and the distal tibia 3 months postoperatively in relation to adjuvant chemotherapy. The plate was removed followed by surgical debridement and immobilisation in a cast. After healing of the infection adjuvant chemotherapy was continued. Six weeks after the completion of adjuvant chemotherapy the nonunion was resected and an autologous bone graft was performed followed by a lateral reosteosynthesis. Full weight bearing was released 12 weeks postoperatively when complete osseous union was documented by plain X-ray.","title":"Bilateral Fibular Graft: Biological Reconstruction after Resection of Primary Malignant Bone Tumors of the Lower Limb"}
{"_id":"880d8e51-89ef-fec4-7709-9aea3a782e00","text":"The aim of this study is to discuss the use and results of the vascular fibula graft in the treatment of bone and soft tissue defects in various regions with different etiologies.","title":"The Use of Free Fibula Flap in Different Extremities and Our Clinical Results"}
{"_id":"881a4ece-39d6-e3a4-d6bc-0e624ed54e6b","text":"In conclusion, in a discovery cohort of breast cancer patients with mixed subtypes and SLN status, high numbers per mm2 of T cells and B cells predicted longer DFS, with B cells having a stronger influence on DFS in multivariate analysis. Reduced numbers per mm2 of SLN B cells were associated with poor outcome in a validation cohort of SLN tumor-negative TNBC patients.","title":"Sentinel lymph node B cells can predict disease-free survival in breast cancer patients"}
{"_id":"881f1f43-9da9-5c15-8e49-d0e6fc0a54aa","text":"The patient had tumor recurrence and a difficult reconstruction for which dermal substitutes proved very useful.","title":"Multifocal cutaneous angiosarcoma of the scalp—A challenging reconstructive case managed with skin substitutes"}
{"_id":"88271268-ded7-f43f-9d0c-9155a2120d0b","text":"Despite its inherent limitations, this study suggests that palatal musculature reconstruction via intravelar veloplasty or reorientation via Furlow double z-plasty significantly reduced the total number tympanostomy tube sets in this population. These data are consistent with recent literature trend indicating improvement in Eustachian tube function and decrease in OME after palatoplasty with either IVV or a Furlow double z-plasty repair.22-26 Patients who underwent initial tympanostomy tube placement at the time of initial palatoplasty trended toward improved COME, likely constrained by a small sample size. Tympanostomy tube placement at the time of initial palatoplasty may be a viable addition to institutional protocol for cleft lip\/palate patient base.","title":"Timing of Tympanostomy Tube Placement and Efficacy of Palatoplasty Technique on the Resolution of Chronic Otitis Media: A Cross-sectional Analysis Brgoch et al"}
{"_id":"88279a49-35f5-d94c-127c-509d9426632e","text":"Historically, melanoma has been typically diagnosed by naked-eye examination and confirmed with invasive biopsy. However, recently the use of reflectance confocal microscopy enables non-invasive bedside diagnosis of clinically equivocal lesions. We present a case in which reflectance confocal microscopy was used to evaluate two skin lesions in the same patient confirming the diagnosis of a melanoma and potentially avoiding invasive biopsy in the second benign melanocytic lesion. Clinicians should be aware of the availability of new non-invasive technologies that can aid in early diagnosis of malignant skin tumors and potentially reduce the number of benign lesion excisions.","title":"Case Report: melanoma and melanocytic nevus differentiation with reflectance confocal microscopy. v1; ref status: indexed"}
{"_id":"882d8e3b-5283-b7d3-e68a-9997b141c784","text":"This tool has been used to screen patients for abdominal wall defects before liposuction or abdominoplasty. It has been used to evaluate repairs of the rectus abdominis diastasis, and for seroma management. Hand surgeons have found numerous applications, such as visualizing tendons and foreign bodies of the upper extremities and guiding injections.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery"}
{"_id":"883113cd-9a4c-5d20-a155-d5dd281437b1","text":"The present study is aimed at evaluating the safety and effectiveness of BTA on the treatment of AGA.","title":"Effectiveness and Safety of Botulinum Toxin Type A in the Treatment of Androgenetic Alopecia"}
{"_id":"8831214b-9269-1057-1c68-41dce29b8556","text":"There are several targeted therapies that have been developed to specifically target MAPK pathway mutations in melanoma, including BRAF inhibitors and MEK inhibitors. These therapies can be effective at slowing the growth of melanoma cells and may be used as part of the treatment for patients with this type of cancer.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"8836aa85-a588-3d4a-f6df-f75cf3f84fd9","text":"Disadvantages of always preserving the SIEV may be prolonged operating times and the possibility of increased donor site complications, such as seroma.","title":"Use of the superficial inferior epigastric vein in breast reconstruction with a deep inferior epigastric artery perforator flap"}
{"_id":"8841c0dd-80cf-27fe-cfee-c5076e1f8e20","text":"Studies from the search result were downloaded into an EndNote database. Two reviewers independently screened titles and abstracts of all obtained studies, ensuring studies met the inclusion criteria. Any disagreements were then consulted with a third independent reviewer. Full texts of studies that were included by title and abstract screening were further reviewed, again independently by the two reviewers. Any disagreements were also consulted with a third independent reviewer as needed.","title":"Keloid treatments: an evidence-based systematic review of recent advances"}
{"_id":"884d2486-c2b2-205e-9c75-3bbc93b076c4","text":"The various parameters were statistically analysed using SPSS software. Independent t test was used to compare the means in both group 1 and group 2. ANOVA followed by Tukey honestly significant difference were done to compare the means among the various grades of ankyloglossia.","title":"Skeletal and dental characteristics in subjects with ankyloglossia"}
{"_id":"884d73a7-6600-0452-8e3e-81d69ba388c6","text":"The gradual training sequence performed using electromyographic biofeedback in therapy is found in Chart 1.","title":"Utilization of electromyographic biofeedback in speech therapy to attenuate the signs of facial aging: a case report"}
{"_id":"8855fa6c-a66d-6f02-551a-6c57cb0ef08f","text":"It should be noted that the dangers that are hidden in the correction of the fixed cervical kyphosis are not usually seen in this flexible kyphotic deformity. However, the patient should be informed about the restricted motions of the neck and the risk of increased falls because of an inability to see the walking surface.","title":"Cervical Spondylotic Myelopathy Secondary to Dropped Head Syndrome: Report of a Case and Review of the Literature"}
{"_id":"885bef47-d84b-5dfe-3378-8ac355a7b534","text":"The diagnosis of fat embolism syndrome typically involves neurological, respiratory and dermatological manifestations of microvascular occlusion 24–72 h after a precipitating event. However, fat embolism causing cerebral large vessel occlusion strokes and their sequelae have rarely been reported in the literature. This case series reports three patients with fat emboli post operatively causing cerebral large vessel occlusions, as well as a review of the literature to identify differences in clinical presentations and outcomes in stroke secondary to fat emboli causing large vessel occlusions compared to those with fat embolism syndrome.","title":"Cerebral Large Vessel Occlusion Caused by Fat Embolism—A Case Series and Review of the Literature"}
{"_id":"885e9373-0e9f-d92c-691c-779423f18870","text":"This case study presents seven patients with cervical SEAs who were successfully treated with surgical decompression by this transvertebral linear midline technique and antibiotic treatment.","title":"Case report: Anterior midline decompression of a cervical epidural abscess: Technical note and case series of seven patients"}
{"_id":"8861769c-3ca1-a570-2ed7-2b42406cf047","text":"Treatment failure according to the definitions of the study occurred in 3 patients. Two patients had rhabdomyosarcoma and one desmoids tumor with doses ranging from 45–50.4 Gy. The two patients with rhabdomyosarcoma received concurrent chemotherapy. Failure occurred in cream and gel treated sites simultaneously in two and in the cream treated site prior to the gel treated site in one patient.","title":"A phase III trial comparing an anionic phospholipid-based cream and aloe vera-based gel in the prevention of radiation dermatitis in pediatric patients"}
{"_id":"88636fa9-3118-f9a7-40fa-2e7c161f9295","text":"Efforts to reduce morbidity by decreasing the extent of axillary dissection must be accompanied by comprehensively quantifying dose and factors that impact dose to the axilla in all subgroups of patients, including those with tissue expanders. This information will be helpful both for recurrence and morbidity endpoints. Our study is the first report of axillary dose in women with tissue expanders undergoing breast only irradiation. This analysis suggests that in patients undergoing PMRT with tissue expanders in place, incidental doses delivered by opposed tangents to the Level I and II regions, as defined by the RTOG contouring atlas, do not provide adequate dosimetric coverage of these regions. This should be considered when designing PMRT treatment fields. However, the clinical significance of underdosing this volume is unknown. In addition, the increased lung dose associated with the lateral expander location should be taken into consideration when placing expanders. How axillary and lung coverage affects endpoints such as axillary recurrence, pulmonary toxicity, locoregional failure, distant metastasis and morbidity remains to be seen and should be the subject of future investigations.","title":"Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction"}
{"_id":"8866db91-451e-0665-3e68-b6fe6a027d78","text":"Surgical Mind provides a medical training service using human body models and VR technology instead of real patients. Aesthetic plastic surgery training service and cataract surgery training service are developed for effective surgical training of doctors and medical students. Aesthetic plastic surgery training service is a service for cosmetic surgery and procedure training developed with a virtual engine. It can be implemented to learn how and where to inject with detailed anatomical information of the face. It can learn where the syringe tip is in the skin precisely within the 0.5 mm error range.","title":"Application of Metaverse Service to Healthcare Industry: A Strategic Perspective"}
{"_id":"886927fe-7741-df04-eb91-bf9885312f1f","text":"Extrascleral extension of choroidal melanoma can occur despite control of the intraocular tumour, and there can be a prolonged latency before extrascleral extension.","title":"Extrascleral extension of choroidal melanoma after iodine-125 brachytherapy treatment: a case series"}
{"_id":"88714045-4a51-311a-2993-c0265b03dd4d","text":"The majority of residents who considered doing a pulmonary fellowship (8 of 15) were in their first year of residency. From personal experience, residents often consider various practice options early on in their training and frequently do not tend to narrow their choices until their second or third year of residency. This observation should be kept in mind when trying to recruit residents for pulmonary fellowship positions by seeking out those residents potentially interested in Pulmonology early on in residency rather than later.","title":"Resident interest and factors involved in entering a pediatric pulmonary fellowship"}
{"_id":"88756635-3b24-abc5-67f2-71a583c3acd9","text":"The main outcome measures were length of exclusive breastfeeding and length of partial breastfeeding.","title":"Breastfeeding challenges and support in a high initiation population"}
{"_id":"887716d2-86eb-6cbb-0539-95364ab8c9c3","text":"The use of myocutaneous\/skin flap for vulvar reconstruction after removal of advanced or recurrent vulvar malignances is associated with a low rate of postoperative complications decreased pain and an improved functional status. Although the recurrence rate in this patient population is high, a reasonable proportion of patients who undergo resection for advanced\/recurrent vulvar cancer and reconstructive surgery appear to benefit.","title":"Outcome of vulvar reconstruction in patients with advanced and recurrent vulvar malignancies"}
{"_id":"88841362-3fc9-ee23-4c71-d29480c9e583","text":"To our knowledge, this is the first report of successful salvage GKR therapy after brachytherapy failure in an eye with choroidal melanoma. GKR is an option for select cases of local recurrence after radiation plaque brachytherapy.","title":"Gamma Knife radiosurgery for locally recurrent choroidal melanoma following plaque radiotherapy"}
{"_id":"88845625-6c2a-cd35-6046-52a57b993805","text":"Our case indicates that the development of blistering lesions during PUVA therapy may be suggestive sign of a bullous disease such as BP and it should be excluded with proper clinical and laboratory approaches immediately after withdrawal of PUVA therapy.","title":"PUVA Induced Bullous Pemphigoid in a Patient with Mycosis Fungoides"}
{"_id":"8887aaea-d42c-5c78-3a90-43e6359b0a56","text":"The grafts are usually harvested from the medial aspect of the auricle; the straight contour of the septal cartilage makes it a secondary option. The costochondral cartilage could be exploited if larger amounts of cartilage are required [43]. Grafts should be secured with absorbable monofilament suture tied in a horizontal mattress fashion with the knots placed superficial to the cartilage graft.","title":"Reconstruction of the Nose: Management of Nasal Cutaneous Defects According to Aesthetic Subunit and Defect Size. A Review"}
{"_id":"8888e28b-68ee-24a4-6dc7-c84bed7cf169","text":"Thus, the clinical feature of an adult XP patient can be characterized by the presence of simultaneous skin cancers in a framework of altered skin and scars of previous surgery.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"88901d22-df5d-d3d5-28d5-37d368d8b5d1","text":"Computed tomography shows that the muscle wall is constantly developing postoperative sequelae after harvesting the DIEP flap, even if these are not directly correlated with a functional impairment demonstrated by the physiatrist.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"88954193-9c10-d7d9-e553-881e0cb5e5c1","text":"CDKN2A (also known as p16INK4a or p16) is a protein that plays a role in the cell cycle, the process by which cells grow and divide. CDKN2A acts as a tumor suppressor, meaning that it helps to regulate cell growth and prevent the development of cancer. Mutations or changes in the CDKN2A gene can lead to an impaired ability to suppress tumor growth, which can increase the risk of cancer. Studies have shown that CDKN2A mutations are more common in melanomas that have spread to other parts of the body (metastatic melanoma) than in localized melanomas that have not spread. CDKN2A mutations are more common in melanomas that develop in people with fair skin and in people who have a history of sun exposure.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"88a1d04b-5b56-2e15-9474-784da7bb2931","text":"At physical examination, the classic early manifestation is a bulla filled with serous fluid and erythema and hemorrhagic and gangrenous lesions come into view.","title":"Necrotizing Soft Tissue Fasciitis after Intramuscular Injection"}
{"_id":"88a55598-605b-2536-3cbe-dee827cd3a78","text":"This study included twelve patients presenting with cancer of the head and neck to Izmir Ataturk Training Hospital and Adnan Menderes University Hospital. Tumor resection and neck dissection was performed in one session by the same surgeon. A single incision was made and a medially based cervicopectoral fascio-cutaneous flap was used for surgical exposure in neck dissection and for closure of defects after tumor resection.","title":"Cervicopectoral flap in head and neck cancer surgery"}
{"_id":"88b95745-e77a-f79c-6b74-c9377ac7bdd6","text":"where d is the difference between two measurements made from the same parameter and n is the number of subjects.","title":"Skeletal and dental characteristics in subjects with ankyloglossia"}
{"_id":"88bc283a-98c7-f018-8e3b-fbe5d69b1d4f","text":"The frequency of adverse events and its small magnitude, as well as the clinical effect of IFN combination, suggest that this new IFN formulation is harmless and sure, being able to be employed in similar therapeutic designs and prolonged treatment schedules, with the aims to offer to these patients an efficacious and safe therapeutic option.","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"88bde6c3-261d-51b0-a573-03f85600d147","text":"Assessments to stratify risk in patients with a history of RIVDU have been developed. Some centers also use integrated care models to assess and manage patients with a history of RIVDU, which may include the provision of counseling and pharmacotherapy on an inpatient and outpatient basis. These multidisciplinary teams may include addiction psychiatry, OPAT pharmacists, infectious disease specialists, and primary care teams and provide a comprehensive approach to the management of patients with a history of RIVDU who require IV antibiotic therapy.","title":"Outcomes of Orthopaedic Infections in Recreational Intravenous Drug Users Requiring Long-term Antibiotic Treatment"}
{"_id":"88bf7372-ef41-cd07-e791-cbba9786ec7a","text":"In daily clinical practice in patients with suspected PTO, the trauma and orthopaedic surgeons have in general the following questions for the medical imaging specialists:","title":"Nuclear medicine imaging of posttraumatic osteomyelitis"}
{"_id":"88c12f65-205c-623e-0294-92d0892aa01a","text":"However, our population represents one of the largest cohorts of LAA thrombosis patients in which comparisons of anticoagulant regimens were performed and corroborates the data on the effect of NOACs in the treatment of LAA thrombus in patients with NVAF.","title":"Prevalence and Rate of Resolution of Left Atrial Thrombus in Patients with Non-Valvular Atrial Fibrillation: A Two-Center Retrospective Real-World Study"}
{"_id":"88c4eb51-f5f1-84cb-3ec5-c0510e9c88ce","text":"While canals in cortical bone can readily be identified and characterised in standard X-ray computed tomographic data in 3D using the negative imaging approach, the soft tissue comprising blood vessels that are putatively contained within the canal networks do not provide the sufficient image contrast necessary for image segmentation. Thus to date it has not been possible to determine whether blood vessels are present within these canals without the addition of a contrast agent.","title":"Simultaneous visualisation of calcified bone microstructure and intracortical vasculature using synchrotron X-ray phase contrast-enhanced tomography"}
{"_id":"88d0439c-19b0-f090-d7a0-0daa2c8924eb","text":"Iatrogenic facial nerve injury is one of the severest complications of middle ear surgery, this study aims to evaluate surgical management and prognosis in the era of improved surgical instruments.","title":"Surgical management and the prognosis of iatrogenic facial nerve injury in middle ear surgery: a 20-year experience"}
{"_id":"88d26e67-e4dd-4245-1b1c-b5f10de335f2","text":"We identified three RCTs and two NRCTs that assessed the effect of alternative supplemental feeding techniques.","title":"Effectiveness of Interventions to Manage Difficulties with Breastfeeding for Mothers of Infants under Six Months with Growth Faltering: A Systematic Review Update"}
{"_id":"88d6479f-06cc-8ee7-a65f-be0ecdfda3b9","text":"A free muscle flap is used to cover the exposed skull. Skin graft covers the muscle flap, and next, the expanded scalp is used to restore the scalp to its original shape.","title":"36-year Follow-up on Scalp Reconstruction Using Free Latissimus Dorsi Muscle Flap, Skin Grafting, and Scalp Expansion"}
{"_id":"88dc44c2-a668-6bfe-1296-a1e7658d4196","text":"In modern day oncologic surgeries, use of the frozen section as an intraoperative guide for surgeons is gaining popularity. The technique was devised a little more than 100 years ago and has advanced in terms of technical expertise and improved microscopic optics. While the role of the frozen section in certain oncologic surgeries like evaluation of margins in squamous cell carcinoma of head and neck and sentinel lymph node evaluation in breast cancer is deemed essential, its role is still a matter of debate in ovarian surgeries [1–3].","title":"Accuracy of intraoperative frozen section for the evaluation of ovarian neoplasms: an institutional experience"}
{"_id":"88e0988c-eb16-696b-7968-dfa5e1d6b1ec","text":"This is the first systematic review on the use of NPWT and dressings following FRI in internal osteosynthesis of the extremity. We did not find any studies comparing the use of NPWT with dressings following FRI. We found ten studies with a total of 115 patients with FRI treated with either NPWT or dressings. Fracture healing was described in less than one third of the patients, and the time to fracture healing was only described in seven out of 115 patients. The data were therefore too small to show an effect of NPWT versus dressings. Debridement was used in eight out of ten studies, which shows that this is a common step in the treatment of FRI.","title":"The use of negative pressure wound therapy for fracture-related infections following internal osteosynthesis of the extremity: A systematic review"}
{"_id":"88ecaf23-862d-b8e4-ccc2-1566db226506","text":"A 34 years old woman was admitted to our institute for a soft palpable mass localized in her left trapezius. She complained about localized discomfort and pain that interfered with her daily activities. In order to better characterize the nature of the mass and its anatomical boundaries, an MRI (Figure 1) was performed which showed an intramuscular lesion of 8 cm × 4 cm infiltrating the cervical portion of the left trapezius without any involvement of the overlying subcutaneous tissues and skin. We subsequently performed an incisional biopsy that established the diagnosis of sporadic DT.","title":"“Functional trapezius muscle reconstruction after resection of a desmoid tumor using an innervated gracilis free flap”"}
{"_id":"88ecccca-9333-d635-bc52-965d2ddda3a2","text":"The objective of our study was to share our experience of associated ILND for patients with advanced plantar melanoma managed at a tertiary care hospital in a low-income country.","title":"Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country"}
{"_id":"88ee7416-ba48-8874-8f73-034cd5bbe9f6","text":"Multiple studies in other subspecialties similarly found that the interview is the most important factor in ranking an applicant. Grabowski and Walker, in a survey of various orthopaedic fellowship directors across all subspecialties, also found that the interview was the most important factor in ranking an applicant. The interview was also found to be the most important factor when ranking medical students for orthopaedic surgery residency positions and was found to have the highest correlation with the final rank of the applicant. Although the applicant may have the opportunity to interact with fellowship directors during informational sessions, courses, or site visits, the interview is the only formal time through the application process that the applicant has direct interaction with their potential fellowship program and can demonstrate their communication skills, maturity level, self-confidence, the ability to listen and articulate thoughts, and personality fit within the program.","title":"The Competitive Orthopaedic Trauma Fellowship Applicant: A Program Director's Perspective"}
{"_id":"88f2dbf2-2e95-8bd0-870c-138458bb8391","text":"Reporting three cases of Maxillary Le Fort II fractures. All patients had undergone open reduction and internal fixation combined with rhinoplasty using diced cartilage wrapped with fascia.","title":"A breakthrough in Maxillary LeFort II fracture reconstruction: Case series of rhinoplasty using diced cartilage fascia graft simultaneously with ORIF"}
{"_id":"88f38831-945b-33a7-1f00-534d1d4c5ab2","text":"Ultimately, photodynamic therapy mediated by either methylene blue or Photogem as monotherapy or in combination with cisplatin has low mutagenic potential and possibly high immunogenic potential, characteristics that support its safe use in clinical practice for the treatment of cervical cancer.","title":"Photodynamic therapy combined to cisplatin potentiates cell death responses of cervical cancer cells"}
{"_id":"88f5e37f-10d2-74a0-1e93-58792aed66d7","text":"We report a case of thoracic chondrosarcoma, which was treated with total resection, using cryosurgrery. Cryosurgery is found to be effective against a localized disease and solid tumors larger than 1 cm. Liquid nitrogen was used to freeze the damaged tissue at a cellular level and form ice crystals inside the cells of the tumor making the excision more efficient and with lower rates of side effects. More damage to the tumor occurs when blood vessels supplying the diseased tissue freeze.","title":"The Value of Cryosurgery in Treating a Case of Thoracic Chondrosarcoma"}
{"_id":"88f78836-265e-4ba9-7c09-7486644ee75b","text":"The NCCN recommends a 4 mm safety margin for low-risk lesions, here we found that the primary tumors of all the studied recurrent BCCs were excised with surgical margins less than 4 mm. Follow up is recommended for all excised BCCs either those of low or high risk histological variants. Size of the primary lesion does not appear a considerable risk factor for local recurrence.","title":"Recurrent cutaneous basal cell carcinoma after surgical excision: A retrospective clinicopathological study"}
{"_id":"88fb6fc4-c3f1-18ef-1cbe-98a5d862c4ae","text":"PDs should participate in educational activities designed to develop leadership and communication skills.","title":"Factors related to the role of programme directors in association with quality in postgraduate medical education – a cross-sectional study"}
{"_id":"890087c2-9ef2-c00c-8a08-974ca0de5127","text":"Steroid injection remains a reliable method for treating solitary bone cysts owing to its low invasiveness. To prevent fractures and allow a full weight bearing, internal fixation in combination with methylprednisolon acetat injections seems to be the most favorable in weight bearing bones.","title":"Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome"}
{"_id":"8913d5de-03c0-047a-a784-75c7d2bc146f","text":"The alginate crust detaches spontaneously from the donor site when healed.","title":"The scalp as a donor site for skin grafting in burns: retrospective study on complications"}
{"_id":"89153cef-8091-0815-09b2-0552ea2cefb1","text":"The skin cancer diagnosis was clinically performed by a senior dermatologist after full body examination, and was assisted by dermoscopy followed by a biopsy for histopathological diagnostic confirmation. Full body examination is performed in the majority of patients attending our dermatology center irrespectively of their initial complaint. Patients with genetic syndromes associated with multiple skin cancers and immunosuppressed by organ transplantation were not included. Follow-up periods were established according to the skin cancer type – every 6 six months for MM in the first 5 years, and thereafter annually; every 6 months for NMSC in the first 3 years, and thereafter annually.","title":"Risk factors for development of new skin neoplasms in patients with past history of skin cancer: A survival analysis"}
{"_id":"891b537a-9f85-928d-7b5a-77bc78381dd2","text":"Surgical procedures should be performed in conjunction with a team experienced in the treatment of hemophilia. Before performing the surgical procedure, ensure that sufficient concentrate of the deficient factor is available.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"8921486d-2313-2c6b-1a25-982f32cc267c","text":"A literature search was performed using a comprehensive PubMed search to evaluate BCC and AK lesion criteria and topical treatment indications. The search was limited to articles in the English language. All types of studies were included in the literature search. Articles not pertaining to BCC and AK lesion criteria or topical treatment options for BCC and AK were excluded. Titles and abstracts were screened for inclusion and exclusion criteria. The screened papers were then reviewed in full text, and those not found to meet inclusion and exclusion criteria were excluded.","title":"Topical Treatments for Basal Cell Carcinoma and Actinic Keratosis in the United States"}
{"_id":"8923865b-dbdd-6db0-5f46-27d94300f1b9","text":"Mild reactions such as urticaria or gastrointestinal symptoms are treated with oral H1 receptor antihistamines preferably in liquid form to enhance rapid absorption. However, there is evidence that other mediators such as platelet activating factors and kinins are associated with severe and potentially fatal reactions. The progression of symptoms is unpredictable, and in these patients, adrenalin must be considered if symptoms do not resolve.","title":"Ingestion of mammalian meat and alpha-gal allergy: Clinical relevance in primary care"}
{"_id":"89257050-8c25-a3b8-e19e-aeca76837fb9","text":"The meaning women give to the detection and diagnosis of breast cancer and the quality of health care in the SUS network are related to their lived experiences in the health services. Women’s accounts of these experiences were analyzed on the basis of Symbolic Interactionism, which allowed to assess their experiences with the received care.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"892cb1af-c62e-23e0-0dca-b3072f5abafd","text":"Unquestionably, the practice of surgery and the environment of care in which surgical care is delivered were in constant evolution and transformation over the last century. Indeed, most would contend that the pace of change and impact of this evolution has accelerated over the last two decades – and many might argue that each year is ever more disruptive. The changes in the surgical environment in the US are far too many to fully articulate: fundamental changes in surgical technologies; the complexity of the surgical conditions we treat, which now commonly require sophisticated interdisciplinary healthcare teams to optimize surgical results; the environment of surgical practice and delivery with increasingly corporate structures and external regulatory oversight. All these factors fundamentally altered the once autonomous and authoritative position of the surgeon caring for a surgical patient.","title":"Surgical leadership in changing times: the American College of Surgeons perspective"}
{"_id":"894ce21d-ca1a-c0b5-7a8c-00dc86ab8fc7","text":"We report here two cases where the preoperative lymphoscintigraphy was found to be fallacious. A 44-year-old female with T2N0 breast cancer underwent preoperative lymphoscintigraphy with Tc99 sulfur colloid which failed to show any uptake in axilla or internal mammary chain. Intraoperative scintigraphy with blue dye and hand held gamma probe identified sentinel lymph node in axilla. Another patient with T2N0 lesion underwent preoperative lymphoscintigraphy which showed a sentinel lymph node in axilla and another in supraclevicular fossa. Intraoperative scintigraphy failed to show supraclevicular node however axillary node was correctly identified.","title":"Fallacies of preoperative lymphoscintigraphy in detecting sentinel node in breast cancer"}
{"_id":"8953537a-979f-6102-9724-4a0f04f09eb5","text":"The selection of the flap from the interatrial septum as an intra-atrial baffle, redirected from the orifices of right anomalous pulmonary veins to the surgically created ASD, could be considered as an effective alternative for patients undergoing surgical repair in an isolated PAPVC to the RA. The present case highlights the importance of high suspicion and accurate diagnosis of PAPVC in adult patients who remain undiagnosed. Additionally, the early detection of PAPVC undoubtedly would lead to the subsequent surgical treatment as a conceivable therapeutic option.","title":"Novel technique of repairing right partial anomalous pulmonary venous connection with intact atrial septum using in situ interatrial septum as a flap in a 68-year-old-woman: a case report"}
{"_id":"8954b7b8-1be8-21e3-a603-cf497f18c08b","text":"Within 24 months of the date of a melanoma diagnosis when attending the screening and baseline visit","title":"Study protocol for a randomised controlled trial to evaluate the use of melanoma surveillance photography to the Improve early detection of MelanomA in ultra-hiGh and high-risk patiEnts (the IMAGE trial)"}
{"_id":"895f8e0a-08fe-6130-cbd2-c0a172b63454","text":"The microenvironment plays an important role in CSC growth, and it is also a promising target for treatment. Agents targeting the microenvironment in ongoing clinical trials are listed in Table 3.","title":"Targeting cancer stem cell pathways for cancer therapy"}
{"_id":"896a6a7b-0370-37a0-41e1-8a038c8a3aa4","text":"Analysis of thrombotic material removed from the right atrium and pulmonary (lobar and segmental) arteries of a patient with acute severe PE who underwent surgical embolectomy showed that distally located thrombi contain more densely packed fibrin fibers compared with the proximal thrombi from the lobar pulmonary arteries and the right atrial thrombus [5]. It indicates that abnormal fibrin is present in thrombi retrieved from patients with DVT and the subsequent PE.","title":"Prothrombotic Fibrin Clot Phenotype in Patients with Deep Vein Thrombosis and Pulmonary Embolism: A New Risk Factor for Recurrence"}
{"_id":"896b19ef-d228-651f-fb9c-011683e41e32","text":"The GRADE Working Group is an informal collaboration of people with an interest in addressing shortcomings such as these in systems for grading evidence and recommendations. We describe here a critical appraisal of six prominent systems and the results of the critical appraisal.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"896c41d8-e237-053a-ed15-3ca92da43887","text":"The surgical procedure consisted of debridement of all infected tissue, anterior corpectomy of C4–C6, and anterior stabilization with a free microvascular fibula graft in combination with posterior stabilization. The FVFG was dissected simultaneously during cervical wound debridement. The superior thyroid artery and external jugular vein were selected as recipient vessels. The FVFG was cut down to 4.5 cm to fit the defect and anastomosed to the recipient vessels (Fig. 2). An anteriorly placed 62-mm plate was used to fix the FVFG to C3 and C7. The scheduled posterior stabilization with internal pedicle screw fixation of C2–Th2 was performed 1 week later. Microbiology of bone samples revealed Staphylococcus aureus, which was treated with culture-guided antibiotics.","title":"Free Vascularized Fibula Graft as Primary Salvage Procedure for Acute Cervical Osteomyelitis Caused by Epidural Abscess"}
{"_id":"89717752-5cc0-8f0b-bbaa-bcd807ea4ad7","text":"The patient underwent mobile total tongue reconstruction with a sensitive anterolateral thigh that recreates a near normal neotongue shape with more projected tip and vertical bulk. This modification of the flap shaping and folding optimizes postoperative oral function. The anterolateral thigh myocutaneous flap creates a free neotongue tip with adequate volume, producing acceptable swallowing function and cosmesis.","title":"Ablation of advanced tongue cancer and mobile tongue reconstruction by using a sensitive anterolateral thigh and vastus lateralis muscle free flap"}
{"_id":"89757932-7241-36e8-d247-7d4121560f9d","text":"This finding can be explained by suggesting that at older ages, aging mechanisms become more apparent and any aesthetic improvement, although of a minimal clinical significance, can be better noticed as compared to those that may occur at a younger age in which to show the same aesthetic improvement it is required to make a substantial change in the facial soft tissues architecture.","title":"Clear aligners’ effects on aesthetics: evaluation of facial wrinkles"}
{"_id":"898335fc-9751-91dd-70dd-eea4883d45cd","text":"Histopathological examination was performed by an experienced dermatopathologist blinded to the measurements of HFUS. The surgical margins were determined based on the Breslow thickness from the pathology report of the incisional biopsy or excisional biopsy, and the safety peripheral surgical margins were in accordance with the NCCN Guidelines. Wide surgical excision combined with a sentinel lymph node biopsy was used for melanoma stages T1b or higher. This approach ensured thorough removal of the tumor while also assessing the potential spread to the nearby lymph nodes, as recommended by the NCCN Guidelines. The results of the included Breslow thickness were derived from the pathology reports of excisional biopsy as well as post-operative pathology reports following wide surgical excision (if incisional biopsy were performed).","title":"The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients"}
{"_id":"8990b035-ef76-c71f-bb1d-83de4152c076","text":"From a practical standpoint, the accuracy in detecting the most aggressive subtype in the preoperative biopsy is more important than the accuracy in diagnosing the histopathological subtype, as the treatment of BCC is strongly based on whether it is histologically aggressive. The presence of an aggressive subtype that is not detected in the biopsy may be responsible for the failure of certain treatments and a higher recurrence rate.","title":"Comparison of basal cell carcinoma subtypes observed in preoperative biopsy and Mohs micrographic surgery"}
{"_id":"89961aca-b633-2e69-3dad-0967cb660d19","text":"Drug reactions for concurrent medications given for routine clinical care as detailed in the product literature (the SMPC or British National Formulary)","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"89a0e817-4663-2663-f22d-a9efa17de078","text":"We conducted this study at an academic medical center with an annual ED census of approximately 45,000 patients. The ED has a residency training program and an active emergency sonography program. The primary investigators of this study were two emergency physicians with expertise in bedside US. We included in this study all adult patients who received a lower extremity venous duplex US examination for evaluation of DVT in the ED.","title":"Non-thrombotic Abnormalities on Lower Extremity Venous Duplex Ultrasound Examinations"}
{"_id":"89a7da27-a35c-6e88-a857-f3807c1fdf2a","text":"The DystoniaDiary electronic patient journal was installed by the participating patients as an app on their own smartphone or tablet device. Access to the DystoniaDiary app was managed by a center-specific passcode provided by the HCP to all participants. Patients were only provided with the passcode after they had given informed consent to participate in the study. At the installation of the app, patients were asked to enter the passcode appropriate to that center.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"89ab2fdb-913a-4ac7-107d-372ddc7d13fa","text":"Here, we report the results of the 439 patients who participated in the EINSTEIN DVT and EINSTEIN PE studies in China.","title":"Rivaroxaban for the treatment of symptomatic deep-vein thrombosis and pulmonary embolism in Chinese patients: a subgroup analysis of the EINSTEIN DVT and PE studies"}
{"_id":"89acf95e-2250-a555-e554-a03df55e51f0","text":"We observed a lower mean age in the group of patients with flap repair, due to different choice of reconstruction in older subjects (a primary closure was preferred in such cases). Along with the small number of subjects, this may represent a bias of our study. However, we found better functional outcomes in patients without flap repair despite older age which could negatively affect oral functions. Future studies with larger samples should better analyze the role of age on functional outcomes after glossectomy. Another limitation of our study is represented by the free speech sample used for evaluation, that reduces the possibility of comparison. Furthermore, the sensitivity of CTCAE dysphagia scale decrease 6-months after head and neck cancer surgery. The strength of our study was the selection of a homogeneous sample of partial glossectomies for pT2 tumors with a maximum dimension between 2 and 3 cm and a depth of invasion between 5 and 10 mm. The exclusion of small tongue resections and hemiglossectomies allowed us to obtain more accurate and valid results. Further studies with larger samples are necessary to compare functional results with free flaps to other reconstruction strategies.","title":"Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas"}
{"_id":"89b59852-f5eb-e0df-ec59-3eeff4b69649","text":"The first most significant limitation of this study is that it was conducted in a single center. As a second limitation is the number of patients enrolled, SLNB technique with lymphoscintigraphy being a procedure available only in a few medical centers in Romania. Third, only a low number of patients had the BRAF gene tested, and no gene subtypes were examined; this information might have some bearing on the connection with SLN positivity.","title":"The Characteristics of Sentinel Lymph Node Biopsy in Cutaneous Melanoma and the Particularities for Elderly Patients—Experience of a Single Clinic"}
{"_id":"89b6cce3-4162-8e90-443c-0083cecaf47b","text":"Reconstruction of large scalp defects after tumor resection is a challenging problem. We aimed at putting an algorithm for reconstruction of those defects.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"89b9dbb2-cd5c-4a09-3ae0-db8f7bacabde","text":"For both malignancies described here, surgical resection of the tumour with clear surgical margins is the main choice of treatment. Both tumours are very rare neoplasms with a similar incidence of four cases or less per million per year. DFSP may affect patients of all ages but is rarely encountered during childhood and it mainly occurs in adults between 20 and 40 years of age. It is a tumour of the dermis and subcutis characterized by a local aggressive growth pattern. Its asymmetric growth and pseudopod-like extensions aggravate tumour resection and account for a high rate of local recurrence of up 60% [10]. A strong correlation between surgical margins and tumour free survival has been demonstrated. Invasion of the underlying fascia and muscle has been observed in patients with a long history of DFSP. In these cases wide local resection may be mutilating and in this case an interthoracoscapular resection would have been required. Fibrosarcomatous transformation of DFSP results in an increased risk of distant metastasis especially into the lungs and an even higher rate of local recurrence [11,12].","title":"Merkel cell carcinoma metastasis and dermatofibrosarcoma protuberans presenting as a collision tumour: a case report and review of the literature"}
{"_id":"89bc0db9-f1e4-ddfa-5725-fe32a47d05f9","text":"The initial ultrasonic liposuction started by the Europeans, emulsified fat with an ultrasonic canula which was then aspirated in the second step. This two stage procedure was time consuming. It was modified in the United States and now a modified suction canula emulsifies and aspirates the fat simultaneously.","title":"Liposuction"}
{"_id":"89bca3f8-22d5-111e-4b24-7b9076f5f6d3","text":"The diagnosis is often challenging and can be delayed. Early diagnosis and treatment are necessary to prevent permanent neurological disability and to minimize spinal deformity.","title":"Surgical management and clinical outcome of cervical, thoracic and thoracolumbar spinal tuberculosis in a middle-European adult population"}
{"_id":"89c8f554-1ba6-5044-7857-2d07cc0fd0ca","text":"The objective of this work was to evaluate the frequency with which particular disorders of the masticatory organ locomotor apparatus occur within the group of patients with osteogenesis imperfecta.","title":"Evaluation of Stomatognathic Problems in Children with Osteogenesis Imperfecta (Osteogenesis Imperfecta − OI) − Preliminary Study Ocena problemów stomatognatycznych u dzieci z wrodzoną łamliwością kości (Osteogenesis Imperfecta − OI) − Badania wstępne"}
{"_id":"89cf42f8-819f-631d-f854-1d95ac181565","text":"CONCLUSIONS The combination of bubbles and US could be efficacious for neovasculature image and cancer therapy. We believe this new formulation shows great promise for both diagnostic and therapeutic applications thanks to its good stability, relatively small bubble size and the simplicity of handling.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"89cfb678-a783-1ad6-fcf4-272a98e49f47","text":"Radiation therapy damages small vessels by reducing smooth muscle density and progressively thickening the sub-endothelial components of vessel wall, leading to progressive occlusion and fibrosis of the vessels.4,8 On top of threatening the perfusion of the flap, radiation induces changes of skin and subcutaneous tissues that lead skin atrophy and firability.4 These changes arise from decreased mitotic activity of the epidermis that leads to the loss of keratinized layers as well as depletion of stem cells within the stratum basalis.4 This concept is demonstrated in the above case report plate extrusion is so common in the setting mandibular reconstruction with reconstruction plates.","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"89d29998-8c6b-da9f-5600-7ccc9c62877b","text":"Tumor destruction caused by PDT is not only a result of direct tumor cell toxicity via the generation of ROS but it is well established that there is also a significant immunological component involved. The great majorities of experimental studies have been done on extra-cranial tumors, and are reviewed in several extensive recent publications[.","title":"Photodynamic therapy mediated immune therapy of brain tumors"}
{"_id":"89d68b7c-9cc2-3961-81fe-4819c8b3b756","text":"In LDI, a movable mirror is used to direct a laser beam onto the skin, so that direct contact is unnecessary. The movement of red blood cells is then rendered as a two-dimensional image [20] in which the area with reduced flow indicates the most hypoperfused area and the target area for treatment. The physician only needs to perform needling or to inject hyaluronidase into the embolic angiogram to become precisely detected by the device. Accurate delineation of the hypoperfused region limits the area subjected to needle punctures and hyaluronidase dose, resulting in less discomfort for the patient and better outcomes.","title":"Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review"}
{"_id":"89dd3f66-b47d-7687-1732-fa98bf6e7a59","text":"Table 1 Univariate analysis of Demographics, Comorbidities and Surgical Factors in relation to presence of DVT after TKR","title":"Chemoprophylaxis in addition to mechanical prophylaxis after total knee arthroplasty surgery does not reduce the incidence of venous thromboembolism"}
{"_id":"89eb07d9-04cf-7100-4854-315db4e0d651","text":"Much of the known orthopaedic experience of NPWT dressings has been with their use in children who develop a deep spinal infection following spinal fusion and instrumentation. Most of these operations were carried out in children who had cerebral palsy, spina bifida or neuromuscular scoliosis. Removal of the metalwork in these children would be associated with significant complications, and many novel techniques have therefore been tried in this specialised subset of patients to try and cure the infection while still retaining the implants. Using VAC® therapy, Canavese and Krajbich report that they were able to retain the metalwork in 32\/33 patients, and cure the infection in 30\/33 patients while van Rhee et al stated there were no signs of chronic infection in 6\/6 neuromuscular scoliosis patients using VAC® therapy and retaining the metalwork.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"89eb73c9-191c-bcfc-480c-7dc60a54738e","text":"Microsurgery is highlighted in the scope of plastic surgery. With this technique, the surgeon can transfer tissues to correct complex wounds. This branch of surgery has become increasingly necessary with the evolution of cancer treatments and changes in the profile of trauma mechanisms1 , 2. This subspecialty is particularly useful in plastic surgery since in school health services it is up to reconstructive surgeons to solve these challenges2.","title":"Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery"}
{"_id":"89f165b9-2676-9d5d-77d0-0983b30c1069","text":"Students with global surgery interest selected for the DGH or CGS programs were partnered with Colombian students and faculty mentors based on their specialty and regional choices. The students were mentored by international ACS faculty pairs composed of RWJMS assistant professors of surgery and Colombian university surgeons engaged in global SSS activities. Research project development and relationship building was initiated through a student performed needs assessment of a particular aspect of the Colombian surgical system. The resulting research project informed the timing and activities for the two planned international rotations (during the first and graduating years of medical school). These two one-month rotations were structured to fulfill DGH and CGS programmatic cultural immersion and research requirements [10].","title":"A longitudinal surgical systems strengthening research program for medical students: the exploration of a model for global health education"}
{"_id":"89f307ce-4bfc-49b8-9d01-c9a53dcd7017","text":"The chest wall can be home to both benign and malignant tumors.","title":"Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience"}
{"_id":"89fa76a5-45d7-f5da-4266-88ec9375fe6d","text":"It is important to note that MR imaging does not expose the patient to ionizing radiation, so it can be used to monitor lesions under treatment.","title":"Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis"}
{"_id":"8a184849-04f2-037d-fd57-d7a4c662a5a0","text":"The early and late toxicity of the radiation therapy and application procedure was analyzed. Complications from the application procedure and acute toxicity were assessed in all 28 patients, and late toxicity was assessed in 20 patients. The data are presented in Table 4.","title":"Interstitial HDR Brachytherapy in the Treatment of Non-Melanocytic Skin Cancers around the Eye"}
{"_id":"8a2458e9-4498-8e4b-4e78-362df80205d1","text":"The reconstruction following resection of head and neck cancer has come a long way with multiple options including various local and free flaps. Each flap has advantages and disadvantages with respect to extent of cancer, patient and resource factors. In recurrence following multiple cancer-directed treatment and resource limited setting, simple and easily reproducible local flaps are the workhorse of the head and neck reconstruction. We have described the technique of the CCP flap after considering above factors and found it useful in reconstruction of large defects of upper neck.","title":"The contralateral based Cervico-pectoral rotation flap for large neck defects"}
{"_id":"8a2febd1-1a10-27d2-5a0a-17888303c6e4","text":"Skin cancers are classified into melanoma and non-melanoma or keratinocyte cancers. No recent data are found about the epidemiology of skin cancers in Saudi Arabia. The current study aims to determine the burden of skin cancer in the last 11 years from 2011 to 2022.","title":"The Burden of Skin Cancers in Saudi Arabia Through 2011-2022"}
{"_id":"8a3c8463-0fc2-5a98-6ea4-8ec2fe472e51","text":"In addition, a viable soft tissue coverage of the distal lower limb was reverse sural artery fasciocutaneous flap that has been reported with acceptable outcomes in carefully selected patients. The hind foot defects are the most difficult to reconstruct successfully and are infamous with high rates of complications and final amputation, particularly if open calcaneal fracture is present. Informed early decision about amputation should be discussed with the patients before reconstruction procedures; as many limb salvage efforts would fail in these patients due to poor functional outcomes, osteomyelitis and infection. Size, location, fracture type and severity in addition to mechanism of injury could predict amputation risk in war-related calcaneal fractures. Amputation could lead to improved activity levels and reduced pain compared with the demanding salvage protocols in these cases.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"8a3cda19-ed56-2519-663f-7cb24b7a6f4b","text":"The main surgical treatment for invasive malignant melanoma consists of wide surgical and examination of the sentinel node and in selected cases complete lymph node dissection. The aim of this review is to present data for the optimal surgical management of patients with malignant melanoma.","title":"Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection for Melanoma"}
{"_id":"8a3ed48f-daab-fbbe-3066-c5177399a93e","text":"A survey of orthopedic hand surgery fellowship programs revealed that as many as 12 papers are discussed in a one-hour conference.15 The most important goal of these meetings is to review the current literature in hand surgery. A slight modification of this format is to have each attendee review one paper from a journal or topic area.17 Each attendee then presents to the group the key contributions of the paper to the topic or specialty area.","title":"Planning and executing orthopedic journal clubs"}
{"_id":"8a4dba2c-c1ea-6611-3d5e-d3a8cc65e9bb","text":"It is difficult to diagnose primary CNS melanoma in the absence of any cutaneous melanosis. A high index of clinical suspicion along with good pathology reporting is the key in diagnosing these extremely rare tumours. PET CT whole body helps to rule out the presence of occult primary anywhere else. It is necessary to differentiate the benign melanocytomas from the malignant melanomas. The preferred treatment option is total surgical excision if feasible followed by postoperative adjuvant therapy with radiation and chemotherapy. The role of BRAF inhibitors, immunomodulating therapies, prophylactic craniospinal irradiation, and intrathecal chemotherapy needs to be evaluated in future.","title":"Primary Intracranial Melanoma with Early Leptomeningeal Spread: A Case Report and Treatment Options Available"}
{"_id":"8a517c9a-396c-041f-dcdd-11a1f045f849","text":"to assess the presence of scar tissue and\/or complete scar excision at histopathology","title":"Long-term oncological outcomes of endoscopic full-thickness resection after previous incomplete resection of low-risk T1 CRC (LOCAL-study): study protocol of a national prospective cohort study"}
{"_id":"8a54fda3-98b1-c8d6-3f57-d749e5343549","text":"Most hospitals do not offer whole leg scans that include the venous system distal to the knee. This is due to the fact that they are not only more time consuming, but they are also technically more difficult. Whole leg scans that do not show a DVT do not typically need repeat imaging to rule out DVT. When proximal leg Doppler scans are negative, repeat Doppler studies are only positive in about 2% of patients. Despite this, having patients follow-up in one week for a repeat venous Doppler after an initial negative study continues to be the standard of care in the emergency department. The continuation of this practice emphasizes the importance of successful diagnosis and the initiation of treatment for venous thromboembolisms.","title":"The Role of Serial Ultrasounds in Diagnosing Suspected Deep Venous Thrombosis"}
{"_id":"8a5ac22b-6b7b-9c2c-f08d-e0051d25909e","text":"Swiss cancer survivors have an increased risk of developing a SPC compared to the general population. This risk is especially high among patients first diagnosed before age 50 years and those surviving at least 10 years. Cancer patients should remain under continued surveillance not only for recurrent cancers but also for new primary cancers. First and second cancers that share common lifestyle associated risk factors are rather common and underlines the importance to promote healthier lifestyles in both the general population and cancer survivors.","title":"The relative risk of second primary cancers in Switzerland: a population-based retrospective cohort study"}
{"_id":"8a5e25f8-d378-453d-06aa-c4344e1d69ce","text":"The recent study by Weinberg and colleagues in trauma patients analyzed the number of units greater than 14 days of age and reported that for patients transfused 6 or more units of pre-storage leukoreduced RBCs that the odds ratio for death was increased for those who were transfused 1 to 2 units greater than 14 days old and that the odds of death were higher for patients who were transfused 3 or more units of RBCs [32]. Although this study did not compare patient groups that specifically matched patients by amount of RBCs, their findings are consistent with the present study results. Not only is there consistency with increased mortality in patients transfused old RBCs there is also consistency in that both studies demonstrate it only takes 1 to 2 units of old RBCs to increase the odds of death and the size of the effect is greater for patients with increased injury indicated by the amount of RBCs transfused. In our analysis patients transfused 10 or more units of RBCs had an approximate doubling of the OR for mortality when compared with patients transfused 5 or more units of RBCs.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"8a71cff6-e0bb-954a-32c7-773f26632002","text":"There is no data monitoring committee planned to be in charge of the trial, since it is a monocentric study with low risk for patient safety.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"8a72d50c-d73d-7fad-7cbb-b5e18fc439b5","text":"For MMS, the tissue is removed from the cancerous area in layers and examined under a microscope in real-time until no more abnormal cells can be seen thereby, conserving a significantly larger portion of healthy tissue. Although the process is quite complex in and of itself, it generally involves a dermatologist removing thin layers of the tissue that needs to be excised and examining it under a microscope. If evidence of cancerous tissue is found, subsequent layers are removed and examined; this process continues until no more suspicious cells can be observed on the slide. Once the cancerous tissue has been completely removed, the wound is closed with sutures or left to heal on its own. This technique offers much more precise control of the complete tumor margin along with the fact that there exist no absolute contraindications to MMS in those deemed suitable for surgery in general [2].","title":"Rise in the Number of Complex Skin Cancers Necessitates Establishing Mohs Micrographic Surgery Fellowships in Pakistan"}
{"_id":"8a85efab-9b82-6057-0b77-39298ddcee43","text":"One interviewee explained how choosing to spend some time working with clinicians had enhanced her practice as a manager in the NHS:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"8a86917a-cd90-9f3a-89f9-9204733093fe","text":"Table 2 summarizes the six different bounding options proposed in this paper.","title":"CNN-Based Approaches with Different Tumor Bounding Options for Lymph Node Status Prediction in Breast DCE-MRI"}
{"_id":"8a891ee1-743e-f395-5198-f27322f6d1cd","text":"Gray scale and CDUS are useful in diagnosis of changes in UC and MCP joints of patients with RA and in monitoring the treatment efficacy.","title":"Gray-scale and color duplex Doppler ultrasound of hand joints in the evaluation of disease activity and treatment in rheumatoid arthritis"}
{"_id":"8a8f91f1-12e2-691f-1331-3947397f6eb7","text":"Retrospective study of pediatric patients with frenulum abnormalities demonstrated the usefulness of the CO2 laser in performing frenectomy and offered suggestions regarding the timing of this procedure.","title":"Clinical Study of Laser Treatment for Frenectomy of Pediatric Patients"}
{"_id":"8a9b84b7-f42f-c1f5-1f6e-07b2a265e2a1","text":"Radiation therapy remains a local therapy, and the majority of patients in this study progressed systemically through their radiation treatments, reinforcing the need for concurrent systemic therapy to control distant metastasis. In spite of this, for patients who were able to be evaluated for biochemical responses after radiation there was a decrease in chromogranin A and catecholamine levels, suggesting a decreased overall disease burden after radiation therapy.","title":"External Beam Radiation Therapy in Treatment of Malignant Pheochromocytoma and Paraganglioma"}
{"_id":"8a9ec24a-7d8b-c893-d51d-d634c5f11cdc","text":"There are a few authors examining the diameter of the vessels in the vascular pedicle of the fibula flap as one of the determinants of its suitability for the head and neck anastomosis. In this regard, They had only examined the diameter of skin perforators. The issue of the vessel diameter may be important as most of researchers addressed microvascular anastomosis to have been carried out on animals vessels at a diameter of 0.8-1.5 mm.28 Therefore, the presence of such thick vessels in the fibula flap provides better microvascular surgery given the possibility of convenient anastomosis.","title":"Evaluation of Anatomic Variations of Fibula Free Flap in Human Fresh Cadavers"}
{"_id":"8a9f9b99-8156-7520-2ad5-d51bdea75071","text":"Color fundus photography of the patient a immediately before GK radiosurgery the lesion has increased in basal thickness and appears enlarging and to extend beyond the previous line of stabilization, and b in December 2017 the tumor continued to regress after the GKR, note the green arrow illustrating change from active fleshy tumor to atrophic one","title":"Gamma Knife radiosurgery for locally recurrent choroidal melanoma following plaque radiotherapy"}
{"_id":"8aa07361-119e-b11d-4670-0cd329fb71a0","text":"Campaign strategy for SunSmart was agreed by the UV Health Promotion Group, whose members include representatives of the National Radiological Protection Board, British Association of Dermatologists and UK Health Departments. It was launched in March 2003 and is due to run until at least 2007.","title":"SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample"}
{"_id":"8aa90eff-e8a0-d9e4-8623-2d69ba5129a8","text":"In the present study, we performed the procedure regardless of clinical or ultrasonic characteristics. FNAC was applied routinely even for those without clinical or imaging evidence of node metastasis in a highly suspicious breast malignancy. Cytology results were compared with pathology after SLNB or ALND.","title":"Sparing sentinel node biopsy through axillary lymph node fine needle aspiration in primary breast cancers"}
{"_id":"8aae98d9-e47d-4e02-de8f-299562c2ac79","text":"Craniofacial surgeons practice in academic settings more often given that most craniofacial patients present in large academic hospitals. In academic settings, craniofacial surgeons, and to a degree microsurgeons, have more resources and opportunities to publish and take on leadership roles within their institution.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"8aaf2931-ec2a-b774-c4dd-080d1b8c1c8d","text":"The treatment of open fracture involves segmental bone loss and large soft tissue defect along with major vessel injury caused by shotgun injury is challenging. Free vascularized osteocutaneous flap such as fibula and iliac crest flap have been reported as reliable flap with satisfactory results [7]. However, the integrity of lower leg vessels is mandatory for the success of this treatment. The injured anterior tibial artery with large trauma zone was an obvious contraindication for free flap reconstruction.","title":"Reconstruction of Gustilo type IIIC tibial open fracture caused by shotgun injury using combination Masquelet technique and cross-leg pedicle flap"}
{"_id":"8ab2cc8a-b053-7fd1-f65a-f4f82748c77b","text":"The number of HSCT patients referred from the oncologists per year has been around 40 (41 in 2005, 37 in 2006) and this figure may increase due to the widening application of HSCTs as a treatment modality. The WGH dental department currently runs four dentist sessions per week, treating just over 100 medically compromised patients per month. This service is supported by one hygienist session per week. As the most common reported conditions in this study population were periodontal, recommendations for the future could include increasing the role of hygienists in treating these patients. Other recommendations include the distribution of further written guidelines for colleagues at distant regional SPCDS clinics to whom the responsibility of pre-transplant dental assessment and care is passed. These would build upon the existing broad RCS guidelines, reflecting more recent experiences and being specific to HSCT patients.","title":"Dental assessment prior to stem cell transplant: treatment need and barriers to care"}
{"_id":"8acd80a5-c6d9-c34d-8541-d09a654b0d4c","text":"Late hemodynamics studies demonstrated the possibility of saphenous vein graft patency between coronary arteries that received sequential bridges, even when these grafts were completely occluded at its origin. The aim of this study was to evaluate the flowmetry of coronary-coronary saphenous vein graft.","title":"Intraoperative model to flowmetry measurement from coronary-coronary saphenous vein graft bypass"}
{"_id":"8ace211a-6b5a-9892-04a6-a1c9a8c9b3c6","text":"Skin scar is often created in cases of deep burns of grade II and grade III and IV that will usually require skin graft.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"8aceeb9e-2cb1-358b-747e-39cb29e3d725","text":"The exclusion criteria for chronic osteomyelitis in this article are as follows:","title":"MRI Manifestations and Diagnostic Value of Chronic Osteomyelitis"}
{"_id":"8ad13489-d0ec-ef6a-a14c-2d8b067b57d9","text":"The elaborate design and appropriate utilization of the costal cartilage for base frame sculpting is a crucial and fundamental procedure in microtia reconstruction, which is as important as the other projected structures. They contribute to achieving a natural appearance of the auricle with harmonious integrity at follow-up.","title":"New strategies for base frame fabrication in microtia reconstruction"}
{"_id":"8ad2191f-fe6b-2a56-6f8a-2ff92c769423","text":"Our experience suggests that LGV and SpV anastomosis prevents gastric venous congestion and that gastric outflow preservation is important. It is vital that suitable revascularization be performed to avoid sinistral portal hypertension. To conclude, LGV and SpV anastomosis can be an effective option to prevent gastric venous congestion when performing TP.","title":"Surgical treatment of gastric venous congestion in association with extended resection of pancreas: a case report"}
{"_id":"8ad22ed8-79dc-b10c-cc0e-0b08f35afeed","text":"The study was approved by the Institutional Review Board and informed consent was obtained from the participant to show her clinical photographs.","title":"Bipedicle Frontal-Occipital Flap for Reconstruction of Post Avulsion Injury of Scalp Temporoparietal Region: A Case Report"}
{"_id":"8adc3036-b592-5b84-9cc1-fd9d2e7825df","text":"There were some discordant results for patient satisfaction. Although most of the patients with optimal clinical results had high scores on the questionnaire from the Michigan Breast Reconstruction Outcome Scale, indicating a high degree of satisfaction; some patients, despite good clinical results, reported low personal satisfaction. This finding may reflect the extremely high expectations of some patients who undergo breast reconstruction. Some of these patients may not understand that a breast reconstruction is not a cosmetic mammoplasty. We observed this finding more commonly in patients who underwent to immediate breast reconstruction instead of a multistage procedure.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"8ae75702-03e6-c025-0c61-aebf600cf60a","text":"Omalizumab should only be administered by a physician or registered nurse who is trained in the recognition and treatment of anaphylaxis; and","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"8ae8d074-ce07-c58b-eaa9-04673a453b24","text":"Although the medical and surgical management of osteomyelitis of the spine is sufficient for most cases, severe cases of infection especially in high-risk patients require novel treatments to improve drug delivery and overcome drug resistance. Several treatment strategies have been identified and few have entered clinical studies. These primarily include improved drug delivery vehicles and combination therapies.","title":"Osteomyelitis of the spine: treatments and future directions"}
{"_id":"8aea740e-807b-4ad6-610a-b8a4f7898de0","text":"Univariate and multivariate analyses were used to determine variables predictive of margin positivity and were conducted separately in patients who had resectable and locally advanced rectal cancer. Univariate analysis used the chi-square and Fisher exact tests; patients with unknown values were excluded from the analyses. A 10% significance level was used as the cutoff to enter variables into the multivariate analysis. Multivariate analysis used logistic regression and included only patients with known values for all variables evaluated.","title":"Predictors of positive radial margin status in a population-based cohort of patients with rectal cancer"}
{"_id":"8aed758e-e463-d209-055a-3107fc034f6c","text":"The fibrin clot shows the surgeon the site of anastomosis, should problems occur and revision surgery be necessary, which is particularly useful when a surgeon unfamiliar with the case is on call. The guidepost of a fibrin clot helps in our own revision surgery and allows the surgeon to reach the site of the microvascular problem much more quickly and finally save some of the flaps. Once the site of the anastomosis is found, the fibrin clot can easiy be removed by pickup forceps and suctioned off. If the problem is other than the anastomosis, then the problem is solved and the flap is placed back into position. Another advantage is protecting the fragile pedicle from disturbance by a plastic drain; we have observed flap losses due to pedicle torsion after removing a drain.","title":"Fibrin glue as a protective tool for microanastomoses in limb reconstructive surgery Fibrinkleber als protektives Hilfsmittel bei Mikroanastomosen in der Extremitäten erhaltenden Chirurgie"}
{"_id":"8af44586-48d6-170a-e104-f2402036fee6","text":"The LD flap could be a safe method for breast reconstruction. It was shown in some studies that the flap would give enough volume for reconstructing of small to medium breasts and in some cases, if It is necessary, a lot of tissues would undergo extended LD flap procedure. On the other hand, prosthesis was used, but a proper decision of the size was difficult. Throughout a one-stage operation involving LD flap and an implant, an oversized skin paddle was employed to enhance the degree of the mastectomy skin envelope, thereby letting the foremost conceivable implant to be used for reconstruction. An oversized implant was important as a result of LD muscle atrophies during first year after operation and its final contribution to the volume of the breast was doubtful.","title":"Latissimus Dorsi Musculocutaneous Flap Inset Innovation in Breast Reconstruction"}
{"_id":"8afac0ad-bb31-64b5-4842-78d8bf8a768f","text":"To establish which of the above strategies will help most effectively integrate AI into your specific plastic surgery research project or practice, it is important to gain a more granular understanding of the mathematical principles behind AI.","title":"A Practical Approach to Artificial Intelligence in Plastic Surgery"}
{"_id":"8afb9c20-ea3c-2cbc-5fbc-ce6d87a63811","text":"Postoperatively, patients are mobilised the day after surgery and are discharged home the following day. The standard protocol for the management of the CSD system was to continue drainage until the daily output total was less than 30 ml in a 24-h period. CSDs were taken off suction at 5 days and continued with ‘free’ gravitational drainage until removal. The philosophy behind this protocol is to prevent propagation of the lymphorrhoea at the drain site by the negative pressure in the cavity. In the case of the 2-LNPWT system, the entire dressings were changed every 3–4 days by the plastic surgery nurses in the dressings clinic until the canister demonstrated little or no drainage over a 24-h period. This was a clinical judgement based upon the volume of altered silica gel compound in the canister at review. In all cases, the drainage period recorded was the number of days calculated from the date of the surgery to the date of removal of the drainage system.","title":"Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma"}
{"_id":"8affacff-0e95-01aa-97c5-586a24a7f4dd","text":"Surgeons who perform the SLN procedure as part of their clinical routine are allowed to perform TAS. TAS is feasible for all surgeons who master the SLN procedure since the only difference is the selective removal of palpable disease, which we expect to be a frequent step in the clinically node-positive patient population of this trial. However, thorough palpation of the axilla is also mandatory during the regular SLN procedure in current clinical practice to remove suspicious findings and minimize the false-negative rate. The difference is that during the regular SLN procedure that is performed as a staging procedure, this step is rarely necessary since it is only performed in clinically node-negative patients.","title":"Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial"}
{"_id":"8b078cef-0855-8258-58d9-f1ab346c7b27","text":"Introduction: Pharmachild is an international registry involving over 100 PRINTO\/PRES centres in 38 countries. The registry was set up to evaluate long term safety and efficacy of treatments in children with JIA","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"8b1a0c1e-40e2-a984-476d-db2ee4299929","text":"The slowdown of metabolic activities that can lead to slowing down of the movement of antibiotics and increasing the chance of it being degraded is due to longer exposure and increasing its resistance to the antibiotic. These events have led to the discovery of substances to penetrate the biofilm matrix and destroy it. These are collectively known as lantibiotics and are different from antibiotics as they act on biofilm, not bacteria.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"8b21e9cb-5196-3bfa-466f-25459c4149c0","text":"To assess the degree of patient satisfaction one year after the cosmetic rhinoplasty in a medical residency facility, using the ROE questionnaire.","title":"Long-Term Evaluation in Aesthetic Rhinoplasty in an Academic Referral Center"}
{"_id":"8b2c8dd9-40ea-1e9b-9e6a-a37961362363","text":"Formaldehyde complicates the dissection of hilar and peripheral lymph nodes, and specimens should be dissected without exposure to formaldehyde solution. Although not included in the 8th TNM staging, it is much easier to detect multiple N1 lymph node positivity of fresh specimens; it can be important for prognosis. We recommend performing N1 lymph node dissection on fresh specimens after the surgical resection of NSCLC for more accurate staging outcomes and determination of an accurate prognosis and treatment strategies.","title":"N1 lymph node detection in lymph node harvesting in non-small cell lung cancer: Formaldehyde exposure is a drawback?"}
{"_id":"8b35784b-7c75-5126-2bac-06b6b30cbfa4","text":"ESBs are performed by inserting the local anesthetic ventral to the erector spinae muscle. Superior analgesia has been observed when comparing ESBs to intercostal blocks.","title":"Regional Anesthesia With Paravertebral Blockade Is Associated With Improved Outcomes in Patients Undergoing Minithoracotomy Cardiac Surgery"}
{"_id":"8b3b8817-468e-8f82-e520-0614c61e7d65","text":"Our results demonstrate that adult periosteal flaps are able to promote bone growth on devascularized adult metacarpals. Ongoing smoking does not seem to prevent achieving bone union, nor does the absence of cancellous bone graft. The color Doppler imaging confirmed that the flaps were perfused at 10 days. We cannot exclude that the sturdy plating provided enough stability to allow by itself bone union however, this seems unlikely since bone devascularization was evident during surgery.","title":"Periosteal medial femoral condyle free flap for metacarpal nonunion"}
{"_id":"8b3d9311-d293-68b2-490f-73a23571fc40","text":"The carved grafts were immersed for 30 minutes in isotonic sodium chloride solution and kept at room temperature. The resulting segments of cartilage might have trimmed edges or to be cut to the desired length and shape without causing the eventual warping. Through an open approach, septal mucosal flaps were elevated in a standard fashion and the cartilage remnants were exposed. Using a segmental reconstruction graft, the remained framework might be reinforced or rebuilt depending on the presence of a caudal or dorsal cartilage strip. Fine adjustment of the height and length of the new septum would be possible by segmental reconstruction.","title":"Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty"}
{"_id":"8b470f3a-270e-a904-3713-857e98d71612","text":"The cephalic vein is a viable option as a recipient vein in free flaps being used in vessel-depleted necks during head and neck reconstruction. It should certainly be considered an option as opposed to the contralateral IJV in cases where there is a high likelihood of recurrence of the carcinoma, so as not to complicate future prognosis and treatment.","title":"Use of Cephalic Vein for Venous Anastomosis in Head and Neck Reconstruction: A Case Series Rahman et al"}
{"_id":"8b51f2d0-6ca0-98a0-cff1-93f9816a2da0","text":"As recipient vessels, the radial artery and two accompanying veins as well as the cephalic vein were prepared under the microscope. The radial artery was severed and the proximal end was anastomosed with the posterior radial collateral artery, while the distal end was anastomosed with the medial collateral artery as a flow-through flap. The two accompanying veins and the cephalic vein were connected using vein couplers. The soft tissue defect could be closed without tension, with the proximal part covering the vessels anastomoses.","title":"Thumb reconstruction after radical tumor resection using free osteocutaneous lateral arm flap with secondary humerus fracture—a case report"}
{"_id":"8b534ebe-e804-e2bb-e20c-b1146f8e7ab7","text":"Localised pixel comparisons between images was used as the method of choice for the detection of axillary lymph node involvement, because of the disadvantages of global linear regression mentioned above. Prior to statistical pixel comparison an image normalisation or pre-whitening stage is carried out. Besides aiding in the detection process directly this image normalisation process has a second important consequence. When performing a statistical test upon a set of data then the power of any such test is directly dependent upon the assumption of independence on each element within the data set. But in the case of image data such independence assumptions are seen not to hold by virtue of each pixel being highly correlated with its neighbours. This interpixel correlation is a consequence of the imaging equipment's finite point spread function or resolution at the short scale, and, at larger scales from sampling common large underlying structures such as the liver in immunoscintigraphy. The image normalisation process ensures a significant pixel to pixel decorrelating effect and therefore the independence requirement of a chosen statistical test is largely met. This normalisation process takes the form of a transformation described by the expression:","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"8b594790-8500-0001-346e-98f362bb2be5","text":"Three separate 0.5 cm vein samples were taken from each saphenous vein. The first sample was taken from the distal portion of the saphenous vein graft immediately after removal and fixed in formalin.","title":"Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery"}
{"_id":"8b5bf815-a1fa-85e3-deda-c59cf84b38b3","text":"Due to the presence of dirt embedded in the edges of the scalp defect and periosteum, a radical debridement was performed, and the open wound was dressed with Xeroform and gauze. Intravenous antibiotics was administered for a week, and daily wound care was done for 12 days.","title":"36-year Follow-up on Scalp Reconstruction Using Free Latissimus Dorsi Muscle Flap, Skin Grafting, and Scalp Expansion"}
{"_id":"8b668e6c-f8c7-3792-2725-f73fdfd61d25","text":"A 27 year-old unmarried female presented to our hospital with worsening pain of the right chest wall region and a recurrent obvious mass adjacent to the lower-inner quadrant of her right breast for 5 months. Two years prior to her current presentation, she presented to a local hospital with a palpable right chest wall mass close to the same quadrant of right breast and underwent a surgical resection. The histological examination showed a typical picture of an aggressive fibromatosis.","title":"Management of a female with recurrence of fibromatosis of the chest wall adjacent to the breast: a case report"}
{"_id":"8b670e1d-213d-14ef-cfed-34e7813f52dd","text":"Because a compression injury often causes neuritis, it is essential to evaluate the surrounding muscles of the nerve during an ultrasound examination, and we therefore included the piriformis muscle, gemelli muscles, internal obturator muscle, and middle gluteal muscles in the musculoskeletal ultrasound examination. The purpose of this study was to describe the ultrasonography technique and discuss the ultrasonographic findings of the sciatic nerve and deep gluteal muscles in 29 dogs with suspected sciatic neuritis.","title":"Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis"}
{"_id":"8b675f05-20bb-4a92-a126-a2d84e87666d","text":"Therefore, the objective of this study is to provide oncologists and primary care physicians managing cancer patients with a therapeutic algorithm based on an extensive literature review of cosmetics associated with targeted therapy for cancer as well as the expert’s opinion based on their experience with the use of dermatological skin-care products and cosmetics.","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"8b6ab54f-2209-27e2-5e82-096a0271ea27","text":"Last but not least, our study noted an apparent correlation between proximal DVT as well as bilateral DVT and the development of PE. All the PEs that had an accompanying DVT in the study had proximal DVT. Li et al. had identified a similar relationship in her study which showed the risk of developing a silent PE in patients with proximal DVT [36]. Larger scale studies would be beneficial in further investigating this possible relationship. Strengths of our study are that we have a large cohort of patients in a 10 year follow up period with no loss to follow up in the public sector. This is due to our National Electronic Healthcare Registry in Singapore which combines patient information in all our public hospitals. However as it does not include the private hospitals, there could have been loss to follow up to private institutions during the study period. Care was also standardized across the study as the methods were part of the hospital protocol. It is also one of the first studies to show a difference in functional outcomes scores (SF-36) between the type of thromboprophylaxis for total knee arthroplasty. A limitation of our study is that we employed the usage of Doppler Ultrasound, which is operator dependent. Thus we could have missed out on certain DVTs that could have been picked up by venograms.","title":"Chemoprophylaxis in addition to mechanical prophylaxis after total knee arthroplasty surgery does not reduce the incidence of venous thromboembolism"}
{"_id":"8b6c3c17-214a-8a92-b44c-6d1c9b7c0aaf","text":"Another difference between the results of the Schmidt et al study and this current study is the absence of two 4th IMAPs in the examined 10 breasts in the Schmidt et al study and presence of the 4th IMAPs in all the examined 20 breasts in this current study. Up to our knowledge, we consider our current study to be the only study—among the English literatures—that addressed exclusively the lower IMAPs, namely the 4th and 5th ones, regarding their size, location, potential number, and their supplying territory in the breasts of living women and not cadavers, and thus additionally proved the possibility of elevating the otherwise discarded inferior mammary dermoglandular tissue in reduction mammoplasties as a flap with known and reliable axial vascular pattern.","title":"Color Duplex Assessment of 4th and 5th Internal Mammary Artery Perforators: The Pedicles of the Medially Based Lower Pole Breast Flaps"}
{"_id":"8b6e01fc-a2c9-fd42-ae71-00979b87c438","text":"Salivary gland tumours are best managed in specialized head and neck clinics because of their rarity and need for thorough workup by a multidisciplinary team of specialists. Surgery forms the keystone of their management since it serves both diagnostic and therapeutic purposes. The most important step is in the surgical planning and preoperative counseling. Large or deep parotid lobe tumours, and those suspected to be malignant, should be imaged preferably with MRI in order to decide on the expected extent of resection and to determine the potential risk to the facial nerve. The whole surgical exercise in removing a parotid tumour revolves around careful identification and preservation of the facial nerve. Injury to the facial nerve causes significant morbidity to the quality of life of the patients. Elective selective neck dissection in clinically N0 salivary gland cancer is recommended when the primary tumour exhibits high-risk features. On the same note, postoperative radiotherapy is useful for tumours at risk of locoregional recurrence. The role of chemotherapy is as yet not well established and investigations of targeted therapy are still at an early stage.","title":"Review of Salivary Gland Neoplasms"}
{"_id":"8b88f687-0385-b471-ca3f-f82144f03af3","text":"The only case of recanalization involved a patient with a C4 preoperative classification and factors that could possibly be considered involved in this outcome include presence of thrombophlebitis prior to treatment, which would provoke histological changes to the thickness of the venous wall because of fibrotic tissues, which could reduce the ablative effects; and the fact that the patient was 75 years old and had already been living with venous vascular disease for a long period of time and, because of this, probably had intimal and medial layers that were significantly thicker and responded less to ablation.11 The patient in question had persistent edema. In this case, the treatment was supplemented with a single session of sclerotherapy at the site of recanalization, after which the patient’s clinical progress was as desired, and the treatment was concluded.","title":"Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser"}
{"_id":"8b8a88f8-397b-72b3-6417-cbdf894fad15","text":"Complications were classified according to Paley classification22. A problem is defined as a potential expected difficulty that arises during the distraction or fixation period that is fully resolved by the end of the treatment period by nonoperative means. An obstacle is defined as a potential expected difficulty that arises during the distraction or fixation period that is fully resolved by the end of the treatment period by operative means. Complications include any local or systemic intraoperative or perioperative complication, a difficulty during distraction or fixation that remains unresolved at the end of the treatment period, and any early or late posttreatment difficulty. True complications were divided into minor or major. Minor complications were problems that did not require additional surgery and major complications were defined as either obstacles that resolved with additional surgery or true complications that remained unresolved at the end of the treatment period (Table 4).","title":"Bifocal or Trifocal (Double‐Level) Bone Transport Using Unilateral Rail System in the Treatment of Large Tibial Defects Caused by Infection: A Retrospective Study"}
{"_id":"8b90e044-1e80-8828-d958-04073fef514a","text":"The comparison between PSG1 and PSG2 indicated that there was an improvement in the parameters assessed with the polysomnographic examination.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"8b98980d-049b-c584-e2dd-8c36cdfe5c5f","text":"The aim of this work is to study the role of NPWT in the healing process of vascularized pedicled and free flaps in traumatic lower limbs.","title":"Failure by congestion of pedicled and free flaps for reconstruction of lower limbs after trauma: the role of negative-pressure wound therapy"}
{"_id":"8b99753a-b2c0-10da-9357-ddb8b7391063","text":"The present case has demonstrated how a bioengineered HAV can be used as an arterial bypass conduit in the setting of prior graft infection. This could provide a unique alternative to other graft options for the treatment of infected vascular prostheses. Further studies to demonstrate the utility of this approach are recommended.","title":"Surgical management of an infected external iliac artery interposition graft with a bioengineered human acellular vessel"}
{"_id":"8bb16135-1232-cfa6-02cf-a8479ee762b6","text":"A small number of the patients who have had their surgery delayed may still not have capacity to give consent, for example, those who are unconscious. If the clinical team in charge of that patient’s care do not think that the patient is able to provide clinical consent for their operation, then the research team will approach a consultee for agreement to randomisation. The patient themselves will be approached for consent as soon as the clinical team deem that they have regained capacity following their operation.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"8bc07e68-b5fb-990d-ec26-a97068772a17","text":"Athletes are concerned about skin cancer however, their use of sunscreen is not optimal suggesting reapplication of sunscreen could be targeted in order to reduce the risk of sun cancer. Awareness of sources of Vitamin D other than the sun may also need to be improved potentially through educational interventions and possibly in conjunction with sun smart messages.","title":"Knowledge and attitudes to vitamin D and sun exposure in elite New Zealand athletes: a cross-sectional study"}
{"_id":"8bc15cc4-7968-836c-0a5f-15275b5a082a","text":"The use of only the dermis portion as a graft for the recipient site has also been reported in the literature. The skin is then harvested in two layers from the same site, a traditional split-thickness skin graft of the upper layer including the corneal layer of the epidermis, and a dermal graft of the lower layer. The upper part is returned to the donor site, whereas the dermal portion is added to the recipient site. This procedure has gained significant interest lately, as it has favourable characteristics that address the donor site as well as issues at the recipient area in the traditional STSG procedure. Especially promising is the fact that the dermal graft is very elastic, and so it may lead to a graft that is expandable. In this case, the need for performing a mesh procedure is reduced or at best avoided.","title":"A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft"}
{"_id":"8bc8b444-c449-4815-387c-3260a8897a91","text":"Although the STIR technique is generally considered a robust fluid-sensitive sequence, intravenous contrast agent administration causes a significant decrease of the signal intensity of bone marrow edema-like signal. This phenomenon of suppressed short T1 values of gadolinium containing tissue may obscure pathological MRI findings. STIR images should not be acquired after intravenous contrast agent administration if positive enhancement is the expected effect.","title":"Short tau inversion recovery (STIR) after intravenous contrast agent administration obscures bone marrow edema-like signal on forefoot MRI"}
{"_id":"8bc94db8-c6d5-4ed3-1283-35c95ca254c7","text":"Table 2 demonstrates that, regarding tumor proximity to the osteoarticular structures, recurrences was significantly higher in tumors adjacent to interphalangeal joints. No recurrence was seen in tumors adjacent to periosteum or in tumors with bone invasion as well as in tumors with no contact with bone or joints.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"8bcf15e1-a2e1-252e-7cf5-83b392f726dd","text":"While each of these three trials had different study designs and eligibility criteria, they all reflect the same notion that patients with clinically occult nodal metastases found by SLND can safely avoid completion ALND with equivalent oncologic outcomes.","title":"Targeting and limiting surgery for patients with node-positive breast cancer"}
{"_id":"8bd33465-9c2e-beaf-eb06-08e1f156c633","text":"In one study that evaluates the effects of clopidogrel versus aspirin in patients at risk of ischemic events, clopidogrel therapy was more beneficial than aspirin specially in patients with peripheral arterial disease.16 There are many experimental and clinical studies that showed the beneficial effect of LMWH and aspirin on flap survival, although some others showed no effect. To our knowledge, there are only two experimental studies that evaluated the effect of clopidogrel on flap viability.17,18","title":"The Effect of Enoxaparin and Clopidogrel on Survival of Random Skin Flap in Rat Animal Model"}
{"_id":"8bd8e377-ca0b-e379-e049-cc13fccc3b9b","text":"Participants can choose to discontinue their participation in the trial for any reason. With participant consent, research data obtained up to the point of discontinuation will be retained for analysis. Participants who decide to stop completing PROMs will continue to be followed up for complications and adverse event reporting through the review of their medical records unless they specifically object. Participants who are unwilling or unable to go ahead with their allocated treatment will be encouraged to continue in trial follow-up as per protocol and their alternative treatment recorded by the clinical staff team.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"8bde95c6-d6ce-1174-8367-93ce4e3088c9","text":"The analysis of the intragroup differences according to the classification of localized or referred muscle pain is shown in Table 4. In the BTA group, a significant improvement was found in both localized and referred pain until day 180, unlike the SS and LD groups that did not display statistical significance. In the analysis according to the classification of localized or referred muscle pain, significant intragroup variations were found for the BTA group when comparing RP subgroup with LM subgroup and MP subgroup from day 14 to day 180, signifying that pain relief was significant and prolonged in the mid-term in patients with localized muscle pain (Table 5).","title":"Treatment of Localized and Referred Masticatory Myofascial Pain with Botulinum Toxin Injection"}
{"_id":"8be4bb8e-cf1b-7126-9e21-732552cad1cd","text":"These data suggest the more attention paid by the surgeons in our country to nasal respiratory complaints in the preoperative period, greater dedication during the surgical procedure to prevent subsequent functional deformities and the use of more controlled techniques to prevent creating functional complications in patients submitted to primary rhinoplasty.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"8be513b5-cf59-1ada-242c-984af0669d7c","text":"Soft tissue calcifications in the oral cavity and maxillofacial region are most often detected as incidental findings on routine radiographic examination. But sometimes these soft tissue calcifications can be serious and may need treatment or follow-up of the underlying cause. Deposition of calcium salt as a result of chronic inflammation, necrosis or scarring in injured tissues despite normal phosphorous and calcium metabolism is called dystrophic calcification. A variety of systemic disorders can be associated with this type of calcification but, still, the pathophysiology is not clear. Here we present a case of dystrophic calcification in the floor of the mouth of an 18-year-old female patient associated with dysphagia which was excised by intraoral route.","title":"Dystrophic Calcification in the Oral Cavity Resulting in Mechanical Dysphagia: A Case Report and Review of Calcification in the Head and Neck Region"}
{"_id":"8be97f07-18f0-562e-a800-e24e19101a40","text":"Table 1 Demographic Table: This will include all the following information in both Enoxaparin and Rivaroxaban Arm","title":"Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre"}
{"_id":"8bea488f-40f5-70fe-d563-5121175bf100","text":"Purpose Mohs micrographic surgery has been advocated as the optimal management of non-melanoma skin cancer in the periocular region. It is a technique that is ideally suited to the removal of skin tumours with a contiguous growth pattern such as basal cell carcinoma and squamous cell carcinoma, allowing examination of 100% of the surgical margin. As a result of this total margin control, the technique offers an unsurpassed cure rate combined with maximal preservation of normal tissue. Following excision of a periocular tumour by a Mohs surgeon, the resulting defect usually requires reconstruction. Our objective was to determine whether the size of defect produced by Mohs surgery and the type of reconstruction required differed from the results we would have expected from standard surgery with a 3 mm excision margin.","title":"Oculoplastic reconstruction following Mohs surgery"}
{"_id":"8bec9981-f5fe-6c9b-cce6-fee8db7041d5","text":"The frequency of malignancy in the final histopathology report compared to the clinical diagnosis is presented in Table 3.","title":"Is it Necessary to Send Clinically Diagnosed Benign Skin and Subcutaneous Lesions Excised Under Local Anesthesia for Routine Histopathological Examination?"}
{"_id":"8bfca701-9b2c-963c-35e1-f348b9330834","text":"The mandibular symphysis is the most commonly used intra-oral donor site. The harvested bone is highly osteogenic and provides a scaffold for bone regeneration. The augmented alveolar bone is then adequate enough to allow optimal implant placement. The advantage of the mandibular symphysis as a donor site is that it is readily accessible and carries little morbidity.3 The morbidity can still be a problem for patients and it is important to highlight such morbidities to patients before considering intra-oral augmentation.","title":"An investigation of post-operative morbidity following chin graft surgery"}
{"_id":"8bfdfdae-5b32-89f9-7a56-958b86e601e6","text":"Below we outline the diagnoses representative of the referrals received and analysed.","title":"Complexity of case mix in a regional allergy service"}
{"_id":"8c03d5cd-f5db-49fe-6855-a68d28d66410","text":"We use a bivariate probit model for the following reasons: First, univariate probit or logit models permit statements about the influence of the independent variables on both dependent variables separately. For example, they would permit conclusions on how being male influences either the probability of becoming a general practitioner or the probability of practicing in a rural area. A bivariate probit model also allows us to assess such hypotheses – in addition, it allows us to test hypotheses on how the independent variables influence the joint probability of working as general practitioner and practicing in a rural area at the same time.","title":"Student characteristics, professional preferences, and admission to medical school Charakteristika von Studierenden, berufliche Präferenzen und Zulassung zum Medizinstudium"}
{"_id":"8c09499f-54e6-6ec5-0924-4ceab7a81588","text":"Informed consent for the case to be published was obtained directly from the patient.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"8c0f7793-2a00-dbeb-07d7-2b2e3764b74f","text":"A potential limitation to this study is one that may actually strengthen the results- the fact that the sample is comprised of both part and full time physician leaders who have self-selected to join the ACPE due to their interest in bettering themselves as leaders. As such, these results may be even more important for healthcare leaders to consider, as even those physicians who are committed to leadership still may struggle with role factors that impact their participation. Although one may find issue with whether or not these results are representative of the entire physician leader population, the significance of the relationships in the model speak to the importance of role related factors and positivity for participation of physician leaders. The sample also is diverse with regard to roles and organization size and type, which may offer a more robust interpretation of the findings; however, a more focused study would have the ability to better analyze the impact of the organizational climate across the sample.","title":"The affect of vision and compassion upon role factors in physician leadership"}
{"_id":"8c1134cf-862d-43b1-2f66-15690835ac73","text":"Though no randomized studies exist that directly ask this question, our literature analysis suggests that lymphoscintigraphy imaging is a very useful tool in further reducing morbidity during sentinel lymph node biopsy.","title":"Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature"}
{"_id":"8c136577-0f0d-7dd4-094f-422e5f78b942","text":"The study protocol specified that treatment was discontinued if the horse showed moderate skin changes in the area treated for more than two days, if the horse showed mild abnormal physical examination parameters for five days or moderate abnormal physical examination parameters for three days, and in the case of significant illness or general deterioration in the condition of the horse.","title":"Effects of Topically Applied Betulinic Acid and NVX-207 on Melanocytic Tumors in 18 Horses"}
{"_id":"8c13873e-4a17-2dec-a8b9-1b0580a3bed7","text":"This study aimed to investigate the potential influence of smoking on microvascular free flap perfusion in head and neck reconstruction. Smoking is a patient factor of increasing interest, as there is a high prevalence of smoking patients undergoing reconstruction with microvascular free flaps in the head and neck region after ablative cancer surgery, and smoking has been linked to cardiovascular changes that may affect flap perfusion, a critical factor for flap survival. Previous studies have mainly focused on the relationship between smoking and flap survival without considering flap perfusion. Only one study investigated the influence of smoking on the flap perfusion of microvascular rectus abdominis free flaps used for breast reconstruction, reporting a decrease in flap blood flow in smoking patients. It remains unclear whether smoking affects microvascular free flap perfusion in the RFFF and ALTF used in head and neck reconstruction, and whether similar flap survival rates in smokers and nonsmokers could be due to unimpaired flap perfusion in smokers.","title":"Smoking and microvascular free flap perfusion in head and neck reconstruction: radial free forearm flaps and anterolateral thigh flaps"}
{"_id":"8c254b55-4b10-cec4-93c2-715e7b9f50b3","text":"Continued technological innovation and advancements in the medical field has made it possible for surgeries that were once thought to require an open approach to now have more minimally invasive options. One of these less invasive options is the use of cryoablation. Cryoablation is a minimally invasive radiology technique to percutaneously target abnormal tissue and freeze them to extremely low temperatures resulting in cytotoxic effects and destruction of intracellular contents (1). Cryoablation has been used in the treatment of multiple solid malignancies, including liver, lung and renal malignancies. The use of cryoablation for the treatment of small breast cancers and focal sites of metastatic disease has continued to gain traction with patients and providers as the procedure is minimally invasive and can be performed in an outpatient setting given the procedure requires only the use of local anesthetic. Even more revolutionary is the idea that cryoablation may lead to increased expression of tumor specific antigens which the body can recognize and use to better identify and eradicate cancer cells especially when combined with immunotherapy agents (1).","title":"An update on the use of cryoablation and immunotherapy for breast cancer"}
{"_id":"8c27eb8a-b4e6-61b0-69e6-1062aa3e6475","text":"Parents of these 2 presented cases have given their consent for the case reports to be published. The signed consent form was obtained prior to the submission of this manuscript.","title":"Marked improvement of neuropsychiatric symptoms following control of allergy symptoms with the use of humanized murine anti-IgE antibody (omalizumab) in 2 patients with severely limited expressive language"}
{"_id":"8c2ccf59-ac2e-9d88-745a-69992be63593","text":"Depending on the size of the defects, small and moderate size scalp defects can be managed with various available local flaps. But sometimes the availability of local flap is questionable and has got certain limitations in case of large defect. For a large defect, even a free flap can also be used but it might be disadvantageous, as it takes a long operating time and the relatively high donor site morbidity-.","title":"Bipedicle Frontal-Occipital Flap for Reconstruction of Post Avulsion Injury of Scalp Temporoparietal Region: A Case Report"}
{"_id":"8c30f58a-376d-7710-bdbd-3b02a50fd83c","text":"The primary aim of this study is to determine if the use of chemoprophylaxis in addition to mechanical prophylaxis after primary TKA reduces the incidence of postoperative VTE in an Asian population. The secondary aim is to identify risk factors associated with increased incidence of thromboembolism after TKA. Our hypothesis is that additional chemoprophylaxis is effective in reducing the incidence of VTE after TKA.","title":"Short-duration chemoprophylaxis might reduce incidence of deep vein thrombosis in Asian patients undergoing total knee arthroplasty"}
{"_id":"8c3a04f1-b8b4-24ed-c5e0-b327be09c051","text":"We note that existing literature on trauma mostly deals with initial assessments, with few studies discussing qualitative prognoses. This study aims to explore the association between the involvement of the PS department and qualitative prognoses for severe trauma patients, and will establish the contribution of plastic surgeons in treatment of major trauma.","title":"Association between the participation of the plastic surgery department and qualitative prognoses in severe trauma patients: A retrospective observational study"}
{"_id":"8c401ca6-38cc-383b-782a-a1fe77188de1","text":"All patients attended physiotherapy three times a week for at least 3 months. Such therapy included relaxation of the muscles around the shoulder girdle, gleno-humeral mobilisation and passive capsular and muscle stretching were applied to avoid pain. At home, patients were instructed to follow through with a home flexibility programme once every 4 to 5 h for the first week after the procedure. The programme included five repetitions of passive stretches for flexion utilising a cane.","title":"Results of repeat manipulation under ultrasound-guided cervical nerve root block with corticosteroid and local anaesthetic injection for recurrence of frozen shoulder"}
{"_id":"8c420bde-e41a-3de8-364e-596549cbbf44","text":"The feasibility phase will take place in five centres over a period of 6 months. The main trial will run, as described below, with the addition of a qualitative substudy assessing patients’ experience of giving consent for the trial and the acceptability of the trial procedures to patients and staff. Screening logs will be kept at each site to determine the number of patients assessed for eligibility and reasons for any exclusion. In addition, the number of eligible and recruited patients, and the number of patients who withdraw will be recorded.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"8c45c332-a556-cd6c-d34e-af444f6a079e","text":"Approximately 2% of all breast cancers occur in women between 20 and 34 years of age and 11% in women between 35 and 45 years. Given the relatively young age at diagnosis and initial treatment, there is a risk of recurrence during the reproductive years. The overall risk of recurrence and timing of recurrence in the context of pregnancy is difficult to evaluate due to the complex associations with other predisposing factors such as age at diagnosis, prior pregnancy history, age at menarche, and family history. Additional considerations include whether or not pregnancy itself affects the long term survival for patients with breast cancer, and whether or not the timing of pregnancy affects any risk of recurrence.","title":"Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review"}
{"_id":"8c4c137f-347a-27ba-6f5a-b7b113b60b4f","text":"The purpose of this multicentre, international case series is to report outcomes of patients with locally advanced periocular BCC who have been treated with vismodegib.","title":"Vismodegib for periocular basal cell carcinoma: an international multicentre case series"}
{"_id":"8c51cff1-d583-20bc-e42f-983dc9810b6f","text":"Compared with nerve stimulation alone, ultrasound with or without nerve stimulation enables the accurate placement of local anesthetic around peripheral nerves and reduces the incidence of vascular puncture, thereby leading to a reduction in the rate of analgesic rescue. However, there was no significant difference in the frequency of rescue analgesic administration for ultrasound guidance with or without nerve stimulation. Furthermore, the addition of nerve stimulation to ultrasound guidance required a long procedural time without any beneficial effect on the success rate of the ultrasound-guided block. Nevertheless, nerve stimulation was used in combination with ultrasound in the present study because ultrasound guidance alone or the combination of the 2 guidance techniques cannot completely prevent intraneural injections that cause neurologic complications.","title":"Comparison Between Ultrasound-Guided Supraclavicular and Interscalene Brachial Plexus Blocks in Patients Undergoing Arthroscopic Shoulder Surgery A Prospective, Randomized, Parallel Study"}
{"_id":"8c52e0d4-d183-185d-4c05-400340d94c31","text":"The application of IMRT should be taken into account for metastatic disease to the parotid gland. Metastasis to the parotid lymph nodes should be examined in patients with NPC before initial treatment and after IMRT. For patients with substantial cervical metastasis, we recommend the resection of the tail of the parotid gland and the inferior parotid lymph nodes during the neck dissection. If intraparotid lymph node metastases are detected, we recommend total parotidectomy and adjuvant therapy.","title":"Metastasis of nasopharyngeal carcinoma to parotid lymph nodes: a retrospective study"}
{"_id":"8c577ee6-b5bc-1af5-c26e-1b0c0b43d6ee","text":"The measurement with a corneometer confirmed the protective role of effective creams used in our Departmets routinely during radiation therapy of breast cancer. This allowed us to identify radiation induced dermatitis in a very early stage compared to only objective examination by allowing to treat early stage patients with a greater hydration or with steroid creams to intervene with early onset of erythema.","title":"Preventing the acute skin side effects in patients treated with radiotherapy for breast cancer: the use of corneometry in order to evaluate the protective effect of moisturizing creams"}
{"_id":"8c608f92-771c-b47e-7de8-1fbfdcede08f","text":"Plastic surgery is by excellence a surgery in permanent search for new reconstructive options. In the last 50 years researches in the field of allotransplantation led to obtaining promising results for solving difficult cases when autologous tissues are not available for reconstruction, despite all the bioethical issues of this subject. This field of composite tissue transplantation evolved constantly, the top of it being total face transplantation, successfully accomplished while being based on the knowledge accumulated. There are many clinical applications of CTA, hand transplantation or only flexor tendon apparatus, lower limb, partial or complete face transplantations represent the most important part for us, plastic surgeons for obtaining the best reconstruction possible.","title":"Transplantation of composite tissue allografts. Scientific bases and clinical applications"}
{"_id":"8c6221ca-f9a2-ffb4-0b8e-6986dcce7240","text":"No additional procedures were performed after the transplantation operations, and all the patients completed their treatment in only one procedural session. Oral antibiotics were administered for 3 postoperative days, and no occlusive dressing was needed except immediate compression of the recipient site and donor site for up to 30 minutes. The patients were able to wash their hair 24 hours after the procedure.","title":"Treatment of Postsurgical Scalp Scar Deformity Using Follicular Unit Hair Transplantation"}
{"_id":"8c660621-1890-38de-6743-e51a71688b63","text":"Functional rhinoplasty is a procedure that can bring significant benefits and improvement to the quality of life of our patients, either when performed alone or combined with cosmetic rhinoplasty. Understanding nasal anatomy and physiology is key for successful management and outcomes. Plastic surgeons must be familiarized with several distinct methods that have been described in order to offer the best possible treatment for the patient.","title":"Functional Rhinoplasty"}
{"_id":"8c740ed1-ae98-4860-6232-03c49d3928f4","text":"Patients were identified as being suitable for lymphadenectomy and the procedure was performed after discussion within the multidisciplinary team meeting. The patients were assessed and appropriately counselled by their surgeon, prior to embarking on surgery. The operative technique consisted of standardised open lymphadenectomy which included an oblique elliptical incision extending from the groin crease infero-medially to the apex of the femoral triangle. The extent of the skin excision was arbitrarily determined intra-operatively by the surgeon depending on the available laxity of the skin overlying the femoral triangle. Skin flaps were raised at the level of the superficial fascia to the extent of the boundaries of the femoral triangle. Inguinal lymph nodes were removed en bloc, incorporating the long saphenous vein in the specimen. Large, visible lymphatics were ligated en masse with vicryl sutures at the proximal and distal limits of the femoral triangle. A sartorius muscle turn-over flap was not performed.","title":"Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma"}
{"_id":"8c77a9c0-ec06-cd33-2785-0efd166d35a4","text":"Importantly, patients feel reassured when they are aware their case has been discussed at an MDT and relieved to know that their treatment decision has been made by multiple specialists who have had the opportunity to hear about their specific case.","title":"Breast Radiotherapy after Oncoplastic Surgery—A Multidisciplinary Approach"}
{"_id":"8c7e7654-8129-629b-20b8-3294d8719c94","text":"Ogonda et al 21 and Yhim et al 22 looked at the most patients on aspirin; both had the lowest rates of DVT. These studies justify future prospective studies to be performed into thromboprophylaxis in arthroplasty patients, to determine safer and effective protocols.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"8c847d92-f576-f330-a9e8-aea676a19f2d","text":"Treatment options for those with metastatic and advanced BCC unable to undergo surgery are limited. The NCCN has updated the BCC guidelines to include vismodegib as an option for high-risk patients who have exhausted other options. Although vismodegib produced many side effects in its clinical trials, reduction in tumor size and potential for complete response make it an attractive therapy option for those ineligible for surgery. Vismodegib is breaking down barriers in BCC and has the potential to leave its imprint on the world of oncology while paving the way for drugs with a similar mechanism of action.","title":"Vismodegib: First-in-Class Hedgehog Pathway Inhibitor for Metastatic or Locally Advanced Basal Cell Carcinoma"}
{"_id":"8c8af8bf-bde8-c8fd-6a07-2cb27ae1de19","text":"Antimicrobial therapy was considered not recommended when the antibiotic was active against the identified or presumed aetiologies but showed an excessively wide spectrum of activity. The duration of antimicrobial therapy was considered excessive when it exceeded the limit indicated by the international guidelines.","title":"Inappropriateness of Antibiotic Prescribing in Medical, Surgical and Intensive Care Units: Results of a Multicentre Observational Study"}
{"_id":"8c94dd15-6b92-adf0-153b-c50da312c3b6","text":"Harvesting skin graft from adjacent scalp for scalp defects will solve most of these problems due to quality and color similarity. Hypertrophic scar formation on the scalp is not common, deformity and itching do not occur and mobility is not impaired but harvesting from scalp. Postoperative pain is also less compared to lower limb donor which will in turn translates in to lower DVT rates. The resultant defect or bald area what make patients skeptical and concerned about harvesting from scalp. Presence of numerous skin appendages and rich blood supply give the scalp the ability of rapid re-epithelialization in superficial layers and collagen and elastin synthesis in deeper layers making donor site repair uneventful and suitable. Presence of hair follicles and hair growth however make scalp prone to crust formation and bacterial contamination,.","title":"Outcome of Comparison between Partial Thickness Skin Graft Harvesting from Scalp and Lower Limb for Scalp Defect: A Clinical Trial Study"}
{"_id":"8c9662d8-3324-9307-365f-16fb13a38912","text":"The aim of this systematic review was to evaluate the existing literature regarding color Doppler ultrasonography used to identify perforators for pedicled perforator flap reconstruction and evaluate the associated risk of major and minor complications.","title":"Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps—a systematic review and meta-analysis"}
{"_id":"8c96858c-7748-f52e-d7f7-37bc289a5b41","text":"Due to a substantial gain of knowledge about the clinical risk and outcome of patients with high risk mutations such as BRCA1 and 2, improved diagnostic possibilities for detecting the genetic predisposition for the development of breast cancer and the awareness for those mutations by health care professionals as well as patients, the demand for prophylactic mastectomy has increased significantly over the last 10 years. Many patients with breast cancer in their medical history ask for a genetic analysis. Gene mutations, for example in the BRCA1\/BRCA2 gene, are frequently detected in this context [18]. Similarly, patients without a personal history of cancer but with a high familial risk of developing breast or ovarian cancer can be identified after investigations of mutation carriers in the family environment.","title":"Implant-based immediate reconstruction in prophylactic mastectomy: is the caudal dermis flap a reliable alternative to synthetic mesh or acellular dermal matrix?"}
{"_id":"8c98a7fc-0d91-89e6-834e-b5b683e7216a","text":"According to the ASCO guidelines of 2005, SLNB is not accurate after NACT and thus cannot be offered to breast cancer patients undergoing preoperative chemotherapy. Chemotherapy is often administered before surgery in patients with stage II or III breast cancer, with large primary breast cancer tumors or lymph node involvement, with the aim of downsizing the size of the tumor so that less extensive surgery will be required. Clinical evidence of disease in the axillary lymph nodes often disappears following neoadjuvant therapy in patients who had initially presented with node-positive disease. It is important to determine whether any disease remains in the nodes after chemotherapy, but the optimal way to make this determination is the subject of debate. Do patients in this situation need to undergo complete dissection of the axilla, with its attendant complications, or can they safely be offered SLNB instead?","title":"Controversial Indications for Sentinel Lymph Node Biopsy in Breast Cancer Patients"}
{"_id":"8c9d91ce-0927-98ea-e7a9-1da86546b9f5","text":"This requires careful evaluation of the patient with repeat imaging and a review of the histology from the initial excision. It will usually require more radical surgery with sacrifice of the facial nerve and overlying skin if there is suspicion of involvement by tumour. Super-radical resections of the skull base have not to date shown convincing evidence of improved survival. Consider chemotherapy and\/or RT for palliation.","title":"Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines SALIVARY GLAND TUMOURS: UK GUIDELINES"}
{"_id":"8ca428fb-f202-d2dd-76f1-cbb1ad2a67cb","text":"The main purpose of this study was to clarify the effect on bleeding reduction of the local injection method using TXA after TKA. The CTBL in the local injection group did not show non-inferiority to that in the drain clamping group. While there was no significant difference in HBL between the groups, DBL was significantly higher in the local injection group than in the drain-clamping group.","title":"The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial"}
{"_id":"8ca937d0-563c-3816-55da-85d9149c0691","text":"Less pain, reduced demand for analgesics and reduced time of operation and a shorter period of follow-up are the other advantages of the endoscopic method. Something that makes this procedure unique is the possibility of performing bilateral tympanoplasty at the same time without a necessarily general anesthesia. Three of our cases in this study received sedation and the other six patients received general anesthesia. In the cases of the selected patients with underlying medical problems or patients’ own preference, intravenous sedation can be done instead of general anesthesia.","title":"Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results Timpanoplastia bilateral transcanal por via endoscópica com cartilagem realizada simultaneamente: resultados iniciais"}
{"_id":"8caadaed-7174-09ce-54eb-29d3f9441d3a","text":"Although the mitotic index is an important prognostic factor in the present analysis, it was not observed in patients with T1 melanoma. As presented in the current consensus, the authors agree that the mitotic index should not be used as the sole criterion to indicate SLNB in patients with thin melanomas. Moreover, the present results suggest that even T1b patients should not receive routine SLNB, since positivity is low and no patient had additional compromised lymph nodes.","title":"How does the mitotic index impact patients with T1 melanoma? Comparison between the 7th and 8th edition of the American Joint Committee on Cancer melanoma staging system"}
{"_id":"8cb896b5-3790-6687-fa14-cce0e7b327aa","text":"Although the use of local antibiotics in the setting of infected BKA has not been published, several studies have demonstrated the efficacy of local antibiotics in other settings. For example, the addition of antibiotics to cement has been shown to decrease infection rates in joint arthroplasty. Similarly, placing antibiotic-loaded PMMA beads into an open fracture site has been shown to reduce acute infection rates in Gustilo type IIIB and type IIIC fractures and the rate of chronic osteomyelitis in type II and type IIIB fractures.","title":"Antibiotic Impregnated Cement Dowel in a Tibial Stump to Salvage Infected Below-Knee Amputation in a Diabetic"}
{"_id":"8cb99dca-2647-d150-fc9c-d4fcd3f4e30e","text":"We have demonstrated that whole SLN analysis by OSNA is a highly sensitive, specific and reproducible diagnostic technique in sentinel lymph nodes after clinical node-negative breast cancer patients have undergone neoadjuvant chemotherapy and that TTL can help to predict additional non-SLN metastases in three different risk groups. However, further studies on a larger number of patients are needed to establish a new nomogram, which includes the results of the OSNA assay.","title":"Total Tumor Load of mRNA Cytokeratin 19 in the Sentinel Lymph Node as a Predictive Value of Axillary Lymphadenectomy in Patients with Neoadjuvant Breast Cancer"}
{"_id":"8cc17f3e-c493-c627-919f-198bde5b706a","text":"Outline of the flaps: Incision was extended posteriorly around the earlobe toward the hairline, behind the ear and then downward 2 cm behind the anterior border of the trapezius muscle. It then transverses the clavicle and deltopectoral groove running parallel to lateral border of pectoralis muscle. The inferior border of the flap runs medially parallel to the clavicle at the fourth intercostals space.","title":"Cervicopectoral flap in head and neck cancer surgery"}
{"_id":"8cc31ef0-7234-6518-8944-094b97ce8600","text":"While a comprehensive review of preoperative patient evaluation is beyond the scope of this paper, identifiable preoperative risk factors will be reviewed.","title":"How to Prevent and Treat Complications in Facelift Surgery, Part 1: Short-Term Complications"}
{"_id":"8cc50930-3ef0-dba1-21a7-8fe06dc09224","text":"The aim of this study was to review our experience with bilateral abdominal free flap reconstruction, analyse patient demographic and surgical data, and identify potential risk factors which may predispose to postoperative complications.","title":"Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients"}
{"_id":"8cc9a764-e469-1867-bb63-4d810d4db525","text":"A standardized approach allows the study to be replicated in different areas or over time with the production of comparable findings.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"8cce22b4-490f-6e66-2003-e5aa62809e4e","text":"This study followed the principles of the Declaration of Helsinki and ethical guidelines of the Swedish Research Council. Ethical approval was obtained from the regional vetting board in Umeå (Dnr 2017-141-31M, 20170530). Since MRI of the breast is not performed routinely after prophylactic mastectomy, the investigation was initially performed for a purpose other than research. In 2016, breast cancer was diagnosed in a single patient who had undergone prophylactic mastectomy at the Department of Plastic Surgery at Umeå University Hospital. This led to the decision by the County Council of Västerbotten, as a quality assurance of hospital care, to offer all women who had been treated with this surgery to undergo a MRI of the breast to detect signs of the development of cancer, as well as establish whether the operation had been performed with enough radicality. All patients in this cohort were offered to participate in the study. All participants gave informed written consent that we could take part of the MRI results as well as review their medical records.","title":"Inter- and intra-observer agreement on evaluating the presence of residual glandular tissue with magnetic resonance tomography following prophylactic mastectomy"}
{"_id":"8cdeb867-f8c8-9239-ac87-eec25a49f1e6","text":"Pathology of FES is incompletely understood. FES might be due to direct effect of fat globules entering into the blood stream following tissue damage or alternatively production of fat intermediaries such as chylomicrons or lipids may play a role.","title":"Management of fat embolism co-existing with thromboembolism may be challenging!"}
{"_id":"8ce2899e-9b0f-102a-4b89-bdf726c8c9dd","text":"There are many factors that can contribute to the efficiency of metastatic colonization, including the capacity of cancer cells to outlive within the systemic circulation, the ability to overcome immune surveillance, and the strength to adapt to and thrive in the microenvironment of the distant site.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"8ce2d752-ebb8-067f-e6b7-1667526e2bb3","text":"The case concerns a female 74-year old patient who had undergone several oncological surgery for a relapsing basal cell carcinoma on the dorsum of the nose. It was three years after the last operation and the patient was very keen on a definitive covering of the affected area (Figure 1), which had been made with an epiphysis but which she was no longer able to tolerate. Various reconstructive surgical operations had been proposed to the patient, but she had always refused them.","title":"Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose"}
{"_id":"8cf5e1cd-1c98-24e3-a71e-173d839538cc","text":"The past history from the parents revealed that patient had a trauma to the lower jaw 2 years back and was not taken immediate care. After a couple of months after the injury, he developed recurrent painful extraoral swelling over the right side of the angle of the mandible which was temporarily subsided on medication prescribed by a rural medical practioner. Later, it resulted in cutaneous sinus tracts openings and was referred to our department for further evaluation. The patient and their family members belong to a low socioeconomic status with inadequate access to oral health care professionals.","title":"Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report"}
{"_id":"8cf62252-2d82-563d-005d-1717521e66c0","text":"The presented antibiotic resistance pattern in chronic osteomyelitis with the very high rate of MRSA strains is alarming and calls for updating of the antibiotic therapy guidelines in the country. Although treatment of chronic osteomyelitis is challenging, good results can be achieved by a single-stage protocol including radical debridement in conjunction with systemic and topical antibiotic. The knowledge of different reconstructive techniques is necessary to reconstruct osseous and\/or soft tissue defects.","title":"Chronic Osteomyelitis - Bacterial Flora, Antibiotic Sensitivity and Treatment Challenges"}
{"_id":"8cf6efe6-a5e6-84cb-2b4e-366a2ae17725","text":"The panel found deficiencies in the management of radiation dermatitis that still remain to be addressed, including the following: inconsistent toxicity criteria; subjective grading of reactions that impedes the interpretation of toxicity findings; little evidence to indicate that any of the currently available products can prevent the development of these skin reactions; and insufficient understanding of the biological mechanisms responsible for the skin toxicity of individual agents, as a greater understanding would lead to the development of rational and more effective management strategies for the skin reactions of patients receiving cetuximab\/RT.","title":"Asian expert recommendation on management of skin and mucosal effects of radiation, with or without the addition of cetuximab or chemotherapy, in treatment of head and neck squamous cell carcinoma"}
{"_id":"8cfa5816-0808-0594-b6ed-8a3a7992c890","text":"Although the posterolateral corner of the knee is infrequently injured in isolation, multiple ligament injuries can be caused by both sports injuries and high-energy trauma and severe disability can occur because of the knee instability and secondary degeneration of the articular cartilage. Problems with the posterolateral corner also occur in conjunction with posterior cruciate ligament ruptures; co-occurrence of these injuries is observed in up to 60% of patients. Reconstruction of the posterior cruciate ligament alone has been reported to be insufficient to restore normal activity.","title":"A proposal for a new morphological classification of the popliteus muscle tendon with potential clinical and biomechanical significance"}
{"_id":"8d22d869-3961-55ae-10d7-b8d2db21294d","text":"In conclusion, we present a rare case of acute allergic contact dermatitis to a Brainlab® thermoplastic mask commonly used for immobilization in head and neck radiation therapy treatment. Dermatitis of the head and neck region during radiation therapy treatment can lead to a significant alteration in the radiation treatment regimen. Future suspected cases of allergic contact dermatitis to thermoplastic masks should be reported with allergic contact dermatitis patch testing results if possible.","title":"Thermoplastic Mask-Induced Contact Dermatitis: A Case Report"}
{"_id":"8d2fdee7-9e31-0495-9a34-3d5184fb5b79","text":"The aim of this study is to assess the role of CDUS in detecting DVT in a large population of COVID-19 patients admitted to ICU for respiratory failure.","title":"Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients"}
{"_id":"8d310dcc-4550-8449-a7f9-7906a557ba73","text":"To finally do it—to give up breastfeeding—can lead to both relief and sorrow. Feelings of sorrow occur when the decision to stop is not decided by the mother but by the infant who fails in taking the breast. Sorrow and grief in the process occur because of intentions that are not possible to accommodate—being willing and not willing to breastfeed the infant. Implicitly, the process of stopping the effort of breastfeeding also includes a feeling of becoming independent again and a relief in having made a clear decision.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"8d33f7db-3c99-9f6c-dbb4-cf3262946f6b","text":"We have shown that aspects of facial contrast decrease with age in adult Caucasian female faces, and that facial contrast is associated with perceived age. Faces with lower facial contrast look older than faces with higher facial contrast, and the same face can be made to appear younger or older by increasing or decreasing facial contrast. Thus, facial contrast can be added to the list of known signs of aging. Among the signs of aging, facial contrast is of particular interest because of its clear relationship to cosmetics use.","title":"Aspects of Facial Contrast Decrease with Age and Are Cues for Age Perception"}
{"_id":"8d38c6ba-5839-8e3e-3f7e-ddb06b4e9d82","text":"Whereas repeated antigen exposure resulted in a decrease in T cell numbers by selecting T cells with high-affinity TCRs, B cells repeatedly activated by antigens generate new clones by producing new B cell receptors through somatic hypermutation. There are reports showing that the frequency of somatic hypermutation increased 6 months after SARS-CoV-2 mRNA vaccination. Thus, the generation of B cells with different B cell receptors may contribute to the increase in spike RBD-specific B dcells by the vaccines. We observed a tendency for an increase in memory B cells specific to the Omicron spike protein at 6 months after the 2nd dose. Other reports have shown that memory B cells that recognize spike proteins of variant strains are also gradually generated after the 2nd dose. It is unknown how memory B cells continue to evolve even a few months after vaccination, but these findings suggest that there are already B cells that have the potential to respond to variant spikes even if there are no circulating antibodies reactive to those variants.","title":"Early CD4+ T cell responses induced by the BNT162b2 SARS-CoV-2 mRNA vaccine predict immunological memory"}
{"_id":"8d3e0298-c4e0-65c9-6dc3-2557fa29d75d","text":"Although nipple sparing and skin sparing mastectomy techniques mostly maintain the original dimensions of the breast skin envelope, a variable amount of skin resection is usually needed at the time of mastectomy, depending on the tumor site and the concerns on the marginal skin flap viability. Thus, immediate expander fill volumes usually fail to reach the final desired amount [8], and often several sessions are needed to expand the skin to its original size following mastectomy. Although, the classical effects of tissue expansion may not be observed in those cases in whom the expander serves solely to preserve the native breast skin, dermal and vascular structure changes accompany those cases where skin resection necessitates postoperative expansion to original breast size for optimum cosmesis.","title":"Does partial expander deflation exacerbate the adverse effects of radiotherapy in two-stage breast reconstruction?"}
{"_id":"8d42130f-b1e8-ed49-92f2-62c435c1b760","text":"The simulation data of the dose characteristics of a single NP show a near zero effect of the iron oxide layer on the photon radiation, whereas part of the electrons lose their energy while travelling through the NP. However, this shielding effect on the electron spectra hardly affects the radial dose profile of the RMNP. Only between 200 nm and 300 nm distance of the RMNP the tissue dose profile shows differences between the three shell topologies. As the range of the emitted electrons in water is 30 µm at most, here the electron dose becomes negligible and the X-ray dose dominant. Hence, in the clinical application where the NPs are encapsulated in the RMNP seed, the electrons will not reach outside of the seed and thus will not contribute to the tumor dose.","title":"Feasibility Study on the Radiation Dose by Radioactive Magnetic Core-Shell Nanoparticles for Open-Source Brachytherapy"}
{"_id":"8d45ac2c-281d-1b2f-4c15-d3a87e65b150","text":"The duty of physics in radiation therapy is to ensure therapeutic quality by providing state of the art technical equipment and procedures, maintaining a safe application of radiation for patients, personnel and environment and by minimizing uncertainties in the therapeutic procedures. Intraoperative radiation therapy (IORT) overcomes many of the technical difficulties by applying radiation directly to the surgically opened tumor bed without irradiating healthy tissue in front of the target. Dose to tissues behind the target is minimized by applying radiation with adjusted penetration such as electrons of appropriate energy or low energy photons (X-rays). Organs of risk within the target area can often be mobilized and removed from the radiation field. Treatment is generally performed with single fields of radiation at a fixed distance between source and target surface which allows minimal treatment planning and usually consists of calculating monitor units for the selected energy and a pre-designed applicator which provides an appropriate dose distribution. Dose distributions in water are generally documented in an atlas for a set of applicators and monitor setting is pre-measured for each applicator and energy.","title":"Present state and issues in IORT Physics"}
{"_id":"8d50207e-62d6-f4e8-3e10-6ec57976f3b8","text":"We conduct a case series study. Data about complex oncological cases in which the 3D reconstruction and printing technology was implemented were collected from January 2016 to January 2018.","title":"Three-Dimensional Printed Model and Virtual Reconstruction: An Extra Tool for Pediatric Solid Tumors Surgery"}
{"_id":"8d5055b2-cda8-602b-dfc6-40c70d62895b","text":"Ultrasound-guided combined femoral and popliteal sciatic block for below-knee procedures was found effective in our study with no complications. This procedure is feasible as it can be conducted by a team of emergency physicians trained in ultrasound and facilitates an early discharge of the patient.","title":"Effects of Ultrasound-Guided Lower Extremity Nerve Blocks for Below-Knee Procedures in the Emergency Department of a Tertiary Care Hospital, Central Gujarat"}
{"_id":"8d5196fc-a16d-32ab-06d0-f1b301adf1ed","text":"Soft tissue defects resulting from trauma and musculoskeletal infections can complicate surgical treatment. Appropriate temporary coverage of these defects is essential to achieve the best outcomes for necessary plastic soft tissue defect reconstruction. The antibiotic bead pouch technique is a reasonable surgical approach for managing temporary soft tissue defects following adequate surgical debridement. This technique involves the use of small diameter antibiotic-loaded bone cement beads to fill the dead space created by debridement. By applying antibiotics to the bone cement and covering the beads with an artificial skin graft, high local dosages of antibiotics can be achieved, resulting in the creation of a sterile wound that offers the best starting position for soft tissue and bone defect reconstruction.","title":"The antibiotic bead pouch – a useful technique for temporary soft tissue coverage, infection prevention and therapy in trauma surgery"}
{"_id":"8d541bfe-fb67-749f-4bef-258ddc4c74d7","text":"In addition, a number of considerations regarding the histological response to vismodegib treatment also remain. One such concern relates to the pattern of tumour regression. If reducing the tumour size prior to surgical excision is a goal of treatment in an effort to preserve tissue, it would be important to know the tumour is regressing homogeneously throughout its margin in an effort to excise any residual tumour as a single focus. A previous report demonstrated a case of tumour regression in a multifocal fashion, resulting in multiple foci of tumour in a patient with a partial response to treatment [9]. This would have implications for definitive surgical excision, with the potential for missing a focus of residual tumour and the possibility of recurrent disease.","title":"Neoadjuvant vismodegib in the management of locally advanced periocular basal cell carcinoma"}
{"_id":"8d5a46c3-2286-62bb-50c5-c2365e12f92c","text":"In 2012, our patient was referred to our ophthalmology team because of the persisting symptoms. She had been started on carbamazepine and botulinum toxin injections to her facial muscles, with minimal symptomatic improvement. A second MRI scan was performed and reviewed by a neuroradiologist. This scan suggested vascular compression of her left facial nerve. A vascular loop protocol MRI showed a loop of her posterior inferior cerebellar artery taking a long course around the seventh and eighth cranial nerves into the meatus and back, resulting in compression of her seventh and eighth cranial nerves.","title":"Facial nerve compression by the posterior inferior cerebellar artery causing facial pain and swelling: a case report"}
{"_id":"8d5db5e7-0982-b51c-c758-6f6a45311e3a","text":"It appears that once the grafts became adherent by 4 weeks, they became hypercellular, maximum being by 8 weeks after which they retained a plateau and by 48 weeks they returned back to the normal cellular pattern once the articular cartilage matured.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"8d6e68f5-128e-1d56-536d-b4a21a91b27d","text":"This is an unexpected result as one might expect wound healing to relate simply to the exent of melanoma invasion into the dermis. Thus one would expect that the least invasive melanoma cells (HBL) would not affect wound healing whilst the most invasive melanoma cells (C8161) would cause more tissue destruction with delayed wound healing. The only results which were as expected were shown by A375SM cells which were moderately invasive and led to TE constructs with moderate wound healing characteristics.","title":"Use of a Tissue Engineered Human Skin Model to Investigate the Effects of Wounding and of an Anti-Inflammatory on Melanoma Cell Invasion"}
{"_id":"8d79fd91-56b4-97b3-c189-fadd7e60fda1","text":"CONCLUSIONS This model can describe the bubble area evolution during the acoustic droplet vaporization enhanced HIFU therapy while using a simple linear acoustic model. The model can also be used in the case when a bubble layer pre-exists to protect the distal area from the HIFU ablation. The heating effect can be coupled to the model in the future and then it can be used as a planning tool in ADV enhanced HIFU therapy and predict the treatment outcome.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"8d8351be-5610-8578-5177-7ac5cda3c131","text":"The operative approach is consistent with the general approach to the fracture and dislocation of the cervical spine. For those patients with preoperative skull traction and reduction, after the fracture site exposure, they were treated with discectomy or autogenous iliac bone graft in mandibular reconstruction and fixed using steel plates. For those patients with preoperative skull traction and no reduction, they were treated with corpectomy. Firstly, the proximal fracture was fixed using steel plates. After reduction by mild pulling effect, they were treated with autologous bone grafts and distal fracture fixation using screw. In the posterior approach: expose the lateral block and clean up the broken bone tissue and decompress by biting away the yellow ligament by rongeur on the fracture site. The screw fixation of lateral mass and pedicle was involved in two vertebral bodies in the upper and lower part of the fracture site. After removing the laminar outer cortex by rongeur or exposure of the bone graft bed by grinding drill, the broken bone mass and fracture of spinous were processed into granular for bone graft between lamina.","title":"Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations"}
{"_id":"8d83b339-88c0-368b-2ac0-f431486c4be6","text":"Suggestions for switching to oral therapy according to the intravenous treatment previously performed are given in Table 8.","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"8d892612-6bdb-1b6d-7a81-25d399edfecf","text":"The actinic keratoses were treated with liquid nitrogen cryotherapy. The back lesions were each biopsied using a shave technique. The red dot on the left mid back showed superficial buds and nodular aggregates of basaloid tumor cells extending from the epidermis into the dermis; there were also telangiectatic blood vessels in the papillary dermis (Figures 18-21). The other back lesions and right hip lesion also showed similar appearing tumor cells along the basal layer of the epidermis and in the superficial dermis.","title":"Red Dot Basal Cell Carcinoma: Report of Cases and Review of This Unique Presentation of Basal Cell Carcinoma"}
{"_id":"8d954885-f625-bf29-1faa-3db1dcdc31da","text":"With local control techniques gaining traction as a treatment option for tumor debulking or cure, the role of cryotherapy needs to be assessed further. The aim of this study is to evaluate current evidence on the efficacy and safety of cryoablation for treatment of DT.","title":"Cryotherapy in extra-abdominal desmoid tumors: A systematic review and meta-analysis"}
{"_id":"8d958ccc-5ecc-e189-0674-9dbf8066c928","text":"A higher number of patients is required to increase the study power. The correlation between the degree of graft damage and the early patency rate controlled by computer tomography was not analyzed.","title":"Influence of Three Different Surgical Techniques on Microscopic Damage of Saphenous Vein Grafts—A Randomized Study"}
{"_id":"8da0db90-cff4-369d-ac50-09a641ae79b6","text":"Topical R1 was applied once a day within 2 hours after radiation therapy. R2 was applied 4 times a day, 3 times during the daytime and a last application just before retiring to bed. R1 and R2 skin treatment was applied from the first day of radiation treatment until 2 weeks after the end of radiation treatment.","title":"Topical R1 and R2 Prophylactic Treatment of Acute Radiation Dermatitis in Squamous Cell Carcinoma of the Head and Neck and Breast Cancer Patients Treated With Chemoradiotherapy Manas et al"}
{"_id":"8da60f24-662c-c360-1e4a-005e5b036d89","text":"Flapless implant surgery has many advantages and also certain disadvantages. While contemplating the use of flapless implant surgery based on this study, we should keep in mind that the cases selected for this study were ideal in terms of quantity of bone and soft tissue biotype. There is significant mean difference in the bone loss for baseline to the third month, suggesting the clinical advantage of flapless implant surgery over the conventional technique. The assessment of pain by VAS and number of analgesics suggest that there is significantly less pain in flapless implant surgery when compared with conventional flap technique.","title":"Clinical Evaluation of Placement of Implant by Flapless Technique Over Conventional Flap Technique"}
{"_id":"8daf5230-4ec2-3b34-de1e-5cbe0172fc51","text":"We described the application of a long intramedullary allogenous fibular graft in plate fixation for a periprosthetic distal femur fracture. We hypothesized that a long fibular bone graft would have biomechanics similar to intramedullary nailing fixation. The combination of plating and nailing was considered solid fixation in our patient, allowing for early mobilization and immediate weight-bearing. The patient demonstrated an excellent outcome 4 months before undergoing an open reduction and internal fixation surgery.","title":"Successful Plate Fixation with Long Intramedullary Fibula Bone Graft for Periprosthetic Femur Fracture: A Case Report"}
{"_id":"8db03bb9-3132-8223-b372-965c3c2034ae","text":"Conclusions Complications of cosmetic dermal fillers are becoming more common and should be considered within a differential diagnosis for unusual orofacial swellings.","title":"Beauty is only mucosa deep: a retrospective analysis of oral lumps and bumps caused by cosmetic fillers"}
{"_id":"8db56178-7c13-cb32-356d-6c764a09360d","text":"Anaphylaxis is a rapid-onset severe hypersensitivity reaction that can be fatal. Although death from anaphylaxis is not common and most episodes of anaphylaxis can be reversed by a single dose of epinephrine, severe anaphylaxis accompanied with cardiovascular collapse can be resistant to treatment and result in death.","title":"Anaphylaxis to Iodinated Contrast Media: Clinical Characteristics Related with Development of Anaphylactic Shock"}
{"_id":"8dbba600-8e4c-393f-5787-a65b3ea5c19f","text":"Although desmoid tumors are more common in the second to fifth decades of life, they can appear in younger children and older adults.","title":"Congenital Desmoid Tumor of the Cheek: A Clinicopathological Case Report"}
{"_id":"8dc08c0b-c98e-9701-61b8-ac11e4a016b9","text":"All DT cells included in this study were created at the MD Anderson Cancer Center and at the Sarcoma Research Lab at the Ohio State University. All cells were authenticated and tested for mycoplasma prior to the start of this study and every six months during the duration of the study. This study was conducted with approval from both the Ohio State University and the MD Anderson Cancer Center institutional review board (IRB) with written informed consent of patients. Sanger sequencing was used to identify CTNNB1 mutational status for all cell lines and corresponding tumors to confirm that the cell lines were truly desmoid tumor cells.","title":"β-catenin S45F mutation results in apoptotic resistance"}
{"_id":"8dc14304-221a-69d2-3773-fa6c369b8a17","text":"Patients with primary and metastatic brain tumors are predisposed to thromboembolism. This review of the literature explores the high prevalence of venous thromboembolism and its negative impact on patients with brain cancer. It outlines the recommended prophylactic strategies to prevent venous thrombosis and analyzes the benefit versus risk of anticoagulation in this population, with a focus on the risk of intracranial bleeding associated with it. Additionally, it explores the exceedingly high prevalence of venous thromboembolism in the setting of brain cancer surgeries and provides guidance on the best methods used for prophylaxis in this setting and discusses the safety of each method perioperatively. Lastly, this review article provides guidance on how to manage venous thromboembolism in patients with brain cancer and discusses the use of vena cava filters in this population.","title":"Venous Thromboembolism in Patients With Brain Cancer: Focus on Prophylaxis and Management"}
{"_id":"8dc74f1b-5b36-58da-7e51-79abf05ccb06","text":"The treatment of penile epidermoid cyst is complete excision. The lesion may recur after excision if some residual cyst tissue is retained. Our patient required circumcision for the identification of the cyst and its excision.","title":"Concealed cysts presenting as 'Club' penis: a case report"}
{"_id":"8dc8c086-33a9-705d-ea13-013c52d941b1","text":"Intraoperative sentinel node detection with the gamma ray detection probe can be challenging as well. More than 95% of the administered radioactivity stays behind at the injection site and may cause nearby located sentinel nodes to be missed. Distinguishing sentinel nodes from second-echelon nodes with the probe is not possible and, as no overview can be provided, certainty about removal of all radioactive sentinel nodes is not provided by the gamma probe.","title":"Sentinel Node Detection in Head and Neck Malignancies: Innovations in Radioguided Surgery"}
{"_id":"8dd0fa6a-dccc-48ad-ae40-61107c09b2a3","text":"The most common site of reconstruction in our study was the lower third of leg which constituted 39% of cases. The fact that lower third of leg is a difficult site for reconstruction with limited options, perforator flaps have been recommended by several clinical studies reported on the application of perforator based local flaps in lower-limb reconstruction.- The size of perforator flap that can be safely harvested has always been a point of argument and bone of contention for plastic surgeons all over the world. The length of the flap in our study ranged from 5 to 19 cm and the width from 3 to 10 cm. The maximum size of flap harvested in our study was 19x10 cm2 for covering the knee joint in a young patient with an exposed knee joint following a road traffic accident.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"8de6190b-24e6-38d5-4d16-1c476b9631c5","text":"Virtual surgical planning is the process of planning and rehearsing a surgical procedure completely within the virtual environment on computer models. Virtual surgical planning and 3D printing is gaining popularity in veterinary oromaxillofacial surgery and are viable tools for the most basic to the most complex cases. These techniques can provide the surgeon with improved visualization and, thus, understanding of the patients' 3D anatomy. Virtual surgical planning is feasible in a clinical setting and may decrease surgical time and increase surgical accuracy. For example, pre-operative implant contouring on a 3D-printed model can save time during surgery; 3D-printed patient-specific implants and surgical guides help maintain normocclusion after mandibular reconstruction; and the presence of a haptic model in the operating room can improve surgical precision and safety. However, significant time and financial resources may need to be allocated for planning and production of surgical guides and implants. The objectives of this manuscript are to provide a description of the methods involved in virtual surgical planning and 3D printing as they apply to veterinary oromaxillofacial surgery and to highlight these concepts with the strategic use of examples. In addition, the advantages and disadvantages of the methods as well as the required software and equipment will be discussed.","title":"Virtual surgical planning and 3D printing: Methodology and applications in veterinary oromaxillofacial surgery"}
{"_id":"8de68ce5-290d-1adc-363c-b72e4ecf7ccd","text":"The procedure should be abandoned and the patient should be monitored for any neurologic dysfunction. Some of the workers do not cancel the procedure as there is no clinical data to support this recommendation. In this situation, the initiation of LMWH therapy should be delayed for 24 hours postoperatively.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"8ded1586-16f2-4390-a586-6541d55cf961","text":"CPP is a widespread, common and debilitating condition affecting millions of women worldwide. The aetiology is complex and multifactorial. PVCS is a common cause of CPP but is underdiagnosed. Confusion regarding the terminology used to describe the condition has added to this controversy as has the early unwarranted emphasis that is was psychosomatic in nature. The recognition that many of these women demonstrate abnormal pelvic venous vasculature was initially made either at surgery or by venography. Advances in non-invasive imaging techniques have revolutionized the diagnosis of all causes of CPP including PVCS.","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"8dfa0026-beba-2ad0-046b-1b0e0d12a58c","text":"The new risk prediction model showed significantly high diagnostic efficacy in the early identification of lung cancer patients with a high risk of VTE. The diagnostic efficacy of the new risk prediction model was higher than the KRS and the PRS in this cohort of lung cancer patients.","title":"Early identification of lung cancer patients with venous thromboembolism: development and validation of a risk prediction model"}
{"_id":"8e003cb2-2a9d-6ef8-1c59-b4ab38e2bd06","text":"Although the knowledge of GPs regarding food allergy and anaphylaxis has previously been studied using questionnaires and hypothetical cases, this study is the first to examine actual epinephrine auto-injector prescription practices and the first to make use of data collected by GPs themselves.","title":"Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands"}
{"_id":"8e04775d-f7c0-7390-7353-470993e73307","text":"We showed that DVT developed or worsened after the operation in two patients taking SERMs before the operation and the incidence was 25%. Ultrasound examination for lower extremities after operation may be recommended in these populations.","title":"Selective estrogen receptor modulators and deep venous thrombosis after an emergent operation in senior women"}
{"_id":"8e04ab28-a749-b288-b4a5-33ed5c01bd20","text":"The decision-making process regarding the entry vessel is as follows. All patients underwent exploration for cephalic vein and deltoid branch of thoracoacromial vein from the same incision. The first preference for catheter implantation was the cephalic vein; however, if it was absent or fibrotic and could not be utilized for implantation, the second choice was the deltoid branch of the thoracoacromial vein. The internal jugular vein was considered the last choice for entry vessel only if the cephalic vein and the deltoid branch of the thoracoacromial vein were both absent. The subclavian vein was not utilized for catheter implantation because of the risk of iatrogenic pneumohemothorax and pinch-off syndrome.","title":"Deltoid Branch of Thoracoacromial Vein A Safe Alternative Entry Vessel for Intravenous Port Implantation"}
{"_id":"8e06bade-c29b-e9e7-d345-9ff8a577d386","text":"The same procedure was performed on the opposite side for patients receiving bilateral blocks.","title":"Evaluation of paravertebral blocks in improving post-procedural pain and decreasing hospital admission after microwave ablation of liver tumors"}
{"_id":"8e097a58-c3ee-70dc-ab6f-e020e3552856","text":"No training was provided and we did not discuss the 12 criteria prior to applying them to the six systems.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"8e14178b-e972-5043-e87d-bd8c1dd21247","text":"The period of highest risk for recurrence was evaluated by plotting the hazard function for time to 1st, 2nd and 3rd recurrence and noting the maximum hazard. The hazard function was estimated from the Kaplan-Meier survival function using the Epanechnikov Kernal smoothing method with a bandwidth of 8 and 101 grid points. Time to first recurrence was calculated from initial diagnosis and patients who did not have any recurrences were censored at their time of death or date last contact. Time to second recurrence was calculated for all patients who had at least one recurrence from date of first recurrence to date of 2nd recurrence or date of death\/last contact if censored. Likewise, time to third recurrence was calculated among patients with at least 2 recurrences as time from 2nd recurrence to time to 3rd recurrence or date of death\/last contact if censored. Since we defined a new recurrence to be at least 30 days from any previous recurrence, any patient who died or was otherwise lost to follow-up less than 1 month after their last recurrence was considered not to be at risk of recurrence and was excluded from calculation of the hazard function.","title":"Hazard-Rate Analysis and Patterns of Recurrence in Early Stage Melanoma: Moving towards a Rationally Designed Surveillance Strategy"}
{"_id":"8e146963-d4bc-e79d-5fe4-c678d29cbe76","text":"Data fusion algorithms need to be developed to integrate the features of images from deep learning models with patient clinical information to provide a final output for the diagnosis of melanoma and nonmelanoma skin cancer, because patient history and clinical metadata have significant importance in the diagnosis of skin cancer [16].","title":"Federated and Transfer Learning Methods for the Classification of Melanoma and Nonmelanoma Skin Cancers: A Prospective Study"}
{"_id":"8e168b87-3c17-a0ea-d176-854cce45bbc5","text":"The ossifications found above and within the substance of the tendon may be the result of a transformation of mesenchymal cells to bone-forming cells in response to the surgical excision of the calcium deposit and suturing of the tendon during the arthroscopic procedure.","title":"Ossifying tendinitis of the rotator cuff after arthroscopic excision of calcium deposits: report of two cases and literature review"}
{"_id":"8e18770f-85d0-6fd1-75de-3acfefcb3966","text":"Table 4 shows the comparison of trends. There was statistically significant decline in scores at 6 months and a significant increase thereafter up to 1 year in both BCT and MRM groups. The scores changed parallelly and similarly in both groups. None of the groups fared better in terms of increase in scores over time. This comparison between the amounts of change in the groups is shown in Table 5.","title":"Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India"}
{"_id":"8e19cc06-4506-ba54-63a5-ce877421617d","text":"The keystone design perforator island flap is useful for the reconstruction of lower extremity defects. We performed a systematic review with the objective of identifying complication rates associated with using the keystone design perforator island flap to treat such defects.","title":"A systematic review of the keystone design perforator island flap in lower extremity defects"}
{"_id":"8e1cc86c-8fee-0f84-7185-cf67ac08df12","text":"A total of 115 patients underwent both planar lymphoscintigraphy and SPECT\/CT, and the data sets were analysed visually to identify discrepancies in nodal detection between these imaging modalities. Nodes were classified as belonging to the left or right side and were localized to the inguinal or pelvic basin.","title":"Investigating the role of SPECT\/CT in dynamic sentinel lymph node biopsy for penile cancers"}
{"_id":"8e2462ed-6dbb-75fe-2de2-e2b7eb917fac","text":"Many bones may not be completely ossified so CT is often needed to provide additional bony and cartilage detail. CT is useful in identifying bony tarsal coalition not visualized on radiographs. CT findings may show subtle trabecular irregularity associated with bone necrosis when plain radiographic findings are normal.","title":"Review for the generalist: evaluation of pediatric foot and ankle pain"}
{"_id":"8e279573-2405-f8b7-c52c-7bb29fc6137a","text":"This quality improvement study analyzes compensation data of 14 pediatric subspecialties and general pediatrics from 3 data sources to determine if different data sources provide varied results.","title":"Comparison of Calculations of the Financial Impact of Fellowship Training by Data Source Calculations of the Financial Impact of Fellowship Training Differ by Source"}
{"_id":"8e29ee89-abcf-7c48-1f68-b29cd3dbfa64","text":"Dissecting cellulitis of the scalp or Hoffman disease or Perifolliculitis Capitis Abscedens et Suffodiens is described as a rare condition of unknown etiology that affects the scalp, characterized by recurrent pustules, nodules with purulent drainage and interconnected sinus tract formation leading to scarring and alopecia.","title":"Surgical management of dissecting cellulitis of the scalp using free latissimus dorsi flap and meshed split–thickness skin graft A case report"}
{"_id":"8e2a6b38-18ba-0ecc-7702-4f737e873295","text":"Infections of the spine are an ever-increasing health concern requiring an often complex and prolonged treatment that can lead to significant morbidity. Of particular interest is the cervical spine where there is an increase rate of post-infectious deformity, secondary neurological deficits and substantially higher rates of associated morbidity and mortality than the thoracic or lumbar spine. In this review, we explore the diagnosis and treatment of spondylodiscitis with particular focus on the cervical spine.","title":"Cervical spine spondylodiscitis: Review of literature on current treatment strategies"}
{"_id":"8e2b1436-8cec-7498-d537-53e668a528f8","text":"Larger clinical trials should be performed to accurately distinguish the efficacy and survival outcomes of immunotherapy when compared with treatment modalities, excluding immunotherapy.","title":"Immunotherapy as a treatment modality for mucosal melanoma of the head and neck: A systematic review"}
{"_id":"8e2d488c-094d-da2b-ae8e-59a4dee7ce61","text":"Loosening of the proximal fibula fixation due to a docking site fracture was found at postoperative 2 months. We elevated the previous flap on the medial side while preserving the membrane and the orthopaedic surgery team exchanged the original proximal plate and screws with larger and longer ones. Additionally, nonvascularized iliac cancellous bone grafts were performed at both docking sites to enhance bone union according to the induced membrane technique.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"8e2df1a8-5706-d5ee-8e38-00da2849d50e","text":"Anatomically, the lymphatic system of the upper extremity starts from the lymph capillaries of the fingertip and palm and circulates through 20 to 40 axillary lymph node regions (sentry nodes).[ We hypothesized that the mechanical removal of the sentry node during the SLND procedure or fibrosis of the sentry node caused by RTx for breast cancer patients may have led to BCRL.","title":"Lymphoscintigraphy in patients with breast cancer-related lymphedema after sentinel lymph node dissection and axillary radiation therapy"}
{"_id":"8e328180-7e0e-bae4-dc87-53b12f1d68b8","text":"Antibiotic treatment by intravenous or oral therapy was started after admission, and the options of antibiotics were guided by local microbiology advice wherever possible to facilitate a more focused therapeutic regimen.","title":"Clinical experience of debridement combined with resorbable bone graft substitute mixed with antibiotic in the treatment for infants with osteomyelitis"}
{"_id":"8e34e296-f2a1-da60-c3e2-693be935f3ce","text":"In conclusion, our reported case seems to be a bit distinctive due to its location on the hand as a rare location of primary cutaneous actinomycosis [6] and especially the recurrence of the lesions along with the surgical scar of the primary lesion excision. Therefore, it is recommended to keep in mind actinomycosis in differential diagnosis of any nodular, draining, or recurrent lesions on the extremities. We also put emphasis on the necessity of prolonged antibiotic therapy when the diagnosis of actinomycosis is made as the excisional surgery would not be adequate alone.","title":"Primary Cutaneous Actinomycosis along with the Surgical Scar on the Hand"}
{"_id":"8e3fbe26-ea84-e8e6-6d5b-f312aa159074","text":"The goal of this study was to evaluate the feasibility and the characteristics of a minimally invasive surgical procedure in which cryosurgery was modulated with PEFs, in the hope that this will improve the effectiveness of cryosurgery and eliminate the problems related to cell survival on the outer rim of frozen tissue as well as produce controlled use of PEF. One dimensional models demonstrated that low and freezing temperatures have a substantial effect on PEF produced electric fields. Furthermore, unanticipated information about the effects of subzero temperature on PEFs was also discovered. This investigation has made clear that both low and subzero temperatures are capable of concentrating the electric field because of the temperature dependence of electrical conductivity. Additionally, this study has demonstrated the ability of low temperatures to increase the magnitude of the electric field.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"8e405e81-1f0c-1b06-aec8-614fe71ad5ca","text":"A particular feature in this case is the difficulty related to the latent tuberculosis infection because of the possible initial interpretation of Mantoux test as pathergy phenomenon and the treatment with isoniazide before starting biological treatment.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"8e425c44-d9cf-fbcd-a964-b2fc2041d1ad","text":"Table 1 Detailed description of the features of 12 reported cases of primary colonic melanoma in medical literature","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"8e484995-22cb-9812-2984-a617a3db0578","text":"Berkes et al have shown a 71% fracture union rate following early postoperative wound infection using the standard techniques described above and implant retention.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"8e5bf929-8840-ae38-f85b-3ed6321b3ad2","text":"We used a protocol of desensitization only on the progressive infusion rate with subsequent prolonging of the infusion time of carboplatin without premedication. The use of small starting doses with a progressive increase is thought to consume an IgE antibody and slowly avoid an acute reaction (CTCAE, v4.0). Prolonging infusion time also allows chemotherapy agent antigens to be delivered in a less concentrated fashion per unit of time and therefore decreases antigenic exposure. The protocol was well tolerated and allowed patients to be treated with response to carboplatin.","title":"Rechallenge to Carboplatin in Children with Low Grade Glioma and Carboplatin Hypersensitivity Reactions"}
{"_id":"8e5d5786-efef-dbdb-1267-d198b3477a8a","text":"We demonstrate the versatility of the free osteocutaneous fibula flap in the reconstruction of extremities following sarcoma resection, presenting reconstructive procedures of all long bones of the extremities.","title":"The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection"}
{"_id":"8e5ddefe-e825-b088-c8ea-b6dbce3664df","text":"We presented two cases where acute deformation of the fractured tibia allowed primary skin closure and avoided the need for soft tissue flaps. We believe that this is a useful technique to consider in certain patients at centres where sufficient expertise with the TSF is available. The fracture must also be deformable in the direction of the wound to permit this. Further studies of this technique are necessary to improve our understanding of patient selection and outcomes.","title":"Conversion of open tibial IIIb to IIIa fractures using intentional temporary deformation and the Taylor Spatial Frame"}
{"_id":"8e68f6fc-65ca-5376-b3fa-ad02ea20b486","text":"A validated grading system for success and AEs seems to be important to assess a patient’s individual risk before the intervention. An appropriate grading system could be valuable for managing resources and determining the equipment and expertise required by endoscopists.","title":"SASE, S uccess and A dverse event S core in E ndoscopic Retrograde Cholangiopancreatography: a Novel Grading System"}
{"_id":"8e691fe7-e842-1c8e-a11f-8499f50e344d","text":"In addition to building new knowledge about the molecular and cellular mechanisms of mandible fracture repair, this study also aimed to explore endochondral routes of promoting mandibular bone regeneration. Autologous bone grafts are the current standard of care for improving healing in clinical cases of malunion or in large bone defects in both long bone and mandibular fractures. While clinical outcomes of autologous bone grafts are generally favorable, they are associated with significantly increased risk to the patient. Autograft procedures typically require a second surgical site, increased surgical time, increased blood loss and are associated with high rates of donor site morbidity.11, 18 Alternatively, bone allografts are readily available, but they have significantly reduced bioactivity and a high rate of clinical failure due to poor osteointegration and osteonecrosis of the graft. Thus, the discovery and development of alternative graft tissues and materials would be clinically beneficial. Unlike bone, cartilage is an avascular tissue that is not only capable of surviving without a vascular supply but is also responsible for recruiting blood vessel invasion for the newly formed bone during endochondral ossification.2, 3 Here we test the efficacy of cartilage grafts in healing mandibular defects using critical‐sized versions of the mandible fracture models described. The central hypothesis of this study is that, despite different developmental pathways, mandible fracture healing parallels long bone repair with cartilage directly contributing to the formation of new bone during native healing or with transplantation.","title":"Chondrocyte‐to‐osteoblast transformation in mandibular fracture repair"}
{"_id":"8e69abd9-9c8c-442e-9784-081dfd7ad1e5","text":"To study international differences in incidence and practice patterns as well as time trends in lower limb amputations related to peripheral arterial disease and\/or diabetes mellitus.","title":"Abstracts DGG"}
{"_id":"8e6afdee-ff00-697c-9aa2-fba2fd5d5c53","text":"Our findings seem to agree with this suggestion. We demonstrate that for the single surgeon, every analyzed intraoperative parameter and also the length of hospital stay was improved the more experience the surgeon gained. Meanwhile, the revision and flap loss rate remained the same. Very high case numbers are required to capture a significant change in flap survival rates throughout the learning curve. This is attributed to the generally very low flap loss incidence.","title":"Breast Reconstruction with DIEP Flap: The Learning Curve at a Breast Reconstruction Center and a Single-Surgeon Study"}
{"_id":"8e73a932-68d5-a21d-3657-e03272d81b6d","text":"We found widespread pulmonary fat emboli in all pigs except sham animals in postmortem biopsies. In seven of 21 pigs in the intraosseous group, we found fat emboli in coronary arteries of the left ventricle. All pigs with coronary fat emboli were from the closed chest group. We did not find fat emboli in renal biopsies or biopsies from the dorsal and ventral cerebrum and cerebellum.","title":"Intraosseous fluid resuscitation causes systemic fat emboli in a porcine hemorrhagic shock model"}
{"_id":"8e7f36cb-ed97-a555-3f30-4ceede51ab6c","text":"Cervical spondylosis is a common and disabling condition. It is generally felt that the initial management should be nonoperative, and these modalities include physiotherapy, analgesia and selective nerve root injections. Surgery should be reserved for moderate to severe myelopathy patients who have failed a period of conservative treatment and patients whose symptoms are not adequately controlled by nonoperative means. A review of the literature supporting various modalities of conservative management is presented, and it is concluded that although effective, nonoperative treatment is labour intensive, requiring regular review and careful selection of medications and physical therapy on a case by case basis.","title":"Nonoperative Modalities to Treat Symptomatic Cervical Spondylosis"}
{"_id":"8e7f588b-4dd6-7b27-751c-f6f6516992f7","text":"One of the patients who underwent an amputation had suffered intense refractory pain during the first month after stenting associated with infection. The second patient presented at the emergency room 1 month after stenting with an extensive lower limb infection up to the thigh.","title":"Primary stenting for femoropopliteal peripheral arterial disease: analysis up to 24 months"}
{"_id":"8e835c2b-42bf-88df-d12c-c723acba4b57","text":"For any tumor that might require a biopsy, consultation with an orthopaedic oncologist is vital to the treatment and neither a biopsy nor definitive treatment should be attempted by an inexperienced surgeon. A biopsy should always be done under the guidance of a surgeon who performs limb-salvage surgery and ideally by the operating surgeon. Image-guided biopsies may not be possible, and an inappropriate biopsy can necessitate amputation. Biopsy principles and techniques can be taught to the local surgeon during initial trips to the region. A pathologist may not be available, and the sample may need to be transported out of the country. If the tumor is aggressive enough on radiographs to warrant a wide resection, then the treatment could be considered without a prior diagnosis, but this is a decision that should be made by the surgeon performing the definitive surgery.","title":"Limb Salvage for Musculoskeletal Tumors in the Austere Environment: Review of the Literature With Illustrative Cases Regarding Considerations and Pitfalls"}
{"_id":"8e894bda-1b44-0b11-fbc5-856eff218a41","text":"Current infant feeding support is often targeted at establishing breastfeeding in healthy term infants, or supporting lactation for preterm infants in the neonatal setting. Breastfeeding presents different challenges for children beyond the neonatal period who have a medical complexity. The tendency to focus on breastfeeding as a preventative public health intervention overlooks the fact that mothers and children with medical complexity often require additional and targeted support to continue to breastfeed. Despite this identified need, there is very little research, policy or clinically specific teaching within paediatrics that is nuanced enough to support this vulnerable population.","title":"Using art to raise awareness of breastfed children with medical complexity"}
{"_id":"8e927d31-9cf9-85b9-7da9-b314b49cdfdf","text":"Some investigators question whether knowledge of a thrombosis is even desirable, arguing that a distal thrombosis does not require treatment. It is true that most distal thromboses are likely to spontaneously resolve,77 and this phenomenon was demonstrated by 1 of the 2 affected patients treated within the study period. However, thromboses may also propagate. A prudent course of management, and one supported by the American College of Chest Physicians,78 is weekly ultrasound scans to confirm resolution.61","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"8e931ecf-1352-d002-f360-f7438b65ee49","text":"Our findings support the complexity of managing dermatology patients who develop malignancies on biologic therapies. Multiple successive agents were often required to gain control of skin disease. While in practice we aim to avoid BAs for at least 5 years after the malignancy diagnosis consistent with current guidelines, in reality this can be challenging.","title":"A retrospective review of the management of patients following a malignancy diagnosis on biologic therapies for the treatment of dermatological disorders"}
{"_id":"8e93edc7-c920-c8a4-636a-cd8a8839b2f3","text":"A third reason for the excellent outcome is likely the fact that in every case an infectious disease specialist was involved and antibiotic therapy had continuously been adapted. In this respect the very low prevalence of MRSA may have helped the excellent outcome.","title":"Is switching to an oral antibiotic regimen safe after 2 weeks of intravenous treatment for primary bacterial vertebral osteomyelitis?"}
{"_id":"8e9763a7-8960-2af0-a671-cfb2530d3598","text":"Injectable drug administration is inevitably accompanied by a risk of injection site reactions. The LAIO preparation used in the current study is oil‐based and highly viscous to limit the rate of uptake from muscle. A preparation of this nature might reasonably be expected to increase the risk of idiosyncratic reactions or infection at the injection site. However, in this study the complication rate was low, recognised as localised and self‐limiting swelling or subcutaneous oedema at the injection site. The fact the reaction seen in the pectoral region was worse than those observed when the drug was injected into the gluteal muscles might suggest avoiding the pectoral muscles if at all possible.","title":"Evaluation of the treatment of equine glandular gastric disease with either long‐acting‐injectable or oral omeprazole"}
{"_id":"8e9d9dc1-aedc-cbf8-8543-12a85fd8ad74","text":"DCs in academic orthopaedic surgery plays a crucial role in the department and is a topic that is understudied. A lack of diversity exists among DCs in academic Sports Medicine in orthopaedics. The position is held predominately by White men with a rank of either full or associate professor and extensive leadership experience. More efforts are needed to increase the diversity of sports medicine leadership within academic orthopaedic programs in the United States.","title":"Academic, Leadership, and Demographic Characteristics of Orthopaedic Sports Medicine Division Chiefs in the United States"}
{"_id":"8e9f32f5-5948-bc71-c45c-e7f2aad95b00","text":"In our study group of patients, there were 17 excisions followed by a direct suture, the rest of the cases being operated with a modified Camille Bernard technique. Lymph adenectomy was performed in the same time with the lip reconstruction in four patients. In all the other cases with a confirmed spinocellular histology examination, lymph adenectomy was done a month to two months after the local block excision of the tumor followed by the lip reconstruction.","title":"Surgical attitude in premalignant lesions and malignant tumors of the lower lip"}
{"_id":"8ec0ead0-c2d5-df02-fed0-6e2e2276a952","text":"The pathological characteristics of our clinical NS cases were high tumour malignancy such as histological grade 3, lymphvascular invasion or chemotherapy refractory. On the other hand, we were unable to find a clear association between the biopsy procedure and NS. Clinical NS that is large enough to be obvious on physical examinations and images may be associated with the tumour malignancy itself rather than with the biopsy procedure. NS was pathologically observed in all of three cases with clinical NS, highlighting the importance of preoperative evaluation and the necessity to excise biopsy scar in all cases with clinical findings.","title":"The significance of biopsy scar excision at the time of skin- or nipple-sparing mastectomy with immediate breast reconstruction"}
{"_id":"8ecf6a8a-cabc-cbf2-5d50-4f02526250ca","text":"Patients must also be educated about the importance of sun protection and the cessation of tanning bed use, if applicable, as these behavioral modifications can lower the risk of developing novel malignancies.6–8 Avoidance of midday sun exposure along with the use of protective clothing and sunscreen are all modifiable risk factors that prevent the development of future malignancies.6–8","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"8ed1eed7-2590-3ea8-3bb6-b5e3403c5f3d","text":"The age of the patients is a decisive factor to achieve optimal results, and it is vital to act as soon as possible and in a multidisciplinary way. The collaboration and motivation of the family also play a decisive role in the resolution of unproductive suctioning in newborns, and it is essential to attend all the check-ups and programmed sessions and comply with the guidelines set out for newborns and accomplish all the tasks assigned.","title":"Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn: Breastfeeding Sessions, Myofunctional Therapy, and Frenotomy"}
{"_id":"8ed7b47f-3005-47f2-5dbc-ddb0487a4e6e","text":"Case 3 was a 57-year old female who was admitted to our unit three years post axillo-bi-femoral reconstruction following explantation of an infected aortobifemoral graft. She presented with pus discharging from the left groin. A CT angiogram aorta reported a focal collection around the left femoral branch of the graft with an area of infiltration of the adjacent fat likely to represent a focal graft infection.","title":"Periodontal Disease and Late-Onset Aortic Prosthetic Vascular Graft Infection"}
{"_id":"8ed7b5d4-c102-52cc-4853-f98411cc3ff2","text":"To our knowledge, this is the first study in an Asian population to report 71 % increased risk in SPMs in women previously diagnosed with uterine cancer. A younger age at diagnosis of uterine cancer conferred an increased risk of second malignancies, and SPMs worsened survivorship in patients who survived uterine cancer.","title":"Increased risk of second primary malignancies following uterine cancer: a population-based study in Taiwan over a 30-year period"}
{"_id":"8ede7805-ef0b-471c-e47f-2f88d39bc750","text":"Reconstruction of the mandible following malignancy has advanced significantly over the years with the aim to restore function and aesthetic outcome. The free fibular osteocutaneous flap is the preferred method of mandibular reconstruction as it provides ample bone for the reconstruction and able to handle multiple osteotomies in addition to providing soft-tissue coverage.1 At the same time, osteosynthesis has been enhanced through the use of titanium reconstruction plates and locking screws, as they provide excellent anchorage and achieve rigid fixation to the bone graft without compressing it, thereby reducing the risk of ischemic bone graft loss.2,3","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"8ee1bacf-2de6-8c3a-0118-fcbf6f887993","text":"In T1 melanomas, we found the histologic type of ALM as an independent prognostic factor for lower rates of DSS. When we microstaged the T1 melanomas, we found that ALM type was both dependent and independent predictor of worse DSS in T1a but only as a dependent poor prognostic factor in T1b melanomas. This inconsistency in the prognostic impact of ALM histologic type across pathologic stages of thin melanoma might be explained by the relatively powerful prognostic impact of greater Breslow thickness and\/or the presence of ulceration confounding the prognostic impact of ALM histologic type in T1b melanomas. For RFS, the ALM histologic type was detected as a dependent prognostic factor for lower rates at the T1, T1a, and T1b pathologic stages, and as an independent prognostic factor for T1b melanomas.","title":"Prognostic significance of acral lentiginous histologic type in T1 melanoma"}
{"_id":"8ee1cf76-beca-7afc-33ec-7cce8d1c0e39","text":"Aim of this study was to identify prognostic factors in melanoma patients with satellite or in-transit metastasis at the time of stage III diagnosis in addition to the presence or absence of concurrent lymph node involvement to allow a more accurate prediction of prognosis.","title":"Prognostic Factors of Melanoma Patients with Satellite or In-Transit Metastasis at the Time of Stage III Diagnosis"}
{"_id":"8eea53da-b530-2b2d-883e-322b22922a40","text":"Mechanisms of allergic sensitization in humans remain largely mysterious, in part because it often occurs at some undetermined time and place before the onset of symptoms. While it is unlikely that desensitization is simply the reverse of sensitization, examination of how different routes of allergen administration influences response may provide some hints into long-standing questions about how sensitized states are established and maintained. In addition, understanding how route of administration influences AIT outcomes could shed light on optimal methods for achieving immunologic non-responsiveness and provide practical options for patient care.","title":"Immunology of allergen immunotherapy"}
{"_id":"8eeec459-a275-44e5-9e7c-70ac22b2e2ea","text":"The aim of the present study was to evaluate whether performing a SLNB or not was associated overall survival in patients who were treated for intermediate-thickness skin melanoma in a population-based setting in the South East area of the Netherlands.","title":"Survival of sentinel node biopsy versus observation in intermediate-thickness melanoma: A Dutch population-based study"}
{"_id":"8efe2ac1-f65e-306a-5ec8-191bc1cbf8df","text":"The diagnosis of DCS has been established on the basis of the clinical appearance and has been confirmed histopathologically.","title":"Surgical management of dissecting cellulitis of the scalp using free latissimus dorsi flap and meshed split–thickness skin graft A case report"}
{"_id":"8f02858f-971f-2d18-58bf-0957d2c04774","text":"The ex vivo GSV diameter after appropriate hydrostatic dilatation is considered the gold standard, since it reveals the true elasticity and distensibility of the vein for its role as an arterial conduit, subjected to greater pressures. To explain the difference between the measurements observed in the preoperative examinations and the measurements performed during surgery, we can deduce that when a healthy person adopts a horizontal decubitus position, venous hydrostatic pressure reduces in the lower limbs and the diameters of the veins also reduce.","title":"Correlations between ultrasound, tomographic, and intraoperative measurements of the great saphenous vein used as an arterial graft"}
{"_id":"8f05f261-cef5-900e-3749-004dc552263f","text":"Hopefully, this concept will pave the way for designing a large randomized clinical trial to investigate if and how addressing the adequacy of splanchnic perfusion more precisely by US can improve the postoperative outcomes of these patients.","title":"Perioperative Renal Ultrasonography of Arterio-to-Venous Coupling Predicts Postoperative Complications after Major Laparoscopic Urologic Surgery"}
{"_id":"8f07efd7-32b3-15fd-e99d-d51e650c5546","text":"The Helsinki University Hospital institutional review board approved the study protocol.","title":"Pelvic sentinel lymph nodes have minimal impact on survival in melanoma patients"}
{"_id":"8f0c38f9-6009-1645-764b-dc8bb6fbd4c0","text":"In the history of plastic surgery we find references of this technique dating back to the 18th century. The earliest reference we have found of this technique came from a study by Mellish [6] in 1904 who mentioned that a doctor in 1777 who ordered a colleague to puncture the skull of a patient with scalp loss until a reddish fluid came out which aided the formation of granulation. The skin on the sides has grown very slowly over time.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"8f110d77-5df9-d75e-bf1b-0d58e31bec1d","text":"Introduction: Social networks are now an effective tool in medical communication used in many specialties. It provides wide access to patients and pears communities because the engagement of all age ranges on Facebook and Instagram is growing. More and more training programs are using these platforms to promote themselves to future students, including those in oral and maxilla-facial surgery. But the impact of specialized medical content has never been studied on the population of working practitioners and residents.","title":"Social Media’s Use and Impact on Oral Surgeons and Oral Surgery Residents"}
{"_id":"8f191354-ae3d-451f-849c-11c03fdf305f","text":"Tissue MPO levels did not differ significantly between the ischemic preconditioning and botulinum groups at 24 h but was significantly lower in the botulinum group at 10 days. Tissue NO levels were significantly higher in the ischemic preconditioning group compared to the botulinum group at 24 h and at 10 days. Serum MPO showed no significant difference between these two groups at 24 h but was significantly lower in the ischemic preconditioning group compared to the botulinum group at 10 days. Serum NO levels were not significantly different at 24 h but significantly higher in the botulinum group at 10 days.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"8f1948e0-8d44-7029-40fa-d3a50dd9a93e","text":"This need for abdominal wall surgery training with its complexity, varied techniques and dealing with patients with on average higher comorbidities has been demonstrated by the data above.","title":"The reality of general surgery training and increased complexity of abdominal wall hernia surgery"}
{"_id":"8f2084f9-46b8-f7d0-2922-31d17f22f35f","text":"Recently, several studies have highlighted differences in the potential compensation of those who choose to undertake fellowship training compared with general pediatricians. Financial considerations are known to play a role in a host of decisions made throughout life, and such studies hypothesize that this compensation differential may impact the decision to pursue subspecialty training in general or in a specific subspecialty. If financial considerations are an important part of the decision process to pursue fellowship training, then it is essential to ensure a clear understanding of the presence and magnitude of these financial implications.","title":"Comparison of Calculations of the Financial Impact of Fellowship Training by Data Source Calculations of the Financial Impact of Fellowship Training Differ by Source"}
{"_id":"8f2417a7-92fb-21ea-6d90-21d60d331b3e","text":"An anonymous survey was sent to all BEAVRS members via email inviting those who have completed a VR fellowship within the past five years to share their experiences. The study adhered to the principles of the Declaration of Helsinki. A proportionate approach to consent was adopted, and participants taking time to complete the questionnaire were deemed to have provided implied consent.","title":"Experience gained during vitreoretinal fellowships in the United Kingdom"}
{"_id":"8f2adcf8-c9ff-68ba-f320-ec8812093e47","text":"Cure rates for non-implant VO were very high with partly short intravenous and overall antibiotic therapy. Switching to an oral antibiotic regimen after two weeks intravenous treatment may be safe, provided that CRP has decreased and epidural or paravertebral abscesses of significant size have been drained.","title":"Is switching to an oral antibiotic regimen safe after 2 weeks of intravenous treatment for primary bacterial vertebral osteomyelitis?"}
{"_id":"8f40b393-ea9f-5529-3476-bd7a431e9006","text":"Despite the unclear underlying mechanism and the lack of histological evidences, our satisfactory and unexpected result supports our experience and our choice of treating posttraumatic facial scar with partial loss of nerve function.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"8f436243-4b40-2c0a-701c-fdf0aa0e4fa4","text":"Since the treatment options for recurrent or persistent NPC are limited, the survival rates poor and the complications severe; there is definitely a place for alternative treatment modalities with more efficacy and less morbidity.","title":"Photodynamic therapy in the therapy for recurrent\/persistent nasopharyngeal cancer"}
{"_id":"8f474f36-feab-cab3-75c5-6ce7b11e8b17","text":"Klein et al.9 showed that microvascular reconstruction, predominantly for head and neck defects, was a viable reconstructive option in a patient cohort with a minimum age of 78 years. Sosin et al.10 showed that mortality and catastrophic flap complications were not increased by age in patients >70 years old who required free tissue scalp reconstruction. However, the head and neck has a rich vascular network. We were interested to see if similar conclusions could be reached in curative orthoplastic surgery for chronic osteomyelitis, where vessels often lie in an area of previous trauma that has been subjected to long-standing infection. Is curative surgery less successful and are the rates of medical and surgical complications higher in elderly patients undergoing excision of chronic osteomyelitis with simultaneous orthoplastic reconstruction including free soft tissue transfer?","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"8f524a20-21eb-2c60-946b-848e5eb48984","text":"Nasal dorsal hump resection sometimes leads to nasal irregularities and converts its smooth contour to an irregular one with sharp edges of bone and cartilage or may also result into an open roof deformity. Especially in thin skinned patients, the edges of underlying skeleton becomes more prominent and eventually gives the patient an “operated–on look” nose. Dorsal nasal grafts are placed under dorsal skin and above osteocartilaginous skeleton to prevent direct contact between skin and underlying irregular dorsum. Some authors have stated the use of autogenous soft tissue grafts such as temporalis fascia and dermal grafts. Temporalis fascia has low resoption rate but it is tinny and enough augmentation cannot be achieved by use of it.","title":"A Comparasion in Graft Resorption between Three Techniques of Diced Cartilage Using Surgical Blade, Electrical Grinder and Grater in Rabbit"}
{"_id":"8f54aaad-8b42-49c4-f410-5c02317f5b18","text":"Specialisation of spinal services has serious implications on the initial management of cervical spine trauma in district general hospitals without on-site spinal units. The lack of equipment and expertise to apply the halo vest device for unstable cervical spine injuries in this set up is highlighted. We recommend training of all trauma surgeons in the application of a halo vest device and making this device available for use.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"8f5d586c-90af-71ac-06e8-c5dc12e803ad","text":"When the lesion is differentiated type of ≤ 3 cm and either UL1or pT1b1 (SM1), size of the residual mucosal lesion should be reassessed by endoscopy. When the sum of the lengths of the resected and residual lesions exceeds 3 cm, gastrectomy with lymphadenectomy should be considered the standard of care. In addition, patients with positive horizontal margin within the portion of submucosal invasion and those who underwent piecemeal resection in which the resection line involved the portion of submucosal invasion should be recommended to undergo gastrectomy with lymphadenectomy, since the histological diagnosis under these circumstances is destined to be uncertain.","title":"Japanese gastric cancer treatment guidelines 2018 (5th edition)"}
{"_id":"8f5e274e-4176-1045-36b2-a0496968c40a","text":"Similarly, there are many gaps in knowledge to be filled in the interpretation of postoperative imaging to properly define radiotherapy tumor volumes in the presence of imaging variability imposed by reconstruction. On the other hand, radiotherapy may be responsible for tissue fibrosis or atrophy, the anatomy of the reconstructed region and the functional outcomes may change after radiotherapy compared to surgery alone. Together, these factors impose challenges for all physicians involved in follow-up","title":"Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know"}
{"_id":"8f60b91e-5e62-0d16-52c7-a2f06ee873df","text":"In order to define the notion of oncological safety margin based on scientific data, several randomized clinical trials have been initiated after the seventies. They aimed to determine the optimal distance between the macroscopic edge of the primary tumor and the surgical incision that would provide a low local recurrence rate with a minimal associated morbidity.","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"8f64fdff-85e4-c83d-9896-624ddd07de3d","text":"For DIEP flaps, the perforators were exposed by carefully incising the rectus sheath with a size 15 blade without excising any of the sheath. The perforator course was then followed through the muscle up to the main pedicle carefully ligating the side branches. At least 2 cm of vessel was preserved at the superior continuity and inferior continuity of the DIE vascular pedicles in case these were needed for intraflap anastomoses.","title":"Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification"}
{"_id":"8f66afdc-d9dd-c14b-dffd-4d85fee4da49","text":"The parents had a concern of excessive sweating of the body which resolved by itself. There was also a history of rashes appearing on the body while the baby was given bathing in the initial few months of life which resolved fully. There was no history of trauma or surgical operation apart from tongue tie release at the age of two months. There is no family history of any allergic disorders.","title":"Recurring Facial Erythema in an Infant"}
{"_id":"8f73a69f-7c1c-3a31-c18d-bf53a5de983b","text":"Particularly in the head and neck region, the smallest possible excision margin is sought to avoid unneccesary mutilation of the skin and mucosa.","title":"Photoplethysmography for demarcation of cutaneous squamous cell carcinoma"}
{"_id":"8f7707b0-2f8a-3f72-7f5e-2b39f255db64","text":"As additional considerations for this case presented, frozen sections were not performed with immunohistochemistry since we have not yet built a significant experience for its use. Surgical management was preferred over topical management due to the low response of basal cell carcinoma to this type of treatment. The reconstruction was performed by the plastic surgery unit due to regulations in the institution; however, we consider that it can also be performed by the same Mohs surgeon.","title":"Combined Mohs Micrographic Surgery in a Collision Tumor"}
{"_id":"8f829243-2991-0f2b-51b9-1321d2071cf4","text":"Laminoplasty is used to decompress the cervical spinal cord and is generally applied in multilevel cervical stenosis without local kyphotic deformity and instability [6]. The superiority of laminoplasty over laminectomy with fusion can be attributed to the protection of the dural membrane from adhesion through the preservation of posterior bony elements in multilevel cervical myelopathy [7]. For patients with degenerative cervical kyphosis with stenosis (DCKS) that require posterior instrumented fusion, posterior decompression with laminoplasty is not only no more complex than laminectomy but also more beneficial in preventing the dura from adhesion and providing an additional fusion bed through the preservation of posterior bony structures.","title":"Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis"}
{"_id":"8f82a78e-0672-ccbe-505b-1f13bffe985d","text":"None of the patients complained of altered chin morphology and indeed recently grafts harvested from the mandibular lower border were reported to show no discernible change of significance in chin morphology.20 Twenty-three (85.2%) patients out of 27 had successful grafts with placement of implants thereafter. Alveolar defects should be augmented at least three months before implant placement but delays greater than six months may result in resorption of the graft.21 Three patients in this study lost their bone graft at the recipient site as they returned for implant placement after three months.","title":"An investigation of post-operative morbidity following chin graft surgery"}
{"_id":"8f843941-58e6-a856-baaf-416cab2b371c","text":"Previous investigations in sheep have shown that LCP fixation of bone defects followed by full, unrestricted weight-bearing is associated with complications such as fractures and may compromise subject retention1. Studies reporting high success rates with this technique often involve the use of some sort of suspension device in the postoperative period11,26. These devices were not used in this study. Postoperative management consisted of limb casts for the first 60 days of the experimental period, followed by splints that did not prevent foot contact with the ground during weight bearing for the remaining 30 days. This strategy was thought to faithfully replicate real-life postoperative recovery in large animal orthopedics18.","title":"Locking compression plate fixation of critical-sized bone defects in sheep. Development of a model for veterinary bone tissue engineering"}
{"_id":"8f89eeac-30f3-795a-3422-46bf986db5b4","text":"Choroidal melanoma may extend into the orbit via direct invasion through the sclera.","title":"Extrascleral extension of choroidal melanoma after iodine-125 brachytherapy treatment: a case series"}
{"_id":"8f9b299d-63f5-03ee-2d01-dbb4ad735a75","text":"It has been suggested that the dynamics of the venous and lymphatic systems interact as a mutually dependent dual outflow system and that derangement of lymph flow could be reversed by surgical treatment of venous incompetence. In this report, we describe a patient in whom lymphatic function was restored after stripping of the great saphenous vein for varicosity. The patient was a 79-year-old woman who had varicose veins along the medial side of an edematous left leg. Lymphatic function was investigated using indocyanine green imaging to evaluate for the presence of lymphedema. Based on the findings, we made a diagnosis of bilateral varicosity of the great saphenous vein with left-sided lymphedema. The great saphenous vein was stripped between the groin and ankle on both sides. At 3 months after the stripping procedure, lymphatic flow was observed immediately after injection of indocyanine green in both legs along the medial side from the foot to the groin. We therefore determined that lymphatic flow had been restored after the stripping surgery. The functions of the venous and lymphatic systems are thought to be closely related, and that, if the function of one declines, the other will also be affected. Treatment of venous system, including stripping, may help to break the vicious cycle of lymphatic stasis and venous insufficiency.","title":"Lymphatic flow restoration after stripping surgery for varicose veins: A case report"}
{"_id":"8f9e1295-f379-3ef8-6351-c3e86f962472","text":"Figure 1 illustrates the dose rates covered in the studies mentioned in this publication. Note the log scale of dose rates and therefore huge range of dose rates considered.","title":"Radiation dose rate effects: what is new and what is needed?"}
{"_id":"8fa4ff79-66f6-2b53-0d66-9be8c02b4f69","text":"Both incorporation and consolidation were observed in over 90% of patients with a low rate of complications. The use of small-particle cortical allograft proved to be an effective alternative to autogenous bone graft in patients with metaphyseal and metadiaphyseal surgical bone defects.","title":"Microparticulate Cortical Allograft: An Alternative to Autograft in the Treatment of Osseous Defects"}
{"_id":"8fa75038-2664-b078-d5b7-a52df81c2432","text":"All surgeries aim to simultaneously decrease invasiveness and enhance effectiveness. There has been a great deal of enthusiasm and effort in many surgical fields to introduce robotics in support of these aims. However, the generally very innovative field of plastic surgery has not integrated robotics into its routine clinical work yet.","title":"Robotic-Assisted Microsurgery and Its Future in Plastic Surgery"}
{"_id":"8fa7b3ee-fbe8-a835-bb16-0ec1a25bba48","text":"No cases of recurrence were recorded among the 25 patients who were treated with adjuvant brachytherapy due to the presence of risk factors. Likewise, there were no cases of regional or distant recurrences in our series.","title":"High-dose-rate plesiotherapy with customized molds in non-melanoma skin cancer: efficacy and safety at 10 years—single institution experience"}
{"_id":"8faa1ce3-adc8-d0af-9f61-b33e17902d0b","text":"Patent blue dye was injected in the subdermal part of the retroaroelar area in 167 patients having surgical treatment for invasive breast cancer. Three stage axillary lymphatic massage was performed prior to making the axillary incision for sentinel lymph node biopsy. All patients had completion axillary sampling or clearance.","title":"Three stage axillary lymphatic massage optimizes sentinel lymph node localisation using blue dye"}
{"_id":"8fb4ec7f-ac02-7d69-6f4b-f07bc2dd8457","text":"The biofilmology community has to reach an agreement on the parameters at stakes for each of the microbiological issues. The antimicrobial screening mediated by biofilm mechanical properties, the biofilm release under the influence of an adapted flow rate of water in clogging pipes or the development of effective cleaning strategies are some of appealing issues of the mechanics of biofilms. Biofilm mechanics requires a common terminology to avoid fallacious analogies between results obtained following different routes. In the following part, we look at microbiological issues of interest in biofilms from a mechanical standpoint. The measurement of these properties following common bases is significant as it allows the determination of important tool as an antimicrobial screening index or an accurate shear stress needed to overcome clogging in water pipe. Depending on the microbiological issue discussed in the previous part, mechanical parameters can be used for several purposes: as indicators allowing to follow a change in the mechanical behavior or as a threshold value for monitoring the presence of a biofilm. A conceptual overview of the place of mechanics in the microbiological community often addressed in the literature is given in Table 1.","title":"Towards standardized mechanical characterization of microbial biofilms: analysis and critical review"}
{"_id":"8fb59b90-1e5a-b2be-1972-f69f85eb6459","text":"Proper planning and meticulous flap dissection and inset using free fibula flap can save many hand and foot from amputations","title":"Experience of Saving Limbs With Free Fibula Osteocutaneous Flaps"}
{"_id":"8fb8b1b2-800c-e365-c82b-c8d2f2c4884c","text":"The outcome assessors and data analysts will be blinded by using a coding system for the participants and treatment groups.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"8fbd9bf8-caa4-7464-3f53-8815b6f82fd4","text":"We find venous Doppler monitoring systems as an easy and reliable method of flap monitoring as has been demonstrated in head and neck 70 and breast free flaps, 71 with a sensitivity of 100% but high false positive rates of up to 13.6%. Most units will have their preferred methods of monitoring depending on local experience.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"8fbdef15-1e86-3d78-d253-c2c516a1dce9","text":"This study explored the extent to which trainee doctors’ perceptions of the stereotype of the surgeon influence their professional identification with surgical specialties. Our findings suggest that the stereotype of the surgeon persists, and that while this can negatively influence professional identification among trainees who are men, the phenomenon is far more salient for women trainees. While some of the women in our study were put off surgical specialties by structural constraints, cultural factors and specifically stereotypes were the dominant themes that emerged. The number of women in surgical careers continues to increase but the pace of change may be hampered by the persistence of gendered stereotypes among junior doctors themselves, as well as in some of their more senior surgical colleagues. Positive role models and mentoring can encourage and support women who are interested in a surgical career to identify with the role, but there is a need for a broader debate encompassing job redesign and surgical identities.","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"8fc6b259-4984-38c7-308c-0a746bd62e80","text":"After analyzing the results of the survey conducted by us, we found that the findings were alarming. It was amply clear that there is not much understanding of our specialty in members of the medical community, and plastic surgery is poorly understood. We feel that if our colleagues from other specialties are not aware of the spectrum of work we do, we ourselves are to be blamed for it. We lag behind in the field of advertisement and awareness creation of our specialty.","title":"Awareness and Perception of Plastic Surgery among Healthcare Professionals in Pune, India: Do They Really Know What We Do?"}
{"_id":"8fcdb5db-e4f1-827c-d8a7-2a8fd93c6fb3","text":"The position of the pulse oximeter should be changed every 20–30 min to avoid any skin burn or nail bed damage that would result from photochemical reaction by the red light (660 nm). All precautions should be taken to avoid direct illumination of the patient with surgical lamps in theatres. Unplanned or emergency surgical interventions within 30 days from the photosensitiser administration should be undertaken only if absolutely necessary and if the potential benefits outweigh the risk to the patient.","title":"From Basic Mechanisms to Clinical Research: Photodynamic Therapy Applications in Head and Neck Malignancies and Vascular Anomalies"}
{"_id":"8fced5b4-a303-691a-1f9d-1b310687d891","text":"The TABBY Assessment Tool is a clear and simple addition to the assessment of tongue-tie in infants and can provide an objective score of the severity of a tongue-tie. Together with a structured breastfeeding assessment it can inform selection of infants for frenotomy. It can be used by clinical staff following a short training and will facilitate translation into other languages.","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"8fd2fe98-cbd7-a972-f939-71323d489eeb","text":"The use of ring fixator with Ilizarov technique has been described for treatment of periprosthetic fractures and deformity correction prior to revision knee replacement. In our knowledge, the use of Taylor spatial frame fixator for deformity correction prior to a primary total knee arthroplasty has not been described in the literature. In our senior author’s experience, two earlier patients (not included in this description) with tibial deformity and concurrent knee osteoarthritis treated with initial deformity correction performed as a staged procedure experienced a significant respite from their osteoarthritic symptoms. These two patients continue to remain symptomatically well managed and are still awaiting the need of replacement surgery.","title":"Extra-articular deformity correction using Taylor spatial frame prior to total knee arthroplasty"}
{"_id":"8fdd53d3-7edb-10d8-5d10-30c9cf191fbc","text":"The choice of the surgery procedure depends on the presence of osteomyelitis and the circulatory condition of the extremity. As osteomyelitis is the main source of wound recurrence, bone affected by osteomyelitis should be removed. Poor blood supply continuing after the failure of a vascular intervention is also incurable.","title":"The appropriate management algorithm for diabetic foot A single-center retrospective study over 12 years"}
{"_id":"8fe0e45e-8451-24b7-97a7-4bf9bd6a92c7","text":"This study focused on the efficacy and recurrence rate among treatments in actual clinical practice. Excision was the most effective modality in the aspects of treatment and recurrence rate. Cryotherapy demonstrated a poor recurrence rate along with occurrence of satellite lesions. In addition, PDT was not comparable to surgical excision due to the relatively low cure rate and high recurrence rate.","title":"Analysis on the Effectiveness and Characteristics of Treatment Modalities for Bowen’s Disease: An Observational Study"}
{"_id":"8fe637de-56a5-55b4-591e-351f1dd0f53e","text":"It has been known for decades that breast cancer patients can experience locoregional recurrence of their disease in the postmastectomy chest wall or regional nodal basins, including the supraclavicular, axillary, and internal mammary regions. Radiation therapy seeks to eradicate occult disease that remains in these locations, not only to reduce the risk of postmastectomy locoregional recurrence, which is a morbid and distressing event, but also to improve overall survival, by eliminating a reservoir from which distant metastases may be seeded or reseeded. The advent of effective systemic therapies has been postulated to increase the likelihood of eradication of distant micrometastatic disease; if disease in the chest wall or regional nodes is the only disease that remains, its eradication becomes particularly important.","title":"Postmastectomy Radiation Therapy: An Overview for the Practicing Surgeon"}
{"_id":"8fe77502-fdfa-4604-685e-479b6bebb17a","text":"The degree of venous congestion can be estimated by describing the percentage of ruborous and violaceous color of the flap skin pedicle, testing capillary refill, and observing color and amount of blood oozing from leech bite sites. Serial photographs can help assess the intensity of venous congestion on a daily basis. The progress of treatment should be also documented.","title":"Recommendations for the Use of Leeches in Reconstructive Plastic Surgery"}
{"_id":"8fe84ba7-280f-4c58-6f72-47c446d554d2","text":"Understanding these concepts and the urge to improve results have pushed the radicality boundaries of exenteration surgery over the last two decades. Previously, absolute contraindications such as involvement of major neurovascular structures (encasement of external iliac vessels, involvement of sciatic nerve), tumour invading above S2, lateral recurrence involving bone and ureteric obstruction were limiting factors due to complexity and failure to achieve clear margins as well as the subsequent risks of those procedures. Nowadays, none of these factors are a definite contraindication for surgery anymore, although an individualized assessment and approach for each patient is still required. Indications and extent of pelvic exenteration procedures have significantly expanded with posterior and lateral exenterations as well pubic bone excision now being performed routinely in many units.","title":"Understanding the Philosophy, Anatomy, and Surgery of the Extra-TME Plane of Locally Advanced and Locally Recurrent Rectal Cancer; Single Institution Experience with International Benchmarking"}
{"_id":"8fe9c1ee-83d0-ee58-3c6d-9744941cf19a","text":"The Authors reviewed the available literature on wound coverage of dorsum and palm of the hand and of the forearm analyzing all the reconstructive options for each area. The aim is to provide a general overview of the coverage of hand wound in order to support the inexperienced surgeon in the management of damaged area reconstruction.","title":"Upper limb traumatic injuries: A concise overview of reconstructive options"}
{"_id":"8fecfecb-4440-3881-6458-37897e82f705","text":"Local flaps are always advantageous compared with microsurgical reconstruction techniques or distant flaps as they are simple and fast to harvest. Cervicopectoral flap may be a good alternative for the surgeons in the treatment of patients with head and neck cancer where co-morbid conditions preclude lengthy operations since a single incision is adequate for excision, neck dissection and reconstruction of the defect.","title":"Cervicopectoral flap in head and neck cancer surgery"}
{"_id":"8ff1c716-e280-2577-04a8-89628cb2f861","text":"Inframammary incision is taken and the area between the pedicle and the crease is resected.","title":"Reduction mammoplasty"}
{"_id":"90088537-0979-1265-1d7c-02c4b161d4a5","text":"LNM can also be induced and regulated by the responses of tumor cells and other cells in the local microenvironment to interstitial fluid flow-related mechanical signals. Indeed, there is strong evidence for the ability of interstitial fluid flow to enhance the glioma cell invasion via the CXCR4\/CXCL12 signaling axis. Interstitial fluid flow can also control breast cancer cell ameboid migration, and transcellular CCR7 ligand gradients can reportedly be shaped by this interstitial flow, thereby promoting the migratory activity of tumor cells and associated LNM. Interstitial flow can also promote macrophage M2 polarization and enable these cells to travel against this flow to access tumors, thus contributing to metastatic progression.","title":"Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions"}
{"_id":"900909fa-caef-424c-b7cf-554de9f74ebb","text":"Diligent surveillance by both the patient and physician can help identify early signs and symptoms of cancerous recurrence and metastasis. There is a paucity of published data addressing the role of primary care physicians in diagnosing and screening for skin cancer. It is unknown how many patients first present to their primary care physician for a suspicious lesion. The current US Preventive Services Task Force does not recommend for or against routine skin cancer screening in patients without a known history of skin cancer. Thus, performing a full body skin examination is left to the discretion of the patient’s primary care physician. Low rates of skin cancer screening by primary care physicians was attributed to lack of training and lack of confidence in diagnosing skin cancer in a 2003 study. However, because most skin cancers are the result of cumulative UV radiation, primary care physicians are uniquely positioned to provide patients with preventative education addressing risk factors, most notably sun protection. Further studies are needed to explore the role of various providers across the healthcare system in diagnosing and treating cutaneous malignancies. Once a diagnosis of squamous cells carcinoma is made, it is recommended that patients undergo skin examinations with a board-certified dermatologist every 3-12 months for 2 years, then every 6-12 months for 3 years, then annually for life.","title":"Ray Resection for Recurrent Invasive Squamous Cell Carcinoma: A Case Report"}
{"_id":"900f7603-0e74-7913-abae-14d5915832b2","text":"The present recommendations focusing on skin, mucosa and nail disorders following oncology treatments were developed following proposals and conclusions reached during a consensus meeting held in November 2011. The working group consisted of six independent European dermatologists and one oncologist.","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"9010bdb7-9502-712f-8a25-aa331cbc6f6f","text":"A multidisciplinary Italian panel of experts was set up to address the following scientific issues:","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"90127215-ccd1-e1df-5755-6f4084156168","text":"We performed a literature review regarding the use of CDU in the preoperative assessment and planning of pedicled perforator flap reconstruction in April 2017 in the PubMed and EMBASE databases, using the search string:","title":"Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps—a systematic review and meta-analysis"}
{"_id":"901aa363-c8e0-6fa4-058d-e0fc1f890f75","text":"One of the main advantages of treatment with topical pharmacotherapy is that it has an effect on the entire ocular surface, including multifocal and subclinical lesions, especially in extensive disease when complete surgical excision is not possible. Topical therapeutic agents are able to penetrate into the tear drainage system and they can treat microinvasive tumors.","title":"Topical pharmacotherapy for ocular surface squamous neoplasia: systematic review and meta-analysis"}
{"_id":"901d2ce5-f16a-bbf0-776b-27797e86e445","text":"One of the most common genetic alterations in the TERT gene in melanoma is the presence of mutations in the TERT promoter region. The C228T and C250T TERT promoter mutations are frequently found in melanoma cases. These mutations result in increased TERT expression and activation of telomerase, leading to the maintenance of telomere length and enhanced cell proliferation. Multiple studies have reported a high prevalence of TERT promoter mutations in melanoma, particularly in cases with aggressive clinical features and poor prognosis.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"90227bf2-daf0-49c0-8a33-7951c3086f98","text":"Scalp injury management is considered very difficult, and the procedures demand careful attention to perform quick and accurate diagnoses and operations. Patients with wide, large scalp defects located in the frontal or parietal regions cannot achieve primary closure without a wide undermining. Oral and maxillofacial surgeons should be active and prepared to assist in any situation as specialists who can immediately diagnose and treat these head injuries based on their extensive knowledge and experience with the maxillofacial skin, muscles, and masticatory muscles. Fundamental management of these injuries is very important to optimize patient care and outcomes.","title":"Scalp injury management by a maxillofacial surgeon in a low-resource hospital"}
{"_id":"9025ebb9-535d-df7b-4cc4-f7f2a90a7d53","text":"Patient 4 received 48 Gy in 20 fractions for a recurrent right posterior scalp melanoma, experiencing grade 2 radiation dermatitis that was well controlled with emollients. There was no evidence of disease recurrence at 3 months post treatment.","title":"3D printed integrated bolus\/headrest for radiation therapy for malignancies involving the posterior scalp and neck"}
{"_id":"9031f3ef-8771-3519-e28d-537be72279d4","text":"Another subtle contrast between the two techniques lies in the fact that while MMS strives to minimize the loss of normal tissue, irregularly trimmed margins may necessitate additional trimming by the reconstructive surgeon to achieve optimal alignment of the wound edges. However, when the same surgeon performing the frozen section surgical excision margin control is also responsible for the subsequent reconstruction of the periocular defect, they can strategically plan clear clinical margins with the reconstruction in mind. This means that it may not be necessary to sacrifice a larger amount of uninvolved tissue compared to what is ultimately sacrificed during MMS [26,33,47].","title":"Recurrence of Basal Cell Carcinoma Treated with Surgical Excision and Histopathological Analysis with Frozen Section Technique with Complete Margin Control (CMC-FS): A 15-Year Experience of a Reference Center"}
{"_id":"903b4c7a-9aa5-0cf6-dfc0-21c604cba372","text":"We undertake remote monitoring of data entered in real time on a secure, anonymised database and conduct monitoring visits of collaborator sites to confirm integrity of data.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"903e484f-3fd8-27f6-7ca0-c71d577f933e","text":"The aim of this prospective study is to assess the efficacy of parasternal block to manage postoperative analgesia, reduce opioid consumption and improve respiratory function in patients undergoing cardiac surgery.","title":"Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study"}
{"_id":"9043f572-2190-885a-e288-097b762b6143","text":"The first limitation was that the patients had knowledge on the regional technique applied, therefore the participants could not be completely blinded to the study, since some of the patients who underwent ESPB had previous experience of MWA performed without blocking. Another limitation may be that the patients included in the study received prophylaxis against nausea\/vomiting with immunosuppressive drugs, and the effect of ESPB on the incidence of nausea\/vomiting could not be evaluated.","title":"Clinical efficacy of ultrasound guided erector spinae plane block in patients undergoing microwave ablation"}
{"_id":"9047f02b-4ae6-b650-b983-58b2a5524bae","text":"The patient underwent mobile total tongue reconstruction with a sensitive anterolateral thigh that recreated a near normal neotongue shape with more projected tip and vertical bulk. This modification of the flap shaping and folding optimized the postoperative oral function.","title":"Ablation of advanced tongue cancer and mobile tongue reconstruction by using a sensitive anterolateral thigh and vastus lateralis muscle free flap"}
{"_id":"9052b80e-dcb0-500a-de23-e6bb4bf34060","text":"In conclusion, we report a case of delayed deep cervical abscess after ACDF and cervical spine instrumentation. Late deep cervical infection should be considered if a patient had a history of ACDF and presents with dysphagia even in the absence of fever or esophageal perforation. In addition to radical debridement and removal of loosed implant, appropriate antibiotics should be used with avoiding over-usage of antibiotics. External Hallo Frame support is recommend for the patient with unstable vertebral fusion.","title":"Late deep cervical infection after anterior cervical discectomy and fusion: a case report and literature review"}
{"_id":"9052dc3e-df4e-342f-dc54-7750253537c8","text":"All the patients with evidence of deep venous thrombosis (both proximal and distal) underwent repeat Doppler study one week after the detection of thrombus to rule out proximal extension of the thrombus. Six patients with distal DVT did not show evidence of further propagation of thrombus on repeat Doppler study. In fact, there was resolution of thrombosis in all the patients. All the three patients who showed evidence of proximal DVT at the time of first Doppler examination and who were subjected to standard thrombolytic treatment did not show any propagation of thrombus. None of the patients developed clinically evident pulmonary embolism while in hospital or during the first six weeks following surgery.","title":"Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?"}
{"_id":"9052f38a-1c84-6568-4dc8-a077bf6fb013","text":"The patient began external radiation 2 months postoperatively to the left total parotidectomy tumor bed using generous margins and tracing the path of the left facial nerve back to the stylomastoid foramen. Lymph nodes were not included since the surgical specimens were negative and spindle cell sarcomas do not generally metastasize to lymph nodes. Left facial droop improved over the course of 6 weeks of 30 radiation treatment fractions. Six months after surgery, PET scan of the head and neck showed no abnormal hypermetabolic foci within the head and neck region to suggest metastatic disease. Nonspecific bilateral hilar hypermetabolic densities were appreciated, so a repeat CAT scan 3 months later was recommended. At a one-year postoperative followup, the patient had no complaints and only marginal facial nerve palsy was noted on exam.","title":"Leiomyosarcoma Ex Pleomorphic Adenoma of the Parotid Gland: A Case Report and Literature Review"}
{"_id":"9061f675-344d-f1b5-8156-7f8a61b9c3d1","text":"Free flap salvage head and neck surgery is a challenging endeavour. Recipient vessels must be of significant calibre and reliable. The ease of dissection and access for microsurgery is an additional benefit.","title":"The thoracoacromial axis in salvage head and neck reconstructive surgery, a case series"}
{"_id":"906cd50f-216d-8352-d10a-0a47b4a2d785","text":"Although the experience with PDT\/PCI produced anti HGG vaccines is limited and no clinical trials have been done, PDT\/PCI appears to be an inducer of immunogenic cancer cell death, an important step in the afferent phase of the immune anti-tumor response. Light activated induced immunotherapy therefore holds the potential to become a complementary therapeutic option for for patients with HGG. Taking into account the penetration limitations of light activated therapies in the brain the further development of ex vivo PDT\/PCI generated APC or peptide vaccines seems the most attractive approach. A deeper and detailed understanding of the induction of the antitumor immunity induced by light activated therapies would allow in the defining of protocols which would focus and enhance the immune system to recognize and prevent the inevitable post-operative recurrence of the tumor. Combining PDT induced anti-tumor vaccines with other therapeutic modalities including check-point inhibitors, is an exciting field to explore. Although not discussed in this review both PDT and PCI have an effect on the vasculature and have been show to temporarily open the blood brain barrier in a limited site specific region[. What additional role this would play in the development of an effective and safe anti-HGG patient therapy, remains to be established.","title":"Photodynamic therapy mediated immune therapy of brain tumors"}
{"_id":"906ddedc-88f0-66d6-59c3-1f2467b27d38","text":"More sternal revisions were associated with better outcomes in our study, which may have been the result of a more thorough revision which stimulates the formation of granulation tissue. Some authors have recommended early sternal reconstruction with a pectoral muscle flap together with surgical debridement of the sternum in a single stage, as it would result in a shorter duration of hospital stay and less time in the ICU after the operation. However, other studies show that delayed closure of the wound with muscle flaps, when systemic infection has subsided, decreases the rate of wound complications compared with early closure.","title":"Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap"}
{"_id":"90750c49-77c2-b4b7-e1dc-53d0e9e7f12f","text":"Repeatedly cited by many of the interviewees as an important aspect of the fellowship was the fellow’s exposure to different styles of leadership. Most interviewees stated that they were able to observe different leadership styles and reflect upon their effectiveness. Leadership behaviours were observed not only in the overseas partners, but also in the UK-based IGH programme directors and the other IGH Fellows. Some interviewees discussed how they reflected on the leadership styles embraced by the individuals they encountered. The following comment does not explicitly state whether the leaders referred to are part of the overseas partnership or the UK-based programme:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"907729f1-8f6d-c130-5726-050506215857","text":"Mounting data demonstrate that the immune system is involved in successful control of cancer in some patients. Nature and degree of immune infiltration into tumors is now recognized as an independent prognostic factor, including for breast cancer. While tumor invasion into SLNs is a key determinant of prognosis, it is important to keep in mind that lymph nodes are immune organs. Alterations in immune profiles in TDLNs are becoming recognized as potential additive information. Through analysis of SLNs, our results suggest that the immune suppressive microenvironment extends beyond the tumor to draining lymph nodes. Important immune changes involve not only T cells, but also B cells and dendritic cells.","title":"Sentinel lymph node B cells can predict disease-free survival in breast cancer patients"}
{"_id":"907a4555-9753-2767-654a-7cd8a541cc41","text":"The use of this flap must be explained to the junior hand surgeons as they are often the ones treating thumb pulp defects in the emergency.","title":"First dorsal metacarpal artery islanded flap: A useful flap for reconstruction of thumb pulp defects"}
{"_id":"907d4d06-d564-df4e-8a42-8cbcb3e691c0","text":"One patient with a latissimus dorsi myocutaneous flap developed partial flap necrosis possibly because the angiosome did not fully cover the flap and defect. Postoperative deep infection occurred in seven patients: in three of these patients because of extensive crushed injury, in three patients because of diabetes mellites gangrene, and in one patient because of postoperative osteomyelitis. Debridement under the flap was needed for eight patients, including one with suspected infection. The soft tissue defects in these eight patients healed after thorough debridement, and the function of the extremities was preserved.","title":"Efficacy of the microscopic parachute end-to-side technique for creating large-to-small venous anastomoses in free flaps in the extremities"}
{"_id":"907ee91e-a15f-78e7-3b57-917651fe727b","text":"This review acknowledges that there is a particular instance where mixed research methods may contribute in assembling evidence from quantitative studies and in-depth analyses of few patients.","title":"Perinatal psychological interventions to promote breastfeeding: a narrative review"}
{"_id":"90833071-1fcc-ee43-fb46-214e844adb5e","text":"Immunohistochemical analyses showed that the best microstructural preservation of the SVGs is achieved by NT harvesting, while the EVH technique significantly reduced the leg wound complication. The development and implementation of the endoscopic no-touch technique could be the best strategy option.","title":"Influence of Three Different Surgical Techniques on Microscopic Damage of Saphenous Vein Grafts—A Randomized Study"}
{"_id":"90893441-9c9c-8def-a2da-4701e253f25f","text":"Tongue tie affects a considerable number of infants and children. It is perhaps interesting that such a simple condition can cause such controversy and diversity of opinions. However, it is important that accurate information and guidance is given to parents with regard to the indications and potential benefits of tongue-tie revision, and that appropriate provisions are in place for those infants and children who require revision. These case reports offer guidelines which can be used by general and pediatric dentists for diagnosis and treatment of a tongue restriction resulting from ankyloglossia.","title":"Clinical Guidelines and Management of Ankyloglossia with 1-Year Followup: Report of 3 Cases"}
{"_id":"90926e8a-2cdf-a787-9166-8ce701715de7","text":"Letters of recommendation and personal connections to applicant\/letter writer were other highly ranked factors when selecting applicants to interview and rank. These factors are evaluated before the interview. These results underscore the importance of applicants selecting appropriate letter writers and networking with mentors in the field. Applicants with poor shoulder and elbow experience in residency or suboptimal technical competence in shoulder and elbow surgery should not be dissuaded from applying. These factors consistently ranked among the least important.","title":"Factors considered in ranking orthopedic shoulder and elbow fellowship applicants: a survey of program directors"}
{"_id":"909aba37-b268-88d0-7cfd-5c0b624828ed","text":"The reconstruction of the middle 3rd of the leg poses a lesser challenge compared to the distal 3rd of the leg. Currently, the free flap is the treatment of choice for large soft tissue defects of the distal extremity. Though it solves the problem of donor site morbidity in the immediate vicinity of the flap, It is however a technically demanding procedure for surgeons with less microsurgical experience. In our environment where there is limitation in the facility and experience for free flaps, the reverse sural artery flap has proven to be one of the few safe options for soft tissue coverage [16] in this part of the leg. The accompanying arteries of the lesser saphenous vein and sural nerve have been utilized with success for harvest of reverse flow sural flap [17]. The sural nerve remains the anatomic landmark for the inclusion of vessels in pedicle of the flap [18]. The sural artery reverse flow flap is nourished by the lowermost perforating branch of the peroneal artery. The sural nerve run vertically down the narrow groove between the two heads of gastrocnemius muscle and pierces the deep fascia halfway down the leg to run subfascially. Passing down this plane, it is joined by the peroneal communicating nerve [19]. In raising the sural artery flap, the sural and the peroneal communicating nerve are transected. Though the numbness in the distribution of sural nerve is not a major concern to many surgeons as it is self limiting [18], there is the potential of patient developing painful neuroma if the stump is not buried in the deep muscular plane. Furthermore, a patient that is not well motivated may have recurrent injury to the numbed area while awaiting sensation to return which can be a recipe for chronic leg ulcer. In a diabetic, there is wisdom on preserving sensation to the foot so as not to contribute to their developing a neuropathic ulcer. In rural area where many walk unshodded to the farm, preserving protective sensation to the foot is no doubt important so as to rehabilitate patient back to his or her means of livelihood as soon as possible.","title":"Sural nerve preservation in reverse sural artery fasciocutaneous flap-a case report"}
{"_id":"909e3dfe-578a-61c4-88ca-f2cd7aa7d00a","text":"We would like to point out a possible limitation of this study, in that we did not perform a physical examination of whether the shoulder joint experienced tenderness before we administered the nerve block.","title":"Preoperatıve Ultrasound-Guıded Suprascapular Nerve Block for Postthoracotomy Shoulder Paın"}
{"_id":"90a252c4-a5c8-a157-00a0-da644cde6054","text":"The study included 19 children from Poradnia Ortopedyczna Polsko-Amerykańskiego Instytutu Pediatrii (UJ CM) in Kraków with genetically diagnosed osteogenesis imperfecta. A group of 20 patients with osteogenesis imperfecta was selected (one child was excluded from the study in the process due to psychomotoric disorders that made it impossible to perform the physical examination). The basic condition for a patient to qualify for the study was the diagnosis of osteogenesis imperfecta . Another selection criterion was the patient’s age which had to range from 1 to 18 years. The criterion that excluded the patient from the test group was the coexistence of a serious psychomotoric disability that made it impossible to perform the physical examination. The above-mentioned patient selection criteria were used to restrict the number of any disturbance factors and in this way achieve the best possible homogeneity of the group.","title":"Evaluation of Stomatognathic Problems in Children with Osteogenesis Imperfecta (Osteogenesis Imperfecta − OI) − Preliminary Study Ocena problemów stomatognatycznych u dzieci z wrodzoną łamliwością kości (Osteogenesis Imperfecta − OI) − Badania wstępne"}
{"_id":"90a2f6d9-a97b-9961-b016-1f79d7d3f79f","text":"The refractory nature of biofilms such as seen in chronic infections and osteomyelitis, endows these bacteria to become persisters. These persisters or recalcitrance, acquired by the bacteria make them resistant to host immunity and to antimicrobials and lead to chronicity of the infection.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"90a8d8a0-a95c-7b19-b2d6-a81dfd9db43d","text":"We conclude that expansions in C9ORF72 associated with AD are a rare occurrence, and in those instances in the literature where these have been reported, the presence of AD may in fact be coincidental and unrelated to the expansion.","title":"Pathological assessments for the presence of hexanucleotide repeat expansions in C9ORF72 in Alzheimer’s disease"}
{"_id":"90a9c8c9-2bae-c3a2-2c94-ff58a284d741","text":"HSI provides valuable data in free flap monitoring. The technique seems to be superior to the gold standard of flap monitoring. StO2 and NIR PI deliver the most valuable data and 40 could be used as a future threshold in surgical decision making. Clinical Trial Register This study is registered at the German Clinical Trials Register (DRKS) under the registration number DRKS00020926.","title":"Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study"}
{"_id":"90b42b3f-ec3d-fc92-f114-9f306058e0fb","text":"Comparing with the severity of nose deformity, nasal septal deviation and radiological investigation (CT scans or plane Radiographs founding’s) children and adolescents were divided into 5 groups. In our study, we have been made the systematic classification of the deviations of the nasal septum taking into consideration not only the classifications in the region of the cartilaginous septum but the position of the nasal septum regarding the external configuration of the nose. The objectives of this classification were to encompass all the pathological alterations of the nasal septum and to document them, in order to implement an adequate surgical technique.","title":"Justification for Rhinoseptoplasty in Children – Our 10 Years Overview"}
{"_id":"90b8d757-0344-2d46-b507-89d3c8cc09b0","text":"We analyzed data concerning 615 patients with early BC who underwent WBI with conventional fractionation at our institution between December 1984 and December 2010.","title":"Waiting time for radiation therapy after breast-conserving surgery in early breast cancer: a retrospective analysis of local relapse and distant metastases in 615 patients"}
{"_id":"90bf1d93-8a96-f087-80be-8a5304dcf9f4","text":"All cyst cases have supported the seeding theory till now and then they were characterized as being successfully treated with surgery without any recurrence.","title":"The Development of Dorsal Nasal Cyst Formation after Rhinoplasty and Its Reconstruction with Conchal Cartilage"}
{"_id":"90bf3d80-4ce1-e59d-acb4-ecbf97cfe0b3","text":"In summary, individuals with NMSC and no prior history of non-skin cancer were more likely to develop another cancer following a NMSC diagnosis, particularly melanomas. Detailed individual risk factors other than age, sex and smoking could not explain this increase in cancer risk overall. Sun sensitive skin type and family history of NMSC explained a small fraction of the excess melanoma risk after NMSC, but adjustment for several other known and putative cancer risk factors did not remove the association between NMSC and subsequent melanoma or other cancers. Understanding the shared risk factors that contribute to multiple malignancies may lead to new etiologic insights. In particular, larger studies incorporating detailed genetic data may help to identify NMSC patients at greatest risk for subsequent cancers and who may benefit from more intensive screening.","title":"Non Melanoma Skin Cancer and Subsequent Cancer Risk"}
{"_id":"90c03f3a-d5a8-f0c6-1ce8-577405afcb9e","text":"Most studies on this subject report an advantage of the skullcap toward the other sites because it is a corticalized bone that undergoes less resorption, leading to more predictable results for the installation of implants, both in the maxilla and mandible, with lower postoperative morbidity. The disadvantages are related to the need for general anesthesia, to the potential complications and to the patient acceptance of cranial surgery more than to its surgical difficulty.","title":"Evaluation of bone availability for grafts in different donor sites, through computed tomography"}
{"_id":"90c441c8-abcc-85ba-7116-abc52c7cbf35","text":"Our data demonstrate that free tissue transfer is a reliable reconstructive method for defects in the head and neck area with high success rates, despite frequent complications.","title":"Free Tissue Transfer in Head and Neck Reconstruction: A Multidisciplinary 15-Year Experience"}
{"_id":"90c69ab3-7926-94f7-296a-c190ce792e59","text":"One of the main advantages of MRI over CT and CBCT is the high soft tissue contrast and the ability to vary the contrast by changing the design of the MRI sequence, as well as the absence of ionizing radiation [30].","title":"An Update of the Possible Applications of Magnetic Resonance Imaging (MRI) in Dentistry: A Literature Review"}
{"_id":"90cf3a02-69d7-4eb7-eb13-97f3fc44e968","text":"Figure 12 shows the mean time taken to optimize all three hull-type RGs for each case, and the number of points comprising the tumor 3D convex hull. Optimization tends to take longer where there are a greater number of points comprising the hull.","title":"Automated elaborate resection planning for bone tumor surgery"}
{"_id":"90da6162-d05e-1162-f1c4-d673b58bccd6","text":"Cutaneous melanoma is becoming epidemic and its incidence is expected to increase. Some well-designed trials have changed the management of CM patient and it is expected that the results of ongoing ones will also bring major changes. Although multidisciplinary approach represents the best standard of care for melanoma patients, surgery remains the best option for most localized cases. Early detection, state of the art biopsy and wide local excision according to rules established by clinical trials can cure the disease. SLNB can identify high-risk patients to whom the opportunity of attending clinical trials may be given. We hope that the future will belong to personalized therapy.","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"90e36f06-ab52-b00f-1224-3329101d94c7","text":"Recent biomechanical studies proved that the fine-wire fixator provides adequate mechanical stability for the fixation of bicondylar tibial plateau fractures. The ring fixator provides good purchase in soft cancellous bone. The tensioned wires function as a scaffold in buttressing the subchondral bone, restore the intrinsic stability of the fracture site with a bridge device, and allow the patient to transfer his or her body weight through the scaffold to allow early weight-bearing.","title":"Complex Tibial Plateau Fractures: Primary Fixation Using the Ilizarov External Fixator. A Two-year Study at Civil Hospital Karachi, Pakistan"}
{"_id":"90e3b6a9-6d46-2a57-9551-f3a16780d9af","text":"Conditions such as vasogenic and cytotoxic cerebral edema require an extensive understanding of pathophysiological reasoning and must be treated accurately and appropriately. The anesthesiologist is required to provide optimal operating conditions and to be capable of early detection and proper management of intraoperative events and complications. As such, any disturbances must be corrected to ensure a smooth operational intervention. Emergence should be well and rapidly controlled to establish assessment immediately after the procedure.","title":"Value of Neuroanesthesiology Fellowship Training"}
{"_id":"90e3ed11-269b-f404-d369-ea9504507e16","text":"A variety of mitigating factors then began to be uncovered that could promote or suppress cell death. The evaluation of the voluminous data on pathways of photokilling is difficult since many of the events characterized are common to any toxic phenomenon. As cells begin to die, an array of enzymes are activated or inactivated and many things begin to happen. There are estimates that the executioner caspases act on hundreds of proteins; dysfunctional mitochondria produce reactive oxygen species and a collection of survival responses appear. Much of this is not unique to PDT, and it is unclear whether interference with these responses can selectively promote or otherwise alter PDT efficacy.","title":"More Adventures in Photodynamic Therapy"}
{"_id":"90e5e029-aee4-aead-3354-d3364d07eebb","text":"Unfortunately, I have also have seen throughout graduate medical education an eroding of the commitment to allow residents to gain these experiences, as these rotations come under assault from hospitals who wish to retain their graduate medical education funding. Most of us in academic medicine agree that hospital funding is essential and understand the financial pressures hospitals are under. However, if we wish to maintain our preeminence in medicine, it cannot be just in new medicines and technologies. The future physician must be able to understand and anticipate the problems of an increasingly diverse population of patients. If we do not understand where they came from and the unique ecological, sociological, and cultural factors that affect them, we will be unable to fully practice a holistic approach to their illness.","title":"Loss of international medical experiences: knowledge, attitudes and skills at risk"}
{"_id":"90edb785-5349-f454-d72e-f03538676a33","text":"Therefore, breast reconstruction and oncoplastic conservation surgery using distinct latissimus dorsi muscle flap offer a good quality of life and help women to better integrate themselves into society and have normal life after the surgery.","title":"A Retrospective Study of Latissimus Dorsi Flap in Immediate Breast Reconstruction"}
{"_id":"90f73b99-dfca-ffd3-169b-d8c2656796ff","text":"Figures 2c and 2d illustrate the temperature distribution and the electric field during thawing. Figure 3c shows that adjacent to the cryoprobe, the temperature inches upwards because of the insulating boundary conditions applied by the probe during thawing. If thawing were extended beyond 90 seconds, the temperature graph would continue to equilibrate toward the phase transition temperature. The temperature distribution has a point of inversion, which appears to be stationary in time at about 0.2 cm from the outer surface. This point of inversion corresponds to the position of the change of phase interface.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"90f8851a-77b8-6773-12ab-8a46baa089e6","text":"Infectious spondylitis is basically a medical disease. Parenteral antibiotics are the mainstay of treatment for infectious spondylitis. Antibiotic treatment must start early to prevent disease progression and development of potentially irreversible neurologic deficits. Identifying the offending pathogen is critical for the administration of appropriate antibiotics. However, antibiotic selection is often guided by empirical evidence because clinicians want to begin treatment as soon as possible. In fact, clinicians routinely prescribe antibiotics for the treatment of infectious spondylitis with no evidence of the causative pathogen or its antibiotic sensitivity.","title":"Exposure of Prebiopsy Antibiotics Influence Bacteriological Diagnosis and Clinical Outcomes in Patients With Infectious Spondylitis"}
{"_id":"90f8b25a-335e-6d1b-ffef-72fbc9dc8b94","text":"Regarding the nine cases referred for allergist evaluation of reactions that occurred after vaccination initiation, seven patients received mRNA vaccines and two received adenoidal vector vaccine. We found hypersensitivity cutaneous reactions in five patients and angioedema in one and other side effects related to administration such as myalgia and fatigue in two and persistent anosmia in one patient (Figure 3).","title":"Role of Allergist Advice in Determining Personal Decisions for COVID-19 Vaccination of People With a History of Allergies"}
{"_id":"91149902-9e58-3172-5f9f-c962e56935fa","text":"The course begins with an interactive survey presented by the instructors, the purpose of which is to cover and impart basic knowledge regarding the healthcare system and bring all the participants up to the same level. In addition, representatives of the executive board and the medical director hold guest lectures to present information on the structure and responsibilities of the executive and supervisory boards of the University Hospital in Munich.","title":"Simulating the physician as healthcare manager: An innovative course to train for the manager role Simulation Gesundheitsmanagement – der Arzt als Gesundheitsmanager: Ein innovativer Kurs zur Ausbildung der Managerrolle"}
{"_id":"91160a56-fe33-51d3-1719-0465d8af02fa","text":"Partial tongue defects can be closed primarily or with full thickness skin grafts to prevent graft contracture. If primary closure or a graft is likely to result in significant tongue tethering, a flap is usually indicated for closure. In practical terms, flaps are commonly required for defects approaching half the tongue and larger. Additionally, a through and through defect communicating with the dissected neck is usually best addressed with a flap to decrease the risk of fistula.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"912367fc-73b6-9eea-0deb-4bc9d9745841","text":"With adequate surgical exposure and meticulous dissection provided by the magnification loupes, we were able demonstrate one of the lowest recurrence rates in the literature. Well-designed studies combining the recurrence rates of several hand surgery centers implementing a standardized treatment are needed to better demonstrate the associated risk factors for recurrence.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"9126ea97-f70c-eb97-077b-1f644535e867","text":"The development of trunk imbalance along with the associated pelvic obliquity can affect both standing balance and walking ability in ambulatory patients. It may also cause sitting intolerance in wheelchair-bound patients due to collapse of the spine and painful costopelvic impingement on the concavity of the scoliosis and these patients are gradually converted into hand-dependent sitters.89 Patients with a severe scoliosis can develop cardiopulmonary complications due to chest distortion which follows the spinal deformity, as well as pressure sores in the buttock area due to asymmetrical loading in the presence of skin insensitivity and pelvic decompensation.11 Associated medical co-morbidities such as gastro esophageal reflux, swallowing disorders, repeated aspiration may also get aggravated with progression of the spinal deformity.","title":"Development and treatment of spinal deformity in patients with cerebral palsy"}
{"_id":"912d024a-4b53-ec6b-b678-a052ff0f28c0","text":"Complete surgical resection is the first line management of this tumor entity.","title":"Desmoid tumors of the abdominal wall: A case report"}
{"_id":"91338aef-4b3f-e4b0-dcef-276171df096a","text":"Because of controversies in previous research results and the probable impact of BTA injection in reducing rhinitis symptoms, this study was performed in order to evaluate the impact of a submucoperichondrial injection of BTA in the treatment of idiopathic non-allergic and persistent AR with a larger sample size in Iran.","title":"Effect of Botulinum Neurotoxin A Injection into the Submucoperichondrium of the Nasal Septum in Reducing Idiopathic Non-Allergic Rhinitis and Persistent Allergic Rhinitis"}
{"_id":"914636cc-d45b-0fad-a6b4-71874e82dc4c","text":"In this study we included primary cutaneous melanomas histologically verified by expert dermatopathologists, and nevi confirmed by two expert dermatologists with clinical and dermoscopic examination. Only lesions on body parts accessible to the MSI device were investigated. If the lesion was larger than the field of view, multiple image sets were captured.","title":"Multispectral Imaging Algorithm Predicts Breslow Thickness of Melanoma"}
{"_id":"914da28a-9239-27ea-ac45-9fe5b6632f71","text":"The patients were followed up until January 2019, with a maximum follow up time of 3 years and a minimum of 13 months.","title":"The Proceedings of the 19th International Cancer Imaging Society Meeting and Annual Teaching Course"}
{"_id":"915a8b44-2675-275b-a638-11726c026857","text":"Secondary procedures may involve dermabrasion for sebaceous skin irregularity if needed. Some cases require a delayed sectioning of the muscle pedicle owing to its thickness. This thickness can impinge on the internal nasal valve impacting the airway. The secondary procedures are performed mostly under local anesthesia. Anticoagulation has not been found to be a contraindication to the primary procedure.","title":"Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction"}
{"_id":"915c0e01-25c0-67a1-c90e-767b79857977","text":"The first step before the application of the external fixation is anatomical reduction of the articular surface. In order to achieve this, a small skin incision is required. The fragments are then fixed to their anatomical place by olive wires adjusted properly to the external fixator. The use of internal fixation is rarely required while the use of bone grafts is very limited.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"91652540-4a3f-d690-ecf6-04eb25a71da6","text":"The prospective observational study uses duplex ultrasound to examine changes in thrombus characterisation, evolution and resolution over time in patients with a confirmed DVT on ultrasound. The primary outcomes of the study are DVT resolution, recurrence and the development of PTS.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"916c7836-ed4b-d318-ffbf-96130f1d194f","text":"Contrary to usual, in XP patients, even small excision often requires accurate reconstructive planning because of an absence of skin pliability and consequent failure of conventional skin border approximation and suture.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"916c8a9f-b293-4989-b602-910075e10c5d","text":"Photosensitizers are frequently used as drugs in photodynamic therapy. Due to accumulation of the photosensitizer within malignant tissue and subsequent illumination with light of a specific wavelength, highly reactive oxygen species arise, which are able to induce apoptosis of the tumor cells. The distribution of the photosensitizer in tissues can be monitored by fluorescence microscopy. However, the major restrictions of this technique are its high limits of detection. Laser ablation coupled to inductively coupled plasma mass spectrometry offers much higher sensitivity enabling the investigation of the fate of the photosensitizers. Tagging of the drugs with Pd enabled the detection by means of ICP-MS.","title":"1st Joint European Conference on Therapeutic Targets and Medicinal Chemistry (TTMC 2015)"}
{"_id":"916f9a79-0f33-76a2-3983-37f50f482e36","text":"In the present case, based on existing documentation and our own previous experience, we recommended forehead flap reconstructive surgery in the appropriated amputated nasal tissue after proper irrigation and debridement with the understanding that further reconstructive efforts would most likely be required.","title":"Use of Forehead Flap for Nasal Tip Reconstruction after Traumatic Nasal Amputation"}
{"_id":"917021c5-6483-873b-01c7-296b23f653c5","text":"No clear evidence of distant metastasis or vaginal wall tumors was obtained by CT examination or pelvic MRI.","title":"Concomitant sentinel lymph node biopsy leading to abbreviated systematic lymphadenectomy in a patient with primary malignant melanoma of the vagina"}
{"_id":"9170effc-831b-35a0-fbed-ef338c5873b0","text":"Ultrasound with color flow Doppler demonstrating monophasic Doppler with lack of venous flow beyond clot burden is shown in Figure 3.","title":"A Case of Phlegmasia Cerulea Dolens"}
{"_id":"91710844-c809-91d4-a98a-cc8bd3f72560","text":"We found that gene expression of both SERPINA3 and TSPAN3 was increased in mutated tumors.","title":"Human microRNA expression in sporadic and FAP-associated desmoid tumors and correlation with beta-catenin mutations"}
{"_id":"91754d54-262e-5a7b-7ed2-ace1052215bb","text":"We counselled our patient not to become pregnant and give birth, primarily because her pelvic pouch would probably necessitate a caesarean section, which would put her at increased risk of abdominal desmoids. The natural history of her disease has proved this to be sound advice.","title":"APC mosaicism in a young woman with desmoid type fibromatosis and familial adenomatous polyposis"}
{"_id":"917a13c6-aa5d-1251-c4af-c2215ade5c4d","text":"The postero-lateral approach was used for THR in lateral decubitus position and the midline anterior medial parapatellar approach was used for TKR. We used one gram of intravenous tranexamic acid thirty minutes prior to incision for both THR and TKR patients and used a tourniquet for TKR to reduce perioperative bleeding. All of our patients of hip and knee replacement were done under epidural anaesthesia followed by subcutaneous injection of low molecular weight heparin 40mg for 5 days from the first postoperative day to prevent deep venous thrombosis. Postoperative follow up of patients were done at1 month, 6 months and then yearly. All patients underwent cemented TKR, elderly osteoporotic patients underwent cemented THR and younger individuals underwent uncemented THR for easier later revision.","title":"Demography of Total Joint Replacement Surgeries Performed in a Tertiary Care Hospital: A Cross-sectional Survey"}
{"_id":"917fb330-f170-41b1-940a-220aa9e8a893","text":"Treatment was terminated when the total number of procedures performed was more than 10, when patients felt comfortable for over 2 weeks during the treatment period, or when patients wanted to stop the treatment.","title":"Integrative Treatment for Tinnitus Combining Repeated Facial and Auriculotemporal Nerve Blocks With Stimulation of Auditory and Non-auditory Nerves"}
{"_id":"918f947f-dbaa-eac5-596d-a8cade05d1dd","text":"In hybrid photoacoustic imaging, the high resolution ultrasound imaging can be used for orientation, as well as for diagnosis, as in conventional ultrasound. The two techniques are synergetic as they are based on different imaging contrasts; ultrasound is based on acoustic impedance which is sensitive to anatomy and photoacoustics on light absorption which is sensitive to molecular properties. The reflective mode hand-held system proved capable of 3D imaging of the entire lymph node. Further research should be directed towards the robustness of this technology for the detection of small melanoma lesions within human lymph nodes and its specificity.","title":"Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging"}
{"_id":"91973c85-b828-039b-af8b-8d1d096fafee","text":"The posterior tibial artery normally arises from tibial-fibular trunk at the popliteal fossa, together with the fibular artery. The classic course of the posterior tibial artery is to run between the triceps surae muscle and muscles of the posterior compartment of the leg before continuing its course posteriorly to the medial malleolus, while the fibular artery runs through the lateral margin of the leg. Studies of both arteries are relevant to the fields of angiology, vascular surgery and plastic surgery. To the best of our knowledge, we report the first case of an anastomosis between the posterior tibial artery and the fibular artery in their distal course. The two arteries joined in an unusual “X” format, before division of the posterior tibial artery into plantar branches. We also provide a literature review of unusual variations and assess the clinical and embryological aspects of both arteries in order to contribute to further investigations regarding these vessels.","title":"Clinical features of a rare anatomical variation of the posterior tibial and fibular arteries Aspectos clínicos de uma variação anatômica rara das artérias tibial posterior e fibular"}
{"_id":"91985d12-68e5-bba9-2716-c0e57abeb1cf","text":"The first stage of the surgery was the posterior cervical internal fixation and the length interception of the vascularized fibular. Patient was immobilized using the cephalostat in the prone position. The posterior region of the neck and left leg was disinfected and skin incision was performed at the level of the posterior midline. The muscles, vessels, and fascia were dissected to expose the lateral mass of the C2 to C7 vertebral body. C2 and C7 were immobilized using 2 pairs of pedicle screws and C4 and C6 VB were immobilized using lateral mass screws. A titanium rod was inserted based on the physiological curvature and inserted into the groove with screws and fixed with pedicle screw caps and subsequently the surgery wound was closed.","title":"Application of vascularized fibular graft for reconstruction and stabilization of multilevel cervical tuberculosis A case report"}
{"_id":"919bcc1e-1724-f148-ddea-b16fe33b1bab","text":"In one of our cases of post burn knee contracture, the flap was islanded on two perforators which were very close to each other, rotated through around 90 degrees and we were able to give inset to the flap without tension and kink on the pedicle. The flap was tunneled below the semitendinosus muscle to improve the reach of flap and to facilitate suturing without undue tension. Then tendon lengthening and repositioning of the muscle underneath the flap was done. The flap was monitored for any vascular insufficiency and when none was encountered, it was decided to retain both the perforators (Figure 6).","title":"Use of Local Perforator Flaps for Post Burn Reconstruction"}
{"_id":"91aa1561-1589-64a0-f0a6-57960dbbdd04","text":"One of the limitations of this survey is that participants were asked to provide self-reported surgical numbers which may therefore introduce bias of recall and perception. In addition, our survey was distributed to BEAVRS members via an email list with voluntary participation which may have resulted in selection bias. Finally, a direct comparison with previous surveys published on US VR fellowships cannot always be made due to the differences in practice and duration of fellowships.","title":"Experience gained during vitreoretinal fellowships in the United Kingdom"}
{"_id":"91ab9c89-8573-565e-7138-e881d411d576","text":"Hematomas may occur due to inadequate hemostasis or due to inadequate drainage of a surgical site. A surgical bed does not need to be completely dry for hemostasis to be adequate. A small amount of oozing is acceptable and will be reabsorbed by the soft tissues. But larger surgical sites have larger vessels and thus pose a greater risk of hematoma. In general, the larger the surgical site, the greater will be the need for drainage. Penrose drains are appropriate for only small wounds. Closed suction drains such as Jackson-Pratt drains are superior in efficacy and can also quantify the amount of drainage.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"91ae0bcb-7fe4-aed6-b251-4b5b8f16ab77","text":"ALND was conducted following a standard protocol, removing all lymph node‐bearing tissue from the thoracodorsal neurovascular bundle laterally to the chest wall medially, from the axillary vein superiorly to the insertion of thoracodorsal vessels into the latissimus dorsi muscle distally, and from the anterior aspect of the axillary vein to the subscapularis muscle posteriorly. At the superior‐most aspect of the axillary dissection, just inferior to the axillary vein, the lymph node tissue immediately lateral to the thoracodorsal vein was also routinely taken. Level II lymph nodes posterior to the pectoralis minor muscle were included as part of the axillary specimen. Level III lymph nodes were removed if indicated for palpable disease.","title":"Comparison of indocyanine green and methylene blue use for axillary reverse mapping during axillary lymph node dissection"}
{"_id":"91af0f2b-e662-ace5-7f60-5b2f4a5e942c","text":"Calcinosis cutis is a known but rare complication from the extravasation of intravenous calcium preparations. Calcium gluconate is a commonly used medication to prevent cardiac arrhythmias in the setting of hyperkalemia and cardiac arrest during resuscitation and life support. Extravasation of calcium gluconate may result in skin necrosis and a bullous reaction in its most severe form, which should be promptly recognized so that treatment can be provided. Pediatric patients are more susceptible to this caustic effect while cases in adults are rare. We report the case of a patient who developed bullous skin lesions with skin necrosis and eschar formation after receiving intravenous calcium gluconate for the treatment of hyperkalemia. The patient required an extensive hospital stay and multiple surgical interventions. This case demonstrates that common medications such as calcium gluconate can lead to significant adverse effects that can be mitigated with proper administration and appropriate education about adverse events.","title":"Calcinosis Cutis as an Unsuspecting Complication of Hyperkalemia Treatment"}
{"_id":"91b0b5a4-0766-2613-7a25-6a1e89cce58f","text":"The study population included 31 consecutive patients with rectal or anal canal adenocarcinoma who underwent inguinal lymph node dissection with curative intent at the National Cancer Center Hospital from 1986 to 2017. Long-term outcomes were assessed and clinicopathologic variables analyzed for prognostic significance.","title":"Long-term outcomes after surgical dissection of inguinal lymph node metastasis from rectal or anal canal adenocarcinoma"}
{"_id":"91b14c59-1703-e556-44b8-e3bff87ebce4","text":"The complications of current treatments with severe potential must be evaluated, diagnosed and treated early to ensure the continuity of the oncological treatment.","title":"The Benefits and Challenges of the Multimodal Treatment in Advanced\/Metastatic Malignant Melanoma"}
{"_id":"91bb1ece-8fb0-3ea2-6dc7-04a743a236dd","text":"Lymph node involvement was confirmed as the most important prognostic factor for melanoma patients with loco-regional skin metastasis including those with unknown primary tumor and stage I\/II patients with skin recurrence. Consideration of the tumor thickness and of the number of involved lymph nodes instead of the exclusive differentiation into presence vs. absence of nodal disease may allow a more accurate prediction of prognosis for patients with satellite or in-transit metastases.","title":"Prognostic Factors of Melanoma Patients with Satellite or In-Transit Metastasis at the Time of Stage III Diagnosis"}
{"_id":"91c46190-5f33-203e-9c7b-5ba4570cbd48","text":"Robotic surgery has definitely made advances across multiple surgery specialties and is now being used to automate follicular unit harvest and transplantation. 38 39 Semiautonomous robotic systems harvest, sort, and process individual single hair grafts or multiple hair grafts. 40 It remains to be seen whether these systems are economically viable related to conventional methods, which required meticulous sectioning of follicular units by teams of technicians.","title":"Overview of Facial Plastic Surgery and Current Developments"}
{"_id":"91c7d4fb-cc66-0790-bace-08d36819bd3c","text":"① Have a history of open fractures and local soft tissue contusion fractures.","title":"MRI Manifestations and Diagnostic Value of Chronic Osteomyelitis"}
{"_id":"91cbdad1-2898-32cf-17ea-dd4a81f5a595","text":"Survival of breast cancer is particularly dependent on nodal status, tumour size, grade and ER status. Nodal involvement is the most important predictor of systemic relapse and is itself determined by the number of nodes involved, the level of involvement in the axilla and perhaps the size of metastases. Advocates of routine block dissection have always claimed that this is the only way to accurately assess the axilla albeit at the expense of increased arm morbidity and the knowledge that up to 70% of patients are node negative and will therefore be overtreated by this technique. The sensitivity and specificity of sentinel node biopsy is without doubt although questions remain as to the clinical importance of minor degrees of metastatic spread identified by immunohistochemical evaluation of such nodal tissue. Nodal sampling, used predominately in the UK, has been criticized because of its potential qualitative inaccuracies although those studies comparing it to block dissection or sentinel node biopsy have shown few differences in axillary relapse rates or survival. While survival is undoubtedly related to the axillary tumor burden at presentation most important prognostic information is gained from the grouping of nodal positivity scores. For practical purposes knowledge of overall outcome is based on whether 1–3, 4–9 or more than 9 nodes are involved rather than from a precise nodal count because of the effect of other prognostic factors such as tumour size or grade.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"91d39647-0f32-95a4-c230-fd7e0d2af7cd","text":"In the present study, we were able to assess and compare the efficacy of saline solution, heparinised blood and DuraGraft in preserving the endothelial structure of saphenous vein grafts by evaluating the percentage of endothelial cell apoptosis in an ex vivo experiment after 2 and 4 h of ischemia from surgical vein harvesting. The main results are the following:","title":"Efficacy of Intraoperative Vein Graft Storage Solutions in Preserving Endothelial Cell Integrity during Coronary Artery Bypass Surgery"}
{"_id":"91d599ed-95ad-a7a2-4b71-54123beb35fc","text":"This prospective observational monocentric study was conducted at the Unit of Hepato-biliary surgery of the University of Verona from February 2020 to December 2021. The patients who were eligible for complex liver surgery were included, and 3DVT and 3DIN were applied for complex open and minimally invasive liver resections.","title":"Hyper accuracy three-dimensional (HA3D™) technology for planning complex liver resections: a preliminary single center experience"}
{"_id":"91d9267b-ba58-3c49-3df0-ddbff3bc8aea","text":"In conclusion, the prevalence of diagnosed VTE is low in patients with syncope. An extremely low 30 day readmission rate with VTE argues against missed diagnoses of VTE. A higher index of suspicion for VTE is necessary for patients presenting with syncope that has specific risk factors for VTE.","title":"Thirty-day readmissions due to Venous thromboembolism in patients discharged with syncope"}
{"_id":"91d9c801-6f2a-a4c7-4f45-79806f1ed1f8","text":"Injection site swelling and pain were the most common local solicited adverse events reported during the 7 day post-immunization period (Tables 3 and 4). The study was not powered for statistical comparisons of event rates between groups, but the frequency and severity of these local events tended to decrease with successive immunizations, especially in the 10 µg group. The proportion of children who experienced local pain or swelling was higher in the malaria vaccine groups compared to the rabies vaccine group. Grade 3 local adverse events consisted mainly of injection site swelling (Figure 2), which was reported in all study groups, but had a higher frequency in the 50 µg malaria vaccine group. Grade 3 local swelling was generally associated with minor injection site pain. Other grade 3 local reactions consisted of injection site pain and erythema. Grade 3 pain was always associated with grade 3 injection site swelling. One participant experienced grade 3 local erythema that was associated with grade 3 injection site swelling with no report of local pain.","title":"Safety and Immunogenicity of an AMA1 Malaria Vaccine in Malian Children: Results of a Phase 1 Randomized Controlled Trial"}
{"_id":"91d9fb0e-2370-365d-3f71-b860c564152b","text":"The constant quality control in which the RDU was submitted also allowed the decrease in the incidence and cancellation rates in the period evaluated. This was possible thanks to the pre-48 h checklist and the constant collaboration and communication with the other clinical services to ensure that patients are fully prepared for the interventional procedure.","title":"Experience and results after the implementation of a radiology day unit in a reference hospital"}
{"_id":"91db7db8-b7b3-f732-7ebf-9df669713f81","text":"Intraoperative real-time imaging with the portable gamma camera provides an overview of all radioactive hotspots in the whole surgical field. Its position can be adjusted to also show sentinel nodes near to the injection area, which are easily overlooked using the probe. The differentiation between sentinel nodes and secondary tier is facilitated, because the amount of radioactivity within each node can be quantified with the portable gamma camera and the intraoperative images can be related to the preoperative scintigraphic images. Furtheremore, sentinel nodes can be exactly localized by on screen visualization, besides the audiological localization by the laparoscopic gamma probe. Figure 4 shows 2 possibilities for intra-operative use of the portable gamma camera. Continuous monitoring can be used to record the whole procedure and stepwise monitoring enables localization of sentinel nodes and detects remaining activity afterwards. If the laser pointer signal matches the technetium signal on screen, this indicates that the sentinel node has been exactly localized. Another clear advantage of the portable gamma camera is the certainty it can provide about the completeness and accuracy of the sentinel node excision, since it shows remaining radioactivity. Figure 4 also shows the comparison of the situation before and after excision.","title":"Sentinel Node Detection in Head and Neck Malignancies: Innovations in Radioguided Surgery"}
{"_id":"91e18851-b91a-d6e5-f46e-55ead7437c37","text":"The purpose of this case report is to inform that it is necessary to confirm the diagnosis by preoperative biopsy, even if there are imaging findings highly suggestive for malignancy.","title":"Extra-Abdominal Desmoid-Type Fibromatosis Mimicking Myxofibrosarcoma"}
{"_id":"91e72827-db1f-70d8-4efb-543bc0c1223d","text":"Before implantation, the individual characteristics of the spheroids were analysed and scored. After scoring, the results of all donor samples were used to form a ranking from high to low levels of the specific parameter. Spheroid characteristics that were analysed included GAG production (both bound in the spheroid as well as released into the cell culture medium as well as the GAG ratio) and expression of chondrogenic markers at both the mRNA level as well as the protein level. The ranking of the individual spheroid characteristics of the individual donors was compared to the percentage newly formed tissue of the same donor.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"91e8f310-03af-e625-8494-c1357660624b","text":"At the operation table, prophylactic antibiotics were given at the time of induction to all the patients and after draping 3-5ml sterilized 1% methylene blue dye was infiltrated with a 10cc syringe in the peri tumoural area of the diseased breast. Gentle massage of breast was done for 1-2 minutes and then after 10 minutes dissection was done in axilla for localization of sentinel lymph node by giving incision in the axilla that incorporates the incision of Modified Radical Mastectomy. The blue colored lymphatic channels were followed which lead to the blue stained node called sentinel lymph node (SLN), the node was recognized and carefully dissected out, and any other stained node if found in vicinity was also removed.","title":"Sentinel lymph node identification by blue dye in patients with breast carcinoma"}
{"_id":"91ea28db-d0bc-8448-2e6a-c6ee67e09967","text":"All the operations were performed under general anesthesia. Existing skin tumors were excised by tumor resection with wide surgical margins whose appropriateness was confirmed by performing frozen section biopsies during the operations. For skin and soft tissue defects caused by trauma, the wounds were debrided until healthy tissue with pin point bleeding could be seen.","title":"Freestyle Local Perforator Flaps for Facial Reconstruction"}
{"_id":"91f58059-4fe5-ff25-8d16-3955f22984e4","text":"All the patients were informed about the procedure and signed a pre-operative consent form for the recording of data in our clinical database. All the patients underwent a clinical facial analysis before the procedure and their medical histories were collected to identify risk factors, such as diabetes mellitus.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"91fd628f-a38a-fe38-6c18-560e478ce8f9","text":"We would like to emphasize that the presented comparisons between data from PALGA and Statistics Netherlands are all based on hypotheses. Direct correlations for these etiological factors could not be explored and possible biases should be taken into consideration.","title":"Time Trends in the Incidence and Treatment of Extra-Abdominal and Abdominal Aggressive Fibromatosis: A Population-Based Study"}
{"_id":"9200bcf7-ce7e-7975-83af-891f6f8c8d97","text":"Therefore, we hypothesized that lymph node metastasis is likely to occur in breast cancer with lower TIL density. If this hypothesis is correct, we can also hypothesize that TILs could be a predictor of SLNM. Since the tumor size is a strong predictor of SLNM, and a prospective randomized trial that omit SLNB for cT1N0 breast cancer patients is in progress, we investigated the correlation between TILs and lymph node metastasis in cT1 breast cancer patients undergoing surgery along with the usefulness of TILs in predicting SLNM for cT1N0M0 breast cancer in this study.","title":"Prediction of lymph node metastasis by tumor-infiltrating lymphocytes in T1 breast cancer"}
{"_id":"920d53e1-43fd-d8fa-0ec6-663c8adee6f5","text":"To better predict treatment efficacy, data from multiple sources have been combined, for example, pharmacokinetic data to determine the concentration of the antibiotic in bone, the uptake and clearance of drugs inside specific cells and the effect of drugs on host cell metabolism or antibiotic activity at various pH levels. However, it is still uncertain whether specific treatments actually reduce intracellular bacterial numbers. Osteomyelitis is best modeled in infected cells using antibiotic concentrations that are known to be achieved in the bone.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"9210af30-12b5-205e-8e09-3322fa3d60f4","text":"The potential for severe systemic reactions following IT injections necessitates the administration of IT in a proper clinical setting. The home and other medically unsupervised settings are inappropriate venues for IT; out-of-office administration has been associated with death, likely because of the lack of recognition of systemic reactions and the failure to administer epinephrine in a timely fashion. Guidelines recommend that injections be given at the prescribing allergist's office or at the office of another physician who is trained and medically equipped for the treatment of systemic IT reactions. Delayed administration of epinephrine is consistently reported as a risk factor for IT fatality. In general, epinephrine (1:1000) should be premeasured and instantly available for intramuscular administration should a systemic reaction occur. Physicians who administer IT supplied to them by an allergist must be provided with specific instructions emphasizing the importance of prompt administration of epinephrine and other resuscitative measures to ensure the safety.","title":"Update on Allergy Immunotherapy"}
{"_id":"92197a17-9b28-695c-657f-0104e17b892d","text":"Since then, significant progression has been made concerning the resuscitation and emergency management of severely burned patients. Most patients with extensive burns will survive their injuries nowadays. This necessitated the development of techniques to close wounds of more than half the body surface area. The autologous split thickness skin graft, which is an epidermal graft with only a thin dermal layer, became the mainstay of burn surgery because of donor site availability and of the potential for reuse of the same site after a couple of weeks. Despite the importance of this development, this only solved part of the problem.","title":"Tissue engineering in burn scar reconstruction"}
{"_id":"921a2138-9945-1bac-078c-1d267c98c604","text":"Misdiagnoses in smaller health centers and delayed specialized medical consultation also contribute to delayed presentation.","title":"Inguinal Lymph Node Dissection for Advanced Stages of Plantar Melanoma in a Low-Income Country"}
{"_id":"9227a461-5f29-e633-e444-fa26b3c4b3f2","text":"It is evident from the above outline that a wealth of information and a variety of approaches are evolving that promise to improve the outcome of radiation therapy beyond the precise and more specific targeting of the radiation dose to the tumor. These approaches are aided and accelerated by rapid advances in synthetic chemistry and in protein structure information. As a result, they are likely to mature quickly and to open a new era of opportunities in radiation therapy. Radiation oncologists are likely to benefit significantly from these developments, if they closely follow them and quickly adapt them to the requirements of treatment of human tumors by IR.","title":"DNA Double-Strand Break Repair as Determinant of Cellular Radiosensitivity to Killing and Target in Radiation Therapy"}
{"_id":"9228aada-fc03-b436-a0d3-ab6340a5ee64","text":"A 27 year old man was diagnosed Maxillary Le Fort I, II and III also mandible fractures due to a fall from motorcycle. There was comminuted nasorbitoethmoid and nasal septum fracture without complaint about difficulty of breathing. An open reduction and internal fixation using miniplate was performed to treat the fracture using bicoronal approach, intra oral approach through upper and lower gingivobuccal sulcus incisions also subcilliary lower eyelid incisions. Then, open rhinoplasty approach was performed. Cartilage graft was harvested from the 6th rib, a small piece of the cartilage graft was inserted into the septum and fixed with 5–0 non absorbable suture, the leftovers cartilage then evenly diced into small pieces and being inserted into 1 cc dysposable syringe. Superficial temporal fascia was harvested and being sutured in cylindrical form covering the syringe filled with diced cartilage, just before final sutures the diced cartilage was injected into the fascia, then final suture was performed sealing the fascia, forming a diced cartilage fascia graft with a cylindrical tube shape. Then, the diced cartilage fascia graft was inserted into the dorsal nasal skin and fixed using a non-absorbable suture in the frontonasal area. Periosteal and alar cinch suture also performed during soft tissue closure.","title":"A breakthrough in Maxillary LeFort II fracture reconstruction: Case series of rhinoplasty using diced cartilage fascia graft simultaneously with ORIF"}
{"_id":"923943cf-7047-9dd9-1143-46f72c48ba34","text":"In this case ICG angiography showed a well perfused flap area across the midline and flap shaping was performed due to the ICG dye uptake to gain the maximum flap tissue. After anastomosis of the flap to the internal mammary artery and vein in an end-to-end fashion the repeated ICG measurement presented patent anastomoses and a well perfused DIEP flap also in the peripheral zones with no relevant change of the blood flow pattern (Figure 3).","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"923c841b-6f65-762f-6fbe-1e1c5f18b3f7","text":"Based on their reported adverse events and recovery period, both Hydrus implantation and OMNI canaloplasty are generally regarded as safe and well tolerated MIGS procedures. The visual recovery period is typically quite rapid, and serious surgical complications related to both surgeries are rare., In this case series of phakic patients on maximum tolerable medical therapy with uncontrolled IOP, a majority of patients saw a significant and clinically meaningful reduction in IOP even when performed as a standalone surgery. This was observed in our case study both in patients who had never had glaucoma surgery, as well those who had previously undergone both traditional filtering surgery and previous MIGS (see Table 9). However, it should be noted that very few patients in the case series were able to decrease the number of IOP-lowering agents used to achieve target IOP. In the setting of patients with uncontrolled IOP already on maximum tolerable medical therapy, standalone Hydrus Microstent implantation with OMNI canaloplasty may not be an effective means of reducing medication burden.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"9246f003-8a6b-8365-02b4-6041389cbb0d","text":"Metastasis within the major salivary gland is not considered as regional disease in the TNM‐classification but refers to cervical lymph nodes. The presence of metastasis in the lymph nodes within the parotid gland is however a negative prognostic factor, with a significantly higher risk for locoregional recurrence. The distribution of intraparotidal SNs may also be dependent on where the tumor is located in the gland. In the present study, SNs in the periparotidal tissue was detected in 13% of patients who underwent parotid tailresection, compared to 47% in patients who underwent superficial parotidectomy. The limited number of patients in this study makes it difficult to draw any conclusions. Nevertheless, our results indicate that one cannot disregard from the risk of intraparotidal sentinel node involvement in tumors located also within the parotid tail. It cannot be excluded that some periparotidal SNs were missed due to shine through phenomenon, since intraoperative lymph nodes are in close spatial relation to primary tumor. However, potential periparotidal SNs located with some distance from the primary tumor are probably at a higher risk of being missed due primary resection if only partial parotidectomy is performed, Furthermore, if no areas with significant gamma probe signal are left within the parotid gland during resection of a malignant tumor, then no potential SNs should be missed but detectable in the histopathological analysis.","title":"Distribution of sentinel nodes from parotid tumors–A feasibility study"}
{"_id":"924edf4c-7994-8152-24ae-bd6086e7c46b","text":"A good knowledge of the characteristic MRI findings of benign and malignant osseous conditions and their role in staging, therapeutic planning and follow-up in the setting of malignancy is essential for optimal patient care.","title":"The role of magnetic resonance imaging in the evaluation of bone tumours and tumour-like lesions"}
{"_id":"924fc09b-df77-5643-c44a-1c23f1aed471","text":"It is useful for the treatment of Grade IIIB open fractures that affect the proximal third of the tibia and for open fractures of the patella with loss of skin substance. It is also useful for the treatment of cutaneous problems after surgery on the proximal end of the tibia complicated by infection or a soft-tissue problem, and it can be used in atrophic pseudoarthrosis to improve blood supply in the area.11–12","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"9254bae2-454a-6c20-c148-2a135b85bfc9","text":"PubMed database was searched for relevant articles from 2002 up to May 2015.","title":"Abstracts and short papers from the 5th Congress of the Polish Thyroid Association, Poznan, 3-5 September, 2015"}
{"_id":"925dea1f-185e-4656-50fa-d3cf94c4108b","text":"This patient had previously undergone multiple incomplete surgical resections of his scalp squamous cell carcinoma. Therefore, it was of upmost importance for this patient to achieve oncological clearance and reconstruction with a single procedure; cosmetic outcome was of secondary priority. The omental flap was thought to be the most reliable option for reconstructing the large defect with the least risk of requiring subsequent surgery. Because of the highly vascular tissue of the omentum, the split-thickness skin grafts also had a good likelihood of success.","title":"Total Scalp Excision and Reconstruction Using a Free Omental Flap"}
{"_id":"9260bf70-71fb-7860-9ca0-0003939643de","text":"Our current study emphasizes the relevance of the proper cellular and structural patterning of antigen passage in the homeostatic immune regulation toward dietary antigens in the SI. As a deviation of antigen passage patterning was associated with food sensitization, it would be interesting to examine the effect of risk factors associated with food allergy on antigen passage patterning to identify a mechanistic link with the development of food allergy.","title":"Thermoneutrality Alters Gastrointestinal Antigen Passage Patterning and Predisposes to Oral Antigen Sensitization in Mice"}
{"_id":"92630c74-cbe2-cc98-0598-a03fff6d3872","text":"As mentioned above, the interspersed periods of bacterial quiescence in chronic osteomyelitis has been a perturbing problem that is readily documented over the years. A particularly interesting case of S. aureus osteomyelitis described a woman who was initially infected in her left femur as a child and treated surgically without antibiotic therapy. Approximately 75 years later the infection returned, and genetic analysis of the infecting pathogen revealed the S. aureus to be of the same strain from 75 years prior, maintaining its sensitivity to penicillin and oxacillin. This case demonstrates an interesting immune evasion strategy in which a single clonal strain of S. aureus can remain quiescent for long periods of time, then awaken decades later to cause serious osteomyelitis.","title":"Evolving concepts in bone infection: redefining “biofilm”, “acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy”"}
{"_id":"9269ea73-ac4d-929b-841f-ad60109cae64","text":"Table 7 The effect of retaining ARM nodes after the ALND procedure on lymphedema","title":"Using the axillary reverse mapping technique to screen breast cancer patients with a high risk of lymphedema"}
{"_id":"926b26c8-a39a-293e-e0b3-74c364ffc328","text":"In selected cases, a transverse wound debridement can allow early soft tissue closure and is effective in producing fracture union without the associated complications of a soft tissue flaps.","title":"Transverse debridement and acute shortening followed by distraction histogenesis in the treatment of open tibial fractures with bone and soft tissue loss"}
{"_id":"926f7e70-227e-9b06-9a03-f1104a412071","text":"Mesh grafting is a technique where the graft is expanded by making slits in it such that it appears like a mesh. The advantage of this technique is that it allows coverage of large body surface areas with a smaller graft.[44]","title":"TISSUE GRAFTS IN VITILIGO SURGERY – PAST, PRESENT, AND FUTURE"}
{"_id":"92798475-8983-f08a-1535-a823be49d752","text":"The main disadvantage of the SIEA flap relates to inconsistent vascular anatomy, with previous reports suggesting that the vessel is absent in one third of patients and of insufficient caliber in another one third.9 However, the majority of studies evaluating this flap have been in the breast reconstruction literature, where the vessels are required to support very large tissue volumes. In the setting of facial volume loss, the required flap volume is significantly less and a smaller caliber vessel will often be sufficient.","title":"Superficial Inferior Epigastric Artery Flap for a Total Parotidectomy Defect Alkureishi et al"}
{"_id":"927e460b-c586-d5a9-c7b9-5b10dd5f034a","text":"Table 4 Intraobserver reproducibility between the scoring point system and the subjective reading for the three different DCIS grading classifications studied","title":"Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis"}
{"_id":"928131ee-6e6c-a5fe-f410-69597fa08d4d","text":"Some of the GPs stated that radiologists could rule out pathology using ultrasound examinations, while that would never be the case with the limited examinations in general practice. It was considered important and necessary to communicate about the differences between ultrasonography performed by a radiologist and a GP both to patients and specialists in the secondary healthcare sector to avoid false expectations.","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"928133f8-3788-926f-0407-0bd40d761c7e","text":"We identified 1,097 presumptive events following 436,828 Td vaccinations. Due to resource constrains, the maximum number of presumptive events selected for chart review at each of the participating MCOs was limited to 200. Two sites had more than 200 presumptive events identified and so for those sites a random sample of 200 presumptive events was selected for confirmatory review. The total number of presumptive events identified for confirmatory review across all sites was 765. Of those, chart review could not be completed for 52 events because the medical record lacked information on the post-vaccination encounter and so chart review was completed for 713 presumptive events.","title":"Frequency of medically attended adverse events following tetanus and diphtheria toxoid vaccine in adolescents and young adults: a Vaccine Safety Datalink study"}
{"_id":"9283019a-6392-fa74-040c-243e68cfdc97","text":"Given the wide applicability of cryosurgery in the field of oral and maxillofacial surgery, we report a case of hemangioma of the oral cavity successfully treated with cryosurgery.","title":"Cryosurgery as an Option for the Treatment of Vascular Lesions of the Oral Cavity"}
{"_id":"9287c5dc-485e-767b-30a8-9ac287ad9d22","text":"Cetaceans have long been considered capable of limiting diving-induced nitrogen absorption and subsequent decompression sickness through a series of behavioral, anatomical, and physiological adaptations. Recent studies however suggest that in some situations these adaptive mechanisms might be overcome, resulting in lethal and sublethal injuries. Perhaps most relevant to this discussion is the finding of intravascular gas and fat emboli in mass-stranded beaked whales. Although the source of the gas emboli has as yet to been ascertained, preliminary findings suggest nitrogen is the primary component. Since nitrogen gas embolus formation in divers is linked to nitrogen saturation, it seems premature to dismiss similar pathogenic mechanisms in breath-hold diving cetaceans. Due to the various anatomical adaptations in cetacean lungs, the pulmonary system is thought of as an unlikely site of significant nitrogen absorption. The accessory sinus system on the ventral head of odontocete cetaceans contains a sizeable volume of air that is exposed to the changing hydrostatic pressures during a dive, and is intimately associated with vasculature potentially capable of absorbing nitrogen through its walls. The source of the fat emboli has also remained elusive. Most mammalian fat deposits are considered poorly vascularized and therefore unlikely sites of intravascular introduction of lipid, although cetacean blubber may not be as poorly vascularized as previously thought. We present new data on the vasculature of air sinuses and acoustic fat bodies in the head of bottlenose dolphins and compare it to published accounts. We show that the mandibular fat bodies and accessory sinus system are associated with extensive venous plexuses and suggest potential physiological and pathological implications.","title":"Vascularization of Air Sinuses and Fat Bodies in the Head of the Bottlenose Dolphin (Tursiops truncatus): Morphological Implications on Physiology"}
{"_id":"928ad1ab-4472-bea5-85c4-d2fa043a6e1a","text":"This section describes the six significant challenges that were identified in the literature.","title":"Federated and Transfer Learning Methods for the Classification of Melanoma and Nonmelanoma Skin Cancers: A Prospective Study"}
{"_id":"928bb9c0-d32d-ac1b-598e-6184d0086c67","text":"The anatomical structure of the hilar is complicated. Therefore, the 3D spatial relationship between the departmental vein, hepatic artery, hepatic vein and tumor in the liver of patients with biliary tract tumor is obtained and this information is the basis of surgical treatment for biliary malignant tumor. In liver surgery, augmented reality technology uses CT and MRI data to reconstruct a 3D image of the liver and intrahepatic vasculature for surgical planning, where the virtual image is superimposed in the surgical field for navigation. The 3D image of the surgical plan is superimposed on the liver surface in a 1:1 ratio, which can achieve the preliminary definition of the liver range of pre-excision of gallbladder cancer or hilar cholangiocarcinoma, and help the surgeon to achieve accurate liver resection. Laparoscopic surgery is the direction of biliary tumor surgery. For laparoscopic liver resection, in addition to tactile feedback, visual feedback is also critical for fine manipulation and vascular management. Augmented reality technology can project a 3D visualization liver model into the surgical area, which helps to solve the problem of uncoordinated hand and eye during surgery. The mixed reality presents the information of the virtual scene in the real environment, and establishes an information loop of interactive feedback between the real world, virtual world and user to enhance the realism of the user experience 32. The application of mixed reality in abdominal surgery is still in its early phase. This new technology displays a 3D model near the surgical site, reducing the shift between the operating space and visualization.","title":"Precise hepatectomy in the intelligent digital era"}
{"_id":"928f543d-fa3a-2d08-327b-148411bfd855","text":"Taxanes are a class of important drugs used in chemotherapy to treat several major cancers. This article reviews a new laboratory discovery that ultrasound can be used as an antidote for the peripheral cytotoxicity of taxane drugs and discusses the potential development and application of low intensity ultrasound to prevent side effects in chemotherapeutic treatment of cancer patients.","title":"Low Intensity Ultrasound as an Antidote to Taxane\/Paclitaxel-induced Cytotoxicity"}
{"_id":"9290c74b-3c98-3ea6-5b81-35ba28cbde5a","text":"PDT has a role in the management of early and late thoracic malignancies. It can be used facilitate minimally-invasive treatment of early endobronchial tumours and also to palliate obstructive and bleeding effects of advanced endobronchial tumours. PDT has been used as a means of downsizing tumours to allow for resection, as well as reducing the extent of resection necessary. It has also been used successfully for minimally-invasive management of local recurrences, which is especially valuable for patients who are not eligible for radiation therapy. PDT has also shown promising results in mesothelioma and pleural-based metastatic disease. As new generation photosensitizers are being developed and tested and methodological issues continue to be addressed, the role of PDT in thoracic malignancies continues to evolve.","title":"Photodynamic Therapy in Non-Gastrointestinal Thoracic Malignancies"}
{"_id":"92953f38-c5a1-49ff-bf18-f8e302e0f5ad","text":"BNCT appears to be a promising treatment modality in the management of cutaneous melanoma, but the number of patients treated with this method is still limited.","title":"Radiotherapy in the Treatment of Subcutaneous Melanoma"}
{"_id":"929b8549-284f-8e4c-bef0-542c09387df0","text":"The patient benefitted from a total parathyroidectomy with partial regression of his symptoms.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"929bc95d-c6e9-e2ce-65ae-34f293da87c6","text":"In the present case, we have demonstrated that the insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.","title":"Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data"}
{"_id":"929db466-e1c6-fb94-5571-0cbcd7523412","text":"A common reason for recipient vessel concern is related to size mismatch resulting in turbulent flow.1 Irradiation is a common reason for the smaller diameter of the internal mammary vessels in this population, but this can also be a normal anatomical finding or variant.1–4 Attempts to use these suboptimal vessels can lead to a higher risk of complications. When suboptimal recipient vessels are encountered, early identification and intervention are key to flap salvage and a successful reconstruction.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"92a11073-5b14-3cf8-c7dc-a9889784bb2c","text":"The rehabilitation will be recorded but left entirely to the discretion of the treating surgeon, as the type of injury will vary between patients.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"92a163a8-ee2a-a0b3-0c72-a3e79cd440c0","text":"It seems that employing dressings with suction or negative pressure has a positive effect on treating open fractures and reducing complications.4,11,14 The aim of this study was to evaluate the effect of NPWT dressing on open fracture wounds in comparison with conventional wound dressing.","title":"Comparison of negative pressure wound therapy (NPWT) &conventional wound dressings in the open fracture wounds"}
{"_id":"92a29e0c-680c-1e33-e7f7-9f1b30adabb4","text":"Arm lymphatics in the axilla could be identified in 100% of the patients, which was comparable to or better than previously conducted studies. Arm lymphatics were predominantly located superior to the uppermost intercostobrachial nerve. This observation aligns with prior research that has reported a low incidence of lymphedema among individuals who have undergone partial ALND, namely below the uppermost intercostobrachial nerve. The use of fluorescein sodium and blue light in the research is advantageous due to their affordability and widespread accessibility, in contrast to alternative fluorescent agents such as ICG with gamma cameras. The utilization of the uppermost intercostobrachial nerve as the superior boundary for ALND can be considered a potentially advantageous surgical refinement aimed at decreasing the occurrence of lymphedema in the upper extremities in a selected group of patients.","title":"Evaluation of Axilla With Sentinel Lymph Node Biopsy (Using Methylene-Blue) and Reverse Axillary Mapping (Using Fluorescein) to Validate Optimum and Safe Axillary Dissection in Breast Cancer"}
{"_id":"92aa65ee-b8f9-895e-62a6-3ac906f350ea","text":"Our study results also show that for most of the biomarkers, the concordance of GEX-based classifiers between the CNBs and surgical specimen were inferior to the concordance observed for the standard IHC. Tumor heterogeneity and sampling error are factors which can be accounted for when a biomarker is assessed using IHC by a trained pathologist. On the other hand, results of transcriptional profiling of tumors using techniques like bulk RNAseq represent the average gene expression levels in the sample, including non-malignant cells found in the sample, which may impact the classification of samples. The development of methods which ensure that the CNB collected for biomarker analyses is indeed rich in tumor cells can potentially improve the analytical validity of GEX profiling in CNBs. An example of a method under experimentation at our local pathology department is obtaining a punch biopsy from the surgical specimen and studying the tumor cellularity in the borders of the punch by H&E staining to ensure that the punch biopsy was taken from a section of the tumor with sufficient malignant cells, prior to extracting RNA for gene expression analysis. Tumor cellularity in the borders of CNBs will also be investigated, although this will be a more complex process.","title":"How Reliable Are Gene Expression-Based and Immunohistochemical Biomarkers Assessed on a Core-Needle Biopsy? A Study of Paired Core-Needle Biopsies and Surgical Specimens in Early Breast Cancer"}
{"_id":"92bfb7ae-dec1-b094-ced5-589ae04ebc1d","text":"Axillary lymph node FNAC is a tool with rapid access and is an office-based device that can be an attractive alternative in the evaluation of lymph node involvement in newly diagnosed breast cancer patients. It may be applied routinely before operation due to its high specificity and PPV, and may play a role in sparing SNLB and proceeding to ALND or neoadjuvant chemotherapy.","title":"Sparing sentinel node biopsy through axillary lymph node fine needle aspiration in primary breast cancers"}
{"_id":"92c7651f-6537-524d-aaca-c72558ea19d4","text":"A further advantage of alginate microfibers relies on the cryoconservation of the cells for further therapeutic uses. Alginate microfibers appear resistant to freezing and allow to maintain highly viable and functional cells after thawing. Consequently, the presented scaffolds may be proposed as tool for in vitro redifferentiation process and recovering of an effective and functional chondrocyte population potentially able to produce a neocartilage tissue in vivo. This evidence is also important in view of a future chondrocyte bank that would be of great help as a permanent source of cartilage cells.","title":"Dedifferentiated Chondrocytes in Composite Microfibers As Tool for Cartilage Repair"}
{"_id":"92d94faf-925e-e65c-0896-ad0ce323418b","text":"The correlation of clinical presentation and histopathologic findings established a diagnosis of nodular basal cell carcinoma with osteoma cutis. The tumor and associated bone were excised using Mohs micrographic surgery, which is a surgical technique that incorporates the microscopic examination of excised margins to ensure the complete removal of cancerous cells while sparing as much normal skin as possible. It is the most effective technique for the removal of squamous and basal cell cancers. In our patient, there has been no recurrence to date.","title":"Basal Cell Carcinoma with Osteoma Cutis"}
{"_id":"92fa9110-9626-162e-25e7-568efd31e2b3","text":"The timing of breast reconstruction postmastectomy averaged 19.9 months, without statistically significant association between reconstruction timing and recurrence rates.","title":"Histologic Examination of Mastectomy Scars during Breast Reconstruction: A Systematic Review"}
{"_id":"9307aa2d-5691-e7f2-059c-3057a5cb7888","text":"The patients were in a supine position with the neck slightly extended. A considerable amount of ultrasound gel was applied to the patients’ neck as a standoff pad. Both conventional sonography and real-time US-E were performed using a Philips IU22 system equipped with a liner probe with a central frequency of 5 MHz to 12 MHz. All examinations were conducted and recorded by three experienced sonographers. Two of these sonographers had more than eight years of experience in sonography and about two months of special training in elastography.","title":"Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules"}
{"_id":"930b941e-f8a8-3744-e2f4-644456173919","text":"Having passed through the skin or oral mucosa, the radiotherapy beam will then pass through the muscles and connective tissues. Trauma to the cells within these tissues results in fibrosis. As the tissues lose their elasticity the ability of the mouth to open becomes increasingly impaired. Generally, reduced incisal opening of less than 35 mm is considered as trismus.16 Should additional muscles in the head and neck be affected stricture will similarly ensue affecting the patient's ability to turn their head and neck.","title":"The dental management of a mouth cancer patient"}
{"_id":"9311aea8-d6d5-a415-92f9-ff80ba36e1f0","text":"The cervicopectoral flap is an excellent alternative for the reconstruction of head and neck. Harvesting and application of the flap is rapid and safe. Only a single incision is sufficient for dissection and flap elevation. This flap achieves perfect surgical exposure, makes neck dissection easy and allows one to perform both tumor resection and neck dissection in one session.","title":"Cervicopectoral flap in head and neck cancer surgery"}
{"_id":"931d6e5a-6201-dfe7-f7aa-fa3d32ca3861","text":"To the best of our knowledge, the present study is the first population-based study to show that breast cancer subtype is an independent factor influencing the utilization of immediate postmastectomy reconstruction. Patients with HER2-overexpressing or triple negative breast cancer were less likely to receive immediate breast reconstruction surgery compared with those with luminal tumors. No significant difference was observed in the type of reconstruction among different subtypes in the modern practice. Moreover, our subgroup analysis demonstrated that the difference of immediate breast reconstruction rates among distinct subtypes varied with different tumor grade and disease stage, and the association between breast cancer subtype and reconstruction rate was not significant in low-grade and early stage patients.","title":"Impact of Breast Cancer Subtype Defined by Immunohistochemistry Hormone Receptor and HER2 Status on the Incidence of Immediate Postmastectomy Reconstruction"}
{"_id":"931fcbdd-b66d-3eed-7bcb-6368e59845c0","text":"This retrospective single-center study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board and Ethics Committee of Fondazione Policlinico Universitario Agostino Gemelli IRCCS on 11 June 2020. Anyone involved in the research agreed to participate and agreed to have the results of the research about them published.","title":"Conventional CT versus Dedicated CT Angiography in DIEP Flap Planning: A Feasibility Study"}
{"_id":"932e7dce-feaf-83b8-bf64-eba05971ee74","text":"The aim of modern medicine is to find an alternative anticancer treatment in order to avoid the adverse side effects of conventional therapies and, most of all, to find a treatment that is specific for cancer cells without damaging healthy cells.","title":"Reactive Oxygen Species Produced by 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Cancer"}
{"_id":"93304308-5040-d7d9-3c17-31dbd02e0ef4","text":"Microvascular free tissue transfer to the wound site can induce angiogenesis and accelerate wound healing even in hypovascular wounds. Various microsurgical free fascio-cutaneous and muscle flaps are described in literature-, but some of the major reasons why surgeons still avoid free flaps are the long operation time, condition of the recipient vessels and the added stress to a diabetic patient who usually has other associated comorbidities.","title":"The Gracilis Muscle Flap: A “Work Horse” Free Flap in Diabetic Foot Reconstruction"}
{"_id":"933093f6-2073-95c8-14ae-131915589098","text":"Facial FD that continues to expand in adults can be extremely deforming and has the highest rate of malignant transformation which can be very difficult define due to the changing nature of the lesions. The aim of the surgical therapy is to prevent pathological fractures and to reduce bone deformities. Only curative surgical recontouring was performed in our case and patient is being recalled to check for recurrence.","title":"Fibrous Dysplasia versus Juvenile Ossifying Fibroma: A Dilemma"}
{"_id":"93358c9d-e2d2-3d2d-3fb1-72c5a8119e6b","text":"Because a leader is not restricted to fulfilling the roles of chair\/chief or program director (PD), it is crucial to expand the definition of “leadership roles” to include all other institutional and organizational positions that surgeons can pursue. Plastic surgeons choose to advance the field in a variety of ways, and taking on a leadership position serves as a significant way of doing so.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"9338d82f-061b-5e39-b959-dd4839596de2","text":"Another possible effect is the increase in postvoid residual urine volume for which clean intermittent catheterization is required transitorily. The most vulnerable populations are patients with nonneurogenic dysfunctions or those who are not under clean intermittent catheterization programs [32]. The combination of toxin injection into the detrusor muscle and into the bladder neck could benefit these patients.","title":"Pharmacotherapy in Pediatric Neurogenic Bladder Intravesical Botulinum Toxin Type A"}
{"_id":"933b6a3a-c065-3e1b-0333-e10df262cb6a","text":"There is also a lack of evidence about the time of follow-up and the imaging method to be used to ensure early detection of recurrence or subsequent breast cancer in treated patients. Further studies are needed to enable a more personalized approach; new diagnostic tools such as artificial intelligence could find their place in tailoring the diagnostic process and determining the appropriate imaging follow-up.","title":"Multiple Papillomas of the Breast: A Review of Current Evidence and Challenges"}
{"_id":"9340d73d-1784-1b13-6fed-4f3bc13bb4ec","text":"In this retrospective study we report the disease characteristics of a group of 41 patients with chronic nonbacterial osteomyelitis collected from 6 Swiss pediatric centers. We were able to show the huge diversity of presentation, disease course and response to therapy.","title":"Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study"}
{"_id":"934ac788-78d9-fc10-b8ca-548585be6f2a","text":"The results of this study demonstrate that using minced split-thickness skin grafts with Pelnac as an overlay is an effective one-step approach for the reconstruction of full-thickness skin defects in rats and can increase wound healing rate and quality. In addition to stimulating cell proliferation and angiogenesis, Pelnac modulated the synthesis and deposition of collagen and increased basement membrane and dermis formation along with the expression of growth factors related to wound healing while reducing scarring. This novel and promising treatment strategy can be applied to traumatic skin wounds caused by burns or injury.","title":"One-step approach for full-thickness skin defect reconstruction in rats using minced split-thickness skin grafts with Pelnac overlay"}
{"_id":"934d8db4-7823-ea68-7ddc-80804396d431","text":"The goal of reconstruction for defects involving the buccal mucosa is to prevent cicatricial trismus. Primary closure can be used for small defects, and split- or full-thickness grafts can be used for moderate ones. For defects involving the majority of the buccal mucosa, a thin, pliable fasciocutaneous free flap such as the RFF or UAP flaps are needed to prevent scar contracture from limiting mouth opening. The ALT flap may also be used in thin patients and may have the advantage of decreased donor site morbidity as compared to forearm flaps. The ALT free flap can also be thinned considerably at the time of surgery, taking care not to injure the perforator blood supply and the subdermal vascular plexus of the flap, as well as reduced secondarily with suction-assisted lipectomy. Buccal mucosa resections that result in through and through cheek defects often require reconstruction with flaps that can either be folded on themselves, deepithelializing a portion of the flap to allow wound closure at the flap margin, or harvested with dual skin paddles. ALT and RAM free flaps can be designed with more than one skin paddle, allowing separate reconstruction of the buccal mucosa and external cheek skin with a single flap. The RFF and UAP flaps can often be safely split when there are multiple branches of the pedicle vessel supplying the proximal and distal skin paddle, but their size usually required them to be used for smaller cheek defects.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"935ab709-9227-e860-8ee1-978850a13025","text":"Basal cell carcinoma and actinic keratosis are two of the most common cutaneous lesions identified in the dermatology clinic. There is established evidence suggesting that topical treatments play a significant role in treating early forms of superficial BCC while also lowering the economic burden of healthcare by alleviating the need for unnecessary biopsies. Considering the expected continued rise in prevalence of BCC and AK in the coming years, topical therapies can decrease the cost of treatment, limit in-office procedures, and lessen the risks associated with surgery, including infection and scarring.","title":"Topical Treatments for Basal Cell Carcinoma and Actinic Keratosis in the United States"}
{"_id":"935b8fcf-0591-2b3b-f494-9cff8793bc5d","text":"Prospective data collection would be the next step of this study to support our current data. As in skin cancer, Mohs surgery is known for tissue sparing. It would be of interest to assess if this leads to a better oral function after surgery compared to conventional margin technique. Speech and swallowing function as well as a quality of life data would be interesting to analyze.","title":"Decreasing loco-regional recurrence for oral cavity cancer with total Mohs margins technique"}
{"_id":"935c7a60-f2c0-4019-70d7-bcfdb0218662","text":"The patient had no family history of Gardner syndrome or familial adenomatous polyposis. The patient was presented to the pediatric oncology tumor board. Because of the young age and the problematic location of the tumor, close clinical and radiological follow-up was recommended. A decision was made to avoid postoperative radiotherapy in this young girl because of the potential side effects of irradiation in this site and age.","title":"Congenital Desmoid Tumor of the Cheek: A Clinicopathological Case Report"}
{"_id":"9362433f-9821-5dff-0233-4f6f0fe4ca4b","text":"The medical profession is constantly under pressure to develop methods to produce competent surgeons and assure healthcare quality. An adequate training curriculum is necessary to ensure that microsurgical techniques are practised well, and to reduce or avoid extreme variation in surgical competence. Microsurgical techniques can be trained in the laboratory using simulation as this provides a good opportunity for young surgeons to practise initial basic microsurgical skills prior to hands-on clinical practise on patients. In a 5-day laboratory workshop training, 60% of trainees had improved in the level of microsurgery skill.","title":"Microgrids: A Model for Basic Microsurgery Skills Training"}
{"_id":"936357bf-68a6-4c21-1c84-de08652dd2da","text":"The results of the analysis of the scattering coefficient in the implantation zones are shown in Figure 18.","title":"Surface Topography of PLA Implants Defines the Outcome of Foreign Body Reaction: An In Vivo Study"}
{"_id":"9363e986-c63b-ef70-d46d-557bcc2b7af0","text":"Including the results of this study, data on more than 300 patients reirradiated for recurrent breast cancer either alone or in combination with chemo-endocrine treatment and\/or hyperthermia have so far been published. Reirradiation is feasible and save at least within the first five years after retreatment with low to modest side effects offering a second curative chance with breast conserving therapy. In palliative intended treatment, results are good to excellent lasting for most of the patients' lifetime. The minimum time interval between first and second radiation treatment should be six months based on published data although the exact time interval is unknown. The duration and percentage of local control is dose dependent. The minimum second radiation dose in fractionated irradiation should be 40 Gy though higher doses might be possible depending on the treatment volume. With regard to possible late side effects, we recommend a dose per fraction of 1.8 to 2 Gy in curative intent. Higher doses per fraction can be given in patients expecting a lifetime of only a few months. Reirradiation can be safely combined with continuous infusion 5-FU or oral capecitabine. Possible alternative radiation techniques to fractionated Megavoltage external beam therapy are brachytherapy and intraoperative radiation therapy.","title":"Reirradiation of recurrent breast cancer with and without concurrent chemotherapy"}
{"_id":"936d36b0-530b-c530-2bf1-17ec7b75bda5","text":"Understanding of the pathophysiology of osteomyelitis facilitates the interpretation of extraosseous fat signal when there is clinical concern for osteomyelitis. Acute superative response from medullary bacterial proliferation can cause an acute increase in intramedullary pressure, ultimately leading to a rupture of the cortex and expulsion of medullary fat into the adjacent soft tissues. Interestingly, foci of extraosseous fat are predominately a feature of acute osteomyelitis and not identified in subacute osteomyelitis patients. This observation is in keeping with the pathophysiology of aggressive acute osteomyelitis resulting in extrusion of medullary fat as opposed to a subacute, slowly progressive process.","title":"Extraosseous marrow fat: an MRI sign of acute aggressive osteomyelitis"}
{"_id":"936d8702-0dbb-e9ec-4364-42ddcb608925","text":"In our series, we found a relatively higher SLNB positivity in patients with pure DCIS than the large series reported elsewhere. This may either be due to the meticulous examination of SLNs by serial sectioning technique or due to our patient selection criteria or both. Although the importance of presence of ITC in SLNs has not been clarified yet, it may be reasonable to perform SLN in selected patients with pure DCIS. SLNB should be considered in cases of DCIS where there is a strong doubt of invasion at the definitive pathology as in patients with large tumors or diffuse pluricentric microcalcifications undergoing mastectomy or high grade DCIS with comedonecrosis or solid cribriform pattern.","title":"Sentinel Lymph Node Biopsy in Pure DCIS: Is It Necessary?"}
{"_id":"9371d656-d33a-1ff0-d254-fc2684ca1f3c","text":"Methods: A total of 65 patients presented with tumors of head and neck and underwent curative tumor resection with different neck dissections at the Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology of China Medical University; from March 2005 to December 2012 were included in the study. After radical tumor excision and neck dissection the resultant complex defects were reconstructed with either platysma flap or the submental flap. The extent of surgical resection, the type of neck dissection and choice of flap reconstruction was at the discretion of the surgical team. The functional outcomes, operative time and characteristics of both platysma and submental flaps were compared and the statistical tests of significance were applied accordingly.","title":"Submental versus platysma flap for the reconstruction of complex facial defects following resection of head and neck tumors"}
{"_id":"9377720a-8ab5-6a8c-f16b-6cf928081f3c","text":"Inferior part of rectus abdominis muscle flap was a reliable and comparable means of reconstruction after APR surgery with low rate of complications and mortality.","title":"Inferior Part of Rectus Abdominis Muscle Flap Outcomes after Abdominoperineal Resection: A Case Series Pilot Study"}
{"_id":"937be59c-0718-f519-1e86-b3a94e53d7ff","text":"Our institution considers reports of cases including information with less than 3 patients to be exempted by the institutional review board. Our institution does not require research of this type to undergo approval by the ethics committee. The patient was informed that data concerning the case would be submitted for publication, and the patient provided consent.","title":"Revision Labiaplasty After Penile Inversion Vaginoplasty Using Costal Cartilage Allograft"}
{"_id":"93802bd0-f45e-160a-e300-82121178879e","text":"A large percentage of patients, those with microscopic nodal disease are undertreated with a ILI. Combining ILI with a systemic therapy would seem to more fully solve the problem, but systemic therapy for advanced melanoma is associated with low response rates. The advantage of the HILP procedure is that the regional basin is addressed and treated with what amounts to a therapeutic lymph node dissection.","title":"Regional Therapy for Recurrent Metastatic Melanoma Confined to the Extremity: Hyperthermic Isolated Limb Perfusion vs. Isolated Limb Infusion"}
{"_id":"93874359-a89c-8e7a-af19-e7b3d9589bf3","text":"Most case reports present cases of diagnosed GIST with subsequent development of Desmoid tumor. Most Desmoid tumors develop in the mesentery or near the area of the previously resected GIST. In rare cases, the Desmoid tumor may develop in an unrelated area. The relationship between Desmoid tumors and GIST has been studied and documented in literature. A cohort study of 28 cases suggests that there is a nonrandom association between Desmoid tumors and GIST [22]. The reason why both these entities are associated with each other is currently unknown. We suggest that the association has to do with their cell origin. The origin of Desmoid tumors is myofibroblasts. These cells have a phenotype between fibroblasts and smooth muscle cells. Although their main function is fibrosis, they also have the ability to contract during wound healing. The origin of GIST is the Cajal cell which is found in many types of smooth muscle tissue. They function as a pacemaker to create slow contractions of smooth muscle in the GI tract. In conclusion, one could say that these two cells are related and perhaps this is why these tumors are associated with each other. The time interval between the development of these two tumors varies greatly from months to years after resection. A study showed an average time of 30 months [22] between these two tumors.","title":"Subsequent Development of Desmoid Tumor after a Resected Gastrointestinal Stromal Tumor"}
{"_id":"93882273-f64d-6cd0-8427-42306ba98c93","text":"In adults, the scalp is the primary choice of donor site in burns above the clavicles because of the good colour match.","title":"The scalp as a donor site for skin grafting in burns: retrospective study on complications"}
{"_id":"939d1068-2f79-3c81-7f71-1c571c76dcfb","text":"Approval from the ethics committee is not required from our institution for a case report.","title":"Successful laparoscopic trans-peritoneal repair of an incisional inguinal hernia, resulting from deep lymph node dissection for melanoma: A case report"}
{"_id":"939fd9d4-e8eb-84b6-e5f4-e13230a0ab8d","text":"In order to identify important systems that we might have overlooked following our appraisal of these six systems we also searched the US Agency for Health Care Research and Quality (AHRQ) National Guidelines Clearing House for organisations that have graded two or more guidelines in the Clearing House using an explicit system [30]. These systems were compared with the six systems that we critically appraised.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"939fdd07-c1a5-3c37-12b2-5cd67fd536cd","text":"The mechanism of the increased vascularization was beyond the scope of this study. Rather, we aimed to reveal the philosophy on the use of increased vascularization in the clinical practice. In the light of the ideas mentioned so far, calibers of choke vessels between posterior intercostals territories are increased when thoracodorsal artery is ligated and the vascular pedicle which has not been dominant before reaches a sufficient size to supply the flap. Despite beneficial effects of delay, its clinical use has turned out to be disadvantageous with the advent of microsurgery. It is desirable that the period of delay should be short. Various optimal periods of delay have been reported and the period of delay varies with the vascular structure and metabolic differences. In this study on distal pedicled latissimus dorsi flap in rats, we found no significant difference between seven-day and five-day delays. However, the above mentioned durations should not be considered as optimal periods of delay as it may take a longer time to confirm the viability of the skin island in this flap. The viability rates with vascular delay were significant compared to controls. It was striking that histological examination demonstrated thickness in vessel walls following dilatation in vessel lumens. This may be that ligation of the main vascular pedicle causes the muscle to put pressure on choke vessels, which causes dilatation in the vessel lumens and the vessel lumens hypertrophy in response. The period of delay can be shortened only if we understand what takes place after the procedure of delay is performed and till the choke vessels between the neighboring vessels are opened. It has been shown that vasoconstrictor substances play a major role in the early stage of the delay and vasodilator agents in the later stages. There have been many studies on the effects of chemicals on the duration of vasoconstriction, tolerance against ischemia and changes in the vascular anatomy. The final effect of vascular delay is a change in vascular anatomy of the flap due to opening choke vessels. Furthermore, it has been shown to increase flap survival in arterialized venous flaps. In this study, the delay period was not shortened by combination of the delay procedures when compared with vascular delay only. However, compared to vascular delay alone, nitroderm was useful in improvement of flap survival although it did not shorten the delay period. In addition, it contributed to surgical delay. In the literature, Cho et al concluded that surgical delay increased the survival rate of the arterialized venous flaps in proportion to delay period. The combination of surgical and chemical delays provided a significantly higher survival rate than surgical delay alone (p < 0.001), and the delay period could be shortened. [7]","title":"The creation of new rotation arc to the rat latissimus dorsi musculo-cutaneous flap with delay procedures"}
{"_id":"93a27c7b-5727-0d47-48b4-9e8d29841ead","text":"We witnessed partial flap loss in one and distal flap necrosis in three patients following post operative venous congestion. In one of these four cases, the flap was repositioned to its native site, due to suspected colour changes and mild congestion intraoperatively and later after 72 hrs was successfully positioned on the desired site. The other three cases were managed with VAC and later STSG. the main reason for flap loss has been attributed to venous congestion which can occur due to kinking of the vein following flap rotation because of thinner wall as compared to that of the artery.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"93a4ada4-15bf-ba05-7c1e-ce476787959b","text":"The study was a retrospective study of all patients undergoing lymph node biopsy at the Royal Glamorgan Hospital (formerly known as East Glamorgan Hospital) for the five-year period 1996 to 2000. Patients were identified from the computerised records of the pathology department. All cases of lymph node biopsy were collected (excisional and incisional) however patients in whom lymphadenopathy was an incidental finding were excluded and thus the cohort consisted of patients in whom the aim of surgery was lymph node biopsy.","title":"Does the surgeon still have a role to play in the diagnosis and management of lymphomas?"}
{"_id":"93a65e62-76a0-9770-e48f-c36375e14dc8","text":"The biggest advantage of ultrasound is its convenience and real-time imaging capabilities. These real-time images may help surgeons observe the blood vessels and nerves around an injection area and the diffusion of anesthetics in real-time, thereby improving the success rate and safety of puncture procedures. While there are relatively few studies on the application of ultrasound guidance in oral and maxillofacial nerve blocks and no widely recognized standards, this comprehensive literature review suggests the superiority of using ultrasound to guide nerve blocks in the oral and maxillofacial region.","title":"Application of ultrasound guidance in the oral and maxillofacial nerve block"}
{"_id":"93ae5475-0eda-9db4-8407-ad057fa1faf0","text":"In CD patients with optimised BT therapy dysphagia may be noticed by one fifth of the patients in about one third of the injection series. It is not associated with a functional deficit and may last several days to 2 weeks. It was not related by patient age or gender, BT total dose, BT dose in the sternocleidomastoid muscle, BT dose in the sternocleidomastoid and scalenii muscles, by BT therapy with bilateral sternocleidomastoid muscle injections, or BT therapy with ABO. Ultrasound guidance is not able to prevent it. Further studies will be necessary to study underlying dystonia associated swallowing abnormalities as a potentially predisposing factor.","title":"Dysphagia in cervical dystonia patients receiving optimised botulinum toxin therapy: a single-center retrospective cohort study"}
{"_id":"93af6026-6cf6-4da3-403e-3841dae255c8","text":"Mucocele, a common benign cystic lesion of minor salivary gland and associated ducts develops following extravasation or retention of mucous material in the subepithelial tissue. Occurrence of mucocele of tongue is considered less frequent when compared to a higher incidence of mucocele in the lower lip of young patients. Different modalities of treatment, such as conventional surgical excision followed by newer techniques like cryosurgery, electrocautery have been proposed to completely remove the lesion and reduce the chances of recurrence. Herewith, we report a novel treatment technique using alginate impression material to aid in complete excision of mucocele of glands of Blandin-Nuhn.","title":"A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report"}
{"_id":"93b808f4-c70b-bb51-ede1-8bea38c4717b","text":"Various delivery systems have been designed recently with the aim of reducing the general toxicity of conventional chemotherapeutics and increasing the therapeutic index of these drugs. Figure 1 shows the delivery platforms that will be discussed in this review.","title":"Enhancing Targeted Therapy in Breast Cancer by Ultrasound-Responsive Nanocarriers"}
{"_id":"93b88cc5-68a5-98f1-8e9a-a2220666ad8c","text":"The datasets generated and\/or analysed during the current study are not publicly available due to the internal nature of the service evaluation, but are available from the corresponding author on reasonable request.","title":"The application of an age adjusted D-dimer threshold to rule out suspected venous thromboembolism (VTE) in an emergency department setting: a retrospective diagnostic cohort study"}
{"_id":"93b98b98-d660-b046-1f69-08cecad1943e","text":"Flap dimensions obtained through the pinch test showed that the IGAP has a bigger cutaneous island when compared to the gluteal thigh flap (216 cm 2 × 160 cm2). The IGAP is a wide flap while the gluteal thigh has its width limited by skin elasticity of the thigh region. On the other hand, the length of the gluteal thigh is bigger than that of the IGAP flap. As a consequence, each flap should be indicated for a certain type of defect. In clinical practice, both of the flaps are suitable for the treatment of most of the defects located in the ischial and perineal areas. The IGAP flap has the advantage of multiple designs of the skin island while the gluteal thigh has an almost fixed design.","title":"Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps"}
{"_id":"93ba4dde-9793-9dc7-9396-826757297bed","text":"This technique may in fact be the only option for patients who are unsuitable for a local or a free flap due to chronic vascular problems. However, the patient should be informed of the need for amputation if it were to fail due to wound breakdown. Other scenarios where this technique may be of use are in situations where microvascular skills are not available such as in many developing countries. This may provide the orthopaedic trauma surgeon with deformity correction skills a potential solution. It is, however, a method that requires very close patient supervision and regular appraisal of progress.","title":"Conversion of open tibial IIIb to IIIa fractures using intentional temporary deformation and the Taylor Spatial Frame"}
{"_id":"93c52348-f1ff-81a4-0cac-e8e14dc8abde","text":"Tracheostomy in children is a relatively frequent procedure at our hospital. The most common indications are glossoptosis and subglottic stenosis. A high mortality rate was found, potentially substantiated by the high number of critical care patients with chronic neurological conditions in this cohort. Our decannulation rate is slightly below other series, probably because of the greater amount of patients with comorbidities.","title":"Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil Traqueostomia em crianças: uma experiência de dez anos em um centro terciário do sul do Brasil"}
{"_id":"93d67381-c3c8-4e6c-b910-b3b22b8af1f0","text":"Placing the transducer at the lateral border of the popliteal fossa, the common peroneal nerve is found inside the gap interposed between the biceps femoris and lateral gastrocnemius muscles. Relocating the transducer caudally, the LSCN can be seen branching from the medial aspect of the common peroneal nerve (Supplementary Video S13). The LSCN descends along the lateral head of gastrocnemius muscle and gives off a communicating branch to connect to the MSCN at the mid-calf level to form the sural nerve.","title":"Ultrasound Imaging for the Cutaneous Nerves of the Extremities and Relevant Entrapment Syndromes: From Anatomy to Clinical Implications"}
{"_id":"93d8d495-3067-a5bb-ab50-c1ee8a1b5606","text":"Here, we demonstrate the use of a venous conduit for flap salvage in a patient undergoing bilateral deep inferior epigastric perforator flap breast reconstruction. Intraoperative venous congestion was identified on the left side. A contributing factor was an unresolvable size discrepancy between the deep inferior epigastric and the internal mammary venae comitantes. A saphenous vein graft can be used to drain the donor inferior epigastric vein to the contralateral internal mammary venae comitantes.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"93d8da39-ed20-91a2-ead4-ef01426792f9","text":"The pseudarthrosis rate in pediatric cervical spine fusions remained high despite frequent use of halo immobilization and autograft. Patients with uninstrumented occipitocervical fusions are at particularly high risk with more than 1 in 3 developing a pseudarthrosis.","title":"Rate and risk factors for pediatric cervical spine fusion pseudarthrosis: opportunity for improvement"}
{"_id":"93da1c72-fe12-b826-8289-3e20465db1da","text":"Although observed patients were considered unfit for SNB, 66% of the observed patients with a regional nodal recurrence still underwent therapeutic CLND. Recently, we showed that excision of clinically positive metastatic cervical lymph nodes followed by radiotherapy is a reasonable alternative for therapeutic CLND in frail patients.33 This new approach was used for one of the three observed patients with cervical macrometastasis. As shown previously, observed patients who developed nodal macrometastasis and underwent regional node dissection had significantly more involved nodes compared with SN-positive patients who had CLND.1 Even though previous research has shown that survival correlates inversely with number of involved nodes, MSS of the observed and SNB groups did not differ significantly in the present study, possibly due to small numbers.12","title":"Focused Ultrasound Surveillance of Lymph Nodes Following Lymphoscintigraphy Without Sentinel Node Biopsy: A Useful and Safe Strategy in Elderly or Frail Melanoma Patients"}
{"_id":"93de2d46-b4ca-41b4-b1c2-e193379ddb00","text":"All these following factors contribute to narrowing the spinal canal","title":"Cervical Spondylotic Myelopathy: Pathophysiology, Diagnosis, and Surgical Techniques"}
{"_id":"93e58f8b-0603-fdad-85ac-2c3b298b678b","text":"This article is intended for oral and maxillofacial surgeons, dental emergency doctors, and neurosurgeons, providing them with more visualization technology choices when performing nerve blocks or neuralgia treatment in daily clinical practice. It is our hope that these providers can develop more safe and effective treatment approaches with the help of visualization technology.","title":"Application of ultrasound guidance in the oral and maxillofacial nerve block"}
{"_id":"93f174b5-ce18-93e3-8b3c-0c3e029c4e9c","text":"This is the first analysis of academic backgrounds of all Canadian plastic surgeons practicing at academic centres. We identified objective data that correlate with being hired at an academic centre. For trainees interested in an academic career, we recommend obtaining a graduate degree during residency, pursuing 1 to 2 fellowships, and training in the city where they would like to eventually be hired. In addition, we were able to analyze temporal trends given the wide age range of current academic plastic surgeons. Finally, we demonstrated that female gender significantly lengthens the time from graduation to first academic job, even after controlling for any other training factor. This gender disparity in time to job acquisition has not previously been reported in the Canadian literature.","title":"What Does It Take to Become an Academic Plastic Surgeon in Canada: Hiring Trends Over the Last 50 Years Ce qu’il faut pour devenir chirurgien plasticien universitaire au Canada: profils d’embauche au cours des 50 dernières années"}
{"_id":"93f2e7bd-54f8-1628-9f72-0f10bbc93a45","text":"The participant may not enter the study if he or she has any one of the following:","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"93f874ed-c9a2-2a28-c6c5-404cc41f8d57","text":"Certainly the infectious risk in a technique such as the one adopted is possible. We must consider that the wound arrived covered in purulent material and that the brief pre-surgical treatment healed it.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"93f8d726-aca2-3f51-6c51-5b1c16e62881","text":"This study aimed to provide a comprehensive literature review and evaluate the effectiveness of various laser wavelengths in the surgical treatment of patients with ankyloglossia.","title":"Efficacy of Various Laser Wavelengths in the Surgical Treatment of Ankyloglossia: A Systematic Review"}
{"_id":"93fcd308-eeaf-c896-6cd5-c768bb0b3e42","text":"In this case, triamcinolone was injected using only the outer cylinder of the indwelling needle, which was inserted in the gap between the flap and peritoneum. Attention should be paid to avoid peritoneal and intestinal tract damage when injecting triamcinolone with a needle in similar cases. Echographic guidance to administer the injection may be more conservative.","title":"Wound exudate reduction from retroperitoneum with facilitation of healing by triamcinolone injection: A case report"}
{"_id":"9401abb7-3954-d2e3-2c38-ae4e1f81d57c","text":"When selecting patients for this approach, good communication between surgical and radiological colleagues in a well-constructed MDT is critical for the accurate assessment of resectability. Expertise from multiple specialities is required to devise a radiological\/surgical plan that highlights potential issues and ensures negative margins. One of the most important aspects of tailoring treatment is focusing the planning of the resection on the maximum possible disease extent identified on MRI imaging, regardless of down-staging post neoadjuvant treatment. It can be seen in our case that there was a moderate reduction in post-treatment tumour volume in subsequent MRI scans; however, the need for S5 sacrectomy was still deemed essential for negative margins. Occult microscopic foci of viable tumour cells can be harboured within any fibrosis remaining on MRI and should be considered to have malignant potential. The final histological analysis following this approach confirmed that resection of the sacrum was necessary for clear margins, despite a reasonable response to adjuvant treatment.","title":"Robotic abdominoperineal resection, posterior vaginectomy and abdomino-lithotomy sacrectomy: technical considerations and case vignette"}
{"_id":"9405b0c5-e557-79e2-3deb-ae6c4c14e39f","text":"To the best of our knowledge, this is the first case about spontaneous rupture of abdominal wall after breast reconstruction using DIEP flap to be reported in the English literature. DIEP flap on breast reconstructive surgery may cause spontaneous rupture of abdominal wall.","title":"Spontaneous rupture of abdominal wall after breast reconstruction using deep inferior epigastric perforator flap following mastectomy for breast cancer"}
{"_id":"9408ad96-e2df-f21c-d12c-bb23aaa22cd2","text":"To the best of our knowledge, few study has ever investigated the effects of BTX injection in masticatory muscles on the cortical bone properties in human craniofacial structures in the 3D manners. Several preclinical studies demonstrated decreased masticatory loading and tensile strength induced by intramuscular BTX injection in masticatory muscles may be associated with cortical bone quality in the craniofacial area, however sparse human studies using 3D modeling technologies have ever attempted to bring this to light. We hypothesized that the decreased masticatory muscle thickness and\/or decreased functional loading would elicit decreased cortical bone quality of the masticatory load bearing area and masticatory muscle insertion sites of the mandible. Therefore, the aim of the present study was to clarify the effects of the masticatory muscle atrophy induced by BTX injection and decreased masticatory functional loading on the cortical bone quality in the mandibular structures using 3D modeling technology.","title":"Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults"}
{"_id":"940d1f20-ec91-599e-a992-e038d0d4c711","text":"Like other free flaps, this thenar free flap also has some risk of failure of flap due to loss of circulation postoperatively. The patient may also complain of pain at the site of detachment of the donor nerve, if the nerve was not carefully dissected and buried, due to neuroma formation. It can sometimes be very tedious to identify the nerve in the flap.","title":"\"A Free thenar flap – A case report\""}
{"_id":"94121778-5e55-0464-24a2-dce45733d8b6","text":"A relatively infrequent but severe complication in spinal surgery is the occurrence of EIs.","title":"The benefit of antibiotic-combined Mg-hydroxyapatite bone graft substitute over autologous bone for surgical site infection prevention in posterolateral spinal fusion: a retrospective cohort study"}
{"_id":"94129898-3f9c-b526-7b3d-54ea7f31ae82","text":"Care is required to avoid damaging nasopalatine neurovascular bundle during laser irradiation; besides, contact with the maxillary bone should be avoided when using CO2 lasers on account of the risk of thermal damage. In addition, it must be taken into account that muscle fibers are thicker in the vestibular zone, while it is advisable not to go beyond the limits of the frenulum insertion area during irradiation.","title":"Comparative study of upper lip frenectomy with the CO2 laser versus the Er, Cr: YSGG laser"}
{"_id":"9415bdcd-9f7d-9765-7dbc-f2735a5655a5","text":"There is no standardized treatment for PVC. All of the different treatment methods must be tailored to each patient on the basis of their symptoms and needs.6 Treatments that have been suggested for PVC include total abdominal hysterectomy, ligature or occlusion of pelvic varicose veins, and hormone therapy. Medroxyprogesterone acetate has been shown to temporarily reduce pain scores, but was associated with side effects such as weight gain and acne. Pelvic venous ligature is rarely used nowadays and total abdominal hysterectomy is unacceptable in young women.7","title":"Endovascular treatment of pelvic venous congestion syndrome in a patient with duplication of the inferior vena cava and unusual pelvic venous anatomy: literature review"}
{"_id":"94195582-7dee-f67f-f088-2f5eb0147eca","text":"Prevention of osteomyelitis and its treatment are still a challenge not only to the veterinary orthopedic surgery but also to the human subjects. Low systemic toxicity and high local antibiotic concentrations are the major advantages of local antibiotic delivery system. Furthermore, there is a possibility that CPC allows bone formation in a bone defect caused by infection because CPC has a character of bone replacement and augmentation.","title":"A New Type of Biphasic Calcium Phosphate Cement as a Gentamicin Carrier for Osteomyelitis"}
{"_id":"941c8e3e-ec34-20ed-fbd6-91c61ddd4435","text":"The popliteal sciatic nerve blocks were performed in a pre-operative holding area primarily by senior level anesthesia residents and regional anesthesia fellows who were supervised by a regional anesthesiologist. A regional anesthesiologist was defined as a board-certified attending anesthesiologist on faculty at Vanderbilt University who spent the majority of their clinical time in the administration of regional anesthesia. The patient was placed in a supine position with routine monitors and provided supplemental oxygen. Midazolam and fentanyl or ketamine were administered and titrated to produce light sedation. After the operative leg was placed in a leg holder, the distal thigh and knee were sterilely prepped circumferentially and draped. Mask and sterile gloves were worn.","title":"Color Doppler ultrasonography of an agitated solution is predictive of accurate catheter placement for a continuous popliteal sciatic nerve block"}
{"_id":"94268bd6-ef5d-4a27-af7a-e34c75857d57","text":"In a few cases, however, orthopedic therapy of the upper jaw alone is not decisive for the treatment of OSAS when it is caused by neuromuscular changes such as a low tongue posture due to ankyloglossia.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"942d6d5f-7e62-b4f3-5712-a907216911f1","text":"Transection and reanastomosis of the major vessels is a useful option of vascular management during rotationplasty for long-term infection of knee prosthesis.","title":"Rotationplasty with Vascular Reconstruction for Prosthetic Knee Joint Infection"}
{"_id":"942d7102-5812-8558-c1bd-dfdc4f073022","text":"The analysis of histological samples was made by specialized and limited uropathologist.","title":"Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution"}
{"_id":"943f6090-501b-30c8-780f-2dfd7617f766","text":"The risk scores were the sums of the products of the individual predictors multiplied by the corresponding regression coefficients. Since some tumor thicknesses were less than 1 mm, we also obtained negative risk scores because tumor thickness was on a log scale.","title":"Quantitative Measurement of Melanoma Spread in Sentinel Lymph Nodes and Survival"}
{"_id":"944f1a45-6d27-0644-61d8-94433866f3b2","text":"The most recent version of the AJCC (7th Edition) recommended including mitotic rate into the staging system as independent prognostic factor. The change was approved by the UICC. However, histopathological characteristics cannot always accurately predict who will relapse and who will remain disease free. Therefore, additional prognostic and predictive markers to determine the potential for metastatic relapse at the time of diagnosis and to guide therapeutic decisions in adjuvant settings even in early stage melanoma patients are urgently needed. Recently, a new molecular classification of melanoma is evolving based on chromosomal aberrations, gene mutations and signaling pathways activation that underlies biologically distinct subsets of melanoma requiring different clinical management. These approaches have already been proven successful in development of novel molecular diagnostics and importantly novel therapy approaches for melanoma patients.","title":"Future perspectives in melanoma research. Meeting report from the “Melanoma Bridge. Napoli, December 2nd-4th 2012”"}
{"_id":"94523a46-de27-b2e6-6b74-f5cdb367aec0","text":"McCraw et al introduced the concept of musculocutaneous flap which allows larger area of soft tissue coverage. This flap has been used to cover large defects around the knee and up to 5cm from the medial maleolus. Cheng et al were able to cover defects 2cm proximal to the medial malleolus by raising the skin paddle as an “island” and cutting the muscle origin. The GMCF is more reliable than a fasciocutaneous flap for coverage of a large defect because it has dual blood supply to the skin, namely from the fasciocutaneous plexus and from the musculocutaneous perforators.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"94538771-8467-ca76-4ced-c4333b6dec36","text":"During the initial four weeks, firstly the patient was educated about the importance of exercise following surgery to avoid complications and to get back to activities of daily living as early as possible. The patient was given ergonomic advice while performing normal activities like avoiding bending activities, sitting using a chair with a proper backrest, avoiding activities that will put a strain on the cervical spine, and rolling in bed using the log rolling technique. To decrease pain and inflammation after surgery ice pack application for 2-6 minutes two times a day was advised. He was educated about bed mobility and transfers and spine stabilization while performing activities. Initially, the patient was allowed to sit with a lumbar roll in a chair or at the bedside with a cervical collar for not more than 30 minutes. He was taught breathing (diaphragmatic breathing) and relaxation exercises and was advised to perform them three to four times a day for 1-2 minutes to avoid postoperative pulmonary complications. To avoid the complications related to prolonged bed rest, the patient was taught isometric exercises of lower limbs like isometrics to quadriceps, hamstring, and gluteal muscles and ankle pumps to increase blood circulation twice a day with three sets of 10 repetitions. He was also encouraged to walk two times a day as per tolerance.","title":"Effectiveness of Multicentric Therapy Post Posterior Cervical Decompression and Fusion for Cervical Disc Disease: A Case Report"}
{"_id":"9455ae61-c4f3-2640-dc7d-3142e711a6db","text":"Long lasting and predictable functional and aesthetic results in a rhinoplasty procedure usually cannot be achieved without usage of various types of grafts. Plenty of graft materials have been introduced in the literature, each having advantages and disadvantages. There is a global consensus that autologous materials are preferred in rhinoplasty. Foreign materials may be proper choices for skeletal augmentation of some specific areas such as cheek or chin, but they may result in disastrous long term complications when grafted to the nasal skeleton.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"945649d6-c824-1bea-70fd-b370b13fe950","text":"Another study limitation was the lack of standardization of skin punch biopsy depth across the clinical study sites. Although all analyses were performed by a single central laboratory, the biopsy samples were collected by different clinicians at different study sites and some biopsy samples were not large enough to apply the analysis method. Additionally, this variability was likely also influenced by the challenge of acquiring skin biopsy samples from children, the quality of which is dependent on skin thickness and elasticity, which is determined by the precise site of biopsy and age of individual.","title":"Clinical disease progression and biomarkers in Niemann–Pick disease type C: a prospective cohort study"}
{"_id":"94624911-13a5-533f-382c-8b959b410973","text":"HBRT with dose of 24 Gy and EBRT 50 Gy and perioperative chemotherapy, three years later developed muscle atrophy in the volume treated. A third patient male with 5 years old had a head neck synovial sarcoma and was treated by HBRT with dose of 24 Gy, one year later he developed dyschromy and teleangiectasy in area treated.","title":"High-dose-rate brachytherapy for soft tissue sarcoma in children: a single institution experience"}
{"_id":"94630fb0-d5dd-8016-42c4-46fec2aec9c8","text":"Qualitative variables were described with absolute frequency and percentage and quantitative variables with median and range.","title":"Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers"}
{"_id":"94682de3-c31f-8b1c-e81b-35eb4b2700ff","text":"The MMSTC included a center-line, rail-mounted mechanical agitator for the purpose of fragmenting thrombus, and aimed to do so while minimizing the risk of vein wall contact and trauma. The plastic agitator measured 5 mm 15 mm and tracked over the outer surface of the distal catheter and that could be moved independently within the treatment zone to fragment thrombus and using 1mm stainless steel wire cannulas.","title":"Multimodal thrombectomy device for treatment of acute deep venous thrombosis"}
{"_id":"946846eb-5185-5395-e0c7-8503bc5f1372","text":"Results of the previous study we reported demonstrated that surgical treatment could not control desmoid tumors, even with negative surgical margin. Considering the functional impairment with surgery with negative surgical margin, a conservative effective treatment modality with fewer complications is desired. Although further investigation will be needed to clarify the responders to meloxicam, we now conclude that conservative treatment with meloxicam is a promising novel modality for patients with extra-abdominal desmoid tumors.","title":"Transition of Treatment for Patients with Extra-Abdominal Desmoid Tumors: Nagoya University Modality"}
{"_id":"94705d5a-7fc3-ffb2-daaa-1dd4f3e5b8e9","text":"It is a preferred option in CPF treatment of bony defects with full union by using bone graft in our 2 cases. We found that this technique requires a strong intramedullary fixation with Kirschner wire or Rush nail and bone grafting to prevent complications such as refracture at the union site. However, more cases and larger studies are needed to provide definitive results in the future.","title":"Refracture, a Potential Complication of the Periosteal Flap Technique Without Bone Graft for Isolated Congenital Pseudarthrosis of the Fibula: A Report of Two Cases and Literature Review"}
{"_id":"9476b593-f43b-0663-c9c8-7a9bc71f823a","text":"The most successful use of clinical PDT appears to be in Asia and Europe where the barriers to widespread utilization are not so steep as in the United States. This is perhaps because the reimbursement procedures and opportunities for research support are different than in the United States. Clinical trials are very expensive here, and it has been estimated that the cost of developing a single drug can be in the hundreds of millions of dollars. This hurdle is a difficult one to overcome. While the idea of unleashing a collection of unproven protocols into clinical practice is clearly not acceptable, the high price of drug development means that the road is very precarious. The use of PDT for treatment of macular degeneration did represent a notable financial success. As interest by the pharmaceutical industry begins to wane, this is reflected in levels of support by the granting agencies. There are currently three major groups supported by NIH program project grants (Penn, Harvard\/Massachusetts General Hospital\/Roswell Park). Support for other research efforts is more limited, perhaps a function of the limited interest in the field by major pharmaceutical organizations.","title":"More Adventures in Photodynamic Therapy"}
{"_id":"947f39c4-3809-1c97-c6e8-53f93ea2c2cc","text":"All procedures performed in this study involving human participants complied with the ethical standards of the institutional research committee and the 1964 Declaration of Helsinki declaration and its later amendments or comparable ethical standards. All samples were properly masked for the performance of this trial. This study was approved by the Review Board of the Austrian Society of Gastroenterology and Hepatology.","title":"SASE, S uccess and A dverse event S core in E ndoscopic Retrograde Cholangiopancreatography: a Novel Grading System"}
{"_id":"94804379-a7aa-10e9-5161-19e1e45ce7d8","text":"Benign tumors are sometimes confused clinically with malignancy, particularly when they are pigmented or ulcerated or inflamed, and histologic examination of biopsy specimen is required to establish a definite diagnosis. Hence biopsy of skin tumors is the gold standard for accurate diagnosis and prognostic assessment of the patient. The knowledge of histopathological patterns can help in prognosis and planning an effective management.","title":"Histomorphologic Profile of Skin Tumors"}
{"_id":"948288c0-eb1e-5bcd-fb28-8cb0adb41806","text":"Our study shows that flap loss, which occurred in 1 of 60 cases was extremely expensive and not provided for in the funding system. It demonstrates the importance of flap monitoring, as in the five cases of successful salvage of compromised flaps, the additional cost was proportionately much less than the potential cost of losing a flap and hospital stay was not particularly longer where a flap was salvaged.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"948433a0-9dc5-c028-9dfe-343039cf095c","text":"During the operation, the vital parameters were always stable and normal. The surgery was performed with excellent compliance on the part of the little patient and the duration of anesthesia was estimated to be more than two hours. The post-operative course was also free from complications and the patient was discharged from the hospital on the third day.","title":"Abstracts of the ICARE 2023 77th SIAARTI National Congress"}
{"_id":"948567f5-592e-aaed-4162-2775118883aa","text":"The patient was admitted for wound care and physical therapy given the severely limited range of motion in her right lower extremity. The patient’s wound care regimen included an initial washout with betadine and saline following which it was packed with a gauze roll and covered with gauze. This dressing was to be changed daily. Given the number of pellets and their dispersal in the soft tissues, it would not have been practical to remove them without significant tissue disruption. Over the next 2 days, her wound was packed with saline wet-to-dry dressings daily and appeared healthy. She showed progress with mobility such that she was cleared for discharge 2 days after her injury.","title":"A rare case of retained sabot after close-range shotgun injury"}
{"_id":"948cef8f-a140-4722-06d3-c0774f85e362","text":"A few mothers described that a new pregnancy hindered the continuation of breastfeeding; all of these mothers breastfed as long as they wanted. The mothers described that their breasts were sore, they felt unwell, their milk supply decreased or the infant did not breastfeed because of a new pregnancy. One mother wanted to cease breastfeeding to regain menstruation to become pregnant again.","title":"Cessation of breastfeeding in mothers of preterm infants—A mixed method study"}
{"_id":"948cf9d0-939c-cb46-da40-89df7343093d","text":"retrospective study was carried out through data from medical records of patients who underwent nasal reconstruction with PMFF due to NMSC at the Cancer Institute of the State of São Paulo (ICESP).","title":"Paramedian forehead flap in the treatment of nasal, non-melanoma skin cancer: a cross-sectional study Retalho frontal paramediano no tratamento do câncer de pele não-melanoma de nariz: um estudo transversal"}
{"_id":"948cff41-eae0-355e-3366-a353da97a1dd","text":"A much smaller cohort of hemophiliacs requires microvascular free tissue transfer. Microvascular free tissue transfer has a reported success rate between 95 and 99% for the reconstruction of ablative defects in the head and neck [6, 7], although the literature reporting success rates of free tissue transfer in hemophiliacs is limited to 6 case reports. Altered hemodynamics may compromise the blood flow and flap survival rate; therefore, strict protocols for microvascular surgery may be even more crucial. It is unclear whether these procedures can be performed safely in the severe hemophilic patient due to the lack of data regarding this topic. The risk of life threatening hemorrhage and flap compromise due to vascular compression from hematoma formation or from vascular thrombosis during these surgeries needs to be further investigated.","title":"Vascularized Free Tissue Transfer in a Patient with Hemophilia B: Case Report and Literature Review"}
{"_id":"9491d8cf-1d23-28db-022a-4d29a3b5b4fa","text":"It will take a consortium of program directors, medical educators and administrators from hospitals and the federal government to deliver all the education and financial requirements needed to grow these opportunities (see Table 2). Program directors and educators must define and study the benefits in detail. They must lay out the specific aims and requirements to make international electives safe, educational and long lasting in their effect. It will take better research and scholarship to define what makes them worthwhile and what benefit they bring to our own population. Hospital and government administers must discuss the ability to support and fund these rotations. For individual hospitals it may bring a better ability to compete for top residents and enhanced reputation. This alone may be worth the financial commitment. The AAMC or individual Residency Review Councils could set up a committee to evaluate how it may enhance medical education. The ability to deliver culturally competent care can be enhanced or met by international rotations when a patient population is not diverse. Lastly, the government, by allowing a small portion of the direct and indirect graduate medical education payments to be applicable for IMs would significantly enhance the ability to residents to participate.","title":"Loss of international medical experiences: knowledge, attitudes and skills at risk"}
{"_id":"94975b0f-5091-4565-3e4b-6da0074fe53c","text":"SCC lesions on the nose and ear have the highest rates of recurrence which might be due to an association with embryonic fusion planes [36]. Therapy should therefore be aggressive as tendency of recurrence is high [37]. A complete excision by means of micrographic surgery with tumor free margins is necessary for a successful outcome and should be attempted whenever possible. Although this tumor tends to grow in a vertical fashion it is less likely to respect the barriers of cartilage and bone than BCC. Consequently intratemporal spread with involvement of the external auditory canal is possible and can lead to conductive hearing loss. With further deep extension facial nerve palsy due to destruction of the facial nerve along its vertical or tympanic segment may evolve, and finally a further advancement into the internal auditory canal and cerebellopontine angle may cause dizziness and\/or sensorineural hearing loss.","title":"Cutaneous lesions of the external ear"}
{"_id":"94a441b7-7638-073e-b689-86c3d251537a","text":"In this study exclusive breast feeding is lower than the recommendation therefore, further efforts are required to increase the practice of exclusive breastfeeding, by maintain the education of people and strengthen maternal health service utilization, such as antenatal care and institutional delivery, In addition, Ensuring mothers receive consistent support and clear advice from trained and skilled personnel about exclusive breast feeding is very crucial.","title":"Exclusive breastfeeding practice and associated factors among mothers of infants age 6 to 12 months in Somali region of Ethiopia"}
{"_id":"94a9b867-4789-aa34-8af6-ecb3ae3cf5cb","text":"Differences in recurrence rates according to diagnosis were statistically insignificant in both age subgroups.","title":"Long-term recurrence of nonmelanoma skin cancer after topical methylaminolevulinate photodynamic therapy in a dermato-oncology department *"}
{"_id":"94b979bc-53a8-37fa-e349-84f706dbb16b","text":"The present results showed that the calculated blood loss in the periarticular local injection of TXA without drain clamping did not show non-inferiority to that in the injection into the knee joint through a drain of TXA combined with drain clamping during TKA. Although one cannot conclude that the local injection method could be an alternative to the drain clamp method in terms of bleeding reduction, local injection of TXA was considered to be a method that can suppress bleeding without injecting fluid into the joint after surgery without drain placement.","title":"The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial"}
{"_id":"94bddd9c-2bbf-e23a-0acf-fb17fb6130a9","text":"We strongly recommend a sentinel lymph biopsy in clinically node negative patients who are having upfront surgery. This involves patients with all clinical T status, with the exception of inflammatory disease and known node positive disease at time of clinical diagnosis.","title":"Guidelines for breast cancer management in Bosnia and Herzegovina"}
{"_id":"94c1ec62-da3e-0ef5-03ab-f8acdb302d9b","text":"We are not sure if this complication could have been avoided. Although we recommend consideration of syndesmotic stabilization or syndesmotic fusion in adults with EDS undergoing FVFG, it is possible that ankle arthritis would result in this patient population regardless. If the syndesmosis was eliminated through screw placement or fusion at the time of FVFG, there is still the possibility of anterior or posterior talar translation due to joint hypermobility, resulting in abnormal wear and eventual joint collapse. In light of this possibility, free fibular graft harvest may be a relative contraindication for patients with EDS. Harvesting of structural grafts from alternative donor sites that do not depend on ligamentous support, such as iliac crest, could be considered primarily in this subset of patients.","title":"Donor-Site Complication of Severe Valgus Ankle Deformity in an Adult With Ehlers-Danlos Syndrome Following Free Vascularized Fibular Grafting"}
{"_id":"94c719a4-c704-44fc-b20c-97fde83a6e33","text":"Because of the age of the patient, the operative procedure was performed under local anaesthesia with sedation instead of general anaesthesia. Although this is a large surgical field to perform under local anaesthesia, in our hospital, the final decision about the most suitable anaesthesia depends on the anaesthetist, who considered the local anaesthesia with sedation as the most appropriated method for this patient.","title":"Chondromucosal Nasal Flap With the Transposition Flap of Von Langenbeck as a Good Election for the Total Lower Eyelid Defect Reconstruction in an Old Patient With an Elevated Vision Loss in the Contralateral Eye"}
{"_id":"94cb5e62-3137-86e1-5545-38bbc226bde8","text":"Our procedure primarily rests upon the adequacy of the reduction achieved before we start the procedure. This prevents the excessive use of image intensifier. In cases where closed reduction was not achieved, we did not hesitate in performing an open reduction with a mini incision. The distal locking was done by a free-hand technique. The reason of malunion in intramedullary nailing was failure to centralize the nail in wide distal tibial metaphysis. Considering the utility of poller screws as proposed by Krettek et al.,19 we used poller screw in seven cases in which the alignment and stability were not satisfactory. In unstable fractures of the lower tibia with associated fibular fracture, we resorted to plating the fibular fracture and locking the nail within 15 mm of the lower tibial articular surface. This has helped in solving the problems associated with unstable fractures. We agree that fibular plate fixation increased the initial rotational stability after distal tibial fracture compared with that provided by tibial intramedullary nailing alone.20","title":"Dynamic osteosynthesis by modified Kuntscher nail for the treatment of tibial diaphyseal fractures"}
{"_id":"94cbe7de-65cc-0337-dba1-7d0007769335","text":"We hypothesize that there is no difference in one or more major complications at 6 months.","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"94d9beba-b017-f3f2-2f1a-9ed4f35caac3","text":"Compared with INB, PVB can provide better analgesia efficacy and cause lower consumption of morphine after thoracic surgery and breast surgery.","title":"Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis"}
{"_id":"94edc695-a403-d605-4c5a-f801c8e7e9b7","text":"However, quantitatively assessment of the effect of PDT for the treatment of NCC is lacking, so as to a standard protocol of PDT for the treatment of NCC is short of foundation. Our review will evaluate therapeutic effect of PDT for the treatment of NCC systematically. We expect that the results from this systematic review for clinical trials will help inform clinical practice in NCC.","title":"Therapeutic effect of photodynamic therapy for nonresectable cholangiocarcinoma Protocol for a meta-analysis and systematic review"}
{"_id":"94f791ca-d8b5-2828-707b-99e95a27b4ca","text":"The procedure could be repeated for the other 3 electrodes (a total of 2 on the median nerve and 2 on the ulnar nerve) taking care to avoid intersections between the electrodes and the output cables. Each TIME has an external marking with different colors to ensure easy identification.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"94fb7e64-3ab9-f12b-d521-a634cbe28fcc","text":"RESULTS The safe and effective use of MRgFUS is affected by fibroid type and location, position relative to adjacent anatomical structures and the presence of coexistent pelvic disease.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"94fcb2de-5c79-e9d1-a5a9-f8f17d479d90","text":"were asked if there were any inconvenience resulted by increased yawning frequency that had also been noticed by their family members.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"95018dbb-b45d-3756-5584-44491c392c41","text":"Program directors were asked about the annual BT caseload at their institution in terms of patients treated as well as the number of fractions. Additionally, data were collected about the length of time residents spend training in BT in terms of months on a BT rotation as well as the number of training hours received.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"9509c13d-be70-bef4-a189-708c8e7c1b6b","text":"Skin cancer survivors experience an increased risk for subsequent malignancies but the associated risk factors are poorly understood. This study examined the risk of a new primary cancer following an initial skin cancer and assessed risk factors associated with second primary cancers.","title":"New malignancies after squamous cell carcinoma and melanomas: a population-based study from Norway"}
{"_id":"9514d38a-9194-b38b-7222-5c1c691292ef","text":"For smaller patients with reduced body habitus, a soft decubitus position with the arm extended to 90 degrees on an arm board can also be sufficient for PLDF harvest without the need for a Spider Arm. This is especially true when harvesting a myofascial flap alone. Incorporation of an overlying skin paddle may require brief retraction of the arm by an assistant to perform posterior cuts.","title":"Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: contrasting shoulder morbidities across mysofascial flaps"}
{"_id":"95152e23-b20c-0d57-5383-40020f5c9e72","text":"The current treatment strategies to treat bone and joint tuberculosis involve prolonged anti-tuberculosis therapy in early stages which often causes systemic toxicity. To circumvent these limitations of poor bioavailability, various implantable ATD carriers have been developed to deliver the drugs locally at the infection site. All the hitherto ATD carriers developed, have shown burst release or were not able to achieve long term sustained release of drugs. In the current study, we have used a ceramic based hydroxyapatite bone substitute as a carrier of two first line anti-tuberculosis drugs, Rifampicin and Isoniazid. The potency of a sulphate hydroxyapatite carrier for bioactive molecules to promote bone healing was established in earlier studies. Apart from achieving long term sustained release of drugs, it can act as a bone filler material to fill the dead space at the debrided site. The local environment with hypoxia and clot formation in the dead space has been found to be favourable for dormant bacteria to start growing again.","title":"A biphasic nanohydroxyapatite\/calcium sulphate carrier containing Rifampicin and Isoniazid for local delivery gives sustained and effective antibiotic release and prevents biofilm formation"}
{"_id":"951bd5bc-b091-331a-ca01-6a27dd3b01c2","text":"The arterialized venous flap was used as a popliteo-pedal bypass with a skin and subcutaneous island flap from the greater spahenous vein. The vein itself was used as bypass to revascularize the foot. By harvesting cutaneous tissue around the vein a flap was created which resembles a so called venous flap. As the vein graft was used to bridge the artery the cutaneous tissue becomes arterially vascularized. These flaps however require a venous outflow. We therefore used a couple of subcutaneous efferent veins to establish venous drainage. This flap type can also be used in traumatic defects of the lower leg and foot. It is able to cover a defect and to increase the perfusion of the foot in one manoeuvre.","title":"Vascular Surgery, Microsurgery and Supramicrosurgery for Treatment of Chronic Diabetic Foot Ulcers to Prevent Amputations"}
{"_id":"951d2179-e388-76e7-c867-fb40c34b7617","text":"Human bite wounds are seen in the emergency department and need evaluation for the need of reconstruction. They are due to occlusive bite injuries. Defects over nose can be reconstructed immediately after debridement or delayed till the wound heals and scar becomes supple. We recommend delayed reconstruction to lessen the chances of infection and cartilage absorption as cartilage graft is needed in most cases undergoing reconstruction. Paramedian forehead flap provides excellent reconstructive option with good contour and color match with minimal donor site scar.","title":"Human Bites Over Nose: Management and Reconstruction"}
{"_id":"9528f2c6-085c-6403-6856-abafd4e13ea6","text":"The patients were instructed to return to the hospital every 2 weeks in the first month and then every month for 2 months.21 Thereafter, the patients were asked to return to the hospital every 3 months for at least 2 years.","title":"Dermatologic Microsutures Using Human Hair: A Useful Technique in Cutaneous Stitching Al azrak and Ogawa"}
{"_id":"9530a0d2-b6fd-219f-e633-059caf311647","text":"According to the recommendation of AJCC, the patients with primary cutaneous melanoma would be managed by the radical excision of the affected skin following the extirpation of the sentinel lymph node. The histological evaluation of Clark's level of invasion, mitotic rate, ulceration, Breslow thickness of the melanoma, and the status of the sentinel lymph node leads the pathologists and the clinicians to determine the TNM stage. The sentinel lymph node as a regional one is considered to be the first node which the tumor cells invade during the drainage from the primary tumor. The presence of tumor cells in the lymph node is an indication for extirpation of other regional nonsentinel lymph nodes. The use of lymphangiogenesis as a reliable predictor of the metastasis in the lymph node has been investigated in the literature.","title":"Lymphangiogenesis and Its Correlation with the VEGF Expression and the Sentinel Lymph Node in Cutaneous Melanomas"}
{"_id":"95397771-b4c2-057a-8b23-ef8e5aa43d2c","text":"Conclusions: Given the significant morbidity early recognition of drug reaction with eosinophilia and systemic symptoms syndrome and initiation of appropriate therapy are imperative in limiting morbidity.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"95483901-00b3-552c-f972-8fc06497462b","text":"The deep inferior epigastric perforator (DIEP) flap has become a mainstay for autologous reconstruction with generally low complications and risk of flap failure.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"954d63c7-2aee-2732-98ce-138205d642cf","text":"It is also accepted that patients may experience postoperative sensitivity from dental procedures such as nonsurgical and surgical procedures and that this discomfort may resolve within 1 to 2 weeks for nonsurgical procedures and up to 8 weeks following surgical procedures. 22 The results from the present study are reasonably consistent with the published figures.","title":"A Survey of Dentists in the Management of Dentine Hypersensitivity: A Questionnaire-based Study"}
{"_id":"955141a5-016a-4a69-6f96-79f7a2692efc","text":"Material and Method: 810 patients of Severe Persistent Allergic Rhinitis of different Age groups of either Sex ranging from 5 years to 63 years were taken.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"955b7cb1-70e5-d0b7-9970-cc639da6ad41","text":"Several respondents indicated a desire to have detailed guidelines and caseloads like medical radiation oncologists when attesting to AMP license requirements. Another recurring theme was that of needed collaboration between various programs to afford residents with exposure to diverse caseloads, particularly those involving newer modalities and radiopharmaceutical administration.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"95621d6e-2df9-5924-e945-6ad847b6c5d6","text":"Although preoperative mechanical prophylaxis in addition to routine postoperative thromboprophylaxis, could be more beneficial without additional bleeding risk in terms of preventing VTE, the additional effectiveness of mechanical prophylaxis during the preoperative period in elderly patients undergoing HFS is still unclear.","title":"Does preoperative mechanical prophylaxis have additional effectiveness in preventing postoperative venous thromboembolism in elderly patients with hip fracture?—Retrospective case-control study"}
{"_id":"9564b52e-623b-3915-fa6e-e8abaabfb0cd","text":"Since knowledge of the instrumentation and of biomechanics of the cervical spine is necessary to avoid complications and to optimise instrumented fusion only experienced spinal surgeons will collaborate with this study. This will prevent a discussion related to the presumed different skill levels of the surgeons in case of an unexpected result.","title":"Design of Lamifuse: a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy"}
{"_id":"9566156f-a498-df1e-d79d-7105c62bc1dd","text":"The best candidates are younger patients with thicker skin and minimal to moderate volume loss. A depot injection at the level of the periosteum essentially traps the gel implant creating a long-lasting effect. Edema and ecchymosis are quite common in this area. Too superficial placement or thin skin in this area can lead to visibly pale nodules or Tyndall effect. Injection of filler into the periocular area is a difficult procedure and only a person with good training and experience should attempt it. One should also be aware of serious side effects such as blindness (see under complications).","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"95717f2a-faac-7ab5-7498-dd02bf89aa39","text":"Five patients had been submitted to procedures without use of any anesthetic: one with local erythema after an esteroid intra-articular infiltration had a positive patch test to betamethasone dipropionate; one with an anaphylactic reaction during a colonoscopy had a positive BAT to metamizol used as analgesic; one with acute urticaria after contrast injection for a thyroid TC had IDT positive to iomeprol. Two patients had a negative workup.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"95745a71-c42d-7917-8f0d-f5802e8f4cb7","text":"This systematic review could serve as a reference for future studies with a higher methodological quality that take into account the above-mentioned aspects.","title":"Effectiveness of Myofunctional Therapy in Ankyloglossia: A Systematic Review"}
{"_id":"95782bb8-94a3-f210-1f6f-9042874ddd28","text":"Bifurcation of sciatic nerve into common peroneal nerve and tibial nerve.","title":"Popliteal lymph node dissection for metastases of cutaneous malignant melanoma"}
{"_id":"957a64af-58bb-e985-f6c0-787ec41d6af8","text":"Using minced split-thickness skin grafts overlaid with Pelnac enables the reconstruction of full-thickness skin defects in a single step and can increase the healing rate while improving the quality of wound healing.","title":"One-step approach for full-thickness skin defect reconstruction in rats using minced split-thickness skin grafts with Pelnac overlay"}
{"_id":"957aeac2-b064-9a51-c55e-d79293857d15","text":"Our data confirm previous studies and support the clinical usefulness of SLNB as a reliable and accurate staging method in patients with cutaneous melanoma. However, the benefit of additional CLND in patients with positive SLN remains to be demonstrated.","title":"Sentinel lymph node biopsy in melanoma: Our 8-year clinical experience in a single French institute (2002–2009)"}
{"_id":"958e9ded-e2af-fd21-f737-44d071d62e78","text":"Her surgical past was remarkable by a Caesarean section one year ago.","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"958f0dba-e119-0365-0f32-fdd945aeecfe","text":"The exclusions were made if the PLNB was not performed in isolation or was done as a part of a more elaborate procedure, for example:","title":"Peripheral Lymph Node Excisional Biopsy: Yield, Relevance, and Outcomes in a Remote Surgical Setup"}
{"_id":"9591f116-379e-b3df-4935-b89e9db98ab3","text":"An important aspect of the preoperative ultrasound examination of the ALT is the accurate assessment of the vascular pedicle, particularly the length. An accurate assessment of the donor vessel is essential, because the short course of this vessel may make it difficult to obtain a vascular pedicle that is sufficiently long to properly reconstruct the site of the primary tumour excision. For this reason, it is essential to obtain detailed, accurate information on both the length of the vascular pedicle and on the anatomical variant of the ALT flap vascularisation, both of which play a role in selecting the optimal reconstructive technique [14].","title":"Colour Doppler sonography in the preoperative assessment of the vascular pedicle from the anterolateral thigh flap: proposal for a mathematical formula to predict pedicle length"}
{"_id":"95954c17-83e4-f144-1a23-f7ddc0e85898","text":"Chronic facial pain is considered one of the conditions that affect quality of daily life of patients significantly and makes them seek medical help. Intractable facial pain with failed trials of medical treatment and other pain management therapies presents a challenge for neurologists, pain specialists, and neurosurgeons. We describe the possibility of proposing peripheral nerve stimulation of the supraorbital nerves to treat patients with medically intractable facial pain. Stimulation of the supraorbital nerves is performed using percutaneously inserted electrodes that are positioned in the epi-fascial plane, traversing the course of the supraorbital nerves. The procedure has two phases starting with a trial by temporary electrodes that are inserted under fluoroscopic guidance and are anchored to the skin. This trial usually lasts for a few days to 2 weeks. If successful, we proceed to the insertion of a permanent electrode that is tunneled under the skin behind the ear toward the infraclavicular region in which we make a pocket for the implantable pulse generator.","title":"Supraorbital Nerve Stimulation for Facial Pain"}
{"_id":"95993196-2559-d185-21fd-d8f91669ac8e","text":"The nose is then taped and casted. Nasal packing were placed and remained in the nose for 10 days under oral amocixillin treatment.","title":"A breakthrough in Maxillary LeFort II fracture reconstruction: Case series of rhinoplasty using diced cartilage fascia graft simultaneously with ORIF"}
{"_id":"959df7ca-b847-50da-6560-f71f2f743684","text":"Women who did not have a diagnostic breast imaging in the last 21 months had higher sensitivity both among women without a previous breast cancer as well as among breast cancer survivors (Table 4). As among women who had a diagnostic breast imaging in the last 21 months, the sensitivity was significantly lower for breast cancer survivors compared to women without previous breast cancer diagnoses.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"959e208f-1162-4dfa-bc33-2b753ba3103f","text":"All the hypotheses discussed above require adequate access for AA to tumors cells with effective distribution throughout the extracellular environment near the tumor.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"95a3601b-d1ea-4bd9-3563-1d00487594aa","text":"This survey highlights the areas and subspecialties that deserve attention as perceived by the current trainee pool.","title":"A survey of current state of training of plastic surgery residents"}
{"_id":"95a8e782-7712-3762-11fa-c8e21fcc2419","text":"One of reasons for abdominal wall rupture in our case was considered the unconscious injury of peritoneum when inferior epigastric vessels were harvested. In the present case, the rupture area was located at caudal side of arcuate line. The bowel herniation occurred from peritoneum to subcutaneous area through lateral of rectus abdominis and anterior sheath, in which the location did not match the course of pedicle dissection. This rupture seems to be not iatrogenic but spontaneous because the perforator located medial of the rectus abdominis and the rupture occurred through lateral of the muscle. It was not completely denied that this case was iatrogenic; however, we raised DIEP flaps in a standard manner, and we could not perform irregular procedure without abdominoplasty.","title":"Spontaneous rupture of abdominal wall after breast reconstruction using deep inferior epigastric perforator flap following mastectomy for breast cancer"}
{"_id":"95aacfc6-7180-5601-74c9-294eb2638e35","text":"Based on our findings, there is a possible association between the increased risk of hemorrhage and the early postoperative use of LMWH. The debilitating outcomes among the majority of these patients warrant the cautious use and further investigation of postoperative LMWH to appropriately quantify the risk. Further comparative studies with a larger sample size are required to provide insight into the pathophysiology of our findings.","title":"Posterior Fossa Hemorrhage Following the Use of Low-Molecular-Weight Heparin: Lessons Learned and Recommendations for the Treatment and Prophylaxis of Postoperative Venous Thromboembolism"}
{"_id":"95ae91b6-4b4b-442e-8dfc-cc0476b87dad","text":"Participants in the population-based New Hampshire Skin Cancer Study provided detailed risk factor data, and subsequent cancers were identified via linkage with the state cancer registry. Deaths were identified via state and national death records. A Cox proportional hazard model was used to estimate risk of subsequent malignancies in NMSC patients versus controls and to assess the potential confounding effects of multiple risk factors on this risk.","title":"Non Melanoma Skin Cancer and Subsequent Cancer Risk"}
{"_id":"95b5eaa4-bf91-c14c-21b8-91b6817fb5c6","text":"Selection of a technique that can safely restore aesthetic features of the scalp while permitting the scalp to perform its protective and functional duties is the ultimate goal of reconstruction. Healing by secondary intention is appropriate for a small defect with a healthy wound base. This method of healing can leave the patient with alopecia that will either to be addressed once healing is complete or masked with routine hairstyling practices. Skin grafting with or without available dermal matrices can allow for coverage of exposed tissue for a patient with scarce local tissue rearrangement options. It is a quick and technically easy procedure, but it does not adequately address contour or hair loss deformities, and carries with it varied donor site morbidity, depending on the size of the defect. Primary closure and local-regional flaps limit alopecia and contour deformities, and they may increase the likelihood of reconstruction with a one-step procedure. Disadvantages include the need for extensive undermining or relaxing incisions that may alter the hairline. There are a number of local flaps available in reconstruction. Use of large rotational advancement flaps for scalp defects helps compensate for the relative inelasticity of the scalp tissue and can carry adequate blood supply. Incision orientation is made with both preservation of the hairline and inclusion of a single scalp pedicle in mind. Tissue expansion is a valuable tool when attempting to reconstruct larger wounds. It does, however, require multiple procedures, carries an increased risk of infection, and is associated with complications in the irradiated patient.7 In our case, a combination approach including healing by secondary intention, local tissue advancement, and scar revision was used to obtain an acceptable aesthetic outcome for the patient.","title":"Hair Braiding-Induced Scalp Necrosis: A Case Report"}
{"_id":"95ba4dc0-ad1e-9741-2c12-c10277e3882b","text":"A shave margin taken by a pathologist is a very thin slice of tissue from a margin surface in question and is usually a size that can be frozen for microscopic intraoperative examination or placed directly in a tissue-processing cassette. Any tumor present in the section examined would indicate a positive margin (Figure 9). In the intraoperative setting, relatively larger surface areas can thus be examined compared to that of a perpendicular section through a margin, providing a yes or no answer. Disadvantages of a shave margin include difficulty in obtaining a shave of a soft surface and in maintaining tissue orientation. The nature of the section also precludes measurement of the clearance of a tumor from a margin. Pathologic shave margins for permanent section are most commonly used to assess margins that are distant from a tumor and are required for completeness of reporting margin status.","title":"Evaluation of Resection Margins in Breast Conservation Therapy: The Pathology Perspective—Past, Present, and Future"}
{"_id":"95bd5964-c5ed-d836-9cbc-7908ac707340","text":"All the studies mentioned above are characterised by limitations such as the study design and a small number of subjects.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"95c6aa66-47ed-8f9b-d396-e9ddc766acc2","text":"When necessary a pelvic lymphadenectomy was performed either as first surgical step or following surgical staging. In any case it was performed bilaterally from the level of the aortic bifurcation along the external iliac vessels to the circumflex iliac vein. Internal iliac lymph nodes are then removed. The obturator lymph nodes were removed taking care to identify the obturator nerve. Para-aortic lymphadenectomy was not routinely performed unless suspicious pelvic lymph nodes or deep endometrial invasion or serous papillary or other abnormal histological types were present. Lymph nodes were removed altogether in one single endobag from the vagina at the end of the operation. The round ligament was only partially divided and the anterior leaf of the broad ligament utilized to prepare the paravesical space. A blunt dissection toward the pelvic floor between the superior bladder artery and the cervix was created on both sides. The vesicouterine peritoneal fold was left aside and retrograde dissection initiated from the sides of cervix. Cervical and vaginal uterine vessels were eventually identified, isolated, and coagulated. At the end of this time the transection of the round ligament was completed by dividing all the anterior leaf down to the vesicouterine peritoneal fold. This was finally mobilized from connections to the lower uterine segment. The infundibulopelvic ligaments were identified as high as possible out of the pelvis. While being grasped and elevated, an incision was bluntly made 1 cm beneath the ligament on the underlying peritoneum. This allowed to push away the ureter before coagulation. These ligaments were coagulated with bipolar over a 2 cm distance and were divided.","title":"The Retrograde and Retroperitoneal Totally Laparoscopic Hysterectomy for Endometrial Cancer"}
{"_id":"95cdaaf6-375c-3dcf-ab09-e8d6fd85959f","text":"In conclusion, our study found distinct vaccine-elicited immune responses between adults and teenagers when both were repeatedly vaccinated in consecutive years. It also provided further supports for the associations between several host factors and antibody responses in a repeated vaccination setting. Notably, we found an interactive effect of age and BMI in the overall population and the adults. Future studies with a larger enrollment of teenaged participants representing a broader range of BMIs may provide additional insights into the interactive effect in the younger age group.","title":"Longitudinal Assessment of Immune Responses to Repeated Annual Influenza Vaccination in a Human Cohort of Adults and Teenagers"}
{"_id":"95d0b03d-d8d9-f8c5-d310-2dab9abb52b2","text":"Despite the recognition that regular postoperative follow up plays a key role in the ongoing care of cancer patients, there is little consensus on the nature of the process and this is reflected in the lack of scientific data in the literature. There are no randomised controlled trials or other studies or series assessing the appropriate follow up protocol for patients after curative oesophagogastric resection.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"95d5e944-aa5f-76ab-ad26-00f2c64efd9d","text":"In patients with cleft lip and palate, bone grafting in the mixed dentition in the residual alveolar cleft has become a well-established procedure. The main advantages can be summarised as follows: stabilisation of the maxillary arch; facilitation of eruption of the canine and sometimes facilitation of the lateral incisor eruption; providing bony support to the teeth adjacent to the cleft; raising the alar base of the nose; facilitation of closure of an oro-nasal fistula; making it possible to insert a titanium fixture in the grafted site and to obtain favourable periodontal conditions of the teeth within and adjacent to the cleft. The timing of the ABG surgery take into consideration not only eruption of the canine but also that of the lateral incisor, if present. The best time for bone grafting surgery is when a thin shell of bone still covers the soon erupting lateral incisor or canine tooth close to the cleft.","title":"Alveolar bone grafting"}
{"_id":"95dc14c0-9275-9c02-dbda-bf581f865f88","text":"Day surgery can be adapted to almost all the oral surgery interventions because these procedures are short-term operations that can be performed with regional anesthesia. Numerous factors contribute to the growing popularity of outpatient surgery;","title":"Oral surgical procedures under local anaesthesia in day surgery"}
{"_id":"95e00b44-2193-22e7-d237-24ccfe235830","text":"The distally based (or reverse) sural artery fasciocutaneous flap has gained much of the attention recently. The flap is found to be reliable and versatile and can be elevated quickly to cover a wound in the distal third of the leg. At the present time, the proper management of soft tissue coverage for a less extensive tibial wound in the junction of the middle and distal thirds of the leg has rarely been discussed in literature and therefore, the optimal reconstruction for this unique clinical problem has not been determined.","title":"Synchronous Soleus and Reverse Sural Flap for Large Soft Tissue Defect Reconstruction of Leg"}
{"_id":"95eb7532-f645-3a7c-929b-d2cc2f44c3a3","text":"Epidermal regeneration was evaluated with the samples harvested 14 days after implantation with or without CE application (Figure 8). First, we confirmed that the epidermis would not regenerate after implantation without CE application because the keratinocytes of the nevus tissues had been totally inactivated due to the HHP treatment. No epidermal regeneration was observed in all six samples in both the fresh without CE group and the cryopreserved without CE group. This result ensured that the epidermis observed in the HHP-treated nevus tissues after implantation with CE would be derived from the applied CE sheets and not from the epidermal stem cells of the nevus tissues. Finally, epidermal regeneration was observed in five of six samples in the fresh with CE group and in four of six samples in the cryopreserved with CE group. Nevertheless, not all the samples achieved epidermal regeneration, and our findings indicated that CE was able to take onto cryopreserved nevus tissue.","title":"Inactivated Nevus Tissue with High Hydrostatic Pressure Treatment Used as a Dermal Substitute after a 28-Day Cryopreservation Period"}
{"_id":"95ed4175-eb9f-4896-f306-c174eb25de6b","text":"Conclusions: PFs require a remarkable wide range of skills that include: leadership, communication and interpersonal skills and fluency with EHR functionality in order to tailor their approach to practice characteristics and specific challenges faced by SIPs and FQHCs. FQHCs and SIPs face many similar challenges that demonstrate a need for ongoing practice facilitation and support from organizations like CHCANYS and PCIP.","title":"Proceedings from the 10th Annual Conference on the Science of Dissemination and Implementation"}
{"_id":"95efa4f9-5ced-45b7-807b-906baefe8c80","text":"Removing this to me will prevent painful dressing changes; patients return to their works and daily activities as well as reduce the cost of treatment.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"95f2cc49-e56b-0067-a894-c66671722859","text":"Global linear regression utilises a two-dimensional co-occurrence matrix or scatter graph. This matrix may for example have dimensions 256×256, where the matrix size determines the maximum count that can be processed in the images being compared. Each pixel count in the two images A and B being compared is used to index into the co-occurrence matrix where the pixel counts in image A is used as a column index and the respective pixel counts in image B provide the row index. Each such location in the co-occurrence matrix is incremented by one hence the result after processing all the pixel counts in images A and B is that of a two dimensional histogram describing the joint pixel count distribution between the two images. If the images are identical the results fall on the line of identity. Deviations from this line can be tested for significance using a Chi square test. A Cluster requirement can then be applied so that, for example, five pixels with significant deviations must be adjacent to be judged significant. This avoids single outlier pixel values. The probability map is then constructed.","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"95f9cc78-4009-cad3-307e-0bfff1fdc164","text":"Early attempts to increase the volume of the flap by including fascial extensions were described by Hokin in 1983 and then by Hokin and Sliverskiold in 1987 taking the whole muscle and lumbar fascia with the largest possible skin paddle running obliquely along the back. The skin paddle could be partly or wholly de-epithelialized for added volume.[1920]","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"95ffe41d-7729-ee62-66bf-abdce3513f3b","text":"Here, we report a case of a desmoid tumor mimicking pleural recurrence of a previously resected lung adenocarcinoma. We adopted an aggressive treatment strategy based on the NGS results and obtained a favorable outcome. We comprehensively reviewed previous reports on desmoid tumors that developed after thoracotomy as well as relevant studies on the clinical significance of genomic profiling of these tumors to highlight the possible utility of NGS for patient care and management.","title":"Clinical application of next-generation sequencing for the management of desmoid tumors A case report and literature review"}
{"_id":"960179b7-82ca-c704-e1b5-35668f517039","text":"In general, LC is a poor prognostic sign. Several studies indicate that the disease course is aggressive and the length of survival short when CML or AML present with leukemia cutis.","title":"EXTENSIVE CUTANEOUS MANIFESTATIONS: PRESENTING FEATURE OF CHRONIC MYELOCYTIC LEUKEMIA IN SECOND BLAST CRISIS"}
{"_id":"9618b5b0-1beb-419d-b08b-8a74ae8bbda5","text":"Once positioned, local anesthesia was administered at the planned entrance site of the cryoprobes. If needed, a dedicated anesthesiologist gave a mild sedation to the patient. General anesthesia was reserved to cases in which the patient was unable to hold the position for the duration of the procedure or could not collaborate.","title":"Percutaneous CT-Guided Renal Cryoablation: Technical Aspects, Safety, and Long-Term Oncological Outcomes in a Single Center"}
{"_id":"961aa09b-77a1-9556-13b1-b25b6653fc81","text":"Although many researchers have focused on recurrence patterns of melanoma, we are still unable to accurately predict the course of the disease in many patients. We believe that most of the biological behavior in the end can be explained by possible unrevealed genetic mutations with distinctive biological behavior. Today, melanoma is characterized and staged by clinicopathologic features. There might be a role for genetic profiling aiming to identify melanoma patients with a misleadingly favorable SLNB pathologic prognosis whose disease is likely to recur in the future.","title":"Nodular Histologic Subtype and Ulceration are Tumor Factors Associated with High Risk of Recurrence in Sentinel Node-Negative Melanoma Patients"}
{"_id":"962213e3-b7cb-555e-d428-dedecb4c2a41","text":"DCM is a common cause of spinal cord injury, and many patients with DCM go on to develop progressive disease leading to neurological deficits and reduced quality of life.","title":"The Relative Merits of Posterior Surgical Treatments for Multi-Level Degenerative Cervical Myelopathy Remain Uncertain: Findings from a Systematic Review"}
{"_id":"962d0c04-1b24-6fdb-7c3c-efa0bc956652","text":"Immediate weight bearing could be started when bone cement was used to fill the cavity. Although bone cement allowed for early rehabilitation, it was a biologically inert material and did not remodel along the lines of stress. Another possible complication while using bone cement was the risk of articular cartilage damage on account of variation in modulus of elasticity between bone cement and articular cartilage and the heat generated during cementation. The heat liberated also resulted in a radiolucent zone at the bone cement interface, which could lead on to micromotions between bone and cement resulting in fractures. The sandwich technique was introduced to overcome this potential problem by packing a layer of iliac crest bone graft between the subchondral bone and bone cement. However, this technique introduced bone graft into the cavity, which could enhance the risk of recurrence.","title":"Giant Cell Tumour Around Knee Managed by Curettage and Zoledronic Acid with Structural Support by Fibula Cortical Struts"}
{"_id":"9631cbdf-6a41-9fed-a37c-f5b1715c5e9b","text":"A prospective non-randomised observational study was conducted at a Tertiary Health Setup in Surat between the period of January 2016 to October 2016 to assess the incidence of DVT in patients including those with sickle cell disease who underwent spine surgery. The purpose of the study was to determine if Sickle Cell Disease is a positive clinical predictor for Deep Venous Thrombosis in spinal surgery patients. All patients undergoing major spinal surgery at our institute, aged 18 years or more at time of surgery, of both genders, who accepted the terms set out in the study and signed the written informed consent form were included in the study. Patients with previous history of thromboembolic complications, on anticoagulant medication before surgery, peripheral vascular disease, diseases of the hematopoietic system, disseminated malignancy, surgery done under local anaesthesia and polytrauma patients were excluded. A total of 96 patients fulfilled the criteria and were enrolled in the study of which 17 patients were lost to follow-up and were excluded from statistical analysis.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"9634dbd8-1b80-0db3-27c6-7c2465ace9b9","text":"Our patient presented for evaluation of his right thumbnail dystrophy. The biopsy of his nail matrix demonstrated calcinosis cutis. Although he was not able to recall a specific injury to the nail plate or matrix, we suspect he had experienced trauma to the distal digit that resulted in dystrophic calcinosis cutis. Subsequently, the calcinosis cutis affected the nail matrix and caused the split midline ridge of his thumbnail plate.","title":"Subungual Calcification and Nail Dystrophy: A Case of a Man With Subungual Calcinosis Cutis and an Associated Split Nail Plate"}
{"_id":"96350803-45e2-cb42-7ac0-ff27981a1a0c","text":"The prognosis of pancreatic cancer is always serious. In most cases, the cancer is diagnosed at an advanced stage. The treatment is based on the combination of many treatment methods. In the presented work, we focus on the analysis of the role of radiotherapy in the radical treatment of pancreatic cancer. Radiotherapy in combination with chemotherapy or as stereotactic radiotherapy after chemotherapy contributes to the improvement of the results of preoperative treatment in pancreatic cancers with borderline resectability. In locally advanced cases, the use of radiotherapy increases the probability of local cure and reduces the intensity of pain. Therefore, the use of radiotherapy in subsequent stages of treatment in patients with locally advanced pancreatic cancer should be considered.","title":"Radiotherapy in Pancreatic Cancer: To Whom, When, and How?"}
{"_id":"96374de3-0f24-a729-7281-0e44bc8ff82e","text":"Case 7 a A young female patient presented with diagnosed case of adenoid cystic carcinoma of the right parotid with involvement of the middle ear b lateral view showing the extension of the tumor into the mastoid area. c Marking of the resection with 1 cm margins. d Excision involved peri-auricular skin, superficial parotidectomy, external and internal auditory meatus. Ear was intact by a bridge of skin at the root of the helix. e A supraclavicular artery flap was designed according to the defect size f Picture showing flap inset and donor site closure over a Redivac drain g Lateral view of patient at 1 month follow up","title":"Taking a step down on the reconstruction ladder for head and neck reconstruction during the COVID-19 pandemic"}
{"_id":"96390702-e3c2-9251-d8ba-ecbadd4c036c","text":"Facial surface electromyography data were collected during 6 basic emotional expressions and 4 primary facial movements from 2 full-face transplantation patients and 10 healthy individuals to determine a strategy of functional electrical stimulation and understand the mechanisms of rehabilitation. A new personalized rehabilitation technique was developed using the wavelet packet method. Rehabilitation sessions were applied twice a month for 5 months. Subsequently, motor and functional progress was assessed by comparing the fuzzy entropy of surface electromyography data against the results obtained from patients before rehabilitation and the mean results obtained from 10 healthy subjects.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"963d97e4-4486-cc49-c0f3-c93bda910cc8","text":"Facial reconstruction is one of the most challenging problems faced by a reconstructive surgeon. We present a case of complex facial reconstruction with a composite trauma to the nose resulting in near total loss of skin and lining along with complete loss of left eyebrow with exposed frontal bone and partial loss of the left eyelid. We combined a temporoparietal fascial flap for reconstruction of the eyebrows and covering the exposed frontal bone and prefabricated forehead flap with skin graft for nasal reconstruction. Proper planning and staging of the surgical procedures and use of local flaps gave us good aesthetic and functional outcome with a satisfied patient.","title":"Complex Nasal and Periorbital Reconstruction Using Locoregional Flaps: A Case Report"}
{"_id":"963e96af-3507-e323-888f-a2092eebca0b","text":"An online survey was sent to all plastic surgeons registered with the College of Surgeons East Central and Southern Africa and respective national plastic surgical societies in the east central and southern Africa regional community. A total of 57 questionnaires were sent. Surgeons' country of practice, years of experience and rate of performing microsurgical procedures were considered.","title":"Challenges in global reconstructive microsurgery: The sub-Saharan african surgeons’ perspective"}
{"_id":"964461c0-06dc-d9a4-7e20-55bae8fc5c35","text":"Patients who underwent interventional procedures at our hospital have also traditionally occupied hospital beds or spots at other Day Units. Since the creation of the RDU these procedures can still be performed in an outpatient setting in our service with similar safety levels, allowing a lower bed occupancy rate in other services. The net gaining of beds due to the implementation of RDU was 3842 over the spawn of the evaluating period. This allowed the shortening of waiting lists and reduction of cancellations, as well as avoiding longer hospitalizations in other units that does not have the RDU flexibility. This has also allowed channeling the increasing demand for biopsies of patients who are candidates for clinical trials, especially from the Oncology Service, without increasing the waiting list of biopsies needed for assistance reasons. The multi-person usage of beds during the day, doubling or tripling its use in some cases, has also contributed to the reduction of waiting lists. This is possible thanks to the coordination between the administration team and radiologists in organizing the schedule and alternating procedures that require more or less post-procedure resting time. Moreover, the armchair can be used up to five or six times during the workday because some procedures require between 30 and 60 min of resting, such as Port-a-cath implantation, superficial soft tissue biopsies, and alcoholizations or radiofrequency ablations of thyroid nodules.","title":"Experience and results after the implementation of a radiology day unit in a reference hospital"}
{"_id":"96452d68-32b0-9067-30c7-81d007262cd3","text":"The study by Martinson et al stated that the risk of TB increases at lower CD4 counts, and suggested that early antiretroviral therapy reduced the population prevalence of TB in HIV infected patients [12]. This suggestion may also be evident in our study as the majority of HIV positive patients in our sample had CD4 counts less than 350 cells\/ul and the commonest lymph node pathology in this group was confirmed and suspected TB.","title":"Patterns of Lymph Node Pathology; Fine Needle Aspiration Biopsy as an Evaluation Tool for Lymphadenopathy: A Retrospective Descriptive Study Conducted at the Largest Hospital in Africa"}
{"_id":"9645ffdc-57f3-ca06-7c92-61116c63a105","text":"Our results revealed that the treatment of melanoma cells with imiquimod evokes a rapid increase in intracellular Ca2+ release and the activation of PERK and IER1α as well as the degradation of calpain, and anticipates a central role for ER stress‐associated pathways in the modulation of imiquimod‐induced apoptosis of melanoma cells.","title":"Imiquimod‐induced apoptosis of melanoma cells is mediated by ER stress‐dependent Noxa induction and enhanced by NF ‐κB inhibition"}
{"_id":"9647058a-1114-f2c2-87f8-74197e5f48a3","text":"In the future, the identification of patients who do not require overtreatment may be possible thanks to the progress which has been made in personalized therapy. In selected BC cases, the optimal tumor response following NACT may lower or even remove the need for surgery, and subsequent therapy may have to consider the tumor biological characteristics and not nodal status. However, we await the completion of additional prospective clinical studies evaluating different approaches.","title":"The Role of Sentinel Lymph Node Biopsy in Breast Cancer Patients Who Become Clinically Node-Negative Following Neo-Adjuvant Chemotherapy: A Literature Review"}
{"_id":"964875ab-873d-c70a-c5d3-0402cf2d24db","text":"In conclusion, we believe that preemptive application of ESPB during MWA procedures has advantages such as reducing perioperative and postoperative analgesic consumption, reducing the need and amount of additional analgesics, reducing minor complications such as nausea and vomiting associated with opioids, and increasing the satisfaction of the radiologist, as well as being an effective method in terms of providing high patient satisfaction by increasing treatment compliance in repetitive sessions by preventing anxiety and psychological trauma that may occur in patients due to the procedure.","title":"Clinical efficacy of ultrasound guided erector spinae plane block in patients undergoing microwave ablation"}
{"_id":"964eedcf-8e51-e0e9-0f21-b825e7ab66de","text":"In summary, concurrent imatinib and radiation therapy appears to be effective at preventing further growth and relieving symptoms associated with locally invasive desmoid tumors, but future studies will be necessary to more thoroughly assess the risk and efficacy of this combination. For carefully selected patients with unresectable desmoid tumors, imatinib and radiation therapy may be a reasonable therapeutic option.","title":"Concurrent Imatinib and Radiation Therapy for Unresectable and Symptomatic Desmoid Tumors"}
{"_id":"96513d32-6683-e003-d4a8-8ef25188db92","text":"Despite the preoperative identification of the perforator vessels with a Doppler, it is necessary to reassess the perforator vessel intraoperatively for pulsation and caliber to assure a viable coverage. 8 Harvesting a PPF in cases of unsatisfying perforator vessel exposes us to a much higher complication rate.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"965c2d47-ca6d-479e-475e-c0432bcf2c59","text":"She decided that she needed to go back and speak with the surgeon again. In the meantime, she was committed to participating in regular breast screening to provide the reassurance she needed while putting the decision about RM \"on the back burner\" Her indication that she was more inclined to withstand the surgery rather than risk ever being told she has cancer, suggests that this decision would not be put aside for the long term.","title":"Time to decide about risk-reducing mastectomy: A case series of BRCA1\/2 gene mutation carriers"}
{"_id":"96697580-9e46-c9a3-b7f9-26ae08661907","text":"A histological determination was made to determine whether there was a tumour present at the surgical margins. If a tumour was present, additional skin was removed and histologically verified until clear margins were obtained.","title":"Metatypical basal cell carcinoma: a clinical review"}
{"_id":"9675970b-8609-b445-27a8-74550f00ef35","text":"In total, 2190 plastic surgeons were included in the analysis. Factors increasing the probability of holding any type of position included fellowships in microsurgery, craniofacial, and hand; an international fellowship; multiple fellowships; a fellowship not otherwise specified; and MBA degree. Training background factors affected probabilities differently for each of the studied positions including chair\/chief, vice chair\/vice chief, program director, plastic surgery medical director, other institutional positions, and national society positions.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"96778677-b6f5-3a5d-57b0-12f5c5287d3b","text":"At 22 months after implantation of the HAV, the patient had required one intervention to restore graft patency after thrombosis. This could have resulted from the initiation of hormone therapy or cessation of antiplatelet therapy in the setting of incompletely endothelialized tissue. Although nearly complete endothelial coverage has been confirmed in HAVs as early as 44 weeks, additional data regarding the risk of HAV thrombosis to guide the type and duration of antiplatelet or anticoagulant therapy is necessary when considering the risks of this approach. A hematology consultation resulted in initiation of anticoagulation therapy. She has continued to demonstrate significant clinical improvement, including resumption of her regular physical activity.","title":"Surgical management of an infected external iliac artery interposition graft with a bioengineered human acellular vessel"}
{"_id":"967ae81b-dc96-195b-50e8-01115cc708fd","text":"The most compressed level and the presence of a signal intensity change in the spinal cord were also investigated on mid-sagittal MRI.","title":"Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament"}
{"_id":"967b92d6-680d-4c74-b840-de9556de7989","text":"Table 5 shows the differences obtained between the main scores obtained in the health-related quality of life scales and the main variables studied.","title":"Long-Term Quality of Life (BREAST-Q) in Patients with Mastectomy and Breast Reconstruction"}
{"_id":"968509e6-065d-01c0-7343-8b03c32c994a","text":"In conclusion, the C-V flap provides a simple and reliable method of nipple reconstruction that enhances confidence and perception of body image. The satisfaction rate at our unit was high and the long-term outcome of projection was not significantly different from the contralateral breast. This reflected a conscious decision by the operating surgeon to design a larger flap to accommodate later shrinkage. Our study was limited by a relatively small sample size from a single institution and there was potential for observation bias when measuring nipple projection.","title":"Nipple Reconstruction Using the C-V Flap Technique: Long-Term Outcomes and Patient Satisfaction"}
{"_id":"9685f50c-48f2-554a-1d33-8ac2ee3cf644","text":"This was followed by the venous phase acquisition after 85 s from the start of the contrast agent injection.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"96863580-d819-ee0b-b158-21c622e8f620","text":"The opportunity to work on a placement outside of the NHS allowed many of the interviewees to gain valuable perspective on both their careers and the way that their local NHS system functioned when they returned. Reflecting on how they felt prior to commencing their fellowship some of the interviewees expressed frustration at working within the NHS:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"968aeda7-f11c-6a68-11aa-cac2fe4447b0","text":"The most common cosmetic procedures were chosen from the American Society of Plastic Surgeons website and served as the search terms for the Google Trends tool from 2004 to 2021. All 19 procedures were examined for overall trends and for changes in the last decade through comparing the data in bisected time periods.","title":"Changing Aesthetic Surgery Interest in Men: An 18-Year Analysis"}
{"_id":"968df710-a091-427a-471c-b0bb16dfa1ab","text":"Figures 2 and 3 indicate a sample of wound healing before and after angioplasty in the patients with angiographic evidence.","title":"Therapeutic Effects of Successful Angioplasty on the Aorta and Lower Limb Arteries on the Healing of Chronic Ischemic Wounds"}
{"_id":"968e8099-8119-e3e4-965d-e8476b31a12b","text":"The fat is then processed with three washes of warm lactated ringers. It is transferred from the revolve to a 60 mL syringe, then into 3 mL syringes for transfer. The majority of the fat is injected through the incision. If additional access sites are needed to optimize the angle of delivery, they can be made with a 16-gauge needle while tenting the skin from the inside with a fat-grafting cannula to protect the device. Constant motion of the syringe while injecting the fat is critical to avoid the clumping of the fat graft and subsequent poor take. Enough fat is injected to fill the space by injecting at least as much as the fluid removed, but not to the point of skin discoloration or the creation of an overly taut skin envelope.","title":"Lipotransfer Strategies and Techniques to Achieve Successful Breast Reconstruction in the Radiated Breast"}
{"_id":"9691ce18-b0cc-fb3c-ee43-2348fca05909","text":"All participants completed the entire treatment and were included in the analyses of primary and secondary outcomes. Means and standard deviations (±SD) were calculated for continuous variables. We used the t-test to compare differences in age and course of disease between the treatment groups. The Wilcoxon test was used to compare the grading of the facial nerve function between patients who underwent manipulative acupuncture under LSCI and those who underwent simple acupuncture because of the unevenness of the variances between the two groups. The paired samples t-test was used to compare HBGS changes over time in each group and changes in blood perfusion before and after acupuncture in the manipulative acupuncture group. The chi-square test was used to analyse categorical variables.","title":"Efficacy of Manipulative Acupuncture Therapy Monitored by LSCI Technology in Patients with Severe Bell's Palsy: A Randomized Controlled Trial"}
{"_id":"9696401c-f27f-6053-ff83-e070b231a769","text":"The methods of harvest, transfer, and inset are significantly different between the two flap variations and clearly have a profound effect on vessel dynamics leading ultimately to differences in skin paddle perfusion. Reassessment on postoperative day 9 showed equilibration of pedicled flap perfusion with the caveat that there was an area of ischemic necrosis at the distal area of the pedicle flap that required revision. In contrast, the skin paddle of the free muscle-sparing TRAM flap showed 100 percent viability at all time points.","title":"Comparative Perfusion Analysis of Free Muscle-Sparing Versus Pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps in Vivo in the Peri-Operative and Late Post-Operative Periods"}
{"_id":"96971551-6ce2-971f-9969-a5654550cc70","text":"Possible complications from the iliac crest may be excessive blood loss, haematoma, delayed wound healing, pain lasting for two weeks to two months, long, adherent and painful scars under belts or clothing and hypoesthesia or anaesthesia over the distribution of the lateral femoral cutaneous nerve. In the cranium there is a risk of penetration of the inner table and harvesting bone graft from the mandible which could cause damage to the roots of the canine and incisor and injury of the mental nerve. Harvesting rib grafts may sometimes lead to post-operative chest infection or pneumothorax","title":"Alveolar bone grafting"}
{"_id":"969a188a-e95a-7216-b598-cfe50e658d4b","text":"The objectives of the present study were to prospectively estimate the incidence of S-PE in a group of patients with lower limb DVT, to assess the risk factors and characteristics of DVT that may have influenced their origin, and to assess the economic and clinical impact of diagnosis in both the short and long term.","title":"Should we look for silent pulmonary embolism in patients with deep venous thrombosis?"}
{"_id":"969b2d9e-ad9e-57b6-b390-cb46cf0539eb","text":"Posttraumatic wounds of the lower leg with soft tissue defects and exposed fractures are a reconstructive challenge due to the scarce availability of local tissues and recipient vessels. Even when a free tissue transfer can be performed the risk of failure remains considerable. When a free flap is contraindicated or after a free flap failure, the cross-leg flap is still nowadays a possible option. We report a case of a male with a severe posttraumatic wound of the lower leg with exposed tibia fracture firstly treated with two consecutive latissimus dorsi muscular free flaps, failed for vascular thrombosis; the coverage was then achieved with a cross-leg flap with acceptable results.","title":"Cross-Leg as Salvage Procedure after Free Flaps Transfer Failure: A Case Report"}
{"_id":"96a0e6bd-9012-4d0c-2ee9-b6abf9984fa1","text":"Patients remained hospitalized in appropriate rooms during the brachytherapy treatment period. General anesthesia was administered during the surgical procedures. Ocular muscles would be relocated when they interfered with plaque position, and then stitched back in the original position after removing the plaque.","title":"106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma"}
{"_id":"96a7f7e6-d8df-9587-63e3-94a3cf04bbe3","text":"The neurotoxin produced by the bacterium Clostridium botulinum, botulinum toxin, was first identified in 1897.2 It can produce muscle weakness or paralysis that has been exploited for treatments of muscle hyperactivity. It was first used by Dr Alan Scott to treat strabismus3 and subsequently prescribed for the treatment of muscle spasms in many other areas of the body. Scott concomitantly predicted other potential future applications, including a role in providing cosmetic enhancement.","title":"A review of the longevity of effect of botulinum toxin in wrinkle treatments"}
{"_id":"96ad2bbd-ecc7-dafc-d9d4-4de3e58fb4eb","text":"Proximal DVT and distal DVT were defined as occurring above the knee and below the knee, respectively.13 Central venous catheter‐related thrombosis was defined according to whether a catheter had been present in the same or a contiguous venous segment within 72 h prior to the diagnosis.14 Major surgery was defined as one that lasted longer than 2 h.5","title":"Venous thromboembolism in major trauma patients: a single‐center retrospective cohort study of the epidemiology and utility of D‐dimer for screening"}
{"_id":"96ae1087-7ad5-51c1-34f7-7d98fbd203b9","text":"The patient returned to the clinic one week later complaining that the pain in his left calf area persisted and could be further aggravated by tiptoeing and weight bearing maneuvers. Again, US examination in the prone position did not reveal any abnormal sonographic findings.","title":"A novel approach to sonographic examination in a patient with a calf muscle tear: a case report"}
{"_id":"96b1cb14-7e23-b3e8-d248-7ad9ca0100aa","text":"The use of concurrent phototherapy or topical corticosteroid did not represent an exclusion criterion.","title":"Patient satisfaction with calcipotriol\/betamethasone dipropionate cutaneous foam for the treatment of plaque psoriasis: The LION real‐life multicenter prospective observational cohort study"}
{"_id":"96b43f4f-a10a-0414-b0e9-498e56f8a624","text":"Asepsis and infection control were rigorously followed for the preparation of the patients in accordance with biosafety norms. An analgesic (paracetamol) was administered in drops based on the weight of each participant 10 minutes prior to surgery for analgesia after the effect of anesthesia applied for the surgical procedure had worn off.","title":"Comparison of the Effects of High-Power Diode Laser and Electrocautery for Lingual Frenectomy in Infants: A Blinded Randomized Controlled Clinical Trial"}
{"_id":"96bc70e2-55dc-f976-2316-7955d47d9aa6","text":"Mastectomy is not an absolute cure in the treatment of an invasive breast cancer because almost always, there is a recurrence risk and possibility of metastasis. As it is impossible to perform the surgery, if the breast cancer progresses to the advanced stages with cutaneous metastasis, the recognition and management of the disease at earlier stages are very important, so it is vital to differentiate between local recurrence and skin metastasis because it would alter the overall treatment decision, prognosis, and patient outcomes.","title":"Cutaneous Metastasis vs. Isolated Skin Recurrence of Invasive Breast Carcinoma after Modified Radical Mastectomy"}
{"_id":"96bcf63d-edda-0744-4308-5bda61b56a84","text":"The creation of the method and models is the result of an iterative process between the surgical and design team similar to Zablah et Al [15]. Numerous designs were explored over the course of months, which involved a co-design process driven by our technological capabilities. Our process began with designs presented to the surgical team by engineers which facilitated the start of a conversation regarding the needs of this specific team. Based on the conversations with the surgical team, the design team worked to create numerous models which attempted to address the surgical needs. The design team took care to propose additional concepts that stemmed from a synthesis of those conversations, which sought to demonstrate new techniques resulting in new concepts. In subsequent meetings this process facilitated deep conversations about the intricacies of procedures providing the design team with more insight into the procedure. These conversations, surgical observations, and iterative process led to a honing of a design which synthesized the design team's technology and capabilities with the needs of the surgical team.","title":"Hybrid modeling techniques for 3D printed deep inferior epigastric perforator flap models"}
{"_id":"96bfd80b-9627-d5cb-819b-68d37ff01904","text":"Varicose vein surgery in its many modalities remains a commonly performed procedure and the incidence of VTE in our large national study was 0.51%. There are a number of limitations for studies using HES data. The two most striking are the potential for miscoding and an underestimation of the total number of VTE episodes due to patients not being admitted to hospital. Nevertheless, the quality of HES data has improved greatly in recent years and HES has been shown as a useful tool to measure effectiveness and for comparative audit. It has also been shown in a systematic review that there is a high level of accuracy for diagnosis.","title":"The incidence of post operative venous thromboembolism in patients undergoing varicose vein surgery recorded in Hospital Episode Statistics"}
{"_id":"96c5b32c-dcef-7080-798d-ec516dbd1cfa","text":"A renewed interest in oral desensitization as treatment for food allergy has been observed in the last few years. We studied a novel method based on the end point skin prick test procedure to establish the starting dose for oral desensitization in a group of 30 children higly allergic to milk. The results (in terms of reactions to the first dose administered) were compared with a group of 20 children allergic to milk as well. Such control group started to swallow the same dose of 0.015 mg\/ml of milk. None reacted to the first dose when administered according to the end point skin prick test. On the other side, ten out of 20 children (50%) from the control group showed mild allergic reactions to the first dose of milk. In conclusion the end point skin prick test procedure results safe and easy to be performed in each single child in order to find out the starting dose for oral desensitization to milk, also by taking into account the individual variability.","title":"Oral desensitization to milk: how to choose the starting dose!"}
{"_id":"96cda17b-86ac-393d-c74c-1e3998a0ea97","text":"Radiation-induced nonmelanoma skin cancer was first reported seven years after the discovery of X-rays, but has received relatively little consideration in the literature. Specifically, nonmelanoma skin cancer after conservative surgery and radiation for early stage breast cancer has not been well studied. We report the case of a woman who developed squamous cell carcinoma of the nipple nine years after conservative surgery and radiation for ductal carcinoma in situ of the ipsilateral breast. We also review the relevant literature available to date.","title":"Squamous cell carcinoma of the nipple following radiation therapy for ductal carcinoma in situ: a case report"}
{"_id":"96ce476d-c351-3e59-4729-e2a60ee3d245","text":"Of patients referred to the ENT ward due to the lamina papiracea (LP) impairment, who had enophtalmy or bony fracture was entered to the study and patients with visual acuity defect or eye movement problems were excluded by an ophthalmologist consult. Also patients with frontal trauma were included if there was a bony defect and were excluded if a soft tissue defect especially associated with a near infected ulcer was detected. Patients with depressed frontal fracture underwent classic open surgery because of future irreparable cosmetic problems following using new methods in these complicated patients. To use Medpor ® in rhinoplasty procedures, patients with deviated nose and who underwent a previous rhinoplasty were excluded due to the lack of septal cartilage which was needed for implanting the material.","title":"Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study"}
{"_id":"96d5bfef-d576-1279-9030-597be010e6a3","text":"Using thousands of primary carcinomas including the most common forms of cancer, we examined somatic mutations in CDH1 and CTNNB1 to assess whether the prevalence of carcinomas with mutations was low, consistent with cancer cell detachment from primary tumors being induced primarily by epigenetic rather than genetic events. We found that, for each gene, over 95% of primary carcinomas across anatomic sites had no CDH1 or CTNNB1 mutations, as well as low prevalences of carcinomas with at least one mutation for the large majority of individual sites. Compared to the other anatomic sites, and taking available sample sizes into account, mutations were more prevalent for CDH1 in breast cancer and for CTNNB1 in endometrial cancer, though still not a large proportion of carcinomas at these sites.","title":"Somatic mutations in CDH1 and CTNNB1 in primary carcinomas at 13 anatomic sites"}
{"_id":"96db8c8d-abdc-642c-4ed9-76fa4e42d5b2","text":"A total of 32 female and male pediatric patients were then finally enrolled in the study.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"96df9014-b3aa-1b14-c94c-30e304c931f5","text":"A known strain of MRSA obtained from a patient of chronic osteomyelitis with known antibiogram was used to prepare a homogenous suspension in normal saline. The approximate bacterial concentration of the suspension was determined by comparing with 106concentration Brown’s opacity tube.17 A 10 μl suspension of the MRSA strain containing 5.5 × 106 colony forming units was then instilled into the metaphyseal defect.","title":"Decal bone matrix as a local antibiotic delivery vehicle in a MRSA-infected bone model: An experimental study"}
{"_id":"96e2be67-42ba-cd93-7f87-5ce944a319f4","text":"Always looking for the best solution to repair what has been damaged, led plastic surgery to the field of composite tissue allotransplantation. All the research from the last fifty years, lab tests, cadaver dissections, immunosuppressive therapy evolution was meant to prove that CTA is a clinical reality. Nowadays, especially hand and face transplantation represent the only solution for desperate cases with no other reconstructive option. We are responsible for the way the future will look like, if the debate on ethical and psychological problems will lead us to the day when these procedures will be as common as the other reconstructive interventions.","title":"Transplantation of composite tissue allografts. Scientific bases and clinical applications"}
{"_id":"96e2dded-2256-f698-4229-8284580ba158","text":"In the European Union, subspecialty training in HNSO remains diverse. However, the Union of European Medical Specialists has initiated steps to standardise subspecialty training in the EU and this is likely to have an impact on the current training structure in the near future. Currently, it is recommended that trainees applying for head and neck surgical oncology posts have the required additional and adequate training in this subspecialty. This is often an essential or a desired requirement in the job descriptions.","title":"Education of trainees, training and fellowships for head and neck oncologic and surgical training in the UK: United Kingdom National Multidisciplinary Guidelines EDUCATION OF TRAINEES, TRAINING AND FELLOWSHIPS: UK GUIDELINES"}
{"_id":"96f19294-eb99-0b61-6718-ecc9e01aadc1","text":"The Ethics Committee of FUSCC granted approval for this study, and all participants consented to the operation procedures as well as their medical information collection by signing informed consent documents.","title":"Survival impact of immediate complete lymph node dissection for Chinese acral and cutaneous melanoma with micrometastasis in sentinel nodes: a retrospective study"}
{"_id":"96f28f4a-586e-35e0-d631-5db6e426bb54","text":"We report two cases of biceps brachii and brachialis paralysis due to musculocutaneous nerve injury in which elbow joint flexion was reconstructed using rotational transfer of the latissimus dorsi muscle with sutures to the radial and ulnar tuberosities, thereby enabling flexion by simultaneous activation of the humeroradial and humeroulnar joints. In cases of associated brachialis paralysis, weaker flexion strength can be expected when the forearm is in a pronated position than when it is in a supinated state. To the best of our knowledge, no previous study has reported the rotational position of the forearm during elbow joint flexion reconstruction.","title":"Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports"}
{"_id":"96f443a6-9805-3dac-8a47-035830125b56","text":"It is important to remember that the nose is a functional organ and not just a cosmetic facial structure; knowledge of its anatomy and physiology is therefore crucial for surgeons performing rhinoplasty. The two objectives of performing any rhinoplasty are to improve the aesthetics and to maintain or restore its normal function. Lack of appreciation of this tenet leads patients to suffer permanent impairment of nasal function.","title":"Secondary rhinoplasty"}
{"_id":"96f93233-0c3a-c828-2214-e1ef0d383256","text":"The key finding in this study was that diagnosing or ruling out DVT in primary health care saves private and public resources. Even considering the cost of training, the savings are still substantial. This finding shows that teaching LCUS to GPs could help with the burden of increasing health care costs. As we are living in a world of scarce resources and rising health care costs, it is important to evaluate scientifically where resources can be saved without compromising the quality of care.","title":"Cost-minimization modeling of venous thromboembolism diagnostics: performing limited compression ultrasound in primary health care reduces costs compared to referring patients to a hospital"}
{"_id":"970f8523-53c1-3877-71a5-cf28e31f3184","text":"Erythematous and squamous crusted lesions on lips mucosa and vermilion","title":"Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases"}
{"_id":"971550e3-56ee-621b-d929-b768afa11dfc","text":"The recipient arteries used in the AVL reconstruction were the brachial arteries in two patients, the popliteal artery in one patient and the femoral artery in three patients.","title":"Efficacy of the Arteriovenous Loop for Free Flap Reconstruction in Patients with Complex Limb Trauma: Case Series and Literature Review"}
{"_id":"97199486-a7ac-5b72-7193-0bae1bd69ee0","text":"Normal mature swallowing occurs when the tip of the tongue is compressed against the incisive papilla, with its dorsum pushing the alimentary bolus through the hard palate toward the oropharynx, with posterior teeth in maximal intercuspidation and orbicularis muscles of the upper and lower lip and mentonian relaxed and promoting lip sealing. A review of the literature indicates different types of atypical swallowing, all of which are potentially responsible for the installation of malocclusions or for treatment relapse, because they characterize situations in which an imbalance between the buccinator, pterygoids, masseter, and temporal muscles.","title":"ANKYLOGLOSSIA AND ITS INFLUENCE ON GROWTH AND DEVELOPMENT OF THE STOMATOGNATHIC SYSTEM A INFLUÊNCIA DA ANQUILOGLOSSIA NO CRESCIMENTO E DESENVOLVIMENTO DO SISTEMA ESTOMATOGNÁTICO"}
{"_id":"971b2df3-70d5-79e7-35fd-391d39ec4343","text":"Cosmetic injections of fillers are common plastic surgery procedures worldwide. Polymethylmethacrylate (PMMA) is a filler approved only for minimally invasive procedures in facial tissue and is among the most frequently used injectable substances for cosmetic purposes. Injection of a large volume of PMMA may lead to the development of severe hypercalcemia and chronic kidney damage in a probably underestimated frequency. In such cases, hypercalcemia develops due to a granulomatous foreign body reaction with extrarenal production of calcitriol. In the present report, we describe the cases of two patients who received injections of large volumes of PMMA and developed severe hypercalcemia and advanced chronic kidney disease. These reports highlight the importance of adhering to regulations regarding the use of PMMA and properly informing patients of the possibility of complications before undertaking such procedures.","title":"Case reports of hypercalcemia and chronic renal disease due to cosmetic injections of polymethylmethacrylate (PMMA) Relatos de casos de hipercalcemia e doença renal crônica devidas a injeções de polimetilmetacrilato (PMMA) por razões estéticas"}
{"_id":"971c158b-82a3-e572-0913-fa2e64889efa","text":"The decision of when to load an implant is an important decision that is made by considering both the surgical and prosthetic aspects, which are responsible for the hard tissue integration to the implant and the final soft tissue results.","title":"Soft and Hard Tissue Management in Implant Therapy—Part II: Prosthetic Concepts"}
{"_id":"971ebede-a139-2374-9bad-fef9e3ae9183","text":"With these statistics in mind, the recommended period of monitoring should be two hours following the first three injections. For subsequent injections, when the risk of anaphylaxis is substantially lower, the observation period can be significantly reduced. The suggested period for monitoring is 30 minutes, but this may be adapted for individual patients following discussion between the patient and the healthcare professional of the continued risk of anaphylaxis. Should patients be unwilling to remain in clinic for the physician-recommended period of monitoring, they should be asked to sign a waiver indicating their preference and abrogating the physician and manufacturer from any responsibility relating to potential anaphylactic events during that time. Physicians need to consider whether they will agree to continue to provide care to such patients.","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"9737750c-850c-a034-8fa9-a7bfd7808d3b","text":"The use of cryoablation, a minimally-invasive image-guided technique to target and kill cancer cells, continues to gain traction within the medical field and with patients. This includes the use of cryoablation for the treatment of small breast cancers and focal sites of metastatic disease. In comparison to open surgical approaches, length of hospital stay and recovery time are decreased with the use of cryoablation. Research studies have also found that cryoablation may actually enhance tumor susceptibility to immunotherapy agents. Immunotherapy enhances a person’s own immune system to identify and attack cancer cells. It is proposed that after cryoablation there is increased expression of tumor specific antigens which the body can recognize as foreign invaders and with the combination of immunotherapy, result in an even more robust and efficient attack on the cancer cells. In this review we aim to highlight some of the recent advances in cryoablation which support the potential for cryoablation to induce these tumor-specific immune responses and thus supporting the use of combining cryoablation and immunotherapy for the treatment of breast cancer.","title":"An update on the use of cryoablation and immunotherapy for breast cancer"}
{"_id":"973ae5c5-c364-1453-e719-0754d34c69c4","text":"Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion. Despite advances in the understanding of these tumors, their natural history is incompletely understood and the optimal treatment is still a matter of debate. Local control is the main goal of treatment and there has been a change in philosophy regarding the management of these tumors from aggressive surgical resection to function preservation. A multidisciplinary approach is essential to plan local control with acceptable morbidity. The current Mayo Clinic algorithm for the treatment of these tumors is based on institutional experience and the available evidence in the literature: asymptomatic\/non progressive lesions away from vital structures are managed with observation and regular imaging; primary or recurrent desmoid tumors which are symptomatic or progressive or near vital structures are managed with wide surgical resection when wide surgical margins are possible with minimal functional and cosmetic loss. When positive or close surgical margins are likely, surgical resection with adjuvant radiotherapy or definitive radiotherapy is preferred. If likely functional or cosmetic deficit is unacceptable, radiotherapy is the treatment of choice. Unresectable lesions are considered for radiotherapy, chemotherapy or newer modalities however an unresectable lesion associated with a painful, functionless, infected extremity is managed with an amputation.","title":"Current Perspectives on Desmoid Tumors: The Mayo Clinic Approach"}
{"_id":"97441426-9303-f72c-6c02-f484d5cab3f1","text":"This is defined as the time to recurrence of disease within 1 cm of previously treated metastases from the date of randomisation. It is measured by the time difference between the randomisation MRI and intracranial failure MRI identifying recurrence. Local intracranial failure rates within 3, 6, 9 and 12 months of follow-up and over the entire study period will also be computed.","title":"Whole brain radiotherapy (WBRT) after local treatment of brain metastases in melanoma patients: Statistical Analysis Plan"}
{"_id":"97497541-e8fd-e918-5050-d6114685c314","text":"Tyrosinase is also used as an immunohistochemical marker in the diagnosis of melanoma. Tyrosinase IHC staining can help confirm the diagnosis of melanoma and distinguish it from other types of skin cancers or benign lesions.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"974c04e8-51e2-548f-cf30-b4d052e70216","text":"For extensive defects or if local options for reconstruction are not available, a free microvascular tissue transfer becomes necessary. The main problem with any flap from another area of the body is the higher shifting of its subcutaneous tissue compared to the sole of the foot. This can lead to shearing of the tissue layers, which can result in the formation of pseudobursa or detachment of the flap from its base. To reduce shearing and the formation of pseudobursa, pure muscle flaps such as the latissimus dorsi flap covered by split skin graft are preferred. The contact of skin graft to muscle is fixed and does not glide thereby minimizing the shifting effect. However, split skin graft is not resistant to pressure and friction, leaving it vulnerable resulting in frequent superficial wounds especially in zones of pressure. Mere muscle flaps lack sensation, even though the restoration of some sensation by coaptation of a native sensory nerve to the motor nerve of a skin grafted muscle flap has been reported [81].","title":"Wound Healing and Therapy in Soft Tissue Defects of the Hand and Foot from a Surgical Point of View"}
{"_id":"974e0b78-cf88-481a-f804-7fb67518d9de","text":"Small areas of osteitis around the body of implants in peri-implantitis may remain contaminated despite mechanical removal of granulation tissue, so it may be useful to treat contaminated bone by topical application of rifampicin.","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"9763c0d1-1b25-8b03-69fc-50ef2a7c20e1","text":"The pathogenesis of thyroid dermopathy involves activation and proliferation of fibroblast triggered by autoimmunity to the TSH receptor, which provokes a cascade of immune processes and overproduction of glycosaminoglycans.[ There is evidence that trauma and injury may initiate or exaggerate the presence of thyroid dermopathy.[ Our case illustrated that her breast enlargement was more evident on the left than on the right after undergoing a second biopsy on the left side.","title":"Bilateral breast myxedema caused by Graves’ disease and responsive to multipoint subcutaneous injection of long-acting glucocorticoid Case report"}
{"_id":"97642d46-c966-09ed-9e87-5c069f0fc41d","text":"Congenital anatomic variants of IVC have been reported with growing frequency in asymptomatic patients because of imaging study developments. The most common variant is duplication of the IVC, followed by left-sided IVC, and azygos continuation of the IVC. However, the pelvic anatomic variants of these anomalies and their relationships with the iliac veins and interiliac communicating veins have not received due attention, even though this knowledge is vital for reducing surgical risk and for defining access strategies in interventional radiology procedures.10","title":"Endovascular treatment of pelvic venous congestion syndrome in a patient with duplication of the inferior vena cava and unusual pelvic venous anatomy: literature review"}
{"_id":"97659a7c-6f25-1122-b3f2-24d9bb4948b5","text":"Because of these considerations, we only recommend performing z-frenuloplasty or 4-flap frenuloplasty under general anesthesia, which is more safely performed in childhood rather than in infancy.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"976961aa-5604-6ac3-2bc0-9c14689fe5a8","text":"With the risk of treatment associated anaphylaxis subsequent to omalizumab administration, the setting for administration is also important. This agent should only be administered by a physician or other licensed health care professional, who is trained in the recognition and treatment of anaphylaxis, and should only be administered in a setting where the appropriate medications and equipment are available to respond to an episode of anaphylaxis.","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"9773a582-78ea-cceb-e58c-ab6ecc7e74df","text":"Descriptive retrospective cross-sectional study based on the medical records and histological lamellae of patients with primary basal cell carcinomas smaller than 1.5 cm submitted to Mohs micrographic surgery and who had the visible tumor analyzed by horizontal histological sections.","title":"Horizontal histological sections in the preliminary evaluation of basal cell carcinoma submitted to Mohs micrographic surgery"}
{"_id":"97879c9d-5e0f-6b5c-b34a-672675afb6e9","text":"It has been a well-known fact that distal tibia fractures have recently been treated by minimally invasive techniques. Literature says that there is risk of disrupting blood supply with open reduction internal fixation leading to soft tissue healing problems. However, we did not face any of these complications in our patients, infection or wound breakdown with implant exposure. Historically, tibial pilon fracture were managed by antero medial approach but one of the major disadvantage in taking this approach is the risk of wound breakdown with exposure of the implant. Implant prominence with antero medial plating has modulated implant removal as a revision surgery. Antero lateral area of distal tibia has shown better soft tissue coverage along with a better direct exposure to the anterolateral fragment. A separate incision for fibula fixation along with conventional distal tibia plating has shown problems with wound healing. Less damage to the periosteal blood supply has been shown in locking plate thus decreasing the incidence of any delayed union or non union or loss of any fixation. Eighteen fractures out of 25 in our study have united within six months with a mean period of 3.95 months (range: 3-6 months). There are several studies that have reported high complication rates related to soft tissue healing using operative management of tibia fracture.","title":"Minimally Invasive Osteosynthesis of Distal Tibia Fractures using Anterolateral Locking Plate"}
{"_id":"9787c93e-c9ae-c482-0830-20156d5e750d","text":"Surgeons with more experience are more likely to obtain a CT scan in their preoperative planning and choose surgical intervention as their definitive management. It has been found that experienced surgeons can predict the usefulness of CT scans for intra-articular displaced DRFs to decide on treatment, but for preoperative planning, the usefulness of CT scans is much harder to predict. Although our study did not address potential reasons that address the causation between surgical experience with the likeliness of obtaining a CT and choosing an surgical intervention, several reasons may explain this effect. Experienced surgeons likely have greater exposure to evidence regarding the relative effectiveness of treatment strategies for DRFs. They also may have increased exposure to new fixation or surgical techniques because of differences in marketing strategies by biomedical companies toward subspecialty groups and experienced surgeons. Future studies are necessary to accurately understand this relationship.","title":"Distal Radius Fracture Management: Surgeon Factors Markedly Influence Decision Making"}
{"_id":"979086e6-f2a0-6bad-6cde-4ec1acb3c8b2","text":"The permanent skin substitutes have the roles of permanently achieving wound closure, replacing the skin components and providing a higher quality skin replacement than the thin autogolous skin graft.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"97908949-f13d-3bab-50e9-190f0a1ad7d1","text":"It is interesting to observe that Mohs surgery and ECT were more frequently utilized for BCC and cSCC therapy in Northern compared to Central and Southern Italy, probably due to the higher availability in the first area. On the other side, immunotherapy was more used in Southern compared to Northern and Central Italy probably due to the presence of more laBCC in this region located in a lower latitude area with higher incidence of UV radiation.","title":"Attitudes among dermatologists regarding non-melanoma skin cancer treatment options"}
{"_id":"979686d6-4767-c042-2146-77f8a5082776","text":"For many it developed their ideas regarding their career choices and provided opportunities for the fellows to explore.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"979a470b-2dd5-e835-bfa8-1e931d548053","text":"Medial thigh lifts were also marked with the patient standing, so as to leave a linear scar along the inseam running from the adductor magnus origin to a point just distal to the area of skin laxity, usually at the level of the medial femoral condyle. The proximal dog ear was chased into the perineal crease as a J-extension.","title":"Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures"}
{"_id":"979f5012-d095-aceb-03ec-0ac12915e6b7","text":"Recent developments at technological advances have led to many outpatient operations;","title":"Oral surgical procedures under local anaesthesia in day surgery"}
{"_id":"97a28cec-8300-4b21-e0a9-68f706e110b1","text":"The three patients in the active group with neosensitization to shrimp showed no symptoms after oral challenge.","title":"Clinical and Immunological Changes of Immunotherapy in Patients with Atopic Dermatitis: Randomized Controlled Trial"}
{"_id":"97abad8c-d20c-1e9b-b4e5-020703683203","text":"This is a retrospective single descriptive study conducted during the period from January 2021 to April 2021 that included Saudi patients aged 18 years and above who underwent primary and revision septorhinoplasty at King Abdullah Medical City Hospital (KAMCH) from January 2015 to March 2020. Patients less than 18 years of age and patients who underwent rhinoplasty only for esthetic purposes were excluded from the study. We reviewed the medical records of all the patients, determined if they underwent septorhinoplasty, and documented postoperative complications to ascertain the rate of each complication.","title":"Causes, Prevention, and Correction of Complications of Primary and Revision Septorhinoplasty"}
{"_id":"97bae27a-bac1-ce87-3f14-b62206ebf338","text":"Twenty-three free flaps and eight regional flaps were performed in 25 patients (Table 2). The patient with Li–Fraumeni syndrome had five free flaps following resection of four asynchronous sarcomas. Another patient with an osteosarcoma involving the mandible also had five free flaps with no flap failure. A free fibular osseocutaneous flap and a superficial ulnar artery forearm flap were performed at initial surgery. Histology showed incomplete margins and a further resection and reconstruction with the contralateral free fibular osseocutaneous flap and superficial ulnar artery forearm flap was performed. Two additional free flaps were performed following flap failure for two other patients.","title":"Outcomes of the Treatment of Head and Neck Sarcomas in a Tertiary Referral Center"}
{"_id":"97c22294-a6f2-bc47-0c78-b595718e5cae","text":"Patients will be invited by a plastic surgery resident who is not affiliated with this study or clinically responsible for the patient. This will be done before POD 5. The patient will then have at least 24 h to decide whether he\/she would like to join the study. The patient will be provided with an information letter and asked to give written informed consent. The study will start on POD 7. If a patient at the UMC Utrecht is randomized to group A and would like to take part in the study but does not want to have the POCT performed, then the patient will still remain in group A (without the blood test).","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"97cc0fa1-0705-b374-a1c9-0fd8ae0c3c37","text":"Generally standard surgical excision is considered a good treatment option for all BCCs arising on the face with 5-year recurrence rates of anything up to 10% providing adequate margins are taken. We would therefore recommend at least a 3-mm margin for standard surgical excision. While it would seem sensible to take larger margins at the sites where subclinical spread is known to be more extensive, these sites are all of great cosmetic and functional importance and therefore striking the correct balance is necessary while considering the option of Mohs' micrographic surgery as an alternative.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"97d2b13c-1fa2-7e25-31f3-55131362a8f9","text":"We also acknowledge that as larger patient samples are studied, the ability to identify key factors and potential predictors of treatment outcome will emerge; the findings of such follow-up investigations may delimit critical factors that may then optimize the selection of patients, in addition to defining the impact of treatment on lesion area. Finally, the effect of multiple applications of HP33 was not examined in the present study; whether a cumulative treatment effect exists is currently unknown. These areas are clearly indicated as valuable areas for future investigation in larger patient samples. But, our assessment of the current data do support the use of hydrogen peroxide as a potentially viable treatment option.","title":"33% hydrogen peroxide as a Neoadjuvant treatment in the surgical excision of non-melanoma skin cancers: a case series"}
{"_id":"97d8e47a-e4f4-8b05-abda-138ce61e313e","text":"The purpose of this case report is to demonstrate early creeping attachment after frenuloplasty only, with the use of the conventional scalpel technique.","title":"Early Creeping Attachment Noted after Mandibular Labial Frenuloplasty"}
{"_id":"97dc23de-d7c0-3749-4f19-7b0243cfae8a","text":"Argon modified polyurethane nanocomposite scaffolds support cell attachment and growth, tissue integration and angiogenesis and are a promising alternative for facial cartilage replacement. This study demonstrates polyurethane nanocomposite scaffolds with argon surface modification are a promising biomaterial for cartilage tissue engineering applications.","title":"Argon plasma modified nanocomposite polyurethane scaffolds provide an alternative strategy for cartilage tissue engineering"}
{"_id":"97e01309-8643-8fe8-b27f-310cd859a151","text":"Small rotational flaps, such as the ergotrid flap, may be used to correct these defects while preserving the natural structure of surrounding anatomy should linear closure be contraindicated.59","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"97e143f1-9db9-9b30-8f53-4a6b7b460905","text":"Non-nasopharangeal head and neck cancers are a locoregional disease with reported recurrence rates as high as 50% after curative treatment. Reirradiation has been effectively used to manage recurrent head and neck cancers and PHDRB is an excellent modality to be used in this indication.Single plane PHDRB implants can deliver a high targeted dose to positive margins and can also increase the surgical margins by 1–1.5 cm thereby improving the local control. An added advantage of brachytherapy implants is that they are not affected by organ motion or respiratory movements.","title":"Perioperative high dose rate brachytherapy in head and neck cancers: case report and review of clinical application Bahl et al"}
{"_id":"97ff6279-75ba-208b-fc6f-09ded56bb092","text":"Patients were followed up every 3 months at the first 2 years after surgery and every 6 months at the subsequent 3 years until the patient died or the study was terminated. Patients were followed up through the outpatient clinic appointment, letter or telephone consultation. The median follow-up was 51 months in the LAP group and 53 months in the NOSES group. All patients were followed up to death or the end of the study in June 2020.","title":"Long-term oncologic outcomes of natural orifice specimen extraction surgery versus conventional laparoscopic-assisted resection in the treatment of rectal cancer: a propensity-score matching study"}
{"_id":"980462c3-f030-4105-1eb2-75dffdf10898","text":"The examiner requested that the patient indicated the level of pain sensation on a scale from 0 to 10 where 2 indicated discomfort and 10 was the maximum pain felt.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"980c0553-bf79-a878-6da0-d4e20dbef9d0","text":"In collaboration with an experienced surgeon, a planar resection was manually prepared for all 20 cases in a custom resection planning software. The surgeon was instructed to plan the cases assuming that the tumor surface mesh included a cuff of healthy tissue required by the principles of wide-margin tumor resection surgery, that the reconstruction could be to their choosing, and that surgical navigation would be available for all cases.","title":"Automated elaborate resection planning for bone tumor surgery"}
{"_id":"9811f65e-eea7-30f3-fb16-e17a51a4ee69","text":"On analyzing the concordance of the clinical tests and the color Doppler for identification of the perforator incompetence, all the positive perforators identified by the clinical tests were also identified to be positive by the color Doppler examination, indicating 100% concordance between the clinical tests and the color Doppler examination.","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"98223873-bf05-d359-f029-da18ff4326d7","text":"The challenge is how identifying the location of extemporaneous examination of the sentinel lymph node in breast cancer given that:","title":"The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management"}
{"_id":"9828569e-c580-e56c-19ab-9b1fb0d7f62d","text":"Handheld Doppler with an 8 MHz vascular probe was used to plan and design a flap for soft tissue defect reconstruction and assess its vascularity following reconstruction. The versatility of flaps was assessed in terms of flap failure and success rate. In our study, we defined flap failure as loss of more than 50% of the flap, flap success as uptake of more than 95% of the flap, and margin necrosis within 2 cm of distal margin of the flap. Further dressings were done till the flap inset line was healthy and clinically observed for healing and any complications. All patients were followed weekly in the first month, fortnightly in the second and third months, and then monthly until the healing was satisfactory.","title":"Immediate Versus Late Flap Coverage for Traumatic Soft Tissue Defects of Lower Extremity: A Comparative Observational Study"}
{"_id":"982c27f4-a0f8-627c-c417-a586b92f1455","text":"The comparison of the 2 groups was done by testing the hypotheses that the probability of a patient having acute radiation dermatitis is greater under the treatment group than under the control group at the different clinic visits. The rejection of these hypotheses at standard significance levels (P ≤ .01) supports the use of R1 and R2 treatment. The P values presented later were obtained using the Wald test for the difference in proportions.23","title":"Topical R1 and R2 Prophylactic Treatment of Acute Radiation Dermatitis in Squamous Cell Carcinoma of the Head and Neck and Breast Cancer Patients Treated With Chemoradiotherapy Manas et al"}
{"_id":"98339236-4b0b-9812-539c-829fd0cbbee1","text":"Focal neurological motor or sensory deficits, aphasia, or hemianopsia are most often the result of a hematoma or parenchymal ischemia easily diagnosed on MRI and CT. Focal or generalized seizures are more common in cerebral venous thrombosis than in other causes of stroke.","title":"Imaging of Cerebral Venous Thrombosis"}
{"_id":"983477d3-1df2-6c90-44ce-939de6042622","text":"Global linear regression utilises a two-dimensional co-occurrence matrix or scatter graph. This matrix may for example have dimensions 256 × 256, where the matrix size determines the maximum count that can be processed in the images being compared. Each pixel count in the two images A and B being compared is used to index into the co-occurrence matrix where the pixel counts in image A is used as a column index and the respective pixel counts in image B provide the row index. Each such location in the co-occurrence matrix is incremented by one hence the result after processing all the pixel counts in images A and B is that of a two dimensional histogram describing the joint pixel count distribution between the two images. If the images are identical the results fall on the line of identity. Deviations from this line can be tested for significance using a Chi square test. A Cluster requirement can then be applied so that, for example, five pixels with significant deviations must be adjacent to be judged significant. This avoids single outlier pixel values. The probability map is then constructed.","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"983b0bb7-6dc9-af5c-1bae-e1fcea02b189","text":"As a next step to understanding the benefits of global health experiences and educational partnerships in the field of Otolaryngology, our study expands significantly on the work of Boyd and Cruz in several ways. We obtained responses from US residents who successfully matched into programs across the nation, directly assessed the impact of an international elective on residency selection and career planning, did extensive analysis to determine differences amongst subgroups, and evaluated barriers to participation.","title":"Going Global: Interest in Global Health Among US Otolaryngology Residents"}
{"_id":"983c7d7c-f849-cd78-a77b-b6a39bd25e10","text":"The case presented here demonstrates that both idiopathic normal pressure hydrocephalus (iNPH) and cervical myelopathy may present simultaneously and result in gait disturbances and imbalance in some patients. For patients with suspected iNPH and myelopathic findings on examination, a cervical spine MRI should be considered to assess for cervical stenosis. Cervical stenosis can mask the effect of CSF diversion in patients with comorbid iNPH and cervical myelopathy.","title":"Clinical Reasoning: A 75-Year-Old Man With Dementia, Incontinence, and Gait Dysfunction"}
{"_id":"983c9577-ceb5-c696-67ed-9a1f52167281","text":"Stage 1 of relevance screening involved two reviewers (AR and LES) independently reviewing each abstract title. Citations proceeded to the second stage of review if both reviewers agreed the citation described primary research assessing the outcome of surgical treatment of cutaneous MCT or did not contain enough information to determine eligibility. When the two reviewers did not initially agree about a citation, a discussion was raised and consensus was determined. If the manuscripts met all inclusion criteria determined for stage 1 of relevance screening and the study was published in English, the manuscript could advance to the next stage of the review. Stage 2 of relevance screening involved evaluation of the full manuscript using the full inclusion criteria and was conducted independently by the same reviewers (AR and LES). Similarly, any disagreements were resolved through discussion and consensus between reviewers.","title":"A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs"}
{"_id":"9843e399-8120-bdfa-9033-240e47dc6b27","text":"A summary of selected experiments can be found in Table 3.","title":"Radiation dose rate effects: what is new and what is needed?"}
{"_id":"98452761-6677-547c-49be-d9b6ad1487da","text":"No consensus has been reached regarding the best solution to the projected physician subspecialist workforce shortage, but many groups are proposing recommendations to increase the number of subspecialists.2 Increasing fellowship positions can result from either expansion of existing programs or development of new ones. The elimination in 2005 of an RRC rule requiring sponsorship of at least three fellowships removed a restriction that put fellowship sponsorship out of reach, especially for community hospitals. Our findings suggest that this rule change has encouraged a substantial increase in available subspecialty fellowships, including many new programs in community hospitals.","title":"Sponsorship of Internal Medicine Subspecialty Fellowships Since 2000: Trends and Community Hospital Involvement"}
{"_id":"984bc703-5743-da3d-b883-deaf96c02f67","text":"BHR was significantly more frequent in children with persistent egg or peanut allergy than in children without food allergy. Oral immunotherapy did not increase BHR and was safe for children on regular asthma medication.","title":"Bronchial hyperresponsiveness and asthma during oral immunotherapy for egg or peanut allergy in children"}
{"_id":"984c0393-6791-a74a-1e9f-19de8adef203","text":"In our clinic, all patients are encouraged to make contact with a psychologist soon after diagnosis to establish a relationship should help be required subsequently. Many patients with ordinary curable melanoma benefit from this service","title":"Malignant Melanoma"}
{"_id":"98503e0b-d159-78bd-45c4-4359dc6624a7","text":"The key venous factors in preventing venous thrombosis include using as many two-vein ETS anastomoses as possible to deep recipient veins.","title":"Analysis of Anastomotic Venous Factors in Traumatic Lower Extremity Injuries Reconstructed by Free Flap"}
{"_id":"9851ebc5-d924-9348-feee-835e06a81e7e","text":"In Trinidad and Tobago external beam radiation is the most common modality used in the treatment of prostate cancer. Radiotherapy is used both as primary therapy and as salvage following radical prostatectomy. Palliative radiotherapy is also widely utilised and is discussed below.","title":"The current state of prostate cancer treatment in Trinidad and Tobago"}
{"_id":"9853f8c0-6f06-9e6e-9e63-5480a6bc2c2b","text":"This is because patients with a history of non-melanoma skin cancer have a 10-fold risk of developing a second malignancy with 30%−50% developing a new lesion within 5 years.6,7","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"985442bd-e6a2-6e3a-5ac0-653fdbb6ae4f","text":"Professionalism in social media has also been subject to discussion among plastic surgeons that use the platform for exposure. Debates on whether a surgeon should post their personal life and views is not clearly elucidated. Although patients younger than 35 prefer or are indifferent to viewing a plastic surgeon's personal life online, patients 35 or older do not prefer the additional exposure. As social media further permeates into everyday life, we expect this finding to further align toward favoring personal posts. More so as the younger public ages, they would express more acceptance toward their surgeons’ social media use in the medical setting. Recently, the main argument in the use of social media in plastic surgery has been in determining what may be deemed as professional or unprofessional. Professionalism in the specialty has been a central subject of debate led by guidance of policies like the ASPS Code of Ethics. Self-regulation by surgeons and researchers in the field also play a large role in determining what is deemed professional even as far as studies of the effect of a plastic surgeon's attire on patient–physician interaction. Yet the idea of professionalism may be affected by the context of what is being judged for medical professionals. One of the most recent examples of this involves the #MedBikini movement in which a now redacted article met negative reception in the medical community due to its judgmental basis centralized around a group of vascular surgeons taking part in activities that the authors perceived as unprofessional. Although the article itself does not provide any substance on professionalism, a large proportion of the responding commentary from physicians against their conclusion reflect a consensus in the community that showing your personal life is not unprofessional.","title":"Content and Engagement Among Plastic Surgeons on Instagram"}
{"_id":"985b1147-ad9d-c490-5dd0-ed8c0167a8ad","text":"This study has some limitations, which include its retrospective single-center nature. Symptomatic patients who presented to a university hospital were included in our analysis. This patient population may be different as compared to patients seen by primary care physicians. No external reference standard was available to confirm the findings. A more comprehensive prospective study is needed to determine the impact of alternative findings on subsequent diagnostic algorithm in patients and the benefits including costs in patient management.","title":"Prevalence and predictors of alternative diagnoses on whole-leg ultrasound negative for acute deep venous thrombosis"}
{"_id":"985cb8be-e3f6-51c4-be01-1c98f5235c3d","text":"Commercialised ESWL treatment can achieve an overall success rate of more than 90% using a mobile lithotripsy system. As expected, an inverse relation between stone size and success rate was found. Patients who do not require treatment with a JJ prior to ESWL will only rarely need treatment with a JJ after ESWL, irrespective of stone size and intra renal stone location.","title":"Efficacy of commercialised extracorporeal shock wave lithotripsy service: a review of 589 renal stones"}
{"_id":"985f0d7a-8e4f-f1c6-092a-83bafd18761f","text":"Unlike most malignancies, in CM the primary tumor staging is not a clinical one, but a histopathological one, because a correct measurement of tumor thickness, Breslow index respectively, is only possible microscopically. Breslow index stands for the thickness of the tumor measured in millimeters from the granular layer of the epidermis to the deepest level of the tumor penetration and it is unanimously considered the most important factor for survival in the early stages of disease.","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"987b5bef-3ee4-6b61-c2a4-7cc0a9cd874e","text":"This retrospective cohort study (surgery on humans) was approved by the Medical Ethics Committees of Tianjin Eye Hospital and followed the Declaration of Helsinki. Due to the retrospective nature of the study, the requirement for informed consent from a parent or guardian was waived by the Medical Ethics Committees of Tianjin Eye Hospital.","title":"Comparative evaluation of conventional and modified frontalis muscle flap advancement techniques in the treatment of severe congenital ptosis: A retrospective cohort study"}
{"_id":"987b97a8-4f9c-ef48-a3ec-1cd662efaaaf","text":"Several studies have determined that chronic and recurrent OM is associated with the development of a bacterial biofilm in the middle ear space. Biofilms are aggregated bacteria within a secreted extracellular matrix which is generally adhered to a surface. Biofilms are typically responsible for a variety of chronic infections in humans, such as chronic sinusitis, intravascular infections (on stents and catheters), and pulmonary infections. Previous studies have shown the presence of a middle ear biofilm in patients with various types of OM, including chronic and recurrent OM, and OM with effusion. It has been established that the aggregated nature of a biofilm is responsible for the lower metabolic activity of these bacteria, increased antibiotic resistance with time, and seeding recurrent infections in enclosed systems such as the middle ear cavity. Such considerations undoubtedly account for the effectiveness of surgical interventions because the microenvironment in the middle ear cavity is physically altered.","title":"Inactivation and sensitization of Pseudomonas aeruginosa by microplasma jet array for treating otitis media"}
{"_id":"988092d8-6f05-b906-1eba-06db8e8a1529","text":"Even though it was not performed in our case, CT is the best modality to identify the nidus in osteoid osteoma, once the suspected area of interest has been identified. CT is the method of choice to characterize bone changes and may differentiate between osteoid osteoma and chronic osteomyelitis. The role of MRI is controversial because of the variable appearance of the lesion and the reactive changes in the bone marrow and soft tissues [1].","title":"Intra-Articular Osteoid Osteoma: Radiological Manifestations"}
{"_id":"9882219c-9936-51be-a089-272b1e4951fa","text":"Of the seven illnesses possibly consistent with an allergic reaction with signs and symptoms other than rash (with or without rash), in most cases there was limited information in the medical record and for all but one the available documentation did not provide information to confirm that the event met the Brighton Collaboration case definition of anaphylaxis. One case did meet that definition, with Level 1 of diagnostic certainty, but this was a 15 year old with known peanut allergy who had anaphylaxis after eating peanuts the day after Td vaccination.","title":"Frequency of medically attended adverse events following tetanus and diphtheria toxoid vaccine in adolescents and young adults: a Vaccine Safety Datalink study"}
{"_id":"9882cec4-a0ed-4169-329f-71269a6918c5","text":"Other methods of radiation delivery include brachytherapy, where a radioactive source is inserted inside or adjacent to the site to be treated. The most widely known example for this is low dose rate (LDR) prostate cancer brachytherapy, where radioactive seeds are permanently implanted inside the prostate. The radioactivity decays over time and delivers the prescribed dose of radiation. Another common brachytherapy scenario is endobronchial brachytherapy, where a tumor inside the airway can be treated with a radioactive source that is placed next to the tumor via a hollow catheter and is removed after treatment is complete. Endometrial cancer and cervical cancer are also often treated with brachytherapy, where radioactive sources are inserted next to the tumor for a calculated length of time and then removed.","title":"Immune Modulation and Stereotactic Radiation: Improving Local and Abscopal Responses"}
{"_id":"98856771-4883-6a92-ecd4-cd0f77e2a5eb","text":"Recovery of motor function after facial nerve injury and manual stimulation of the denervated and reinnervated muscles of the whisker pad is not associated with alterations in the expression of lesion-associated neurotrophic factors FGF2, IGF1 and NGF in the denervated muscles at an end-point analysis of 2 months after surgery. This finding does not exclude alterations in the trophic factors expression, which might have taken place in the musculature earlier after nerve injury.","title":"Trigeminal Sensory Supply Is Essential for Motor Recovery after Facial Nerve Injury"}
{"_id":"9887cea6-5b0b-d6d4-52f0-8262db3b8d8d","text":"Patients with CSM are referred by a general practitioner to a consulting spine surgeon at a large center. Four large spine centers in Sweden are participating in the trial with patient enrolment to secure the reach of the target sample size. No specific strategy to promote the recruitment of patients is used.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"98897f41-741e-aba4-38b3-1f27209d7ded","text":"The association of NPWT and biological mesh implant prevented us to adopt other reconstructive procedures as regional or distant flap which could be much more invasive in our complicated patient.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"9890d19f-7a01-28b2-bfe4-8f5281647853","text":"This study aimed to explore whether acellular dermal matrix can be used as a single treatment to promote wound healing. 7 patients with lower extremities cutaneous deficiency exposing bone or tendon, were covered by Pelnac, which was an acellular dermal matrix product approved by China Food and Drug Administration. All the wound was treated by Pelnac without flaps and skin graft. The external dressing was changed every 10 days.","title":"Acellular dermal matrix for one-stage treatment of lower extremity full-thickness skin defect: a case series"}
{"_id":"989316c6-c75f-cb01-f3b6-aae6d23e0aa5","text":"In conclusion, MDM is significantly associated with a positive SLNB status. Mixed subtype is a predictor for RFS but does not influence OS. The distinction between pure and mixed desmoplastic subtype is an important prognostic indicator for DM and continuing making this distinction in future practice is essential.","title":"Desmoplastic melanoma: The role of pure and mixed subtype in sentinel lymph node biopsy and survival"}
{"_id":"9894df21-7e06-7ac5-ec76-727ffe15b3f4","text":"32 patients with established infected non-union of the tibia were initially considered for the study.4 patients rejected the fixator at the initial stage and preferred amputation. 4 patients after initial acceptance opted out of the study and 2 patients failed to report back after initial acceptance. The rest 22 patients were included for Ilizarov ring fixation over a 3 year period prospectively.","title":"Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study"}
{"_id":"989816ab-82a6-21e7-81ee-77eea877137f","text":"Women in this rural cohort who had a more positive attitude towards breastfeeding had a longer duration of both exclusive breastfeeding to six months and any breastfeeding to 12 months. Further research examining the breastfeeding attitudes of specific subgroups such as men, grandparents and adolescents in rural areas will contribute to the evidence base and help to ensure that breastfeeding is seen as the normal method of infant feeding.","title":"The influence of infant feeding attitudes on breastfeeding duration: evidence from a cohort study in rural Western Australia"}
{"_id":"98a63069-5fdf-bf59-5bb0-e99e19504d37","text":"The majority of students in this program supported the idea of having anatomy as an anchor for the international exchanges. Due to the limited amount of time the students could spend with their peers, a significant number of groups decided not to focus on learning anatomy related topics from each other during their small group sessions. This demonstrates that students appreciated the networking opportunity initiated via the anatomy course. With the exception of reports generated by this group of authors there are no reports that link the discipline of anatomy to internationalization of medical education [230].","title":"An International Partnership of 12 Anatomy Departments – Improving Global Health through Internationalization of Medical Education"}
{"_id":"98a77afe-4fcb-fed4-fdc5-dfc1aa3e43e7","text":"Erythematous and edematous indurated plaque 7 days after the first dose of the mRNA-1273 vaccine","title":"Delayed skin reaction after mRNA-1273 vaccine against SARS-CoV-2: a rare clinical reaction"}
{"_id":"98b64dce-e433-9b31-5bb1-c32c4bcf12a4","text":"Conclusion: Combination of nebulized salbutamol and fluticasone propionate had better efficacy than nebulized salbutamol in children with mild and moderate asthma attacks","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"98b70e41-dbad-89ee-600c-434cd692e91c","text":"A theoretical advantage of NPWT is the time-dependent reduction in the wound surface area and hence reconstructive demand. However, there is a lack of high-quality, long-term data to support this thesis. In our experience, soft tissue cover that results from healing by secondary intention in the context of OM is likely to be unstable and poorly vascularized scar tissue that is prone to recurrent soft tissue infections and breakdown. Furthermore, large soft tissue flaps such as the anterolateral thigh (ALT) or latissimus dorsi can cover the vast majority of osteomyelitic defects.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"98c1223c-b84e-812f-3fde-53fb662b4ebf","text":"Ethical approval was obtained from the institutional review board of the Makerere University College of Health sciences and the Mulago Hospital ethics committee. A written informed consent was obtained from the study participants.","title":"Deep venous thrombosis after major abdominal surgery in a Ugandan hospital: a prospective study"}
{"_id":"98d21087-9721-a395-863c-9dcc6e6a5fa8","text":"Given these reported findings, this study was designed to evaluate the usefulness of ultrasound as quantitative measures of radiation response in preserved breast skin, and to try to find influencing factors for ARD.","title":"The role of ultrasound quantitative parameters in the assessment of acute radiodermatitis after breast-conserving surgery"}
{"_id":"98d247cd-4422-6aac-4b7a-de718ab0fa94","text":"The first reoperation was in the APC WBAT cohort with an ISS backing out at 3 months that required revision and another screw implanted – this did not result in any loss of reduction.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"98d808b1-7045-c050-68e3-8e68f607337e","text":"Integrating elements of the business world as part of physician leadership was not considered possible because of ethical issues related to the field of medicine guiding the work of all physicians, irrespective of the hierarchical level.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"98da9044-f268-c783-19aa-7d3a1c40a4b3","text":"MRI of the left shoulder was done eleven days after admission in view of the persistent shoulder pain and static inflammatory markers. It revealed acute osteomyelitis of the proximal metaphysis and diaphysis of the left humerus with marrow involvement. Shoulder joint septic arthritis was suspected due to a large joint fluid collection, multiple intramuscular abscesses and axillary lymphadenitis. He underwent a second arthrotomy washout and debridement of the left shoulder joint. Pus and slough from the joint and surrounding tissue which were sent separately for culture and sensitivity grew Salmonella sp, sensitive to ampicillin. Subsequently, antibiotics were changed to intravenous unasyn ampicilin and sulbactam. He responded well as evidenced by clinical and radiological improvement. The sickle cell disease workup which included Haemoglobin electrophoresis was negative. Throat swab culture were subsequently reported to be negative.","title":"Salmonella Osteomyelitis in a one year old Child without Sickle Cell Disease: A Case Report"}
{"_id":"98de8b32-8c7d-4edd-44be-0043bb2b456d","text":"Each dog was placed in dorsal recumbency with forelimbs oriented cranially and dissection was performed on one hemithorax of each cadaver. Once the skin was removed, the pectoralis superficialis and pectoralis profunda muscles were separated from the sternum and laterally reclined to expose the rectus thoracis and rectus abdominis muscles. These muscles, which were sectioned between the first costal cartilage and caudally to the xiphoid process, were reclined dorsally to identify the distal muscular branches of the intercostal nerves after crossing the internal and external intercostal muscles. The external and internal intercostal muscles between the second and ninth costal cartilages were separated from their caudal costal cartilage insertion and from the sternum and reclined cranially in order to identify the TTP, the internal intercostal membrane, the path of the intercostal nerve and the internal thoracic artery and vein. The transversus thoracis muscle was identified and separated from the endothoracic fascia and the costal pleura.","title":"Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers"}
{"_id":"98e0b691-7692-567a-8504-402aaa8d1988","text":"Many related this new confidence with the ability to effectively work as a leader:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"98e89d90-0d37-c81e-6fd9-4b4ae2035ffa","text":"Table 1 Rates and numbers of men using sperm cryopreservation for testicular cancer in the CECOS network from 1990 to 2013 and predictions after 2013 derived from the Poisson regression model and the Verhulst model","title":"Sperm cryopreservation incidence in men with testicular cancer: towards a stabilization in testicular cancer incidence? Results from the CECOS network"}
{"_id":"98ee8ec4-ed48-a55b-39c4-21684493106e","text":"A secondary healing strategy may be an option for the treatment of vulvar cancer in situations of nonextensive surgical wounds when primary closure of the wound is not possible. Further studies are needed to evaluate the use of the hydrofiber in the routine clinical practice of the surgical treatment of patients with vulvar cancer.","title":"Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control study"}
{"_id":"98f76808-3ccb-8687-45d0-0a6d3b55e717","text":"In consideration of the location of parotid tumors, tumors are often located in the inferior lobe. Parotid tumors in the inferior lobe often present with level IIa or IIb lymph node metastases rather than intra-parotid lymph node metastases, possibly because lymphatic flow within the parotid gland is directed from above to below. The metastatic route of a parotid malignancy is assumed to involve the flow of lymph within the parotid gland and the location of the parotid tumor; however, the underlying mechanisms currently remain unclear and warrant further study.","title":"Role of Intra-Parotid Lymph Node Metastasis in Primary Parotid Carcinoma"}
{"_id":"98f8dc9d-9bf3-e2be-1e13-fd02f1aec8ed","text":"Head and neck cancers include several histologically distinct cancers that originate in the upper airways. Advances in surgery and radiotherapy over the past few decades have resulted in improved loco regional control however this has not translated to an improved overall survival in all studies. This is due in part to the development of second primary tumours and distant metastases, which occur in up to 20% of patients [1]. Current clinical staging systems frequently fail to predict tumour biology and outcome highlighting the need for more sensitive and specific methods for the detection of spreading tumour cells.","title":"Long term survival following the detection of circulating tumour cells in head and neck squamous cell carcinoma"}
{"_id":"990f14d2-f353-29ea-bc84-68801673af9c","text":"Sternoclavicular joint osteomyelitis is a rare disease that has increased in incidence at our institution. From our review, a minority of patients were successfully treated with antibiotics alone with or without percutaneous drainage without debridement. These patients likely had very low grade infection without large abscess or osteomyelitis. However, based on our experience and published data, most patients fail this method of therapy. Many of the patients we have seen with SCJ infection had been on antibiotic therapy for weeks before we were consulted, with little or no improvement in symptoms.","title":"Treatment of Sternoclavicular Joint Osteomyelitis with Debridement and Delayed Resection with Muscle Flap Coverage Improves Outcomes"}
{"_id":"9912823e-32e7-7280-fc6e-7fd227910cbf","text":"The WHO recommends exclusive breastfeeding for at least the first six months of life, as this reduces the risk of infectious diseases of the gastrointestinal tract and respiratory system.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"992696c5-5608-5b31-8432-67ee6122d30a","text":"Program directors were asked about the importance of BT as a treatment modality, whether they thought BT utilization will increase in the future, as well as their thoughts on the adequacy of the status of BT training.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"9927d5bc-e47e-bac9-c32b-d0c8c2e1f036","text":"Breast carcinoma is the most common cancer of women worldwide including 23% of all female cancers.1 In Pakistan it isaccounted for 23% of all and 41% of female cancers.2 Histopathology is considered as the Gold standard for the diagnosis of Breast cancer.3 The axillary lymph node status is a significant measurement to plan the consequent adjuvant treatment of breast carcinoma and is also the most important prognostic factor. It is assessed by sentinel lymph node (SLN) biopsy which is defined as the lymph node that receives lymphatic drainage from tumorearliest4 therefore this node has the highest chances to containmetastatic breast cancer.","title":"Sentinel lymph node identification by blue dye in patients with breast carcinoma"}
{"_id":"9928caf3-f8ec-4e04-f5a4-44c9cea1469b","text":"Although there is no written protocol, it seems that the anesthetic technicians were much more compliant to the time of first dose and postoperative antibiotic duration. This is possibly because the technician's main training and job skills are related to operation room; on the other hand nurses have wider scope of work for patients on the ward.","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"992925a2-f658-6c73-8bab-1921253da19c","text":"Our findings suggest that a 1 cm excision margin is inadequate for cutaneous melanoma with Breslow thickness greater than 2 mm on the trunk and limbs. Current guidelines advise a 2 cm margin for melanomas greater than 2 mm in thickness but only a 1 cm margin for thinner melanomas. The adequacy of a 1 cm margin for thinner melanomas with poor prognostic features should be addressed in future randomised studies.","title":"Wide versus narrow excision margins for high-risk, primary cutaneous melanomas: long-term follow-up of survival in a randomised trial"}
{"_id":"992af774-645f-1d9d-120b-60389ce6aa5a","text":"We did early management of these wounds with good results. Despite possible problems in detecting perfusion and viability of the affected tissues, some experts suggested use of tourniquets in order to minimize excessive blood loss in serial debridements. However, tourniquet must be released at the end of each debridement procedure to reassess the remaining tissues and the need for further debridement. Debridement is very important in these injuries, our preferred method is serial conservative debridement until cleaning and good vascularized bed for reconstruction, this is especially important for early skin graft coverage.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"992ce1d2-0e40-268d-3916-b5f9a89e6673","text":"The results presented in our study are comparable in terms of LC with surgical results from similar series.","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"9932814d-7d05-7293-cd77-36a9be6973e9","text":"Patients were seen on follow-up visits 6 to 8 weeks after end of reirradiation and thereafter every 4 to 6 months. All other patients were contacted by telephone or their gynaecological and medical oncologist were interviewed.","title":"Reirradiation of recurrent breast cancer with and without concurrent chemotherapy"}
{"_id":"99336751-301a-8cfc-4297-40f5184185f7","text":"Identification of risk factors associated with upstaging invasive cancer and SLN metastases may allow us to evaluate whether SLNB is justified in patients with DCIS. This study aimed to assess predictors of upgrade to invasive disease and SLN positivity in patients undergoing surgery and SLNB for DCIS to determine whether it can be safely omitted.","title":"De-escalation of Sentinel Lymph Node Biopsy in Patients With Ductal Carcinoma In Situ"}
{"_id":"9936aa90-8fcb-a5e7-8b2d-634df5400994","text":"The various attributes the neurosurgeon implemented to encourage the growth of his surgical practice are described in Table 1.","title":"Building a Brain Tumor Practice: Objective Analysis of Referral Patterns and Implications for the Growth of a Subspecialty Surgical Program"}
{"_id":"99374298-1932-78f4-edaf-ad708e382d48","text":"Ear tags or accessory auricles are branchial cleft remnants that clinically appear as asymptomatic nodules or papules in the preauricular region. They occur in various syndromes affecting the first and branchial arches during embryogenesis. The presence of an ear tag can have a psychological impact on one's life due to its unesthetic appearance, thereby affecting their quality of life. Talon cusp usually occurs in the maxillary central or lateral incisor. A fissured tongue or cerebriform tongue is characterized by the presence of horizontal or vertical grooves, usually affecting the dorsum of the tongue. Ankyloglossia or tongue-tie is a developmental anomaly in which the lingual frenum is abnormally attached to the ventral surface of the tongue. It can cause difficulties in breastfeeding in infants and in the pronunciation of certain vowels in adults. The concurrent occurrence of the ear tag along with the talon cusp in the mandibular second molar has not been reported in previous literature. We present a unique case of a 24-year-old non-syndromic individual with the concurrent occurrence of the ear tag along with a rare clinical occurrence of talon cusp in the mandibular second molar, fissured tongue, and ankyloglossia.","title":"Concurrent Occurrence of Ear Tag With Posterior Talon Cusp, Fissured Tongue, and Ankyloglossia: A Case Report"}
{"_id":"9937d3c7-a2fe-3f8c-376d-1615fd21472a","text":"The patient was able to ambulate immediately with the protection of a waist brace and had to be careful not to twist or bend during the first 3 months after the procedure.","title":"One‐stage Debridement via Oblique Lateral Interbody Fusion Corridor Combined with Posterior Pedicle Screw Fixation in Treating Spontaneous Lumbar Infectious Spondylodiscitis: A Case Series"}
{"_id":"994fb384-77b5-b0f5-300f-1da2f22c5fc7","text":"Our observation suggests that IC can be simple and effective alternative treatment for SCC patients whose condition is not suitable for or who refused operation.","title":"Successful treatment of cutaneous squamous cell carcinoma with intralesional cryosurgery Case report"}
{"_id":"99529998-4894-d06b-a496-aa1198d097af","text":"These findings are consistent with and extend prior reports by confirming that broad differences in secondary surgery among cleft centres in Western Europe also occur in the USA. During the 1990s, investigators found differences in both clinical outcomes and use of secondary surgery among cleft centres in Western Europe.12 18 31–34 Cleft centres in the UK achieved the worst outcomes, and this led them to consolidate centres and impose statutory mandates for outcome reporting from each centre.35 Small intercentre studies in the USA found similar differences in clinical outcomes and use of secondary surgery across cleft centres.19 36–38 However, our study is the first to examine whether differences among smaller groups of North American cleft centres generalise to cleft teams in the USA.","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"9957633b-5381-d658-e9a6-5751cd50b886","text":"We found that the extended submental perforator flap has a significant role in the repair of larger postoperative defects related to upper airway malignancy, particularly in functional reconstruction. Related reports show that if there is a large defect in the site in the upper airway away from the submental region, the conventional submental flap will not be able to fully cover such a defect [16, 17]. The extended submental perforator flap increases the size of the tumor area to 3–5 × 3 cm compared with the conventional submental flap, which can make up for the defects of the latter and complete the full structural remodelling and functional reconstruction of the above areas.","title":"Application of prolonged submental perforator flap to repair the postoperative defect of upper airway malignancy"}
{"_id":"9959219f-d85f-62b9-86c5-2794c18696a6","text":"Even if the existence of a perforator has been sufficiently evaluated preoperative, there may be no perforator near the midpoint of thigh. Surgeons should proceed with the operation keeping in mind that there may not be a perforator, even if there is preoperative evidence that a perforator is present.","title":"Preoperative perforator localization in anterolateral thigh free flap using acoustic doppler and computed tomography angiography"}
{"_id":"995c9659-7bf6-d3ce-56c8-8826325c4bab","text":"Patients identified as receiving warfarin for a first unprovoked proximal DVT or PE and who are eligible for the trial (Table 1) will receive a brief information sheet about the study during their anticoagulant clinic appointment. They will also be given a post card to return to the research department stating their willingness in principle to take part in the study, for their GP to be contacted and their records to be accessed for the purpose of checking their eligibility for the study. The patients GP will simultaneously be sent a summary of the trial and informed that one of their patients wishes to participate. The GP will be asked to complete a form to state whether they wish their practice to take part in the study.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"995fd25c-b25b-4ff4-3c59-b762fd1105bc","text":"In plastic surgery practice, sexuality appears to be a rarely discussed subject (with gender and genital surgery subspecialties as the exception). Although scholars and patients emphasize the importance of sexuality in postoperative quality of life, plastic surgeons express limited urge to be trained in this subject and prefer patient information and referrals. To improve early detection of sexual issues and create a safe space for patients to discuss the topic with their surgeons, the authors stimulate more education on sexuality during plastic surgery training.","title":"Discussing sexuality in the field of plastic and reconstructive surgery: a national survey of current practice in the Netherlands"}
{"_id":"99628e79-6705-8443-e28c-35cffc4ad3a6","text":"Second, safety indicators: Only a very small number of studies have reported the gastrointestinal adverse effects of antibiotics, and most studies focused on efficacy and bacterial eradication rates. Therefore, attention should be paid to the safety of antibiotics in future to avoid adverse events in clinical applications. In addition, preclinical trials for OM treatment should take into account the rigor of design and the standardization of outcome assessment to improve the quality of the study and provide a reference for the clinical treatment of OM as much as possible.","title":"Comparing the efficacy of different antibiotic regimens on osteomyelitis: A network meta-analysis of animal studies"}
{"_id":"99644cb6-cd67-2a9f-64c5-a1cfd1a25d07","text":"Radiation therapy to treat cancers in pelvis or abdomen inevitably involves the exposure of normal tissues in the path of the beam of photons and the tissue surrounding the tumor. Radiotherapy for pelvic or abdominal cancers can injure the normal kidneys. Even with kidney‐sparing methods during radiotherapy for cervical cancer, the absorbed dose to the kidney can reach 10 Gy, a dose that can cause renal injury. , Information from studies on damage to normal tissues from radiation may be applied to other cancer therapies and to accidental or intentional radiation exposure.","title":"Irradiation of the kidneys causes pathologic remodeling in the nontargeted heart: A role for the immune system"}
{"_id":"9968fbc7-8105-60ea-690e-b541b0dd2c5c","text":"Pulmonary performance is another interesting result to underline. Postoperative chest pain is usually evaluated with the patient in a supine position in the absence of movement. Respiratory evaluation could be a way to evaluate parasternal block efficacy when the thorax is moving.","title":"Ultrasound Guided Parasternal Block for Perioperative Analgesia in Cardiac Surgery: A Prospective Study"}
{"_id":"99693d77-8fd2-1601-6ec1-4adb02ecc921","text":"There are 60 cases with the third degree burn of hand are selected who are treated after the skin grafting in the rehabilitation center treatment from May 2017 to November 2018. And there are equally divided into the control group and the observation group by the random digital table method. When the hand skin graft is fully alive, the control group is given conventional joint stretching and exercise therapy, and the observation group is additionally increased extracorporeal shock wave therapy. Then, the Jamar hydraulic meter is used to measure the grip strength after three weeks.","title":"Abstracts from the 12th Asia Pacific Burn Congress Singapore. 14-17 August 2019"}
{"_id":"9969bf7f-c5f5-3b16-04a7-993d1322f50c","text":"One patient with SBC fell down the stairs and refractured the bone 9 months after implant removal. We consider that this was an accident and not associated with implanted UDPHAp. The patient underwent internal fixation again, and could perform normal daily activity with stage 4 radiographic assessment at the final follow-up. Some studies reported that postoperative fracture occurred in the early postoperative period after bone grafting with HAp for benign bone tumors and recommended that full weight-bearing should be delayed for at least 3 months for patients with lower extremity tumors. To reinforce bone strength and avoid postoperative fractures, we generally use internal fixation in patients with preoperative pathological fractures or impending fractures due to cortical impairment of tumor extension. There were no fractures in the early postoperative period in this study.","title":"Radiographic and clinical assessment of unidirectional porous hydroxyapatite to treat benign bone tumors"}
{"_id":"996b0bc7-385c-7ae7-1fdc-83e1b4a8b6b3","text":"The cervical spine is complex, and surgical management of cervical disease remains a significant challenge. An understanding of cervical biomechanics as well as the normative data for cervical alignment is necessary to manage complex cervical pathology. To the best of our knowledge, this is the first study to systematically investigate the effect of the occipital orientation on the cervical spine. The results of our study demonstrated that the occipital orientation was significantly correlated with the cervical sagittal curvature. Accordingly, there was also a linear correlation between OI and cervical lordosis like that between PI and lumbar lordosis, which could serve as a guideline for the assessment of the sagittal alignment of the cervical spine and the reconstruction of lordosis during surgery. Furthermore, it is very important to remember that the spinal regions are not independent of one another. Cervical lordosis not only depends on both thoracic kyphosis and lumbar lordosis but also has a relationship with the occipital orientation. Cervical lordosis can be considered to be an adaptation by which the cervical spinal segment changes relative to the occipital orientation and the other spinal segments to attempt to maintain the head over the pelvis and maintain a horizontal gaze.","title":"Influence of the Occipital Orientation on Cervical Sagittal Alignment: A Prospective Radiographic Study on 335 Normal Subjects"}
{"_id":"996ea092-da60-77ac-5359-1e1bda6ab8a2","text":"The findings of our study are not similar but consistent with the foregoing publications. The complications of general anaesthesia after elective pediatric dermatologic operations were very low, as shown in a multicenter study that was conducted to evaluate the safety and adverse events of general anaesthesia which included 270 children between two months and eighteen years of age [2].","title":"Risk of General Anesthesia in Pediatric Skin Procedures with Projection on Tumescent Anesthesia"}
{"_id":"9976bc2c-1f6c-2256-7d5b-8371ab2b7659","text":"The identification of factors influencing the adherence to the recommended guidelines sheds light on clinicians’ practice and decision-making regarding excisional margins. Hopefully this data will promote correct surgical behavior in the future in order to achieve greater compliance with the guidelines.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"99841870-f25e-3782-f847-97f2d85d9eb7","text":"It is likely that women undergoing mastectomy as a second or third surgery, that is a completion mastectomy after BCS rendering positive margins, have a higher risk of POCs than those undergoing mastectomy as a first procedure. Here, women with more than one cancer-related breast surgery were excluded in order to provide a cleaner comparison of two surgical methods. It should thus be considered that the presented POC rates may neither be representative of BCS consisting of repeated surgeries nor for completion mastectomy after attempted BCS.","title":"Medical and surgical postoperative complications after breast conservation versus mastectomy in older women with breast cancer: Swedish population-based register study of 34 139 women"}
{"_id":"998bbd72-d9a1-4d53-0580-ace13060f690","text":"Allograft skin as a practical and effective adjunct to omental free flap for post-traumatic lower extremity reconstruction. It can facilitate the resolution of edema and prevent flap desiccation, allowing time demarcation of partial flap necrosis and confirmation of flap viability prior to definitive skin autograft. This is particularly useful for large surface area contaminated highly irregular traumatic lower extremity wounds.","title":"Allograft as an Adjunct for Free Omental Flaps for Lower Extremity Coverage of a Mangled Lower Extremity"}
{"_id":"9991a589-6b21-6307-eede-d858204b5585","text":"This study suggests that the financial relationship between newly independent physicians and industry developed in the early years of independent physician practice, with surgical specialty physicians and male physicians accepting higher industry payments.","title":"Trends in Industry Payments to Physicians in the First 6 Years After Graduate Medical Training Industry Payments to Physicians in the First 6 Years After Graduate Medical Training"}
{"_id":"99a50fa8-0098-eb7c-eae9-56fad191a5c6","text":"Each fellow has completed a one-month ultrasound rotation at our academic institution including more than 80 hours of ultrasound scanning time with experienced ED sonographers. Fellows have participated on average in over 190 hours of quality assurance and educational teleconferences with our local US division.","title":"A Novel Multimodal Approach to Point-of-Care Ultrasound Education in Low-Resource Settings"}
{"_id":"99a8bbc7-5438-7222-8e0b-979e43317e72","text":"Indocyanin green fluorescence is a potential valuable potential tool in the detection of SLN in patients with oropharyngeal cancer which warrants further investigation.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"99acebeb-f36c-c568-9098-d0c342561c05","text":"Chronic ICBG harvest site pain and discomfort is reported by a significant percentage of patients undergoing this procedure more than three years following surgery, and these complications are associated with worse patient-reported disability and somewhat worse physical health, but not with mental health. These findings suggest that morbidity associated with autologous ICBG harvesting for spinal surgery is clinically important and enduring. A significant negative impact is apparent even after controlling for persistent low back pain and extremity pain.","title":"Prospective evaluation of chronic pain associated with posterior autologous iliac crest bone graft harvest and its effect on postoperative outcome"}
{"_id":"99b1cb31-8a28-0e43-8179-51ad7a3f2772","text":"The differentiation in identity from a clinician to a leader offers a unique perspective of study that could greatly impact how we understand physician leadership. The challenge for healthcare organizations concerned with improving physician leadership goes beyond selection and development (Stoller, 2009), with a greater focus needed on how physicians understand and construe their roles as leaders. As a unique group of highly educated, professionals that place such a high value in their individual role as clinicians, the nature of physician leadership is shaped by how they embrace and understand their role as a leader. The findings of this study may also be applicable to other professional services leaders who are part time and\/or temporary, while they retain their professional role as an individual contributor.","title":"The affect of vision and compassion upon role factors in physician leadership"}
{"_id":"99b41df5-267a-b377-5603-aeb5cfc78092","text":"The basic principle in surgical release of ankylosis is the aggressive resection of the ankylotic mass. This technique is broadly termed gap arthroplasty and frequently employs the use of an interpositioning material to prevent recurrence.","title":"Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis"}
{"_id":"99b451ef-34bc-249a-c049-202f0db1093f","text":"Furthermore, the adhesive tapes and casts used and the lack of sufficient face washing can also lead to proliferation of propionibacterium acnes and acne vulgaris. After one month when the casts and tapes are removed and the face is more frequently washed, it is concurrent with the beginning of the reduction in acne incidence. It is noticeable that in patients presenting with acne, areas other than nasal skin such as the chest and back are also involved which opposes the hypothesis on the effect of the above mentioned factors.","title":"Post-Rhinoplasty Acne, Frequency and Role Players"}
{"_id":"99b48591-6936-1e85-ba68-ba02de7ece9e","text":"GRADE tables with full assessment of the individual comparisons are presented in Table 4. Overall the quality of evidence was very low to moderate due to imprecision, inconsistency and large effect.","title":"Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection A systematic review and meta-analysis"}
{"_id":"99b659de-64c1-73cb-dcdd-18e83198c234","text":"The limitations of the SIF include unwanted hair growth on the flap and the much more concerning potential for transfer of malignant upper neck nodes leading to recurrent cancer [1]. However, recurrence related to level I nodal seeding has not been our experience in over 80 regional transfers of this type. Patient selection is important: there is no increased risk of recurrence when the SIF is used in clinically node-negative patients [14]. We have used this flap in a number of patients with positive level I nodes, most of which were only identified with final pathology. A concerted effort is made to complete a thorough compartmental lymphadenectomy during flap harvest, and with this approach there have been no cases of disease recurrence. Our second case outlines a potential complication of combining the osteocutaneous SIF with adjuvant radiation therapy when the patient has previously received radiation to the same area. The loss of overlying soft tissue is detrimental to the bony component of the flap. Therefore, it is important to consider previous radiation exposure when assessing patients as candidates for the osteocutaneous SIF when adjuvant radiation treatment is anticipated.","title":"Composite submental flaps in facial reconstructive surgery involving the zygoma and orbit"}
{"_id":"99b8d426-4ab8-7cb8-455b-19ea46c509fa","text":"The major steps involved in our proposed algorithm are as follows:","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"99bbe981-c915-2b6c-9c74-360f594d3350","text":"It is recommended to repeat the injections no earlier than 3 months after the first injection, in order to avoid the development of neutralizing antibodies which would attempt against the efficacy of future injections. If after the first two injections there is no clinical or urodynamic response, physicians are advised against repeat injections.","title":"Pharmacotherapy in Pediatric Neurogenic Bladder Intravesical Botulinum Toxin Type A"}
{"_id":"99c7ad45-532a-cd5b-7d33-80d11ad00fb4","text":"The importance of leadership development in the early stages of careers in the NHS has been highlighted in recent years and many programmes have been implemented which seek to develop leadership skills in healthcare professionals. The Improving Global Health (IGH) Fellowship scheme is one such programme, it provides a unique leadership development opportunity through an overseas placement with a focus on quality improvement work. This evaluation examines the impact of completing an IGH Fellowship on the career and leadership development of participants, who are referred to as Fellows.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"99ed4b44-62aa-e323-bd35-3376251dca78","text":"The results of the studies included in this review are limited by the relatively small number of patients sampled for the studies, allowing only qualitative analysis. Within the limitations of this study are the small groups of patients with various types of implants, the limited number of adequate studies and the fact that patients who were qualified for nose reconstruction had undergone oncological operations of various scope, which significantly affected later possibilities of choosing the implantation site and, thus, the prognosis as to the maintenance of implants. This is similar to our patient, for whom the scope of the operation was so extensive that we were not able to place the third implant properly.","title":"The Latest Craniofacial Reconstructive Techniques Using Anchored Implants after Surgical Treatment of Nasal and Paranasal Sinuses Tumors"}
{"_id":"99ee602b-936a-cd06-a60d-64085085e87a","text":"A review of 47 patients who underwent 51 free flaps to reconstruct orbital or periorbital defects between September 2006 and May 2011 was performed at our tertiary care facility. Thirty-five patients were male and 12 were female. The average age at the time of surgery was 65. The majority of the resections were completed for invasive cutaneous malignancies. The spectrum of pathology encountered in the series is outlined in Table 1.","title":"Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction"}
{"_id":"99ee70ac-3d50-45b8-3838-0fad1f6cad6a","text":"The first stage of the protocol was the data collection of the clinical history and the second stage of the protocol included an anatomical and functional evaluation.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"99f23d5a-2a9d-6903-adfb-a9efd501d188","text":"There are no quantitative data reported on the extrusion force profile. While this aspect is linked to practice, it would be useful to produce quantitative data to better understand the optimum force profile required to extrude a given filler from the syringe in an even and smooth manner.","title":"Evaluating hyaluronic acid dermal fillers: A critique of current characterization methods"}
{"_id":"99fbb493-1f9b-b488-31b1-335bb319dc1e","text":"Leaving the lateral motor nerves intact certainly plays a role in the avoidance of severe deformation of the abdominal rectus muscle and major complications such as hernia or swelling.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"9a0bfa79-78ae-a6fe-a6a1-974793adbc5a","text":"In the reported case, the authors performed gap arthroplasty and intraoral distraction as a one-stage treatment, followed by mandibular contouring surgery and prosthetic treatment for unilateral TMJ ankylosis with facial asymmetry. The results demonstrate that stable outcomes after concomitant gap arthroplasty and distraction can be ensured by maintaining the occlusion with a splint until prosthetic treatment.","title":"Simultaneous gap arthroplasty and intraoral distraction and secondary contouring surgery for unilateral temporomandibular joint ankylosis"}
{"_id":"9a384547-ac6c-4d33-7947-a9184e2893fa","text":"This patient later on went on to have multiple surgical procedures such as spinal instrumentation, open reduction and fixation with plating for right syndesmotic ankle fracture and external fixation for right lower leg both bone fracture. He was then followed for 8 weeks in the out-patient department following discharge during which he recovered well without any neurovascular deficit.","title":"Prone Positioning for Management of Fat Embolism Syndrome in a Patient with Spine Fracture; An Unusual Scenario and Review of Literature"}
{"_id":"9a3ba60f-2a4d-fc38-2e8b-cc0314fdd149","text":"As with the measures of functional abilities, the same informal caregiver was interviewed by the assessor who filled in the scales.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"9a3d5f9c-b3c9-dcc7-8c00-9c48a74a536a","text":"Postoperatively, the patient is instructed to strictly elevate the foot. The splint is typically changed on the second postoperative day. We schedule follow-up in clinic 2 weeks after surgery for removal of skin sutures, and the patient is then placed in a below knee plaster cast. Patients will typically remain nonweight bearing for 6 weeks after surgery, and then begin progressive weight bearing in either a walking cast or CAM walker boot until fully weight bearing and with evidence of bony union.","title":"Use of the SIGN IM nail system to stabilize tibiotalocalcaneal arthrodesis in two African hospital settings"}
{"_id":"9a3e45f4-5163-4e8f-fe14-96b565919914","text":"We can assume that the preoperative US of the regional lymph node not only spares some patients from undergoing a SNB procedure, but because of its higher sensitivity in comparison to palpation, it should also reflect in the smaller amount of the tumour burden detected in regional lymph nodes and, as such, also in the patient’s survival. A previous study conducted by Zgajnar and colleagues from our institute revealed that patients with early breast cancer and US uninvolved axillary lymph nodes have a significantly lower tumour burden in the axillary lymph nodes compared to those with only clinically uninvolved lymph nodes.28 However, to the best of our knowledge, this is the first study investigating the impact of a preoperative US examination of regional lymph nodes on the amount of the detected tumour burden in regional lymph nodes in clinically node negative melanoma patients.","title":"Lower tumour burden and better overall survival in melanoma patients with regional lymph node metastases and negative preoperative ultrasound"}
{"_id":"9a44c6ef-cb9b-4453-334e-e6e95a055beb","text":"The adequacy of surgery appears to be the most important milestone in the therapeutic approach of melanoma. Even if surgery is fundamental in the different stages of the disease, there is quite a variability concerning the extension of the surgical treatment related to primary and lymphnodal disease. Phase III randomised trials have shown that wide margins, elective lymph node dissections, and prophylactic isolated limb perfusions have not improved survival and cannot be considered the standard of care in the routine management of primary melanoma. The surgical subgroup of the EORTC Melanoma Group is developing a new version of the surgical survey questionnaire including new treatment modalities like isolated limb infusion and electrochemotherapy, which were not frequently in use some years ago, to obtain new data to be compared to the nearly ten-year-old data.","title":"Surgical management of melanoma: an EORTC Melanoma Group survey"}
{"_id":"9a518691-58d3-6685-ffab-14275ace41a1","text":"In lethal primary metastatic prostate cancer, biopsy material is often the only accessible cancer tissue. Lack of tissue quantity limited the use of biopsy cores for analyzing higher numbers of molecular markers and standard histopathologic evaluation for clinical diagnosis simultaneously. Recent advances in single cell analytics have paved the way to characterize a tumor in more depth from minute input material such as biopsies. We therefore aimed to develop a biopsy needle, which generates two cores side by side from the same punch: one for standard histopathologic analysis to allow for routine diagnostics and the second one for single cell analytics.","title":"Single punch, double biopsy"}
{"_id":"9a546e2a-5aa3-7cd5-34ed-57451e55e800","text":"Increased IAP may lead to increased venous stasis thus causing deep vein thrombosis especially when surgery is prolonged,11 so deep vein thrombosis prophylaxis should be done in such patients.","title":"Challenges in Paediatric Laparoscopic Surgeries"}
{"_id":"9a5506b6-c464-e4ed-e767-19ec79d83c25","text":"Compared with the placement of a paravertebral block alone, combining blocks targeting the pectoral musculature with a paravertebral block for modified radical mastectomy reduced the sedative and analgesic requirements during operation and provided more effective postoperative analgesia.","title":"Paravertebral Block Plus Thoracic Wall Block versus Paravertebral Block Alone for Analgesia of Modified Radical Mastectomy: A Retrospective Cohort Study"}
{"_id":"9a5635b2-a000-a035-c3b0-bb6ef24161df","text":"Hematoma and infection that are the main reasons for the rejection were similar in both groups.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"9a587b4c-28cb-6acf-bcd5-f9940f0214a4","text":"Although a less potent sensory blockade was provided by SCBPB compared with ISBPB, a better motor blockade profile and lower incidence of Horner's syndrome might be obtained when using SCBPB. Despite the discrepancies in the sensory blockade assessment in the early postblock period, neither of the 2 brachial plexus blocks required conversion to general anesthesia due to inadequate sensory anesthesia. In addition, the patients receiving either SCBPB or ISBPB required opioid analgesics with a comparable frequency and benefited from similar surgical anesthesia and postoperative analgesia. In conclusion, SCBPB can be performed as an alternative to ISBPB in patients undergoing arthroscopic shoulder surgery.","title":"Comparison Between Ultrasound-Guided Supraclavicular and Interscalene Brachial Plexus Blocks in Patients Undergoing Arthroscopic Shoulder Surgery A Prospective, Randomized, Parallel Study"}
{"_id":"9a5b0f38-5e4f-fb5c-ccde-4ad474b61ae1","text":"Our study has both strengths and weaknesses. To our knowledge, ours is the first study to investigate the association of CLL and second cancers in the Australian population. This study was based on the Australian Cancer Database records of all cases of cancer in Australia since 1982 and information available on vital status of these patients by linkage with the National Death Index. The large dataset enabled us to analyse site-specific risk of second cancers following CLL, as well as to describe age and latency patterns for second cancer risk. We were able to adjust the SIRs for decade of diagnosis, which may be a potential confounding factor.","title":"Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study"}
{"_id":"9a5b55f8-4a7c-2a8b-5ba8-75aa30ccb5c6","text":"A limitation of our study is the inability to correlate the different mutations with clinical features due to the limited number of patients considered.","title":"Human microRNA expression in sporadic and FAP-associated desmoid tumors and correlation with beta-catenin mutations"}
{"_id":"9a5b670e-8a28-2495-1e4a-3980b3434ae3","text":"A multitude of different diseases—benign and malign—can require surgery of the liver. The liver is an especially challenging organ for resection planning due to its unique and interindividually variable anatomy. This demands a high amount of mental imagination from the surgeon in order to plan accordingly - a skill, which takes years of training to acquire and which is difficult to teach. Since the volume of the functional remnant liver is of great importance, parenchyma sparing resections are favoured. 3D reconstructions of computed tomography imaging enable a more precise understanding of anatomy and facilitate resection planning. The modality of presentation of these 3D models ranges from 2D monitors to 3D prints and virtual reality applications.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"9a5f2881-c13f-bd57-c662-2185d2368b1f","text":"To the best of our knowledge, this research is the earlier systematic description of DVT in patients with ARDS and of distinct associations among clinical characteristics and DVT in patients with direct and indirect ARDS.","title":"Prevalence, risk, and outcome of deep vein thrombosis in acute respiratory distress syndrome"}
{"_id":"9a600258-1f01-2820-7ca6-6602e0257a3a","text":"The patient was prescribed the use of Brava for four weeks prior to autologous fat transplantation: 10 hours a day for the first 3 weeks, and 22 hours a day in the week prior to operation. It was possible for the patient to use the Brava system also at work. The patient was supplied with the prescribed skin care products for use with the Brava system. Autologous fat transplantation was performed a total of 7 times over a period of 19 months. Fat transplantation volumes ranged between 30 cc and 200 cc and total transplanted fat was 957 cc. A Khouris 3 mm extraction cannula connected to a 10 cc syringe was used to harvest fat. The harvested fat was then centrifuged at 1200 rpm and the supernatant oil was removed. The prepared adipose tissue was then injected subcutaneously and into the pectoral muscle using a Coleman type 2 cannula on a 3 or 10 cc syringe. Scar tissue was subjected to rigottomy with 3 dimensional micromeshing using a 12- to 18-gauge needle. Brava therapy was resumed 8 weeks after each of the fat transfers. Furthermore, in conjunction with the aforementioned 7 autologous fat transplantations, the patient also underwent mastopexy and excision of a suture granuloma of the left breast and z-plasty of the mastectomy scar of the right breast.","title":"Delayed Total Breast Reconstruction with Brava"}
{"_id":"9a62fe78-82da-cd80-5f29-183bdb8f5ef1","text":"Injectable autologous material that can be used beneath the nasal skin envelope will be very helpful to approach ideal surgical results. Autologous cartilage is the most frequent graft material in rhinoplasty and numerous studies have evaluated the long term viability of different forms of this valuable graft in rhinoplasty. Considering the consistency and shape of the cartilage that is highly dependent to the location of harvesting, multiple manipulations have been proposed to make it more malleable and advantageous for the purpose of camouflage. Crushed cartilage, minced cartilage and diced cartilage with or without wrapping in fascia are the most popular examples.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"9a64679d-ded1-3513-e640-86447da79dfc","text":"The results were quite positive, as the female population generally participated freely, and there were only difficulties in the second evaluation phase due to the incompatibility of schedules and the fact that it was necessary to wait 3 months after the first evaluation.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"9a656dfa-c8c8-2b1d-6bf7-1aa00659e291","text":"Forty-two patients with scalp malignancies were enrolled in this study. Tumors were resected to a 1 cm negative margin and defects were reconstructed according to their size and to patient general condition.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"9a79268e-b9dc-5900-ed43-3f76edb81002","text":"We have evaluated simpler and perhaps cheaper alternatives, but have found this one most effective. Although a traction pin or elongated cement spacer are options, this technique infers stability due to the intramedullary nail having been designed for load bearing and the distal locking screws preventing rotation.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"9a79e1a5-defe-4916-0e90-e216b235b5cc","text":"However, the College did comment that it would have been prudent for the physician to obtain new written consent for the patient when she returned from her 2-year absence, as well as being informative for the patient. The College stated its expectation that physicians should obtain patient consent for each procedure, a process which includes a discussion with the patient of the risks and benefits of the procedure and documentation of that discussion in the medical record.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"9a840e71-3f89-f27c-699f-6546bf95e571","text":"An important note is that in contrast to SLA and FDM, which most often require support structures to print overhangs in objects, SLS does not need supports because the surrounding powder supports the unconnected parts; this allows for printing of previously impossible geometries. In SLA and FDM supports are essential because of the time required for the thermoplastic material to harden and thus for the bonding of the layers.8–10","title":"Printing the Future—Updates in 3D Printing for Surgical Applications"}
{"_id":"9a85d700-b264-d0fd-c341-cc9ce3e6b152","text":"Patient adherence and physician compliance with ePRO completion and views. The curve for patients indicates the percentage of questionnaires completed for patients still receiving treatment. The curve for physicians indicates the percentage of physicians viewing a completed questionnaire in relation to an out-patient visit","title":"Electronic reporting of patient-reported outcomes in a fragile and comorbid population during cancer therapy – a feasibility study"}
{"_id":"9a867a41-3a5e-b320-b913-fe70f66877ef","text":"The use of autologous bone graft primarily at the docking site in cases of acute shortening hastens docking site consolidation in comparison to docking site treatment with compression alone.","title":"Role of Primary Autologous Bone Graft at Docking Site in the Treatment of Infected Non-union Tibia Using Rail Fixation System"}
{"_id":"9a869c3a-d678-5355-d51c-3865389d998c","text":"The technique adopted allowed an immediate reconstruction limiting the discomfort to the patient with few dressings and complete healing in about 1 month. Scalp, the graft is completely rooted in 3 month.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"9a8cb42e-b744-d879-9e3b-3d1b07af166b","text":"There was more new bony callus in the bone defect in group C than in other groups by gross observation and X-ray radiography at 2 and 4 weeks. The Micro-CT results showed more new bony callus, bone trabecula and higher bone mineral density in group C. Fluorescent labeling results showed the speed of new bone formation in Group C was faster than that in other groups, among which the control group had the slowest speed of new bone formation. The result of histology had shown that the trabeculae in bone callus in group C had a regular form, the trabeculae were wide and had a more become osteoblast around them.","title":"Effects of different intensities of intermittent pneumatic soft-tissue compression on bone defect repair"}
{"_id":"9a922f07-d837-b001-2b6e-be30d7ddc0ee","text":"Infants who fail their OAEs must be examined by an ENT physician. It is necessary that the examiner have experience with infants because of the difficulty in assessing their tympanic membranes, having in mind the narrowness of the external ear canal.","title":"The influence of the type of breastfeeding on middle ear conditions in infants"}
{"_id":"9aa75ad5-7d3d-72d2-a7f8-b771631c71e3","text":"In conclusion, this study confirms that CMA is not always associated with hypersensitivity to beef. We found that diet supplementation with yogurt reduces the allergenicity of milk, but does not reduce the risk of cross-reactivity between milk proteins and BSA. The present model may be useful for understanding the mechanisms underlying allergic reaction and developing new products to prevent food hypersensitivity, as well as to gain a deeper understanding of the correlation between humoral and cellular responses. Our results show that it is possible to silence the immune response by administering modified by fermentation allergenic proteins, with weak antigenic potential. Our in vitro results suggest that early exposure to BSA could also change immune system response to milk allergens, but this need more study. To fully characterize the mechanism of cross-reactivity between milk proteins and BSA, a variety of milk proteins should be studied in the future. Further, future studies should focus on the possibility of immune response induction by adoptive transfer of sensitized lymphocytes.","title":"Milk and Meat Allergens from Bos taurus β-Lactoglobulin, α-Casein, and Bovine Serum Albumin: An In-Vivo Study of the Immune Response in Mice"}
{"_id":"9aaef902-25eb-1847-f933-7e0762020c46","text":"One notable risk for patients with cervical myelopathy is the development of myelopathic symptoms secondary to minor trauma, particularly with neck hyperextension. There is a paucity of literature assessing the true prevalence of spinal cord injury from minor trauma in these patients, but it remains a concern for care providers nonetheless.","title":"Degenerative Cervical Myelopathy: Clinical Presentation, Assessment, and Natural History"}
{"_id":"9ab1f7d2-7468-5de5-8ee2-9ff716350b78","text":"Due to the broad spectrum and challenging nature of microsurgery, there is an eminent need for a structured concept of microsurgical education and skills-training. We present a successful curriculum that has been carried out by our Department of Surgery over two decades. Our department has been developing clearly defined teaching concepts for many years. A properly funded education benefits trainees as well as hospitals and university departments. The established methods can be continuously used and reproduced with the highest level of quality assurance.","title":"Microsurgical training course for clinicians and scientists: a 10-year experience at the Münster University Hospital"}
{"_id":"9ab53fef-4a9b-565f-a378-a1357073bb70","text":"Here, we report a case of severe soft tissue atrophy that appeared along with scar formation after mandibular reconstruction through the fibular free flap procedure. This led to normal occlusion collapse after it was established, and the midline of the mandible became severely deviated to the affected side that was replaced with the fibula free flap, leading to facial asymmetry. We corrected the malocclusion with a secondary operation: a sagittal split ramus osteotomy on the unaffected side and a sliding osteotomy on the previous fibula graft. After a healing time of 3 months, implants were placed on the fibula graft for additional occlusal stability.","title":"Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction"}
{"_id":"9abbf0ad-eab3-5291-afd9-3fe35a89c507","text":"There were 3 complications in our series. Two patients with left UCLP experienced L-shaped cartilage graft displacement that required revision surgery. Both cases involved the displacement of the proximal part of the dorsal onlay component due to exceedingly large dorsal nasal pocket. One patient with BCLP had minor wound dehiscence over the columella. The wound dehiscence settled uneventfully with conservative management.","title":"Augmentation Rhinoplasty in Cleft Lip Nasal Deformity: Preliminary Patients' Perspective"}
{"_id":"9ace58a1-40ab-9348-dace-cb2239e8bf2d","text":"We agree with Delay et al. that subtotal division of the LD tendon leaving a small muscle bridge to protect the pedicle would be a reasonable alternative. This may help to minimize the bulk while still offering some protection to the pedicle. This technique should lead to only a temporary bulge which improves considerably with time as it is expected that a degree of muscle disuse atrophy will occur to some extent despite keeping the thoracodorsal nerve intact.[12]","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"9ad3d87a-fb7d-245e-644b-6afa925f1327","text":"Complications following cosmetic procedures seem to be less acceptable for both the patient and the surgeon. On the other hand, patients who are a candidate for undergoing elective cosmetic surgeries may be more sensitive about their body appearance. The initial objective of this study was to evaluate the incidence and characteristics of post-rhinoplasty acne besides identifying its underlying risk factors. The most important clinically relevant finding was a significant correlation between the incidence of acne and the anxiety, depression and stress levels.","title":"Post-Rhinoplasty Acne, Frequency and Role Players"}
{"_id":"9ad73d3b-ae0e-e214-616c-22bd11927df8","text":"We report our experience with the use of Botulinum toxin injection in 38 patients (64 injections) with severe dysthyroid strabismus. Three quarters of the injections led to a decrease in the angle of the squint by a mean 75% of the initial deviation. The average duration of effect was two months. Twenty six patients went on to surgery after stabilisation of their squint and endocrine status. Six patients achieved a stable long-term result with Botulinum toxin only. We suggest these results of treatment of early dysthyroid myopathy are more consistent with the characteristics of inflammatory spasm than contracture. The value of Botulinum toxin as a temporary means of maintaining binocularity in these young patients is discussed.","title":"Botulinum toxin therapy in dysthyroid strabismus"}
{"_id":"9ae06c0b-2530-4946-513f-d6fcbff63c3d","text":"It is crucial that dermatologists adopt safe practices in aesthetic dermatology and this article highlights the do's and dont's of filler practice to ensure successful outcomes for the patient and the physician.","title":"Dermal Fillers: Do's and Dont's"}
{"_id":"9ae12ad8-e006-6a4f-150e-ce01bfc494a2","text":"Within the limitations of this study, it can be concluded that flapless implant surgery results in lesser loss of marginal bone and also results in better patient comfort; however, proper patient selection and technique is essential for a successful flapless implant surgery.","title":"Clinical Evaluation of Placement of Implant by Flapless Technique Over Conventional Flap Technique"}
{"_id":"9ae256da-1053-fc04-d76a-5167ec3df665","text":"As central hubs for the induction of adaptive immunity, individual LNs process lymph containing local information from the tissues that drains via collecting lymphatic vessels from proximal tissues and organs. The human body contains an estimated 500 to 600 LNs that are surrounded by dense connective tissue and associated with particular nerves, lymphatic vessels, and blood vessels, with many of these LNs presenting in concentrated clusters found in specific anatomical locations.","title":"Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions"}
{"_id":"9ae4b6d9-699e-b3c3-3e75-64595773e999","text":"Looking for an appropriate skin substitute for temporary and permanent coverage of wounds remains one of the main obstacles of medical researchers.","title":"Human Split-Thickness Skin Allograft from Brain-Dead Donors"}
{"_id":"9ae7cbad-473d-5811-70ec-ba6f7263715d","text":"For the successful reconstruction of facial defects, various perforator flaps have been used in single-stage surgery, where tissues are moved to adjacent defect sites. Our group successfully performed perforator flap surgery on 17 patients with small to moderate facial defects that affected the functional and aesthetic features of their faces. Of four complicated cases, three developed venous congestion, which resolved in the subacute postoperative period, and one patient with partial necrosis underwent minor revision. We reviewed the literature on freestyle perforator flaps for facial defect reconstruction and focused on English articles published in the last five years. With the advance of knowledge regarding the vascular anatomy of pedicled perforator flaps in the face, we found that some perforator flaps can improve functional and aesthetic reconstruction for the facial defects. We suggest that freestyle facial perforator flaps can serve as alternative, safe, and versatile treatment modalities for covering small to moderate facial defects.","title":"Freestyle Local Perforator Flaps for Facial Reconstruction"}
{"_id":"9aecb8fd-22e4-f36e-13ed-97eda15a5fb6","text":"Planar lymphoscintigraphy and CrystalCam show a perfect agreement for the localized SLN in the head and neck region as illustrated in Table 5. This is mostly due to the increased flexibility in handling CrystalCam in this region. CrystalCam could easily be held at different angles and distances from the skin surface. The two SLNs missed by both planar imaging and CrystalCam may be due to superimposed SLNs which are difficult to differentiate using 2D imaging modalities.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"9aeecd40-5be3-dff7-134e-7b5c679db623","text":"Cementation using methylmethacrylate has shown encouraging results6 [Figure 1]. It is postulated that the exothermic reaction of methylmethacrylate generates local hyperthermia which induces necrosis of any remaining neoplastic tissue, yet it does not extend to the normal tissues to result in local complications.7 In theory, the possibility that the polymerization of methylmethacrylate may produce a local chemical cytotoxic effect cannot be excluded. Cytotoxic agents like methotrexate and adriamycin have been incorporated in bone cement and other drug delivery systems in an attempt to reduce recurrence.89 Even pathological fractures through a giant cell tumor are not a contraindication to treatment by curettage and cementation.1011 Cryosurgery using liquid nitrogen first propagated by Marcove, though used in some centers, is associated with a high incidence of local wound and bone complications.1213","title":"Treatment of giant cell tumor of bone: Current concepts"}
{"_id":"9afac106-17fe-9738-73e7-81228936c2ac","text":"The figure shows the mean cost for the uncomplicated cases in the first column, comparing it to those requiring further surgery. It is evident that unplanned surgery increases the overall cost of the encounter and that each operation increases the overall cost more.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"9afb186c-ad11-aabb-81a2-b29caa0a12b7","text":"This is an important issue to be considered because introduces the concept that splanchnic tamponade due to venous congestion is not necessarily caused by fluid overload but may be due to other conditions affecting vascular compliance such as abdominal hypertension or abdominal compartment syndrome, leading to the development of the new concept of “dry” splanchnic tamponade.","title":"Perioperative Renal Ultrasonography of Arterio-to-Venous Coupling Predicts Postoperative Complications after Major Laparoscopic Urologic Surgery"}
{"_id":"9b00526f-b086-8504-6183-c79e693c1772","text":"The results must be viewed in the current context of the dire breastfeeding rates in the UK, where only 23% of infants are exclusively breastfed at six weeks, with this figure dropping to 1% at six months. Within this study of dyads attending the IBC, breastfeeding was sustained at a far higher rate, providing support for the role of combined chiropractic and midwifery care for the problems of breastfeeding. Improving maternal experience of feeding is also an important factor in sustained breastfeeding. Whilst the design of this study does not allow these outcomes to be directly attributed to the intervention provided in the IBC, and it should be noted that mothers in this population were generally highly motivated, these results were positive and encourage further investigation. Additional study comparing mother-infant dyads attending the IBC with routine care would be beneficial to better understand the effect of this clinic.","title":"ECU convention 2017 research presentations Limassol, Cyprus. 25-27 May 2017"}
{"_id":"9b020281-ecaf-00a9-76d5-cd3c0b14e0e8","text":"The finding that similar levels of dissatisfaction with the shape of the nose in profile and in photographs was reported in a study conducted in Norway and one conducted in Lebanon may suggest that concerns about the appearance of the nose are not limited to a specific cultural or ethnic group. It is possible that there are universal aesthetic standards for the appearance of the nose that are commonly held across different cultures and populations. Additionally, it could be that social media and the widespread access to images of people from all around the world have increased exposure to different facial features and have led to the development of similar aesthetic preferences. Another possibility is that there may be cultural and societal factors in our country that contribute to a heightened focus on the appearance of the nose. It could be that the culture places a high value on physical appearance, and this emphasis on appearance leads to a higher level of dissatisfaction with the shape of the nose. Additionally, it could be that there are specific cultural or societal pressures in our country that lead people to be more self-conscious about the appearance of their noses.","title":"Ethnic Rhinoplasty: A Middle East-Centered Patient Satisfaction Survey Using the FACE-Q Questionnaire"}
{"_id":"9b18c8fa-34b3-b1ab-dca6-b1d4e0e852c3","text":"In cases where the tumor infiltrated bone or other cavities or was far from the needle to be injected, the intralesional synergistic combination of IFNs application was combined with its intramuscular application and combined with 1 cycle chemotherapy every 21 days (overall 4 cycles).","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"9b21b92e-3157-602e-4ba6-e8b263474ac5","text":"Numerous year-long research fellowships are available for applicants who wish to improve their chances of matching into an orthopaedic surgery residency. Research fellowships provide applicants with an opportunity to gain invaluable research skills, present at conferences, and build connections with orthopaedic faculty. The information provided by this study may serve as a resource for medical students interested in pursuing an orthopaedic research fellowship to help strengthen their residency application. Future studies should track graduates of research fellowship programs, determine their level of satisfaction with the fellowship experience, and determine whether they successfully matched into orthopaedic surgery.","title":"Gap Year Research Fellowship Opportunities for Medical Students Interested in Orthopaedic Surgery"}
{"_id":"9b2ca090-652e-f86a-2e76-7300db49a8d7","text":"The 5-year survival rate for patients with breast cancer, in whom disease has spread to local lymph nodes, is 85%. However, many live with the complications of surgery to remove the lymph nodes in the armpit thus impacting their quality of life. In recent years, new approaches have been developed to minimise surgery and reduce complications. The aim of this systematic review was to assess the feasibility and accuracy of two minimally invasive surgical procedures, Marked Lymph Node Biopsy and Targeted Axillary Dissection as an alternative to complete removal of the axillary lymph nodes after upfront chemotherapy in patients in whom cancer spread to the regional lymph nodes. Our findings confirm that these procedures can safely replace more radical surgery in women who have responded well to upfront drug treatment. Therefore, although further research to determine long-term outcomes is required, this review concludes that it is reasonable to offer such patients the option of less invasive surgery thus avoiding over treatment and enhancing quality of life.","title":"The Evolving Role of Marked Lymph Node Biopsy (MLNB) and Targeted Axillary Dissection (TAD) after Neoadjuvant Chemotherapy (NACT) for Node-Positive Breast Cancer: Systematic Review and Pooled Analysis"}
{"_id":"9b3379fc-759d-9a52-9ee4-b9c69abaa3cb","text":"Pedicled versus Free We advocate a low threshold for using free flaps in the lower limb. The availability of local tissues, particularly in the middle and distal thirds of a tibia, is limited and locally compromised soft tissues are often inappropriate for locoregional transfer. Pedicled flaps in the lower extremity are associated with an unacceptably high partial or total failure rate, particularly in patients with multiple comorbidities such as diabetes mellitus, venous insufficiency, and peripheral arterial disease.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"9b36581e-b73b-9fe7-1d13-034987302922","text":"Statistical difference in the detection time was observed between autologous tissue and implant group. On the other hand, there is no difference in recurrence tumor size or survival time. A further study is necessary to identify the different detection time of local recurrence.","title":"Is There a Difference in the Diagnosis and Prognosis of Local Recurrence between Autologous Tissue and Implant-Based Breast Reconstruction?"}
{"_id":"9b45b69f-525f-a61a-102e-f4f27b9e7125","text":"The lymph drainage pattern was noted and sentinel node or nodes were marked and sent separately for sentinel node pathological examination.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"9b478ab0-97fb-faf8-ef8c-38c0739b259e","text":"VTE is a common problem in patients with brain cancer and has a significant negative impact on this population. The use of prophylactic anticoagulation in the outpatient setting is not recommended. Brain cancer surgery is a high risk for thromboembolism; therefore, a combination of both pharmacologic and mechanical prophylaxis is recommended perioperatively. Therapeutic anticoagulation is safe and effective in this population is. Strong evidence for the utilization of a vena cava filter in this population is lacking.","title":"Venous Thromboembolism in Patients With Brain Cancer: Focus on Prophylaxis and Management"}
{"_id":"9b480780-bef6-3702-42a5-5cc3bc5faecb","text":"Since 1972, researchers and doctors have studied the anatomy and functionality of the groin flap, which has been proven to be dependable as a pedicle or free flap for tissue coverage of the forearm and hand, seeing how quick and easy its harvest is and its reliable blood supply.","title":"Versatility of unilateral propeller groin flap for coverage of large scrotal defects and its impact on testicular function"}
{"_id":"9b4964a0-013a-6dd9-cb8b-959710f163b7","text":"Despite this, it has not been possible to determine which type of laser source has the best clinical results. Consistent randomized controlled trials are necessary to compare the benefits and drawbacks of the various surgical laser devices currently available.","title":"Laser Surgical Approach of Upper Labial Frenulum: A Systematic Review"}
{"_id":"9b4c0929-0e38-9932-98a2-2ccb4c35d94d","text":"The thoracodorsal artery and vein course along the thoracic wall on the undersurface of the latissimus muscle. Overall, the extramuscular pedicle length varies between 6 and 16 cm and is about 9 cm on average.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"9b4e0f9a-6584-b43b-4089-2685dd30b4ae","text":"Some key informants emphasised the importance of considering patient preferences and acknowledging that these may differ from those of the clinician, especially if the clinician holds strong views on the role of SN biopsy in melanoma management (Patient Factors: Patient Preferences). There was an increasing sense that patients diagnosed with melanoma had a right to be staged as accurately as possible.","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"9b4ea85f-72dd-8ffc-f69b-284901a38d5b","text":"As the literature has evolved, academics have become more interested in leadership as a process rather than a defined set of traits or skills. Such models include those of Tannenbaum and Schmidt's13 where leadership is classified according to the different styles of behaviour that are observed. In the 1980s, this taxonomy was used to distinguish leaders from managers; leaders being seen as those who do the right thing, compared to managers who do things right.1 Leadership in this manner was seen as a process of influencing others12 in the context of a relationship. This idea gained ground in the 1990s as tall hierarchical managerial structures within organisations were replaced with flatter networks. As such, leadership became important for specific time limited tasks or projects and so became more dispersed and less associated with a defined role in an organisation.12,14 This led to the development of contingency theories,15 which advocated that leaders need to adapt and change their behaviour according to their environment.","title":"What is clinical leadership and why might it be important in dentistry?"}
{"_id":"9b5ce495-1794-f4aa-234e-f7d5759632c2","text":"Our case series demonstrates potential benefits and indications for 3D printing in veterinary oral and maxillofacial surgery by improving the diagnosis and treatment of pathology through more accurate preoperative planning. Veterinary medicine faces a unique challenge where canine skull shape can range from brachycephalic with short and wide cranial proportions as seen in breeds such as English bulldog in Case 1 and Boston terrier in Case 2 to mesaticephalic with medium muzzle length and intermediate cranial proportions in breeds such as Labrador retriever in Case 3, and dolichocephalic with long and narrow cranial proportions and long muzzle [10]. Our 3D printed skull in Case 1 with maxillary osteosarcoma enhanced both the surgeon’s and pet owner’s understanding of the tumor extent leading to the augmentation of treatment plan from curative intent surgery with wide margin to conservative margin with postoperative radiation therapy in order to reduce the potential high risk of morbidity with wide margin. Traditional 2D images of CT or CBCT can be challenging for pet owners to interpret; allowing the owners to see and physically manipulate the 3D model of their pet facilitated comprehension of the surgical complexity, possible complications, and enriched the informed consent process resulting in proceeding with the conservative margin surgery followed by radiation therapy as in Case 1.","title":"3D printing for surgical planning of canine oral and maxillofacial surgeries"}
{"_id":"9b671ae6-6876-355c-7aec-0bd2268f8242","text":"With the recent breakthrough in melanoma treatment and availability of multiple effective agents, the choice of agent or agents and the timing of treatment sequence would be crucial for successful outcome in designing a neoadjuvant treatment for metastatic melanoma. While targeted therapy such as BRAF and MEK inhibitors can effect early shrinkage of tumor bulk increasing the resectability of target lesions, the durability of response with this class of treatment has not been uniformly reported and may not have significant impact on overall survival. Conversely, immune checkpoint therapy can confer a durable disease control but tumor shrinkage is protracted several months and responses in multiple lesions may not be uniform, i.e. progression in some lesions and regression in others. Identification of optimal patient population and optimal combination for neoadjuvant approach and the concurrent biomarker studies would further advance our treatment of metastatic melanoma patients. With limited data available in the neoadjuvant treatment of melanoma with these new agents, we are eagerly awaiting the results of the University of Pittsburgh trial of ipilimumab in the stage IV setting.","title":"Neoadjuvant treatment of melanoma: case reports and review"}
{"_id":"9b7a2a23-8c52-3282-9c07-d83231fd54ac","text":"Finally, our patients were evaluated taking into account the contraindications of treatments. The efficacy and tolerability were the same in both groups as estimated by the patient and the observer. As with any minimally invasive technique, both BTA and PNE were well tolerated, with no significant contraindications. No side effects were detected with BTA, while four cases of self-limited pain and bruising at the puncture site were reported in the PNE group. In our experience, it is useful and convenient to localize the affected muscles by EMG, so in this study we used needle electrodes that allow BTA injection at the same time. Multipoint injection achieves more uniform contact between BTA and the innervated muscle areas, which is especially advantageous when infiltrating larger muscles. It is important to bear in mind that local diffusion of BTA may depend on the volume and dose administered and that large volumes may impair the integrity of the muscle fascia, so this is another aspect we have taken into account to minimize side effects in our study. It is generally accepted that low doses of botulinum toxin should be administered to limit the associated adverse effects [7].","title":"Botulinum Toxin and Percutaneous Needle Electrolysis for the Treatment of Chronic Masticatory Myalgia"}
{"_id":"9b7ae61d-5bae-a577-1128-89b1a644bbde","text":"The injured upper limb on many occasions necessitates cover with a full thickness flap from a distant region. Even in the modern era of micro-vascular surgery, pedicled distant flaps still have a place in the soft tissue reconstruction of the hand and forearm. In the past, the abdominal skin was used based on sub-dermal random blood supply, and the flap size was restricted by the length to breadth ratio. The description of the axial groin flap revolutionized the management of hand injuries[1] and has remained a workhorse for management of hand injuries. However, this flap has some limitations; mainly the dependent position of the limb that leads to flap oedema. The groin flap may be insufficient if large areas of hand and adjacent forearm need to be covered. The coverage of elbow defects with this flap can be quite cumbersome for the patient. So we were looking for a flap that can cover the hand and adjacent forearm defects, has consistent anatomy, is easy to harvest and is positioned higher up in the trunk so that the postoperative oedema is less","title":"The pedicled thoraco-umbilical flap: A versatile technique for upper limb coverage"}
{"_id":"9b86e0c5-baa0-8bbf-271c-25a9e184ef55","text":"For patients who are not eligible for brachytherapy because of particular conditions, other curative treatment options for cervical cancer boost may include external beam radiation therapy with modulation intensity, surgery by radical hysterectomy, or palliative treatments by chemotherapy and immunotherapy. SBRT is a highly precise and targeted form of external radiation therapy that delivers a high dose of radiation to a small specific area in one or more sessions. It can be used as an alternative for cervical cancer patients unfit for brachytherapy boost. Our data confirmed the dosimetric superiority of brachytherapy, compared with SBRT, in terms of target volume coverage and sparing of at-risk organs. Therefore, we look forward to additional clinical trials to assess the outcomes of these approaches.","title":"Brachytherapy Versus Stereotactic Body Radiotherapy for Cervical Cancer Boost: A Dosimetric Comparison"}
{"_id":"9b8d1211-1772-2286-a36a-d06fdedf1499","text":"NHS breast and plastic surgery units in the UK offering both subpectoral and prepectoral immediate IBBR to women following mastectomy.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"9b8e07da-93d4-da6f-8728-48be0bd46bac","text":"To report a rare case of a lateral frenum hypertrophy in an infant, this paper describes the case of a girl who came to a first dental appointment when she was 4 months old. A hypertrophic lateral frenum in the upper left canine region was detected. A great depression in the gingival rodet separated the anterior maxillary segment from the posterior one and also decreased the lip mobility in this region. A frenectomy was performed when the patient was 11 months old and the clinical follow-up was done up to the age of 30 months. There was normalization in the vestibular insertion of the lateral frenum, lip mobility, physiological development of the maxilla, and eruption of the upper incisors, canines, and first primary molars. Infants should go to a dental examination precociously in order to detect possible congenital and development alterations.","title":"Surgery Management of Rare Hypertrophic Frenum in an Infant"}
{"_id":"9b96c5a7-d096-80b4-2894-c88f81c290c7","text":"The main limitation of our prospective non-comparative study is the absence of data before the instauration of the RDU to make a comparison between both situations. Data before the inception of the unit was scattered and extremely hard to obtain since the patients rested in other services beds after an interventional procedure, making us unable to have control over that data.","title":"Experience and results after the implementation of a radiology day unit in a reference hospital"}
{"_id":"9b98997b-c864-a2ec-2e4b-02ed36ac57c5","text":"In our small series, all patients tolerated the procedure well and recovered without any adverse events. The 4 patients each lost between 500 and 1000 mL of blood in the operating room and required transfusion of 1 to 2 units of packed red blood cells. Ischemic flap necrosis did not occur in any of the patients, although there was further pressure necrosis of the flap in one patient. One patient developed heterotopic ossification of the distal aspect of the flap, which was excised during a subsequent procedure. Leg amputation did not alter the ability of the patients to transfer out of bed or to wheelchairs. Subjectively, most found mobility to be more facile since they did not have the excess weight of their nonfunctional leg. In addition, they all worked with physical and occupational therapy after their surgeries.","title":"Pedicled Fillet of Leg Flap for Extensive Pressure Sore Coverage"}
{"_id":"9b9eb10a-8d1d-7da9-f3d8-49d566e6e0db","text":"The strength of this study is that to the best of our knowledge it is the first large series that uses strict diagnostic criteria and compares the outcomes with respect to different surgical and antibiotic treatment modalities for this rare infectious complication. Limitations of the study are due to its retrospective design. First, direct comparison of the different surgical and antimicrobial treatment strategies has to be interpreted with caution because the patient groups were small as well as heterogeneous. Second, surgical management might have changed over the study period with a tendency toward more graft-preserving techniques. Third, the small sample size for patients who had been diagnosed with peripheral PVGI prevented adequate statistical analysis of this group.","title":"Surgical and Antimicrobial Treatment of Prosthetic Vascular Graft Infections at Different Surgical Sites: A Retrospective Study of Treatment Outcomes"}
{"_id":"9ba1ea21-392b-a168-e83b-f84259d3c5e3","text":"In addition to 2 isolated nodal recurrences in areas of ENI, 2 patients experienced nodal recurrence that we do not attribute to ENI. One patient developed a nodal recurrence in a contralateral level 1 node outside of the RT target volume and would not have been removed through an elective neck dissection; therefore, we do not consider this event a failure of ENI compared to the surgical alternative. An additional patient simultaneously recurred in the primary site and regional node, which suggests that the nodal recurrence could be a secondary event related to metastasis from the primary site recurrence rather than failure of the ENI to sterilize subclinical disease.","title":"Efficacy of elective nodal irradiation in skin squamous cell carcinoma of the face, ears, and scalp"}
{"_id":"9ba2f268-b1b5-8112-4f98-e4d9bf8f665d","text":"The field of melanoma treatment research is dynamic, and new discoveries and advancements continue to shape the future of treatment. Ongoing clinical trials and translational research are crucial for furthering our understanding and improving outcomes in advanced melanoma.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"9ba4b270-1704-fa6f-fc68-77da8287b497","text":"Printing life-size anatomic models can benefit in several aspects, including education of young surgeons on models allowing for tactile and 3D inspection of the tissues. The models can also be further used for performing mock surgeries thus improving the prediction of the outcomes. These models may also be used for presurgical adaptation of instrumentation, thus reducing the operation time and achieving superior compatibility.","title":"Printing the Future—Updates in 3D Printing for Surgical Applications"}
{"_id":"9baa5be8-5e92-7edd-b6d2-18a6a3719f55","text":"When we elevated and transposed the flap, the SSV got oriented in a reverse direction. As the vein had competent valves, venous outflow was not allowed in the reverse direction. An additional venous outflow mechanism was thought to be provided by the venules that accompanied the vasa nervorum of the sural nerve and vasa vasorum of the SSV. This system ensured an antegrade flow towards the distal leg perforators and eventually into the vena comitantes of the peroneal artery. Venous blood can flow from SSV to these concomitant veins via oscillating avalvular veins, thus passing blood from superficial to deep venous systems. It is imperative to safeguard these systems during flap elevation.,,","title":"Reverse Flow Superficial Sural Artery Fasciocutaneous Flap: A Comparison of Outcome between Interpolated Flap Design versus Islanded Flap Design"}
{"_id":"9bada73e-fecf-78f7-6247-824710d268d7","text":"External beam radiotherapy is the recommended but expensive treatment option for localized prostate cancer. Prostate cancer is the most common cancer in men worldwide. A cost-effectiveness study is needed given the excessive cost of radiotherapy treatment and the high prevalence of prostate cancer. The aim of this systematic review was to assess and identify studies that examined model based economic evaluation of external beam radiation therapy for the treatment of localized prostate cancer.","title":"Model-based cost-effectiveness analysis of external beam radiation therapy for the treatment of localized prostate cancer: a systematic review"}
{"_id":"9bb073a1-b77e-74a8-81be-31d6b2fccd44","text":"Osteomyelitis is inflammation of the bone, usually caused by an infectious agent. It can originate from trauma or surgery or it can originate from hematogenous seeding. Acute osteomyelitis presents with less than 2 weeks of symptoms whereas subacute infections have symptoms that persist for two weeks or more and chronic infections last months or longer.","title":"Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol"}
{"_id":"9bbd7767-cb47-628b-d659-f99c4d5b0e1f","text":"In conclusion, it is important to be aware of AS in the differential diagnosis of head and neck cutaneous lesions because it may mimic a benign lesion at early stages and is often associated with difficult disease control, as it was described in our patient. Surgery is the cornerstone of treatment, frequently followed by chemoradiotherapy. Skin substitutes are a potential solution with proven efficacy in the present case to the complex reconstruction of large scalp defects caused by aggressive tumors such as AS, with the potential benefit of local surveillance, usually not suitable with other options, such as free tissue transfer.","title":"Multifocal cutaneous angiosarcoma of the scalp—A challenging reconstructive case managed with skin substitutes"}
{"_id":"9bc99566-26cf-2410-2a23-f9a85ad1bb36","text":"Our study began before the ACOSOG Z0011 trial [8] that reported in 2010 no statistically significant differences in local or regional recurrence after median follow-up of 6.3 years between those randomized to sentinel node dissection alone versus completion axillary dissection in patients with clinically negative axillae and T1 or T2 invasive breast cancers treated with lumpectomy and radiation and 1 or 2 positive sentinel nodes. As a result of this trial, surgeons indicated that they would perform sentinel node biopsy even after a positive percutaneous node biopsy to determine if only one or two nodes were positive rather than perform axillary dissection in patients with tumors less than 5 cm. Consequently some surgeons have requested that radiologists not biopsy suspicious nodes in these patients. However, the Z0011 patient population had a low tumor burden with median tumor sizes of 1.6 and 1.8 cm, and a high percentage of micrometastases and solitary positive nodes, suggesting that their outcome may be different than those with positive percutaneous node biopsies. Although the Z0011 trial results have called into question the value of preoperative tissue sampling of axillary nodes in a selected population, the preoperative detection of metastatic adenopathy at the time of breast cancer diagnosis will continue to be helpful in management of patients with a larger tumor burden and allow many women to have axillary dissection at the time of definitive breast surgery, sparing them an unnecessary sentinel node procedure. For patients who will undergo neoadjuvant chemotherapy, the Z0011 results do not apply; percutaneous axillary node sampling will aid in proper staging prior to treatment.","title":"Ultrasound Guided Core Biopsy versus Fine Needle Aspiration for Evaluation of Axillary Lymphadenopathy in Patients with Breast Cancer"}
{"_id":"9bd8cc45-4087-14df-cc79-ba2e6f92055f","text":"Published studies have identified microbial endogenous porphyrin molecules as the key photosensitive targets which initiate the lethal oxidative damage exerted by 405 nm and other violet light wavelengths [19, 32]. Since human blood also contains porphyrins and porphyrin derivatives, it was important to establish that inactivation by 405 nm light in our study was a result of the photoexcitation reaction within the microbial contaminants and not a consequence of excitation of any photosensitive molecules within the plasma, and this was evidenced by the absence of antimicrobial toxicity to bacterial contaminants seeded into the 405 nm light-exposed plasma. Qualitative analysis of the rabbit plasma and human plasma also detected no notable fluorescence emission peaks between 500 and 700 nm when excited at 405 nm, thus indicating no significant levels of free porphyrins or other photoexcitation sources within the plasma which might have acted as exogenous photosensitizers for the inactivation of the microbial contaminants.","title":"A New Proof of Concept in Bacterial Reduction: Antimicrobial Action of Violet-Blue Light (405 nm) in Ex Vivo Stored Plasma"}
{"_id":"9bdf2d64-186d-577a-c318-779824e515cf","text":"Other imaging modalities were done as needed, results of U\/S and colored Doppler examination were compared to MR imaging in cases of venous and lymphatic malformations, it was compared to angiography either CT or conventional in case of high flow malformations and compared to the clinical data in cases of infantile hemangiomata.","title":"Role of ultrasound and colored Doppler examination in the diagnosis and the classification of the superficial soft tissue vascular anomalies"}
{"_id":"9be36c2d-f4f6-94f3-5d6a-0efc48772a05","text":"In this study we showed that the initial safety, feasibility and mechanism of ice slurry-induced cryolipolysis of VAT in rodents. Although more studies will be needed in large animals to demonstrate the safety and feasibility of this approach, slurry could potentially serve as a novel method for safe and selective reduction of abdominal VAT in obese patients that cannot tolerate current obesity treatment methods.","title":"Selective reduction of visceral adipose tissue with injectable ice slurry"}
{"_id":"9bef8404-f925-2e61-72ab-f76e22a1bc23","text":"Starting treatment was defined as the earliest treatment that a patient was on during the study period. A single treatment switch was defined as any change in treatment group. Patients that switched more than once were classified as undergoing multiple switches. Time on treatment was defined as the overall time documented in EMA on a given treatment prior to the first switch during the study period.","title":"Real-world health outcomes in adults with moderate-to-severe psoriasis in the United States: a population study using electronic health records to examine patient-perceived treatment effectiveness, medication use, and healthcare resource utilization"}
{"_id":"9bf2e315-8372-11be-0a22-3f907922d999","text":"This protocol adheres to the Standard Protocol Items for Randomised Trials56 guidelines.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"9c027521-8492-ca44-f6d0-423169cc53e8","text":"No significant difference was observed in terms of DVT plus death from any cause in the atorvastatin and rivaroxaban groups. It also showed that that administering 20 mg atorvastatin daily did not differ significantly from 10 mg rivaroxaban daily for 3 months for the thromboprophylaxis of DVT in cancer patients with high risk of thrombosis undergoing chemotherapy.","title":"The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy"}
{"_id":"9c0825b6-a0c1-5032-cb31-8c72509ef242","text":"Prospective study that included patients with facial dystonia that were going to receive a periocular botulinum toxin injection for the first time or six months or more after the previous injection. A Pentacam® examination was carried out in all patients before and 4 weeks after the injection.","title":"Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm"}
{"_id":"9c0a93ed-0954-b3be-a40d-ab02d4e61428","text":"This study demonstrated that it is crucial to consider patch testing for corticosteroids to detect allergic hypersensitivity in patients present with angioedema and urticaria after a course of steroid treatment. The development of worsening symptoms after initiating corticosteroids should alert physicians to consider the possibility of an allergic hypersensitivity reaction to various classes of steroids. Furthermore, the patch test can confirm an allergy to previously utilized corticosteroids, and identify sensitivity to unencountered corticosteroids in order to minimize medical errors.","title":"A Case Report of Steroid-Induced Angioedema and Urticaria"}
{"_id":"9c1896b2-01ba-0584-67de-4353499434da","text":"TSALD in maxillary and mandibular arches was present in both group 1 and group 2 and was statistically significant in the maxillary arch (Table 6). The mandibular and maxillary anterior crowding could be due to arch constriction seen in maxillary and mandibular regions. However, the magnitude of mean TSALD was greater in group 2 when compared to group 1. The reasons for increased TSALD in group 2 could be due to the severity of the malocclusions included in that group.","title":"Skeletal and dental characteristics in subjects with ankyloglossia"}
{"_id":"9c18d5d5-7961-b549-c27c-2057c40ede14","text":"The tympanosclerotic plaque calcification process is similar to other types of pathological calcification. Ectopic calcification has long been studied both structurally and ultra-structurally. There are basically two methods for depositing calcium crystals in tissues other than bone, namely metastatic and dystrophic calcification. Metastatic calcification occurs passively by serum calcium phosphate crystal precipitation in patients with certain diseases in which serum levels of these crystals is elevated. This type of calcification appears to depend on hypercalcemia and hyperphosphatemia, which have an essential role in the process. Dystrophic calcification involve a complex active cell mechanism that has been widely researched without much success. It is seen as calcification of arteries and viscera in chronic renal disease. Certain authors have questioned the role of elevated serum calcium and phosphorus in the pathophysiology of this type of calcification, although various papers have associated these two conditions.22, 23, 24","title":"Myringosclerosis in patients with chronic renal failure: comparative analysis with a control group"}
{"_id":"9c202ae5-5f7a-ab5d-4b9a-7c06cd447758","text":"Cryosurgery must take a rightful place in pancreatic cancer therapy and should be considered as a reasonable alternative to existing types of surgery, or should be used as a component of multimodal therapy. The rationale for the combined use of topical cryosurgery, chemotherapy, and immunotropic therapy to increase anti-cancer therapy resistance and its capacity to eliminate tumors seems to be particularly promising.","title":"Immune Status of Pancreatic Cancer Patients Receiving Cryosurgery"}
{"_id":"9c24d046-e09c-81df-1448-3434b2af0b65","text":"This study is a systematic review of the genotype-phenotype associations of desmoids tumors in patients with FAP (Additional file 1). A literature search was undertaken to find all cases of desmoids tumors that had a described mutation in the APC gene. This was further refined by controlling for the frequency distribution of mutations in a reference database of APC gene mutations in FAP patients. The aim of this study is to better define the correlation between APC gene mutations and desmoid tumor formation. This could provide future targets of research for pathophysiology and surveillance programs.","title":"Desmoid tumors complicating Familial Adenomatous Polyposis: a meta-analysis mutation spectrum of affected individuals"}
{"_id":"9c25a1bf-2e34-ff6b-85f8-fe11145a6f69","text":"When we dealt with the juvenile age category, the sexual dimorphism of the upper part of the frontal bone and primarily area of the mandible was less apparent than in young adulthood. Sexual dimorphism in young adulthood was the largest and significant in all the monitored areas of the face. In the first and second age categories, the nasal length, eyebrow ridges, and upper lip were more protruded in males, while the superior part of the forehead and the cheeks were more protruded in females. Protruded cheeks and a more rounded face in females seemed to be the most stable sexual dimorphic features during aging (see maps of significance of all investigated categories).","title":"Three-dimensional analysis of modeled facial aging and sexual dimorphism from juvenile to elderly age"}
{"_id":"9c279c6a-59b1-fbf2-cf76-dbc214fbfc67","text":"If radiation is planned after surgery or if radiation has been given previously, more durable, well-vascularized lining of the orbital cavity with soft tissue rather than just spontaneous epithelialization or skin graft coverage is necessary to avoid chronic bone exposure and osteoradionecrosis. Among local pedicled flaps used, the most common ones are the temporalis muscle flap and temporoparietal fascia flap. The temporalis muscle flap, based on the anterior and posterior deep temporal arteries arising from the internal maxillary artery is thin enough to permit a reasonably secure fit for orbital prostheses, even without osseointegrated implants but results in a depression at the donor site, which may be cosmetically unfavorable in many patients [27]. The temporoparietal fascia flap covered by a split-thickness skin graft may be preferable in that there is no donor site deformity. In both cases, reach of these two flaps may be limited and it may be necessary to remove the lateral orbital wall in order to cover the entire orbital cavity. Large scalp or forehead flaps should be avoided when other reconstructive options are available because of their donor site disfigurement.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"9c2c4941-07ba-a3a7-ec2f-f819dd53d2b1","text":"On the 10th day, muscle degeneration in the preconditioning group was higher than the IR and the Botulinum A toxin groups.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"9c2d39c7-89ac-2d9f-d1f9-64e3a0c761ec","text":"In patients with a traumatic ASDH a clear correlation between MLS and thickness of the hematoma was found. All patients with MLS exceeding the thickness of the hematoma by 3 mm or more died. In our opinion, it is the first time that such a strong correlation has been reported. The main purpose of this study was to draw attention to this relation that could considered to be incorporated as a factor in future prognostic models. It should not be used as a standalone predictive factor!","title":"Midline shift in relation to thickness of traumatic acute subdural hematoma predicts mortality"}
{"_id":"9c2efeac-4cba-6e6e-44c4-1bb4edc175d7","text":"Initially, the invention of ESIN gave reason to hope that children who sustained a displaced long-bone shaft fracture would benefit from shortened hospitalization and rapid functional rehabilitation. The biomechanical idea of transforming bending forces by intramedullary nails into compressing and distracting forces and thus stimulating callus formation together with limiting shearing movements at the fracture site promised high effectiveness and early mobilization.","title":"Slow Recovery of Weight Bearing After Stabilization of Long-Bone Fractures Using Elastic Stable Intramedullary Nails in Children"}
{"_id":"9c374a45-2f26-ac75-33f4-6c1a231a63ed","text":"Based on our experience on distraction osteogenesis by bifocal or trifocal bone transport using unilateral rail system, we concluded that radical debridement and resection is the most important task in the treatment of tibial defects caused by infection. Preoperative planning is critical for both successful resection and frame mounting. Pin tract infection is a universal problem which can be avoided by regular cleaning. The decision between bifocal or trifocal approaches needs to be decided according to patient, bone quality, defect size, surrounding soft tissue condition, etc. In conclusion, both bifocal and trifocal bone transport using unilateral fixation system can be used successfully to reconstruct large tibial defects caused by infection. It could significantly reduce lengthening index with better functional outcome by trifocal bone transport compared with bifocal bone transport approach.","title":"Bifocal or Trifocal (Double‐Level) Bone Transport Using Unilateral Rail System in the Treatment of Large Tibial Defects Caused by Infection: A Retrospective Study"}
{"_id":"9c3a1656-362a-ed07-4c68-24172a32cc9b","text":"Integrity of the subscapularis and teres minor tendons and quality of the corresponding muscles should be assessed as they either need to be addressed intraoperatively and\/or influence the clinical outcome.","title":"Surgical Management of Massive Irreparable Cuff Tears: Latissimus Dorsi Transfer for Posterosuperior Tears"}
{"_id":"9c484c51-9ce0-b12f-74a3-8eba2ea60a66","text":"A randomized study to compare ECT with wide excision in patients with local cutaneous melanoma undergoing sentinel lymph node biopsy is planned.","title":"Perspectives in Melanoma: meeting report from the Melanoma Bridge (December 3rd–5th, 2020, Italy)"}
{"_id":"9c4e0505-da70-fd40-a8d4-96f0c445eb81","text":"Regulatory decision-makers indicate an expectation of a reasonably detailed documentation process for informed consent, consisting of both a signed consent form and documentation in the patient record that provides a narrative of the informed consent discussions with the patient each time that treatment is provided. In light of the STF Decisions, practitioners should consider implementing strategies to reflect in the record and on the consent form that the specific risks deemed to be material, special or unusual are documented in both the record and the consent form.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"9c556d65-486c-4366-58b1-a35a22406825","text":"The datasets analysed during this study is available from the corresponding author on reasonable request.","title":"“Sentinel lymph node imaging with sequential SPECT\/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study”"}
{"_id":"9c58b1b8-4c2e-7650-7da3-2272bc784421","text":"Oral and maxillofacial surgeons are medical specialists that can immediately diagnose and treat these scalp injuries based on their medical knowledge and experience with the maxillofacial region.","title":"Scalp injury management by a maxillofacial surgeon in a low-resource hospital"}
{"_id":"9c59e286-4ada-8386-57ce-45ffa1175684","text":"Although the use of IFS currently remains a controversial topic [19], our retrospective study has demonstrated that its use in our institution has yielded a higher rate of complete excisions with low false negative results. Despite the drawbacks of an extended operating time and increased surgical costs, patients can still enjoy a multitude of benefits where the balance between complete excision and best cosmetic outcome is achieved. Patients with lesions in the head and neck region would require greater preservation of both form and function and, thus, would most benefit from IFS analysis in the treatment of NMSC. Another group of patients who would greatly benefit from the use of IFS in NMSC treatment includes those requiring more complex reconstruction after tumour excision, as surgeons have increased confidence of clear margins prior to performing complex reconstructions.","title":"Use of Intraoperative Frozen Section in the Surgical Management of Patients with Nonmelanoma Skin Cancer"}
{"_id":"9c5cc407-0c7f-9bcf-d452-81fdfc2bc17f","text":"Doppler ultrasound of the hepatic, portal, and intra-renal veins can be used as an adjunct to inferior vena cava ultrasound and other parameters such as body weight to assess venous congestion in patients with heart failure. Having a simultaneous electrocardiographic tracing helps with accurate interpretation of the waveforms by delineating the phases of cardiac cycle.","title":"Evaluation of Venous Congestion Using Beside Ultrasonography by the Nephrology Consultant: The VExUS Nexus"}
{"_id":"9c5cf274-d084-5440-203f-1ba3ff00d30a","text":"No local complications after the UGPT were detected. The patient did not need local or systemic therapy for pain management after treatment.","title":"Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint A case report"}
{"_id":"9c631015-4cf4-d219-fd44-8b4620474e75","text":"We conclude that specific IgE sensitization in children with allergy-like symptoms is common and sensitization to multiple allergens occurred more often than mono-sensitization. Number of clinical symptoms at inclusion was higher in the atopic group compared to the non-atopic while the number of symptoms in the atopic group could not be correlated with number of positive allergens. Age seems to play a crucial role when estimating the prevalence of sensitization, since there is a significant positive correlation between patient age and the number of sensitizations.","title":"Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation"}
{"_id":"9c673911-3045-6ce7-7ae9-830763bfff1a","text":"The four studies show significance in the relationship between the lingual frenulum alteration and OSA. Further studies with surgical intervention are needed, as well as polysomnographic examinations before and after lingual frenectomy in a larger sample of the population.","title":"Is ankyloglossia associated with obstructive sleep apnea?"}
{"_id":"9c6a4559-60b3-3902-9525-b2f586a4360b","text":"Conclusion: These results suggest that topical application of betamethasone to lesional skin would be beneficial for control of atopic dermatitis by acting on epidermal LCs and inhibiting the development of Th2 cells.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"9c6c1038-8fe6-d46b-a034-a5230b4d53a4","text":"It is possible to conclude that, although there are divergences on the indication of the clinical-surgical intervention for the correction of ankyloglossia, there is a consensus in the literature about the negative effect of functional imbalances caused by ankyloglossia on the correct growth and development of the stomatognathic system. All the researched authors report the need to establish neuromuscular balance in order to achieve stable esthetic-functional goals.","title":"ANKYLOGLOSSIA AND ITS INFLUENCE ON GROWTH AND DEVELOPMENT OF THE STOMATOGNATHIC SYSTEM A INFLUÊNCIA DA ANQUILOGLOSSIA NO CRESCIMENTO E DESENVOLVIMENTO DO SISTEMA ESTOMATOGNÁTICO"}
{"_id":"9c6d5004-9d4a-1ac8-2aa0-33499b64a47e","text":"The majority of patients underwent standard DIEP flap reconstruction but the following may differ between units.","title":"Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients"}
{"_id":"9c6e3b8e-9828-83c2-d279-75ee3e2cb42e","text":"Patients must be diagnosed with MRI since it is nowadays a gold standard. Preoperative and postoperative scores are important in evaluating the patients’ condition and improvement. The results from our patient series also reinforce the notion that immediate surgery should be the preferred treatment method for cavernomas. Intraoperative neurophysiologic monitarization should assist the surgery in order to prevent complications. In conclusion, microsurgery is a gold standard method that we recommend for cases of cavernomas, which will not recur if gross total resection is achieved.","title":"Spinal Cavernomas: Outcome of Surgically Treated 10 Patients"}
{"_id":"9c7113b9-99c4-e26d-ef60-1e9d730a2efc","text":"This study indicates that VasoView EVH technique causes no endothelial damage in comparison with OVH. This study could be a molecular confirmation for the innocuous of EVH technique.","title":"Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium"}
{"_id":"9c753675-92ac-4368-c706-6a8389c46aad","text":"Interestingly our results showed that there was a reduction in the mean TTC of the group studied from baseline to intervention, 20.36 min at baseline to 17.82 min with the introduction of ORDIs. When this is broken down this can be mostly attributed to a marked improvement in the novice group. We have attributed this improvement to task familiarity and consolidation of technical skills. This group had never performed a microsurgical anastomosis prior to the first session. We observed a marked improvement in technical efficiency from session one to session two even with the presence of ORDIs. Looking at the consultant group there was a more modest improvement in TTC between session one and session two, 13.38 min at baseline to 13.15 min with ORDIs. This we feel highlights the gained automaticity of the consultant or expert group in that the introduction of ORDIs had little to no effect on surgical efficiency. The most interesting group to analyze in relation to TTC is the trainee group as the authors believe this group is reflective of the true effect of cognitive distraction and external stress on microsurgical skill acquisition and the impact of training, as this represents the cohort that is in the microsurgical learning curve where distraction has been shown to have the greatest effect (19).","title":"Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance"}
{"_id":"9c798a9f-9602-5ce9-9e13-221a01fd4a1d","text":"Use of an antibiotic carrier is an alternative method of maintaining high local concentrations of antibiotic without systemic exposure. These substances incorporate an antimicrobial to prolong its half-life and provide predictable elution characteristics. They may also serve additional roles, such as filling dead space and providing mechanical support for limb alignment. The ideal antibiotic carrier would provide prolonged antibiotic concentrations at an effective level and achieve complete antibiotic release to minimise subtherapeutic elution time. It would also be versatile and have compatibility with the desired antibiotics, and fully resorbable with minimal risk of allergies, and systemic or local adverse effects.","title":"Local Antibiotic Delivery Options in Prosthetic Joint Infection"}
{"_id":"9c820271-9729-19d8-6f0f-221a8d690978","text":"Objectives: To implement the Registry with the new recently described AIDs and genes and modify the web-system to make it suitable for the collection of longitudinal data and for a better collection of data regarding treatment.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"9c85486d-b006-de14-9bd5-9c4e74aa23b0","text":"Due to the clearance rates being lower than for surgical treatments, PDT is not generally recommended for management of nodular BCCs on the head or neck. While primary superficial BCCs on the face may be amenable to treatment is not recommended for recurrent disease.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"9c8ccaf1-40ac-28bf-ab0a-674c5829d1a2","text":"Tuberculosis of the upper cervical spine is seen during the first three decades of life and seen equally in both sexes. The clinical picture ranges from nonspecific symptoms to severe neurological complications and death because of instability and cord compression. As the disease progresses, it starts involving the ligamentous structures nearby and also causes osteolytic erosion of the odontoid process or the C1 vertebra, which may lead to subluxation. The spinal cord at the upper cervical region can be damaged by vertebral subluxation, compression by an abscess, or by direct invasion of tuberculous bacilli so it should be treated urgently [6].","title":"Reconstruction of the Odontoid Process by a Tricortical Iliac Crest Graft in a Case of Tuberculosis of C1, C2, and C3 Vertebrae"}
{"_id":"9c98319f-b74f-8d1a-9234-42e7f6b5454f","text":"Skin hydration is also an index to evaluate the function of skin barrier. Skin hydration of the three groups showed a statistically significant increase at week one, four, or twelve after the treatment. One week and four weeks after the treatment, the skin hydration in the nanomicroneedle group and the intradermal microdroplet group increased more significantly than that in the intramuscular injection group; then twelve weeks after the treatment, the skin hydration in the intradermal microdroplet group was higher than that in the intramuscular injection group and nanomicroneedle group. It can be inferred that better skin barrier function can be achieved by BoNTA topical treatment, especially in nanomicroneedle group and the intradermal microdroplet group.","title":"A Comparative In Vivo Study on Three Treatment Approaches to Applying Topical Botulinum Toxin A for Crow's Feet"}
{"_id":"9ca3013a-6a59-ceb2-a092-23070da81f60","text":"Axial CT image of the pelvis demonstrates a large area of bulky soft tissue calcification in the right ischiofemoral space (white arrow)","title":"Resolution of calcinosis using bisphosphonates in overlap syndrome – a case report"}
{"_id":"9ca336c9-eff6-e9d1-d170-9a892956050a","text":"Aging is a multifactorial process demonstrated by loosening and ptosis of the soft tissue of the face and neck due to gravity and loss of the distinct contour of the neck and jawline. This, hence, results in the stigmata related to facial aging.","title":"Facial Contouring after Permanent Filler Removal with Combined Facelift and Fat Grafting: A Case Series"}
{"_id":"9ca4f9a2-1f8d-47fa-9b58-09fd24f9a3dd","text":"The Dermatology Department will be the primary recruitment and trial site until the maximum planned number of 115 psoriasis patients has been included. Supplemental patient recruitment may be used by contact with dermatologists in practice or by advertisements in local newspapers, at public institutions or social media on the internet.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"9cb41c1e-7cb2-82aa-2f80-001eff720d8e","text":"According to the latest European consensus on desmoid tumors, surgery should be considered in cases of progression to medical or radiation therapies, always considering location and age. When surgery is carried out, it should always be done trying to preserve function and after considering all the alternatives for it. Cases of mesenteric or retroperitoneal tumors not associated with familial polyposis can be treated initially with surgery due to the morbidity and symptoms they cause.","title":"Desmoid-Type Fibromatosis"}
{"_id":"9cb64523-b8a9-119a-7f29-2d3c30723b84","text":"A multidisciplinary approach is required to treat patients with NSCLC. Surgical resection is considered the most important curative option. Survival differences in patients undergoing surgery have shown the importance of lymph node involvement in prognosis, and these differences have led to increasingly detailed staging of patients. In this context, changes were made to the T and M groups during the eighth stage. The introduction of criteria such as more than one N1 lymph node involvement may increase the prognostic importance of staging and help determine better treatment strategies.","title":"N1 lymph node detection in lymph node harvesting in non-small cell lung cancer: Formaldehyde exposure is a drawback?"}
{"_id":"9cbe4b4d-9f36-c8e4-2014-4f10c3b2582b","text":"A summary of the assessment is presented in Figures 2 and 3.","title":"Interventions to improve tolerability of local anesthetic intradetrusor Botulinum toxin injections: A systematic review"}
{"_id":"9cbfa3b1-ce61-f2a7-3040-9f22eae1b97b","text":"Laparoscopic cholecystectomy is the most frequently performed abdominal intervention by residents, which is expected given the high incidence of cholelithiasis in our country . This high number of laparoscopic cholecystectomies wields an essential part during the process of learning and acquisition of laparoscopic skills of our residents.","title":"IMPACT OF A SIMULATED LAPAROSCOPIC TRAINING PROGRAM IN A THREE-YEAR GENERAL SURGERY RESIDENCY IMPACTO DE UM PROGRAMA DE TREINAMENTO LAPAROSCÓPICO SIMULADO EM RESIDÊNCIA DE CIRURGIA GERAL DE TRÊS ANOS"}
{"_id":"9cc586da-4fc8-cd12-5b5a-b1f9f59c1972","text":"This study was undertaken by the Association of Surgeons in Training as part of a national workforce survey for doctors in surgical training. The authors gave due consideration to the ethical dimensions of this anonymous non-mandatory questionnaire survey, and no concerns were identified. Completion of the questionnaire was taken as consent to participate.","title":"Clinical Fellowships in Surgical Training: Analysis of a National Pan-specialty Workforce Survey"}
{"_id":"9cc6cb56-f3f6-91f6-62fe-57837e7b920c","text":"3D imaging technology has been used for diagnosis and treatment planning in medicine and dentistry for decades, but sparse in vivo studies about bone properties using this technology have been undertaken. To the best of our knowledge, the present study is the first in vivo study that attempts to reveal the properties of cortical bone structures of the mandible using 3D-modeling technology. However, this study has several limitations. Firstly, because this study was based at a tertiary medical center, it might provide limited information about the interactions among cortical bone quality and muscle thickness in ordinary individuals. Because all participants in the present study were patients with myofascial TMD, the degree of orofacial pain could influence the masticatory performance. Secondly, due to a lack of data about systemic bone mineral density, the results could show knowledge about the associations between muscle and bone in a restricted focal area. Thirdly, the present study only provided information about the cortical bone quality of the mandible not trabecular bone quality. Despite of advances of 3D modeling technologies, no reliable and valid method for evaluating trabecular bone qualities using conventional CT data has been developed. Finally, because of the characteristics of the retrospective study, the present study inevitably had problems with bias in sample selections. However, to overcome this limitation, homogeneity of the samples in each group including initial status of the orofacial pain and the cortical bone quality was confirmed through statistical methods. Future prospective community-based cohort studies including systemic bone mineral density data and focal trabecular bone quality data of the mandible with ordinary individuals in diverse age ranges would be necessary to elucidate the role of masticatory muscles in bone quality of the craniofacial structures.","title":"Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults"}
{"_id":"9cc7846a-dbe0-fc4d-6c5c-30966c0001e5","text":"The aim of this study is to investigate whether patients undergoing ILND due to lymph node metastasis from melanoma will benefit from prophylactic iNPWT (Smith&Nephew). The primary aim is to evaluate whether patients treated with iNPWT will experience less seroma formation than patients treated with standard dressing, measured by the need of seroma aspirations by skin puncture. The secondary aims are to examine whether the use of iNPWT results in a reduction of other major complications, length of hospitalization, and improved patient quality of life. The safety of iNPWT in the oncological setting will be evaluated by comparing the distribution of patients with regional recurrence between groups.","title":"Prevention of seroma following inguinal lymph node dissection with prophylactic, incisional, negative-pressure wound therapy (SEROMA trial): study protocol for a randomized controlled trial"}
{"_id":"9ccd89c2-c79d-22ec-c72e-67f391a19fbd","text":"Free tissue transfer is a powerful reconstructive tool that allows import of healthy tissue into heavily scarred areas. In our institution, the standard reconstruction technique for patients with chronic osteomyelitis and significant soft tissue compromise involves a single-stage approach with free tissue transfer immediately after osteomyelitis excision and orthopaedic reconstruction. We routinely use free muscle flaps covered with unmeshed split-thickness skin graft as they are reliable, have acceptable donor site morbidity, contour well and due to their high vascularity, can aid osseous healing and deliver parenteral antibiotics to the affected site.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"9cd275e2-d476-0790-0e31-6878906b93fb","text":"In secondary research, the resulting synthesis is only as good as the primary data on which the synthesis is built. Whilst most included studies were of medium and high quality, a major limitation we encountered in our review was that most primary studies included only insight into the impact of surgical leadership interventions on individual leadership in isolation and did not consider the impact on the team or wider department. Because of this limitation in the literature scope, we adopted an individual skills-based framework to summarise the results in Table 4. Whilst this framework facilitates simple presentation of the results, it highlights a wider problem of how narrowly leadership is often conceptualised in surgery. We also found that primary studies often did not provide enough interventional detail to determine fidelity and understand how different aspects of leadership interventions influenced which outcomes and why.","title":"Advancing leadership in surgery: a realist review of interventions and strategies to promote evidence-based leadership in healthcare"}
{"_id":"9cd3f595-da99-1ccc-cc54-6eb07e3eb2a7","text":"The participants are allowed to withdraw at any time throughout the study. If the participants withdraw from the study before the end of the trial, they are asked to have data collected including an MRI assessment. The reason and date of the withdrawal will be recorded, and the data before the withdrawal will be asked to retain.","title":"Efficacy and safety of GLucocorticoid injections into InfrapaTellar faT pad in patients with knee ostEoarthRitiS: protocol for the GLITTERS randomized controlled trial"}
{"_id":"9cd72be5-974c-c2ae-8491-e84af3c9fbef","text":"Results from a recent Danish survey among 2.736 senior physicians is in line with our findings [40]. Almost one-third of the senior doctors expressed a desire to retire before the age of 65. Younger doctors were more prone to indicate a desire for early retirement than older doctors. Four out of ten senior doctors pointed to dissatisfaction with working conditions as the main reason for wanting early retirement before the age of 70. In contrast to the Norwegian case it seems that specialty and region mattered for these results as doctors working in psychiatry and surgery and in the Danish Capital Region reported higher levels of dissatisfaction. About one out of three answered that they seldom or never receive recognition from management. A similar number reported a lack of respect and unfair treatment in the work place [40]. Although these data are not fully comparable, the tendency in a similar health care setting appears to corroborate our indications of the importance of organisational and leadership factors for physicians’ well being and intentions to leave the work place.","title":"Should I stay or should I go? The role of leadership and organisational context for hospital physicians’ intention to leave their current job"}
{"_id":"9cd90a63-82d0-cd16-6350-ea957df38f22","text":"In all cases, the highest uptake was observed for the sulfonate ester photosensitizers and the lowest for the sulfonated one. The replacement of the sulfonic groups, which are ionized in PBS, by the sulfonate ester groups appreciably enhances cellular uptake. Under these conditions, the chromophore of sulfonate ester porphyrins seems to be stable. Their higher cell uptake is consistent with the higher cell membrane permeation of neutral and amphiphilic drugs. They seem to combine enough lipophilicity to increase the affinity toward cells but not as much as to aggregate extensively in an aqueous culture medium. Based on the singlet oxygen quantum yields and the amount of photosensitizer present in the cells, it can be expected that sulfonate ester derivatives are interesting photosensitizers for PDT.","title":"Enhanced Cellular Uptake and Photodynamic Effect with Amphiphilic Fluorinated Porphyrins: The Role of Sulfoester Groups and the Nature of Reactive Oxygen Species"}
{"_id":"9ce42350-cd83-ccc1-d58a-5e523839499b","text":"In vivo measurements were performed in six patients participating in a phase IB clinical trial to TLD1433 for NMIBC for the 12 sensors cage device. The positioning of the sensors was achieved by first placing the distal end of a ridged cystoscope at the bladder neck where the urethra starts. A sheath carrying the fiber bundle and isotropic emitting source was inserted through the cystoscope’s working channel, and the fiber bundle assembly extended until its distal end of the design touched the bladder’s dome. Pushing the three flat fiber bundles further through the working channel while keeping the cystoscope to bladder dome distance constant and pulling back on the control sting resulted in the expansion of the fiber cage until, ideally, the three arms abutted to the bladder wall. The proximal end of the fiber cage assembly was connected to a 12-channel photodiode array utilizing highly sensitive Hamamatsu detectors (S8745-1, Hamamatsu, Hamamatsu City, Japan) as the anticipated irradiances would generate only 80 nW to optical power per sensors. Irradiances were recorded continuously and time-integrated to derive the radiant exposure. Excitation light delivery was terminated when the average of the responding sensors reached the target radiant exposure of , shown in animal experiments to be a safe exposure resulting in tissue necrosis.","title":"Minimal required PDT light dosimetry for nonmuscle invasive bladder cancer"}
{"_id":"9ce876d2-6342-047d-4ed3-50d3c7a34bde","text":"SLNB has been used as the standard of care for surgical staging in several cancers, and the National Comprehensive Cancer Network (NCCN) included and recommended SLNB in its guidelines for stage I cervical cancer patients. However, the SLN metastasis detection via SLN biopsy in early-stage cervical cancer remains controversial. This study was aimed at investigating the feasibility and accuracy of the combined tracer method for localization of SLN in the initial stages of cervical cancer and to evaluate the clinical value of SLN biopsy in replacing pelvic lymph node resection. The size of the tumor, the extent of lymph node metastases, and the depth of invasion all play a role in the success rate of SLN identification. Based on our findings, we believe that sentinel lymph node biopsy is viable when the tumor≦4 cm in diameter. The use of nuclide and blue dyes as tracers has a low reliance on objective conditions and medical technology, and it has a high detection rate. The identification of SLN combined with 99mtechnetium-labeled sulfur colloid and methylthioninium chloride has a good accuracy and is safe for the assessment of the status of pelvic nodes in patients with initial stage cervical cancer. Furthermore, using sentinel lymph node biopsy to assess pelvic lymph node metastases to guide postoperative treatment has significant clinical implications for patient survival and recurrence rates. To properly validate the results of this study, large sample-sized clinical trial studies of SLNB in China are needed.","title":"Clinical Study of Sentinel Lymph Node Detection to Evaluate Pelvic Lymph Node Metastasis to Determine the Prognosis of Patients with Early Cervical Cancer"}
{"_id":"9ce9a181-fabf-2632-4d40-b4fff4be39eb","text":"Conventional antibiotic therapy is often insufficient to eradicate biofilm infections. Rather than the singular therapy of the direct treatment of biofilm formation or proliferation, we recommend combination therapies that are intelligently targeted according to the characteristics of their material composition at each stage of formation. The advantages of these special therapies have been described in detail above, but there are still some shortcomings that need to be overcome.","title":"Strategies to prevent, curb and eliminate biofilm formation based on the characteristics of various periods in one biofilm life cycle"}
{"_id":"9ce9ecd0-886c-6025-b76e-d8ce2cdaf94a","text":"There is general agreement in Europe that valuable information about varicocele can be obtained using colour flow Doppler, and that evaluation of the presence and characteristics of venous reflux is useful when physical examination alone is insufficient to determine whether treatment is required. Additionally, colour Doppler evaluation plays a key role in the assessment of persistence or recurrence of varicoceles after surgical treatment; veins often remain dilated and clinical examination alone cannot fully assess the presence or absence of persistent venous reflux.","title":"Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations"}
{"_id":"9ceadd05-6051-af4b-d4e2-01d06c711d65","text":"In summary, excision of the contralateral but not the ipsilateral infraorbital nerve reduced the collateral branching, and\/or increased elimination of the branches of regenerating nerve fibers after buccal nerve transection and surgical repair. This beneficial effect diminishes the extent of the inevitable postoperative misdirected reinnervation of target muscles by regenerating nerve fibers. A possible explanation for this effect of the contralateral sensory injury is that the excision of IOn forces the rat to use the side with the intact sensory innervation. This, however, is the same side as that with the transected facial axons. Thus, we may assume that the intact ipsilateral afferent input strongly stimulates the axotomized motoneurons to elongate axons, to innervate the piloerector muscles and thus to provide motor basis for vibrissae rhythmical whisking.","title":"Trigeminal Sensory Supply Is Essential for Motor Recovery after Facial Nerve Injury"}
{"_id":"9cf6f9e8-d11a-7bc9-3394-a8a9f5f1baca","text":"Extending the study to multiple sites may be a better demonstration of applicability to the NHS. A major current drawback to this is the lack of suitable clinical centers in the United Kingdom that currently have the expertise in using VivaScope. In practice, the variable levels of expertise and cost of training could be a barrier for the adoption of the device. There is potential to find greater benefit in clinics with a large cohort of patients being monitored for high-risk moles but this would apply to only a limited number of services in the United Kingdom, as opposed to every hospital that has referrals for skin cancer.","title":"Evaluating the Diagnostic Accuracy of Reflectance Confocal Microscopy to Diagnose Skin Cancer: Protocol for a Prospective, Multicenter Study"}
{"_id":"9d02760d-38b3-d291-c3d6-a434b92bbd9f","text":"The demand for clinical fellowship experience increased in line with trainee seniority. The reasons for this are likely to be multi-factorial and may reflect an increase in self-rated concerns regarding clinical performance or confidence as completion of training approaches. This conclusion is supported by the finding that across all surgical specialties 73.1 % of respondents believed a fellowship was necessary to obtain clinical competence for independent surgical practice. This implies either perceived shortcomings in the current surgical training curriculum or an over-estimation of the competence level required at the completion of formal training. It also implies a belief among respondents that fellowship training is able to impart the skills and knowledge required for independent surgical practice.","title":"Clinical Fellowships in Surgical Training: Analysis of a National Pan-specialty Workforce Survey"}
{"_id":"9d06b0bf-4c5f-f1ee-06d8-6891081f4811","text":"In 93% of trials the participants indicated that the high contrast face looked younger. This overwhelming effect indicates that participants used facial contrast as a cue in perceiving age, and that faces with increased facial contrast were perceived as younger. In order to determine whether the effect size was different for faces of different ages, we used a logistic regression model with repeated measurements. We found no interaction between the effect of the facial contrast manipulation and the age of the face. This means that the effect of facial contrast was not different for faces of different ages. The results from study 3a are shown in Figure 4 .","title":"Aspects of Facial Contrast Decrease with Age and Are Cues for Age Perception"}
{"_id":"9d1ca240-7b91-0a22-7c31-a685d071f21f","text":"This retrospective study was approved by the institutional review committee and ethics committee at the First Hospital of Jilin University. Written informed consent to participate in this study was obtained from each patient. The inclusion criteria were patients who had a unilateral foot or ankle injury with complex soft tissue defects and who had undergone various pedicled or free flap procedures. Only the initial pedicled or free flap procedure and its complications were studied. Patients were excluded if they had a bilateral foot or ankle injury because repeated data analysis can increase the sample error. Although secondary flap procedures were performed, the secondary transplanted flap and its complications were not the focus of our study. Considering the above-mentioned criteria, we carefully reviewed hospital records and found that 144 patients met these criteria between February 2007 and December 2014.","title":"Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis"}
{"_id":"9d24c7bc-223b-920b-3656-d537ec69873f","text":"In the current study, similar clinical and histological features were found in patients with primary and recurrent BCC of the eyelid. No differences in tumor location or histology type were found between the two groups of patients, suggesting that incomplete tumor excision may be the major cause of lesion recurrence.","title":"Histological and Clinical Features of Primary and Recurrent Periocular Basal Cell Carcinoma"}
{"_id":"9d2722ab-416c-ea82-e929-ec03c8ad282d","text":"It is still unclear whether the benefits of anticoagulation outweigh the risks of anticoagulant treatment for distal isolated DVT because of the low risk of progression and recurrence of VTE. About 15% of distal isolated DVT will develop with thrombus progression to the popliteal vein and risk of PTE.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"9d2790c4-9ac5-0797-9c89-074fac4cb198","text":"While any number of palatoalveolar defects is possible, Okay et al. [5] have recommended distinguishing defects based on whether function can be satisfactorily restored with an obturator or if a free flap is required. Palatoalveolar defects that spare both canine teeth can often be successfully treated with an obturator. In these cases, cantilever forces resulting in unstable prosthetic retention are minimized because of the favorable root morphology of the canine adjacent to the obturator and the substantial arch length provided by the remaining alveolus. Thus, defects including unilateral posterior palatomaxillectomy defects or anterior defects limited to the premaxilla, which bears the 4 incisor teeth, can be obturated and should be considered separately from those that cannot, including those that involve half the palate and those that involve the entire anterior arch or whole palate.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"9d2af7a1-0079-304b-bf3d-a9fa45e54f3c","text":"In cases where flap compromise occurred more than 24 hours after free flap surgery, thrombolysis with urokinase infusion was administered for salvage treatment regardless of the presence or absence of arterial thrombus, in the presence of venous thrombus or venous insufficiency. In that case, both arterial reliance and the congestive flap was confirmed in re-exploration more than 24 hours postoperatively, and intra-flap thrombosis was suspected due to decreased venous drainage, so it was necessary to actively perform thrombolysis in a way that has less systemic side effects through external venous drainage while using thrombolytic agents at high concentrations.","title":"Safe and effective thrombolysis in free flap salvage: Intra-arterial urokinase infusion"}
{"_id":"9d36e937-6b6d-6be8-0df3-b338f61280b0","text":"The management of defects after sinonasal cancer surgery is a major challenge for patients. Many technical advances in techniques for reconstructing sinonasal defects after sinonasal cancer surgery have been described in recent years. The increasingly common use of vascular pedicled flaps and free flaps, both endonasal and extranasal, is contributing to the meaningful reduction in surgical complications. The impact of reconstruction techniques on postoperative imaging and radiotherapy planning should be taken into account more systematically to assess post-operative radiotherapy effects on reconstructed anatomy, flaps and grafts.","title":"Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know"}
{"_id":"9d4701a3-91d2-ebc1-5c54-0c1e2088348c","text":"The programs at Rush University Medical Center, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, New York University (NYU) Langone Health, and the Hospital for Special Surgery provide multiple fellowship opportunities in various areas of orthopaedics such as spine, sports medicine, and adult reconstruction. Rothman Orthopaedic Institute at Thomas Jefferson University Hospital and NYU Langone Health also offer the opportunity to complete a second year of research depending on the research fellowship selected. The University of Alabama at Birmingham Orthopaedic Research Fellowship guarantees a residency interview at University of Alabama at Birmingham on completion of the fellowship. None of the other research fellowship programs specified whether they guarantee a residency interview to research fellows.","title":"Gap Year Research Fellowship Opportunities for Medical Students Interested in Orthopaedic Surgery"}
{"_id":"9d4a3131-3ba4-7341-2ed2-fb2c71558934","text":"Among the 103 patients enrolled in this study, 22 patients had positive DVT results. Sixteen patients had DVT only at the veins distal to the popliteal vein. There was one patient each with DVT only at the femoral vein and DVT only at the superficial femoral vein. Two patients had DVT at the popliteal vein alone, and two patients had DVT at both the popliteal vein and the vein distal to the popliteal vein.","title":"Risk factors for deep vein thrombosis even using low-molecular-weight heparin after total knee arthroplasty"}
{"_id":"9d53cc54-b764-50d8-c5c0-59c50d0acc23","text":"An STSG combined with an Integra® matrix was performed immediately after the trauma. A second surgery was performed after three weeks to remove the silicone layer of the Integra® and to apply skin grafts to the underlying neodermis. The average surgical time was between 60 min and 90 min depending on the lesion size. The mean hospitalization was 5 days, following which all patients were discharged in the absence of complications.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"9d5bd74b-2689-6586-6f72-63bcca70cdef","text":"The medial perforators are therefore the vessels of choice on which the DIEP flap harvest is based.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"9d61c228-6fd6-1686-d295-20c95cc484d3","text":"PE is difficult to diagnose based on clinical symptoms alone and may have a broad spectrum of presentations ranging from shortness of breath, tachypnea and syncope to fever, side stitch and hemoptysis.","title":"Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care"}
{"_id":"9d6407cc-4735-bd33-f025-4f0a1a1f9f02","text":"It was collectively decided at this point that further testing should be avoided. Additional imaging was deemed unnecessary and management of the patient returned to standard of care surveillance following DIEP surgery.","title":"The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan Case report: The appearance of cartilage in breast reconstruction as a mass on CT"}
{"_id":"9d66db61-df03-4a1c-fb80-baeb55b936a1","text":"Primary breast cancer is divided into invasive breast cancer and ductal carcinoma in situ according to pathology. T1 disease is defined as a primary tumor size of less than or equel to 20 mm; T2 disease is defined as a primary tumor size of more than 20 mm but less than or equal to 50 mm; T3 disease is defined as a primary tumor size of more than 50 mm [30]. The pathologist diagnosed each lymph node as benign or malignant.","title":"Imaging features of sentinel lymph node mapped by multidetector-row computed tomography lymphography in predicting axillary lymph node metastasis"}
{"_id":"9d6bd129-51f8-add4-d348-613250cb788e","text":"In the era of targeted therapy for locally advanced and metastatic RCC, treatment paradigms using combinations of medical and surgical therapies in patients diagnosed with localized recurrence after nephrectomy are paramount to maximize the oncologic outcome.","title":"Surgical Management of Local Recurrences of Renal Cell Carcinoma"}
{"_id":"9d6db242-4ae4-f32a-aa72-f8a4168ef189","text":"Ideally all antibiotics should be stopped at least 2 weeks preoperatively to improve the culture rate of causative organisms from intraoperative samples. This may not be possible if the patient is overtly septic but is achievable in the majority. Surgery should not be undertaken prior to completing investigation and treatment of concurrent medical conditions and must be properly planned.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"9d713821-713a-17c9-5bd3-01f441ed41c1","text":"Due to the small number of reported cases, it is difficult to ascertain the exact aetiology of this rare presentation. The picture is further clouded by the fact that the patients in our cohort did not proceed to have this reaction in previous or future treatments with ONA. This raises a few scientific questions as to the possibility of why these three patients had such similar reactions in a small-time frame, with both host and drug factors needing exploration. One common factor in all three of our patients is the drug used. The manufacturer preparation process or storage of the toxin in certain batches cannot be excluded as a cause.","title":"Nodular Eruptions as a Rare Complication of Botulinum Neurotoxin Type-A: Case Series and Review of Literature"}
{"_id":"9d7c3b17-b51a-92ba-1c40-72c696bd5795","text":"A questionnaire survey was conducted among patients who had contracted and recovered from SARS-CoV-2 within a month. The survey aimed to investigate various indicators in patients who had received botulinum toxin A injections at the same site before and after their infection, including pain scores and allergic reactions and the occurrence of complications.","title":"The impact of SARS-Cov-2 infection on the periocular injection pain and hypersensitive reaction to botulinum toxin type A: results from clinical questionnaires"}
{"_id":"9d7e8f32-ce92-dc88-9a15-fe73b85f418f","text":"The correlation between superficial BCC and complications was probably due to the higher number of stages required for removal, which increases the length of the surgery, resulting in a higher probability of bleeding and therefore an increased likehood of necrosis.","title":"The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital"}
{"_id":"9d812b39-7120-74d5-1941-a6078ddf71c1","text":"Prophylactic excision at the puberty stage is recommend according to standard surgical treatment because NSs are known to pass through a proliferation phase with rapid morphological and histological changes at this stage.[ However, considering the very low incidence of malignant transformation at this stage according to some studies[ and complications such as alopecia after widely applied prophylactic excision surgery in adolescent patients, prophylactic excision needs to be carefully considered.","title":"Malignant transformation of nevus sebaceous to basal-cell carcinoma: Case series, literature review, and management algorithm"}
{"_id":"9d8667bf-e3bf-d42a-45ca-e90ab839e99f","text":"This was a retrospective study based on the medical records; thus, we were unable to evaluate costs and surgical times after the change in the clinical approach in our hospital after the publication of the ACOSOG Z0011 study. Studies that evaluated cost reduction associated with the elimination of complete axillary dissection, did not consider the risk of surgical re-approach due to the presence of more than two SLNs with macrometastasis or capsular extravasation. The cost of a second surgery remains to be evaluated. Even the ACOSOG Z0011 trial did not report the rate of surgical re-approach in the group subjected to SLND alone. The rate of surgical re-approach in this study was very low and answered this question. In addition, this was the first study in our country to address the findings of Z0011 implementation, which was important to encourage conservative surgical treatment of the axilla in our country and other developing countries, with the aim of disseminating this practice and benefiting patients.","title":"Survival and recurrence with or without axillary dissection in patients with invasive breast cancer and sentinel node metastasis"}
{"_id":"9d8af568-e138-b8d4-d58e-bab2c8ee87ec","text":"Acral melanoma is a rare and often late-presenting subtype of melanoma. Surgical resection is the primary treatment of localized disease, with amputation in some instances. Whenever there is regional lymph node involvement, the performance of lymphadenectomy has a prognostic role and can potentially improve survival outcomes. The importance of controlling the regional nodal disease by surgical removal, however, is controversial, and there is still no consensus on the therapeutic role of CLND. Minimally invasive techniques are a safe option for nodal metastatic melanoma treatment, with oncologic results comparable to those of open inguinal lymph node dissection. The case presented in this report, where a patient with an acral melanoma who underwent a Lisfranc amputation and endoscopic groin lymph node dissection for the treatment of regional lymph node metastasis, is significant in Ecuadorian medical literature because it represents the first reported case of its kind. Our aim in documenting this case is to add to the expanding pool of information on acral melanomas and to improve the quality of medical treatment available for patients in Ecuador and worldwide.","title":"Video-Assisted Endoscopic Inguinal Lymph Node Dissection for Acral Melanoma"}
{"_id":"9d905d50-6149-8b3b-e8c6-dc4ada2187d7","text":"Our primary aim was to estimate the incidence of further procedures after intra-articular steroid injection for BTOA in adults in the NHS in England. Secondary aims were to identify factors associated with proceeding to further intervention, especially surgery, serious complications and whether having a BTOA injection prior to surgery affected the risk of serious surgical site infection.","title":"Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis"}
{"_id":"9d97d886-17c6-d8ab-2f1b-289f4cb6d32d","text":"An epidermoid cyst is a rare benign tumor which can occur and cause severe neurological deficits. Complete excision is the standard treatment but is hard to reach, so recurrences after subtotal excision are not uncommon. Special attention should be paid to the treatment for recurrent lesions because repeated recurrence may lead to malignant transformation. Complete excision at the utmost with the help of postoperative radiotherapy can serve as an ideal choice.","title":"Repeated recurrent epidermoid cyst with atypical hyperplasia A case report and literature review"}
{"_id":"9d9f3bda-d476-38e2-3394-24bb1a800dce","text":"Recently, more attention has been given to shoulder rehabilitation with a focus on muscle strengthening and range of motion maintenance in breast cancer patients after mastectomy and breast reconstruction.[ However, to our knowledge, ours is the first study to objectively measure postoperative shoulder function after various surgical methods of breast reconstruction. Strength and range of motion of the shoulder joint are critical for a better postoperative quality of life in cancer survivors. The findings of the present study provide valuable information regarding postoperative quality of life and physical function and provide guidance for discussing treatment plans and options with breast cancer patients.","title":"Quantitative analysis of shoulder function and strength after breast reconstruction A retrospective cohort study"}
{"_id":"9da104ce-0f9f-65c2-7b98-e1f3197f0723","text":"Fibula free flap mandible reconstruction is the standard procedure after wide resection of the mandible. Establishment and maintenance of normal occlusion are important in mandible reconstruction both intraoperatively and after surgery. However, scar formation on the surgical site can cause severe fibrosis and atrophy of soft tissue in the head and neck region.","title":"Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction"}
{"_id":"9dc2f11c-b324-c378-6044-78de2d316485","text":"When investigating the non-lactating breast for abnormalities the patient is often placed in the posterior oblique position with the breast to be examined raised. The objective of this position is to flatten the breast and bring the internal structures more parallel to the ultrasound beam. Thus the degree of obliquity depends on the size and shape of the breast and may vary during scanning. Upright positions are used occasionally to determine if there is either floating debris or dependent levels within cystic lesions. For the lactating breast it may be necessary to use a combination of oblique and upright positions to adequately examine the entire breast, particularly in women with very large breasts. Warm ultrasonic gel is used for scanning to enhance the transmission of sound through the skin into the breast and maintain good contact [3,18,19].","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"9dc61c4a-f58e-6718-0178-755d5fb8798c","text":"This patient suffered from burnt scar contracture of the chest and abdomen, which resulted in an undeveloped left breast and chest contracture belt with longitude. For reconstruction, we employed a thin skin graft from the back and hip region and autologous dermal matrix. HA was used in the bottom portion of the secondary defect outlined by the black line, as opposed to the higher portion. Despite the relaxation of scar contracture after one year, the underdeveloped breast was not symmetrical with the normal breast. There were no hypertrophic scars or delayed healing at the donor locations. The bottom portion of reconstructive tissue healed better with the addition of HA than the top portion did without the addition of HA.","title":"Basic and clinical study of the effect of exogenous hyaluronic acid on the quality of acellular dermal matrix combined with thin intermediate split thickness skin graft"}
{"_id":"9dc860d2-2494-e381-bdb3-fa653d87333e","text":"A potential option for patients in whom PJI is suspected, but preoperative diagnostic workup has been inconclusive, joint biopsy with sampling of periprosthetic and synovial tissue has been proposed. These procedures can be performed arthroscopically, through needle biopsy or as incisional open biopsies with no approach being clearly superior to the others. Previous studies reported high sensitivity and specificity for routine synovial biopsies in the diagnosis of low-grade chronic PJI. However, there is a lack of studies on open synovial biopsies in cases of inconclusive or intermediate preoperative score results in the diagnostics for chronic PJI in TKA. This study investigated if there is a benefit of open incisional biopsies after inconclusive results of preoperative serum and synovial markers.","title":"Poor performance of open incisional biopsy for the microbiological diagnosis of periprosthetic knee joint infection"}
{"_id":"9dc886a1-1614-2faf-eaa3-7fb186ccf96a","text":"Table 1 Summary of the criteria to determine the nuclear grade for the DCIS classifications studied","title":"Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis"}
{"_id":"9dc97fb3-f0dc-9a15-19cf-dfdb02a0e95c","text":"The TABBY Assessment Tool is a simple addition to the assessment of tongue-tie in infants and can provide an objective score of tongue-tie severity. Together with a structured breastfeeding assessment it can inform selection of infants for frenotomy. It can be used by clinical staff following a short training and will facilitate translation into other languages.","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"9dcc95a9-d6ac-07cc-b7ca-511275ce1a3a","text":"Fortunately, 3D virtual surgical planning is now available to remove many of the hurdles involved in determining the best plan and transferring it to reality.","title":"Treatment of post-traumatic deformities"}
{"_id":"9de28d81-978c-1ac5-c2bf-df042bc1f4b1","text":"Further history was obtained from the patient’s family members on day 5 of admission, who stated that the patient had received bilateral gluteal and lip injections with silicone from an unlicensed professional. She had received these routinely over several years and a few days prior to her onset of symptoms. On receiving this information, it was concluded that the patient was experiencing diffuse alveolar hemorrhage secondary to suspected silicone embolism syndrome.","title":"COVID-19 Infection Or Buttock Injections? the Dangers of Aesthetics and Socializing During a Pandemic"}
{"_id":"9df1c128-6578-b865-3711-413434b43d2e","text":"Given the limited availability of stage information in our dataset, further indirect context can be gleaned by comparing our prevalences of primary carcinomas with at least one mutation to United States national tumor stage distributions by anatomic site. Comparing SEER stage distribution numbers to our results requires caution because SEER samples are geographically-representative and include all diagnoses for that anatomic site, such as in situ tumors or sarcomas. Nevertheless, across sites, the SEER distributions broadly resemble our available Profile stage data in that the proportions of patients displaying evidence of detachment at diagnosis tend to be much greater than our observed CDH1 or CTNNB1 mutation prevalences in primary carcinomas.","title":"Somatic mutations in CDH1 and CTNNB1 in primary carcinomas at 13 anatomic sites"}
{"_id":"9df81eb9-1c7d-7ee4-8805-bb1e5cbe0a0d","text":"We used the Surveillance, Epidemiology, and End Results (SEER) database to assess differences in the risk of SPCs in patients with primary melanoma before and after the FDA approved ICIs. We also analyzed changes in the incidence of SPCs with the increased adoption of ICIs as part of the standard of care. Our study hypothesis is that the pattern of SPCs that develop in patients with melanoma has altered in recent years.","title":"Assessment of Trends in Second Primary Cancers in Patients With Metastatic Melanoma From 2005 to 2016 Trends in Second Primary Cancers in Patients With Metastatic Melanoma, 2005-2016"}
{"_id":"9df846fd-7789-e9d1-a983-9a00d7dbd3b3","text":"A total of 1701 pregnant women who attended their first antenatal visit at the NCCHD were registered between 2003 and 2005. A total of 1550 newborn babies were enrolled in the study between March 2004 and August 2006. The target population in this study was children who were followed up until they reached the age of 13 years, completed all variables for questionnaires, and underwent medical examinations and blood tests.","title":"Pollen Food Allergy Syndrome in Allergic March"}
{"_id":"9df995dc-18db-b832-b718-1da2fba7d8f2","text":"There are several potential sources of heterogeneity in this study. Although the study design and data collection was conducted correctly there is a risk of high heterogeneity of the study group which can form a problem when comparing parameters. The observed variability is due to differences at the clinical level of melanoma—in included studies there was no division into types of recurrence (locoregional or distal).","title":"Does It Really Pay-Off? Comparison of Lymphadenectomy versus Observational Approach in Skin Melanoma with Positive Sentinel Node Biopsy: Systematic Review and Meta-Analysis"}
{"_id":"9df9bff8-fdc2-9f1d-83bb-130339f31415","text":"The most important finding of this study is that even if anaphylactic reactions occur during build-up phase all patients in our small cohort could continue VIT and reach the maintenance dose with an adapted regimen. This is in accordance with previous studies [17] and supports the approach that all pediatric patients who have experienced a severe generalized anaphylactic reaction to bee venom can and should complete VIT—even if an adverse reaction occurs during the build-up phase—as VIT is the only causal treatment option for hymenoptera allergy and offers reliable protection against further anaphylactic episodes.","title":"Anaphylactic reactions in the build-up phase of rush immunotherapy for bee venom allergy in pediatric patients: a single-center experience"}
{"_id":"9dff1741-f31d-d25c-1af8-459f6f312104","text":"Calcinosis is a rare but morbid complication of JDM, and experience treating calcinosis is low but varies among physicians. Screening methods for calcinosis and the perceived relationship to active JDM also vary, reflecting low rates of targeted calcinosis therapy separate from overall disease treatment. IVIG and bisphosphonates are most frequently used and considered most successful when treating calcinosis, but many other immunosuppressive and alternative agents are utilized.","title":"Proceedings of the 2016 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting Toronto, Canada. 14-17 April 2016"}
{"_id":"9e00fe09-9c60-91e7-2978-93c08fd09b54","text":"The patient reported that symptoms had ceased after embolization of the pelvic varicose venous plexuses and she remained asymptomatic and in follow-up 30 months after the intervention.","title":"Endovascular treatment of pelvic venous congestion syndrome in a patient with duplication of the inferior vena cava and unusual pelvic venous anatomy: literature review"}
{"_id":"9e09bab1-d129-f36a-7cef-45c67485430d","text":"With SA moving towards the NHI, there is a need for clear delineation of roles and values of the FP in order to improve teamwork among different professionals within the healthcare services for the requisite operational efficiency. The potential exists for the burden of disease to be eased with greater involvement of FM in PHC. However, the shortage of specialist posts for FM registrars upon completion of the training has been highlighted by participants. Unless addressed, these shortages will negatively affect the potential impact which FM could have on patient care.","title":"Perceptions of specialists in the public sector, on the role and value of family medicine"}
{"_id":"9e0c78b5-fd8c-b661-11ad-f40d7f0db731","text":"As our concept of facial rejuvenation has evolved, the midface has become an area of interest to oculoplastic surgeons. The midface is involved in the extended eyelid complex and also is affected by descent of the facial tissues during the aging process of the body. Drooping of facial skin and deepening of the nasolabial sulcus are characteristic features of midface descent. Several surgical methods that achieve vertical elevation are available to address this problem[1]. Today, the surgical techniques are shaped by an improvement in inert suture materials and interest for less invasive surgeries by the public. Herein, we describe and report the results of a simple and effective treatment for midface descent which is less invasive than the traditional deeper plane facelift surgeries. The purpose of the current paper is to describe two years follow up of 35 patients with mid-face descent of various causes who were operated using suture mid-face cable suspension at the division of orbito-facial surgery, Jules Stein Eye Institute.","title":"Suture midface suspension"}
{"_id":"9e1aa4cc-6daa-11b1-dc8f-58f9e14e22f2","text":"The randomised intervention in this trial is the dressing (standard or NPWT) applied to the closed fracture wound at the end of surgery. This intervention occurs at a single time point, and compliance is therefore defined as the proportion of participants in each arm receiving the treatment to which they were randomised. The number (and percentage) of participants receiving the assigned dressing and receiving another dressing or no dressing in each arm will be summarised as well as the reasons for not receiving the randomised treatment. Details of what was provided instead will also be summarised.","title":"Wound Healing In Surgery for Trauma (WHIST): statistical analysis plan for a randomised controlled trial comparing standard wound management with negative pressure wound therapy"}
{"_id":"9e1aa778-7536-7981-7e5c-fb6fdebb4b3e","text":"In our clinical case, the resulting bacteria from the apical infection of the second maxillary premolar moved through the missing buccal bone to the buccal soft tissue and rich injected material in the left cheek. The bacteriological identification of the causative pathogen was not done as the patient did not mention the history of dermal filler.","title":"Infected Facial Tissue Fillers Caused by Dental Infection"}
{"_id":"9e201b15-7005-5e51-27d1-ad6504dc537a","text":"T: Special care must be taken with the correct measurement of tumour size, taking into account the presence of spicules that do not oversize the actual size of the tumour, since this leads to changes in the management of surgery or surgery and chemotherapy.","title":"The Proceedings of the 19th International Cancer Imaging Society Meeting and Annual Teaching Course"}
{"_id":"9e222285-1fb2-65ee-2ed0-0c6192fc393a","text":"An additional injection could be re-attempted before a general anesthetic. Lymphatic mapping and SLNB are preferably performed before wide excision of the primary lesion. Occasionally, the primary lesion might be too close to the draining basin and wide excision can be undertaken first so that the signal does not interfere with SLNB.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"9e2b022d-c27f-e5cd-b63c-0ed843acfddb","text":"The cohort was split at the patient level such that no training data could appear in the testing set. All variables were included in the model to optimize the predictive potential without introducing background noise.","title":"Machine learning methods to predict presence of residual cancer following hysterectomy"}
{"_id":"9e30cf5b-f430-6fa0-917f-b7feb312880b","text":"Background: Human skin allograft has been used as wound coverage for a long time; it is one of the most successful and widely used dressings for burn wounds in the world.","title":"Human Split-Thickness Skin Allograft: Skin Substitute in the Treatment of Burn"}
{"_id":"9e346720-8a56-da2b-982a-0e9b29785c51","text":"The particle of the fractured bone was taken out of frontal sinus and then Medpor® titanium plate was curved like other sides of forehead and fixed by the surrounding tissues.","title":"Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study"}
{"_id":"9e3a7cc7-8ae0-83c6-a90e-bf491bd50fa9","text":"The present population-based cohort study aimed to assess the incidence of POCs in older patients following the most common breast surgical interventions in this age group, namely BCS with adjuvant RT and mastectomy without RT, and evaluate potential associations with survival.","title":"Medical and surgical postoperative complications after breast conservation versus mastectomy in older women with breast cancer: Swedish population-based register study of 34 139 women"}
{"_id":"9e3d4130-487c-9790-93cf-e777f5647851","text":"Considering the clinical value of timing of recurrence, we introduced two models according to time of recurrence as early and late recurrence. Accordingly, our models showed that only radiotherapy and stage of cancer remained to be significant in recurrence of > 5 years. This is an important clinical finding as it aids significantly in the understanding of late recurrence in BC patients.","title":"Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?"}
{"_id":"9e4347b7-98ce-7f4e-3b9a-d99eab25ec25","text":"We report a case of multiple and recurrent UTCs after three surgical removals. Although the result in a single case cannot be taken as an indication of effectiveness for UTC, our case suggests the importance of imaging examination before surgical excision. Further investigations are needed to elucidate the recurrence mechanism of UTC.","title":"Multiple uremic tumoral calcinosis in periarticular soft tissues with chronic renal failure: a case report"}
{"_id":"9e4c2cf4-af87-9a26-42f5-4e65d773f74a","text":"Infection following TRUS Bx is one of the most common and significant complications in patients undergoing prostate biopsy and can entail hospitalization and additional cost. In fact most postbiopsy hospitalizations result from infectious causes. Antimicrobial prophylaxis is recommended for all patients undergoing prostate biopsy, irrespective of risk factors. Several prophylaxis protocols have been suggested in order to reduce the incidence of infectious complications but none has demonstrated unequivocal superiority.","title":"Addition of Ceftriaxone and Amikacin to a Ciprofloxacin plus Metronidazole Regimen for Preventing Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Randomized Controlled Trial"}
{"_id":"9e4cbc2d-5e73-bd01-38de-3cef8076c08f","text":"All the patients who had nodal metastases on core biopsy underwent level 3 axillary clearance as a primary procedure at the time of resection of the primary tumour. The lymph node stage was determined by the number of positive nodes on the histology of the surgical specimen; lymph node stage 1 if no nodes were involved, lymph node stage 2 if three or less nodes were involved and lymph node stage 3 for four or more involved nodes. Those patients who did not have nodal metastases confirmed histologically preoperatively underwent axillary node sampling with or without sentinel node augmentation, depending on the surgical preference. Those patients who were shown to have axillary nodal metastases subsequently underwent either radiotherapy if stage 2, or axillary clearance if stage 3.","title":"Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer"}
{"_id":"9e50db9f-77e3-86a0-68ec-acb8ec70df22","text":"The strengths of this research are that we systematically searched a range of databases and used a variety of synonyms and related terms to capture all relevant data. We did not limit the search by time or language, to maximize the reach, and used broad inclusion criteria to allow us to include both observational and interventional studies. However, given the lack of a standardized definition and limited research on ankyloglossia, we were unable to find many studies directly relevant to our question. The only primary research we did find was of poor quality and had significant limitations.","title":"Maternal folic acid supplementation and the risk of ankyloglossia (tongue-tie) in infants; a systematic review"}
{"_id":"9e52422c-c464-cdad-0b34-8964408f6ee0","text":"We would otherwise be accepting a risk of leaving consistent residual axillary disease in 50% of the cases. it may be in these cases where the literature shows that the theoretical risk does not manifest recurrence.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"9e5985ca-e078-b976-a007-9fb70ec9af03","text":"Although most cases present as localized disease treatment should be definitive due to high rates of local or systemic recurrence. Treatment includes excision of the lesion, lymphadenectomy, postoperative radiotherapy and chemotherapy depending on the stage of the disease. Even when locoregional control is achieved close surveillance is required due to high rates of relapse.","title":"Merkel cell carcinoma of the upper extremity: Case report and an update"}
{"_id":"9e5d3920-9318-da99-3c3d-f8b4a8c0cfce","text":"The tissue equivalence image as a stand-alone image was not considered to be of major diagnostic value. Besides the fact that this image is not appropriate for the evaluation of bony structure nor for the visualization of diagnostic details of the bone, two of the three readers considered the overall image quality to be bad, while one considered it to be moderate. Furthermore, one of the readers considered the diagnostic acceptability to be valid only under limited conditions while the other two readers rated it to be bad or even unacceptable.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"9e6265cb-d3db-55ba-2529-e99e405ca311","text":"Each attending surgeon was also required to record all adverse events throughout the study period. A central panel of investigators classified each adverse event in relation to the surgery; any discrepancies among reviewers were resolved by consulting source documents. Perioperative complications were defined as surgery-related events occurring within 30 days of surgery.","title":"Comparison of laminoplasty and posterior fusion surgery for cervical ossification of posterior longitudinal ligament"}
{"_id":"9e66e647-ec92-6609-41b5-24193a60b23a","text":"Dyspnea and hypoxia can also occur with pulmonary embolis and pneumonia. Cerebral dysfunction will occur with hypoxia or meningitis, but the rash of meningococcal septicemia spreads rapidly all over the body.","title":"Emergency management of fat embolism syndrome"}
{"_id":"9e68e253-8c16-0ba9-7f7b-aa076267f77c","text":"The objective of this study was to compare VTE outcomes among surgical patients before and after the initiation of a nonmandatory VTE risk-stratification tool. The primary outcome measure was inpatient VTE events, defined as any pulmonary embolism or deep venous thrombosis diagnosed during the inpatient admission period for each patient by either symptomatic workup or incidental imaging. Secondary outcomes were defined as prescription of VTE chemoprophylaxis, choice of VTE chemoprophylaxis medication, prophylaxis prescribed on discharge in the very high risk patient subgroup, and compliance with EHR tool utilization.","title":"Electronic health record risk-stratification tool reduces venous thromboembolism events in surgical patients"}
{"_id":"9e6a398c-7bd2-d7de-73cd-5ddd3d153e80","text":"The minimal clinically important difference was estimated by asking 4 international active spine surgeons what they would consider a clinically significant difference in mJOA score. The mean of the values is considered the MCID.","title":"Design of Lamifuse: a randomised, multi-centre controlled trial comparing laminectomy without or with dorsal fusion for cervical myeloradiculopathy"}
{"_id":"9e6ccfdf-a786-dd7d-691a-16cb1edb0ff5","text":"It is unclear to what extent the form of the carrier impacts the difference in clinical outcomes. In a previous study, it was shown that there is improved bone formation when Cerament G has good initial contact with the bone cavity. Cerament G may be able to achieve better bone contact because it can be injected into cavities and coat the surface of the endosteum, unlike the premade Osteoset T pellets. It is not clear to what degree the contrasting physical properties of the two materials (one as pellets and the other as an injectable paste) may explain the difference in clinical outcomes between the two groups.","title":"A comparison of clinical and radiological outcomes between two different biodegradable local antibiotic carriers used in the single-stage surgical management of long bone osteomyelitis"}
{"_id":"9e6e186b-d985-46ca-13ef-8049f0031382","text":"Considering the higher incidence of prophylactic mastectomies and the present controversy on sentinel lymph node biopsy in this type of surgery, our study adds to the literature by specifically addressing this subject in a high risk for occult carcinoma women, BRCA1\/2 mutation carriers, and to whom preoperative breast magnetic resonance imaging (MRI) was routine. Our objective was then to review the outcomes and clinical utility of sentinel lymph node biopsy in prophylactic mastectomy in a consecutive group of systematically evaluated high risk for occult carcinoma women.","title":"The Use of Sentinel Lymph Node Biopsy in BRCA1\/2 Mutation Carriers Undergoing Prophylactic Mastectomy: A Retrospective Consecutive Case-Series Study"}
{"_id":"9e73729e-664a-638a-f17d-e9f388b3e1a2","text":"In the literature, the statement that the condition is associated with changes in breastfeeding is recurrent Studies consequently focus on reporting the beneficial effect of surgical correction on breastfeeding indicators. The effects of changes in breastfeeding can be variable, while the assessments carried out in most studies are in the first weeks of life, a period in which breastfeeding difficulties are common. There is therefore a physiological bias in the diagnosis and observed outcome.","title":"Ankyloglossia severity in infants: maternal pain, self-efficacy, and functional aspects of breastfeeding Gravidade da anquiloglossia em bebês: dor materna, autoeficácia e aspectos funcionais do aleitamento materno"}
{"_id":"9e76be40-16e4-e197-d598-96ebc75a3eb8","text":"We conclude from this study that there is no statistically significant difference in the number of lymph nodes or number of positive nodes harvested from the axilla, regardless of timing of axillary clearance or the use of SLNB. The goal of axillary clearance is to remove all potentially involved lymph nodes and fatty tissue, and using the number of nodes as a measure of adequacy of tissue retrieval, we have shown equivalence between each technique in our unit. Therefore, even in more surgically challenging circumstances, such as the scarred axilla of a previous SLNB, surgical technique is robust in ensuring adequate clearance of the axilla.","title":"The Axillary Nodal Harvest in Breast Cancer Surgery Is Unchanged by Sentinel Node Biopsy or the Timing of Surgery"}
{"_id":"9e7b2044-75fd-7497-eb7c-0bfccff6098d","text":"Melanoma is the most serious skin cancer with a high mortality rate that reminds the necessity of performing the histopathological analysis of any pigmented lesion after biopsy, as well as the detection of the history of pigmented lesions. , , Herein, we presented a rare case of metastatic malignant melanoma originated from a pigmented scalp lesion by passing 2 years from the primary excision of the nevus that had not been examined microscopically before. Moreover, the primary lesion was probably excised with inadequate care regarding the marginal safety in surgical procedure.","title":"Malignant melanoma of parotid glands from a neglected lesion: A case report"}
{"_id":"9e7eb864-d470-a4e2-f8ab-713265753d38","text":"In this series the majority of patients underwent lower limb surgery under epidural using a gracilis muscle flap for soft tissue cover. This is safer and more cost effective than general anaesthesia, avoiding the use of inhalational gases. The unit has a long established routine use of invasive doppler monitoring, which allows early detecting of vascular problems, particularly in muscle flaps where clinical flap monitoring is more difficult2. It maximises the chance of flap salvage. A recent meta analysis suggested invasive doppler increased the chance of flap salvage but did result in a higher rate of unnecessary to return to theatre4.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"9e80c8eb-3042-90bc-9852-b704bb62ca51","text":"Participation in bilateral and equitable international electives is a unique experience of personal and professional growth. There is an interest in these opportunities during residency training among Otolaryngology residents that is not reflected in availability within training programs. This suggests the need for development of humanitarian outreach exposure through global health experiences during surgical residency training.","title":"Going Global: Interest in Global Health Among US Otolaryngology Residents"}
{"_id":"9e83ecd3-a89f-16c6-2e8e-438ef08ee30d","text":"One of the main limitations that restrict the use of most therapies is the size of the lesion. In cases of GCT in the distal radius, a lower rate of recurrence has been reported after the use of surgical resection compared with curettage when the tumor has expanded beyond the cortex. Resection of the lesion will produce a defect in the distal radius requiring reconstruction with either arthroplasty or arthrodesis using vascularized or nonvascularized bone grafts. Bone grafts can be taken from the tibia, the proximal part of the fibula, the iliac crest, or the distal part of ulna in and effort to preserve the motion of the wrist joint.3","title":"Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius"}
{"_id":"9e872b6c-350a-3cc9-846d-991e3327fe21","text":"It is easier to detect lymph node involvement without introducing formaldehyde into the sample. We recommend that N1 lymph node dissection be performed on fresh specimens to detect more lymph node involvement.","title":"N1 lymph node detection in lymph node harvesting in non-small cell lung cancer: Formaldehyde exposure is a drawback?"}
{"_id":"9e88cf46-5857-f678-6ffc-0b52df2b0f89","text":"The prevention and treatment of radiation dermatitis is required for all radiation oncology patients, regardless of the intensity of therapy. Skin care is an important function of the radiation oncology nursing staff, and the skin is routinely evaluated by the attending physician. Reducing skin toxicity is important, because it allows a patient to complete a continuous course of RT and minimizes the intensity of radiochemotherapy interactions that are common among patients who receive combined modality therapy. No product has been identified as the superior treatment for radiation dermatitis. Therefore, skin reactions remain a common cause of patient discomfort and cancer treatment delay.","title":"A phase III trial comparing an anionic phospholipid-based cream and aloe vera-based gel in the prevention of radiation dermatitis in pediatric patients"}
{"_id":"9e950461-e120-ccdd-6ba4-0e3c2501081e","text":"The modified algorithm for the postoperative osteomyelitis following fracture fixation according to the stability of the hardware and Cierny–Mader type represents a good clinical efficacy in the management of postoperative osteomyelitis. This procedure is simple and shows promising results; more clinical evidence is needed to confirm the existing findings and optimize the treatment of postoperative osteomyelitis following fracture fixation.","title":"Modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny-Mader type"}
{"_id":"9e9c0221-bca9-248d-8984-c1728e342c16","text":"Some of these can be treated by liposuction alone if the breasts are found to be predominantly fatty. Close attention must be paid to skin tone and elasticity before the option of liposuction alone is given to the patient.","title":"Reduction mammoplasty"}
{"_id":"9eaca8cc-6e2d-f998-d985-68d98c1fc78a","text":"The patient was advised to undergo a robotic bilateral inguinal lymphadenectomy.","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"9eacbc1a-6523-3807-0bcc-63f146817783","text":"This supports the theory that distant metastasis originates from the primary melanoma and that metastatic dissemination is orchestrated in a parallel rather than serial fashion.29 The recent results of the MSLT-II study also support this theory as immediate completion lymph node dissection did not improve melanoma-specific survival among patients with sentinel-node metastases compared to observation with frequent nodal ultrasonography and dissection only in patients in whom clinically detected nodal recurrence had developed.31 Therefore, the Halstedian hypothesis of contiguous metastasis from the primary tumour through the lymphatics to regional nodes and then to distant sites as the sole mode of disease spread should be rejected.29 The model of differential spread proposes that there are multiple independent dissemination pathways with some melanomas able to metastasise only to regional lymph nodes, others able to metastasise only haematogenously and others still able to metastasise haematogenously and via the lymphatic system.32,33 Indeed, metastatic patterns vary widely among melanoma patients and the drivers behind the preferential patterns of metastasis among different melanomas remain largely unknown. One explanation is that this may be due to intratumoural heterogeneity and metastatic dissemination that occurs from genetically distinct subpopulations of the primary tumour.34","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"9eb14f4b-39b9-7fbb-bf7e-1258fd78f9ae","text":"Acute pyogenic cervical spinal infection with concomitant vertebral osteomyelitis is a life-threatening disease with increasing incidence and associated with complications such as sepsis, myelopathy, kyphotic deformity, and spinal instability.","title":"Free Vascularized Fibula Graft as Primary Salvage Procedure for Acute Cervical Osteomyelitis Caused by Epidural Abscess"}
{"_id":"9eb23239-4408-71e7-f1d9-630921750695","text":"We reviewed all medical records of the enrolled cases. Recurrence interval was defined as the interval months between the date of first surgery for primary cancer and the date of postoperative MRI where recurrent lesion was detected. The stage of primary cancer by AJCC 7th edition, histology, and the subtype by hormone receptor of primary and recurrent cancer were reviewed.","title":"Usefulness of postoperative surveillance MR for women after breast-conservation therapy: Focusing on MR features of early and late recurrent breast cancer"}
{"_id":"9eb7a33d-ef92-08b6-58d2-5e7d14ad4fc1","text":"In this prospective study with 107 patients we evaluate ROE score before surgery and at 3 and 6 months later, allowing more precise results about satisfaction.","title":"Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study Avaliação dos desfechos estéticos e funcionais em cirurgia de rinoplastia: um estudo prospectivo"}
{"_id":"9eb94fbd-374a-1478-6c28-26e629119575","text":"The results presented in this study suggest that electromyographic biofeedback improved uptake of more adequate orofacial habits. However, future studies with a larger number of subjects and control group should be carried out, given that currently no studies were found that demonstrated differences between the outcome of interventions performed with and without the association of this therapeutic resource(.","title":"Utilization of electromyographic biofeedback in speech therapy to attenuate the signs of facial aging: a case report"}
{"_id":"9ebb7331-45b5-f134-22d2-8a641df8a404","text":"The biological concept is the possibility to transfer portions of skin to another side without vessel anastomosis, due to the limited amount of tissue cells transferred, that can be successfully supported by the underlying healthy tissue.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"9ec55b66-6171-6d47-9b68-8852e654678f","text":"This study aimed to clarify the epidemiology and associated factors of developing VTE during the perioperative period in a tertiary care hospital in Japan.","title":"Prevalence and associated factors of developing venous thromboembolism in the perioperative period"}
{"_id":"9ec5a7fd-13f5-499d-ea50-a1685d6dcdb2","text":"A summary of local immunity modifications in both untreated BCC and during therapy with Hh pathway inhibitors is shown in Table 1.","title":"Basal Cell Carcinoma and Hedgehog Pathway Inhibitors: Focus on Immune Response"}
{"_id":"9ec743f0-811c-c8c9-7a42-40976ccb877f","text":"The recognition of the importance of early nutrition has led to increasing research on human milk. The results of this research indicate that human milk should be the standard and exclusive infant feeding in the first months of life. These facts led to the initial recommendation of the WHO that infants be exclusively breastfed for 4 to 6 months before introducing any other fluid or food, with continuation of breastfeeding up to 2 years. According to the WHO definition, exclusive breastfeeding means no other food or fluids (including plain water and juices). Infant milk formulas are considered complementary food.8 In 2001, the WHO extended the period of exclusive breastfeeding to 6 months instead of the period 4 to 6 months. However, there is still debate about the optimal duration of exclusive breastfeeding.910","title":"Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations"}
{"_id":"9ec8406f-6b44-3707-4701-a374a1e9612e","text":"Frequencies and reasons of device removal throughout the study were documented every cryotherapy cycle.","title":"Impact of Cryotherapy on Sensory, Motor, and Autonomic Neuropathy in Breast Cancer Patients Receiving Paclitaxel: A Randomized, Controlled Trial"}
{"_id":"9ec94c03-c1a4-2c6e-c239-e712c0dc6062","text":"Currently, the gold standard for grafting is autologous cartilage,15,16 because of its inherent biocompatibility and relatively low complication rates. Costal cartilage also provides the most duration strength and adequate amount with well-established suturing and carving techniques to minimize warping in the application of costal cartilage.9,17–19","title":"Prospective Clinical Trial Evaluating the Outcomes Associated with the Use of Fresh Frozen Allograft Cartilage in Rhinoplasty"}
{"_id":"9ecc80ba-e297-51fd-f395-69cf2fc1965f","text":"While public health respondents said that they lack formal authority over climate change’s health impacts or drivers, respondents from all groups believed that the public health sector has a lot of informal authority amongst communities and decision-makers. They believe that public health professionals could use this informal authority to provide greater leadership and possibly even move towards formal mandates for public health to address climate change.","title":"Challenges and Opportunities for Advancing Work on Climate Change and Public Health"}
{"_id":"9ecf29e1-6037-6dca-a4a4-f3228babad54","text":"The effects of the injections lasted for 6 months, after which the patient received another set of injections of the same dose utilizing the same technique. The BTX effects in the second and third sessions lasted for about 8 months each. The patient was doing very well on his last follow up visit with no reoccurrence of the movements or adverse reactions to the injection.","title":"Ultrasound-guided botulinum toxin A injection in the treatment of belly dancer’s dyskinesia"}
{"_id":"9ed229ed-7b63-3e07-d53e-5ffcdcf22809","text":"The most important way to avoid these complications is preparing the graft by separating it from the epithelium as much as possible and avoiding unnecessary trauma during the osteotomy.","title":"The Development of Dorsal Nasal Cyst Formation after Rhinoplasty and Its Reconstruction with Conchal Cartilage"}
{"_id":"9ed90c77-d9a9-f63b-aa3c-c2509f66b532","text":"compression ultrasound performed at 2 cm intervals from the common femoral vein to the ankle including the peroneal and posterior tibial veins in the calf,","title":"Prevalence and predictors of alternative diagnoses on whole-leg ultrasound negative for acute deep venous thrombosis"}
{"_id":"9edca9f2-993b-26e3-8c03-76383b21ff6b","text":"Vismodegib has been used in the management of locally advanced BCC not suitable for surgery or radiation therapy.","title":"Neoadjuvant vismodegib in the management of locally advanced periocular basal cell carcinoma"}
{"_id":"9edf1a43-946d-8a41-2fd9-de70268a1f66","text":"For all studies only articles reporting studies of women with stage 1–3 breast cancer who had no distant metastases and were in remission after surgery were reviewed. Further particulars of patients are described in the tables.","title":"Options for early breast cancer follow-up in primary and secondary care - a systematic review"}
{"_id":"9ee0f6f0-5c4c-c94d-f7a0-1e742be29dc8","text":"Table 4 Association between infant feeding and autism symptoms in children with ASD","title":"Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: a national multicentre survey"}
{"_id":"9ee837d0-0b92-559c-6c2f-fa88e5679162","text":"The lingual frenulum is a dynamic three‐dimensional structure formed by a central fold in a layer of fascia that extends across the floor of the mouth with high degree of morphologic variability between different individuals. The presence or absence of a short or tight lingual frenulum alone may or may not be directly associated with impairments of tongue mobility. Many patients with restrictive lingual frenulum may have only minor difficulties and may compensate for limitations in tongue movement. Patients may compensate for tongue movement, for example by lifting the mandible and\/or the floor of the mouth. The compensations, in some cases, may not be benign and can be the genesis of future oro‐facial myofunctional or temporomandibular disorders.","title":"Assessment of posterior tongue mobility using lingual‐palatal suction: Progress towards a functional definition of ankyloglossia"}
{"_id":"9ef21796-46bd-2ec8-9325-abceb28d05dc","text":"Tables 2 summarizes the characteristics of the patients included in the selected studies. Table 3 shows the outcomes comparing Observation vs CLND in SLN positive patients among the studies.","title":"Lymphadenectomy after a positive sentinel node biopsy in patients with cutaneous melanoma. A systematic review"}
{"_id":"9ef48c43-9790-acbd-ae7f-d883a4ebc40d","text":"The present research shows that it is pointless as previously thought to describe the association between the fibular collateral ligament attachments and the PLT, due to too great morphological variability and in many cases the PLT is combined with fibular collateral ligament via additional bands. Previous studies included a very small research sample, hence probably why the authors did not observe such significant morphological differences.","title":"A proposal for a new morphological classification of the popliteus muscle tendon with potential clinical and biomechanical significance"}
{"_id":"9ef52c18-a294-33cf-4062-ebb3b22e546c","text":"Oncologic reconstruction following surgical excision of non-melanoma skin cancer is highly dependent on the risk classification of the tumor and the size and location of the post-excisional defect.8 Delaying oncologic reconstruction until negative margins are confirmed on histology lowers the risk of tumor seeding and the need for multiple reconstructive procedures. While patients with high-risk malignancies should always have confirmed negative margins before reconstruction, patients with low-risk malignancies may elect to undergo immediate reconstruction.8","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"9ef71966-7996-942e-9ca1-b51edabc1fb4","text":"Skin malignancy surgery was important in our study. Skin malignancy entities require urgent surgery because of their aggressive nature. We performed surgery for all types of basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Considering the restrictions and limited outpatient clinic admissions, delayed presentations were commonly observed. Fear of the COVID-19 mortality among older people can further delay the admissions because most of the skin malignancy patients were in the risk group of age for COVID-19, especially in the head and neck region. Thus when performing surgery, it is best to select the appropriate reconstruction method both for reducing the operative time and hospitalization stay time postoperatively. Reconstruction after resection of skin malignancies is especially important in the head and neck region. Pushing the maximum conservative treatment option within the reconstructive ladder can shorten the time of surgery, hospitalization and further visits to hospital and thus reduces the risk of transmission. It is appropriate to use the pedicled and safer flaps instead of free flaps for reconstruction [10]. Tracheal intubation time is important for both the patient and the operating staff because longer mechanical ventilation time produces more aerosols which can lead to increased risk for COVID-19. When possible, local or regional anesthesia techniques should be selected to reduce the risk of transmission via aerosol generated procedure. Most of the upper extremity trauma and skin malignancy surgery can be performed without general anesthesia. However, it is important to detect the cases which can be quicker and comfortable with general anesthesia.","title":"Risk Assessment of Surgical Interventions Performed on Non-Infected Patients During COVID-19 Pandemic"}
{"_id":"9ef858b5-4fe0-c7dd-dc09-73f0035bca82","text":"The survey was administered anonymously and voluntarily to all otolaryngology residents in the United States via an email to otolaryngology residency program directors of the 106 ACGME accredited Otolaryngology Residency Program Directors for distribution to their residents. The survey was accessed via a SurveyMonkey© website link in the email. The survey was available for three months, and two reminders for participation were sent via the original method of communication. The estimated total number of residents who could have participated is 1,560.","title":"Going Global: Interest in Global Health Among US Otolaryngology Residents"}
{"_id":"9efec2df-695d-e362-2858-fa17e0bf7e56","text":"The presence of a tissue surrounding the surgical breach with numerous actinic lesions, some of which are in epitheliomatous evolution, excluded the possibility of practising transposition in the flap from neighburing areas with grafting in the site of donation of the flap.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"9f042735-4f68-d0c3-0a13-f05ff8511f7b","text":"Findings: Intervention fidelity and adaptation emerged as a multi-level construct operational at the cooperative and practice levels. At the cooperative level, external practice facilitators were encouraged to use an overarching conceptual framework and specific support activities with each participating clinic, but there was considerable variation in the extent to which cooperatives encouraged and allowed tailoring those activities to the needs and desires of individual practices. At the practice level, facilitator interview and log data showed significant variation across practices in number, duration, and mode of facilitator encounters as well as in types of support activities provided. For example, facilitators in one cooperative delivered the planned 15 visits over the intervention period while others tailored the number and duration of facilitator visits to the needs of the practice so that number of visits ranged from 5 to 48 over one year.","title":"Proceedings from the 10th Annual Conference on the Science of Dissemination and Implementation"}
{"_id":"9f0575d3-f7f6-c21c-5f21-9fe1f70c80a4","text":"A male patient was sent for observation from the hepatology unit with a history of erythema and itching which had appeared immediately, 10 min after administration of an iodinated unspecified CM, 6 weeks previously. The patient did not present impairment of vital parameters. Resolution of skin signs and pruritic symptoms occurred 2 h after cortisone and antihistamine therapy, as practiced in case 1.","title":"The involvement of osmolarity in the safety of contrast media"}
{"_id":"9f06e35e-7896-764a-19ed-bab73efe0ae9","text":"Given the continued controversy over selection criteria for SLNB in patients with thin melanoma, and the relatively unknown factors associated with a false‐negative SLNB performed in this specific population, we reviewed our experience with SLNB in thin melanoma patients to evaluate for clinicopathologic characteristics associated with the presence of nodal disease and to identify risk factors for a false‐negative SLNB.","title":"Regression in thin melanoma is associated with nodal recurrence after a negative sentinel node biopsy"}
{"_id":"9f086218-5cdd-68c7-ba8c-bf3cd0b2b354","text":"Routine imaging of the reconstructed breast can diagnose local recurrence with limited harm, generating few additional investigations. However, which patients may benefit and whether this improves outcome is unclear as the number of cases in our audit is small and the event is thankfully rare.","title":"PB.20. Audit of 5 years of routine screening mammography of the reconstructed breast"}
{"_id":"9f0f1740-096f-1315-6fc4-4068e4e3421d","text":"The National Institute for Health and Care Excellence (NICE) guideline recommends that all patients should be mandatorily evaluated for the risk of VTE and bleeding at hospital admission and reassessed 24 hours after the procedure for readjustment of prophylaxis, if necessary. This guideline also recommends the adoption of pharmacoprophylaxis for patients classified as high risk for developing VTE who will undergo conventional surgery for LL varicose veins .","title":"Protocol for prophylaxis of venous thromboembolism in varicose vein surgery of the lower limbs Protocolo para a profilaxia do tromboembolismo venoso em cirurgia de varizes dos membros inferiores"}
{"_id":"9f172ef4-70d7-f95f-8136-ba2caaff7e9b","text":"This study is looking to identify the appropriate methods for preoperative evaluation of the skin flap thickness using clinical examination, breast ultrasound, breast MRI and mammography, the correlation with the intraoperative findings and also its importance for the aesthetic outcome after immediate implant-based reconstruction. The appropriate surgical method of implant based immediate breast reconstruction should be done knowing that the skin flap thickness can help the surgeon choose the adequate implant placement and avoid complications like skin flap necrosis, implant animation and implant edge visibility.","title":"Assessment of Mastectomy Skin Flaps for Immediate Implant-Based Breast Reconstruction"}
{"_id":"9f1cd5cc-012d-7839-f1d3-bc7d246a005d","text":"Until such a time as the accuracy of imaging and core needle biopsies can reliably determine pCR surgery with histological assessment of the resected specimen is likely to remain a corner stone of effective treatment, accurate assessment of pCR, and reduction of local regional recurrence.","title":"Evolving Trends in Surgical Management of Breast Cancer: An Analysis of 30 Years of Practice Changing Papers"}
{"_id":"9f241c2b-d970-d770-f3f6-6e06991390fd","text":"SLNB in head and neck cancer has not translated into regular clinical practice in many centers, but given that it is now a recommendation in the NCCN guidelines [23] and a quality standard in the NICE guidelines, the technique might be adopted progressively. SLNB is a valuable technique as it enables the identification of the sentinel lymph nodes of the tumor, which can be processed for histology. Only if the SLN is positive for malignancy on histologic examination is a neck dissection subsequently performed, which should reduce operative morbidity in patients who have a negative SLN.","title":"Sentinel lymph node mapping using ICG fluorescence and cone beam CT – a feasibility study in a rabbit model of oral cancer"}
{"_id":"9f31e3e9-af31-adda-7a80-ea4eee66e436","text":"This is the first animal model to simulate nasal airway reconstruction. ePTFE reinforcement is more effective in reducing cross sectional area when a vacuum is applied than irradiated cartilage.","title":"Preventing nasal airway collapse with irradiated homologous costal cartilage versus expanded polytetrafluoroethylene: a novel animal model for nasal airway reconstruction"}
{"_id":"9f3b5778-1500-566b-54eb-110368cfe626","text":"The detectability of melanoma and non-melanoma skin cancers is comparable to that of skin cancers obtained in similar screening projects. The early stage disease was confirmed for the detected melanoma and skin cancer. The incidence rate of CM and NMSCs among the program participants was higher than in general public.","title":"Screening for Melanoma and Other Skin Cancer Shows a Higher Early Melanoma Incidence: Social Educational Program “Life Fear-Free”"}
{"_id":"9f3fb89d-a57f-8aad-6e70-f839deddfdc3","text":"We retrieve the data contained in the questionnaire from the electronic medical record system. And enter the data into the EXCEL table for sorting and analysis. The epidemiological status and risk factors of DVT in patients with femoral neck fracture in 2019 were analyzed.","title":"Epidemiological status and risk factors of deep vein thrombosis in patients with femoral neck fracture"}
{"_id":"9f4c6aad-fd2c-1395-cedc-d754032dbf48","text":"This study was performed in the course of normal solo clinical practice and where any critical findings were made only using the xSPECT\/CT reconstruction this information was directly communicated with the referring practitioners.","title":"The clinical value of xSPECT\/CT Bone versus SPECT\/CT. A prospective comparison of 200 scans"}
{"_id":"9f4d5d27-d928-3cb1-2ea0-700f1883bf46","text":"The other possibility was the weakness of abdominal wall caused by two transvaginal deliveries. Although she underwent abdominoplasty due to separated linea alba, abdominal wall rupture occurred. The last possibility was that the resistance of the abdominal pressure could not be maintained by sacrificed intercostal nerve. Spontaneous rupture in our case is considered the complex of these elements.","title":"Spontaneous rupture of abdominal wall after breast reconstruction using deep inferior epigastric perforator flap following mastectomy for breast cancer"}
{"_id":"9f5182f6-40c1-7083-6688-c69f98bda2c7","text":"That there is potential to increase the proportion of women retaining a breast is best demonstrated by the variation we observed across Cancer Networks, and in particular that Networks seemed to perform consistently so across all four patient groups. This suggests that the structure and process by which care is delivered in these Networks play an important role in determining the specific pathway followed by women, and both require investigation.[29] Moreover, while the variation across Cancer Networks was greatly influenced by the proportion of women receiving BCS, there was not a uniform picture across the networks in terms of the use of BCS and reconstruction. Among Networks with a high proportion of women having BCS, there were Networks with both high and low proportions of women having mastectomy with reconstruction. This reiterates the importance of reporting BCS, mastectomy, and reconstruction together when investigating the provision of breast cancer services.","title":"The Proportion of Women Who Have a Breast 4 Years after Breast Cancer Surgery: A Population-Based Cohort Study"}
{"_id":"9f53cd85-827c-a7cd-f3ae-ef23140167e7","text":"The donor area is left to heal entirely by secondary intention or may be partially covered with the remaining pedicle after the second stage. Safety of performing SRF under local anesthesia has been well documented with low complication rates when applied with appropriate techniques. SRF is an effective repair method for full-thickness helical defects that has relatively little operative morbidity. High esthetic and functional results may be obtained restoring the ear size and shape.","title":"Staged retroauricular flap for helical reconstruction after Mohs micrographic surgery *"}
{"_id":"9f56cf73-4670-715a-431a-b60f6585f473","text":"Botulinum toxin is the treatment of choice as the first line therapy for BEB. The only drawback is that the effect wears off in about 12 weeks and the injections are to be repeated every three months. This demands patients’ motivation and affordability.","title":"Efficacy of botulinum toxin in benign essential Blepharospasm: Desirable & undesirable effects"}
{"_id":"9f5934a5-3c01-b77c-6161-89a26205138a","text":"The patients were retained in the hospital for six days after surgery, during which they were assessed daily by the plastic surgery department as well as the orthopedics department. A physiotherapist was also involved to assist in early mobilization. The patients were then assessed by an oncologist, and subsequently, five to seven cycles of chemotherapy were given as advised by the oncologist.","title":"Free Vascularized Fibular Graft Transfer in the Reconstruction of Defects for Premalignant and Malignant Musculoskeletal Conditions of the Femur in a Tertiary Care Setting in Pakistan: A Series of Six Cases"}
{"_id":"9f59e478-0ef2-88dd-863c-47733f44172e","text":"Because tuberculous lesions always involve the anterior and middle columns of the spinal vertebrae, many researchers have concerns about whether posterior surgery can accomplish focal debridement completely with its limited visual field, how it may affect the stability of the spine and whether it may cause intraspinal infection. We have designed a new posterior approach for treating spinal TB that effectively addresses the above problems. From January 2006 to January 2012, 290 patients with spinal TB have undergone surgery comprising debridement, interbody fusion and internal fixation via a posterior approach only in our hospital. In this paper, we present a typical case of a 68‐year‐old male patient who was admitted to our hospital with thoracic TB and underwent surgical treatment comprising debridement, interbody fusion and internal fixation via a posterior approach only to illustrate the clinical efficacy and feasibility of this new surgical procedure.","title":"Treatment of Spinal Tuberculosis by Debridement, Interbody Fusion and Internal Fixation via Posterior Approach Only"}
{"_id":"9f6b1e65-0e12-4b46-2f35-55e51cef9119","text":"The remaining tumor tissue at the edges of the resection will inevitably invalidate oncological and reconstructive procedures, promoting early local recurrence and preventing wound healing.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"9f6cc200-1d12-c2c5-97bc-52c43a59a79b","text":"The pedicled latissimus dorsi flap is an especially useful option for salvage reconstruction of large head and neck defects. When used as a pedicled flap, the latissimus still has excellent reach; this is often an area of concern when using regional pedicled flaps for large head and neck defects. The extended length allows it to reach defects high on the head and the entire neck. The abundant available muscle and potential for a wide skin paddle make it good for resurfacing large surface area cutaneous defects and for filling defects requiring a large amount of bulk (Figure 10). The bulk of the entire latissimus dorsi flap can sometimes be challenging to tunnel, fit, and contour to certain defects in the head and neck. It can provide a very large surface area skin paddle that can still usually allow primary closure at the donor site. The surface area is unrivaled among pedicled flaps. There is some versatility in the type of tissue taken with this flap. It is possible to harvest this as a muscle‐sparing or even thoracodorsal artery perforator (TDAP) flap, although this is uncommonly done for head and neck salvage reconstruction as the arc of rotation of this variant is limited. There is also flexibility in the amount of skin included and it can also be used as a purely musculofascial flap. Vascularized rib can also be included but has limited practical utility.","title":"Regional pedicled flap salvage options for large head and neck defects: The old, the new, and the forgotten"}
{"_id":"9f6cc746-c00d-f2a5-d392-e390698e61b5","text":"The evidence suggests that DIEP flap has become the preferred choice for immediate breast reconstruction, for better cosmesis can be achieved with skin and soft tissue. In certain situations, such as the case with inadequate abdominal tissue to replace the breast or a very dominant superficial venous system, we had success with the thoracodorsal artery perforator flap as an alternative.","title":"Deep Inferior Epigastric Perforator Flap for Immediate Breast Reconstruction following Mastectomy in Breast Cancer Patients: An Initial Experience in Vietnam"}
{"_id":"9f93e7c1-0f74-19fa-eb30-11885185e824","text":"AAPM Report 249 characterizes the guidelines and essential curriculum for a residency in medical physics. Published in 2013, it updates prior reports written in 2006 and 1992. The report is now nearly 10 years old and may not reflect the current state of professional practice and patterns of care. The stated requirements for medical physicists are generally topical and do not require a specific number of cases. In comparison, training radiation oncologists are required to accumulate and document a minimum number of cases in various body sites, using various modalities and techniques. In order to understand how well contemporary medical physics residencies can address the requirements of the Report 249, requirements were evaluated and grouped by topical area. These topical areas are discussed in this section.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"9f956582-953e-c395-0901-14efceb37d3d","text":"The purpose of this study was to evaluate the incidence of complications following mandibular reconstruction and to analyse possible contributing factors.","title":"Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study"}
{"_id":"9fa0953c-e836-1622-6e46-63df0837b680","text":"In all cases, an infectious disease specialist prescribed culture-specific intravenous (IV) antibiotics for the duration of 6 weeks followed by culture specific oral antibiotics until bony union or joint fusion which has been the protocol at our institute. Patients were monitored clinically and via laboratory testing every week after surgery during systemic antibiotic administration. The infection was considered controlled by the absence of clinical infection (drainage, cellulitis and warmth) without any antibiotic treatment for at least two weeks. Patients were followed far beyond two weeks with a minimum of two years. Laboratory values were not followed beyond the antibiotic treatment course regularly. If the infection was thought to be poorly controlled or recurring then serum ESR and CRP were obtained. Patients were considered to have bone union\/fusion once three of four cortices were united on radiographs and the patient was pain free when bearing full weight. Clinical follow up then was every 3 months in the 1st year and every 6 months during the 2nd year after surgery.","title":"Antibiotic Cement-Coated interlocking Intramedullary Nails in the Treatment of Septic Complex Lower Extremity Reconstruction; A Retrospective Analysis with Two year Minimum Follow up"}
{"_id":"9fa9aa0d-312b-575a-2d25-f4ca65929e3c","text":"The majority of NMSCs operated on in our institution occur in the head and neck region. This is a particularly sensitive area because of the need to obtain cancer-free margins and ensure the best cosmetic and functional outcomes. IFS of margins offers surgeons the benefit of ascertaining clear margins while keeping the size of resection and, hence, degree of reconstruction to a minimum.","title":"Use of Intraoperative Frozen Section in the Surgical Management of Patients with Nonmelanoma Skin Cancer"}
{"_id":"9fb19b05-f329-8094-a45f-4fd3b8619114","text":"The objective of our retrospective study was to systematically evaluate the clinical results of osteomyelitis treatment in diabetic foot infections using a multidisciplinary approach including surgical debridement, systemic antibiotic therapy and a gentamicin-eluting bone graft substitute and to compare the results with treatment outcomes in the literature.","title":"Multidisciplinary Approach for the Management and Treatment of Diabetic Foot Infections with a Resorbable, Gentamicin-Loaded Bone Graft Substitute"}
{"_id":"9fb56618-2fc8-bd45-600b-3e9a5492df84","text":"dPDT using natural sunlight to activate photosensitizers is advantageous in its lower cost and reduced pain. It is a promising method to treat AK under the concept of field cancerization. Current studies suggest that the prognosis of dPDT is noninferior to cPDT. dPDT is licensed to treat AK in Europe with the support of randomized trials and consensus guidelines. There are limited reports on PDT on other skin tumors or inflammatory skin diseases other than AK. Based on the history of the development of cPDT, we can expect that the application of dPDT will grow exponentially shortly. Further noninferiority studies between dPDT and cPDT are warranted.","title":"Daylight Photodynamic Therapy: An Update"}
{"_id":"9fb5e891-2838-0cec-dd6f-25ebb07dd2b4","text":"In this respect, the properties of the embedded chondrocytes after a freeze and thaw procedure have been investigated. The obtained results suggest that the microfibrous embedded chondrocytes could be employed to deliver the freshly thawed constructs at the operating theater.","title":"Dedifferentiated Chondrocytes in Composite Microfibers As Tool for Cartilage Repair"}
{"_id":"9fbce768-23b1-d4f9-a64f-9a5fd4326682","text":"Our data indicated that the fused segment may be overloaded on the lower or upper adjacent disc prosthesis, which may result in impairment or dislodgement. The wide range of ROM recovery measurements may be attributed to the types of prosthesis used, as well as the X-ray shooting technique and the position of the patient at that moment. The flexibility of the cervical region compared to the thoracic and lumbar regions may also remarkably influence the angle measurements.","title":"Anterior hybrid construction of multilevel cervical disc disease and spondylotic spinal stenosis: surgical results and factors affecting adjacent segment problems"}
{"_id":"9fc1297a-1778-c208-8c6c-3a8a7323a3e9","text":"The preoperative local anesthesia is carried out together with or without sedation accordingly to patient compliance and the difficulty of the procedure.","title":"Cryoablation and Immunotherapy: An Enthralling Synergy for Cancer Treatment"}
{"_id":"9fc47e6e-ed66-99a0-3ac5-12680571cede","text":"FMC concentration on postoperative day 1 was a useful early indicator of DVT volume after knee surgery. Monitoring FMC could enable selective identification of patients with a high thrombus volume, which is associated with a high risk for pulmonary embolism.","title":"Fibrin monomer complex on postoperative day 1 is correlated with the volume of deep vein thrombosis after knee surgery"}
{"_id":"9fc638a0-1390-d046-af25-db895be48d2b","text":"Preoperative evaluation of a patient with multiple myoma and infertility who presented to our department seeking surgical management. Hyper Accuracy 3D image was obtained, and a 3D digital image reconstruction of the uterus delineating the exact number, volume, and location of the fibroids was created. The 3D digital image was available during the surgical procedure which helped to plan the surgical steps allowing a systematic surgical approach resulting in an effective surgery with minimal blood loss.","title":"Incorporating 3D reconstruction in preoperative surgical planning of Multiple Myomectomy"}
{"_id":"9fc7af8d-61ca-d73d-0d68-46a3dc2abf9b","text":"There were also a few changes in contrast that were specific to one group of faces or another. For instance, the luminance contrast around the mouth increased with age in the Chinese faces and tended to increase with age in Latin American faces, though it did not change in the black South African or French Caucasian faces. The yellowness contrast around the mouth increased with age in Caucasian and Chinese faces but did not change in the Latin American and black South African faces.","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"9fcb4bdf-3ec3-ce9c-8ecf-b9615bbd4d22","text":"Microscopic description showed large homogenous masses of calcified material separated by thick fibrous bands of septa. Numerous giant cells and macrophages were observed in the septa confirming it to be calcinosis cutis.","title":"Idiopathic Calcinosis Cutis over Elbow in a 12-Year Old Child"}
{"_id":"9fdf8c1b-8c78-621f-5c8f-0e56e89e2e12","text":"The National Institute for Health and Care Excellence Breast Cancer Quality Standard states that, irrespective of age, patients with early breast cancer should be offered the full range of appropriate management unless precluded by significant co-morbidity. This was further endorsed by the UK All Party Parliamentary Group on Breast Cancer in 2013, which stipulated that treatment choices should be determined by patient fitness and not chronological age alone. Moreover, the European Society of Breast Cancer Specialists and the International Society of Geriatric Oncology recommend that patients aged 70 years or more should be offered the same surgical options as younger patients, including oncoplastic surgery, once preferences and co-morbidities have been considered.","title":"Oncoplastic breast surgery in older women with primary breast cancer: systematic review"}
{"_id":"9fe2d6d6-cf37-9260-1755-ffa654e03434","text":"Simultaneous reconstruction with Ilizarov method and free tissue transfer is safe but requires careful planning and logistic considerations. The outcomes from this study are equivalent or better than those reported after staged surgery.","title":"Simultaneous debridement, Ilizarov reconstruction and free muscle flaps in the management of complex tibial infection"}
{"_id":"9fe9a789-5121-f33d-517b-83bb7fe6d3fa","text":"In addition to reporting the reliability of these techniques, this case series demonstrates the versatility of vein grafts and highlights the feasibility of an end to side anastomosis to a stump on a vein graft. Four different vein graft constructs were implemented in this case series (Figure 5), and the use of vein grafts for venous pedicle extension was prevalent. While extending vein grafts to inflow pedicles remains a viable option, the collective experience of this group with extensive degloving and radiation injuries suggests that the quality of outflow vessels was comparatively less optimal (posing challenges in dissection due to fragility and small caliber) when compared to inflow vessels within the zone of injury. Vein grafting allowed for outflow to larger caliber veins in multiple instances. The use of vein grafts for venous pedicle extension alone is not widely represented in the literature, as most papers focus on arterial pedicle extension or AV loop creation.","title":"Reliability of Long Vein Grafts for Reconstruction of Massive Wounds"}
{"_id":"9fecba8e-6248-b9d7-a249-99fa4cf02589","text":"The present findings underscore the need for further studies to define the type of surgical cut made with thermal instruments so that the heat is not dissipated to adjacent tissues and to determine the power required for each case according to patient age and the clinical condition of the lingual frenulum. Future studies should investigate the most suitable parameters for the use of a high-power diode laser for newborns [30,31].","title":"Comparison of the Effects of High-Power Diode Laser and Electrocautery for Lingual Frenectomy in Infants: A Blinded Randomized Controlled Clinical Trial"}
{"_id":"9feeab8c-16ac-d7b3-f43b-5655f74d7d72","text":"A study of 1795 patients with stage I and II MCC showed no differences between wide surgical excision and Mohs micrographic surgery regarding the presence of residual tumor at the surgical margins, and no difference was observed in OS between the two treatment modalities. Histopathologically negative margins are related to better local control and survival, especially in cases of localized disease treated solely with surgery. In all cases of surgical treatment, SLNB should be planned before a definitive excision, as the surgery may alter lymphatic drainage.","title":"Merkel cell carcinoma: epidemiology, clinical features, diagnosis and treatment of a rare disease"}
{"_id":"9fef9d0e-bb35-bbd6-269f-96ec0ad251c3","text":"Tumoral calcinosis is a condition characterized by the deposition of calcium phosphate crystals in the periarticular soft tissues, resulting in large calcified masses up to 20 cm in diameter.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"9ff808ae-9e5f-25bd-d3df-12b777c8a975","text":"The eye and its adnexal structures can give rise to first or consecutive primary malignancies or to encounter metastasis. Our aim was to define the characteristics of the second primary neoplasms affecting the eye and its adnexa and find the risk modifying factors for them after malignancies elsewhere in the body.","title":"Second primary malignancies of eye and ocular adnexa after a first primary elsewhere in the body"}
{"_id":"a002b41b-d572-dab9-dc4e-fca4cb1642d3","text":"The primary objective was to investigate the CrystalClearView tool which corrects for the count rates of one nuclide falling into the energy window of another nuclide due to overlapping energy windows when imaging two nuclides with photopeak energies close to each other. Localized SLNs are marked on the patient's skin with a 57Co pen‐point marker not only in this study but in routine clinical practice as well. Investigating the effect of CrystalClearView in dual nuclide imaging is paramount due the overlapping energy windows of the 99mTc and 57Co.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"a006636c-3481-e70f-9cb2-d3fe5c1e308f","text":"DVT following total joint arthroplasty and surgery for lower limb fractures in Indian patients is not as common as reported in the Western literature. A high level of suspicion and close clinical monitoring is mandatory, routine chemoprophylaxis is perhaps not justified in every patient undergoing lower limb surgery in our opinion. More trials involving a larger number of patients and at multi centers, in future, would be required to confirm the findings of our study.","title":"Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?"}
{"_id":"a0083572-efec-1132-19a2-d0042b8a07bb","text":"These concerns become even more critical when lesions are large in size, a situation that offers the additional challenges of minimizing the sacrifice of lesion-free tissue and directly seeking to reduce negative aesthetic changes. When these concerns are weighed collectively, one can see that treatment of malignant lesions of the face must balance multiple concerns with the desire of not only effecting treatment success from the standpoint of eliminating cancer, but doing so in a manner that explicitly minimizes the resulting surgical defect. Any effort that can facilitate the potential for smaller surgical excisions holds significant potential to ally additional morbidities that center around posttreatment cosmetic defects. Therefore, the question of how effective PDT is if employed presurgically emerges. That is, could PDT be used as an initial treatment with the specific goal of reducing lesion size so that the potential impact of secondary surgery for histologic cure could be achieved? For this reason, we chose to descriptively assess a group of consecutive patients who presented to our clinic with pathologically confirmed malignant lesions of the face.","title":"Neoadjuvant Use of Photodynamic Therapy in Basal Cell and Squamous Cell Carcinomas of the Face"}
{"_id":"a00d6b77-84d5-95ed-af48-ab8f9373b16a","text":"Most participants found it difficult to remember exactly when they first noticed the lesion. A lack of awareness that it could be skin cancer was the main reason for delay. The majority were aware of the skin lesion and that it sometimes caused physical discomfort such as irritation or bleeding and failed to heal. The lesion was often attributed to being a minor skin condition, a symptom of old age that might heal on its own and nothing to worry about.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"a00f69da-2220-f5e4-3e4d-d05084542156","text":"The aim of this study is to verify whether the non-invasive time and frequency NIRS signal analysis technique can provide information about the differences between the AK skin lesion area before and after a topical treatment, providing information to monitor the response to treatment or potential regression and progression of skin lesions.","title":"Non-Invasive Analysis of Actinic Keratosis before and after Topical Treatment Using a Cold Stimulation and Near-Infrared Spectroscopy"}
{"_id":"a02e68ea-4d8f-bfd9-045f-ada579f8d2f1","text":"We considered resolution of the infection process and closure of dehiscenses in the surgical wound as favorable outcomes in the cases of treatment, and good progress of the surgical wound without complications when this therapy was used prophylactically.","title":"NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY TERAPIA COM PRESSÃO NEGATIVA EM FERIDAS NO TRATAMENTO DE LESÕES GRAVES APÓS ARTROPLASTIA TOTAL DO JOELHO"}
{"_id":"a038ff79-e603-f43a-6841-116077103ac3","text":"The ability to perform larger trials is limited by the rarity of mucosal melanomas of the head and neck.","title":"Immunotherapy as a treatment modality for mucosal melanoma of the head and neck: A systematic review"}
{"_id":"a03946fe-0145-6afd-9efb-93329f87d158","text":"There is often a perceived barrier to complex surgery being undertaken in the elderly. Greater co-morbidities and a relative lack of physiological reserve due to aging could lead to the perception of an increased incidence of perioperative morbidity and mortality4. However, if anything, our study found the reverse to be true. Our only perioperative mortality was in the younger cohort and a patient in the older group had statistically less chance of requiring further unplanned surgery. Perhaps, the reluctance to undertake complex reconstructive surgery in the elderly is due to concern that operation times will be longer or that medical complications and length of stay are increased15? Again, our series did not support these perceptions.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"a039f318-7935-5fa6-be2b-4fa7fd793eda","text":"The false negative rate was 6% in the antegrade massage group and zero per cent in the three stage axillary lymphatic massage group. The new technique also improved the sensitivity and specificity from 70 and 88 per cent with simple antegrade massage to 84% and 100% with a three stage massage.","title":"Three stage axillary lymphatic massage optimizes sentinel lymph node localisation using blue dye"}
{"_id":"a03c0f4d-4f7c-4425-51a5-887b24400758","text":"Of the assessed clinical and epidemiological variables, only the presence of ephelides and a history of previous sunburns were identified as predictive factors for thin melanomas, facts not consistently reported in previous studies. This result can be explained by the acknowledgment of ephelides and sunburns as risk factors for the development of skin neoplasms and the consequent adoption of secondary prevention measures, such as the use of regular skin self-examination.","title":"Predictive factors of melanoma thickness"}
{"_id":"a03d92f7-9624-ad2f-d61e-135f088cfbc4","text":"Repair of skin defects associated with tissue loss which are too large to be repaired by primary suturing, is done using skin grafts or flaps. The same rule applies to scalp defects, moreover scalp has some unique features,. Thickness of skin and presence of hair follicles in the scalp make it a good donor for partial thickness skin graft. If skull is not exposed the treatment option is skin graft, but in case of skull exposure flap is the answer for this need-. Primary repair is dependent on defect diameter, usually scalp defects of smaller than two centimeters are amenable to primary repair but larger defects need skin graft transplant. Skin grafts with partial or full thickness are harvested from lower limb, thigh and neck. Given to its visibility neck is seldom used as a donor for skin graft particularly in children and young adults. The resultant linear scar following a full thickness graft harvest and a superficial scar as discoloration following partial thickness graft harvesting is what patients are always concerned about.","title":"Outcome of Comparison between Partial Thickness Skin Graft Harvesting from Scalp and Lower Limb for Scalp Defect: A Clinical Trial Study"}
{"_id":"a04215d4-371e-8f03-91f7-2f260b511e47","text":"One of the surgical options is reverse autogenous interpositions grafts using the saphenous or cephalic vein [12] when the defect is wide and requires bridging it up. Synthetic graft can also be used but the added cost in procuring the material in out setting is a discouraging factor. The other option is end to end anastomosis in a defect that is not wide, in which the anastomosis must not be under tension after repair. There is the lateral repair when there is lateral laceration or following arteriotomy to evacuate intraluminal clot as we did in one of the patients with blunt vascular injury in which intraluminal thrombose was formed.","title":"Delayed brachial artery reconstruction after traumatic injury: a case for sustainment of surgical intervention"}
{"_id":"a0421f69-5db0-2040-9fe4-4ca6be356b74","text":"Treatments should be planned as follows after evaluation of curability based on the histological examination of the resected specimens.","title":"Japanese gastric cancer treatment guidelines 2018 (5th edition)"}
{"_id":"a049cd61-8759-4d69-41f4-f1409088d6b8","text":"Cervical spondylosis is a common problem encountered in modern orthopaedic practice. It is associated with significant patient morbidity related to the consequent radiculopathic and myelopathic symptoms. Operative intervention for this condition is generally indicated if conservative measures fail; however there are some circumstances in which urgent surgical intervention is necessary. Planning any surgical intervention must take into account a number of variables including, but not limited to, the nature, location and extent of the pathology, a history of previous operative interventions, and patient co-morbidities. There are many different surgical options and a multitude of different procedures have been described using both the anterior and posterior approaches to the cervical spine. The use of autograft to achieve cervical fusion is still the gold standard with allograft showing similar results; however fusion techniques are constantly evolving with novel synthetic bone graft substitutes now widely available.","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"a04c6d09-f868-1ae3-f378-cfa21067b2a1","text":"The application limits the collateral shrinkage that usually affects the graft after maturation and permits grafting on uneven surfaces with sub-optimal perfusion.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"a04dfe9e-b05f-75af-4010-1077f377ed13","text":"Propeller flaps are a reliable option for reconstruction in carefully selected patients with traumatic defects of the lower limb and malleolus. We found that the effective safe distance was 3.5 cm from the flap to the wound.","title":"Predictors of the surgical outcome of propeller perforator flap reconstruction, focusing on the effective safe distance between the perforator and the wound edge"}
{"_id":"a050ff7e-d487-17c9-159d-64778179799f","text":"We found both transposition flap of von Langenbeck and rotation cheek flap (Mustardé flap) as the most appropriated techniques for this case. We finally decided to use transposition flap of von Langenbeck because this technique is less traumatic and better to avoid or even correct a residual ectropion.","title":"Chondromucosal Nasal Flap With the Transposition Flap of Von Langenbeck as a Good Election for the Total Lower Eyelid Defect Reconstruction in an Old Patient With an Elevated Vision Loss in the Contralateral Eye"}
{"_id":"a054c50e-3766-14c9-5272-1d53f2fc6e67","text":"To confirm that the visual differences in evidence between the Danish twin composites were reflective of facial aging differences in other Caucasian populations, perceived ages of British females aged 45–75 years were estimated. The estimated means were used to create 2 composite images representing women who looked either old or young for their age. In addition, 50 and 70 year chronological aged composites were created. Similar differences to those in evidence in the twin composite image comparisons were in evidence in the British perceived and chronological age composite comparisons (Fig. 2), confirming that the differences between the Danish twin composites were reflective of features that correlate with perceived age in Caucasian populations and change with age.","title":"Why Some Women Look Young for Their Age"}
{"_id":"a05894bf-7c6a-3f39-1f9f-bb3c194fdc61","text":"All cases of VTD of extremities were diagnosed by Duplex ultrasound. Term immobility was used for patients who were hospitalized or bed bound for more than 7 days at the time of VTD diagnosis.","title":"Incidence and risk factors of venous thromboembolism (VTD) in patients with amyloidosis"}
{"_id":"a05bb48b-0c3d-fa99-a151-70351c162516","text":"This review is to update the reader on the available data on biofilm. A pilot review done among academics and students in a medical college showed large gaps in knowledge on the topic. Osteomyelitis was described as an entity in 1852 by Edouard Chasseignac. John Hunter described the sequestrum in 1746. Antonie van Leeuwenhoek first detected biofilm from scrapings of his teeth and described them as animalcules.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"a05cf40e-695d-4108-ec0d-8052d044d15d","text":"All patients were subjected to postoperative mouth opening exercises from the day of the operation with the help of an IOS, which was based on an impression taken during surgery. All patients were sufficiently comfortable moving their mandible according to the IOS’s guiding plane and impingement, and satisfactory results were achieved, in which MMO was improved by 35 mm more than 6 years after surgery.","title":"Gap arthroplasty with active mouth opening exercises using an interocclusal splint in temporomandibular joint ankylosis patients"}
{"_id":"a0661f2c-8dd8-dd31-34cf-e937ed7ff181","text":"After photosensitizers combined with nanocarriers are intravenously injected into cancer patients or tumor-bearing mice, they can accumulate in the tumor tissue. They produce ROS only when excited by light of a specific wavelength and exhibit cytotoxic effects on tumor cells. As other normal tissues that have not been exposed to light irradiation are preserved, PDT has the following advantages and disadvantages compared to the existing standard cancer treatment such as surgery or chemotherapy.","title":"Current Limitations and Recent Progress in Nanomedicine for Clinically Available Photodynamic Therapy"}
{"_id":"a07664d5-2d0c-67c7-c064-bd47726bf44b","text":"Allergy to lignocaine and the other amide local anaesthetics used in dentistry is extremely rare. If an acute reaction is strongly suggestive of an allergic response, early referral for thorough investigation is required.","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"a07818de-c1a5-b8c2-1568-1e32523386da","text":"Initial evaluations revealed that the topics covered and the presentations were well received. Subsequently, the course was moved to earlier in the academic year to prepare them for contract negotiations and then to Sunday nights to decrease interruptions and allow spouse participation.","title":"Evolution of a Novel Business Leadership Course for General Surgery Chief Residents"}
{"_id":"a0867610-262b-efcd-da53-9fe30e1e4499","text":"The fact that we observed few adverse effects in shoulder function, strength and pulmonary function, as well as the long vascular pedicle of this wide and voluminous muscle, makes the latissimus dorsi flap a reliable option for reconstruction of the thorax after DSWI.","title":"Deep sternal wound infection – latissimus dorsi flap is a reliable option for reconstruction of the thoracic wall"}
{"_id":"a0867ebb-7a64-6bf7-99f4-b85f75a67893","text":"The number of patients for each primary melanoma site is reported in Table 1.","title":"The Lymphoscintigraphic Study of Unpredictable Head and Neck Cutaneous Melanoma Lymphatic Drainage"}
{"_id":"a08caf11-07d4-ea7c-12b7-0ef700d56414","text":"This study revealed the specialty of plastic surgery was face area in trauma care. We thus argue that plastic surgical care is imperative for trauma patients, and expect to be implicated in trauma system planning.","title":"A quantitative analysis of trauma patients having undergone plastic surgery"}
{"_id":"a090f842-b9e1-643f-a41f-293edcf7c608","text":"Recently Wildsmith and colleagues12reported the investigation of 25 patients, who were initially diagnosed as being allergic to local anaesthetic drugs: most of those patients15 had received dental treatment. Six of the dental patients were diagnosed as suffering from phobia, panic or anxiety and one patient had received an intravascular injection (being affected by the adrenaline content of the cartridge). One of the patients in that series was shown to be allergic to metabisulphite. Latex allergy accounted for problems with three patients — and the relevance of latex allergy to dental local anaesthesia has recently been drawn to the attention of the profession.16","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"a094f72a-0c07-1a88-5175-575f1be01953","text":"For patients with a history of radiotherapy or previous surgery, we considered the issue of the vascular pedicle’s length for selecting a safe flap to possibly avoid grafts, if the same reconstructive quality can be maintained. Grafts for arterial pedicle elongation were used in these patients mainly for the inferior third or for the middle third reconstruction when there were no alternatives.","title":"Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team’s Experience"}
{"_id":"a0981530-1992-77cf-2cf3-de0a3c041cd3","text":"The outer ear itself plays a functional role in audition by collecting and transmitting sound. Additionally it has an important effect on facial appearance and therefore on the individual psychological disposition. Although the auricles skin macroscopically shares the anatomy and physiology of the bodys skin it shows some histological differences compared to the rest of the bodys skin. This specific anatomical peculiarities should be considered when treating skin lesions on the ear.","title":"Cutaneous lesions of the external ear"}
{"_id":"a0a18dcc-35fc-dc52-2f2b-b5855d589997","text":"Only meaningful comparisons between groups that had expressed some heterogeneity are reported in the Results section.","title":"Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma"}
{"_id":"a0b3ea31-a409-88ea-4afc-ade6da321501","text":"Reconstruction of firearm injuries and the birth of plastic surgery","title":"The Role of Plastic Surgeons in Addressing Firearm Morbidity and Mortality"}
{"_id":"a0b6b15d-9559-6e48-b6d5-29c5c29b21f1","text":"For each classification, the proportion of the different histologic grades found for all cases by the scoring point system and the subjective reading was also estimated.","title":"Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis"}
{"_id":"a0b79c4b-db6f-2e13-7105-377f81aa27dc","text":"There is no current published estimate of the direct cost of AK to the Australian government. We aimed to use Medicare data to report the annual numbers of AK treatments between 1994 and 2012, calculate the direct costs associated with these treatments and predict the numbers and costs from 2013 to 2020.","title":"Cost for the treatment of actinic keratosis on the rise in Australia v2; ref status: indexed"}
{"_id":"a0bc98e9-e60d-bfe5-712f-11e71a2cf7e3","text":"The basis of this work was the hypothesis that peripheral MRA in the steady state using a blood pool contrast agent to image the size and quality of great saphenous veins would be a useful adjunct to arterial phase MRA to improve the performance of peripheral bypass surgery in patients with PAOD. Thus, the purpose of this study was to prospectively determine the accuracy of high-spatial-resolution steady-state MR angiography using the blood pool contrast agent Gadofosveset trisodium in comparison to color-coded duplex ultrasound (DUS) as the standard of reference in order to assess the usability of autologous saphenous veins for subsequent peripheral bypass surgery. Results were correlated with intraoperative findings.","title":"Mapping of Autogenous Saphenous Veins as an Imaging Adjunct to Peripheral MR Angiography in Patients with Peripheral Arterial Occlusive Disease and Peripheral Bypass Grafting: Prospective Comparison with Ultrasound and Intraoperative Findings"}
{"_id":"a0bdc1de-47d0-28c4-8c79-709669eea2fc","text":"The lack of the group difference when considering BTA critical ratio suggests that when taking into account body width and lateral trunk movement there is no difference in the action judgements of adults with and without DCD. However, the range of BTA critical ratios for the DCD group was between 1.10 and 1.78, for the typically developing group between 1.06 and 1.42 and so it is clear that at least some of the adults with DCD are continuing to show elevated critical ratios even when body width and lateral trunk movement is taken into account. This could be explained by movement variability which is considered in the next section.","title":"How Do I Fit through That Gap? Navigation through Apertures in Adults with and without Developmental Coordination Disorder"}
{"_id":"a0bf0b56-bacd-5d03-dae9-549537d8173e","text":"The mortality of the patients was divided into two categories, early and late mortality. Early mortality within 30 or 90 days after PVO diagnosis were investigated. The clinical outcomes were investigated in patients with at least a 90-day survival. Recurrence was defined as having recurrent symptoms and signs after the completion of antibiotics and receiving a second course of intravenous antibiotics.","title":"Treatment outcomes in patients with pyogenic vertebral osteomyelitis who have cirrhosis"}
{"_id":"a0c6185c-aacb-8f4c-fce4-df8bd7fc6426","text":"The primary goal of reconstruction is to line the orbital cavity with durable tissue as well as to exclude the nasal or sinus cavities when the medial or inferior orbital wall has been removed and protect the brain when the orbital roof has been removed. Additionally, the patient's desire for prosthetic rehabilitation should be considered when planning the reconstruction. A deep orbital cavity facilitates prosthetic fit while a bulky flap that sits flush with the face or bulges outward may not securely hold a prosthesis without osseointegrated implants. A bulky flap may also cause the prosthesis to protrude unnaturally.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"a0cb54da-398a-eff8-5283-7c4adac4f5cf","text":"Functional impairment after debridement of the sternum and reconstruction using a pedicled latissimus dorsi flap is considerable. However, the sequelae are not to be attributed to the reconstruction alone but are caused by the multimorbid state and the underlying illness of the patient.","title":"Deep sternal wound infection – latissimus dorsi flap is a reliable option for reconstruction of the thoracic wall"}
{"_id":"a0cd4c8f-ba4d-a9ee-2805-119aba0fa6f7","text":"Single level cervical disc herniation causing neck pain and \/ or radicular pain with or without neurological compromise is a common affliction. The surgical treatment options which include simple discectomy with or without fusion and with or without instrumentation are largely successful in yielding excellent relief of signs and symptoms post operatively and during followup.1 Although each procedure has its merits and demerits, it is still unclear if one surgical technique is superior over the other.1 Operative time and hospital stay were found to be slightly shorter for anterior cervical discectomy compared with anterior cervical discectomy with fusion.1 The clinical and radiographic findings of some of the common techniques of anterior fusion for cervical disc herniation such as Cloward fusion with autograft, Cloward fusion with freeze-dried bone, BAK-C device fusion and cage have the advantage of affording more stability, with less chances of development, of late kyphotic deformity, but on the other hand, there is concern related to graft donor site morbidity, and \/ or devices and the need for more manipulative force needed intra operatively for graft or device insertion during operation.2 Although during the last three decades, the anterior approach to the cervical spine with inter-body fusion has been increasingly preferred, but some other retrospective studies on surgical procedure without interbody fusion report that the bone graft and hence fusion is not important for successful operative treatment of single level herniated cervical disc.3","title":"Single level cervical disc herniation: A questionnaire based study on current surgical practices"}
{"_id":"a0d02fb5-e69c-283c-fddf-5be80864d97b","text":"Ultrasound guidance is effective and recommended for routine use in the reduction of distal radius fractures.","title":"Ultrasound-Guided Reduction of Distal Radius Fractures"}
{"_id":"a0d326d0-8dcf-b004-23b1-8dbbd9df79ce","text":"Those individuals who started low down the curve should be considered for a skeletal augmentation, not only to reverse the aging changes but also to bring their natural state higher up the curve so that the soft tissues are better supported for a more attractive look. With more youth, these individuals have more in reserve against future aging. Facial bone structures also explain the observation that we tend to age like our parents, a familial trait that we inherit from them.","title":"Changes in the Facial Skeleton With Aging: Implications and Clinical Applications in Facial Rejuvenation"}
{"_id":"a0d6714b-2885-1b5a-57e4-be479a3176e1","text":"Therefore, it is important to carry out more studies in this population to increase knowledge regarding the clinical characteristics of rosacea in these individuals so that the diagnosis is made early, and it is also important to increase knowledge about the safety and efficacy of the treatments instituted as well as to determine the side effects that can result from them.","title":"Rosacea Topical Treatment and Care: From Traditional to New Drug Delivery Systems"}
{"_id":"a0e98a72-f076-f1a0-b80a-e6032fac61d9","text":"Surgical indications in the treatment of osteomyelitis include irrigation and débridement of subperiosteal collections or adjacent abscesses, failure to respond to antibiotics, or to obtain tissue samples to help guide selection of antibiotic therapy. Surgery is also indicated in cases of articular extension to reduce the risk of severe complications such as permanent cartilage damage. Procedural options for addressing septic arthritis of the hip include aspiration, arthroscopy, and open arthrotomy, with open arthrotomy still the mainstay and benchmark for treatment in most centers.","title":"Pediatric Acetabular Osteomyelitis Treated With Hip Arthroscopy"}
{"_id":"a0ec55ae-d8cb-8b98-46eb-dfdf946dac71","text":"Regarding a possible association between anosognosia and symptoms of depressed mood in AD patients, our results showed that the lack of awareness of their deficits is not influenced by the presence of depressed symptoms, as described by another studies.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"a0ed6883-9ad4-6255-6bc9-53f31eccfb23","text":"Background: Growing evidence has emerged that a subset of melanoma patients shows signs for spontaneous anti-tumor immune responses and T cell infiltration into tumor sites, which represents an important prognostic value and which is associated with clinical responses to immunotherapies. However, the underlying molecular mechanisms that can explain the absence of a T cell response in the majority of patients are not defined.","title":"Melanoma and immunotherapy bridge 2015 Naples, Italy. 1–5 December 2015"}
{"_id":"a0f01356-7671-2d03-a7a1-416e226a775e","text":"For the patient with complete NAC necrosis that needed reoperation with implant replacement, the progression of the skin flap necrosis was observed during the period in which the patient refused the second surgery and was treated conservatively. Excision of the affected skin and the exposed part of the synthetic mesh was performed along with the implant replacement – an Expander was placed instead of the anatomical one.","title":"Assessment of Mastectomy Skin Flaps for Immediate Implant-Based Breast Reconstruction"}
{"_id":"a0f07f42-0fc2-3666-8787-6f4ca17f1e38","text":"A retrospective review was performed to assess hospital records of 10,750 dental patients who received oral surgery under local anaesthesia at the Istanbul University Department of Oral and Maxillofacial Surgery from August 2013 through June 2016.","title":"Oral surgical procedures under local anaesthesia in day surgery"}
{"_id":"a0f83186-1369-89fd-a306-869a24103539","text":"Conclusions: The use of the artificial skin cover in the patient with decompression craniectomy resulted in a distinct, lasting decrease in intracranial hypertension below the value of 20 mmHg. This method may be recommended as an extreme procedure to solve intracranial hypertension in patients with decompression craniectomy and a continuing increase in ICP. Informed consent to published has been obtained from the patient.","title":"37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)"}
{"_id":"a0fce32c-8628-4885-81a2-a76af0706727","text":"MRI is well known to be the preferred imaging study to evaluate salivary gland masses. It shows the margins of the tumor more sharply than does the CT scan. MRI is especially helpful in case of facial nerve infiltration where it gives an abnormal enhancement of the invaded segment and an increase in nerve diameter [9].","title":"Metastatic Parotid Myoepithelial Carcinoma in a 7-Year-Old Boy"}
{"_id":"a0fe0ffa-e970-e5e6-75be-c350d8d040a9","text":"An electron arc treatment technique with external scatterer for the treatment of KS on the skin of the foot was evaluated and applied clinically. This technique could be useful for treating multifocal skin diseases including cutaneous KS on the arms and feet.","title":"Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi’s sarcoma in the distal extremities"}
{"_id":"a10cf859-7b35-1337-3b85-70829164d824","text":"In short, this method is simple and easy technically. Sufficient padding on the defect area is possible as fasciocutaneous advancement flap and thick central portion of gluteus maximus muscle flap compared to conventional coverage of relatively thin origin portion are combined for coverage of the defect area with ample thickness, especially in sacral sores going to the bone. The thickness of the muscle flap is well maintained reducing the recurrence risk of pressure sore. Muscle donor-site morbidity is tolerable causing fewer difficulties in postoperative ambulation with detachment of partial medial lower portion of muscle with minimal complications. There is less limitation of the rotation arc due to independent coverage of fasciocutaneous flap which facilitates in setting the flaps. When preparing for the possibility of 2nd and 3rd operation in patients prone to pressure sores recurrence, upper portion of the ipsilateral gluteus muscle can be conserved. The padding of the central portion of muscle, which has rich blood supply, to the debrided bone might help fight dormant infection. On the other hand, the disadvantage of this method is the possibility of longer incision if bilateral fasciocutaneous flap is used and the operation time can be prolonged. The use of fasciocutaneous flap on the contralateral side can cause difficulty in reoperation with fasciocutaneous flap or gluteus maximus myocutaneous flap from the contralateral side causing possible scarring or adhesion. The division of the lower fiber of gluteus maximus muscle can weaken limb adduction although the other adductors, the pectineus, and gracilis muscles can substitute this function.","title":"Combined V-Y Fasciocutaneous Advancement and Gluteus Maximus Muscle Rotational Flaps for Treating Sacral Sores"}
{"_id":"a11142f0-ed18-5c5f-bb42-463237cde0f6","text":"All participants were observed for any potential adverse reactions to the injection of pegulicianine or use of pFGS from the time of injection until hospital discharge. Participants had a final safety assessment at the first postoperative visit. Any reported adverse events were monitored until resolution. All adverse event data and data analyses were reviewed by the study’s independent data safety monitoring board.","title":"Clinical Impact of Intraoperative Margin Assessment in Breast-Conserving Surgery With a Novel Pegulicianine Fluorescence–Guided System A Nonrandomized Controlled Trial Clinical Impact of Intraoperative Margin Assessment in Breast-Conserving Surgery Using a Novel Fluorescence–Guided System"}
{"_id":"a1172386-7d88-21b4-6dcb-32a7794cdcef","text":"Because the bed of a wound is usually contoured whereas the foam pad is completely flat, the flat surface of the foam pad comes into contact only with part of the wound bed. Although the foam pad is meant to set itself to the wound as soon as the vacuum is applied, our opinion, based on our experience, is that this does not always take place with complete effectiveness on irregular-shaped wounds. The filler material always needs to be in contact with the wound surface for suction to be at its most effective.6 When this does not take place, this means that parts of the wound bed are not being treated. Furthermore, if the wound base is curved, as often happens with large wounds that extend around the surface of a leg or an arm, the “shape memory” of the foam causes it to lift up out of the wound until it is sealed. It therefore usually requires several members of the theatre team to hold the foam in place and then to apply the covering drape to achieve a complete seal.","title":"Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective"}
{"_id":"a11cb9ff-817e-b45d-b7d2-60edda0b34cc","text":"Patients with severe CP have a significant risk of infection due to inherent immunodeficiency aggravated by poor nutrition. Apart from pulmonary infection they can also develop urine or deep wound infection in the postoperative period and this can threaten the surgical outcome. The presence of an active urine infection can increase the risk of a deep wound infection. Patients who are double incontinent have a significant risk for developing deep wound infections due to direct contamination.","title":"Development and treatment of spinal deformity in patients with cerebral palsy"}
{"_id":"a1264202-dbee-2f64-ee70-01c53cc203b5","text":"All patients underwent a complete physical examination together with a biopsy of the primary lesion for histology.","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"a12baeea-233a-16f5-66fc-94bf99fd9167","text":"The integration of a nonmandatory electronic health record risk-stratification tool was associated with a significant reduction in venous thromboembolism events. Extended chemoprophylaxis was prescribed in nearly half of general surgery patients at very high risk for postdischarge events.","title":"Electronic health record risk-stratification tool reduces venous thromboembolism events in surgical patients"}
{"_id":"a12d1bb2-b464-76f3-0e68-3df1b118dcda","text":"In the group of women in whom drainage was not performed, needle aspiration was carried out whenever necessary up to the time of their discharge from hospital. The patients were advised to return once a week for assessment and for seroma aspiration as required. As in the drainage group, the volume of fluid aspirated was recorded, as were any other complications.","title":"Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial"}
{"_id":"a138853a-b97f-06ea-2d33-db6587c515db","text":"All procedures and methods in this retrospective study were carried out in accordance with the 1964 Helsinki declaration and its later amendments. The study design was approved by the institutional review board of Shanghai Ninth People’s Hospital, and informed consent was obtained from all individual particpants included in this study","title":"Using radiomic features of lumbar spine CT images to differentiate osteoporosis from normal bone density"}
{"_id":"a138e255-1eea-74c8-135c-cd6107fa54bc","text":"In our experience we tested five different products in one hundred patients. The formulations of creams used showed good results. For all of them we received a satisfactory result, with only five patients with a grade 3 dermatitis and twenty with a grade 2 dermatitis. It is impossible for us to draw a conclusion about the question of what product is more active also because the number of patients is too small and because there are too many variables in the groups. In fact there are personal differencies, of the phototypes, but also differencies about the age of patients and the therapies that they received before, such as chemotherapy, or after surgery and concomitantly with radiotherapy, like ormonal therapy. The largest number of patients with a recorded skin toxicity a month after radiotherapy, in group D of our study, can be related to the patient’s biggest breast volumes, although we do not have a statistical significance. Moreover the values of corneometry allow us to attribute a good moisturizing effect for products used in five groups of patients. Certainly the creation of a multidisciplinary team has allowed, with the corneometry conducted at the same time of the clinical evaluation, to identify cases of skin toxicity in a first phase and to determine the appropriate treatment to prevent the onset of dermatitis of high level which may affect the tolerance of treatment for these women.","title":"Preventing the acute skin side effects in patients treated with radiotherapy for breast cancer: the use of corneometry in order to evaluate the protective effect of moisturizing creams"}
{"_id":"a13aea32-0df0-801c-b46d-44bbb6071314","text":"Nose is one of the most important aesthetic unit of the face.Management of nasal trauma plays a significant role in the practices of the majority of facial and reconstructive surgeons. Replantation, although technically very challenging, is undoubtedly the procedure of choice following traumatic nasal amputation. Here we present an illustrative case report of the traumatic amputation of a nasal tip that was treated successfully with a paramedian forehead flap and further nasal reconstructive surgery. Use of the forehead flap was performed five hours after the occurrence of trauma and was followed by surgical repair about three weeks later. This case presents evidence that a forehead flap as a full-thickness composite graft can survive with an acceptable clinical outcome. In this particular case, the final result was satisfactory.","title":"Use of Forehead Flap for Nasal Tip Reconstruction after Traumatic Nasal Amputation"}
{"_id":"a1442567-ba72-322c-6137-aa541bc55d78","text":"Six of the nine surgeons had completed a one-year pediatric ophthalmology fellowship, but the opportunities for hands on surgery during this training varied (Table 2). Two surgeons were enrolled in a fellowship training program at the time of the survey but had not yet completed this. Another surgeon had not had formal fellowship training but was being trained and mentored by one of the other participating surgeons and visiting ophthalmologists from high income countries.","title":"Limitations in cataract surgical services for children in Ethiopia: a nationwide survey of pediatric cataract surgeons"}
{"_id":"a144e4df-8b18-7c57-2cbb-c3f735a81ec1","text":"Clinical diagnosis of DVT is a challenge, since the classic signs and symptoms are not always displayed. Therefore, a combination of clinical findings with risk factors grouped in a prediction system and use of supplementary tests is the best way of making a diagnosis.4","title":"Evaluation of the diagnostic management of deep vein thrombosis in the emergency department of a tertiary hospital in Santa Catarina, Brazil: a cross-sectional study"}
{"_id":"a146a7e8-6fcf-c01d-3d02-4fe8d0e75db8","text":"Previously, we reported that age was negatively correlated with spike IgG levels in males, and this was associated with reduced cTph cell activation at 1 week after the 2nd dose. The age-related reduction in the antibody response in males was also observed at all time points, but this reduction was milder after the 3rd dose. As the frequencies of cTph cells after the 2nd dose and memory B cells after the 3rd dose were positively correlated, individuals with weak CD4+ T cell responses at early time points may especially benefit from the 3rd dose. These findings emphasize the importance of the booster vaccine in individuals with weak CD4+ T cell responses to the primary vaccines.","title":"Early CD4+ T cell responses induced by the BNT162b2 SARS-CoV-2 mRNA vaccine predict immunological memory"}
{"_id":"a1497780-ca60-fef3-6f21-b34c52d388db","text":"Appropriate handling is clearly the first step toward accurate diagnosis and staging of RCC and these issues were considered by an expert group convened prior to the conference. After deliberation by the conference delegates, it was recommended that the initial sampling section should be along the long axis of the kidney. It was considered that this could be in the mid lateral plane of the kidney or through the collecting system or vascular system. It was agreed that the optimal method to identify renal sinus venous invasion is to open the kidney along probes placed in large venous channels. It was further agreed that margin involvement should be assessed by inking suspicious areas, the perinephric fat margin and hilum of radical nephrectomy specimens or the renal parenchymal resection margin and perinephric margin of partial nephrectomy specimens. At present there is no information in the literature as to how best demonstrate perinephric fat invasion and it was agreed that the fat overlying the tumor should be kept intact, with multiple perpendicular cuts made, with a view to sampling suspicious areas.","title":"The ISUP system of staging, grading and classification of renal cell neoplasia"}
{"_id":"a14b248f-68be-2e01-41cf-ecb9b11e6906","text":"All rhinoplasty surgeries were performed at the same hospital by two surgeons with at least 10 years of rhinoplasty experience.","title":"Ethnic Rhinoplasty: A Middle East-Centered Patient Satisfaction Survey Using the FACE-Q Questionnaire"}
{"_id":"a14b8b7f-3969-d75f-00b8-cbaf42d74110","text":"DIEP flap breast reconstruction surgery is now a popular option following mastectomy. Advantages include a strong blood supply to the newly implanted tissue, faster recovery time compared with the transverse rectus abdominis myocutaneous flap procedure, the sparing of donor site muscle, a reduction in abdominal fat and smaller risk of lymphoedema than with larger operations that typically also involve surgery to the axillary region. DIEP flap reconstruction is performed with free tissue transfer from the abdominal wall using a microvascular technique. The perforator vessels from the abdominal flap are anastomosed onto the internal mammary vessels that are approached by removing a small portion of rib. Figure 4 illustrates how the DIEP procedure is performed.","title":"The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan Case report: The appearance of cartilage in breast reconstruction as a mass on CT"}
{"_id":"a14ea232-fce8-535c-e223-ac7302f0ca1e","text":"Preoperative OPG showing well defined radiolucency on the right side of the ramus of the mandible with egg shell thin inferior border, without any pathological fracture and tooth displacement","title":"Unraveling the challenges in the diagnosis and management of desmoplastic fibroma of the mandible–a case report"}
{"_id":"a14f21ee-c0fb-589c-9d83-297ada2fda33","text":"The patient was treated with radical resection of the right tibia shaft and reconstructed with a hemi-tibia shaft fresh-frozen allograft and free microvascular fibula transplant. Through a medial approach to the leg, a total of 19 cm of the tibia with 2 cm margins at the proximal and distal end was removed. A free vascularized fibula was harvested from the contralateral limb in a manner that its length would permit direct contact or overlap with the tibia proximally and distally. The graft was prepared with preservation of the peroneal vessels, which were later anastomosed to proximal branches of the posterior tibial artery. No skin island was used as an implanted pulse oximeter ensured patency of the anastomosis. The allograft used was a fresh frozen tibia that approximated the patient’s size (Bone Bank Allografts, San Antonio, TX). The tibia allograft was then cut longitudinally approximately 50% of its circumference to enable space for the free vascularized fibula to be recessed. The hemi-tibia allograft was fixated to the native bone with two pelvic reconstruction plates that were contoured for placement. The fibular autograft was lagged to native bone distally and allograft proximally. The contact between the free fibula and native tibia as well as the space between fibula and allograft were supplemented with a mixture of iliac crest autograft and cortico-cancellous bone allograft.","title":"Hemi-tibia allograft and free microvascularized fibula transplant reconstitute the tibia shaft with side to side healing: 7 year follow up of a 14-year-old boy with adamantinoma"}
{"_id":"a1579edf-0b17-fd9e-a9e6-2c6ae16e41fe","text":"The excellent imaging and sensing properties shown by gold nanorods qualify them as excellent for photothermal therapy. On the other hand, porphyrin and derivatives show excellent properties as photosensitizers due to the fact that they have more than one absorption band on the near-infrared region; the phenomena allow for the penetration deeper into the tissue, and hence, they have excellent use in photodynamic therapy. Photodynamic therapy shows minimal invasion to tissues while photothermal therapy is specific to tumor cells or affected area.","title":"Encapsulation of Gold Nanorods with Porphyrins for the Potential Treatment of Cancer and Bacterial Diseases: A Critical Review"}
{"_id":"a172e2f1-adde-f9b6-d98a-a2fbfd6f68b4","text":"This study sought to further elucidate the perfusion of free and pedicled flaps both in the initial perioperative time period and with long term analysis. Previous studies have clearly shown that ICG dye with the Spy Elite system can be used to predictably look at the skin perfusion and therefore perforator blood supply of TRAM flaps. This study capitalized on a unique opportunity to look at the skin\/perforator perfusion of a pedicled and free muscle-sparing TRAM flap side by side in the same patient over time. The rectus abdominis muscle flap has long been used as a workhorse flap for breast and chest wall reconstruction and is a valuable resource in the armamentarium of any reconstructive surgeon.-","title":"Comparative Perfusion Analysis of Free Muscle-Sparing Versus Pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps in Vivo in the Peri-Operative and Late Post-Operative Periods"}
{"_id":"a1757ea6-6b67-852c-fd5b-7dbb5d4ae7f6","text":"Infection was one of the main worries when dealing with implant insertion following external fixation with a report of 10.8% of deep infection, including late osteomyelitis after a consolidation period had been completed. The use of the locking plate during external fixator application and the insertion of the retaining screws on the plate during the removal of the external fixator with completion of distraction was not associated with the deep soft tissue infection and osteomyelitis. No deep infection in the plating area was found with the sequential use of the internal fixator after the removal of the external fixator. Consistent with this, the insertion of the plate after distraction in our series was not associated with any deep infection.","title":"Submuscular Plate Stabilisation After Lengthening: Standard and Modified Techniques"}
{"_id":"a179de97-1a6d-11d4-ff7f-c519448ab635","text":"In this article, we show that ADM can replace skin grafts and flaps to promote the regeneration of full-thickness skin defects. Although contraction of the wound cannot be completely avoided due to the poor extensibility of the skin at these injured sites, it is still possible that the wound can healed by regeneration. Furthermore, we found that PELNAC has certain anti-infective ability. Although the wound initially appears to resemble skin necrosis or pus formation after being covered with PELNAC for a period of time, it then starts to become drier, and the Pelnac eventually promotes regeneration. This is consistent with the results of our current animal experiments that showed that the infection rate of the wound was reduced after the use of ADM.","title":"Acellular dermal matrix for one-stage treatment of lower extremity full-thickness skin defect: a case series"}
{"_id":"a17f922d-8464-10bd-9b5c-7a68cf022fa4","text":"Surgery is the method in which the cancer cells are treated with a combination of chemotherapeutics, and excisional removal of tissues with the use of certain surgical instruments are used for the procedure. The traditional method of removing cancerous cells by using a scalpel to a certain depth is also a type of surgery. Different kinds of surgical methods are used to treat cancerous tumors which are described as such [133].","title":"Skin cancer: understanding the journey of transformation from conventional to advanced treatment approaches"}
{"_id":"a1816d94-227f-27a7-d86e-9b85b055d6b0","text":"Supraorbital nerve stimulation is now considered a valid modality of treatment for patients with medically intractable facial pain and can be offered as a reliable alternative for the patients while discussing the proper plan of management.","title":"Supraorbital Nerve Stimulation for Facial Pain"}
{"_id":"a184a95b-cee2-a795-dfaf-35791332f407","text":"We routinely use tourniquet with the leg partially exsanguinated by elevation. The distal segment of the skin with its deep fascia is elevated first. The skin incision is extended proximally in the midline curving medially as it approaches the popliteal fossa. The sural nerve and the short saphenous vein are retracted laterally and protected during dissection. It is our common practice to temporarily secure the skin paddle to the muscle with sutures to prevent accidental shearing during flap elevation.","title":"Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice"}
{"_id":"a185a117-4b38-2e9d-84f3-bd35697d4900","text":"When comparing the success of primary facial movements before and after FES to that of emotional movements before and after FES, the success of emotional movements is more evident, which suggests that rehabilitation is important and that there may be changes in the cortical representation of facial emotional movements in facial transplant cases. We think that motor programs related to emotions are influenced before the transfer and that there are problems in transferring the universal motor program to the periphery after the transfer. The fact that disorders such as those associated with face sensation have been shown is also a feature of this result [6, 8].","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"a185c87d-aedf-b802-bae0-c956dd5d196e","text":"Ability to tan was not a differentiating risk factor for melanoma, SCC, or BCC. PLR analysis showed a trend toward significance in the comparison of the 3 cancer types, although it did not demonstrate a significant difference between the 3 skin cancers in susceptibility to burn or hair color. Interestingly, the red-hair phenotype did not have a differentially higher effect on the risk of melanoma versus that of SCC or BCC. Family history of melanoma and nevus counts emerged as significant risk factors for melanoma as compared with SCC and BCC in this analysis.","title":"Heterogeneity in Host Risk Factors for Incident Melanoma and Non-Melanoma Skin Cancer in a Cohort of US Women"}
{"_id":"a186147e-5da1-3916-097c-41ed95c7f4e3","text":"After treatment, patient the received oral food challenge with 120 g of wheat for the confirmation of tolerance acquisition. the patient show any symptoms and signs even with running just after intake of wheat no more for more than a year.","title":"Specific Oral Tolerance Induction Using IFN-Gamma in 2 Cases of Food-Dependent Exercise-Induced Anaphylaxis"}
{"_id":"a18890a8-dd30-0e17-4d18-d86ae365837b","text":"Durability and viability of various forms of cartilage grafts and usage of wrapped or bare graft were studied by some authors. Although some studies have shown the long-term prognosis of the irradiated allograft cartilage and adipose-derived stem cells in nasal reconstruction, no solution with respect to the improved prognosis of the graft has yet been accepted by the plastic surgeon community.Applications of these materials in cases of depletion of autogenous cartilage have not been accepted generally. As a result of this conflicting information and difference in resorption rate, application of stem cells for restore and improve the graft outcome is new concept and backbone of our research.","title":"Effects of the Human Amniotic Membrane on the Cartilage Graft: Prognosis and Absorption in White Rabbits"}
{"_id":"a188a1e4-4913-085d-67c6-2d0df1337379","text":"We believe that though there is enough evidence in the Western literature to advocate routine thromboprophylaxis for patients undergoing total joint replacement and surgery for fractures of lower limb, there is not yet enough evidence to justify the same for Indian patients undergoing major lower limb surgery. Though it is perhaps not appropriate to make any definite recommendation about chemoprophylaxis only on the basis of our research, we strongly agree with Gillespie et al.23 and advocate that the orthopedic surgeons should use pharmacological prophylaxis only for the high-risk patients (advanced age, past history of DVT, presence of varicose veins, obesity, malignancy, immobilization, etc.) in whom the potential benefits clearly appear to outweigh the risks. However, a close clinical monitoring with a high level of suspicion for DVT and pulmonary embolism must be exercised. A duplex sonography should be preferably carried out on all the elderly and high-risk patients undergoing total joint arthroplasty or surgery for lower limb fractures between the seventh and 14th postoperative day and a repeat ultrasonography should be performed on all the positive cases to rule out proximal propagation of thrombus. Trials involving a larger number of patients in future are required to confirm findings of this research which would help resolve the dilemma for the orthopedic surgeons in India whether or not to subject their patients undergoing lower limb surgery to chemoprophylaxis for DVT and PE.","title":"Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?"}
{"_id":"a1899002-c61c-3125-07b6-9132b628f2a3","text":"Rising academic surgeons are faced with a myriad of clinical and academic opportunities and interests, and they may face uncertainty regarding which interests will actually be sustainable throughout their careers. To develop further clarity, we prompt you to contemplate on what you want your professional identity to be beyond surgeon. Professional identities can include educator, innovator, leader, advocate, or scientist, and you can take on multiple roles to fit your goals. Attending faculty development and education-focused meetings and having open discussions with peers and faculty pursuing varying interests is one way to familiarize yourself with the various routes within academic surgery and determine which career goals feel like a good fit. Actively seeking out opportunities to explore your careers will assist you in identifying career goals that align best with your values and interests. Ask yourself the following questions to further assist you:","title":"Twelve-step Approach for Academic Development Planning in Academic Surgery Climbing the Academic Uphill With Strong and Steady Steps"}
{"_id":"a18b6ba1-c1e5-4d86-5b69-3f583f870e4a","text":"An immediate reconstruction requires a fine preop planning, may lengthen of several hours the overall surgery time and may hinder an eventual second look for oncologic purpose because of skin flaps transposition.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"a18fd6ba-0309-fd78-b502-f8c61633e1cb","text":"The scope of this work is to evaluate how the presence of CTL in the structure of an HA hydrogel affects the rheological performances of the gel. Resistance against hyaluronidase, swelling, cohesivity and rheological properties are investigated in order to assess the viability of these materials to use as dermal fillers, also by comparison with some commercially available products.","title":"New Directions in Aesthetic Medicine: A Novel and Hybrid Filler Based on Hyaluronic Acid and Lactose Modified Chitosan"}
{"_id":"a1972f60-fa00-5a20-2574-aba5cedc0212","text":"The aim of this study was to quantify the rates of microbial persistence and replacement found at repeat surgery in a large group of patients re-presenting with confirmed orthopaedic infection. Further, we used this cohort to investigate the potential impact of local antibiotic use on antimicrobial resistance in all recurrent infections.","title":"Microbial Persistence, Replacement and Local Antimicrobial Therapy in Recurrent Bone and Joint Infection"}
{"_id":"a1981a3e-c7b8-4320-738d-3477708ed955","text":"This study found an incidence of silent pulmonary embolism of 66% for lower limb DVT, much higher than that reported previously. These are more frequent when the proximal veins were affected. The figure of DD has a low specificity in the diagnosis. According to this study the confirmation of S-PE appears unnecessary since its presence does not imply an increase in immediate or delayed morbidity or a change in treatment strategy.","title":"Should we look for silent pulmonary embolism in patients with deep venous thrombosis?"}
{"_id":"a19a7651-60a4-dcdc-c4ef-59dcc30cd64f","text":"Since no direct studies have investigated the additional reduction in sensory morbidity that LS images and TBM may provide during SLNB, an indirect assessment of this potential was performed by extracting sensory morbidity data on SLNB from studies comparing the morbidity of SLNB to that of ALND [1–20] as described below.","title":"Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature"}
{"_id":"a19b4b45-92e9-bd15-c7ce-09c8d35712bf","text":"• Ensuring that the randomisation forms, radiology report forms and discharge forms are completed and either entered on line or sent to the coordinating centre promptly and that copies are kept in a site file and patient notes.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"a19e6566-ad18-d407-73b3-a6bf9ffcf93f","text":"Pulmonary vein thrombosis (PVT) is rather an uncommon condition which presents nonspecifically and is usually associated with lung malignancy and major pulmonary surgery. Rarely could no cause be found. It causes increased pulmonary venous pressure leading to pulmonary arterial vasoconstriction and subsequent pulmonary arterial hypertension and subsequently can cause cor pulmonale if not addressed in timely fashion. Other associated complications like peripheral embolization and stroke have also been reported. This case emphasizes the importance of maintaining high index of clinical suspicion especially when CT pulmonary angiogram is negative for pulmonary embolism.","title":"Idiopathic Pulmonary Vein Thrombus Extending into Left Atrium: A Case Report and Review of the Literature"}
{"_id":"a1a2ca1b-2531-7cda-8fd2-cdb6047864c9","text":"In this cross-sectional study of 83 patients with newly diagnosed melanoma, sentinel lymph node detection via indocyanine green and multispectral optoacoustic tomographic imaging was concordant with the detection frequency of conventional lymphoscintigraphic imaging with technetium Tc 99m.","title":"Assessment of Nonradioactive Multispectral Optoacoustic Tomographic Imaging With Conventional Lymphoscintigraphic Imaging for Sentinel Lymph Node Biopsy in Melanoma Nonradioactive Multispectral Optoacoustic Tomography vs Lymphoscintigraphy for Sentinel Lymph Node Biopsy"}
{"_id":"a1a50cbe-d690-eedb-6c72-3bea850909b5","text":"6 months after the injury, the patient is satisfied with the flap. He is happy about the texture of the flap which matched the other fingers","title":"\"A Free thenar flap – A case report\""}
{"_id":"a1a5bf0f-5ef5-786d-670c-7111c5e87898","text":"We also looked at patients whose hospital stay exceeded fifty days, this was the case for two patients who did not have surgical complications. One patient was living abroad and had a two stage procedure and therefore had to stay as an inpatient for the removal of an infected IM nail and subsequent reconstruction. This was the only patient in the group who did not require additional surgery but that still cost more than £30,000.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"a1b669d2-f9a0-4074-1cd3-47f5bc7b9728","text":"Published reports of the occurrence and treatment of superior gluteal artery injuries after antegrade femoral nailing are scarce, perhaps because of the rarity of the complication. A thorough understanding of superior gluteal artery anatomy is critical to understand and prevent this complication.","title":"Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation Superior Gluteal Artery Bleed After Cephalomedullary Nail Fixation"}
{"_id":"a1b8e0db-7a3d-8dbb-5b0b-272ddb5c7074","text":"This case report highlights the value of treating segmental bone loss, large soft tissue defect and vascular injury caused by shotgun injury using the Masquelet technique in combination with cross-leg pedicle flap coverage. We recommend this effective and safe method to restore bone and soft tissue defect simultaneously without the need for microsurgery while ensuring an excellent outcome.","title":"Reconstruction of Gustilo type IIIC tibial open fracture caused by shotgun injury using combination Masquelet technique and cross-leg pedicle flap"}
{"_id":"a1bc0cee-2a7e-64bd-3e57-68940a484f9e","text":"The main message from the study is that radiotherapy decreases the risk for local relapse even in low risk patients after conservative breast surgery. However, it remains to be confirmed that radiotherapy decreases the rate of mastectomies in this carefully selected and closely followed subgroup of patients, where the option for reexcision and radiotherapy may still be available when radiotherapy has not been given primarily. In general our recommendation is to give radiotherapy to all patients with invasive breast cancer after conservative surgery to avoid local relapses, and we agree that omission of radiotherapy should be done only in the context of a clinical study.","title":"Relative harms and merits of postoperative radiation following conservative surgery for low risk breast cancer"}
{"_id":"a1c9eb34-019b-bf68-cbbd-b79b5626f320","text":"Classical fat embolism is characterised by the triad of respiratory distress, mental disturbances and petechial skin rash occurring 12 to 72 hours after the initial incident responsible for the fat embolism. The pulmonary fat embolism syndrome exists as a spectrum, from embolism of fat without clinical symptomatology to the full-blown syndrome with a mild or even fulminant presentation.","title":"Pancreatitis with an unusual fatal complication following endoscopic retrograde cholangiopancreaticography: a case report"}
{"_id":"a1e0286a-7fa8-e71a-c162-1c0f57812a43","text":"The aim of this study was to explore a possible relationship between the presence of anosognosia symptoms and cognitive domains, functional abilities, and neuropsychiatric symptoms in pAD patients and normal elderly controls.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"a1e214ea-2e8f-fa8c-a19d-bf76c52a90a4","text":"Regarding these clinical and histopathological data, the diagnosis of actinomycosis was made. Moreover, we asked the patient to bring us any histopathology report of the tumor excised on his hand about one year before his admission. Surprisingly, the diagnosis of actinomycosis had also been mentioned in that report. But he had not come to his surgeon for any further treatment and the recurrence of the lesions occurred on the surgical scar. The patient was treated with intravenous penicillin G for four weeks and then oral penicillin. Resolution of symptoms and sings occurred but the patient did not come back for further follow-up.","title":"Primary Cutaneous Actinomycosis along with the Surgical Scar on the Hand"}
{"_id":"a1ef267a-7add-39ac-b3e0-212a9935d02c","text":"Our study included several experienced radiologists and allowed a variety of sampling devices to simulate actual clinical practice. While axillary node FNA is technically easy to perform for one experienced in image-guided procedures, the radiologist must obtain an aspirate that is both sufficient in the amount of material and at the same time not overly bloody, to enable an optimal interpretation. It is not clear why there were fewer false negative results when multiple FNA entries were performed, as the total number of needle excursions likely did not differ greatly. Perhaps the chance of obtaining a better sample was increased by using different entry sites or obtaining less blood mixed with cells from the node. The number of slides used, actual number of excursions, and length of procedure were not recorded, which could have affected the results. In some institutions, a pathologist is present when cytologic samples are obtained and can request additional sampling if the specimen is deemed suboptimal; the presence of a pathologist at the time of sampling could have improved the yield from FNA. In our institution, immunostains may be used to aid in interpretation when FNA alone is performed. Our pathologists have extensive experience in cytopathology but in this study there were no immunostains used in the cytologic evaluation; because the pathologists knew that additional tissue would be examined by core biopsy, a factor that may have decreased the sensitivity of FNA.","title":"Ultrasound Guided Core Biopsy versus Fine Needle Aspiration for Evaluation of Axillary Lymphadenopathy in Patients with Breast Cancer"}
{"_id":"a1fc035e-78b2-bd72-4949-143e99d5d44b","text":"Copolyamide is an active substance that causes granulomatous reactions with potentially severe functional and aesthetic complications that can be triggered years after the first injection. Low-pressure aspiration should be used with caution as a removal method: although esthetically superior to a direct approach, it does not allow for radical removal and can promote local and regional migration. In infectious cases, only a direct approach should be used, as one can remove the maximum amount of filler while preventing migration. The process of removing the filler requires several consecutive interventions, especially if it is associated with a local infection where several washings and debridements are necessary to get rid of all the incriminated material.","title":"Management of a Large Quantity of Permanent Gluteal Copolyamide Fillers (Aqualift\/Activegel): Literature Review and Algorithm"}
{"_id":"a207a2ec-4cf2-2c7f-845e-9dfec4f7090f","text":"Subsequently, a straight incision over the fifth rib was carried out, and around 8 mm length of the right fifth rib along with attached chondral part was harvested (Figure 10). The attached perichondrium was left in place without being stripped off to protect the cartilage from being sheared off the harvested rib upon functioning. The harvested graft was subsequently secured laterally to the left mandibular ramus through a submandibular incision, and the cartilage component was confirmed to be seated on the left glenoid fossa after slight smoothening of the edges of the costal cartilage. The graft was fixed with 3 bicortical screws in a line to the lateral side of the ramus without complete tightening of the middle screw to protect the curved from fracture from excessive force of the screw on the middle of its harvested length (Figure 11).","title":"TMJ Ankylosis in Children: A Case Report and Literature Review"}
{"_id":"a2120d74-3443-43aa-e720-6a0ed44a6170","text":"In conclusion though free flaps are now considered the gold standard in covering extensive defects of the flaps, a combination of local flaps can obviate the need of free flap. The temporal parietal fascia flap in combination with the scalp flap may allow one to cover extensive defects involving the temporal and frontal aspect of the scalp. These flaps are reliable and easy to raise and have low donor site morbidity. They are also suited in patients who may not withstand long operative times.","title":"Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound"}
{"_id":"a21e864e-74c1-c8e6-df16-b838dd2ba1fe","text":"The current study demonstrates that routine scheduled annual clinical follow-up appears to add little value in the detection of breast cancer recurrence or new primary detection. Close radiological surveillance, as well as a standardised pathway in which patients with a history of breast cancer with new breast symptoms can be seen in a timely manner, is likely to identify the majority of local breast cancer recurrences or new primary. The study also demonstrates that whilst surgical and non-surgical treatments for breast cancer have become more personalised over the last decade, surveillance programmes remain generalised with little focus on identifying patients who are at higher risk for recurrence and therefore require close surveillance. It is likely that there is still a role for assessing patients deemed to be higher risk on a scheduled clinical basis annually, but this study demonstrates that many patients do not require scheduled annual outpatient visits, as is the case currently. It is estimated that the institution in which the study was performed schedules close to 5000 “follow-up” appointments annually, placing a huge economic, time and financial burden on specialist staff who oversee this programme.","title":"Assessing Mode of Recurrence in Breast Cancer to Identify an Optimised Follow-Up Pathway: 10-Year Institutional Review"}
{"_id":"a2208698-1552-6c99-4698-1b9f2da6d7ac","text":"In this study, CEUS technique was applied to the examination of diseased lymph nodes to guide lymph node biopsy, increase the positive rate of puncture, and compare whether FNA and CNB have significant differences in the diagnosis of metastatic lymph nodes, so as to provide reference for clinical diagnosis of metastatic lymph nodes.","title":"Comparative study of core needle biopsy and fine needle aspiration in the treatment of metastatic lymph nodes guided by contrast-enhanced ultrasound"}
{"_id":"a2232a85-2eef-2631-3b6b-d95d175bccec","text":"Our study demonstrated a positive correlation between the number of female members and women on the Board of Directors in state and regional orthopaedic societies. This finding is consistent with previous research demonstrating that female mentors encourage more women to join the field of orthopaedics. However, only a few societies had female presidents within the past 10 years. Increased female representation in orthopaedics could provide diverse perspectives, which may enhance patient care. Future studies should seek to identify and implement effective ways to increase gender diversity and women in leadership positions within the field of orthopaedic surgery.","title":"Women in Leadership in State and Regional Orthopaedic Societies"}
{"_id":"a223d77e-df12-b91d-0ed7-f9e5cf81ff88","text":"Incidence of PC was greatest in those diagnosed with PC in the same year as their CM diagnosis, with a subsequent rapid decline in risk after 5 years. This may also be associated with the patterns of care following the initial CM diagnosis. Australian guidelines for skin cancer diagnosis recommend follow-up of melanoma patients should be conducted 3 to 6-monthly for 5 years following the diagnosis of a stage I-III melanoma. This increased vigilance in the first 5 years would involve health checks possibly including prostate specific antigen testing (PSA) and digital rectal examination for middle aged or older men, which will increase the likelihood for detecting asymptomatic PC, especially in the first year for all latent or undetected cancers. The reduced risk of PC after 5 years may reflect the decline in surveillance for CM after 5 years or the fact that any men with latent disease may have already been detected shortly after diagnosis.","title":"An initial melanoma diagnosis may increase the subsequent risk of prostate cancer: Results from the New South Wales Cancer Registry"}
{"_id":"a2297ffd-7848-bdc8-4bdc-09b0ac0f796d","text":"Rarely, an expectant therapy has been advocated for unresectable lesions as some of these tumors have been known to regress spontaneously. Spontaneous regression has been noted in female subjects at the onset of either the menarche or the menopause, suggesting that hormonal change might be involved. The premise of such an advocacy is that it is not a malignant condition and has never metastasized. But then there are other researchers who report that the cells of desmoid tumor were highly proliferative with their biological activity bearing resemblance to fibrosarcoma and believe in grouping desmoid tumors as of low grade malignancy [7, 11].","title":"Desmoid Tumor of the Buttock in a Preadolescent Child"}
{"_id":"a22ac54f-601b-7452-37f2-2d3689007adb","text":"The survey was disseminated globally through The Upper Gastrointestinal Surgery Society (TUGSS) and reached surgical doctors via email and social media platforms. Surgeons were encouraged to share the survey freely, allowing for a broader range of respondents and capturing a more comprehensive understanding of the challenges faced by overseas surgical trainees.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"a22b3fe8-a968-ac69-29f2-228d0b4ce2f7","text":"Objective: A hemisplit turndown tibialis anterior muscle flap is described for coverage of distal leg wounds with preservation of active extensor function for open wounds of the distal ankle is presented. This is a new flap not previously described and is another local option for coverage of selected distal leg wounds. Methods: A description of the operative procedure and a clinical successful example is presented. Results: The split hemitibialis anterior turndown muscle flap was successful and preserved function of the muscle and tendon. Conclusions: This is another option for coverage of difficult wounds of the lower extremity without sacrifice of function of the donor muscle.","title":"Split Hemianterior Tibialis Turndown Muscle Flap for Coverage of Distal Leg Wounds With Preservation of Function Gundlapalli et al"}
{"_id":"a22d0a98-3495-6a68-9d81-401eb667e696","text":"The clinical and histological diagnosis of an adverse granulomatous reaction to a dermal filler is often challenging for diverse reasons, including COVID-19 vaccinations. An awareness of this manifestation mimicking a salivary gland neoplasm is significant to ensure the correct diagnosis and treatment. Patient education regarding the name and nature of the injected filler material and the possibility of adverse reactions is important.","title":"Delayed adverse reaction to a natural dermal filler mimicking salivary gland neoplasia"}
{"_id":"a22f7df0-6902-7990-c5fc-3594aadf52ab","text":"In IBR, ODF need to be taken into account, as these factors influence the time selected for reconstruction because of possible clashes between the reconstructive procedure and ancillary treatments and their effect on the complication rate.","title":"Oncoplastic surgery in the treatment of breast cancer"}
{"_id":"a22fd7ff-4168-f78b-e1e8-c6695c91c7fb","text":"The study was carried out over a period of 1 year on 25 adult, male Indian rabbits after obtaining permission from the institutional animal ethical committee. A full-thickness osteochondral defect was created by shaving off the whole articular cartilage of the patella of the left knee. The defect thus created was grafted with free periosteal graft. The patella of the right knee was taken as a control where no grafting was done after shaving off the articular cartilage. The first animal was used to study the normal histology of the patellar articular cartilage and periosteum obtained from the medial surface of tibial condyle. Rest 24 animals were subjected to patellectomy, 4 each at serial intervals of 2, 4, 8, 16, 32 and 48 weeks and the patellar articular surfaces were examined macroscopically and histologically.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"a2475826-84d6-a984-b3a1-4110ed1a50ef","text":"In this Northern European cohort, subjects with clinically relevant tree nut allergy were generally allergic to two or more tree nuts and close to half of them also to peanuts. There were two distinct and independent allergic phenotypes; the majority of hazelnut allergic subjects were also allergic to walnut, and all but one subject with cashew allergy were dual allergic to pistachio. These findings are consistent with a strong sIgE correlation between hazelnut and walnut and a close to total sIgE correlation between cashew and pistachio.","title":"Patterns of Clinical Reactivity in a Danish Cohort of Tree Nut Allergic Children, Adolescents, and Young Adults"}
{"_id":"a24767e1-4dd2-d3ff-d032-ec576b967a0c","text":"This study observed that rates of limb amputation and revascularization in community-dwelling patients with PAD are high and results of lower extremity evaluation by noninvasive ABI identify patients with PAD at highest risk for these outcomes. Additional observations included that PCA is strongly and independently associated with amputation and severe PAD is independently associated with revascularization. We also observed that guideline-recommended strategies for secondary risk prevention are underused, confirming a recent national survey. However, the prior report provided no data on PAD severity and did not capture the longitudinal experience of individual patients. Moreover, the present study addressed these knowledge gaps in a community setting and included results of lower extremity arterial evaluation by ABIs to assess PAD severity and the presence of PCA as well as longitudinal follow-up.","title":"Association of Ankle-Brachial Indices With Limb Revascularization or Amputation in Patients With Peripheral Artery Disease Association of Ankle-Brachial Indices With Limb Revascularization or Amputation"}
{"_id":"a24858f0-f31d-8b53-3a25-a42f4f035d54","text":"The independent prognostic value of lymphadenectomy in relation to overall survival is uncertain, but its role in local disease control is evident.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"a24a8dd0-38f2-bf26-3420-2c115d2e85f8","text":"There were two post-surgical visits with a 1 and 3 month interval between them and the surgery to facilitate covering all possible outcomes.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"a24b8cbf-7f41-0d14-fd1a-aa503c34b0be","text":"The aim of the study was to evaluate the proper timing for the reconstructive procedure for the patients who underwent mastectomy.","title":"Timing between Breast Reconstruction and Oncologic Mastectomy—One Center Experience"}
{"_id":"a25185c5-2b2c-aa36-82c1-a10d41159e72","text":"Secondary tumors of the chest wall can arise from direct metastasization by breast and lung cancer or from neoplasm located elsewhere in the body, and their incidence is higher than that of primary tumors.","title":"Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience"}
{"_id":"a26811e3-a17c-f63a-75b6-d3219aab9e11","text":"Early radiation lesions consist of an acute inflammatory response and tissue vessel friability that can significantly affect the success of immediate surgery.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"a2685518-6275-a4c5-3161-e73f91aa5a7f","text":"The manufacturing process used to produce HA dermal fillers involves breaking down the initial crosslinked gel into smaller HA gel fragments or particles. This process allows the gel to flow through a needle for injection under the skin. After fragmentation, the gels may still be too stiff and hence resistant to deformation and potentially difficult to inject. In order to overcome this, some manufacturers introduce un‐crosslinked HA as a lubricant to reduce the strength of the gel during injection (and therefore the force required for injection). While this un‐crosslinked HA aids the smooth injection of the gel, it has a short residence time under the skin and thus does not contribute to the persistence of the gel at the site of injection.","title":"Evaluating hyaluronic acid dermal fillers: A critique of current characterization methods"}
{"_id":"a268697e-0524-d8e3-9057-5e2b7cfc0883","text":"These quality indicators aim to provide clinicians and healthcare authorities with a quantitative background of optimal standard of care and an evidence based framework for improving quality of care across Europe at institutional and national levels. The ultimate aim is to improve oncologic outcomes by minimizing treatment related morbidity and complications profiles, and to homogenize treatment care across Europe and beyond. These quality indicators are intended to give practitioners and administrators a quantitative basis to improve care and organizational processes notably for recognition of the increased complexity of modern external radiotherapy and brachytherapy techniques. They also facilitate the documentation of quality of care, comparison of performance structures, and establishment of organizational priorities as a basis for accreditation in European countries. The key characteristics of an ideal indicator are clear definition, clinical relevance, measurability, and feasibility in clinical practice. The quality indicators and proposed targets are based on the standards of practice determined from available scientific evidence and\/or expert consensus.","title":"ESGO\/ESTRO quality indicators for radiation therapy of cervical cancer"}
{"_id":"a268c6ca-1de8-12e1-5503-904ffe3f0a7c","text":"The most common complications known in the case of KDPF are wound infection and dehiscence. 5 13 14 15 This is probably due to the intrinsic tension at the suture line and through the central region of the flap. One option to avoid dehiscence at the closure line is to allow the donor site healing by secondary intention.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"a26ae8b5-8416-d0fc-8a7b-2b0ac0a8e356","text":"On basis of the microbiological findings and preoperative score for PJI TKAs were classified as aseptic or PJI according to the ICM Criteria. During revision surgery following the biopsy, a minimum of three to five intraoperative deep tissue samples for additional microbiological analysis were taken and processed as described above. The culture results of incisional biopsies were compared to the culture results of revision surgery. To calculate sensitivity and specificity of incisional biopsy, diagnosis of PJI based on ICM criteria with respect to the findings of revision surgery were used as gold standard.","title":"Poor performance of open incisional biopsy for the microbiological diagnosis of periprosthetic knee joint infection"}
{"_id":"a26fac7c-ff87-fe9d-3987-20cdafa9e7c8","text":"While the former cannot be successfully treated with surgery, the latter may have the last chance of cure through an aggressive surgical procedure.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"a273568f-7d71-c38a-12de-3b06d46646db","text":"To prevent VTE development, it has been recommended that chemical prophylaxis be applied after total knee and total hip arthroplasties and after open reduction\/internal fixation of proximal hip fractures. Nagase et al reported that fondaparinux in combination with mechanical prophylaxis prevents postoperative PE after total hip or knee arthroplasty.","title":"Risk Factors for Venous Thromboembolism After Spine Surgery"}
{"_id":"a27971a4-3b3c-2c4e-fe33-7ffeb598aff0","text":"The purpose of this study was to assess using Pentacam® the effects of periocular botulinum toxin injection on the ocular surface and anterior chamber parameters in patients diagnosed with essential blepharospasm and\/or hemifacial spasm. We document for the first time a narrowing of the anterior chamber angle after the injection that may be the cause of the angle-closure glaucomas observed after these injections.","title":"Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm"}
{"_id":"a27d6047-5931-1b94-11f8-f79c94fceb96","text":"The expandable SVG external support system was found to be efficacious in reducing SVG’s non-uniform dilatation and neointimal formation in an animal model early after CABG. This novel technology may have the potential to improve SVG patency rates after surgical myocardial revascularization.","title":"Expandable external support device to improve Saphenous Vein Graft Patency after CABG"}
{"_id":"a2893cd3-6bcc-1621-29c0-f96e7af37f07","text":"Patients were divided into three groups based on their treatment regimens:","title":"Comparison of Enoxaparin and Rivaroxaban in the Prophylaxis of Deep Venous Thrombosis in Arthroplasty"}
{"_id":"a29066db-51e1-8a4c-f66f-0ca1406183df","text":"The mainstay of treatment of symptomatic desmoid fibromatosis is surgical resection, and in the case of abdominal tumor, it can be more dangerous when it invades adjacent organ. We report a case that required additionally multidisciplinary approach for surgery and postoperative treatment of huge abdominal desmoid tumor which infiltrate bone and pericardium beyond abdominal cavity.","title":"Rib and pericardium invaded huge abdominal mass in young woman: A case report with literature review"}
{"_id":"a296d338-9ed7-e4ef-6505-2630cb1e250e","text":"Markings for the lateral autologous breast sling procedure include the midline, planned lateral flap incisions used for the release of the flap, and critical transition lines of the breast, specifically the inframammary fold and the planned anchoring position to the pectoralis major (Figure 1). This anchor position is determined by the manual elevation of the lateral breast flap tissues to the anterior axillary fold and evaluation of the resultant lateral breast curve. If concurrent revision procedures are to be completed, their markings are completed as indicated. Fat grafting donor sites of the abdomen and flank and their recipient sites are marked.","title":"The Lateral Breast Flap Sling: A Novel Technique for the Revision of Autologous Breast Reconstructions"}
{"_id":"a29c2a2b-701f-9996-5d23-e5bfdad15021","text":"In addition to PCA, gabapentin has also been effective in decreasing neuropathic pain and may permit the use of lower doses of narcotics. The optimal effect of gabapentin is not observed immediately, and therefore it is recommended that this drug be started approximately 1 week prior to the start of immunotherapy and titrated up to a full dose over the course of several days. For the same reason, gabapentin should not be started and stopped each cycle but rather taken continuously during the five courses of immunotherapy.","title":"Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications"}
{"_id":"a2a07c7e-53e9-d887-9f07-195600887f38","text":"Considering the patient initially presented with pain in her calf, it seems reasonable to assume that the DVT was limited to the distal segment of the lower limb in view of the negative proximal ultrasound scan, although these tests have false negative rates. Distal ultrasound scans are not performed by sonographers largely because of lack of training, as well lower sensitivity and specificity for calf DVT, though studies do suggest with the appropriate training, it can be considered a valid and feasible test, but it may be reasonable to make an alteration to the guidelines in view of the severe complications that arose from a distal DVT in this case. This alteration may require more invasive investigations such as contrast venography or a lower threshold for starting anticoagulation if the D-dimer is raised, even if the proximal ultrasound was clear.","title":"Missed Massive Pulmonary Embolism and the Hidden Threat of a Distal Deep Vein Thrombosis"}
{"_id":"a2a2265d-3952-0f27-8508-42c83ec2ccea","text":"Any surgical or anesthetic complications occurring within 4 weeks of implantation were recorded.","title":"Comparison of single-injection ultrasound-guided thoracic paravertebral block with transversus abdominis plane block in peritoneal dialysis catheter implantation: a randomized controlled trial"}
{"_id":"a2a2e44a-281f-8a3b-959b-900ed57a4f56","text":"The most common side effect is transient skin reactions at the site of the injection that resolve with continuing the treatment. Chest pain and flushing are also of the other transient complications occurring immediately after the injection.","title":"Multiple Sclerosis in Children"}
{"_id":"a2ae6e57-ece1-9141-19a6-6c4074e811e3","text":"Table 3 Efficacy and safety outcomes of clinical trials with NOACs for the treatment of VTE","title":"The diagnosis and treatment of venous thromboembolism in Asian patients"}
{"_id":"a2baaff9-96d4-eb1a-046b-da9e3e8a194a","text":"Sub populations of bacteria evolve into phenotypically different resistant states expressing varied biofilm-specific antimicrobial resistance genes. Other bacteria within the biofilm may produce enzymes and exotoxins which result in local tissue invasion leading to the formation of fulminant infection. The reduced growth rate of bacteria due to accumulation of waste products, incomplete penetration of metabolic substrates together with mechanical and osmotic challenges in penetrating a biofilm makes the biofilm-based bacteria more resilient.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"a2be9997-fdd7-14f4-4097-325cc1856504","text":"The split hemitibialis anterior turndown muscle flap, for distal lower leg wounds, adds another local procedure to the armamentarium of a reconstructive plastic surgeon, a simple but effective local flap procedure to manage these difficult soft tissue defects in selected patients with adequate vascular supply of the limb.","title":"Split Hemianterior Tibialis Turndown Muscle Flap for Coverage of Distal Leg Wounds With Preservation of Function Gundlapalli et al"}
{"_id":"a2c995d2-f4e2-be12-21b4-1a2c14b7c6f9","text":"The reconstruction of large surgical breaches in which the scalp was removed leaving the bone bare has always been a difficult problem to solve.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"a2ca0b59-66d1-e62b-fd77-2d449466b8e2","text":"The results of our study of 3D cones at multiple echo times demonstrates a high level of anatomical detail is retained even in the presence of SPIOs. Tracking SPIO labelled MSCs with UTE MRI has been previously reported in a rodent tumor model, but has not been shown in musculoskeletal applications, nor shown in a large animal model. Standard acquisition schemes using Cartesian readouts cause bony and SPIO induced signal loss, thereby interfering with the interpretation of MRI cell MR imaging and tracking. Imaging of SPIO-labelled MSC has been reported by several authors in a number of different tissues. Previous MSC SPIO imaging studies in the joints of experimental animals have typically measured T2* with Cartesian gradient echo where the anatomical fidelity is compromised in the presence of SPIOs. However, imaging of SPIO-labelled cells in joints poses a imaging challenge due to the presence of dense bone, whether subchondral and osteoarthritic, and, if present, of the highly magnetic SPIOs that appears present in nearby fluid capsules. This difficulty has led to previous studies raising questions over the specificity of the sequences used for SPIO imaging in the joint.","title":"Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model"}
{"_id":"a2da8b39-3f84-ff2e-8a3f-dae9824eccd5","text":"Despite the lack of standardization in reporting symptom relief, this review has shown that cryoablation can decrease symptoms and improve quality of life. Cryoablation can be performed for iterative symptomatic palliation in a setting of symptomatic recurrence.","title":"Cryotherapy in extra-abdominal desmoid tumors: A systematic review and meta-analysis"}
{"_id":"a2dd8e3b-f639-69af-1145-17d85b4e6ee5","text":"All data generated or analyzed during this study are included in this published article. The data used to support the findings of this study and a complete and detailed test protocol can be obtained from the first author and corresponding author.","title":"Ultrasound-guided transversus thoracic muscle plane-pectoral nerve block for postoperative analgesia after modified radical mastectomy: a comparison with the thoracic paravertebral nerve block"}
{"_id":"a2ef92da-1fce-d63f-7faa-0f3b46681303","text":"To make a new classification system that includes a new branching pattern of facial nerve trunk that has not been described before, also to mention a simple method of how to identify the facial nerve trunk, all that will help the new surgeon in performing parotidectomy with less complications and unpredictable outcome.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"a2f0cde2-e2ec-550b-cd8b-6cda7e3f9e0a","text":"Gluteal fat grafting will remain in the spotlight for years to come as surgeons continue to investigate techniques to improve safety. To avoid serious complications, it is imperative that surgeons have a firm understanding of the gluteal anatomy, especially of the underlying gluteal veins. This topic deserves more attention, and further studies are needed on outcomes as surgeons begin to implement recommendations outlined in recent literature aimed at improving patient safety during gluteal augmentation with fat grafting.","title":"The Safe Gluteoplasty: Anatomic Landmarks to Predict the Superior and Inferior Gluteal Veins Muresan et al"}
{"_id":"a2f2009c-d329-c5f0-49c1-b1b8aebe4c1c","text":"Postmastectomy immediate reconstruction has a positive impact on psychosocial and sexual health than total mastectomy alone; however, conserved breast cases has better cosmetic scores. Physical well-being found similar in all three groups of surgical interventions. More research projects should be carried out in this regard with inclusion of all patients in public and private sector hospitals of rural and urban areas to better understand which factors compel patients to attain highest standards of quality of life after curative surgery.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"a2f90ff1-a71c-592f-4c23-9c4b0b31d2d8","text":"If hypersensitivity or allergic symptoms resolve promptly following the previously mentioned interventions, the patient may resume dinutuximab at half the original infusion rate without resumption of cytokine during the same day. If the patient is stable the following day, cytokines may be resumed.","title":"Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications"}
{"_id":"a3001cca-bdfb-2cc1-b708-1ab9ebd91f35","text":"In our case, we decided to adopt NPWT in a patient who presented an abdominal dehiscence in order to reduce time of hospitalization and to obtain total abdominal wall closure.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"a30485d3-aeff-a7e6-42bc-b05b5245201e","text":"3 weeks after surgery all patients had subjective alteration in sensibility of the nasal tip and the adjacent upper columellar skin. This alteration was perceived as heaviness in 19 patients in group one and 17 patients in group two; 6 patients in group one and 8 patients in group two stated that the nasal tip and adjacent columella felt different from remaining nasal skin.","title":"Comparing the Alteration of Nasal Tip Sensibility and Sensory Recovery Time following Open Rhinoplasty with and without Soft Tissue Removal"}
{"_id":"a30c4d41-cf4c-a2a0-b884-f9e908f9cacf","text":"When the facial nerve has been already recognized as total paralysis, dissection is carried out along the main trunk of the facial nerve to the proximal intra-facial canal and distal to the cancer so that facial nerve reconstruction can be achieved after resection of the tumor. We accomplish this by removing the mastoid process and identifying the facial nerve in the vertical section of the temporal bone. Frozen examination of the proximal and distal nerve is checked prior to nerve reconstruction.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"a312ddd5-380d-9019-8f00-58e5381278fd","text":"Soft tissues posttraumatic defects of the lower leg are a challenge for reconstruction, especially when bone or eventually a fracture is exposed.","title":"Cross-Leg as Salvage Procedure after Free Flaps Transfer Failure: A Case Report"}
{"_id":"a314ac21-653c-77f1-317e-8d8cc3a4d0eb","text":"How this report contributes to current knowledge: Anaphylaxis in newborn period is very rare. Our case was interesting that to our knowledge this is the first case of anaphylaxis in a newborn induced by first dose of an antibiotic. We wished to attract attention that severe drug reactions can also be seen in early life.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"a31ab48b-b21a-5621-5e2a-f259c7f9d84a","text":"This study widens the possible application of NPWT confirming its therapeutic role also if applied on biological mesh in complicated patients.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"a31d618c-5995-f8a6-c541-3075f851bfd3","text":"In cases where there is a strong suspicion of PE and anticoagulant therapy is contraindicated, a diagnostic evaluation is warranted without any waste of time. The basic management include supportive management and timely delivery of the fetus. Once the PE is confirmed, other measures especially like IVC filter may be needed. In case of concern for isolated DVT without PE, it is better to diagnostically evaluate the patient before anticoagulant therapy is instituted.","title":"Strategies for Diagnosis and Prevention of Venous Thromboembolism during Pregnancy"}
{"_id":"a31d9c11-3511-3572-b6c4-223c04c92dd6","text":"This narrative review illustrates the interdisciplinary aims and challenges of sinonasal reconstructive surgery using flaps or grafts. It is particularly relevant to radiologists and radiation oncologists, at a time when intensity modulated radiotherapy (IMRT) and proton therapy have the potential to further contribute to reduction of morbidity following on strategy initiated by surgeons.","title":"Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know"}
{"_id":"a328a435-de28-5b52-098e-aee92cdb07cd","text":"Although it seems that tendency for allergy shot in children is less than adults, but reactions in children is less than adults and children better tolerate allergy immunotherapy.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"a329baec-e63e-da32-8f35-36d2863375fa","text":"The current study had some limitations. The number of patients included in the study was relatively low compared to previous studies. Since we did not perform bilateral PVB, we were not able to compare unilateral PVB and bilateral PVB with regards to their effectiveness and complication rates. As the study included only patients who underwent elective cholecystectomy due to cholelithiasis, we were not able to generalize our results to all those undergoing cholecystectomy for any reason. Future studies with a larger number of patients are warranted, including patients with other biliary pathologies.","title":"The Efficacy of Ultrasound-Guided Paravertebral Block in Laparoscopic Cholecystectomy"}
{"_id":"a3316e3e-ec30-f2a3-f856-8b008bca2cfa","text":"Defects of complex aesthetic subunits of nose and eyebrow and limited availability of donor area contribute to the difficulties encountered in achieving a good aesthetic functional outcome in complex facial reconstructions. Because of its ideal color and texture, forehead skin is acknowledged as the best donor site with which to resurface the nose.1 Surgical treatment is extremely difficult with the combined defects of skin, cartilage, and nasal mucosa. Besides, efforts geared toward ascertaining the best aesthetic outcome, an important concern is restoring normal nasal function. The prefabricated forehead flap has been used to provide an anatomically sufficient amount of nasal skin and nasal mucosa for whole-layer wide nasal defects in only three sessions without necessitating an additional flap.2","title":"Complex Nasal and Periorbital Reconstruction Using Locoregional Flaps: A Case Report"}
{"_id":"a33535be-c8ec-76db-84e8-acbddd8386a5","text":"In the Stroop test, the incongruent condition consists of naming the color of ink in which a color name is printed when the color is incongruent with the name. This condition elicits the Stroop effect that implies a significant slowing of performance. The response tendency or task set of reading the word, through life-long experience with reading is initially activated more strongly than the novel response tendency or task set naming the color. A number of studies have shown a deficit in Stroop test performance by patients with pAD, and evidence suggests that this deficit is due to a breakdown in inhibitory processes that occurs early in the course of the disease. These results are in line with those obtained by other studies suggesting that pathology for frontal brain regions is typically associated with executive dysfunction and also with poor behavioral insight.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"a33b2b4c-71bb-fe70-ded5-14f278587b24","text":"The mechanism of DF development is suggested to be associated with hereditary diseases, mechanical stimuli, and a history of exposure to radiation appear to be involved as pathogenetic factors in sporadic development. Surgical resection is the first-line treatment for MDF, but the postoperative high local recurrence rate is problematic. Drug therapy and radiation therapy are selected for cases in which radical resection is not possible or for recurrent cases. However, the number of examined cases is small and sufficient evidence has not been accumulated for most treatment strategies, it is expected that the optimal treatment at the time of recurrence will be further verified by the accumulation of MDF.","title":"Ruptured mesenteric desmoid-type fibromatosis without emergency surgery: A rare case report"}
{"_id":"a33eab3e-405b-dd5c-5ea1-99e11612f6d2","text":"Others directly related the confidence that they had gained to their choice to pursue jobs that they would not have applied for prior to the fellowship. One interviewee explained that the confidence she had gained had made her more articulate and enhanced her abilities to deal with conflict:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"a33eb4f2-1033-59a9-cac9-b7a19c1c9ebe","text":"In this study, we used a pasteurized intercalary autogenous bone graft combined with a vascularized fibula graft for bony defects after tumor resection in the patients with osteosarcoma and acquired good oncological and functional outcomes. Furthermore, we were able to prove that prosthetic reconstruction was similar to reconstruction with recycled pasteurized autograft in terms of local recurrence and metastasis, while a higher rate of revision was noted in patients with prosthetic reconstruction.","title":"Evaluation of the Efficacy of Pasteurized Autograft and Intramedullary Vascularized Fibular Transfer for Osteosarcoma of the Femoral Diaphysis"}
{"_id":"a344d1d1-9210-6ec0-46c1-e14fa83b8ea9","text":"Culture results of fluid\/pus from sinuses or open wound are not reliable in establishing the causative agent of osteomyelitis due to the high chances of contamination of superficial contaminants. Bone fragments obtained during surgery have been recommended as ideal sample to establish pathogens causing osteomyelitis. This study investigated pathogens causing osteomyelitis among patients undergoing orthopedic surgical treatment at Bugando Medical Centre.","title":"Methicillin resistant Staphylococcus aureus causing osteomyelitis in a tertiary hospital, Mwanza, Tanzania"}
{"_id":"a345a1c1-2952-d336-7a62-afc61a8f8b8e","text":"There was some variation in the treatment of our three cases due to different practitioners treating each case and due to patient wishes. Whilst two of the patients declined systemic steroids to treat the lesions and opted to have the topical treatment only, all three cases resolved completely in similar time frames: two weeks for redness and itching to resolve, and six months for complete resolution of the swelling without scarring. This could suggest that the systemic steroids given did not provide any further benefit or that the condition is self-limiting and does not require any treatment.","title":"Nodular Eruptions as a Rare Complication of Botulinum Neurotoxin Type-A: Case Series and Review of Literature"}
{"_id":"a347b498-0419-05a3-d58e-fca33b5a5226","text":"The appropriate duration of parenteral antibiotic treatment in patients with pyogenic spondylodiscitis after surgical intervention could be guided by the risk factors. The duration of postoperative intravenous antibiotic therapy could be reduced to 3 weeks for patients without positive blood culture or abscess formation.","title":"Appropriate duration of post-surgical intravenous antibiotic therapy for pyogenic spondylodiscitis"}
{"_id":"a34c7992-3bd3-b135-9e84-9f08421b43e3","text":"Intraoperative computed tomography scan is a useful tool to assess the remaining volume of the abnormal bones.","title":"Enthesopathy of the bicipital tuberosity of the radius treated under intraoperative computed tomography"}
{"_id":"a34ec52c-512f-6960-2873-3244968dc0c6","text":"To date, however, clinical studies specifically assessing the feasibility and success rate of secondary SLNB in dogs with scars from prior surgical excision of the primary tumor that have been referred for further staging and\/or adjuvant treatment options are lacking. This study therefore aimed to investigate the feasibility and utility of SLNB in a cohort of dogs presenting with scars from previously excised solid malignancies.","title":"Sentinel Lymph Node Biopsy Is Feasible in Dogs with Scars from Prior Local Excision of Solid Malignancies"}
{"_id":"a357e87b-125d-4402-d36a-5d2a8c8c9921","text":"Examples of practical performance simulations have been studied for five probes, showing that nodes at less than 115 mm from the injection site may be poorly localized, with even the best performing probe requiring at least 51 mm separation to allow for detection in the high background area near the injection site. The best probes allow for SLN localization between 20 to 30 mm closer to the injection site than the poorest performing probes [44].","title":"Sentinel Lymph Node Evaluation: What the Radiologist Needs to Know"}
{"_id":"a35abbdf-9dfe-6f62-a4d3-d287cf0a2f01","text":"In addition to gaining perspective on their careers and the NHS, many interviewees believed that they had developed personal insight through reflective practice whilst completing the fellowship. In some instances this was expressed as a new awareness of qualities that they already possessed, and in other instances it involved recognising a gap between their perception of self and reality. Some interviewees reported that the programme empowered them to gain confidence in skills they had not previously recognised:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"a35e391b-ed18-323f-a08f-65e60c1778e5","text":"In the group with the caudal dermis flap, 4 patients developed skin necrosis, which all healed conservatively due to the sufficient blood supply through the dermis flap. In the group with the use of a synthetic mesh or acellular dermal matrix, skin necrosis was found in three cases. In one of these patients the implant was exposed and had to be removed.","title":"Implant-based immediate reconstruction in prophylactic mastectomy: is the caudal dermis flap a reliable alternative to synthetic mesh or acellular dermal matrix?"}
{"_id":"a35e53aa-84ba-f1db-6e0e-54ab0233fbda","text":"The future application of SAM treatment. A Ultrasound thermal and acoustic properties can improve local drug delivery, improve wound and bone healing and reduce arthritis progression. B Ultrasound treatment may reduce the progression of osteoarthritis by reducing the rate of osteophyte formation and inflammatory cell activation","title":"Sustained acoustic medicine for the treatment of musculoskeletal injuries: a systematic review and meta-analysis"}
{"_id":"a3618b66-7da6-dafd-b3a5-94e7fac048a6","text":"We carried out a prospective study to determine the incidence of DVT. Present study included 125 patients undergoing total knee and hip joint arthroplasty and surgeries for fractures of the lower limb over a three-year period. All the patients underwent duplex ultrasonography between the seventh and 14th postoperative day. No mechanical or chemical form of DVT prophylaxis was used.","title":"Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?"}
{"_id":"a36395f1-6724-d82b-cb76-c5c071dca271","text":"CNB is a safe and effective method for the preoperative diagnosis of thyroid nodules. The proposal of the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group suggestion 2015 is objective, operable and highly valuable for pathological classification of thyroid nodules on CNB. Under this framework, the inaccuracy and limitations of biopsy is the main cause of inconsistency between diagnosis based on CNB and resected specimens. The most beneficial strategy for cases classified as indeterminate, suspicious for malignancy and malignant on CNB may be to treat them as malignant. Cases classified as benign by CNB but considered malignant or suspicious for malignancy by ultrasound should be followed up closely and require rebiopsy. Cases classified as follicular neoplasm by CNB should be treated with surgical operation, and the capsular and vascular infiltration should be detected microscopically to further clarify whether the lesion is benign or malignant.","title":"Pathological diagnosis of thyroid nodules based on core needle biopsies: comparative study between core needle biopsies and resected specimens in 578 cases"}
{"_id":"a3686611-f551-f609-b1dc-e327beeb0585","text":"Laser speckle flowgraphy demonstrated a significant decrease in blood flow at the edge of MC flaps. This method is useful for evaluating blood flow in the microvasculature of free flaps used in plastic surgery.","title":"Free Flap Blood Flow Evaluated Using Two-Dimensional Laser Speckle Flowgraphy"}
{"_id":"a36d46c0-c9d9-d1b1-dcca-e597f0e9a5ec","text":"The patient is given a full informed consent of the arthroscopic procedure, including temporary and occasionally permanent facial nerve weakness of the forehead and upper eyelid. The very small risk to the external ear canal and the middle ear also needs to be discussed.","title":"A Modified Technique of Temporomandibular Joint Arthroscopic Operative Surgery of the Superior and Inferior Joint Spaces"}
{"_id":"a36f7582-c55e-4141-2b5c-efdf5f768d11","text":"Treatment of early and multiple unresectable cutaneous recurrences of melanoma is a major therapeutic problem. The favorable outcome obtained in the present study shows that ECT is a reliable, easy, fast and effective procedure that provides benefits in terms of curative and palliative treatment for unresectable cutaneous lesions without adversely impacting on the quality of life of patients.","title":"Long-lasting response to electrochemotherapy in melanoma patients with cutaneous metastasis"}
{"_id":"a3704233-1551-c24f-f9cf-687520e60c84","text":"In case of small superficial lesions, we preferred the use of either full thickness skin grafts or other small local flaps. In more complex situations, the use of more than one flap is used as we can combine the use of forehead flap with cheek advancement flaps in reconstructing a defect resulted from excision of a lesion in the nasal ala that extends to the cheek by this combination. The angle between the nose and cheek is preserved and the cosmetic outcome is much better.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"a3715cd5-2df9-fecd-fa0d-7a50dc9fd935","text":"Negative pressure wound therapy is a safe and effective alternative to muscle flap coverage and primary closure following sternoclavicular joint resection in patients who are at risk for poor wound healing.","title":"Clinical Effectiveness of Negative Pressure Wound Therapy Following Surgical Resection of Sternoclavicular Joint Infection: A Case Report"}
{"_id":"a377b9f7-5238-dda0-2acb-98aef02e2934","text":"The main finding of this study is that NPWT can be used safely to treat post-TKA wound complications and infection without complications and without impeding patient rehabilitation, with promising initial results.","title":"NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY TERAPIA COM PRESSÃO NEGATIVA EM FERIDAS NO TRATAMENTO DE LESÕES GRAVES APÓS ARTROPLASTIA TOTAL DO JOELHO"}
{"_id":"a38fcdbf-9aa1-0679-840e-8e55c44dac81","text":"The side effects are much less frequent and severe compared to chemotherapy. Sunlight exposure have shown that photosensitivity is not a real burden for these patients and only limited adverse events were related to this problem [28]. In general, patients in this part of the world have a colored skin that makes them less prone to sunburn. The fact that people in the tropics generally avoid sun exposure also helps to minimize the problems around the photosensitivity.","title":"Photodynamic therapy in the therapy for recurrent\/persistent nasopharyngeal cancer"}
{"_id":"a3922250-a158-1098-019b-3d72b854824d","text":"We reviewed the medical records of patients who received definitive or postoperative proton therapy for nonmelanoma skin cancer with clinical perineural invasion at our institution and updated patient follow-up when possible. All patients were treated with curative intent with or without the delivery of concurrent systemic therapy. We report disease control rates and the rates of late toxicity among this cohort.","title":"Passively Scattered Proton Therapy for Nonmelanoma Skin Cancer with Clinical Perineural Invasion"}
{"_id":"a396c0c3-b530-8853-ed26-c507a182747f","text":"This pilot study was conducted to evaluate for the first time the use of attached surface probes with the O2C analysis system, which has already been shown to be a reliable method for flap perfusion monitoring in microvascular head and neck reconstruction with unattached surface probes. The findings showed that attached surface probes were comparable to commonly used unattached surface probes in terms of technical feasibility and patient safety. Moreover, attached surface probes could also provide the basis for continuous 24-h flap perfusion monitoring as the next step in flap perfusion monitoring. However, in terms of the quantitative measurements and thus the agreement between and interchangeability of attached and unattached surface probes, the attached surface probes studied were not comparable to the commonly used unattached surface probes, and calculation of measurement values for one surface probe based on the measurement values of the other surface probe are not accurate. With regard to clinical implications, further studies are needed to determine cut-off values distinguishing between sufficient and insufficient flap perfusion when using attached surface probes with the O2C analysis system and, consequently, to preserve the usefulness of the O2C analysis system for making decisions about the need for flap revision in microvascular head and neck reconstruction.","title":"Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study"}
{"_id":"a39afb56-1a1b-2974-89aa-4563b0ec8160","text":"The objective of this study will be to systematically evaluate published observational studies that present incidence of incomplete surgical excision amongst adult patients with non-melanoma skin cancer worldwide.","title":"Global incidence of incomplete surgical excision in adult patients with non-melanoma skin cancer: study protocol for a systematic review and meta-analysis of observational studies"}
{"_id":"a3a82ce5-dfe3-970f-b6ca-691cb032c6ee","text":"Although competition and selection is inevitable in a surgical career, being female should be no reason to avoid one. Furthermore, the surgical profession is under increasing pressure to open its doors to a wider selection of medical graduates. The simple argument is, that by increasing the numbers of applicants, one is more likely to appoint the best candidate for the post. If it is the case that gender stereotyping exists from an early age, then it should be discouraged. This has been achieved in medicine as a whole and there is no obvious reason why it could not be done for surgery.","title":"Who wants to be a surgeon? A study of 300 first year medical students"}
{"_id":"a3a86e68-1119-f7ea-0961-45c29364e4ba","text":"The tumors of the mice from the control group with the introduction of the photosensitizer without irradiation, and from the group with laser exposure without the introduction of the PS did not differ from the tumors of the mice of the control group without any treatment.","title":"On the Pathomorphological Pattern of the Efficiency of Photodynamic Therapy of Murine Melanoma B16 Using a New Photosensitizer Based on Chlorin e6 Conjugate with a Prostate-Specific Membrane Antigen"}
{"_id":"a3ad4887-31f6-3edd-51d3-bc984c0b8d71","text":"In this article, we present four cases of pediatric patients affected from solid tumor lesions in which 3D reconstruction and printing technology was used in surgical planning, as they were cases in which the surgery was technically complex and or the complete resection presented an important forecast implication.","title":"Three-Dimensional Printed Model and Virtual Reconstruction: An Extra Tool for Pediatric Solid Tumors Surgery"}
{"_id":"a3aeeecd-9060-f96f-47a9-dbb7d1cebf6a","text":"Head reconstruction after skin cancers resection represents a continuous challenge for Dermatologist and Plastic Surgeons.","title":"Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes"}
{"_id":"a3b8000e-cb1f-2325-0021-509e1067eeee","text":"When compression ultrasound is complemented by Doppler color flow evaluation (“duplex” sonography), the sensitivity for thrombosis detection is about 96%, with a high negative predictive value (99%).73","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"a3d1b61e-5cb5-84d5-2ce4-69e96a7273ae","text":"Osteomyelitis is an inflammatory infectious condition of bones. It occurs either acutely or chronically, depending on the virulence of contributing pathogens, the immune system efficacy and the remodeling capacity of the involved bones. The clinical course of the disease leads to destructive or sclerosing patterns of the involved bone. Low-virulent bacteria plus a young immunocompetent patient with a high capacity for bone remodeling is more probable to show a sclerosing form of the condition. Osteomyelitis is rare in young people except when there is a traumatic condition.","title":"A Localized Sclerosing Osteomyelitis at the Periapex of a Vital Tooth: Report of a Misdiagnosis"}
{"_id":"a3ecf9a7-cf47-aed3-ded7-11924fec7ec7","text":"Our findings supported that use of either FTSG or STSG in scalp lesions were equal choices.","title":"Full- or Split-Thickness Skin Grafting in Scalp Surgery? Retrospective Case Series"}
{"_id":"a3f25eb5-91fe-5f73-6b32-e623da154925","text":"The major limitation of our study is that it was conducted in a single center with a small number of patients and was retrospective in nature. Although generalizations about the few reported cases could not be made easily, several marked differences might be helpful in managing patients with HCC and PVTT. Nonetheless, the argument that patients who tolerate additional locoregional therapy are naturally in a better condition than patients not receiving locoregional therapy could come across. Indeed, although HCC with PVTT is considered an advanced stage in the BCLC classification, patient in good clinical condition with better hepatic functional reserve and the presence of collateral circulation following PVTT might tolerate additional locoregional therapy and theoretically experience a better outcome. However, the accumulated data and this study have shown that an aggressive attitude using multidisciplinary treatment can effectively provide benefits to patients with HCC.","title":"Efficacy of External Beam Radiation-Based Treatment plus Locoregional Therapy for Hepatocellular Carcinoma Associated with Portal Vein Tumor Thrombosis"}
{"_id":"a3f3f75b-2cc8-ba4a-dcca-f98049ea98e3","text":"ADM is a nonautologous biologic material formed from the decellularization of human dermal matrix by a controlled sterilization process that removes the epidermis and the cells from the dermis leaving dermal matrix components including collagen fibers, elastin, proteoglycans, and the vascular scaffold intact. ADM is safely used for various methods of hand reconstruction. ADM is known to neovascularize when in the human body. This property makes ADM more resistant to infection making ADM recommended for use in the repair of contaminated abdominal hernias.","title":"Use of Acellular Dermal Matrix to Prevent Recurrence of Radioulnar Heterotopic Ossification"}
{"_id":"a3fa9ac6-a099-a1c0-dc9b-611b8598d8e1","text":"Of importance for such studies is the availability of synovial tissue. Patient material becomes available as remnant material after joint replacement surgery, or via synovial biopsy. Functional studies on synovial tissue are often limited to a small number of patients as material needs to be used immediately when becoming available. Thus, timing is an important issue, hampering optimal planning and synchronization of an experiment. A solution would be to cryopreserve the valuable synovial tissue in such a way that the thawed synovial tissue performs identical to freshly obtained material. To our knowledge there are no studies describing cryopreservation of human OA synovial tissue in which the disease characteristic cell functions and interactions are maintained.","title":"Functional Tissue Analysis Reveals Successful Cryopreservation of Human Osteoarthritic Synovium"}
{"_id":"a3fc9f65-5083-9181-34a6-edc51e1933ef","text":"We now know that a service provided by a trained specialist is more efficient and more cost effective; diagnostic decisions are made earlier and unnecessary investigations avoided; operations conducted by specialists produce better results for technical reasons; the interpretation of imaging techniques and the reading of histology is much more likely to produce definitive opinions if carried out by experts.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"a402d3d9-c1df-4e42-e0bb-4679a9fcdc75","text":"On the basis of a few reports, the existence of a particle in a liquid provides a nucleation site for the cavitation bubble because of its surface roughness and bubble collapse. There are two procedures to use GNPs, as stated below:","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"a405ba17-703a-f2e6-d1b3-d4318a95511e","text":"Previously, we concluded that impaired blood flow parameters are probably a result of endothelial alterations due to prior radiation. If our hypothesis is true, this difference should not show up in non-irradiated recipient beds and this is what we have seen in our study. However, we could only show a correlation between reduced recipient bed perfusion and the occurrence of complications in the early postoperative period. Therefore, further studies must clarify the particular function of recipient bed perfusion for free flap viability in the early days after surgery. Also the link between approximating flow curves and histological alterations should be further investigated.","title":"Recipient bed perfusion as a predictor for postoperative complications in irradiated patients with microvascular free tissue transfer of the head and neck area: a clinical analysis of 191 microvascular free flaps"}
{"_id":"a40be3a2-2bff-8d3e-6dd1-4b66f7baab59","text":"The reason for the failing diagnosis in the first examination underlies the subtlety of the injuries but also the limited spatial resolution and contrast properties of the available X-ray images. Conventional X-ray radiography shows an overall projection of the entire scanned area, with superposition of bone and tissue components yielding a limited image contrast and quality of the bone system. The superposition of bone and soft tissue in the conventional images is one of the reasons why many subtle bone injuries are not visualized properly on conventional X-ray images, while CT or MR reduce this superposition showing considerably better sensitivities for fracture detection.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"a41a67d4-bb1d-b09b-0bd2-0cb1bf530b70","text":"The reconstruction of the scalp following avulsion injury has always been a great challenge for plastic surgeons. Although rare, scalp avulsion injuries mostly occur in working places and in female patients, it is often caused because of accidents related to their comparatively longer hair.","title":"Bipedicle Frontal-Occipital Flap for Reconstruction of Post Avulsion Injury of Scalp Temporoparietal Region: A Case Report"}
{"_id":"a41bf27c-8020-2733-0b2e-b971fc858b83","text":"When making a subcutaneous tunnel through which the flap pedicle passes, it is expanded wide enough to pass two fingers so that the flap pedicle is not pushed. The distal part of the flap was set in a teardrop shape, and a 2 cm incision was made at the proximal part of the connection line so that the flap can be sutured without pressure and tension when the flap and the skin of the defect are sutured.","title":"Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap"}
{"_id":"a41f7c26-55b2-e147-9615-eb930a1cf316","text":"In this study, we have found that simply injecting a small amount of antigen into dermal region can induce antigen-specific IgG efficiently and can also diminish IgE production. We think that ID injection has great potential for application in allergy immunotherapy and could be epoch making in the history of vaccination.","title":"Intradermal Delivery of Antigens Enhances Specific IgG and Diminishes IgE Production: Potential Use for Vaccination and Allergy Immunotherapy"}
{"_id":"a420b045-9900-adfc-2a17-1ee643775369","text":"Our case illustrates the degree to which sentinel lymph node biopsy has improved the ability to stage the patient with breast cancer. Not only can intense histological and immunohistochemical analysis be limited to a small number of nodes that have the highest probability of containing metastases, but it also allows identification of first echelon draining nodes that would normally be missed with a standard axillary node dissection.","title":"A level III sentinel lymph node in breast cancer"}
{"_id":"a42b76c0-4060-afda-1d85-523deb37501a","text":"By choosing a broad, pragmatic approach to include all flaps, we accept that there will be inherent differences between different anatomical sites like the lower extremity, breast, head and neck. We will perform subgroup analysis if possible and will discuss any apparent differences in the descriptive analysis where applicable. There will be confounding factors and inherent bias due to the likely non-experimental, observational nature of the primary data that will be included. This will limit the validity of our conclusions and is unavoidable. We will however perform a thorough risk of bias assessment using the ROBINS-I tool to appropriately weight the reliability of the data we encounter during our analysis. We will scrutinise the data for presence of unmeasured variables that may affect the primary and secondary outcomes and will discuss their impact where applicable.","title":"Protocol for a systematic review of venous coupler devices versus hand-sewn anastomosis for microsurgical free flap reconstruction"}
{"_id":"a43c64da-0ed1-8999-15c4-85046b8957d8","text":"The goals of soft tissue reconstruction in the hand should be to replace what has been removed with tissue that is as identical as possible. One can easily infer that the hand is an area of the body with a relative paucity of skin. A lesion of 6 mm diameter and Breslow thickness of 1 mm requires a minimum of 2.6 mm diameter skin excision. On the dorsum of the finger this encompasses a large portion of the circumference and can be function limiting if not appropriately reconstructed. There are instances where the recommended margin may not be able to be performed. It is thus prudent to spend time counseling the patient beforehand.","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"a43df520-ae9c-7973-2ff9-1bddfbb58b1d","text":"Rigorous preoperative screening and adequate thrombosis management are required. Before surgery, adequate screening should be performed to select patients who have thrombus formation, who have a reduced risk of pulmonary embolism, who have the good inflow and outflow tracts on CT scans, and who are at low risk of developing IVC thrombosis or new acute deep venous thrombosis in the presence of good blood flow. During the surgery, it is important to ligate the lumbar vein on the side of the IVC adjacent to the lumbar spine to significantly reduce hemorrhage. After surgery, anticoagulation therapy may be discontinued after 3–6 months with a patent IVC and no new acute deep venous thrombosis.","title":"Removal of inferior vena cava filter by open surgery after failure of endovenous retrieval"}
{"_id":"a4501b33-6559-191c-211b-1a7a72e52d80","text":"Among the autonomic symptoms experienced by patients with atypical parkinsonian syndromes and PD, gastrointestinal symptoms including constipation appeared to be the most common.","title":"Neurological update: non-motor symptoms in atypical parkinsonian syndromes"}
{"_id":"a452672b-ac74-491a-7e66-03c588e847e1","text":"This paper explores the literature for available studies examining mucosal melanoma of the head and neck and the different treatment modalities available. We searched for treatment modalities consisting of immunotherapy with or without other treatment modalities. We compared these with treatment options that did not involve immunotherapy. The results showed a clear improvement in survival outcomes when immunotherapy was used compared to survival outcomes without immunotherapy at all yearly intervals studied. However, it is pertinent to point out that all studies included a small number of patients, and in many cases, did not clearly define their own inclusion criteria. This could be because the presentation of the disease is variable in terms of both site and duration.","title":"Immunotherapy as a treatment modality for mucosal melanoma of the head and neck: A systematic review"}
{"_id":"a453a827-91c2-7f55-1b2c-c281dd2e1bb9","text":"Lower extremity arterial thrombosis has an acute onset and obvious symptoms. The outcome of NS complicated with arterial thrombosis was unsatisfactory due to the high rates of limb loss. Early diagnosis and prompt treatment of arterial thrombosis secondary to NS and primary nephrotic disease are of the utmost importance for patient outcome.","title":"Acute lower extremity arterial thrombosis associated with nephrotic syndrome in adults: case series and literature review"}
{"_id":"a459f6c1-4825-746f-6d9f-bea329c01cef","text":"The Caprini and Khorana scores are recommended by the American College of Chest Physicians guidelines as an objective screening method to identify patients at high risk of VTE who might benefit most from prophylactic anticoagulation 31. However, other specialized VTE risk scores require more extensive clinical validation.","title":"Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care"}
{"_id":"a45c2b9c-7383-ac7d-231e-419c48ac6c83","text":"In human pathology, vessels with different mechanical properties are connected not only in kidney transplantation but also in all organ transplants and whenever a prosthetic or human vascular segment is inserted in a patient's arterial vessel. As a result, the difference in the mechanical properties of connected vessels generates blood flow turbulence and shear stress when blood and wall biology systems are activated, with the risk of stenotic complications like those encountered in renal transplantation.","title":"Donor\/Recipient Delta Age: A Possible Risk for Arterial Stenosis in Renal Transplantation"}
{"_id":"a4618bb0-e398-99d4-4c03-e52aeb33b908","text":"The study of osteomyelitis and implant infection is better understood now after the elucidation of biofilm as the cause of chronic bone infection. There is still some way to go to understand and eradicate implant infections. The use of multiple strategies starting with the recognition of the slimy appearance of biofilm to the use of mechanical removal of biofilm by debridement, the eradication of dead space, and lastly to the required concentrations of antibiotics that are needed to eradicate biofilm will help to reduce the incidence of osteomyelitis.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"a47283cc-583b-bed6-23f5-e9bad555e175","text":"We found that filming of flaps after dissection of the flap to be transferred, but before ligation of the pedicle from the donor site, produced inferior results compared to filming after anastomosis to the receiving site in the head and neck. We hypothesize that this is due to greater perfusion of the head and neck region, such that blood flow through the face and mucosal surfaces is more apparent and can be more easily contrasted to the free flap blood flow. Another possibility is that the feeding artery and receiving vein within the head and neck provide better perfusion to the free flap than its native vessels. Furthermore, issues with reperfusion hyperemia cannot be discounted.","title":"Noninvasive Free Flap Monitoring Using Eulerian Video Magnification"}
{"_id":"a47510ff-ebfe-132b-746f-78205584066f","text":"Women in cardiothoracic surgery report significantly high rates of experiences with bias that may prevent qualified women from advancing in positions of leadership. Poor gender diversity at the leadership level also has negative consequences for the quality of work being done by national and international organizations. Our survey clearly demonstrated that across the 2 main European cardiothoracic associations, there is still a lower percentage of women in leadership roles or positions of influence. Although some of this difference may be influenced by sampling bias, with the majority of female respondents being at a more junior level compared to the male respondents, it is also indicative of the fact that women remain clustered at the junior ranks of most of the institutions to which they belong. The results confirm the hypothesis that women and men have significant differences with regard to their lived experiences and that some of these differences translate into higher attrition for women. Most of the women surveyed experienced gender discrimination and reported to have thought about leaving our speciality because of this discrimination.","title":"The impact of gender bias in cardiothoracic surgery in Europe: a European Society of Thoracic Surgeons and European Association for Cardio-Thoracic Surgery survey"}
{"_id":"a480d51e-5435-9370-3283-95dc18e387a7","text":"The patient chronically continued to have unstable skin over the scalp and kept developing recurrent ulceration. On 29 March 2012, the patient was admitted throw the clinic due to his chronic condition of recurrent open wounds for many years.","title":"The use of an omental flap for the reconstruction of a burn injury to the scalp: A case report"}
{"_id":"a4833080-ee07-fe94-e0af-247b6e18d4ed","text":"The WHO checklist is a generic risk assessment tool that can be used with most of interventional treatment and within all surgical specialties. Plastic Surgery involves wide range of surgical procedures from a small lump removed under local anaesthetic to a major reconstructive procedure requiring several hours in the operating theatre. Long hours in the operating theatres do not go without risks, and the technical part of the surgery may just represent one part of the whole process. Formation of a clot or an embolism may lead to serious complications and fatal outcomes. Even minor plastic surgery procedures pose its own risks; wrong site surgery is just one example of what can go wrong. With an extensive and endless list of risk factors, plastic surgery should not be considered to be any less of a risk than any other type of surgery, and full implementation of risk assessment tools including surgical checklists is recommended in order to minimize adverse effects.","title":"WHO Surgical Checklist and Its Practical Application in Plastic Surgery"}
{"_id":"a487543e-fd05-154f-8a81-c8bedf52fe0c","text":"Conclusion: More data must be acquired to undergo risk assessments on the probability of occurrence of allergic reactions in Canadian allergic individuals consuming products with PALs. Allergen management guidelines linked to industry and regulation stakeholders will be proposed following the results of the risk assessments.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"a48e5c71-51ea-3629-ad6b-1421622d22e3","text":"We investigated whether patients with T1DM are at a relatively high risk of VTE development.","title":"Type 1 diabetes is associated with an increased risk of venous thromboembolism: A retrospective population-based cohort study"}
{"_id":"a49a5185-511c-bc65-af77-d7bcd98dec4c","text":"A comparison of the demographic data of the PFPS and normal groups is presented in Table 1. No significant differences were observed between the groups.","title":"Improvement of Pain and Function by Using Botulinum Toxin Type A Injection in Patients with an Osteoarthritic Knee with Patellar Malalignment: An Electromyographic Study"}
{"_id":"a49bb1e5-f6b2-16e8-5b99-8fd103eb217f","text":"• Separate assessments should be presented for judgements about the quality of the evidence and judgements about the balance of benefits and harms.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"a49fafd6-fb4e-94d6-9ebe-84319eaadb04","text":"Patients with FEMA after PFP will be recruited. This study will be conducted in the First Affiliated Hospital of Zhejiang Chinese Medical University.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"a4a659c0-d56d-1ccd-1b3e-74f168eca9a1","text":"P28 Successful desensitization to a high dose of methotrexate in a delayed type hypersensitivity reaction","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"a4c0d069-627c-c15b-d3d8-499d1302d3a6","text":"A significant concern raised by a few FPs was that registrars were insufficiently exposed to leadership roles to prepare them to take on these roles once qualified as specialists:","title":"Workplace-based learning opportunities in a South African family medicine training programme"}
{"_id":"a4c396cc-ed11-0267-3602-642cabc0ebe9","text":"The data from the ACGME reports may also affect the workforce count. Although the ACGME is unable to distinguish which board will eventually certify each trainee, the organization has historically assigned all dermatopathologists to dermatology and all molecular pathologists to medical genetics even though, based on ABPath data, since 2004 a total of 61% of the 1166 dermatopathology trainees and 99.8% of the 391 molecular pathology trainees have been pathologists. We believe it would be more useful and appropriate to assign these trainees to the specialty in which most are certified.","title":"Reevaluation of the US Pathologist Workforce Size Reevaluation of the US Pathologist Workforce Size"}
{"_id":"a4cd43a2-b009-4d84-0ddd-81efcdf428ad","text":"We sought to decrease the rate of SSIs in all surgical procedures by utilizing the most used antibiotics within the Department of Neurosurgery at Arrowhead Regional Medical Center. Our findings indicate that the ideal time to administer preoperative antibiotics stands at 40 minutes prior to the incision for cefazolin and 45 minutes before incision for clindamycin because these antibiotics will be at peak levels in tissue. Furthermore, both antibiotics should be readministered during the earlier end of the redosing range to maintain a high tissue concentration. This information provides the basis for further research in the field of post-surgical infections, as we can help elucidate the true ideal time for antibiotic prophylaxis by further testing.","title":"The Ideal Time to Administer Pre-operative Antibiotics: Current and Future Practices"}
{"_id":"a4d2d009-0430-2dcd-6745-5836b4b3086b","text":"Our report demonstrates successful surgical management of a transverse vaginal septum and the complications that can occur at the surgical site. It illustrates the importance of monitoring a vaginal septum resection site for restenosis and the unique management necessary when a young patient is apprehensive about vaginal dilatation. Vaginal dilatation is crucial after excision of TVS. Long-term follow-up is important for the surgical success and potential issues that the patient may encounter throughout her life.","title":"Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision"}
{"_id":"a4dac1e9-325c-65c6-d9c7-dd8c15f473bd","text":"Through our case, we were able to present a rare condition along with the multiple treatment modalities needed to stabilize the patient. Timing is a crucial factor in VO in the presence of mass effect with cord compression, and management is necessary to avoid permanent disability. Standardized guidelines in the management of complicated osteomyelitis are lacking, making it difficult to manage these patients in a timely manner. We share our experience with a complicated case of VO in the hopes that there be a higher index of suspicion leading to efficient treatment.","title":"Paravertebral Abscess Secondary to Vertebral Osteomyelitis in an Intravenous Drug User"}
{"_id":"a4e94804-f3ed-48ac-1e73-766af584ede4","text":"Once the anterior border of the latissimus dorsi muscle is visualized, an avascular plane can be easily developed between the deep surface of the latissimus dorsi muscle and the serratus anterior muscle of the chest wall. Once this plane has been confidently established, the incision can be extended superiorly towards the axilla. The layer between the deep latissimus dorsi muscle and anterior chest wall can then be bluntly dissected to reveal the scapular tip, teres major muscle, and vascular anatomy of the thoracodorsal system [Figure 1]. Depending on the patient body habitus, a variable amount of subcutaneous tissue should be bluntly dissected away from the vascular pedicle. Figure 3 depicts the anatomic view of this dissection. After identifying the latissimus dorsi branch, this segment of the muscle should be traced superiorly towards the subscapular system and its takeoff from the axillary artery and vein to maximize the PLDF arc of rotation. In our experience, it is important to take down the circumflex scapular veins to aid in pedicle rotation and confirm favorable geometry after rotation. The nerve to the latissimus dorsi will be intimately associated with the vascular pedicle and should be transected. Once the latissimus dorsi vascular pedicle has been confidently isolated, the angular and serratus anterior branches are ligated along with the circumflex scapular branch. Figure 4 demonstrates the ligation of these branches and subsequent muscular cuts used to isolate the latissimus dorsi from its inferior and humeral attachments.","title":"Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: contrasting shoulder morbidities across mysofascial flaps"}
{"_id":"a4ea6b8a-0547-d373-5d9c-b38169cc6989","text":"According to literature review, no one treatment for BCC is completely superior and other treatment methods do offer reliable alternatives. In this context, the treatment of NMSC with HeberPAG is a valuable option for many patients suffering from this skin cancer. Never before such kind of IFN formulation have been used for the treatment of patients and represents an encouraging therapeutic option for NMSC.","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"a4ea8f8d-3002-ebc7-34a9-dd0ec848061b","text":"One calcaneal osteomyelitis had clinically healed between three and six months after surgery, and five cases clinically resolved between seven and fourteen months after surgery.","title":"Multidisciplinary Approach for the Management and Treatment of Diabetic Foot Infections with a Resorbable, Gentamicin-Loaded Bone Graft Substitute"}
{"_id":"a4f5f513-2cf7-471c-17d2-295e2d303f54","text":"Surgical evaluation of the levels I–III by palpation is mandatory to ensure that there is no palpably suspicious disease left behind in the axilla after TAS. The length of the incision and the opening of the clavipectoral fascia has to be chosen accordingly. Therefore, a minimum incision length of 2–3 cm is recommended. In case of palpably suspicious nodes left behind in the axilla after TAS, the patient must be excluded und typically undergoes ALND according to the decision of the treating surgeon.","title":"Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial"}
{"_id":"a4f8ce8b-e797-c3b5-cb33-1a697e131755","text":"Despite a negative SLN status, patients with Stage IIB\/IIC melanoma demonstrate poor melanoma-specific survival when compared to Stage IIIA patients. In this study, we hypothesized that a molecular profile at the level of the SLN would provide potential insights into risk of disease recurrence and serve as a prognostic biomarker of patient outcomes regardless of the presence of SLN melanoma metastases. Gene expression profiling was performed on SLN biopsies using U133A 2.0 Affymetrix gene chips. Our study suggests a novel 12-gene SLN signature risk score which may predict disease recurrence in cutaneous melanoma patients managed with wide excision of the primary tumor and SLN biopsy.","title":"Sentinel Lymph Node Gene Expression Signature Predicts Recurrence-Free Survival in Cutaneous Melanoma"}
{"_id":"a4f949f7-042a-e17a-5834-3f3d4e232196","text":"In summary, our study provides in-vivo evidence of CSF tracer drainage to cervical lymph nodes in humans. The temporal course of lymph node enhancement coincided in time with brain glymphatic enhancement rather than with CSF enhancement. This is in contrast to previous animal studies demonstrating lymphatic drainage from CSF via the cribriform plate and nasal mucosa, and at a much shorter time span. In the end, improved knowledge of human brain lymphatic drainage is expected to shed new light on pathogenic mechanisms behind degenerative and inflammatory brain diseases.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"a50cc6c5-dd85-01dd-df34-b9aab4d774b3","text":"Each center identified patients diagnosed with SS or MRCL for eligibility review. Patients diagnosed with advanced SS or MRCL and treated with at least 1 line of systemic anticancer therapy for locally advanced\/unresectable or metastatic disease between 1 January 2005 and 31 December 2015 were eligible for inclusion in the study. The diagnosis of SS and MRCL for each patient was required to be validated by a documented signed pathology report detailing the diagnosis. Surgical pathology notes and\/or radiology reports were used to determine the disease status. Tumors were considered locally advanced or unresectable if the resection margin of the tumor had evidence of positive tumor in the surgical margin or if the primary tumor was deemed inoperable per a source‐verified clinic note documenting that the tumor was not operable with no evidence of distant metastasis. Stage IV or metastatic disease was determined using evidence from either a radiology report that documented at least one or more distant metastatic lesions or through clinic notes that stated that the tumor was metastatic prior to the start of systemic anti‐cancer therapy. Patients were excluded from the study if they had a history of another cancer within 2 years prior to their SS or MRCL diagnosis, except excised in situ carcinoma or non‐melanoma cutaneous malignancies. Patients without clinical records of tumor imaging or systemic anticancer therapy administration were excluded.","title":"Clinical outcomes of patients with advanced synovial sarcoma or myxoid\/round cell liposarcoma treated at major cancer centers in the United States"}
{"_id":"a50dd49a-20b0-5e46-e436-3179c3bfd24f","text":"Some strengths are its pragmatic design which we hope will allow the appropriate representation of patients with the target infections, the multicenter participation, and previous experience in trials in which the antibiotic used is that of standard practice.","title":"Efficacy and safety of different antimicrobial DURATions for the treatment of Infections associated with Osteosynthesis Material implanted after long bone fractures (DURATIOM): Protocol for a randomized, pragmatic trial"}
{"_id":"a50f5423-c62a-1656-62f8-c022e27a0504","text":"We have followed all twelve patients for a minimum period of 24 months. All patients had radiological and clinical union with a mean time to union of 17 weeks. In one case superficial surgical site infection was noted and successfully treated with intravenous antibiotics, and in another, transient peroneal nerve palsy was identified and resolved in six months.","title":"Autologous Nonvascularized Fibula Graft and Locking Compression Plating for Failed Fixation of Humeral Shaft With Atrophic Gap Nonunion"}
{"_id":"a5109bfa-c187-7950-10e6-4c69e0721e8e","text":"The purpose of this study is to evaluate the percentage of Ob\/Gyn residents in the U.S. who identify academic leadership as a personal goal. We hypothesized that fewer women than men identify leadership as a goal during residency, and that women who do aspire to leadership are more likely to have had specific mentorship addressing leadership and have seen leadership modeled among women in their department.","title":"Leadership aspirations among residents in obstetrics and gynecology in the United States: a cross-sectional analysis"}
{"_id":"a515de0a-84bd-ce92-3157-1f12d37e2d06","text":"The diagnostic accuracy of the three techniques across studies that had used contrast venography as reference test could not be compared due to a lack of studies in both groups.","title":"Diagnostic accuracy of three ultrasonography strategies for deep vein thrombosis of the lower extremity: A systematic review and meta-analysis"}
{"_id":"a517cc28-fd45-6aa2-b0a6-41dc1a70ef3f","text":"To achieve the goal of drug delivery, an array of different biomaterial based drug delivery systems (DDS) have been designed. However, the incessant local delivery of single ATD could increase the propensity of drug resistant strains that might enhance the chances of relapse of infection. Moreover, biofilm formation on the hydrated matrix secreted by the pathogen on the inert surface of implants is the primary cause of implant rejection and revision surgery. Pathogens embedded in biofilms have been shown to act as a barrier to the penetration of antibiotics thus reducing the antibiotic susceptibility compared to their planktonic counterparts. This leads to persistent or recurrent infections and thus forcing the clinicians to resort to revision arthroplasty.","title":"A biphasic nanohydroxyapatite\/calcium sulphate carrier containing Rifampicin and Isoniazid for local delivery gives sustained and effective antibiotic release and prevents biofilm formation"}
{"_id":"a5185eda-2f70-8ee7-dd7a-4a354d283110","text":"In this biomechanical study, supplemental cable cerclage wiring in distal tibial spiral fractures treated with a medial angle stable locking plate effectively increased construct stiffness and reduced interfragmentary movement significantly. Axial movement and more important shear movement and rotation were reduced by a clinically relevant amount. Comparison of partial and full weight-bearing conditions reveals that patients with this specific distal tibial fracture stabilized by angle stable plate fixation with supplemental cable cerclage wiring can be allowed immediate post-operative weight-bearing as tolerated and therefore earlier mobilization.","title":"Supplemental cerclage wiring in angle stable plate fixation of distal tibial spiral fractures enables immediate post-operative full weight-bearing: a biomechanical analysis"}
{"_id":"a52e91f7-b311-8770-ae5a-d3acb61aa4bb","text":"Microporous nanohydroxyapatite beads impregnated with vancomycin or gentamicin or fosfomycin could be employed as an alternative product of choice for chronic osteomyelitis treatment. Within the scope of this study, good outcomes in infection treatment were observed throughout the follow-up period and the material was safe and well tolerated while providing the enhancement in quality of life of the patients.","title":"Efficacy and Safety of Antibiotic Impregnated Microporous Nanohydroxyapatite Beads for Chronic Osteomyelitis Treatment: A Multicenter, Open-Label, Prospective Cohort Study"}
{"_id":"a5323d65-29ab-4f60-6e24-e06d15430dbe","text":"Positioning the skin monitor of the DIEP flap where the implant was exposed serves two purposes: adequate flap monitoring and to avoid further breast deformity by replacing missing tissue lost due to skin necrosis. The rest of the flap needs only to be deepithelialized as it is proven that the dermis plays a significant role in enhancing the overall DIEP flap perfusion through the preservation of indirect linking vessels in the subdermal plexus [37].","title":"Immediate implant replacement with DIEP flap: a single-stage salvage option in failed implant-based breast reconstruction"}
{"_id":"a534a4db-5478-3619-1192-aaa8eb7cd33e","text":"The questionnaire started asking about the most prevalent chronic dermatoses in Portugal. The second question addresses the factors related to prevalence of chronic dermatoses. A group of 4 questions assesses the most characteristic lesions of psoriasis, atopic dermatitis, seborrheic dermatitis and acne. Another group of 4 questions measures the knowledge about the most prescribed pharmacotherapeutic groups for the treatment of psoriasis, atopic dermatitis, seborrheic dermatitis and acne. A question measures the information about the factors that influence adherence to skin treatment of chronic dermatoses. Another question assesses the most appropriate instructions to explain the dose of topical medicine. A group of 3 questions included the assessment of the behaviour to instruct the patient about the duration of corticosteroid, immunomodulators and anti-infectious topical treatment. The next 2 questions rely on asking the pharmacist if they instruct the patient on the mode and the frequency of application of topical medicines. The two followed questions address the indication of clear and precise dosage regimen instructions for topical treatment and the factors that influence it. The last 2 questions are related to the prevalence of adherence to topical treatment of chronic dermatoses and the perception of the importance of pharmaceutical intervention in the improvement of the disease. The patients’ protocol also included a sociodemographic questionnaire, assessing gender, age and education and a questionnaire regarding the interaction with pharmacists.","title":"Knowledge and Practices of Community Pharmacists in Topical Dermatological Treatments"}
{"_id":"a5391329-ec35-8bdd-dddd-9cfcaf9e581d","text":"Previously, outcomes for rectal cancer management in British Columbia were reported for the year 19961. In that retrospective review, worse outcomes were associated with positive margins and a shorter distance from tumour to anus. At that time, BC Cancer Agency guidelines for rectal cancer specified that postoperative chemoradiation be given for stage ii and iii cancers and that preoperative chemoradiation be given for clinically fixed tumours. The 1996 data indicated that the surgical technique of total mesorectal excision (tme) was not consistently performed as the surgical technique of rectal cancer excision.","title":"Predictors of positive radial margin status in a population-based cohort of patients with rectal cancer"}
{"_id":"a53b00ba-78fb-f076-674d-e8a008855559","text":"About a third of the respondents felt that cosmetic surgery clinics which are active on social media seemed more appealing to them, which may be because of the clear and possibly glorified display of the services provided. Almost a third of the study population preferred consulting plastic surgeons who are famous on social media; this may be owing to the excellent reputation of the doctor as advertised by different influencers or by hearing the patient’s recommendations. Additionally, the study showed that close to half of the population is against advertising cosmetic surgeries on social media platforms; this might be due to belief that clinics would prioritize monetization over the quality of patient care.","title":"Influence of Social Media on the Decision to Undergo a Cosmetic Procedure"}
{"_id":"a547eb6f-f0e5-d155-b4b7-74a1b4b858f1","text":"The small sample size and the possible variability among the radiologist who performed the axillary ultrasound and core biopsy of axillary lymph node are the limitations of our study.","title":"Preoperative Ultrasound-guided Core Biopsy of Axillary Nodes for Staging of Clinically Negative Axilla in Breast Cancer Patients – A Pilot Study"}
{"_id":"a54aea1e-ec17-0bb0-e63e-7f31650a3d50","text":"In this article, we present a perforator-based flap design for earlobe reconstruction with preoperative perforator detection by pencil doppler to ensure the maximum vascularity of the used flap. Thirty cases of earlobe reconstruction were performed in the Department of Plastic and Reconstructive Surgery at Tanta University in the period from July 2015 to July 2019 using the technique described in this article.","title":"Freestyle perforator flap in earlobe reconstruction"}
{"_id":"a554d6b1-b2eb-6e65-5936-38bb900ff046","text":"In 2012 the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery and the American Society of Mohs Surgery released a consensus guideline regarding the appropriate use of Mohs surgery. At that time the only acknowledged uses were for lentigo maligna and melanoma in situ. Areas of the body were stratified into groups of Area H, M, and L, of which the hand and nail unit were considered Area H. Mohs micrographic surgery was deemed an appropriate technique based on their analysis for lentigo maligna and melanoma in situ of the hand and nail unit [22]","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"a557dc65-5d0f-fff8-2082-eda0d9f342fe","text":"In contrast to these findings, a prospective comparison of guided vs. unguided biopsy for histological and microbiological diagnostics in 40 patients with chronic pain after TKA and inconclusive joint aspiration, Scheele et al. reported negative results for PJI in 36 cases with intraoperative positive findings in the following revision in 4 patients. Unfortunately, all four patients with a suspicious biopsy for PJI denied a revision of the TKA making determination of sensibility and specificity impossible. Nevertheless, this data already alludes to the challenge of organisms isolation and correct diagnostic of low grade PJI following previous inconclusive diagnostics. To our knowledge, the present study is the first to assess specificity and sensitivity of open incisional biopsies following an inconclusive diagnostic workup and comparison with intraoperative tissue samples from the subsequent TKA revision.","title":"Poor performance of open incisional biopsy for the microbiological diagnosis of periprosthetic knee joint infection"}
{"_id":"a56adcc4-4c9c-b727-7e1e-a9b2bdc190d6","text":"In addition to this aspect, the presence of nanoparticles in the hair follicles can also favor the release of active ingredients capable of manipulating the proliferation and differentiation of the hair follicle stem cells. Potential applications could be directed to the treatment of dermatological conditions and wound healing.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"a56c2dfe-2bc3-52c0-7509-eaaeb6b941d1","text":"Why is doctor's delay so common in subacute osteomyelitis? In the acute osteomyelitis patients concomitant septic arthritis was rare however, elevated body temperature and acute phase reactants were more common. Hence these patients seemed to appear more ill. The subacute osteomyelitis patients tended to be older and it is possible that parents and doctors are less concerned about the signs and symptoms these children present. It would have been interesting to know whether the acute phase reactants had been more elevated prior to hospital admission. In Norway, CRP is frequently used as a marker of inflammation in primary care. Perhaps more use of ESR could help to identify patients at an earlier stage.","title":"Childhood osteomyelitis-incidence and differentiation from other acute onset musculoskeletal features in a population-based study"}
{"_id":"a5712d49-cf50-04dc-9a10-5c7d1980b12b","text":"This study was conducted according to the institutional and ethical rules concerning research on tissue specimens and patients and exempted from requiring informed consent from the patients.","title":"Reasons of not having breast reconstruction: a historical cohort of 1937 breast cancer patients undergoing mastectomy"}
{"_id":"a573cdbc-b85f-b818-a935-14ffe6e83f3a","text":"The internal mammary graft is a physiologically active conduit that is dependent on flow dynamics. One emblematic reported case evidenced that competitive flow through the nonobstructive native LAD in combination with an impedance of flow through the LIMA due to a severe lesion in the LAD distal to the anastomosis led to a functionally occluded LIMA. When the obstruction in the proximal LAD progressed, and the distal obstruction was successfully angioplastied, the LIMA flow dynamics improved, allowing for its dilatation and restoration of patency. Therefore, an angiographically occluded internal mammary graft may be only functionally occluded and reversible even when the occlusion is demonstrated several days apart.","title":"Prophylactic Left Internal Mammary Artery Graft In Mildly-Stenosed Coronary Lesions. Still An Open Discussion"}
{"_id":"a577f8da-7a5e-8b93-bde2-ed598304f2fd","text":"In conclusion, this study suggests that a 5 mm or greater histologic margin may increase survival in head and neck CuSCC patients, which correlates with the recommendations for Oral SCC. Further prospective studies are required to provide appropriate guidelines for managing advanced or high risk CuSCC.","title":"Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck"}
{"_id":"a583121c-7602-4619-5a6a-fcaef77b2bd3","text":"Skin conditions such as atopic dermatitis and urticaria are illustrative of pruritic dermatosis.","title":"Patient-Centric Design of Topical Dermatological Medicines"}
{"_id":"a58ee8f1-43f5-e0a1-b116-2fd690a546ef","text":"Notwithstanding the high number of published papers on hand GCTTS, the treatment represents still a challenge for the hand surgeon. Since the tumor may penetrate into joints and bone cortices, extend into tendon sheaths and enclose neurovascular structures, establishing the correct balance between a complete and aggressive tumor removal along with the preservation of vital tissues poses major difficulties. In this study, we analyzed the recurrence rate in our patient series and investigated the correlation between recurrence and known risk factors. We found the overall recurrence rate as 6% and joint capsule adjacency as the only significant risk factor.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"a5903c51-2b19-dbd1-acb1-5e3f7a44d395","text":"To the best of our knowledge, this the first study that summarizes the data regarding imaging findings and surgical management in patients with RA and cervical spine involvement. Plain radiographs have an important role to play in the evaluation of cervical spine involvement in RA. Given that radiological findings present at a later stage, screening of patient with CS involvement with CR is encouraged. MRI enables the early detection of soft tissue involvement and spinal cord compression. AAS was the most frequently encountered radiological abnormality. Although the incidence of cervical spine instability has been decreased after the addition of the biological agents in the management of RA, surgery has still a vital role in the therapeutic approach.","title":"Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis"}
{"_id":"a59b5617-d047-b562-763c-1aa02485e58f","text":"In the period between January 2013 and September 2019, a total of 1901 women with primary cN0 invasive breast cancer underwent a sentinel lymph node biopsy at our Surgical Oncology Unit, according to the aforementioned inclusion criteria.","title":"Effects of the number of removed lymph nodes on survival outcome in patients with sentinel node-negative breast cancer"}
{"_id":"a5b3af8e-6fa4-2ef1-a2d9-9c21f7d39416","text":"Leadership roles in medicine are often regarded as positions that require a significant dedication toward business-oriented tasks.4 An MBA degree is likely the most apt education surgeons can receive to gain exposure to the necessary skills. Given their desire to pursue an MBA degree in the first place, surgeons with an MBA are more likely to pursue leadership roles due to a desire to lead others and take on business-oriented work from prior educational exposure.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"a5b6c817-b24d-4f66-c43f-3df0686e4a01","text":"The purpose of this study was to examine the development of growth in infants with ankyloglossia throughout the first 6 months of life.","title":"Does neonatal ankyloglossia interfere in the growth of infants during the first 6 months of life? A case series nested in a cohort study"}
{"_id":"a5bbe516-3ef4-c689-539e-5c1e81d4b40f","text":"The aims of this review are to detail the immunocryosurgery protocol with the addition of practical tips for its successful application in the every-day clinical practice, compile data on the mechanism of action, and to delineate indications and possible future applications. Most of the available data originate from the treatment of BCC, of all histological types and localizations, and the general principles reported herein mainly reflect on evidence and experience related to the treatment of this common skin cancer.","title":"A Review of Immunocryosurgery and a Practical Guide to Its Applications"}
{"_id":"a5c26d02-875f-c718-5b3f-2bd052e7e86f","text":"Two photon-imaging systems have attracted a lot of research due to a number of advantages including the fact that there is enhanced penetration of light in the tissue or cells. The systems also have low fluorescence, and the photodamage on the living cells is reduced with their use. Using photodynamic therapy to treat cutaneous maligneous and intraperitoneal tumors has been researched to be one of the excellent pathways to use. The method however uses photosensitizers which currently have a lot of pitfalls, problems that can be solved by development of a new improved photosensitizer or enhancing the already existing ones. The aim will be to increase the cytotoxicity, selectivity, and protection against degradation.","title":"Encapsulation of Gold Nanorods with Porphyrins for the Potential Treatment of Cancer and Bacterial Diseases: A Critical Review"}
{"_id":"a5cf68a0-9154-c03a-84f9-15ed94d8349f","text":"Thermoplastic masks are commonly used in radiation therapy to immobilize a patient's head and neck during treatment. They are primarily composed of non-toxic polyester compounds that can be manipulated with heat to mold the shape of a patient's head and neck. There is little previously reported evidence of these masks causing allergic contact dermatitis. We present a case of a 44-year-old female with a history of squamous cell carcinoma of the right tonsil with multiple enlarged lymph nodes following surgical excision of the right tonsillar mass and ipsilateral neck dissection elected to undergo adjuvant radiation therapy with volumetric modulated arc therapy (VMAT) technique without concurrent chemotherapy. A thermoplastic mask was issued prior to radiation therapy. Following the mask fitting, the patient developed an allergic contact dermatitis reaction of the head and neck in areas covered by the mask. Her symptoms worsened with continued use of the thermoplastic mask and radiation therapy. As the patient continued and eventually finished the radiation treatment regimen, the dermatologic symptoms failed to respond to topical facial moisturizer and steroid treatment. The contact dermatitis reaction did not completely dissipate until about three months following completion of radiation therapy and contact with the thermoplastic mask. Thermoplastic masks are not known to cause an allergic contact dermatitis reaction. There is only one other reported case documented in the literature. Such reactions can alter the course of radiation therapy if symptoms are severe enough to disrupt treatment or if they cause worsening of the radiation dermatitis. Allergic contact dermatitis to thermoplastic masks should be well documented in the future to better understand the cause and possible risk factors related to the reaction.","title":"Thermoplastic Mask-Induced Contact Dermatitis: A Case Report"}
{"_id":"a5d1340a-eee2-4f60-5250-b31d47f6a7b6","text":"This case highlights the importance of systemic therapy for desmoid tumors and increasing awareness of this rare disease so that medical treatments can be considered with or without surgery. This report is limited because it is a single case report. Nonetheless, given that there were no significant side effects, and with the overall positive response to therapy, future studies can evaluate the specific role of tamoxifen and sulindac at a molecular level. This could pave the way for additional targeted therapies. The morbidity associated with surgery for desmoid tumors suggests that such targeted medical therapies would be of particular benefit.","title":"A Desmoid Tumor Responding to Systemic Therapy With Tamoxifen and Sulindac"}
{"_id":"a5d2bf21-b30d-20f6-33d1-c487448cc574","text":"Sentinel node techniques include the use of blue dye or Tc labelled sulphur colloid. Both are carried by the lymphatics to the first node draining the tumour.","title":"Recent advances in imaging breast cancer"}
{"_id":"a5daf5b9-a2e1-7d08-1293-c96740e7de92","text":"In summary therefore, this study presents the first report of the effect of chronic glucose deprivation on the sensitivity of breast cancer cells to photodynamic therapy. Chronic exposure to low glucose levels has a protective effect on the cells, possibly due to induction of stress proteins, but this requires further study. This may inhibit the efficacy of ALA-PDT in the treatment of bulky tumours and further work is needed to assess whether induction of transient hyperglycaemia may reverse this. It must also be remembered that low glucose and hypoxia usually co-exist and as both have an inhibitory effect, this suggests that PDT for bulky tumours may have inherent limitations.","title":"Aminolaevulinic acid-induced photodynamic therapy: cellular responses to glucose starvation"}
{"_id":"a5e08b86-5788-076e-f402-015392b6d0fb","text":"This study suggests that there is no significant difference in postoperative block level or pain score during coughing for thoracoscopic surgery between ultrasound-guided parasagittal and transverse intercostal approach, but the parasagittal approach takes longer and has a higher failure rate.","title":"A Comparison of Puncture and Continuous Pump Analgesia With Two Different Approaches to Thoracic Paravertebral Block for Thoracic Surgery"}
{"_id":"a5e6e133-2756-1a38-b6b8-ebac12e0cd50","text":"Postsurgical pathological analysis confirmed a diagnosis of desmoid tumor, also known as aggressive fibromatosis, whereas DNA sequencing revealed a CTNNB1 mutation, a somatic genetic marker found in approximately 90% of desmoid tumor cases.","title":"Total Resection of Pediatric Desmoid Tumor of the Left Neck with Utilization of 3D Virtual Surgical Planning"}
{"_id":"a5e707a8-5ad2-d70a-69b2-02438e025c73","text":"Table 4 demonstrates the results of data mining for concurrent inflammation, which reveals a relationship between spinal TB and inflammation. The greatest proportion of granulomatous inflammatory factor expression features can be seen in the types of vertebral bone destruction and the greatest proportion of spreading granulomas in paravertebral lesions.","title":"Meta-Analysis and Data Mining-Based Study on the Expression Characteristics of Inflammatory Factors and Causes of Recurrence in Spinal Tuberculosis"}
{"_id":"a5e83137-060d-4d68-b242-8f52a0dd9f5e","text":"Decreased procedure time is a commonly cited advantage of barbed sutures and may also offset the additional cost of their use.6-8,10 Warner and Gutowski7 noted a significant decrease in plication time of abdominoplasty flaps when using the bidirectional Quill barbed suture. A similar observation was made by Rosen,8 whose operation length for the same procedure decreased by 15 minutes when the bidirectional barbed suture was used. In the current study, there was no significant difference in procedure length observed between the 2 groups. The likely explanation for this is that the abdominal wound closure in a DIEP flap at our institution is usually performed by an assistant while the microsurgery is in progress. As a result, the precise length of time for this portion of the procedure in isolation is not recorded in the operative log. It is our impression, however, that abdominal closure is indeed quicker with the unidirectional barbed suture. As no difference in the length of time that the patient spends on the operating table can be attributed to the use of the barbed suture, this observation alone is not an indication for the use of the device in the context of free flap breast reconstruction.","title":"Early Experience With Barbed Sutures for Abdominal Closure in Deep Inferior Epigastric Perforator Flap Breast Reconstruction"}
{"_id":"a5ebf75d-9321-3117-6a89-741500f83c9a","text":"A 54-year-old African-American woman developed a pigmented papillary squamous cell carcinoma in the palpebral and bulbar conjunctiva of the right eye in areas that received no sun exposure. In situ hybridization performed on the tumor showed human papilloma virus 16. The left eye showed a pedunculated nonpigmented conjunctival dysplasia. The tumors were extirpated by cryosurgery and topical interferon alfa 2b in the right eye and simple surgical excision in the left eye.","title":"Pigmented Viral-Associated Conjunctival Carcinoma"}
{"_id":"a5f972fd-35c8-592a-beef-41ed82bfab9f","text":"Each institute has discretion in deciding who is offered a fellowship based on the current research priorities of the institute. Institutes and centers vary in their process for awarding a fellowship. For this study, the authors interviewed staff at various institutes and centers who provided a representative view of the variation in procedures across the organization. Through interviews, the authors learned that the process for awarding fellowships is more complex than funding proposals with the best scores.","title":"Advancing biomedical science through investments in elite training"}
{"_id":"a6003492-18a2-bdcf-e61a-a57de20b01a3","text":"Recurrence is probably associated to local invasion into cancellous bone beyond radiographically visible margins in absence of tumor encapsulation. Recurrence rate can apparently be reduced with a more aggressive treatment by performing a partial or complete segmental bone resection with tumor free margins of 1.5 cm. Such a treatment can be preferred in the maxilla, where the closeness to the maxillary sinus, the zygoma and the lower part of the orbital cavity can be a critical factor in case of recurrence (6).","title":"Odontogenic myxofibroma: A concise review of the literature with emphasis on the surgical approach"}
{"_id":"a60764f3-57e0-3956-995b-3a51ba31d350","text":"Rosacea is a skin condition that can cause redness on the face; therefore, the use of cosmetic products that reduce this redness is important psychologically for the patient, as it camouflages the redness, making the face more harmonious. These cosmetics should not contain any fragrances and should not be irritants or sensitizers due to the low tolerance of skin with rosacea.","title":"Rosacea Topical Treatment and Care: From Traditional to New Drug Delivery Systems"}
{"_id":"a607e09a-6ff3-1afa-228b-f2ea20810c95","text":"Penile melanoma prognosis depends on the initial clinical stage of the disease. The risk of lymphatic involvement seems to be related to the same risk factors used to assess cutaneous melanoma. Clinicians can thus assess penile melanoma using the AJCC staging system. The use of sentinel lymph node biopsy to determine staging is also becoming more common and could replace prophylactic bilateral inguinal dissection.","title":"Penile melanoma: a 20-Year analysis of six patients at the National Cancer Institute of Peru, Lima"}
{"_id":"a6142cf2-ebe9-6aa3-76e6-d305bce1dd13","text":"110 elite New Zealand outdoor athletes volunteered to participate in an interview with a trained interviewer. The interviewer asked the athletes questions on their Vitamin D knowledge, attitudes and practices regarding sun exposure as well as their concerns about skin cancer.","title":"Knowledge and attitudes to vitamin D and sun exposure in elite New Zealand athletes: a cross-sectional study"}
{"_id":"a61a584a-575a-a106-0e40-997fbed2ba67","text":"Studying the 5th IMAP-relevant information comparatively between ours and Schmidt's was ignored as actually it would not have any impact on delineating the reliable vascular anatomy of the medially pedicled lower pole breast flap, because Schmidt's study already stated that the 5th perforator vascular territory lies below the inframammary fold, and so it is not included within the tissue flap in question. Therefore, including the 5th IMAP in the flap pedicle will not substantially influence the flap perfusion and furthermore will confine the rotational capacity of the flap.","title":"Color Duplex Assessment of 4th and 5th Internal Mammary Artery Perforators: The Pedicles of the Medially Based Lower Pole Breast Flaps"}
{"_id":"a61d1841-2325-d1fa-53f1-7c06cd8e3ad2","text":"The connective scaffold virtual spaces appeared maintained as well as the surface texture. Where the material was injected, it generated areas with a homogeneously finely fibrillar appearance that was in very close contact with the collagen and elastic fibres. The histological effectiveness of the investigation highlighted the aesthetical and biostimulatory effect produced by injections of hyaluronic acid into tissues, in order to stimulate these tissues to complete the initial action performed by the filler. These intracellular structures are characterized by the emission of lamellar cytoplasmic prolongations and show aspects of nucleocytoplasmic activation constituted by a hypertrophy of the endoplasmic reticulum and of the Golgi complex [20, 21]. The histological results in a previous study showed that this treatment is associated with an increase in collagen and hyaluronic acid that suggests a restoration of the cellular metabolism of the epidermis [22]","title":"Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure"}
{"_id":"a61dcc45-64c4-dbef-9605-6dc78f758d8b","text":"When STS and DPT with the eliciting BL were negative, and reaction occurred more than six months before the study, the study was repeated three weeks later using the same protocol.","title":"Changes in Sensitization Patterns in the Last 25 Years in 619 Patients with Confirmed Diagnoses of Immediate Hypersensitivity Reactions to Beta-Lactams"}
{"_id":"a6236d6c-34a5-3b2b-9d4a-9e0c9a5bbf88","text":"Patients with asymptomatic microscopic PNI may benefit from local adjuvant radiotherapy over a wide field but do not necessarily require treatment to the entire course of the relevant cranial nerve [13].","title":"The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer"}
{"_id":"a6260bfc-aa42-af17-1d44-31e00f25cfa3","text":"Many patients prefer continued care in the primary care setting, avoiding the stress of hospital visits, so routine follow up visits could be shared between the hospital clinic and the primary care setting. General practitioners embarking on follow up will be only those willing to undertake the work and there must be good and rapid communication lines between the surgical team and the primary care physician.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"a62ab5d9-7ac2-080c-3b59-9628cda3f5cc","text":"The audit dataset was randomly split such that each group reviewed 119 exams (total 357 exams) and each expert was asked to assess 17 exams performed by each of the seven sonographers. In this way, each exam was judged by at least two separate experts. In order to avoid bias each expert was blinded as to the name of the sonographer being reviewed and the assessment of the other experts.","title":"Audit of transvaginal sonography of normal postmenopausal ovaries by sonographers from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) [version 1; referees: 2 approved"}
{"_id":"a62bc044-d653-b019-1185-c47996630480","text":"Ability to breastfeed is one of the most crucial public health issues facing infants worldwide, and is particularly relevant given recent reports of the UK having the lowest sustained breastfeeding rate in the world. Effective means of supporting and improving breastfeeding should be a high healthcare priority. In this context, a combined chiropractic and midwifery clinic was developed to support mother-infant dyads struggling with suboptimal breastfeeding; however effectiveness of this approach has yet to be assessed. This study was designed to begin to address this question.","title":"ECU convention 2017 research presentations Limassol, Cyprus. 25-27 May 2017"}
{"_id":"a62c5bf7-d474-057c-2965-be786459b063","text":"Dentoalveolar surgery and especially surgical removal of third molar teeth continues to be the most common surgical procedure performed in the speciality of oral & maxillofacial surgery.","title":"Experience versus complication rate in third molar surgery"}
{"_id":"a6348a32-db31-5318-3f0e-42f19a865c07","text":"Table 2 illustrates the types of aesthetic treatments performed using guided SEFFI alone or combined with other procedures. The guided SEFFI procedure was applied as a single procedure in more than 60% of the cases and involved all face areas. About one-tenth of the patients received a fat graft combined with a botulin toxin treatment or hyaluronic acid filling; fewer patients underwent other combined procedures.","title":"Guided Superficial Enhanced Fluid Fat Injection (SEFFI) Procedures for Facial Rejuvenation: An Italian Multicenter Retrospective Case Report"}
{"_id":"a64035ff-2bd0-3bb4-9b0f-f9e7ce004999","text":"Patients with severe arterial obstructive disease and critical limb ischemia associated with vascular graft infection have elevated morbidity and mortality rates and are at high risk of limb loss. We present the case of a 76-year-old male patient with left lower limb critical ischemia and a femoropopliteal vascular graft infection. We used a hybrid treatment approach with an open surgical approach to the inguinal and popliteal regions and used the vascular prosthesis as endovascular access for direct recanalization of the superficial femoral artery, because the long occlusion and extensive calcification had frustrated initial attempts at endovascular treatment. After endovascular recanalization, the infected graft was removed. Used in conjunction with open surgery, advances in endovascular techniques and materials offer new solutions for patients when usual procedures fail.","title":"Hybrid treatment for lower limb revascularization in a patient with vascular graft infection: a case report"}
{"_id":"a6457a2c-e986-4c2f-b423-b3e9ba512096","text":"In the present study, patients did not receive radiotherapy prior to surgery. The average BMI was 25.5 and both patients with partial NAC necrosis had a smoking history. The incision for the mastectomy can be crucial for the flap safety. Small incisions are appreciated by the patients but it might need retracting the skin too much and using retractors for an extended period can affect the vascularization of the skin flaps. Most of the NSM in our study were performed using a lateral or inferolateral incision. One incision was radial, close to the NAC and the patient had a partial NAC necrosis.","title":"Assessment of Mastectomy Skin Flaps for Immediate Implant-Based Breast Reconstruction"}
{"_id":"a6460f18-a331-e441-eb05-1dbd09ccf99e","text":"The patient underwent further breast reconstruction 3.5 months postmastectomy that included bilateral nipple reconstruction and fat grafting. The patient was found to have a contour irregularity in the superolateral aspects of the bilateral‐free flaps (left greater than right) at the junction of the mastectomy skin and the edge of the flap. Using standard Coleman technique, 30 cc of lidocaine with epinephrine was injected into the lateral aspect of the abdominal donor site. After allowing sufficient time for vasoconstrictive effect, approximately 68 cc of processed fat was harvested and processed by rolling the harvested fat on a Telfa pad. This material was then injected into the superior pole concavity at multiple sites bilaterally. The abdominal donor site was revised without complications. The patient presented to plastic surgery clinic 6.5 months after mastectomy for evaluation of two palpable nodules in the upper outer quadrant of the right reconstructed breast at the 9 and 10:00 positions. The nodules were thought to be consistent with fat necrosis in the postsurgical setting, and no further workup was obtained.","title":"Unusual recurrence of breast cancer in a BRCA‐variant patient after fat grafting SKENDELAS et al."}
{"_id":"a657286d-fa16-0704-4c69-fcf585f1219c","text":"In addition to the inherent drawbacks of all retrospective studies, one noted limitation is that no patients enrolled in this study had received targeted therapy or immunotherapy, due to the relatively late entry of relevant drugs into China.","title":"Surgical resection margin for T3–T4 primary acral melanoma: a multicenter retrospective cohort study"}
{"_id":"a65e7be2-c03c-e2aa-12fe-83701d3f07a2","text":"The compression technique in the hands of PoCUS experts demonstrated high accuracy in the diagnosis of TR-CVCd and should represent a standard in the routine examination of dialytic patients. The training of PoCUS inexperienced students for the diagnosis of TR-CVCd is feasible but did not lead to a sufficient level of sensitivity.","title":"Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients"}
{"_id":"a6647c8f-8871-cd57-136b-410b9ca4c613","text":"CONCLUSIONS Three dimensional simulations of focused ultrasound ablation has been perfomed in a patient specific geometry. Simulation using multiple GPUs can sufficiently reduce the simulation time and can help to construct surgical planning platform. High ultrasound power and nonlinear propagation effects with appropriate treatment planning can sufficiently reduce the treatment time. We theoretically showed that the treatment time can be reduced to few minutes. The presented model can be used in planning tools for the thermal ablation of tumour in other organs.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"a6651f27-44a4-f062-fd09-92aebf63c830","text":"Physeal transfers via free vascularized fibula flaps have been well reported, resulting in the successful creation of a neoglenofibular joint. However, these constructs are known to be complicated by early graft fracture. The addition of allograft to a vascularized fibular physis has not been reported on in the upper extremity. It was previously believed that the proximal humerus did not need additional structural support because the vascularized fibula has been shown to hypertrophy and approach the diameter of the humerus; however, graft fracture is common. In this case report, the additional structural support of an allograft helped prevent graft fracture within the first-year postoperatively while maintaining an open physis and allow for epiphyseal hypertrophy and growth. In addition, it allowed for repair of the rotator cuff to allow for some forward elevation of the arm.","title":"Composite-Free Vascularized Fibular Epiphyseal Flap and Proximal Humeral Allograft for Proximal Humerus Reconstruction in a Pediatric Patient"}
{"_id":"a6681f0c-dfda-d56b-7a92-9e9e436a70c4","text":"A 30-year-old patient with concave deformity of the right ala causing a depression was corrected using a horizontal mattress. The columella was reinforced with a strut graft to which the medial crura and domes were approximated","title":"Secondary rhinoplasty"}
{"_id":"a66bdb2e-3ad5-5c14-b51f-7a8434407458","text":"A randomized controlled prospective study was designed to investigate the effectiveness of ultrasound-guided preoperative single TPVB and ESPB for perioperative analgesia in thoracoscopic pulmonary lobectomy. It was hypothesized that a single preoperative ultrasound-guided TPVB and ESPB for thoracoscopic pulmonary lobectomy could reduce the visual analogue score (VAS) of postoperative pain and reduce the dose of perioperative sufentanil and postoperative remedy analgesics.","title":"Ultrasound-guided single thoracic paravertebral nerve block and erector spinae plane block for perioperative analgesia in thoracoscopic pulmonary lobectomy: a randomized controlled trial"}
{"_id":"a66c6a5c-05a2-8a15-b15a-835e534cd89c","text":"This clinical case vignette established the influence of age and need for endocarditis prophylaxis on clinical decision making.","title":"How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons"}
{"_id":"a66c79d4-07ad-749c-0a44-1b83b4c49d99","text":"The Allen’s test is a simple bedside test that should be performed bidirectionally to exclude radial artery occlusion, which may compromise flap harvest. Radial artery occlusion will become increasingly common as the radial artery is used more frequently for endovascular access procedures.","title":"The Allen’s test: revisiting the importance of bidirectional testing to determine candidacy and design of radial forearm free flap harvest in the era of trans radial endovascular access procedures"}
{"_id":"a6714541-b181-d451-3194-6c612c53d45c","text":"A longer follow up period would provide further data on the long-term outcomes of the patients and the durability of effect of the study intervention.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"a6723915-43fd-0637-fc05-de4e853f38cb","text":"In order to define categories of feeding practices, participating mothers were asked several questions about feeding practices since the baby was born. These included whether she had given any food or fluids other than breastmilk since birth, but also included specific questions about ever having given the baby formula milk or water, and about pre-lacteal feeds. Only those who consistently reported having given only breastmilk, were classified as EBF. Those who reported currently breastfeeding but who reported giving other food or fluids at any time since birth, were categorised as mixed breastfeeding. Similarly, infants attending with non-maternal caregivers were categorised as EBF if the carer reported that the infant had never been given any food or fluids other than breastmilk. Odds ratios were provided using logistic regression for comparisons of prevalence of the respective feeding modality across the two surveys. Multi-variable logistic regression was used to adjust odds ratios for demographic or social characteristics differences at the two time points. A Kaplan Meier curve and log rank test is used to analyse time to stopping breastfeeding. Hazard ratios were calculated using a Cox regression model for assessing changes in duration across the two surveys adjusted for mother returning to work or school, HIV status and urban or rural setting.","title":"Are we doing enough? Improved breastfeeding practices at 14 weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa"}
{"_id":"a685e9cb-9ef2-417c-0352-95a787334e61","text":"A pedicled perforator flap on the face can increase flap mobility and provide a flap that contains only necessary tissue and presents cosmetically satisfactory results.","title":"Freestyle Local Perforator Flaps for Facial Reconstruction"}
{"_id":"a69b03a0-e025-18d1-5fc8-ba9310412800","text":"Post-resection margins were measured with the same ruler as the pre-incision margins shortly after the tumor was resected either by the main investigator or another member of the surgical team. The anterior margin was used from this point on as a reference for all tumor specimens.","title":"An Analysis of Tumor Margin Shrinkage in the Surgical Resection of Squamous Cell Carcinoma of the Oral Cavity"}
{"_id":"a69c90aa-748e-bb2f-bc6d-bbcf90645e94","text":"In this study, we developed and evaluated a novel wide-field electron arc technique to overcome the disadvantages of previous techniques. Our method has several advantages for the treatment of widespread skin cancer on cylindrical regions such as the arms and legs.","title":"Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi’s sarcoma in the distal extremities"}
{"_id":"a69ca69d-639b-aacb-4b6e-636d26f6cd0d","text":"Here we provide the first report on routine use of MP in 3 centers in the US. The effect on the rate of re-excision procedures was based on comparison to historical records.","title":"The impact of use of an intraoperative margin assessment device on re-excision rates"}
{"_id":"a69d5768-ee00-3df0-65fa-334ab4d4e6b9","text":"Diagnosis of spondylodiscitis is a combination of laboratory results as well as imaging results in a patient with the appropriate history.","title":"Cervical spine spondylodiscitis: Review of literature on current treatment strategies"}
{"_id":"a6a091f3-9a38-1111-f8e5-0c7482c905c2","text":"Each trainee will be awarded an Annual Record of Competency Progression certificate (ARCP). This is to ensure that there is documentary evidence to confirm that the trainee has met his or her targets for the year and is progressing satisfactorily. Annual Record of Competency Progression certificate panels are required to examine evidence of competence and increasingly this is being carried out with more structure and objectivity than was the case with the Record of In Training Assessment system. It is thus imperative that evidence to support acquisition of competency is recorded. An ARCP panel may recommend specific targets that need to be attained (ARCP 2) or an extension to training time if a trainee requires more time to progress safely (ARCP 3).","title":"Education of trainees, training and fellowships for head and neck oncologic and surgical training in the UK: United Kingdom National Multidisciplinary Guidelines EDUCATION OF TRAINEES, TRAINING AND FELLOWSHIPS: UK GUIDELINES"}
{"_id":"a6a09792-7f2f-28ba-6d9e-af4df07bff62","text":"A total amount of 20 mL of lipoaspirate was harvested from the abdomen with the same technique of fat transplantation. Lipoaspirate was sent to the laboratory for cell cultivation within 1 hour and processed for ADSCs isolation.","title":"Improvement of Mouth Functional Disability in Systemic Sclerosis Patients over One Year in a Trial of Fat Transplantation versus Adipose-Derived Stromal Cells"}
{"_id":"a6a9990d-f623-7c12-37d5-fd22afaad717","text":"The surgeons in charge were obliged to verbally describe the surgical procedures, and drawings were used to explain the advantages and disadvantages of the surgical methods to the patients and their parents. This took place several days before the surgical intervention. One day before the scheduled operation, patients and their parents were seen again to address any remaining questions. Selection of patients for the two procedures was thus based on the preference expressed by families after having been informed by the surgeon in charge.","title":"Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children"}
{"_id":"a6b58797-cf45-b967-7878-8eb028c1c18f","text":"The use of free fibular flap has been widespread since it was first described by Taylor in 1975 [11]. The presence of a free fibular flap to augment the construct does not provide strength to the overall construct. However it does appear to hasten the time to full weight bearing. Presence of free fibular flap appears to reduce the number of secondary procedures required.","title":"Complex Biological Reconstruction after Wide Excision of Osteogenic Sarcoma in Lower Extremities"}
{"_id":"a6b86ee0-9b8d-9859-6c1a-e8fa3e404458","text":"One explanation for the high false positive rate might be that in unclear cases the radiologist might intuitively tend to report a positive than a negative margin for maximum oncologic safety. In addition, there is no consensus on which radiological margin width should result in a recommendation for re-excision.","title":"Does conventional specimen radiography after neoadjuvant chemotherapy of breast cancer help to reduce the rate of second surgeries?"}
{"_id":"a6b87987-69f5-1fd5-aede-524a5159b0cd","text":"In summary, percutaneous CEUS could effectively localize SLNs for guiding SLNB in patients with early breast cancer, and also could be used to evaluate its tumor involvement based on enhancement patterns of the nodes. However, specificity of diagnosis of SLN metastasis is low. The SLNs with unevenly enhanced or not enhanced have to be cautiously considered as positive nodes. The enhanced patterns for characteristics of SLN need further study to improve specificity and provide more valuable information for SLN staging.","title":"Percutaneous contrast-enhanced ultrasound for localization and diagnosis of sentinel lymph node in early breast cancer"}
{"_id":"a6b89d7b-b60a-4bbc-c7bb-dd203d890d7e","text":"Although nearly half of symptomatic VTE events in first 4 weeks occur during the first postoperative week, a substantial number of events occur several weeks after surgery. These data will inform clinicians and guideline developers about the duration of postoperative thromboprophylaxis.","title":"Timing of symptomatic venous thromboembolism after surgery: meta-analysis"}
{"_id":"a6b91e4f-da87-bf78-7dce-3f36b3d9160a","text":"We believe that microsurgical reconstruction with a latissimus dorsi flap is a reliable option for providing stable coverage of these types of defects. It allows aggressive surgical resection of the tumor and complex reconstruction. It also brings a robust blood supply to help decrease infections and improve healing and circulation, especially in light of the need of further radiation therapy.","title":"Invasive Squamous Cell Carcinoma of the Scalp and Calvarium: A Multidisciplinary Approach Stark et al"}
{"_id":"a6c23380-abd2-79ed-4617-3d56a9833eda","text":"We performed a multicenter retrospective cohort study to determine the rate of breast cancer recurrence in women who underwent an immediate as compared to a delayed autologous DIEP flap breast reconstruction. Our aim was to analyse the association in timing and breast cancer recurrence between immediate and delayed DIEP flap reconstruction.","title":"The difference in local, regional and distant breast cancer recurrence between the immediate and delayed DIEP flap procedure; a retrospective cohort study"}
{"_id":"a6c62c5a-85d7-8544-d4dc-e0b2e9ccab75","text":"For cSCC, a rapid cooling is preferred since it leads to faster intracellular crystal formation that results in better destruction of tumor cells.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"a6d078f1-f432-fdfa-fd54-fa9f5374d790","text":"Another theme that emerged was the mother’s interpretation that the infants actively ceased breastfeeding. The mothers explained that their infants were no longer interested in breastfeeding or that the infant did not want to breastfeed. Other descriptions noted that the infant chose to cease or was ready to cease breastfeeding. The mother’s interpretation that the infant rejected breastfeeding was a more active action than the mother’s interpretation that her body or her infant was showing the way. Perceived negative feedback from the child further reduced the desire to breastfeed among mothers who breastfed as long as they wanted.","title":"Cessation of breastfeeding in mothers of preterm infants—A mixed method study"}
{"_id":"a6d68a1f-6507-280e-b897-bc2768f9ff71","text":"Infections are expected much less frequently in biological reconstructions than during the implantation of mega prosthesis. The cause of infection in biological reconstructions is either inadequate soft tissue coverage or osseous nonunion. Infection occurred in one of our patients who had received reconstruction of a proximal tibial defect (patient 7). Infection occurred despite a medial gastrocnemius flap and an additional fasciocutaneous flap and was accompanied by synchronous nonunion which was cured surgically.","title":"Bilateral Fibular Graft: Biological Reconstruction after Resection of Primary Malignant Bone Tumors of the Lower Limb"}
{"_id":"a6d9e988-8c68-9e49-3200-7c65ba1ecdcc","text":"The vermilion should preferably be marked prior to incision to prevent distortion of this important aesthetic junction that occurs during injection and subsequent surgical dissection. It is also important to remember that primary closure of these defects should not result in any appreciable microstomia. If this occurs, a secondary reconstruction option should be used. Advancement flaps are best suited for correcting central defects of the upper and lower lips. The reconstructed lip tends to be tighter than the opposing lip, which may be more pronounced when the lips are together. This effect will generally decrease over time.,","title":"Lip Reconstruction after Tumor Ablation"}
{"_id":"a6e0024c-6973-9d74-4a92-a9c890a86113","text":"A patient will be excluded from the study if any of the following scenarios are present:","title":"Efficacy and safety of different antimicrobial DURATions for the treatment of Infections associated with Osteosynthesis Material implanted after long bone fractures (DURATIOM): Protocol for a randomized, pragmatic trial"}
{"_id":"a6e3feab-f7c3-8ba4-579f-79a232f4cdf3","text":"Among other activities the Humanitarian Committee will be addressing the development of a register of active members willing to join a rapid response team to assist in the event of international crises (initiative 11) and optimizing future ICOPLAST efforts by seeking advice from members previously involved in disaster relief programs (initiative 12).","title":"Establishing Priorities for the International Confederation of Plastic Surgery Societies"}
{"_id":"a6e4e771-69bf-fc42-66c7-4b55896320ff","text":"Before proceeding with allograft ACLR, it is imperative that surgeons be familiar with graft processing techniques and infection risk, as different techniques have been shown to affect risks of graft failure and subsequent revision surgery. Allograft processing begins with careful screening of the donor patient to minimize the risk of communicable diseases. After allograft harvest, grafts must be sterilized before they can be stored for eventual transport and usage for ACLR. There are a number of sterilization methods including ethylene oxide, low- or high-dose gamma irradiation, and supercritical carbon monoxide among other techniques. All methods of allograft sterilization have been found to compromise the structural integrity of the allograft to varying degrees. Gamma irradiation has been found to have a dose-dependent relationship with delayed graft healing and increased risk of failure. Newer sterilization techniques including supercritical carbon dioxide and the use of gamma irradiation in conjunction with antioxidants have been developed and have yet to demonstrate significant improvement in mechanical properties of the grafts in comparison to previous methods. With graft processing and sterilization, risk of disease transmission with allografts is extremely small, and risk of surgical infection has not been shown to differ markedly in comparison with autografts. Allografts can be stored as fresh frozen, freeze dried, or cryopreserved and typically remain frozen for approximately 2 to 4 weeks until serologic studies are complete to confirm that the grafts are disease free.","title":"Graft Selection in Contemporary Anterior Cruciate Ligament Reconstruction"}
{"_id":"a6e5d593-f87b-c0e0-a162-96360d6bdb12","text":"The failure to achieve exclusive direct breastfeeding in any infant in the present study may be partly explained by the fact that the setting of the study did not have as must lactation support as described in the study by Maastrup et al.40. Indeed, the authors speculated that the high percentage of preterm infants who were discharged home and were directly breastfed may reflect the high priority of supporting breastfeeding in NICUs, which is associated with the cultural custom of breastfeeding initiation and is typical of Denmark. In a retrospective study of 88 infants born at a gestational age of <34 weeks, Briere et al.8 reported that 51% of the 41 preterm infants who were fed exclusively human milk had directly breast fed two days before discharge. However, it must be taken into account that in the study by Briere et al., 46% of the enrolled infants were older, with a gestational age at birth of 32 and 33 weeks, than were the infants enrolled in the present study; thus, the achievement of direct breastfeeding in these infants could have been easier due to their better neurodevelopmental maturation. Furthermore, only infants who had received maternal human milk for longer than 7 days were enrolled, whereas infants with a diagnosis of short bowel syndrome and those who were discharged home still requiring tube feeding were excluded.","title":"Effect of co-morbidities on the development of oral feeding ability in pre-term infants: a retrospective study"}
{"_id":"a6e81313-d74e-dce5-9f39-b0cb83481b7b","text":"Another issue related to adopting the MCS as a standard practice is whether the benefits are related to costs.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"a6f28f38-5708-047d-65e4-ca110bd37e55","text":"An experienced team leader said that during the treatment of traumatized patients all the team members are alert and therefore it is his job to remain calm.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"a6f6572e-83d0-5af0-3aff-51f26b647285","text":"In cases of acute uncomplicated osteomyelitis and septic arthritis, antibiotic treatment can be provided intravenously for a short period of a few days and then orally until the end of the disease. The improvement in the clinical status and the inflammatory markers can be used by clinicians to decide on the timing of the switch to oral therapy. The latter should only be administered if the patient is capable of taking it adequately and only if it has the same spectrum of coverage as the antibiotic used parenterally.","title":"Update on the Management of Pediatric Acute Osteomyelitis and Septic Arthritis"}
{"_id":"a6f680d0-2193-16b1-50f8-f6a3d1f380d1","text":"Detailed description of outcome results and complications is reported in Table 1. Almost all the various forms of perforator flaps were used in the present series. Figure 1-5 shows few index cases. In almost 50% of the cases propeller flap was used while as the other forms like perforator plus with transposition and rotation modes of movement were also used. 8 patients in our series developed complications, out of which 4 patients had minor complications which included infection, wound dehiscence and congestion of flap. These patients did not require any secondary procedure and were managed conservatively. We witnessed partial flap loss in one and distal flap necrosis in three patients. In one of these four cases, the flap was repositioned to its native site, due to suspected color changes intraoperatively and later after 3 days was successfully positioned on the desired site. The other three cases were managed with VAC and later STSG.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"a6f92660-fb17-4d80-48b9-af8f72396080","text":"Dorsal hump reduction can be recommended with accuracy and safety without compromising the nasal airway.","title":"Component Rhinoplasty"}
{"_id":"a6f9be62-9da1-b239-e751-92ffbfe6da2a","text":"Biofilm is created when a quorum number is achieved using a quorum sensing mechanism that aggregate bacteria. Once the quorum number is achieved, the biofilm acquires all the qualities that make it distinct from planktonic bacteria.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"a6f9c584-9875-0cd2-e30b-471bc2f4684d","text":"In conclusion, we propose that this rare and elusive clinical entity should be considered by clinicians and pathologists when encountering a soft tissue tumour in children and young adults. Although the number of documented cases is increasing, we believe that there is still insufficient clinical experience and lack of awareness about its existence. Since adequate surgical excision leads to complete cure of this benign lesion, awareness among clinicians is vital in offering the best possible care to the patients.","title":"Unusual case of recurrent thigh lump in a girl: a case report"}
{"_id":"a7103065-afd2-2898-3b9e-f5dfac30cfb3","text":"A working prototype of a novel CSBT device was built using 3D-printing technology that provides a safe and economically attractive means of improving radiation delivery to complex treatment sites.","title":"Novel design and development of a 3D-printed conformal superficial brachytherapy device for the treatment of non-melanoma skin cancer and keloids"}
{"_id":"a71826e4-2123-7b83-ec5f-2dc818b0094b","text":"Split-thickness skin grafts can be used in conjunction with VAC® therapy for reconstruction of irradiated defects with acceptable results following preoperative radiation therapy of soft tissue sarcomas or remote exposure to radiation.","title":"Outcomes of skin graft reconstructions with the use of Vacuum Assisted Closure (VAC®) dressing for irradiated extremity sarcoma defects"}
{"_id":"a719155c-2fd9-d236-f244-0050ea8eff4f","text":"Identification of both strengths and weaknesses are key to molding future goals and the ADP.","title":"Twelve-step Approach for Academic Development Planning in Academic Surgery Climbing the Academic Uphill With Strong and Steady Steps"}
{"_id":"a71ce020-985c-f333-75a7-6019b18db55e","text":"Much more still needs to be done in the application of PACT in dermatological and control of infectious diseases, especially in the management of acne and skin infections in general. Given the wide range of bacteria, it has been noted that the potential application of PACT in the treatment of infectious diseases is still lagging even with the positive acceptance of photodynamic therapy in treatment for other diseases such as psoriasis and skin cancers. There is, therefore, a need for researchers to further explore this application.","title":"Photodynamic Antimicrobial Chemotherapy: Advancements in Porphyrin-Based Photosensitize Development PACT: Advancements in Porphyrin-Based Photosensitizers"}
{"_id":"a71d425c-5611-dad4-2871-6eeea0cd301f","text":"Osteomyelitis in children is a serious disease in children requiring early diagnosis and treatment to minimize the risk of sequelae. Therefore, it is of primary importance to recognize the signs and symptoms at the onset and to properly use the available diagnostic tools. It is important to maintain a high index of suspicion and be aware of the evolving epidemiology and of the emergence of antibiotic resistant and aggressive strains requiring careful monitoring and targeted therapy. Hereby we present an instructive case and review the literature data on diagnosis and treatment.","title":"A Case of Acute Osteomyelitis: An Update on Diagnosis and Treatment"}
{"_id":"a71e7760-448d-1a40-255e-50b759ee8b10","text":"There is a distinct learning curve involved in the use and finding the optimal balance between brightness, infra red and contrast settings with the infra red video camera.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"a72aaba2-cec7-028a-a900-ba6812b9389d","text":"Convenience sampling was done and minimum sample size was calculated as follows:","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"a730022c-83e0-c63b-0a3c-e8d6eaea1e14","text":"The tibia was the most reported site of infection with some studies specifically reporting tibial disease. Due to the relative poor blood supply to the tibia compared with other long bones, we would have expected the highest recurrence rate at this anatomical location, but reported recurrence was low and less than that at other sites.","title":"A systematic review of the single-stage treatment of chronic osteomyelitis"}
{"_id":"a73c4652-bd55-32ef-b044-6cad73eada62","text":"The results of this study 2 months following treatment demonstrate specific modifications of the CaHa filler injected in the deep dermis of the skin. These modifications are due to extracellular interactions of the big cells surrounding the filler microspherules with their constitutive material. Our observations support a mechanism without phagocytosis of the injected material, in other words, without a rapid removal of the injected material by phagocytic cells. Due to the action of the big cells closely related to microspherules, their constitutive material is slowly released filling the extracellular matrix with a long smooth action. The treatment is safe, without stimulation of the immune system and\/or any other kind of adverse reactions. Furthermore, our morphological findings demonstrate the stimulation of the fibroblasts activity and a related active regeneration of the connective tissue. This renewal of the molecular components of the extracellular matrix increases support and strength to the skin, constituting an additional, restorative and physiological filling action aesthetically and functionally in sync with the action of the injected filler.","title":"Microscopic and ultrastructural evidences in human skin following calcium hydroxylapatite filler treatment"}
{"_id":"a747619a-0780-4b59-5841-846b25209446","text":"Similar findings were reported in other studies [44, 45] where it was explained that the reason for less EBF despite high initiation rate among their participants was due to many factors such as employment and deficient knowledge and education about exclusive breastfeeding benefits to mother and infant. So, despite this initial supportive breastfeeding environment in UAE hospitals, our results clearly indicated that hospital policies based on national recommendations are not sufficient to maintain EBF to 6 months postpartum.","title":"Prevalence and multivariable predictors of breastfeeding outcomes in the United Arab Emirates: a prospective cohort study"}
{"_id":"a74cd6d8-80d6-8dd2-8291-c667c857a3eb","text":"Primary melanoma of the colon is a rare clinical entity in medical literature. Whenever a seemingly primary melanoma is detected in an atypical location such as the colon, it is prudent to conduct a thorough clinical investigation to consider the possibility of metastatic disease. We have presented a review of 12 cases of primary melanoma of the colon that have been reported in the literature so far in order to gain a better understanding of the unique features, symptoms, diagnosis and management of this rare tumor. However, it is acknowledged that further studies are needed to document the long term follow-up, survival advantage and safety profile of the management approaches employed in patients with primary colonic melanoma. Based on a synthesis of the current data, it appears that the management of primary colonic melanomas should focus primarily on surgical resection, unless the disease has metastasized to distant sites where surgery may have a more limited palliative role. Targeted biological therapies are a promising prospect in the management of primary colonic melanoma in the future and should be explored further.","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"a75513bf-e62d-3cf5-1ba9-9d4ef5fbcf8f","text":"This article addresses the potential clinical value of surface electrical stimulation in the acute phase of denervation after the onset of facial nerve or recurrent laryngeal nerve paralysis. These two nerve lesions are the most frequent head and neck nerve lesions. In this review, we will work out several similarities concerning the pathophysiology features and the clinical scenario between both nerve lesions, which allow to develop some general rules for surface electrical stimulation applicable for both nerve lesions. The focus is on electrical stimulation in the phase between denervation and reinnervation of the target muscles. The aim of electrostimulation in this phase of denervation is to bridge the time until reinnervation is complete and to maintain facial or laryngeal function. In this phase, electrostimulation has to stimulate directly the denervated muscles, i.e. muscle stimulation and not nerve stimulation. There is preliminary data that early electrostimulation might also improve the functional outcome. Because there are still caveats against the use of electrostimulation, the neurophysiology of denervated facial and laryngeal muscles in comparison to innervated muscles is explained in detail. This is necessary to understand why the negative results published in several studies that used stimulation parameters are not suitable for denervated muscle fibers. Juxtaposed are studies using parameters adapted for the stimulation of denervated facial or laryngeal muscles. These studies used standardized outcome measure and show that an effective and tolerable electrostimulation of facial and laryngeal muscles without side effects in the early phase after onset of the lesions is feasible, does not hinder nerve regeneration and might even be able to improve the functional outcome. This has now to be proven in larger controlled trials. In our view, surface electrical stimulation has an unexploited potential to enrich the early therapy concepts for patients with unilateral facial or vocal fold paralysis.","title":"Selective Electrical Surface Stimulation to Support Functional Recovery in the Early Phase After Unilateral Acute Facial Nerve or Vocal Fold Paralysis"}
{"_id":"a7555de8-be4f-09bc-cc6f-67478a35b368","text":"The patient, who is on tacrolimus secondary to his heart transplant, was treated urgently with enoxaparin and then bridged to warfarin as an outpatient. After completing five weeks of outpatient anticoagulation therapy with warfarin, the patient denied any swelling or discomfort of the right upper extremity. Ultrasound evaluation showed that the thrombi had completely resolved. A sequential musculoskeletal ultrasound did not show any occlusion of blood vessels due to muscle hypertrophy. He was continued on anticoagulation and was approved to continue bowling as tolerated.","title":"Upper Extremity Deep Vein Thromboses: The Bowler and the Barista"}
{"_id":"a75d2a26-1b95-6280-e209-6760d70ef6b5","text":"Retreatment with a second full course of radiation to the whole breast is used with caution as increased toxicity of skin and subcutaneous tissue is feared. Nevertheless, in recent years several investigators reported on reirradiation either alone or combined with concurrent hyperthermia or chemotherapy. Irradiation was applied as external beam therapy, brachytherapy or intraoperative radiotherapy.","title":"Reirradiation of recurrent breast cancer with and without concurrent chemotherapy"}
{"_id":"a75f382b-f913-5ab9-c5df-fa44bf086468","text":"Fellows further engage with their NGO partners in educational programs such as collaboration with Project ECHO’s Climate Change and Human Health interactive webinar series, development of curricula with GCCHE and efforts to develop a novel Climate and Health Responders Course in collaboration with NOAA and Project ECHO.","title":"Creating climate-informed physician leaders: The evolution of a physician fellowship in climate and health science policy"}
{"_id":"a7609326-92a4-3a21-b109-1582b31fa6c5","text":"The aim of the present study is to provide more evidence on the management and strategies of flap failure in lower extremity reconstruction using secondary free flaps. In this context, we analyzed a cohort of 1.016 consecutive lower extremity free flaps to provide recommendations for salvage reconstruction using free tissue transfer.","title":"Microsurgical Strategies after Free Flap Failure in Soft Tissue Reconstruction of the Lower Extremity: A 17-Year Single-Center Experience"}
{"_id":"a760b668-54ca-336d-77aa-77bb9b1e4023","text":"In patients that did not achieve adequate IOP response despite Hydrus Microstent implantation with OMNI canaloplasty, it is important to note that the study intervention did not preclude or hinder further surgical or medical treatment. In this case series, both typical filtration surgery and additional MIGS were performed following Hydrus Microstent implantation with OMNI canaloplasty without event. In these patients, surgical options remained unrestricted and surgical intervention itself was not made more technically difficult due to previous Hydrus Microstent implantation and OMNI canaloplasty. In addition, patients’ IOP response to subsequent surgery was not diminished. When all these factors are considered as a whole, this case series suggests that Hydrus Microstent implantation combined with ab interno canaloplasty with the OMNI Surgical System is a reasonably safe and well-tolerated method of reducing IOP in phakic patients with open angle glaucoma with uncontrolled intraocular pressure on maximum medical therapy. Furthermore, this intervention does not preclude any further surgical treatment with standard filtration surgery or MIGS.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"a7633fa4-9b6a-16f0-7a3f-d3e3bb09b0d6","text":"Such approaches are recommended only when the patient refuses surgery or surgery cannot be performed.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"a7661f3d-418b-2e35-d42d-1097b5960841","text":"These examples describe a sustainable ethos of mentorship in the workplace. Further, they provide evidence of the development of interprofessionalism, one of the core tenants of transformative health education. As Afya Bora alumni continue to grow and develop into healthcare leaders in their respective countries, they will bring to the table the emerging understanding that transformative leadership involves supporting and fostering the careers and work of colleagues on different levels.","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"a7675a75-23d6-80d6-a48f-ad15ed69b792","text":"Gaining knowledge and understanding of the selective sensitivity to ultrasound energy of cancerous cells having different biomechanical properties is of fundamental as well as practical interest. This knowledge, combined with one of the primary advantages of ultrasound treatment, namely its potential for localized noninvasive application, should provide a solid basis for future clinical studies into personalized selective superficial cancer therapy.","title":"Cell stiffness predicts cancer cell sensitivity to ultrasound as a selective superficial cancer therapy"}
{"_id":"a769002b-59fb-16c5-1a8a-b0bb30fca9cd","text":"The participants of Study 2 are MBA students and their subordinates from a top business school in China. One of the researchers first asked the MBA students to rate the OI and EC and their demographic information at Time 1. Next, they were asked to invite five subordinates from their teams to take part in the survey at Time 2. These team members rated their perception of team collective efficacy and demographic information. Finally, the MBA students rated team performance at Time 3. All the questionnaires were electronic and sent via the Internet.","title":"Employee–Organization Relationships and Team Performance: Role of Team Collective Efficacy"}
{"_id":"a769d2a2-e6dd-204b-bc48-27137b9d0489","text":"The initial biopsy should not compromise, by flap transfer or transverse orientation of the incision to the long axis of the extremity, a subsequent sentinel node biopsy in a patient who can be eligible for this procedure.","title":"Surgery of Primary Melanomas"}
{"_id":"a76b20e5-baef-e0db-db10-36f3335c1c2b","text":"This report is based upon data from 36 evaluable participants. Multiple biological markers were analyzed on the biopsy samples of all 36 participants.","title":"Dynamic changes in cellular infiltrates with repeated cutaneous vaccination: a histologic and immunophenotypic analysis"}
{"_id":"a76d58e6-22e4-d2cc-d5fe-cadc20c6d38b","text":"Subsequent coronary angiograms performed at our institution were reviewed in followup when available.","title":"What Is the Best Proximal Anastomosis for the Free Right Internal Thoracic Artery during Bilateral Internal Thoracic Artery Revascularization? A Prospective, Randomized Study"}
{"_id":"a776a2d8-d424-a0dc-3532-6b6cff018510","text":"Craniofacial trauma is a common occurrence in motorcycle accidents, and many of these cases involve individuals who use motorcycles as their daily means of transportation. As a result, there have been numerous cases of craniofacial surgery, but there is a shortage of craniofacial surgeons and facilities to adequately manage these cases.","title":"The simplified tailor-made workflows for a 3D slicer-based craniofacial implant design"}
{"_id":"a7770add-455e-e5f2-29c6-f6cf54d7ddf9","text":"Primary outcomes were the diagnostic accuracy and morbidity of a needle core biopsy, including the risk of a pathological fracture in those with an impending fracture, and the delay in instigating treatment. Secondary outcomes included the incidence of primary sarcomas of bone, the incidence of a new second malignancy in patients with a previous malignancy, and the estimated survival of these patients with and without previous malignancy.","title":"The Importance of Awaiting Biopsy Results in Solitary Pathological Proximal Femoral Fractures Do We Need to Biopsy Solitary Pathological Fractures?"}
{"_id":"a7793033-41d0-1a93-6841-a049677860a7","text":"Malignant melanoma was found to be the least common malignant tumor constituting only a single case in this study. Similar results of less frequency of melanoma were seen in various other studies from Asia. This is in contrast to the higher frequencies of melanoma from Australia and European countries.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"a77cbcaa-948f-ab5d-8892-e13586940c63","text":"The recommendation for SLNB surgery relies on the probability of a positive SLNB. The strongest predictor of a positive SLNB is its tumor Breslow thickness. SLNB is offered to patients with melanomas thicker than 1 mm (T2 and above), since the probability of positive SLNB exceeds 10%. Thin melanomas (< 1 mm) are divided into T1a (< 0.8 mm, non-ulcerated) and T1b (> 0.8 mm but < 1 mm or ulcerated). The SLNB positivity probability is below 3% in T1a melanomas but can be up to 5–10% in T1b melanomas, with the caveat of historical Breslow thickness reporting with two decimals (< 0.75- vs. > 0.75-mm thickness) instead of one decimal as it is now required by the 8th edition of the American Joint Committee on Cancer TNM staging system [29, 30]. Therefore, SLNB is not indicated in T1a melanomas, unless there is uncertainty about the real microscopic depth staging (positive deep margin). Other pathological features can also predict a higher probability of positive SLNB in thin melanomas, namely mitotic index > 2\/mm2, young age, and lymphovascular invasion [31]. Therefore, SLNB can be discussed and considered in T1a melanomas with these adverse pathological features, even though their presence in < 0.8-mm-thick melanomas is very rare.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"a77da3f0-c6bb-90a6-ff0a-879dd1f3b7ae","text":"A retrospective study was carried out on all diabetic patients who underwent chronic foot ulcers that were reconstructed with free flap transfer in Plastic and Reconstructive Department of Ajou University Hospital from 2011 to 2019. Free flap was indicated for patients because they had soft tissue defects with exposure of bones and\/or tendons that could not be treated by other simple procedures. We excluded patients who suffered from acute wounds such as trauma or tumor resection. Patients were divided into two groups based on their vascular status: severe PAD group with grade 4 and 5 vascular stenosis (Table 1), and non-severe PAD group with others. All the patients of severe PAD group underwent PTA in at least one of three main arteries for increasing the distal perfusion for the foot via the pedal arch. Patients were followed up for more than 6 months.","title":"What is the impact of infrapopliteal endovascular intervention on free flap survival in diabetic foot reconstruction?"}
{"_id":"a77e2338-40ec-0683-2cfe-e5fc071be8dc","text":"It was thus concluded that it is extremely important to breast tissue changes early so that there can be a follow-up of the evolution of the alterations, which could have several advantages.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"a781b13a-b1e0-543e-500b-13264165aa00","text":"All animals were treated in accordance with the Ethical Guidelines for Investigations of Experimental Animals of the Nippon Dental University School of Life Dentistry at Niigata.","title":"Dual-modality imaging with 99mTc and fluorescent indocyanine green using surface-modified silica nanoparticles for biopsy of the sentinel lymph node: an animal study"}
{"_id":"a78279f7-d15d-58e4-6897-1e8ee9a0edb5","text":"Peripheral nerve field stimulation, also known as subcutaneous neurostimulation or sometimes targeted subcutaneous stimulation, is an alternative approach in which the surgeon inserts one or more electrodes into the region of most severe pain near the distal branches of the targeted nerves within the subcutaneous tissue. Its stimulation produces paresthesia-mediated pain relief that is diffuse along the painful area but could not be well defined or correlated to a specific dermatome [25].","title":"Supraorbital Nerve Stimulation for Facial Pain"}
{"_id":"a786dee3-ee53-7ab1-711a-947e3990beb5","text":"The aim of this article was to determine outcomes in patients with squamous cell carcinoma of the hypopharynx (SCCHP) in whom the free posterior tibial flap was used for primary reconstruction of hypopharynx defects after cancer resection.","title":"Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma"}
{"_id":"a792ce65-7546-4450-ac24-00620b88f909","text":"The discrepancy between DO and MD surgeons spans all levels of medical training, from medical students to academic faculty. Many osteopathic programs do not have direct partnerships with academic general surgery programs; thus, opportunities to find mentors and research opportunities are limited. Many osteopathic students have to go beyond their own institution to other residency programs and academic institutions to seek mentorship and research. This may have impacted both research opportunities and opportunities to network. To address this discrepancy, action must be taken by osteopathic medical schools and leaders of the field to ensure that DO students receive better access to mentorship and research support to foster an academic career.","title":"Cross-Sectional Study of Osteopathic General Surgeons in University-Based General Surgery Departments"}
{"_id":"a798a47b-07b2-0ea8-284d-a7a6fc21cfbb","text":"Table 2 Dangling protocol for patients in group A in the free flap group","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"a79f3f14-27cc-4e60-c617-ab23acd01140","text":"The animal study was reviewed and approved by SUNY Downstate IACUC.","title":"Red Light Phototherapy Using Light-Emitting Diodes Inhibits Melanoma Proliferation and Alters Tumor Microenvironments"}
{"_id":"a7a073d6-5285-2fec-c765-84aad826d2a7","text":"Due to the high and rising incidence of skin cancer, most health care providers will invariably encounter patients at risk for it. Therefore, our overall objective is to promote more patient counseling on skin cancer prevention, in order to aid in increasing patient awareness and potentially reducing the disease burden of nonmelanoma and melanoma skin cancer. As medical school curricula progress towards more integrative models of learning, sessions such as this one could provide simple and effective solutions for knowledge dissemination with a minimal time commitment and very low financial cost to achieve a lasting impact.","title":"A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence"}
{"_id":"a7a90409-21bc-d791-a64a-916c8920f75e","text":"In total, a variety of antibiotic substances and combinations were used for intravenous or oral treatment for the respective diagnosis. In patients where the causative pathogen was identified, initial treatment was effective in all but one child who presented with Kingella kingae osteomyelitis.","title":"Impact of a pediatric infectious disease consultation service on timely step-down to oral antibiotic treatment for bone and joint infections"}
{"_id":"a7ad531c-2c2a-dd5a-29df-7cb9f8e257aa","text":"In this review the Authors will refer to the most commonly used methods to cover soft tissues injuries affecting the dorsum and the palm of the hand and the forearm (excluding fingers). The aim is to show all flap reconstructive options so as to support the inexperienced surgeon during the management of traumatic injuries of the upper limb.","title":"Upper limb traumatic injuries: A concise overview of reconstructive options"}
{"_id":"a7b0e415-ef3a-48d9-ff75-172f44cabd14","text":"Materials: Patients with SC USG catheterization of the brachiocephalic vein from March 2013 to July 2017 installed in Pediatric Critical Care Unit.","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"a7bab8ff-47d4-3fca-2a0e-b17312610da0","text":"Gruen and Kline also recommend that the lesion should be carefully resected until normal appearing fascicles and a bit further both proximally and distally of the lesion and nerve graft should be interposed, if no action potential or if poor amplitude was recorded across the lesion. More extensive nerve resection is made to avoid that the interpositioned nerve graft may eventually deteriorate as well, leading to a longer graft and therefore to poorer results [34]. In our opinion, extensive nerve resection and following nerve grafting has to be considered in patients with more distal located focal lesion without muscle atrophy. Otherwise, there is always the possibility of worsening disability or pain after surgical treatment of the nerve. Those criteria meet only in a few cases so that nerve resection should usually not be performed.","title":"Modern treatment of perineuriomas: a case-series and systematic review"}
{"_id":"a7bcecef-b484-e41a-b64f-e4914a882ec6","text":"After the tourniquet was released, the skin paddle of the flap was not perfused. Assessment of the radial artery with pencil Doppler confirmed a pulse in the proximal artery but this was lost at the proximal end of the skin paddle. No pulse was obtainable within the borders of the flap. The distal artery clip was removed and there was no flow-through observed. A Fogarty catheter was then inserted from the distal end of the radial artery, however there was significant resistance towards the proximal end of the flap suggesting stenosis of the vessel. The catheter was passed proximal to the stenosis and on inflation and withdrawal of the catheter flow through the flap was able to be re-established however this was not sustained. A decision was made at this time to abort the RFFF. A left anterolateral thigh flap was raised without complication and used as reconstruction.","title":"The Allen’s test: revisiting the importance of bidirectional testing to determine candidacy and design of radial forearm free flap harvest in the era of trans radial endovascular access procedures"}
{"_id":"a7d8c9e6-82f5-9d4e-d258-bcf9aff43643","text":"This is a retrospective study of patients who underwent breast reconstruction and desired an enhanced postoperative nipple projection. The patients underwent a single session of injection with a hyaluronic acid filler as an outpatient. The filler was injected intradermally at the base of the nipple until the desired nipple projection was obtained.","title":"Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique"}
{"_id":"a7d8ccb1-ee56-8589-c714-e15f589ed665","text":"The combination of findings was indicative for a soft tissue infection with additional multifocal osteomyelitis, at the MTP I already with initial osseous destructions.","title":"Atypical Osteomyelitis Caused by Mycobacterium chelonae—A Multimodal Imaging Approach"}
{"_id":"a7dc5a49-f936-78ab-5e7f-4a9f41483461","text":"Ultrasound screening avoids unnecessary anticoagulation and identifies patients with early subclinical thromboses. One need not wait for a large proximal thrombosis to propagate unseen and undetected. As proponents of chemoprophylaxis point out, the presenting clinical sign of VTE may be sudden death.79","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"a7dd3118-3a13-1acb-741d-cdd30ac30878","text":"Prospective surveillance protocols, designed to assess both the optimal follow-up interval and use of imaging modalities will be critical in order to move forward. Based on our data, structuring a program tailored to risk of recurrence based on the time since diagnosis is one approach for future work. A proposed strategy for surveillance might be to combine routine physical exam with more sensitive radiologic modalities, eg CT or PET\/CT, for patients felt to be at high risk of recurrence based on current staging and prognostic information during the first year after diagnosis, as this was the highest risk period for in our overall population. Imaging and clinical exams could be performed at 3–6 month intervals depending on initial risk, and the follow up interval could subsequently be extended in the second and third years. With regards to specific subsets of patients, in this study, only a minority of patients underwent a sentinel lymph node biopsy. In the current era, sentinel lymph node assessment is considered at our institution for most patients with primaries >0.75 mm or thinner lesions with adverse features such as ulceration or an elevated mitotic rate. For patients who meet these criteria, but elect not to proceed with lymph node assessment, focused sonographic imaging and clinical exam of the lymph node basin may be a reasonable option, as a high proportion of nodal recurrences were seen in this study. The Multicenter Selective Lymphadenectomy Trial II (MSLT-2; NCT00297895), in which patients with a positive sentinel node are randomized to receive either serial ultrasound and clinical exams or completion lymph node dissection will hopefully address the utility of this strategy in patients with a positive sentinel lymph node. While the optimal follow up for patients who elect not to undergo any lymph node assessment remains undefined, the high rate of nodal relapse in this study suggests that this may be a reasonable option for this patient population as well. As the risk of recurrence peaked in the first two years in this study, intensive screening with radiologic studies and frequent physical exams beyond this point may be less useful, as relatively fewer recurrences would be detected. This study represents an initial step in creating a framework for future prospective evaluation of surveillance strategies by identifying high risk periods for recurrence. In the current era of resource management, a data driven method of surveillance for melanoma patients, as well as the determination of the most common sites of recurrence may allow for a defined surveillance strategy that is both cost effective and patient focused.","title":"Hazard-Rate Analysis and Patterns of Recurrence in Early Stage Melanoma: Moving towards a Rationally Designed Surveillance Strategy"}
{"_id":"a7df1555-5052-5f57-30de-f24b37fa3846","text":"Fine needle aspiration cytology (FNAC) was developed at the turn of the century and has become a popular diagnostic tool as it is rapid, painless, safe, inexpensive, does not require any anaesthetic or hospital admission and leaves no scar [3]. In addition to confirming the diagnosis of lymphomas, one of the important roles of FNAC is the exclusion of metastatic squamous carcinoma as this requires an alternative therapeutic approach. There is a question as to the accuracy of FNAC in the diagnosis of lymphomas as the tumours often contain malignant and reactive elements and the FNAC may only have sampled the reactive regions leading to false negative results. Another disadvantage of FNAC of lymphomas is that it does not provide the cellular architecture required for the accurate subtyping of the lymphoma.","title":"Does the surgeon still have a role to play in the diagnosis and management of lymphomas?"}
{"_id":"a7e18f10-3af4-8431-fb73-a2c3e4e44d8f","text":"A validated cryopreservation protocol is of high importance in research. In the first place to obtain reproducible results and in the second place cryopreservation offers the possibility to pre-select tissue at certain characteristics to be used in a study. Furthermore, if the same cryopreservation protocol is used it offers the possibility to combine synovial material obtained at multiple locations. An important effect we foresee by improving the availability of human synovial tissue for research is that this could lead to a decrease in the number of experimental animals. The possibility to perform more complex and larger experiments (for example drug compound testing) with human material instead of mice will prevent generation of results that cannot be translated to the human situation. Related to this is the increasing interest in precision medicine [33–35], followed by an increasing demand for human tissue. Precision medicine includes the adjustment and development of therapies and drugs for specific patient subsets with a similar genetic background, leading to for instance a similar response to treatment. This will improve healthcare by applying the best therapy to each patient, additionally this approach will be more cost effective and prevent possible side effects in patients not benefitting from a therapy. The development of precision medicine and the existing research lines using human synovial tissue of both pharmaceutical companies and universities are dependent on the availability of high quality patient material. By performing mechanistic and intervention studies, the development of new treatment options for OA would likely benefit from the use of cryopreserved synovial tissue.","title":"Functional Tissue Analysis Reveals Successful Cryopreservation of Human Osteoarthritic Synovium"}
{"_id":"a7ea5fa3-7eb7-8d4f-a6cd-449e363e5a8c","text":"P6 Intraoperative severe anaphylactic reaction due to patent blue v dye","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"a7f37195-2bc3-2861-c308-1c27aa168ff6","text":"These three commonly used tracers were selected for breast cancer SLNB in the present study.","title":"Comparative observation of common tracers in sentinel lymph node biopsy of breast cancer and a study on simplifying its surgical procedure"}
{"_id":"a7fa3bcf-8540-9160-87fb-9f0cc653353f","text":"Low patency rates of saphenous vein grafts remain a major predicament in surgical revascularization. We examined a novel expandable external support device designed to mitigate causative factors for early and late graft failure.","title":"Expandable external support device to improve Saphenous Vein Graft Patency after CABG"}
{"_id":"a7fd0099-9a3e-a2c9-27f6-73a59f3e800a","text":"After comparing the BT of the initial punch biopsy specimens with that of the wide excision specimens in the same patients, the higher value was considered as the final BT. For the other pathologic parameters, the worse pathologic findings between the initial punch biopsy and wide excision specimens were defined as the final pathologic parameters. To evaluate the survival rate among patients based on changes in BT, patients were classified into two groups based on a change in Breslow depth: the thickness was increased or decreased on comparing samples from the initial punch biopsy and final wide excision. In group 1, the BT of a punch biopsy specimen was equal to or greater than that of a wide excision specimen, and in group 2, the BT of a punch biopsy specimen was less than that of a wide excision specimen.","title":"Effect of changes in Breslow thickness between the initial punch biopsy results and final pathology reports in acral lentiginous melanoma patients"}
{"_id":"a8062d62-586e-cfc7-e1ca-817dcfb37d72","text":"In some cases, we used external splints for further immobilization of the grafted areas. The hidden donor site of the subgluteal crease was preferred. This was the back-hoarse area in our study due to its great advantage to give us a large sized skin graft with minimal and most hidden donor site morbidity. The possible two disadvantages are disturbance of subgluteal sulcus in some cases with poor planning. The second is that it has a thicker skin compared to other common donor sites. Although we found that thick skin was advantageous in certain clinical scenarios. Excision of the subcutaneous fat directly beneath the subgluteal crease is suggested to facilitate primary donor site closure and to recreate the crease back.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"a8068a7f-5ee4-f25d-d5f2-cfded089792d","text":"The role of mentorship and sponsorship of women by women is critically important in achieving maximum career potential, as demonstrated in recent papers in various surgical specialities [8]. This approach plays a crucial role in countries where there is a lack of exposure of women from the earliest stages of their careers to female role models or mentors [9]. European societies can play an important role in providing support for women who commence a career but who might subsequently become discouraged and abandon it, unless they receive this positive support. A recent review of mentoring programmes and scholarships sponsored by the WTS demonstrated that participation in these structured programmes was associated with successful pursuit of career milestones at significantly higher rates, likely due to fostering of a supportive community for women trainees [3].","title":"The impact of gender bias in cardiothoracic surgery in Europe: a European Society of Thoracic Surgeons and European Association for Cardio-Thoracic Surgery survey"}
{"_id":"a80b3b85-fe7f-b4f0-eaa5-30f36eac2926","text":"Patients generally deemed suboptimal for prepectoral reconstruction include patients with larger breasts, as these patients would require larger implants that could cause circulatory compromise in the skin flaps. Similarly, patients with significant ptosis are excluded from single-stage procedures as repositioning of the nipple-areola complex at the apex of the breast mound may lead to ischemic compromise. Patients that have undergone radiation either preoperatively or in an adjuvant setting are also at higher risk for complications. Our spacer technique allows for these skin flaps to recover before being filled to the appropriate size.","title":"Immediate Prepectoral Breast Reconstruction in Suboptimal Patients Using an Air-filled Spacer"}
{"_id":"a8171bb1-988f-284c-9ee3-405d19e32287","text":"The media has the greatest influence on vitamin D knowledge across households. New sun-safe strategies should be implemented at news outlets highlighting the benefits of UV exposure while indicating sun protective strategies which do not lower vitamin D levels.","title":"Attitudes, Behaviors, and Risks of Sun Protection to Prevent Skin Cancer Amongst Children, Adolescents, and Adults"}
{"_id":"a8188f90-9d24-8591-7b27-4b48cd26bde8","text":"These advantages make diode and erbium lasers popular choices for tissue retraction in dental practice, as they offer improved patient comfort and better clinical outcomes.","title":"A Comparative Analysis of Post-Retraction Changes in Gingival Height after Conventional and Surgical Gingival Displacement: Rotary Curettage, Diode and Er:YAG Laser Troughing"}
{"_id":"a81acd81-ea8e-e957-6053-a13f19a06998","text":"Information on the course of pregnancy, postnatal period and symptoms of dysfunction of the chewing motion system and other data obtained through interview and questionnaire are presented in table II, taking into account the distribution of the tests by gender.","title":"Evaluation of Stomatognathic Problems in Children with Osteogenesis Imperfecta (Osteogenesis Imperfecta − OI) − Preliminary Study Ocena problemów stomatognatycznych u dzieci z wrodzoną łamliwością kości (Osteogenesis Imperfecta − OI) − Badania wstępne"}
{"_id":"a81b9b05-3c5c-0b16-b731-7b3f63a0bbbf","text":"Considering the low risk of proximal extension distal DVTs and the low risk of finding an incident DVT after a first negative examination, our results are insufficient to support the routine repetition of the US examination.","title":"Ultrasound screening for asymptomatic deep vein thrombosis in critically ill patients: a pilot trial"}
{"_id":"a81fc8dc-4bab-912c-9ca3-09dbf8c02901","text":"CT is a sensitive imaging modality that can detect smaller bone lesions in sarcoidosis. It can provide detailed information on the extent and location of the bone involvement.","title":"Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis"}
{"_id":"a82a09ce-368a-be94-73a7-305e08b9df8c","text":"The IOUS surgical technique described thus far normally relies on the surgeon to mark the projected tumor margins on the skin of the breast before the first incision is made. The surgeon then inserts the probe into the wound multiple times in an effort to determine the relation between the tumor and the surrounding tissue once surgery proper has started. Once the excision has been completed, the specimen is examined ex vivo (i.e., ultrasound examination of the excised specimen), followed by additional shaving excisions if one of the excision margins if found to be too close to the edge of the tumor. In the COBALT trial, the authors used ultrasound during the entire procedure in order to gauge the distance of the resection line from the edge of the tumor in all directions and the entirety of the volume of the specimen without using any marker inside or around tumor.","title":"Intraoperative ultrasound in breast cancer surgery—from localization of non-palpable tumors to objectively measurable excision"}
{"_id":"a82a0a00-e61b-736b-887f-eed10700a209","text":"The approval of a medical product requires extensive and distinct clinical trials. Yet, the preselected group of volunteers who attend those clinical trials is limited. Every single person has a unique genetic profile affecting the functionality of any cell type of the immune system. It becomes obvious that drug-hypersensitivity reactions in most cases disorganize the adaptive immune system, resulting in severe cellular autoimmune reactions. In the past, these reactions resulted in the mandatory determination of distinct genetic profiles and at worst in the exclusion of patients from the desired medication. It is clear that these scenarios of hypersensitivity reactions following drug treatment represent an unpredictable challenge for the health care system.","title":"HLA-B*57:01\/Carbamazepine-10,11-Epoxide Association Triggers Upregulation of the NFκB and JAK\/STAT Pathways"}
{"_id":"a82cfdf5-5854-bf41-b73e-e92367b173dd","text":"The outcomes in most articles are clearly discussed but the outcome parameters or results of different test are not reported. Most of the authors did not use any parameters as CRP or erythrocyte sedimentation to define that infections were eradicated but they only mentioned that infection was eradicated in all or a part of the patients. The same problems of reporting data occurred at the bone growth and degradation of bone graft substitutes. Thereby, none of the studies described how they exactly measured bone growth and degradation of bone graft substitutes using imaging techniques.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"a82dc51b-43b9-a500-1d30-bdb8c85d9d25","text":"In patients with coronary artery disease, sudden cardiac death and myocardial infarction are the most common adverse events that occur. When these situations occur, the underlying pathology is in situ thrombosis, which is primarily caused by rupture of the atherosclerotic plaque of the underlying atherosclerotic artery, and rarely by erosion of the plaque itself. In similar ways, acute limb ischemia is characterized by sudden decreases in perfusion in the limbs that can lead to tissue loss and may require early intervention to prevent further complications.","title":"Acute Coronary Syndrome: Disparities of Pathophysiology and Mortality with and without Peripheral Artery Disease"}
{"_id":"a839c91a-a8e1-3706-555d-fa0b37dae16f","text":"Preoperative planning is a crucial step for any entire surgical procedure. A deep knowledge of the anatomical geometry of the patient is necessary to plan the best surgical strategy and to reduce the risk of surgical errors. Within this context, it is clear how important it is to use surgical simulators that allow the physician to simulate the operation before entering the surgical room, improving self-confidence and reducing stress during actual surgery [34]. Specifically, during this phase, the surgeon can test multiple surgical strategies in order to identify the best one in terms of results and timing. We have introduced a general pipeline to produce a low-cost 3D patient-specific anatomical model that would allow surgeons to conduct an accurate and successful preoperative planning process. The pipeline is the result of an analysis of literature on the use of 3D printing and tissue mimicking materials for education and surgical planning, and aims to introduce neurosurgeons and clinical engineers to a cost-effective and in-house preoperative simulation. The pipeline considers different fabrication methods that can be used based on the challenge and goal of preoperative planning, but are also strictly dependent on the specific pathological case. Different manufacturing choices can be made, but one of our objectives was to minimize production costs to make preoperative simulator usage more accessible and more common in clinical practice. We have reported our experiences with the neurosurgery team of Florence Meyer Children’s Hospital, focusing on four 3D printed models that were used to plan surgeries by following the pipeline proposed. The simulators produced allowed the surgeon to identify, in some cases, alternative surgical routes to the traditional ones, thus avoiding the risk of neurological deficits caused by a possible injury of healthy tissue. In addition, better surgical results have been obtained thanks to an in-depth knowledge of the volumes of diseased tissues and spatial relationships with other anatomical regions. In conclusion, the presented methodology aims to provide a clear and systematic procedure to make the creation of physical simulators in the clinical practice more affordable to provide benefits both for residents’ education and for senior surgeons involved in preoperative planning and simulation. Objective measurement of the surgical performance improvements requires a long-term observation of the clinical outcomes in a clinical trial. Using this perspective, future work will focus on the collection of quantitative experimental results on the improvement of surgeon performances using a simulator produced according to our methodology.","title":"Current Practice in Preoperative Virtual and Physical Simulation in Neurosurgery"}
{"_id":"a846f9aa-222e-383c-9d26-13626896787f","text":"This study also showed that free flap failure was associated with longer hospital stay, confirming previous results [46,47]. These previous studies reported that hospital stay was longer and hospital costs were higher in patients who did than in those who did not experience free flap failure in breast and head and neck reconstruction. It is therefore important to anticipate and pay special attention to patients with factors predictive of flap failure who are undergoing reconstruction of the extremities.","title":"Prognostic Nutritional Index is a Predictor of Free Flap Failure in Extremity Reconstruction"}
{"_id":"a84d3109-d35d-5404-3870-dcebe1a4087b","text":"In conclusion, this is one of the first studies to attempt to identify, quantify, and characterize international experiences available to general surgery residents within the general surgery residency training programs in the US. In a time of growing demand for surgical care worldwide and an increasing global health interest among US residents, these results will help pave the way for the development of future collaborations between general surgery residency programs and residents interested in providing surgical care abroad. Ultimately, these electives will help to develop well-rounded and globally diverse surgeons who are better able to care for patients of all nationalities both locally and abroad.","title":"Current status of international experiences in general surgery residency programs in the United States"}
{"_id":"a84ea98b-a5bc-cb31-f0f9-f465a68609a7","text":"In conclusion, desmoids arising in the lower extremity are extremely rare. They can mimic vascular tumors given their typical clinical and radiographic appearance. The possibility of an extremity desmoid tumor should be kept in mind when evaluating an extremity mass, but the diagnosis should be made only on the basis of a detailed histological examination. It is difficult to achieve complete resection because of their propensity for local invasion. For this reason, tumors should be removed as soon as possible after identification in order to achieve the most optimal resection possible.","title":"Extra-Abdominal Fibromatosis (Desmoid Tumor): A Rare Tumor of the Lower Extremity Arising from the Popliteal Fossa"}
{"_id":"a850be19-dc11-eb90-e85a-df33bedd1f5b","text":"Thirty patients with post-tumor resection of the face were reconstructed with free style local perforator flaps between January 2014 and November 2016. Doppler was used to identify the perforator vessels preoperatively.","title":"Free Style Perforator Flaps for Aesthetic Facial Reconstruction"}
{"_id":"a85a0552-1148-a157-d107-7eb5c9a42d0c","text":"Fracture after PAL technique occurred at the plate- bone-junction, which was the site of stress riser. Fracture of the tibial distraction callus and failure of the locking plate attributed to less stable fixation were also reported. Knowing these facts, we ensured our plates were stabilised by at least six cortices on each side and found neither fracture nor implant failure in our series. We preferred using a locking plate to ensure that an adequate number of screws could be placed in the limited space.","title":"Submuscular Plate Stabilisation After Lengthening: Standard and Modified Techniques"}
{"_id":"a85e764d-8ddd-c669-17db-5583bacc4d18","text":"To print vascularized skin models with complexity and resolution matching in vivo structures, print resolution needs to be improved and printing time reduced. The ability to bioprint hierarchical vascular networks while building complex tissues and the ability to recapitulate vascular flow in vitro [98] are critical for fabrication of transplantable organs.","title":"Skin bioprinting: the future of burn wound reconstruction?"}
{"_id":"a85f94ba-22cf-9564-b928-de46e865c99e","text":"The trend of fewer women in leadership roles and those women holding lower-ranking roles parallels the gender disparity in academic surgery, even though our data show women were found to have more advanced degrees than men. This suggests there is a systemic bias that exists not only in academia, but also within surgical organizations. It is possible that women may be gaining additional advanced degrees to compensate for their lack of leadership and publication rates when applying for academic positions or possibly pursuing these degrees in hope of becoming more qualified for leadership positions.","title":"Leadership Amongst Regional and National Surgical Organizations: The Tides Are Changing"}
{"_id":"a863c0b6-ecea-79dd-4056-ad02e31686fb","text":"A further point of interest is linked to the selective toxicity towards cancer cells by H2O2.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"a867a80a-0146-9f96-59f8-2d3c61068571","text":"Different strategies were undertaken during surgery to minimize complications due to PVDs if diagnosed preoperatively: avoid harvesting saphenous vein graft from the ischemic leg or inserting IABP through the stenosed femoral artery, higher bypass perfusion pressure was maintained in case of a stenosed carotid artery, vascular surgeon consultation was sought for any intervention needed, and recommendations for conduit harvesting before admitting the patient for elective surgery.","title":"Assessment of carotid artery stenosis and lower limb peripheral ischemia before coronary artery bypass grafting operations: a non-randomized clinical trial"}
{"_id":"a868fcca-69af-b234-a427-6db06b5cd1c4","text":"For digital artery repair we used vein graft. We insisted on the quality of debridement of the arterial ends for successful revascularisation.14 Some surgeons practice rerouting of an arterial pedicle from an adjacent digit but that technique results in the sacrifice of a major artery of the digit and a donor site problem as well.15 Our approach is to anastomose two or three veins end to end when possible or use an interpositional venous graft and close the skin defect using small local flaps or full-thickness skin grafts.7 However, we must follow the patient carefully for a long time as in any microsurgery procedure and be aware of the possibility of occurrence of a late arterial failure.16","title":"Finger avulsion injuries: A report of four cases"}
{"_id":"a86e62a8-b8ac-b7d5-e157-3e48347b4ec3","text":"A total of 65 of the 84 selected participants provided complete responses to the questionnaire. The demographic data of mothers and infants are shown in Table 1.","title":"Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace"}
{"_id":"a86f8ad1-c34b-5c66-bf0c-d72633cfdd08","text":"The most heroic and beautifully performed vascular and bony reconstructions are wasted without concomitant soft tissue coverage of these repairs. Suboptimal coverage can lead to prosthesis infection, subsequent hardware exposure, or loss with eventual amputation. The strategy of meticulous resection as well as reconstruction of bone and soft tissue works together for optimum results. This strategy may require additional microvascular skills on part of a single surgeon or two surgeons can work together as a team.","title":"Complex Biological Reconstruction after Wide Excision of Osteogenic Sarcoma in Lower Extremities"}
{"_id":"a87149d3-d9f1-931f-c210-70f761ea4d60","text":"The results of our study show that our flap specific complication rates are similar to those reported in major publications (Table 4) and examples of our complications are illustrated in Figure 4. We have demonstrated a distinct learning curve with a reduction in complications as the series progressed, which can be explained by modifications to the operative technique and peri-operative care as experience increases.","title":"Breast reconstruction with deep inferior epigastric perforator flaps"}
{"_id":"a877153b-4183-0c55-469a-3d6fe0b580e9","text":"Laimian stated that as the mission of health education guidelines are to warn against health threats, the requisite for effective training in controlling and preventing of breast cancer is attention to the structure of attitudes of women and proposed approach to encourage health monitoring (27).","title":"Women’s Perspective of Breast Self-examination"}
{"_id":"a8792535-d1ae-0d7d-fb33-6f30e32275ac","text":"The same factors from the previous discussion apply to both NIRS and VLS; the higher power spectral density of the sources used and the better photon capture capabilities of the point detectors compared to a spectrometer mean that the performance of the proposed system can be much higher (in fact, the studies that preceded the development of the system presented in this article were performed with such systems). Compared to these methods, the main shortcoming of the proposed DRS system is its inability to provide tissue oxygen saturation, which may be useful in some situations (although it is true that this is a measure that can be achieved by increasing the number of interrogation wavelengths of the system). Nonetheless, an important aspect that distinguishes the system here presented is the, comparatively very low, cost of implementing a potential final commercial instrument, as both hyperspectral systems and optical spectrometers are notoriously expensive pieces of equipment. It could be added that an advantage common to all the systems analyzed above is that they do not require specially trained professionals to interpret the results obtained, which are a clear representation of the hemodynamic scenario present in the measurement area.","title":"Design and testing of an optical instrument for skin flap monitoring"}
{"_id":"a87ea080-2531-03a1-a2fa-88a20e9b526a","text":"We found only one scientific publication on behavioral differences at work and at leisure in outdoor workers; a Canadian study reporting significantly better use of shirt with sleeves and hat as well as slightly better overall sun protection behavior at work than at leisure [55]. We found no studies comparing outdoor and indoor workers use of sun protection at leisure and on sun holiday.","title":"Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers"}
{"_id":"a883d0eb-18d7-f535-bf57-c9994be88ce5","text":"The citations retrieved from each search were stored in commercially available reference management software.1 Electronic and hand scanning of the resultant citation library containing the citations from all searches was performed to identify any duplicate citations. If duplicity or multiplicity of the same citation was present, only the most complete citation was retained. Reviewers performed hand searching of article reference lists as the review progressed to identify other potentially relevant citations. If a potentially relevant citation was identified by this method, it was manually added to the citation library on the reference management software.","title":"A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs"}
{"_id":"a8876ccb-79c7-aed7-2b6e-d0ee9373cbd3","text":"Legal educational background: take the proportion of the number of top managers with legal educational background to the size of the top management team.","title":"The Influence of Top Managers on Environmental Information Disclosure: The Moderating Effect of Company’s Environmental Performance"}
{"_id":"a888426d-24ba-1850-8814-8dd696c3ae1a","text":"We also elected this approach to reduce surgical risk and morbidity associated with surgery. The use of C1-2 fusion is a known safe treatment for atlanto-axial instability and has been extended as a treatment for painful arthritis. Some authors have even recommended occipital cervical fusion to treat associated occipital cervical instability and adjacent segment disease. This indirect treatment demonstrated radiographic improvement with good functional outcome.","title":"Retro-Odontoid Pseudotumor with Cervical Medullary Compression: A Case Report"}
{"_id":"a88ffe1c-fa5d-89c9-cb28-63593c0a7e01","text":"the probability of positive SLNB exceeds 10%. Thin melanomas (< 1 mm) are divided into T1a (< 0.8 mm, non-ulcerated) and T1b (> 0.8 mm but < 1 mm or ulcerated). The SLNB positivity probability is below 3% in T1a melanomas but can be up to 5–10% in T1b melanomas,","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"a8b1ecd0-464e-8368-76da-a0f193fc2253","text":"The study was conducted in accordance with the 1975 declaration of Helsinki and under Institutional Review Board approval.","title":"The benefit of antibiotic-combined Mg-hydroxyapatite bone graft substitute over autologous bone for surgical site infection prevention in posterolateral spinal fusion: a retrospective cohort study"}
{"_id":"a8b6ef9f-2078-05cb-4187-62a5c626ed5b","text":"There are shortcomings in the current traditional ways of sentinel lymph node detection. Sentinel lymph node mapping by ICG fluorescence in patients with oropharyngeal cancer is a new potential method of demonstrating the first station lymph drainage basin as well as the associated lymph drainage patterns as it allows for direct visualization. Further development with controlled studies in this field is needed.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"a8b7cd9a-3924-8cca-b663-36b5817687f5","text":"The characteristics of this system is requirement of threading sensors and measurement of regional oxygen saturation almost 2 or 3 cm beneath its sensors. Consequently, this is especially suitable for buried flap with no skin paddle and can be acceptable in case of skin graft over muscle flap, while it is unfitted for monitoring of shallow region in thin flap or intraoral reconstruction.","title":"A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy Takasu et al"}
{"_id":"a8c062d4-a9fa-ce49-1d20-08bbd7c4b461","text":"En bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy has now been replaced by radical wide excision and selective inguinal lymphadenectomy based on the stage and location of invasive vulvar cancer. Early stage lateral cancers can be effectively treated by radical wide excision and ipsilateral superficial inguinal lymphadenectomy. Lymph node mapping using perilesional injection of radiocolloid and blue dye may identify sentinel lymph nodes which can be removed, thereby avoiding the morbidity of full inguinal lymphadenectomy in selected patients with early stage disease.","title":"Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva"}
{"_id":"a8c3c127-ea99-a30f-cf94-c1e37238ef47","text":"Both the conventional and modified surgeries were performed by one skin crease incision. The width of the double eyelid line incision was designed to be less than the width of the tarsal plate. After skin incision, the portion of the orbicularis oculi that covers the upper third of the tarsal plate was removed, and then the orbicularis oculi and orbital septum were separated in the direction of the eyebrow direction up to just below the supraorbital margin. The orbital septum was opened while the eyeball was gently pressed to remove the proper amount of extruding preaponeurotic fat. The FM flap was separated from the orbital part of the orbicularis muscle by subcutaneous separation at the lower edge of the eyebrow.","title":"Comparative evaluation of conventional and modified frontalis muscle flap advancement techniques in the treatment of severe congenital ptosis: A retrospective cohort study"}
{"_id":"a8cf9aca-2cd2-9455-8581-e2c82d73943e","text":"A major issue in follow-up is the management of preventive hormone therapy. 75% breast cancers are hormone dependent and thus susceptible to hormone therapy. In a survey of breast cancer specialists in the UK the management of this therapy was highlighted as the most important aim of follow-up [29]. Preventive treatment and the management of chronic disease is typically the premise of General Practice not the specialist unit at the hospital. In the light of new preventive treatments available and the need to monitor long term side effects such as osteoporosis, it is likely that the majority of this care should be transferred to General Practice where informational needs for local support networks and other services could also be more easily met.","title":"Options for early breast cancer follow-up in primary and secondary care - a systematic review"}
{"_id":"a8d5ed74-0e9b-30f7-8e41-bad9b105c3b0","text":"When participants have returned all the medication packages prescribed during the study period at week 48, the medication packages will be weighed by a blinded assessor and returned to study participants.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"a8d8da03-0c55-92e0-8c7d-191d5793edd7","text":"This was followed by 50 Gy in 25 fractions of conventional radiation to the left neck completed by October 2014. The radiation was given with concurrent pembrolizumab. He had no side effects from the combination treatment.","title":"High-Dose Radiation as a Dramatic, Immunological Primer in Locally Advanced Melanoma"}
{"_id":"a8e02ade-d0e1-8cf8-cb7f-f352fcd48e24","text":"Patients suffering from dental phobia and SPR will experience good patient satisfaction after implant treatment under general anesthesia.","title":"Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study"}
{"_id":"a8e0a15d-04b0-04a6-bbd5-4e38cd3ea11e","text":"All animal procedures were performed in accordance with the approval of the Committee of Bioethics and Biosecurity from the Pontificia Universidad Católica de Chile.","title":"Pannexin-1 Channels Are Essential for Mast Cell Degranulation Triggered During Type I Hypersensitivity Reactions"}
{"_id":"a8e81404-666d-efdc-893b-64ca164642e3","text":"CEUS is probably superior to DUS in terms of diagnostic accuracy for the follow-up of patients with iliac vein stent stenosis.","title":"Doppler ultrasound and contrast-enhanced ultrasound in detection of stent stenosis after iliac vein stenting"}
{"_id":"a8f0d71b-32de-b768-f1fe-91f9425e985e","text":"P30 Characterization of erythema multiforme and severe cutaneous adverse reactions hospitalizations","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"a8fa04db-91fe-2d6a-3980-4e41610ac8b0","text":"Our results are quite different from literature needing further multicentric studies on NMSC to clarify the difference.","title":"Non-metastatic Non-melanoma Skin Cancers: Our 3 Years of Clinical Experiences"}
{"_id":"a90c8501-9e0f-b67a-6173-d9662239304f","text":"Previously failed screw fixation with or without bone grafting can be encouragingly treated with a vascularized MFC graft, leading to satisfied patients thereafter.","title":"Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union"}
{"_id":"a90f689b-06dc-3ade-8a18-6cdcac9f2420","text":"Plain X-rays and CT are specifically useful to image the degree of fracture union and to search for small sequestra, but are less suitable for determining the exact localisation of infected bone.","title":"Accuracy of diagnostic imaging modalities for peripheral post-traumatic osteomyelitis – a systematic review of the recent literature"}
{"_id":"a91119f3-d06c-a39c-e85b-304ae85efb2e","text":"In summary, our data provides further support for the favourable outcome following margin control in the excision of DFSP. This approach demonstrates very low recurrence rate with optimum conservation of normal tissue, and would be the treatment of choice for DFSP.","title":"Dermatofibrosarcoma protuberans treated by micrographic surgery"}
{"_id":"a912dd41-122f-49e7-8e46-3da2224ef177","text":"Developing cartilage constructs with injectability, appropriate matrix composition, and persistent cartilaginous phenotype remains an enduring challenge in cartilage repair. Fourteen patients with minor contour deformity were treated with fluid cartilage filler gently injected as autologous fluid graft in deep planes of defect of the nose that were close to the bone or the cartilage. A computerized tomographic scan control was performed after 12 months. Pearson’s Chi-square test was used to investigate differences in cartilage density between native and newly formed cartilages. The endpoints were the possibility of using fluid cartilage as filler with aesthetic and functional improvement and versatility. Patients were followed up for two years. The constructs of fluid cartilage graft that were injected in the deep plane resulted in a persistent cartilage tissue with appropriate morphology, adequate central nutritional perfusion without central necrosis or ossification, and further augmented nasal dorsum without obvious contraction and deformation. This report demonstrated that fluid cartilage grafts are useful for cartilage regeneration in patients with outcomes of rhinoplasty, internal nasal valve collapse, and minor congenital nose aesthetics deformity.","title":"Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage"}
{"_id":"a9132289-11cc-4a68-b835-31ec30a436af","text":"For partial breast PBT most adverse outcomes were graded as mild and there were no severe adverse outcomes from scanning PBT to the partial breast. However, the main justification of the extra cost of PBT compared with standard photon radiotherapy is the predicted reduction in the risks of cardiovascular disease and second cancers. For partial breast photon radiotherapy, these risks are likely to be very small for most patients because radiation doses to the heart, lungs and esophagus are usually <1Gy. Therefore it is more difficult to justify the excess costs of partial breast PBT compared with partial breast photon radiotherapy.","title":"Proton Beam Therapy for Early Breast Cancer: A Systematic Review and Meta-analysis of Clinical Outcomes"}
{"_id":"a9199b60-4d77-1586-1f90-2fe421044a58","text":"The aim of this study was to report the outcomes of ipsilateral fibular transposition using the Huntington procedure for the reconstruction of tibial defects in paediatric patients.","title":"The Huntington procedure: still a reasonable option for large tibial defects in paediatric patients"}
{"_id":"a91f3ad8-731e-8219-43a7-caade41fa08b","text":"The treating surgeon will determine the final grade of the open fracture at the end of the debridement of the wound as per routine practice in the operating theatre, and then patients will automatically be enrolled into the study via the online randomisation system.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"a921ae9c-fe04-c262-1274-833723935576","text":"While spondylolisthesis of the lumbar spine is a common disease, only a few cases of cervical spondylolisthesis have been well-documented. Compression of the lumbar spine results in a milder neurologic impairment than compression of the cervical spine, mainly due to the spinal cord ending around the level of L1. Even minor anatomical changes in the cervical region can lead to cervical myelopathy and paralysis.","title":"Operative management of a non-traumatic cervico-thoracic spondylolisthesis: a case report"}
{"_id":"a92b343d-6dfc-ac68-15c5-fe69c7cd281a","text":"Intracavitary application of brachytherapy sources followed by external beam radiation is a common practice in radiotherapy of carcinoma of the cervix. Since the application of brachytherapy sources results in characteristic dose distributions, modulated external photon beams should be added in a way to achieve the desired cumulative dose distribution over the target volume. Several techniques used in practice have been described.1–4","title":"Dosimetric verification of compensated beams using radiographic film"}
{"_id":"a92d281a-7fb9-43ef-0302-157ac71f008b","text":"Skin defects of the nose can be a surgical challenge for facial plastic surgeons. Often, invasive surgery of the nose is accompanied by aesthetic issues for the patient. Hence, following invasive surgery of the nose, a reconstructive procedure should be performed to correct the morphological and aesthetic issues. This can help to restore the aesthetic features of the nose. Of the several reconstructive procedures available for nasal tip defects, the axial frontonasal flap is regarded as a good option for nasal tip reconstruction. Herein, we describe our experience with the axial frontonasal flap for the reconstruction of nasal tip defect in 15 patients. We also would specify the indications for the use of this flap and describe in detail the surgical technique.","title":"The Axial Frontonasal Flap for Nasal Tip Defect: A Single Centre Experience"}
{"_id":"a9306e70-1156-ec63-258a-062cbcdbf6fa","text":"The ideal substance for injection must consistently provide pleasing cosmetic results with low side effects despite repeated use. CosmoDerm (Inamed Aesthetic) is a recombinant human collagen that is grown from a single tissue cell line and is resorbed by 9 months. This temporary soft tissue filler has been used successfully to define the lip roll and is amenable to small rhytid treatment.","title":"Lower Lip Necrosis"}
{"_id":"a93deb31-b67d-7736-a7be-1f2a5efa718a","text":"In our early experience, VEIL was a safe and feasible technique in patients with penile carcinoma with non palpable inguinal lymph nodes. It allows the removal of inguinal lymph nodes within the same limits as in conventional surgical dissection and potentially reduces surgical morbidity.","title":"Video Endoscopic Inguinal Lymphadenectomy (VEIL) -a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma"}
{"_id":"a93f9669-d20b-5ffe-fdd4-8d0576717782","text":"The bone may be harvested from either the lateral or the medial edge of the scapula. The lateral scapular bone flap, based on the vertically oriented parascapular branch of the circumflex scapular artery, has a shorter vascular pedicle but is thicker. The medial scapular bone flap, based on the horizontally oriented cutaneous scapular branch of the circumflex scapular artery, is thinner but associated with a longer pedicle and minimal disturbance of the teres major and minor muscles and the glenohumeral joint, resulting in less postoperative shoulder stiffness. Approximately 10 to 14 centimeters of linear bone may be harvested from either the lateral or medial aspect of the scapula.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"a94132fd-6b5c-ca54-a18a-86b7d0a3666d","text":"PET\/CT is a powerful imaging tool that can provide important information for the diagnosis and management of periprosthetic infections of the hip joint. PET\/CT has several advantages over traditional imaging modalities such as X-ray and MRI in the evaluation of periprosthetic infections. Synthesizing the evidence showing its accuracy will help to inform the clinicians and decision makers to add the imaging technique to the guidelines and make it a standard protocol for these patients. Hence, this review was done to find the accuracy of PET\/CT for diagnosing the periprosthetic infection of the hip.","title":"Diagnostic accuracy of positron emission tomography\/computerized tomography for periprosthetic joint infection of hip: systematic review and meta-analysis"}
{"_id":"a9483cc7-25ca-e6a3-1b57-9f5faa8f35cf","text":"The combination of predisposing factors, symptoms and clinical findings allows the classification of patients with suspected VTE into different categories of clinical probability of VTE, which correspond to a higher actual prevalence of confirmed PE. This pre-test assessment can be done empirically or by using prediction rules which are a key step in the diagnostic algorithms of VTE.","title":"Diagnostic Approach for Venous Thromboembolism in Cancer Patients"}
{"_id":"a94af511-ea65-8ed5-f3e5-9206ea4e97d9","text":"Trainees not only have the opportunity to access services through the OSA, but also serve and develop foundational competencies to eventually serve in an OSA leadership position. This workshop provided trainees early exposure to OSA administration to realize a career in academic medicine beyond the faculty role.","title":"Office of Student Affairs: Engagement and Leadership Opportunities for Medical Students, Residents, and Fellows"}
{"_id":"a952cc4e-eb18-a581-f4af-5173b6d1f41c","text":"The patient reported the appearance of new lesions on the hands immediately after the second dose.","title":"Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases"}
{"_id":"a956a5bc-c20d-71c1-ee63-2f09b2478a2a","text":"We present a unique case of a patient with a presumed delayed traumatic cervical spinal epidural hematoma revealed to be a spinal epidural abscess requiring surgical intervention.","title":"Delayed Presentation of a Cervical Spinal Epidural Abscess of Dental Origin after a Fall in an Elderly Patient"}
{"_id":"a9579393-1f52-7935-b83a-72dfcf34aec9","text":"In this review the state of the art of various strategies concerning topical delivery of active compounds to skin structures have been taken into consideration, described and discussed in view of their potential interest in the targeting of stem cells.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"a95d2d84-bd13-6e47-b360-17bcb032db68","text":"The recognition of the regenerative properties of lipoaspirate in radiated fields is leading to the simplification of breast reconstruction in this otherwise complicated patient population. The optimal strategy for this requires knowledge of the harmful effects of radiation, their time course, and the biomolecular pathways by which lipoaspirate reverses them. Though not yet fully understood, it is clear that applying autologous lipotransfer can significantly improve breast reconstruction outcomes in irradiated patients. The ease of these fat-grafting procedures along with their use and application throughout the body makes them very well-known to most plastic surgeons and may be leading to a paradigm shift in approaching the radiated breast. This has the potential to improve options and access to reconstruction for this ever-growing patient group.","title":"Lipotransfer Strategies and Techniques to Achieve Successful Breast Reconstruction in the Radiated Breast"}
{"_id":"a962d1e0-055b-67ca-c2a8-c6ad94b0b3f0","text":"Mohs micrographic surgery is commonly used to treat in situ and invasive basal cell cancers and squamous cell cancers. “Slow Mohs” is a variant of Mohs micrographic surgery in which the tissue is sent for immunohistochemistry but undergoes “complete margin assessment.” While a survey demonstrated that the use of traditional Mohs by Mohs fellowship trained dermatologists is relatively uncommon for melanoma in situ and invasive melanoma (11% and 4%), the use of “slow Mohs” for melanoma in situ and thin invasive melanomas (less than 1 mm in invasive thickness) is more common (67% and 44%, respectively). Seventeen percent of Mohs fellowship trained dermatologists also utilize “slow Mohs” for invasive melanomas that are 1 mm in thickness or greater [22]. While the technique is used by many dermatologists, there is tremendous variation in the details of the technique used beyond the broad categories of standard versus slow Mohs. Variations were noted in the use of debulking excisions and the minimum size of the peripheral margin during the first stage of excision [23]. A prospective randomized trial comparing standard pathologic assessment “bread-loafing” wide local excision versus complete margin assessment wide local excision for melanoma in situ and T1a melanomas commonly used in Mohs micrographic surgery has been proposed led by Dr. Wesley Yu through the SWOG cancer cooperative group. Currently, Mohs micrographic surgery is not recommended by the NCCN (National Comprehensive Cancer Network) Guidelines as the standard treatment strategy for primary cutaneous melanoma [24].","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"a962d54b-a3f3-4941-6ddc-96011a50d7ef","text":"This study was not without limitation. As we had limited number of individuals in some of the categories, all variables in our database were not applicable in the final model due to the limited number of data. Taking into consideration that individuals who were recently (less than 10 years from their initial diagnosis) added to our registry may not have had the chance to present signs of recurrence, we considered those without recurrence of more than 10 years from their initial diagnosis of BC and this decreased the size of the comparison groups.","title":"Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?"}
{"_id":"a965ccec-c626-2e15-18d4-8f7a945adab3","text":"Computed tomography (CT) has been used to obtain a better visualization of invasive root resorption, and is a useful resource to provide an accurate diagnosis of the extension and location of the resorption. Although it is not always necessary, CT can be very helpful in some cases to overcome the difficulties of conventional radiography is distinguishing the lesion from normal anatomic structures. This is advantageous to both patients and clinicians for addressing the treatment strategy more comprehensively.","title":"Comparison between two tomographic sections in the diagnosis of external root resorption"}
{"_id":"a9673ba3-8ba4-718b-f478-12d6ee594072","text":"The utility of external beam radiotherapy for the treatment of malignant brain tumours is compromised by the need to avoid excessive radiation damage to normal CNS tissues. This review describes the current status of targeted radiotherapy, an alternative strategy for brain tumour treatment that offers the exciting prospect of increasing the specificity of tumour cell irradiation.","title":"Targeted radiotherapy of brain tumours"}
{"_id":"a9697376-d473-a598-c41d-014bb6c6d813","text":"Their use has to be limited to patients with small tumors in low-risk locations who are not candidates for standard ablative treatment.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"a97701a4-8776-f0d8-e315-3f451316afd0","text":"Recent studies have clearly demonstrated the relevance of miRNAs in regulating the cellular metabolism in several human diseases, but their role in the desmoid tumor remains substantially unexplored.","title":"Human microRNA expression in sporadic and FAP-associated desmoid tumors and correlation with beta-catenin mutations"}
{"_id":"a9867b2b-6b50-94f8-0fdb-3f4c5aa732fa","text":"The cases selected for the use of BTA underwent comparison against a previous audit of all (33) laparostomies undertaken at the same centre from 2010 to 2017, which did not involve the use of BTA. No adjustment was made in order to validate the comparison due to the low number of cases.","title":"Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases"}
{"_id":"a9a6f568-2f3b-d796-d0b8-639ab2f72815","text":"LiJun was adopted from China at the age of three years. She had been abandoned as a young baby and placed in an orphanage where she lived until adoption. Staffing levels in the orphanage were low and while it appeared that the carers had a genuine affection for LiJun they could not provide individual care or a stimulating environment. Thus, at placement LiJun was developmentally delayed and exhibited other symptoms associated with long-term institutionalisation. The transition to her adoptive family was abrupt and LiJun was overwhelmed and very distressed by what was happening to her. However, the morning after placement she started interacting with her new family showing an immediate preference for her adoptive father. While LiJun appeared generally happy during the day she had great difficulty going to sleep and would also frequently wake during the night at which time she expressed anger or sadness in her cries. During her night distress she vehemently rejected her mother but would accept comfort from her father.","title":"Mental health, attachment and breastfeeding: implications for adopted children and their mothers"}
{"_id":"a9ae2db5-a09a-6023-3d18-84099008a1f3","text":"How did medical school prepare you for these kinds of challenges?","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"a9b231ff-a1bd-a4e2-e204-a3f7f5179913","text":"Table 2 Pooled estimates of sensitivity and specificity stratified by US technique","title":"Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis"}
{"_id":"a9b355ed-dd84-0954-d9b6-ca70e85919ce","text":"This pragmatic randomised controlled trial will compare standard dressings with negative pressure wound therapy in the treatment of wounds associated with open fractures of the lower limb.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"a9b699d0-258b-35b9-b088-b03accf437af","text":"This study might contribute to reducing the frequency of CT scans in orthopedics. CT is useful as it provides a large amount of information and can be applied to accurate 3D reconstruction, albeit at the expense of higher radiation exposure and medical costs. Our method of 3D bone reconstruction from X-ray images incurs much less radiation exposure. Thus, it is expected to partly solve one of the problems in CT and would be potentially useful in the clinical field.","title":"2D–3D reconstruction of distal forearm bone from actual X-ray images of the wrist using convolutional neural networks"}
{"_id":"a9b97489-d2f5-4a91-8404-8073f299b678","text":"In recent years, the use of general anaesthesia has increased in and outside of the operating room because of an increase in patients with cancer and cerebrovascular disease and with changes in disease structure. While there are many reports on PBT showing good therapeutic results in cancer treatment, an optimised treatment plan is required for highly accurate treatment. This requires time for proper alignment, immobilisation during irradiation, and general anaesthesia or sedation to suppress body movement. Given that general anaesthesia and sedation need to be performed several times daily, it is important to properly select subjects who are most in need of anaesthesia. While it has been considered safe for PBT to be performed under general anaesthesia in children, little information is available on the indications for general anaesthesia among patients who receive PBT.","title":"Age as a decisive factor in general anaesthesia use in paediatric proton beam therapy"}
{"_id":"a9bdcd62-1982-4e31-b267-7158efedcb07","text":"A rigid simulator part is certainly appropriate to reproduce the bone tissue but also, when needed, to reproduce a rigid replica of the soft tissues. The latter is preferred when neurosurgeon does not need to interact with the simulator through real surgical instruments, but instead needs to simply train the proprioception and observe the spatial relationships between the anatomical elements. When the simulation requires distinguishing soft tissues from rigid tissues, the soft parts are fabricated by casting silicon materials in rigid shell molds, thus following the same fabrication process of other rigid parts.","title":"Current Practice in Preoperative Virtual and Physical Simulation in Neurosurgery"}
{"_id":"a9c07c42-963d-ea74-ce16-69b3e88a47fb","text":"The motives for seeking subspecialty training are numerous and varied. Plastic surgeons seek subspecialty training in order to obtain additional expertise in a narrow field so that they can provide superior patient care. Some seek fellowship training in order to reach a sense of mastery in a subspecialty field [19]. Some pursue fellowship training because they find one particular subspecialty more satisfying and wish to limit their practice to that area. On a less altruistic note, subspecialty training may be pursued to achieve a marketing advantage over colleagues who practice the specialty more broadly, or to attain a higher level of job security. Other motives include seeking a higher professional income and searching for a safe harbor in terms of the threat of malpractice litigation [19].","title":"Sub-specialization in plastic surgery in Sub-saharan Africa: capacities, gaps and opportunities"}
{"_id":"a9c9b062-c0c6-32b3-24db-554938c4cfbc","text":"This report represents the first documented use of NPWT to aid healing of an actively infected, open wound following extensive surgical debridement 10 days post-Cesarean section, confirming both the efficacy and tolerability of NPWT for the treatment of severe bacterial cellulitis in obstetric debridement.","title":"Negative pressure wound therapy aids recovery following surgical debridement due to severe bacterial cellulitis with abdominal abscess post-cesarean A case report (CARE-Compliant)"}
{"_id":"a9ce52df-e2b9-792c-705b-f4135df7c38f","text":"It is also important in the initial planning not to destroy possible options as the opposite donor site. This was the reason in our case to choose the second in order reconstructive option and not to go for the contralateral radial forearm flap.","title":"Dorsalis Pedis Free Flap: The Salvage Option following Failure of the Radial Forearm Flap in Total Lower Lip Reconstruction"}
{"_id":"a9cf64bd-72b6-5d40-d8f1-c0bcf987b898","text":"Figure 3 shows a schematic of measuring blood flow in a free jejunal flap. It takes only about one minute to the measurement preparation of laser speckle flowgraphy. We measured the blood flow of the flap before the main nourishing vasculature had been separated and after the artery and the vein had been anastomosed and the flaps had been sutured. For surgery involving the mesopharynx and the nasal cavity, after the flaps had been sutured the laser could not be applied vertically. Therefore, it is not possible to measure blood flow accurately following placement, so it was measured during sewing.","title":"Free Flap Blood Flow Evaluated Using Two-Dimensional Laser Speckle Flowgraphy"}
{"_id":"a9cfa3d9-b065-5ec0-334b-3b26116ab2e6","text":"For this reason, we conducted this randomized study to investigate the clinical need for anticoagulant prophylaxis to prevent postoperative VTE in patients who undergo laparoscopic CRC surgery.","title":"Efficacy and safety of anticoagulant prophylaxis for prevention of postoperative venous thromboembolism in Japanese patients undergoing laparoscopic colorectal cancer surgery"}
{"_id":"a9d40b97-958c-4e47-25af-4f9f0a421d8a","text":"Third, after 3 months of age, frenuloplasty with 2-flap z-plasty or 4-flap technique yields greater absolute improvements in tongue mobility and speech metrics when compared with the traditional horizontal-to-vertical frenuloplasty, and frenuloplasty is associated with decreased reoperation when compared with the traditional frenotomy.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"a9d491e5-3647-565d-9b70-fdc0d6a044cd","text":"Successful treatment of uveal melanomas with preservation of the eye and visual function is one of the great achievements in oncology in the twentieth century. Plaque brachytherapy as well as external beam radiotherapy with charged particles therapy (CPT) can achieve very high rates of local control and play an important role in eye preservation. However, it is still challenging to optimize radiation treatment especially in larger tumors with regard to tumor control, visual outcome and treatment related side effects.","title":"106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma"}
{"_id":"a9d58dba-6533-a588-efc9-2b3297339966","text":"Summarizing that AI has made significant contributions to the field of plastic surgery, revolutionizing various aspects of patient care and surgical procedures. Here are some key roles of AI in plastic surgery:","title":"Artificial Intelligence Revolutionizing Plastic Surgery Scientific Publications"}
{"_id":"a9d9714c-2475-81e8-40fe-6c630fb58135","text":"During the perioperative period, all rules for hygienic prosthetic surgery are followed meticulously to reduce the likelihood of bacterial contamination. Patients with implant reconstruction will receive one prophylactic dose of an antibiotic 30 min before surgical incision and two doses in the 24 h after surgery. The drains remain in place until the output is less than 20 ml within 24 h for 3 consecutive days.","title":"Patient-Reported Outcomes and Complications Following Breast Reconstruction: A Comparison Between Biological Matrix-Assisted Direct-to-Implant and Latissimus Dorsi Flap"}
{"_id":"a9de15d9-7732-4b6a-c2b5-6f266ba79f89","text":"Table 3 shows a sensitivity analysis of mean patient costs using NPWT and standard treatment. While some changes did occur with respect to the mean difference in cost, patients allocated to NPWT had consistently higher costs.","title":"Cost analysis of negative-pressure wound therapy versus standard treatment of acute conflict-related extremity wounds within a randomized controlled trial"}
{"_id":"a9e3b4c2-dee0-1acf-e626-6bd9ac0dad4a","text":"Primary chest-wall tumors are infrequent, and they represent a wide and heterogeneous group of neoplasms that includes both benign and malignant neoplasms","title":"Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience"}
{"_id":"a9ea490d-d364-5c0f-70eb-584a461ea5ea","text":"Controlled data for the longevity of the filler materials published by the manufacturing company may not always be available. Both this and the fact that individual results may vary should be explained to the patient.","title":"Dermal Fillers: Do's and Dont's"}
{"_id":"a9f1bd33-33ba-fd30-2c41-0a691b17261c","text":"Several studies have reported that women with clear margins after surgery for DCIS have lower rates of local recurrence than do women who have involved margins,12 23 24 25 as does our study. Although guidelines recommend that margin widths do not need to be more than 1 or 2 mm,22 26 our study suggests that having margins greater than this may confer some further benefit. Further studies examining margin distances in DCIS may be helpful provided that they differentiate between occurrences of invasive breast cancer and recurrences of DCIS, consider precise margin width rather than just broad categories, consider different treatment groups separately, and have sufficient power in terms of numbers of women and length of follow-up.","title":"Invasive breast cancer and breast cancer mortality after ductal carcinoma in situ in women attending for breast screening in England, 1988-2014: population based observational cohort study"}
{"_id":"a9fbcd87-aadd-57e7-a118-d855f39d1314","text":"Secondary skin closure after NPWT has been attempted successfully in our institution for several years as we increasingly saw successful results. However, the lack of literature on secondary skin closure of infected wounds after NPWT preconditioning prompted us to retrospectively analyze our practice of secondary skin closure in 200 consecutive cases in which a secondary skin closure was attempted when the patient and wound condition appeared suitable for it. As a secondary skin closure bears several advantages to the patient, this treatment option has become the primary treatment choice at our institution. In our retrospective analysis, we see that patients who did not receive a secondary skin closure most likely had prohibiting factors for a secondary skin closure. Naturally, a comparison between these two groups is not feasible but the analysis of patient and wound characteristics might shed light on the following questions:","title":"Successful surgical closure of infected abdominal wounds following preconditioning with negative pressure wound therapy"}
{"_id":"a9fea26b-efa0-0e84-7290-7566031b8098","text":"Participants in this group will receive TEA treatment at two predefined points once a week for eight weeks. Point selection and details of this procedure were based on a consensus of clinical experts and modified from those used in previous study [22].","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"aa0350e6-1126-45f9-180a-c4a81631e046","text":"SC and AP wrote the first manuscript draft and critically contributed to the final version of the manuscript. All authors contributed to the article and approved the submitted version.","title":"Editorial: Immune Responses to Persistent or Recurrent Antigens: Implications for Immunological Memory and Immunotherapy"}
{"_id":"aa05f542-5f05-38c5-276c-46b761b4e364","text":"The present data confirm the deleterious impact of various cancers on semen quality. Leukaemia was associated with the worst semen quality and the highest number of semen samples that could not be frozen. We suggest that sperm quality may have decreased even before anti-neoplastic treatment and that sperm banking before treatment should be strongly recommended for cancer patients. A sperm banking programme before gonadotoxic therapy requires close cooperation between assisted reproduction centres and cancer clinics.","title":"Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience"}
{"_id":"aa0e497d-dcb6-92d2-4f3a-b72dc6298fe4","text":"Recent findings show that the prevalence of ERBB4 mutations in melanoma is relatively low compared to other genetic alterations like BRAF or NRAS mutations.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"aa116676-2c6a-c306-f793-99d5a616fbee","text":"Latissimus dorsi musculocutaneous flap is one of the most frequently performed reconstructive techniques in surgery. Latissimus dorsi muscle has two arcs of rotation. It is classified as type V muscle. This muscle can be elevated on the thoracodorsal artery to cover large defects in the anterior chest and also, the muscle can be elevated on the segmental vessels to cover midline defects posteriorly. The aim of this study was to create a new arc of rotation on a vertical axis for the muscle and investigate effectiveness of vascular and chemical delays on the latissimus dorsi muscle flap with an inferior pedicle in an experimental rat model. We hypothesized that the latissimus dorsi muscle would be based on inferior pedicle by delay procedures.","title":"The creation of new rotation arc to the rat latissimus dorsi musculo-cutaneous flap with delay procedures"}
{"_id":"aa141e83-55b6-72a9-945b-3a301c17c855","text":"Further details regarding scalp reconstruction are beyond the scope of this discussion, but can be found in encyclopedic papers in the plastic surgical literature.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"aa29376d-ec11-3057-b51b-4b376574a2eb","text":"The technique to harvest a fibula flap has been described previously.13,14 An incision was made on the lateral aspect of the leg over the fibula. An overlying skin paddle can be harvested with the fibula in situations where additional soft tissue is required. In the cases we present, a skin paddle was not required, and therefore, only the fibula was harvested. The peroneus muscle was retracted anteriorly, and a 1 mm cuff of muscle was left over the bone. Dissection proceeded anteriorly, and the anterolateral intermuscular septum and interosseous membrane were divided. The common peroneal nerve and associated superficial and deep branches, along with the anterior and posterior tibial vessels were identified and preserved. Osteotomies were performed distally and proximally, at the fibular neck and 6 cm above the ankle joint. The distal fibula was left for ankle joint stability. The tibialis posterior was divided and the vascular pedicle was divided distally. The flexor hallucis longus and other musculature of the deep posterior compartment were dissected from the bone, and subperiosteal dissection was made proximally to increase pedicle length. The prepared flap was then passed over the tibialis anterior and through a subcutaneous tunnel into the defect in the tibia and femur at the knee. The fibula was bivalved as necessary by a transverse osteotomy, creating 2 vascularized struts that each contained a full thickness of fibula and shared a periosteal blood supply. This construct was placed within the medullary canal after bone windows were created. The periosteum of the superficial bone strut was sutured to the surrounding soft tissues so it would not be displaced during closure. The pedicle was checked for signs of twisting of the vessels or compression from the bony tunnel. The patellar remnant and arthrotomy were closed over the grafts and flaps, and the wound was closed.","title":"Arthrodesis Using Pedicled Fibular Flap After Failed Infected Knee Arthroplasty"}
{"_id":"aa29c7e3-7882-2f62-e640-149ea301c010","text":"The cyanoacrylate group did not exhibit any significant change in the medial layer of the saphenous vein grafts, whereas Masson’s Trichrom staining demonstrated significant separation and oedema between the tunica media and intima in the untreated saphenous vein graft group.","title":"Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model"}
{"_id":"aa2b2385-9697-c657-b9dc-56142bc37d43","text":"If the free nasal mucosa flap or fascia lata was used, the nasal cavity should be packed with a sponge and removed 1–2 days after the surgery. If a vascularized nasoseptal flap was used, the sphenoid sinus and nasal cavity were packed with iodoform gauze and removed 7 days after the surgery. The lumbar drain is not used irregularly after surgery.","title":"Intradural fat graft packing is not indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries"}
{"_id":"aa2b3bd6-5c73-c305-2a2f-a961fec74fea","text":"DVT is associated with the formation of a blood clot in a deep vein in the body. However, blood clots can occur most often in the large veins of the calf and thigh muscles. Depending on the size, a blood clot that forms in a vein can narrow the vessel or close it completely. The consequence is the appearance of pain and swelling in the leg, as well as of serious complications such as a pulmonary embolism when a blood clot travels to the lungs leading to the inhibition of blood flow [5].","title":"Factors Affecting the Formation and Treatment of Thrombosis by Natural and Synthetic Compounds"}
{"_id":"aa34517e-c57b-7c2b-9920-1845d99587b1","text":"Morphometric angiographic analysis of the vascular network was performed using a method described by Takeshita et al.. A composite of 5 mm2 grids was placed over the flap area. The total number of grid intersections and intersections crossed by an ICG-stained vessel were counted individually by an observer blinded to the treatment regimen. An ICG vessel score was calculated for each ICG angiography, as the ratio of grid intersections crossed by vessels divided by the total number of grid intersections in the flap. Furthermore, the time from injection to the first ICG signal in the flap was recorded.","title":"Conditioning of microvascular venous flaps in rats"}
{"_id":"aa38102e-fce5-acee-415b-9091ff011001","text":"Preserving the viability of the NAC and minimizing the occurrence of venous congestion depends in large part on the possibility of having a double pedicle arterial flow and maintaining the venous drainage.","title":"The McKissock's technique in reduction mammaplasty: A comparative study of outcomes and complications in 211 consecutive patients"}
{"_id":"aa447d19-39fd-4003-3093-24f19e70aa83","text":"The patients urinary splaying was due to a deflecting lip of tissue and not due to stenosis which is more common. Simply incising the lip and suturing the edges resulted in satisfactory voiding without bothersome misdirection.","title":"Revision Labiaplasty After Penile Inversion Vaginoplasty Using Costal Cartilage Allograft"}
{"_id":"aa475318-2c3f-7409-a342-4ecb168e67d3","text":"Yellow ink is used as a neutralizing pigment to harmonize with the client’s skin color when performing permanent makeup on eyebrows and eyelashes.","title":"Analysis of microstructural characteristics and components of red and yellow ink pigments used in permanent makeup"}
{"_id":"aa488088-3821-0b4f-49aa-928bfe327dcf","text":"The clinical and demographic data for all 8 patients is given in Table 1.","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"aa4c7bad-c527-a83c-5f1e-5b0609f92a7b","text":"OAS collected and arranged the patient’s data regarding the choroidal melanoma diagnosis and treatment and wrote the manuscript. JEM performed the radiation treatment of the tumor in first and second interventions and was a major contributor in writing the manuscript. JSD diagnosed the patient from start and follow her, discovered the recurrence, performed the needle biopsy and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.","title":"Gamma Knife radiosurgery for locally recurrent choroidal melanoma following plaque radiotherapy"}
{"_id":"aa530a04-ebe3-fd88-014d-852700d3c3f6","text":"Indication is the soft tissue coverage of large defects of the leg.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"aa5b197f-2271-5066-7646-f8a560978e5f","text":"It is well established that UV radiation exposure plays a major role in the development of skin cancer. Certain risk factors make an individual more susceptible to its harmful effects include light skin and eye color, red or blonde hair, and a tendency to freckle. A prior history of melanoma or NMSC substantially increases the risk of developing a subsequent skin cancer. Unfortunately, several studies have shown that while a previous history of skin cancer resulted in increased sun protective practices compared with controls, many patients continued to engage in unprotected episodes of sun exposure resulting in a sunburn prevalence similar to controls. Low levels of perceived skin cancer risk, inconvenience, and lack of knowledge on skin cancer and sun protection strategies are possible explanations for this paradox.","title":"Assessing individual patients’ knowledge of benign versus malignant skin lesions in the dermatology clinic population"}
{"_id":"aa5ea8db-8d66-ca1d-470a-4a19e172fd38","text":"This study explores the hypothesis that combining the minimally invasive surgical techniques of cryosurgery and pulsed electric fields will eliminate some of the major disadvantages of these techniques while retaining their advantages. Cryosurgery, tissue ablation by freezing, is a well-established minimally invasive surgical technique. One disadvantage of cryosurgery concerns the mechanism of cell death; cells at high subzero temperature on the outer rim of the frozen lesion can survive. Pulsed electric fields (PEF) are another minimally invasive surgical technique in which high strength and very rapid electric pulses are delivered across cells to permeabilize the cell membrane for applications such as gene delivery, electrochemotherapy and irreversible electroporation. The very short time scale of the electric pulses is disadvantageous because it does not facilitate real time control over the procedure. We hypothesize that applying the electric pulses during the cryosurgical procedure in such a way that the electric field vector is parallel to the heat flux vector will have the effect of confining the electric fields to the frozen\/cold region of tissue, thereby ablating the cells that survive freezing while facilitating controlled use of the PEF in the cold confined region. A finite element analysis of the electric field and heat conduction equations during simultaneous tissue treatment with cryosurgery and PEF (cryosurgery\/PEF) was used to study the effect of tissue freezing on electric fields. The study yielded motivating results. Because of decreased electrical conductivity in the frozen\/cooled tissue, it experienced temperature induced magnified electric fields in comparison to PEF delivered to the unfrozen tissue control. This suggests that freezing\/cooling confines and magnifies the electric fields to those regions; a targeting capability unattainable in traditional PEF. This analysis shows how temperature induced magnified and focused PEFs could be used to ablate cells in the high subzero freezing region of a cryosurgical lesion.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"aa7374d7-f785-73b2-f107-ddf558132bce","text":"After the initial surgery, the biopsy revealed a 4-cm papillary carcinoma of a predominantly classic and focally follicular pattern located in the left thyroid lobe and several scattered microscopic satellite lesions in the rest of the thyroid parenchyma with focal thyroid capsular infiltration, without exceeding it. Angiolymphatic invasion images were not observed.","title":"Papillary thyroid carcinoma with desmoid fibromatosis: a case report and review of literature Carcinoma papilar de tiroides con fibromatosis desmoide: reporte de caso y revisión de la literatura Carcinoma papilífero de tireoide com fibromatose desmóide: relato de caso e revisão da literatura"}
{"_id":"aa7ec806-e5af-658f-9414-7dfbcd65ac6d","text":"The adoption of the advanced virtual reality protocol made possible to perform surgeries that in the past years were not feasible, due to the complexity of anatomical relationships with the tumor. Surgeons retrospectively reviewed the same number of cases operated for malignancies in DFC before the implementation of this protocol in a time span ranging from 2015 to 2018, as virtual-reality technologies were introduced in routine practice since 2019 at our institution. Compared with the group studied by applying the advanced computerized reconstruction, patients operated in the past showed a mean surgical time increase of 85 min (SD ± 47 min), due to phases related to tumor exposure and strategy-making, whereas in the group studied and operated using the computer-guided protocol, navigation helped to target the disease from the beginning of surgery in both endoscopic and open phases; therefore, the major benefit in terms of surgical time reduction using the computerized workflow occurred in the approach phase. Additionally, in the group operated between 2015 and 2018, four patients had macroscopic disease residual, as localization of the tumor was only performed on raw imaging data and it was not possible to interactively check the intraoperative field in relation to a virtual project using navigation. Surgeons were asked to define their approach toward surgery both before and after the introduction of the advanced virtual anatomical reconstruction, and they unanimously reported a change in mindset, with an increase in their preoperative understanding of the patient’s anatomy and diminished frequency of intraoperative imaging consultation, due to deeper understanding of the case and availability of navigation.","title":"Anatomical Computerized Exploration to Excise Malignancies in Deep Facial Compartments: An Advanced Virtual Reality Protocol for a Tailored Surgical Approach"}
{"_id":"aa7f28cf-fd07-5991-0266-ba9360ac5a5f","text":"The purpose of this study was to characterize subjects treated at the Orthognathic Surgery Unit of the Otorhinolaryngology and Head & Neck Surgery Unit of a medical school.","title":"Service Profile of Orthognathic Surgery of a Medical School"}
{"_id":"aa7fe83f-7b70-d2d6-b11d-355dc7a9b6df","text":"It was noted that the pain experienced during treatment tapered off\/subsided together with the time of exposure to the red LED light.","title":"Topical Photodynamic Therapy with Different Forms of 5-Aminolevulinic Acid in the Treatment of Actinic Keratosis"}
{"_id":"aa83abb2-f568-b84f-8764-65c181a150fd","text":"Another important benefit of the double flap technique is enhancing better healing at the stoma site and prevention of granulation tissue and epithelialization. Thus, this may lead to a reduction of the chance of blockage of the new stoma, which explains the higher success rate of the double flap technique versus the single flap technique. In addition, the double flap technique enhances a better ostium opening.","title":"Endoscopic dacryocystorhinostomy: A comparison of double-flap and single-flap techniques"}
{"_id":"aa8459a4-dc69-953b-339b-5f6f0aecd625","text":"We present our experience with versatility of this osteocutaneous flap to allow reconstruction and salvage of extremitity sarcomas. There were no operative or postoperative complication and all the four patients had good limb function. The flap was found to be versatile as it could be used for either upper limb or lower limb and for large defects. The results were better in upper limb than in lower limb.","title":"The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection"}
{"_id":"aa999d50-38c4-6845-06b2-30bf55355da6","text":"To our knowledge, this is the first study which quantifies the detrimental impact on QoL due to topical treatment for patients with AD and shows that this increases with time spent and number of applications. The magnitude of these values highlights the importance the UK general public place on the time required for topical applications, unpleasant cosmetic properties and interference with daily life that are associated with intensive skincare regimens. Moreover, it further emphasises likely reasons behind poor treatment adherence and the need for better patient support and optimal treatments that provide clinical relief and can be easily integrated into daily life.","title":"Process utilities for topical treatment in atopic dermatitis"}
{"_id":"aa9e76c5-0eae-3731-f969-9e9bbb7befe2","text":"This study gives real-life insight into the implementation of ePROs in cancer care and highlights that physicians may need more quantitative documentation of the positive benefits of using ePROs in order to endorse the use of ePROs in daily clinic. Thus, this study urges for continuous feasibility testing before software implementation, at the very least in the respect of both patients and providers.","title":"Electronic reporting of patient-reported outcomes in a fragile and comorbid population during cancer therapy – a feasibility study"}
{"_id":"aa9f04f4-6443-e6f7-4247-5909ffe85459","text":"Introduction Currently there are no consensuses in the national guidance on thromboprophylaxis following major elective lower limb surgery. Emerging clinical evidence suggests that aspirin could be just as effective as anticoagulants with a lower cost. The aim of this study was to provide an update based on literature of the past 3 years for the use of aspirin as thromboprophylaxis after knee and hip arthroplasty.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"aaa6d606-83eb-34e7-4a78-d7051e625219","text":"In general, the assessment of the effect of MR on SLN positivity is limited by the fact that not all patients undergo SLNB, either due to AJCC guidelines at the time of diagnosis, patient choice, surgeon judgment, or a combination of these factors. Our study is beneficial in that it is encompasses a large number of patients who were treated at a single institution with a long history of melanoma care with relatively consistent care between providers.","title":"Predictive accuracy of elevated mitotic rate on lymph node positivity and recurrence in thin melanomas"}
{"_id":"aaaba80e-3006-30b3-6790-ed73e5690efc","text":"The angle of inclination of the flap advancement is determined by the location of the defect. Placement of incisions may be guided by anatomic subunit considerations such as avoidance of crossing the nasal alar groove. Adding a superior curve of the flap at the leading edge decreases the lateral to medial excursion demands of the flap by adding a superior to inferior advancement. The flap gains its length from the muscle pedicle elasticity, from the release of fascial attachments at the nasal bones and piriform aperture, the release of inelastic cheek skin from the cutaneous island, and by straightening the pedicle’s contour curve at the nasal cheek junction.","title":"Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction"}
{"_id":"aab924b3-21ea-e04a-09e7-b1fcf43c4153","text":"Surgery may play a role even in the advanced and metastatic cSCC.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"aabe7178-4672-fb47-ec86-b58102acf1e3","text":"P73 A clinical case of DRESS syndrome in a child after administration of amoxicillin-clavulanic acid","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"aabe9cf6-5969-f9b1-45a3-7aed4356516e","text":"All ultrasound examinations of the weanling thoroughbred horses performed in early spring. The haircoat at this time was not very long or dense, and the fine hair and skin of the thoroughbred weanling permitted adequate ultrasound beam penetration and quality image acquisition. In some cases, the area of interest was brushed to remove dirt or debris from the hair and to allow direct alcohol application to the skin and hair. In some cases, repeat application of alcohol was necessary for optimal imaging, which was well tolerated by the horse. It was not possible to clip the joints of these horses for the examinations, and in clinical practice it would not be feasible to clip each horse for ultrasound on aesthetic grounds. Ultimately all joints in all horses were imaged fully with good image quality yielding comparable, repeatable images.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"aac081eb-991c-b941-7afa-133d01a060bb","text":"In February 2015 the national board of health in Denmark published a new follow‐up programme for breast cancer, stating that breast cancer survivors aged 50‐79 years who had mastectomy should have biennial mammography screening as the only routine follow‐up. Breast cancer survivors aged 50‐79 years who had lumpectomy should have a diagnostic mammography including breast palpation and ultrasound examination 18 months after the operation and thereafter biennial mammography screening as the only follow‐up unless less being the carrier of a risk increasing gene mutation. , Prior to 2015, the Danish guidelines from 2004, 2010 and 2012 recommended that breast cancer survivors had a clinical breast examination at least every 6 months for 5 years and thereafter every 12 months for 5 years. , , The 2012 guidelines recommended that low‐risk patients could stop being followed with clinical breast examinations after 3 years. The 2004 and 2010 guidelines recommended that breast cancer survivors had mammography and eventual ultrasound every second year, although the 2004 guidelines recommended annual mammography to all breast cancer survivors who had lumpectomy. In the 2012 guidelines breast cancer survivors who had mastectomy were recommended to have biennial mammography screening whereas breast cancer survivors who had lumpectomy were recommended a diagnostic mammography 18 months after the operation, followed by biennial mammography, and eventually mammography screening.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"aac123cd-2557-2762-1b1f-e006e6751edc","text":"To the best of our knowledge, there has been only one prospective controlled study in which patients who were operated on after VR was used for preoperative planning were compared with patients who were operated on without VR being used for preoperative planning [4]. All of the patients had skull base tumors. The patients for whom VR was used had significantly shorter operation duration and length of stay, and significantly more improvement in Karnofsky performance scores at discharge and at 6 months follow-up. The VR group also had significantly fewer cerebrovascular injury complications. These results suggest that the use of VR can improve outcome in patients with skull base tumors. Future research is needed to determine whether using VR can improve outcome for patients with sellar tumors.","title":"Stereoscopic virtual reality models for planning tumor resection in the sellar region"}
{"_id":"aac2e695-e5f4-ff17-d5bc-92cfbb3283bd","text":"In summary the publications give no clear answer concerning the superiority of any of the models. The use of ionization chambers with small electrode separations and a high bias voltage should keep the recombination losses small but this must be confirmed for every installation.","title":"Present state and issues in IORT Physics"}
{"_id":"aacb2f93-45f6-7579-80bc-07ab98c8c3ed","text":"Edge based models utilize image gradient as an additional constraint to construct force to direct the motion of the contour. These models usually have edge based stopping constraint to intercept the contour evolution on the object boundaries [10]. High noise and weak or deficient borders of humeral head in PD images make edge based methods less suitable.","title":"Segmentation of Bone with Region Based Active Contour Model in PD Weighted MR Images of Shoulder"}
{"_id":"aaea2153-6115-49bc-1908-1e3d876e27ff","text":"The results of Vancouver Scar Scale are shown in Table 3.","title":"Minimally Invasive Harvesting Technique for Costal Cartilage Graft: Donor Site, Morbidity and Aesthetic Outcomes"}
{"_id":"aaec4911-60d3-e4de-6127-063e25408406","text":"The purpose of this study is to determine the correlation between non-technical risk factors and the perioperative flap survival rate and to evaluate the choice of skin flap for the reconstruction of foot and ankle.","title":"Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis"}
{"_id":"aaf0d6ab-a1e4-7254-49b0-5f24cf87bedc","text":"During our work we noted great diagnostic value of ultrasound examination of involutional changes of soft tissues of the lower third of the face and neck to determine all the causes of contour deformities and to define minimally invasive methods for their correction. Some clinical cases are present for illustration.","title":"Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques"}
{"_id":"aaf24fe4-1c54-1fda-8ab7-80a67523b3fc","text":"The repeat BCG stimulation of PBMC obtained from BCG vaccinated individuals shows enhanced immune activation with respect to increased anti-BCG titre, IFN-γ and ADA activity without concomitant increase in CD4 and CD8 cells. This study provides some basics data in future experiments in animal models with respect to repeat BCG vaccination.","title":"Assessment of immune response to repeat stimulation with BCG vaccine using in vitro PBMC model"}
{"_id":"aaf8ccdd-b843-c86f-64c3-df26a1884514","text":"After informed consent has been obtained, the investigator obtains baseline data from the study participants, which will be entered in the randomization module in the electronic data collection program REDCap. The investigator will assign participants to the intervention based on the results of the randomization.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"aaf9661c-3cac-b848-a52a-918c67f684f5","text":"Completion of this service evaluation of the JDA clinics has allowed the department to recognise the high demand for such multidisciplinary clinics due to the high number of patients presenting with abnormalities which required multidisciplinary assessment and management. Following the service evaluation, more oral surgery specialists were allocated for the JDA clinics and the clinics were run more frequently. The service evaluation also aided the evolution of the JDA clinics by recognising the need for the use of enhanced imaging modalities such as cone beam CT scans (CBCT) and the development of patient pathways for the multidisciplinary management of many of these complex patients.","title":"The orthodontic-oral surgery interface. Part one: A service evaluation and overview of the diagnosis and management of common anomalies"}
{"_id":"aaf99c4c-04cc-c890-beae-f272b9551f40","text":"The authors describe a surgical technique using the alar cartilages as spreader grafts. All Caucasian patients with bulbous tips who underwent primary rhinoplasty were included. All patients have been evaluated after 3 to 4 months and after 1 and 2 years by aesthetical and functional criteria.","title":"Alar cartilage—an alternative for spreader graft in primary rhinoplasty"}
{"_id":"ab00df0f-0c3e-3680-d36b-f447a0dfa99d","text":"PDD of doubtful skin lesions relies on the fluorescent properties of an exogenous drug or endogenous compound in response to a light source. Topical agents are utilized to stimulate the reproduction of endogenous photosensitizers that produce a photodynamic effect when exposed to the light of specific wavelengths and energy. Photodynamic therapy (PDT) is the combination of absorption light and the photosensitizer. This technique also helps prior to surgery to detect the cancerous cells by using the photosensitizer. Fluorescence spectroscopy is performed on the tissues by using the photo sensitizer. Non-melanoma skin cancer can be diagnosed by fluorescence spectroscopy by both in vivo and ex vivo method. Auto-fluorescence is used to detect the presence of an abnormality in malignancy. The fluorescence intensity of dermal collagen is generally lower in tumour than in the normal tissues. Synchronous fluorescence method with time-resolved fluorescence technique can also be used for this applications. Modern reports on fluorescence spectroscopy methods for skin cancer diagnosis are summarised in Table 6.","title":"Skin cancer detection using non-invasive techniques"}
{"_id":"ab04c87b-5c5a-99aa-a4a3-29c451aaaecf","text":"Approximately four months after starting pembrolizumab, the patient developed a bilateral widespread pruritic erythematous rash with some nodularity on the shins. Topical steroid cream therapy was initiated by the treating dermatologist. Skin biopsies of the nodular area were interpreted as moderate to well-differentiated keratinizing squamous cell carcinoma with keratoacanthomatous features. The patient was then referred to oncology for treatment of presumed multifocal squamous cell carcinoma on his lower legs. The patient was assessed by radiation oncology but given his clinical presentation of bilateral leg involvement with some response to topical steroid treatment, additional biopsies were requested to better target areas for potential radiation therapy. Multiple biopsies from each leg were taken, targeting and mapping the different nodular and erythematous areas.","title":"Immune-Checkpoint Induced Skin Toxicity Masked as Squamous Cell Carcinoma: Case Report on Mimickers of Dermatological Toxicity with PD-1 Inhibition"}
{"_id":"ab04ea61-d926-88bc-bfa6-6ed3ea8839bc","text":"In view of the number of cases of SPCs observed in the skin in both sexes, it is advisable to recommend a skin examination in all patients. Cancer follow-ups could be extended beyond 5 years since primary tumors can be followed by an SPC after a substantial amount of time.","title":"Cancer Prevention for Survivors: Incidence of Second Primary Cancers and Sex Differences—A Population-Based Study from an Italian Cancer Registry"}
{"_id":"ab04fff3-d385-6cd1-cb03-b465945498fa","text":"The study is anticipated to commence in May 2022. It is anticipated that it will require two years for enrolment of patients to be completed. Patients will be followed up for 1 year, unless they are diagnosed with NMOSD or MOG optic neuritis. This subgroup from the original cohort will be followed up for 5 years.","title":"Optic neuritis: A South African hospital-based prospective study protocol"}
{"_id":"ab07adf9-26bd-552f-3c62-ac78c35b9ae2","text":"Specimens were obtained from patients undergoing abdominal skin reduction surgery in inpatient and outpatient surgical settings. Skin specimens were cleaned in a method adapted from the former Yale Skin Bank’s methods. The specimens were attached to the autoclave container for the dermatome using towel clips or sutures to provide tension. Normal saline clysis was injected subdermally and a Padgett Electric Dermatome was used to obtain skin grafts. These were then photographed and discarded.","title":"Methods in obtaining split-thickness skin grafts from skin reduction surgery specimens"}
{"_id":"ab0bf8eb-8e23-7848-1b2e-b365b0babb3c","text":"Participants in this group will receive STEA treatment at two predefined points (same as TEA group) once a week for eight weeks. Patients in the STEA group will undergo the same procedure as those in the TEA group except that there will be no thread in the TEA device.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"ab32cec4-f34b-592e-fa57-c92f180741f0","text":"In summary, our study demonstrated that dual agent mapping for SLNB and ICG for ARM is a valuable technique after NST to determine the required number of SLNs for oncologic safety, to preserve axillary drainage and to prevent lymphedema. The concerns regarding the accuracy of the SLNB technique together with anxiety of the risk of lymphedema could be reduced via triple mapping.","title":"Triple mapping for axillary staging after neoadjuvant therapy: Axillary reverse mapping with indocyanine green and dual agent sentinel lymph node biopsy"}
{"_id":"ab37cc74-a2c4-7ea6-13d0-82e45da12829","text":"The Scale is one of the standardized appliances for scar wound assessment. It was described by Sullivan in 1990 and is the most used scar assessment method in the world.","title":"Minimally Invasive Harvesting Technique for Costal Cartilage Graft: Donor Site, Morbidity and Aesthetic Outcomes"}
{"_id":"ab3cd79d-6302-e285-5a82-9951c95ee978","text":"The pertinent take home message from this case report would be, pyomyositis is a rare infection of the skeletal muscle that is difficult to diagnose as it mimics a wide array of conditions and presents with vague signs and symptoms. It must always be kept in the back of a clinician’s mind whenever a patient presents with muscle pain especially in the immunocompromised population. The nature of the disease calls for quick diagnosis and initiation of treatment due to the possibility of septicaemia if left undiagnosed. The prognosis of the disease is excellent if treated early.","title":"An Unresolving Case of Pyomyositis: A Case Report"}
{"_id":"ab3fe80c-3fc9-9c10-88d6-c24d517ebea9","text":"It should be emphasized, that this phenomenon occurs because the electric field vector is normal to the boundary of the two regions of different conductivity. If the electric field were parallel to this boundary, then the equivalent circuit would be two resistors in parallel, rather than in series, and there would be negligible field enhancement or possible field decrease, depending on the relative electrical conductivity of the tissues. The particular configuration developed in this study is a direct consequence of the fact that the cryoprobe serves both as the heat sink and as the electric source. The configurations used in this study were chosen particularly to accomplish this effect.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"ab41447b-f999-dc42-83d5-5697144755f4","text":"With the progressive improvement of reconstructive methodology together with the increasing demand of better outcomes in terms of functional and aesthetic recovery, to date, a comprehensive skin cancer treatment should include adequate procedures to let the patient returning to a normal life.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"ab42f095-0f35-4552-81c8-d8556fc1483e","text":"The skin bridge between the flap and the defect was elevated to create a subcutaneous tunnel and deliver the skin paddle into the defect through it or was pedicled above the skin, and later on transected after 10 to 15 days.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"ab49b809-7657-7d87-0040-2f133bb61712","text":"Another finding was that children with ASD who had complementary foods introduced after 6 months of age had more severe developmental delays in adaptive, fine motor, language, and general developmental levels than those who had complementary foods introduced within 4–6 months of age. This may be because the severity of the neurodevelopmental delay affects the timing of the introduction of complementary foods in infants. Therefore, children with severe developmental delays have a later introduction of complementary foods. Studies have found that infants who had complementary foods introduced before 26 weeks of age have better exercise capacity than infants who had complementary foods introduced after 26 weeks of age [43]. However, the relationship between supplemental food introduction and neurodevelopment may be influenced by body weight and oral development, so further cohort studies controlling for relevant confounders are needed to clarify the relationship.","title":"Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: a national multicentre survey"}
{"_id":"ab4c36d3-ac88-42ed-8626-05150e1f43f8","text":"SOM faculty who facilitated the LI offerings underwent a training session before each of the respective activities. The activities also leveraged both content expertise and resources from the BS and SOM, such as faculty from the Institute for Healthcare Quality Improvement and the Outdoor Education Center. The Peak Performance simulation, which has been described in more detail separately, utilized executive coaches from BS as well as clinical SOM faculty who underwent training prior to the activity.","title":"Medical Student Leadership Development through a Business School Partnership Model: A Case Study and Implementation Strategy"}
{"_id":"ab4ce7f5-74a8-ad26-d3f7-0af0a6e852c0","text":"Where amputation was selected as treatment, the patients were reviewed and counselled pre-operatively by clinical psychology and amputation rehabilitation services. Level of amputation was determined in consultation with the rehabilitation services based upon limb function and the location of infection with the intention of clearing all infected tissue.","title":"Long-term outcomes of lower limb post-traumatic osteomyelitis"}
{"_id":"ab4f56fd-4e7b-0c17-80cd-7e11de132be3","text":"The findings from published trials provide reassurance that the GMFs compared with CMFs evaluated are safe and well tolerated by infants who cannot be breastfed. However, it is important to note that the current evidence base is not yet sufficient to definitively conclude whether GMFs offer clear benefits for health outcomes compared to CMFs. Therefore, healthcare providers should carefully consider the individual needs and circumstances of each infant and family when recommending a feeding option. Further RCTs are needed to better understand the potential advantages and disadvantages of GMFs compared with CMFs and to inform clinical practice. It is worth noting that breastfeeding remains the natural and optimal nutrition for infants, and healthcare providers should encourage and support breastfeeding whenever possible.","title":"The Effect of Goat-Milk-Based Infant Formulas on Growth and Safety Parameters: A Systematic Review and Meta-Analysis"}
{"_id":"ab563df4-f504-0c3b-a168-003e0fd8d0eb","text":"Some informants have expressed their unhappiness and distress on loss of body image due to the surgical treatment with one breast being removed or the scar that remained on her chest.","title":"Women’s Perspective of Breast Self-examination"}
{"_id":"ab5ab001-77b6-7cae-1b53-2cd51a84ebcf","text":"The wound healing assay was performed based on previous studies by measuring cell migration. The cell migration is defined as the time taken to close an open wound after a linear ‘scratch’ or wound is created across a monolayer of cultured cells.","title":"Comparative Evaluation of the Effectiveness of Novel Hyaluronic Acid-Polynucleotide Complex Dermal Filler"}
{"_id":"ab5dde3e-3b77-a08a-cf10-d60fa60dbdc9","text":"In our study we used open procedure for using Medporc titanium in revision rhinoplasty surgery in 8 patients. In these patients we used Medpor® as collumelar strut to have good projection and rotation in the patients with tip ptosis. These plates were fixed with 6–0 nylon to the medial crura of both lower lateral cartilages. We also used Medpor® as only lower lateral cartilage graft in 5 patients. We put these plates in pocket over the cartilages through marginal incision and sutured the incision. This technique used to augment the cartilage in patients with pinching of lower lateral cartilage.","title":"Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study"}
{"_id":"ab6cd731-182e-60df-57a8-e78549ed9923","text":"In the follow-up checks, which continue to date and that occur every 6 months for the first three years after cryosurgery and then every 12 months, no local or distant metastatic repetitions have been highlighted and the patient appears to be in an apparent state of good health.","title":"Cryoablation and Immunotherapy: An Enthralling Synergy for Cancer Treatment"}
{"_id":"ab75bc37-7b89-240f-dd17-f72eb234bca1","text":"Complications from cervical spine surgery have the potential for catastrophic complications because of the proximity to the vertebral arteries, the airway and the spinal cord. Furthermore, constructs applied to the cervical spine may be less robust because of the smaller size of the anchors and the minimal amount of bone available for purchase.","title":"Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review"}
{"_id":"ab817286-1dd2-cf16-8d86-7d388246b840","text":"Early mobilization and physiotherapy are mandatory for better surgical outcomes and to avoid the joint stiffness and reduce deformities and disabilities.","title":"The Surgical Treatment of Mycetoma"}
{"_id":"ab832824-7e81-b876-a2cc-4d88fd63479d","text":"Proper administration of subcutaneous enoxaparin injections relies on pinching a segment of subcutaneous tissue and injecting the needle into the isolated area. Some practitioners may administer the injection by simply pressing into the anterior abdominal wall without isolating a secure subcutaneous fat pad. Such a technique could compress the superficial fat and lead to injection of intramuscular tissue or a blood vessel. In Figure 1, we show the depth of this patient's inferior epigastric artery in relation to the length of needle typically used in enoxaparin injections. This shows the plausibility of a routine enoxaparin injection piercing the inferior epigastric artery if not administered correctly.","title":"Fatal Retroperitoneal Hematoma in a Patient Receiving Enoxaparin for Bilateral Pulmonary Emboli"}
{"_id":"ab9031d4-6044-c5a2-9e6d-085a292e9607","text":"The WHO recommends exclusive breastfeeding in the first 6 months of life. Our objective was to evaluate trends in infant nutrition in Saudi Arabia and the degree of compliance with WHO recommendations.","title":"Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations"}
{"_id":"ab996b88-2578-d961-4f36-ab425d51cc32","text":"Coinciding with Daniels et al (11), we observed that small sized lesions tended to be unilocular where as the larger lesions were multilocular and showed more aggressive behaviour provoking complications such as severe reabsorption of the roots of adjacent teeth, radicular displacement of adjacent teeth or an included tooth and expansion of the cortical bones.","title":"Central odontogenic fibroma: Retrospective study of 8 clinical cases"}
{"_id":"ab9c5efb-1797-54b6-7464-47fbb2196d7c","text":"At our institute, since 2006 when SLN biopsy was adopted as the standard of care, SLN biopsy was included in the initial surgery if it involved a mastectomy. Most surgeons performed WLE alone for a preoperative diagnosis of DCIS, while some surgeons selectively offered SLN biopsy together with the initial WLE if the likelihood of histological upgrade to invasive carcinoma was deemed to be high. In this study, we have reviewed our data to evaluate the outcome of SLN biopsy performed together with the initial surgery for a preoperative diagnosis of DCIS. In addition, we sought to identify the subgroup of patients who were at risk of a histological upgrade to invasive carcinoma since they would benefit from having SLN biopsy performed at the time of the initial surgery.","title":"Sentinel Lymph Node Biopsy Should Be Included with the Initial Surgery for High-Risk Ductal Carcinoma-In-Situ"}
{"_id":"abb9902d-a326-917c-8f82-20e36606b172","text":"The first key element of the developed TTOP intervention involves educating the patients regarding their condition and its treatment.","title":"Development of an adherence-enhancing intervention in topical treatment termed the topical treatment optimization program (TTOP)"}
{"_id":"abc6c04f-af80-fc91-04c1-6d756fac5411","text":"Table 2 describes the tumor characteristics of the first melanomas, compared with the characteristics of subsequent melanomas. The most common site for both first and second primary melanomas was the trunk. Superficial spreading melanoma was the most common histological type in both first and second primary melanoma.","title":"Multiple primary melanomas: A literature review"}
{"_id":"abd5e061-c3e0-c02e-73bc-1eb993dd3e75","text":"A summary of the data relating to antibiotics with protein biosynthesis inhibition as a mode of action is shown in Table 1.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"abdaa8a9-95de-e963-9699-e71374fdcfdc","text":"The dressing is removed after 8 days and the stitches after 12 days.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"abdc8883-b883-1f86-0e29-777f890ef8a5","text":"The ability to be a leader for each individual employee and take the situation at hand into account was considered important elements of good physician leadership. The informants presumed physician leaders to possess – through their previous medical and working career – the knowledge, skills and understanding of the support needed by physicians at different career stages.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"abe0b35a-d842-7861-7030-97bd6f14bd48","text":"Axillary lymph node dissection was performed through the same incision for patients with modified radical mastectomy. A separate 4 cm incision was made in the axilla, two finger breadths below the hair bearing skin and perpendicular to the lateral edge of the pectoralis major for patients with WLE.","title":"Measuring upper limb function and patient reported outcomes after major breast cancer surgery: a pilot study in an Asian cohort"}
{"_id":"abe81fb6-c34c-361d-7725-6c1198f8f464","text":"In summary, analysis of gene expression patterns in two soft tissue tumors, DTF and SFT, has allowed identification of at least two different nonneoplastic subtypes of stromal cells. Furthermore, analysis of the gene expression signatures of these soft tissue tumors in a breast carcinoma expression dataset has suggested that there may be molecularly distinct patterns of stromal reaction in breast cancer. These stromal reaction patterns appear to be correlated with differences in the biology of the tumors that are reflected in clinical outcome.","title":"Determination of Stromal Signatures in Breast Carcinoma"}
{"_id":"abe98ee1-163b-a8f9-f8a7-9dcd74d4bc24","text":"Our results show that pulp therapy did not significantly alter the outcome of the crowns, with teeth that were pulpally treated showing higher failure rates. One of the reasons for this could be the fact that those teeth that needed pulp therapy had less tooth structure than the teeth that were not pulpally treated. This is significant given that the greatest type of failure observed was debonding of the crown.","title":"Factors Influencing the Survival of Preformed Zirconia Crowns in Children Treated under General Anesthesia"}
{"_id":"abecac80-2d2b-10ef-023e-af9b213c839c","text":"The incidence of postoperative hemorrhage in the tonsillectomy group was higher than previously reported from retrospective studies. We believe that part of the higher postoperative hemorrhage rate in the present study may be attributed to our strict follow-up, which included questions directly related to complications, including postoperative hemorrhage. Other prospective studies have similar unexpected high rates of postoperative hemorrhages after cold steel dissection tonsillectomy.","title":"Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults A Randomized Clinical Trial Laser Tonsillotomy vs Conventional Tonsillectomy in Adults"}
{"_id":"abee96de-a0f9-d1e2-daa4-8452c04f56aa","text":"The only disadvantage noted with the use of LAOMCM flap is the loss of the angle between the cheek and the nose which is straightened in contradiction to forehead flaps which can preserve this angle.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"abf62658-ad8a-5818-ace8-62b63620b338","text":"During the period from June 2017 to June 2018, we followed 57 cases of surgically resectable benign tumours in the parotid region treated with parotidectomy at our department. Two patients exhibited bilateral tumours; each side was considered an independent case. Four experienced surgeons performed the surgical procedures, which included tumour enucleation, tumour and partial superficial parotidectomy without nerve dissection and tumour and partial superficial parotidectomy with the dissection of the main trunk or branches of the facial nerve. Each procedure was carefully selected according to the preoperative diagnosis as well as the size, texture and location of the tumour. And enucleation was only applied to cases diagnosed as warthin tumour before surgery.","title":"Drain fluid amylase as a predictor of postoperative salivary fistula in cases with benign parotid tumours"}
{"_id":"abf76de8-2371-754b-14c2-d05d0d4ae574","text":"In patients with tumoral calcinosis due to secondary hyperparathyroidism, earlier PTX is suggested to be an effective strategy for the treatment of TC.","title":"Effects of parathyroidectomy on tumoral calcinosis in uremic patients with secondary hyperparathyroidism"}
{"_id":"abfca9fb-3f1f-2cec-894c-f02fafb64b17","text":"Abdominal wall closure and flap viability are to be checked every day and covered by vaseline gauze. Patient should not sit nor walk for five to seven days and thus physiotherapy is of uttermost importance. Urinary catheter is kept at least for five days.","title":"PERINEAL REPAIR AFTER ABDOMINOPERINEAL EXCISION WITH RECTUS ABDOMINIS MYOCUTANEOUS FLAP RECONSTRUÇÃO DO PERÍNEO APÓS AMPUTAÇÃO ABDOMINOPERINEAL COM RETALHO PEDICULADO DO MÚSCULO RETO ABDOMINAL"}
{"_id":"ac0179d4-d24b-5cf6-6091-2b26f1290897","text":"Our data show a dramatic increase in fellows and fellowship sponsorship in this last decade, particularly in the last four years since the RRC changed the special requirements. This impact has happened in places where there are many community programs, such as New York State, and the bulk of the new programs are in community hospitals, many of which are sponsoring fellowships for the first time. There has been an anecdotal perception that the RRC does not favor community hospital fellowships and that loss of accreditation after early accreditation visits would be an issue for various reasons, including not fulfilling research requirements. However, this does not appear to be the case. None of the recently accredited fellowships have been identified with problems as of 2008.","title":"Sponsorship of Internal Medicine Subspecialty Fellowships Since 2000: Trends and Community Hospital Involvement"}
{"_id":"ac0a89ce-0aac-85ad-7895-504589c02735","text":"Malignancy has been and continues to be strongly associated with increasing age worldwide. However, in Uganda, some cancers occur at ages much lower than those reported internationally. Colorectal and breast cancer have been notable in this regard with the latter occurring in patients 10 to 15 years younger in Uganda as compared to the US [15]. The average age of patients with a diagnosis of malignancy in our study was 47.3 years, which is well below those in other countries. All patients who developed DVT in our study had a malignancy with two of the patients being below 30 years old. It would thus appear that malignancy is an important risk factor and is independent of other risk factors such as age and obesity.","title":"Deep venous thrombosis after major abdominal surgery in a Ugandan hospital: a prospective study"}
{"_id":"ac18c144-60dc-ebd6-8b0d-eb060dd7f288","text":"Based on this review, we believe that PDT deserves a more central position in cancer treatment, either as part of a multimodal approach or as standalone treatment for early disease, palliative care or salvage treatment. With the discovery of new PSs and nanobased formulations, current limitations can be overcome and together with established and improved protocols, better equipment and improved dosimetry can make PDT a strong alternative for conventional treatments. Clinical studies show its enormous potential while preclinical studies indicate there still is room for improvement on multiple fronts.","title":"Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions"}
{"_id":"ac1f2b34-f64f-99f0-6d28-fda1fe91e027","text":"The aim of the study was the macroscopic and radiological presentation of the vascular system supplying the sternum, in particular the compensating blood supply routes in the event that the internal mammary artery is no longer available after use as a bypass vessel.","title":"Anatomic study of the vascular perfusion of the sternum and its clinical relevance in deep sternal wound infection Anatomische Untersuchung der sternalen Gefäßversorgung und ihre klinische Relevanz bei tiefen sternalen Wundheilungsstörungen"}
{"_id":"ac21e27c-f6c5-7457-4e30-9c2c9a5d250d","text":"One suitable perforator had been chosen and the flap had been designed suitable enough to fit into the expected defect. Intraoperatively, exploration of the chosen perforator had been done before raising the flap to make sure that it was suitable for the vascular supply of the flap and for its proposed movement into the defect. Whether the perforator would be skeletonized or not, would be governed by the needed movement of the flap to be in set without any compromise of its blood supply (Figure 1-4).","title":"Free Style Perforator Flaps for Aesthetic Facial Reconstruction"}
{"_id":"ac25640b-96da-85a3-2fca-4a11232472e8","text":"It is the first study that evaluates the differences in the risk of developing a subsequent KC depending on the primary diagnosing skin cancer subtype. We have shown that the crucial risk factors for subsequent KC development are male gender, an aggressive tumor subtype, and a previous history of multiple skin cancers. This observation has strong implications for clinical care, non-invasive diagnosis, and monitoring. The risk for the next new KC over time is significantly lower after a first BCC or SCC diagnosis than a previous medical history of multiple skin cancer diagnosis. BCC subtypes with aggressive growth patterns predispose not only to increased risk for the recurrence, but also they are expected to be at an increased risk for a subsequent tumor. Patients with their first KC, especially low aggressive subtypes of skin cancer, might be the group most likely to use preventive counseling, while patients presenting with a previous diagnosis of infiltrative or basosquamous subtypes of BCC might benefit from careful and more frequent screening for potential skin cancers.","title":"Risk Factors and Clinicopathological Features for Developing a Subsequent Primary Cutaneous Squamous and Basal Cell Carcinomas"}
{"_id":"ac284a52-8855-9111-0f82-cadb9f8d4b69","text":"The Chair of the BTSC Unit 72 has reviewed the required Conflict of Interest statement on file for each member of BTSC Unit 72 and determined that disclosure of potential Conflicts of Interest is an adequate management plan. The members of Unit 72 attest that they have no potential Conflicts of Interest related to the subject matter or materials presented in this document.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"ac2d0cb5-457e-e692-477f-347997a905c8","text":"The preparation of the GSV was carried out through an inguinal incision and a few auxiliary incisions along the saphenous vein. The vein was dissected and measured with a ruler as seen in figure 6. Branches were ligated, the vein was cut to size if necessary and anastomosed at its proximal and distal ends. Absolute values were not compared statistically because measurements were performed on dissected veins that are not in the same physiological condition as in vivo.","title":"Mapping of Autogenous Saphenous Veins as an Imaging Adjunct to Peripheral MR Angiography in Patients with Peripheral Arterial Occlusive Disease and Peripheral Bypass Grafting: Prospective Comparison with Ultrasound and Intraoperative Findings"}
{"_id":"ac32fc2d-65bb-96be-85d3-8f63bfaed7dc","text":"Our findings also suggest that not all women are put off surgery by the traditional stereotype and male dominated sub-culture: some see it as a challenge and have the self-confidence to face it. There is also a growing awareness that the number of women in surgery is rising and that this may bring about changes in the surgical sub-culture and stereotype. Some women trainees are actively challenging the narrative about how surgeons should think and behave. This transformative capability that some young women believe they can bring to surgery raises the possibility that, as the number of women surgeons increases, not only will traditional stereotypes be increasingly challenged, but the ways in which the specialty is practised may also be changed.","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"ac403c9a-3747-2a3e-7d2a-66936eaedbd8","text":"The vascular access for chemotherapy was always wrist radiocephalic or elbow cephalic, basilica or medial cubital vein to branchial fistula. Wobbes et al123 suggested, when suitable vessels were unavailable in the upper extremities, an arteriovenous fistula be performed in the inguinal region using the long SVG. In 100 consecutive patients with various malignancies, 142 operations were performed to establish an arteriovenous fistula giving vascular access for chemotherapy. Radiocephalic fistula was established in 88 operations on 76 patients and functioned well in 64%. In 13 patients whose arms offered no alternative possibility, 15 long SVGs were implanted in the inguinal region. Guba et al124 successfully administered chemotherapeutic agents, blood products and hyperalimentation solutions and recurrent diabetic ketoacidosis via vascular access procedures in 13 patients. Vascular access for chemotherapy by an autologous SVG fistula was also reported by Levey et al,125 who created in infants and children with malignancy, a loop fistula from the SVG to the superficial femoral artery. Such access could provide with rapid dilute chemicals and last as long as 3 years.","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"ac455c5d-f153-c39d-4f3d-1e6d1d39eb62","text":"The present study reveals an important role of COM in association with the risk of fracture. Patients with COM are at an elevated risk of developing fracture, regardless of the presence or absence of the comorbidities. The fracture risk for patients with COM could be greatly increased because of comorbidities, particularly for the elderly and those with osteoporosis. The site with the highest incidence of fracture was lower limbs. Both fall and accident are the causes leading to fracture for COM patients. These findings could be used to prompt clinical alerts. Clinicians should provide COM patients with timely consultation on fracture prevention, particularly of knowledge in fall and accident prevention for the elderly patients with osteoporosis and other comorbidities.","title":"Population study evaluating fracture risk among patients with chronic osteomyelitis"}
{"_id":"ac47ef4d-9e44-477c-bd22-6dfdc204afd2","text":"Patients with mental illness causing the inability to comply with the clinical trial protocol; or any other condition that can render the individual unsuitable for inclusion in the trial, as determined by the principal investigator.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"ac493fc5-5e76-bca0-5802-2c5cc9a3859e","text":"These studies may promote the development of novel drugs and therapeutic strategies for PDTs.","title":"Clinical Prognostic Factors and Integrated Multi-Omics Studies Identify Potential Novel Therapeutic Targets for Pediatric Desmoid Tumor"}
{"_id":"ac5737c2-5eec-6c76-948c-8f106c2013fd","text":"Studies have demonstrated various mechanisms by which anticancer agents cause mucositis. Cytotoxic anticancer agents can cause damage to the basal cells by inducing cytokine and free radical release, leading to the inhibition of apoptosis and mucosal epithelium formation. Furthermore, bone marrow suppression caused by anticancer agents can lead to secondary mucositis as a result of an oral infection.","title":"A pilot study of the clinical evidence for the methodology for prevention of oral mucositis during cancer chemotherapy by measuring salivary excretion of 5-fluorouracil"}
{"_id":"ac6c83e0-45e8-8d34-a91b-070da7f5b170","text":"Meanwhile, negative SLNB should be observed at intervals between 2 to 6 months for 2 years, with decreasing intervals thereafter. The use of imaging should be guided by clinical findings rather than by routine due to high false-positive rates, and the lack of survival benefit in detecting asymptomatic distant metastases. Positive sentinel nodes should be treated with complete node dissection and radiation depending on the level of the nodal disease. Once there is involvement in distant sites, therapy is primarily for palliation. The literature on the management of recurrent and metastatic diseases is particularly limited. The only consensus seems to be that the outcome of high stage MCC is gravely unfavorable.","title":"Ileocaecal recurrence of Merkel cell carcinoma of the skin: a case report"}
{"_id":"ac9445c2-4dd8-5ab5-da76-0be0be59eb31","text":"Scrotal calcinosis is a benign condition that occurs in young adults. Clinicians have to reassure patients because the nodules concern an intimate part of the body. Urologists have to keep in mind the aesthetic prejudice and the functional aspect of the surgery. An acceptable restitution of the scrotal skin integument after surgical excision is imperative. Better knowledge of the etiopathogenic aspects of scrotal calcinosis may lead to more efficient surgical procedures with the aim of ensuring better results and preventing recurrences.","title":"Scrotal calcinosis: two case reports"}
{"_id":"ac953f8d-d832-2386-c3e4-65ce5e9e13a5","text":"The standard radiograph of the pelvis showed a predominantly calcified medial structure projecting onto the pubic symphysis with calcifications of the soft parts of the left thigh and diffuse mediacalcosis (Figure 1).","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"ac99b797-a72b-fbb3-24d6-305a20d6ed26","text":"In conclusion, these cases illustrate two cases of UEDVT presenting in two patients with histories of repetitive use of their arms, one as a bowler and the other as a barista. Clinical awareness of UEDVT in a patient with recent repetitive upper extremity movement is vital to avoid potentially disastrous complications. In the case of the bowler, treatment with anticoagulation and strict follow-up for the development of hypercoagulable disorders or malignancy have allowed the patient to return to the bowling alley. In the second case urgent awareness of the need to obtain surgical intervention was needed. Even once the thrombosis in her subclavian vein had been removed, she still did not have circulation in her subclavian vein when her arm was abducted. That a surgical intervention almost did not occur was seen when the patient was sent home from the emergency ward on anticoagulation alone. Fortunately, she was seen and referred the next day and operated on expeditiously.","title":"Upper Extremity Deep Vein Thromboses: The Bowler and the Barista"}
{"_id":"ac9d488d-1367-6f52-1e00-9a4087f8e70c","text":"Public health physicians must increasingly play a key leadership role not only in the health sector, but in the wider public sector. The best candidates will therefore be individuals who demonstrate the ability to work effectively within teams, and who bring leadership qualities to those teams.","title":"Educating public health physicians for the future: a current perspective from Aotearoa New Zealand"}
{"_id":"ac9e1bf3-643a-f0bf-dba3-5f148a423429","text":"The general surgery department in this study showed a better adherence in selection of antibiotic compared with OBGYN and orthopedic department, a finding shared with a Turkish study which showed that general surgeons use antibiotic prophylaxis more appropriately [19]. On the other hand OBGYN had much better adherence to the dosing time and duration possibly because most of surgeries done in this department are cesarean sections which follow agreed on non-written protocol.","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"aca2d769-7b6f-153d-08b5-aed127c0a9c3","text":"First, with a total flap loss of less than six percent, we have shown that combined PPFs were a reliable and promising reconstructive approach in the reconstruction of large soft tissue defects, which has thus far received little attention from a research perspective.","title":"Combined versus Single Perforator Propeller Flaps for Reconstruction of Large Soft Tissue Defects: A Retrospective Clinical Study"}
{"_id":"aca652e8-1fcf-95f3-7907-ec2a3d448ee4","text":"In our initial experience using this technique to augment the venous outflow in the SGAP flap, we have found it to provide reliable and persistent improvement in venous congestion. While CTA guided the design of our flap skin island, we did not need to alter the position and dimensions of the flaps to include the second perforator, as they had a tendency to fall within the standard flap territory. Venous congestion was identified intraoperatively after successful anastomosis of the primary perforators of the superior gluteal artery and vein and subsequent anastomosis of an additional vena comitans resulted in clinically observable improvement in the venous congestion. It is important to note that there is often a dominant vena comitans in each pedicle, which contributes more to the overall venous outflow of the flap. Typically, one of the venae comitantes will be much larger than the other and, more importantly, quite attenuated. This vessel should be identified as dominate and used as the secondary venous outflow.","title":"A Novel Technique for Augmenting Venous Outflow in the Superior Gluteal Artery Perforator (SGAP) Flap Carruthers et al"}
{"_id":"aca7ea2c-b269-e17b-bdcb-43bfd80a89a5","text":"Starting at the bottom of the reconstructive ladder, healing by secondary intention is a viable option for reconstructing excisional defects. Secondary wound closure may be used for small, superficial defects located in areas where the risk of structural distortion secondary to wound contraction is low.52 While this form of reconstruction is non-invasive, patients are often left with an unsightly hypopigmented scar that may be undesirable for some patients.52","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"acbce80c-324b-f9e3-c641-14184fdba7ed","text":"The objective of this present study is to show our experience with NPWT in treating surgical wounds in patients with infections after TKA, associated with or independent of dehiscence, and also as a prophylaxis in wounds considered to be at risk for healing problems.","title":"NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY TERAPIA COM PRESSÃO NEGATIVA EM FERIDAS NO TRATAMENTO DE LESÕES GRAVES APÓS ARTROPLASTIA TOTAL DO JOELHO"}
{"_id":"acbf06df-4609-14c5-e9a7-4fecc4493dc6","text":"We report a case of a Gustilo type IIIC open fracture with massive loss of the tibial diaphysis. After the damaged, tibialis posterior artery was repaired at the level of the ankle during emergency surgery, and immediate intramedullary insertion of the ipsilateral fibula on its peroneal arterial pedicle between the two preserved edges of the tibia was performed in a single procedure. To our knowledge, this is the first case in which emergency single-stage acute tibialization of the fibula is described.","title":"Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture"}
{"_id":"acc2c866-449c-f9d9-52af-9f89641026a9","text":"Table 1 lists the relationships between the scores adopted and risk stratification of clinical and surgical patients and also the thromboprophylaxis recommended by the ACCP in each case. Very low and low-risk surgical patients were classified as a single category since they have the same prophylaxis recommendation.","title":"Evaluation of deep vein thrombosis prophylaxis in a general hospital"}
{"_id":"acc7388e-f8bb-afd7-ace7-bf38df0fb7fe","text":"Nerve block technology is widely used in clinical practice for pain management. Conventional nerve localization methods, which only rely on palpation to identify anatomical landmarks, require experienced surgeons and can be risky. Visualization technologies like ultrasound guidance can help prevent complications by helping surgeons locate anatomical structures in the surgical area and by guiding the operation using different kinds of images. There are several important and complex anatomical structures in the oral and maxillofacial regions. The current article reviews the application of ultrasound guidance in oral and maxillofacial nerve blocks.","title":"Application of ultrasound guidance in the oral and maxillofacial nerve block"}
{"_id":"accb5817-c1f1-151e-aaca-5208f05397f0","text":"The incidence of DVT in patients with direct and indirect ARDS has not been investigated.","title":"Prevalence, risk, and outcome of deep vein thrombosis in acute respiratory distress syndrome"}
{"_id":"accc5afa-3831-be72-8934-ff8f9e61822c","text":"The study was approved by the Ethics Committee of Hainan Hospital of People's Liberation Army General Hospital. This study conformed to the Declaration of Helsinki, and all participants provided written informed consent. All patients received the treatment for 12 months and were followed up every 3 months, 4 times in total during and after completion of the treatment. Any alteration in hair growth of the head and associated adverse events were recorded during the treatment and at each follow-up visit. Representative photographs of the head were acquired before and after each treatment.","title":"Effectiveness and Safety of Botulinum Toxin Type A in the Treatment of Androgenetic Alopecia"}
{"_id":"accfca7c-56cf-511a-753f-a4a05967039f","text":"Surgical management is mainly indicated when the patient suffers from myelopathy and\/or neurological dysfunction. Surgery typically consists of a decompressive procedure to relieve the compression of the spinal cord in combination with a fusion procedure which aim to eradicate any instability. This stabilization process also prevents further progression into VS or SAS.","title":"Radiological assessment and surgical management of cervical spine involvement in patients with rheumatoid arthritis"}
{"_id":"acd2cd85-3d93-2da3-4544-8f314a23784c","text":"Appropriate timing of administration of the first dose of chemoprophylaxis is not clear. Studies have shown that administration of the first dose of chemoprophylaxis within 6 hours can significantly increase the risk of bleeding.24 We found a significant difference in hematoma formation in patients receiving preoperative dalteparin, which led to a change of our practice of giving dalteparin only postoperatively. The average timing of the first dose after surgery varied because of daily ward practicalities, but still we achieved a low VTE prophylaxis prevalence overall.","title":"Risk of Thromboembolism Following Body-Contouring Surgery After Massive Weight Loss Griffin et al"}
{"_id":"acdc16ad-aa04-7901-94fd-737ac300274c","text":"Radiotherapy is used by oncology teams to destroy cancer cells by damaging cellular DNA. In head and neck cancer, this treatment modality is commonly used as an adjuvant to primary surgery. An external beam is used to target specific sites. The total dose of radiotherapy delivered is undertaken in daily fractions over the course of six weeks. However, it may also be employed before surgery as a neoadjuvant technique or in cases of advanced end stage cancer to manage symptoms.","title":"The dental management of a mouth cancer patient"}
{"_id":"acde31d5-e2b4-2c41-85e3-8505ceb06d5d","text":"Filler injection or implantation is a progressing revolutionary subject. Although the widely available kinds in many implications are considered safe, post filler adverse events are not uncommon. These reactions range from mild reactions such as edema or erythema to detrimental reactions such as recurrent infected granuloma or vascular occlusion, which are predominantly related to non-FDA approved materials. Here, we presented a patient with a significant history of gluteal augmentation using unlicensed silicone who developed extensive retroperitoneal fibrosis complicated by deep venous occlusions and obstructive uropathy.","title":"Retroperitoneal Fibrosis after Chronic Abscesses of Silicone Fluid Fillers in a Case of Gluteal Augmentation"}
{"_id":"ace38026-3382-02d8-92f4-298e65f39265","text":"Several lessons were learned from this case. The first was that all procedures should only be performed after full discussion between the reconstructive surgeons. This means that a multidisciplinary team approach is very important. We were able to save the limbs thanks to new procedures such as the use of the fractured segment of fibula, which was an idea derived from close discussion between the orthopaedic and plastic surgeons. The second lesson was that one procedure is not enough for a severe Gustilo–Anderson type IIIB open fracture. Combination techniques should be considered, such as sequential chimeric free flaps, one-stage vascular fibular grafts, the induced membrane technique, and the fix and flap technique with bridging therapy using NPWT. The third lesson was that we should always think about future rehabilitation of multiple open fractures. Donor site morbidity should be considered before the final reconstruction. A fourth lesson is that we should consider that there is always a way to save the leg. In some situations, the use of an ipsilateral fractured fibula transfer along with a sequential chimeric flap may offer another option for specific severe trauma cases.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"ace52cd7-e0ba-3f13-8030-e4cd1dd33739","text":"The primary outcomes were the cumulative incidence and the clinical risk factors of proximal ADVT at admission and AVDT and SDVT at discharge.","title":"Asymptomatic and symptomatic deep venous thrombosis in hospitalized acutely ill medical patients: risk factors and therapeutic implications"}
{"_id":"aceb57d5-02d0-054e-5273-8b1699f8921b","text":"Early detection of severe sepsis and prompt aggressive treatment of the underlying organ dysfunction is an essential component of improving outcome of critical ill patients.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"acee16ea-b9d2-9dac-aa04-9a89efb79acf","text":"The statistical analysis plan will be locked prior to analyses being undertaken and will be made freely available at the time of publication.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"acefd7e5-bd80-0d25-918d-0047e3b8bf3a","text":"In VTE patients requiring chronic anticoagulation, both time to start thrombin generation and time to peak thrombin generation derived from CAT may predict the risk of minor bleedings on rivaroxaban. Together with unprovoked etiology of VTE, time to start thrombin generation were found to be independently associated with a predisposition to minor bleedings. However, CAT parameters are not accurate enough in the prediction of minor bleedings in patients on VKA. Our findings require further validation in the larger studies.","title":"Delayed Thrombin Generation Is Associated with Minor Bleedings in Venous Thromboembolism Patients on Rivaroxaban: Usefulness of Calibrated Automated Thrombography"}
{"_id":"acf2df14-181d-56cf-ed48-f8edbe65b1aa","text":"This work serves to define the magnitude of PSM as a surgical challenge in the most common solid cancers in the US. Treatment algorithms vary considerably depending on cancer site and stage, but surgical excision remains axiomatic. A PSM commonly translates into worse prognosis and additional burden to patients and the healthcare system by necessitating adjuvant therapies. Our findings may be helpful to prioritize efforts aimed at mitigating PSM, thereby optimizing value and improving patient outcomes.","title":"Positive Surgical Margins in the 10 Most Common Solid Cancers"}
{"_id":"acf31bf4-48c1-71cb-c564-2b4ce93c3f84","text":"Figure 3d shows that the relationship between temperature and electrical conductivity produces an electric field that also has a point of inversion around 0.2 cm, which is the outer edge of the frozen lesion. Figure 3d shows that the electric field in the frozen region drops precipitously during thawing to a constant value of 32 V\/m (for the 1 V potential on the cryoprobe). It is apparent that if the temperature in the frozen region during thawing stays at the phase transition temperature, the electrical conductivity in the frozen region will remain constant throughout thawing and (in Cartesian coordinates) the electric field in the frozen region will remain constant as well. This suggests that if PEFs are applied during thawing they will be confined and delivered in the frozen region across cells that are all at the highest possible subfreezing temperature. This could allow for precise design of PEF by utilizing electrical parameters that only affect thawing cells in the frozen tissue at the phase transition temperature.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"acfc63d1-f2d5-c750-1f09-7f62f3ba5a5e","text":"We then concluded that those breastfed implants had less ENT changes and as well as less acoustic immittance change, thus enabling OAEs. Breastfeeding alone can be considered a protection factor against middle ear changes.","title":"The influence of the type of breastfeeding on middle ear conditions in infants"}
{"_id":"acfe25fe-497b-70b3-9c54-021979c110b0","text":"In other words, this noninvasive approach is highly precise, while it is quick and cost‐effective to detect skin lesions malignant and reduces rate of false negative and false positive estimates that lead to additional costs and psychological stress on suspected patients.","title":"Early diagnosis of skin cancer by ultrasound frequency analysis"}
{"_id":"ad009837-aa6f-e5c7-a8e9-e4e57961db1f","text":"This study was conducted with only 15 patients over a period of less than 3 years. Further studies should be conducted in the future with additional patients with various affected areas and different types of postsurgical cicatricial alopecia and over longer periods. Specifically, the difference in the histological background of the underlying infrastructure found in the dermis and along the hair follicular unit between the normal scalps and postsurgical scalps with scars should be identified to explain the different hair graft survival rates. Additionally, the average graft survival rate in this study was 80.67%, which was higher than that previously expected for hair transplantation in cicatricial alopecia but still lower than the average survival rate for normal tissues. Various approaches, such as preoperative fat grafts and adipose stem cell grafts, could be combined in advance with hair transplantation to increase the quality and pliability of scar tissue and ultimately increase the graft survival rate [33–35].","title":"Treatment of Postsurgical Scalp Scar Deformity Using Follicular Unit Hair Transplantation"}
{"_id":"ad069357-fe0f-2f13-272f-b41edf90c432","text":"During the time of this study, the total number of elite postdoctoral fellowship awards granted decreased; however, their impact as an early career training mechanism to keep individuals in federally funded, future, independent science careers was robust. Of interest to note, the number of fellowship applications decreased during the years when federal funding of biomedical research doubled. Applicants most likely shifted from applying for their own research grants to being signed on to their mentor or supervisor’s grant as the decrease in applicants occurred when funding for postdoctoral researchers on elite independent research grants and research program grants became more available. Postdoctoral appointments on these types of grants did not require postdocs to develop a research proposal distinct from their mentors’ research in order to be appointed. This may influence the direction of their careers and should be studied further.","title":"Advancing biomedical science through investments in elite training"}
{"_id":"ad0ab736-3fbe-e902-e86d-89051151ecb3","text":"This study shows the utility of free functional latissimus flaps to provide coverage and restoration of knee range of motion following resection of a soft tissue sarcoma of the thigh. Although these procedures are technically demanding, they allow for most patients to ambulate without gait aids and to return to all activities of daily living who would otherwise have substantial impairment in function of the extremity.","title":"Free Functional Latissimus Dorsi Reconstruction of the Quadriceps and Hamstrings following Oncologic Resection of Soft Tissue Sarcomas of the Thigh"}
{"_id":"ad113545-63e7-2ad9-a3a7-725b2f33e9b7","text":"Children with ASD have a shorter duration of breastfeeding, a later introduction of complementary foods, and poorer acceptance of complementary foods than TD children. These feeding patterns may be related to the symptoms and growth of children with ASD. The research suggests that continued breastfeeding for longer than 12 months may be beneficial in reducing ASD symptoms and that infants who have difficulty introducing complementary foods should be followed up for neurodevelopment.","title":"Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: a national multicentre survey"}
{"_id":"ad131dfa-20b6-9137-2751-0e5e231e426e","text":"Photodynamic therapy is also an option under trial in which medical researchers seek to improve the efficacy and use in the treatment of mesothelioma. Researchers hope to develop photosensitizers that specifically target cancer cells and have more toxic reactions. They also hope to find a more effective means of administering the necessary light which can penetrate tissue and treat larger tumors.","title":"Malignant mesothelioma"}
{"_id":"ad1a7d78-5e5f-90d2-90d5-09c73e900094","text":"The objective of the treatment planning process for EBT using the surface applicators is to calculate a dwell time to deliver the prescribed dose at a specified depth. The process for EBT surface application treatments follows a similar approach as traditional Ir-192 HDR brachytherapy using the Leipzig applicators. In both modalities, a prescription depth and dose are chosen, an applicator size is selected, and the patient is treated for a dwell time. The key distinction between the two modalities is the calibration and calculations associated with the EBT 50 kV source versus the Ir-192 source.","title":"The initial experience of electronic brachytherapy for the treatment of non-melanoma skin cancer"}
{"_id":"ad28981f-ddc5-03c9-12e5-730d12cd94aa","text":"VR Fellowships exist in the UK and fellow experience is normally shared anecdotally between medical professionals.","title":"Experience gained during vitreoretinal fellowships in the United Kingdom"}
{"_id":"ad31f80e-cd2a-c1ff-504a-381d8bd73478","text":"Motamed and Davami believed that composite graft was preferable for females while the superficial temporal artery island flap seemed more suitable for males.8","title":"Complex Nasal and Periorbital Reconstruction Using Locoregional Flaps: A Case Report"}
{"_id":"ad3587e4-b9e0-a931-f550-fd233691fc03","text":"Descending dissection of the major nervous trunks and proper identification of cutaneous sural nerve rami from their origins.","title":"Popliteal lymph node dissection for metastases of cutaneous malignant melanoma"}
{"_id":"ad3da4d2-1339-a4a0-4896-516e6b6fab9b","text":"The digital dorsal fascial island flap and the crossfinger flap are commonly used in hand surgery with reliable blood supply. The crossfinger flap anastomosed with dorsal digital nerve can make the finger more sensitive and restore the sensory function earlier (12). We combined the two flaps to repair the soft tissue defect degloving injury of the distal segment of the finger, which can repair the wound defect at one time and preserve the function of the finger to the greatest extent (22, 23), while reducing the damage to the donor site and recovering the function of the affected finger as soon as possible. This method can change the large damage into several small damage areas, and change the large defect area into two small defects from the three-dimensional point of view. This operation method is suitable for clinical application and has a high application value.","title":"The Clinical Effect of Digital Dorsal Fascial Island Flap Combined With Crossfinger Flap for Repairing Distal Degloving Injury and Sensory Reconstruction"}
{"_id":"ad57e2d8-7365-dda9-e8ff-cfad31a10b93","text":"The disadvantages of performing a biopsy are the risk of propagating an impending fracture into a complete fracture, and the morbidity associated with the delay necessitated by the process and interpretation of the biopsy. In patients with impending fractures, one-third did lead to completed pathological fracture following biopsy; however, this was often not at the time of biopsy but after a median period of 12 days post-biopsy, which may reflect the hazards of transferring patients to and from a diagnostic center and the delay of the pathway while awaiting the biopsy outcome before definitive treatment.","title":"The Importance of Awaiting Biopsy Results in Solitary Pathological Proximal Femoral Fractures Do We Need to Biopsy Solitary Pathological Fractures?"}
{"_id":"ad58a78c-7e44-b126-704d-e675127b17e4","text":"Cutaneous scarring can cause patients symptoms ranging from the psychological to physical pain. Although the process of normal scarring is well described the ultimate cause of pathological scarring remains unknown. Similarly, exactly how early gestation fetuses can heal scarlessly remains unsolved. These questions are crucial in the search for a preventative or curative antiscarring agent. Such a discovery would be of enormous medical and commercial importance, not least because it may have application in other tissues. In the clinical context the assessment of scars is becoming more sophisticated and new physical, medical and surgical therapies are being introduced. This review aims to summarise some of the recent developments in scarring research for non-specialists and specialists alike.","title":"Cutaneous Scarring: A Clinical Review"}
{"_id":"ad5b83de-937b-d241-7b93-9123050b4d6a","text":"Diagnosis of this syndrome on the first presentation may be challenging for clinicians. Symptoms including pain and swelling of the limb with possible redness strongly suggest DVT.","title":"Acute osteomyelitis, thrombophlebitis, and pulmonary embolism: a case report"}
{"_id":"ad5d96bc-744e-c481-f704-082faa2825ad","text":"The versatility of latissimus dorsii flap, good aesthetic and functional results and its simple execution made it an important option in the armamentarium of the oncoplastic breast surgeon. Also, morbidity of the donor site was minimized without sacrificing muscles or nerves.","title":"Lateral Thoracodorsal Flap Revisited: An Underappreciated Workhorse"}
{"_id":"ad5e4088-6848-cabd-b09c-f4ab91d6db5e","text":"The injected fat is gently massaged and dispersed to prevent deformities or sharp edges between treated and untreated areas. It is important to refrain from applying pressure on a single point to prevent visible deformities. When treating the perioral area, the endotracheal tube should be held firmly by the surgeon to prevent inadvertent movement of the tube. A finger should be placed inside the mouth behind the lips to guide fat grafting to the lips and to prevent puncture of the internal part of the lips.","title":"Total Facial Autologous Fat Grafting for Treating Skin Manifestations in Scleroderma"}
{"_id":"ad615a1e-73e4-0776-ec09-83cf75815572","text":"Clinically they are characterized by sterile inflammation attacks. By the time they were well defined only in the pediatric age group.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"ad6a8ee8-c3f2-dcf6-254e-624a77ca35a9","text":"Between November 2009 and July 2012 11 patients were operated with the flap technique. We operated nine men and two women aged between 10 and 66 years. The surgical indications were acute trauma in four patients and post-traumatic osteomyelitis in seven patients. The small defects were covered ranging from 3x3 to 6x3 cm. The patch was applied with proximal stalk in most cases.","title":"Extensor digitorum brevis flap on the treatment of lower limb injuries"}
{"_id":"ad6ab831-ee98-da1f-4e1d-1223b748f50d","text":"EMDA of intravesical alkalinized lidocaine, intravesical, alkalinized lidocaine without EMDA, and a reduction in the number of injection site were all associated with improvements in patient tolerability during LA BTA injections. Further research should address which subgroups of patients find the procedure most painful and would benefit most from these interventions.","title":"Interventions to improve tolerability of local anesthetic intradetrusor Botulinum toxin injections: A systematic review"}
{"_id":"ad6b6389-c514-9797-4116-a96d804023c7","text":"Deep ILNM is the most accurate factor for predicting PLNM in PSCC according to our data. We recommend that patients with deep ILNM should be referred for pelvic lymph node dissection. Involvement of deep ILNs indicates poor prognosis. We propose that patients with metastases of deep ILNs may be staged as pN3.","title":"Deep Inguinal Lymph Node Metastases Can Predict Pelvic Lymph Node Metastases and Prognosis in Penile Squamous Cell Carcinoma"}
{"_id":"ad6b78dd-aa9d-b5f0-9978-555bd0f2ba32","text":"Although the patient numbers in this study are limited, SSL is demonstrated to be feasible for patients whose cancer has previously been treated with ALND. In these cases where the dissected axilla is an anticipated drainage basin, alternative lymphatic drainage pathways should be considered. Preoperative lymphoscintigraphy can be helpful in delineating the location(s) of the SLNs in these complicated cases and can guide the surgical plan. It is not clear from our study if the lymphatic drainage through a previously dissected axilla represents de novo lymphatic formation or residual lymph channels. There is evidence of lymphatic growth in humans following ALND (Stanton et al) with lymphedema. Although the complex interplay of cytokines responsible for lymphangiogenesis has been well defined in animal models, that understanding has yet been translated into human medicine.12 In patients with previous ANLD, we cannot exclude either the possibility of lymphangiogenesis or of residual lymphatics. Unraveling the complexity of these drainage patterns in patients with previous ALND requires lymphoscintigraphy as a helpful means of identifying SLNs. Additional study will be needed to further validate these conclusions.","title":"Reoperative Selective Sentinel Lymphadenectomy Combined With Lymphoscintigraphy Is Technically Feasible for Cutaneous Tumors of the Upper Extremity After Radical Dissection of Regional Lymph Node Basins for Breast Cancer Miranda et al"}
{"_id":"ad72ed9f-782b-590a-d8d9-1408422cc69d","text":"Ankyloglossia, or tongue-tie, is a congenital anomaly that is characterized by a short lingual frenulum.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"ad75a91a-dd44-8c8a-17e3-af5b5d3fcf68","text":"A 35-year-old man has been referred to our Dermatology Clinic with the complaint of painful firm immobile nodules along with a surgical scar on the dorsum of his hand. There were also pus drainage and ulceration in some part of the scar. He claimed that there was a tumoral swelling at the dorsum of his left hand in the second metacarpal area for 12 months. It had been gradually increased in size and led to the restriction of the movement of the index finger. Therefore, he came to an orthopedic surgeon and underwent a tumor excision operation about six months ago. He completely improved after this surgery and did not follow up any further treatment. Four months after the surgery, some painful immobile ulcerated nodules with low discharge appeared on the way of the surgical scar. He works as an electrical technician but there was no obvious history of trauma or significant medical problem. Physical examination showed swollen areas at the dorsum of the left hand and palpable tender immobile nodules on the surgical scar with low discharge. Some nodules showed ulcerated crusted surface (Figure 1).","title":"Primary Cutaneous Actinomycosis along with the Surgical Scar on the Hand"}
{"_id":"ad7c40c7-bb28-be2c-5bf1-8662c13da763","text":"The defect found after releasing burn contracture was resurfaced by five diverse modalities was questionable. Most of our patients had simple skin contractures involving fingers, full thickness and split thickness skin grafting was used in bulk of patients compared to loco regional flaps, despite of complete release of contracture and available physiotherapist in our plastic surgery department the non-compliance and poor follow up of rehabilitation protocol was noted in recurrent cases. Whereas other patient with compliance and proper follow up had achieved adequate hand drive, aesthetically acceptable hand and had better quality of life. This study will be adding data in medical institute which can be beneficial in option the better treatment planning. There are certain limitations about study are small sample size of patients, single centre study and no randomization was done. Further prospective studies and randomization will help decreasing the limitations.","title":"Surgical Management of Post Burn Hand Deformities"}
{"_id":"ad83b951-616f-7ee7-564c-04dd4634e795","text":"As yet, there are no evidence-based clinical guidelines for the prophylaxis and treatment of radiation dermatitis.27 The R1 and R2, Lactokine-based, topical agent has been described previously in a case report as a potential prophylactic treatment option.17 The results are awaited of a controlled clinical evaluation of R1 and R2 as a topical skin treatment in patients wit SCCHN.17 We have reported the findings of the first study to evaluate R1 and R2 in the prevention and alleviation of radiation dermatitis in a controlled study in the clinical setting of a radiation oncology service.","title":"Topical R1 and R2 Prophylactic Treatment of Acute Radiation Dermatitis in Squamous Cell Carcinoma of the Head and Neck and Breast Cancer Patients Treated With Chemoradiotherapy Manas et al"}
{"_id":"ad8cb0bc-d362-aea3-2fc3-38dd8255b199","text":"Do you experience or have you experienced chest pain prior to the admission?","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"ad8d5568-1112-fd6c-3424-f8039583f611","text":"The sacrifice of the ninth pedicle was necessary to allow the LD muscle to reach the defect satisfactorily.","title":"The “Reverse” Latissimus Dorsi Flap for Large Lower Lumbar Defect"}
{"_id":"ad94c982-0386-0640-7e59-c2f7bd51d300","text":"We thank the patient and her family for participating in this study.","title":"Bilateral breast myxedema caused by Graves’ disease and responsive to multipoint subcutaneous injection of long-acting glucocorticoid Case report"}
{"_id":"ad984a11-5cf9-b848-fa58-e39d211071a2","text":"The diagnosis of cellulitis was made solely at the discretion of the treating physician as there are no widely accepted criteria and cellulitis is diagnosed on clinical grounds [1]. It is therefore possible that other illnesses may be misdiagnosed as cellulitis. This uncertainty is an unavoidable aspect of management of cellulitis. There is limited application of the results of this study to those patients at very high risk due to the low number of these patients included. This primarily includes those with a hypercoaguable state, such as those with active malignancy. Anticoagulation will reduce the chance of DVT, but the small number of patients on anticoagulants were included as thrombosis can still occur, especially when anticoagulation is subtherapeutic. A large proportion of patients were taking aspirin but this does not substantially reduce venous thromboembolism [16]. The method of insonation of the femoral and popliteal veins was performed in accordance with current guidelines but only a single ultrasound was performed in the assessment of DVT. It is possible that calf DVTs were missed by this approach and clinical pathways recommend a repeat ultrasound at 5–7 days for those in the high risk group to ensure propagation of calf DVT into the femoral veins has not occurred [10]. No patients were diagnosed with DVT during the 3 months of follow up, which makes this unlikely to have an important affect on the estimated prevalence.","title":"Prevalence of concurrent deep vein thrombosis in patients with lower limb cellulitis: a prospective cohort study"}
{"_id":"ad9bbf0c-389b-a3a2-a3cd-02d109a98ead","text":"Malignant melanoma is a rare disease in Asia, and knowledge on its characteristics and clinical outcome in Asian patients is limited. The purpose of this observational study was to determine the clinical presentation and outcome of patients with melanoma in China.","title":"Clinical presentation, histology, and prognoses of malignant melanoma in ethnic Chinese: A study of 522 consecutive cases"}
{"_id":"ad9c58f2-3bce-37b9-e487-0e6dc5a36f4c","text":"We have produced a pictorial version of an established clinical tool to assess the severity of ankyloglossia and undertaken two initial audits in a single centre. The picture version of the tongue assessment tool works well and is a useful addition to the assessment of tongue-tie in infants. It is quick and easy to use, can be used as a training tool and is straightforward to translate into other languages. The TABBY only assesses tongue structure and function and not the impact on feeding. When used it should be combined with an evaluation of breastfeeding using a structured assessment tool, and a discussion with the mother about the comfort and perceived efficacy of breastfeeding.","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"ada290ae-7890-ac0f-8785-c397635a7df2","text":"It is important that, following debridement, the bone is sufficiently stable to allow weight bearing. Post-operative weight bearing is important to minimize the risks of worsening osteopenia, poor bone healing, muscle wasting and joint contracture. An assessment of the bone stability is made intraoperatively following excision. In cavitary defects, with an intact bone, it may be advisable to apply a simple unilateral external fixator to allow full weight-bearing. In our practice, ~15% of patients with CM type II and III OM have external fixation to prevent fracture and allow full weight bearing (the fixator usually remains in place for ~8 weeks).","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"adac7039-779d-57d5-a07b-c8920a6c551c","text":"Our methodology accurately assesses the adequacy of surgical resection margins for determination of which individuals may need further resection to the affected breast in order to minimize the potential risk of local recurrence while attempting to limit the volume of additional breast tissue excised, as well as to determine which individuals are not realistically amendable to BCS and instead need a completion mastectomy to successfully remove multifocal disease.","title":"Standardized and reproducible methodology for the comprehensive and systematic assessment of surgical resection margins during breast-conserving surgery for invasive breast cancer"}
{"_id":"adb212bc-c84c-a514-06f0-f4ced3004f68","text":"Primary care of these cases by conventional orthopedic surgeons who are not specifically trained in orthopedic oncology has a major impact on the recurrence rate. In our study, 20 patients were referred by general orthopedic surgeons. Therefore, we advise that the recurrences be handled carefully, and preferably by an orthopedic surgeon who has had training in oncology. In experienced hands, the likelihood of recurrence does not rise if these are further sufficiently curetted or excised according to the degree of the lesion. However, in comparison to primary de novo lesions, further treatment in recurrent lesions with curettage or excision becomes challenging and should be handled by a person with expertise in this field due to the scarring and fudging of tissue planes. The advantage of this study is that all cases were handled by a single orthopedic oncological surgeon and the same team in a single institution. In a reasonably large series of 22 patients, there is a good follow-up period of 2-10 years. In conjunction with the operating surgeon, each case was examined histopathologically by pathologists with musculoskeletal onco-pathology training, and radiologically by an experienced radiologist. The fact that 20 patients were initially treated by general orthopedic surgeons elsewhere and referred to us after a recurrence is one of the study’s limitations. It is unclear if many of these cases actually involved microscopic illness or a residual macroscopic tumor. It is unknown how well the curettage has been executed. Since we have included cases of recurrence after curettage as well as after resection, there is no comparison between the cases in light of prior treatment.","title":"A Tertiary Care Centre Experience of Recurrent Giant Cell Tumor Around the Knee Joint"}
{"_id":"adc1d013-79f4-c863-6886-efcc493f66d8","text":"PCD is a rare condition with high morbidity and mortality, often presenting as a triad of severe pain, swelling, and cyanosis of the affected limb with extensive DVT. Its recognition warrants timely and aggressive intervention with anticoagulation, thrombolysis, or thrombectomy to prevent progression to venous gangrene with possible limb loss or death. Heparin remains the anticoagulant of choice for acute treatment. Early recognition and treatment of PCD can prevent the development of CS by mitigating the early propagation of thrombosis. Right lower extremity involvement due to iliac vein compression is much less common than disease on the left but can occur. Similarly, the development of CS with eventual limb amputation and death can occur even with emergent fasciotomy. While our patient had a negative outcome, our case adds to the current literature and highlights the importance of identifying and treating PCD, as it is reversible if the patient undergoes appropriate therapy early. This case also highlights the role of antibiotics especially in the initial stages of management when an infectious etiology cannot be excluded.","title":"Right Lower Extremity Phlegmasia Cerulea Dolens Due to Iliotibial Vein Thrombosis With Compartment Syndrome and Circulatory Shock: Case Report and Review"}
{"_id":"adc5336e-964c-47a7-08a7-bb524ab7949b","text":"On the other hand, the costal cartilage or costa grafts have the inherent limitations because of their age-related changes. Calcification in both costal cartilage and costa will change with the increase of age. These histological changes can results in the difference of biomechanical properties, which can affect the treatment effects. So-Eun Han reported that calcification and the associated stiffness of costal cartilage with increasing age were important factors that leaded to unexpected absorption and poor surgical results. Wofford believed that costochondral costal grafts were better used in children and adolescents because of the poor quality of costa in the elderly. Thus, it is an important problem how to evaluate the morphological and histological characteristics before surgery and calculate the degree of calcification of costal cartilage or costa.","title":"Characteristics of Chinese Costal Cartilage and Costa Calcification Using Dual-Energy Computed Tomography Imaging"}
{"_id":"adcc3b25-7032-368b-5b51-3ab285d04031","text":"An 11-year retrospective study was conducted including patients diagnosed with an STS that underwent curative intent treatment at our Center for Musculoskeletal Surgery from January 2010 to December 2020.","title":"Surgical Margins in Soft Tissue Sarcoma Management and Corresponding Local and Systemic Recurrence Rates: A Retrospective Study Covering 11 Years and 169 Patients in a Single Institution"}
{"_id":"add2aeaa-f679-4bd9-84a5-3d694ca181a0","text":"The surgical utilization of ultrasound or LASER has been advocated for boosting skin tightening during liposuction, facilitating the creation of variable degrees of muscle definition. Both technologies have shown a great capacity for eliminating fat and are a good indication for secondary cases, facilitating fat removal and potentially decreasing bleeding and causing less swelling and bruising.","title":"Prevention of Umbilical Sagging After Medium Definition Liposuction"}
{"_id":"add3fd4d-4a28-94c9-f416-9f799f7aaa01","text":"In lymphatic disease contrast enhanced ultrasound has successfully been used to assess lymph nodes and superficial lymphatic networks in the extremities (57). Injection of contrast inside inguinal lymph nodes is an effective technique to confirm the position of the needles before intranodal dynamic contrast magnetic resonance lymphangiography when fluoroscopy is not available (58). During intranodal or intrahepatic dynamic contrast magnetic resonance lymphangiography thoracic duct outlet cannot be directly visualized and therefore fails to accurately demonstrating thoracic duct patency. Contrast enhanced ultrasound is a simple, save method that allows direct visualization of lymphatic flow into the venous system to confirm patency and may become a routine procedure in the future before or after dynamic contrast magnetic resonance lymphangiography (54). This is particularly important in patients where obstruction of the thoracic duct outlet is suspected as the success of innominate vein turn down procedures or lymphovenous anastomosis is highly dependent on unobstructed flow in these patients.","title":"Current diagnostic and therapeutic strategies for the management of lymphatic insufficiency in patients with hypoplastic left heart syndrome"}
{"_id":"add54df7-781f-0730-98fd-5daf318abff4","text":"With better understanding of the mechanism of actions of BTX, new uses are being recognized and hence the indications for the use of BTX have expanded. However, it is important that the physician understands the anatomy and physiology and the pharmacology of BTX properly to derive maximum benefit for the patient.","title":"Botulinum Toxin: Non-cosmetic Indications and Possible Mechanisms of Action"}
{"_id":"add98eed-52b3-e8b8-4e8c-30ad2cc6d134","text":"Methods: Retrospective review of all CESM conducted in our hospital from Sept 2020 to September 2022. Data collated from Radiology Information System and PACS. Representative cases were selected to highlight the most common indications and contraindications as well as illustrate artefact issues and imaging pitfalls encountered in our initial learning curve.","title":"Sixth Annual Mediclinic Middle East Research Conference"}
{"_id":"add9dfd7-5150-1490-3fc7-ad8bcc22c494","text":"Postoperative complications were defined as any adverse developments that required intervention, compromised the postoperative course or when readmission to the hospital was required. A distinction was made between surgical and systemic complications. Surgical complications were defined as adverse events considering the flap, recipient site or donor site. Systemic complications were defined as medical adverse events not considering the flap, recipient site or donor site. Patients with multiple surgical or systemic complications were classified as one surgical or one systemic complication for statistical analysis.","title":"Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction"}
{"_id":"addc5ab4-73ea-a58c-c21a-992c4330ff0e","text":"Clinicopathological data from the Dutch nationwide network and registry of histopathology and cytopathology were retrieved from patients diagnosed with primary cutaneous melanoma in The Netherlands between 2003 and 2014. SLNB enactment was analyzed per year. Multivariable regression models were developed to assess the determinants of SLNB enactment.","title":"Trends in Sentinel Lymph Node Biopsy Enactment for Cutaneous Melanoma"}
{"_id":"adde3dca-d658-ca15-a5a1-84427294d057","text":"The innervated gracilis free flap represents a great choice for functional reconstruction of small and medium defects of trapezius muscle following tumor resection. The availability of muscular innervated tissue with minimal donor site morbidity, allows the surgeon to perform radical resection with greater disease-free margins and better control of disease without concern about reconstruction options. However, the rarity of the disease and the related prognosis requires more evidence to outline a defined therapeutic and reconstructive algorithm.","title":"“Functional trapezius muscle reconstruction after resection of a desmoid tumor using an innervated gracilis free flap”"}
{"_id":"ade72c6e-518b-35ee-2d67-a60ac79a7f08","text":"To provide better guidance for the application of biologic agents in ridge augmentation procedures, evidence to support their use should be consistent with the specific procedure. To further investigate the ability of biologic agents to improve the outcomes of guided bone regeneration procedures, a prospective study with better controlled variables is indicated.","title":"Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study"}
{"_id":"ade7a9da-5c27-ee40-ea43-54ac937afbbc","text":"The mothers are seeking advice and support in finding a situation that can work to finding solutions through resistance as an existential extremity. They are relentlessly walking the uphill struggle to finding solutions. A vulnerability becomes prominent in the continuous striving to breastfeed or to give it up; there are no apparent solutions, nothing to cling on to, like a constant wavering between powerlessness and joy. There is relief when solutions are found and care is offered and given, but there is also grief and despair at the discovery of physiological hindrances that would have been possible to avoid or adjust at an earlier stage if they had been seen and confirmed. An increased belief in themselves becomes present when looking back, thus strengthening the sense of motherhood and the insights that grow with the struggle. Gaining confidence, they can move on.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"adeb545b-8fe3-91d7-10b3-7f415dda1e77","text":"Grafting from the ipsilateral fractured fibula with sequential chimeric flaps may allow more rapid rehabilitation of patients because reconstruction is faster and donor site morbidity is reduced. This procedure may provide a good option for Gustilo IIIB tibiofibular fractures in special circumstances.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"adf79ef1-ff6b-eb10-912a-169f57ffb866","text":"This study shows that high risk food-allergic patients that visit their GPs are often not prescribed an EAI. Thus, previously identified low rates of EAI ownership may be partly due to GPs not prescribing this medication to patients for whom it would be appropriate to do so. These data suggest that there is a need for improvement of the quality of care for high risk food-allergic patients in primary care.","title":"Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands"}
{"_id":"adff2bd3-b96c-7218-5e47-de9129b55777","text":"Chest computed tomography showed a pleural mass adherent to the thoracotomy site. Positron emission tomography revealed mildly increased metabolism with a maximal standardized uptake value of 2.7 within the tumor, suggesting local recurrence of the previous neoplasm. Exploratory thoracotomy and en bloc resection of the tumor revealed spindle cells in a massive collagenous tissue consistent with a desmoid tumor.","title":"Clinical application of next-generation sequencing for the management of desmoid tumors A case report and literature review"}
{"_id":"adff9057-3c8e-9f01-2055-e3582defd2b7","text":"Since their popularization in the 1970s, free flap reconstruction is still gaining in importance in Plastic and Reconstructive Surgery. They represent salvage procedures for extremities or reconstruction methods of choice after cancer.","title":"Seasonal Impact on Free Flap Surgery in Terms of Flap Loss and Wound Healing Disorders: A Retrospective Cohort Study of 158 Free Flaps"}
{"_id":"ae018f8c-cc65-08c1-878c-3735ab970e21","text":"Idiopathic scrotal calcinosis is a rare condition characterized by the idiopathic deposition of calcium in the scrotal dermis leading to the formation of a single nodule or multiple nodules of different sizes. Historically, it was first reported by Lewinski in 1883 and named as idiopathic scrotal calcinosis by Shapiro in 1970 [1]. It is benign and common in the third decade of life.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"ae10726e-7134-20a6-1ec9-703e62156141","text":"The detailed analysis of the responses is shown in Table 4.","title":"Awareness and Perception of Plastic Surgery among Healthcare Professionals in Pune, India: Do They Really Know What We Do?"}
{"_id":"ae1f8a88-6afa-1221-4780-b54ad3489b38","text":"Having knowledge about these complications helps us to know which of them needs prompt medical intervention and which of them will resolve with time and just needs giving reassurance to the patient.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"ae2a8a02-4cfd-dde2-bb1d-accc4af5e73c","text":"Achieving acceptable margins at the time of primary lumpectomy surgery may be increasingly important as techniques for intraoperative radiotherapy evolve and ablative approaches to the lumpectomy cavity are explored.21 When oncoplastic closure techniques are used, it is especially important to avoid positive margins. Reexcision procedures may be difficult in these cases because it can be virtually impossible to accurately identify the specific margin to be reexcised.22","title":"A Randomized Prospective Study of Lumpectomy Margin Assessment with Use of MarginProbe in Patients with Nonpalpable Breast Malignancies"}
{"_id":"ae344dd5-13f5-93d5-7f5b-de75c30bd7ec","text":"In conclusions, the low nasal tip projection in the Asian nose may be secondary to the retropositioned ANS as well as the drooping nasal tip in the Western elders. We could confirm that filler injection between the medial crura and the retropositioned ANS westernizes the Asian nose. This temporary method may be useful to predict the results of ANS augmentation with other permanent fillers and to make a space to be filled with them.","title":"Westernization of the Asian Nose by Augmentation of the Retropositioned Anterior Nasal Spine With an Injectable Filler"}
{"_id":"ae352453-ad9c-78d8-e687-dcc9b30a51aa","text":"Frenectomies can also be carried out following orthodontic treatment. In this instance, surgical access may be difficult but there is the advantage that scar tissue contraction may contribute to keeping the diastema closed. Despite the proposed advantages and disadvantages of the different timing of carrying out a frenectomy there is little evidence to support the type and timing of any surgical intervention.5","title":"The orthodontic-oral surgery interface. Part one: A service evaluation and overview of the diagnosis and management of common anomalies"}
{"_id":"ae3cc92e-f9ef-ceec-ed45-112b26359334","text":"Superficial venous thrombosis is a common disease and a risk factor for thromboembolic complications similar to those related to DVT. Knowing the diagnoses and the appropriate treatment for each situation is important to ensuring patient comfort and avoiding these significant complications.","title":"Guidelines for superficial venous thrombosis"}
{"_id":"ae48e0f9-da4c-92b8-4271-ba7f5590dc57","text":"ACWE model can satisfactorily segment a desired object having weak and deficient edges. This property of ACWE model matches up with our needs because PD images have a very poor transition between soft tissues and bones and some part of the border of bone is destroyed especially in images which has bone edema and cortical deformity. On the other hand PD images have a low SNR than other MR modalities which is also suitable for ACWE model which has ability to segment noisy images.","title":"Segmentation of Bone with Region Based Active Contour Model in PD Weighted MR Images of Shoulder"}
{"_id":"ae49b294-4f9a-5b48-5b9f-0539c34c8fff","text":"The literature search was expanded to include trials concerning follow up of common cancers such as breast, lung and colorectal. There are several randomised controlled trials examining the effects of intensive versus non intensive follow up for these common cancers. The American Society of Clinical Oncology breast cancer follow up guidelines have shown no significant survival advantage with an intensive surveillance protocol instead of a clinically based protocol [21]. There is no consensus regarding the follow up of patients after curative resection for colorectal cancer. The British Society of Gastroenterology guidelines suggest there is no evidence that frequent follow up visits carry significant survival advantages or benefits to patients whereas other meta-analyses have shown some survival benefit as metachronous tumours can be diagnosed earlier [22, 23]. However these tumours have completely different biology and treatment options compared with oesophagogastric tumours, so recommendations regarding the follow up of these cancers while providing a useful framework may not be transferable to oesophagogastric cancer patients.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"ae4c5b2e-e475-9ad2-6afb-464621e4c0b0","text":"Tempromandibular joint (TMJ) is a complex skeletal structure but it is important for normal functioning of the jaw also it's considered the most active functioning joint of the body. Essentially it has two joints with bilateral synovial articulation are connecting below with mandibular bone to the temporal bone of skull from above. Although of this bilateral articulation, these two joints work one unit so they are dependent of each other. TMJ is considered a unique type of joints in the body.","title":"True bony TMJ ankylosis in children: Case report"}
{"_id":"ae4cac12-946a-c5d5-7922-e1b64e29738b","text":"We are convinced that the highly positive results of our study lie in the adoption of a standardized surgical setup applied by an experienced surgeon. The patients required minimum follow up and no patients were lost during the follow-up. A follow-up of 3 years and more may be considered sufficient to rule out future recurrences.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"ae6d82aa-3d3f-418e-b4cd-3d8e13b029e6","text":"We had a series of 71 cases of septoplasties. We used autologous grafts as their consistency is similar to the nasal tissues, they are easily carved to the required size and shape with minimal resorption and with no manifeations of rejection., In one study, the 5th rib on the right side was harvested despite lacking a reasonable medical evidence that is the best rib to use. It seems mostly a matter of individual choice and personal preferences to which rib is going to be selected as the donor site.","title":"Autologous Diced Cartilage in Nasal Septoplasty"}
{"_id":"ae704e5c-3a47-db0b-c913-10687d8e4667","text":"One of the fundamental factors influencing the end result is the transfer of a free flap with well-vascularised inner and supporting midlayer framework at the same time. In achieving the desired shape and harmonious proportions, prefabrication of tissues can be shaped with 3D –laser scanning and the help of nose replica mold and custom made titanium coated cage. Furthermore, we think that innervation of the inner lining would improve patient’s quality of life even more, such as improving various nasal symptom perception and detection of hazardous external temperatures. The aim of this report is to present a novel approach of two-stage total nasal reconstruction with innervated prefabricated osteocutaneous radial forearm flap.","title":"A Unique Method for Total Nasal Defect Reconstruction - Prefabricated Innervated Osteocutaneous Radial Forearm Free Flap"}
{"_id":"ae715773-412b-ec4b-2293-4e78dc540d81","text":"Considering the less invasive technique used and taking into account the difficulty in dealing with a case of dental ankylosis in the upper anterior region, the methods used were successful for both the functional and esthetic aspects. Figure 8 shows the end of treatment intrabuccal photographs and periapical radiograph.","title":"Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics"}
{"_id":"ae751c99-3feb-8843-0121-5521cc91d243","text":"A sufficient preoperative planning is essential for an extensive surgical procedure, such as the oncological resection and microsurgical reconstruction of malignancies of the scalp.","title":"Microsurgical Reconstruction of Extensive Oncological Scalp Defects"}
{"_id":"ae88f5f6-dadb-96ee-7953-9668801758c6","text":"If a low lying frenum is associated with a midline diastema and is assessed as being likely to prevent orthodontic closure of the diastema a frenectomy is indicated. The frenectomy can be carried out before orthodontic treatment, during treatment, or following removal of the orthodontic appliances. A frenectomy during orthodontic treatment carried out just before space closure allows good surgical access and space closure can be started following the frenectomy, contraction of the scar tissue may aid closure of the diastema. A frenectomy before orthodontic treatment allows for better surgical access, however, scar tissue may have formed once the patient is ready to commence orthodontic space closure and this may impede space closure.","title":"The orthodontic-oral surgery interface. Part one: A service evaluation and overview of the diagnosis and management of common anomalies"}
{"_id":"ae8a235f-f251-c10d-7a1f-60fbcb455a44","text":"In this patient, the defect was too large to be repaired by a simple conventional bone graft or by a vascularized flap from the iliac crest. In addition, a contralateral comminuted fracture interfered with our ability to use the other fibula as a vascularized graft, and it was impossible to perform an internal segmental bone transfer or acute shortening and relengthening as, after debridement of devitalized tissues, the remaining tibial bone stock was poor.","title":"Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture"}
{"_id":"ae904bba-4f03-55ac-cfe4-8b000ed3ef93","text":"Our results overall suggest that an initial approach of active surveillance should be considered for patients with smaller and minimally symptomatic DTs, while indicating that TKIs, local ablation, and surgery achieve similar outcomes in patients with more aggressive disease. Larger randomized prospective studies comparing specific treatment modalities will be needed in the future to validate our observations.","title":"Management of Patients with Newly Diagnosed Desmoid Tumors in a First-Line Setting"}
{"_id":"ae96bfe0-c382-3ec3-1360-df2b0fa4b9db","text":"The need for informed consent by the patients was waived by the ethics committee owing to the retrospective nature of the study.","title":"Clinical Usefulness of a Modified Mohs' Technique and Topical Application of Zinc Oxide Powder for Treating Skin Infiltration Caused by Unresectable Malignant Tumors"}
{"_id":"ae992eb8-6ecf-2452-2060-fd5861cdb5fc","text":"In contrast prior pregnancy has been reported to ameliorate the course of intra-abdominal desmoids in patients with FAP [26]. These authors compared the growth and progression of FAP related desmoids in 22 never pregnant patients with 25 similar patients who had been pregnant at least once. The patients who had been pregnant had smaller tumors, less surgery and a more benign course overall. These authors go as to far as to suggest that consideration should be given to possible therapy with hormone combinations of progesterone, prolactin and estrogen. It should be noted that these findings were reported only for FAP related desmoids and whether they are applicable to sporadic pregnancy associated desmoids is not clear.","title":"Desmoid Tumors in Pregnant and Postpartum Women"}
{"_id":"ae9bca28-61ec-3500-7290-525aa687f6ad","text":"Out of 12 cases of primary closure, two cases developed wound dehiscence because of infection, out of which one patient managed with secondary suturing and the other required a rotation flap. All cases of primary skin grafting healed well. All cases of transposition flap with skin grafting at the donor site went uneventful, and the dog ear at the base was revised later.","title":"Reconstruction of Scalp and Forehead Defects: Options and Strategies"}
{"_id":"aea4b62d-cbde-c10e-c4d7-9ec4ed531550","text":"The condition is characterized by the shortening or poor insertion of a band of submucosal connective tissue, a dynamic structure that connects the wall of the lower mandibular arch to the floor of the mouth, which is responsible for a balance between mobility and stability of lingual movement. Ankyloglossia is a hereditary condition; it is more prevalent in male babies, but not all cases can be explained by genetics. Clinical procedures or even surgical corrections may be necessary in some cases to improve indicators related to breastfeeding.","title":"Ankyloglossia severity in infants: maternal pain, self-efficacy, and functional aspects of breastfeeding Gravidade da anquiloglossia em bebês: dor materna, autoeficácia e aspectos funcionais do aleitamento materno"}
{"_id":"aea72f55-c9fe-8d93-cce9-8de159202869","text":"Blood collected on and around the biopsy specimen should be washed with normal saline or the residual local anaesthetic agent present in the syringe. Excess of blood around the tissue gives a false impression of vasculitis with extravasation of red blood cells on the scanner view and may mislead an amateur dermatopathologist.","title":"Techniques of Skin Biopsy and Practical Considerations"}
{"_id":"aea8d230-c541-6bae-45cc-3e42e2b039f1","text":"Osteotomies may be completed while the flap is left in situ or during the inset of the flap into the mandibular defect. Performing the osteotomies while the pedicle is still attached to the leg has the advantage of minimizing ischemia time. Also, any injuries to the pedicle can be identified well in advance of revascularization, an advantage that is perhaps most important when rigid fixation and skin paddle inset are performed prior to the microvascular anastomosis. Other surgeons prefer to perform osteotomies after the pedicle is divided due to increased freedom of movement, potentially avoiding traction injury to the pedicle blood vessels.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"aeab3844-7bb7-16e2-c2bb-994d10f0c3ca","text":"Establishing surgical tactics and techniques that enable the procedure to be performed more easily can stimulate the continuity of training and improve the general quality of the microsurgeon during training.","title":"Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery"}
{"_id":"aeac2f0f-7276-21a9-1257-7e91b2d4c823","text":"A review of the literature on the surgical treatment of basal cell carcinoma was performed to establish an algorithm for the management of basal cell carcinoma, which could assist in the choice of surgical procedure and decide on surgical margins, taking into account the major factors which influence complete cure. This study was done to evaluate if small, well-defined primary BCCs can be excised using narrow surgical margins.","title":"Surgical Margin of Excision in Basal Cell Carcinoma: A Systematic Review of Literature"}
{"_id":"aeb90504-613e-4587-0b01-59f1a1ea8e56","text":"Guided SEFFI in combination with 1470 nm interstitial laser lifting with optical fiber is a perfect match for the treatment of facial aging.","title":"Guided Superficial Enhanced Fluid Fat Injection (SEFFI) Procedures for Facial Rejuvenation: An Italian Multicenter Retrospective Case Report"}
{"_id":"aec09999-04e2-0dc8-c1b5-9ce7affde215","text":"All items gathered by either the literature search or by the qualitative patient focus group interviews were provided to the expert focus group and discussed. Regarding the task and allocation guidelines the experts discussed and shorted out all of the different items and finalized the content as well as structure of two guidelines; one intended to be used by the treating physician and one to be used by the nurse. Regarding, the patient questionnaire once again all items were discussed and the experts decided which of these should be included in the final version of the questionnaire. Importantly, it was proposed to rephrase all items as statements rather than questions.","title":"Development of an adherence-enhancing intervention in topical treatment termed the topical treatment optimization program (TTOP)"}
{"_id":"aec91e7b-f83a-6f81-de80-fa41526bec3d","text":"In this study all patients, whose burn waste shave been treated with primary graft were compared with patients who were treated using secondary grafts. In this study, type of waste and its location, extent and size of them are not considered in the sample selection. There were no age limit and all patients who have been hospitalized with burn scar detection participated in the study.","title":"Survey of Early Complications of Primary Skin Graft and Secondary Skin Graft (Delayed) Surgery after Resection of Burnwaste in Hospitalized Burn Patients"}
{"_id":"aec99104-786c-0bf7-aa82-1b2edb7cdf16","text":"Rib cartilage is an outstanding material in reconstructive septorhinoplasty, especially in revision surgery with a low rate of complications compared to other materials. In this study, the results of oblique splitting of rib grafts were evaluated in 25 patients operated for primary and secondary septorhinoplasty.","title":"Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty"}
{"_id":"aecb750b-a423-1b1f-6131-055fce9fc133","text":"Reactions do not occur with every ingestion of red meat in comparison with a typical IgE-mediated food allergy where there is reproducibility of a reaction with every exposure to the trigger food. Patients mostly report reactions after eating large, fatty portions of red meat or organs, for example, kidney or liver. The rate of lipid absorption may play a role in the delayed reactions. Part of the delay may also be a result of conversion and processing of fats to chylomicrons and then further to low density lipoprotein particles of various sizes.","title":"Ingestion of mammalian meat and alpha-gal allergy: Clinical relevance in primary care"}
{"_id":"aecfd3a0-fec8-d503-a89b-98bdeb01a0aa","text":"Breastfeeding is strongly associated with one’s identity as a mother, and initial breastfeeding difficulties can make the infant totally ignore or refuse the breast. These situations not only complicate previous intentions to breastfeed the infant but also cause wounds to the identity as a mother and in some cases causing distress and anger toward the infant.","title":"Caught on the Fringes of Life: Mothers’ Lived Experiences of Initial Breastfeeding Complications"}
{"_id":"aee4618e-2cd2-ec3e-c32f-26103fd353ba","text":"In this limited sample it would appear that FNAB culture technique is severely inadequate in identifying pathogens in diabetes foot wounds in comparison to superficial swab technique and gold standard deep tissue biopsy. FNAB cultures missed microorganisms in two thirds of wounds and had a high false negative rate.","title":"A pilot study comparing superficial wound swab, deep tissue biopsy and fine needle aspiration biopsy in identifying infecting organisms in foot ulcers due to diabetes"}
{"_id":"aeed4fac-79e3-d172-e801-833e9c1186d1","text":"Three patients had been referred because the dental practitioner had observed localised swelling several hours following treatment – and one patient also developed a rash. One history indicated that there had been a bleed and the swelling was a haematoma, and the allergy tests proved negative. The other two could have been allergic in nature, but neither patient tested positive to local anaesthetics. Both patients had received restorative treatment, so had been exposed to a variety of materials — and one had returned to their practitioner for further treatment without local anaesthesia, after the referral but before testing and had again developed localised swelling. In these cases, it was recommended that the patients were referred to another specialist to identify the provocative material.","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"aeef235c-1c1d-e990-3be8-44e6dbd2463b","text":"The proximal tibia should be dissected at the posterior capsular attachment for 1-2 cm, staying proximal to the soleal arch to confirm the location of the popliteal artery with the doppler at the level of the tibial joint line. Following this, the soft tissues are elevated off the posterior proximal tibia medial to the artery. This includes the major insertion of semimembranosus and the origin of popliteus.","title":"Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty"}
{"_id":"aef4ae54-7c82-a114-37d1-c11407a0c36d","text":"Treatment of intra-articular fractures of the distal tibia is challenging due to the difficulties they present in achieving anatomical reduction of the articular surface of the ankle joint and the instability that may occur due to ligamentous and soft tissue injury. Numerous methods of treatment for these fractures have been reported, including conservative treatment with cast, open reduction and internal fixation and the combination of different types of external fixators with or without internal fixation [1].","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"aef583ab-2b14-179a-e893-56f6cb51a247","text":"Logistic regression analysis was again performed on the same variables as before, with the addition of T2 response as possible predictor. T2 response proved to be the most important factor in predicting T3 optimal response. In some instances, it was observed that patients with low T2 response had still a moderate response on T3, while the opposite was never true, meaning that at T3 patients had either improved or maintained their previous response level. The predictive value of T2 response was more evident in patients with OV and LLV as shown in Table 5. None of the predictors were found to be useful in the multivariate model.","title":"Humoral Response after Two Doses of BNT162b2 mRNA Vaccine Has a Role in Predicting Response after Three Doses That Is Related to Plasma HIV Viremia and Nadir CD4+ Cell Count in HIV-Positive Patients"}
{"_id":"aef8293d-899a-86b5-6119-e7f423bf5d07","text":"The growth of maxillary length is mainly through bone deposition with the palatal suture and the maxillary tuberosity and peaks at the age of 11 years. The growth center is at the posterior margin of the maxilla indicated by the arrow in Fig. 7a, which shows strong salience, while the salience in this region disappears consistently after the age of 11 years.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"aefb99e8-c412-2ab1-b4fe-928f8afe2327","text":"One patient in the series required a further knee arthroscopy 1.4 years postharvest after complaining of clicking and grinding behind the patella and reporting a Lysholm score of 68. At the stage I arthroscopy, this patient was noted by the surgeon to have a small grade III chondral defect on the trochlea; at this follow-up arthroscopy this defect was observed to be larger and was subsequently debrided. The chondral harvest site on the lateral trochlea was found to have healed with a good level of fill and with good integration with the surrounding native articular cartilage, but had a softer consistency. There were also some fronds present here, which were debrided. Five years postarthroscopy, this patient now reports a Lysholm score of 91.","title":"Evaluating Joint Morbidity after Chondral Harvest for Autologous Chondrocyte Implantation (ACI) A Study of ACI-Treated Ankles and Hips with a Knee Chondral Harvest"}
{"_id":"af0384d7-7e40-cd44-018d-1f788d064566","text":"Combination therapy represents an active area of research in melanoma treatment.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"af05754f-87d8-f018-569d-0851168b824a","text":"Understanding the factors that may contribute to poor standards of care is most important. There are no formal data to document and to explain why treatment guidelines are not followed. It has been hypothesized that reasons for poor adherence to guidelines in daily practice may be considered such as strength of habit without any identified reason, lack of knowledge or confidence in treatment guidelines and concerns about safety in fragile patients [14].","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"af1b32f5-65e0-9805-6053-04b602e0426e","text":"Table 1 Merkel cell carcinoma treated with radiotherapy alone in the past 20 years in Japan","title":"Complete remission of Merkel cell carcinoma on the upper lip treated with radiation monotherapy and a literature review of Japanese cases"}
{"_id":"af2c2672-7d47-6233-30d7-b29aa6f8b543","text":"The patient developed persistently elevated IOP at POM3, and Xen 45 gel stent implantation performed at POM4 subsequently fibrosed and failed thereafter. The patient then underwent AGV surgery which has been effective in controlling IOP out to POM7 from AGV.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"af2e3eae-ec5b-1375-481e-36ded06c6780","text":"The advent of biologic wound agents has permitted secondary closure to be applied broadly with significant improvements in aesthetic outcomes.8 For example, reconstruction of isolated vermillion defects using traditional methods, such as myomucosal tongue flaps, has largely been replaced by secondary closure with the use biologic wound agents because of their superior aesthetic outcomes and absence of donor site morbidity (Fig. 3).50","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"af33fc82-3274-b7d0-ebc9-f3b8d5dafd5b","text":"The change in treatment strategies from initial surgery with or without radiotherapy to initial nonsurgical management has been fueled by several studies and increasing expertise about this disease with its unpredictable behavior. The level of evidence is limited by the rarity of this disease. The Dutch cohort represents a unique and large group of patients with data on real-life practice. Within this group, analyses show that a 25% response rate and 52% stable disease rate was achieved using initial nonsurgical management.","title":"Outcome of Nonsurgical Management of Extra-Abdominal, Trunk, and Abdominal Wall Desmoid-Type Fibromatosis: A Population-Based Study in the Netherlands"}
{"_id":"af3d2fbf-c9c9-2d49-8b89-3fd536377f40","text":"A previously healthy 50-year-old white male developed a deep vein thrombosis consequent to surgical placement of a titanium rod to correct a fracture of the femur and he was maintained for over a year on daily oral doses of Coumadin 9 mg and aspirin 325 mg. When he began to bruise spontaneously with multiple large hematomas appearing without provocation, he requested that his primary care physician reconsider the anticoagulation. Because of his age, sex, and the possibility of an inherited or acquired anticoagulant protein deficiency he was maintained on Coumadin and a thrombophilia work up was ordered. Test results were interpreted as deficiencies in both protein C and protein S and he was instructed that life-long therapy with Coumadin was necessary. Is this a correct evaluation by his primary care physician?","title":"Assessment of specific risks for the recurrence of deep vein thrombosis: a case report"}
{"_id":"af4104af-6421-9740-0c18-befe0a9ccbfc","text":"These findings suggest that establishing policy and pipeline programs to address significant racial and ethnic disparities in cancer care leadership positions is crucial for change.","title":"Racial, Ethnic, and Gender Representation in Leadership Positions at National Cancer Institute–Designated Cancer Centers Racial, Ethnic, and Gender Representation in Leadership Positions at NCI-Designated Cancer Centers"}
{"_id":"af42e35f-193a-14fd-5705-9b4b4016b0cc","text":"In many studies investigating the effects of ESPB on acute and chronic pain, when ESP block is used as a part of a multimodal analgesia plan, it was reported in the literature to be an interfascial plane block with a wide range of indications. Goel et al reported that intraoperative and postoperative 24-hour total opioid consumption in lumbar spinal fusion surgery was lower in the block group than in the control group. Compared to the block group, NRS scores of the control group were reported to be significantly higher in the first 48 hours after surgery. Krishna et al reported that the need for fentanyl decreased significantly in the intraoperative and postoperative periods in patients who underwent ESPB in the preoperative period in their randomized controlled study with 106 patients who were going to undergo cardiac surgery. In another study in which thoracic epidural analgesia and ESPB methods were compared in 50 patients who underwent cardiac surgery, they reported the amount of fentanyl used in the ESPB group in the intraoperative and postoperative period was significantly lower. In this study, the total opioid consumption during the MWA procedure and the total amount of opioids needed together with the post-procedure period was lower in the ESPB group (p<0.001). Although all of the patients in the control group needed additional fentanyl throughout the procedure, only 5 patients in the ESPB group needed additional fentanyl (p<0.001). The difference in total opioid consumption and additional fentanyl need during the MWA procedure in both groups can be explained in that the local anesthetic injected with ESPB moves along the fascia in the paravertebral, caudal and cephalic directions and provides effective somatic and visceral analgesia in a wide area from the C7-T2 dermatomal level to the L2-3 level.","title":"Clinical efficacy of ultrasound guided erector spinae plane block in patients undergoing microwave ablation"}
{"_id":"af486683-2d09-dffd-5f0d-523390c7d81a","text":"Most of articles found were original works and follow up studies. Some of review articles touching the problem of meniscal preservation methods were also taken into account as a support of this paper. Among 53 references 15 concerned fresh allograft, in 17 papers problem of deep-frozen meniscal allograft was raised and in 18 studies cryopreserved menisci were referred. Lyophilized meniscal allografts were mentioned in 9 reviewed articles.","title":"Preservation and sterilization methods of the meniscal allografts: literature review"}
{"_id":"af489855-6ddf-1045-f0b8-e570e090f75b","text":"On close inspection, we observed a 5 cm long linear hypertrophic scar in the right cheek proximal to the nasolabial fold. Mouth movements were conserved except for a partial limit to mimic movements and his ability to smile.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"af48ab24-5f03-93c4-ced6-9bde0097cdc8","text":"In this study, we describe our experience with the use of an axial frontonasal flap for the reconstruction of a nasal tip defect. We would also specify the indications for this flap and describe in detail the surgical technique.","title":"The Axial Frontonasal Flap for Nasal Tip Defect: A Single Centre Experience"}
{"_id":"af4d6d82-3825-62cf-dbff-a82226014dce","text":"In sinonasal cancer surgery, a fundamental challenge is to understand the postoperative imaging changes after reconstruction. Misinterpretation of post-operative imaging may lead to a misdiagnosis of tumor recurrence. Because radiotherapy planning is based on imaging, there are many gaps in knowledge to be filled in the interpretation of postoperative imaging to properly define radiotherapy tumor volumes in the presence of flaps. On the other hand, radiotherapy may be responsible for tissue fibrosis or atrophy, the anatomy of the reconstructed region and the functional outcomes may change after radiotherapy compared to surgery alone. This narrative review illustrates the interdisciplinary aims and challenges of sinonasal reconstructive surgery using flaps or grafts. It is particularly relevant to radiologists and radiation oncologists, at a time when intensity modulated radiotherapy and proton therapy have the potential to further contribute to reduction of morbidity.","title":"Interdisciplinary challenges and aims of flap or graft reconstruction surgery of sinonasal cancers: What radiologists and radiation oncologists need to know"}
{"_id":"af509991-eaba-5bce-f3f6-fdb0ebe4cd9a","text":"After DIEP surgery, some evidence exists for post-operative imaging with CT or MR angiography to assess vascular anatomy and perfusion but this is as yet far from established practice and would typically take place within a week of surgery. By comparison, the most prominent change to implanted cartilage following DIEP surgery that we have noted in our case is calcification that happens only after several months have passed.","title":"The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan Case report: The appearance of cartilage in breast reconstruction as a mass on CT"}
{"_id":"af5ba5d4-f1ca-9351-0cd1-f4e849588242","text":"The carved Yusha nasal implant was inserted into the surgical pocket and adjusted to a central position. A deep cavity was then dissected into the caudal end of the nasal septum for the insertion of the vertical board of the prosthesis. The vertical board was inserted into the cavity as the medial foot of the bilateral alar cartilage. The bilateral fornix of the alar cartilage was sutured to fix the prosthesis in place.","title":"Design and Application of a Novel Silicone Nasal Implant"}
{"_id":"af6db804-dd4e-d5fe-6574-56b6db21de63","text":"This retrospective study included 633 patients with invasive melanoma who underwent SLNB in 7 referral centers certified by the Brazilian Melanoma Group from 2000 to 2015. It belongs to a larger database of 1,343 melanoma patients with and without sentinel lymph node biopsy. The data from each patient were stored in a provisional database reviewed by an attending physician and sent back to the melanoma center for correction due to errors or incompleteness; corrected data were included in the definitive database. A statistician or physician was responsible for analyzing the data and responding to any questions raised by the authors. The database used for analyses identified patients only by numbers. The study EC29\/15 has been approved by A.C. Camargo Cancer Center Ethics Committee on Research.","title":"Absence of Tumor-Infiltrating Lymphocyte Is a Reproducible Predictive Factor for Sentinel Lymph Node Metastasis: A Multicenter Database Study by the Brazilian Melanoma Group"}
{"_id":"af6f6a7f-0170-30b9-38f4-53f2b528b989","text":"After nine sessions performed over nine weeks, it was possible to observe functional and aesthetic changes, leading to more harmonious facial muscle movements. We noted reduced values attributed to swallowing and to signs of facial aging. We also observed a reduction in contraction of the orbicularis oris and mentalis muscles while swallowing and reduced nasolabial and labiomentonian grooves and static periorbital wrinkles. Awareness and proprioception of tongue contraction and position during swallowing and of mimicry muscle contraction during smiling and speech, contributed to reduced perioral muscle contraction and attenuated labiomentonian and nasolabial grooves.","title":"Utilization of electromyographic biofeedback in speech therapy to attenuate the signs of facial aging: a case report"}
{"_id":"af777fc3-67a4-c6d9-c5a1-f64b1b7835ed","text":"Patients were divided into two groups by reference to their treatment preferences. The therapy group included those who refused local injection, and the local injection group those who consented to injections of local anesthetic and steroid into the fat pad.","title":"Ultrasonography-Guided Injection for Quadriceps Fat Pad Edema: Preliminary Report of a Six-Month Clinical and Radiological Follow-Up"}
{"_id":"af7a29fc-1e54-7f76-e006-f39f7c154e28","text":"If the breast lesion consisted of microcalcifications with or without a mass, the entire specimen was sampled after inking and embedded in paraffin after orientation. In cases with a palpable mass, complete sampling of the mass and surgical margins were performed and samples from the surrounding tissue were evaluated for margin evaluation after the specimen was inked. In cases of mastectomy, in addition to complete sampling of microcalcifications or mass, samples of the surrounding tissue and nipple areola complex were also examined. The distance of the tumor to the specimen's inked edge was reported for every marking margin and the margin width was considered as the narrowest distance between the tumor and any inked margin. Microinvasion was defined according to the 7th edition of AJCC staging system [20], which was considered as a microscopic focus of invasion of cancer cells extending beyond the basement membrane into the adjacent tissue, with no focus greater than 0.1 cm in dimension.","title":"Sentinel Lymph Node Biopsy in Pure DCIS: Is It Necessary?"}
{"_id":"af7dce2e-4fc4-55f9-5079-3b36a6df1592","text":"Age was the only independent risk factor for periorbital wrinkling in the study population overall, although many previous studies have suggested that sun exposure is related to wrinkling. Cumulative lifetime sun exposure has been reported to increase periorbital wrinkling in particular,33–36 yet we did not see an association with reported exposure. None the less, reported high SPF sunscreen use was independently protective in our population, suggesting a role for sun exposure in wrinkling. Creasing of the periorbital skin also results from smiling and squinting21 and it is suggested that the repetitive contraction of underlying lateral orbicularis oculi can lead to ‘crow’s feet’ due to changes in the elastic properties of the dermis over time.37 It may be that we did not see a strong relationship between wrinkling in this site and sun exposure because there is too much variation due to patterns of facial movements to see a smaller effect of reported sun exposure.","title":"The determinants of periorbital skin ageing in participants of a melanoma case–control study in the U.K."}
{"_id":"af81634a-ac40-c32d-a7d1-34b2ecc5b651","text":"Our lingual laser frenotomy protocol provided significant breastfeeding improvement in the mother-newborn dyads with low intraoperative pain and no significant complications.","title":"Lingual laser frenotomy in newborns with ankyloglossia: a prospective cohort study"}
{"_id":"af828f8c-2b7a-cb1a-71cd-bfebe7fc9542","text":"Both brachytherapy and photon-based external beam PBI possess distinct advantages, with brachytherapy providing superior conformality and normal breast tissue sparing, and photon PBI serving as a noninvasive treatment option that can avoid the perioperative pain and potential morbidities of brachytherapy. The increased tissue sparing with brachytherapy is a potentially significant advantage as a reduction in the amount of breast volume irradiated has been associated with a decrement in late cosmetic outcomes in photon PBI series [18].","title":"Proton Therapy for Partial Breast Irradiation: Rationale and Considerations"}
{"_id":"af863807-c43f-228d-cdd3-0f44a6be8fcc","text":"Our patient's clinical course was complicated by an unrecognized infectious process in the deltoid where the LAIA paliperidone palmitate had been administered. It was later confirmed, after the patient was extubated, that she had been experiencing increasing right shoulder pain starting 2 days after her most recent injection. This delayed identification of the infectious process was associated with an increase of ICU resource utilization, including increased length of stay and time on the ventilator. It was not until nearly 2 weeks into admission that there was an inadvertent discovery of abscess and necrotic tissue. It is not possible to know the exact mechanism in which the shoulder infection began but with all injection site reactions administration technique and sterile processes should be questioned. We also could not investigate the product for contamination as it administered prior to admission. It is possible that the patient's dosing had increased the risk for this injection site adverse event. The patient's dose was 234 mg every three weeks and above the FDA approved maximum dosing of 234 mg every 4 weeks. The high dose and more frequent administration may be a risk factor for injection site reactions [4]. The clinical rationale for the dosing was clear; however, in that every 4-week administration of paliperidone palmitate resulted in the emergence of psychotic symptoms 3 weeks after an injection. When the dosing interval was changed, the patient was reported to have improved control of psychotic symptoms.","title":"Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention"}
{"_id":"af8b862a-a94a-6c92-7ef2-86904a4a979f","text":"In total 19 locoregional recurrences were reported from 867 patients in 19 studies, 53 distant recurrences were reported from 811 patients in 16 studies. There were nine breast cancer deaths reported from 383 patients assessed in nine studies, and 22 deaths from any cause reported from 499 patients assessed in 11 studies. Further analysis was not performed because most studies did not provide information on the timings of these events.","title":"Proton Beam Therapy for Early Breast Cancer: A Systematic Review and Meta-analysis of Clinical Outcomes"}
{"_id":"af8c0625-a2d0-1fc1-56ec-8d54f229a5b3","text":"Long term skin complication such as fibrosis is a common late side effect of radiotherapy treatment for breast cancer patients and is considered to be a dose-limiting factor during the therapy. Quantitative and objective assessment of late skin reactions is helpful for oncologists and clinicians to estimate the efficacies of radiotherapy regimens or prediction of cosmetics outcome of these patients","title":"An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy"}
{"_id":"af9590b3-5e3f-a837-2c65-68ada7af0c2d","text":"This study demonstrates that it is feasible to measure photographic density using a basic function in PACS and apply the data to assist in the diagnosis of osteomyelitis.","title":"Early diagnosis of jaw osteomyelitis by easy digitalized panoramic analysis"}
{"_id":"afaa9807-5081-cc9a-c251-94290b311db3","text":"We only included patients with an active history in the database for at least three years prior to the index date. We excluded patients older than 90 years of age from the study population, those with a history of other prior or current cancers except non-melanoma skin cancer, and those with recorded alcoholism or human immunodeficiency virus infection prior to the index date.","title":"Metabolic syndrome in relation to risk of meningioma"}
{"_id":"afc30e60-79e0-244e-1535-e3be640d3b5f","text":"It is believed that the cases in which LEED was higher than average were selected cases in which the surgeon’s preoperative and intraoperative clinical analysis revealed a need to administer additional energy to achieve total obliteration of the venous segment, confirmed by the high standard deviation of energy level compared to the mean for the sample.","title":"Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser"}
{"_id":"afc51819-a646-d7d9-9f0f-4a0d9216e929","text":"When a defect in the anterior capsule or subscapularis muscle is present, either by surgical resection of soft tissue tumour or as result of a chronic retracted subscapularis tear, the pectoralis minor muscle can be used as a bipolar musculotendinous pedicle flap, in order to close the anterior defect of the glenohumeral joint capsule. It provides enough length of the pedicle to ensure full abduction and external rotation and some functional activity to assist internal rotation. Combined with tendon transfer of the pectoralis major and latissimus dorsi, glenohumeral stability was provided and proved sufficient in this case. In a quickly aging society, this pedicle flap may present a new surgical repair in the armamentarium of the shoulder surgeon especially in chronic instability and subscapularis tendon tear cases.","title":"Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint"}
{"_id":"afc5d8d8-881a-ef0f-f569-351c2d74c6aa","text":"There was a crossover study that compared the duration of pain relief when using only local anesthetics versus using both local anesthetics and BTA together in performing a lumbar sympathetic ganglion block in nine patients with CRPS in the lower extremities [13]. When BTA was used, the median time taken to return to the level of pain prior to the procedure was 69 days, whereas only 8 days were required when only local anesthetics were used. In addition, with the exception of one patient who complained of nausea and vomiting, which improved without any particular treatment, there were no incidents of adverse effects. This shows that a long-term blocking effect can be safely attained by injecting BTA near the sympathetic ganglion in humans.","title":"Lumbar Sympathetic Block with Botulinum Toxin Type A and Type B for the Complex Regional Pain Syndrome"}
{"_id":"afcb8c6f-493a-07b6-3f1e-36907b904238","text":"Consequently, it is of interest to examine to what extent tumour thickness may be reduced by deep curettage and examine to which degree this may affect treatment outcome.","title":"Pre-Treatment Deep Curettage Can Significantly Reduce Tumour Thickness in Thick Basal Cell Carcinoma While Maintaining a Favourable Cosmetic Outcome When Used in Combination with Topical Photodynamic Therapy"}
{"_id":"afd37075-e22a-145a-719d-05699f177a6e","text":"A bird-shaped incision was designed from the nasal columella and its base, extending to the outer alar foot of the affected side. The flap was lifted and separated to expose the alar cartilage completely. Suture the graft with the medial feet of the bilateral alar cartilage and the superior lateral cartilage of the septal cartilage. The costal cartilage was carved into an ideal shape and placed into the subfascia space of the nasal dorsum. The lower lateral cartilages and nasal valves were addressed. The septoplasty and the caudal extension grafting were performed. The nasal columella and the prosthetic head side and medial foot are raised with the nasal tip. After adjusting the coverage of cartilage in its natural state, the wound is sutured.","title":"3D Printing Technique Assisted Autologous Costal Cartilage Augmentation Rhinoplasty for Patients with Radix Augmentation Needs and Nasal Deformity after Cleft Lip Repair"}
{"_id":"afd710e7-138e-bd2b-1dc5-441fe96c29ee","text":"Overall, the usage of Canadian plastic surgery fellowship program websites during the application cycle remains uninvestigated. Further research should survey plastic surgery fellowship trainees to investigate what program characteristics influenced their decision to apply and also where they received most information about their program from. This study could be used further by the Canadian Society of Plastic Surgery (CSPS) to create a centralized administrative process that mandates the comprehensiveness of program websites and ensures they are kept up to date.","title":"How Comprehensive Are Canadian Plastic Surgery Fellowship Websites?"}
{"_id":"afdb51af-c4a0-1980-ebf5-07c7acc3c727","text":"There were no complications associated with the filler injections to the nipple. All nipples remained subjectively soft to the touch following filler injection. All patients reported satisfaction with the cosmetic results.","title":"Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique"}
{"_id":"afdda3a7-fcce-1883-d8aa-208842e6557b","text":"We describe a successful system for immediate postoperative NIPPV for a patient with ALS following midface reconstruction with a fibula free flap, with excellent healing without vascular compromise of the free flap postoperatively. Keys to avoidance of pedicle or free flap compression by the NIPPV mask in this case included a medial tunnel for the free flap pedicle along the inner aspect of the mandible, as well as use of a full face NIPPV mask with a soft sealing skin interface that did not cause direct pressure to the free flap. This case also highlights important perioperative considerations for the head and neck surgeon when treating ALS patients, including extremity function when considering the donor site, as well as concerns for difficulty with decannulation following tracheotomy.","title":"Immediate postoperative non‐invasive positive pressure ventilation following midface microvascular free flap reconstruction"}
{"_id":"afe281cf-61e7-ebd4-e1fd-117d91f74d29","text":"Oral anticoagulation was discontinued based on a clotting profile negative for thrombophilia and Doppler ultrasonography pattern consistent with normal blood flow in the deep veins of the right calf and thigh predicting a minimal calculated risk for DVT recurrence.","title":"Assessment of specific risks for the recurrence of deep vein thrombosis: a case report"}
{"_id":"afe47747-7c06-65de-2398-df87d73c0828","text":"In summary, we present a variation in internal mammary vein anatomy which we believe has not previously been described in the literature. Not only does this case report add to the body of work on the internal mammary vessel anatomy, but it will also guide microvascular reconstructive surgeons who are faced with unexpected anatomical variations with their intra-operative decision-making and ultimately successful flap transfer.","title":"An unusual “venous circle” of the internal mammary vein encountered during microvascular anastomosis and implications for practice"}
{"_id":"aff04384-d906-d271-7860-2040087e8678","text":"In conclusion, if criteria are taken into account in patients with breast cancer, such as detailed evaluation of the axillary region and echogenic hilus obliteration or eccentric placement, complete anechoic or hypoechoic appearance of the lymph node, and asymmetric cortical thickening, metastatic lymph nodes can be identified by ultrasonography with high sensitivity and positive predictive value. Axillary US may guide the radiologist to carry out an FNA to rule out metastases before deciding whether to perform SLNB.","title":"Preoperative Evaluation of Axillary Lymph Nodes in Malignant Breast Lesions with Ultrasonography and Histopathologic Correlation"}
{"_id":"affaa018-671a-645e-bd66-8e0790b3ff4b","text":"Osteomyelitis is an inflammatory process accompanied by bone destruction, most frequently caused by bacteria that spread to the bone marrow and tissues near the bone. Therefore, pediatric bacterial osteomyelitis was diagnosed when clinical signs or symptoms of inflammation localized to a skeletal segment and at least one radiologic sign of bone destruction and\/or resorption were present in children younger than 18 years, in the absence of another plausible diagnosis. Osteomyelitis can be further classified into acute or chronic and uncomplicated or complicated. Acute osteomyelitis is diagnosed within 4 weeks of onset, whereas chronic infection is a more prolonged, often indolent disease process with sequestration and\/or recurrence at the same site weeks to years after treatment of the initial infection at that site. Any osteomyelitis that involves two or more bones, spreads to the physis and adjacent joint or soft tissues, and\/or requires further diagnostic or therapeutic interventions may be classified as complicated.","title":"Clinical report and predictors of sequelae of 319 cases of pediatric bacterial osteomyelitis"}
{"_id":"affe00f1-bba1-74d4-76c9-ef1523244ecb","text":"An open oral food challenge is performed in patients with alpha-gal antigen sensitisation but an unclear history of meat allergy. The principle of an oral food challenge is to give the suspected food in incremental doses at 15 minutes intervals, under close medical supervision. However, the alpha-gal allergy often presents with a delayed reaction and the oral food challenge is different from the traditional one. A full dose of 150 g of pork in an adult patient is given at once with close monitoring for at least 8 h. Informed consent is obtained before the procedure, and an experienced allergy clinician with resuscitation skills performs this procedure. Beef challenges produce more severe reactions than pork.","title":"Ingestion of mammalian meat and alpha-gal allergy: Clinical relevance in primary care"}
{"_id":"b0002dac-632a-d15a-fff3-95a1ecf6c7b8","text":"Negative attitudes were higher among those who reported burning easily in the sun and positive attitudes were lower. The belief that a suntan made people look healthier was also higher among those who were married\/living as married compared to those who were single, widowed or divorced.","title":"SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample"}
{"_id":"b0059ebb-29c6-b056-ef36-8845fee2f796","text":"TK and IN were major contributors in harvesting the vascularized free fibula and in writing the manuscript. IF and TF analyzed and interpreted the patient data and performed the excision of the tumor and bone fixation of the fibula. MS performed the analysis of MRA and magnetic resonance imaging. All authors read and approved the final manuscript.","title":"Assessment of vascularized free fibula transplantation revealing a congenital aplastic posterior tibial artery: a case report"}
{"_id":"b00914c9-52a5-8ee1-4cf9-090bcaffad5b","text":"Since this is a retrospective cohort with the limitations that have already been covered in this material, this study can be classified as evidence level 2b.","title":"Rate of saphenous vein occlusion and side effects at 1 year follow up after 1470 nm endolaser"}
{"_id":"b00fe5e2-0c27-b74e-b48b-26db12f70865","text":"All patients left the hospital with a good volume filling of their defects and were generally satisfied with the cosmetic outcome.","title":"Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection"}
{"_id":"b0141541-8bca-7018-873a-a1380901d391","text":"• CT and MRI play an increasingly important role in evaluation of patients with lumbar spine surgery","title":"Imaging of lumbar spinal surgery complications"}
{"_id":"b0174861-6181-5c44-7f2e-487b87deba24","text":"The average score for clarity of career plan before joining the NHS was 54 out of 100.","title":"Surgical Training in the United Kingdom's National Health Service: The Challenges for International Medical Graduates"}
{"_id":"b01fb234-a2cd-3c28-d331-864935d2f920","text":"Considering that excision of SLNs at the latissimus dorsi lateral margin may increase lymphedema of patients whose SLNs located at level 1 were negative, we further surprisingly found if a patient has metastasis to the latissimus dorsi lateral margin SLNs, she always has metastasis to SLNs in level 1 (expect for the latissimus dorsi lateral margin) at the same time. This result reminds us that maybe there is no need to excise SLNs at the latissimus dorsi lateral margin in SLNB. Because our study contains a relatively small number of patients, the decision regarding whether SLNs at the latissimus dorsi lateral should be excised still requires further large clinical studies.","title":"Retrospective observational study about reducing the false negative rate of the sentinel lymph node biopsy Never underestimate the effect of subjective factors"}
{"_id":"b022caf9-4494-952e-6db4-d98c71d3fcdc","text":"The current study was undertaken to review the effect of different types and duration of thromboprophylactic modalities on VTE incidence and to evaluate the incidence and risk factors for bleeding complications in patients undergoing surgery for colorectal cancer.","title":"Venous Thromboembolism Following Colorectal Surgery for Suspected or Confirmed Malignancy"}
{"_id":"b0261ad4-7e90-1f87-741e-f44bf91b356d","text":"The origin of the suggestion that the patient might be allergic to local anaesthetics.","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"b02a9a07-683b-1ac4-1657-41e415533d33","text":"The vascular prosthesis infection may be a result of the not perfect aseptic regime and bacterial contamination during surgery. Also, bacterial translocation to the vascular graft may occur from wound infection or intracavity abscess or due to the formation of erosion or fistula between the digestive tract and the graft. The less common cause is transient or chronic bacteremia, which can bring about the transmission of infection to synthetic materials in the body, especially in the early postoperative period when the endothelialization of the graft is not complete. Other surgical procedures near the vascular graft or paravasal thrombus inflammation with bacterial translocation also may be the reason for vascular graft infection.","title":"Vibrio metschnikovii: Current state of knowledge and discussion of recently identified clinical case"}
{"_id":"b032541a-3ea1-9e8c-bad5-baa18595aee0","text":"It is important to identify risk factors for VTE that develop after spine surgery. Although it has been reported that early gait training is important for preventing VTE, it takes a long time for muscular strength to improve to the extent required for walking. Even when neurological symptoms recede in DVT patients, those who could not walk well preoperatively have problems walking postoperatively.","title":"Risk Factors for Venous Thromboembolism After Spine Surgery"}
{"_id":"b034a8e2-5877-fb92-aa71-9b000e75c814","text":"A combination of Natriumthiosulphate was administered intravenously, which is a common therapy for calciphylaxis and a specific surgical approach to this complex disease was initiated when the patient arrived at our department. The patient had necrosis on the abdomen and both thighs as well as partially superinfected wounds with oxacillin resistant staphylococcus aureus (Figure 1). A bone scintigraphy revealed no increased activity of calcium carbonate in thighs or the abdominal area.","title":"Calciphylaxis – a challenging & solvable task for plastic surgery? A case report"}
{"_id":"b037dcf6-07a1-9047-8380-597686e8fcd8","text":"Accordingly, when planning to either use internal thoracic arteriovenous perforating branches as recipient blood vessels in breast reconstruction or elevate a pedicle or free deltopectoral skin flap, the position and thickness of the principal perforators should be confirmed using proper imaging beforehand.","title":"A Study of Internal Thoracic Arteriovenous Principal Perforators by Using Multi-detector Row Computed Tomography Angiography Okumura et al"}
{"_id":"b0403891-126d-6c00-a00f-caa9f1726859","text":"The surgical treatment of cervical spondylosis and resulting cervical radiculopathy or myelopathy has evolved over the past century. Surgical options for dorsal decompression of the cervical spine includes the traditional laminectomy and laminoplasty, first described in Asia in the 1970's. More recently the dorsal approch has been explored in terms of minimally invasive options including foraminotomies for nerve root descompression. Ventral decompression and fusion techniques are also described in the article, including traditional anterior cervical discectomy and fusion, strut grafting and cervical disc arthroplasty. Overall, the outcome from surgery is determined by choosing the correct surgery for the correct patient and pathology and this is what we hope to explain in this brief review.","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"b04444f2-807a-441b-a039-d2137ddc38b2","text":"A PubMed database comprehensive search was conducted to identify all relevant articles according to assigned key words.","title":"Intraoperative ultrasound in breast cancer surgery—from localization of non-palpable tumors to objectively measurable excision"}
{"_id":"b04532f7-b1c2-5434-e8b0-8c63e3884550","text":"Five studies contributed to the descriptive subtheme of Managing Infant Symptoms. In these studies, mothers who use substances described challenges they had when their infants experienced symptoms of NAS including feeding difficulties and inconsolable crying. Mothers who use substances discussed the stress and feelings of inadequacy when they were unable to console their infant. Mothers who use substances reported crying when observing their infants having tremors and irritability. Nurses in these studies confirmed that consoling and feeding infants with NAS were challenging for mothers who use substances. Nurses described times when mothers who use substances preferred infants to be medicated when seeing withdrawal rather than trying other nonpharmacological methods first, which would involve their engagement with their infants.","title":"Factors Associated with Maternal Engagement in Infant Care When Mothers Use Substances"}
{"_id":"b046a0ce-c3fd-9a91-1f4b-c134f67cea0c","text":"This study targeted a total of 98 patients whose symptoms were confirmed as osteomyelitis under clinical, radiologic, pathological diagnosis at the Department of Oral and Maxillofacial Surgery in the Seoul National University Dental Hospital (SNUDH) over 11 years from 2008 to 2017. Cases that were clinically diagnosed as osteomyelitis but were not radiologically diagnosed due to technical limitations were not included in the study. After exclusion of three cases that were concluded to be non-osteomyelitis under clinical and pathological diagnosis even though the possibility of osteomyelitis was suggested radiologically, a total of 95 patients were analyzed in the final research.","title":"Early diagnosis of jaw osteomyelitis by easy digitalized panoramic analysis"}
{"_id":"b0475e59-6531-b377-6409-6770e6284fd3","text":"In adult patients, three or more vertebral body affection with initial vertebral body loss of one to 1.5 vertebral body height in a dorsal or dorsolumbar spine, need to be taken up for kyphosis correction. Children younger than seven years of age with three or more vertebral body affection in dorsal or dorsolumbar spine with two or more spine at risk segment will have a progressive kyphosis with growth; hence those should be undertaken for correction of kyphosis and stabilization of spine in active stage of disease. The radiological signs of spine at risk are; a) subluxation or dislocation of the facet joint at the apex of the kyphus b) presence of retropulsion c) translation of the vertebral column in coronal plane d) posterior toppling sign (i.e. if a line drawn along the anterior border of the distal healthy vertebra in an upward direction that meets the upper half of proximal healthy vertebra then it has chances of progressive kyphosis.13 Hence these cases should undergo kyphosis correction.","title":"Kyphosis in spinal tuberculosis – Prevention and correction"}
{"_id":"b0498bf4-8443-1bd9-fe9f-01d883f4ef5e","text":"Table 1 Univariate analysis of factors associated with the choice of BCS or mastectomy for patients eligible for BCS","title":"Non-doctoral factors influencing the surgical choice of Chinese patients with breast cancer who were eligible for breast-conserving surgery"}
{"_id":"b04f4a24-0b57-9557-b195-bff27ec10441","text":"Keloids as unusual scars are injury remnants characterized by bizarre cosmetics and painful itching. This study assessed outcomes of surgical excision and brachytherapy in intractable keloids.","title":"Outcomes of Surgical Excision and Brachytherapy in Intractable Keloids"}
{"_id":"b05c4c75-6615-6b25-33c9-f6073ad8e93f","text":"The proportion of women with a breast at 4 years was defined as the primary outcome measure and was determined by the pattern of surgical procedures that they underwent. The proportions of women with a breast at baseline and at intermediate times were regarded as intermediate outcomes. At baseline, women were assigned into one of three treatment categories based on their initial cancer surgery: BCS, mastectomy alone, or mastectomy with immediate reconstruction. Two further treatment categories were created for women who went on to have a delayed reconstruction or who lost their reconstruction. Women were allocated to the appropriate treatment category at 1, 2, 3, and 4 years after initial surgery based on their initial category and type of breast procedure they had undergone during the subsequent years (if any). The proportion of women with a breast at each time point included only those women with BCS or an intact reconstruction after mastectomy. Women who had undergone mastectomy alone or who had suffered a loss of reconstruction were labelled as not having retained a breast.","title":"The Proportion of Women Who Have a Breast 4 Years after Breast Cancer Surgery: A Population-Based Cohort Study"}
{"_id":"b06128b6-8168-dbe5-2397-555e94a0de6a","text":"Histologic results from this study corroborate findings from previous reports. Connective tissue was incorporated into ePTFE, which is likely responsible for its bond to surrounding tissues, and for the support and stability of the lining flap. These findings support the idea that ePTFE may be superior to autograft and allograft in preventing flap airway collapse.","title":"Preventing nasal airway collapse with irradiated homologous costal cartilage versus expanded polytetrafluoroethylene: a novel animal model for nasal airway reconstruction"}
{"_id":"b06381ee-9c7e-6414-f39a-284185a0c05e","text":"We analyzed the retrospective clinical and photographic records of 20 patients with burn scar contracture with webbing. We performed 10 cases of V-M plasty and full-thickness skin graft at the finger sides and 10 cases of whole web and finger graft.","title":"Abstracts from the 12th Asia Pacific Burn Congress Singapore. 14-17 August 2019"}
{"_id":"b064be04-6290-494f-42cd-32eeeedc54f0","text":"The complementary use of infant formula should be carefully evaluated, since the prescription of breastmilk substitutes at maternity hospitals may encourage mothers to do the same when they return home, believing that they are incapable of producing enough milk for the newborn.(","title":"Breastfeeding versus free distribution of infant formulas by the Public Health System"}
{"_id":"b067554f-f618-b571-acef-a7d907f182e7","text":"The skin incision is carried down through the skin and subcutaneous tissue through the fascia of the anterior deltoid muscle. The SCAIF is then dissected from distal to proximal in a subfascial plane. As the flap is harvested more proximally, the underside of flap is checked with a handheld Doppler to confirm inclusion of the supraclavicular artery. The pedicle can also be visualized in the medial third of the flap by transillumination of the skin. Proximally, a 1 to 2 cm cuff of subcutaneous fat surrounding the pedicle is preserved to avoid injury to the source vessel. Several sensory nerves are encountered during the dissection and can be divided to increase the arc of flap rotation. Once the flap dissection is completed lateral to the pedicle, the remaining medial skin incisions are performed to complete the skin island paddle.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"b0755e6f-68cc-e2eb-c4b2-4ff42c38561e","text":"The skin and abdominal wall were reflected laterally. The LFCN was identified deep into the inguinal ligament, close to its origin at the ASIS. The femoral nerve was identified deep into the midpoint of the inguinal ligament. Soft tissues superolateral to the pubic symphysis were dissected to identify the iliopectineal line of the pelvic girdle. This was traced inferomedially to identify the obturator foramen and the obturator nerve running through the obturator canal.","title":"Fascia Iliaca Blocks: A Cadaveric Study Comparing the Suprainguinal Approach to the Loss of Resistance Technique"}
{"_id":"b0761dba-3709-76e7-8651-1b0142a9cbb7","text":"Patients with ankylosing spondylitis are at significant risk for sustaining cervical spine injuries following trauma predisposed by kyphosis, stiffness and osteoporotic bone quality of the spine. The risk of sustaining neurological deficits in this patient population is higher than average. The present review article provides an outline on the specific injury patterns in the cervical spine, diagnostic algorithms and specific treatment modalities dictated by the underlying disease in patients with ankylosing spondylitis. An emphasis is placed on the risks and complication patterns in the treatment of these rare, but challenging injuries.","title":"Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis"}
{"_id":"b079650f-38d8-d4ef-c4ff-423eeb7f418e","text":"Group size of 25 patients in each group is sufficient for statistical analyses; however, it is possible that a skew between groups occurs due to very large tumours in need of extensive resection associated with higher perioperative risks. If applicable, a subgroup analysis with and without said outliers will be considered.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"b07b3061-2c2c-f839-fd75-0072a0935b1d","text":"A retrospective study investigated 23 patients receiving percutaneous cryotherapy who refused systemic chemotherapy or failed previous chemotherapy (see Table 5). PFS after cryosurgery was 17 months for 11 patients with UC in the metastatic stage of the disease among included patients. The study concluded that percutaneous cryotherapy may be a safe and efficacious treatment option for metastatic bladder cancer.","title":"Epidemiology, treatments, and related biomarkers of locally advanced or metastatic urothelial carcinoma in Chinese population: A scoping review"}
{"_id":"b07e3b9e-4482-0f82-a5d8-3dc1d3b58022","text":"The second stage of the reconstruction took place one month after the first phase when the paramedian forehead flap showed adequate ingrowth (no signs of necrosis or venous congestion). Preoperative clamping of the pedicle was not performed. The second stage consisted of release of the pedicle of the forehead flap. The glabellar donor site was closed by a V-Y plasty, advancing a small remnant of the pedicle into the remaining donor site. The lateral part of the flap was tailored to the defect and was slightly thinned by resecting a portion of the subcutaneous tissue. In order to obtain a normal eyelid aperture, a partial lateral canthotomy was performed which released the cicatrisation that arose after the previous reconstructive stage.","title":"Reconstruction of an Extensive Periocular and Bilamellar Defect of the Lower and Upper Eyelid Using Local, Regional and Free Chondral Graft Techniques: A Case Report"}
{"_id":"b07ed68d-dfc0-936c-ee6d-0195509c80c7","text":"Virtual endoscopy can be simulated at any stage of the surgical planning, even in open surgery allowing to represent multiple scenarios which replicate the endoscopic vision encountered by the surgeon. In this respect, virtual endoscopy might also be useful to anticipately visualize the results of endoscopic exploration, establishing its correct timing within the surgical sequence and which vision correlates with a specific phase, overall improving the orientation of the surgeon.","title":"Anatomical Computerized Exploration to Excise Malignancies in Deep Facial Compartments: An Advanced Virtual Reality Protocol for a Tailored Surgical Approach"}
{"_id":"b082874e-f7e5-369a-720a-0bc59fe905e3","text":"Patients with localized lesions are generally good candidates for surgical excision. This, however, must be balanced with the risk of damage to deep structures if neuromuscular involvement is suspected. In this patient’s case, primary nerve repair was possible despite partial radial digital nerve resection with nodule excision. Before his procedure, we counseled this patient that neurovascular structures may be compromised, and complete debulking may be abandoned intraoperatively if those risks were deemed too great. In patients with particularly large lesions or extensive involvement of critical structures, more conservative debulking may be offered with the understanding that the risk of recurrence may be higher in these cases. Although the relative rarity of the idiopathic subtype limits our understanding of its incidence of recurrence, multiple studies demonstrate high recurrence rates in other subtypes of the disease.","title":"Idiopathic Calcinosis Cutis of the Hand"}
{"_id":"b08326c7-da11-a755-c5ec-fa25c9884010","text":"The ultimate goal in treating facial fractures is to obtain an accurate and stable reduction while minimizing external scars and deformity. For ZMC injuries that have fracture instability or comminution, an open reduction and internal fixation is indicated with the coronal approach as the main access for complex zygomatic arch repairs. This approach can lead to alopecia, loss of sensation posterior to the incision, risks of traction injury to the frontal branch of the facial nerve with temporal hollowing, and excessive blood loss. More recently, endoscopy has been used to assist in the treatment of ZMC and Le Fort III fractures. Endoscopy can be performed through stab incisions and thus avoids the need for extensive coronal exposure for zygomatic arch repairs. 75 Endoscopy allows for in situ reduction and fixation under magnified visualization while only requiring small, well-concealed incisions.","title":"Overview of Facial Plastic Surgery and Current Developments"}
{"_id":"b084d53a-8ae0-f242-c0df-aee178af242a","text":"The squamous cell carcinoma of the penis metastasizes essentially via the subcutaneous lymphatic system by embolization from the superficial to the deep inguinal lymph nodes and lastly to the pelvic nodes without missing the previous compartment.[2728]","title":"Radioguided surgery in urological malignancies"}
{"_id":"b0868fc8-4c0e-d884-330f-3150474604ab","text":"All participants were female, older than 18 years and had a diagnosis of breast cancer in the breast to be reconstructed. Reconstructions after prophylactic mastectomy were excluded, as well as women who had a metastasis at the time of mastectomy. Women who had a delayed reconstruction and experienced a recurrence after mastectomy, but before reconstructive surgery, were excluded as well. These women were excluded, because this study aims to determine the association between timing of reconstruction surgery and first recurrence and these women were no longer a risk for a first recurrence.","title":"The difference in local, regional and distant breast cancer recurrence between the immediate and delayed DIEP flap procedure; a retrospective cohort study"}
{"_id":"b0872386-3d95-5ade-38e9-3508e30cce95","text":"Axillary hyperhidrosis causes considerable emotional and social problems affecting the daily life.","title":"Treatment of Primary Axillary Hyperhidrosis with Botulinum Toxin Type A: Our Experience in 50 Patients from 2007 to 2010"}
{"_id":"b0921f2e-49c2-1648-1f3a-2b6d4610da05","text":"Radioiodine therapy is one of the radical and relatively safe methods of treatment of hyperthyroidism.","title":"Abstracts and short papers from the 5th Congress of the Polish Thyroid Association, Poznan, 3-5 September, 2015"}
{"_id":"b0a8274a-56e6-4121-177b-2e7d674d04c3","text":"In light of new adjuvant treatment options and new indications for checkpoint inhibitors, and the lack of survival benefit after CLND, we can expect open surgery to decrease in melanoma disease.","title":"Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection for Melanoma"}
{"_id":"b0a8403d-720a-1e7b-fb37-3a2cecd62260","text":"Since after the botulinum toxin injection we find significant differences in the anterior chamber angle but not in the keratometric values and the anterior chamber volume and depth, we interpret the reduction of the iridocorneal angle may be due not to the relaxation of the orbicularis oculi muscle but to relaxation of the pupillary sphincter. However, a limitation of the current study is that we did not measure the pupil diameter.","title":"Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm"}
{"_id":"b0aa1014-a4d5-c143-08bd-5801f069b41e","text":"Dailey et al.22 state that it is conceivable that further wrinkle reduction may be achieved with a treatment regimen that extends beyond 20 months,22 but there is paucity of data for treatments longer than one year. The study found that satisfaction improved with each treatment cycle; arguably those who were unsatisfied may be more likely to drop out.","title":"A review of the longevity of effect of botulinum toxin in wrinkle treatments"}
{"_id":"b0b2225b-0c19-4906-d015-ad932c867598","text":"It is especially important to have a deep knowledge of the anatomy of the site where the Mohs micrographic surgery is going to be performed, as this has different implications for both the time of resection and the time of processing of the surgical specimen [5].","title":"Combined Mohs Micrographic Surgery in a Collision Tumor"}
{"_id":"b0b7a83a-9025-ccaa-430e-d0008c0aed6f","text":"The inferior part of rectus abdominis muscle flap seems to be a reliable and comparable means of reconstruction after APR surgery with low rate of complications and mortality.","title":"Inferior Part of Rectus Abdominis Muscle Flap Outcomes after Abdominoperineal Resection: A Case Series Pilot Study"}
{"_id":"b0ba7690-7825-8b18-1077-54a2c2157abd","text":"The use of a composite free fibula inside other biological grafts provides a reasonable and durable option for extremity osseous oncologic reconstruction, with an acceptable complication rate and good functional results. Nonunion mainly occurs in the diaphyseal junctions and can be treated with local bone grafting. There was no obvious difference in blood loss, union time, or functional outcome between the vascularized and non-vascularized fibular grafts in lower extremity reconstruction. This may be related to the influence of the resection length on the choice of reconstruction method. Compared with a vascularized fibular graft, a shorter operation length can be obtained with a non-vascularized fibular graft. The two plates used as internal fixation methods are recommended for lower extremity reconstruction, especially in the femur. The interesting outcomes verified in this study show the importance of further comparison studies with larger sample sizes to other reconstructive methods.","title":"Long-Term Follow-Up of Biological Reconstruction with Free Fibular Graft after Resection of Extremity Diaphyseal Bone Tumors"}
{"_id":"b0cebe32-c869-3d70-8d88-b5ac888a9a59","text":"Arterialized retrograde free venous flaps have been shown to behave differently from other configurations of venous flaps and to be safe. They are a useful tool in the hand of the microsurgeon and can be considered as a primary tool for reconstructing complex composite defects in the extremities. Nevertheless, their physiology is still unclear and further research is needed to help further understand their behaviour","title":"Retrograde Free Venous Flaps for Extremity Reconstruction: A Roadmap"}
{"_id":"b0d2f891-70cc-1c79-f815-dea658483672","text":"Longevity of results is a crucial issue in the use of fillers. Patients should always know fully the duration of results expected for proper planning. As stated above, controlled data for the longevity of the filler materials may not always be available. Both this and the fact that individual results may vary should be explained to the patient.","title":"Dermal Fillers: Do's and Dont's"}
{"_id":"b0d783d0-583b-2ec8-7df1-5c5b70ecc29c","text":"This could be the first meta-analysis of second malignancies in MCC. We have restricted our search to include population based studies because such studies are the best fit for overall analysis of associated risks for many diseases. Many of the individual studies assert that being diagnosed with MCC poses an increased risk of being diagnosed with second primary cancer. Our results are consistent with previous reports that people with MCC are at a significantly higher risk for developing second malignancies when compared to the general population, and such risk would be present 1 to 5 years after having MCC as primary cancer. Our study asserts that patients who are diagnosed with MCC are 52% more likely to develop second cancers after one-year period as compared to the general population. The risk of developing malignant melanoma was two times more likely in patients with MCC as compared to other common malignancies. Thus we derived that, after diagnosis of MCC, there is a need to emphasize on the screening and prevention of second cancers along with the treatment of MCC.","title":"Risk of Second Cancers in Merkel Cell Carcinoma: A Meta-Analysis of Population Based Cohort Studies"}
{"_id":"b0de29c3-d21d-ddea-771a-ce08657cd230","text":"Preoperative evaluation of the presence and extension of CAD and timely coronary revascularization is important to decrease the perioperative risk and improve the postoperative long-term prognosis by choosing optimal treatment strategies. Exercise ECG testing, stress myocardial perfusion scintigraphy, or stress echocardiography for the detection of obstructive CAD are often contraindicated in this type of patients because of lower limb disabilities and limb infection requiring emergency surgery. Over one-third of perioperative MACE occurred in patients with negative results of such testing.","title":"Coronary artery calcium score and coronary computed tomography angiography predict one-year mortality in patients with type 2 diabetes and peripheral artery disease undergoing partial foot amputation"}
{"_id":"b0e0c076-4f34-3695-2852-953d3497013a","text":"A variety of pedicled and free flaps could be used to cover the lower extremity war wounds. Reverse sural fasciocutaneous flap as a safe and quick pedicled flap requires no microvascular expertise. This flap is based on sural vessels and is a versatile option covering the lower limb wounds particularly in patients suffering multiple trauma or vascular pathologies. A recent systematic review of the literature reported trauma as the most common indication of the distally based sural fasciocutaneous flap. This flap has been used most frequently to cover heel, ankle and foot defects, respectively.","title":"Early Reconstructions of Complex Lower Extremity Battlefield Soft Tissue Wounds"}
{"_id":"b0e12b6c-f5ba-18d6-7ce5-344985358cb5","text":"Few side effects concerning the cervical nucleoplasty have been reported and no serious side effects have been known; potential serious complications of nucleoplasty are neurovascular injury to adjacent structures or post-operative spondylodiscitis.","title":"Percutaneous cervical coblation as therapeutic technique in the treatment of algo-dysfunctional pain of discal herniation"}
{"_id":"b0e3010e-3d7c-e9c4-0a4d-463d1706081f","text":"We admit that the sensitivity and specificity reported in this paper do not represent the greatest sensitivity and specificity that could be achieved using the two-point compression technique with more experienced operators. This begs the question: how many ultrasounds does one have to perform to achieve proficiency in compression ultrasound?","title":"Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis"}
{"_id":"b0f781ac-e683-cf81-fdda-00e7ab8517ea","text":"The present study performed sentinel lymph node biopsy in patients with T1T2 breast cancer, who had non-pathologic lymph node in clinical examination and ultrasound, to evaluate the pathologic results of axillary sentinel and non-sentinel lymph nodes and to determine the relationship between tumor subtype and the extent of involvement. In addition, it tried to predict the possibility of axillary lymph node involvement based on the ultrasound results and tumor subtype. According to the results of this study, could be sentinel biopsy used in patients with palpable and normal lymph node in ultrasound? Could they enjoy the benefit of sentinel biopsy and avoid axillary dissection merely due to palpability of the lymph nodes?","title":"Sentinel Node Biopsy in Early Breast Cancer Patients with Palpable Axillary Node"}
{"_id":"b0ff80b8-3ba4-6695-f55a-b43eb2f9932d","text":"Less invasive treatment approaches to treat chronic PSD are typically performed in an outpatient setting and offer reduced morbidity, low recurrence rates, and shortened periods of time to return to work or social activities. In conclusion, more radical operations of PSD should be reserved for recurrent PSD where less invasive approaches have failed several times.","title":"Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children"}
{"_id":"b106c3eb-500b-7db7-a8f2-52caee95e326","text":"Chest wall imaging on the affected side in those who had undergone mastectomy was only performed when a clinical symptom\/sign was detected by the patient or clinician.","title":"Assessing Mode of Recurrence in Breast Cancer to Identify an Optimised Follow-Up Pathway: 10-Year Institutional Review"}
{"_id":"b10d889a-df4f-325a-873f-0837ab4286d4","text":"An important limitation of this study is the fact that the performance and detailed compliance of the unrestricted and hypoallergenic diet was not strictly supervised by online diaries and strict controls every day. Thus, dietary mistakes cannot be fully excluded and some allergy patients may have reduced the intake of a certain staple foods when perceiving symptoms or suspecting a food as allergic trigger. This may lead to a lower UMH production during unrestricted diet and may have influenced the diagnostic accuracy of UMH detection negatively, as we have shown clearly higher UMH levels during DBPCFC when freshly prepared allergens were applied solely [29]. But the aim of this functional mediator study was to explore UH and UMH excretion in patients with food-related symptoms during the typical clinical situation, mostly at home, when patients experienced their postprandial symptoms.","title":"Excretion of urinary histamine and N-tele methylhistamine in patients with gastrointestinal food allergy compared to non-allergic controls during an unrestricted diet and a hypoallergenic diet"}
{"_id":"b110a72f-b546-4720-1a16-9688cf69fa93","text":"Local antibiotics can be administered in high concentrations with little systemic toxicity, avoiding adverse antibiotic reactions and removing concerns with compliance. While systemic antibiotics are routinely administered following surgery, to target any residual organisms, the perfusion into treated bone defects might be suboptimal, resulting in low antibiotic penetration. Unlike systemic antibiotics, local antibiotics are not reliant on the often-compromised perfusion present at the site of infection to achieve antibiotic delivery. Insertion of antibiotic directly at the site of infection achieves a concentration many times greater than would otherwise be achieved by systemic therapy, while minimizing systemic toxicity. This has the additional benefit of impeding biofilm formation on devascularized bone. An animal model has demonstrated that local delivery of antibiotics into a bone defect is superior to systemic antibiotics alone at 14 days following surgery.","title":"A comparison of clinical and radiological outcomes between two different biodegradable local antibiotic carriers used in the single-stage surgical management of long bone osteomyelitis"}
{"_id":"b1173a89-2b2a-4615-610b-d8d03004116b","text":"The straws were stored at 4 °C for 15 min and then suspended 5 cm above of liquid nitrogen for 10 min before being stored in liquid nitrogen. For semen thawing, straws were placed at room temperature for 1 min and then transferred to a beaker at 37 °C until all ice crystals had melted. Azoospermia was confirmed by centrifugation of the entire semen sample at 3000 ×g for 15 min.","title":"Male cancer patient sperm cryopreservation for fertility preservation: 10-year monocentric experience"}
{"_id":"b11d6d19-6f34-546c-7bac-47341bdf7e44","text":"3) All the authors have read and given approval of the final manuscript version to be published. Each author has participated sufficiently in the work to take public responsibility for appropriate portions of the content.","title":"Salvage of failed free flaps used in head and neck reconstruction"}
{"_id":"b128a86a-9682-564e-2949-077e9455c0db","text":"One possible explanation for this data divergence could be the fact that our sample was based on patients who were referred for ultrasound mapping for varicose vein surgery. Furthermore, the presence of patients classified as C3 and C4 may increase the incidence of JSF and GSV reflux in this specific sample.","title":"Patterns of flow drainage from varicose veins originating in the incompetent great saphenous vein Padrões de drenagem do fluxo das varizes oriundas da veia safena magna incompetente"}
{"_id":"b13299ac-abcf-25a7-8967-477a5d04f9d6","text":"Patients should have a CDU of the veins in both legs between Day 7 and Day 10 and usually between Day 25 and 30. We define minimum acceptable technical standards for ultrasound equipment and stipulate that the trial ultrasonographers should have performed CDU to diagnose DVTs as part of a clinical service. We asked them to visualise the popliteal and femoral veins in both legs but do not insist that they routinely visualise the six deep veins in the calf since detecting thrombosis in these is far less reliable. We obtain a hard copy of positive scans to enable our trial radiologist (JR), who is blinded to group allocation, to verify each primary outcome. We do not perform central verification of negative scans because, with ultrasound techniques, meaningful verification of static images is difficult. If the second ultrasound is delayed to more than 30 days and shows a popliteal or femoral DVT, it is included in the primary outcome. However, we do not include a proximal DVT in our primary outcome which only comes to attention because of symptoms starting more than 30 days after enrollment because this might introduce bias.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"b1346e45-a131-b5a7-6a39-9cec8b37b991","text":"We present a surgical technique and the preliminary results of breast cancer excision after insertion of a specially constructed marking needle into the tumor, controlled by intraoperative ultrasound.","title":"Optimization of breast cancer excision by intraoperative ultrasound and marking needle - technique description and feasibility"}
{"_id":"b1361f7c-d19f-f29f-b5f7-a1f16b125d98","text":"It is worth noting that the use of this combination therapy is effective in vismodegib naïve patients and it is not effective in patients previously treated with vismodegib as it has a poorer response [14].","title":"Hedgehog Pathway Inhibitors: Clinical Implications and Resistance in the Treatment of Basal Cell Carcinoma"}
{"_id":"b1389a55-5e1e-47bf-0e6a-662bc7640f5c","text":"We have previously characterized the humoral response of natural antibodies (IgM) in a murine cancer model using 4T1 cells [11]. As the BPA is an important EDC and its impact on immune regulation has been demonstrated, we evaluated the variation of the humoral immune response, which is caused by BPA in the B cell populations and measured this by flow cytometry. We measured the B cell function by the reactivity of IgM antibodies to tumor cell 4T1 breast cancer antigens in mice that received a single neonatal exposure to bisphenol A.","title":"Neonatal Bisphenol A Exposure Affects the IgM Humoral Immune Response to 4T1 Breast Carcinoma Cells in Mice"}
{"_id":"b1398ec5-9ba5-2987-715d-e42bc5283236","text":"We evaluated the performance of a group of residents in various stages of their neurosurgical education in a task 3D HD exoscope. The exoscope appeared to perform better when used to identify deeper structures while starting from outside the surgical field; otherwise, neither device seemed to offer significant advantages compared to the other in the execution of the task when the whole group was considered.","title":"Exoscope and operative microscope for training in microneurosurgery: A laboratory investigation on a model of cranial approach"}
{"_id":"b145bdf2-db7f-329a-bb55-26ab368ac75b","text":"Removal of filters by open surgery is not a routine procedure and is mostly used in patients with a broken or displaced filter, or with abdominal pain and after the failure of endovenous removal. Selection criteria were as follows: patients aged <70 years, with no contraindications to anticoagulants, and no serious cardiopulmonary disease that would prevent the procedure; IVC is patent at least in unilateral iliac veins, with no thrombus or retaining a small amount of old thrombus in the lower limb veins and IVC, above situations can be considered as low risk of pulmonary embolism after removal of the filter; failure to retrieve the conical filter by endovenous method because of severe tilt or CT scan showing the penetration of filter hook into the IVC wall; patients did not accept permanent placement of a filter or had a strong desire for filter retrieval or accept of filter retrieval by open surgery.","title":"Removal of inferior vena cava filter by open surgery after failure of endovenous retrieval"}
{"_id":"b148d31a-9eeb-c20a-aedf-3a887e3160e1","text":"Two retrospective reviews, each with over 300 free tissue reconstructions for the lower limb, found that anastomosis of one rather than two veins did not affect the rate of flap survival. 68 69","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"b14bdd21-ebfc-3d7a-2ea4-6a71e38277de","text":"Patients who previously had an axillary lymph node dissection and had a cutaneous tumor indicating SSL with an anticipated lymphatic drainage pattern to the dissected axilla were identified. Demographic data and medical histories were collected from each of the patients.","title":"Reoperative Selective Sentinel Lymphadenectomy Combined With Lymphoscintigraphy Is Technically Feasible for Cutaneous Tumors of the Upper Extremity After Radical Dissection of Regional Lymph Node Basins for Breast Cancer Miranda et al"}
{"_id":"b1527a55-3a2b-a174-d2ae-a59c9db6dc7d","text":"Our study showed that the surgical and conservative treatment options are useful for local control of desmoid tumor. We believe that surgical internvetion is the best option for primary lesions, located where wide margins can be reached with low functional and cosmetic morbidity. Conservative treatment is an alternative for large lesions after multiple recurrences and in cases in which surgery will result in significant functional limitation.","title":"EXTRA-ABDOMINAL DESMOID TUMOR: LOCAL RECURRENCE AND TREATMENT OPTIONS"}
{"_id":"b158dca9-187d-cf8a-f380-f781c309d561","text":"Some fellows also stated that after the fellowship, they were in a more competitive position to be considered for new jobs, or felt more confident while applying. This illustrates a separate phenomenon by which the act of completing a leadership training program confers additional qualification for leadership a priori, as illustrated here:","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"b15c94e5-9566-df58-3b15-378b574bc252","text":"Although the flap anatomy is reliable, there are cases where there is a need for improvisation and use of the microsurgeon's creativity. To achieve a harmonic breast form and to successfully perform the microsurgical part of the surgery can possess a challenge even for an experienced reconstructive breast surgeon.","title":"Use of the superficial inferior epigastric vein in breast reconstruction with a deep inferior epigastric artery perforator flap"}
{"_id":"b15f0420-236d-3599-d921-7778ffd4eb05","text":"A summary on main studies using biopsy for intraocular tumors, with the reported complications and purposes has been provided in Table 2.","title":"Uveal Melanoma Biopsy: A Review"}
{"_id":"b17630d5-4290-26ce-12d2-0517b6a92b8b","text":"The diagnosis of autosomal dominant osteopetrosis OAD is often made following a complication or following a radiological workup.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"b182ae1f-0d25-0cd3-61b6-a95661658ece","text":"We have adopted the following techniques to reduce pain during local anaesthesia:","title":"How to Make Local Anesthesia Less Painful"}
{"_id":"b18beb06-fabd-f508-aad8-1d97f9f9d359","text":"Complications and toxicity directly attributable to radiation were difficult to assess due to the multidisciplinary nature of the treatment for locoregional recurrence and the presence of pre-existing treatment effects. Complications clearly due to therapy received for the initial cancer diagnosis were excluded, unless this significantly changed after completion of radiotherapy. A total of 8 patients in this study developed a grade 3 or greater complications attributed to radiation, including one instance of brachial plexopathy in each dose group and one instance of radiation associated sarcoma in the dose escalated group.","title":"Radiation dose escalation for loco-regional recurrence of breast cancer after mastectomy"}
{"_id":"b18ee91d-64a8-b143-bef6-57cd2d25a267","text":"In our case, the DIEP flap survived after the repair of the arterial perforator segment with the contralateral SIEV and demonstrated only a small area of fat necrosis.","title":"Use of the superficial inferior epigastric vein in breast reconstruction with a deep inferior epigastric artery perforator flap"}
{"_id":"b19390bd-c0b0-c831-9da0-633b0ed6281b","text":"Understanding the sequelae of lip augmentation with dermal filler products allows clinicians to provide safe and effective treatment. Nodules that present months to years following filler treatment may represent a foreign-body granuloma. A combination of oral antibiotics, intralesional or oral steroids, and surgical excision successfully treated the majority of cases in our study. Future studies evaluating the development of granulomas should include treatment injection methods and techniques to better elucidate potentially related causes.","title":"Delayed Granulomas as a Complication Secondary to Lip Augmentation with Dermal Fillers: A Systematic Review"}
{"_id":"b195569d-e2fa-8d1b-40f6-e9388ee019f3","text":"Vestibularly, the design of the flap is similar to a flap for the treatment of multiple recessions in mucogingival surgery therefore it involves the following:","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"b19657a0-5a1c-f0f9-23ce-837d8be79ee1","text":"All dogs were hospitalized for 1–2 days after preoperative ultrasonographic visualization of the suspected migrating plant material while awaiting surgical exploration.","title":"Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs"}
{"_id":"b1975cd5-2666-a3a0-376f-cb63314b5d49","text":"In conclusion, current study did not reveal differences in dose distribution in organs at risk among patients receiving PMRT with or without breast implants. Dosimetric characteristics and definition of CTV in patients with implants urges further evaluation. Further studies specifically addressing consequences of implants on PMRT planning and delivery will shed light on oncologic safety.","title":"No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction"}
{"_id":"b1affec1-e75d-a0bb-4ee5-e7ddc6857fd1","text":"The LDMF was first described in the late 1800s by Italian surgeon Tanzini4 as a novel approach to repairing breast amputation. It was not until the 1970s however that the LDMF began to evolve into its current state. Schneider et al5 and Olivari6 described their experiences with latissimus flaps following mastectomy and radiation in 1977. In 1978, the technique of a skin island over the muscle flap was promoted by Bostwick et al.7 Bostwick et al7,8 described utilization of the LDMF with and without silicone prosthesis. Later, Maxwell argued that the flap could be utilized even if surgeons sacrificed the main thoracodorsal trunk as the flap could be sustained by collateral circulation.9 This collateral circulation was found by Fisher to be from reversed flow of the serratus branch of the thoracodorsal artery.10","title":"Latissimus Dorsi Myocutaneous Flap for Breast Reconstruction: Bad Rap or Good Flap?"}
{"_id":"b1b845f5-f326-0018-1600-7bef11a6a9a8","text":"In conclusion, the extended LD flap is another good alternative that can be offered for autologous breast reconstruction. The flap is primarily indicated for those who are not suitable candidates for TRAM flaps or for that group of patients who would prefer the back donor site and are reluctant to proceed for the prolonged recovery of the pedicled TRAM or for the possible morbidity and the complexity of free tissue transfers. The disadvantages of the flap lie in the high incidence of seroma which usually responds to repeated aspirations. Also noted is the mild contour deficiency of the back, which usually improves with time and may be acceptable to most patients. However, obese patients should be warned that this deformity may be more obvious on their backs. Other disadvantages are the limitations in the size of the flap making it unsuitable for certain groups of patients who have very large and\/or severely ptotic breasts unless a contralateral procedure (reduction\/mastopexy) is to be done.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"b1c0b1b5-501c-c304-f378-b94382f1ea72","text":"The project was approved by the Scientific Project Analysis Committee of the hospital.","title":"Assessment of the adherence to and costs of the prophylaxis protocol for venous thromboembolism"}
{"_id":"b1c224dc-395c-70f7-2ddc-35deb5f0c46a","text":"The novel technique is about the modification of the implantation method of iliac screws: using anatomical entry point (medial and caudal to PSIS, rather than the posterior superior iliac spine at high level) with bone resection around entry point for any prominence in addition to musculofascial closure above iliac screws and submuscular insertion of rod that overcome drawbacks of other implantation techniques especially wound irritation and complications. All these factors, in addition to using a single rod technique (rather than double rod) minimize the posterior soft tissue trauma with better skin healing process. In addition, this standardized protocol allows better TIFI insertion in both the sagittal and axial plane to avoid screw malposition.","title":"Does minimally invasive percutaneous transilial internal fixator became an effective option for sacral fractures? A prospective study with novel implantation technique"}
{"_id":"b1c90fe2-21b3-0f42-8830-75b4835a25d2","text":"The lucrative return on investment for the use of social media in private practice is undeniable. Based on the top social media accounts highlighted in this study (Table 1), we see that there is much benefit for the utilization of social media platforms in the private practice setting. However, the role of social media in the academic setting remains in question. Many established academic plastic surgeons cited in the literature, especially senior academic surgeons, believe that the increased use of social media is leading to negative views on the specialty of plastic and reconstructive surgery. However, it is apparent that social media usage is increasing among residents in training and residency applicants to gain information on plastic surgery programs and their faculty, resources, and overall program setup. As such, the use of social media in academic plastic surgery has expanded to include not only plastic surgeons but residency programs as well. In the academic space, social media can be an asset for the expansion of the professional network among plastic surgeons, specialists, and the public. Our study demonstrates a similar trend with increased engagement among personal posts. In a study of posts by public residency program Instagram pages, Irwin et al show that the ideal posts to gain popularity involve content that includes residents operating and enjoying life outside of the hospital. The growing impact on social media in the academic setting has been considered an inevitable aspect of the specialty of plastic and reconstructive surgery. Integrating social media strategy and philosophy from top private plastic surgeons can be a helpful framework for forming a guideline for the use of platforms—like Instagram—for future discourse in academic plastic surgery and surgical training.","title":"Content and Engagement Among Plastic Surgeons on Instagram"}
{"_id":"b1d403e2-47d6-512d-7c4f-14d4a612d5e4","text":"PVR can be done safely with a low risk of PVT. Standard postoperative thromboprophylaxis with prophylactic dosing is sufficient to prevent PVT.","title":"Abstracts DGAV"}
{"_id":"b1e39dd5-58f3-0367-15c8-75acaca1f3ca","text":"Correlation coefficient had been applied to assess the relationship between the two Deltas.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"b1ebbd45-0fab-5079-dac1-2ae9f6b1820a","text":"Skin substitutes are required in the acutely burned patients as well as in those requiring extensive post burn reconstructions. These have important impact in the care and outcome in the burn victims.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"b1ece433-360d-2fcf-8034-88f0ed5f6338","text":"Although several studies have identified risk factors for local recurrence in TSGCT, none have analyzed possible risk factors for osteochondral destruction and progression in combination with those for local recurrence. Given that TSGCT is a benign neoplasm, the primary endpoint of treatment should be to maintain the function of involved joints. Surgery to reduce the recurrence rate in TSGCT occasionally causes morbidity of involved joints. This makes it important to analyze factors influencing local recurrence and osteochondral destruction together.","title":"Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study"}
{"_id":"b1ecfe9c-59a2-1513-2180-e057a679378c","text":"The cartilage shaving may be also stored in the freezing (-19oc) temperature for 1 to 1.5 years before using in a touch up procedure. Long term clinical outcome in this study supports the finding that cartilage microstructure is not destroyed when prepared as injectable cartilage shaving, but more comprehensive studies on long term in vivo survival of this type of graft in animal models is being performed to prove its efficacy.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"b1f0a604-a18c-eee3-bd68-5aeaf2eb115e","text":"The characteristics of a good obturator will improve swallowing, speech function, minimise nasal fluid leakage from the antrum and nasal spaces, restore facial aesthetics including the teeth and facilitate masticatory function and speech. A surgical obturator can be provided at the time of surgery to facilitate function and haemostasis in the immediate post-operative period, and this can subsequently be replaced with a more definitive prosthesis once the maxillary defect has healed to a more stable condition.","title":"A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient"}
{"_id":"b1f206ac-f70c-83df-916b-accbcc718421","text":"In this article, we report the exceptional case of a patient diagnosed with a cervical chordoma that presented at clinics with sudden extrusion of a cervical vertebral body expandable cylinder through the oral cavity.","title":"Oral extrusion of a vertebral body replacement device after chordoma tumor growth and radiation: case report and review"}
{"_id":"b1f82dc5-c4c1-d149-d223-91a1f832fac3","text":"With the randomized controlled study design, we generated robust evidence regarding the efficacy of cryotherapy supported with appropriate CIPN measures of PRO and electrophysiological assessments. PRO, though subjective, were designated as the primary outcome as they represent the direct impact of neuropathy on the lives and daily functioning of patients. Electrophysiological assessments objectively characterize the function of large and small nerve fibers after exposure to chemotherapy and mitigate the risk of placebo effect (48). The consistent results observed between these measures further substantiated our findings. The main limitation is the high rates of cryotherapy interruption which might have compromised the validity of our efficacy results. However, this was likely an accurate representation of patient behavior if cryotherapy were to be implemented in clinical practice. This emphasizes the need for future studies to improve the cryotherapy regimen before it can be introduced as a possible preventative strategy for CIPN.","title":"Impact of Cryotherapy on Sensory, Motor, and Autonomic Neuropathy in Breast Cancer Patients Receiving Paclitaxel: A Randomized, Controlled Trial"}
{"_id":"b1fc67ea-5be1-b83f-e7b9-09417d26c7d9","text":"Among the post-operative complications, facial nerve weakness was thought to be due to segmental resection or an intentional nerve cut when those approaches were used or due to irritation during the operation. Facial nerve function gradually recovered through rehabilitation treatment such as physical therapy. With respect to post-operative facial nerve function, the HB grades were closest to normal in cases in which the nerve was not transected (Table 1). Patients were able to close their eyes completely in all cases except those involving segmental resection. Prognosis was better in cases involving an intentional cut than in those involving segmental resection, and prognosis was also better when one of the five branches of the facial nerve was transected than when the temporofacial or cervicofacial trunk was transected. Although a conservative approach to the facial nerve yielded better recovery of nerve function, a radical approach might be required to completely resect the mass and prevent recurrence.","title":"Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review"}
{"_id":"b206d659-87e1-2030-f8ae-1cb7779d2ac2","text":"There has been lot of changes in understanding the concept of fat conservation in Blepharoplasty. The cause of facial aging was focused on gravitational pull.","title":"Blepharoplasty"}
{"_id":"b209c474-d096-b663-f78d-fd2a9375e005","text":"With regard to the search for care in the SUS network, the participants emphasized obstacles to performing exams that are essential to the diagnosis of breast cancer. Aspects related to the municipal management and service delivery are thought to hinder access to specialized services and increase wait time for diagnosis.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"b20a5e54-2ec8-f2dc-56bf-66340351c39d","text":"Funnel plots are presented in Appendix 4. None of the analyses reached the minimally required 10 included studies for adequate assessment of publication bias. As a result no conclusions can be drawn on the presence or absence of publication bias.","title":"Timing of preoperative antibiotic prophylaxis in 54,552 patients and the risk of surgical site infection A systematic review and meta-analysis"}
{"_id":"b212862c-6b25-1e58-0c3b-6dc071802d2c","text":"Patients underwent close follow-up if the sentinel lymph node remained unmarked or the procedure had to be terminated intraoperatively to avoid iatrogenic vascular or nerve injury due to the location of the lymph node.","title":"Sentinel lymph node biopsy for high-thickness cutaneous squamous cell carcinoma"}
{"_id":"b21b1620-a1e2-20dd-7c60-234b8d49fbbf","text":"In our study, 3 patients presented with transient marginal mandibular nerve neuropraxia during recovery from RFAL. The “wry mouth” symptom was reported immediately after the RFAL treatment and 2 of them achieved full recovery in 1 week, whereas the remaining patient recovered in 4 weeks without other adverse effects. This finding is consistent with previous reports that nerve recovery occurs after remyelination and that sensorimotor functions can usually be fully restored within days to weeks without sequelae. Neuropraxia was caused by temporary interruption in the conduction of nerve impulses and motor function, which was a consequence of trauma to the nerve fibers without nerve rupture. Given that the marginal nerve was dominant for lower lip depressor function, temporary unilateral neuropraxia of the marginal branch of the mandibular nerve resulted in paralysis of the ipsilateral depressor anguli oris muscle. When performing RFAL to the neck, it is not recommended to go above the mandible and medial to the marionette lines where the marginal mandibular nerve is typically found. However, the position of the marginal mandibular nerve with respect to the mandibular border varies, and it is often asymmetrical. To prevent nerve injuries, DiBernardo et al showed the importance of mapping the marginal mandibular nerve prior to performing RF skin-tightening procedures on the neck to prevent nerve trauma.","title":"Bipolar Radiofrequency-Assisted Liposuction for Cervical Contouring in Eastern Asians"}
{"_id":"b21b62df-00a7-c6b8-b827-6a57738162f5","text":"Here, patients report with long standing severe kyphosis with a history of being treated for spinal TB, 10 or more years ago and now present with signs of upper motor neuron spinal cord injury or paraplegia. The cause may be a reactivation of old healed lesion at kyphus or intrinsic changes in spinal cord due to continued stretch on internal salient.","title":"Kyphosis in spinal tuberculosis – Prevention and correction"}
{"_id":"b2268c04-a179-22c3-d03b-fd42e46a9305","text":"Patients at low risk of allergic reactions included those with a history of sensitivity to aeroallergens or insect bite (including patients receiving immunotherapy for these allergens), food, latex, or contrast media or prior nonanaphylactic reaction to a single drug group or those who had chronic urticaria. Patients receiving immunotherapy or biologic therapy were instructed to delay that treatment for at least 1 week after immunization with the BNT162b2 vaccine. Patients at low risk of allergic reactions were recommended to be immunized in regular settings, with 30 minutes of observation after immunization. Patients and their GPs were instructed to inform our referral center of anaphylaxis or any adverse reaction to the vaccine. Moreover, any significant allergic reaction required notification to the MOH in Israel.","title":"Prevalence of Allergic Reactions After Pfizer-BioNTech COVID-19 Vaccination Among Adults With High Allergy Risk Allergic Reactions After COVID-19 Vaccination Among Adults With High Allergy Risk"}
{"_id":"b228acfa-f536-3b87-9e74-5cb6f7ae58ff","text":"Randomly divided the 67 patients with invasive arterial pressure from January 2017 to June 2018 into experimental group and control group .There were 32 cases in the experimental group and 35 cases in the control group, the control group used the color Doppler ultrasound technical and the experimental group used B-Flow combined with color Doppler ultrasound technology. To select the standard artery blood detaining invasive arterial pressure, to compare the success rate of catheterization, catheter time and incidence of arterial thrombosis after intubation between the 2 groups;","title":"Abstracts from the 12th Asia Pacific Burn Congress Singapore. 14-17 August 2019"}
{"_id":"b22ca934-2507-3da1-3440-ed663af3a2bf","text":"In this paper, we have looked at the use of fillers postrhinoplasty to reduce the risk of revision surgery. Rhinoplasty is associated with revision rates that are higher than the senior author's rate and we believe this is because we advise patients to consider fillers for nose shape refinement postoperatively. This advice is now given to patients at the initial consultation. Some patients are engaged with such a process of using fillers and others are keen to avoid any intervention including fillers.","title":"Postoperative Fillers Reduce Revision Rates in Rhinoplasty"}
{"_id":"b23815cd-ea09-bbcb-3214-c5b26e875c76","text":"Catherine was born full-term with a life threatening condition that had been detected antenatally. As a self-protection mechanism, her parents emotionally withdrew from her during pregnancy and although surgery post-birth was successful and Catherine was no longer at risk, her parents remained detached from her. Thus, Catherine spent the first four months of her life in hospital with minimal interaction with her parents or other adults. Catherine did not gain weight in the early weeks of life, was diagnosed as failure to thrive and had a gastrostomy tube inserted. The insertion of the gastronomy tube did not result in weight gain but reduced the amount of human contact Catherine experienced because feeding did not require her to be held. Catherine was not provided with emotionally sensitive care or affection during her time in hospital. At four months of age and weighing 3.2 kg her parents relinquished her for adoption and she was placed in foster care. At the time she entered foster care, Catherine had developed an aversion to interaction with others and would turn away if spoken to and stiffen if touched. However, her foster mother provided her with responsive care and Catherine formed an attachment to her. Catherine was in foster care for ten weeks before being placed for adoption at 6.5 months of age. Post-placement for adoption, Catherine grieved her foster mother deeply and although she tolerated her adoptive father she rejected her adoptive mother and would turn her head and push her mother away if she attempted to carry her facing towards her. Her adoptive mother had previously breastfed other adopted children placed as newborns but her early offers of breastfeeding to Catherine were strongly rejected. Catherine weighed only four kilograms at placement and had a strong aversion to bottle-feeding. She would take only small amounts of milk via a bottle and only if she was held upright and facing away from the caregiver. Sucking was not pleasurable for Catherine, she did not suck on a pacifier or her thumb and would gag and vomit if her mother attempted to reinsert the bottle teat after Catherine had pushed it out of her mouth. Catherine's mother worked towards promoting the emotional and physical health of her child by committing to carrying Catherine in a sling whenever possible, being responsive to her and always remaining close to her. Within a few weeks Catherine developed a preference for her adoptive mother and would not tolerate any physical separation from her. Her mother also worked to overcome Catherine's oral aversion and changed her infant formula to one more pleasant tasting to that previously used and persisted with bottle feeding. As a result, Catherine developed a love of sucking. At this time Catherine also began to gain weight (though her energy intake had not increased), which allowed for the removal of the gastronomy tube. When Catherine's health had improved her mother decided to reattempt breastfeeding. Catherine was being bottle-fed very frequently at this stage and her mother decided that she would always be the one to feed her and that she would attempt the transition to breastfeeding by making bottle-feeding progressively more like breastfeeding. Thus, her mother used a short bottle, which made it easier to turn Catherine towards her as she fed and would switch sides during feedings. She also allowed Catherine to suck at the bottle after all the milk had been consumed for as long as she wanted to, which was often for many minutes. Once she was bottle-feeding well her mother threaded the tube of a breastfeeding supplementer through a bottle teat and held this over her nipple while Catherine sucked and obtained milk from the supplementer. When she felt that Catherine was ready, she replaced the bottle teat with a nipple shield with the supplementer tube placed through the end and finally she removed the nipple shield so that by her first birthday Catherine was suckling direct at the breast. Once breastfeeding began, her mother noticed an increase in Catherine's confidence and security. Thus, when Catherine was hospitalised shortly after starting breastfeeding, she not only surprised her doctors by her speed of recovery but by the marked improvement in the way she coped with the stress of medical procedures. Previous post-adoption hospitalisations had seen Catherine show terror whenever she was approached by someone wearing a white coat but on her first hospitalisation after breastfeeding initiation she spent much of the time while in hospital breastfeeding and allowed herself to be examined without showing distress. Post-breastfeeding initiation Catherine also experienced acceleration in developmental progress and a detachment from bottles to which she had developed an emotional connection. By the time of weaning at two years of age, Catherine had caught up physically and developmentally and was using her mother as a secure base when exhibiting normal explorative behaviour.","title":"Mental health, attachment and breastfeeding: implications for adopted children and their mothers"}
{"_id":"b23b63b1-e1d0-0874-0e31-31e7c777bb2f","text":"Hospital admission during pregnancy is associated with an 18-times increase in the risk of VTE compared with the baseline risk outside of hospital and the risk remains elevated after birth, for the next 28 days. When admitted to hospital, the risk is higher in the third trimester of pregnancy and in women over the age of 35 years.20","title":"Venous thromboembolism in women: new challenges for an old disease"}
{"_id":"b241e5d2-2a2f-b6fc-20ec-36a4098613f4","text":"The MBCN can be injured during surgeries near the axillary fossa, such as lymph node dissection and breast augmentation. Physicians should consider the possibility of MBCN entrapment if their patients have complaints of paresthesia over the axilla and the upper arm. During US examination, the MBCN is suggested to be scanned from the distal arm where it is less likely to be injured during an intervention in the axillary region.","title":"Ultrasound Imaging for the Cutaneous Nerves of the Extremities and Relevant Entrapment Syndromes: From Anatomy to Clinical Implications"}
{"_id":"b247226d-ba9a-82b5-ebcc-e7f2bda9e9a3","text":"Online fellowship program websites are more commonly becoming the primary information resource used by prospective applicants. This study aimed to analyze the online content of Canadian plastic surgery fellowship program websites.","title":"How Comprehensive Are Canadian Plastic Surgery Fellowship Websites?"}
{"_id":"b249e7f1-2467-d318-8d72-8bebc53d168e","text":"The shortcomings of our study are the lack of a direct comparison with a control group and the small number of cases. Also, our operation method may have higher technical requirement than conventional technique of total segment resection. Nevertheless, this surgical technique of vascularized bone flap sliding is a feasible alternative method for the treatment of chronic tibial osteomyelitis involving the anterior tibial cortex with intact and healthy posterior cortex. It allows for earlier removal of the frame and a reduced EFI without recurrence of infection.","title":"L-shaped corticotomy with bone flap sliding in the management of chronic tibial osteomyelitis: surgical technique and clinical results"}
{"_id":"b253de99-00c8-3ce6-b853-b258bf717893","text":"The graft thickness according to the readings on the dermatome is only an indication of the thickness of the graft. The graft thickness can also be influenced by the amount of pressure and the angle applied during harvesting. For a more accurate statement on the graft thickness, the measurements of the graft are needed. No standardised measuring device is available on market today. In our Burn Centre, we are currently developing such a device, to more accurately answer the question of the thickness of a graft compared to the setting of the dermatome and complications in wound healing of the donor site.","title":"The scalp as a donor site for skin grafting in burns: retrospective study on complications"}
{"_id":"b25a3798-dbc5-00af-39ba-6e328bd16d3e","text":"Serum immunoglobulin concentrations measured in the patients in the study group were the following:","title":"Immunological aspects predicting metastatic sentinel lymph node in early breast cancer patients"}
{"_id":"b25cd132-d7a8-6164-15de-7238025ccd65","text":"To know the clinical characteristics of the main differential diagnoses of actinic keratoses and how to use the auxiliary methods for diagnosis is crucial in this process.","title":"Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects"}
{"_id":"b266823a-72a0-ed08-9139-e167e8bd4d44","text":"Chronic pain is prevalent in the NF population and is a source of significant morbidity. While previously reported in the context of controlling acoustic neuroma growth, we report a series of NF patients with refractory pain that was successfully treated with bevacizumab. Bevacizumab was overall well tolerated and all patients have elected to pursue continued therapy for pain control. We believe that bevacizumab should be considered for as an option for NF patients with refractory pain.","title":"Bevacizumab for Treatment-Refractory Pain Control in Neurofibromatosis Patients"}
{"_id":"b27a621a-8219-7992-b53a-ce9ae4668935","text":"The management of an infected nonunion in the distal femur remains one of the greatest challenges in fracture surgery [6]. Not only for the surgeon: distal femur fracture nonunion has a devastating impact on the patient's function and quality of life. We present a case report of a patient whose infected nonunion of distal femur fractures had been treated with different novel techniques such as the Masquelet procedure and revision of a failed locked plate with a locked femoral nail complicated by Ca-P cement dislocation. After a thorough literature review, we could not find any similar cases which mark our case as a technical novelty.","title":"Infected Nonunion of the Distal Femur in the Elderly with Bone Loss: Case Report and Treatment Options"}
{"_id":"b27e6150-fa3b-ef7d-4767-76adac93fb82","text":"Malaysia is reported to have the third highest fatality rates from road traffic accidents in Asia. A good percentage of fractures are open, and many fractures requiring implant surgery get infected with ensuing chronic osteomyelitis.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"b286ddde-c115-c869-d02a-7a136bef30e6","text":"(2) Another pattern was a lymphatic a lymphatic vessel running directly from the lateral edge of the parenchyma and through the posterior surface of the breast into the lower axilla, and then to the lymph node located at the midaxilla. Several lymphatic drainage pathways from the areolar area were observed. Several streams from the areola joined together before they drained to the axilla.","title":"Sentinel lymph node biopsy for breast cancer patients using fluorescence navigation with indocyanine green"}
{"_id":"b2873560-d2a3-1f3a-7b91-bd15d15809a5","text":"There has been recent interest in the use of negative pressure wound therapy (NWPT) as an adjunct to parenteral antibiotics in the treatment of infection in orthopaedic patients with metalwork in situ. To address some of the limitations of standard NPWT in this situation, the senior author has developed a modified method of treatment for infected metalwork (excluding arthroplasty) in orthopaedic patients that includes irrigation and skin closure over the standard NPWT dressing.","title":"A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings"}
{"_id":"b287e078-8240-84ea-7f83-151484f7c78c","text":"The size of the ventricular cavities and good visibility of the sulci may be diminished in case of diffuse edema. Conversely, the volume of the ventricular cavities may sometimes be increased due to increased cerebrospinal fluid production and poor reabsorption. In these cases, the diagnosis of ventricular size change is greatly facilitated if the patient has previous neuroimaging findings.","title":"Imaging of Cerebral Venous Thrombosis"}
{"_id":"b28c10ba-d618-4b54-697c-39a9b58df496","text":"If suitable proximal suture is not possible, two maneuvers can be used: vascular bridges with vein grafts at the same time as the flap, or the initial use of a saphenous loop to provide healthy recipient vessels close to the lesion with a large vascular flow followed by fixing of the flap. It is important to bear in mind the caliber and length of the pedicle for each flap and its hemodynamic characteristics, which will make it more or less tolerant to a vascular bridge flap.1478","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"b2908114-0c9a-1d6f-695a-150d9cedfb34","text":"Biopsy tract or surgical site infections create a more complicated tumor bed and increase the risk of local contamination by spread through surrounding cellulitis or edema and by the tumorigenic effect of many inflammatory markers. Because of these risks in our patient, the ulcerated and infected tissue was thoroughly excised. In addition, at the time of wide resection, a wider than normal ellipse around the biopsy site was used to remove any potentially contaminated tissue. During the initial excision of infected tissue, great care was taken to avoid undermining the surrounding area because elevating large flaps or crossing tissue planes is well known to increase the risk of tumor contamination.","title":"The Management of an Open Biopsy Tract Site Infection and Ulceration in the Setting of Osteosarcoma"}
{"_id":"b29c623e-df5e-05b9-6b33-2a743487465f","text":"The second stage consisted of the removal of the tissue expander and reconstruction of the defect. The flaps were planned before removing the tissue expander considering the size and shape of the defect and the quality and quantity of the expanded scalp. During designing of the expanded scalp flap, we ensured matching of the hair direction with the recipient site, especially in the reconstruction of the frontal hairline or ‘sideburn’. When the hair direction of the expanded area was parallel to the adjacent defect or situated in the posterior region, a simple advancement flap corrected alopecia adequately. However, if the hair direction of the expanded area was too much angular to the adjacent defect, then a rotation flap or rotation-advancement flap was preferred. We performed capsulectomy by cutting the surrounding capsule of the expander base in order to encourage mobility of the expanded tissue without problem of flap survival. All the data were entered in SPSS version 16 and analyzed accordingly. The Mean ± SD were calculated for numerical variables as well as frequencies and percentages were calculated for categorical variables.","title":"Reconstruction of post burn scalp alopecia by using expanded hair-bearing scalp flaps"}
{"_id":"b29e8fe2-7fdf-790d-6e3d-8cad874d10f3","text":"Patients who experienced hypersensitivity reactions during therapy should be provided with symptomatic treatment for particular manifestations.","title":"Immune Reactions in Major Types of Oncological Treatment"}
{"_id":"b2b15465-d9d3-7bd0-2b6c-47f0cbd565b3","text":"Frenotomy is the most common procedure for correction of ankyloglossia as it is simple, quick and can be done as an outpatient procedure [8]. Various techniques of frenotomy have been defined in literature ranging from cold dissection, electrocautery to lasers. All these procedures are simple and bloodless. But the limitation of these procedures is the chances of recurrence due to which the patients might require revision surgery in the form of frenotomy and frenuloplasty [6,8]. In our case the harmonic scissor has been used to perform the bloodless frenotomy to release the ankyloglossia in an adult with higher grade of ankyloglossia under local infiltration anesthesia. Harmonic scissor uses ultrasonic energy which gets converted into mechanical energy which cut and coagulate the vessels up to 2 mm in size simultaneously without lateral dissipation of thermal energy and hence prevent the collateral damage with subsequent better healing and little chances of recurrence. There is also no need to apply hemostatic ligature which otherwise would block the salivary gland ducts. Our patient was followed up for six months and has had no signs of recurrence.","title":"Harmonic Lingual Frenotomy for Ankyloglossia: A Newer Novel Technique"}
{"_id":"b2b46c40-a952-64b8-435e-61d9aeca17e2","text":"Also of clinical importance is the finding that there is no specific time point at which sampling of venous blood had to be done during surgery; at least within the short time frame that was investigated in this study. Our results further suggest that there is no need to collect artery blood for flap quality assessment.","title":"Early risk prognosis of free-flap transplant failure by quantitation of the macrophage colony-stimulating factor in patient plasma using 2-dimensional liquid-chromatography multiple reaction monitoring-mass spectrometry"}
{"_id":"b2b56c8f-4d44-5832-6d80-b5de7f42c52f","text":"In conclusion, this small retrospective series of a single oncological and reconstructive surgical team demonstrated that with careful skin paddle position, monitoring buoy flaps need not be subsequently resected as they were well accepted by patients. The algorithm presented can assist plastic surgeons in the decision-making process of selecting the design and location of the sentinel skin paddle, thus enabling standard monitoring without recourse to invasive and expensive equipment.","title":"An Algorithm for Selecting Buoy Skin Paddle Design for Flap Monitoring in Total Autologous Breast Reconstruction After Nipple-Sparing Mastectomy"}
{"_id":"b2bc4ea8-df33-c33d-8306-318334b2e088","text":"Parotidectomy is one of the most frequent modes to treate tumors of parotid gland. Previous studies documented a variation in the facial nerve branching which might risk facial nerve injury during Parotidectomy.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"b2c18345-b898-a1ad-17c6-12da7d613ec9","text":"Clinical exam and\/or radiological studies are not a substitute to SLNB, since upwards of 20% of patients who are clinically node-negative have metastatic involvement.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"b2d3e561-f3e2-fb53-601c-613bcce2b529","text":"This fact is fully understood, given the medical knowledge of the correct nasal anatomy, the professionals’ experience in the systematic nasal evaluation when the visual and tactile stimuli are associated during the physical examination, in addition to the need for the detailed evaluation of all the aesthetic deformities of a patient previously submitted to a rhinoplasty.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"b2d760f4-1e90-58fa-4f95-540e3085eaa3","text":"In conclusion, CO2 is a valuable adjunct to iodinated contrast agents for evaluating and treating lower extremity arterial disease, minimizing the total volume of iodine contrast and thus preventing or reducing the overall incidence of CIN, especially in patients suffering from chronic kidney disease. Our study showed compelling evidence that the incidence of CIN was halved and renal function was largely maintained with use of CO2 compared to iodinated contrast medium. Finally, no more than 25mls of iodinated contrast should be allowed during angiography in high-risk patients. A future study should assess CO2 angiography without CIN prophylaxis as this could improve efficiency for the service and convenience for the patient.","title":"Carbon dioxide angiography during peripheral angioplasty procedures significantly reduces the risk of contrast-induced nephropathy in patients with chronic kidney disease"}
{"_id":"b2d9c49e-e69f-e40b-8548-7c21fc18e530","text":"The treatment of venous ulcers is mostly based on the employment of advanced wound care dressings, regenerative matrices, dermal substitutes, and skin grafts. In the last few years dermal substitutes and regenerative matrices have been developed to treat different kinds of ulcers. Dermal substitutes and regenerative matrices are a major topic of concern for the surgeon and staff involved in the management and closure of vascular ulcers. There have been two major approaches to the provision of a cell-free matrix for replacement of the dermal component of skin: the first one is to fabricate a matrix with the required physical and chemical structure; the second approach envisages the use of decellularized allogenic human skin.","title":"Interaction between a Regenerative Matrix and Wound Bed in Nonhealing Ulcers: Results with 16 Cases"}
{"_id":"b2d9f798-0449-af4d-d5de-61bfcfd6a3b5","text":"The data in this qualitative study are derived from a multicentre randomized controlled trial where 270 mothers of preterm infants provided 496 written comments through questionnaires containing open-ended questions. The questionnaires were sent to the mother three times during the first 12 months after birth. A thematic network analysis based on hermeneutical philosophy was used to analyse and interpret the resulting data to describe the mothers’ experiences of breastfeeding.","title":"A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth"}
{"_id":"b2e12eed-26b6-5a78-23e9-da50d306073e","text":"The results of this retrospective study show no significant survival difference in pN+ breast cancer patients with 10 or less removed lymph nodes compared to more than 10 removed lymph nodes.","title":"Does the number of removed axillary lymphnodes in high risk breast cancer patients influence the survival?"}
{"_id":"b2e64723-547f-4dff-1689-73885fb2562d","text":"The COVID-19 vaccine referral center was created in Sheba Medical Center primarily as an information center for vaccine recipients and health care workers. In the vaccine center, a team of trained personnel from the infectious diseases unit and the infection prevention and control unit received applications for vaccination by phone or email. Among their assignments was to define patients as low risk vs high risk for allergies or with contraindication to be immunized according to the Israel Ministry of Health (MOH) and the CDC. Patients could approach the center on their own behalf or via request of their general practitioner (GP). This cohort study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline for observational studies and was performed in accordance with the Declaration of Helsinki and in agreement with the institutional regulations and approval of the Sheba Medical Center institutional review board. Patient consent was waived as the data were deidentified.","title":"Prevalence of Allergic Reactions After Pfizer-BioNTech COVID-19 Vaccination Among Adults With High Allergy Risk Allergic Reactions After COVID-19 Vaccination Among Adults With High Allergy Risk"}
{"_id":"b2feb9a0-cf23-06b5-0709-d287aefe523b","text":"Correction of nasal deformities secondary to multiple operations and trauma is a wide and complicated subject. To approach the difficult problem, the surgeon must be in total command of the situation with good knowledge of the anatomy and physiology. In my opinion, only an open transcolumellar approach will allow one to properly diagnose the severe pathology. Reconstructing the anatomy with multiple techniques described by so many good surgeons is superior to all other camouflage operations performed through a limited, constricted and dark field of the endonasal approach. If the open approach exposure is done along the correct lines and planes, there will be no significant observable scarring and deformity of the columella in any type of skin. The best material to use is autogenous cartilage and bone.","title":"Secondary rhinoplasty"}
{"_id":"b303aed2-1d38-fa65-bea0-3c046d9f262a","text":"Data monitoring is performed on a weekly basis by the main coordinator and controller with the support of the local coordinator to ensure that all events, PROMs, and radiology are performed according to the protocol.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"b307feea-658e-0d7d-f333-ae47fc981f66","text":"The study was performed on 18 advanced parotid cancers which was more than 4 cm and invaded around the facial nerve. Thirteen cases were fresh cases and 5 were recurrent cases.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"b30d4e1d-e5c2-9283-d6d8-0bd333f17c16","text":"Intraoperative ultrasonography is a safe and readily available tool that improves success of surgical removal of plant material within the iliopsoas muscles region via ventral midline laparotomy.","title":"Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs"}
{"_id":"b30e153c-9a80-9cac-1a29-c36afdea44fd","text":"Repetitive clamping of the femoral artery for IPC induced a significant repetitive decrease of mean leg muscle rSO2 in patients with and without sevoflurane preconditioning.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"b3139b85-fdaf-28c8-34ff-8b6f9dd3a877","text":"Bibliometric analyses of ophthalmology publications in the past have shown that on average, ophthalmologists are a prolific group. A study on ophthalmologists associated with the American Academy of Ophthalmology found that 100 random ophthalmologists taken from an ophthalmologic subspecialty from one year will publish approximately 37 articles, with those in vitreoretinal and neuro-ophthalmology publishing the most [10]. Scholarly productivity and associated impact factors of research also increase with fellowship training and advancement in academic rank from assistant professor to professor [11]. In a study on productivity of ophthalmologists in academic departments through the United States, authors found significantly higher research output amongst faculty with higher academic rank [12]. This is unsurprising in the context of the ophthalmology landscape given the current trends towards fellowship training. Ophthalmologists who decide to pursue fellowship training and positions at academic medical centers are the same ones who enjoy research and have the skills to publish meaningful papers and ascend the academic ladder. Depending on their respective cultures, academic institutions also have varying degrees of emphases on research productivity. The main question for institutions with lower than average research productivity then is how to incentivize their faculty to publish more frequently.","title":"The Effect of a Points System on Incentivizing Academic Behaviors of Attending Ophthalmologists"}
{"_id":"b317849f-fb14-8b7e-3340-6994db983fc9","text":"The clinical and statistical data did not show a statistically significant association between SP and the occurrence of at least one of the complications examined. For this reason, SP may be considered the treatment of choice for pleomorphic adenomas located in the superficial or deep portion of the parotid gland. SP, partial or complete, is recommended for tumors larger than 3.5 cm in diameter, when the lesion is in the deep or superficial lobe of the parotid gland or in case of tumor recurrence. The advantage of ECD, which is preferred when lesions are smaller than 3.5 cm, includes the removal of the mass with adequate margins of healthy parotid tissue and a reduction in the side effects after surgery preserving the parotid function even though it is associated to a higher risk of recurrence in our experience [22]. Total parotidectomy is the appropriate treatment of choice in most recurrences and in cases of large adenomas involving both deep and superficial parotid gland’s lobes.","title":"Clinico-histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10-year retrospective study—a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma"}
{"_id":"b3223e72-639c-abd9-3e31-7d4e2285460d","text":"Since the previous edition of these guidelines, significant changes have taken place in the training and assessment of surgeons and oncologists who treat patients with head and neck cancer. For those intending to become head and neck surgeons, a fellowship in head and neck surgery is virtually mandatory. This paper summarises the current career structure to specialise in head and neck oncology and surgery in the UK.","title":"Education of trainees, training and fellowships for head and neck oncologic and surgical training in the UK: United Kingdom National Multidisciplinary Guidelines EDUCATION OF TRAINEES, TRAINING AND FELLOWSHIPS: UK GUIDELINES"}
{"_id":"b326eb4e-cf9a-6ee7-38b1-cb1516e1a240","text":"Common themes running throughout the studies were the importance of early mobilization, with some studies saying patients should be mobilized on the first postoperative day. Some, including Ogonda et al, 21 combined aspirin with mechanical prophylaxis; and others even employed a risk stratification system before selecting the type of thromboprophylaxis. These points are recommended for all patients undergoing major lower limb orthopedic surgery by the AAOS 1 and ACCP 2 guidelines.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"b32acd83-6ac3-f084-5c46-b2558d1c9ca5","text":"Surgical practices are consolidating over time and shifting from solo and small practices to practices with greater numbers of surgeons. The association between hospital consolidation and surgical practice consolidation, as well as the shift of larger surgical practices toward inpatient hospital settings, suggests that vertical integration of hospitals may play a major role in motivating surgeons to join larger practices. Further research is needed to assess whether this consolidation has had a positive or detrimental association with access and outcomes for patients.","title":"Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US"}
{"_id":"b32dca3c-ab4c-95c8-1a7a-32feb826fc66","text":"The patient did not have a medical history of cutaneous autoimmune nor herpetic diseases and he did not report any change in his usual epilepsy medical treatment, consisting of valproate.","title":"Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases"}
{"_id":"b32dfc2f-9dc3-0a1c-2228-500826bf666c","text":"When the defect is relatively large, or when the surrounding tissue has limited elasticity, double opposing modified Dufourmentel flaps are useful for closing the defect as seen in Figure 2. The flaps are designed as mirror image double opposing flaps. The excisions are curved at A and at C to facilitate closure.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"b333fdd6-2589-6d66-cdc8-cb45c95d0a15","text":"A STSG is harvested from the donor area with a dermatome (a surgical instrument used to produce thin slices of skin) and the donor area is left for re-epithelialization. A reason for using this type of graft for skin cancer patients is that they often present with recurring skin cancer, requiring more surgery and therefore it could be argued to leave their full skin graft reserves for tumors located in the face. In this study we did not consider the cosmetic aspect of what graft to use.","title":"Full- or Split-Thickness Skin Grafting in Scalp Surgery? Retrospective Case Series"}
{"_id":"b34334f7-09c6-582d-5d0d-087bf248c72c","text":"This study was a retrospective study with inherent limitations, and the cohort included 394 participants. In particular, the injury conditions and the degree of initial debridement of referral patients were evaluated through hospitalization data; the lack of an initial assessment of primary injury conditions may lead to selective bias. We recommend the early reconstruction of Gustilo IIIb fractures to accelerate wound healing and bone reunion, as well as early referral to a higher-level hospital with orthoplastic capabilities after an aggressive and thorough initial debridement carried out by senior surgeons.","title":"Early Reconstruction Delivered Better Outcomes for Severe Open Fracture of Lower Extremities: A 15-Year Retrospective Study"}
{"_id":"b3455f51-3870-6016-ce71-7f400a1866d9","text":"Anesthesiology fellowship program directors perceive a more negative impact from women having children during fellowship compared with men. Also, the findings regarding off-cycle resident applicants for fellowship could have a negative impact on fellowship opportunities for the residents. These differences may have important implications throughout the career of men and women anesthesiologists.","title":"A Nationwide Cross-Sectional Survey of Anesthesiology Fellowship Program Directors: Attitudes on Parental Leave in Residency and Fellowship Training"}
{"_id":"b3493d14-186d-d373-a570-b168b74cb76f","text":"The postoperative course was uneventful and the patient was discharged at the 9th postoperative day.","title":"Desmoid tumors of the abdominal wall: A case report"}
{"_id":"b34a3e2f-84e8-ac88-3d59-eb9ef9f6a2ea","text":"In our patient, the hemangioma grew in the lateral part of the gluteus maximus muscle insertion superficial to the greater trochanter and disturbed the smooth movement of the iliotibial band over the greater trochanter. Such an etiology has not been reported before in the literature.","title":"Snapping hip caused by a venous hemangioma of the gluteus maximus muscle: a case report"}
{"_id":"b34d84c9-258f-3548-8942-1f2a540a3f6c","text":"The cationic porphyrins 51, 52 and 53 were immobilized on chitosan by adding each porphyrin dissolved in THF to a solution of chitosan in an aqueous acetic acid solution.","title":"Porphyrin Photosensitizers Grafted in Cellulose Supports: A Review"}
{"_id":"b3570b99-9baa-04b8-8121-e32d67913f6d","text":"We were initially concerned about the possibility of native-valve infective endocarditis given the echocardiographic findings; however, in review of the echocardiogram with the reading cardiologist, these findings were felt to be most consistent with prior rather than active endocarditis. This interpretation was supported by his clinical stability while under observation prior to his operation and his serial negative blood cultures drawn while the patient was off antibiotics. Due to clinical stability and need for indefinite suppressive antibiotics, we did not utilize combination antimicrobial therapy.","title":"Burkholderia cepacia complex Cervical Osteomyelitis in an Intravenous Drug User"}
{"_id":"b35b587e-2b08-4799-8016-ad148d034ade","text":"Despite efforts to achieve local control and minimize the effects of treatment on normal tissues, damage to bone and soft tissues may be unavoidable. Synovial cell sarcoma commonly arises near tendon sheaths and joint capsules of adolescents and young adults and may be in close proximity to an epiphyseal growth plate during a time of rapid growth. The situation is made worse if the tumor is located around the distal femur or proximal tibia. Among the four epiphyseal plates in the lower extremity that contribute to the growth of the limb, those around the knee make the most significant contribution, with the distal femur and proximal tibia accounting for 50–90% and 57% of limb growth, respectively depending on age [22]. In our study, Case 1 was eight years old at the time of diagnosis and had a tumor lateral to the joint capsule of the left knee. Case 2 was nine years old at the time of diagnosis and had a tumor lateral to the left distal femur and in close proximity to the joint space. It was less than one year after diagnosis and definitive management that both patients developed a clinically significant angular deformity and leg length discrepancy.","title":"Valgus and varus deformity after wide-local excision, brachytherapy and external beam irradiation in two children with lower extremity synovial cell sarcoma: case report"}
{"_id":"b35de231-4bbf-438b-ba8b-a1e0559c2513","text":"In this study, we have proposed a new standardized histopathology scoring system to assess disc degeneration and regeneration in the rabbit lumbar spine, based on previous literature and current practices by research groups in the field. Seventy‐three percent of previously published papers using rabbit models for degeneration or regeneration did not perform histologic scoring in their studies, highlighting the significant need for a simple, standardized histopathology scoring system for rabbit models. As a majority of studies in the rabbit model that perform histology scoring have utilized the grading scheme proposed in 2005 by Masuda et al, , this scoring system was utilized as the basis of the proposed scoring system. The Masuda scoring system for disc degeneration included categories for characterizing changes to the AF and NP, but did not include scoring of the EP to assess cartilage and bony EP remodeling, or scoring for cellular changes occurring with regeneration which provides information on the biological action of regenerative strategies. Scoring of these features was therefore included in the proposed scoring system, modified from scoring systems utilized by Chujo et al and Ashinsky et al. Because the use of decalcified, paraffin processed sections is recommended for scoring, the endplate features included in the scoring system are focused solely on morphologic changes to this region. Researchers interested in studying alterations in calcification of this region would need to employ alternative methods, such as microcomputed tomography or cryo‐ or plastic sectioning to quantify or visualize endplate calcification.","title":"Development of a standardized histopathology scoring system for intervertebral disc degeneration and regeneration in rabbit models‐An initiative of the ORS spine section"}
{"_id":"b369e34a-d7c1-4765-ce69-f4752b65dc4e","text":"In this study, a better tissue repair was observed in the group treated with therapeutic ultrasound when compared to the control group, the issue of tumor resection does not interfere with the healing process, but it is mainly related to the issue of recurrent tumor lesions. There was no tumor recurrence lesion in the 15-day period that could compromise the use of therapeutic ultrasound, but this time is too short to state that this treatment modality does not cause any risk to cancer patients. In this study, it can be inferred that the use of therapeutic ultrasound is indicated for the repair of skin wounds, and in addition, the use of thermography as an alternative to evaluate the evolution of this tissue repair process by measuring the temperature of the wound bed. Thus, the results found related to tissue repair favorable to the use of therapeutic ultrasound are consistent with the literature.","title":"Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats"}
{"_id":"b36a19fb-b67c-0911-2684-89d8402ee7c6","text":"Scalp can safely be used as donor site for skin graft to be used for scalp defects associated with better results and lower complication rates compared to other donor sites.","title":"Outcome of Comparison between Partial Thickness Skin Graft Harvesting from Scalp and Lower Limb for Scalp Defect: A Clinical Trial Study"}
{"_id":"b3732ad3-f02d-b368-e0aa-bcae1891b4cf","text":"A better understanding the oncogenic characteristics related to cSCC in regions of high and low sun exposure will improve the management and therapeutic strategies for these patients.","title":"Increased Risk of Local Recurrence in Cutaneous Squamous Cell Carcinoma Arising in Sun-Exposed Skin: A Retrospective Cohort Study"}
{"_id":"b374f8bb-693a-edc9-8838-0b24ffb16450","text":"Our data suggests that intraoperative FS in SCC can be useful in selected cases. However it is not advisable as a routine approach.","title":"The impact of frozen sections on final surgical margins in squamous cell carcinoma of the oral cavity and lips: a retrospective analysis over an 11 years period"}
{"_id":"b3785f45-0726-09ed-ebb7-cdd2d0cd2a59","text":"This trial showed that both fascial plane blocks have comparable analgesic efficacy in patients undergoing MRM. One of the strengths of our study is the use of standardised weight-based volume and concentration of local anaesthetic, providing an equitable comparison of the analgesic efficacy of ultrasound-guided SAP and ESP block in patients undergoing MRM.","title":"Comparison of the Efficacy of Ultrasound-Guided Serratus Anterior Plane Block Versus Erector Spinae Plane Block for Postoperative Analgesia After Modified Radical Mastectomy: A Randomised Controlled Trial"}
{"_id":"b37ab271-a8df-abe9-d878-f99cf73282a6","text":"We report a case of 60 year old Caucasian female with history of long standing diabetes and chronic kidney disease stage 5 who presented with a very high calcium phosphorous product, markedly elevated intact PTH levels and X-ray changes consistent with diagnosis of calciphylaxis. Patient was initially managed by parathyroidectomy and later on was also treated with intravenous sodium thiosulfate thrice weekly with each hemodialysis session for duration of 10 weeks.","title":"Non-healing painful ulcers in a patient with chronic kidney disease and role of sodium thiosulfate: a case report"}
{"_id":"b37e4229-fe07-1b01-ac97-a62d1830b166","text":"Survival rate and functional results are summarized in Table 2 and Table 3.","title":"Retrograde Free Venous Flaps for Extremity Reconstruction: A Roadmap"}
{"_id":"b37f0064-8c84-58b4-e9ba-e7cb62479266","text":"All the patients completed the study and no complications or side effects related to the WBC procedures were observed.","title":"Whole-Body Cryotherapy Decreases the Levels of Inflammatory, Oxidative Stress, and Atherosclerosis Plaque Markers in Male Patients with Active-Phase Ankylosing Spondylitis in the Absence of Classical Cardiovascular Risk Factors"}
{"_id":"b380a424-69ff-67d9-5628-f947530fec23","text":"The best response is seen in combination therapy with a BRAF inhibitor and a MEK inhibitor and in particular when dual therapy is used at the outset. Durable responses can be seen with ipilimumab which extend beyond 4 years","title":"Malignant Melanoma"}
{"_id":"b38436e5-cafd-2222-3156-b643400fc6ae","text":"The development of murine models of anaphylaxis that mimic the physiological and immunological characteristics of human anaphylaxis has facilitated the understanding of the underlying mechanisms of both phases of allergic immune response. The different models developed for different types of allergens differ not only in the type of allergen used, but also in the protocol of sensitization including different doses and in the parameters applied to the evaluation of the sensitization. In particular, some models of allergen sensitization use intraperitoneal via in the presence of adjuvants or adjuvant-free, oral immunization with the mucosal adjuvant cholera toxin, and more, intranasal or epicutaneous sensitization with or without the use of adjuvants. Some model requires multiple sensitizations or a single sensitization.","title":"Anaphylaxis induced by Thalassophryne nattereri venom in mice is an IgE\/IgG1-mediated, IL-4-dependent phenomenon"}
{"_id":"b399510e-5239-9e27-7162-b4e2c1e6a4ce","text":"Further studies are required to calculate ICH and VTE rates with and without prophylactic anticoagulation after posterior fossa craniotomy. It is critical to analyze VTE and ICH outcomes and implement the conclusion drawn through prospective studies.","title":"Posterior Fossa Hemorrhage Following the Use of Low-Molecular-Weight Heparin: Lessons Learned and Recommendations for the Treatment and Prophylaxis of Postoperative Venous Thromboembolism"}
{"_id":"b39a71af-279a-b45a-5196-4058f35a2bbb","text":"Although NPWT is widely used in other areas of medicine and is related to improved healing and limb preservation in the treatment of open fractures, it has not yet been proven for use in arthroplasty surgery. A pilot study conducted by Gillespie et al. in primary hip arthroplasties suggested that a randomized trial with 900 patients would be required to detect differences in the incidence of complications such as infection, due to the low absolute risk of this complication. Several prospective studies and randomized trials are currently underway to test the efficacy of this therapy.","title":"NEGATIVE-PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX INJURIES AFTER TOTAL KNEE ARTHROPLASTY TERAPIA COM PRESSÃO NEGATIVA EM FERIDAS NO TRATAMENTO DE LESÕES GRAVES APÓS ARTROPLASTIA TOTAL DO JOELHO"}
{"_id":"b39fb685-c908-652b-0536-1505e99599e7","text":"Histologic analysis of the operatory specimen confirmed the diagnosis of a desmoid tumor of the abdominal wall.","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"b3a5b900-bb6d-ed07-5c3f-694929fc1915","text":"Having diverse providers in the field of orthopaedic surgery may be beneficial for patient care. In 2011, Borkhoff et al found that women faced barriers such as minimization of their symptoms and attribution of symptoms to emotional rather than physical causes when interacting with their primary care physicians and orthopaedic surgeons throughout the referral and recommendation process for total joint arthroplasty. They suggested interventions such as cultural competency training to help improve patient-physician interaction and reduce gender disparity. Similar to other professions, male and female physicians display different communication styles that affects the patient-physician relationship. Female physicians are more likely to address a patient's psychosocial needs and emphasize preventive services than their male counterparts. Furthermore, patients of female physicians are more likely to display a higher level of satisfaction with their care.","title":"Women in Leadership in State and Regional Orthopaedic Societies"}
{"_id":"b3a846c2-1734-70c1-b7b7-0c7bf856af6b","text":"To suggest regarding the timing of oral surgery and laser treatment for frenulum abnormalities in the pediatric population.","title":"Clinical Study of Laser Treatment for Frenectomy of Pediatric Patients"}
{"_id":"b3b00681-828d-8902-5c71-ee38c90bda59","text":"This prospective, cohort study was conducted among female patients who underwent BCS, total mastectomy with and without reconstruction at Breast Surgery Unit of our tertiary care centre from 1 January 2015 to 31 December 2021. The research project was ethically approved by the Research Ethics Committee of the Institution and principles of Helsinki Declaration were duly followed14. The study has been registered with German Clinical Trials Register (DRKS) and carried out according to the reporting guidelines of STROCSS criteria15.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"b3bb4a1c-6067-16ce-d038-1a1e75e2a488","text":"The Color Doppler ultrasound study was under taken in 42 patients. We used the Logic 400 (WIPRO GE) with 5 MHz linear transducer in real time B mode. Groin, thigh, popliteal fossa and leg were scanned in both longitudinal and transverse plane in both the limbs. All the three components of ultrasound examination of the vein viz. imaging, Doppler and compression were used. The results were assessed by an experienced radiologist. Our initial plans were to get the Doppler studies once during the first week and another at third week but due to various constraints, it could be done only once between 6-18 days of hospitalization. In the remaining 28 cases contrast venography was done. The absence of the normal phasic Doppler signals arising from the changes in the venous flow, incomplete color fill-in and failure to compress the vascular lumen were taken as positive signs on ultrasound color Doppler whereas contrast venography showed the filling defect due to thrombus. No fixed interval could be followed between the time of injury and investigations performed due to variable time between injury and hospitalization and appointment given by the radiologist for the said investigation.","title":"Venous thromboembolism in acute spinal cord injury patients"}
{"_id":"b3bec8f0-f0f9-f92a-d3be-3f7d40edd0a6","text":"We reviewed 10 patients with osteomyelitis of the femur who were initially diagnosed as having bone tumors and were subsequently transferred to our institution.","title":"Osteomyelitis of the femur mimicking bone tumors: a review of 10 cases"}
{"_id":"b3c049a0-872f-f021-4fae-3ccf75527f3f","text":"These results provide the first formal description of the training and practice patterns of FPRS-trained microvascular surgeons. They describe a diverse fellowship training experience that often results in robust microvascular practice. The maintenance of substantial microsurgical caseloads after fellowship runs counter to the perception of high levels of burnout from free tissue transfers among microvascular surgeons.","title":"Fellowship training in microvascular surgery and post-fellowship practice patterns: a cross sectional survey of microvascular surgeons from facial plastic and reconstructive surgery programs"}
{"_id":"b3c20f32-2946-196d-f2eb-fb5a6b62cefb","text":"Clinical core and cutaneous punch biopsies remain a valuable tool in the diagnosis of breast malignancy in patients who have clinically suspicious lesions in the presence of normal breast imaging. This is particularly true when the lesion involves the nipple areolar complex. It is therefore imperative that breast clinicians retain these skills.","title":"Clinically guided core biopsy and cutaneous punch biopsy in the evaluation of breast lesions: a necessary test or an obsolete skill?"}
{"_id":"b3c23f50-5f3f-cbcf-2041-2f9ee89f6a46","text":"A portion of 20–50 ml diluted methylene blue was slowly injected into the sinus tract or wound. The skin adjacent to the sinus tract was resected and the area with skin pigment change was also excised extending to the deep tissues. The affected skin tissues stained by methylene blue were thoroughly resected. Both necrotic and sclerosis bone defects were removed until evident errhysis was observed. The medullary cavity stained with methylene blue was thoroughly debrided. After repeated lavage, operative instruments were replaced, the operative tables were arranged, and bone defect sections were treated smooth and the surface of the flaps was specifically designed.","title":"Combined application of latissimus dorsi myocutaneous flap and iliac bone flap in the treatment of chronic osteomyelitis of the lower extremity"}
{"_id":"b3ca1309-12c2-ef43-1139-40ee0b9888ad","text":"Similar to general surgeons, Dutch orthopedic and plastic surgeons demonstrate poor knowledge and skills regarding surgical informed consent. Increased awareness, better training and use of modern tools including standard forms and online software programs will improve the SIC process and will optimize patient care.","title":"Challenging the knowledge base and skillset for providing surgical consent by orthopedic and plastic surgeons in the Netherlands: an identified area of improvement in patient safety"}
{"_id":"b3e4e8be-f700-c23d-0f16-1c9302774b16","text":"While plastic surgeons have been historically indispensable in reconstruction of posttraumatic defects, their role in Level I trauma centers around the world has not yet been clearly approved. This study aims to assess the contribution of plastic surgeons in major trauma care by evaluating the characteristics of trauma patients underwent plastic surgery at a Level I trauma center.","title":"A quantitative analysis of trauma patients having undergone plastic surgery"}
{"_id":"b3eb3bd8-0eb3-fda2-404b-002f6d7f2ed9","text":"We are sometimes obliged to remove all draining veins from the stomach depending on the tumor size, tumor location, and invasion depth. RGEV and left ovarian vein anastomosis and LGV and IMV anastomosis were performed to effectively reduce gastric congestion. Unfortunately, the RGEV was already removed during the initial surgery in our case. The ideal anastomosis in our case was that between the LGV and stump of the SpV. The advantage of this was the short distance of each vein without tension of the anastomosis.","title":"Surgical treatment of gastric venous congestion in association with extended resection of pancreas: a case report"}
{"_id":"b3eb4726-f02b-b0ac-24c2-49aadf8b8581","text":"We used a BK Medical color Doppler ultrasonographer with a 10–12 mHz linear transducer. The settings were set for small peripheral vessels and low flow velocity to enable detection of flow in the perforators. Skin availability adjacent to the defect was evaluated in terms of possible flap options. Once identified, the area of interest was examined moving the transducer very slowly until a pulsating perforator was identified at the deep fascia level. Perforators in the area were mapped according to size and located with a permanent marker. The skin flap was subsequently designed to include the biggest perforator available and preferably to allow the least possible angle of rotation including as many perforators as possible in the design.","title":"The freestyle pedicle perforator flap: a new favorite for the reconstruction of moderate-sized defects of the torso and extremities"}
{"_id":"b3ec5ea5-0f02-d5fc-58c0-b692247411fc","text":"The authors declares that there is no conflict of interest regarding the publication of this paper.","title":"Upper limb traumatic injuries: A concise overview of reconstructive options"}
{"_id":"b3f22a74-7f81-5f4b-2511-e6d2231aa38e","text":"Clear guidance and education on how comorbidities may affect therapy might increase healthcare providers' adherence to existing guidelines 23-25. Pilot studies using programs and guidance protocols to facilitate treatment decisions in Brazil and Argentina have demonstrated improvements in the level of appropriate anticoagulation administered to patients with or at risk of VTE 26,27. The aim of this review is to outline an algorithmic approach for primary care providers in Latin America for VTE diagnosis in ambulatory patients and to discuss current and emerging options for the treatment of these patients.","title":"Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care"}
{"_id":"b3f5a334-0379-e9fa-9a58-77db0480e3cb","text":"Historically, it has been very difficult for IMGs to match into US plastic surgery programs, and while there are a variety of factors involved, emerging data such as this study are making it clear that this historical trend is not based on differences in academic achievement. As many in the medical community suggest, IMGs who graduate from rigorous international schools perform as well as their US counterparts on the USMLE examinations and deliver as good, if not better, care to their patients.10","title":"International Medical Graduates in the US Plastic Surgery Residency: Characteristics of Successful Applicants Kokosis et al"}
{"_id":"b3f8374c-668f-84f4-78c9-183b49f6d6be","text":"JF is the president elect of the American Society of Ophthalmic Plastic and Reconstructive Surgery. JF and KC serve as section editors for the American Academy of Ophthalmology board review book series. JF is an oral examiner for the American Academy of Ophthalmology. KC is an oral examiner for the American Society of Ophthalmic Plastic and Reconstructive Surgery. CC is an assistant professor and Department Chair of Ophthalmology and Oculofacial Plastic and Reconstructive Surgery Section Head at Ohio University\/Doctors Hospital. JF and KC are assistant professors of Ophthalmology at Ohio State University. CC, JF, and KC are all fellows of the American Academy of Ophthalmology and American Society of Ophthalmic Plastic and Reconstructive Surgeons. JF and KC are fellows of the American College of Surgeons, and CC is a fellow of the American College of Osteopathic Surgeons.","title":"Intraorbital foreign body projectile as a consideration for unilateral pupillary defect"}
{"_id":"b3fa1deb-3ae4-b5e7-ffe3-a2b7783e29a5","text":"In the first study, we measured facial contrast in a set of 289 facial images of Caucasian women aged between 20 and 70 years old, to determine whether facial contrast varies with age. To determine whether facial contrast is related to age perception we had participants estimate the age of 150 of the faces in a second study. In the third study we manipulated facial contrast to determine whether it is causally related to perceived age. Each of thirty faces was manipulated to create new versions of the face with either increased or decreased facial contrast. In a forced-choice design, participants were shown both modified images and instructed to determine which face looked younger. A second group of participants were shown the modified versions of each face individually and asked to estimate its age.","title":"Aspects of Facial Contrast Decrease with Age and Are Cues for Age Perception"}
{"_id":"b40fd754-b191-1677-101c-bd2ba193ffd4","text":"It is well recognized and also commended that young surgeons show widespread willingness to consolidate their clinical and operative experience under supervision by undertaking clinical fellowships after core general surgery training.","title":"The reality of general surgery training and increased complexity of abdominal wall hernia surgery"}
{"_id":"b4113ffc-d575-f9af-fd0f-151e4365bb65","text":"The purpose of this study was to verify potential risk factors for a decreased SLN detection rate in patients who underwent SLNM with periareolar nuclide injection only. We focused on the influence of tumour localization and method of preoperative biopsy hypothesizing that","title":"Impact of Tumor Localization and Method of Preoperative Biopsy on Sentinel Lymph Node Mapping After Periareolar Nuclide Injection"}
{"_id":"b4144a55-d619-69e2-58cb-5e89f005b7fe","text":"Cardiovascular autonomic symptoms such as neurogenic orthostatic hypotension and orthostatic dizziness are important contributors to recurrent falls. Such NMS are commonly associated with MSA, although less commonly may also be reported by patients with other atypical parkinsonian syndromes.","title":"Neurological update: non-motor symptoms in atypical parkinsonian syndromes"}
{"_id":"b416e700-80a5-46c0-439b-d96c586713ea","text":"Between 2007 and 2013, a total of 362 patients underwent breast reconstruction after partial or total mastectomy for breast cancer in Kyungpook National University Hospital. Clinicopathologic characteristics and the occurrence of fat necrosis were assessed during surveillance for 10 years of mean follow-up period.","title":"Natural course of fat necrosis after breast reconstruction: a 10-year follow-up study"}
{"_id":"b42c69dc-75e8-f8dc-a8ef-48eb0a1b4be2","text":"Despite efforts made to avoid sun exposure with clothes and sunscreens, from adolescence on melanoma and NMSC have great chance to occur on all the body surfaces, even if the head and neck area and dorsum of the hands remain the more subjected to disease.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"b4320e80-f7a3-5782-9210-a23e20edeab7","text":"We have presented a series of 141 cases who have been referred to a specialist bone infection centre within the UK. Pre-referral microbiology may be useful in cases where surgery is not being performed and antibiotic suppression is required, or in cases where there is no growth during intra-operative sampling. We have demonstrated that the presence of a sinus, a long time from the sample being taken and the results from surgical sampling are more likely to give inaccurate representation of current microbiology. Importantly, in the cases of previous debridement surgery, there is an increased risk in having either MDR, XDR or PDR isolates which should be planned for in future treatments.","title":"Pre-Referral Microbiology in Long Bone Infection: What Can It Tell Us?"}
{"_id":"b435574c-77e6-6409-20fe-cc764941e2c5","text":"Use of FTSG for reconstructing raw areas in acute and chronic wounds has to be safely reconsidered regardless of wound size. It’s still a sound and reliable tool which can decrease the necessity of complex flap coverage. Subgluteal skin crease is relatively a new donor site to be considered for large grafts with primary direct closure.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"b4371eba-4425-847c-d331-113b1dfbace2","text":"We started this project by reviewing the literature, dissecting cadavers and checking the consistency of the neurovascular pedicle. Our first case was successful and we intend to use this flap to cover medium to large digital soft tissue defects when conventional means are not feasible.","title":"\"A Free thenar flap – A case report\""}
{"_id":"b43bc7bf-d49d-793b-083a-9007b19e1939","text":"Filler injections are the most common aesthetic procedures used for volume correction. Various techniques have been described in the use of fillers. This article reviews the available literature on a new technique using the intraoral approach for injection of fillers.","title":"Intraoral Approach: A Newer Technique for Filler Injection"}
{"_id":"b43e78ce-0f51-44d8-dde7-e4d4d4cafa88","text":"Information and data from publications were supplemented by publicly available results data from study registries and unpublished CSRs provided by manufacturers or IIT investigators.","title":"Negative pressure wound therapy in patients with wounds healing by secondary intention: a systematic review and meta-analysis of randomised controlled trials"}
{"_id":"b45c0f3b-2849-d59f-58a5-637d1d90226b","text":"The registry of the DBCG and the Danish National Patient Register (DNPR) was used to identify all women with an incident diagnosis of operable stage I–III breast cancer who underwent BCS or mastectomy between 1996 and 2008. To ensure correct retrieval of the exposure, defined as reoperation for postoperative bleeding within 14 days following primary breast cancer-directed surgery, patients were considered eligible for inclusion in the study if there was a difference of 1 day or less between the recorded date of primary surgery in the DNPR and DBCG database.","title":"Breast cancer recurrence after reoperation for surgical bleeding"}
{"_id":"b4676fc4-c07d-4142-ad7e-8a96862de4c5","text":"Cells were plated into 25 cm2 tissue culture flasks and allowed to attach for 24 h. On the basis of the cell counting experiments, plating density was modified for different glucose media to give similar cell densities at the time of assay. The standard culture medium was then removed and replaced with, either: 25, 1 or 0 mM glucose medium. The cells were then incubated for 48 h. The old medium was then removed and replaced with, either: 25, 1 or 0 mM glucose medium to which 1 mM ALA had been added and the cells incubated in the dark for 4 h. The cells were then washed and trypsinised and counted using a Neubauer Haemocytometer and trypan blue to determine the number of viable cells per flask. The concentration of PpIX in the medium was determined at the end of the incubation period by mixing the medium with an equal volume of methanol and perchloric acid. The protein precipitate was removed by centrifugation and the fluorescence of the supernatent determined on a spectrofluorimeter with excitation at 406 nm and emission at 604 nm (Perkin Elmer Ltd. UK). The concentration of PpIX in the medium was then determined by comparison with a standard curve of fluorescence against PpIX concentration. This amount was then adjusted to reflect the amount per viable cell.","title":"Aminolaevulinic acid-induced photodynamic therapy: cellular responses to glucose starvation"}
{"_id":"b4707621-22f5-4d07-f2c9-34670d0fd983","text":"In the light of no best consensus being recommended, the recommended management against permanent blindness is to offer prompt retrobulbar hyaluronidase by a trained practitioner. None of our 53 survey responders have given retrobulbar hyaluronidase in practice, including those who have described involvement with patients with visual alteration following HA filler administration in the periocular area.","title":"Awareness of management of hyaluronic acid induced visual loss: A British National Survey"}
{"_id":"b47fd3c7-1e5b-ecfc-7065-29eda8bae160","text":"This study, of patients receiving CRT therapy for SCCHN and breast cancer in a single radiation oncology center, supports the use of R1 and R2 as a safe and effective topical skin treatment. R1 and R2 treatment has been shown to prevent or delay the onset of radiation dermatitis, to reduce the severity of radiation dermatitis, and to contribute to patient QOL during radiation treatment.","title":"Topical R1 and R2 Prophylactic Treatment of Acute Radiation Dermatitis in Squamous Cell Carcinoma of the Head and Neck and Breast Cancer Patients Treated With Chemoradiotherapy Manas et al"}
{"_id":"b483b7ed-29c3-315c-32f7-cf9bc80e20a8","text":"Primary leptomeningeal melanoma is an extremely rare disease of the central nervous system. There are no standard treatment protocols with a poor prognosis in very few reported cases. Immunotherapy in primary brain melanoma has not been successfully applied so far.","title":"Primary leptomeningeal melanomatosis successfully treated with PD-1 inhibitor pembrolizumab A case report"}
{"_id":"b484df66-b97f-25c5-2f24-936b5d8285e2","text":"Although the vulva is a rare location of PG formation, it should be considered as a differential diagnosis of any polypoid or sessile lesion at this site. Since it sometimes may occur with underlying diseases or malignant conditions, taking medical history and performing physical examination are recommended. Complete surgical excision and primary closure of the lesion are the medical treatment of choice with very low recurrence rate. In clitoral PGs, in order to avoid compromising the neurovascular bundle of the clitoris, meticulous dissection and preventing usage of electrocauterization are highly suggested.","title":"Vulvar Pyogenic Granuloma in Adult Female Population: A Case Report and Review of the Literature"}
{"_id":"b486b643-fdd9-8ad4-2a50-b5cb351fb05c","text":"'Willing and desiring the said Acte in every behalff to be observed and kept the xxth day of Octobre in the xxjth yere of the Raigne of owre Soueraigne lorde Kyng Henry the viijth have exhibite and presented their peticion thereupon made with a Boke conteyning dyvers Statutes Actes and Ordinances hertofore devised ordeyned and made for the ffelauship of Barbors Surgions and their Successors.'10","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"b489cc22-d266-00fc-73ea-79a59d77ab5f","text":"There is contracture of the graft when it is harvested because of the contraction of the elastin fibers. Contracture also occurs at the recipient site. These two factors lead to achromic fissures and perigraft halo. Overlapping of graft edges at the recipient site can prevent these complications.","title":"TISSUE GRAFTS IN VITILIGO SURGERY – PAST, PRESENT, AND FUTURE"}
{"_id":"b49a7f5c-094c-3949-857e-0056492d1c33","text":"Mincing residual skin grafts and replacing them back to the donor site reduces the healing time and improves the quality of the scar.","title":"Use of Minced Residual Skin Grafts to Improve Donor Site Healing in Split-Thickness Skin Grafting"}
{"_id":"b49d818b-2a53-bb5f-7df3-37fd24e0236f","text":"Despite concerns that the use of imiquimod may promote tumourigeneseis and increase the rate of transformation to LMM only one case has been reported.17 Systemic side effects can also occur with a flu like illness, shooting pains and general malaise, and although this was not directly reported in this group these symptoms have been seen in other patients using imiquimod by the observer.20","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"b49ff06a-b947-dffc-7948-869b61601919","text":"For practical purposes, we generated a nomogram to easily personalize the prediction of patient prognosis. More precise risk stratification is important for adequate patient information on the severity of the disease and is especially useful for selecting patients who can benefit most from adjuvant therapy. Moreover, our nomogram could enable physicians to personalize the intensity of patients follow up as well as to optimize patient allocation within the frame of clinical trials.","title":"The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)"}
{"_id":"b4a0105b-0d61-69b1-4dd7-bf2b52e5056f","text":"It is important to note that the individuals who undertook the IGH Fellowship self-selected through a desire to apply for the fellowship. Whilst leadership development was not the most frequently stated motivation for applying to the programme it was an important factor and so it is likely that the individuals undertaking the IGH Fellowship had some interest in leadership prior to commencing the programme.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"b4acc853-c3f2-1bc7-4eeb-664f1a8fbeba","text":"Non-allergic reactions such as elevations in hepatic transaminases do not necessitate discontinuation of isoniazid unless clinical hepatitis or more than 5-fold increases over the upper limits of normal occur. Clinical judgment is required as other host factors can increase the risk of isoniazid hepatotoxicity.","title":"Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy"}
{"_id":"b4c468b7-58b1-3d9a-4d5a-835a45b295a3","text":"The limitations of this study are the relatively small number of patients who used venous grafts, and the low incidence of recurrent HCC that may impact statistical bias. We did not measure the regeneration power of the anterior sector with and without occluded venous graft which needs another study. The percent of graft congestion that can affect graft function and its risk on HCC recurrence still needs further study.","title":"Successful use of venous graft from native liver with hepatocellular carcinoma during living donor liver transplantation with no impact on recurrence rate: A retrospective cohort study"}
{"_id":"b4d07b3c-18e3-0056-0232-129c74b45c3c","text":"Every medical student who has completed the University of Maryland Department of Orthopaedics Research Fellowship has successfully matched into an orthopaedic surgery residency. All 19 graduates of the Mayo Clinic Sports Medicine Clinical Research Fellowship have matched into residency. The program brochure specifically mentions nine previous research fellows, eight of whom matched into orthopaedic surgery and one into pediatrics. The University of Texas at Austin—Orthopaedic Value-Based Health Care Fellowship for Medical Students uniquely permits their fellows to attend business and management meetings and complete coursework in executive education courses. In addition to their research responsibilities, the program at the University of Texas at Austin allows their fellows to gain leadership experience through supervision of medical students and undergraduates in patient recruitment and data collection. Similarly, the programs at Children's Hospital of Philadelphia, Harvard\/Massachusetts General Hospital, and the Rothman Orthopaedic Institute also permit their fellows to manage and mentor the research team.","title":"Gap Year Research Fellowship Opportunities for Medical Students Interested in Orthopaedic Surgery"}
{"_id":"b4f14bc9-2910-25fa-bc33-bbec0a8bfff4","text":"Although the risk of VTE associated with caesarean in isolation is low, the rate of VTE occurrence becomes significant when there is a relationship with other risk factors, and so thromboprophylaxis should be prescribed.29 Delivery of anticoagulated pregnant woman should be scheduled for 37 to 40 weeks. Low molecular weight heparin should be withdrawn 12 hours before delivery if given at prophylactic dosages, or 24 hours before if administered at intermediate or full dosages, enabling safe administration of spinal or epidural anesthesia. Pregnant women on LMWH should be instructed not to administer the dose if they experience contractions or release of liquids.23","title":"Venous thromboembolism in women: new challenges for an old disease"}
{"_id":"b4f1ebec-d9a9-4e6d-a999-a1edcd72ab19","text":"This study aims to show the superiority of the HSI technique over already established monitoring procedures and that it can thus reduce the occurrence of vascular complications.","title":"Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study"}
{"_id":"b4f4ec91-1890-ccdf-ed78-a73f7b82f460","text":"Osteomyelitis is a common occurrence in orthopaedic surgery, which is caused by different bacteria. Treatment of osteomyelitis patients aims to eradicate infection by debridement surgery and local and systemic antibiotic therapy. Local treatment increases success rates and can be performed with different antimicrobial bone graft substitutes. This review is performed to assess the level of evidence of synthetic bone graft substitutes in osteomyelitis treatment. According to the PRISMA statement for reporting systematic reviews, different types of clinical studies concerning treatment of osteomyelitis with bone graft substitutes are included. These studies are assessed on their methodological quality as level of evidence and bias and their clinical outcomes as eradication of infection. In the fifteen included studies, the levels of evidence were weak and in ten out of the fifteen studies there was a moderate to high risk of bias. However, first results of the eradication of infection in these studies showed promising results with their relatively high success rates and low complication rates. Due to the low levels of evidence and high risks of bias of the included studies, these results are inconclusive and no conclusions regarding the performed clinical studies of osteomyelitis treatment with antimicrobial bone graft substitutes can be drawn.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"b4f4f461-2fc0-0f3e-2fea-14be7ab0fef0","text":"The point of new commissure must be predetermined with accuracy and preoperative marking of the normal landmarks are very important. For better cosmetic and functional outcome and to change the vermilion border the measurements and observations should be jointly considered and matched. Bauer et al used a technique combines triangular mucosal flaps at the commissure and reconstruction of the oral and buccal musculature, and skin closure using a W-plasty. They emphasized that this techniques results in a less conspicuous scar, prevents the lateral drift of the commissure and yields consistent clinical results.","title":"Bilateral Transverse Facial Cleft as an Isolated and Asyndromic Deformity"}
{"_id":"b4f88308-4bc2-0127-1f38-d645c8bb9e2a","text":"More than 2 million allografts each year support more than 1 million annual tissue transplants . Used in reconstructive surgery for musculoskeletal injuries, allografts avoid the major complications associated with use of autogenic materials . In addition, allograft skin and amniotic membrane have unique properties that make them irreplaceable and indispensable in the treatment of serious burn injuries . The risk of transmitting infectious disease from donor to recipient necessitates sterilization.","title":"Unintended consequences of the potential phase-out of gamma irradiation [version 1; referees: 2 approved]"}
{"_id":"b4fec87d-1b9a-e6c7-3368-235959f3e125","text":"In practice, patients often present with near total trismus and altered upper airway anatomy, thus providing inadequate mouth opening for direct laryngoscopy. An awake tracheostomy is technically demanding owing to patient neck position and should be considered only as a last resort.","title":"Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis"}
{"_id":"b503029d-bde0-7906-6ce9-ec3b97fbc1c0","text":"The survey compiled after the second dose of the vaccine was evaluated to investigate whether the patients who had had an immediate adverse reaction, possibly of an allergic type, had undergone the second injection of the vaccine and had developed a similar reaction.","title":"The Prevalence of Immediate Hypersensitivity Reactions to the BNT162b2 mRNA Vaccine against SARS-CoV-2: Data from the Vaccination Campaign in a Large Academic Hospital"}
{"_id":"b5067838-9416-2855-e5a7-9825231f3bc0","text":"When vermilion replacement requires more bulk or the oral mucosa is not available, anterior-based tongue flaps are useful and when using W-shaped excisions in young patients where disguising defects is more difficult, a design that places the W limbs in the submental fold can be considered. Sand et al., in a recent study comparing vermillion mucosal advancement flaps with direct primary closure of vermillion defects, observed that mucosal advancement flaps resulted in better maintenance of vermillion width compared with primary closure. Mucosal cross-lip flaps use the labial mucosa from one lip to reconstruct a vermillion defect of the opposing lip. A novel technique has been described by Manafi et al as Mutual cross lip musculomucosal flaps for correction of major vermillion defects which is very helpful in cases of lip hemangioma. The major disadvantage of these flaps is that the reconstruction must be staged, with pedicle division occurring 2 or more weeks after initial flap positioning.","title":"Lip Reconstruction after Tumor Ablation"}
{"_id":"b506c29f-c43f-a6ae-23ab-8eb69f964f27","text":"Central to delivering on this mission is the identity of surgeons as leaders, leaders in their practices, leaders in their hospital systems, leaders in education, and leaders in developing quality programs to serve the surgical patient. Inherently, surgeons are placed in an empowered position in their roles of performing surgery for patients, simply by virtue of their acknowledged accomplishments in education and training. While once this empowerment was held with authoritative leadership, the modern form of surgeon leadership empowerment now is a responsibility to serve as a collaborative leader of a high-performance team. The ACS developed many programs to support surgeons in this empowered leadership role to ensure that they are well prepared over their many decades long surgical careers to be able to provide not only high-quality patient care but also, for those who are so placed, to train the next generation of surgeons, to create educational platforms to support lifelong learning for surgeons in practice, to advocate for optimal resources and environments in which surgeons care for their patients, and to advance and contribute to healthcare systems to ensure surgical excellence. Delivering on these goals to optimize the surgeon’s ability to provide quality care to their patients is the core purpose of the ACS.","title":"Surgical leadership in changing times: the American College of Surgeons perspective"}
{"_id":"b50a187f-fdd5-7c78-4778-3e80c9564d1c","text":"Posterior laminectomy with instrumented fusion is a standard procedure for treating degenerative cervical kyphosis with stenosis (DCKS). Two major disadvantages of the surgery are adhesion of the dural membrane with significant disfiguring of cervical spine and a small fusion bed around the lateral mass. One of the advantages of laminoplasty over laminectomy is the protection of the dural membrane from adhesion through preservation of posterior bony elements. This study presents the surgical outcomes of laminoplasty, instead of laminectomy, as a decompression method applied in posterior instrumented fusion for DCKS.","title":"Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis"}
{"_id":"b50a7906-bf5a-502f-72bc-5b2dcab05a94","text":"In our study, the time elapsed between performing rhinoplasty and registration of complaints was also investigated, which is a relatively new approach in this field, and it had not been considered in previous studies. Most of the cases reported dissatisfaction less than 6 months after their operation. The lowest number of complaints is related to the categories of 4 to 5 years and above 5 years. This result may indicate that they are more likely to complain earlier on because that is when they are first seeing the results. Most people would not wait years to make a complaint about their surgery, even though the appearance of the nose is still affected by initial complications such as postoperative swelling and has not yet been fully recovered [25, 27].","title":"Patient dissatisfaction following rhinoplasty: a 10-year experience in Iran"}
{"_id":"b50c3274-adc5-896e-332a-1833ae604c42","text":"The reconstruction of scalp and face after wide skin cancer resection remains a formidable clinical challenge. To our knowledge, this is the first report in literature of the use of Pelnac® in head skin cancer surgery and of the use of the FACEQ skin cancer module to analyze the patient outcomes.","title":"Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes"}
{"_id":"b512c310-b068-1e4f-e39a-d2059ff22f1d","text":"This study examined the prevalence and correlates of skin cancer screening behaviours among individuals at high risk of developing melanoma due to strong family history.","title":"Skin cancer screening behaviours among individuals with a strong family history of malignant melanoma"}
{"_id":"b517bb88-ad5f-b21d-2e66-559796dce4c0","text":"Skin graft is one of the most indispensable techniques in plastic surgery and is often used to treat various wounds. A split-thickness meshed skin graft is usually used for large or complicated wounds. However, dressing a large or complicated skin graft is very difficult due to the factors such as the site on the body and size and shape of the wound, such as multiple wounds or those affecting the pudendum, entire circumference of the arm or legs.","title":"The use of gauze-based negative-pressure wound therapy with Y-connector for dressing full-circumference skin grafts on both lower limbs"}
{"_id":"b52bad1a-f9ef-5b23-0557-fe3fb87acac5","text":"Photodynamic therapy in oncology has been a heated topic in the PDT field, since the mainstream regimens could not fully live up to the high expectations of the patients. The dual selectivity achieved by the preferential photosensitizer uptake of malignant cells and the targeted laser illumination enable PDT to be utilized for both curative and alleviative purposes. The comparatively transient and tolerable adverse effects profiles make this treatment a good alternative regimen that can be considered when standard treatment fails or cannot be tolerated.","title":"Preclinical Study of Antineoplastic Sinoporphyrin Sodium-PDT via In Vitro and In Vivo Models"}
{"_id":"b53054b6-4927-a233-e232-e516bb74a24a","text":"CT follow-up on the next day ideally shows ground glass density completely surrounding the target lesion with a peripheral zone of consolidation.","title":"The Proceedings of the 19th International Cancer Imaging Society Meeting and Annual Teaching Course"}
{"_id":"b5307a05-a610-9629-0536-3724792b2480","text":"From December 2008 through December 2010, women with suspected or recently diagnosed breast carcinoma and at least one lymph node in the ipsilateral axilla judged to be abnormal in sonographic appearance were approached for participation in this IRB-approved, HIPIAA-compliant prospective study. 105 women gave written informed consent to undergo ultrasound guided FNA, immediately followed by core biopsy of the same node, followed by clip placement. Patients unable to consent due to language or comprehension difficulties and patients deemed emotionally too fragile to discuss the subject of metastatic disease required in the consent form were excluded. Other patients excluded themselves, not wishing to undergo a second needle procedure for research purposes. One patient was excluded due to difficulty accessing the node with a core biopsy due to its location. The outcome of percutaneous node sampling was correlated with surgical pathology from sentinel node excision or axillary dissection.","title":"Ultrasound Guided Core Biopsy versus Fine Needle Aspiration for Evaluation of Axillary Lymphadenopathy in Patients with Breast Cancer"}
{"_id":"b53121ae-5b92-5cd3-b98e-0fc88b6c7a29","text":"Vascular imaging such as US allows quantification of the number and spacing of blood vessels and to assess blood flow in a non-invasive and functionally relevant way. Therefore, US has the potential to assess the immediate efficacy of anti-vascular therapy. Power Doppler US is a technique that displays the strength of the amplitude in colour, rather than speed or direction information, by using the amplitude of a Doppler shift to detect moving matter. Noise is assigned a uniform colour that remains constant while flow is shown as a contrasting colour. As a result, PDUS has three to five times the sensitivity of conventional colour Doppler for the detection of flow. Although the sensitivity of the technique certainly varies with both vessel calibre and flow rate, previous studies have demonstrated Doppler detection of flow through tumour vessels as small as 10–20 μm.","title":"Power Doppler ultrasound and contrast-enhanced ultrasound demonstrate non-invasive tumour vascular response to anti-vascular therapy in canine cancer patients"}
{"_id":"b5342b89-47dd-093e-e013-67e94ecb7db8","text":"Post-radiation wound break down over the posterior aspect of the cervico-thoracic region can lead to significant morbidity and disfigurement. The trapezius and the latissimus dorsi muscles components can be used as flap transfer to address the large defect. The use of latissimus dorsi flap alters the glenohumeral function and this leads to reduction in the range adduction and extension over the shoulder, causing shoulder fatigue.1 Hence, a better understanding of the vascular anatomy of the trapezius muscle led to the development of the musculocutaneous trapezius flap.","title":"Trapezius Rotational Flap for Cervico-thoracic Wound Breakdown in Post-radiotherapy Necrosis : A Case Report"}
{"_id":"b53a276e-e7a9-e666-c63a-65cf1cd33a86","text":"To estimate the risk of medically attended local reactions following Td vaccination in adolescents and young adults we conducted a six-year retrospective cohort study assessing 436,828 Td vaccinations given to persons 9 through 25 years of age in the Vaccine Safety Datalink population from 1999 through 2004.","title":"Frequency of medically attended adverse events following tetanus and diphtheria toxoid vaccine in adolescents and young adults: a Vaccine Safety Datalink study"}
{"_id":"b53a3b14-5f64-8401-c882-2cc6367ba812","text":"The most common symptoms include swelling and edema (11 of 20, 55%), erythema (six of 20, 30%), rash10,15,19,21,31 (six of 20, 30%), pruritus (seven of 20, 35%), and granulomatous inflammation (four of 20, 20%). Guo et al reported two cases of severe and subacute hypersensitive reaction that occurred in patients with a history of corona virus 2019 vaccination but with no BTA allergic history. Zhuang et al reported a case of herpes zoster that occurred in a patient with no BTA allergic history after receiving BTA injection. Balighi et al reported a case of delayed-type BTA allergy and granulomatous inflammation that occurred 11 months after the patient received BTA injection. All allergic symptoms listed in Supplemental Digital Content 1 (https:\/\/links.lww.com\/PRSGO\/D2337) could be alleviated with corticosteroids. However, there have been no articles reporting allergic symptoms occurring in other sites instead of the injection sites so far.","title":"Mild Allergic Reactions after Botulinum Toxin Injection: A Case Series and Literature Review"}
{"_id":"b5443250-0217-71cb-6bb9-59c89e14e91f","text":"In the CT based 3 D model we tried to visualize the tumor mass and the peritumoral tissues considering our mapping biopsy strategy and the tissue miRNA expression results. In the 3D model the clinical tumor mass and the peritumoral tissue locating at 1 cm distance from the macroscopically tumorous margin - where similar miRNA patterns were proved - presents in red tone colors with precise compilation (Figs. 6,7). Surgical excision carried out in this zone can result a high risk of tumor recurrence. Yellow color represents peritumoral tissue at 2 cm distance from the tumor margin. This is a safety field with a better epigenetic patterns differing from the tumor. In case of resecable tumors the surgical resection is highly recommended in this area to avoid the locoregional recurrence. This model can be utilized in preoperative surgical planning to decide the optimal tumor resection line. In case the surgical line affects the functionality (swallowing, breathing and speaking) we prefer the organ preservation among therapeutical modalities (chemoirradiation). The 3D software might be effective in assisting preoperative planning, especially in current clinical settings. Our approach enables the risk estimation of malignant disease progression before the operative intervention on the basis of genomic and epigenetic characteristics of the tumor and the peritumoral mucosal surface and the surgical safety margin can be determined in consideration with the anatomical situation of the mucosal landscape. This strategy could facilitate the complex planning of surgical excision. In some cases, where the anatomy does not permit a more extended surgery according to the 3D model and tumor removal was carried out in the 1 cm zone which is still histologically tumor-free but high recurrence risk is indicated by genomic evaluation a closer patient follow-up is highly recommended.","title":"Visualization of mucosal field in HPV positive and negative oropharyngeal squamous cell carcinomas: combined genomic and radiology based 3D model"}
{"_id":"b5491104-3479-b955-9115-2d6757f8c9d0","text":"Based on the cases reported in the literature, different injury can be seen with avulsion or rupture of flexore digitorum superficialis.","title":"A successful surgical treatment of a closed rupture of flexor digitorum superficialis in surgeon’s hand. A case report and review of literature"}
{"_id":"b5495299-bff8-e8e5-5446-c0ffbc313378","text":"Table 1 Summary of all patients with tibial shaft fractures treated with TSF","title":"Management of high-energy tibial shaft fractures using the hexapod circular external fixator"}
{"_id":"b54c8281-2eed-a9fe-4391-222fb4717543","text":"Interestingly, although flap perfusion is critical for flap survival, the effects of smoking on flap perfusion has not been adequately studied. Only one study showed that smoking is associated with impaired perfusion of microvascular rectus abdominis flaps used for breast reconstruction in terms of reduced flap blood flow.","title":"Smoking and microvascular free flap perfusion in head and neck reconstruction: radial free forearm flaps and anterolateral thigh flaps"}
{"_id":"b54cce27-781f-c61e-5d8c-1d396121a629","text":"Our recruitment coordinator and representatives of Covidien provide onsite training to nursing staff in the correct sizing, fitting and monitoring of IPC. This is supplemented by a training video and web-based training. We ask nursing staff to record their use of IPC on the medication chart to increase compliance and aid monitoring. We stipulate that both treatment groups should receive the same medical care that could include, depending on local protocols, early mobilisation, hydration, antiplatelet or anticoagulant drugs. The local coordinator extracts information from the medication charts on the compliance with IPC and use of antiplatelet and anticoagulant drugs during the admission and records this on our hospital discharge form, so we can check that these aspects of medical care are used equally in the treatment groups.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"b54f176c-cdaf-9cb1-d76c-d01ea699ec97","text":"This case report demonstrates the successful management of facial deformity in a patient with long-standing TMJ ankylosis through orthomorphic correction. The utilization of an STL model for surgical planning and the use of cancellous bone graft contributed to satisfactory postoperative healing and improved facial aesthetics. Further research and large-scale studies are warranted to evaluate the long-term outcomes and determine the optimal surgical approaches for patients with TMJ ankylosis.","title":"Orthomorphic Correction for Facial Asymmetry in a Patient With Long-Standing Temporomandibular Joint Ankylosis: A Case Report"}
{"_id":"b554a442-649a-04c8-cc68-fd7b12c478ad","text":"Relative concordance is notable between the decisions regarding immediate versus delayed definitive upper extremity reconstruction and the reconstructive technique chosen at the time of pre-resectional planning or intraoperatively. Appreciation of difficulties in establishing truly negative margins should lead to a customized and individualized approach for the reconstructive management of each patient. The recognition of the value of staged or delayed definitive reconstruction should be the modus operandi of the orthopedic-plastic surgery team treating advanced upper extremity malignancies.","title":"Upper extremity sarcoma: impact of current practice guidelines and controversies on reconstructive approaches"}
{"_id":"b554beb2-959f-ce32-1962-21434ace1148","text":"The purpose of this study was to evaluate the success and complications of tissue expansion in the correction of post burn scalp alopecia. Our technique employed an insertion site distal to the area needed to be expanded, attempting to minimize complication like extrusion & wound dehiscence.","title":"Reconstruction of post burn scalp alopecia by using expanded hair-bearing scalp flaps"}
{"_id":"b561d823-67e1-40f5-cad6-f47f4f4655f8","text":"A viable skin allograft can re-vascularise by inosculation like autologous split skin graft. In addition, skin allograft can provide growth factors and essential cytokines while creating chemotaxis and proliferation at the wound beds. As the skin allograft can increase vascularity in the wound bed, including promoting angiogenesis with enhanced capillary ingrowth on the wound bed, it has been used for burn wound bed preparation. The freshly excised burn wound could be optimised and conditioned to prepare for subsequent autografting by application of skin allograft.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"b561f772-be16-b730-bc6e-5f9d26a7d628","text":"The impact testing method consists of fists in dynamic braking of the sample and reading the result from the scale of the measuring instrument. The test was performed using the Charpy pendulum hammer.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"b564b07e-fe0a-0467-f300-791072f08357","text":"In our experience, cosmetic phalloplasty has evolved in time moving in a direction of increased safety. The substitution of silicone spacers with inverse periosteal fascial sutures, which we have already described, and the use of autologous fat have marked the end of rare but significant complications that in the past led to reoperation. At the moment, we employ a surgical technique that keeps complications to a minimum and and results in great patients’ satisfaction. Patients who undergo combined elongation and girth enhancement phalloplasty are particularly satisfied compared to those who undergo a single operation which is probably linked to the availability of an overall greater penile volume. In Italy, there is no validated test for the measurement of patients’ satisfaction in cosmetic penoplasty and the absence of a measurement of patients’ satisfaction is also a limitation of our study.","title":"Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases"}
{"_id":"b564e27a-d2e6-3c7f-f5b3-d12da0049355","text":"The survival and recurrence data relating to AJCC staging is displayed in Table 2.","title":"Melanoma in Buckinghamshire: Data from the Inception of the Skin Cancer Multidisciplinary Team"}
{"_id":"b565f614-ddde-7315-8e2a-2d2f8f3a94a0","text":"Unlike cited literature, this study defined the distance of flap advancement and not the maximal size of the defect. Maximal defect size can overestimate the effectiveness of the flap compared with its advancement distance.","title":"Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction"}
{"_id":"b56788e7-2508-2638-1f1d-8b428417f410","text":"Safety was assessed as the recording of adverse events from the time of the first injection to 3 years after the last injection. A research nurse called the patients to assess adverse events during the first 5 days after each injection. Safety laboratory parameters were assessed at screening, after the third ILIT injections and after the first pollen season following treatment (Table 2).","title":"Intralymphatic immunotherapy with one or two allergens renders similar clinical response in patients with allergic rhinitis due to birch and grass pollen"}
{"_id":"b56c5717-8541-dfc9-cc45-807139a6aa02","text":"Figure 10 shows the iceball volume and lethal volume for three cryoprobes cryosurgery with freezing time evolution. Both iceball and lethal volumes’ growth rate is high at initial freezing stage and becomes lower at later freezing stage. In fact, this growth rate would approach zero after a longer freezing time, while it could not be observed in present short freezing time.","title":"Computational study of the effects of arterial bifurcation on the temperature distribution during cryosurgery"}
{"_id":"b56e3d4a-8a8c-22de-11c4-4dee83326911","text":"To the best of our knowledge, this is the first study investigating how proficiency gain curves are influenced by annual surgeon volume and surgeon age. A possible explanation for the ‘surgeon volume effect’ is that a higher annual volume during a shorter time period facilitates a more effective acquirement of new skills. A possible explanation for the results regarding surgeon age is that younger surgeons may be more responsive to obtaining new skills, both intellectually and practically, relative to their older counterparts. As the age of each surgeon was defined at their case 1, referral of more complicated cases to older surgeons cannot explain the results.","title":"Surgeon Volume and Surgeon Age in Relation to Proficiency Gain Curves for Prognosis Following Surgery for Esophageal Cancer"}
{"_id":"b58b13f8-edb9-4f11-43a6-9d0fbfb89bac","text":"Our intervention applies modern virtual 3D surgical models during preoperative planning and adheres with the principles of total surgical resection with negative tumor margins, when possible, which our team found both possible and successful. We advocate for close, long-term follow-up to monitor for recurrence, and support mindfulness of the unique experiences and development of the pediatric patient when planning treatment and providing guidance throughout recovery.","title":"Total Resection of Pediatric Desmoid Tumor of the Left Neck with Utilization of 3D Virtual Surgical Planning"}
{"_id":"b59234ae-de73-2a73-1a0a-2ad215eb9de7","text":"This is a pilot study that demonstrates the safe and efficacious use of hyaluronic acid filler to achieve stable nipple projection in women who underwent breast reconstruction. All patients in this study had satisfactory increases in nipple projection following the hyaluronic acid filler injection. All patients were satisfied with their results at 6 months following the filler injection.","title":"Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique"}
{"_id":"b593d99b-7ece-df0d-b802-bf6ba389cdd0","text":"These studies all point to a prolonged and excessive activation of T cells that then leads to the T cell mediated damage in the sHLH presentation in COVID-19. While this is evidence that the pathophysiology of sHLH meets the definition of a Type IV hypersensitivity reaction, the etiology of that prolonged and excessive stimulation is an active area of study.","title":"COVID-19: Infection or Autoimmunity"}
{"_id":"b59c127c-4a14-7859-7812-8950e8d0c2d9","text":"The research shows that a probable diagnosis in such tumor cases could be made by sufficient pre-op scanning before surgical operations and although angiolipoma has been rarely seen in lumbar posterolateral space, it can be seen in lumbar region and mimic schwannoma as producing symptoms and signs of spinal cord and nerve root compression.","title":"Lumbar Spinal Angiolipoma with Expanding Left Neural Foramen Mimicking Lumbar Schwannoma; Case Report and Review of The Literature"}
{"_id":"b5a35297-7d10-f34e-3b0e-01b920844188","text":"Though cutaneous horn can be removed by simple detachment and cauterization of the base, a full thickness wide local excision with an adequate margin should be obtained for histopathological analysis, keeping in mind the frequent association of malignant\/premalignant changes at the base. Cryosurgery is not advocated for the treatment of giant cutaneous horns as it does not ensure full thickness excision of the tumor and also it is not appropriate for the treatment of squamous cell carcinomas.","title":"Carcinoma Buccal Mucosa Underlying a Giant Cutaneous Horn: A Case Report and Review of the Literature"}
{"_id":"b5a36d09-6e90-5fe8-8c8f-0fee195e4779","text":"Inferior vena cava filter placement may be indicated in high-risk cases where the use of thromboprophylaxis is contraindicated due to certain coexisting morbidities.","title":"Strategies for Diagnosis and Prevention of Venous Thromboembolism during Pregnancy"}
{"_id":"b5a4d4cb-ce2b-6297-961d-ec8dd8bc8ad4","text":"This evidence opens a discussion concerning the optimal methods for monitoring and the need for integrated diagnostic procedures in cases with suspicious US and negative cytology reports.","title":"The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours"}
{"_id":"b5a9e6d8-297e-34ff-63f5-d3392909c955","text":"The images acquired of the clinically normal weanling horses showed multiple repeatable echogenic changes within the trochlear ridges of the femur and talus, and within the sagittal ridge of the metacarpal and metatarsal bones. These changes were not associated with joint effusion or swelling. Futher study would be required to compare the ultrasonographic findings to the radiographic findings at the time of ultrasound, and to the radiographic findings at the time of yearling radiographic imaging.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"b5aedcbe-5735-242f-a47b-cbfddf9e911c","text":"Pacemaker component allergy is a relatively uncommon cause of erythema and pain at the pacemaker implantation site. Diagnosis of a pacemaker component allergy first requires awareness of the problem and then thorough allergy testing with the appropriate allergy test kit provided by the manufacturer. Pacemaker component allergy can present as painful erythema with pruritus covering a large area around the device and may occur months after the implantation procedure. Therapy with a topical corticoid may permanently resolve the skin reaction; otherwise, a more extensively coated or a gold-plated device may need to be implanted in place of the original device [2].","title":"Chronic lymphocytic leukemia skin infiltration mimicking an ICD pocket infection: a case report"}
{"_id":"b5af58ce-56d2-597f-df24-c7594a4c0ce6","text":"Allergy to two or more tree nuts was observed in most cases. Hazelnut-walnut dual allergy was common but not exclusively observed as concomitant allergies. Allergy to cashew was coincided in all but one of the assessed subjects with pistachio allergy. Half of all assessed subjects were allergic to peanuts. Oral symptoms followed by a skin reaction were the most common symptomatology that lead to OFC cessation and subjects often presented with symptoms from two or more organ systems. OFC threshold levels were within the same range, but cashew was distinguished from other nuts by causing allergic symptoms at the lowest dose. Clinical reactivity and the allergy patterns were to some extent reflected by sIgE levels and by correlations in sIgE between the nuts.","title":"Patterns of Clinical Reactivity in a Danish Cohort of Tree Nut Allergic Children, Adolescents, and Young Adults"}
{"_id":"b5ba6571-eb5f-1fdc-ce2e-8d5645e482b3","text":"Physeal viability and long bone growth can be confirmed by measuring from the tip of the epiphysis to the distal aspect of the plate or screws. Our graft demonstrated approximately 3 cm of longitudinal growth in the first 27 months after transfer. This is consistent with previous studies showing an annual growth rate of 0.7 to 1.35 cm per year in 24 patients including proximal humerus and distal radius physeal transfers. In the series, five cases had premature physeal closure and five had graft fracture.","title":"Composite-Free Vascularized Fibular Epiphyseal Flap and Proximal Humeral Allograft for Proximal Humerus Reconstruction in a Pediatric Patient"}
{"_id":"b5bcb313-d7ca-6eaf-13ff-7a2d08357208","text":"Dermatologists should be aware of the limitation of preoperative biopsy in the diagnosis of aggressive subtypes of BCC.","title":"Comparison of basal cell carcinoma subtypes observed in preoperative biopsy and Mohs micrographic surgery"}
{"_id":"b5be5555-88da-8045-25ba-43a4251d7302","text":"This difference between the assessments made by patients and surgeons is consistent with the findings of Tobin and Webster et al., that showed patients are less critical regarding their postoperative appearance when compared to the surgeons responsible for their surgeries.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"b5c74677-481d-b660-c846-f7182ae401f2","text":"This phase is composed of different steps: the passage through the needle and the immediate integration into the soft tissues. The rheological feature that is an expression of injectability through the needle is complex viscosity. Major filler producers provide needle sizes of 30 G or 27 G, with a few volumizing fillers needing a 25 G or a 23 G needle. Adequate viscosity is necessary to allow the injection through fine needles and to maintain a good capacity of volume restoration in the filler. To achieve this balance, manufacturers have developed specific technologies and formulations for their HA fillers. They must possess sufficient elasticity but also sufficiently low viscosity to be extruded through a thin needle. The lower the viscosity is, the lower extrusion force is needed by the injector to push the filler through the syringe. Another useful parameter to describe the filler during this phase is the yield stress. The yield stress indicates the shear force intensity that determines the disruption in the filler’s physicochemical structure and loss of viscoelasticity. Low yield stress increases the risk for the filler to be subject to excessive shear deformation and undergo a structural alteration during injection through a fine needle. Moreover, a filler with a low η* also has a low shear thinning point and is easily injected because it does not need a high pressure on the syringe plunger.","title":"The Rheology and Physicochemical Characteristics of Hyaluronic Acid Fillers: Their Clinical Implications"}
{"_id":"b5dfb65e-cf86-9b40-9ec1-365f6d465aac","text":"Extended Soft tissue defect of leg include middle and distal parts have always been a challenge for many plastic surgeons and also frustrated problems for patients and families. The main goals of soft tissue reconstruction is to cover exposed bone, tendon, or hardware. Small and moderate-size wounds of the leg may be better served by the use of local and regional flaps, but in large defects, these flaps are not available and more complex and different flap designs are required. This study focused on authors experiences when appling simultaneous sural and soleus flaps from one incision for soft tissue reconstruction in large soft tissue defect of the leg.","title":"Synchronous Soleus and Reverse Sural Flap for Large Soft Tissue Defect Reconstruction of Leg"}
{"_id":"b5e22bd5-d21e-5f52-23f9-3180320086f9","text":"Patients were concerned that although the lesion had been removed, it might come back and they worried about further lumps and bumps.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"b5e29d86-a0de-8bf2-f2fc-ae7f1d5f6bf9","text":"In our retrospective study, the use of radiation therapy achieved a high degree of palliation with minimal toxicity in a cohort of heavily pretreated patients with symptomatic GISTs.","title":"External beam radiation therapy for locally advanced and metastatic gastrointestinal stromal tumors"}
{"_id":"b5e33fca-79cd-f338-1173-3b43579e0ef8","text":"When biological mesh was completely overlaid with granulation tissue, the remaining loss of tissue in the lower abdominal area was closed with a split-thickness skin graft taken from the left thigh. The graft takes roots perfectly allowing total closure of abdominal dehiscence after 55 days from patient transferral to our department. No recurrence and local complications occurred with a postoperative follow-up of 6 months.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"b5e7b90b-f79f-1d7e-8cc1-d21e4d1c9f26","text":"The DA approach for THA has increased in popularity over the past two decades for a variety of reasons including perceived benefits of decreased postoperative pain and improved early functional outcomes. With this increase in use, it is important to understand whether a clinical benefit outweighs the potential risk of adopting this procedure. A commonly cited drawback of the DA approach is the learning curve associated with performing the procedure. The current literature regarding the learning curve for the DA approach focuses primarily on the experiences of mid-career arthroplasty surgeons who switch from an alternative approach, such as PL, to the DA. There is little reported evidence regarding the experiences of arthroplasty fellowship-trained surgeons who routinely performed the DA approach with supervision during their training. To our knowledge, this is the first study to assess learning curves comparing recent fellowship-trained DA surgeons with recent fellowship-trained PL arthroplasty surgeons. Although there was a significant curve for all surgeons in the first 50 cases, we reported no differences in the learning curve regarding complications when comparing the DA and PL approach for fellowship-trained arthroplasty surgeons.","title":"Total Hip Arthroplasty Learning Curves Based on Approach for New Fellowship-trained Surgeons"}
{"_id":"b5e8fa66-2da3-a574-8e2e-839c6fd4b901","text":"Surgeons tend to pay less attention to the donor site during breast reconstruction using deep inferior epigastric artery perforator flaps because attention is focused on microanastomosis and breast shaping. Therefore, donor site closure is typically performed by a secondary operator. We present consistently reduced operative times and improved scar quality using an absorbable dermal staple.","title":"Donor-site closure using absorbable dermal staple for deep inferior epigastric artery perforator flaps: its efficacy and cosmetic outcomes"}
{"_id":"b5f6b33c-336f-3b58-6a41-37f04e099507","text":"In case 4, where arterial thrombosis occurred, the FSO2 value rapidly dropped over approximately 15 minutes, which may demonstrate the fact that arterial inflow decreases rapidly with arterial thrombosis. In addition, although the FSO2 value did not bottom out because of thrombus formation, we deduced that the patient's vasculature was not completely occluded and that a small amount of arterial blood continued to flow into the transplanted flap. In contrast, in case 5, where a venous thrombosis occurred, the speed of the decline was slower than the speed of decline in cases of arterial thrombosis, which required approximately 1 hour. This is likely due to the fact that since the expansion of the vascular network inside the flap allows a certain amount of arterial inflow to be accepted even after outflow tracts are blocked by venous thrombosis, the reduction of arterial inflow was milder than in arterial thrombosis. In addition, we inferred that FSO2 reached the minimum value because arterial inflow was completely blocked when the flap resistance reached its maximum value, at which time flap congestion was detected clinically. Although findings of flap ischemia are difficult to identify in cases of arterial thrombosis, in both arterial thrombosis and venous thrombosis, clinical changes in flap color seem to first occur when arterial inflow is almost completely blocked. The INVOS system is thought to be a sensitive system for detecting the process of thrombus formation and the progression of decreasing arterial inflow before arterial inflow is completely blocked. This suggests that the INVOS system is a valuable tool that enables the clinical diagnosis of thrombosis at a site of anastomosis and allows for earlier monitoring.","title":"A Novel Method of Noninvasive Monitoring of Free Flaps With Near-Infrared Spectroscopy Takasu et al"}
{"_id":"b5fa7559-efee-3fdf-4aab-c1c17a7572b5","text":"The adoption of this promising imaging technology into gynaecologic surgery is feasible and should be further investigated. Additional studies evaluating the clinical impact of using Hyper Accuracy 3D imaging in the preoperative planning of patients with gynaecologic surgical pathology are needed.","title":"Incorporating 3D reconstruction in preoperative surgical planning of Multiple Myomectomy"}
{"_id":"b610873c-1857-5444-cd16-f0b239fe377e","text":"Second, decrease in CD4 T cell responses was not reversed by replenishing immune cells from the PRE group (with higher responses before reexposure), suggesting the downregulation of T cell responses is not due to redistribution of immune cells, but an active and dynamic process that protects the ENA subjects from allergic reactions ARE to mouse allergens. While allergy is commonly attributed to pathological immune reactions absent in nonallergic individuals, missing the above protective immune regulation may also be a cause of allergy.","title":"B cells modulate mouse allergen-specific T cells in nonallergic laboratory animal-care workers"}
{"_id":"b6115a19-9164-1151-9b69-41dde07d7a38","text":"For secondary analyses, we excluded from the subgroup of patients presenting PVO with SND without neurological evolution follow-up. To deal with multiple vertebral level affected cases in multivariable analysis, we considered only the level of the clinical spinal cord compression. A Cox proportional hazards model was performed to identify factors associated with functional outcome. We defined the critical event as the first date on which was recorded a Rankin score of 3 or less. Variables were included in the model if they had a degree of significance below 5% in the univariate analysis apart for duration of antibiotic treatment which was forced. The final model was selected with the best goodness of fit.","title":"Characteristics of and risk factors for severe neurological deficit in patients with pyogenic vertebral osteomyelitis A case–control study"}
{"_id":"b615a194-c1f7-c159-e624-8f65bce39c03","text":"The utilization of the ESLR method in lymph node dissection along the left RLN during minimally invasive esophagectomy has been demonstrated to be both safe and effective. This innovative approach not only enhances the quantity of dissected lymph nodes along the left RLN but also significantly reduces the incidence of postoperative RLN injury, all without causing a prolongation of operative time. Moreover, patients subjected to this method may experience improved long-term survival rates. Considering these advantages, the ESLR method holds the potential for widespread adoption in esophagectomy procedures.","title":"A novel technique for lymphadenectomy along the left recurrent laryngeal nerve during minimally invasive esophagectomy: a retrospective cohort study"}
{"_id":"b63609a9-1ac8-b618-12ec-5b70395e570c","text":"We anticipated that improving the quantification and characterization of anosognosia in EOD would help clinicians, patients, and their family to reduce diagnostic delay and improve identification of people at greater risk of potentially dangerous behaviors.","title":"Anosognosia in Early- and Late-Onset Dementia and Its Association With Neuropsychiatric Symptoms"}
{"_id":"b63fc8a0-8add-eec3-f734-51c4f57392c9","text":"Primary outcome measures focussed on the curative behaviour of the different bone graft substitutes. It was assessed if there was an eradication of the osteomyelitis. Secondary outcome measures are the biodegradability and the influence on bone regeneration of the bone graft substitute material.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"b65508aa-231b-c772-28f0-7d9bb1093491","text":"In summary, minimally invasive ILND appears to be safe with a decreased overall complication rate and reduced length of stay when compared to open ILND. Blood loss appears to be equivalent between minimally invasive and open techniques while operative time is longer with minimally invasive ILND.","title":"Utility of Minimally Invasive Technology for Inguinal Lymph Node Dissection in Penile Cancer"}
{"_id":"b65536d7-e999-8d3d-937f-410a4d181edc","text":"Thrombophilia screening shows positive lupus anticoagulant and IgM anticardiolipin antibody levels of 26 MPL U\/ml. This first measurement was taken within 2 days of starting anticoagulation with LWMH. A second measurement to confirm or rule out a possible coagulation disorder was not performed at 12 weeks due to patient refusal, so a definitive diagnosis was not possible.","title":"A rare cause of deep vein thrombosis: inferior vena cava agenesis Agenesia da veia cava inferior: uma causa rara de trombose venosa profunda"}
{"_id":"b656c50b-475b-7330-cd7a-21acfcef23ce","text":"All pigs survived throughout the 300 min experiments without interventions other than maintenance fluid therapy.","title":"Intraosseous fluid resuscitation causes systemic fat emboli in a porcine hemorrhagic shock model"}
{"_id":"b6592abc-e9ef-0131-b8bf-a789924a7388","text":"Primary tuberculous osteomyelitis is a rare entity. Increasing incidence of TB and HIV coinfection with emergence of drug resistance pose a major challenge for developing countries. Early diagnosis and prompt initiation of treatment is the only means to decrease the morbidity due to the disease.","title":"Primary tuberculous osteomyelitis of the mandible mimicking a parotid fistula"}
{"_id":"b65d64f5-f076-fafa-b09e-c3b8d07ef254","text":"Our experience with reconstruction of extensive lateral skull base defects utilising the ALT flap did not confirm the high risk of complications neither at the recipient site nor at the donor site. None of the 17 patients experienced complication at the donor site. At the recipient site, complications were recorded in two patients who developed a local haematoma and one patient experienced a partial flap necrosis that occurred 3 weeks after surgery.","title":"Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection"}
{"_id":"b65da8f5-25c1-82b0-3e4f-8a27e9bcd3fb","text":"Host optimization in the setting of orthopedic infection is necessary and may require consideration beyond the obvious risk factors, especially in patients with seemingly normal general health who are suffering from infectious complications. Preoperative screening could allow immunological abnormalities in this “silent” population to be identified and treated before surgery to prevent postoperative orthopedic infections.","title":"Immunological evaluation of patients with orthopedic infections: taking the Cierny–Mader classification to the next level"}
{"_id":"b664306d-abf0-a0f5-83ad-a20de655aaf1","text":"In our study, we aimed to assess how efficiently melanoma staging systems can predict the occurrence of nodal metastases in thin melanoma and whether there are any other additional criteria to improve this rate.","title":"Is it Necessary to Perform Sentinel Lymph Node Biopsy in Thin Melanoma? A Retrospective Single Center Analysis"}
{"_id":"b664b531-15b0-3919-3467-477540876075","text":"CT and US images were evaluated to determine the level of detail provided by each imaging modality using a predetermined set of criteria based on the amount of detail visible in the abscess cavity. Images were categorized as demonstrating any details within the abscess cavity or not. If abscess cavity contents were visible, the contents were further characterized as demonstrating fine details or not. Imaging was summarized using a four-point scale based on the degree of visible detail with higher numbers corresponding to greater detail (Figure 1). Both CT and US findings were determined using the same adjudication process described above. All interpretations of the image detail were performed by physicians who were blinded to patient characteristics and the results of alternative imaging.","title":"Comparison of computerized tomography and ultrasound for diagnosing soft tissue abscesses"}
{"_id":"b66de918-60dc-8a46-1a1a-eec01a1cb34b","text":"Regarding the indications of prophylactic lymphatic dissection for parotid cancer, it is important to consider the presence of lymph nodes within the parotid gland, mainly in the superficial lobe and lower pole, and lymphatic flow through intra-parotid lymph nodes towards cervical lymph nodes. The extent of neck dissection and parotidectomy for parotid cancer needs to be discussed in more detail in the future and depends on the presence or absence of neck and intra-parotid lymph node metastases. Positive intra-parotid lymph node metastasis has been identified as a predictor of an increased risk of positive cervical nodal metastasis.","title":"Role of Intra-Parotid Lymph Node Metastasis in Primary Parotid Carcinoma"}
{"_id":"b671429c-0527-8b56-f803-0b67049ca6d1","text":"The quality of the life is greatly affected by nasal cartilage pathologies, a common form of facial abnormalities. The demand for cartilage quality and quantity is highly associated with donor site morbidity and possible surgical complications, including infection and resorption, which limits the ability to correct nasal cartilage pathologies. Nasal reconstruction involves the restoration of degraded or lost tissue. Cartilage tissue engineering offers solutions to the nasal defects that produce a filler of smaller defects, a scaffold to promote repair and a full implant as structural support. In the present study, we evaluated the role of scCO2 processed dPNCG cultured with ADSCs and chondrocytes for potential future rhinoplasty application. We found dPNCG cultured with chondrocytes led to the production of a 3D cartilage histotypic culture, which can be used as a full implant for structural support in rhinoplasty.","title":"A novel 3D histotypic cartilage construct engineered by supercritical carbon dioxide decellularized porcine nasal cartilage graft and chondrocytes exhibited chondrogenic capability in vitro"}
{"_id":"b675a36b-e798-7154-a494-b8084a39d370","text":"The etiology of radial nerve lesion is most often traumatic, and almost all patients belong to the male working-age population. Iatrogenic nerve injuries were frequent and most often a consequence of open reduction and internal fixation of the humeral shaft. The nerve lesions of neoplastic and idiopathic entrapment origin are less frequent in our population.","title":"Etiological and epidemiological characteristics of surgically treated radial nerve lesions: A 20-year single-center experience"}
{"_id":"b675a978-0f12-0afb-1c53-924f93a8b53a","text":"The main objective of this study was to assess semen characteristics of patients with testicular cancer at the time of cryopreservation, before their treatment, and after thawing, to assess the consequences of this technique on sperm quality. A secondary objective was to evaluate the rate of use of cryopreserved sperm after cancer treatment.","title":"Semen quality before cryopreservation and after thawing in 543 patients with testicular cancer"}
{"_id":"b680c343-aef4-4e6a-4bc7-098ad2552765","text":"For those patients who are able to give consent before their operation, namely those who have been transferred or are waiting up to 72hrs for their operation, will be approached by the research team for consent into the study.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"b680f7f5-992e-e467-d2fe-f2fad34cfe58","text":"There is a wide variation in the practice of TM amongst OBS. Further research and guidance would be useful to standardise practice, particularly management of involved margins and coding for optimal reimbursement.","title":"Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England"}
{"_id":"b6862e8d-71e7-8ad9-2a79-c4e45e7326e8","text":"Chan et al showed in their study that ultrasound could determine the size, depth, and exact location of the brachial plexus and its neighboring structures. Real-time ultrasound imaging could help guide the block needle to reach target nerves with fewer attempts. Siegenthaler et al reported that visualization of the suprascapular nerve with ultrasound was better in the supraclavicular region compared with the supraspinous fossa for effectiveness of both nerve block and pain relief. Williams et al compared the ultrasound-guided technique with nerve stimulation and found that ultrasound guidance was superior in nerve blocking. Using a high-resolution ultrasonography technique, anesthetists could visualize nerve structures directly for nerve blocks at all levels and monitor the distribution of local anesthetics. Saha et al performed a large-sized retrospective study and stated that physical examination of the shoulder before applying a suprascapular nerve block was beneficial in reducing ipsilateral shoulder pain. Their decision was that if the pain was of musculoskeletal origin, then a suprascapular nerve block could be carried out postoperatively.","title":"Preoperatıve Ultrasound-Guıded Suprascapular Nerve Block for Postthoracotomy Shoulder Paın"}
{"_id":"b689ee79-b7a9-e996-dc60-253e9ce1bf5f","text":"Even though breastfeeding peer support strategies are not new to the health system, we found that in an in-patient environment the eligibility criteria, identification, training and supervision of breastfeeding peer supporters differs from one context to another. Similar to other peer support programs, BFPS were described with the concepts of shared experiences and social matching. In our review, consistently, BFPS were defined as mothers often from a similar community, as mothers of admitted infants who have current or previous breastfeeding experience and are interested in supporting others who may be facing breastfeeding challenges. Other important concepts were age of the BFPS to be similar with most mothers, they should also have similar culture and heritage and in some instances education level was important. To adopt breastfeeding peer support strategies into the health system a consistent definition of peer supporters is important as it will help guide objective identification and recruitment and facilitate comparability of results from different in-patient peer support interventions. In addition to shared experience and social matching, our results highlight another important peer support characteristic, the ability to provide emotional, appraisal and informational support. This finding is consistent with what has been described in a content analysis by Dennis et al. [36] and suggests that shared experience, social matching and an additional inherent skill to provide mothers with emotional and informational support are the key qualities of a good peer supporter. This is important as identifying the right peer supporter is a crucial step towards a successful breastfeeding support programme.","title":"A scoping review of breastfeeding peer support models applied in hospital settings"}
{"_id":"b68be002-0e5c-cff6-67d9-48f631191171","text":"The primary aim of this systematic review and meta-analysis is to pool epidemiological data of biologic injection site reactions to provide better estimates of injection site reaction prevalence. Secondary aims are to summarize the types of injection site reactions encountered and make recommendations for improving injection site reaction reporting in the literature. We also hope to provide future clinicians and patients with the tools to make informed decisions about biologic treatment.","title":"A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections"}
{"_id":"b68d1eef-b179-4c79-872a-5eccda31e683","text":"Additional parameters to be evaluated during the first hours after birth are:","title":"Clinical Scoring Systems in the Newborn Calf: An Overview"}
{"_id":"b68fd19b-5077-4232-3285-467726644fd5","text":"We treated the patient with full anticoagulation using subcutaneous low molecular weight heparin and oral warfarin, and his signs and symptoms gradually resolved over the next few days. On subsequent follow-up at 3 months, he remained well and asymptomatic and repeated venous Doppler ultrasound revealed complete resolution of the left axillary thrombosis. Following the guidelines from the American College of Chest Physicians, which recommend anticoagulation for a minimum of 3 months for all patients identified with uncomplicated primary upper extremity DVT, we discontinued his warfarin.","title":"Upper Limb Deep Vein Thrombosis: A Case Report of an Increasingly Common Condition"}
{"_id":"b69e6272-d044-2b74-396a-4e0b9d110a53","text":"Another important point was also noted that general practitioners gave some kind of information in only 2.6% of the students. This indicates poor knowledge of the specialty among the general public and even in the doctors. This also warrants the extension of the similar study among doctors. Thousands of hours are spent in plastic surgery training; none of the time is dedicated to community relations and public information. We have learned how to provide a service but not how to sell the product.","title":"Views of College Students on Plastic Surgery"}
{"_id":"b6a4f657-8679-a29c-aecd-e0ae1728972e","text":"In conclusion, radiologically identifying epidural abscess regardless of neurologic symptoms is the strong risk factor for surgical treatment for pyogenic spondylitis. In addition, surgical treatment should be considered as early when patient presents initially elevated CRP and high BT with epidural abscess for the better clinical outcome for pyogenic spondylitis.","title":"Spinal epidural abscess as predicting factor for the necessity of early surgical intervention in patients with pyogenic spondylitis"}
{"_id":"b6acbf43-9324-26ed-c572-6208be849db3","text":"To our knowledge, hyperpigmented patches secondary to leukemia cutis are rarely described in the literature. Dermatologists could have an important role in diagnosis of internal diseases including leukemia. Postponing the diagnosis of leukemia cutis means delaying the diagnosis of the underlying leukemia, which lead to poor prognosis. Early diagnosis of leukemia cutis can lead to better outcomes and may direct to an underlying malignancy.","title":"Leukemia cutis presenting as hyperpigmented patches. A rare presentation"}
{"_id":"b6afaf83-ddc7-95d5-afb4-f1b446b0dbbc","text":"Dermatofibrosarcoma protuberans (DFSP) of the breast is a dermal fibroblastic neoplasm requiring wide excisional margins due to recurrence rates ranging from 26 to 60%. The current literature on reconstructive options and utility of Mohs micrographic surgery for DFSP of the breast is scarce. We describe surgical management of DFSP of the breast at our institution with the largest case series reported to date.","title":"Wide local excision, Mohs micrographic surgery, and reconstructive options for treatment of dermatofibrosarcoma protuberans of the breast: A retrospective case series from Mayo Clinic"}
{"_id":"b6bb89cb-ae7c-4a37-8ca9-574499e3647a","text":"Uncomplicated SSTIs are at low risk for life- or limb-threatening infection unless they are not properly treated. Patients who have uncomplicated SSTIs can be treated with either empiric antibiotic therapy according to likely pathogen and local resistance patterns or simple surgical drainage.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"b6bc39ea-5e60-157a-4a09-8423a0f75520","text":"It is a practical reality of modern medicine that a patient attending a clinic for cosmetic procedures will be in the care of more than one health professional. In the context of multiple health professionals, it is common practice to have a nurse or other staff provide information about treatment to the patient. This raises the question of appropriate delegation of the duty of disclosure and obtaining informed consent.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"b6bd92ea-f066-cbf0-38e5-46b09ded2659","text":"The aim of the present study was to describe the diagnostic accuracy of open tissue biopsy in patients with scheduled THA revision surgery, a clinical suspicion of low-grade chronic PJI but negative microbiology from synovial joint aspirates.","title":"Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery"}
{"_id":"b6cce5b0-6c15-f10a-7545-bd11ff51089c","text":"Local flaps remain usually inadequate since donor sites in the upper limb are restricted and such defects are fairly large in size.","title":"Salvage of Upper Limb following a Severe Crushing Trauma: Immediate Reconstruction with a Free Flap and Subsequent Hyperbaric Oxygen Therapy"}
{"_id":"b6cd4185-eb99-777b-6184-a9bda035fe5e","text":"Besides its retrospective nature, this study has several other limitations. The likely reason why none of our findings reached the level of statistical significance may be that there were few cases and thus the study was underpowered. Even though the fact that the diagnosis was not made with biopsy in all patients, bone biopsies cannot be commonly performed because they are an invasive application and require surgical experience and skills. Even though it is not considered the gold standard in diagnosis of osteomyelitis, MRI is a diagnostic method, which has high sensitivity and specificity for DFO if it is interpreted by an experienced radiologist.-","title":"Antibiotherapy with and without bone debridement in diabetic foot osteomyelitis: A retrospective cohort study"}
{"_id":"b6d0d79c-3b9b-e29e-6955-c3fb01129296","text":"A clinical case where multiple conditions independent of each other like Marfan syndrome and temporomandibular joint ankylosis in a patient together contributing towards the development of obstructive sleep apnea has been explained in this clinical paper and our experience at its effective management. Patients with such conditions often suffer through a lot of physical and esthetic issues. We were able to successfully help the patient with its most basic activities like speech, mastication, breathing and sleeping through surgical intervention and physiotherapy.","title":"Management of unilateral temporomandibular joint ankylosis & orthomorphic correction in a patient with Marfan syndrome: A rare case report"}
{"_id":"b6d154b4-5d7b-90e1-df04-27294e9654cf","text":"Figure 3 shows the overall scores obtained by the different images or image combinations. The conventional radiograph image obtained a total score of 63 points out of the maximum of 75 possible points in the sum of all quality criteria. The bone-equivalence image obtained 73 of a maximum of 75 possible points in the sum of all quality criteria. Since one of the readers detected a slight improvement in the overall image quality, the combination of bone-equivalence image and tissue equivalence image obtained 74 of a maximum of 75 possible quality criteria points. The addition of the bone-tissue-overlay image did not provide any additional value.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"b6d8918c-9023-a1a7-cb20-1dfae072581f","text":"The patient underwent a wide local excision of the primary tumor and left superficial and deep inguinal node dissection.","title":"Kikuchi-Fujimoto lymphadenitis imitating metastatic melanoma on positron emission tomography: a case report"}
{"_id":"b6dc99c9-0521-cf1b-7b5c-7aea765346ac","text":"The adverse events reported in this study are similar to the described for the IFNs reported in the literature, as for type of adverse event, intensity and relation of causality, what indicates us that our synergistic formulation of IFNs possesses similar therapeutic safety profile as other market pharmaceutical presentation of IFNs.","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"b6df1134-c54c-2db7-8260-1d4596603a74","text":"Acral lentiginous melanoma is a subtype of melanoma defined by the World Health Organization.21 The Clark classification of melanomas, which is based on different epidemiological and genetic features, is not free of criticism due to the overlapping of the histopathologic criteria on which it is based.22","title":"Survival analysis and sentinel lymph node status in thin cutaneous melanoma: A multicenter observational study"}
{"_id":"b6e191f4-660c-c7a4-c960-b8adb1dde553","text":"O’Dowd pointed out that biomechanical factors favor the posterior approach to reconstruct the tension band in a single approach surgery, but the clinical results favor anterior approaches. Kirzner reported patients with facet joint distraction of 3 mm or more to have a worse NDI and visual analogue score for pain after undergoing anterior cervical decompression and fusion for the treatment of cervical spine injury. Our study shows that satisfactory reduction and fixation can be achieved through both anterior and posterior approaches, and there are no significant differences in the improvement of JOA scores or the NDI between groups during a minimum 10-year follow-up period. Kwon reported there were no statistically significant differences in pain score, the SF-36 mental and physical scores or neurological scores in comparisons between anterior cervical plate fixation and posterior lateral mass screw-plate and\/or interspinous wire fixation for unilateral facet injuries. However, the mean operating room time with the anterior approach was longer than with the posterior approach.","title":"Comparison of anterior and posterior approaches for treatment of traumatic cervical dislocation combined with spinal cord injury: Minimum 10-year follow-up"}
{"_id":"b6ea153b-fb25-48fa-8f34-7f75ba14df6e","text":"The surgical principles of managing biofilm-related OM are to:\n\nUndertake adequate microbiological sampling\nPerform complete excision of all macroscopically devitalized tissue and implants\nManage postexcision dead space\nEnsure adequate skeletal stabilization, and\nProvide immediate wound cover.\nFailure in managing chronic OM usually stems from violation of one or more of these five principles. The most important aspect is to ensure that all macroscopically devitalized tissue and biofilm are excised to prevent recurrence. As long as healthy bleeding tissue is left behind, any planktonic bacteria still present should be adequately eradicated by the immune system and appropriate antibiotics.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"b6f248fa-aaaf-dfd0-b751-c1d1ec188fc9","text":"Subcutaneous injections of botulinum toxin type A are a promising treatment option for patients with unsatisfactory response to drug therapy or neurosurgical intervention. Its effects are expected to last for at least 3 months, so it could be a potential long-term treatment.","title":"Botulinum neurotoxin type A in the treatment of classical Trigeminal Neuralgia (BoTN): study protocol for a randomized controlled trial"}
{"_id":"b6f99fba-2f27-e374-7771-7e313d8b9eca","text":"The expected percentage of flap necrosis is low for FDMA flaps, Zhang et al 13 reports a partial necrosis of 2 of their 42 flaps in their case series, Couceiro and Sanmartín 6 report a partial necrosis of 2 of their flaps in a 10 flaps case series, 5 of the island flaps and 5 of them racquet flaps.","title":"The First Dorsal Metacarpal Artery Flap Family: A Review"}
{"_id":"b6faea05-1dc9-07bc-f5d8-3dce0a5fc9c6","text":"The decision to graft or leave a moderately stenosed vessel during a cardiac surgical procedure depends on some calculations by the surgeon. In clinical practice, the balance of these estimations of the future of both the lesion and any graft placed to that territory must be weighed against other surgical considerations, such as the availability of conduit, the number of grafts, and other operative procedures needed, such as valvular or aortic repair. Faced with a moderate lesion, the surgeon might commonly choose between leaving it alone or placing a saphenous vein bypass. The greater risk of progression of left-sided moderate lesions and high graft patency rates when bypassed, suggests that the balance of clinical judgment lies in favor of grafting moderate left-sided lesions. Data from postoperative angiography in predominantly asymptomatic patients receiving contemporary secondary prevention therapies suggests that bypass grafting best treats moderate lesions in the left coronary system during multivessel revascularization. However, right-sided lesions may reasonably be left alone because they are unlikely to progress and are not likely to require subsequent revascularization. These data may assist coronary surgeons in a joint clinical dilemma.","title":"Prophylactic Left Internal Mammary Artery Graft In Mildly-Stenosed Coronary Lesions. Still An Open Discussion"}
{"_id":"b6fb80d5-f0d9-820e-16a5-9d991825a57e","text":"Excessive accumulation of compounds in cellular compartments is often a pathological process. Storage of useless materials may be a result of a deficiency of catabolic enzymes, but disturbed catabolism may also occur without any apparent genetic defects leading to underlying enzyme deficiencies. When the primary storage in a particular disorder leads to secondary lipid accumulation, it may result in incorrect vesicular or protein trafficking, signal transduction and membrane disability.","title":"Lipophagy and Lipolysis Status in Lipid Storage and Lipid Metabolism Diseases"}
{"_id":"b6fb9594-4403-757a-cdb4-67a0e174bf07","text":"One day after the second dose of the vaccine she presents disseminated dermatosis with erythematous plaques in shoulders, cleavage, abdomen, hips and tights along with bilateral muscle aches 10\/10 in VAS in both pelvic and scapular members. 7 weeks later she noticed edema and a violaceous coloration in both eyelids accompanied by weakness with a symmetrical pattern affecting the proximal muscles of the four extremities that limited her daily life activities and later on started with dysphagia to both solids and liquids that made her seek medical assistance in our hospital.","title":"Dermatomyositis post vaccine against SARS-COV2"}
{"_id":"b6fbfaa0-9bf0-17ed-6244-e4483ffa9dfe","text":"It is known that allergic reactions could be more severe with unstable asthma and during the pollen season 37, 38. So, a combination of unstable atopic comorbidities and involvement of cofactors could lead to even more severe reactions. Since atopic comorbidities are frequently present in the food allergic population it seems important to minimize a potential negative influence by optimizing the treatment of any atopic comorbidity.","title":"Cofactors in allergic reactions to food: physical exercise and alcohol are the most important Versluis et al."}
{"_id":"b704fe1a-658b-8f5d-f4b3-9a33a26ff3c0","text":"Patients were preferably treated in the prone position. In case of anterior lesions, the oblique or lateral decubitus positions were used. The interposition of the costophrenic sinus for the treatment of tumors located at the upper renal poles was not always predictable beforehand because the interposition may not be present in the preoperative imaging. When this occurred, it required an oblique position on the same side of the costophrenic sinus or, less often, a lateral decubitus to limit lung expansion and free the path for the cryoprobe. The position was changed in case of tumor proximity to the bowel to allow its displacement. Particular attention was paid to make the patient feel comfortable to allow collaboration for the duration of the procedure. Treatment in the supine position was carried out if no other option was possible.","title":"Percutaneous CT-Guided Renal Cryoablation: Technical Aspects, Safety, and Long-Term Oncological Outcomes in a Single Center"}
{"_id":"b71116d0-6512-179a-6b6a-67d35eed8a4d","text":"Subgroup analyses of the primary and secondary outcomes by interaction terms in regression models are planned, to investigate if the dermatology nurses or the percentage of nurse-contacts made by telephone affect the intervention.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"b713bb66-10c8-668f-9ead-79a45b242a28","text":"General surgery chief residents are typically well equipped for board examinations but poorly trained to deal with the business challenges of surgical practice. We began a business leadership course to better prepare them for their careers.","title":"Evolution of a Novel Business Leadership Course for General Surgery Chief Residents"}
{"_id":"b713c865-1d64-bf80-d06f-f22cc843c0d4","text":"NPWT is traditionally utilized for wound management and soft-tissue salvage after the development of complications. The immediate postoperative application of NPWT after reconstruction using flap coverage is seldom reported. We evaluated the effectiveness of the immediate postoperative application of NPWT following muscle or fasciocutaneous flap coverage for lower leg reconstruction. All flaps survived without complications in 14 of 16 patients following the application of NPWT immediately after reconstruction.","title":"Immediate application of negative pressure wound therapy following lower extremity flap reconstruction in sixteen patients"}
{"_id":"b7164abf-c1f2-57cb-8f59-31682532cbbc","text":"The workflow of using 3D printing in surgical applications is described in Figure 8. The process begins with 2D sections of different imaging utilities such as computed tomography or magnetic resonance imaging. Image acquisition is critical because the final accuracy of the object depends on the quality of the acquisition. Image sections should be reconstructed with isotropic voxels of 1 mm or less.32 Thin sections will require much processing, and thick sections result in a less accurate result. Cardiac models appear accurate when acquiring 0.5 mm sections.33 Thin objects such as the orbital floor requires thinner sections.34","title":"Printing the Future—Updates in 3D Printing for Surgical Applications"}
{"_id":"b7196e35-ab39-9751-ada8-fd55d8d28ccd","text":"For T1 tumors, a gross resection margin of 2 cm should be obtained. When the tumor border is unclear and difficulties in deciding on the resection line are expected, preoperative endoscopic marking by clips of the tumor border based on the biopsy results would be helpful.","title":"Japanese gastric cancer treatment guidelines 2018 (5th edition)"}
{"_id":"b71c6f0b-b126-4aa2-4b10-8f7aa410b0af","text":"Table 1 Demographic and Clinical Characteristics of Patients with Direct and Indirect ARDS","title":"Prevalence, risk, and outcome of deep vein thrombosis in acute respiratory distress syndrome"}
{"_id":"b72677aa-6052-4f27-ec22-1e4f35b8c689","text":"Upon initial examination of the anatomy of the vasculature in the region of the Pty and peribullar sinuses, it becomes apparent that although there are homologies that may be drawn, the general pattern of venous investment seems relatively random. However, upon closer examination, it becomes evident that the locations and connections of the plexuses are relatively consistent between individuals, with only the localized branching patterns within the plexuses showing much variability. Nonetheless, it appears that in addition to those structures with likely homologies to generic mammalian structures, almost every available space between the jugular veins and distal head structures is filled with plexuses of anastomosing veins, forming what can only be considered a complex of countless collateral pathways. Although deciphering the exact anatomy of the venous structures themselves is important, the connections between those structures may be equally important from a functional perspective, as they form collateral pathways and alternate routes for transport of emboli and compartmentalization of gases.","title":"Vascularization of Air Sinuses and Fat Bodies in the Head of the Bottlenose Dolphin (Tursiops truncatus): Morphological Implications on Physiology"}
{"_id":"b72c2637-615a-0a0a-7c34-edf079fb883c","text":"In this study, we showed that ultrasound-guided CNB could determine the tumor type of a parotid neoplasm with a low rate of post-procedural complications and guide further treatment, as the histological architecture can be evaluated from the CNB specimen and subtyping of lymphoma is possible. In the case of a histologically confirmed lymphoma, an unnecessary surgical intervention may be avoided if the diagnosis is established on CNB and the correct treatment may be promptly instituted. In this study, all patients with a diagnosed lymphoma were referred to the oncologist to initiate the correct treatment.","title":"Diagnostic Accuracy and Post-Procedural Complications Associated with Ultrasound-Guided Core Needle Biopsy in the Preoperative Evaluation of Parotid Tumors"}
{"_id":"b72c4f26-a25e-591a-3b4f-0a55d3051542","text":"A better understanding of the clinical features and pathophysiologic basis of bacterial and tuberculous spondylodiscitis contributing to their imaging appearances help the radiologist to make an accurate diagnosis and differentiate infections from other abnormalities which may mimic infections. This may result in early diagnosis and prompt initiation of appropriate treatment to avoid complications such as abscess formation, spinal deformities and neurological deficits.","title":"Magnetic resonance imaging of bacterial and tuberculous spondylodiscitis with associated complications and non-infectious spinal pathology mimicking infections: a pictorial review"}
{"_id":"b72e759b-1560-b588-e1a8-58709840003b","text":"Clinical diagnosis of venous thromboembolism (VTE) is known to be unreliable.65–72 A clinical diagnosis is confirmed by ultrasound or venography in only about 20–35% of patients,66,67,69,72","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"b737a202-895d-2701-ed12-719f39f602b8","text":"In our experience limb salvage surgery in the presence of major vascular infiltration necessitating vascular reconstruction can be safely performed. Post-operative wound related complications are more in this group of patients. However, long term functional outcome is acceptable. Multi-modality treatment approach is needed in this group of patients to achieve optimal oncological outcome. These aggressive tumors may have poorer outcome but this should not deter surgeons from performing limb salvage in this subset as these patients still would have a useful limb during their lifetime.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"b738c433-1044-586b-1925-e173abf06c91","text":"Pedicled digital artery perforator flaps provide a versatile option for the reconstruction of fingertip and thumb tip defects. Various flap options are available for use depending on the reconstructive need. They are quicker and easier to perform than free flaps and can provide excellent outcomes in suitable cases.","title":"Homodigital Pedicled Digital Artery Perforator flaps for fingertip reconstruction - a review of flap options"}
{"_id":"b73aef75-6a99-b6a3-d659-e6c29bd14d66","text":"The desire of many to look young for their age has led to the establishment of a large cosmetics industry. However, the features of appearance that primarily determine how old women look for their age and whether genetic or environmental factors predominately influence such features are largely unknown. We studied the facial appearance of 102 pairs of female Danish twins aged 59 to 81 as well as 162 British females aged 45 to 75. Skin wrinkling, hair graying and lip height were significantly and independently associated with how old the women looked for their age. The appearance of facial sun-damage was also found to be significantly correlated to how old women look for their age and was primarily due to its commonality with the appearance of skin wrinkles. There was also considerable variation in the perceived age data that was unaccounted for. Composite facial images created from women who looked young or old for their age indicated that the structure of subcutaneous tissue was partly responsible. Heritability analyses of the appearance features revealed that perceived age, pigmented age spots, skin wrinkles and the appearance of sun-damage were influenced more or less equally by genetic and environmental factors. Hair graying, recession of hair from the forehead and lip height were influenced mainly by genetic factors whereas environmental factors influenced hair thinning. These findings indicate that women who look young for their age have large lips, avoid sun-exposure and possess genetic factors that protect against the development of gray hair and skin wrinkles. The findings also demonstrate that perceived age is a better biomarker of skin, hair and facial aging than chronological age.","title":"Why Some Women Look Young for Their Age"}
{"_id":"b7475858-f2cb-738f-e801-c3e620329012","text":"The study has two basic limitations. The first limitation is that the study could not able to whether the morbidity results to score lower BPI or the morbidity comes because of the lower BPI. Recall bias and the secondary nature of data sources might impose some risk of bias for the actual estimation of the outcome of interest.","title":"Higher breastfeeding performance index is associated with lower risk of illness in infants under six months in Ethiopia"}
{"_id":"b74f75cc-64b1-acce-08dd-0c80677296b7","text":"Biologic drugs are used for moderate to severe HS or in nonoperable patients, and have shown promising results.8 However, they are speculated to be associated with increased risk of nonmelanoma skin cancer due to their immunosuppressive properties. Further, it is well known that chronic skin inflammation is linked to higher risk of malignant transformation as our case supports. Further research focusing on the risk of developing SCC in HS patients is needed to elucidate whether long‐term treatment with biologics may lead to prevention or promotion of malignant transformation of chronic skin inflammation. Our patient did not receive biologic therapy.","title":"Fatal outcome of malignant transformation of hidradenitis suppurativa: A case report and literature review"}
{"_id":"b7512281-ac9c-1ec1-dc12-e4e2bd278119","text":"Free tissue transfer is a feasible option and we advocate for its use as the primary method for repairing large scalp defects. As techniques improve and technology continues to advance, immediate postoperative morbidity from microvascular free tissue transfer will likely decrease. A prospective study should be conducted to evaluate further differences in each group. A multicentered study would likely be necessary to obtain a signification number of patients to adequately evaluate each surgical option.","title":"Evaluation of Options for Large Scalp Defect Reconstruction: A 12-Year Experience Eck et al"}
{"_id":"b755088e-67ee-5c18-6975-fef0ee8c0b07","text":"Whenever dysphagia occurred in our patient series its duration was limited from several days to 2 weeks maximum.","title":"Dysphagia in cervical dystonia patients receiving optimised botulinum toxin therapy: a single-center retrospective cohort study"}
{"_id":"b7593048-d5d7-f4ad-7030-576f9e75cf94","text":"Whereas others reported that they did not believe that their leadership behaviour had changed although they were able to reflect upon leadership styles:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"b763b05a-06f1-fee4-2ecb-b6a9d08c5767","text":"Removing the risk factors and an early detection of clinical aspects may facilitate the diagnosis leading to a great treatment plan that can quickly improve the clinical condition of the patients. The pediatric dentist could make an early diagnosis during the clinical examination by evaluating the presence of a short lingual frenulum and an oral malocclusion [8].","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"b76a7cd0-2420-2ee1-7d25-a8ed1b6dbaf9","text":"We hypothesized that the occurrence of M. chelonae in farmed sturgeons was only a secondary event related to its presence in a stressful rearing environment and subsequent to a dystrophic calcinosis occurred in previously damaged tissues.","title":"Mycobacterium chelonae associated with tumor-like skin and oral masses in farmed Russian sturgeons (Acipenser gueldenstaedtii)"}
{"_id":"b76b163e-86c6-f761-c753-42f59384b651","text":"It appears that immunosuppression is indeed a risk factor for worse outcome among cSCC patients, and that these patients seem to experience better outcome when treated with adjuvant radiotherapy, thereby justifying the recommendation of the NCCN to consider adjuvant radiotherapy in these cases.","title":"The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer"}
{"_id":"b76b1eeb-91fc-fd99-5723-7ec8645fa6c8","text":"Achieving a level of technical skill and confidence in surgical operations is the main goal of plastic surgical training. Operating rooms were accepted as the practical teaching venues of the traditional apprenticeship model. However, increased patient population, time, and ethical and legal considerations made preoperation room practical work a must for plastic surgical training. There are several plastic surgical teaching models and simulators which are very useful in preoperation room practical training and the evaluation of plastic surgery residents. The full thickness skin with its vascular network excised in abdominoplasty procedures is an easily obtainable real human tissue which could be used as a training model in plastic surgery.","title":"Excised Abdominoplasty Material as a Systematic Plastic Surgical Training Model"}
{"_id":"b774f3c5-a795-4aa7-f836-9fae1c9df56a","text":"One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Our study aims to review the currently available evidence from randomized trials regarding duration of both parenteral and oral therapy for pediatric acute osteomyelitis.","title":"Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol"}
{"_id":"b7830234-0011-9ac7-d458-471028281db5","text":"Radiotherapy is rarely used as a primary treatment modality instead of surgery which is the curative treatment of choice for all types of primary melanoma lesions. Poor performance status of the patient with severe comorbidities or refusal of proposed surgery are potential but less plausible motives in clinic for replacing surgery with radiotherapy.","title":"Role of radiotherapy in melanoma management"}
{"_id":"b7842ea4-bc6e-b14e-4a5f-c4f71a3148ae","text":"Obviously, the current findings would contribute to the body of evidence regarding the use of preoperative mechanical thromboprophylaxis to lower the incidence of VTE further following HFS in elderly patients. However, well-controlled prospective studies or large multicenter studies are needed to draw conclusions on the efficacy of preoperative mechanical thromboprophylaxis in these patients.","title":"Does preoperative mechanical prophylaxis have additional effectiveness in preventing postoperative venous thromboembolism in elderly patients with hip fracture?—Retrospective case-control study"}
{"_id":"b78c0b65-cf37-ce23-6d3f-8b2e38d2d7ac","text":"Most of the skin resection patterns can be combined with most pedicles.","title":"Reduction mammoplasty"}
{"_id":"b78f1f8a-7549-fd8c-ca6c-c029b1ab9904","text":"This case report highlights an uncommonly reported situation of a patient who develops vertebral osteomyelitis without a definitive source of infection. When implanting a foreign body, deep infections are a possible risk that requires immediate attention from clinicians. If there is a concern for osteomyelitis radiographically, even in an uncommon situation when a medical workup returns inconclusive, explant of the SCS and administration of antibiotics is warranted. A thorough assessment of infection clearance must be carried out prior to any consideration of re-implant of the SCS.","title":"Lumbar Spine Osteomyelitis After Permanent Spinal Cord Stimulator Implantation: A Case Report"}
{"_id":"b790777e-34da-3ac7-287f-814b19c5e52a","text":"These data place our center as the Italian reference center by numbers of patients for the cryopreservation and transplantation of ovarian tissue. Many European hospitals and fertility centers have included OTC in their fertility preservation programs alongside commonly used methods, with about 23 ovarian tissue banks distributed in these countries (21).","title":"Ovarian tissue cryopreservation and transplantation: 20 years experience in Bologna University"}
{"_id":"b7911c86-1f67-d7a5-0296-20d1c66fc715","text":"The goals of wrist joint reconstruction with a vascularized fibula free flap following en bloc GCT resection include restoration in range of motion and strength, minimizing instability and pain, and preventing recurrence. The literature describes the technique of arthrodesis with a vascularized graft of the fibula shaft as a more useful and reliable procedure for reconstruction of the wrist after excision of the GCT in the distal end of the radius compared to wrist arthroplasty with the vascularized fibular head.10-14","title":"Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius"}
{"_id":"b791d84c-fbd8-270d-d977-ec3de2326c10","text":"The records of 1087 patients undergoing surgical removal of third molar teeth were prospectively collected. This included 569 cases in which the removal of third molar teeth in outpatients was performed by three specialists in surgical dentistry in the Department of Oral and Maxillofacial Surgery, Eastman Dental Hospital, London. The prospective records of 518 cases in which the same procedure was performed during the same period by 4 residents (senior house officers) in oral and maxillofacial surgery were also recorded. The cases were analysed to examine incidence of any postoperative complications.","title":"Experience versus complication rate in third molar surgery"}
{"_id":"b79c6de7-ad80-0847-a8d2-f7bdc8c2eb5c","text":"We feel that our novel approach provides several advantages over other methods of treating this disease. With delayed bone resection and flap coverage, we had none of the previously decreased wound healing complications like seroma or hematoma or surgical site infections described with immediate bone resection and flap coverage. We feel that the viability of bony structures can be more easily assessed at the time of the second operation when purulent material has been adequately drained and inflammation has decreased. Also, delayed resection allows time for culture results and sensitivities from the initial debridement to return so that antibiotic therapy can be appropriately targeted in the interim if the offending microorganism is not known preoperatively. This prevents wound closure in the setting of the infected field if the patient is on inappropriate antibiotics, predisposing the patient to wound complications. Although not proven, we strongly feel that the vascularized muscle flap itself provides the additional benefit of direct antibiotic delivery to the site of infection once the flap is in place, which helps to eradicate the remaining microorganisms and obliterate dead space. Also, delaying bone resection and flap coverage allows time for pathologic confirmation that the affected bone is free from malignancy, which could alter surgical plans.","title":"Treatment of Sternoclavicular Joint Osteomyelitis with Debridement and Delayed Resection with Muscle Flap Coverage Improves Outcomes"}
{"_id":"b7a25fb1-c3d7-ed92-6712-550d8d79edf5","text":"Besides larger lesions, PDT is also not indicated for metastasizing tumors. Almost all clinical studies exclude patients with tumor metastasis as it is almost impossible to reach those tumors with light. Metastasis remains one of the largest challenges in cancer therapy and PDT is no exception.","title":"Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions"}
{"_id":"b7a99b3f-6ecc-a9f8-ab56-7fc155d80fc8","text":"CT scan with sagittal and coronal reconstructions may be needed to assess if there is spinal instability. A SINS classification can be helpful when determining the stability of the spine. If there is a posterior wall defect or pedicle\/facet joint involvement, then CT can determine the safety of cement placement within the vertebral body. If patients get a recurrence of pain after a successful cement augmentation, then sagittal T1 and STIR images of the spine should be repeated to see if there is a new fracture that could develop following myeloma treatment.","title":"The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG)"}
{"_id":"b7aa8010-1f45-6495-edfc-1e23589836e8","text":"Limitations of this study include a low overall response rate and the possibility that information reported by the participating radiation oncologists does not truly represent their practice. Nevertheless, surveys have been used previously to more broadly understand the scope of practice within various medical fields including radiation oncology [20-22]. This questionnaire was not formally validated and was only sent three times to potential participants, which may have contributed to the relatively small number of participating physicians. It is also likely that physicians who do not treat breast cancer were also less likely to respond to the survey limiting the potential number of respondents. As most of the participants were members of ASTRO and the instrument was written only in English, our findings emphasize the perspectives of English speaking physicians who are mostly American. Furthermore, willing participants may have had a greater interest in radiation and reconstruction due to frequent experience with reconstruction in their patients. Therefore, the study results could be biased to reflect the views of physicians frequently encountering reconstruction although an effort was made to assess respondents based on the rate of reconstruction seen among breast cancer patients in their radiation center. Results regarding treatment of the reconstruction were purposely limited to radiation oncologists who see patients with breast reconstruction to determine the current practice of those physicians, as data regarding radiation management of breast reconstruction is lacking. The study was admittedly limited to radiation society membership lists and e-mail addresses to which we had access, resulting in poor response rates from physicians located in South America, Asia, and Africa.","title":"Breast reconstruction and post-mastectomy radiation practice"}
{"_id":"b7aeaf99-b71f-bd64-a35c-3a027789c8cf","text":"We successfully achieved limb salvage for a complex femoral defect after osteosarcoma resection. The defects of the femur and the femoral vessels were reconstructed with bilateral FVFG and autologous vein grafts, respectively.","title":"Simultaneous reconstruction of the bone and vessels for complex femoral defect"}
{"_id":"b7b27794-2e38-6e72-2f5d-2deb33d96fe9","text":"Computed tomography (CT) is useful for assessment of bone stability and fracture healing. It can identify small sequestra. If fludeoxyglucose positron emission tomography computed tomography is available, this can provide accurate targeting of infected areas particularly when there is widespread abnormality in the bone morphology or in the presence of metalwork. It can help determine if segmental or a more limited excision is required. Radiolabeled white cell scans alone are not useful as they have a low specificity. 22","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"b7bd39e4-0ff0-1e6c-2096-093894db6c59","text":"All authors have significantly contributed to the manuscript and all agree with its contents. All authors have read and approved the manuscript. Authors do not have any relevant financial interests in the findings from this manuscript.","title":"Sentinel lymph node biopsy in melanoma: Our 8-year clinical experience in a single French institute (2002–2009)"}
{"_id":"b7c2dfb3-1f1e-f2fd-aa8b-54fb3944a2d7","text":"All adult patients undergoing elective vascular procedures with incisions for arterial exposure at the lower limb are eligible to participate.","title":"Incisional negative pressure wound therapy for the prevention of surgical site infection after open lower limb revascularization – Rationale and design of a multi-center randomized controlled trial"}
{"_id":"b7cc3de3-b665-0971-22f8-5760228f03b7","text":"2D liver borders are eliminated employing a fast marching level set technique on the CTA abdominal picture by characterizing liver borders as the reproducing front final location. The vascular centerline is determined using a subvoxel precise skeletonization method. The centerline can be computed as the cheapest path between an ending point and a beginning point by performing a gradient descent over the fast marching distance map.","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"b7cdff36-63aa-91f2-d98a-7a6b454b5e0d","text":"Table 2 depicts a summary of primary studies on PDT in pleural malignancies.","title":"Photodynamic Therapy in Non-Gastrointestinal Thoracic Malignancies"}
{"_id":"b7d068da-bd11-4f36-ea3a-deeaba7cc8ae","text":"The patient was offered cryosurgery or electrocauterization to remove bothersome lesions as she wishes.","title":"Blue Rubber Bleb Nevus syndrome: case report from Syria"}
{"_id":"b7d74d12-87c5-04ab-ea38-8855ca652e3c","text":"OBJECTIVES Randomized phased arrays have been used for generating and steering single focus and multiple foci with low levels of grating lobes due to the breakage of periodicity of the elements and are considered as useful source of HIFU. However, the reliance of HIFU on MRI for real time visualization of the targeted tissue is a major constraint in its clinical use due to the high cost of MRI and its low temporal resolution. There is a need to study the imaging capabilities of a therapeutic random phased array transducer for guiding the treatment process.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"b7d88fcd-18a1-6079-f184-d16d89b53fb4","text":"Most adnexal carcinomas of the skin are highly malignant and difficult to diagnose clinically or even histologically.","title":"Adnexal carcinomas of the head and neck"}
{"_id":"b7dbea2c-3f2d-5dac-f6dd-ed63ee32b7d7","text":"The use of soft tissue fillers for facial rejuvenation is increasing rapidly and the complications, unfortunately, follow the same path. Blindness caused by intravascular filler injections is a rare but devastating complication. Knowledge of the individual arterial anatomy may aid the injector in avoiding injecting into an artery and thus to prevent blindness.","title":"The Usefulness of Magnetic Resonance Angiography to Analyze the Variable Arterial Facial Anatomy in an Effort to Reduce Filler-Associated Blindness: Anatomical Study and Visualization Through an Augmented Reality Application"}
{"_id":"b7e26bba-f925-dd23-d26b-9bdd730f68ba","text":"We report a case in which a patient receiving paliperidone palmitate, an LAIA, experienced septic shock related to an unidentified abscess associated with the injection site of the medication. This case reminds clinicians that injection site reactions are possible with all LAIAs and that injection site infection should be ruled out when a patient presents with sepsis. Due to the limited data published on injection site reactions, clinicians should continue to report such events. Further study is required to assess if antipsychotics with alpha-adrenergic blockade affect vasopressor requirements in the setting of severe sepsis.","title":"Paliperidone Palmitate Associated with Necrotizing Deep Tissue Infection and Sepsis Requiring Surgical Intervention"}
{"_id":"b7e57efc-f669-3d47-c71e-c30c17214c90","text":"In summary, we have described a successful reconstructive technique using a pectoralis major flap combined with gastric pull-up for patients with advanced SCCHP after total laryngopharyngoesophagectomy. The functional and oncologic outcomes from this study suggest that this combined flap technique is a reliable method for reconstruction for patients with advanced SCCHP after radical resection. Furthermore, as gastric pull-up alone may be insufficient to restore intestinal continuity in patients with a small stomach or whose resections extend farther than the level of the tongue base, the pectoralis major flap might be routinely considered as an additional flap for patients undergoing gastric pull-up after total laryngopharyngoesophagectomy.","title":"Combined use of gastric pull-up and pectoralis major flaps for massive defects after total laryngopharyngoesophagectomy in patients with advanced hypopharyngeal carcinoma"}
{"_id":"b7e62632-f629-c1d1-9eec-8166ed8c1331","text":"In this study the decrease of leukocytes count to 3 000 during the IFN combination treatment was observed one time in a single case. ASAT values were increased in a single occasion in two patients and never duplicated the values during the IFN combination treatment.","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"b804664d-965b-8449-8f45-3fd67fed7957","text":"The ROC curves for changes in DeoxyHb at the calves and feet and changes in oxygen saturation at the feet are shown in Figure 4. The ROC curves were only calculated for parameters that were significantly different between limbs with and without clinical improvement.","title":"Detecting Changes in Tissue Perfusion With Hyperspectral Imaging and Thermal Imaging Following Endovascular Treatment for Peripheral Arterial Disease"}
{"_id":"b808e318-d977-220c-7c23-cd7d4853f57f","text":"As we consider the anatomy of the breast, the vascular supply comes from the internal mammary vascular system with a contribution from the superficial branch of the lateral thoracic artery and some branches of the thoracoacromial pedicle.","title":"The McKissock's technique in reduction mammaplasty: A comparative study of outcomes and complications in 211 consecutive patients"}
{"_id":"b80e0e3a-3f2e-0df2-9d17-4b38fe77d64c","text":"This study is limited by a small sample size of 15, predominantly male, White, and older than what may be representative of other PWID populations within NYC or the U.S. Potential bias in participant responses could have occurred given participants were recruited and interviewed in a medical setting, and a member of the research team conducting the interviews included a medical doctor. Convenient recruitment of participants may introduce bias and limits generalizability of the results. Future work should aim to validate our proposed theory with larger samples and increased diversity within the participants.","title":"Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage"}
{"_id":"b8141537-789d-7dfa-393a-5e71d0faaef5","text":"The literature suggests that CT may be beneficial in confirming the diagnosis of mastoiditis in patients who do not present with a clear clinical picture.7 Future studies should examine scenarios in which CT can be avoided altogether in patients with acute infection and when head CT alone or other lower-radiation temporal bone CT techniques may be sufficient, thereby limiting radiation exposure if surgical intervention is unlikely. Additionally, recognizing the clinical signs and symptoms associated with acute infection of the temporal bone can help guide initial medical management in the emergency setting for situations when surgical intervention may be delayed or unnecessary. The literature suggests that uncomplicated mastoiditis, meaning no neurologic deficits or sepsis, should be managed with intravenous antibiotics, and CT temporal bone should only be obtained if deterioration or lack of clinical improvement is observed.15,16 Of note, no patients in our cohort had sepsis, which would have allowed us to further assess the utility of CT temporal bone specifically among patients with this acute concern. Operative intervention should be considered as a reasonable next step following medical management in such cases of disease progression or lack of improvement.21","title":"Utility of Temporal Bone Computed Tomography in Pediatric Emergency Medicine"}
{"_id":"b818b9f0-4375-3bea-cb77-7a172d51e75e","text":"Many factors can impact the feasibility and accuracy of SLNB after NAC, including the status of the axillary lymph nodes, and it is therefore necessary to know whether SLNB after NAC for node-positive breast cancer patients is accurate or not. The crucial issue is whether SLNB for such patients can achieve outcomes comparable to those in clinically node-negative patients without chemotherapy. The patient selection criteria as well as the technique of mapping and detecting the metastasis of sentinel lymph nodes vary across individual studies; thus, it is difficult to determine individual patient approaches in clinical practice. This systemic review attempts to collect data for evaluation.","title":"Feasibility and Accuracy of Sentinel Lymph Node Biopsy in Clinically Node-Positive Breast Cancer after Neoadjuvant Chemotherapy: A Meta-Analysis"}
{"_id":"b819c7ac-41ed-a8fa-d55e-5788a88f7cb4","text":"preoperative chemical component separation with BTA is a safe and effective adjunct to hernia repair in CVH repairs where a challenging midline fascial approximation is anticipated.","title":"Preoperative botulinum A toxin as an adjunct for abdominal wall reconstruction: a single-center early experience at an Academic Center in New York Toxina botulínica A pré-operatória como adjuvante na reconstrução da parede abdominal: experiência inicial em Centro Acadêmico em Nova York"}
{"_id":"b81bbf36-6d27-5f2a-8408-0640b0f32fdc","text":"Osteomyelitis is an inflammation of bone and bone marrow that develops in the jaws usually after a chronic infection.It may be classified as acute, subacute or chronic osteomyelitis depending on the clinical presentation. Osteomyelitis of the mandible is rare in developed countries and can be attributed to increased availability of antibiotics and higher standards of oral health. The incidence of osteomyelitis may increase in remote rural and regional centers in developing countries because of inadequate access to oral health care professionals. The typical age of presentation is in the fifties to the sixties with males more likely to be affected. Predisposing factors include radiotherapy (osteoradionecrosis), immunocompromised, uncontrolled diabetes and patients on immunosuppressive therapy.","title":"Chronic Suppurative Osteomyelitis of Subcondylar Region: A Case Report"}
{"_id":"b82eb5a9-963d-8b33-9afe-9f41566e20c2","text":"In the skin complications after dermal filler treatment, marked pain and characteristic reticulated erythema in the skin distribution of the affected vessels is often developed. Due to the implementation of our protocol in these patients, we managed to avoid an irreversible necrotic complication of the face in both cases.","title":"Early hyaluronidase use in preventing skin necrosis after treatment with dermal fillers: Report of two cases [version 2; peer review: 2 approved"}
{"_id":"b83de51b-79b8-47e3-a1e9-33a78ff04fb8","text":"Where there are drug interactions, a switch to a more suitable option is necessary, however we recognize that there are not many alternative therapies for treatment of DVT; therefore this may not be practical. Newer drugs like factor Xa inhibitors also pose a challenge due to drug-drug interactions in patients on TB treatment and ART as is the case of warfarin. LMWH which is the recommended anticoagulation therapy in patients with cancer, may be suitable for this patient population, an area that also needs to be explored further considering the similar mechanisms of thrombosis involving an increase in inflammatory markers.","title":"Challenges in achieving a target international normalized ratio for deep vein thrombosis among HIV-infected patients with tuberculosis: a case series"}
{"_id":"b83f1173-b6dd-663c-8742-57baed93f28e","text":"All patients with suspicious clinical breast findings and normal imaging who underwent a clinical core and\/or cutaneous punch biopsy from 2012 to 2019 were reviewed retrospectively. Patients with subsequent breast malignant diagnosis were analysed.","title":"Clinically guided core biopsy and cutaneous punch biopsy in the evaluation of breast lesions: a necessary test or an obsolete skill?"}
{"_id":"b84664b3-7f49-3c16-5bca-700cc9001f32","text":"The first dose of study medication was administered at the study site. Subjects were required to remain at the study site for 20 to 30 minutes after administration of the first dose to monitor for any AEs. Subsequent treatments were self-administered by the subject once daily at home. Eating and drinking were not allowed for 5 minutes after administration. If any significant adverse event such as wheezing, dyspnea, severe oral swelling, or sign of generalized anaphylactic reaction was observed or reported, the investigator was to evaluate the subject to determine whether treatment should be initiated; in such cases the observation period was to be extended for at least an additional 30 minutes, and upon leaving the clinic the subject was instructed to contact the clinic immediately if the reaction reoccurred or a new reaction appeared.","title":"A phase 3 trial assessing the efficacy and safety of grass allergy immunotherapy tablet in subjects with grass pollen-induced allergic rhinitis with or without conjunctivitis, with or without asthma"}
{"_id":"b8504af7-fdb1-27b8-c6b1-096bb5e60ec7","text":"Although it is commonly anticipated that experience plays a major role in medicine and specifically in plastic surgery, our data further support the expectations in a single-surgeon study. Experience is a key factor in improving the quality of treatment in breast reconstruction. With an increase in experience comes a decrease in operation time and length of hospital stay. Although microsurgery and breast reconstruction are difficult to master, persistence and further performance of surgeries seem to improve the surgeon’s skills in favor of the patients as well as the overall experience of the medical institution.","title":"Breast Reconstruction with DIEP Flap: The Learning Curve at a Breast Reconstruction Center and a Single-Surgeon Study"}
{"_id":"b8570240-131d-34cb-830c-952bc0765bf7","text":"Table 2 Sonomorphological characteristics of the lymph nodes which were further assessed with fine-needle aspiration cytology","title":"Fine needle aspiration cytology of lymph nodes in breast cancer follow-up is a feasible alternative to watchful waiting and to histology"}
{"_id":"b857d7d5-dfb9-7082-4279-582499b4814f","text":"The aim of this study was to select specific characteristics of spheroids before implantation that would be a predictive marker for the regeneration potential of spheroids after implantation. Neither general spheroid characteristics as spheroid size or cellularity, nor the gene expression of the chondrogenic markers ACAN, CRTAC1 or S100B were a predictive marker for the potency of the cartilage cell transplant. These spheroid characteristics did not correlate to the level of tissue regeneration in the condyle chip model after co-cultivation for 12 weeks, as shown using the Spearman’s correlation test. Although it was shown that spheroids of different donor samples produce different amounts of GAGs and the ratio of bound to released GAG (per spheroid) showed a trend of a positive correlation with tissue regeneration capacity of spheroids, this could not be confirmed by Spearman’s correlation test that only showed a trend and not a statistical significant correlation.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"b863601b-7c23-a3f1-b3dc-427f61cb9da1","text":"It is important to note that the management of DFSP should be individualized, and treatment decisions should be made in consultation with healthcare professionals experienced in managing the disease. Regular follow-up and monitoring are crucial for detecting any signs of recurrence or metastasis.","title":"Advancing Cancer Research: Current Knowledge on Cutaneous Neoplasia"}
{"_id":"b86d3d12-f48c-aeee-a11c-bee291d17ece","text":"Costal cartilage is often employed as an accessory to enhance the mechanical strength of the implant and plays a supporting role similar to that of tracheal cartilage. In addition to costal cartilage, there is also nasal septum cartilage and other cartilages. However, these materials are more commonly used in tissue engineering as a source of preseeded cells.","title":"Reconstruction of the trachea and carina: Surgical reconstruction, autologous tissue transplantation, allograft transplantation, and bioengineering"}
{"_id":"b86f4298-1f74-dedb-22ef-1a780f3455da","text":"In this review, a total of 15 articles of 15 different studies were included for final analysis (Figure 1). The different search methods provided a total of 1578 records at first. Searching the PubMed database gave 515 results, whereas a comparable search in the EMBASE database resulted in 410 hits. The systematic search in the Web of Science databases resulted in 653 records. To be sure that no important trials or studies were missed, the complete search was also controlled and executed by a librarian of the Maastricht University. After adjusting all duplicates, this search gave 1245 results. These results were assessed on their titles and 1119 studies were discarded because of different reasons. Of the remaining 126 studies, 101 studies were excluded because the abstract showed they did not meet the eligibility criteria. After examining the full text articles of the 25 remaining articles, 10 articles were excluded because of different reasons. Three studies were excluded because they treated infected ulcers in diabetes treatment and no osteomyelitis; four studies were discarded because full text was not available; one study was excluded because the study only reported in vivo elution characteristics and the last two studies were excluded because they were congress abstracts without an article.","title":"Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis"}
{"_id":"b8777b34-f993-f935-411e-c1fa29b756ab","text":"In this study we retrospectively analyzed our aggregate experience of using the Ilizarov method and external fixation for the purposes of femoral lengthening, deformity correction, and repair of nonunions and bone defects.","title":"Femoral Reconstruction Using External Fixation"}
{"_id":"b87b4813-463d-f6a0-45eb-114cea6c1a03","text":"Regional flaps, such as the paramedian forehead flap, are frequently employed to reconstruct the nose (Fig. 5).56,60 This interpolated flap, along with cartilage grafting, is used to provide coverage, lining, and support to the reconstructed nose in a 2-stage procedure. This procedure is considered to be the gold standard treatment for complex nasal reconstruction because it produces excellent aesthetic outcomes with minimal donor site morbidity.60 In addition to its efficacy, this procedure has demonstrated complication rates as low as 4%, making it a reliable and safe reconstructive modality","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"b87f4960-d5d0-cb3a-ae90-e675d88ab71a","text":"Written informed consent was obtained from the patients for publication. Institutional approval was obtained from the Institutional Review Board at Jordan University of Science and Technology. This study was conducted in accordance with the Declaration of Helsinki.","title":"Endoscopic dacryocystorhinostomy: A comparison of double-flap and single-flap techniques"}
{"_id":"b889d626-8c29-fc46-c9a8-04f7457313c8","text":"The radiolucent property of STS foam can be overcome by filling the dead space of the catheter with contrast and pulsed controlled injection under fluoroscopic guidance. Injecting foam distally can ensure smaller pelvic branches are effectively embolized. This technique followed by coil embolization has offered the best outcomes for patients.","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"b896377b-5fbd-c6db-195b-5ac5d4dda3f7","text":"The average time between ultrasound examination and surgery was 5 days.","title":"Accuracy of Pretreatment Ultrasonography Assessment of Intra-Abdominal Spread in Epithelial Ovarian Cancer: A Prospective Study"}
{"_id":"b8a52ac9-d3a0-5351-5924-0567135e89e0","text":"Data were collected using android devices and uploaded to a centralised server in real time using proprietary software. Extensive data quality checks were conducted by a dedicated quality control team ensuring data completeness and validity.","title":"Are we doing enough? Improved breastfeeding practices at 14 weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa"}
{"_id":"b8b5bffb-34a8-b9bb-8db7-734c12fb0de4","text":"There were 7 complications involving the skin envelope and wound. Superficial epidermolysis near the vertical scar occurred in 4 patients, and minor wound dehiscence occurred in 3 patients. Four of these complications were treated conservatively and 3 patients received a surgical revision. The two patients with exposition of the prosthesis underwent removal of the implant. Six months after implant removal one of these patients underwent a pedicled TRAM flap procedure, which maintains a cutaneous pad to replace the lost skin mound. The second patient refused to undergo autologous reconstruction and 6 months after removal received a tissue expander.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"b8b6e4c5-1469-d4b0-ffdc-b927bf116bf0","text":"Reconstruction can be performed immediately after debridement or may be delayed until other contributing factors are eliminated. Options low on the reconstructive ladder, such as primary closure and skin grafting, are less appropriate methods for closing a sacral wound. Primary closure of these wounds is avoided because of the high rate of recurrence with closure over the bony prominence. Skin grafting has a low success rate and is often precluded because of the frequent presence of a bony wound bed and the absence of adequate soft tissue bulk. Flaps are usually more efficacious methods of reconstruction as they allow vascularized tissue to facilitate wound healing and provide padding to redistribute pressure over the area. Common flap options for sacral pressure ulcers include musculocutaneous and fasciocutaneous flaps. Numerous random skin flaps and free flaps have also been described. The gluteus maximus muscle is used often for musculocutaneous flaps and may be designed as a rotation flap, advancement island flap, or split flap. Thoracolumbar, posterior thigh, extended tensor fascia lata, and total thigh flaps may be used when alternatives are necessary. Fasciocutaneous flaps, such as the superior gluteal artery perforator flap, have been proposed by some to have advantages over musculocutaneous flaps in the treatment of sacral pressure ulcers. Some of the considerations when choosing the appropriate flap include size and recurrence of the pressure ulcer, the ambulatory status of the patient, and prior surgeries performed to reconstruct the defect. Our preferred method of reconstruction is a gluteus maximus musculocutaneous V-Y patterned flap. A second option is a flap from the posterior thigh.","title":"Sacral Pressure Ulcer"}
{"_id":"b8ba790c-c030-36fb-7617-233d2df10312","text":"Primary and secondary intention wound healing is improved by targeting NETs through DNase1 treatment or genetic KO, as assessed by wound closure time and scar appearances. Additionally, wound stability was not affected by DNASE treatment. The results suggest that overall wound healing is accelerated and DNase1 appears to be a promising option to reduce scar formation; which should be evaluated in humans.","title":"Therapeutic Targeting of Neutrophil Extracellular Traps Improves Primary and Secondary Intention Wound Healing in Mice"}
{"_id":"b8c4a429-ac7a-bb45-b79f-87490a087860","text":"The aims of the present study were to define the number of women with screen-detected cancer with low-volume axillary disease (a single sentinel node with a macrometastatic deposit) who are found to have no further lymph node metastases on completion ANC, and to identify factors that may predict residual metastatic nodal burden upon subsequent completion axillary surgery. This could then be used to offer more informed treatment choices, such as the option to avoid completion axillary surgery after the initial finding of a single positive sentinel node in screen-detected invasive breast cancer.","title":"Residual lymph node tumour burden following removal of a single axillary sentinel lymph with macrometastatic disease in women with screen-detected invasive breast cancer"}
{"_id":"b8c623fc-d2fc-70b7-bed1-04af63e25663","text":"After operative exploration of the injured artery we proceeded with the debridement of the site of the injury. The distal part of the vessel routinely underwent thrombectomy with a Fogarty catheter to ensure sufficient backflow. Primary repair or primary anastomosis was practiced if it was not leading to any narrowing to the injury site or to undue anastomotic tension. If narrowing or tension were pending, a graft was inserted. Although an autologous saphenous vein graft from the contralateral site was our first choice, PTFE (Polytetrafluoroethylene) graft was used if the saphenous vein was unavailable, of the vein was of insufficient diameter or if the time needed to harvest the vein would be detrimental to the patient’s outcome. Whenever graft was used, great care was taken to cover it with viable muscle or other well perfused soft tissues available. In most cases venous injuries were dealt with by ligation. In cases of injury of large diameter veins which could be repaired by simple suturing, ligation could be avoided. We never attempted to repair any venous injuries by complex techniques, such as fashioning of a spiral graft. In all cases venous repair preceded the arterial one.","title":"Penetrating arterial trauma to the limbs: outcome of a modified protocol"}
{"_id":"b8c6ceec-404c-eb01-82ee-76168ecb9770","text":"'Also it is ordained that no person enfranchised of the craft shall take any apprentice before that apprentice has been presented to the masters or Governors to confirm that he is clean and without chronic disease or serious infirmity whereby the King's people might take hurt. The fine for failing to do so being 11 shillings.'14","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"b8cdc620-a908-bd67-d7e7-987b63352df1","text":"Cartilage grafts are generally accepted for the restoration and reconstruction of nasal contours. The main concern that plastic surgeons may need to address after surgery pertains to the resorption and disfigurement of the grafted cartilage, especially in allogenic and heterogenic grafts.","title":"Effects of the Human Amniotic Membrane on the Cartilage Graft: Prognosis and Absorption in White Rabbits"}
{"_id":"b8ce334a-5462-b98b-f4ca-7114a5fb54a6","text":"There has been a previous report of flap success despite accidental subcutaneous injection of low dose enoxaparin immediately adjacent to the perforators [16]. The authors commented that this was inappropriate and could have resulted in flap failure. Our cases extend the literature and confirm that local intraflap LMWH administration should not be considered an absolute contraindication for free flap harvest. If injections have been administered in the flap area, preoperative CT angiography [17] should be used to confirm the integrity of the intraflap vasculature prior to free tissue transfer. Despite clinically and radiologically evident bruising, while there is a theoretical risk of fat necrosis should perfusion be compromised, we have not experienced this in our clinical practice and estimate the probability of this to be low. To confirm the viability of the perforators selected for intraoperative use on CT angiography, we recommend the adjunctive use of a handheld Doppler probe immediately preoperatively. Importantly, it is also now our practice to advise patients to avoid injecting proximal to potential lower abdominal donor sites once a decision for DIEP flap harvest has been made and if local areas on one side appear bruised on clinical examination we consider using the vessels on the contralateral side, albeit keeping in mind the optimal perforator anatomy delineated by CT angiography.","title":"Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus"}
{"_id":"b8d4363b-f755-4970-4b65-6f73e602db83","text":"Except for four patients, a stable coverage could be reached in the first operation. Three of these patients received a local scalp rotation flap in the first operation and needed an additional free flap because the local flap was no longer sufficient for coverage after wound healing deficiency or tumor relapse. The superficial temporal artery or external carotid artery served as recipient vessels. In special cases, venous grafts or an arteriovenous loop (AV loop) were used as extensions for the recipient vessels.","title":"Reconstruction of composite defects of the scalp and neurocranium—a treatment algorithm from local flaps to combined AV loop free flap reconstruction"}
{"_id":"b8d49d93-bb54-f454-fa83-8bbad24017e1","text":"The relationship between allergen sensitization and allergic symptoms has numerous aspects that are currently under investigation. It is indeed one of the central interrogates of Allergy. Although intuitively logical that the stronger the sensitization the more probabilities of inducing symptoms, the problem is more complex and includes the conjunction of several predisposing and protecting factors related to the environment and the genetic background. However, since sensitization patterns, as well as other situations, are very unique in the Tropics, their study could help understanding the natural history of allergy and direct future research. In the following three sections we present the type and effects of sensitization on allergy symptoms under the particular conditions of the Tropics.","title":"Particularities of allergy in the Tropics"}
{"_id":"b8d68bff-b0fb-4439-4944-79cd822a2534","text":"The mitotic index is no longer used to classify T1 melanoma patients into T1a and T1b, so it should not be used to indicate sentinel node biopsy in these patients.","title":"How does the mitotic index impact patients with T1 melanoma? Comparison between the 7th and 8th edition of the American Joint Committee on Cancer melanoma staging system"}
{"_id":"b8e25085-91cf-4744-4369-e027ea71ada7","text":"Written informed consent was taken for the publication of this report.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"b8e80aa4-208b-700f-b3d8-9dc39e9cc51e","text":"The question remains whether local or systemic antibiotic prophylaxis is the best choice for reducing the risk of prosthetic vascular graft infection. When a local prophylaxis is used, the dose of antibiotic delivered to the operative site could be important in eliminating infections, as most of them are due to contamination at the time of implantation. Simple soaking in an antibiotic solution immediately prior to implantation is an easy way of impregnating the prosthetic graft that can be done extemporaneously by the surgeon himself. But during this procedure the risk of contamination of the graft increases.","title":"Systemic and local antibiotic prophylaxis in the prevention of Staphylococcus epidermidis graft infection"}
{"_id":"b8e81b8a-6643-4eb4-4ee8-aa67ec20f2f1","text":"Then asked if he could sense the irritation made by a piece of paper on the tip of his nose.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"b8ec6e19-7ea0-af22-f992-d7fe01506461","text":"In patients presenting with clinically or radiologically suspected inguinal nodal metastases there are two surgical treatment options: inguinal or ilioinguinal lymph node dissection. These procedures improve local control rates and provide prognostic information. The indications for either operation remain contentious, and they are both associated with a risk of significant morbidity.","title":"CT diagnosis of ilioinguinal lymph node metastases in melanoma using radiological characteristics beyond size and asymmetry"}
{"_id":"b8ef96f5-0242-4a39-2cee-d3656cecae6d","text":"Patients with cervical infection associated with refractory kyphosis deformities are difficult to treat. Rapid correction of refractory kyphotic curve increases the danger of spinal cord injury and paralysis. Moreover single-stage correction of refractory curves may expose the patient at a risk of implant failure secondary to high bone-screw corrective forces. Especially in infectious vertebra where most of the anterior and middle column are destroyed by the disease lesion, reducing the anatomy for adequate hardware purchase to maintain correction. The main objective of preoperative traction is to reduce major neurological risk while effectively obtaining correction at a regulated safe ways. In our spine department, halo-traction is part of normal routine when dealing with rigid kyphosis or other spinal deformities such as scoliosis and kyphoscoliosis.","title":"The pre-surgical role of halo-traction in patients with cervical infection associated with refractory kyphosis: a retrospective study"}
{"_id":"b8f618ec-5648-0671-b106-81e66bba0414","text":"The ARM technique is a good method to help distinguish the upper extremity lymphatic drainage system from that of the breast in the axillary region. The loss of ARM nodes could be correlated with lymphedema after axillary surgery. For patients who undergo SLNB, the ARM technique could assist in more precise SLN resection and avoid unnecessary nonsentinel ARM node resection. For patients who undergo ALND, ARM could help predict which patients are more likely to have a high risk of lymphedema by assessing the rate of residual ARM nodes. Patients with a decreased number of remaining ARM nodes in either the SLNB or ALND procedure are considered to be a high-risk group for lymphedema and should undergo early interventions to prevent lymphedema. However, we do not recommend preserving ARM nodes to prevent lymphedema in patients undergoing ALND because of issues related to oncologic safety issues. Finally, prospective studies are needed to find proper lymphatic tracers in cases where patients undergo ARM and SLNB procedures simultaneously.","title":"Using the axillary reverse mapping technique to screen breast cancer patients with a high risk of lymphedema"}
{"_id":"b900c66b-d763-f0c9-66ae-2b6212ea66f7","text":"With mainstream adoption of the concept that biofilm formation is the defining characteristic of chronic infection, the struggle to adequately define the term biofilm sharpened. Unreliable MIC information made it apparent that the gap between clinical microbiology and the reality of infection was wide and not well understood. In 2010, Springer Publishing released a book titled “Biofilm Infections,” which included an exhaustive list of in vivo models of chronic infection. Two years later, Williams and Costerton proposed that the use of planktonic bacteria to model infection in vivo may be a limiting approach to the study of chronic infection, quietly calling into question all but three of the models reviewed in 2010. Caution is warranted when disruptive concepts enter medical discourse; however, the term “prudence of the lowest order” may be appropriate here, if translation of biofilm science to clinical practice has lagged in development because of this caution. We contend that the clinical dogma of biofilm and planktonic bacteria being interchangeable scientifically or that these infections are binary in nature is profoundly misleading in infection research and must be challenged more loudly. By understanding the history of clinically relevant biofilm in both scientific and clinical contexts, we can provide a foundation to design more relevant and functional studies in the absence of clear definitions and regulatory guidance.","title":"Improve Integration of In Vitro Biofilm Body of Knowledge to Support Clinical Breakthroughs in Surgical Site Infection"}
{"_id":"b900dc30-013e-6ee4-c4ef-438ee069c7ca","text":"To repair soft tissue defects, a filleted flap was used for 1 patient due to complete loss of upper limb function, and we had to remove her upper limb. A pedicle latissimus dorsi myocutaneous flap was used in 1 patient because the soft tissue defect was relatively small. For the remaining 15 patients, free DIEP in combination with contralateral TRAM flaps were used; among those cases, a bilateral DIEP flap was used for 1 patient because both sides of the internal thoracic artery had been ruined by lesions in the distal end. A DIEP flap in combination with a free TRAM flap was used in another patient. Due to weak perfusion of the superior epigastric artery, we had to cut off the rectus abdominis and anastomose the inferior epigastric artery. A pure free DIEP flap was used in 1 patient due to the relatively small defect. In 12 patients, free DIEP in combination with pedicle TRAM flaps were used. The size of each flap ranged from 15 cm × 6 cm to 40 cm × 15 cm. All free flaps need recipient vessels in the chest wall or neck. Among the 15 patients for whom free DIEP flaps were used, the thoracoacromial artery and vein were used as recipient vessels in 3 patients, the lateral thoracic vessels in 2 patients, and the superior thyroid artery and jugular vein or branches in 3 patients. Branches of the thoracodosal artery and vein were used in 2 patients. Subscapular vessels were used in 1 patient. The transverse cervical artery and vein were used in 1 patient. The proximal part of the internal thoracic artery and vein was used in 1 patient. The bilateral proximal part of the internal thoracic artery was used in 1 patient due to the presence of two blood vessel pedicels, and thoracic vessels and lateral thoracic vessels were used in 1 patient due to the presence of two sets of blood vessel pedicles.","title":"Reconstruction of chronic radiation-induced ulcers in the chest wall using free and pedicle flaps"}
{"_id":"b9012b98-191c-a939-5822-0393dc709c45","text":"After a horizontal incision is made with a 15C blade in the middle of the stretched frenulum, the tongue is lifted to gently open the wound in vertical dimension to visualize layer of fascia. A small V-shape incision is made to perform superficial frenulectomy. Care should be taken not to damage the venous branches and the lingual nerves, as they run close to the midline. Another horizontal incision is made through the second layer and blunt dissection is performed through epimysium to reveal the anterior fibers of the genioglossus muscle. It is recommended to put one traction suture in the upper aspect of the wound to stretch the muscles (Figure 2).","title":"Miofrenuloplasty for Full Functional Tongue Release in Ankyloglossia in Adults and Adolescents—Preliminary Report and Step-by-Step Technique Showcase"}
{"_id":"b9020844-2acc-5412-5f2a-38d0fd5bf9c2","text":"If residual equinus is observed after the adduction of the foot and the varus deformity of the heel has been corrected, a simple percutaneus tenotomy of the Achilles tendon is performed. We prefer to perform the tenotomy in the operating room with the patient under general anesthesia, which allows optimal analgesia for the infant. This setting also provides the surgeon with the controlled environment; with hopefully optimize the safety of this procedure. This approach differs from the Ponseti [4] who prefers that the Achilles tenotomy should be done in the clinic with topical and\/or local anesthesia. Tenotomy is performed when 15 degree of the dorsiflexion is not obtained with the use of casts after correction of varus and adductus deformities. After the tenotomy, an additional long leg cast with knee flexed in 90 degree is applied and left in place for three weeks to allow for healing of the tendon.","title":"Mid-term results of ponseti method for the treatment of congenital idiopathic clubfoot - (A study of 67 clubfeet with mean five year follow-up)"}
{"_id":"b9052065-6e42-0e79-a310-9e61931f2a49","text":"Two 4-mm skin punch biopsies are taken under local anesthesia, including one from active psoriatic skin and one from clinically healthy skin neighboring the psoriatic biopsy area with a minimum distance of 2 cm from the psoriasis biopsy. The biopsy locations have the same priority for body sites as the skin swabs. After collection, biopsies are immediately cut in two parts and processed separately for RNA sequencing and immunohistochemistry.","title":"Multiscale Biology of Cardiovascular Risk in Psoriasis: Protocol for a Case-Control Study"}
{"_id":"b90d27d6-afb6-ee49-e9c4-4ca0086beaf4","text":"The incidence of skin cancer is increasing globally. Various studies from Nepal has also shown an increasing trend in skin cancers. Skin biopsy is a simple and inexpensive procedure, which identifies the architectural pattern of tumor and growth of infiltration to distinguish the malignant tumour. It is important to diagnose the malignant skin tumors due to its therapeutic implications and aggressive nature. Management of benign tumors are usually done for cosmetic reasons.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"b910b67e-7275-74e7-9a4c-03249d7314a4","text":"The aetiology, site, size and characteristics of the defect and surrounding area were analysed. In designing the flaps, the vascular axes and the distribution of the perforators which could sustain them were taken into consideration. A hand-held Ultrasound Doppler was used preoperatively and intraoperatively to detect perforator vessels in the donor site area. Perforator artery selection before flap harvesting was based on vessel size and distance to the area of the defect. Once the perforator was identified, the flap was designed around the perforator or perforators according to the location and size of the defect. The dimensions of the flap were based upon the size of defect and the movement of the flap, taking into account the need to avoid excessive tension on the margins of the flap during suturing.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"b911df65-061d-4579-5eb2-7c20d8e29edc","text":"Involvement of infrapopliteal vessels that needs to be treated is common in Asian diabetics. While early limb salvage rates up to 1 year are similar, the 3 year limb salvage rates in Asian diabetics are lower than the western population.","title":"Critical limb ischaemia in a diabetic population from an Asian Centre: angiographic pattern of disease and 3-year limb salvage rate with percutaneous angioplasty as first line of treatment"}
{"_id":"b913acb2-b38a-8e15-a84f-4e1f828b0de8","text":"The color Doppler combined with the clinical diagnosis can reduce the number of negative explorations by the rate of 16 unnecessary explorations per 10 patients. This finding indicates that a combination of both the clinical tests and the color Doppler ultrasound will have a higher accuracy in detecting perforator incompetence. A combination of the clinical tests and the color Doppler assessment would amalgamate the benefits of both, a higher detection rate and a lower false positive rate, thereby reducing the number of negative explorations and disfigurement post surgery.","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"b919ab2c-f34d-c7b6-7599-3acf1f262525","text":"The patient was taken to the operating room and placed under general anesthesia in a prone position. The incision was made around the mass with 1 cm of skin margin. Dissection was carried out until reaching the calcaneus, where en bloc excision of the cutaneous mass was made, in addition to the macroscopically abnormal calcaneal bone, leaving in place the superior part of the calcaneal tuberosity that holds the Achilles tendon.","title":"Squamous Cell Carcinoma of the Heel Invading the Calcaneus Treated by Radical Excision and Reverse Sural Flap"}
{"_id":"b91fd0d4-4d08-da9a-151f-ac8bb16ed8e0","text":"The clinical presentations range from a painless palpable abdominal mass to bowel obstruction or perforation and chronic hydronephrosis due to ureteral infiltration.","title":"Multimodality imaging features of desmoid tumors: a head-to-toe spectrum"}
{"_id":"b91fde9f-a62c-1918-097b-5b201fceb269","text":"Within the limitations of this study, it can be concluded that flapless implant surgery results in lesser loss of marginal bone and also results in better patient comfort when compared with the flap technique, provided that proper patient selection is essential for carrying out flapless implant surgery.","title":"Clinical Evaluation of Placement of Implant by Flapless Technique Over Conventional Flap Technique"}
{"_id":"b9356870-3041-7c54-4120-df92a1205f3f","text":"Doi et al4 stated that functional LD island pedicle musculocutaneous flaps can be used to restore the flexion or extension of the wrist and digits. By retaining the facial origin of the LD from the posterior crest of the ilium, the entire muscle may be transferred without dividing its neurovascular pedicle and microneurovascular anastomoses. Its facial origin successfully reached the finger flexor or extensor muscles of the forearm. The transfers restored active finger flexion or extension.4 Favero et al5 stated that the transfer of functioning free muscle for the restoration of finger flexion is an uncommon procedure, and LD musculocutaneous free tissue transfer was performed in patients in an attempt to provide soft tissue coverage and active digital flexion. Although preoperative grip strength was doubled, postoperative strength was still only about 31% of that on the opposite side. All patients required at least 1 tenomyolysis or revision tenorrhaphy before the best clinical outcome was achieved.5 Chang et al6 ascribed upper extremity reconstruction to be very challenging owing to the unavailability of expendable local muscles.","title":"Case Report: Modified Latissimus Dorsi Muscle Transfer for Radial Palsy, Presentation of a New Technique"}
{"_id":"b935c495-9e57-a586-8d40-13bb64a175d3","text":"In osteonecrosis the success of interventions that forestall or prevent femoral head collapse and maintain hip function would represent a substantial achievement in the treatment of this disease. A review of recent literature regarding bisphosphonate, anticoagulant, and vasodilators and biophysical modalities have demonstrated efficacy in reducing pain and delaying disease progression in early stage osteonecrosis. Though it has been considered still insufficient, to support their routine use in the treatment or prevention of osteonecrosis of the hip. Core decompression with modification of technique is still one of the safest and most commonly employed procedures with evidence based success in the pre-collapse stage of AVN of femoral head. The additional use of bone morphogenic protein, and bone marrow stem cells may provide the opportunity to enhance the results of core decompression. At present, the use of large vascularised cortical grafts, the other surgical procedure with high success rate is still not common due to technical difficulty in surgery. Likewise osteotomies are also not getting common as arthroplasty is getting more acceptable, so is awaited without any intermediate big surgical interventions.","title":"Management of avascular necrosis of femoral head at pre-collapse stage"}
{"_id":"b936ba25-53e1-a5d2-f400-40e7c222c10f","text":"A secondary analysis was carried out to evaluate the risk factors for the development of local recurrence and metastasis in the group of patients with cSCC located in areas of low sun exposure, as well as the time from the moment of diagnosis of the primary cSCC and the appearance of local recurrence or metastasis. The period of risk for the development of a local recurrence or metastasis was calculated from the date of diagnosis of primary SCC to the date of last review, date of death or development of local recurrence or metastasis. A univariate analysis was performed to determine the variables influencing the prognosis in the subgroup of patients with cSCC in areas with low sun exposure.","title":"Increased Risk of Local Recurrence in Cutaneous Squamous Cell Carcinoma Arising in Sun-Exposed Skin: A Retrospective Cohort Study"}
{"_id":"b94fb42d-f3fe-5731-58f8-37768b08cb25","text":"Cryotherapy should only be administered from 4 weeks (visit 2) onwards if in the opinion of the investigator this is in the best interests of the patient and after assessment of the response to topical treatment to date. Careful consideration should be given to delaying cryotherapy beyond 4 weeks where a response to topical treatment is observed in the interest of preserving the integrity of the randomised comparison. If a participant is unable to tolerate the allocated treatment, after dose modifications as appropriate, alternative treatment can be administered at the discretion of the investigator. For the purposes of the trial, early use (within 4 weeks of the start of randomised treatment) of alternative treatments and topical treatment switch to the opposite arm before 16 weeks is considered a topical treatment failure. Participants should continue to be followed up and receive vaccinations as per protocol.","title":"Human papillomavirus infection: protocol for a randomised controlled trial of imiquimod cream (5%) versus podophyllotoxin cream (0.15%), in combination with quadrivalent human papillomavirus or control vaccination in the treatment and prevention of recurrence of anogenital warts (HIPvac trial)"}
{"_id":"b950aec4-1811-9c1e-ebf8-c3c529da03be","text":"All patients with chorionic osteomyelitis were underwent a staged operation procedure.","title":"Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis"}
{"_id":"b954d8eb-b209-05ef-6aa6-18a37a864e2c","text":"Fluid cartilage has the advantage of getting injected into the mucosa or skin in closed space and allowing the surgeon to incrementally fix the deformity, and to the extent desired with specific analysis of the changes in the surface.","title":"Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage"}
{"_id":"b95cad92-4621-7e26-15d8-67694888ab5a","text":"This case is educational as it shows that the treatment of breast cutaneous melanoma is similar to that for any skin parts with surgery remaining the main therapeutic option. It also shows that mastectomy is unnecessary as it does not improve the results obtained by wide local excision of melanoma.","title":"Primary cutaneous melanoma of the breast: A case report"}
{"_id":"b95e568a-9306-a8a3-e0f3-2e52fc1b8ef9","text":"Sperm cryopreservation incidence in TC confirms a trend toward a slight attenuation or plateau in the TC incidence rate. With regard to TC incidence, the Verhulst model seems more efficient than the Poisson model. As a matter of public health policy, it is important to follow up TC incidence and sperm cryopreservation so that the decrease in this disease can be confirmed or refuted. In the meantime, it remains and will always remain important to identify the causes of TC and trends in the incidence of the disease, and to protect the health and future fertility of young men.","title":"Sperm cryopreservation incidence in men with testicular cancer: towards a stabilization in testicular cancer incidence? Results from the CECOS network"}
{"_id":"b96282f6-4a4c-b2aa-aaba-db00284c9a6d","text":"Twenty fibula free flaps harvested from 10 fresh human corpses were enrolled. The number and type of skin perforators and their origin were recorded during the flap harvesting. After the completion of flap harvesting, the length of vascular pedicle and diameter of the artery and vein at the origin, the fibula length, the distance of the head of fibula to the site of peroneal artery bifurcation and harvesting time were also recorded.","title":"Evaluation of Anatomic Variations of Fibula Free Flap in Human Fresh Cadavers"}
{"_id":"b96ce210-ebb3-d4eb-0922-ae38dff929c6","text":"In the development of new technology for implantable neurostimulatory electrodes for the management of phantom limb pain in amputee patients, a design of a cadaveric model has been developed with detailed steps for innovative transfascicular insertion of electrodes. Overall design for electrode and cable implantation transcutaneous was established and an operating protocol devised.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"b9734fe9-fa95-0667-1984-f8bb49ca50d8","text":"The Tampere University Hospital Sarcoma Unit registry identified a total of 359 sarcoma patients from January 2006 through October 2013. This research was approved by the Tampere University Hospital Research Committee and a patient photography release consent form was obtained.","title":"Primary flap reconstruction of tissue defects after sarcoma surgery enables curative treatment with acceptable functional results: a 7-year review"}
{"_id":"b974b439-927f-0ad2-3352-c310c28adffd","text":"Results from the assessment of ALA-induced fluorescence are shown in Figure 4","title":"Enhanced effects of aminolaevulinic acid-based photodynamic therapy through local hyperthermia in rat tumours"}
{"_id":"b97ad940-85e4-5079-aa2f-c8c714bc3396","text":"In this study, the authors confirmed that both BTA and BTB can be used with no serious side effects when used for an LSB in patients with CRPS type 1 in their lower extremities. In terms of the duration of pain relief, BTB was found to be more effective than BTA. However, this research is limited in that it was a retrospective study and did not include many patients in the BTA group. A well-designed, randomized prospective study is needed to compare the effects of the two types of BT in LSB.","title":"Lumbar Sympathetic Block with Botulinum Toxin Type A and Type B for the Complex Regional Pain Syndrome"}
{"_id":"b97ca7fe-6117-2395-c9f8-5e1d772257b4","text":"The main complaint among these women was a palpable, painless mass of the breast. Two patients presented pain of the breast region, while one patient mentioned tenderness of the respective axilla. In 11 patients the mass was located on the right breast, while in the remaining 11 patients it was found in the left breast. The clinical examination revealed a solitary mobile tumoral lesion in all the patients, measuring between 3–12 cm. Three patients presented with dilated veins of the overlying skin and in one case bluish discoloration of the skin of the breast above the tumor was present. A palpable mass of the respective auxiliary region was observed in two women.","title":"Phylloides tumor of the breast: a rare neoplasm, though not that innocent"}
{"_id":"b97e5de3-9ec8-7985-4397-e61ff2d6b146","text":"This study is subject to a number of limitations. The chronic and recurrent nature of osteomyelitis dictates our inability to fully assess the eradicative capabilities of either material fully. Vancomycin, in the absence of a study control, could have contributed to the outcome resulting in infection eradication. To truly relate to the clinical setting, animals would require monitoring for subtle systemic compromise both with haematogenous and biochemical markers. To fully appreciate the characteristics of the composite in comparison to PMMA, one should conduct mechanical testing to fully evaluate both bone strength and stiffness in and around the defect. Finally, this study is comparing a ceramic to an acrylic material. As such, the resorptive and osteoconductive characteristics differ. Future efforts will focus on comparing bone void filling materials with similar characteristics in an infection model that may be more relevant to current surgical techniques.","title":"Vancomycin-laden calcium phosphate-calcium sulfate composite allows bone formation in a rat infection model"}
{"_id":"b980db31-3af7-da82-4e58-4bc342d0d249","text":"All patients were then contacted by a standardized telephone interview for an assessment of their long-term effects of the BoNTA treatments and their current health condition.","title":"Periorbital injections of botulinum toxin a: a novel therapeutic option for convergence spasm in neuropsychiatric disorders"}
{"_id":"b9832c85-1453-2ad5-eb37-d3b0d462d88a","text":"The same process of rotation and translation described for the conical hull is used to generate the flat-based hull. The convex hull of the tumor mesh and the origin is computed, and all lines connecting the focal point to the tumor 3D hull are extended beyond the most distant point (tumor or bone) within the hull profile. The lines are then shortened from the focal point until the position of each connecting line is equal to the minimum tumor value, effectively removing the tip of the cone. The planar facing cut requires no additional inputs and is calculated by discarding all healthy bone voxels with a position less than the minimum tumor value in the local coordinate space. The RG is then transformed back to the initial coordinate space.","title":"Automated elaborate resection planning for bone tumor surgery"}
{"_id":"b986a61f-632c-6cb9-b6f6-e03a285b16a3","text":"The datasets analyzed during this study is available from the corresponding author on reasonable request.","title":"The effects of intermittent negative pressure on the lower extremities' peripheral circulation and wound healing in four patients with lower limb ischemia and hard‐to‐heal leg ulcers: a case report"}
{"_id":"b98a7e73-75c4-7fc5-6b13-28826beef51f","text":"Locking compression plate in proximal tibia plateau fractures act as a good biological fixation provide stable fixation, articular reduction and limb alignment even in difficult fracture situations. Fixation of proximal tibia plateau fractures with plate gives excellent to good knee society score, faster union time with satisfactory functional and radiological outcome.","title":"Evaluation of Radiological and Functional Outcome of Intra-articular Proximal Tibia Plateau Fracture Treated with Plating"}
{"_id":"b98c42b8-5b9e-a6a9-dfb0-c16813fbcd1c","text":"Ultrasound guidance, HBV infection and the female sex were risk factors of LAST with LPBs and SNBs. For patients infected with HBV or female patients receiving LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator guidance should be used to improve the safety.","title":"Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial"}
{"_id":"b98cb37d-2774-1ba3-d514-843a4f832235","text":"In conclusion, the breast unit is moving towards a de-escalation of axillary surgery even in the setting of NAC. The results demonstrated that lymphatic mapping with SLNB maintained its expected staging and prognostic role. Sentinel lymph node biopsy is an acceptable procedure with a general good prognosis and low axillary failure rates in patients with cN0 or cN+ BC undergoing NAC who subsequently remained or became ycN0. The use of SLNB only in these patients did not translate into impaired oncological outcomes; however, further studies are needed to examine what effect lowering the FNR after SLNB only could have on the prognosis of these patients.","title":"Sentinel Lymph Node Biopsy in Breast Cancer Patients Undergoing Neo-Adjuvant Chemotherapy: Clinical Experience with Node-Negative and Node-Positive Disease Prior to Systemic Therapy"}
{"_id":"b99ef955-7dd3-15b0-c544-47cca72fbe92","text":"The case was discussed in the tumor board meeting and the decision was made to achieve an adequate loco-regional control by wide local excise. The operation was done in a left lateral decubitus position under general anesthesia with oro-tracheal intubation. Total excision of the lesion was done with a 2 cm free margin down to a deep sub-facial plane exposing the gluteal maximus muscle which was found to be free of the disease. The resultant soft tissue defect was covered with a split thickness skin graft taken from the left thigh. Part of the graft was lost because of a localized pseudomonas infection which healed completely with daily wound care and without surgical intervention. The final histopathology diagnosis was well-differentiated and well defined completely excised lipoma-like liposarcoma, therefore adjuvant radiotherapy was not indicated. The patient was followed for about 16 months showing no evidence of recurrence.","title":"Giant gluteal lipoma-like liposarcoma: a case report"}
{"_id":"b9a923fb-0e31-b1b6-cbae-a2b4d28f6bf5","text":"Dosage reduction or temporary interruption of AIT may be justified in the case of:","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"b9a9bc61-0b68-50a0-808c-16f1c1ef4ce5","text":"Around 10% of patients receiving epinephrine for anaphylaxis have a suboptimal response to a single dose of epinephrine, as assessed by a health care professional. These data are important in informing guidance on the provision of EAI for patients at risk of anaphylaxis in the community.Clinical implicationsAround 10% of anaphylaxis reactions are treated with more than 1 dose of epinephrine, including when the decision to administer a further dose was made by a health care professional.","title":"Use of multiple epinephrine doses in anaphylaxis: A systematic review and meta-analysis"}
{"_id":"b9abd951-779d-b530-9fc6-d413bfdd13d0","text":"In this technique, thin split thickness skin grafts are harvested from the pigmented donor area and transplanted at the recipient sites as continuous sheets of tissue grafts.","title":"TISSUE GRAFTS IN VITILIGO SURGERY – PAST, PRESENT, AND FUTURE"}
{"_id":"b9b45b5f-a336-4d65-bd6d-7fe639cf6ac3","text":"An excisional biopsy, a common alternative in neoplastic skin conditions, is performed when the entire tumour is needed for histopathological examination, or when melanoma is suspected. This depends on the size and location of the lesion and can be performed using a larger 4–6 mm diameter punch biopsy, a deep shave biopsy, or with a fusiform excision . These biopsy techniques coupled with histopathology are able to provide accurate diagnosis of the disease occurrence and progression, however the downsides of these techniques are that they require local anaesthesia and sutures in addition to the time required to carry out the procedure. Furthermore, samples are generally fixed with formalin that hinders molecular analysis. Molecular fingerprinting of skin disease has the potential to dramatically improve diagnostic sensitivity and open the door for personalised medicine . To date, there have been no reports on biomarker profiling of lesional samples in a prospective study due to the lack of suitable technologies to perform multiple sampling over time. This is due to the iatrogenic issue of cutting out the lesion through biopsy precluding further study of that lesion.","title":"Microbiopsy engineered for minimally invasive and suture-free sub-millimetre skin sampling v2; ref status: indexed"}
{"_id":"b9b47b81-52a7-8987-0177-1d41022b9e3b","text":"Regarding surgery, the importance of surgical resection margins can no longer be underestimated. Literature has reached consensus on the adverse effect of positive resection margins on local control of STS. Positive margins and local recurrence also seem to have an important influence on overall survival. However the concept of an ideal surgical margin remains unclear. There is a high need for standardisation and guidelines concerning good surgical margins for ESTS resection.","title":"Soft tissue sarcoma of the extremities: pending questions on surgery and radiotherapy"}
{"_id":"b9c5d5b6-a82d-3a0a-ebcd-9be532c5e01c","text":"A variety of pathological states can result in calcified and high-attenuation PNs. The imaging evaluation of pulmonary nodules (PN) is based on clinical history, size and appearance of the nodule and feasibility of obtaining a tissue diagnosis. We have discussed the various patterns of calcification in benign and malignant PN and suggest ways to avoid pitfalls when unusual patterns are encountered as calcification in PN as a criterion to determine benign nature is fallacious and can be misleading. The differential considerations of calcified and high-attenuation lung lesions including calcified granuloma, PH, carcinoid and lung metastases or a primary bronchogenic carcinoma have been discussed and presented as a pictorial assay emphasizing the various patterns of calcification in PN to aid diagnosis and to discuss the differential diagnosis and the pathogenesis where it is known.","title":"The calcified lung nodule: What does it mean?"}
{"_id":"b9d8fb14-b91c-e057-f128-92ac5633f02a","text":"The myoadipofascial flap was folded under the skin paddle in a way to provide the best possible projection with fullness mainly formed inferiorly to match the other breast. The muscle was anchored to the underlying muscle bed and the lateral contour of the breast mound was defined with the addition of some sutures to the lateral chest wall.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"b9e1295d-f49c-e88f-26d4-fd61f87fd29d","text":"Ipilimumab was approved by the FDA for treating metastatic melanoma in 2011, and numerous targeted therapies have been approved by the FDA since then. Immune checkpoint inhibitors and targeted therapies have emerged as key components of metastatic melanoma treatment in recent years. Immune checkpoint inhibitors might present a more severe toxicity profile with organ-specific irAEs than traditional treatments. Among these adverse events, gastrointestinal toxicities are some of the most common irAEs. Our study observed an increased risk of SPCs for cancer of the small intestine. Although such observations might be correlative rather than causative, it is possible that the irAEs affect the development and progression of SPCs. The exact relationship between gastrointestinal irAEs and SPCs needs further investigation. Most previous studies of irAEs have focused on the short-term toxicity of ICIs with a duration of weeks to months, but the long-term effect of ICIs has not been broadly investigated. Furthermore, using ICIs has dramatically improved melanoma outcomes. With patients now surviving longer after treatment, it is becoming increasingly important and clinically relevant to better understand the patterns of SPCs in the ICIs era to promote the best quality of life of patients. Although better rates of incidental detection with more sensitive imaging tools and more frequent use of ultrasound may explain the increase in incidence, we also expect more sensitive imaging technology to detect other solid tumors, which we did not observe here. Very importantly, we cannot determine whether the change in the pattern of SPCs is caused by ICIs; future studies are warranted to further elucidate the relationship between ICIs and SPCs, particularly those focused on the risk of subsequent cancer after immunotherapy.","title":"Assessment of Trends in Second Primary Cancers in Patients With Metastatic Melanoma From 2005 to 2016 Trends in Second Primary Cancers in Patients With Metastatic Melanoma, 2005-2016"}
{"_id":"b9ed3587-524c-a352-521e-23597a82118e","text":"The knowledge of the specific allergens involved in exposure-related allergic reaction is a prerequisite for the development of diagnostic and therapeutic tools, so we have recruited Italian bakers reporting allergic symptoms and using Italian common wheat flours like the Bolero one.","title":"Glucose\/Ribitol Dehydrogenase and 16.9 kDa Class I Heat Shock Protein 1 as Novel Wheat Allergens in Baker’s Respiratory Allergy"}
{"_id":"b9ef514f-4e73-9c0f-4231-424cf86e1641","text":"The reproducibility SLN detection in patients with cancer of the oesophagus\/GOJ following nCRT was very poor. nCRT appears to alter lymphatic drainage patterns and thus may affect detection of SLNs and potentially also the accuracy of an SLNB in these patients. On the basis of these initial results, we abort further patient recruitment in our institution.","title":"“Sentinel lymph node imaging with sequential SPECT\/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study”"}
{"_id":"b9ef7f4d-28dd-e8a9-8134-8cd94b99f03e","text":"We employed advanced imaging techniques to characterise a large region of the ilium of a mouse with pelvis osteomyelitis. Significant osseous changes were detected at a microscopic scale. In the highly deformed left part of the pelvis, staphylococcal abscess communities (SACs) and lesion tissue could be detected and dominated the bone. Similar bone tissue changes had been previously reported for chronically florid osteomyelitis. It was further found that the infection was not homogeneously distributed in the bone and also that slices with almost intact healthy bone tissue with a high osteoblastic activity at the outer trabecular bone regions were found in between slices with severe osteomyelitis-induced osseous changes.","title":"Insights into S. aureus-Induced Bone Deformation in a Mouse Model of Chronic Osteomyelitis Using Fluorescence and Raman Imaging"}
{"_id":"b9f5f26c-7946-8e82-7da7-0a22bb068ef8","text":"Their preliminary data highlighted the ease of obtainability, avoidance of donor-site morbidity, flexibility of the graft characteristics, and low complication rates, indicating that fresh frozen, nonterminally sterilized cartilage is an ideal source for revision rhinoplasty. Mohan et al. reported only one complication (infection, 2%) among a cohort of 50 CCA revision rhinoplasties over an average period of 3.35 months (range, 1–18 months).5 Another article examined 186 segments of the fresh frozen costal cartilage in vitro and showed that the degree of warping was generally lower in a freezer setting than at room temperature.26 The team further suggested that the Profile costal cartilage grafts that are older and appear more yellow in color should be used for more sturdy support and younger, more white grafts should be used for providing soft contour augmentation.8 This feature, along with numerous available precut shapes and sizes, allows specifically customized planning and treatment for rhinoplasty patients. The most recent study by Dr. Rohrich and his team reported on long-term outcomes of 226 cases, up to 9 years (range, 6 months to 8 years), with no concern related to the longevity of the CCA implant8 (2.7% warping, 2.7% infection, and 2.2% revision). Thus, significant resorption, warping, or graft displacement at 6-months and 12-months follow-up was not anticipated in our cohort. Of note, we have not found prospective studies on the use of CCA.","title":"Prospective Clinical Trial Evaluating the Outcomes Associated with the Use of Fresh Frozen Allograft Cartilage in Rhinoplasty"}
{"_id":"b9f92452-8439-575d-d675-57b461b7d113","text":"However, some limitations exist, such as the anatomical limitation due to the requirement of 2 arterial communication vessels around the anastomosis site and more than 2 VC; more time and effort are required for multiple venous anastomoses; and increased possibility of torsion or kinking of the pedicle due to multiple anastomoses.","title":"Anterolateral thigh free flaps with T-shaped pedicles and multiple venous anastomosis for extremity reconstruction"}
{"_id":"b9fa0bf7-fbba-d741-0b18-f3e48b18e1b3","text":"All of them repeated the treatment till 2010 with a duration of symptom relief ranging from 4 to 12 months, with a median of 6 months and a number of repeated treatments from 2007 to 2010 ranging from 3 to 5, with a median of 4 times.","title":"Treatment of Primary Axillary Hyperhidrosis with Botulinum Toxin Type A: Our Experience in 50 Patients from 2007 to 2010"}
{"_id":"b9fa9805-d697-8424-7fb6-90733e4bd382","text":"Time available for dental treatment before transplant is limited and appointments should, whenever possible, be scheduled alongside other medical appointments. The second most common management issue in this study was the limited time available for treatment. The majority of patients required more than one appointment and the average time between referral and admission for initiation of myelosuppressive treatment was a month. Taking this and the guidance that extractions should ideally be completed at least ten days before the induction therapy into account, the time available for dental treatment may be reduced to two weeks.15","title":"Dental assessment prior to stem cell transplant: treatment need and barriers to care"}
{"_id":"b9fb64b4-bb1c-f1b7-2430-8167818dd859","text":"To conclude, the perforator flaps in lower limb reconstruction are a viable option in the armamentarium of a reconstructive surgeon. This is a versatile technique and with decreased donor site morbidity limited to a single body area. These flaps do not involve sacrifice of any of the main arteries. They can cover very distal defects of the leg. There is a specific like to like soft tissue replacement leading to a better cosmetic and reconstructive outcome. The operative time taken for perforator flaps is not significantly higher than that for other fasciocutaneous flaps.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"b9feb7f7-e3a8-50e6-a249-cfad71448340","text":"The search was limited to articles published in English and Spanish during the last 10 years.","title":"Foreign body granulomatous reactions to cosmetic fillers"}
{"_id":"ba000b99-232a-fca8-22b1-4cc6d6ca0c85","text":"The Global Breastfeeding Scorecard 2019 urges that primary care facilities offer individual advice on infant and child feeding, seeking the goal of 80% of countries whose health institutions provide this advice by 2030. It emphasizes the importance of improving access to qualified breastfeeding counseling by providing specialized guidance that helps to make informed decisions and overcomes difficulties for breastfeeding, focusing on new mothers who have the greatest lack of knowledge and confidence [15].","title":"Lactation counseling for maintaining exclusive breastfeeding in adolescent mothers: a trial protocol"}
{"_id":"ba045c09-fb1d-b5e1-672f-581222ce66ae","text":"Presence of signal changes on MRI, such as hypo-hyper signal changes due to gliosis on T1and T2 weighted images, which are detected when myelophaty occur because of chronic compression of cervical disc material and spondylosis on the spinal cord and presence of cystic changes due to myelopathy was an important consideration for 62 surgeons to perform FGI and 48 preferred FGI even in the presence of mild to moderate signal change on vertebral column, such as dehyderation of disc material, degenerative process such as hyperthrophy of facet joint and ligaments of the adjacent level and deformity of the vertebral body seen on T2 and T1. Some surgeons believe that signal changes in the spinal cord, as seen on MRI, suggest not only a greater chance of having spinal instability12324 but also some degree of neurological deficit which can be detected on physical examination. In our study, in the presence of signal change in the spinal cord, 48 surgeons preferred the technique of FGI as with surgical manipulation the chance of developing delayed spinal instability and recurrent disc herniation is still higher in this group of patients. In the survey, 72 surgeons expressed belief that FGI is necessary when previous operations (simple discectomy or discectomy with graft) at the same level had failed. Re-operation had no effect on decision making of 16 neurosurgeons.","title":"Single level cervical disc herniation: A questionnaire based study on current surgical practices"}
{"_id":"ba05a36d-2e68-1688-ddc0-17105fc23533","text":"The surgery is performed under general anesthesia. The surgical team is made up of a neurosurgeon and 2 dermal surgeons. The surgical time from the beginning of the cut to closure was 1 h and 10 min. An intraoperative antibiotic coverage was made with 2 g. of intravenous cefazolin and a post-surgical antibiotic coverage with 1 g of ampicillin and clavulanic acid every 8 h for 10 days.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"ba0678bc-2bce-cad0-f5d0-b5cfcef0a361","text":"In contrast to what happens in these patients, the doses and intervals used in patients with dermatological autoinflammatory diseases are much lower and the introduction of the new targeted immunosuppressive drugs seems to clearly modify the incidence of these cancers [1].","title":"Psoriasis Therapy and Skin Cancer: A Review"}
{"_id":"ba0a58fc-567d-8b3e-0909-a2f904875f0a","text":"The ARM procedure improves the precision of SLNB and is also feasible and oncologically safe. Because of the small number of patients in our study along with the lack of follow-up information, additional investigations that include multicenter collaborative studies ought to be performed to ensure higher data reliability.","title":"Relationship between Upper Extremity Lymphatic Drainage and Sentinel Lymph Nodes in Patients with Breast Cancer"}
{"_id":"ba10689d-3b4b-6efe-25a4-8058057f08f1","text":"Breast size was also thought to be an important determinant of the social class to which a person belonged and efforts to change or reduce the breast size were to help assimilation in a particular social class, especially in countries like Brazil, which have a cultural and racial mix in society.[2]","title":"Reduction mammoplasty"}
{"_id":"ba10bda0-7b53-2494-a26b-8ab4d2e6d8a7","text":"Shoulder and elbow orthopedic fellowship PDs consider certain factors to be more important than others when ranking fellowship applicants. Our results provide useful information to medical students and residents who plan to pursue fellowship training in shoulder and elbow surgery.","title":"Factors considered in ranking orthopedic shoulder and elbow fellowship applicants: a survey of program directors"}
{"_id":"ba13e2c9-53f7-f4c9-d210-a9e61514f03f","text":"The purposes of this study are to explore sociodemographic factors that affect breastfeeding initiation and duration as well as to describe the association between attitudes towards breastfeeding (as outlined in the IIFAS) and actual breastfeeding initiation and duration.","title":"Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study"}
{"_id":"ba212fa3-efdc-2cfc-bd7a-8d3308592b36","text":"All elements of the interventions were either previously available or tested for use in association to the campaign, used in other studies or pilot tested independently in small groups of 10–20 persons.","title":"Novel sunprotection interventions to prevent skin cancer: A randomized study targeting Danes going on vacation to destinations with high UV index"}
{"_id":"ba2b7344-32de-4b2e-76a6-2d0d6db01ba7","text":"Stereotactic radiation therapy consists of delivering ablative ultra-high doses of radiation to a precise target in a very limited number of fractions. Because of its ability to drastically shorten treatment duration and its potential radiobiological advantage, interest in this technique for the treatment of localized prostate cancer has increased over the past decade. At the same time, brachytherapy remains a time-tested technique that has excellent, proven outcomes with a very long follow-up, setting a standard of treatment for all subsets of the disease and a reference against which emerging techniques should be compared. We propose a critical literature review to report on the respective levels of evidence of stereotactic radiation therapy and brachytherapy for the treatment of localized prostate cancer.","title":"Stereotactic Radiation Therapy versus Brachytherapy: Relative Strengths of Two Highly Efficient Options for the Treatment of Localized Prostate Cancer"}
{"_id":"ba2e4ac9-3c17-41ed-1320-31ac90988f1e","text":"Symptoms of allergic disease in young children are generally unspecific and the diagnosis without objective tests could be an arbitrary process. The paediatric section of the European Academy of Allergy and Clinical Immunology has recently published a position paper with recommendations on allergy testing in children to improve the identification of allergy and quality of care [16].","title":"Phadiatop Infant in the Diagnosis of Atopy in Children with Allergy-Like Symptoms"}
{"_id":"ba303612-fc5d-f37b-de12-6f7d0586a60a","text":"UAL is presumed to enhance skin retraction by a controlled thermal stimulation of the dermal collagen. The results with the use of UAL in large-volume liposuction in patients with lax skin have been good and in this series have even shown to decrease concurrent lipectomies.","title":"Liposuction"}
{"_id":"ba30a59f-8e4f-3fd9-fe1c-e1bed10ba169","text":"The purpose of this study was to prove the safety and feasibility of the management of implant exposure after nipple-sparing breast mastectomy and implant-based reconstruction with implant removal and immediate replacement with DIEP flap.","title":"Immediate implant replacement with DIEP flap: a single-stage salvage option in failed implant-based breast reconstruction"}
{"_id":"ba3494a5-9df3-afe5-b225-5fff86d000a8","text":"④ It can be seen that the bone is thickened and hardened, the bone marrow cavity is irregular, and there are dead bones of different sizes. It can be seen that the fracture does not heal and the false joint is formed.","title":"MRI Manifestations and Diagnostic Value of Chronic Osteomyelitis"}
{"_id":"ba353957-7f36-b1bd-052b-a3fd346deac7","text":"Respecting the principles of the 1975 Declaration of Helsinki, we collected medical records and photographs of 310 consecutive patients who underwent nasal reconstruction after excision of NMSC, between January 2011 and January 2016.","title":"Surgical Treatment with Locoregional Flap for the Nose"}
{"_id":"ba49da8e-c71a-6829-a5f7-fc3802a941f9","text":"There are no specific guidelines to our knowledge for the management of the primary CNS melanomas as they are a rare tumor. There are no published randomised trials which would help us in the management of these tumours.","title":"Primary Intracranial Melanoma with Early Leptomeningeal Spread: A Case Report and Treatment Options Available"}
{"_id":"ba4be705-aee7-3237-54c1-13e34efc1da9","text":"Many surgeons agree that the indications for reconstruction after resection are as follows:","title":"Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience"}
{"_id":"ba4e8d71-5a01-42da-bf1b-eba65dd7ac33","text":"Explorative ultrasound scans were described as an additional examination that was performed after the initial diagnostic process and a conclusion had been reached. Indeed, some GPs described occasionally booking patients for a new consultation to have enough time to perform the ultrasound examination. Some GPs described how the focused examinations were conducted within the timeframe of the consultation, while others described that the duration of the consultation was extended with 5–10 min, which sometimes made them fall behind schedule.","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"ba4e936f-27cd-ee0a-d95f-554f61730386","text":"The present study revealed that ultrasound-guided PVB for LC is a useful and safe approach for pain management during and after LC for elective cholecystectomy due to cholelithiasis. PVB with a single unilateral injection can provide efficient analgesia. Furthermore, PVB combined with general anesthesia also reduced postoperative complications, and preoperative application of the block reduced the rate of intraoperative opioid requirement.","title":"The Efficacy of Ultrasound-Guided Paravertebral Block in Laparoscopic Cholecystectomy"}
{"_id":"ba4f268e-8321-bfc3-d0b4-8e153b52c652","text":"The establishment of a murine model of anaphylaxis induced by T. nattereri fish venom represents a progress, since elucidates the cellular and molecular mechanisms of the allergic reaction and becomes a valid proof for proposing therapeutic intervention to prevent and treat allergic episodes in human victims.","title":"Anaphylaxis induced by Thalassophryne nattereri venom in mice is an IgE\/IgG1-mediated, IL-4-dependent phenomenon"}
{"_id":"ba50d3dc-0c56-260b-873a-a7c05fd48c34","text":"Vitiligo, characterized by depigmented macules is a common disorder with a high psychosocial impact. Surgical treatment is indicated in resistant stable vitiligo that does not show adequate response to medical therapy. Stability of the disease process is the most important parameter to achieve a successful outcome. Conventional surgical modalities are tissue grafts such as punch grafting, suction blister grafting and split thickness skin grafts. The choice of surgical treatment depends on type of vitiligo, extent and site of lesions, availability of equipment and expertise of the treating surgeon. Split thickness skin grafting is the most successful out of all tissue grafting methods. Recent advances include autologous non-cultured epidermal cell suspensions and cultured melanocyte suspensions or sheets. Hence though surgical treatment of vitiligo is evolving over the years, the basic etiopathogenetic mechanisms need to be elucidated to achieve long term successful results.","title":"TISSUE GRAFTS IN VITILIGO SURGERY – PAST, PRESENT, AND FUTURE"}
{"_id":"ba51c9a7-4d41-736c-c937-4c90e2d74b04","text":"This study found that patients with a history of VTE who underwent surgery had a high recurrence risk of VTE, which remained increased up to 6 months after surgery. High-risk individuals may be identified based on the type of surgery and the presence of additional factors. Our results stress the need for a revision of the thromboprophylactic approach following surgery in patients with a history of VTE, the duration and dosage of which may need to be intensified and individualized.","title":"Risk and Risk Factors Associated With Recurrent Venous Thromboembolism Following Surgery in Patients With History of Venous Thromboembolism Recurrent Venous Thromboembolism After Surgery in Patients With History of Venous Thromboembolism"}
{"_id":"ba544c12-21f6-cf65-2626-1f684de4ea8d","text":"In a similar case report, Fowler and Breault reported a creeping attachment of 1.0 mm after frenectomy with the scalpel technique in the anterior mandible after 4 weeks [3]. In the present case report, the same protocol with Fowler and Breault was followed but the creeping attachment was noted as early as 10 days postoperatively. Furthermore, full coverage of the root surface was noted along with the interproximal soft tissue fill. The results remained stable for 6 months, and a second soft tissue surgery was avoided. Our incidental findings are in accordance with the existing literature and indicate a potential of coronal creeping attachment after removal of high frenal insertions in the anterior mandible which can result in complete root coverage preventing further need for mucogingival surgeries.","title":"Early Creeping Attachment Noted after Mandibular Labial Frenuloplasty"}
{"_id":"ba689efa-31b0-1ece-81ac-89d3fbd2ffdd","text":"The first four techniques are used commonly, whereas the last three are only used in special situations. It is important to place the filler in the right place and the bevel orientation is not a significant issue at any site.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"ba6a082b-6aa5-450d-93a8-a685afb196c5","text":"On the basis of this observation, it is reasonable to speculate that the late circulating melanoma cells detected in our patients can be shed from secondary organs. If this were true then the presence of circulating malignant cells in the setting of high-risk melanoma patients would be a marker of the existence of micrometastatic disease.","title":"Prognostic significance of the sequential detection of circulating melanoma cells by RT–PCR in high-risk melanoma patients receiving adjuvant interferon"}
{"_id":"ba6c2351-921f-eab5-0449-c4f76a918e78","text":"Local breast cancer recurrence dynamics are similar to DM dynamics for both ERP and ERN tumours following mastectomy while following conservative surgery plus RT such a similarity is restricted to ERN tumours only. Therefore, delays observed in the IBTR risk peaks for ERP tumours following conservative surgery and postoperative RT are a remarkable exception to the otherwise common recurrence risk rhythm. This clinical behaviour is likely to reveal a ER related relationship between tumour cells and the breast tissue, which may play a dominant regulatory role upon ERP breast tumour cells with more stringent constraints than upon ERN cells, for which the time to overt recurrence is similar to the corresponding time of the other tissues.","title":"Recurrence and mortality according to Estrogen Receptor status for breast cancer patients undergoing conservative surgery. Ipsilateral breast tumour recurrence dynamics provides clues for tumour biology within the residual breast"}
{"_id":"ba714913-e216-4834-02ca-08d688adeb1f","text":"As plastic surgeons, we are privileged to answer a helping call to many patients that are in need. These patients arrange from congenital anomalies, burns, various soft and bone tissue defects after cancer and trauma to providing solutions to what was once thought difficult such as allotransplant, transgender surgery, and even complications arising from the abnormality of lymphatic functions. As plastic surgeons we have achieved remarkable advancement in the field of aesthetic and reconstructive surgery. However, there are enormous disparity between different parts of the world where reconstruction may not even be available due to lack of plastic surgeons or resources. We hear stories about how people unnecessarily amputate their limbs, form disabilities from poor care, and live with congenital deformities that may leave a stigma in their society. As plastic surgeons we could bring lasting impact to these countries by sharing knowledge, providing care, and sending resources. We could help them dream what can be possible and help them a step closer to realizing this dream. We have many wonderful charities and missions in the field of plastic surgery that has continuously served these underprivileged patients around the world. We have many surgeons who work with charity missions or even on their own provide help. But the progress remains slow despite the current work by various institutions and individuals. So, what do we need to do to reach more patients and to help them transform their lives?","title":"Charity Mission: Bringing Meaningful Impact and Sustainability"}
{"_id":"ba71ef21-44ca-9dd7-5619-aa1ca8d0d060","text":"This study was conducted on 10 female patients with bilateral huge breasts who presented for reduction mammoplasty. A signed written informed consent was obtained from each patient regarding her agreement on participation in this study. A preoperative sonographic assessment of the internal mammary artery perforating branches in the 4th and 5th interspaces was performed, followed by intraoperative double check of the Duplex-obtained data.","title":"Color Duplex Assessment of 4th and 5th Internal Mammary Artery Perforators: The Pedicles of the Medially Based Lower Pole Breast Flaps"}
{"_id":"ba803bca-c49e-59f9-1b70-7b0a7dfeef2e","text":"We collected data from patients diagnosed with TC who underwent sperm cryopreservation in the French national network of sperm banks. Trends in the incidence of sperm cryopreservation were estimated through two statistical models: the commonly used Poisson regression model and the Verhulst model.","title":"Sperm cryopreservation incidence in men with testicular cancer: towards a stabilization in testicular cancer incidence? Results from the CECOS network"}
{"_id":"ba80e3a7-1b1e-64d2-b23a-45685f212200","text":"Another issue regards the clearance of resection margins, if the ablative extent has been maximum in relation to patient conditions, no matter if definitive histology would report R1 or close margins.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"ba81baf9-503d-8747-b1e2-f8d19b1591e6","text":"We strongly support offering breastfeeding instructions and assistance to mothers after delivery. The present findings are in agreement with data from a trial conducted with mothers who received breastfeeding instructions by telephone and daily support from nurses during hospitalization and home visits for 3 weeks. The group of mothers that received this assistance spent an average of 40 more hours breastfeeding their infants and used infant formulas significantly less than those who did not receive this assistance. There was also less of a need for visits to the health-care provider as well as fewer tests and medical appointments [32]. Breastfeeding involves more than a mother’s desire to breastfeed. It is a dynamic process affected by socioenvironmental factors related to experiences after the onset of breastfeeding [33]. One study showed that more than half of mothers discontinued breastfeeding due to the perception of inadequate milk or other breastfeeding problems and consequently began using infant formulas [34]. The discontinuation of breastfeeding may be related to depressive symptoms or the need to return to work or school. Breastfeeding instructions should focus on nutritional counseling and breastfeeding should be supported both during postpartum hospitalization and immediately after discharge [35].","title":"Does ankyloglossia interfere with breastfeeding in newborns? A cross-sectional study"}
{"_id":"ba834166-b9f4-6f3d-1763-341151fb0726","text":"Our objective was to apply this methodology to the study of hard tissues, specifically the cortical bone of the tibiofibular junction of adult mice in attempt to detect the presence and size of blood vessels within the canal networks, in the absence of any contrast agent. We have now shown that propagation-based phase contrast-enhanced tomography can indeed resolve soft tissue comprising blood vessel details in undecalficied murine bone, when an appropriate propagation distance is chosen. Furthermore, this technique allows for simultaneous visualisation of the cortical bone microstructure including osteocyte lacunae and canal networks alongside the blood vessels themselves.","title":"Simultaneous visualisation of calcified bone microstructure and intracortical vasculature using synchrotron X-ray phase contrast-enhanced tomography"}
{"_id":"ba83d1c0-8356-862a-8129-770244df4366","text":"There were no differences between the groups in relation to the occurrence of unilateral or bilateral otorhinolaryngological changes.","title":"The influence of the type of breastfeeding on middle ear conditions in infants"}
{"_id":"ba8f196d-163a-b686-8d80-6076e07a760f","text":"Studies( conducted through ultrasound have shown the importance of tongue movements to extract milk in breastfeeding. When making a dynamic analysis to explore the tongue movements in relation to the jaw during breastfeeding, a study observed constant oscillations in the jaw and tongue, without the movement of the buccinator muscles. It described that the movement of the anterior part of the tongue was predicted by oscillations in the jaw, while the posterior part of the tongue was curved to make swallowing easier and to coordinate with breathing(.","title":"Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles Efeito da frenotomia lingual na amamentação e na atividade elétrica dos músculos masseter e supra-hióideos"}
{"_id":"ba938580-e477-d25d-f3af-7df3696226b2","text":"In summary, we demonstrated that a delay in diagnosis was associated with neurological progression after ACF, and that imposing ligamentous flavum might become a compression factor if the diagnosis is delayed. Furthermore, SCD was smaller among patients with progression. These factors should be included in future studies of neurological complications of cervical spine trauma surgery. In cases of cervical spine injury with these factors, additional posterior decompression or more meticulous bone excision during anterior fusion might be beneficial preventive measures for clinical implementation.","title":"Risk factors for spinal cord injury progression after anterior fusion for cervical spine trauma: a retrospective case-control study"}
{"_id":"ba9d9c5a-069d-0b05-9d9f-b7e3d10181d7","text":"TZ holds a Career Development Award from the American Society of Clinical Oncology. SOPH holds the Wharton Chair in Reconstructive Plastic Surgery and is chief of the Division of Plastic Surgery, Department of Surgery, University Health Network. SOPH and TZ are supported by grant funding from the Canadian Breast Cancer Foundation and the Canadian Institutes of Health Research. SAM is medical director of the Perioperative Blood Conservation Program at the University Health Network. HC is director of the Pain Research Unit at Toronto General Hospital. The other coauthors do not have any information to report.","title":"Transversus abdominis plane block following abdominally based breast reconstruction: study protocol for a randomized controlled trial"}
{"_id":"ba9fdbc0-ffe1-d768-4e04-7bdff3ef63ea","text":"Conclusions: The introduction of prophylaxis of venous thromboembolism in postoperative patients of cerebral aneurysm is a safe practice and should be established routinely in this group of patients.","title":"38th International Symposium on Intensive Care and Emergency Medicine Brussels, Belgium. 20-23 March 2018"}
{"_id":"baa087e1-7e93-bfa7-b8f6-cf0a00990dcb","text":"More precise data on the healing time of the donor site could not be obtained from the files due to the fact that most children were at home at the time of healing. Either the child was treated in the outpatient clinic, or, in case of clinical admission, had left the hospital at the fifth postoperative day when take of the transplant was judged to be good. Thus, the patient was at home when the donor site had healed and the alginate crust detached. When they were next evaluated at the outpatient clinic, a few days later by a medical professional, the exact date was not noted in the file, as it was only possible to objectively appraise whether the site had healed, not when.","title":"The scalp as a donor site for skin grafting in burns: retrospective study on complications"}
{"_id":"baa55de5-0658-e5e9-296e-7c2f3653d846","text":"The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven.","title":"Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up"}
{"_id":"bab2da6f-882f-ba6d-da4d-507fcaee1230","text":"As surgical disease is being brought into the global health spotlight, there is increasing recognition that education is key to addressing the vast burden of disease. Designing and evaluating educational initiatives in a complex field such as surgery is highly challenging, and the complexities of training only become further amplified in the global arena. Multiple educational initiatives have been previously implemented, each with their own strengths and limitations, but consensus is growing that these must continue to improve to keep pace with the increasing number of patients and the challenges of delivering care. To meet this challenge, Operation Smile and the University of Southern California propose a “fellowship without borders,” built on the principles of competency-based education and utilizing existing service platforms. This program leverages high patient volumes in the mission setting to more rapidly train in-country providers and gathers valuable data to systematically evaluate and improve the program. Further data collection is ongoing to determine the validity of the evaluation instrument, the generalizability of pilot results and the impact of training on surgical disease burden.","title":"Competency-Based Education in Low Resource Settings: Development of a Novel Surgical Training Program"}
{"_id":"bab3a20a-8f39-175b-5d66-23c39c8ebfcc","text":"Several parameters were used to evaluate the height of the face. Facial height was determined as the distance between the nasion and gnathion points. The trichion point (the point between the forehead and the scalp) was not used because it is the most variable point, as a result of hair loss during aging. The middle facial height was the distance between the glabella and subnasale points. The lower facial height was the distance between the subnasale and pogonion points. The ratio between the middle and lower facial heights was calculated to describe which facial part contributes to the facial height changes during aging.","title":"Effect of aging and body characteristics on facial sexual dimorphism in the Caucasian Population"}
{"_id":"bab46868-60e7-4b98-de44-0fda74196684","text":"Third, duplex scanning was the exclusive imaging modality during the procedure. The Doppler color ultrasound allows for a more precise visual image of the thrombus than radioscopy, aiding in the prevention of blood vessel embolism when working in the anastomotic space. Ultrasound decreases radiation exposure for the patient and, most importantly, for the personnel by allowing for shorter durations for radioscopy. Although sonography cannot provide the same panoramic image of the fistula as radioscopy, we believe that a comprehensive and careful evaluation of preoperative color Doppler Ultrasound and skilled ultrasound techniques can compensate for this flaw.","title":"Recanalization of thrombosed aneurysmal hemodialysis arterovenous fistulas using a hybrid technique based on data from a single center"}
{"_id":"babb88d2-58d3-912d-141b-caef6d2b7f58","text":"Bone scintigraphy allows the early detection of these deposits and the assessment of their progressive nature.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"babd1717-7f36-f5d6-0b91-a1ee974cfc1d","text":"Our patient presented with subacute abdominal pain and distention that increased in severity over a few months and was associated with constipation and fever.","title":"A Sporadic Giant Mesenteric Desmoid-Type Fibromatosis in a Teenage Female: A Report of a Rare Case"}
{"_id":"babd314a-5962-3f9f-9002-e895d4fbd249","text":"The effects of neoadjuvant chemotherapy on the accuracy of SLNB are likewise not well studied. The underlying mechanisms by which alterations in lymphatic drainage following chemotherapy may occur and thus affect lymphatic mapping are poorly understood. Suggested factors include fibrosis of lymphatic structures, as well as lymphatic obstruction by cellular debris or tumour embolization.","title":"“Sentinel lymph node imaging with sequential SPECT\/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study”"}
{"_id":"babf50d6-3b36-875a-bb8f-e8a0a75a32ac","text":"The patient was then referred to our Department for surgical evaluation. Despite the breast mass occupied whole the upper and external quadrants of the right breast, it was mobile on the underlying muscular layers. Enlarged lymph nodes were palpable in the right axilla. We therefore performed a right modified radical mastectomy, with sparing of the pectoral muscles, completed with a level III axillary lymphadenectomy in order to remove the enlarged axillary lymph nodes.","title":"Primary non-Hodgkin's breast lymphoma: Surgical approach"}
{"_id":"bac63424-2040-7d1c-ff04-0a2578c31414","text":"Skin sparing mastectomy and immediate breast reconstruction for early breast cancer is associated with low morbidity and low rate of local recurrence.","title":"Skin Sparing Mastectomy and Immediate Breast Reconstruction (SSMIR) for early breast cancer: Eight years single institution experience"}
{"_id":"bac9f4c1-90a4-1958-f4fc-9643c597c7ac","text":"In cases with suitable wound bed and diameter of ≥ 2cm repair was done directly with partial thickness skin graft, in patients with skull bone exposed however repair with flap from adjacent scalp was needed which the resultant defect was repaired with skin graft. In this study the skin graft was harvested from adjacent scalp. Hair was shaved if needed then the borders of an area of roughly equal size to the defect was marked using methylene blue in parietal, temporal or occipital region, the area then was injected with normal saline to elevate the skin and facilitate harvesting the graft, then the graft was harvested using D80 or D42 automated dermatome or a manual dermatome with an mean thickness of 0.04 inch. The donor site was then covered with a semi occlusive dressing comprising of a layer of petroleum gauze and a layer of sterile gauze. The recipient area was covered with tie over the dressing method according to plastic surgery principles. The head including the donor and recipient sites was then covered with a tubular net bandage as a whole. Almost 50% of scalp area can be used as donor site, so a 50% scalp defect can be repaired using the intact other half. After 24-h donor site dressing except the last layer was removed, after 5 d recipient site dressing was removed and the graft was evaluated.","title":"Outcome of Comparison between Partial Thickness Skin Graft Harvesting from Scalp and Lower Limb for Scalp Defect: A Clinical Trial Study"}
{"_id":"bacc7ee7-e084-fad1-cadf-6b897a9d1547","text":"To evaluate usefulness of removing mastoid process in managing advanced parotid cancers to contribute identifying and preserving facial nerve.","title":"Impact of removing mastoid process for advanced parotid cancer on facial nerve identification, preservation and reconstruction"}
{"_id":"bad03f5e-081b-5c14-bb1f-5b8b732d5375","text":"The reconstruction of large bone defects poses many challenges in oral and maxillofacial surgery. Although autologous bone grafts are considered the gold standard in bone defect repair, there are some concerns related to the limited supply and donor site morbidity.","title":"Bone regeneration of minipig mandibular defect by adipose derived mesenchymal stem cells seeded tri-calcium phosphate- poly(D,L-lactide-co-glycolide) scaffolds"}
{"_id":"bad08644-0758-c135-aaf1-fae1b9e2381b","text":"The common physical examination findings suggestive of degenerative disc disease of the cervical spine may include neck pain, radiculopathy, and myelopathy. These symptoms may occur alone or in combination. All these were a part of the questionnaire. The findings on X-ray and MRI of the cervical spine suggestive of degenerative changes such as sclerosis of adjacent vertebral body or osteophyte formation and the manner in which that may affect the operative decision making were asked. The questionnaire is shown on Table 1. Those who did not answer the complete questionnaire were excluded. All information of the check list was analyzed with SPSS software.","title":"Single level cervical disc herniation: A questionnaire based study on current surgical practices"}
{"_id":"bad7fd51-cd38-6046-af39-e27aebf54a7d","text":"Ankyloglossia is classified according to severity into 4 grades by Coryllo [6]. In type I frenulum is thin and elastic and anchors the tip of the tongue to the ridge behind lower teeth. Type II has fine and elastic frenulum and the tongue is anchored 2 - 4 millimeters from the tip to the floor of the mouth close to the ridge behind the lower teeth. In type III the frenulum is thick and stiffened, and anchors the tongue from the middle of the underside to the floor of the mouth. In the case of type IV the frenulum is posterior or not visible, but when touching the area with the fingertips, the examiner can feel tight fibers anchoring the tongue, with or without a thickened, shiny surface on the floor of the mouth.","title":"Harmonic Lingual Frenotomy for Ankyloglossia: A Newer Novel Technique"}
{"_id":"bad863f9-7b2b-726e-440d-b47b8212628a","text":"The use of lymphatic mapping and SLN identification in these patients may help reduce the morbidity of surgery without compromising the identification of higher-risk patients who require adjuvant treatment. The SLN protocol of enhanced pathologic evaluation of removed nodes may also provide a much more detailed evaluation of these nodes and the potential for identifying micrometastasis that may have been missed with traditional pathologic evaluation (31).","title":"Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT\/CT"}
{"_id":"badfe261-da43-b9f8-768b-2e64383471cd","text":"The infrequent use of CT scan post-surgery means it can be difficult for clinicians to decipher the unusual and unexpected appearances of implanted costal cartilage when CT scans include portions of reconstructed breast tissue following DIEP surgery. As a consequence of the size and position of implanted cartilage and the typical history of cancer in DIEP reconstruction patients, there is a real risk of misdiagnosis of these masses by radiologists. This case illustrates how without sufficient dissemination of information on uncommon imaging appearances such misdiagnoses can occur and emphasizes the importance of improving awareness about unconventional radiological presentations originating from rarer surgical practices.","title":"The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan Case report: The appearance of cartilage in breast reconstruction as a mass on CT"}
{"_id":"bae467fd-72d0-487a-687a-4f2068d8f9cf","text":"Intraoperative anaphylactic shock due to allergy to patent blue V was diagnosed.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"bae9746e-6afd-110b-9e32-2cd483b974e0","text":"These results emphasize the difficulty of predicting an individual’s risk for thrombus persistence reliably. This may be of greater significance when medication adherence and adequacy of anticoagulation cannot be easily assessed.","title":"Prevalence and Rate of Resolution of Left Atrial Thrombus in Patients with Non-Valvular Atrial Fibrillation: A Two-Center Retrospective Real-World Study"}
{"_id":"baeac549-60cd-16db-bca9-120c00725dbf","text":"Other clinicopathological parameters were also tested with suspicious lymph nodes and T status showed a significant correlation to N status while UICC stage significantly correlated with suspLN. That UICC stage and N status were significant as well can be easily explained because N1 automatically leads to an UICC stage of IIIb. Parameters like tumor size, multifocality or number of nodules showed no significant correlation which might have different reasons. On the one hand it is possible that the sample size is too small for example for number of nodules which nearly reaches significance with p = 0.087. On the other hand, tumor biology might not be defined through tumor size for example. A solitary ICC with a diameter of 8 cm might be less aggressive than three nodules with largest diameters of 3 cm. But this is prospect of ongoing investigations, not part of this study to answer and might be better understood in the future with other procedures like next generation sequencing (NGS).","title":"Relevance of suspicious lymph nodes in preoperative imaging for resectability, recurrence and survival of intrahepatic cholangiocarcinoma"}
{"_id":"baec78b2-26d1-3170-94a1-be704da9068a","text":"Resection margins were adjusted according to fluorescence by exciding 2 mm over than the fluorescence margins. The histological extent of the tumor was found to be comparable with the fluorescent margin, as free margins of all the excised lesions were 2 mm or more.","title":"Fluorescence‐guided surgery for non‐melanoma and melanoma skin cancer: Case series and a brief review of the literature"}
{"_id":"bafc7f17-ab0d-5212-c5be-3a8ced84990f","text":"Only persons at the main study center with defined roles will have access to the final trial data set.","title":"TRIM study protocol - a prospective randomized multicenter Trial to assess the Role of Imaging during follow-up after radical surgery of stage IIB-C and III cutaneous malignant Melanoma"}
{"_id":"bafdefb7-6ebf-2780-56d4-502095c255ae","text":"Treatment of distal tibial intra-articular fractures is challenging due to the difficulties in achieving anatomical reduction of the articular surface and the instability which may occur due to ligamentous and soft tissue injury. The purpose of this study is to present an algorithm in the application of external fixation in the management of intra-articular fractures of the distal tibia either from axial compression or from torsional forces.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"bb054225-a071-1aa9-6fae-7cda8377a720","text":"All patients > 50 years old evaluated for possible VTE who presented to the emergency department over a consecutive 12-month period between January and December 2016 with a positive D-dimer result. Clinical assessment records and reference standard imaging results were followed up by multiple independent adjudicators and coded as VTE positive or negative.","title":"The application of an age adjusted D-dimer threshold to rule out suspected venous thromboembolism (VTE) in an emergency department setting: a retrospective diagnostic cohort study"}
{"_id":"bb068430-ac83-a2a8-da24-7133b093ddc4","text":"An extremely interesting aspect is represented by the possibility to decontaminate an implant surface without changing its surface microtopography and therefore without affecting its physical properties.","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"bb12cb1f-d878-8d07-030a-534ce823f1b7","text":"Resident and fellowship stipend and physician annual salary data were obtained for the academic year 2021 to 2022. Data from the AAMC Survey of Resident\/Fellow Stipends and Benefits report were used for resident and fellowship stipends.","title":"Comparison of Calculations of the Financial Impact of Fellowship Training by Data Source Calculations of the Financial Impact of Fellowship Training Differ by Source"}
{"_id":"bb16ebc0-eba3-9bd3-a41e-ffa123596d0b","text":"Awareness of early signs of an allergic reaction resulting from accidental exposure","title":"Peanut Allergy: An Overview"}
{"_id":"bb1819f0-ede7-bcb9-6181-7390057dd54e","text":"Objectives: We aim to document the characteristics of CNO in an Asian Paediatric population and describe the utility of the Jansson Clinical Score for these patients.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"bb1ddade-2c78-d703-649f-a3585e4d6b9a","text":"Due to possibility for complications following a facelift surgery with a history of fillers, there are critical steps in a surgeon's preoperative evaluation of a potential facelift candidate. It is not only important to include a thorough investigation of a patient's history of filler treatments, but it is also imperative to clarify whether the patient experienced skin discoloration after filler treatment, which could be indicative of a history of vascular injury. Furthermore, the location of injury should also be ascertained, as the vascularity of the skin flaps raised during a facelift could be affected, and potentially increase the risk of wound healing complications postoperatively from a facelift. It may be difficult to obtain this history from a patient as most patients have undergone filler placement by different injectors, had different products injected, and therefore, often cannot recall what was used and where it was placed in their face. It may be prudent to discuss the potential increased risks with these patients at their preoperative visit when obtaining consent.","title":"Potential Effects of Repetitive Panfacial Filler Injections on Facelift Surgery and Surgical Outcomes: Survey Results of the Members of The Aesthetic Society"}
{"_id":"bb2044d8-70dd-b2a8-6025-2b6b293088fd","text":"Between January 1996 and December 2005, 133 consecutive patients with groin lymph node metastases underwent superficial and deep dissection at the National Cancer Institute, Naples. Lymph node involvement was clinically evident in 84 patients and detected by sentinel node biopsy in 49 cases.","title":"Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors"}
{"_id":"bb21f4f0-090a-4dbd-70e0-5c48dcef05b8","text":"All patients undergoing endovenous ablation will undergo duplex ultrasound assessment of the treated great saphenous vein at 6 weeks and 6 months to assess for recanalisation.","title":"DEep VEin Lesion OPtimisation (DEVELOP) trial: protocol for a randomised, assessor-blinded feasibility trial of iliac vein intervention for venous leg ulcers"}
{"_id":"bb2e017f-57d4-f154-ebc5-4224d385a786","text":"To conclude, our study presents the result of a large real-life cohort of SLE patients in which we could demonstrate a high occurrence of ADA to RTX after the first exposure, highlighting how the patients more in need of RTX are also the ones more affected by the phenomenon of immunogenicity. In comparison to AAV, the reason for immunogenicity may be related to intrinsic immunological features of SLE. We believe that our findings should encourage further studies and the implementation of screening of SLE patients in the clinical routine.","title":"First exposure to rituximab is associated to high rate of anti-drug antibodies in systemic lupus erythematosus but not in ANCA-associated vasculitis"}
{"_id":"bb3667ed-8711-42a6-5bbe-b55f1afe78ea","text":"The novelty of this method lies in the fact that lymphatic flow is also reconstructed in the proposed approach. This is because approximately 10 cm of the afferent lymphatic vessels are being transferred with their lymph nodes, which creates a new pathway from the proximal arm. The lymphatic flap has been previously described in one report, and this is the first paper to describe the use of the lymphatic flap simultaneously in autologous breast reconstruction using the DIEP flap [14].","title":"Simultaneous Lymphatic Superficial Circumflex Iliac Artery Perforator Flap Transfer from the Zone 4 Region in Autologous Breast Reconstruction Using the Deep Inferior Epigastric Artery Perforator Flap: A Proof-of-Concept Study"}
{"_id":"bb3a4d51-c7df-3664-3c6f-5ce0af10b73e","text":"STSGs are usually harvested from the upper anterior or lateral thighs, but almost any body region can be used if necessary. After harvest at the donor site, the graft is applied to the defect and a dressing is placed over to secure contact with the wound bed and prevent bleeding and formation of hematoma by providing slight compression. The dressing is held in place using either sutures or staples, and remains until the patient arrives for the first outpatient visit, typically on the fourth-seventh day after surgery.","title":"Full- or Split-Thickness Skin Grafting in Scalp Surgery? Retrospective Case Series"}
{"_id":"bb3d394b-c6fd-40a7-772e-f4984af8f2e3","text":"Today, the role of the vasculature in skeletal pathology remains poorly understood as the structural nature of skeletal tissue has made it exceptionally difficult to directly investigate the vasculature within it. Bone blood vessels are deeply encased in the calcified tissue and techniques applicable to soft tissue are frequently difficult to apply to the skeleton, such as confocal laser scanning microscopy or light sheet microscopy. What we do know is that the processes of bone growth, mineralisation, repair and rejuvenation are dependent upon the vascular supply. Bone cells can communicate with the vasculature in normal conditions and a loss of this communication could be involved in the onset of bone pathologies. Indeed, loss of osteoblast derived pro-angiogenic vascular endothelial growth factor (VEGF) in mice results in an osteoporotic phenotype and also negatively impacts fracture repair and reduced levels of circulating VEGF have been found in postmenopausal women. Improved imaging allowing for rapid and accurate quantification of the bone vasculature could better inform our ideas about the role the vasculature plays in driving degenerative bone disease such as osteoporosis.","title":"Simultaneous visualisation of calcified bone microstructure and intracortical vasculature using synchrotron X-ray phase contrast-enhanced tomography"}
{"_id":"bb3e2927-b9c8-155d-101b-99463d3427f1","text":"Overall, there is a considerable potential benefit to topical treatments for BCC and AK, and further studies will be crucial in elucidating the role that these therapies play in treating these lesions in the future as BCC and AK prevalence continues to rise.","title":"Topical Treatments for Basal Cell Carcinoma and Actinic Keratosis in the United States"}
{"_id":"bb3eea47-75ec-db46-02b5-ab940c9ceccf","text":"Desmoid tumors are rare lesions without any metastatic potential but a strong tendency to invade locally and to recur. These tumors are associated with women of fertile age, especially during and after pregnancy.","title":"Desmoid tumor of the abdominal wall: a case report"}
{"_id":"bb43430d-f34e-709f-e505-c670ca009739","text":"Therefore, the female population will be able to know their bodies better and achieve early diagnosis of malignant breast pathology at an early stage, consequently increasing the success of treatment and reducing the mortality rate due to breast cancer.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"bb46e831-f240-3413-cd41-487bdb4a3ddc","text":"Overall, it is difficult to determine whether an educational program such as the Biodesign Innovation Fellowship makes a significant difference in the career trajectories and contributions of its trainees. One could reasonably ask if these individuals would excel independent of the training program. Although this study does not definitively answer this question, it suggests that the training program is seen as having a positive influence by its alumni. The Biodesign alumni hold more leadership roles in health technology than the comparison group of talented individuals with similar educational backgrounds. This difference is especially pronounced at the executive level, perhaps due to the high rate of start-up activity among Biodesign Innovation Fellowship alumni. The fellowship alumni unanimously report that the training was beneficial to their careers and a high percentage believe it was influential on their career pathway.","title":"The Impact of Postgraduate Health Technology Innovation Training: Outcomes of the Stanford Biodesign Fellowship"}
{"_id":"bb476803-e438-8c24-f5cf-b4562e963147","text":"The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer LL and the handling editor declared their shared affiliation at the time of the review.","title":"The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management"}
{"_id":"bb489898-8475-3209-5aa9-187039743ce4","text":"This is a case report and it did not require ethical approval from ethics committee according to our institution.","title":"Ruptured mesenteric desmoid-type fibromatosis without emergency surgery: A rare case report"}
{"_id":"bb48ff9f-2c66-a774-a4ad-e75ba01800f5","text":"Ultimately, it would probably be most rational to do scans more frequently with rapidly progressive tumors and therapies that are very expensive or more toxic and to do them less frequently with tumors that are more slowly progressive, and with therapies that are relatively inexpensive and less toxic, particularly if there are no highly effective alternatives. These analyses could help in informing such decisions. Our analyses do not give a perfect final answer to the question of optimal scan frequency, but they do provide an evidence‐based starting point.","title":"Optimal frequency of scans for patients on cancer therapies: A population kinetics assessment"}
{"_id":"bb493b2f-5d03-7efd-ca83-5c102a99792f","text":"It is known that subclinical or asymptomatic PE may be present in up to 50 % of patients with acute DVT. Incidental or unsuspected VTE found during the evaluation of scheduled CT scan evaluations in cancer patients is common, accounting for 2–5 % of all CT scans. Incidental PE currently represents about 50 % of PE burden in cancer patients. Moreover, the incidence of incidental VTE is likely to increase further with the improvements of imaging techniques. Limited data from retrospective and observational cohorts of patients suggest that patients with incidental VTE would have similar outcomes with regard to overall survival and the risk of bleeding and VTE recurrence compared to patients with acute symptomatic events [29]. Unfortunately, there is a lack of evidence from prospective interventional studies to assess the best management of incidental VTE and whether anticoagulation is indicated or beneficial in patients with incidental VTE remains controversial. Expert recommendations suggested treating incidental VTE with standard full-dose anticoagulation therapy similarly to symptomatic events. However, in cases where the diagnosis of VTE is doubtful or questionable such as in cases of isolated subsegmental PE, additional confirming tests such as compression venous ultrasonography or CT scan pulmonary angiography should be performed.","title":"Clinical guide SEOM on venous thromboembolism in cancer patients"}
{"_id":"bb4a45d7-8459-874b-85f4-a1b4d2b8d71f","text":"It has been noted in patients that are found to have SFN from other causes that their symptoms may pre-date a positive skin biopsy. This begs the question of whether this may be the case with SFN in FM as well. The recent observation of severity being related to confirmation of SFN supports this idea that as the symptoms worsen so too may the damage that is being done to the nerves. Perhaps there is some pathological process in the tissues that results in irritation and damage of the small nerve fibers that when left unabated eventually leads to the destruction of these vulnerable axons. These questions are important to consider in future research efforts and IENFD can provide a reliable end point measure for future studies in this area.","title":"Intraepidermal Nerve Fiber Density as Measured by Skin Punch Biopsy as a Marker for Small Fiber Neuropathy: Application in Patients with Fibromyalgia"}
{"_id":"bb4ec0ee-acbd-3717-41b4-5881d632793a","text":"For this study, fourteen adult sheep underwent cardiac revascularization using two vein grafts for each; one to the LAD and the other to the obtuse marginal artery. One graft was supported with the device while the other served as a control. Target vessel was alternated between consecutive cases. The animals underwent immediate and late angiography and were then sacrificed for histopathologic evaluation.","title":"Expandable external support device to improve Saphenous Vein Graft Patency after CABG"}
{"_id":"bb53d1d7-c71e-56a5-6aed-fc0b95e2301c","text":"Persistent osteomyelitis is a severe and challenging problem in bone surgery. We describe a surgical intervention in a young adult which combines a bone debridement process, a plastic muscle flap sealing and the administration of a novel bone substitution material with anti-infective properties. After 1 year, the patient showed no signs or symptoms of a reoccurrence of infection with full load capacity of the treated leg.","title":"Treatment of a chronic recurrent fistulized tibial osteomyelitis: administration of a novel antibiotic-loaded bone substitute combined with a pedicular muscle flap sealing"}
{"_id":"bb541d0d-75b4-1c1f-9ce8-572a79442122","text":"As the literature does not have any specific guidelines, a newer method was adopted in this patient to fill the void created after removing the diseased tissue by a tricortical iliac crest graft resembling the excised tissue. The tricortical iliac crest graft has following advantages:","title":"Reconstruction of the Odontoid Process by a Tricortical Iliac Crest Graft in a Case of Tuberculosis of C1, C2, and C3 Vertebrae"}
{"_id":"bb62c845-e6c1-6b17-7041-472594e6958e","text":"Table 8 Proposed switch to oral therapy on the basis of intravenous therapy","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"bb712c88-ff52-6360-26c8-ae75d2eca5ba","text":"To confirm our hypothesis that culture results of the slice site are reliable and bacteria ascend from the foot instead of from skin, blood, or other nearby source of infection and affect the amputation outcome, further investigations and analysis are in progress.","title":"Section’s osseous slice biopsy during major amputation of lower extremity: preliminary results of prospective cohort study"}
{"_id":"bb7dbfa7-7eae-63a9-7c9f-f71cd1b93a63","text":"Most of the perforators in the gastrocnemius myocutaneous flap are located 7–18 cm from the popliteal crease., The lesser saphenous vein can also be included with the flap in order to increase venous drainage or as the sole outflow for the flap. Use of Doppler to map the location of skin perforators, may aid in ensuring adequate vascularity to the skin.","title":"Gastrocnemius Myocutaneous Flap: A Versatile Option to Cover the Defect of Upper and Middle Third Leg"}
{"_id":"bb801b6a-b897-fe72-019f-10e4b7ab8195","text":"The nature of these injuries means that a majority of patients will be operated on immediately or be on the next available trauma operating list, depending on access to an appropriate operating theatre. A small number of patients are transferred between hospitals or wait for an operation, and could potentially give consent prior to randomisation. These are the patients who may wait up to 72 h before surgery.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"bb83d236-0cf6-de6f-8570-f91bd3ba583f","text":"Introduction: Calcaneal osteomyelitis is an uncommon and challenging condition. In this systematic review we aim to analyse the outcomes from concomitant use of bone debridement and soft tissue management for patients diagnosed with calcaneal osteomyelitis.","title":"Surgical Treatment and Outcomes of Calcaneal Osteomyelitis in Adults: A Systematic Review"}
{"_id":"bb873817-df23-2df4-af75-2720f033ba78","text":"The timing of breast reconstruction postmastectomy averaged 19.9 months, without statistically significant association between reconstruction timing and recurrence rates. Postreconstruction follow-up periods ranged from 60 to 87 months.","title":"Histologic Examination of Mastectomy Scars during Breast Reconstruction: A Systematic Review"}
{"_id":"bb8b296b-14a2-73f4-e7a5-455eedc2ae07","text":"After treatment, patient received oral food challenge with 120 g of wheat for the confirmation of tolerance acquisition. The patient show any symptoms and signs even with running just after intake of wheat no more for more than 2 years.","title":"Specific Oral Tolerance Induction Using IFN-Gamma in 2 Cases of Food-Dependent Exercise-Induced Anaphylaxis"}
{"_id":"bb92a587-9225-a541-c8fc-575167372e74","text":"This study using a standardized patient and two diagnostic models shows that diagnosing or ruling out a DVT in primary health care can help save resources. The cost of teaching LCUS to GPs is low in comparison to the potential savings. To reveal the actual costs of the LCUS protocol compared to the standard protocol, a larger prospective multi-center study with LCUS controlled with whole-leg US is needed.","title":"Cost-minimization modeling of venous thromboembolism diagnostics: performing limited compression ultrasound in primary health care reduces costs compared to referring patients to a hospital"}
{"_id":"bb9eaecb-5584-1d82-bc2a-c4c9bfa57d8b","text":"Hence, the present manuscript exclusively focuses on patients with locally advanced OSCCs involving the external skin, independent of their medical history regarding the sequence of the disease. This heterogeneous cohort integrating patients with primary and recurrent disease was chosen because it offers the possibility to exemplify and discuss aspects of synergism between surgical oncology and reconstructive surgery.","title":"Full-Thickness Tumor Resection of Oral Cancer Involving the Facial Skin—Microsurgical Reconstruction of Extensive Defects after Radical Treatment of Advanced Squamous Cell Carcinoma"}
{"_id":"bb9fd5b0-3e93-2eae-649d-0122e9b36c6c","text":"Repigmentation of the vitiligo lesions occurred due to a variety of patterns, however, a perifollicular distribution of the pigmentation after exposure to UV irradiation was observed. This fact indicates an important involvement of the precursors of the melanocytes residing in the hair follicle. Melanocytic stem cells represent a promising object of study for new research aimed at clarifying their role in repigmentation and at developing therapeutic strategies capable of an effective modulation of their differentiation and consequent migration.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"bba7374e-1437-5ac1-b549-414dbebcb6d8","text":"Research suggests that mastectomy is associated with a higher risk of intraoperative bleeding and postoperative complications than BCS. However, mastectomy alone and BCS combined with radiotherapy have equal efficacy in terms of preventing breast cancer recurrence. Results from the present study show that the association of postoperative bleeding with breast cancer recurrence is not modified by the extent of primary surgery.","title":"Breast cancer recurrence after reoperation for surgical bleeding"}
{"_id":"bba7e76b-3ff3-718e-6639-05e3d07d0d2e","text":"The main problem in MRI is the acquisition time to get a large number of image samples for a good reconstruction of the image. So a patient has to stay and endure a long time in an MRI machine. The problem of long acquisition time in a machine can be reduced by making development either on the hardware side or the software side. The changes in the software side can be implemented more easily than for the hardware side through efficient algorithms. These algorithms are mainly based on compressed sensing (CS).","title":"Improved Reconstruction of MR Scanned Images by Using a Dictionary Learning Scheme"}
{"_id":"bbaa7dcf-aed9-58ef-2306-352e70fedf75","text":"Table 3 summarizes the numerous randomized prospective trials already published or still pending that evaluate the role of SBRT for the treatment of localized prostate cancer. These trials compare SBRT against BT or normofractionated DE-EBRT for the treatment of LR and IR disease. They also assess SBRT in a strategy of treatment intensification for more aggressive diseases as discussed later on in the manuscript.","title":"Stereotactic Radiation Therapy versus Brachytherapy: Relative Strengths of Two Highly Efficient Options for the Treatment of Localized Prostate Cancer"}
{"_id":"bbabafd1-8a5f-e70c-b447-a48a4a5a4193","text":"The study group consisted of patients who had been admitted to the cardiovascular surgery department and had been diagnosed as presenting lower-extremity deep vein thrombosis. The patients with this condition had had signs and symptoms such as pain and swelling in the leg at the time of admission. After the initial examination on patients whose clinical condition had given rise to a suspicion of deep vein thrombosis, lower-extremity venous duplex ultrasonography was routinely carried out in order to confirm the final diagnosis. All the patients with lower-extremity deep vein thrombosis received anticoagulant therapy consisting of warfarin sodium, low molecular weight heparin or new oral anticoagulant agents such as rivaroxaban.","title":"Association between vitamin D levels and lower-extremity deep vein thrombosis: a case-control study"}
{"_id":"bbaf2689-9afb-666a-9bc3-f36fc04fc7f7","text":"In order to explore whether a different starting time of the intervention has an effect on the rate of exclusive breastfeeding, a subgroup analysis was carried out according to different types of subjects. The results of the study showed that there was no significant difference between the pregnancy group and the postpartum group for the increase in the rate of exclusive breastfeeding at 1, 2, 3, and 6 months after delivery, indicating that the time to start the intervention had no effect on the increase in the breastfeeding rate. The forest plots are shown in Figures S1-S4 in Multimedia Appendix 2.","title":"The Value of Mobile Health in Improving Breastfeeding Outcomes Among Perinatal or Postpartum Women: Systematic Review and Meta-analysis of Randomized Controlled Trials"}
{"_id":"bbb0fdd1-72ce-21c1-c90b-77d46597d975","text":"An effective procedure for patients with traumatic or neoplastic defects is vermilion advancement. However, due to the shortcoming of this method in providing vermilion in patients with lip hemangioma lesions that involve skin and mucosa around the defect this method may not be effective.","title":"Repair of Large Lip Vermilion defects with Mutual Cross Lip Musculomucosal Flaps"}
{"_id":"bbbb7a2c-6bb6-be57-ae27-2cd0763c0a9a","text":"Introduction: Curative surgical treatment of chronic osteomyelitis often requires free tissue transfer if there is significant soft tissue compromise. We investigated whether age influenced outcomes of curative osteomyelitis excision in those patients requiring free muscle flap soft tissue reconstruction.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"bbc86de2-8bec-8a89-4eb7-378a1fd55a59","text":"Calcanectomy is an effective alternative to below knee amputation for chronic heel ulceration with bone infection.","title":"Results of calcanectomy in the surgical management of heel ulceration with osteomyelitis in the high risk patient"}
{"_id":"bbcb5239-4c98-0ebf-2aa9-8e11180b91a3","text":"Only 20% of respondents from our survey would always offer mastectomy for involved margins. Reexcision can be challenging due to the glandular rearrangement during mammaplasty and should only be considered after careful discussion within the MDT if the operating surgeon is confident of the orientation of tumour bed and tumour histology is favourable. In addition, the original operating surgeon should undertake this procedure expeditiously to ensure accurate reexcision. We did not assess whether routine cavity shaves were performed at the time of operation and whether this has any bearing on rates of involved margins.","title":"Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England"}
{"_id":"bbccda5e-0911-2f54-57e7-86cc1f8a0ab2","text":"The present study examined whether or not the use of dynamic images alters the outcome of sentinel lymph node assessment in patients with malignant skin neoplasms of the upper and lower extremities. Some lymphatic channels were observed using early phase dynamic images only, and sentinel lymph node assessment was altered in some cases. Determination of whether a lymph node is a sentinel lymph node depends on visualization of the lymphatic network. In the cases of the lower extremities, the average diagnostic confidence value of sentinel lymph node assessment is usually higher with observation of dynamic images. In many cases, information about lymphatic flow was added with observation of dynamic images and it was helpful for sentinel lymph node assessment. It is necessary to use dynamic images alongside skillful observation in assessment of sentinel lymph nodes.","title":"Contribution of dynamic sentinel lymphoscintigraphy images to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities"}
{"_id":"bbd083f0-5304-5806-1336-5fcf6623e286","text":"Our study concluded that the prevalence of skin tumors is increasing and the condition is seen more commonly in females. Benign skin tumors are commoner in young age groups whereas malignant skin tumors are more seen in elderly. This indicates the requirement of more screening facilities and extensive dissemination of information regarding the indolent lumps and bumps of the skin that are most often under looked by the patients. This can lead to early help seeking behavior and subsequently early detection and treatment for the condition.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"bbd3d748-57c2-f7ca-cda8-6a7810907389","text":"BTX actions on hyperactive smooth muscles like sphincter Oddi or anal spincter - just to name only two of them - is mediated by action on the autonomic nervous system. BTX action on smooth muscle does not differ from the action on striated muscles.","title":"Botulinum Toxin: Non-cosmetic Indications and Possible Mechanisms of Action"}
{"_id":"bbd72ddb-a9d1-22cd-61da-db7c08884503","text":"Fasciocutaneous flaps like the antero lateral thigh flaps take a relatively longer time for dissection as compared to the gracilis and may also requires secondary debulking to facilitate footwear use. Omer Ozken et al discussed the reliability of free flaps in diabetic foot reconstruction in 13 patients, they used fasciocutaneous and muscle flaps but favoured the former because of better tissue match and the ease of post-operative monitoring. In all our patients, we were very comfortable with the gracilis flap, post-op monitoring was not an issue as we noted the muscle colour and bleed through the skin graft fenestrations. None of our patients needed secondary debulking as the flap atrophied well and took the contour of the foot.","title":"The Gracilis Muscle Flap: A “Work Horse” Free Flap in Diabetic Foot Reconstruction"}
{"_id":"bbdf81f8-6a0a-fd41-7d1c-afce5ba09aef","text":"The pedicle opening was spatulated three times of their diameter and anastomosed as an end-side fashion to common carotid artery and internal jugular vein with prolene 8\/0 under 3x loupe magnification. Little maneuver such as pedicle dissection at the mesentry or orientation of arteriotomy and venotomy may be required for good adjustment. Proximal opening of the jejunal tube was spatulated and anastomosed to the side of pharyngotomy or closed primarily. The distal ostomy was closed two month later after complete healing of the wound.","title":"Anastomosis of Free Flap Pedicle to Great Vessels"}
{"_id":"bbf1b09c-75cf-7973-67fe-3c06c9e79a94","text":"The sentinel lymph node identification is usually carried out by preoperative localization using Tc99 colloid and gamma camera or by intraoperative localization using hand held gamma probe or by dye technique. Majority of the centers use a combination of techniques and it has been reported that the triple method using all of the above gives the best results [8–10].","title":"Fallacies of preoperative lymphoscintigraphy in detecting sentinel node in breast cancer"}
{"_id":"bbf71925-828b-64b7-6df1-8c75b5e2742d","text":"The photoinactivation mechanism is induced after the photoinactivation of an endogenous substance inside bacterial cells by producing free radicals which determine cytotoxic action [35]. It is important to underline that the quantity of photosensitive endogenous substances differ according to the type of bacterial strain in variable manner.","title":"5-Aminolevulinic Acid and Red Led in Endodontics: A Narrative Review and Case Report"}
{"_id":"bbf7d9d5-aeda-1428-86f4-0b2175202725","text":"Direct light like the operating light will interfere with the picture quality and visualization ability and may need to be dimmed or switched off in order to optimize the visualization of fluorescent SLN. Settings on the video camera may be set in such a way that there the surgical field and tissues are identifiable on the monitor.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"bc06513a-6059-7fa1-7746-e76931d063b3","text":"Melanoma is a complex and heterogeneous disease and tumor may be composed of distinct cell populations with distinct molecular features and varying response to treatment. Inter-and intra-tumor heterogeneity within primary tumours and between primary and metastatic sites as well as developing resistance suggest the need for novel approaches to identify predictive markers closer to patients’ tumor allowing for rational design of combination therapies instead of using a single biopsy assumption. Additional challenge is how to use the knowledge that cancer development and progression depends on immune system and stroma and several areas of new investigations provide promissing insights with regard to development of successful treatments. Other studies including the role of microbiota, mechanisms of rejection and metastasis process are essential for continuous progress in the treatment of melanoma. Thus, it is important that the agents to down-regulate the immune suppression, drugs targeting vasculature or crucial regulators of metastasis complimentary to targeting tumor cells are considered for rational therapeutic strategies.","title":"Future perspectives in melanoma research. Meeting report from the “Melanoma Bridge. Napoli, December 2nd-4th 2012”"}
{"_id":"bc17e6ff-26d1-d1f7-bfc6-803f971ca81d","text":"Another key element is that IRT may be used also in fragile and elderly patients without additional risks, because it is usually well tolerated.","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"bc18d01d-a843-253b-d20e-097a4c289e64","text":"In this context it can be assumed that the selective toxicity of peroxides requires high concentrations and sufficiently long times to kill cancer cells.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"bc1c327c-c97e-2875-c360-049303537cd7","text":"Our results elicit the potential of combined therapy in diminishing the toxicity of antineoplastic drugs. Ultimately, photodynamic therapy mediated by either methylene blue or Photogem as monotherapy or in combination with cisplatin has low mutagenic potential, which supports its safe use in clinical practice for the treatment of cervical cancer.","title":"Photodynamic therapy combined to cisplatin potentiates cell death responses of cervical cancer cells"}
{"_id":"bc1d5cb8-a1da-5b4a-24fb-7ce1d0589d60","text":"All normal test results were confirmed by the radiologist, and 3 patients with abnormal findings on EPUS examination were subsequently diagnosed as having distal DVT or superficial thrombophlebitis.","title":"Point-of-care ultrasound in patients with suspected deep vein thrombosis (DVT)"}
{"_id":"bc2d638a-e323-b538-08cf-1682e1ee5f8f","text":"In Brazil, given the shortage of residency places and given the personal need to begin working, it is common for physicians to begin practicing internal medicine and to informally practice plastic surgery. They may occasionally obtain a license in plastic surgery, following a review of their knowledge and experience by the medical association.","title":"Plastic surgery professional misconduct: a cross-sectional study on cases between 2008 and 2017, filed before the São Paulo State Medical Board"}
{"_id":"bc35576f-f641-1854-0c90-404caf1fc8d4","text":"The aim of our study is to assess if the administration of allergen and protective vaccines during one visit is a safe option, and, additionally, if the reduction in time between the two injections to 30 min impairs the tolerance of both vaccines. Based on the fact that allergen vaccines and vaccines against infectious diseases have different mechanisms of action, we assumed that the suggested simultaneous procedure is safe for patients. We decided to check the incidence of adverse effects to evaluate the safety of double vaccination.","title":"Simultaneous Influenza Vaccination and Hymenoptera Venom Immunotherapy Is Safe"}
{"_id":"bc35dfea-df78-fa0d-d37f-ed0c880727d5","text":"Wrinkles and sagging of the skin are the two major signs of skin aging. The underlying mechanism is still poorly understood. The wrinkled skin has an accumulation of altered elastic fibers and degradation of collagen bundles in the dermis. Enhanced elastase activity in dermal fibroblasts is mainly associated with UVB wrinkling mechanism. The activation of cytokine expression in epidermal keratinocytes by UVB irradiation causes the secretion of IL-1α and GM-CSF which penetrates into the dermis. This stimulates the expression of skin fibroblast elastase which cleaves the elastase fibers leading to a loss in its configuration thereby leading to reduced skin elasticity leading to wrinkle formation.","title":"Anti-aging and Sunscreens: Paradigm Shift in Cosmetics"}
{"_id":"bc35ebd5-3a20-84bf-1653-6a688f52c7a9","text":"Qualitative work with patients who sustain hip fractures identified mortality as an important metric.24","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"bc3743f6-a0b7-615e-d2cb-d3fd670e5bf3","text":"Given the lack of awareness regarding the protective effects of sunscreen against skin cancer and aging, medical students should be educated with the help of awareness campaigns and initiatives. Medical students represent a vital asset to society as future health care providers; hence, equipping them with adequate knowledge on sunscreen benefits would ultimately lead to increased sunscreen use among both patients and the general population.","title":"Prevalence and Predictors of the Use of Sunscreen Amongst Medical Students: A Multi-center Cross-sectional Study"}
{"_id":"bc3f8872-2e9a-a6a4-02c4-8943565cdc23","text":"Patients who sustain other injuries which may affect the primary outcome measure will have their injuries documented, but will be included in the analysis.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"bc4768ac-5849-f169-965b-ae89db5000d4","text":"We proposed five steps to create an implant model based on the mirror technique implemented on the 3D Slicer as follows:","title":"The simplified tailor-made workflows for a 3D slicer-based craniofacial implant design"}
{"_id":"bc499d90-7aa6-c3af-300e-d325eb867e13","text":"Cervical radiculopathy is a frequently encountered neurologic condition and is most often caused by encroachment of a cervical nerve root. It typically presents with neck and arm pain and sometimes sensory loss or loss of motor function in the affected nerve root distribution. The most common cause of cervical radiculopathy is degenerative features, including reduced disc height, osteophyte formation, and disc herniation.","title":"Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy A Randomized Clinical Trial Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy"}
{"_id":"bc563fbd-63f0-2d49-33d5-bc69182d9d31","text":"Fondaparinux administration and early disease-stage CRC appeared to be risk factors for postoperative bleeding in patients with pharmacological thromboprophylaxis undergoing surgical treatment for CRC. Patients’ hypercoagulative condition depending on disease progression of CRC might be related to the occurrence of postoperative bleeding following CRC surgery.","title":"The impact of pharmacological thromboprophylaxis and disease-stage on postoperative bleeding following colorectal cancer surgery"}
{"_id":"bc5f1415-d110-21c9-f46e-6ff893e1484e","text":"Several pathologies can present with calcified masses in the soft tissue and involve the paraspinal region, as previously mentioned. Although most tumoral calcinosis aetiologies show similar characteristics on imaging, careful evaluation could potentially raise suspicion for particular entities in the differential diagnosis.","title":"Tumoral calcinosis in the lumbar spine secondary to systemic sclerosis: a rare cause of radiculopathy in an adult with advanced disease Liberato et al"}
{"_id":"bc5fccb9-4bf5-9fc0-c93e-8025446c04f7","text":"The anatomical model itself already presents a huge benefit compared to the 2D images as it is displayed as a 3D structure compared to the stack of individual images. Furthermore, the different structures are highlighted in different colors and borders are clearly visible. This improved form of information visualization alone can bring clear advantages to the surgical planning process. Nevertheless, our findings indicate that seeing these models in VR and interacting with them through virtual hands might have an even bigger advantage. The fact that the surgeons reported better spatial understanding and described the data as more memorable, which is attributable (1) to the stereoscopic view of VR as shown by McIntire et al. (6) and (2) the ability to interact with the data themselves. Directly interacting with the data yourself has been shown to benefit understanding and learning of anatomy (22). Also, the embodiment that arises from the interaction in VR is linked to improved implicit learning (23) which could transfer to the implicit learning of the individual anatomical structure and, therefore, an easier recall during the surgery. These concepts can also be found in the observation that all surgeons used head movements and rotated the model extensively to get a particular view of the model they were interested in. They also reported the ability to view the model from different angles and the ability to rotate the models with their hands as one of the most important features of the tool. While we cannot clearly distinguish the advantages of the model alone and the advantages added by the VR and its interactive nature, the observations and statements of the surgeons clearly suggest that VR brings substantial additional value. The fact that the interaction, in general, was perceived as easy and intuitive indicates that the design choice of being able to interact with all components with only one button and a flat menu structure worked well and contributed to the overall positive impression.","title":"Virtual Reality for Surgical Planning – Evaluation Based on Two Liver Tumor Resections"}
{"_id":"bc69341a-64a6-4f52-168d-3abf09f41dac","text":"This particular case of unusual venous anatomy raises specific issues related to microvascular anastomosis including problems with finding an ideal site of anastomosis and concerns with potentially creating a site of turbulent flow if this variant is not dealt with correctly. A decision was made during the operation to preserve and incorporate the natural confluence of the two birfurcating veins for a number of reasons.","title":"An unusual “venous circle” of the internal mammary vein encountered during microvascular anastomosis and implications for practice"}
{"_id":"bc6a080d-bd4f-9915-83d6-a8435fa0ead6","text":"The authors believe that a comparison of the proposed system with comparable non-invasive alternatives that are commonly used for perfusion measurement today will provide a better insight into the characteristics and capabilities of the instrument. It should be made clear that the device developed in this work is a technological demonstrator, which in no way maximizes the performance achievable by the proposed method. However, as this section shows, it has provided very respectable results.","title":"Design and testing of an optical instrument for skin flap monitoring"}
{"_id":"bc6b628a-c33d-906a-95fe-88adfb94a487","text":"This supports the theory that distant metastasis originates from the primary melanoma and that metastatic dissemination is orchestrated in a parallel rather than serial fashion. The recent results of the MSLT-II study also support this theory as immediate completion lymph node dissection did not improve melanoma-specific survival among patients with sentinel-node metastases compared to observation with frequent nodal ultrasonography and dissection only in patients in whom clinically detected nodal recurrence had developed. Therefore, the Halstedian hypothesis of contiguous metastasis from the primary tumour through the lymphatics to regional nodes and then to distant sites as the sole mode of disease spread should be rejected. The model of differential spread proposes that there are multiple independent dissemination pathways with some melanomas able to metastasise only to regional lymph nodes, others able to metastasise only haematogenously and others still able to metastasise haematogenously and via the lymphatic system. Indeed, metastatic patterns vary widely among melanoma patients and the drivers behind the preferential patterns of metastasis among different melanomas remain largely unknown. One explanation is that this may be due to intratumoural heterogeneity and metastatic dissemination that occurs from genetically distinct subpopulations of the primary tumour.","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"bc6d5c94-6fe5-ee4d-0987-10957cef4218","text":"As a program director I am privileged to see first hand the effect international electives have on our residents' lives and careers. I see how they improve their clinical care along with their ability to function in our highly diverse emergency department. I have witnessed multiple residents' careers and lives change due to the ability to practice abroad. For example, residents who spent international medical electives abroad are now improving emergency medical systems in developing countries as well as helping foster the development of the specialty overseas. Just as important, however, is the clear change I see in residents who now can understand why cultural and ethnic influences may predispose someone to a certain disease entity or hinder them from actively participating in care that we feel is essential to their well being. These experiences lead to better patient understanding, more culturally appropriate interactions and a greater ability to think on a global scale when constructing a differential diagnosis.","title":"Loss of international medical experiences: knowledge, attitudes and skills at risk"}
{"_id":"bc711b08-521e-0c15-a034-dff75e0e8211","text":"Her situation was further complicated when she developed acute right inguinal swelling and pain a few days after her biopsy while she was on the heparin. Concern for a possible arterial bleed led to a CT scan of the extremity which revealed a hyperdense fluid collection with air fluid levels within the anteromedial right thigh, measuring 6.4 x 13.2 x 14 cm without contrast extravasation. The patient was started on vancomycin and piperacillin-tazobactam for presumed infected hematoma and underwent urgent incision and drainage. Her antibiotics were stopped after two days when cultures from the site were negative for any organisms.","title":"The Role of Serial Ultrasounds in Diagnosing Suspected Deep Venous Thrombosis"}
{"_id":"bc7ab341-b028-e383-81fd-a30a43fc5c44","text":"We demonstrated that downregulation of CD4 T cell responses in ARE was reversed by depletion of B cells and the suppressive effect was reproduced after B cells were added back, implying that B cells are likely the key regulators. Further B cell exchange study showed that ARE B cells were able to suppress PRE T cells; these results confirmed that B cells are the cell type present in the APCs responsible for the allergen-specific modulation (suppression) ARE. In future studies, a dilution series of B cells in mixing studies with PRE and ARE samples will have to be considered to elucidate the mechanisms and thresholds of suppression. In addition, one important limitation of this study is that our findings do not address how the phenotype of antigen-specific B cells changes after antigen reexposure. It would be certainly interesting to evaluate if they are critically required to mediate the suppressive activity.","title":"B cells modulate mouse allergen-specific T cells in nonallergic laboratory animal-care workers"}
{"_id":"bc7ae866-4d02-6c8c-3b31-3b26de3125a8","text":"'If any matter of strife or debate be between any person of the said Craft, God forbid that any of them raise the matter under the Common Law. The person aggrieved shall first make his complaint known to the Masters or Governors in order that they may sort out the matter. Only if they are unable to do so within 13 days shall it be lawful for the matter to be referred to the Common Law'.16","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"bc7bcac7-c4fb-9e4c-b933-5ec3c8e9801c","text":"Longer follow up of the participants will help to know if this type of contest helped them to get better scores in Mexican Plastic Surgery Boards and if they get better involved to present papers in congress and to have better practice, academic or private. Pecha Kucha contest was a good experience for majority of participant. They found a helpful contest in order to be better prepared as plastic surgeons and future speakers. The ideal time between images and words is 80% to 20%. This is the first experience to an educational game for most of the participants. Besides, most of programs request classes to their residents, few of them explain how they want the presentation.","title":"How to Improve Speaking Skills in Plastic Surgery Training? Survey in Residents Participants in Pecha Kucha Contest"}
{"_id":"bc805398-880d-9058-099c-59ced58375f4","text":"Quality care presupposes breaking down dichotomies between primary health care actions and specialized care actions and is related to professional performance at all levels of care within the health care network.","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"bc8262cd-8604-685e-ed29-190d0b51f769","text":"The other possible indications for the use of the flap would be in the lower limb defects with small bony gap and large soft tissue loss. The entire TFL muscle with or without the overlying skin is available to cover relatively large soft tissue defects. In the head and neck, whether mandibular reconstruction can be possible with this flap is a question worth pursuing, even though the initial report by Baker was disappointing. The flap may be suitable for reconstructing small defects of the mandible with external skin and soft tissue loss. Given the structure of the flap, it may be difficult to use it in presence of large mucosal defects. The vascular part of the bone may extend only for up to 5–6 cm and hence longer segmental defects may not be suitable for reconstruction by this flap. The constant branch to the gluteus medius [Figure 14] may be retained and dissected, allowing the harvest of a longer segment of bone. This will need confirmation by further dissection studies.","title":"Tensor Facia Lata-iliac crest osteocutaneous flap for orbitomaxillary reconstruction: A preliminary report"}
{"_id":"bc87c950-06da-a0b3-028b-5cea3eabdd82","text":"In certain circumstances, phytochemicals may especially help with the treatment of skin cancer. First, both the patient and the practitioner have easy access to precancerous and cancerous skin lesions. This assists in the design of topical treatments that can be administered just to the suspected malignant region of change while causing little harm to healthy skin. It may be necessary to provide a phytochemical orally to cure different internal organ tumors, which would have an impact across the body. Second, both doctors and patients can quickly assess if a skin lesion therapy was successful. Skin biopsies are very minimally invasive, although most malignancies need invasive pathological proof. Future investigations on the efficiency of phytochemicals in treating skin cancer may therefore be made simpler. The majority of local adverse effects may be readily identified using topical treatments, which may help patients experience less pain and lower their risk of developing more severe or long-lasting side effects.","title":"Skin cancer: understanding the journey of transformation from conventional to advanced treatment approaches"}
{"_id":"bc8837c2-612f-40c7-45d8-45ed3cfd78de","text":"Methods: We looked retrospectively into the case records of six patients who have been undergoing treatment for CNO in the Paediatric Rheumatology Unit of the University Hospital. Inclusion criteria were the diagnosis of CNO, evidence of at least one lesion of osteitis confirmed by imaging and onset of symptoms before age 18 years.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"bc89a931-24be-1158-dada-41175f97013a","text":"Table 3 and Figure 9 show the hardness measurement results of individual composites using the ball indentation method.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"bc8e106d-c54d-8580-7bbe-9a05c1bd824e","text":"Struggling with breastfeeding may also be associated with having too much milk and thus being confronted with extreme bodily changes in the breasts. Such bodily changes in the breast may in some cases be experienced as very trying and, in some cases, these changes of the breast can be perceived as disgusting.","title":"A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth"}
{"_id":"bc8fb0d5-8ab3-50e9-6fab-c61e99dc1f7b","text":"The inferior border of the submandibular gland was released and separated from the digastric muscle. The proximal ends of the external maxillary artery and anterior facial vein were identified in the superior border of the deep surface of the posterior belly of the digastric muscle and were well-protected. The posterior border of the submandibular gland was then separated, and the distal ends of the external maxillary artery and anterior facial vein were both ligated with no damage to the marginal mandibular branches of the facial nerve. The superior border of the submandibular gland was released with its duct severed.","title":"Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers"}
{"_id":"bc91afe4-6be7-c482-9ffc-abad53600d2c","text":"Healing by secondary intention and granulation may be the simplest treatment after tumor resection. The entire process can take months and requires daily wound care with wet to dry dressings. When completely healed by secondary intention, the orbital cavity is only slightly shallowed with granulation tissue but allows easy inspection for local tumor recurrence. Wound closure can be accelerated by using a meshed or unmeshed split thickness skin graft to line the orbital cavity. Similar to healing by secondary intention, the split thickness skin grafting of the orbital defect also results in excellent visualization of the orbital cavity. Due to their thinness, skin graft reconstructions usually result in a deep orbital cavity that provides an excellent fit for an orbital prosthesis if one is desired by the patient. When there is no history of prior radiation and no postoperative radiation is planned, secondary intention and skin grafting even on bare orbital bone are usually successful methods for addressing the standard orbital exenteration wound.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"bc989bb8-0e2a-f27c-f0d3-b07f0bd0217e","text":"Shotgun injuries and their associated sequelae often require more operations and resource utilization compared to other firearm injuries [10]. Detection requires knowledge of shotgun mechanics as well as a high degree of vigilance in the examination and management of the patient.","title":"A rare case of retained sabot after close-range shotgun injury"}
{"_id":"bc9f6c22-35c0-149d-9183-029ffa783dca","text":"We have demonstrated that patients with early-stage breast cancer with focally positive tumor-exposed margins following BCS could avoid re-excision without any detrimental effects on local control or their survival. We showed that an adequate boost dose to the tumor bed following WBRT was sufficient to eradicate residual tumor at the surgical margins if the amount of residual disease is limited.","title":"Efficacy of radiation boost after breast-conserving surgery for breast cancer with focally positive, tumor-exposed margins"}
{"_id":"bca54384-8d66-2703-5071-c8fce53bf49d","text":"Perforator propeller flaps are an important addition to the armamentarium of the plastic surgeon for the management of burn wound and sequelae. These flaps are simple, safe, and versatile and must be considered as the primary option for treatment of burn wounds and sequel wherever possible.","title":"Use of Local Perforator Flaps for Post Burn Reconstruction"}
{"_id":"bca5b5cd-37c7-4475-2b3a-98016e498594","text":"All AVLs were performed in a two-step intervention and the greater saphenous vein was employed in four patients and the cephalic vein in two patients.","title":"Efficacy of the Arteriovenous Loop for Free Flap Reconstruction in Patients with Complex Limb Trauma: Case Series and Literature Review"}
{"_id":"bca656e4-9fd7-5d72-ef26-f319bc880373","text":"Follow-up studies will also address some of our limitations. First, patients in the discovery cohort were diverse in their disease characteristics and not uniformly treated or followed. The validation data set, while having more homogeneous patient characteristics, were also not uniformly treated or uniformly followed. Although, both sample sets were collected based solely on availability, we expect limited bias since the immune cells were not known at the time of selection. We also recognize that the validation cohort was small, preventing multivariate adjustment for patient characteristics and that the survival separation based on CD20 cells might be exaggerated due to the dichotomy in patient selection. Nevertheless, the fact that these results were noted in a limited diverse set of patients in our discovery cohort and confirmed in our smaller validation study in TNBC patients, suggests that the impact of CD20 is substantial and can be observed even in small studies with diverse patient characteristics and treatments.","title":"Sentinel lymph node B cells can predict disease-free survival in breast cancer patients"}
{"_id":"bcabd40e-51fb-a1e2-04c0-9dd5f4faa4c2","text":"Whilst surgical trainees performed local anaesthesia cases in this review predominantly, it is important to note that rates of incomplete or positive margins did not rise sharply. These LA cases are often valued developmental opportunities early in a surgical career and reinforced that trainees are likely vigilant in achieving appropriate margins.","title":"Keratinocyte Skin Cancers in General Surgery: The Impact of Anaesthesia, Trainee Supervision, and Choice of Reconstruction"}
{"_id":"bcb20d1e-d27f-eecc-ac6b-53f8e3986adf","text":"Utilizing the same aseptic technique and under ultrasound guidance, a total of 240 units of BTX was injected into the rectus abdominus muscles bilaterally, in which 40 units\/site in a total of 6 sites were administered. The patient reported marked improvement and she was able to sit on the chair and walk independently 3 weeks after the injections with no side effects. She has been on regular follow ups every 6 months, to which she received BTX reinjection over a period of 48 months. On her last follow up, the patient documented maintained therapeutic effects of the injections with no adverse events.","title":"Ultrasound-guided botulinum toxin A injection in the treatment of belly dancer’s dyskinesia"}
{"_id":"bcb3ef36-0778-d703-7a6b-14b16a0a905c","text":"The use of PV venous graft of native liver with HCC for venous reconstruction is a feasible and valuable option in LDLT with good patency rates and no risk of HCC recurrence.","title":"Successful use of venous graft from native liver with hepatocellular carcinoma during living donor liver transplantation with no impact on recurrence rate: A retrospective cohort study"}
{"_id":"bcb686bd-f4ce-564e-beb1-be08f4e49928","text":"Although some literature have suggested that women undergoing breast conservation surgery have better outcomes on selected psychosocial and quality of life measures then those of mastectomy.","title":"Women’s Perspective of Breast Self-examination"}
{"_id":"bcb6d358-ec8f-d3d2-d812-5b2cfb15cfb0","text":"A microsurgical latissimus dorsi flap was performed for resurfacing a large soft tissue defect of the forearm with exposure of the vital structures and contaminated wound. Early coverage of a defect is a generally accepted concept to achieve a better functional result. The authors present a case report where a free latissimus dorsi flap with subsequent hyperbaric oxygen therapy allowed a successful single stage reconstruction of this complex severely contaminated defect.","title":"Salvage of Upper Limb following a Severe Crushing Trauma: Immediate Reconstruction with a Free Flap and Subsequent Hyperbaric Oxygen Therapy"}
{"_id":"bcbece22-3f7e-bac8-426c-9343f79172fb","text":"discontinue oral therapy 3 to 5 weeks after the switch if there are no complications;","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"bcbf4ec8-16cc-7a80-4d98-d81c93c4f1de","text":"In the first scenario, when the nodal involvement on imaging is doubtful or possibly going to be positive, it is advisable to go ahead and perform radical cystectomy and complete nodal clearance. It is of extreme importance that no gross residual disease is left behind, the clearance is meticulous and one practices extended lymphadenectomy (Level I, II and III) in order to achieve better long-term results. The Level I dissection is limited to the obturator fossa, Level II dissection extends over to the genitor-femoral nerve and typically up to the common iliac bifurcation and Level III dissection includes the pre-sacral tissue and extends up to the origin of the inferior mesenteric artery. This approach gives not only excellent chance of clearance of the disease, but more importantly enables us to have accurate pathological staging. Node negative patients can be observed while node positive patients could be offered adjuvant chemotherapy. If it appears that gross residual disease is going to be left behind it is advisable to close and have neoadjuvant chemotherapy and perform post chemo salvage surgery.","title":"Treatment of locally advanced and metastatic bladder cancer"}
{"_id":"bcc95118-3749-9b84-e935-7326d02049bf","text":"As demonstrated in this case study, GCFs may continue to proliferate until completely removed. GCFs can be treated by conservative surgical excision without subsequent recurrence. A case can be made for early recognition and treatment of lesions to minimize surgical intervention.","title":"Giant Cell Fibroma in a Paediatric Patient: A Rare Case Report"}
{"_id":"bcceffdb-1bca-33ba-fe14-0f2ddf8eb32c","text":"Tumorigenesis of DT is a poorly known multistep process involving progressive cell proliferation with a potential role of APC and CTNNB1 gene mutations.","title":"Human microRNA expression in sporadic and FAP-associated desmoid tumors and correlation with beta-catenin mutations"}
{"_id":"bcda6a7c-ca15-cac1-4866-c32b965d8713","text":"This study aimed to assess the perception and attitude of Fakeeh students towards cosmetic rhinoplasty.","title":"Perception and Attitude of College Students toward Cosmetic Rhinoplasty"}
{"_id":"bce31b04-5fb0-4a98-fd89-caac4121092a","text":"Table 1 Distribution of patients on the basis of clinicopathological features and time delay","title":"Waiting time for radiation therapy after breast-conserving surgery in early breast cancer: a retrospective analysis of local relapse and distant metastases in 615 patients"}
{"_id":"bce80384-003a-3c49-7621-4e70770dbe46","text":"The study target population is formed by patients older than 14 years, with IOM implanted after a long bone fracture diagnosed during the study inclusion period, and who are treated by DAIR.","title":"Efficacy and safety of different antimicrobial DURATions for the treatment of Infections associated with Osteosynthesis Material implanted after long bone fractures (DURATIOM): Protocol for a randomized, pragmatic trial"}
{"_id":"bcec058c-9893-0610-7fb3-bdd91ce352c3","text":"An ulnar artery to superficial palmar arch bypass using a cephalic vein graft from the left forearm was performed. Initial dissection was carried out under tourniquet control with release prior to anastomosis. Access to the superficial arch was obtained through a palmar incision, incorporating the carpal tunnel. There were several thrombi in the ulnar artery, including one just proximal to the superficial arch and another in the distal wrist. The ulnar artery appeared to be thrombosed in the distal forearm and proximal wrist and up into the proximal hand. However, the proximal ulnar artery had pulsations and a strong Doppler signal. The distal superficial palmar arch also had a good Doppler signal, suggesting a patent artery, likely from collaterals. The distal ulnar artery was therefore used for inflow and the proximal superficial arch for outflow.","title":"Surgical Treatment Options for Subacute Ischemia of the Hand: Case Report and Literature Review"}
{"_id":"bcee4f91-f1f7-844b-48d5-a5ed19b7db5f","text":"In conclusion, we describe a case of refractory JDM with skin ulcerations and extensive intramuscular calcifications that were poorly responsive to conventional therapy but were subsequently successfully treated with abatacept. Our patient initially underwent surgical excision and increase in immunomodulation, but her calcinosis continued to progress which prompted use of abatacept. We found that use of abatacept was associated with improvement in her functional outcome and recurrence did not occur. As treatment late in the course of JDM has been associated with a greater amount of dystrophic calcium salt deposition, rheumatologists should explore use of abatacept early on in disease course. Further studies are needed to validate the use of abatacept for treatment of calcinosis in children with JDM and to evaluate the long-term outcomes.","title":"Abatacept in the Treatment of Juvenile Dermatomyositis-Associated Calcifications in a 16-Year-Old Girl"}
{"_id":"bcf05501-d20a-b804-a8d8-6a312fd4d117","text":"Patients were excluded if they had distant metastases, previous radiotherapy for SCCHN or breast cancer, ongoing participation in any other clinical study or trial, or concomitant treatment with an EGFR inhibitor. Patients who were pregnant or breast-feeding were excluded from the study, as were those with known hypersensitivity to any of the R1 and R2 treatment components. Patients with previous or concurrent cancer within 5 years of starting the study and any other social or medical conditions that would affect participation in or evaluation of the study were excluded.","title":"Topical R1 and R2 Prophylactic Treatment of Acute Radiation Dermatitis in Squamous Cell Carcinoma of the Head and Neck and Breast Cancer Patients Treated With Chemoradiotherapy Manas et al"}
{"_id":"bcf6b3d9-317f-1776-7039-d6c2bb309e0b","text":"Although this serves as a preliminary report, the findings are very promising when it comes to new therapeutic approaches for rhinoplasty. Furthermore, using experimental protocols in actual clinical care and employing the substantial regenerative capacity of the human tissue can create new approaches.","title":"Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage"}
{"_id":"bcf8d7a7-f883-6dcb-9fe4-5325624724d7","text":"The patients wore intermittent pneumatic compression devices or elastic compression stockings from the induction of general anesthesia to the morning of POD 1 for prophylaxis of postoperative DVT. Postoperative ambulation was initiated on POD 1. None of the patients received routine prophylactic anticoagulation for DVT.","title":"Evaluation of perioperative D-dimer concentration for predicting postoperative deep vein thrombosis following hepatobiliary-pancreatic surgery"}
{"_id":"bcf9446d-ef16-8bdf-e6d5-325e99ed59bd","text":"The reduction mammaplasty resection combines wide local excision of a breast malignancy with reduction mammaplasty in a patient who desires breast reduction. Reduction mammaplasty resection may be performed with or without nipple preservation depending on the location of the cancer. When the nipple-areolar complex is preserved, recentralization of the nipple is generally performed to move the nipple-areolar complex to a more anterior and superior position on the breast mound. The principal oncological advantage of the reduction mammaplasty is the ability to achieve wide local excision of large breast malignancies, especially those that might not be amendable to breast conserving surgery using the standard lumpectomy. Breast rearrangement is useful for masking larger segmental defects and simultaneously creating an aesthetic breast mound. The versatility of this approach makes it suitable for resection of lesions located between the 4–8 o'clock axes of the breast, as well as in the retroareolar or supra-areolar position. The reduction mammaplasty resection is regarded to be among the more complex oncoplastic breast conserving procedures and should not be performed by surgeons lacking appropriate training in plastic or oncoplastic surgery. Its inclusion in this paper is meant to provide a broad overview of the approach for surgeons considering appropriate training in oncoplastic surgery.","title":"Oncoplastic Approaches to Breast Conservation"}
{"_id":"bcfda7d3-9623-4de9-4201-1ad231ecc861","text":"Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty.","title":"Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series"}
{"_id":"bd000b05-ec76-7b30-bf41-ecb7edb43930","text":"Directors and division heads viewed the fellowships as a means to spread their influence by providing a beneficial training experience to individuals who would establish a practice in other regions or countries. Trainees perceived that the fellowship would enhance their own reputation via the means of additional training\/scholarship.","title":"Fellowship training: a qualitative study of scope and purpose across one department of medicine"}
{"_id":"bd03590a-d496-cae2-9793-41f0d82113b8","text":"The ultrasound appearance has been poorly described in the literature; the lesions present as multiloculated masses with a calcified peripheral shell and fluid content.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"bd09bf82-dd7d-e3c9-e33b-d7245dcf05b4","text":"Extended excision with intraoperative local chemotherapy and postoperative radiotherapy was performed and a dramatic reversal of symptoms was gained 4 weeks after surgery, with a total dose of 46 Gy. Postoperative pathological examination revealed epidermoid cyst with mild to moderate atypical hyperplasia.","title":"Repeated recurrent epidermoid cyst with atypical hyperplasia A case report and literature review"}
{"_id":"bd140281-188c-6981-bb8a-5cd40ff9885c","text":"The forehead flap is acknowledged as the ideal donor for midface reconstruction due to its color and texture match, vascularity, and ability to resurface all or part of the reconstructed area.3 The flap is usually designed as an esthetic unit and comprises the hairless skin of the forehead between the scalp and the eyebrows and extends laterally to the preauricular and temporal hair-bearing skin. The inferior border of the flap should lie immediately above the eyebrow, primarily to include the inferior branch of the superficial temporal artery but also to improve the donor site deformity by the use of a skin graft as a forehead esthetic unit. The flap is generally elevated at the level of the periosteum. It is possible to elevate the flap superficially to the frontalis and corrugator muscles to preserve facial expression.4 The superficial temporal artery is considered the dominant pedicle of the flap. The motor inervation of the flap is through the frontal branch of cranial nerve VII (of the facial nerve). Brow elevation function is completely lost with the use of the standard forehead flap. The sensory nerves supplying the flap arise from supratrochlear, supraorbital, and auriculotemporal nerves.3,4,5","title":"The Forehead Flap"}
{"_id":"bd16675d-fcfa-83fd-3e01-ff04ace0934f","text":"Improving effective leadership of individuals, groups, and healthcare organisations is essential for improving surgical performance and indirectly improving health outcomes for patients. Numerous systematic reviews have been conducted which seek to determine the effectiveness of specific leadership interventions across a range of disciplines and healthcare outcomes. The purpose of this realist review is to systematically synthesise the literature which examines in which context and for whom leadership interventions improve leadership of surgeons, surgical teams, and trainees.","title":"In which context and for whom can interventions improve leadership of surgical trainees, surgeons and surgical teams and why: a realist review protocol [version 1; peer review: 3 approved, 1 approved with reservations]"}
{"_id":"bd1b3331-2074-5dc6-b815-848ead9f1d46","text":"Complete surgical excision remains the gold standard treatment for GCTSS. Recurrence is the single most important issue that preoccupies both the patient and the treating surgeon. Besides incomplete excision and joint involvement, there is no consensus on the effect and contribution of previously identified risk factors for recurrence. Thanks to an adequate surgical exposure and meticulous dissection provided by the magnification loupes, we had one of the lowest recurrence rate reported in the literature. Well-designed studies combining the recurrence rate of several hand surgery centers with standardized treatments are needed to better demonstrate the associated risk factors for recurrence.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"bd21629b-7c36-60a0-dbde-b5293c621c22","text":"We report an incidence of local recurrence that is half of what has been shown in several other studies with marginal resections. The most probable explanation for this difference in our view is the median follow-up time of 40 months. Only 13 out of 40 patients had a follow-up of more than 60 months. Taking into account that local recurrence developed in most of the other studies in patients more than 60 months after surgery, it is likely that our local recurrence rate will increase over time and this represents a limitation of our study. There is data indicating that the risk of local recurrence is correlated with the time of follow-up [17].","title":"The role of surgical margins in atypical Lipomatous Tumours of the extremities"}
{"_id":"bd26e68a-fab8-d26a-e901-5a705ca3ff4c","text":"Treatment plan included the extraction of the four first maxillary and mandibular premolars aiming to correct the Class II malocclusion and especially to open space mesial and distal to the ankylosed tooth in order to perform the osteotomy surgery.","title":"Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics"}
{"_id":"bd2ddbfd-1719-4800-13a9-bf362e0a3ccf","text":"The use of hyaluronic acid filler for enhancement of nipple projection has not been well characterized. Here, we report on the use of hyaluronic acid fillers for nipple projection in a series of patients.","title":"Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique"}
{"_id":"bd34166e-9c3b-2ebf-659f-36ded3797bfc","text":"Presence of definite or probable DVT in the popliteal or femoral veins detected on a screening compression Doppler ultrasound scan, which was not clinically suspected before the scan.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: statistical analysis plan"}
{"_id":"bd442dda-0cb5-bda8-bebe-a1c1daa31f4d","text":"There are essentially 3 separate categories of neck contracture for which different surgical concepts are advocated.2 Isolated vertically oriented scar bands can usually be released with Z-plasties. Scar contracture involving burned skin with intervening normal skin can be treated with incisional release and skin grafting or local flaps. Local unburned tissue can be expanded and recruited to provide improved color and skin texture. Severe neck contracture involving most of the neck skin generally requires excision and release of the platsyma, and the entire esthetic unit of the neck should be addressed to improve the functional and esthetic result. Local island flaps as well as free flaps may also provide well-vascularized tissue to resurface large area defects.3–5","title":"Mentosternal Contracture Treated With an Occipito-Scapular Flap in a 5-year-old Boy: A Case Report"}
{"_id":"bd4e174b-0c03-e25e-a8b5-04a7aa726004","text":"Clearly, early recognition and appropriate complete wide local excision of fibromatosis that is confined to the breast and is without concomitant involvement of adjacent chest wall structures is widely advocated in the literature and is fully embraced by the present authors. This local surgical management strategy will prove to be curative in most cases of fibromatosis involving the breast alone, and can avoid the need for more radical resections to obtain clearance of the surgical margins. However, as is apparent from our reported patient who had preoperative suspicion of involvement of the chest wall musculature, the potential of fibromatosis to display a locally aggressive and infiltrating growth pattern and the resultant high propensity for local recurrence when incompletely excised clearly supports the use of a more aggressive resection approach to assure clearance of the surgical margins and should be considered in similarly selected patients.","title":"Management of a patient with multiple recurrences of fibromatosis (desmoid tumor) of the breast involving the chest wall musculature"}
{"_id":"bd50d686-9b91-bef9-baa7-efbd915c2890","text":"A second repair with skin graft will permit an early detection of local relapse but functionally and aesthetically can be unsatisfactory.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"bd547040-788f-28ae-9315-a66bf479cdc9","text":"This retrospective study involved patients treated in a single tertiary centre and a referral centre for advanced trauma services from January 2015 until December 2019. Referral cases from nearby hospitals which do not provide specialised orthopaedic services for pelvic and acetabulum injuries were also included in this study.","title":"Study of Deep Vein Thrombosis Screening by using Ultrasound Doppler in Patients with Pelvic and Acetabulum Fractures Requiring Operative Intervention"}
{"_id":"bd579158-e532-03ae-78ee-f7b15f547df1","text":"The complexity of the wound also influenced the number of different antibiotic substances given to the patients, with those with open fractures receiving the highest number of different antibiotics.","title":"Long-term experience with a collagen-elastin scaffold in combination with split-thickness skin grafts for the treatment of full-thickness soft tissue defects: improvements in outcome—a retrospective cohort study and case report"}
{"_id":"bd58ca68-c592-74b4-f9b8-687706ba3248","text":"The EUROLINE test kit (EUROIMMUN, USA) was used as a semiquantitative in vitro assay for the detection of human IgE antibodies to airborne and food allergens in the serum or plasma. The test kit contains test strips coated with parallel lines of 21 different allergen extracts. The test strips were first moistened and incubated with patient serum in the first reaction step. Positive samples showed specific IgE antibodies binding to the allergens. The readout for the EUROLINE kit is shown in Supplementary Table S1.","title":"Cell-bound IgE and plasma IgE as a combined clinical diagnostic indicator for allergic patients"}
{"_id":"bd5a0cb6-d4aa-8b0e-7fba-7bb1938dae0d","text":"In the event that a lactating mother with COVID-19 is too unwell to breastfeed the child, expressed breast milk or formula feeds should be considered, and these should be prepared using hygienic practices as recommended by government and regulatory bodies of the given region.","title":"African League Against Rheumatism (AFLAR) preliminary recommendations on the management of rheumatic diseases during the COVID-19 pandemic"}
{"_id":"bd5dc323-38a6-1203-b902-5a95707ee4b4","text":"This commentary will discuss the background and potential utility of photodynamic therapy in the treatment of cancer, with a brief mention of other implications. Some thoughts on future directions or lack thereof are also included.","title":"More Adventures in Photodynamic Therapy"}
{"_id":"bd5ebaac-c4ce-d12e-fcc3-06b7a4de76eb","text":"Osteomyelitis must be treated with prolonged antibiotic therapy and consultation with an infectious disease specialist. The limited literature and our collective experience indicate that osteomyelitis in the setting of FD is difficult to diagnose and to successfully treat [50–54]. We have managed patients that developed osteomyelitis of the jaws after attempts at exposure and orthodontic movement of impacted teeth. It may resolve with prolonged antibiotic treatment and pain management, however en bloc resection of the FD lesion may be required for refractory pain and persistent infection.","title":"Clinical guidelines for the management of craniofacial fibrous dysplasia"}
{"_id":"bd7494bd-75c7-a231-5e93-14571f4c4fc8","text":"Recent investigations of novel treatments have had some promising results. Application of a hydrogel scaffold after excision had low recurrence rates, though have not yet been compared in randomized comparative trials. Both drug-loaded and drug-free microneedle arrays have been tried as a less invasive and painful option, but the clinical improvement has not been shown to be durable as a monotherapy. ESWT with and without IL TAC has been shown to have similar results to IL TAC, which shows promise and warrants further investigation. Topical imiquimod after excision was shown to have reduced recurrence compared to excision with IL TAC, which is a good option for accessible lesions such as ear keloids. Colchicine as an oral therapy started 1 month prior to excision showed no recurrence and was well tolerated, which is a promising systemic therapy option.","title":"Keloid treatments: an evidence-based systematic review of recent advances"}
{"_id":"bd74f7e2-dbe8-ea47-3927-767203c2cee5","text":"Patients who had undergone breast reconstruction after mastectomy reported better sexual function and body image and fewer depressive symptoms than patients who had undergone mastectomy alone. Sexual dysfunction was associated with the absence of a marital partner and a higher level of education and was more frequent in the mastectomy group.","title":"Sexuality, depression and body image after breast reconstruction"}
{"_id":"bd76050b-e8c1-34fb-37ee-7c4cdcd6ed14","text":"Orthopaedic trauma fellowship directors rated personal recommendations higher than other subspecialties. In a similar survey, orthopaedic sports medicine fellowship directors rated personal recommendations as the fifth most important factor, whereas we found it to be the third most important factor surveyed. Personal recommendations may hold greater importance in orthopaedic traumatology because it is a much smaller network than sports medicine. It has been suggested that when applicants have positive personal connections with a program either directly or through their mentors, this increases their likelihood to match at that particular fellowship program.","title":"The Competitive Orthopaedic Trauma Fellowship Applicant: A Program Director's Perspective"}
{"_id":"bd77a357-8281-490a-7f93-816ba43c5b1e","text":"The presence of positive margins upon histologic examination of the surgical specimen warrants further treatment. The management of patients with positive margins is largely dependent on the patient’s ability to undergo surgical excision or radiation therapy.6,7 In the absence of Mohs micrographic surgery, patients with positive margins are treated with further excision regardless of their tumor’s pre-excision risk classification.6,7 Frozen section techniques are recommended in these cases to ensure that the margins are sufficiently clear before reconstruction.6,7 Patients who are unsuitable candidates for surgery should undergo radiation therapy.6,7 A multidisciplinary tumor board should be consulted in cases where negative margins cannot be achieved and surgical excision and radiation therapy can no longer be tolerated.6,7 The tumor board can then decide which form of chemotherapy would be able to best treat the patient’s malignancy.","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"bd87950e-a5fd-74e3-f3ba-87d7ed180f6a","text":"We reported a rare case of metal object entrapment in cervical spinal canal during an anterior cervical surgery. Under certain circumstances, retention of a small foreign object in spinal canal may not lead to neurological complications. When failed to remove an entrapped foreign body, it may be safe to leave it in the spinal canal for further observation.","title":"Entrapment of a metal foreign body in the cervical spinal canal during surgical procedure A case report"}
{"_id":"bd931acf-fe3c-3095-e82e-56228a24dd7f","text":"The delay of implementing dermoscopy widely in the hospital and other healthcare is due to the lack of training among the physicians. This made an adverse impact in getting such product to the market field. However, usage of higher end resolution camera and instrumentation set up must provide a better result that is indirectly failed to achieve due to insufficient training. Thus proper training, knowledge and experience sharing of practitioners are must for better diagnosis. The use of computer-aided diagnosis in finding the skin lesions could be furtherly enhanced using various pre-processing techniques and segmentation method that would be more informative and satisfying the needs. It is the need for analyzing various attributes and can also be included in dermoscopic techniques so that it is easier to link with computer-aided analysis. The optical methods like OCT and PDD are still under investigation stages; this could be improved by defining the borders of suspicious lesions particularly in non-melanoma skin cancer and the common skin disorders. Further exploration is required in using the laser for detecting melanoma.","title":"Skin cancer detection using non-invasive techniques"}
{"_id":"bd95f474-7b7d-c3be-9175-1a6c15d5e4a8","text":"Participants are recruited from 30 secondary care centres, all of which are NHS hospitals in England or Scotland. All sites currently use 6 weeks of IV antibiotic therapy as their standard initial treatment for some or all categories of bone and joint infection, and all are able to deliver IV antibiotics to patients after discharge from hospital.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"bd965ea6-0b90-ca94-d7c0-4ac22d0c1153","text":"The flaps included as lateral island flaps were angled at less than 45 degrees from the horizontal. At a 45 degree angle of inclination or higher, the flaps were classified as superolateral island flaps or superior nasal island flaps and were not included in the analysis.","title":"Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction Use of a Lateral Extended Nasal Island Flap for Nasal Reconstruction"}
{"_id":"bd99d81c-47c2-9684-f8cb-08b05c53c2ab","text":"Clinicians may be more likely to add biologic agents in cases of greater severity where obtaining significant augmentation is more challenging. The same is true for esthetic areas with high visibility and patient expectations. The addition of biologic agents in this study occurred more frequently for ridge augmentation of anterior areas, likely with the aim of optimizing the outcome in the esthetic zone with its more challenging anatomy. This may cause some bias in the results since the use of biologics was not randomized equally to anterior and posterior sites. A randomized controlled trial would be necessary to fully mitigate this potential confounding factor.","title":"Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study"}
{"_id":"bda565ab-f1fb-6ad6-0385-dd233a0e8a17","text":"Figure 9 shows the 3D printed multicolor models of the three cases.","title":"Exploring the Potential of Three-Dimensional Imaging, Printing, and Modeling in Pediatric Surgical Oncology: A New Era of Precision Surgery"}
{"_id":"bda6b102-efc4-784b-25c5-d1653e8a4088","text":"Many methods have been applied to the research of human ageing, such as genomics, where the expression levels of RNAs were studied as a function of ageing to characterize age-associated changes in skeletal muscle gene expression of healthy individuals, proteomics, where a proteomic ageing clock comprised of proteins was proposed to predict the human age in the studies of human proteomics ageing, and clinical investigations, which focused on how dietary and pharmacological interventions promote a healthy lifespan by influencing energy intake and circadian rhythms.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"bda9c6f7-b171-4d59-625f-19e01ad862fa","text":"There were 1606 respondents whose demographics are summarized in Table 2. Breast cancer survivors who reported undergoing a mastectomy were on average about three years younger at the time of surgery and at the time of survey compared to those who underwent a lumpectomy. There was a statistically significant difference between the BMI of the two groups where the average BMI in mastectomy respondents was 27.1 and the average BMI in lumpectomy patients was 28.2. The reason for surgery was predominantly the presence of stage I and II unilateral breast cancer among respondents. Among ductal carcinoma in situ (DCIS) patients, a significant number of respondents chose a mastectomy instead of a lumpectomy.","title":"Choosing Mastectomy vs. Lumpectomy-With-Radiation: Experiences of Breast Cancer Survivors"}
{"_id":"bdace37a-b782-20fc-f24a-ac8ceaf73998","text":"Good results were reported overall for all breast reconstruction procedures, with more reserved scores for LD. The DIEP reconstruction appeared to be the most satisfactory and best experienced reconstruction method for patients, despite the complexity of the intervention. Clinicians should be encouraged to consider DIEP as the principal choice for breast reconstruction.","title":"Defining the Ideal Breast Reconstruction Procedure After Mastectomy From the Patient Perspective: A Retrospective Analysis"}
{"_id":"bdb33970-ad26-d087-acd6-14b221be02c3","text":"To summarize the safety and effectiveness of high flow extracranial to intracranial saphenous vein bypass grafting in the treatment of complex intracranial aneurysms.","title":"Safety and effectiveness of high flow extracranial to intracranial saphenous vein bypass grafting in the treatment of complex intracranial aneurysms: a single-centre long-term retrospective study"}
{"_id":"bdc4947f-dfc4-a499-5108-da0c4cb5b5bc","text":"When we compare the index of radial nerve neuropraxia in our work with studies that evaluated it after osteosynthesis of fractures treated with absolute stability, the incidence of neurological impairment was similar.9 Therefore, the hypothesis is that neuropraxia occurred due to manipulation of nerve during the course of the accessory pathway. We found no cases of nerve interposition in the fracture focus. However, despite the high rate of neurological impairment, neuropraxia was treated with complete motor and sensory recovery after a maximum of seven months of follow-up. Therefore, the realization of the accessory pathway and identification of the radial nerve were beneficial to objectively exclude nerve interposition in the fracture or between the plate and the bone.","title":"Fracture of distal humerus: MIPO technique with visualization of the radial nerve"}
{"_id":"bdcb71d7-51aa-0b95-bf94-29bc46fe45ca","text":"Table 1 Details of the 7 previous studies investigating the presence of a hexanucleotide expansion inC9ORF72in patients with Alzheimer’s disease","title":"Pathological assessments for the presence of hexanucleotide repeat expansions in C9ORF72 in Alzheimer’s disease"}
{"_id":"bdcbe1ff-3db2-768e-644b-79d841707fed","text":"Computerized tomographic (CT) venography protocol can be performed for the evaluation of the DVT. The intravenous contrast is injected though peripheral vein without cannulation of the lower extremity and CT images are obtained with timed protocol coinciding with filling of lower extremity vein. CT venography is usually preformed with CTPA in cases where PE is suspected in conjunction with DVT.","title":"Advances in the Diagnosis of Venous Thromboembolism: A Literature Review"}
{"_id":"bdd0a596-b07e-efdc-4b15-119770e0d847","text":"This retrospective study examined recipient vessels and vascular anastomosis techniques in 18 consecutive patients who underwent free flap transfer at an early stage after suffering open fracture of the lower extremity.","title":"Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity"}
{"_id":"bdd0dc6e-ec67-c861-1a4f-60d6d177805b","text":"As the effectiveness and minimal adverse effect profiles of perineural blockade in pediatric surgery were not yet fully determined, we conducted this randomized controlled trial to investigate the efficacy and safety of ultrasound-guided TAP block, QL block, and CEB for perioperative analgesia on pediatric patients during the first 24 h following unilateral lower abdominal surgery.","title":"Comparison of ultrasound-guided transversus abdominis plane block, quadratus lumborum block, and caudal epidural block for perioperative analgesia in pediatric lower abdominal surgery"}
{"_id":"bdd18be5-76e2-21ef-57d1-b2ba7103bdf1","text":"The aspects related to surgical technique are also found in the present study. The majority of malignant tumors were completely excised, while benign tumors were mostly treated with subtotal excision in order to preserve the facial nerve. For grade III or IV malignant tumors, one can choose to undergo postoperative chemotherapy along with radiotherapy or participate in clinical trials for innovative treatments.[","title":"A retrospective study of nonneoplastic and neoplastic disorders of the salivary glands"}
{"_id":"bdd1f244-c8df-9454-bf21-8b9770a9c41e","text":"Periimplantitis therapy is a major challenge for the dentist. Treatments with enzymes could be a promising option to improve the mechanical cleaning process during flap surgery. Here, the only lysozyme showed significant biofilm destabilisation. Dextranase or Subtilisin A showed only a tendency to support the destabilisation of the biofilm within the cell-compatible application concentration. It is probable that lysozymes or other enzymes can also be used in other wounds, such as during debridement of open ulcerations or to support disinfection processes. Possibly, enzymes could also be used to clean contaminated implants in other parts of the body to reduce chronic inflammation.","title":"Enzymatic biofilm destabilisation to support mechanical cleansing of inserted dental implant surfaces: an in-vitro pilot study"}
{"_id":"bdd6c383-9952-5a01-7bce-2aee2ecd7b6c","text":"Meanwhile, our results indicate a greater percentage of plastic surgeons pursuing microsurgery and craniofacial fellowships over the years. Microsurgery fellowship was first established in the 1980s, and although the increase in microsurgeons may be due to the increase in number of programs, there has also been an overall increase in competitiveness in matching, as shown by Cooper et al, signifying a growing interest among plastic surgeons.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"bddb1205-69e3-899d-d89e-8bbf93f453d6","text":"In contrast to surgery where compliance during the treatment procedure is not an issue, the application of imiquimod is totally dependent on the patient and therefore detailing the procedure and the anticipated adverse events is of paramount importance. We have observed that patients that fail to apply imiquimod the previous 1–2 days prior to the cryosurgery session have a reduced clearance rate.","title":"A Review of Immunocryosurgery and a Practical Guide to Its Applications"}
{"_id":"bde426a4-49ff-2b24-209d-2d95c1d4c20e","text":"The dermatologic surgeon should be familiarized with different options for auricular reconstruction. Primary closure and skin grafts were the most frequently used repair methods.","title":"Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases"}
{"_id":"bdef42cd-8e3e-9604-6302-f9d30afd94e7","text":"One of the main aims of skin surgery is the complete excision of NMSC and MSC. If the neoplasm is not totally included in the resection, a second enlargement procedure must be performed, with an increase in management costs and greater discomfort for the patient. Although many techniques have been proposed in the literature to achieve complete resection, as Mohs micrographic surgery and confocal microscopy, fluorescence can be more easily applied in the routine use since it is a widespread and accessible practice.","title":"Fluorescence‐guided surgery for non‐melanoma and melanoma skin cancer: Case series and a brief review of the literature"}
{"_id":"bdf0a4b8-20c6-7be4-4a0b-e607174be1c2","text":"Our sample size has limited our study in such that we required more males to be included, as females are the majority at Fakeeh College.","title":"Perception and Attitude of College Students toward Cosmetic Rhinoplasty"}
{"_id":"bdf13155-97b9-eab1-211d-00cf8f7a4c3d","text":"Inconsistent levels of compliance by the patients could have influenced the improvements of the parameters unevenly.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"bdf1b2e1-3095-c253-dcbf-e922639123a6","text":"Since these patients already have a compromised pulmonary function extra pleural anterolateral or costotransversectomy approach is advocated32. The other advantages of this approach are that it allows direct exposure of internal salient and it does not jeopardize the already compromised pulmonary function. Here the posterior 5 cm of three crowded ribs at apex are removed along with the transverse processes. Care is needed to remain extra pleural or retroperitoneal. Segmental intercostal nerves serve as a guide to intervertebral foramina. Two or three pedicles at apex are removed and dura is seen. One or more intercostal vessels are excised. The pleura is elevated at the apex of kyphosis. The removal of posterior half of the collapsed vertebrae is done with a high speed burr leaving behind posterior rim until last to avoid forward migration of dural sac. This allows spinal cord to be transposed anteriorly and adequate length of anterior dura is exposed [Figure 7]. Cortical strut grafting is performed as far anteriorly as possible after exposing the proximal and distal limits of angular kyphus.","title":"Kyphosis in spinal tuberculosis – Prevention and correction"}
{"_id":"bdfb2426-644e-df64-4825-0b5b7cbe73ec","text":"Treatment of scalp lesions need to be particularly careful, and might also be more difficult due to the presence of hair. Cutting hair before treatment can be helpful to localize the extension of the lesions.","title":"Usefulness of Photodynamic Therapy as a Possible Therapeutic Alternative in the Treatment of Basal Cell Carcinoma"}
{"_id":"be06a757-606c-8c3f-4f0b-5831dc332489","text":"The present study describes the sonoanatomical landmarks for the t-TTP approach in canine cadavers. This approach enables the administration of a methylene blue-lidocaine solution in the target plane using an in-plane technique and the staining of multiple intercostal nerves between T2 and T7 with a single injection point, although the results observed are not regular and depend on the volume injected.","title":"Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers"}
{"_id":"be0afccb-b4bd-74a9-3235-e09d9f5c8708","text":"Bone remodeling is the final phase of fracture healing. Osteoclasts continue to remove necrotic bony tissue to accommodate space for the newly formed bone.6 Simultaneously, osteoblasts replace the trabeculae bone with compact bone through endochondral ossification.1 The only footprint left of bone repair is a thickened area on the surface of the bone lacking the presence of a fibrotic scar.67","title":"Low-intensity pulsed ultrasound: Fracture healing"}
{"_id":"be1510bc-0b3d-430e-76d6-53c7ae911224","text":"The purpose of this meta-analysis was to determine the positive rate of SLNB in thin melanoma and to summarize the predictive value of different clinical and high-risk pathological features for positive results of SLNB.","title":"Predictive Values of Pathological and Clinical Risk Factors for Positivity of Sentinel Lymph Node Biopsy in Thin Melanoma: A Systematic Review and Meta-Analysis"}
{"_id":"be153649-35bc-06e7-f81b-809e77e97829","text":"The woman in this report presented with an asymptomatic mobile nodule. The tumor was completely removed when an incisional biopsy was performed. Microscopic examination established the diagnosis of a benign subepidermal calcific nodule.","title":"Mobile Subcutaneous Calcinosis Cutis: A Case Report of a Mobile Solitary Subepidermal Calcified Nodule on a Woman’s Leg and a Review of Mobile Subcutaneous Tumors"}
{"_id":"be1add76-a033-eb19-da88-4e7c4278c1e4","text":"Creating double flaps to cover any exposed lacrimal bone may reduce the rate of postoperative adhesions over the nasolacrimal duct ostium. A larger body of evidence on the clinical outcomes and complication rates of different methods used in endoscopic DCR is needed. Larger and controlled randomized trials that compare these approaches as well as studies of innovation and novel techniques that may advance our progress in treating primary NLD obstruction and improve results in our patients, are warranted.","title":"Endoscopic dacryocystorhinostomy: A comparison of double-flap and single-flap techniques"}
{"_id":"be1e72b7-ce76-de9a-025b-3ec4b079b6f4","text":"Primary malignant melanoma of the vagina is an extremely rare disease affecting 3% of patients with malignant vaginal tumors. It is rare compared to primary malignant melanoma of the skin and its prognosis is unfavorable even in patients with Stage I disease. Here, we report a case of primary malignant melanoma of the vagina and discuss our experience with regard to previously published literature.","title":"Concomitant sentinel lymph node biopsy leading to abbreviated systematic lymphadenectomy in a patient with primary malignant melanoma of the vagina"}
{"_id":"be2362cf-e3c8-7c51-3621-5b39a3c78506","text":"The availability of PBT for breast cancer has increased over recent decades, and the technology has advanced. Since 1990 around 95 PBT centers have opened for clinical use worldwide including 41 in the USA and 30 in Europe. Early PBT was delivered using passive scattering which spreads a narrow proton beam so that it is wide enough to cover the clinical target. By 2014 most centers were delivering PBT via uniform scanning or pencil beam scanning both of which use magnetic fields to steer narrow proton beams across the clinic target, enabling better sparing of normal tissues. In particular better skin-sparing is possible with pencil beam scanning technology because of its enhanced dose modification capabilities.","title":"Proton Beam Therapy for Early Breast Cancer: A Systematic Review and Meta-analysis of Clinical Outcomes"}
{"_id":"be239c20-dd44-e1af-383f-929b916ee459","text":"Finally, evidence supporting the superiority of earlier timing of frenotomy on infant breastfeeding duration and efficacy was not conclusive.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"be2724fc-4166-607f-83bd-a5f307542a21","text":"Patients have been divided in two main groups, according to their nodal status and for each group local recurrence rates and overall survival have been analyzed comparing patients with positive margins and those with negative margins after wide local excision and adjuvant radiotherapy [Table 1]","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"be284637-0a20-28f0-7068-03ca906d1ed1","text":"Three patients underwent nonsurgical primary rhinoplasty, two patients underwent secondary rhinoplasty, and nine patients underwent nonsurgical sequelae rhinoplasty. The most common indications were minor contour irregularities. It is very important for the authors that there was an incremental injection of the fluid cartilage to the desired location with repeated visual and tactile evaluation after each injection.","title":"Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage"}
{"_id":"be2d51aa-a9e4-11e7-e376-8aac55da54d2","text":"Limitations of this study include the inherent weaknesses associated with the retrospective nature of this study. This was also a rather small sample size for each surgeon, but previous literature supports 40 to 50 cases for the DA learning curve, which is included in our sample size for each surgeon. Notably, these were truly the first 100 cases of our DA surgeons because there was no primary THA performed through another approach by these surgeons. This study also reports the results between six different surgeons with varying perioperative management, intraoperative techniques, and postoperative protocols at different institutions, which may bias results but does lend to the generalizability of this study. Despite this, the goal was to capture the learning curve regarding the complication rate of a newly trained fellowship surgeon in practice. Our study illustrated the importance of fellowship training and the humility and prudence one must exhibit during their first year of practice, regardless of the approach.","title":"Total Hip Arthroplasty Learning Curves Based on Approach for New Fellowship-trained Surgeons"}
{"_id":"be33d9a4-7037-0b3d-86e4-d007f1e631b0","text":"For primary melanomas of the lower back, there should be a high suspicion for drainage to subcostal nodes so that they may be identified intraoperatively. Even if not evident on initial lymphoscintigraphy, they may be found intraoperatively with the gamma probe after the primary melanoma is widely excised. Subcostal SNs can be challenging to locate due to their small size and location abutting or beneath the associated rib. When lymphatic mapping identifies a subcostal SN, it should be excised along with other identified SNs, as the removal of subcostal nodes may alter staging, treatment and prognosis and possibly prevent late recurrence whose resection is more morbid.","title":"Subcostal lymph nodes: An unusual sentinel lymph node basin in cutaneous melanoma"}
{"_id":"be39a2cb-3906-15a5-2568-e211062f682d","text":"While most cases of polymicrobial vertebral osteomyelitis are secondary to hematogenous seeding, direct inoculation during spinal surgery and contiguous spread from adjacent soft tissue are also potential routes whereby pathogens may infect the spine.","title":"Polymicrobial vertebral osteomyelitis after oesophageal biopsy: a case report"}
{"_id":"be4c271b-4bba-82c0-7d9a-8d725c260400","text":"In particular, we observed many lumps formed by the physical compression of titanium dioxide particles in the taupe yellow ink pigment. These agglomerated surfaces were very smooth. We assumed that such a compacted surface lump is an artifact produced when the titanium dioxide raw material is manufactured.","title":"Analysis of microstructural characteristics and components of red and yellow ink pigments used in permanent makeup"}
{"_id":"be4ce40f-a6cb-a7df-a96b-63405adfdc86","text":"All patients were randomly assigned to the PTB group and the control group according to a pre-set randomized number table. The allocation sequence was concealed to patients and anesthetists in the operation room, but not for the senior anesthesiologist who performed the paravertebral block or taped the catheters. The anesthesiologist in the operation room, nurses in the ICU, and doctors responsible for looking after the patients during the operation and follow-up were blinded to the allocated intervention according to the protocol.","title":"Ultrasound-guided paravertebral blockade reduced perioperative opioids requirement in pancreatic resection: A randomized controlled trial"}
{"_id":"be4d783b-d896-6e21-c075-817f0b06120c","text":"The use of intravascular ultrasound in patients presenting with acute coronary syndrome may reveal large thrombi that are difficult to image using conventional angiographic techniques. Intravascular ultrasound can therefore be used as a tool to select lesions requiring distal protection.","title":"Intravascular ultrasound to guide the management of intracoronary thrombus: a Case Report"}
{"_id":"be50073f-f293-a519-114c-3a27b94d4393","text":"Defect closures in old and frail patients are demanding procedures due to their high rate of comorbidities, but technically do not differ from younger patients. The principles of the reconstructive ladder must be followed to avoid unnecessarily long operation durations. Free flap procedures are considered to be safe and reliable even in the “oldest” old. A proper therapy regime should be designed preoperatively to avoid unnecessarily long hospital stays and immobilization. Maintaining quality of life, independency and functionality must also be considered. Further investigations need to be done about the correlation of flap loss and preoperative frailty scores in the oldest old patients since such studies with large sample sizes are missing.","title":"The Role of Free Tissue Transfers for Defect Coverage over the Body in Geriatric Populations"}
{"_id":"be5e305d-9cfd-cb2f-f56f-6bcb167508ca","text":"Considering the toxicity (largely due to off-target effects) and rapid development of adaptive resistance to targeted therapies in addition to the low response ratio and the enormous cost of immunotherapies, it is important to identify economical and effective existing drugs. Herein, we believe that ABZ is such a compound that exhibits great potential for future clinical use in melanoma therapy. We showed that ABZ inhibits melanoma cell proliferation in vitro with very low IC50 values of approximately 1000 nM. Moreover, ABZ significantly suppressed the growth of xenografted melanoma tumors with low toxicity. These results indicated that ABZ is an existing drug that may serve as a potentially effective melanoma therapy. However, whether ABZ can be used as an adjuvant for the treatment of melanoma in combination with other drugs still needs to be further explored.","title":"Novel therapeutic strategy for melanoma based on albendazole and the CDK4\/6 inhibitor palbociclib"}
{"_id":"be5e4de0-1895-752a-b1ab-3cfc71b0cc07","text":"Of note, patients who had instability due to implant loosening were excluded from this study because revision surgery was almost routinely performed in these patients, and one of the goals of our treatment was to prevent progression to additional screw loosening and change because of biofilm formation. The following is a brief overview of two representative cases, in which we did or did not use a toothbrush based on this treatment policy.","title":"Effectiveness of Toothbrushing Technique for Biofilm Removal and Postoperative Infection Control after Spinal Fusion Surgery: A Retrospective Study"}
{"_id":"be67b52c-4fa2-c699-7a06-7c0c55d31232","text":"This describing technique is adequate bone removal and excellent intraoperative joint mobilization.","title":"True bony TMJ ankylosis in children: Case report"}
{"_id":"be6810cd-7acb-b689-49e3-c4923df87cf6","text":"The analysis of the correlation between the topographical location of cutaneous melanoma and the intraoperative identification of sentinel lymph nodes.","title":"Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma"}
{"_id":"be685c8a-b4c3-d9a6-a4e5-be0ffc8c167e","text":"PJI is an excellent model for chronic hardware infection because of convenient anatomical characteristics that isolate it from systemic influences and limits the spread of infection to unrelated tissues. Chronic hardware-related musculoskeletal infection is historically an orthopaedic issue, but recent advances in tissue engineering and medical device complexity have brought the challenge of dSSI to new frontiers. We have demonstrated that biofilm terminology is rapidly being adopted by groups less likely to use historic terms such as prosthetic or periprosthetic infection, but lags in specialties such as orthopaedics where highly influential translational research occurs. The potential exists for this to negatively affect study design, and discussion is warranted.","title":"Improve Integration of In Vitro Biofilm Body of Knowledge to Support Clinical Breakthroughs in Surgical Site Infection"}
{"_id":"be6cc474-169b-8c24-2bcb-f7a7e7cd568b","text":"A soleus muscle flap can be considered as an option. Based on the previous studies, the authors used the soleus muscle flap for reconstruction of an open tibial wound in the junction of the middle thirds of the leg and reverse sural with good success. For reconstruction of a wound in the distal third of the leg, a microvascular free tissue transfer has been considered as a standard surgical procedure of the choice because in general, there are no reliable local options available for reconstruction.,","title":"Synchronous Soleus and Reverse Sural Flap for Large Soft Tissue Defect Reconstruction of Leg"}
{"_id":"be77c84d-4b74-34c6-9fcc-c23cabe37aa6","text":"The main outcome of this study is the similar rate of SSI of the 2 groups. The use of BITAs is considered by many Authors a significant risk factor for sternal dehiscence and mediastinal wound infection, as it leads to severe acute impairment of sternal blood supply. Single ITA harvesting leads to a 90% loss of hemisternum blood supply and bilateral ITAs mobilization can devascularize the entire sternum and compromise the healing of the sternal wound [5-7], especially in diabetic patients that are at higher risk of SSI. Diabetes is a well known risk factor for postoperative sternal SSI, but this study did not find significant differences between patients with single or bilateral ITAs harvesting. Even the multivariate analysis confirms that only BMI is an independent risk factor for SSI.","title":"Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate"}
{"_id":"be782747-3280-810b-03fd-4a9038d582e5","text":"We used several doses of radiation throughout this study to elicit different responses from fibroblasts; 5 Gy to induce cell death, 3 Gy to promote senescence, and 2 Gy to activate myofibroblast transformation. When radiation therapy is delivered clinically the isodoses to surrounding normal tissues are minimized with image guidance and arc beam treatment planning. The amount of radiation delivered to normal tissue at maximal voltage may range up to 20% of the dose delivered to the tumor. Thus, it is reasonable to assume cells in surrounding tissues will see variable doses by several Gy over the course of fractionated radiation therapy and that those cells will respond differently according to those doses.","title":"Adipocytes protect fibroblasts from radiation-induced damage by adiponectin secretion"}
{"_id":"be7fb7cc-5cfd-a00f-02bd-bc452fe295b0","text":"Since there is no survival benefit and the impact on staging is minimal, what remains to justify routine retrieval of PSLNs? Creating precise criteria for harvesting pelvic lymph nodes warrants randomized controlled trials or at least a large multicentre retrospective study, as suggested by Swords and colleagues. Although only few studies exist on the importance of PSLNs, they mostly agree on the very limited impact of PSLNs on staging and treatment of PSLNs. Apart from the rare cases where PSLN is the only or most radioactive SLN, it seems reasonable to omit routine retrieval of PSLNs.","title":"Pelvic sentinel lymph nodes have minimal impact on survival in melanoma patients"}
{"_id":"be838c66-667e-decb-c51a-ea86f4eba5ce","text":"Heterogeneity among the included studies was substantial and is a major drawback of this review. Although BCT was performed in the majority of patients for all reviewed studies, the results in each individual study were not given separately for BCT versus mastectomy. With regard to adjuvant treatment, most of the studies reported that adjuvant treatment was given according to the national guidelines, but the adjuvant treatment was not specified for those patients with a recurrence. Radiotherapy on the axilla was also given in 10 of these studies but a substantial number of patients in each study did not receive that therapy. This is an important issue because the MA.20 preliminary report demonstrated a reduction in locoregional recurrence when the axilla has been irradiated.63 This makes it difficult to form definite conclusions about the influence of adjuvant systemic therapy and radiotherapy on the recurrence rate. The absence of the distinction between micrometastases and ITCs in some of the studies is also a drawback because patients with ITCs in the SLNB are nowadays classified as “node-negative patients,” not requiring a cALND. Recently Jakub et al.64 suggested that not the number of positive SLN, but the number of positive non-SLNs is important for prognosis. Details about this issue of additional non-SLN positivity are lacking in the reviewed studies.","title":"Axillary Recurrence After a Tumor-Positive Sentinel Lymph Node Biopsy Without Axillary Treatment: A Review of the Literature"}
{"_id":"be969c02-0a4b-0d62-f196-05ed71186a76","text":"There were a few interviewees who were more pragmatic in their responses and highlighted a new awareness of their own transferable skills and the opportunities globally for healthcare:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"be9ad8d1-5375-5533-0609-eabb113f89f9","text":"This prospective study involved partially edentulous patients lost their teeth in one or both jaws and treated under general anaesthesia with screw retained fixed implant bridges between 1 January 2006 to 31 December 2012 in a private clinic in Stockholm, Sweden. Informed consent was obtained from all individual participants included in the study. All treated patients had to be in a good general health condition to be eligible for general anaesthesia which was performed and monitored by an anaesthetist. The implant surgery itself did not differ from conventional implant procedure used for non-phobic patients treated without general anaesthesia.","title":"Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study"}
{"_id":"be9b8cb0-1e0e-6e70-324c-b68df1784f57","text":"The presence of combined infection was retrospectively retrieved from the medical records and classified as follows:","title":"Treatment outcomes in patients with pyogenic vertebral osteomyelitis who have cirrhosis"}
{"_id":"bea96994-cc18-0c7f-9f5e-dceb8c441bd3","text":"For continuous variables, medians and IQRs for nonnormally distributed variables and means and SDs for normally distributed variables were evaluated. Differences between medians were evaluated with Wilcoxon signed rank tests, whereas differences between means were evaluated with Student t tests as appropriate.","title":"Venous Thromboembolism Chemoprophylaxis Adherence Rates After Major Cancer Surgery Venous Thromboembolism Chemoprophylaxis Adherence Rates After Cancer Surgery"}
{"_id":"beaba862-a557-fa14-2ef7-bc07aad4eb3f","text":"Patients underwent ultrasound assisted liposuction to remove superficial fat over the upper and middle back as well as helium activated radiofrequency to tighten the skin using subdermal coagulation.","title":"Successful Back Contouring With Elimination of Back Rolls Using Ultrasound-Assisted Liposuction and Helium-Activated Radiofrequency"}
{"_id":"beaf99c1-6926-3f4c-340a-858afc2e0d6d","text":"Figure 4(b) shows detection of humeral head from a PD weighted left shoulder MR image. The shape of the humeral head is not exactly a circle; thus some parts of the area of interest may remain out of the circle defined by circular Hough transform. To involve whole humeral head in ROI we enlarged radius of circle found by circular Hough transform.","title":"Segmentation of Bone with Region Based Active Contour Model in PD Weighted MR Images of Shoulder"}
{"_id":"beafb191-fca5-7a76-612d-4c5ddc78ece2","text":"This study presented herein mainly focuses on the oncologic safety of postmastectomy IBR. In the cohort of 389 consecutive breast cancer patients who underwent mastectomy alone and mastectomy followed by IBR by the single senior breast surgeon (XZ) and were followed up for a median time of over 6 years, the authors failed to find any evidence for a statistically significant difference in the incidence of LRR and DM among patients who underwent mastectomy only compared to patients who underwent mastectomy followed by IBR. Moreover, the median follow-up time in the Mx+IBR group was significantly longer than that of the Mx alone group. Even during the longer follow-up period, the incidence of LRR and DM in the Mx+IBR group appears to be a little lower than that in the Mx group, though there is no significant difference. The rate of LRR in the two cohorts of our study was too low to perform any analysis and make any further significant conclusions based on molecular subtypes. Taken together, these findings argued against the notion that IBR may compromise oncologic safety of surgical management of breast cancer.","title":"A Single-Center Retrospective Analysis of Local and Distant Relapse of Breast Cancer Following Immediate Breast Reconstruction According to Molecular Subtypes"}
{"_id":"beb42e96-15f0-f941-452e-9b23e482990e","text":"Lower limb DVT can lead to PE, which can be detrimental and potentially fatal. The importance of screening and surveillance for DVT pre-operatively should be emphasised under these circumstances, especially in detecting asymptomatic patients to allow the administration of appropriate treatment and prevent further morbidity and mortality. Therefore, this study was performed to determine the incidence of lower extremity DVT in patients with pelvic and acetabulum fractures and the importance of preoperative screening with Doppler ultrasound prior to surgical intervention.","title":"Study of Deep Vein Thrombosis Screening by using Ultrasound Doppler in Patients with Pelvic and Acetabulum Fractures Requiring Operative Intervention"}
{"_id":"beb6f6b8-6ffa-5434-7ac9-5e90954c61bf","text":"Sentinel lymph node biopsy is a highly accurate and low-morbidity procedure that has been endorsed by the AJCC as a valuable staging tool for MM patients who are at risk of clinically occult nodal metastases. Although most of the technical aspects of SLNB have been thoroughly studied, clinical observations have led us to add further refinements to the procedure. Avoiding the use of blue dye in the head and neck region, enlarging the time elapsed between the intradermal radioactive tracer injection and the surgery and, most importantly, introducing the distance of the lymph basin from the biopsy site as a factor defining the excision sequel can optimize our SLNB results.","title":"Increasing the Efficacy of SLNB in Cases of Malignant Melanoma Located in Close Proximity to the Lymphatic Basin"}
{"_id":"bebaa49f-1423-c57b-7769-3c6d7ea2057f","text":"There are a number of adverse events that might occur with IPC use. For example IPC might increase the risk of PE by squeezing the leg in patients who have already developed a DVT; patients who attempt to mobilize with the IPC sleeves attached might fall and suffer injury; or the sleeves or intermittent pressure may cause patients to develop skin breaks on their legs. Any of these events could be fatal.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: statistical analysis plan"}
{"_id":"bebb36e2-e267-fc8c-a4cb-e3e115552e5d","text":"Chronic trauma or traumatic occlusion has the potential to induce osteomyelitis and should be considered as a possible diagnosis in differentiating periapical radiopacities, even in relation to vital teeth.","title":"A Localized Sclerosing Osteomyelitis at the Periapex of a Vital Tooth: Report of a Misdiagnosis"}
{"_id":"bebc350f-7850-f7fa-944d-e2f776cf007e","text":"While there is no prospective randomized clinical trial currently available to evaluate the efficacy of SLNB in CTCL, there is evidence to suggest that it may play an important role in proper staging for this disease. Cases like the one presented here demonstrate the utility of proper staging and provide support for the idea of routinely using this modality as a diagnostic method. It has proven to be effective and is currently the gold standard for other malignancies with much higher incidence. Therefore we suggest its use more frequently for CTCLs and other malignancies where precise staging can lead to proper treatment and more accurate prognosis for patients.","title":"Radiographically Negative, Asymptomatic, Sentinel Lymph Node Positive Cutaneous T-Cell Lymphoma in a 3-Year-Old Male: A Case Report"}
{"_id":"bebd78c1-b1ab-1d99-86c8-05915d65fd6e","text":"Sensory recovery and sensation to touch was followed in order by two point discrimination and warm versus cold discrimination.","title":"Sensory Recovery with Innervated and Noninnervated Flaps after Total Lower Lip Reconstruction: A Comparative Study"}
{"_id":"bed2af92-e432-5161-6d71-e73a4db5dc4c","text":"The HES database was used to identify all patients with at least one diagnosis of osteomyelitis (identified using International Classification of Disease version 10 codes: M86*) recorded between 1 April 2013 and 31 March 2017. From this cohort, we identified all patients who underwent at least one surgical intervention to treat osteomyelitis during this time period (identified using surgical codes from the Office of Population Censuses and Surveys Classification of Surgical Operations and Procedures, 4th Revision). The first procedure for osteomyelitis identified in this time period was labelled as the index procedure. The time period between admission to hospital for the index procedure and subsequent discharge was labelled as the index inpatient period. Thus, the earliest surgical procedure during the observation period was labelled as the index procedure for the centre in which it was undertaken. All subsequent healthcare utilisation would therefore be linked to the index centre, irrespective of where it was received in England. All included hospitals had an orthopaedic surgery department and were staffed by qualified orthopaedic surgeons, though not necessarily those with a specialist interest in managing infection cases.","title":"A retrospective cohort study comparing clinical outcomes and healthcare resource utilisation in patients undergoing surgery for osteomyelitis in England: a case for reorganising orthopaedic infection services"}
{"_id":"bed976c1-cc8b-abc6-0297-06e9856d7551","text":"TFL has been well established as a muscle and musculocutaneous free flap. Including the iliac crest as a vascularised bone component, even though it has been described previously, has not been found to be used extensively. This flap is a safe and robust method to transfer part of the attached iliac crest, especially to cover the maxillary and orbital defects. The flap anatomy makes it easy to raise and master the technique.","title":"Tensor Facia Lata-iliac crest osteocutaneous flap for orbitomaxillary reconstruction: A preliminary report"}
{"_id":"bee04ca6-b2af-bb12-6f40-05cd75709516","text":"The reported 5-year recurrence rates of non-melanoma skin cancers following brachytherapy range from 1% to 13%.49","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"bee34234-a1ff-bc74-1852-eccab54ef702","text":"The other issue which is usually overlooked is that using malleable materials as onlay grafts without suture fixation during an open rhinoplasty procedure carries the risk of displacement when the skin flap is returned back. Besides, the efficacy of the graft in complete resolution of contour deformity cannot be precisely evaluated unless the skin envelope is returned back, so repeated manipulation of the volume and position of the graft may be needed, each time having the above mentioned risk of moving the skin flap back and forth.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"beeecfb5-612c-2384-4a0f-130c95d3334d","text":"Assessment of the frequency of particular disorders of the masticatory organ locomotor apparatus within the group of patients with osteogenesis imperfecta, and an attempt at assessment of their impacts upon child development.","title":"Evaluation of Stomatognathic Problems in Children with Osteogenesis Imperfecta (Osteogenesis Imperfecta − OI) − Preliminary Study Ocena problemów stomatognatycznych u dzieci z wrodzoną łamliwością kości (Osteogenesis Imperfecta − OI) − Badania wstępne"}
{"_id":"beef8f45-23e8-bedd-5436-6b76e7885953","text":"General anesthesia is a safe and effective behavioral management method for uncooperative children's dental treatment. The use of biocompatible pulp capping materials and preformed crowns improved the success rate of treatment and prolonged the survival time of affected teeth.","title":"Success rate of the treatment of early childhood caries under general anesthesia: A retrospective cohort study in different periods"}
{"_id":"bef35e48-df7e-ac49-8c2d-5582b8819ff9","text":"Tuberculous osteomyelitis of the mandible is a rare entity. However in a country like India where tuberculosis is endemic, it should be an important differential when considering jaw swellings of long duration.","title":"Primary tuberculous osteomyelitis of the mandible mimicking a parotid fistula"}
{"_id":"bef477c7-9689-ad22-215e-87ecd7124035","text":"Historically, in Canada, plastic surgeons performed surgery around the hand and wrist. However, this study demonstrates that 84% of the items in the hand and wrist section were ranked as being important for residents in orthopaedic surgery to learn during residency. This would suggest that this population of orthopaedic surgeons have the opinion that common conditions of the wrist and hand are important for orthopaedic surgeons in non-university practices to be able to perform with proficiency. Only 16 accredited academic centers exist within Canada. Graduating orthopaedic surgeons may not choose to practice in a university setting and referring to tertiary care centers is becoming more difficult. Obtaining and maintaining skill sets associated with the hand and wrist may become more essential for those surgeons wishing to practice in non-university settings. Hence, these individuals will need to be very good generalists or establish themselves in a group practice where complimentary subspecialty skill sets exist within the group of practicing surgeons.","title":"What orthopaedic surgery residents need to know about the hand and wrist?"}
{"_id":"bef711ce-dd29-587f-06b8-feaa2e2c39d5","text":"The mean time interval between surgery and date of suing was about 2 years and 4 months; this fact means that major complaints have been raised after a couple of years from the surgery date, and thus, time passage does not warrant that the patients will not sue.","title":"Litigation After Nasal Plastic Surgery"}
{"_id":"bf01bd43-3da2-fad1-a569-67b74507bb7a","text":"This study aims to explore the effect of different demonstration modes in planning of liver resections in order to provide surgeons with a tool to facilitate adequate planning in complex situations as well as to teach this important planning step to younger surgeons. The sample size for the study of 100 participants is expected to be attainable within two years in this high volume centre. However delayed inclusion can be seen in many clinical trials since the start of the COVID-19 pandemic, thus sufficient time to prolong recruiting, if necessary, is accounted for.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"bf069035-7eee-3993-ed97-cd0de486d01b","text":"Insights regarding the development of new vehicles with better organoleptic features, as well as new studies on patient preferences and on the therapeutic effects of topical vehicles on clinical outcomes, need to be continuously analyzed and translated in the update of the TPPs for the most common skin disorders.","title":"Patient-Centric Design of Topical Dermatological Medicines"}
{"_id":"bf1527ee-6465-f950-e4d3-423d322c4f05","text":"Like the uncertainty around the costing of the decellularised graft, the effectiveness of the decellularised graft has also been estimated using many assumptions. As there are currently no clinical studies evaluating the outcome of a decellularised bone graft for IBG during an RHA,10 the probability of requiring a further revision was estimated from a study of demineralised bone matrix with allograft bone.17 However, decellularised bone grafts have better mechanical properties than demineralised bone matrix and allograft bone for high load applications and have reduced immunogenicity.22 Therefore, the model used in this cost-effectiveness analysis could have underestimated the health benefit of the decellularised bone graft.","title":"Cost-effectiveness of decellularised bone allograft compared with fresh-frozen bone allograft for acetabular impaction bone grafting during a revision hip arthroplasty in the UK"}
{"_id":"bf170020-483c-1c3e-f80b-99c07f2f2b92","text":"The present study has not fully elucidated how the B cells inhibit immune reactivity to mouse antigens. More studies will address whether cell contact is required and the involvement of neutralizing antibodies in the suppressive activities of B cells. Of note, the IgG4 response in the absence of IgE is suggested to protect against the development of allergic sensitization (19, 20). Therefore, it is reasonable to speculate that the observed modulation of IgG4 ARE to mice could be associated with a protective effect or control of mouse sensitization. It would certainly be of interest to elucidate this hypothesis in ensuing occupational prospective studies.","title":"B cells modulate mouse allergen-specific T cells in nonallergic laboratory animal-care workers"}
{"_id":"bf1846f7-9fe0-6ab4-9995-1527dd6da8ce","text":"Other Caprini risk assessment scale lists both the history of venous diseases of lower extremities and tumor as the risk factors of venous thrombosis, and many scholars think that patients with history of venous diseases of lower extremities or tumor will increase the risk of venous thrombosis. Although the results of the study showed that the incidence of DVT in patients with the above diseases is high, but because the sample size of patients with the above diseases in this study is small, there is no statistical difference, which needs further study of large sample size.","title":"Epidemiological status and risk factors of deep vein thrombosis in patients with femoral neck fracture"}
{"_id":"bf250fc9-fb5e-730d-f943-10f5b96ae926","text":"Patients and their families experience the tragedy of a sunless life, since the major triggers for skin cancer development are UV rays.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"bf2706f6-3571-f2f3-4c51-a918b837b45d","text":"The ultrasound guided approach was mandatory in this case in order to avoid implant puncture or pneumothorax. It proved to enhance precision and provide a more goal oriented fat injection. In addition, it allowed good estimation of the thickness and homogeneity of the fat layer injected over the target area.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"bf2f9122-efa0-8ef7-04a5-121c188a2e55","text":"Seven studies contributed to the descriptive subtheme of Model of Postpartum Care. In these studies, participants described challenges to maternal engagement when the mothers were unable to room-in with their infants at the hospital. Mothers who use substances often described logistical barriers to visiting their infants such as having transportation and food. Mothers who use substances also described the physical exhaustion from traveling back and forth to visit their infant at the hospital. The lack of privacy in the nursery sometimes prevented mothers who use substances in engaging with their infants such as through skin-to-skin care and breastfeeding.","title":"Factors Associated with Maternal Engagement in Infant Care When Mothers Use Substances"}
{"_id":"bf319983-3bbf-4a95-ddcd-49a6e3a1f665","text":"As 30% of head and neck BCC’s are nasal, consideration of reconstructive options following resection is an important part of patient management. The vascularised helical rim flap allows reconstruction of all 3 layers of the nasal ala with a good aesthetic result due to adequate matching of contour, colour and texture. The location of any scarring is inconspicuous in comparison to a local forehead flap that could also be used to reconstruct such a defect.","title":"Reconstruction of a full thickness nasal alar defect following resection of a BCC with a vascularised chondrocutaneous helical rim flap: a case report"}
{"_id":"bf4012af-a171-7fa7-3138-803f21175d76","text":"The novel use of rhPDGF is an interesting approach which may be helpful in more recalcitrant cases 25.","title":"Surgical Treatment and Outcomes of Calcaneal Osteomyelitis in Adults: A Systematic Review"}
{"_id":"bf506f25-33a5-872a-84cf-1df3195c3619","text":"Compression stockings will be used by patients as advised by the clinician treating the DVT and the researchers will not influence their utilisation.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"bf5c81a2-c091-91bf-8c1f-44298b1bb825","text":"Paediatric radiology plays a pivotal role in the diagnosis of childhood osteomyelitis and can also be used to guide therapy and intervention.","title":"Childhood osteomyelitis: imaging characteristics"}
{"_id":"bf61916e-bc59-1e2a-ef25-68049c9f2505","text":"Instead of the silicone implants previously used for repair and reconstruction of the auricle and nose lost due to accidents and disease, a new treatment method using tissue-engineered cartilage has been attracting attention. The quality of cultured cells is important in this method because it affects treatment outcomes. However, a marker of chondrocytes, particularly auricular chondrocytes, has not yet been established. The objective of this study was to establish an optimal marker to evaluate the quality of cultured auricular chondrocytes as a cell source of regenerative cartilage tissue. Gene expression levels were comprehensively compared using the microarray method between human undifferentiated and dedifferentiated auricular chondrocytes to investigate a candidate quality control index with an expression level that is high in differentiated cells, but markedly decreases in dedifferentiated cells. We identified glial fibrillary acidic protein (GFAP) as a marker that decreased with serial passages in auricular chondrocytes. GFAP was not detected in articular chondrocytes, costal chondrocytes, or fibroblasts, which need to be distinguished from auricular chondrocytes in cell cultures. GFAP mRNA expression was observed in cultured auricular chondrocytes, and GFAP protein levels were also measured in the cell lysates and culture supernatants of these cells. However, GFAP levels detected from mRNA and protein in cell lysates were significantly decreased by increases in the incubation period. In contrast, the amount of protein in the cell supernatant was not affected by the incubation period. Furthermore, the protein level of GFAP in the supernatants of cultured cells correlated with the in vitro and in vivo production of the cartilage matrix by these cells. The productivity of the cartilage matrix in cultured auricular chondrocytes may be predicted by measuring GFAP protein levels in the culture supernatants of these cells. Thus, GFAP is regarded as a marker of the purity and properties of cultured auricular chondrocytes.","title":"Glial Fibrillary Acidic Protein as Biomarker Indicates Purity and Property of Auricular Chondrocytes"}
{"_id":"bf664fa3-9094-41d8-f3a1-e01f6ad9adbf","text":"Mechanical methods may be used alone or along with pharmacological thromboprophylaxis. These devices augment venous blood flow and thus prevent venous stasis in the leg veins. They are contraindicated in patients with established DVT.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"bf6b7520-84eb-cf9d-7a3b-20256d056aa8","text":"Multispectral optoacoustic tomographic imaging may allow nonradioactive detection of sentinel lymph nodes at a frequency similar to the current radiotracer standard.","title":"Assessment of Nonradioactive Multispectral Optoacoustic Tomographic Imaging With Conventional Lymphoscintigraphic Imaging for Sentinel Lymph Node Biopsy in Melanoma Nonradioactive Multispectral Optoacoustic Tomography vs Lymphoscintigraphy for Sentinel Lymph Node Biopsy"}
{"_id":"bf72e2eb-b1d8-a588-91ad-b9cc5842e3dd","text":"Osteomyelitis is an inflammatory process of bone and marrow contents. These changes in bone are primarily seen in soft tissue followed by calcified tissue. It is an opportunistic infection due to the complication of some other conditions rendering the host susceptible to disease. Consequences of this infection range from draining tract to malignant transformation. Various etiological factors are involved in origin of the disease; among them, fungal origin is rare. Specific feature in fungal osteomyelitis is the involvement of maxillary sinus with a complaint of sinusitis associated with diabetes mellitus. Here, we discuss a case of osteomyelitis with fungal infection involving the maxilla. The patient is under medication for the past five years due to diabetes.","title":"Mucormycotic Osteomyelitis Involving the Maxilla: A Rare Case Report and Review of the Literature"}
{"_id":"bf8bbb51-1954-567d-76f5-5374c7bbecd9","text":"The development of DVT is a constant risk in any hospital setting. Although most DVTs are occult and can resolve spontaneously, complications from it arises when the clot dislodges and blocks narrower veins of major organs such as the heart, lung and brain, which can result in catastrophic outcome. Prophylaxis of DVT is therefore an integral as part of any patient care.","title":"Deep Vein Thrombosis and the Neurosurgical Patient"}
{"_id":"bf8d7c43-40b0-1273-6bc4-4d676644dc9d","text":"All patients considered for chemotherapy treatment should be offered a full blood count and a chemistry panel testing for kidney function and liver enzymes and a sedimentation rate. The latter laboratory tests are considered basic resources for cHL treatment. Serology testing for HIV, hepatitis B and C are strongly encouraged.","title":"Resources-Stratified Guidelines for Classical Hodgkin Lymphoma"}
{"_id":"bf9a251e-0851-bb15-a583-52092f627adc","text":"BFP excision is acknowledged as an effective surgery to improve the facial silhouette and capacious cheeks in younger patients. There were no specific studies performed to determine if it can also improve the ptotic face in middle-aged patients, with limited efficacy of BFP excision for this age group due to already reduced skin elasticity potentially leading to postoperative drooping. Therefore, BFP excision was carried out in this age group to observe the efficacy. When results were examined 12 months postoperatively, the observations were reasonable lower facial slimming, improvement of marionette lines, nasolabial grooves, and slight elevation of lateral mouth corner angles. These effects are thought to be obtained from the release of BFP weight burden at the lower face. While the improvements gained from BFP excision are not superior to facelift surgery, BFP excision can be a preliminary procedure before facelift surgery is seriously considered. However, BFP excision should not be performed in patients with severely diminished skin elasticity as excision of BFP volume may cause additional ptosis. Hence, careful selection of suitable candidates with good skin elasticity is also critical.","title":"Aesthetic Values of the Buccal Fat Pad Excision in Middle-Aged Patients"}
{"_id":"bf9d1c77-bc79-7751-5510-b2721d51d467","text":"All 197 patients in this study has no recurrence after surgery. Postoperative recurrence is often thought to be related to improper surgical operation of ETS, such as incomplete dissection of the thoracic sympathetic nerve trunk or partial lateral branching, residual nerve regeneration and neuroanatomical variation, suggesting that the operator should try to accurately and adequately dissect the thoracic sympathetic nerve chain on the rib surface and its collateral fibers within 2 cm lateral to avoid thoracic sympathetic nerve regeneration under direct vision during the operation.","title":"Comparison of the efficacy of ETS with different segments for palmar, axillary and plantar hyperhidrosis"}
{"_id":"bf9f5e2a-0481-ef1a-a573-992be0e9a4d7","text":"Patients will be instructed by the investigator to report the occurrence of all AEs. The following events are reported by the investigator within the trial:","title":"Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial"}
{"_id":"bfa2abd0-5f0c-f92a-6228-86bc9063f646","text":"We begin prophylactic AC treatment in patients undergoing intracranial surgery on the first day after surgery, as long as postoperative CT scans do not show any signs of residual bleeding. Patients with postoperative or perioperative hemorrhage are mainly anticoagulated after 3–5 days following a repeat CT scan without any sign of a growing hemorrhage.","title":"Perioperative anticoagulation in patients with intracranial meningioma: No increased risk of intracranial hemorrhage?"}
{"_id":"bfa340a3-4517-ff93-0a97-9a3d829d4345","text":"All of the interviewees agreed that the experience was a valuable one and was positive in developing their leadership skills. The local expectations and the high level of supported autonomy contributed to the perceived effectiveness of the fellow’s development:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"bfa66d2d-970c-952e-dde9-82b9e450d836","text":"Some examples of local adverse reactions observed in the studied patients are presented in Figure 8.","title":"Topical Photodynamic Therapy with Different Forms of 5-Aminolevulinic Acid in the Treatment of Actinic Keratosis"}
{"_id":"bfa7463c-403d-c474-5194-c5138f082200","text":"Large adiposity of the abdomen, arms, or inner thighs tends to have excess volume of fat whose weight overstretches the panniculus and results in a ptosis of the skin overlying the area. In these cases the need is to reduce the large fat volume to permit effective skin retraction and MALL effectively addresses the issue better as the amount of skin shrinkage after this procedure is remarkable and the clinical results are appreciable [Figures 10–11].","title":"Liposuction"}
{"_id":"bfb8e12c-d2bb-645c-01b4-d5cc032dfea0","text":"The clinical outcomes of this study indicated that shoulder arthrodesis using FVFG was effective for local tumor control and the preservation of shoulder joint movement. Shoulder arthrodesis provided a stable shoulder girdle with satisfactory function and acceptable complication rates. The bone healing times in patients with vascular anastomosis were shorter. Thus, it could be stated that the FVFG technique could be effectively applied for the reconstruction of bone defects.","title":"A Retrospective Study of the Functional Outcomes in Patients with Proximal Humeral Bone Defect after Shoulder Fusion or Prosthetic Replacement"}
{"_id":"bfbe5cef-976e-956e-3725-94a7fe4d90cf","text":"Breast cancer and malignant melanoma cells are well known to travel via the lymphatic system and migrate to regional lymph nodes. Thus, removal of regional lymph nodes has been a part of the surgical strategy for treatment of these cancers since Moore proposed axillary node dissection for the treatment of breast cancer in 1867 [1]. Sappey described the lymphatic system in the torso as being divided into 4 territories by the central midline and a horizontal line at the umbilical level, and he found that each lymph quadrant drained into the ipsilateral axillary or inguinal nodes in 1874 [2]. His anatomic findings have become the guiding principle in selecting which lymph basin needs to be removed in the treatment of a primary tumor [3].","title":"Lymphatic Territories (Lymphosomes) in a Canine: An Animal Model for Investigation of Postoperative Lymphatic Alterations"}
{"_id":"bfbe9545-af9e-6c7b-b125-4eecad24ee91","text":"In both cohorts, 2 groups were identified: cosmetic augmentation and breast reconstruction. The breast reconstruction group included patients who received a breast implant after mastectomy for cancer or prophylactic reasons. Patients who underwent reconstructive breast implant surgery for benign reasons or congenital deformities were excluded because of the small population size of this subcohort.","title":"Prevalence of Local Postoperative Complications and Breast Implant Illness in Women With Breast Implants Local Postoperative Complications and Breast Implant Illness in Women With Breast Implants"}
{"_id":"bfc172d5-1045-62f7-09f9-0e809936690d","text":"Advances in the surgical management of the axilla have led to changes in practice and more judicious use of ALND that may minimize morbidity from surgery. From the viewpoint of drug development, assessment of response to neoadjuvant chemotherapy remains paramount, and appropriate assessment of residual disease—the primary endpoint—is critical. Therefore minimizing the FNR of axillary surgery to ensure more consistency in clinical trial data, without mandating ALND for all patients is necessary. The key elements to improve the accuracy of the assessment include proper staging and identification of nodal involvement at diagnosis, and appropriately targeted management of the axilla at the time of surgical resection. The I-SPY2 trial team revised their protocol, establishing requirements for surgeons treating patients on the trial as outlined above, to maximize value of axillary assessment, minimize surgical complications, enable modern axillary management and prevent drop off in enrollment. At the same time, standardizing the protocol helps maintain fidelity of the primary endpoint and generate appropriate data to continue to advance drug development. In the era of trials that promote a precision medicine approach, we have made the appropriate improvements to surgical management of the axilla and allow the standards and treatment to evolve accordingly. These surgical standards would be appropriate for neoadjuvant clinical trials with pCR as endpoint and for clinical practice.","title":"Surgical Standards for Management of the Axilla in Breast Cancer Clinical Trials with Pathological Complete Response Endpoint"}
{"_id":"bfc56d85-5b25-c1a6-ce94-0792bf696f51","text":"The allograft was rejected in an interval of time that varied between 14-21 days, but in this period of time the more shallow burns will heal and provide material for autograft.","title":"Surgical management of extensive burns treatment using allografts"}
{"_id":"bfcdb2ad-3f8b-427d-b9f6-a0513b4ae348","text":"Sun exposure is a primary preventable risk factor for skin cancer. Sunscreen has been shown to reduce the risk of certain skin cancers such as squamous cell carcinoma and melanoma. We aimed to assess the prevalence and predictors of sunscreen use among medical students in Karachi.","title":"Prevalence and Predictors of the Use of Sunscreen Amongst Medical Students: A Multi-center Cross-sectional Study"}
{"_id":"bfd7528a-f00b-c0cb-9e5e-328984abcd6c","text":"Despite finding favor for use in breast reconstruction and elsewhere, the SIEA flap remains an infrequently utilized option in the head and neck surgery, with only 2 case reports describing its use in the setting of hemifacial microsomia or traumatic contour defects.5,6 The flap was also described as part of a combined soft tissue and bony reconstruction with the deep circumflex iliac artery flap in a series of 12 patients with oral cancer in 2011.8","title":"Superficial Inferior Epigastric Artery Flap for a Total Parotidectomy Defect Alkureishi et al"}
{"_id":"bfdb7197-3049-1a2b-1d8e-03be33857ef3","text":"Skin grafting is frequently utilized for facial reconstruction following surgical excision. Full-thickness skin grafts are used to treat small, superficial facial defects and can produce excellent aesthetic results if the graft is color-matched to the tissue surrounding the defect.51,53,55,56 Split-thickness skin grafts are primarily used to cover large defects, particularly those of the scalp, because of the minimal donor site morbidity associated with harvest.8 Skin grafts require an underlying vascular bed to survive after placement over the defect. Should an adequate vascular bed not exist, acellular dermal matrices may be used to develop one before graft placement.8","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"bfe16e0d-ebd6-96f7-945d-3035095f0479","text":"SLNs were re-evaluated retrospectively on two plain images by two readers in consensus: one nuclear medicine resident with 4 years experience in breast imaging and one board certified specialist in radiology and nuclear medicine with 15 years experience in breast imaging. The lymphoscintigraphy was categorized depending on the visual signal intensity of the SLN using the following primary categories: either sufficient nuclide uptake with possible skin mark or weak or missing nuclide uptake without a skin mark. The time between biopsy and nuclide injection was registered.","title":"Impact of Tumor Localization and Method of Preoperative Biopsy on Sentinel Lymph Node Mapping After Periareolar Nuclide Injection"}
{"_id":"bfe438e0-b84f-00f2-f187-18bd58bf4ec9","text":"Subjects can leave the study at any time for any reason if they wish to do so, without any consequences. The investigator can decide to withdraw a subject from the study for life-threatening medical reasons. If during the study it is anticipated that there is a very high risk of total flap necrosis, the treating physician can decide to withdraw the patient from the dangling part of the study. This applies to patients in both groups A and B. This risk will be an estimation based on the clinical experience of the surgeon. For ethical reasons, we believe that this possibility is important in this study. The patient will still be included for the secondary objectives. If a patient experiences an adverse event which prevents the patient from adequately performing a dangling or a non-dangling protocol, that patient will be terminated from the study for the primary study outcome. If possible, the patient will still be included for the secondary objectives.","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"bfe4c0cb-ad3f-fb8f-188f-cc3eec75d93d","text":"Improved quality patient care: Day case surgery can be performed with the same or even greater health care quality than surgery involving patient hospitalization. Previous studies showed that day surgery leads to better results than surgery with hospitalization, with fewer and less serious postoperative complications and a lower readmission rate.","title":"Oral surgical procedures under local anaesthesia in day surgery"}
{"_id":"bfe5dbe4-3bcf-d870-ae35-c121f9343c71","text":"The perioperative incidence of VTE was substantially lower in this study than in previous reports for Western populations. Patients who were female, had ORIF and multiple surgeries were highly associated with the occurrence of VTE.","title":"Prevalence and associated factors of developing venous thromboembolism in the perioperative period"}
{"_id":"bfe7c5e6-3bf3-3413-5dc1-b03c125f97a5","text":"These assumptions seem to reflect the results obtained by the physiatrist.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"bff443d7-32f2-e569-2bb4-357235a92d88","text":"Plastic surgery is a constant battle between blood supply and beauty. The end result of a reconstructive procedure is primarily attributable to the stability of the vascular component, which is fundamental in that it ensures survival and proper functioning of tissues that have been transferred to the recipient site. The lower limb has always been known for poor wound healing and, since the first steps of the plastic surgery, as a scarce source of flaps for reconstruction. Soft tissue reconstruction of the lower limb is hence, challenging. Due to limited mobility and a paucity of overlying skin, even small soft tissue defects of the lower limb generally need flap coverage.","title":"Perforator Flaps for Reconstruction of Lower Limb Defects"}
{"_id":"bff6f33d-ae01-bc41-51ea-1e83bdc026e4","text":"The results obtained from this study indicated how the condition of the short lingual frenulum affected the severity and intensity of the OSAS pathology. This trial demonstrated that diode laser lingual frenectomy therapy can improve the severity of OSAS in pediatric patients.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"bffaa780-f747-8586-3aff-242e1b15914e","text":"The study was designed according to the Declaration of Helsinki and approved by the Local Ethics Committee. Each patient provided a written informed consent for participation.","title":"Effect of flap design and duration of surgery on acute postoperative symptoms and signs after extraction of lower third molars: A randomized prospective study"}
{"_id":"bffd19f1-55bd-188c-b2c0-47e42dccf87e","text":"The authors noticed that 60% of the PD cases in the present study occurred during periods of treatment interruption superior to 8 weeks. The authors agree that as long as the adverse events are tolerated, vismodegib can be taken on a continuous regimen and that intermittent regimens should limit the intervals without treatment to a maximum of 2 months, if possible. Importantly, in poor tolerability cases, an intermittent regimen should always be discussed before deciding to stop the treatment. The authors believe that the study’s outcomes using vismodegib could be improved with a stricter protocol for cases that require an intermittent regimen.","title":"Vismodegib for treatment of periocular basal cell carcinoma – 6-year experience from a tertiary cancer center"}
{"_id":"c00a397c-6d18-0d82-01b1-3713644d2e02","text":"Ultrasound‐guided BTA injection into salivary glands can effectively reduce saliva secretion. We also found that the time of changing cannula was shortened obviously and the incidence of recurrent pneumonia infection was reduced. BTA injection of salivary glands to cure drooling could advance to the clinical therapy in severe neurological patients after tracheotomy.","title":"Botulinum toxin in the treatment of sialorrhea in severe neurological patients with tracheotomy"}
{"_id":"c00deef2-3844-da34-3641-0918823a66d3","text":"The medial head or the lateral head can be used. The medial head is more commonly used and is bigger than the lateral head, because the muscular body is smaller and the fibula constitutes an obstacle to passage of the flap to the knee. It is an excellent coverage of the lateral aspect of the metaphysis of the tibia810 [Figure 1]. The combination with a cutaneous paddle at the distal level of the muscle and over the distal aponeurosis makes it possible to use a bigger flap to cover part of the medial third tibia of the leg.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"c00ecf24-487f-187a-c015-c1436f4a9f70","text":"Surgical risks in the hand include damage to the digital neurovascular bundles and wound complications, with the caveat that excised lesions may recur. In our experience, these pitfalls can be avoided with complete excision, careful dissection, and identification of sensitive anatomy. Surgical excision of idiopathic calcinosis cutis of the hand is an effective and definitive treatment for these lesions, with no reported recurrences in the literature.","title":"Idiopathic Calcinosis Cutis of the Hand"}
{"_id":"c011988c-f605-24c2-3a02-8a7f956a8eb2","text":"The diagnosis of a bone or joint infection was confirmed in 54 children, 30 suffered from (infective) osteomyelitis, 16 from bacterial arthritis and 8 from discitis. We excluded two patients with chronic infection due to tuberculous osteomyelitis and Brucella discitis from further analysis because they were not considered appropriate for a comparison on the role of oral versus intravenous antibiotic treatment due the length of standard therapy.","title":"Impact of a pediatric infectious disease consultation service on timely step-down to oral antibiotic treatment for bone and joint infections"}
{"_id":"c0162085-162c-9ea8-506b-de243c317d36","text":"We were not able to pool data from multiple studies given the heterogeneity of measurements used for quantifying outcomes. Data extracted from eligible studies were analyzed using a narrative approach. This synthesis aimed to provide an evidence-based review of all prospective data regarding keloid treatments and outcomes in the last decade.","title":"Keloid treatments: an evidence-based systematic review of recent advances"}
{"_id":"c017673e-b481-00c6-53e5-45cb51f6151c","text":"We suggest the use of validated pre-test probability models in conjunction with D dimer testing and selective use of objective diagnostic imaging to increase the cost-efficiency and accuracy of VTE diagnosis.","title":"Guidance for the treatment of deep vein thrombosis and pulmonary embolism"}
{"_id":"c01b153a-a5a7-1539-4a0c-17774951a8b4","text":"In light of evidence of reactions to CM, which frequently occurred on first exposure, the role of osmolarity may be considered one of the most important factors to study in the choice of which alternative CM to use.","title":"The involvement of osmolarity in the safety of contrast media"}
{"_id":"c022b315-583c-8a3c-a915-64c372aa70c4","text":"Boundaries of area with surgical anesthesia after a TPVB or TAP block. Note: each dot represented one patient whose lateral boundary of area with surgical anesthesia reaching to that line at that dermatome segment","title":"Comparison of single-injection ultrasound-guided thoracic paravertebral block with transversus abdominis plane block in peritoneal dialysis catheter implantation: a randomized controlled trial"}
{"_id":"c0286805-c2c6-3d96-ed88-3b3ea8d3edb5","text":"The patient signed a consent form before surgery and publishing this report.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"c02c220b-0ae4-7744-448f-2d30dc872a60","text":"Step 1: Racket incision is made just proximal to the skin crease in the popliteal fossa with a longitudinal extension perpendicular to this incision that extends to the anterior superior iliac spine.","title":"Rotationplasty for Severe Congenital Femoral Deficiency"}
{"_id":"c0332bcc-ce17-5a32-c0d5-ba41d49e0c53","text":"The IGH Fellowship successfully fosters healthcare professionals to recognise and develop their leadership skills and behaviours and subjectively has a positive impact on their career development. The process involves experiential learning, reflection and evolving cultural intelligence, which in turn helps to develop self-awareness, increases self-efficacy and subsequently leads to positive changes in career choice. Three interviewees reported that they felt that their skills were not recognised on returning to the UK, suggesting a disparity in the perceived opportunities to utilise these skills on returning to the NHS. In order for the NHS to face the significant challenges of the twenty-first century, it is essential that healthcare professionals are supported in taking on leadership roles in the early stages of their careers. For the 41\/74 fellows who self-reported positive career impacts through finding or creating opportunities to utilise the skills that they developed on the programme, valuable outcomes in terms of engaging with quality improvement work and leadership have been reported. It is essential that continuing evaluation is conducted into the effectiveness of leadership development programmes and the perceptions of such programmes to pave the way for innovative leadership within the NHS, whose survival is dependent upon the strengths of its staff and its ability to adapt to the changing environment.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"c033a2d0-c456-4f77-4b5c-b539df8ca3c0","text":"The FA also provides many fasciocutaneous and musculocutaneous perforators to supply the skin and muscles, albeit they are more common in the distal portion of the FA. These branches exhibit arterial anastomoses with each other in the subcutaneous tissue, and it appears that the second, third and fourth musculocutaneous branches have larger diameters and should be used for fibular flaps.11 , 12","title":"Clinical features of a rare anatomical variation of the posterior tibial and fibular arteries Aspectos clínicos de uma variação anatômica rara das artérias tibial posterior e fibular"}
{"_id":"c035e09b-8518-2445-0906-86975664ba74","text":"EN is an inflammatory lesion characterized by tender subcutaneous induration with a flushed surface, predominantly on the bilateral lower legs. EN occurring after olaparib administration is considered to be very rare. This article describes such a case and reviews the relevant literature.","title":"Development of Erythema Nodosum After Olaparib Treatment in a Patient With Recurrent Breast Cancer and BRCA2 Mutation: A Case Report"}
{"_id":"c037af42-1d56-93a1-9599-cf73f3252bd9","text":"The identification of SLN combined with 99mtechnetium-labeled sulfur colloid and methylthioninium chloride has a good accuracy and is safe for the assessment of the status of pelvic nodes in patients with initial stage cervical cancer. Nuclide as a tracer has low dependence on objective conditions and doctors' technology and has a good detection rate. In our study, we believe that SLN biopsy is feasible when the tumor is ≦ 4 cm. Large scale clinical trials are required in China expand the sample size and validate the results of this study.","title":"Clinical Study of Sentinel Lymph Node Detection to Evaluate Pelvic Lymph Node Metastasis to Determine the Prognosis of Patients with Early Cervical Cancer"}
{"_id":"c039bf00-b7d5-5815-1dfa-d0ea21f3a561","text":"Only patients presenting a squamous cell carcinoma of the oral cavity were included in the study, the hospital chart had to be complete and each patient had to have at least one year of follow-up. Patients were excluded if they had an oral cavity cancer within 5 years of the current diagnosis, another synchronous primary cancer, or prior radiation therapy for a head and neck cancer. Loco-regional recurrence was defined as a tissue-proven cancer recurrence at the primary site or in the regional lymph nodes within 5 years of the initial treatment. Time of recurrence was defined as the time between the date of the surgery and cancer recurrence on a pathology specimen.","title":"Decreasing loco-regional recurrence for oral cavity cancer with total Mohs margins technique"}
{"_id":"c0582b6b-3697-cce7-732f-86097b9da40c","text":"This type of treatment that catalyzes H2O2 to generate oxygen inside tumor tissue to improve the hypoxic environment often integrates PDT with other treatment options to achieve enhanced therapeutic outcome. It is believed that this combination strategy would realize the strongest tumor inhibition effect.","title":"Solutions to the Drawbacks of Photothermal and Photodynamic Cancer Therapy"}
{"_id":"c06103e1-65ab-9a88-956e-515ed7b6cf3f","text":"In summary, early fast enhancement is the most important feature of recurrent lesions on postoperative breast MRI for both early and late recurrence groups. Any new lesion with size of 1cm or larger detected on MRI within 12 months after BCT at the same quadrant as the lumpectomy site, should be considered suspicious and further workup is needed. Also, if any new lesion shows early fast enhancement and delayed washout pattern regardless of its location and size after 12 months from BCT, emphasis should be made on the lesion due to the possibility of recurrence.","title":"Usefulness of postoperative surveillance MR for women after breast-conservation therapy: Focusing on MR features of early and late recurrent breast cancer"}
{"_id":"c061e836-6811-6a14-dd18-67f0fc512fa6","text":"Dual antibiotic prophylaxis, consisting of cefazolin and gentamycin, was administered promptly upon arrival to the emergency department. Antibiotic administration was estimated to be within three hours from the time of injury. A brief bedside irrigation with 3 L of sterile saline was performed and the wounds were dressed with moist gauze. The patient was then provisionally stabilized with a moldable long leg fiberglass splint and sent for additional preoperative imaging. Preoperative radiographs are provided in Figure 2A-2C. After imaging was completed, the patient was brought to the operating room for urgent wound debridement and open reduction internal fixation of the right lower extremity.","title":"Circumferential Negative Pressure Wound Therapy with Instillation and Dwell Prior to Delayed Flap Coverage for a Type IIIB Open Tibia Fracture"}
{"_id":"c0734433-4ca8-04da-ba1f-6d32fbd593ab","text":"Objectives: To report the observed effectivness of riuximab on JDM and associated calcinosis","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"c07646a9-fb4f-dc17-39ce-bffc9ec33805","text":"Once late-onset deep SSI after instrumented spinal surgery is confirmed, debridement should be performed as early as possible because the infection may spread to nearby areas, which would hinder the treatment of the infection, especially in the case of a high-pressure abscess, and the implants may be loose, leading to internal fixation failure and a lack of adequate spinal fusion. Additionally, certain bacteria can attach to the surface of implants and form a biofilm that makes the infection difficult to treat. The reason for these difficulties is ascribed to the fact that bacteria produce and embed themselves in a matrix of an extracellular polymeric substance and thus can form biofilm colonies that are resistant to antibiotic treatment [13]. Removal of the implants in debridement offers the advantage of eliminating microorganisms harbored in biofilms on the surface of the implants, thus increasing the chance of eradicating the infection. Nevertheless, this potential advantage must be weighed against the risks of prematurely removing implants that are essential for maintaining normal spinal alignment and preserving spinal stability.","title":"Management of late-onset deep surgical site infection after instrumented spinal surgery"}
{"_id":"c07d7d5b-2856-3231-e3d9-7ced9a57db4a","text":"a Side positioning of the patient making a two team approach possible b Debridement of the sternum and harvesting the latissimus dorsi flap with a 18x7cm skin island simultaneously c Fully harvested myocutaneous flap solely connected to the body by a skeletonized 12 cm long pedicle (double arrow) making a wide advancement of the flap into the anterior mediastinal region possible d Fixation of the tendinous part of the latissimus muscle on the thorax wall preventing the vessels from uncontrolled tension and movement (double arrow) e The muscular part of the flaps fills up the deep cavity of the mediastinum and the skin island makes a relaxed closing of the already retracted skin edges possible f 1 Week post operatively the flap shows an excellent state of perfusion without any signs of wound healing disorder","title":"Deep sternal wound infection – latissimus dorsi flap is a reliable option for reconstruction of the thoracic wall"}
{"_id":"c07fc2de-e566-fcf6-046f-bee9020bf919","text":"After comparing the preoperative biopsy with the findings of MMS, the cases were classified as discordant when the histopathological subtypes present were not identical. The presence of any area of a given histological subtype was considered for the assessment.","title":"Comparison of basal cell carcinoma subtypes observed in preoperative biopsy and Mohs micrographic surgery"}
{"_id":"c08088dc-e2c0-a6df-f52a-5ec0449353e1","text":"The clinical diagnosis is based on the variable positivity to the different clinical tests determined by the location of the calcific deposits. The acute clinical symptomatology of an intra-articular calcification is usually characterized by invasive pain, associated with severe functional limitation of the shoulder movements with consequent severe impairment of daily life and working activities.[","title":"Ultrasound-guided percutaneous treatment of a calcific acromioclavicular joint A case report"}
{"_id":"c0816b70-e773-18cb-9fd4-da81fdd46d5c","text":"When comparing BRONJ and bacterial osteomyelitis based on photographic density changes of similar aspects in panoramic radiograph through t test by comparison of B1 and C1 or B2 and C2, there was no significant difference in photographic density. This result means that it is not possible to classify BRONJ and bacterial osteomyelitis by quantitative analysis of panoramic radiograph. There have been many attempts to segment radiologic characteristics of BRONJ in panoramic radiograph and CT, but a clear standard could not be defined, in line with the results of this study [24–26].","title":"Early diagnosis of jaw osteomyelitis by easy digitalized panoramic analysis"}
{"_id":"c0837d81-2ca7-30d3-f51a-df28a8040578","text":"All procedures performed involving human participants were in accordance with the ethical standards of the institutional review board of Aichi Cancer Center. Informed consent was obtained from the patient for this publication.","title":"The significance of biopsy scar excision at the time of skin- or nipple-sparing mastectomy with immediate breast reconstruction"}
{"_id":"c08549b3-20cb-eaa1-7132-0abde32c1e7b","text":"The treatment of complications should be aggressive and initiated as soon as possible after occurrence. Effective treatment of complications and assuring patients in the interim are the keys to successful practice.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"c0910de7-e913-d2c5-7819-a0db83dd811d","text":"In our patient, no evidence of cystic structure was found around the calcified material and CEA was negative. This suggested that SCs did not result from eccrine epithelial cysts as proposed by Ito et al. Although there was no epithelial lining around the calcified nodule, there was fibrosis adjacent to the atrophic stratified squamous epithelium. This type of histopathology was consistent with the findings of Song et al.","title":"Scrotal calcinosis due to resorption of cyst walls: a case report"}
{"_id":"c098381d-8842-c839-7f4e-6c376acadb42","text":"This case presents with a very typical presentation of radiation recall dermatitis following a dose of trastuzumab, which has not previously been associated with radiation recall. The clinical distribution of the skin reaction following the geometrical borders of the radiation field, the time to onset of 3 days, and the time to spontaneous resolution of 14 days are all consistent with previous reports of radiation recall dermatitis. There are several additional interesting facets to this case, which pose further questions and possible mechanisms for radiation recall reactions. This lady's documented history of skin hypersensitivity to numerous allergens including latex raises the question of whether this may predispose a person to developing radiation recall dermatitis. Secondly, as the recall dermatitis only developed after she received her trastuzumab infusion in the ipsilateral arm to which she received radiotherapy, there may be a dose-dependent response and a possible threshold dose exposure that triggers a radiation recall reaction. Similar to previous cases, this lady was able to complete the remainder of her planned trastuzumab treatment without another recall reaction, although a rechallenge in the ipsilateral arm was not attempted.","title":"Radiation Recall Reaction Induced by Adjuvant Trastuzumab (Herceptin)"}
{"_id":"c099e29f-8498-df80-e4f8-0bbc2e1b4e63","text":"A persistently wide tip after primary rhinoplasty (21% of cases) may be due to failure of the surgeon to account for a thick inelastic skin-soft tissue envelope when modifying the dome region. A common error of omission leading to a persistently wide tip is the failure to straighten convex lateral crura. Dome narrowing will not result in a defined triangular tip appearance if the lateral walls are curving outward. Unless the curvature is straightened with a suture technique or lateral crural struts, there will be a persistently wide tip. This complication can be detected from the basal view of the nose. When using lateral crural struts, strong segments of cartilage are required to overcome the curvature of the existing alar cartilage. After separating the vestibular skin from the undersurface of the lateral crura, the grafts are sutured to the undersurface of the curved cartilages. The caudal attachment of the lateral crus and skin should remain intact to prevent caudal migration of the graft.","title":"Causes, Prevention, and Correction of Complications of Primary and Revision Septorhinoplasty"}
{"_id":"c09db13a-fefc-a57f-a34b-b15fd75dd544","text":"Osteomyelitis is a type of bone inflammation that is induced by infection, largely caused by the infectious organism of Staphylococcus aureus. Young children and the elderly with diabetes are most at risk for developing osteomyelitis. The infection may reach the bone via the bloodstream or via a local injury and consequently induces a severe inflammatory response followed by progressive bone destruction. Infection causes osteoblasts apoptosis and promotes osteoclast activities that are accompanied by an increase in RANKL expression in tissues surrounding the infection sites. Intravenous or oral antibiotic treatment for osteomyelitis is essential, and this treatment may last for many weeks. Surgical intervention is sometimes needed to drain infectious fluid and remove damaged tissues [146].","title":"Interplay between Inflammation and Pathological Bone Resorption: Insights into Recent Mechanisms and Pathways in Related Diseases for Future Perspectives"}
{"_id":"c0a12db7-5cff-25e3-ebee-8fdd5b4dda24","text":"This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients' satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients' satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.","title":"Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom"}
{"_id":"c0a5bd86-fc0d-7d10-3e4d-af0baf488ddd","text":"An electronic survey was submitted to fellowship directors and consisted of 16 factors included in a fellowship application. Respondents were asked to rate the importance of these factors for applicants they interviewed on a 1 to 5 Likert scale, with 1 being not at all important and 5 being critical.","title":"The Competitive Orthopaedic Trauma Fellowship Applicant: A Program Director's Perspective"}
{"_id":"c0ab7f3e-3bcf-1b2d-513c-f046112d2ebe","text":"Surgical intervention in the form of epineurotomy by multiple longitudinal incisions and external decompression to relieve the internal pressure throughout the involved segment is considered the treatment of choice after failure of steroids.","title":"Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities"}
{"_id":"c0b1c3ab-5ab5-9176-88a8-35f785dff621","text":"DeBakey vascular dilators are commonly used during cardiovascular surgeries to confirm and dilate coronary artery stenosis or dilate the lumen of the harvested internal mammary artery (IMA) to resolve arterial vasospasms. 5 The forceps dilator is mainly used for vessel dilation in microsurgery, while the DeBakey vascular dilator is rarely used. A case in which the IMA was dilated using a DeBakey vascular dilator in autologous breast reconstruction has been reported. 6 However, there have been no case reports on using the DeBakey vascular dilator during free flap surgeries of the lower extremity.","title":"Mechanical Dilation of the Recipient Vessel with the DeBakey Vascular Dilator in Lower Extremity Reconstruction: A Report of Two Cases"}
{"_id":"c0b7acb7-69a7-e029-ca6b-35406dd94fff","text":"We showed that a slow freezing cryopreservation protocol using commercially available CPA solutions and a homemade CPA solution can protect human OA synovial tissue from cryodamage. We have validated a protocol to determine the viability of the tissue after cryopreservation, including an extensive analysis of the tissue functionality after thawing. Three CPA solutions were identified that performed equally well. A next step is to perform a reproducibility study, in which other labs will use our cryopreservation protocol to test if our results are reproducible. Furthermore, this study can be used as a template to investigate the possibility to cryopreserve the even more complex synovial tissue of rheumatoid arthritis patients and isolated primary cells acquired by synovial tissue digestion.","title":"Functional Tissue Analysis Reveals Successful Cryopreservation of Human Osteoarthritic Synovium"}
{"_id":"c0b882c7-af92-4c2c-de5d-59c5165042e8","text":"Most photosensitizers used in PDT and fluorescence diagnosis (FD) are based on the porphyrin structure because generally porphyrin accumulates on cancer cells as opposed to the surrounding nearby healthy cells and because their fluorescensing properties are used for the detection of the cancer cells. Therapy resulting from the photosensitizers is based on the production of singlet oxygen when the photosensitizer is exposed to light. A major setback however for PDT is that it does not work best on distal metastasis [215].","title":"Encapsulation of Gold Nanorods with Porphyrins for the Potential Treatment of Cancer and Bacterial Diseases: A Critical Review"}
{"_id":"c0c733f0-31af-5fd9-72eb-869382d78ac8","text":"A total of 72 pediatric patients (3 to 16 years old) undergoing elective surgery under general anaesthesia with tracheal intubation were recruited. Before surgery, DSE with a linear ultrasound transducer placed in the transverse plane at the level of thyrohyoid membrane and the neck circumference were measured for each patient. All patients were routinely intubated using a videolaryngoscope and visual findings were graded according to the Fremantle Videolaryngoscope Scoring System.","title":"Abstracts of the ICARE 2023 77th SIAARTI National Congress"}
{"_id":"c0d12190-caaa-6128-cac9-e1e2f822ab56","text":"Sunscreen is often the most used form of sun protection, albeit the least useful [10, 29, 57]. In this study, sunscreen was also the most used form of sun protection at leisure and especially so on sun holiday for outdoor and indoor workers alike. It is our opinion that the marketing of sunscreen and lack thereof for UV protective clothing and hats is the main reason for this. Aside from avoiding the sun around noon, the use of UV protective clothing and hat should be first priority as sun protection. Accordingly, the results of this study showing that avoiding the sun around noon at work and the use of long trousers and shirt with sleeves at leisure and on sun holiday is rare in Danish outdoor workers should be a matter of concern.","title":"Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers"}
{"_id":"c0d6d090-0128-23a9-66a3-88e9b1b28134","text":"Childhood osteomyelitis can be a challenging problem to both the clinician and the radiologist as the clinical presentation can be variable in severity, and laboratory results are relatively unsupportive in the diagnostic workup. Radiology plays a pivotal role in its diagnosis and can also be used to guide therapy and intervention. This review discusses the pathophysiology of childhood osteomyelitis and the clinical presentation. With respect to radiological imaging, it will focus on the application of radiological techniques in the diagnosis of childhood osteomyelitis and the reported levels of evidence for the use of these techniques (Table 1).","title":"Childhood osteomyelitis: imaging characteristics"}
{"_id":"c0d6f66f-7b03-6984-6d85-5e8eade5f2c7","text":"Calciphylaxis is a rare condition characterized by calcification of the blood vessels in the subcutaneous tissue with tissue ischemia. Calcium deposition is observed within scarred and occluded blood vessels of the subcutaneous tissue when a biopsy of the lesion is performed. Calciphylaxis is usually associated with end-stage kidney disease. We describe the case of a patient with mild renal insufficiency and without end-stage kidney disease, who underwent a wound biopsy with pathology suggestive of pyoderma gangrenosum with calciphylaxis. The wound was successfully treated with surgical debridement, topical antibiotic, and systemic steroid therapy with significant improvement over the course of management. The patient underwent a workup in order to determine the potential causes of calciphylaxis.","title":"Calciphylaxis in a Biopsy of Pyoderma Gangrenosum in a Patient Without End-Stage Kidney Disease"}
{"_id":"c0dca133-7f61-de5b-aa26-96c18f2933c9","text":"Complications and misdiagnoses are occurring after infant frenotomy. Physicians and dentists should work closely with lactation professionals to provide skilled breastfeeding support and to evaluate for other confounding problems that might impact infant breastfeeding before referral for frenotomy. Randomized controlled trials of optimized lactation support vs. frenotomy and of scissors vs laser in performance of frenotomy are needed.","title":"Complications and misdiagnoses associated with infant frenotomy: results of a healthcare professional survey"}
{"_id":"c0dd9cee-5487-2aef-ba60-af64b76464c1","text":"Extrusion force is another important parameter of high clinical relevance as it relates to the force that the physician must apply to allow the HA filler to flow through the needle.","title":"Evaluating hyaluronic acid dermal fillers: A critique of current characterization methods"}
{"_id":"c0e9f052-a42f-30ea-0aa6-b4b38d420f0b","text":"By excluding CMA by DBPCFC most parents are convinced the symptoms of their child are not caused by CMP and are willing to permanently stop an unnecessary elimination diet. This study shows that it is important to include late reactions to CMP in the DBPCFC test. By ignoring these late reactions the diagnosis of CMA would have been rejected unjustly in 37,5% of the children in our study. Also, by ignoring late symptoms parents could remain convinced that these symptoms are attributable to CMP and therefore would unnecessarily continue an elimination diet.","title":"Double-blind placebo-controlled food challenges in children with alleged cow’s milk allergy: prevention of unnecessary elimination diets and determination of eliciting doses"}
{"_id":"c0ee492a-5506-7fbe-17f6-46b915df4859","text":"Team members other than team leaders considered the leader's competence the most important factor determining their confidence in a trauma setting. They became insecure if the surgeon was newly educated or if the team leader was an experienced surgeon with little knowledge about trauma surgery.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"c0f4d00f-35ba-c8fc-0a6e-aeaae6fcc06a","text":"Locking reconstruction plates have led to significant improvement in osteosynthesis and graft anchorage in mandibular reconstruction following the free fibula osteocutaneous flap. Plate extrusion is the most common complication associated with mandibular reconstruction, occurring in approximately 20% to 48% of cases; often necessitating plate removal once the bone flap has united to the mandible. Radiation therapy is a known risk factor to the development of such a complication and it presents further challenges to the successful removal of the reconstruction plate. Several reports have been published regarding plate removal in the setting of orthopedics that describe the management of jammed or stripped locking screws, but few in the setting of mandibular reconstruction. In this case, we report the successful removal of an exposed titanium mandibular reconstruction plate from a 41-year-old woman 12 months after her initial reconstruction with a free fibula osteocutaneous flap and radiation therapy. The approach was selected because the chin and neck skin could not be expected to be raised for full plate exposure secondary to radiation-induced skin changes (thinning and friability). We also discuss the use of previously employed methods of plate removal in various settings as well as their inherent strengths and weaknesses.","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"c0f82792-072b-d638-8cea-99c27ca69235","text":"12 months post baseline the main themes to emerge at one year post diagnosis were Satisfaction and Not sure what to look for?","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"c1059174-b608-808f-308e-5045f83e90aa","text":"Whereas more than half of the members of the surgical community in Switzerland had a mentor, only a small proportion of participants reported involvement in a structured mentoring program. Mentoring exhibited a significant impact on subjective support for career advancement, subjective career advancement, and objective criteria for professional career advancement for male surgeons but not for their female counterparts. The pursuit of an academic career was not influenced by the presence of a mentor–mentee relationship.","title":"Mentoring in general surgery in Switzerland"}
{"_id":"c111bd9d-5188-c81f-2914-c3f8dba94c64","text":"SLNB has become a cornerstone in the assessment of the lymph node basin for staging and therapeutic planning in melanoma and MCC. The management of cSCCHN continues to evolve toward embracing SLNB. The role of completion neck dissection after positive SLNB in CHNM continues to be evaluated. The specific factors that predict a greater risk of LNM for cutaneous head and neck cancers generally include depth of invasion, tumor size, mitotic rate, ulceration, immunosuppression, and other histopathological factors. The limited data on CHNM warrants additional prospective trials to assess the therapeutic benefit of SLNB and the utility of completion lymph node dissection in high-risk patients. An evolving understanding of molecular and genetic biomarkers should be included in patient risk stratification, as more reliable markers under standardized processing become available. We can then offer our patients more personalized treatment and precision surgery to allow for better outcomes.","title":"Predictors of Nodal Metastasis in Cutaneous Head and Neck Cancers"}
{"_id":"c112d1b3-80d3-1235-f13a-e14781ae7829","text":"The axillary dissection for axillary nodes from breast cancer is still the standard of care its routine use in node negative breast cancer has been questioned due to morbidity associated with the axillary dissection. SLNB has improved the morbidity in patients with node negative breast cancer, while providing the much needed prognostic information. Although these techniques have been successful, they are still evolving, and SLN biopsy is not yet considered the standard of care in breast cancer.","title":"Fallacies of preoperative lymphoscintigraphy in detecting sentinel node in breast cancer"}
{"_id":"c113ba45-46ae-b130-4730-082c997a94ee","text":"No major donor site morbidity was observed. The only discomforts that patients noticed in the area of the medial femoral condyle were postoperative swelling, pain and hypesthesia in the area around the scar. All of these symptoms disappeared after 1 year or less.","title":"Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union"}
{"_id":"c12129bc-e953-681c-6cc5-34406fbf69a7","text":"It is important to note that both Padau predictive rule and Wells criteria may need to be further modified for validation within South Africa to reflect the additional risk for DVT associated with these infections because they exclude HIV and TB, which were the two most common observed known risk factors in this study population. Further studies using appropriate designs and incorporating these scoring tools, which score HIV as risk factor, are recommended to test the validity of these tools for the local South African setting.","title":"The profile and frequency of known risk factors or comorbidities for deep vein thrombosis in an urban district hospital in KwaZulu-Natal"}
{"_id":"c121d960-7a2a-774c-918f-eec5ba97cf77","text":"Screening, recruitment, adherence to allocated procedure and completeness of primary outcome data will be presented by study group as a Consolidated Standards of Reporting Trials flow chart, overall and per centre. Secondary outcome measures will be presented as summary statistics at each assessment point. Summary statistics for the two study groups combined will be presented at the end of the pilot phase if the study continues into a definitive trial, with pilot data included in the definitive trial analysis.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"c1252969-59d5-cd8b-f11b-043e27362c14","text":"Adverse reactions, caused during the inflammation and healing process, or even later, can be induced by the injection of dermal filler and can present a variety of clinical and histological characteristics. In this study we aimed to review the adverse reactions associated with the injection of aesthetic filling materials in the face and neck.","title":"Adverse reactions to the injection of face and neck aesthetic filling materials: a systematic review"}
{"_id":"c128ac78-e5c0-93db-bd31-2c67ffcdbf0f","text":"This single use tool was used to evaluate the variables above.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"c12b7e89-2e2c-c7f9-0421-7ca64fc3331c","text":"The appearance of the eruption along Blaschko’s lines on the left forearm of case #1 as the exclusive cutaneous site of involvement 2 weeks after receiving the vaccination in the left deltoid encourages a presumption of causality. The unilaterality of three of the four Blaschkoid cases is not unexpected as most cases of acquired Blaschkoid eruptions are unilateral. However, the exclusive localization of the lesions to the same (left) side as the vaccination injection sites in these patients strengthens the argument for a causal relationship between the vaccination and the cutaneous eruption.","title":"COVID-19 Vaccine-Induced Lichenoid Eruptions—Clinical and Histopathologic Spectrum in a Case Series of Fifteen Patients with Review of the Literature"}
{"_id":"c12d9781-a21d-5de8-94ac-60ae018f7c59","text":"It is still a matter of debate whether tibia diaphyseal fractures should be treated conservatively or not. Surgery is rarely required for the treatment of tibia fractures.6 Sarmiento et al.,1 in 1000 consecutive closed diaphyseal tibial fractures treated with functional bracing, concluded that the high union rate and low morbidity associated with functional bracing of closed tibial fractures should be considered rather than expensive surgery. External fixator is one of the treatment options for compound fractures of the tibia and has the advantage of being technically easy to perform, preventing soft tissue stripping, ease of removing hardware, and provision for caring the injured tissues.","title":"Dynamic osteosynthesis by modified Kuntscher nail for the treatment of tibial diaphyseal fractures"}
{"_id":"c130204d-9131-d203-f2ed-8b4efae5043b","text":"An integral part of adult learning is the timely and regular provision of constructive feedback. This has to be used correctly to ensure it is viewed in a positive manner. Feedback should be timely, relevant and constructive, usually given to best effect in private immediately after a learning event. Provision of written and verbal feedback is an integral part of WPBAs and aids in the agreement of areas for development.","title":"Education of trainees, training and fellowships for head and neck oncologic and surgical training in the UK: United Kingdom National Multidisciplinary Guidelines EDUCATION OF TRAINEES, TRAINING AND FELLOWSHIPS: UK GUIDELINES"}
{"_id":"c135c0e9-0ca4-c216-0e5d-c239ea7623fb","text":"It is important to consider osteomyelitis in immunosuppressed individuals as it is a difficult entity to treat. It may progress to involve infection of the cranial cavity and brain. It is imperative to suspect the diagnosis early and offer treatment with antibiotics. Optimal glycaemic control in diabetics is mandatory to prevent such infections.","title":"Maxillary Osteomyelitis: A Rare Entity"}
{"_id":"c13a1f32-6c51-a362-78f1-76d16bf0526e","text":"There were some instances in which the residents did not completely follow study protocol. This resulted in some ultrasound videos not being available for our review. Moreover, some residents only recorded their overall start and finish times instead of the time it took to complete each individual leg. In these cases, the time for each leg was recorded as the total time for both legs, when the time actually would be about half that length. This means the overall time to complete a two-point compression ultrasound is likely shorter than seven minutes.","title":"Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis"}
{"_id":"c146cb4f-922e-03d7-8d6b-d2fa8a4897b5","text":"This study explores the potential of this new approach to identify melanoma metastasis ex vivo in human lymph nodes. A specific purpose was to correlate spectral images with known reference spectra to differentiate melanoma metastases from blood related artifacts in intact human lymph nodes. The other purpose was to investigate the value of a hand-held photoacoustic-ultrasound system capable of 3D imaging.","title":"Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging"}
{"_id":"c1533b60-4172-ac63-6f99-a341643a9bb5","text":"Different clinical entities may be associated to an OCA. In some of these the allergic origin is established and the relationship with well known allergenic substances has been clearly demonstrated. Other entities recognize a multi factorial origin and a delayed hypersensitivity reaction may be one of the etiological factors involved (Table 1).","title":"Unmet diagnostic needs in contact oral mucosal allergies"}
{"_id":"c156ac75-4910-1a2c-e198-4feb3cdd79f8","text":"All the GPs said that they had selected an individual ultrasound catalogue of focused examinations based on their patient population, professional interests and ultrasound training. The individual catalogue included ultrasound examinations that were meaningful for the GP. Most of the GPs had limited their catalogue to simple clinical conditions within a few anatomical areas, while more experienced GPs had a larger catalogue.","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"c15a310a-fd74-d11a-5466-106a6e1b747f","text":"The prevalence of vascular surgery for peripheral vascular trauma among vascular surgeries operated in our study was similar to other studies done in similar settings. Vascular injury needs urgent intervention and appropriate management will result in a high chance of limb salvage and survival.","title":"Peripheral Vascular Trauma among Vascular Surgery Cases Operated in a Tertiary Care Hospital: A Descriptive Cross-sectional Study"}
{"_id":"c15ab4b6-8ed4-f036-c4e9-22b49455f793","text":"External beam radiation therapy (EBRT) used to be a standard Rb therapy until it became clear that this therapy significantly increased SMN risk while also affecting the eye and anatomy of the orbit itself. Currently, EBRT is mostly avoided due to fear of SMNs and established treatment alternatives such as IAC and IVitC.","title":"Subsequent Malignant Neoplasms in Retinoblastoma Survivors"}
{"_id":"c16ae4a7-c259-ae07-35d2-d133b0e5217a","text":"It was seen that the pear-shaped dose distribution characteristic of intracavitary brachytherapy with dose fall-off outside the target could be achieved with IMRT at the level of point A. HDR_BT allows higher mean doses to be delivered to PTV with reduced critical-organ doses as compared to IMRT. Nevertheless, IMRT can be considered as an option to replace intracavitary brachytherapy in situations where HDR brachytherapy facilities are unavailable or when noninvasive treatment techniques are preferred.","title":"Dosimetric comparison of high dose rate brachytherapy and intensity-modulated radiation therapy for cervical carcinoma"}
{"_id":"c16d08a0-edeb-c85a-c4e5-1c112a4ce6c2","text":"The endoscopic endonasal approach for olfactory grooves meningiomas has many advantages over traditional craniotomies. Helpful is early devascularisation of the tumour with the bilateral ligation of the anterior and posterior ethmoid arteries, which are responsible for the arterial irrigation of the tumour.15, 16","title":"Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note Técnica endoscópica endonasal utilizando duplo retalho para reconstrução de grandes defeitos da base anterior do crânio: nota técnica"}
{"_id":"c16eb010-aab5-115f-9e3a-d9528e53d0eb","text":"Placement of silicone implants in tissues typically induces an inflammatory response characterized by an infiltrate consisting of macrophages, foreign body giant cells, and a variable number of plasma cells and lymphocytes which initiates fibrosis. Fibrosis is a process triggered by complex reactions in vivo normally induced by foreign body material. It serves as a defence mechanism in response to infection, foreign body material and autoimmune factors amongst others.","title":"Expression of NF-κB-p65 and α-SMA in the Study of Capsules formed by Surface Textured Implants Versus Foam Covered Silicone Implants in a Rat Model"}
{"_id":"c1744f1d-86b3-98ff-4d49-283b481d947a","text":"The aim of the study was to explore the safety and reliability of emergency 1-stage radical debridement and reconstruction using titanium mesh filled with autologous bone for patients with cervical spine infection complicated by epidural abscess.","title":"Emergency 1-stage anterior approach for cervical spine infection complicated by epidural abscess"}
{"_id":"c176f8f6-3e28-3024-95c8-d7ff4c51e3d3","text":"In this article we present our initial clinical experience in utilizing the free posterior tibial flap for primary reconstruction of hypopharynx defects after tumor excision for the treatment of 10 SCCHP patients, and evaluate the procedure-related outcomes of these patients.","title":"Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma"}
{"_id":"c1770e6e-ee5f-e5c8-906d-e38eecd2db5e","text":"Poor outpatient glycemic control among patients with DM has been associated with increased surgical site infections, longer inpatient lengths of stay and higher mortality [3–7]. Although there are few data on whether optimizing outpatient glycemic control reduces these risks, the development of processes to identify patients who have the worst metabolic control would provide opportunities for intervention. Measures taken to decrease the severity of hyperglycemia before the day of surgery could at least improve the chances of successfully transitioning a patient within a desired glucose range across the continuum of surgical care. Careful planning would also help to avoid disruptions, such as a sudden cancellation on the day of surgery that might occur from unanticipated severe hyperglycemia. The goals of this analysis were to examine referral patterns for medical evaluation of DM patients with an HbA1c greater than 8% and to estimate the ideal window between a preoperative medical review and the day of surgery that might be needed to optimize glucose levels in patients who have poor glucose control.","title":"Relationship between the timing of preoperative medical visits and day-of-surgery glucose in poorly controlled diabetes Timing of preoperative visits"}
{"_id":"c17b4217-7476-4d08-a7bd-c09156436131","text":"In the current article, virtual models of only hard tissues were used for the surgical planning, therefore the clinical crowns of the teeth were not as detailed. To generate more realistic hybrid digital models, optical scans acquired with an intraoral scanner should be added on top of the hard tissue models for an even more precise planning process that will be expanded on in a future project.","title":"Digital three-dimensional visualization of intrabony periodontal defects for regenerative surgical treatment planning"}
{"_id":"c17fe125-2576-0b64-26c0-feb494ab38a0","text":"Their clinical symptoms, signs of atopy, type of allergic reactions involved and the main causative food allergens detected during BPCFC are summarized in Tables 1 and 2 for the whole group. Table 3 shows all individual reactions of each allergy patient related to serum IgE, atopy status and the allergy type involved.","title":"Excretion of urinary histamine and N-tele methylhistamine in patients with gastrointestinal food allergy compared to non-allergic controls during an unrestricted diet and a hypoallergenic diet"}
{"_id":"c1849279-906c-bc06-f7b4-cf8be1937569","text":"In order to explore the reasons for taking part, benefits and challenges within the context of the experience of traumatic injury the research question for the study was: what are patients’ experiences of taking part in a trial of standard wound management versus NPWT whilst they are in acute care.","title":"Participation in a trial in the emergency situation: a qualitative study of patient experience in the UK WOLLF trial"}
{"_id":"c1863877-ab02-6bf6-0ed6-3f41ed37b4fa","text":"In patients with recurrent or second primary ipsilateral breast cancer, axillary staging is the key factor in locoregional control and a strong prognostic characteristic. The efficient evaluation of lymphatic drainage of re-sentinel lymph node biopsies (re-SLNBs) has remained a challenge in the management of ipsilateral primary or recurrent breast cancer patients who are clinically lymph node negative. This study explores whether a SLNB for patients with primary or recurrent breast cancer is possible after previous axillary surgery. It evaluates potential reasons for mapping failure that might be associated with patients in this group.","title":"Management of sentinel node re-mapping in patients who have second or recurrent breast cancer and had previous axillary procedures"}
{"_id":"c18fb8d7-d45c-c6d0-eb5c-2c939d3505b9","text":"In addition to generating oxygen in situ to improve the hypoxic environment, researchers also explored other ways, such as transporting oxygen through biological materials or cells in the body to the tumor site, thereby improving the hypoxic environment of the tumor.","title":"Solutions to the Drawbacks of Photothermal and Photodynamic Cancer Therapy"}
{"_id":"c1900a0b-8ac6-e6cd-49f8-dfd11e6e2e36","text":"The first step in the determination of drug imputability is appropriate characterization of the eruption as a type IV delayed hypersensitivity reaction. One should consider the morphology and histopathology of the eruption as well as the presence of any associated laboratory derangements (see Fig. 1 and section on utility of patch testing for specific types of reactions below).","title":"The Role of Patch Testing in Evaluating Delayed Hypersensitivity Reactions to Medications"}
{"_id":"c193988e-2a76-f8fb-28df-f1b097405549","text":"The basic markings of breast meridian and inframammary fold are made.","title":"Reduction mammoplasty"}
{"_id":"c1959a07-6c78-b7da-f2ea-9b0bd39f06ed","text":"A survey questionnaire was developed and sent to all Otolaryngology Residency Program Directors for distribution to all current Otolaryngology residents in the US.","title":"Going Global: Interest in Global Health Among US Otolaryngology Residents"}
{"_id":"c1968243-facd-66ae-3d2e-b2da8d462cac","text":"The aim of this study was to describe the etiological and epidemiological characteristics of patients with surgically treated radial nerve lesions of various origins.","title":"Etiological and epidemiological characteristics of surgically treated radial nerve lesions: A 20-year single-center experience"}
{"_id":"c19be253-935a-63e1-0933-37346f3a7120","text":"There are multiple directions that future studies could take. A comparison of gross surgical margins, final histologic margins and oncologic outcomes would certainly be informative. This would help to determine what gross margins are required to obtain a pathologic margin goal of 5 mm or more. There is hope that data from outside centers will eventually be added to the study to provide more robust data.","title":"Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck"}
{"_id":"c1a68884-bf07-8fab-2283-159509941bf7","text":"The pooled proportion for the fixed effects and the random effects models was performed. The fixed effects model pooled proportion assumed a common true effect among studies: a summary effect is an estimate of the common effect size. The random effects model pooled proportion assumed a variation between studies: a summary effect is the weighted average of the effects.","title":"Non-Melanoma Skin Cancer Clearance after Medical Treatment Detected with Noninvasive Skin Imaging: A Systematic Review and Meta-Analysis"}
{"_id":"c1a7d222-4190-fc2e-3ccd-07dd91de3e66","text":"The external approach provides a wide undistorted exposure to the bony and cartilaginous framework of the nose, allowing the accurate evaluation and precise surgical control. An aesthetically pleasing good dorsal nasal profile is a sinequanon for a successful rhinoplasty result.","title":"Component Rhinoplasty"}
{"_id":"c1a9e604-fae5-b856-84c4-0630d870a5e6","text":"The extent of clinical margins has been extensively studied in six large randomized clinical trials [7,8,9,10,11,12]. Systematic reviews of the literature continue to demonstrate the limits of the current understanding of appropriate margins, particularly for intermediate thickness (1–2-mm thickness) primary melanomas [6, 13, 14]. Practice guidelines vary significantly throughout the world. While guidelines universally support at least a 1-cm radial margin, the extent of resection for melanomas thicker than 1 mm varies from 1 to 3 cm [3, 15,16,17,18]. The MASC (Melanoma and Skin Cancer Trials) activated the MelMart trial in 2020 that randomizes patients who have a T2b or thicker primary melanoma (without nodal or distant metastases) to 1 cm or 2 margins. The SWOG cooperative group activated the trial (S2015) in 2022 to facilitate accrual to the trial in the USA. The worldwide target accrual is 2998 subjects. The trial’s primary endpoint is disease free survival, but secondary endpoints include overall survival, morbidity, and patient-reported outcomes.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"c1ad51f7-01d1-2d83-f9f4-0b788e7be8a5","text":"Vascularized bone grafts have been shown to expedite time to bony union, especially in cases of spinal pseudarthrosis. Vascularized ICBG offer an adjunct to spinal reconstruction procedures by maximizing potential for solid bony union and providing a reasonable alternative to free bone transfer. This technique follows consistent anatomy, ease of harvest within the operative field, and minimal donor site morbidity. For patients with complex spinal pathology or previous fusion failure, the vascularized ICBG offers a rescue or salvage strategy and should be an available tool in the reconstructive surgeon’s armamentarium for spinal fusion.","title":"Vascularized Iliac Bone Graft for Complex Closure During Spinal Deformity Surgery"}
{"_id":"c1b23616-4f5e-f7c1-d22c-4ee294a2d6ab","text":"Early recognition and appropriate treatment are very important to improve the outcome of pulmonary fat embolism. Considering that liposuction and fat grafting are increasingly common cosmetic surgeries, our aim is to raise awareness for this rare adverse event.","title":"Rare case of pulmonary fat embolism and acute respiratory distress syndrome after liposuction and fat grafting: a case report"}
{"_id":"c1bb62c1-278f-0b81-7f2b-de239ba41b44","text":"a) Record thrombus morphology, evolution and resolution in a DVT patient population to identify the level of variation in response to anticoagulation treatment and provide more precise and quantitative disease characterisation in response to treatment.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"c1c0bf81-6363-b279-1a47-68b46e02a15a","text":"Since the free skin flap can be used to repair defects in DIEP reconstruction, we avoid skin-sparing mastectomy in T2 patients and prefer mastectomy to remove sufficient skin directly above the tumor. In over 20 years of our own institution's experience, this was the only case in which removal of the whole reconstructed autologous flap was necessary due to local recurrence. Imaging and needle biopsy results before the primary surgery did not suggest an extremely high risk of local recurrence, and the course of the disease was difficult to predict. Postoperative chest wall irradiation was also not indicated.","title":"A Case of Breast Cancer With Ulceration of a Reconstructed Nipple Due to Local Recurrence"}
{"_id":"c1c202f4-2033-2c54-86e3-c2b23cefb07f","text":"This is a description of a trauma team situation that failed:","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"c1c702c5-58eb-e594-62cb-268b110e6609","text":"Bipedicled free abdominal flaps widen the pool of patients who can benefit from the advantages of autologous tissue breast reconstruction. This series shows that the technique of transferring the entire lower abdominal flap on two vascular pedicles is reliable whilst being associated with minimal morbidity. The indications for double-pedicled flaps in the present series were usually a combination of factors which included the patient’s body habitus (relative size of the breast versus the lower abdomen) and their preference for totally autologous reconstruction. This was especially when adjuvant radiotherapy was planned. The decision whether to undertake a unipedicled or bipedicled DIEP flap was a clinical one made preoperatively in the ­outpatient clinic.","title":"Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification"}
{"_id":"c1cc9705-04ab-122d-d7f9-fc5a22855c00","text":"In conclusion, postoperative defect repair of nasopharyngeal malignant tumors with a submental flap through the parapharyngeal space is a simple and feasible approach with sufficient tissue volume, minimal trauma, and a high success rate. It thus resolves the difficulty of repairing large wounds in the nasopharynx and reduces postoperative complications. This method is reliable and effective for postoperative defect repair of most malignant nasopharyngeal tumors, and it is worthy of widespread promotion. Preoperative CT is used to examine the submental flap reflux vein and predict its course, facilitating easier harvesting of the submental flap and ensuring its survival.","title":"Reconstruction of nasopharyngeal defect with submental flap during surgery for nasopharyngeal malignant tumors"}
{"_id":"c1d34347-b7ce-befa-5a77-5b3426b3bd8d","text":"Six weeks represent a critical stage in the postnatal period when breastfeeding practice among UK mothers declines markedly. The presence of trends in inequalities in breastfeeding continuation at 6 weeks can help to predict which women might be more likely to discontinue breastfeeding early. This can inform anticipatory planning and prioritisation of breastfeeding support strategies and responses for the most at-risk women.","title":"Trends and inequalities in breastfeeding continuation from 1 to 6 weeks: findings from six population-based British cohorts, 1985–2010"}
{"_id":"c1d642a4-9b29-b632-cc6a-833116805647","text":"Different from the impact on the detection rates of sentinel lymph node, it is unknown that whether BMI as a significant variant affects the successful identification of ARM nodes. We evaluated the BMI's impact on the detection of ARM nodes, and did not find significant association of BMI with the identification in both the ICG group and MB group. In previous studies, Ponzone and colleagues found that BMI seemed to be negatively correlated with ARM identification, but there was no statistical difference. In contrast, Pavlista and colleagues found that lymphatics of the upper extremity were more difficult to visualize in overweight patients in an anatomic study of the lymphatic drainage of the upper extremity. Therefore, it is necessary to further explore whether BMI is associated inversely with the identification of ARM nodes.","title":"Comparison of indocyanine green and methylene blue use for axillary reverse mapping during axillary lymph node dissection"}
{"_id":"c1d6497c-297b-e733-59f8-ef49da23d855","text":"When choosing the suprapectoral placement of the implant, the adipose tissue in the upper outer quadrant to the axillary tail and inner quadrants is responsible for not having a visible implant edge. However, if the contour of the implant is visible, the shape of the reconstructed breast can be improved by lipofilling techniques. Clinical evaluation through the use of the pinch test was highly correlated with the aesthetic result and patients with a pinch test of at least 1.2 cm in the superior pole had a more natural aspect of the reconstructed breast. The pinch test can be influenced by the grade of the breast ptosis.","title":"Assessment of Mastectomy Skin Flaps for Immediate Implant-Based Breast Reconstruction"}
{"_id":"c1d6d0c6-e365-8d85-851d-4b45bbd60f32","text":"All the three authors disclose any financial and personal relationships with other people or organisations that could inappropriately influence of our work.","title":"Reconstruction of Gustilo type IIIC tibial open fracture caused by shotgun injury using combination Masquelet technique and cross-leg pedicle flap"}
{"_id":"c1e2e403-0e46-cdab-304c-3e44a044a50a","text":"This analysis of current literature provides an insight into the links between inflammation and cancer.","title":"Mediators of Inflammation in Topical Therapy of Skin Cancers"}
{"_id":"c1e520dd-1a02-4563-3bb5-78b827117c9b","text":"Patients with a positive sentinel node should undergo a full inguinofemoral lymphadenectomy followed by postoperative radiation therapy to the involved groin and pelvis. However, if the sentinel lymph nodes identified by mapping are histologically negative after review by an experienced multidisciplinary team, no further treatment is indicated.","title":"Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva"}
{"_id":"c1ec5620-01c7-774d-71be-9337b2ec9cd7","text":"Our institution has had a positive experience with performing vein patching from cryopreserved cadaveric aortic tissue at the time of controlled operative take-back following damage control as described in the second case below. We suggest that this method when used to reduce IVC stenosis from primary damage control repair may reduce the incidence of IVC thrombus, deep venous thrombosis, lower extremity edema, and pulmonary embolus, and may result in overall improved outcomes. Below we discuss the technique used with two patients who suffered gunshot wounds to the abdomen resulting in multiple injuries including direct injury to the IVC. Both patients presented in March of 2021 to our urban level 1 trauma center and underwent initial damage control repair of the vein with obvious narrowing but were later definitively repaired using vein patching. In our opinion, IVC patching should be considered routinely in hemodynamically sufficient patients during early take-back definitive abdominal operations.","title":"Patching of the Inferior Vena Cava Following Lateral Venorrhaphy in Penetrating Traumatic Injury"}
{"_id":"c1ecee0e-8f16-795e-b37f-5a8a3e087848","text":"There were both positive and negative attitudes towards the NHS expressed by the interviewees following the fellowship. Many explained that the experience of working in a foreign system allowed them to gain an appreciation for working within the NHS:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"c1f7c69e-7a9a-c481-7438-7534cf304252","text":"The main tasks during reconstruction of composite tissue defects with deep infection include adequate bone and soft tissue coverage, elimination of dead space, and reconstruction of the soft tissue envelope with good blood supply to prevent recurrence of infection.","title":"Simultaneous reconstruction of septic composite defects in lower extremities: Combination of fasciocutaneous perforator flap and Masquelet technique"}
{"_id":"c1f9be6a-332d-1f88-42a2-94198b953b9e","text":"Hanasono and Langstein suggest defects between one third and two thirds of the lip with sufficient lip tissue and commissure involvement can be closed with the Karapandzic as the first choice and the Estlander as secondary choice. When the commissure is not involved, the defect may be closed with the Karapandzic or the Abbe. In 2011, an extended Karapandzic flap technique was described by Sood et al. in patients with larger defects as an alternative to micro-vascular free flaps and regular Karapandzic flaps with good results.","title":"Lip Reconstruction after Tumor Ablation"}
{"_id":"c1fabbc5-a6ec-8948-78d5-4a36af6d2d53","text":"In a multidisciplinary approach, she underwent an open reduction internal fixation (ORIF) of radius with a vascularized fibular osteocutaneous free flap to replace the proximal radius and overlying soft tissue. Radial head arthroplasty was performed at the proximal end of the fibular graft because the short segment of the native proximal radius remains.","title":"Use of Osteofasciocutaneous Fibular Free Flap and Radial Head Arthroplasty in Trauma for Limb Salvage and Continued Elbow Function"}
{"_id":"c1fc25fc-98c9-e886-e950-5dbea9a01ff0","text":"In the late 18th century, Carpue found a description of this Indian technique, which gave rise to the modern era of nasal resurfacing with the use of a pedicelled forehead flap. His basic technique laid the foundation for modern nasal reconstruction for the next century. These techniques were later modified and popularized by other surgical pioneers. Here, we present the case of recent traumatic nasal tip amputation during an altercation which was successfully repaired using the paramedian forehead flap technique and further nasal reconstructive surgery.","title":"Use of Forehead Flap for Nasal Tip Reconstruction after Traumatic Nasal Amputation"}
{"_id":"c200fd22-0fb6-692a-f77a-a26dc132ecb0","text":"Materials and methods: We reviewed the medical records of 28 patients referred to our clinic for allergic reaction associated to an invasive procedure in the last 2 years regarding administered drugs, type of reaction and results of the allergological workup.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"c20ffd5b-f678-0316-093b-b02622887fb3","text":"The planar scintigraphy as shown in Figure 3 demonstrated a prominent focus on radiotracer distribution in the ipsilateral axilla; both peri-areolar injection sites were grossly identified. Higher resolution also revealed tracer transit through lymphatic channels towards the axilla. SPECT-CT images revealed radiotracer avidity in a prominent mildly enlarged rounded lymph node (11 mm) in the ipsilateral axilla as shown in Figure 4. The report concluded successful localization of the ipsilateral axillary lymph node as a sentinel node. In the case of the patient whose images are shown in Figure 2, a maximum number of counts were detected by intraoperative gamma probe from a node that was previously identified as a sentinel on SLN lymphoscintigraphy; hence, it was further confirmed as the sentinel node. The same node and two more in its proximity were removed by the surgeon during the frozen section. As shown in Figure 2, histopathological findings of the frozen section sample revealed metastatic involvement of two lymph nodes (one sentinel and one in its approximation), later on, axillary nodal clearance including excision of an additional 6 to 7 nodes in the vicinity of sentinel node was performed along with mastectomy. This is how radionuclide mapping of sentinel nodes played a significant role in the surgical management of breast cancer patients","title":"Sentinel Lymph Node Mapping in Breast Cancer: Initial Experience of a Multidisciplinary Team"}
{"_id":"c2137f7e-9c2c-0b80-8658-ed4e062a736d","text":"According to our data, SLNB with focused immunohistopathology appears to be at least as sensitive as ALND with routine lymph node analysis.","title":"Is the sentinel lymph node biopsy more sensitive for the identification of positive lymph nodes in breast cancer than the axillary lymph node dissection?"}
{"_id":"c2157b5a-fd6b-ead1-5f67-eb3f9e6c1b21","text":"The most significant adaptation we made to the curriculum was moving the meetings from Monday morning to Sunday evenings. This move was accompanied by a change in setting from the university to a more informal setting at a faculty’s residence. A key benefit to this change in setting was the ability to provide childcare during the lectures and discussion. These changes provided a significant increase in spousal attendance. In addition, according to the evaluations, the residents found the lectures to be much more enjoyable and productive. The informal setting allowed for better and more comfortable discussions. The change to Sunday evenings also provided childcare opportunities, allowing for the spouses to attend the meeting without much difficulty.","title":"Evolution of a Novel Business Leadership Course for General Surgery Chief Residents"}
{"_id":"c21a67ce-9c7c-6c45-54cb-e262e67d8046","text":"Materials used for reconstructive surgery are varied and their use is largely dependent upon the surgeon’s preference and the chosen technique. Autologous tissues such as bone, temporalis fascia and cartilage are most commonly used as they do not present the risk of rejection and are able to provide adequate support. However, using autologous material increases morbidity for the patient as a second surgical site is required for tissue extraction. It has been reported in some cases that the donor site can cause a higher level of pain than that of the augmentation site [5]. The use of autologous material also increases surgical time, has unpredictable resorption and is difficult to model to an appropriate shape.","title":"Periorbital Reconstruction by “Periorbital Patch” Technique Using a Pericardium-Based Collagen Membrane and Titanium Mesh"}
{"_id":"c21d7a1d-f819-98c1-992a-0ebd489b21d7","text":"The study participants were instructed to remain supine in bed during the first MRI cans. All transfer of study subjects between the neurosurgical department and the MRI suite, and between the bed and the MRI table, was performed by the hospital staff to allow for the patient remaining in the supine position. For practical purposes, patients were allowed to move without restrictions after the final MRI of day 1 and until the next morning (approximately 24 hours after contrast agent injection). Thirteen of 19 patients were also scanned at 48 hours.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"c21ebf9a-71af-1156-13d6-b6e33675d5e3","text":"Women more strongly disagree that most of the surgeons would consider a female chairperson a supportive and comfortable figure, compared to the men.","title":"The impact of gender bias in cardiothoracic surgery in Europe: a European Society of Thoracic Surgeons and European Association for Cardio-Thoracic Surgery survey"}
{"_id":"c224744c-09f4-46a1-2435-8cab0c264c39","text":"The histology of the skin biopsy of the patients was analysed histologically as depicted in Figure 1. The defining histological characteristic found in all the cases was extensive calcification of small and medium-sized vessels of the dermis and subcutis layer with typical calcific thrombogenic microangiopathy. The deposition of calcium in the media was either segmental or circumferential and was accompanied by intimal hyperplasia, fibrosis, and thickening with smooth muscle fibre atrophy. Table 2 shows mean biochemical profile of subjects with CUA at diagnosis and within 6 months after. Calcium-phosphate product was similar in both groups, while serum parathyroid hormone was significantly lower after the diagnosis.","title":"Calcific Uremic Arteriolopathy on Multimodal Combination Therapy: Still Unmet Goal"}
{"_id":"c2279fe9-d5e6-0cf0-1b95-4d13ca6f5e1b","text":"The patients had been explained about the study and informed consent was taken. The patients were explained about the effects, possible side effects and the expected duration of the useful effects of the injection. These patients were requested to attend the clinic regularly, initially after three days and then weekly for two weeks and then every month for three months and later on every three months for repeating the injections.","title":"Efficacy of botulinum toxin in benign essential Blepharospasm: Desirable & undesirable effects"}
{"_id":"c22847f7-70a9-72e7-bf62-05ccefe03067","text":"Postoperative complications occurred in 5 patients, including 3 patients with skin irritations due to nail end protrusion and 2 patients with superficial wound infections. All patients were treated with removing the nail and administering skin disinfection.","title":"Can intraoperative ultrasound visualize the closed reduction and elastic intramedullary nail fixation processes of double forearm fractures in children?"}
{"_id":"c22f8f9a-24b2-5622-77b0-3747b393f5e9","text":"The patient was a 23 year old male who presented with an anterior abdominal wall mass in December 2007 following an emergency laparotomy for blunt abdominal trauma in June 2006. He was referred to Kenyatta National Hospital from a district hospital where an incisional biopsy had been done and reported as benign fibromatosis. There was no family history of Familial Adenomatous Polyposis (FAP), colorectal disease or similar condition in any of the close relatives.","title":"A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report"}
{"_id":"c23afda3-96f9-573a-2caa-64433364fd87","text":"Australia and New Zealand have the highest skin cancer incidence rates worldwide, and sun exposure is the main risk factor for developing skin cancer. Sun exposure during childhood and adolescence is a critical factor in developing skin cancer later in life.","title":"Testing Wearable UV Sensors to Improve Sun Protection in Young Adults at an Outdoor Festival: Field Study"}
{"_id":"c23b2507-7aa3-b8c3-17ee-26241d0149b2","text":"We retrospectively analyzed the clinical data of 218 patients with hyperhidrosis who were admitted to the Department of Thoracic Surgery of Gansu Provincial People’s Hospital for surgical treatment from April 2014 to August 2021. The patients were divided into three groups according to the method of ETS and the perioperative clinical data and postoperative follow-up data were collected to compare the near and long term outcomes of the three groups.","title":"Comparison of the efficacy of ETS with different segments for palmar, axillary and plantar hyperhidrosis"}
{"_id":"c23de5eb-9537-225e-5f8c-0703576036b7","text":"Our modified biopsy system will allow for simultaneous acquisition of tissue cores for diagnostic and scientific analysis from solid tumors or metastatic sites.","title":"Single punch, double biopsy"}
{"_id":"c240d8f7-5d5b-4a8d-fd80-3e8a914a4ec5","text":"We were interested in evaluating how the diagnosis of bone tumors is actualized according to the knowledge provided by new imaging. The answers to our Quiz confirmed that XR was the most effective tool in primary evaluation. The additional information of CT and MRI provided moderate benefits to confirm the malignancy of the lesion. Thus, a patient with a suspected malignant lesion on the XR should be referred without delay to a reference center. CT and MRI are not necessary before then. Conversely, a CT or an MRI were useful to confirm a suspected benign bone tumor. These findings should help to reduce unnecessary cost and undue delays.","title":"The appropriate and sequential value of standard radiograph, computed tomography and magnetic resonance imaging to characterize a bone tumor"}
{"_id":"c2449631-1ac8-f5c0-ba8b-c4a3550e9ebe","text":"The study was carried out in compliance with the ARRIVE guideline.","title":"Conditioning of microvascular venous flaps in rats"}
{"_id":"c249824a-8fe4-a9b5-5b8e-5bd505da5f67","text":"We first marked the location of the superior gluteal artery which is one-third of the distance between the posterior superior iliac spine and the greater trochanter and inferior gluteal artery which is half the distance between the posterior superior iliac spine and the ischial tuberosity. A handheld Doppler was used to confirm the location. We marked and elevated a larger flap than needed by 3-4 cm. The flap design incorporated the superior gluteal artery and its perforators and or the inferior gluteal artery and perforators, depending on size needs.","title":"Anatomical Considerations and Plastic Surgery Reconstruction Options of Sacral Chordoma Resection"}
{"_id":"c24af541-98b1-c347-2783-b5813f8540ab","text":"In addition to the cytotoxic effects, PDT could exert its beneficial effects through other mechanisms. Different experiments conducted in vivo on diseases other than skin cancers have revealed that the positive action exerted by oxidative stress after PDT could be due to its action on the immune system.","title":"Oxidative Stress and Photodynamic Therapy of Skin Cancers: Mechanisms, Challenges and Promising Developments"}
{"_id":"c250925e-363c-70bf-4752-1d5211df6751","text":"We suggest that the proper evaluation of costal cartilage development should be performed through radiological analysis before the microtia reconstructive surgery using the autogenous costal cartilage. The standard protocol should be developed for the timing of surgery taking into consideration the age, weight, psychological issue and development of the costal cartilage of the patient, who is undergoing microtia reconstructive surgery. Based on our study, we suggest that microtia surgery using tissue expander should be performed after 9 years of age to reduce the chances of chest wall deformity caused due to more cartilage harvest.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"c25427c2-4d7f-8e31-d180-7c6b2339ccae","text":"Further savings in the management of bone and joint infection might be possible by defining the optimal duration of therapy. At present, there are few trial data to guide duration and, in the opinion of the authors, there may be considerable redundancy in current standard treatment protocols. The benefits of limiting systemic antimicrobial exposure may well include a reduction in selection for antibiotic resistance and a consequent cost saving in managing treatment failures or transmission events.","title":"Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial [version 4; peer review: 2 approved]"}
{"_id":"c25428d9-7b96-9e26-c980-50c363c010ed","text":"It can be concluded that, in the study, the median breastfeeding duration among preterm infants was below the recommended period and its discontinuation was associated with less than 32 weeks of gestational age and with the fact that the preterm was no longer receiving exclusive breastfeeding at the first outpatient consultation. When these two variables were associated, their negative effect on the median breastfeeding duration was potentiated. These results emphasize the need of adopting strategies to establish and increase the duration of exclusive breastfeeding, especially among preterm infants less than 32 weeks of gestational age.","title":"Duration of breastfeeding in preterm infants followed at a secondary referral service Duração do aleitamento materno em prematuros acompanhados em serviço de referência secundário"}
{"_id":"c25535e7-8dbc-54fb-b1d2-17e749843e6a","text":"The projection of the array onto the skin at each element was used to determine the rod displacement. The length of each of the cylindrical rods on the hexagonal lattice array of the 3D-printed conformal shape was matched to the rod displacement calculated with the array such that each rod in the array would be 0.3 cm from the skin. In practice, the rods would not all be the same distance from the skin. A Monte Carlo simulation of several rods of the device and their distance to the skin would instead be used to determine how best to arrange the rods so that the dose is applied to the target volume while sparing the volume outside of that target.","title":"Novel design and development of a 3D-printed conformal superficial brachytherapy device for the treatment of non-melanoma skin cancer and keloids"}
{"_id":"c2593a41-d403-3fdf-6240-3ce00bf16e23","text":"This review aimed at informing the update of the WHO guidelines for prevention and management of growth faltering among infants u6m. We identified seven studies—two on NNS and five on alternative supplemental feeding techniques that assessed the effectiveness of interventions to manage breastfeeding difficulties in mothers or caregivers of infants u6m with growth faltering to improve breastfeeding practices and increase breastmilk intake.","title":"Effectiveness of Interventions to Manage Difficulties with Breastfeeding for Mothers of Infants under Six Months with Growth Faltering: A Systematic Review Update"}
{"_id":"c25f4d95-47ac-4f4c-75c3-9d6bb0659dcc","text":"Of the 56 patients, 47 cases who received an autologous skin graft had their wounds repaired successfully. A further six cases were treated with local flaps and three cases were treated with axial flaps for wound repair. Of all the patients, two cases underwent amputation due to irreparable damage and three cases passed away due to acute renal failure and hemorrhagic shock.","title":"Xenogenic (porcine) acellular dermal matrix is useful for the wound healing of severely damaged extremities"}
{"_id":"c260c208-b957-f80a-d930-86ffb5c5295b","text":"Parenchyma and fissures were reported to be difficult to treat. Glue and liquid bandages as well as antiseptic creams were considered to be the most useful.","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"c26a8cd6-f8e6-be13-696d-c3c4f33f5995","text":"All of the effector mechanisms thus far described are components of the peripheral immune response. There is thus interest in the extent to which antibody entry from blood contributes to demyelinating pathology.","title":"Hypersensitivity Responses in the Central Nervous System"}
{"_id":"c26bdee7-f713-cc2a-aa0a-ff63ddb03948","text":"These studies can hopefully help consolidate the role and importance of radiotherapy combined with immunotherapy as a leading treatment modality for unresectable cSCC.","title":"The Role of Radiation Therapy in the Treatment of Non-Melanoma Skin Cancer"}
{"_id":"c26cc269-0319-6af5-4724-d88d09f3beb6","text":"A further class of irradiation techniques in intra and perioperative radiotherapy uses the Xoft Axxent miniature X-ray tube or conventional radioactive afterloading sources. Although radiation is often applied in several postoperative fractions, the surgical procedures concerning target preparation and also the radiotherapy issues of target coverage are comparable to IORT. Especially accelerated radiotherapy of breast cancer with intraoperatively placed balloon catheters is often considered as alternative to IOERT. Other techniques using intraoperative flaps and also intraoperatively placed catheters for later irradiation will not be discussed.","title":"Present state and issues in IORT Physics"}
{"_id":"c26f4a10-6751-776c-7e84-b17b8f165f13","text":"Both standard wound dressings and NPWT have been used widely in the civilian and military settings, and there are no specific risks associated with the use of either type of wound management—other than a potential reduction in the rate of wound complications, which is the focus of this trial.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"c2822134-d239-2884-a682-78ad4899d2e0","text":"Realist review methods were used to review the literature describing interventions and strategies which aim to promote evidence-based leadership in healthcare. We aimed to generate a programme theory to explain in which context and for whom surgical leadership interventions work and why. Thirty-three studies and seven stakeholders contributed towards the development of our programme theory which consists of 19 CMOCs. Our findings suggest that surgical leadership interventions improve leadership when feedback is delivered in a timely manner, on multiple occasions and by a range of trusted and respected people. With regard to negative or more developmental feedback, we identified that it is best provided privately. Feedback from seniors to juniors or peers should be delivered directly, whereas feedback from juniors to seniors should be provided anonymously.","title":"Advancing leadership in surgery: a realist review of interventions and strategies to promote evidence-based leadership in healthcare"}
{"_id":"c28f086b-89a0-14e9-6095-81c1be5555a2","text":"Chin et al, in their work, performed a ESP block at T7 level in afresh cadaver and assessed the extent of injectate spread using computerized tomography. There was radiographic evidence of spread extending cranially to the upper thoracic levels and caudally as far as the L2‐L3 transverse processes. This metameric extension was considered by us the most suitable to our surgical intervention, so we decided the level of execution of the procedure was at T7.","title":"Ultrasound‐guided Erector Spinae Plane Block (US‐ESPB)—Anesthetic block: Case report"}
{"_id":"c291f803-994a-f559-e03b-70140979a1ca","text":"Nineteen cases of early and late recurrence groups were detected only on MRI. Of the seven cases of early recurrence group, 6 lesions were developed at the same quadrant as the lumpectomy site. The size of these cases was larger than 1 cm at the time of detection. Of the twelve cases of late recurrence group, half of the lesions were developed at a different quadrant from the lumpectomy site. The number of lesions which measured 1 cm or larger was smaller than that of the early recurrence group. In other words, the MR-only detected late recurrent lesions had a tendency to be smaller than early recurrent lesions. Also, they tended to develop at an unexpected site including different quadrant from the lumpectomy site. However, there was no statistically significant difference between the two groups due to the small number of cases. This finding suggests that breast MRI can be helpful in detecting disease recurrence at least 12 months after BCT. If the lesions are smaller than 1cm or located at an unexpected site of breast, the lesions could be missed or be underestimated on mammography or ultrasound.","title":"Usefulness of postoperative surveillance MR for women after breast-conservation therapy: Focusing on MR features of early and late recurrent breast cancer"}
{"_id":"c295455e-e19f-0602-1c66-481d536d6b17","text":"Surgical exploration of the sciatic nerve should be considered when clinical suspicion of sciatic nerve entrapment is evident and no improvement of symptoms is apparent after four to six months of conservative treatment with nonsteroidal anti- inflammatory drugs (NSAIDs), physiotherapy, rest, and muscular stretching. The nerve is carefully dissected and any potential areas of compression from fibrous bands or veins must be recognized [3]. In our case, the reason for bilateral sciatic nerve pressure was the unusual oblique course of the terminal junction of SSV before it drained into the PV and the position of sciatic nerve between the two veins. Ligation of the terminal branch of SSV and subsequent nerve release led to symptoms resolution and the patient fully returned to sports activities without complaining of any pain or numbness of the lower legs.","title":"Bilateral Sciatic Nerve Compression Due to Abnormal Termination of the Small Saphenous Vein Into the Popliteal Vein: A Rare Mechanism of Pseudoclaudication of the Lower Extremities"}
{"_id":"c29bcca0-276f-6723-2e04-e7e96dd7e6b0","text":"We raised the question that \"Is it justifiable to use EGFR inhibitors for patients having recurrence in the previously irradiated field?\" We may need further research to answer this question which may guide the physicians in choosing appropriate drug in this scenario.","title":"Lack of Cetuximab induced skin toxicity in a previously irradiated field: case report and review of the literature"}
{"_id":"c2ae38f9-cbae-7de4-1e55-4f54f6fb71fd","text":"Twenty patients with osteosarcoma and 12 with metastatic disease received chemotherapy before surgical reconstruction; one patient with hemangiosarcoma did not receive preoperative chemotherapy because he had a pathological fracture at the initial presentation. Postoperative chemotherapy was administered to 32 patients. The other patients with chondrosarcoma and giant cell tumors did not receive chemotherapy.","title":"A Retrospective Study of the Functional Outcomes in Patients with Proximal Humeral Bone Defect after Shoulder Fusion or Prosthetic Replacement"}
{"_id":"c2bc1bb7-2536-eae7-5ceb-4185b2118ec2","text":"We were particularly interested in the small group of patients requiring additional unplanned surgery during the episode of care. We anticipated the complication rate to be high given the often longstanding chronic inflammation and multiple previous procedures, making microsurgery more challenging than in acute circumstances. Although microvascular surgery and free tissue transfer is well established surgery is complex and it is accepted complications including the need for urgent revascularization in inevitable in a small proportion of patients3. We hypothesised further emergency surgery would significantly add to the total cost of treatment and not be adequately accounted for in the renumeration.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"c2bca6a0-4f6b-1f7c-2fbf-509ef7d66e19","text":"Chronological skin ageing is an inevitable physiological process that results in thin and sagging skin, fine wrinkles, and gradual dermal atrophy. The main therapeutic approaches to soft tissue augmentation involve using dermal fillers, where natural fillers, such as autologous fibroblasts, are involved in generating dermal matrix proteins. The aim of this study was to determine the global transcriptome profile of three passages of dermal autologous fibroblasts from a male volunteer, focusing on the processes of the cell cycle and cell proliferation status to estimate the optimal passage of the tested cells with respect to their reimplantation.","title":"Global Gene Expression of Cultured Human Dermal Fibroblasts: Focus on Cell Cycle and Proliferation Status in Improving the Condition of Face Skin"}
{"_id":"c2bf5fdf-44c0-7fb2-48b4-56bab5b01bf0","text":"The dilemma regarding setting asymptomatic thromboembolism as an outcome does not end at what screening tool should be used and when the screening should be carried out as it is not fully clear whether one or both legs should be imaged. There are very limited clinical data to support the use of bilateral ultrasonography in patients with suspected unilateral DVT. In post-operative surveillance, some researchers have favoured screening the operated leg only but many other authors have suggested that bilateral venography is crucial. More recently, Warwick and Samama have reported that up to 20% of post-operative DVT occurs in the contralateral leg. In a systematic review of prospective studies that gave DVT as the primary outcome based on bilateral venography following surgery for elective hip or knee arthroplasty or hip fracture, the risk of isolated DVT in the non-operated leg was estimated to be 4–5%. The authors concluded that performing venography on both legs reduced the risk of missing the diagnosis and improved the efficacy of the study.","title":"Graduated compression stockings in hip fractures"}
{"_id":"c2bf6c68-11ac-8618-21a8-5d1a97ec1e44","text":"No immediate allergic reaction following vaccination was recorded, and there had not been any incidents of anaphylactic reaction or shock following the vaccination. This also denotes the allergic reaction to the components of the vaccine is minimum, but the scale of the population may give us limited knowledge. During the initial phase of the vaccine development, it has been privy to transverse myelitis and pyrexia, which has not been demonstrated among our study population. Immunothrombosis following vaccination had been reported as a very rare adverse event following vaccination among the population with low platelet count; however, none of the members of the study population had shown any sign of such condition. As these are very rare adverse events, our study population data may be limited in this regard and may require further study with a larger population.","title":"Adverse Events Following COVISHIELD Vaccination Among Adult Population in Bangladesh"}
{"_id":"c2c28042-3dd0-e52c-e43c-1c6c5ca37b25","text":"While bupropion is generally a well-tolerated medication for various mood disorders, it has been known to cause delayed hypersensitivity serum sickness-like reactions in a small percentage of patients. Symptoms of this reaction can include pruritis, urticaria, angioedema, and polyarthralgias, which can be very concerning for patients given the sudden onset of symptoms and the potential for rapid evolution and failure of symptoms to resolve spontaneously. Discontinuation of the offending agent with the use of conservative measures such as oral antihistamines and topical steroid creams have been shown to aid in the resolution of such symptoms. However, refractory or severe cases can be managed with systemic corticosteroids. Clinicians may consider counseling patients regarding the possibility of this adverse reaction when initiating bupropion with prompt discontinuation and consideration of initiation of various other therapies for their underlying conditions if such a reaction occurs.","title":"Bupropion-Induced Delayed Hypersensitivity Serum Sickness-Like Reaction"}
{"_id":"c2cb4235-c246-5b9f-b4cb-825f398b0cf6","text":"Patients were treated with either prednisolone alone, or a combination of acyclovir 400 mg five times a day and prednisolone 1 mg\/kg per day for 5 days and were gradually tapered over the next 5 days. Facial physiotherapy was offered to all patients irrespective of severity of facial weakness.","title":"Evaluation of prognostic factors in patients with Bell's palsy"}
{"_id":"c2ce59a5-c212-76ea-a6a9-d1254f6da79b","text":"As shown in Tables 2 and 3, MRI features demonstrated high diagnostic performance in evaluating suspected PJIs, but the individual MRI signs of PJIs around the prosthesis varied or were inconsistent among all included studies. The important MRI findings of PJIs are summarized as follows:","title":"Diagnostic value of magnetic resonance imaging for patients with periprosthetic joint infection: a systematic review"}
{"_id":"c2d7adb1-cf9f-60b6-2561-248d209de669","text":"Although resection is the only radical treatment option for DT according to the current consensus, medical therapy also has an important role in the treatment of patients with comorbidities or in those where resection is contraindicated. Chemotherapy has a relatively high complication rate for patients, and the results of radiotherapy treatment were not optimistic. Therefore, NSAIDs offer another treatment option for DT with fewer side effects. However, additional clinical trials and molecular analyses should be performed to test the effect of NSAIDs in the treatment of DTs.","title":"Complete remission of pancreatic head desmoid tumor treated by COX-2 inhibitor—a case report"}
{"_id":"c2da4054-cad7-b8fa-fd6c-31a32d532ab0","text":"The guidance is based on 12 studies and reports that have been published since 2011.","title":"Public health round-up"}
{"_id":"c2e0d46b-c829-3647-b8f6-d6cbd6f8074a","text":"Desmoid tumors are locally aggressive benign tumors arising from connective tissue and are classified as soft tissue sarcomas that do not metastasize. The name is derived from the Greek word desmos that means tendon-like. These tumors are also known as aggressive fibromatosis and have an unpredictable natural history that varies depending on risk factors. They are treated as sarcomas because of their locally aggressive nature and a high local recurrence rate. The causes behind desmoid tumor development are enigmatic and their clinical course is unpredictable. Disease progression also varies widely depending on multiple syndromic risk factors. At this time, there is no scientific consensus over best treatment practices for this tumor type. Treatment can potentially be a combination of observation, systemic therapy, surgery or radiation therapy. Here, we have described a case of a female patient with a sporadic desmoid tumor that successfully responded to tamoxifen and sulindac.","title":"A Desmoid Tumor Responding to Systemic Therapy With Tamoxifen and Sulindac"}
{"_id":"c2e445fa-c490-c0cd-3a5a-2545ee3605d6","text":"Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. If a long vascular pedicle length is required, LD flap or ALT flap should be considered. In patients in which OM flap is contraindicated, latissimus dorsi and ALT flaps are indicated due to the large volume they provide and, as a result of the possibility of a two-team approach and shorter operation time, the ALT flap seems to be superior to the LD flap. If aesthetic outcome is a priority, the OM flap should be considered for reconstruction of extensive scalp defects.","title":"Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps"}
{"_id":"c2e63619-8f61-3d43-32c4-911ef116e5c4","text":"There were 64 free flap and 59 pedicled or local flaps utilized in 122 treatment episodes. One patient had reconstruction with a combination of two flaps. The types of free and pedicled or local flaps employed are shown in Tables 2 and 3 respectively.","title":"Preoperative Radiotherapy and Wide Resection for Soft Tissue Sarcomas: Achieving a Low Rate of Major Wound Complications with the Use of Flaps. Results of a Single Surgical Team"}
{"_id":"c2f55cb1-eaaa-5271-7d8c-ca31cd801b67","text":"Examination revealed tenderness over the flexor sheath of the involved finger with extension lag of 30 degrees and bulge at the palm over the distal palmar crease.","title":"A successful surgical treatment of a closed rupture of flexor digitorum superficialis in surgeon’s hand. A case report and review of literature"}
{"_id":"c2f6273c-da61-f1b8-db97-7756e387306e","text":"The median time of anaphylaxis symptom onset was 14 min after vaccination, and most symptoms occurred within 30 min of vaccination. Eleven had onset after 30 min, nine within 2 h, one within 9 h and the remaining one within 20 h. Most patients received at least one treatment and had fully recovered at the time of review without any deaths.","title":"Reports of anaphylaxis after coronavirus disease 2019 vaccination, South Korea, 26 February to 30 April 2021"}
{"_id":"c2f7117b-1772-7403-7e12-98ccc5c24926","text":"The prospective study was approved by the ethics committee of the University of Erlangen-Nuremberg. Type of cleft, gender and patient age at the time of surgery were documented. Patients were included in the study when primary closure of the lip had been carried out within the first year of life and no frontal teeth of the maxilla as well as of the mandible were missing. Patients were excluded from the study if they had undergone previous attempts to correct for the whistling deformity.","title":"Single horizontal Y-V vermilion plasty including orbicularis oris muscle repair for secondary correction of the whistling defect: A universal technique"}
{"_id":"c2fc6cb3-ebf0-7e7e-729f-6bce94fb2e22","text":"Botulinum toxin injection without electromyographic guidance is safe and effective in the treatment of consecutive esotropia without causing recurrent exotropia. Successful botulinum toxin injection is likely in patients with an initial postoperative esodeviation of 18PD or less at one month after exotropia surgery.","title":"Botulinum toxin injection without electromyographic guidance in consecutive esotropia"}
{"_id":"c2fd3ada-ecd2-045a-90e3-3ff3b7a8b78f","text":"Jaroma and Ritsila10 in their study concluded that free periosteal grafts on the chondrectomized articular surface of patelle differentiated into cartilage. Chondrocyte proliferation was somewhat slower in the series with the fibrous layer of the periosteum facing the subchondral bone than in the series with the cambium layer facing the articular surface. In our study, we stitched the cambium layer of the graft facing the subchondral bone believing that the mesenchymal cells will get adherent to the subchondral bone and start proliferating.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"c2fd6078-9fbe-53c4-c6ac-cc0c791eca76","text":"Others described specific skills they had learned during both didactic modules and attachment site experiential learning. In describing how these new skills affect their work, alumni use language that evidence both action and maintenance phases of behavior change in the Health Leadership Development Model.","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"c303b97c-1b4a-fb7b-afd5-0e0494cb8b0f","text":"Soft tissues: Primary closure with temporary deformity is ideally suitable for IIIb open fractures with an anteromedial wound. This may be of variable size which should be possible to close without compromising vascularity. Adequate subcutaneous tissue must be present to support the skin and prevent wound breakdown during deformity correction.","title":"Conversion of open tibial IIIb to IIIa fractures using intentional temporary deformation and the Taylor Spatial Frame"}
{"_id":"c3048556-54de-286e-df07-da70f44baa13","text":"The multiple data points on patient-rated control of symptoms over time can be visualized to provide a long-term view of response to injected botulinum toxin treatment and could support clinical decisions on the timing or dosing of subsequent therapy for an individual patient. An example of a single patient who recorded data over a 197-day period is shown in Figure 6. In this case, the patient reported the onset of the benefit of treatment at 12 days after injection, with the wearing off of benefit starting at day 40 and loss of benefit at day 48. The patient-reported control of their symptom scores varies over time and there is an apparent response in symptom control after their initial botulinum toxin injection and after a second injection at day 110. Similar patterns of change in control of symptom scores relative to dates of injection were observed in 6 other patients with long-term data. In contrast, some patients recorded very little variation in control of symptom scores over time (observed in 12 patients with long-term data). An example is shown in Figure 7.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"c306fec9-0971-2380-49c6-c5108d94d197","text":"In summary, this report described a very rare case of ON following the administration of a BTA injection into the MR for management of diplopia that occurred in a healthy young patient. The patient was managed with oral prednisolone. Complications of the BTA injection should be explained to patients before administering the injection. Ophthalmologists should also be aware of these complications, especially when being used in therapeutic injections into the extra-ocular muscles.","title":"Optic Neuropathy following Botulinum Toxin Injection into the Medial Rectus Muscle for Diplopia"}
{"_id":"c30c25cc-782c-41d1-794b-92c86687e46f","text":"This was a retrospective study of patients treated at the Head and Neck Surgery Department at our institution from 2014 to 2018. During this time period, a total of 69 reconstructive surgeries of the head and neck regions were performed using the ALT flap. All patients were assessed preoperatively by CDS.","title":"Colour Doppler sonography in the preoperative assessment of the vascular pedicle from the anterolateral thigh flap: proposal for a mathematical formula to predict pedicle length"}
{"_id":"c30df167-cba8-67f5-333c-dd84607a79c7","text":"Because limited compatibility data are available regarding the compatibility of most antibiotics and dinutuximab, the antibody or cytokine infusion is often stopped for a short period while the antibiotic is given through the central line. The infusion can then be resumed at the full rate and does not need to be escalated again.","title":"Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications"}
{"_id":"c30e4336-aa31-0a35-5c95-5c9c721dcfee","text":"We developed a survey to assess whether topics pertaining to sexual function were discussed during plastic surgical consultations. In 2016, all 385 members of the Dutch Association for Plastic Surgery were invited via post mail to participate.","title":"Discussing sexuality in the field of plastic and reconstructive surgery: a national survey of current practice in the Netherlands"}
{"_id":"c31cf7ee-6a11-eb2c-04ca-e35af7145a43","text":"Cutaneous squamous cell carcinomas are very rare in children. The recommended treatment for localized cancers is surgery with sufficient margins which can sometimes be mutilating especially for facial localizations. We report a rare case of facial skin carcinoma in a 13-year-old girl measuring 3 cm in diameter infiltrating the tip of the nose. The treatment was an exclusive external radiation therapy with a dose of 70 Gy in 35 fractions in standard fractionation. The technique used was intensity-modulated conformational radiotherapy. It was proposed as an alternative to surgery which could be mutilating. A complete tumour response was obtained with a good aesthetic result and without major toxicity.","title":"Cutaneous squamous cell carcinomas of the nose in a child treated with external radiation therapy: a case report"}
{"_id":"c31e5b65-6e42-9c05-d89d-112b23b442ae","text":"The use of models by the clinical team, despite being heavily involved in the design process, required mental adjustments. The first 5 models elicited skepticism from the clinical team as the accuracy of the perforator locations. Once the team validated the locations against the images and the model was found to be accurate, the team routinely reported surprise by the visual location of anatomical features after reviewing imaging. This outcome reflects the changing analysis methods a clinician undergoes when transitioning from 2D computer graphics to a tangible 3D spatial representation of the same data [4].","title":"Hybrid modeling techniques for 3D printed deep inferior epigastric perforator flap models"}
{"_id":"c323b1c7-74ec-742b-1f33-c70b6f3c94f8","text":"The tibia was approached through an anterior incision over the site of the pseudarthrosis and just lateral to the tibial crest. The deep fascia of the anterior compartment was divided at this level. The fibrous Hamartoma and abnormal bone surrounding the site of the pseudarthrosis were then excised completely to the normal shaft of the tibia. The medullary canal of both tibial fragments was reamed with a drill until suitable rod could be inserted. If the fibula had the pseudarthrosis, the fibrous tissue at site of fibula also needed excision. In case of intact fibula which could prevent the apposition of the tibial fragments, it should be osteotomized and fixed with an appropriately sized Kirschner wire after intramedullary rodding of the tibia.","title":"Wrapping grafting for congenital pseudarthrosis of the tibia A preliminary report"}
{"_id":"c325ab35-576c-1333-9a07-de7f7a4bc24b","text":"The choice of systemic therapy in the preoperative setting is dependent on tumor biomarker classification performed on the preoperative CNB together with clinical and radiological tumor staging. Furthermore, the type of medical treatment offered to patients unfit for surgical excision of the tumor is also based on the biomarker status classification determined on a CNB. Although many local and international guidelines permit biomarker assessment on either CNB or surgical specimens, variability in biomarker status between paired CNB and surgical specimens, with the potential to impact choice of therapy have been previously reported [14,15].","title":"How Reliable Are Gene Expression-Based and Immunohistochemical Biomarkers Assessed on a Core-Needle Biopsy? A Study of Paired Core-Needle Biopsies and Surgical Specimens in Early Breast Cancer"}
{"_id":"c3274c70-dc21-3f6d-45e8-392f1dc2ee46","text":"Acetabular osteomyelitis and associated septic arthritis have traditionally been treated with open surgical débridement. However, arthroscopic lavage of the hip has been described for treatment of septic arthritis of the hip for both children and adults. There is no previous report of the use of arthroscopic techniques to treat acetabular osteomyelitis. In our case, an arthroscopic approach was chosen because it was felt it would provide the best visualization of the articular defect and enable adequate débridement while preserving healthy cartilage. In choosing the most appropriate surgical approach, it is crucial to determine the precise anatomic location of the infection on perioperative imaging. In addition, it should be recognized that hip arthroscopy can be technically challenging. Importantly, the surgeon is experienced and comfortable with the technique and associated equipment before attempting its use in acetabular osteomyelitis.","title":"Pediatric Acetabular Osteomyelitis Treated With Hip Arthroscopy"}
{"_id":"c329d8f4-5678-fd68-552b-44428be283e1","text":"This area of flap loss in the pedicle flap was likely secondary to initial flap edema and pedicle rotation as mentioned above. Important to note is that perfusion in all tissue outside of the area of ischemic necrosis had equal perfusion to the free muscle-sparing flap at this time point as measured by fluorescent intensity. While there were small differences seen in perfusion between the two flaps on postoperative days 9 and at 4 months, these differences were deemed clinically insignificant in the face of vastly increased perfusion of both flaps during the first post-operative week.","title":"Comparative Perfusion Analysis of Free Muscle-Sparing Versus Pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps in Vivo in the Peri-Operative and Late Post-Operative Periods"}
{"_id":"c329f048-e12b-13e4-86bc-d5f4cc4611bf","text":"In cancer patients, insertion of a vena cava filter is only indicated for patients with contraindications to anticoagulant therapy, as described in this case, surgery or invasive procedure within 1 month of surgery. It remains unclear whether permanent or retrievable filters are preferable in the cancer setting. It is reasonable to select a retrievable filter when the contraindication to anticoagulation is expected to be transient, even though serious concerns have been raised with relation to the safety of retrievable filters.9 At our service, we have decided to preferentially fit retrievable filters in situations such as that described in this case and remove them postoperatively.","title":"An alternative approach to treatment of inferior vena cava filter perforation Tratamento alternativo para perfuração de veia cava inferior por filtro"}
{"_id":"c332ee26-9585-b518-61ff-bcd145486c93","text":"Despite numerous studies published regarding SLNB, many aspects must be addressed, such as accurate measurements of lymph flow, evaluation of particle sizes suitable for lymphatic vessel diameters and clinical medical policy based on the presence or absence of metastasis to SLNs. Further, methods are not available for accurate diagnosis of the presence or absence of metastasis without extracting SLNs nor are methods for treating lymph node metastasis without excision. Methods to identify SLNs in carcinomas other than breast cancer are under development.","title":"Establishment of a model of sentinel lymph node metastasis using immunodeficient swine"}
{"_id":"c337262f-486c-4831-bce2-6060108220f1","text":"As a primary choice for anastomosis, mammary arteries were used for the first vessel grafting in all 47 patients, and saphenous veins were used for the remaining number of anastomoses needed.","title":"Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium"}
{"_id":"c33b781e-6983-3c0f-846c-7a172b6aa234","text":"In two cases the lymphatic drainage pattern around the submandibular gland could be identified and followed to the appropriate sentinel lymph node. (Figure 6) A further two cases demonstrated distinct ICG uptake in the submandibular gland that did not represent lymphatic tissue. As soon as more than 5 mm tissue covers the SLN it will probably hinder the identification of the fluorescent tissue.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"c33c2882-ea83-b642-1a87-eb97b6fce238","text":"The collective effect of these clinical trials is that much of the treatment of patients with RT is now based on prospective clinical trial data of efficacy and toxicity rather than historical and empirical practice. There remains, however, considerable progress to be made in further improving outcomes for patients, by ensuring that existing clinical trial evidence is translated into global clinical practice, and by instigating further research into novel technologies and drug–RT combinations.","title":"Practice-changing radiation therapy trials for the treatment of cancer: where are we 150 years after the birth of Marie Curie?"}
{"_id":"c33f6c82-bc9b-e60a-b9af-a754a298c9a3","text":"This study aimed to examine the value of using a fibula segment positioning guide in mandibular reconstructions with fibula grafts. We found significant difference in the errors between reconstructions performed with or without the positioning guide, in the mean total 3D distance and the vertical error at the mesial point of the anterior fibula segment. Considering the CAD\/CAM processes required for creating positioning devices, the positioning guide provided significant benefit over the use of a fibula cutting guide alone.","title":"Precision of fibula positioning guide in mandibular reconstruction with a fibula graft"}
{"_id":"c341c195-a920-7ac3-91ea-f1a91109302f","text":"The authors report a case of a young female who was diagnosed with RRD with PVR 6 days after botulinum toxin injection into the extraocular muscle. The patient was healed completely through surgical intervention.","title":"Vitreous hemorrhage and Rhegmatogenous retinal detachment that developed after botulinum toxin injection to the extraocular muscle: case report"}
{"_id":"c343bd00-36f0-5668-c61a-f488894f4f7f","text":"The manufacturing process is very important and influences delivery, and both a quick and slow release of the drug from SLN can be achieved: the cosmetic or pharmaceutical active agent is dissolved in the melted lipid phase, which is dispersed by high speed stirring in an aqueous surfactant solution heated at the same temperature. The obtained mixture is homogenized in high pressure conditions producing an o\/w nanoemulsion. The emulsion droplets crystallize after cooling yielding lipid nanoparticles presenting a solid matrix.","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"c344b943-5176-f1f6-9d07-e48b557aa7a8","text":"Early recognition of a possible infection and therefore a prompt and accurate diagnostic strategy is essential for a successful treatment of posttraumatic osteomyelitis (PTO). However, at this moment there is no single routine test available that can detect osteomyelitis beyond doubt and the performed diagnostic tests mostly depend on personal experience, available techniques and financial aspects. Nuclear medicine techniques focus on imaging pathophysiological changes which usually precede anatomical changes. Together with recent development in hybrid camera systems, leading to better spatial resolution and quantification possibilities, this provides new opportunities and possibilities for nuclear medicine modalities to play an important role in diagnosing PTO.","title":"Nuclear medicine imaging of posttraumatic osteomyelitis"}
{"_id":"c3466f09-1660-c767-ed26-b12d61e3b554","text":"Most of the interviewees said that their colleagues’ perception of them had changed following the fellowship, with some reporting positively the results of greater confidence, taking the initiative and being proactive. However, some were unsure whether perceptions about them had changed as they had not been established within a role for a long enough period of time to have received feedback.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"c34b1a54-843e-a31c-3b27-9aa812622348","text":"There remains a notable absence of evidence on the comparative effectiveness of NPWT systems in practice across a range of wound types and clinical settings. The objective of this study was to compare the performance of the RENASYS NPWT system and V.A.C. therapy in the management of a range of chronic and acute wounds treated in a community setting in Canada.","title":"A Retrospective Comparison of the Performance of Two Negative Pressure Wound Therapy Systems in the Management of Wounds of Mixed Etiology"}
{"_id":"c34cf6c2-9209-0e26-29eb-4dfc87b5bbc9","text":"This study discovers elements of good physician leadership in a Finnish health-care context in which no similar prior empirical research has been carried out.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"c34dfa91-9969-945d-15e7-162f4c54f16f","text":"The problem of the exact spatial localization of the tumour on the basis of two-dimensional MR images has always posed a problem for neurosurgeons. It has been partially overcome by the introduction of computer programs for 3D visualization of medical images. Preoperative 3D visualization of medical images allows a neurosurgeon to perform interactive preoperative 3D planning. The virtual reality environment in which the surgeon reaches with both hands into a computer-generated stereoscopic 3D space can be created.6 Surgical targets can be defined and the most suitable surgical approach to the lesion can be selected. In addition, 3D visualization can be employed intraoperatively to locate planned targets by visually matching the computer generated 3D surfaces with the intraoperative view.5 3D visualization proves to be adequate and accurate for locating superficial brain tumours in cases where transfer of planned surgical targets to the surgical field is possible.5","title":"New developments in surgery of malignant gliomas"}
{"_id":"c350420e-8a23-65ac-beac-086ce66ec6cc","text":"She underwent correction of deformity and treatment of non-union using principles of distraction osteogenesis in a TSF fixator. The frame fixator was stabilised with two half pins and an olive wire for the proximal ring and three olive wires for the distal ring. The two rings were connected with six struts, and a computer-generated programme was used for correction. An uneventful deformity correction along with proximal tibial union was achieved at 42 weeks.","title":"Extra-articular deformity correction using Taylor spatial frame prior to total knee arthroplasty"}
{"_id":"c3598cf7-b905-7abd-541f-9b68d1c76ecf","text":"Trauma is the leading cause of death for young people in Norway. Studies indicate that several of these deaths are avoidable if the patient receives correct initial treatment. The trauma team is responsible for initial hospital treatment of traumatized patients, and team members have previously reported that non-technical skills as communication, leadership and cooperation are the major challenges. Better team function could improve patient outcome. The aim of this study was to obtain a deeper understanding of which non-technical skills are important to members of the trauma team during initial examination and treatment of trauma patients.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"c36350ba-1729-76bf-9796-80df98bc90c7","text":"We recommend that all patients should undergo leg compression via sequential compression devices and\/or compression hose in the preoperative holding area on the day of surgery, which should be continued intraoperatively and postoperatively until the patient starts ambulating at least three times per day. In the operating rooms, care should be taken when positioning the patient to maximize venous return and prevent stasis, which is a key promoter of coagulation. For patients who undergo posterior fossa surgery, we propose the cautious use of anticoagulation to prevent intracranial bleeding as described in the following section.","title":"Posterior Fossa Hemorrhage Following the Use of Low-Molecular-Weight Heparin: Lessons Learned and Recommendations for the Treatment and Prophylaxis of Postoperative Venous Thromboembolism"}
{"_id":"c36624ee-9f88-9518-6c74-d5e8f029c42e","text":"There is conflicting evidence related to factors affecting the rates of recurrence of idiopathic club feet using the Ponseti method. We attempt to evaluate the predictors of success and failure in our physiotherapy-led Ponseti club foot clinic.","title":"Prolonged use of foot abduction brace reduces the rate of surgery in Ponseti-treated idiopathic club feet"}
{"_id":"c367b6f4-5a3c-c3e1-1051-325d863fe44f","text":"All complications and surgical interventions related to the index wound will be recorded.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"c36c0dc6-fd37-ac6d-e0c7-f024678ec2e9","text":"The results of our study suggested that using nasoalveolar molding as a presurgical orthopedic treatment could improve the shape of the nasal cartilage with surgeon's corrections.","title":"Nasal molding prevents relapse of nasal deformity after primary rhinoplasty in patients with unilateral complete cleft lip: An outcomes‐based comparative study of palatal plate alone versus nasoalveolar molding"}
{"_id":"c3771a81-8552-febf-10fd-821ebbf9f5ef","text":"The current practice of feeding of Saudi infants is very far from compliance with even the most conservative WHO recommendations of exclusive breastfeeding for 4 to 6 months. The high prevalence of breastfeeding initiation at birth indicates the willingness of Saudi mothers to breastfeed. However, early introduction of complementary feedings reduced the period of exclusive breastfeeding. Research in infant nutrition should be a public health priority to improve the rate of breastfeeding and to minimize other inappropriate practices.","title":"Trends in infant nutrition in Saudi Arabia: compliance with WHO recommendations"}
{"_id":"c3877525-263a-bed4-8f67-05963064365c","text":"One in three physicians is more than 55 years old, an increase of 6 percentage points over the past 7 years.","title":"Public health round-up"}
{"_id":"c38bb5ce-0744-3dee-98d9-19fdb2f86662","text":"The accurate assessment about burn wound depth and the profound understanding on wound development process are the pathophysiological basis of the wound management. The appropriate timing and area of the wound excision should be chosen with the concept of damage control operation. Tangential excision is applicable to not only deep dermal but also full-thickness burn wounds. The depth of tangential excision should effectively remove necrotic tissues and reach down to the level of the underlying viable dermis or subcutaneous tissue. Tourniquet can be not used during limb tangential excision surgery, instead, the wounded limb has been kept elevated as much as possible. If fresh wound after tangential excision is still obviously dropsical, multipoint puncture reaching down to fascia should be performed for drainage. The wound after tangential excision within 14 days especially 7 days post burn should be grafted with viable alloskin or xenoskin for temporary coverage and later on autoskin. Grafting of autologous microskin overlain with sheet alloskin should be applied onto the wound after tangential excision, of which the blood supply tend to be improved after 7 days post burn. Perioperative especially intraoperative management should be strengthened.","title":"Abstracts from the 12th Asia Pacific Burn Congress Singapore. 14-17 August 2019"}
{"_id":"c38d67df-0d25-6052-10d5-cea77391c143","text":"The accuracy of coding is another concern outside the remit of this paper. A recent study highlighted important coding errors that led to a significant loss of revenue in an ENT department in York7. There is also the problem, that there are no codes available for combined surgical procedures which include microvascular tissue transfer and complex bone reconstruction for osteomyelitis.","title":"Costs and renumeration of osteomyelitis treatment involving free flaps: implications of return to theatre"}
{"_id":"c38e2a2a-c80f-6212-733f-431623f28306","text":"Erythema and edema were assessed shortly after and 7 days after PDT.","title":"Topical Photodynamic Therapy with Different Forms of 5-Aminolevulinic Acid in the Treatment of Actinic Keratosis"}
{"_id":"c3940a40-6048-d1c4-9dc3-4637440b7b75","text":"HCV is a disease with a long period between infection and symptoms developing. Because infected people are mainly asymptomatic and risk behaviour may have occurred a long time ago individuals often do not consult health professionals to discuss potential disease infection. As in general a large high risk group is people who share injection equipment and other injection paraphernalia, for example cookers, filters and spoons, and drug injection is an illegal activity, which often does not meet with social approval, light to moderate injectors, or past injectors who do not currently inject, may not disclose their risky behaviour to their health provider. Being unaware of the risk behaviour the health provider is unable to recommend HCV screening. Also HCV is extremely easy to catch via injecting. Past injectors who no longer inject may not perceive themselves to be at risk.","title":"Estimating the prevalence of infectious diseases from under-reported age-dependent compulsorily notification databases"}
{"_id":"c39baf1e-b3ff-00ba-4ace-31599e868ceb","text":"In conclusion, we could demonstrate that a supplemental cable cerclage increases the stability of an angle stable plate fixation in spiral fractures of the distal tibia. Construct stiffness is increased and interfragmentary movements are reduced to an extent that an early mobilization of the patient without major post-operative weight-bearing restrictions seems possible. Whether these results could be transferred to in vivo conditions and whether a supplemental cerclage could eventually provide accelerated bone healing as well as better functional results has to be proven in future randomized clinical trials.","title":"Supplemental cerclage wiring in angle stable plate fixation of distal tibial spiral fractures enables immediate post-operative full weight-bearing: a biomechanical analysis"}
{"_id":"c3aad30e-8161-b733-c58b-fc8a99c171df","text":"The aim of this study was to review the literature regarding current recommendations for the diagnosis of ankyloglossia in newborns, its potential impact on breastfeeding, indications for surgical treatment and its efficacy.","title":"Diagnosis, Classification and Management of Ankyloglossia Including Its Influence on Breastfeeding Diagnostyka, klasyfikacja i leczenie ankyloglosji z uwzględnieniem skal oceny w aspekcie karmienia piersią"}
{"_id":"c3b1b423-0367-fb2b-adb8-e534cad3c24c","text":"While there are several studies that have correlated the different types of imaging exams with each other and with the functioning of the arterial graft constructed from the GSV, primarily with respect to the diameter of the vessel employed, no studies were found that report the correlation between the two types of examination and preparation of the vein during the surgical procedure.","title":"Correlations between ultrasound, tomographic, and intraoperative measurements of the great saphenous vein used as an arterial graft"}
{"_id":"c3bf114f-7ce9-3bab-a71a-8d0689379e9c","text":"The main concern of doctors and patients following surgery is unpredictable scar formation and so any slight improvement of the scars seems to be marvelous. In recent years, various therapeutic methods, medical and surgical methods have been used to improve keloid scars, but these interventions have not yield optimal results. High recurrence rate is the most highlighted concern, and there is not any accepted as gold standard method for keloid scar treatment. One of the relatively successful methods in refractory keloid treatments is combination of surgical resection and brachytherapy.","title":"Outcomes of Surgical Excision and Brachytherapy in Intractable Keloids"}
{"_id":"c3c22785-3fef-1350-0329-1170f1e32266","text":"This research opens up the possibility of generating cartilage grafts with the precise purpose of improving the existing limitation in current clinical procedures.","title":"Human Chondrocytes from Human Adipose Tissue-Derived Mesenchymal Stem Cells Seeded on a Dermal-Derived Collagen Matrix Sheet: Our Preliminary Results for a Ready to Go Biotechnological Cartilage Graft in Clinical Practice"}
{"_id":"c3d02480-5f90-fc1b-14f0-083abc1e2d42","text":"One of the limitations of this study was using cotton swabs for cryotherapy. The disadvantage was the absence of control over the temperature achieved within cells and the area of freezing that makes it hazardous to be employed intraorally, though being more available for clinicians. [ 26 ] Another limitation was that the two blinded observers, who were supposed to express their opinion about the degree of depigmentation, visited the patients clinically before and after the operation with an interval of one month which could have given rise to some inaccuracy in the study. Having two other observers analyzing the area of pigmentation in Microsoft Paint using the gridlines option would probably compensate for this predicament.","title":"Comparison of Surgical Blade and Cryosurgery with Liquid Nitrogen Techniques in Treatment of Physiologic Gingival Pigmentation: Short Term Results"}
{"_id":"c3d89189-5b5b-8d5a-0933-4150aa7fd6ce","text":"The use of very accurate surgically directed radiotherapy in the form of brachytherapy for very early disease may be justified in some cases i.e. where the surgical sequelae outweigh the disadvantage of using a modality which in essence can only be used once. We must consider carefully the bystander tissue irradiation which may have a significant adverse host effect when treating localised early cancer [93]. Very early lesions in the form of T1\/early T2 disease are more appropriately surgically treated with an adequate margin of surgical excision with perhaps adjunctive therapies used at the margin of the lesion in cases of adverse histopathological features. Electroporation to the margin may also be considered in selected cases [94]. Both modalities are limited by availability and brachytherapy in particular by the additional patient burden in the form of a period of isolation for radiation protection purposes.","title":"Clinicopathological parameters, recurrence, locoregional and distant metastasis in 115 T1-T2 oral squamous cell carcinoma patients"}
{"_id":"c3edbcc8-c616-baf1-a3a4-f99c55d2a98b","text":"Hip and knee arthroplasty patients are at high risk of venous thromboembolic complications. These disorders have been well studied in this population and it is accepted that total joint arthroplasty recipients require chemical anticoagulation due to risk factors for venous thromboembolism (VTE) inherent to the surgical intervention. Accordingly, there have been numerous studies examining the utility and efficacy of post-operative VTE chemoprophylaxis following surgery; however, there are few clinically relevant, concise resources for the orthopedic surgeon that summarize data regarding post-operative anticoagulation in the context of available therapeutic options and current perioperative standards of practice. Periodic reexamination of literature is essential as conclusions drawn from studies predating perioperative protocols that include early mobilization and sequential compression devices as standards of practice in total joint arthroplasty are no longer generalizable to modern-day practice. The purpose of this review is to provide a thorough and concise, albeit non-exhaustive review of clinically relevant literature regarding VTE prophylaxis in hip and knee arthroplasty. This was achieved by highlighting recent literature with the highest levels of evidence available. Accordingly, our authors sought to review known mechanisms of action and highlight recent literature—outlining both advantages and considerations of the most commonly encountered and clinically relevant chemical anticoagulation agents.","title":"Review of Therapeutic Options for the Prevention of VTE in Total Joint Arthroplasty"}
{"_id":"c3f62ae5-edc6-aaa0-edbd-8b4681ded7fd","text":"Considering the risk analysis of cardiovascular events, endoscopic procedures are low risk. Thus, suspension of the procedure is not required for cardiovascular intervention, except in severe cardiovascular conditions already mentioned in the section of perioperative evaluation algorithms of this guideline. In addition, most drugs that are included in the cardiovascular therapy do not need to be discontinued and can be ingested with minimal water. In fact, the most important issue is whether the patient makes use of antithrombotic drugs due to the potential risk of endoscopic bleeding and thromboembolic events caused by discontinuation of these drugs.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"c3fa5f7d-fa83-9f8d-57da-b90346374f41","text":"To date, two small molecules targeting SMO have been approved in the treatment of metastatic BCC or for patients with local advanced BCC ineligible for surgery or radiation therapy: vismodegib and sonidegib.","title":"Basal Cell Carcinoma and Hedgehog Pathway Inhibitors: Focus on Immune Response"}
{"_id":"c3fcbb73-2527-cfb1-7aa3-bc604dca9438","text":"Gousheh et al3 described the technique of transferring the LD muscle as an island flap for the restoration of digital flexion or extension in 28 patients. The LD muscle is raised down to the posterior iliac crest and prolonged with the glutealsuperficial fascia. They believe that this method is particularly suitable for extensive and prolonged paralysis of the lower elements of brachial plexus and can be used also for severe Volkmann's contracture.3","title":"Case Report: Modified Latissimus Dorsi Muscle Transfer for Radial Palsy, Presentation of a New Technique"}
{"_id":"c3fcf6a1-14f7-9dc7-6cc4-fccfd95bd742","text":"We propose a simple intraoperative transformation for the coverage of moderate skin defects in the limbs. It allows intraoperative transformation of a PPF into a KDPF where there are insufficient perforator vessels. This also provides an alternative plan in cases of unpredictable intraoperative events.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"c3fd46fc-ed09-8671-fdd8-27c78e1f096f","text":"If those receiving the fellowship are more likely to remain in science and have an independent research career, then this is evidence that federal governments can effectively invest in the public good of science through supporting early career training. Programs similar to the NRSA promote and encourage research independence while at the same time training young scientists to write grants. This imprints on them the relevant techniques and knowledge for a future that includes successfully funded research projects. By encouraging young scientists to lean in early through independently applying for training funding, the federal government can continue to advance the scientific frontier.","title":"Advancing biomedical science through investments in elite training"}
{"_id":"c4049ee0-1830-ab82-0706-a37975a35f1f","text":"All patients had standardized ultrasonography of the vascular soft tissue swelling with that excess gel was used. Linear high frequency probes were used to perform ultrasound examinations, then color Doppler examinations were performed, examination of the lesions were done with special techniques as Valsalva maneuver, compression of the lesion and limb dependency as needed.","title":"Role of ultrasound and colored Doppler examination in the diagnosis and the classification of the superficial soft tissue vascular anomalies"}
{"_id":"c405472f-41ee-83c4-6bb8-514115a710a9","text":"Ki67 is a cell cycle regulatory protein for which a particular antibody is used to confirm the presence of a nuclear antigen that is only found in tissues with a high rate of cellular proliferation, and is otherwise missing in normal tissue. The expression of Ki67 correlates with the progression of the disease: a greater Ki67 level is connected with thicker tumors and, as a result, a less positive prognosis for the patients.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"c40987e8-a887-7ca7-0d09-19f023058e8c","text":"Numerous studies have evaluated the use of autologous abdominal tissue for breast reconstruction; nevertheless, complications and donor site morbidity rates vary significantly. The study aims to compare the literature regarding morbidity of the donor site and complication rates of breast reconstruction with autologous abdominal flaps.","title":"Morbidity of the Donor Site and Complication Rates of Breast Reconstruction with Autologous Abdominal Flaps: A Systematic Review and Meta-Analysis"}
{"_id":"c40f4f8b-6c8a-3cdd-d39e-96aecf156d43","text":"The DMC is composed of three members, two of whom are specialists in infectious diseases and the other a senior statistician. None are involved in recruitment, randomisation or follow-up for trial participants or contribute to the trial in any way other than through the DMC. The DMC met to discuss the study design and standard operating procedures shortly before the start of the study. The DMC evaluate the frequency of endpoints in an unblinded analysis annually in a closed meeting and make recommendations to the trial steering committee. Although the DMC may recommend suspension or cessation of the trial at any time, it is expected that they would only recommend early stopping if there was a very significantly worse outcome in the PO antibiotic group as compared to the IV group, as determined for example by the Haybittle-Peto stopping boundary.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"c412bba6-3808-c1b9-8904-2b3f081abcd2","text":"The dorsal nasal cyst formation is a rare and late complication of rhinoplasty. The most important thing to avoid this complication is to be sure from cleaning all of the epithelium from the prepared graft and avoiding any unnecessary trauma. Complications seen after rhinoplasty can be reduced by increased surgical experience.","title":"The Development of Dorsal Nasal Cyst Formation after Rhinoplasty and Its Reconstruction with Conchal Cartilage"}
{"_id":"c41b1b8b-134c-1eb7-97ea-68b1893c5fe0","text":"A total of 18 patients were included in this study. The demographic data of the patients are shown in Table 1.","title":"Lumbar Sympathetic Block with Botulinum Toxin Type A and Type B for the Complex Regional Pain Syndrome"}
{"_id":"c4273be3-9b1a-2eb0-d5a5-9112a3171bab","text":"There were no changes in caveolin and eNOS in the vein endothelial in EVH technique in this study. These results are very important for evidence-based decision and in molecular view, there are no structural and cellular viability harm effect found in EVH compared with OVH.","title":"Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium"}
{"_id":"c43e2130-bbd1-9835-5f79-d9eb0f28859d","text":"The ethics committee of the Tumor Hospital of Ganzhou Review Board approved the study protocol (20101201), and the study was conducted in accordance with the principles of the Declaration of Helsinki regarding research involving human subjects. Each of the patients provided written informed consent to participate after the nature of the study had been explained to them.","title":"Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers"}
{"_id":"c43ffcfa-84da-903f-be5b-c3be0570cb78","text":"Though the endoscopic surgery like the Subfascial Endoscopic Perforator Surgery (SEPS) is being performed for the perforator ligation, open subfacial ligation or stab phlebotomy is still the most commonly performed operations for addressing the perforator incompetence, as the SEPS require endoscopic facility and the expertise for doing the endoscopic surgery. Thus, considering the high sensitivity of the color Doppler leading to unnecessary explorations, the addition of the clinical tests would improve the specificity and thus can reduce the number of negative explorations. This advantage can reduce the duration of the surgery by avoiding needless explorations and hence reduce the cost of the surgical treatment and better cosmetic outcome by avoiding a surgical scar.","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"c44185f8-665c-e632-b724-c41f930ed64f","text":"While the quality indicators in this document are most valid for patients receiving their complete treatment in the same center, where all technical requirements for treatment of cervical cancer are available, especially access to modern brachytherapy techniques, referral networks should be in place for centers that do not have access to brachytherapy techniques, with appropriate failsafe mechanisms to avoid lengthening of overall treatment time or waiting times between diagnosis and initiation of treatment. Centralization to these highly specialized centers is encouraged to ensure quality assurance and maximal effort at all levels.","title":"ESGO\/ESTRO quality indicators for radiation therapy of cervical cancer"}
{"_id":"c4420db5-560d-ea1c-62b5-6163a179b663","text":"This work aimed to qualitatively evaluate the evolution of patients submitted to a hyperbaric oxygen therapy for the treatment of vascular occlusions resulting from the use of soft-tissue fillers.","title":"Vascular complications with injection implants: treatment with hyperbaric chamber"}
{"_id":"c4478eef-167e-35dc-20eb-ebb58c4f086e","text":"The initial management was surgical in 21 of 22 cases, including tumor resection within healthy borders in 12 patients and simple mastectomy in 5 cases. The two patients with enlarged lymph glands were treated by modified radical mastectomy, and there were two cases where subcutaneous mastectomy and silicone prostheses insertion was performed. Among them, there was a woman who presented at our clinic with the diagnosis of benign cysteosarcoma phylloides, from a recent breast biopsy performed elsewhere, who underwent wide local excision of the remaining tumor. This patient had two local excisions of a benign cytosarcoma phylloides eight and four years previously. There was also one patient who manifested local recurrence of benign CP, having undergone simple mastectomy six months before at another institution. The remaining patient had undergone a previous simple mastectomy three years ago for the management of malignant CP and did not present any signs of local recurrence, but only clinical signs of pulmonary and pleural metastasis.","title":"Phylloides tumor of the breast: a rare neoplasm, though not that innocent"}
{"_id":"c44bcdb4-c5c2-072c-495e-ccddf6527416","text":"In all patients, the surgical procedure was performed under general anaesthesia, in a supine position and with a tourniquet applied at the proximal thigh. A direct lateral approach to the DF was performed. After incision, the dissection continued anteriorly towards the anterior extensor muscular lodge of the calf with identification of the tibia, interosseous membrane and the anterior tibial vascular pedicle and posteriorly, towards the posterior flexors muscular lodge with identification of the peroneal muscles and posterior tibial vascular pedicle. The fibular vascular pedicle was ligated proximal to the tumour and neurolysis of the external peroneal nerve was performed.","title":"Distal Fibula Reconstruction in Primary Malignant Tumours"}
{"_id":"c44cc145-fd18-a63c-b25e-8521cacd4b84","text":"SSIs after spinal fusion can lead to devastating morbidity and mortality. The use of an intraoperative toothbrushing technique during the first I&D surgery of SSIs after spinal fusion surgery can reduce the failure rate and need for revision surgery by effectively removing the biofilm of pathogenic bacteria. We suggest that this easy and convenient method is an excellent option for treating spinal infections.","title":"Effectiveness of Toothbrushing Technique for Biofilm Removal and Postoperative Infection Control after Spinal Fusion Surgery: A Retrospective Study"}
{"_id":"c452f62b-23d7-9f41-23c9-c58e3b062254","text":"The present study revealed that the fat pad between the proximal rectus femoris and the joint capsule—also surrounded by the iliopsoas and gluteus minimus—extended distally deep to the gluteus minimus tendon and superficial to the vastus lateralis, and posterolaterally to the anterior portion of the gluteus maximus tendon. The fat pad contained loose connective tissue and segmented by the deep aponeuroses of the rectus femoris, gluteus minimus, and iliopsoas. Ultrasonographic analysis revealed that the shear wave velocity in the fat pad was significantly lower than that in the joint capsule.","title":"Spatial distribution of loose connective tissues on the anterior hip joint capsule: a combination of cadaveric and in-vivo study"}
{"_id":"c4598089-c969-47fe-b641-5177b1d1ff1b","text":"After fixation in formalin, the main tissue specimen was measured and sectioned into three pieces that included the various margins of the lesion. These tissue sections were then embedded in paraffin. Sections of 4 μm were prepared from the paraffin block using a microtome, mounted on glass slides and stained by haematoxylin and eosin for microscopic evaluation.","title":"Histological and Clinical Features of Primary and Recurrent Periocular Basal Cell Carcinoma"}
{"_id":"c45c893a-6c3f-ef7b-70b1-fa0339698f20","text":"Dominant perforators may not travel directly to the dermis as shown in experimental studies of primary ALT flap thinning.11 Although dermal perfusion has been shown to correlate with actual perforators in a swine model, they may not directly map the perforators, which may be more noticeable in larger thighs where perforators may take indirect paths before reaching the subdermal plexus.12 Our method does not identify if a multipaddle ALT can be raised because the perforators are not directly visualized; however, this can be utilized after flap elevation to assess viability of multiple paddles prior to separation.","title":"Near-Infrared Laser-Assisted Indocyanine Green Imaging for Optimizing the Design of the Anterolateral Thigh Flap"}
{"_id":"c4616fd1-d5a4-d30c-b999-ea8cf0480e5e","text":"We observed that respondents who reported having used harm reduction practices including cleaning injection sites with alcohol and cleaning used needles with bleach or alcohol were more likely to have experienced a bacterial or fungal injection site infection. Interestingly, this same group who reported using harm reduction techniques was also more likely to have ever engaged in all forms of non-sterile drug preparation practices. Because the survey did not assess timing of when respondents employed these practices relative to when they experienced injection site infections it is unclear if these harm reduction practices started prior to developing infections, or if they began engaging in safer practices as a result of having experienced complications in the past. One potential hypothesis is that those who experienced any type of injection-related infection may have received harm reduction education in conjunction with other medical care accounting for the higher use of these infection prevention practices in this group. Further research focused on the time frame during which specific injection practices were used, and the timing of injection-associated infections is needed.","title":"Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder"}
{"_id":"c4789147-0b01-e7eb-42a9-8731f8f52234","text":"Another important issue of concern in the procurement of the anterior sector graft is the hepatic vein drainage of segment IV. Inevitable segment IV congestion will occur if the dominant hepatic vein drainage stems from the MHV.[ However, we carefully evaluated the venous outflow in segment IV in this case and it was found to be left hepatic vein dominant. As a result, only focal segment IV congestion was noted postoperatively.","title":"Right anterior section graft for living-donor liver transplantation A case report"}
{"_id":"c47bcdf3-71c9-ab95-889e-f52d9d6d4865","text":"Improvements in the early detection and the treatment protocols have led to more cancer survivors, hence an increase in the number of patients developing subsequent cancers. We found that the overall risk of developing a second primary EOA malignancy increases significantly following a cancer diagnosis compared with the incidence of the primary EOA malignancies in general population. This is consistent with many other studies that documented the incidence of second malignancies among cancer survivors. Understanding the pattern of second malignancies is essential for planning the follow-up and screening protocols after the first cancer diagnosis.","title":"Second primary malignancies of eye and ocular adnexa after a first primary elsewhere in the body"}
{"_id":"c47eb813-bab7-2bb1-a53c-fb372f2d9e59","text":"Corrugator supercilii is located beneath the frontalis and orbicularis oculi, and it draws the eyebrows medially downward. It is supplied by the temporal branch of the facial nerve and supreatrochlear artery. It is used as the principal target muscle during botulinum toxin injection as it is regarded as the muscle causing glabellar lines.","title":"Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain"}
{"_id":"c48ab335-b860-0286-e11d-261a22f5ca07","text":"All ultrasound and MRI images were randomly assigned and measured 3 times by the two researchers at a minimum of 1 week interval. The two researchers had approximately 5 years and 2 years of experience respectively in ultrasound measurement of scoliotic spine. Prior to the study, each researcher was still required to practice ultrasound scanning at the supine position, data acquisition and measurement for more than 10 subjects. During the coronal curvature measurements they were blinded to all subjects' information and performed the measurements independently. The time required was approximately 5 minutes for the ultrasound data measurement.","title":"Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis"}
{"_id":"c48f05a2-0821-66ef-37d1-6dd86b1cfc89","text":"The popliteal region demonstrates extensive morphological variation in the muscular system. The popliteal region and plantaris muscle are very variable and a tensor fasciae suralis can be present. A comprehensive understanding of the morphological variations in this region is required for making correct diagnoses and planning effective treatment and rehabilitation. For example, any type of proximal attachment of the plantaris muscle can be associated with a range of conditions such as patellofemoral pain syndrome. In turn, the type of tendon connection, or even the belly of the popliteal muscle itself, can influence the stability of the knee and its support by the popliteal ligaments or even the fibular collateral ligament.","title":"Impact of plantaris ligamentous tendon"}
{"_id":"c48f2fa5-b1e0-be07-e926-a31e5c12f9b5","text":"Our data extend the role of androgens to a mesenchymal tumour, aggressive fibromatosis. It explains the observation that male Apc1638N develop larger number of tumours, and suggests that androgen receptor-blocking agents could serve as a novel therapeutic approach to aggressive fibromatosis. Perhaps individualised therapy based in part on the relative expression of the specific sex steroid hormone receptor will prove efficacious.","title":"Testosterone regulates cell proliferation in aggressive fibromatosis (desmoid tumour)"}
{"_id":"c491ba42-0252-50a0-9c35-857ae3dae292","text":"Women with persistent risk factors should be given pharmacological thromboprophylaxis for a minimum of 6 weeks postpartum, while those with transitory factors during prepartum and peripartum should be given pharmacological thromboprophylaxis up to hospital discharge, or 2 weeks postpartum.25","title":"Venous thromboembolism in women: new challenges for an old disease"}
{"_id":"c49f0252-a275-0041-b7db-7cdc0522f511","text":"To avoid complications especially to the ossicular chain, we tried to include patients with a narrow preoperative GAP. Considering different kinds of perforations in this study, we tried to keep the proper distance with ottic in order to avoid injury to the middle ear components. We also tried to provide a good visual field on ossicular chain during the operation using different angled endoscopes in addition to utilizing precise surgery technique. We also avoided the overheating of middle ear components by frequent repositioning and keeping the endoscope in a proper distance to allow tissue cooling.","title":"Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results Timpanoplastia bilateral transcanal por via endoscópica com cartilagem realizada simultaneamente: resultados iniciais"}
{"_id":"c4a2a091-ed48-e76b-e8e9-5f90ccd7719d","text":"The error arising from performing the osteotomy without the use of a mandible cutting guide was computed by measuring the distances between the cut right mandibles in the surgery simulation and the postoperative model. The error in superimposing the mandibular images was analyzed by examining the total 3D error in the right mandible reference area.","title":"Precision of fibula positioning guide in mandibular reconstruction with a fibula graft"}
{"_id":"c4b0ba3b-c2e9-e2a7-264e-765a969a1f42","text":"The management of skin carcinoma of the face in a child is particularly difficult because of its rarity. A multidisciplinary decision weighing the benefits and risks of each therapeutic modality is necessary for optimal treatment. What we can learn from our case report is the possibility of replacing surgery with exclusive radiotherapy in facial skin carcinomas to avoid mutilating surgery which impacts the quality of life of these young patients negatively.","title":"Cutaneous squamous cell carcinomas of the nose in a child treated with external radiation therapy: a case report"}
{"_id":"c4b0bd99-1e80-7256-97b4-db600bd454d6","text":"Oesophagectomy with abdominal and mediastinal lymphadenectomy is an extensive surgical procedure which requires thoracoabdominal approach regardless of whether it is performed as an open or minimally invasive operation. Theoretically, the degree of lymphadenectomy could be reduced in selected patients if there were a reliable method for limited and targeted lymph node sampling.","title":"“Sentinel lymph node imaging with sequential SPECT\/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study”"}
{"_id":"c4b12206-8a12-9812-3f53-05c1b29df020","text":"This study is the preliminary investigation of the suitability of in vivo ciprofloxacin release from HAp-ciprofloxacin bone implants in rabbit tibia, after implantation, and these implants can be useful for the treatment of bacterial bone infections like osteomyelitis. The results of the study displayed the availability of elevated local antibiotic concentration at the implanted site with the limitation of systemic antibiotic exposure, which can be useful to minimize the risk of systemic toxicity-related side effects.","title":"In Vivo Ciprofloxacin Release from Hydroxyapatite-Based Bone Implants in Rabbit Tibia: A Preliminary Study"}
{"_id":"c4b3661d-15d2-66b0-8418-3a0e866e76fe","text":"Intraoperative pneumothorax during breast reconstruction can be difficult to diagnose. Even a small pneumothorax can become a tension pneumothorax under positive pressure ventilation. The clinical finding of venous congestion in a pedicled latissimus dorsi flap, which could not be explained by problems with the vessels, preceded other signs of a tension pneumothorax in the case presented here. Given the difficulties of access to the chest by the anaesthetic team during breast procedures, this has the potential to be a useful adjunct in the diagnosis of this potentially serious intraoperative complication.","title":"Diagnosing Intraoperative Pneumothorax in Patients Undergoing Autologous Breast Reconstruction: A Useful Clinical Sign"}
{"_id":"c4c480c2-56af-d94e-7bde-a468743b8763","text":"The patient had multiple previous scars on the breast which could potentially impede arterial inflow or venous outflow to the NAC, and this presented a significant challenge. There were no prior operative reports available. We proceeded with the following steps to help formulate our surgical plan:","title":"Preoperative MRI to Improve Aesthetic Outcomes in Secondary Mastopexy Augmentation: A Step-by-Step Approach"}
{"_id":"c4ce7e3d-882b-59c9-4472-2c4b92b419fe","text":"The high sensitivity observed in our cohort is also due to the wide neoplastic involvement of the lymph nodes as highlighted by the histological examination. All the US false negatives are in fact due to presence of micrometastasis and\/or isolated tumour cells, findings that are more difficult to identify with US.","title":"The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours"}
{"_id":"c4d0777b-c5e3-b349-8834-4d7231e8c3fb","text":"The results presented here show that among patients who underwent multiple procedures, we were able to inject twice the volume of fat into the treated areas between the first and last procedure. The ability to inject increasing amounts of fat over time, indicates that the treatment led to improved facial tissue elasticity.","title":"Total Facial Autologous Fat Grafting for Treating Skin Manifestations in Scleroderma"}
{"_id":"c4d1adfc-e471-6230-4bb4-013cbb23a74a","text":"The transplants were carried out after the cancer treatment was completed and after a remission period of at least 2 years. The tissue was transplanted into women who had POI and also those women without POI who did not get pregnant spontaneously and required transplantation to increase the chances of pregnancy.","title":"Ovarian tissue cryopreservation and transplantation: 20 years experience in Bologna University"}
{"_id":"c4d7d213-9e07-a65c-f966-5ce1ba234c18","text":"This study aims to assess the occurrence and timing of VTE during a 10 year follow-up period in female patients who underwent breast surgery to analyze possible correlated factors and the overall survival.","title":"Incidence and Risk Factors for Venous Thromboembolism in Female Patients Undergoing Breast Surgery"}
{"_id":"c4da2826-67c1-ce7a-2638-5c40fe4af5fe","text":"When indicated, facial nerve decompression for BP is usually recommended within the first 2 weeks of onset of facial paralysis. Nonetheless, our results suggest that patients with severe BP could benefit from decompression surgery within 90 days after onset of symptoms in the absence of an opportunity to proceed earlier to surgery. Further investigation is still required to confirm our findings.","title":"Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience"}
{"_id":"c4de6def-920d-c7a5-6a67-e4bce020dcc8","text":"Twelve months postoperatively, she developed thinning of the chin skin and exposure of the anterior portion of the mandibular plate. CT scan confirmed bony union of the free fibula to the mandible bilaterally. Her skin was very thin throughout the neck and, interestingly, the skin had epithelialized under the exposed reconstruction plate. At this time it was decided to approach her plate directly and in a manner that would safely not disrupt the bone graft and epithelialized skin below the reconstruction plate. A small extension of the skin opening was performed in the lateral direction on both sides. The exposed screws were removed transcutaneously. The titanium reconstruction plate was then removed with a single cut on both sides, immediately proximal to the point of initial exposure using a Large Surgical Pin Cutter. The plate was then removed and the skin was closed in simple fashion with 5-0 nylon sutures that were removed 2 weeks later. The wound went on to heal well.","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"c4df7f42-50c4-1c58-3355-76b1c44d92a9","text":"The Institutional Review Board of two participating institutions approved this study with a waiver of informed consent due to its retrospective nature. All procedures performed were in accordance with the ethical standards of the institution and with the 1964 Declaration of Helsinki (and its later amendments).","title":"Local Recurrence in Young Women with Breast Cancer: Breast Conserving Therapy vs. Mastectomy Alone"}
{"_id":"c4dfc935-0e27-911c-c191-570a2bf6a5b0","text":"Since this is a retrospective study, no change of clinical practice can be recommended based on the results. Although we assessed 1044 margins, the power of the statistical analysis is limited by the low prevalence of positive margins especially in the cCR subgroup.","title":"Does conventional specimen radiography after neoadjuvant chemotherapy of breast cancer help to reduce the rate of second surgeries?"}
{"_id":"c4e04872-4882-d8ff-5916-3d7dba63ee8a","text":"Malignant tumors of the parotid gland require radical resection with adequate soft tissue margins. Radical parotidectomy is advocated for the surgical treatment of high-grade malignancies and recurrent benign tumours of the parotid that intimately involve the facial nerve. Radical parotidectomy involves total extirpation of the parotid gland in conjunction with resection of the facial nerve. Sacrifice of the facial nerve is mandatory if the facial nerve is preoperatively paralyzed. Consideration should be given to grafting of the facial nerve if the proximal and distal stumps following resection of a segment of the facial nerve are available for coaptation with a nerve graft, and are histologically confirmed as uninvolved by the tumour.[11]","title":"Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy"}
{"_id":"c4ea81a7-0c00-c166-d264-c34c55a5319f","text":"Antiplatelet or anticoagulant medications (such as low molecular heparin) were also not routinely conducted postoperatively. Elastic stockings wearing and early lower limb function exercise were the only postoperative antithrombotic prophylactic treatments for the enrolled patients until the onset of DVT by Doppler ultrasonography or clinical symptoms.","title":"Plasminogen activator inhibitor-1: a risk factor for deep vein thrombosis after total hip arthroplasty"}
{"_id":"c4eee06e-8141-55c7-3722-82f7e70ae96b","text":"It is hard to directly discriminate a very big periapical lesion, a cyst with unclear boundary or other positive tumor, and osteomyelitis only by photographic density information from a radiograph. Because the detailed entity of osteomyelitis is essential for its final treatment process, other diagnostic tools such as dental CT scanning are also essential for its discriminations. If diagnosis of osteomyelitis is performed based on the principle of considering a radiograph together with clinical diagnosis, medical history, and visual inspection at the time of diagnosis, this should not present a major program. In cases of a focus in which a change in photographic density is observed in panoramic radiograph, it would be possible to make a quantitative diagnostic standard by performing the same process.","title":"Early diagnosis of jaw osteomyelitis by easy digitalized panoramic analysis"}
{"_id":"c4f00bdd-ec25-844c-1805-57e85374e1c5","text":"FuzzyEn parameter can be defined from the time series as follows:","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"c4f1d8a0-e4b1-ab63-1fc6-fe43ede469f8","text":"Free cartilage graft –In nasal reconstruction, cartilage grafts are most frequently harvested from the nasal septum and auricle. For alar reconstruction, although septal cartilage can be used to construct the alar framework, auricular cartilage is preferred. The natural curvature of the conchal cartilage is well suited for recreating the convexity of the ala. The cartilage from the concha cymba and concha cavum can be approached from an anterior or posterior skin incision. Once harvested, the conchal cartilage can be shaped and trimmed to match the native alar curvature, and can be thinned down to 1 mm while maintaining its convexity. During placement of the graft, a small pocket should be dissected at the alar facial sulcus to anchor the lateral aspect of the graft to prevent prolapse into the vestibule. Driscoll and Baker reviewed 50 patients with alar defects requiring free cartilage grafts and concluded that it produces good aesthetic results when combined with additional reconstruction procedures. They report a partial loss of skin flap in 6% of the patients when combined with a forehead flap or melolabial flap, and partial loss of lining flap in 8% of the patients when combined with intranasal lining repair. 3 Free cartilage grafting is surgically reliable, can be easily combined with other locoregional flaps in alar reconstruction, and has been established as the gold standard for skeletal support in intermediate and full-thickness alar defect reconstruction.","title":"Comprehensive Algorithm for Nasal Ala Reconstruction: Utility of the Auricular Composite Graft"}
{"_id":"c4fa77ae-f183-4ff7-b25b-f0324cb3df64","text":"Participants for this study were recruited in three main ways. The first major source of participants was MBA students or alumni from the Business School of Singapore Management University, the National University of Singapore and Nanyang Technological University. Candidates are required to have at least 3 years' work experience to be able to apply for this MBA programme, and a significant proportion of students on this programme had already owned and operated their own businesses. The second major source was the undergraduate innovation and entrepreneurship clubs in these same universities. Members of these clubs are current undergraduates or graduates, either preparing to start their own businesses or having just started their own businesses. Lastly, the survey links were also posted on various online social media platforms to allow other relevant people who were interested in this study to complete the surveys.","title":"Established and Nascent Entrepreneurs: Comparing the Mental Health, Self-Care Behaviours and Wellbeing in Singapore"}
{"_id":"c4fae625-b7e3-1bc6-4e01-92a6fcb6bf3e","text":"Postoperative ear packing in conventional surgeries, which leads to considerable hearing loss and causes a transient activity limitation to the patient, is not applied in endoscopic method since all the procedure is done with only few stiches in cartilage harvesting site without any other postauricular incisions.","title":"Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results Timpanoplastia bilateral transcanal por via endoscópica com cartilagem realizada simultaneamente: resultados iniciais"}
{"_id":"c502c378-b80b-1408-5d62-69c059c614bf","text":"The method and type of fixation both anterior and posterior was recorded alongside whether the patient had suffered multiple injuries, with those other injuries also noted.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"c505c1a4-78f5-e731-cdb6-c007062bccad","text":"Day case surgery is an expanding area of health care and a valuable method of treating patients in many aspects of oral surgical practice. Different medical and dental specialties can benefit from this ambulatory approach to treatment, which also reduces treatment costs.","title":"Oral surgical procedures under local anaesthesia in day surgery"}
{"_id":"c50ad7f2-a371-7fb5-2a6c-c0eaa8c2ea9b","text":"For the purpose of this paper, MVT is defined as combined thrombosis of gastrocnemius or soleus calf veins whereas isolated MVT refers to an isolated thrombosis of gastrocnemius or soleus calf veins, often referred to as isolated IGSVT.","title":"Evidence for treatment of muscular vein thrombosis in orthopaedic patients"}
{"_id":"c50c3f40-b6a2-2362-0d38-76f908b5e2b5","text":"Chemotherapeutics are one of the basic components of oncological regimens, both in the form of adjuvant, neoadjuvant or palliative therapies and strategies combined with drugs from other groups. The possibility of using cytostatics in oncology with the entire spectrum of applications is limited by a number of side effects. Most of these are due to significant toxicity, but the administration of some drugs is also associated with an increased risk of hypersensitivity.","title":"Immune Reactions in Major Types of Oncological Treatment"}
{"_id":"c50fe52d-5509-99e0-354b-3fab582a5523","text":"Mutations in the NRAS gene are reported, as NRAS is a member of the RAS family of proteins and is activated by growth factors and other signaling molecules.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"c511dc8f-796d-5bfc-f6dd-7bfeffbb4db9","text":"If the clinician is satisfied that the patients has a proximal DVT (with or without a confirmatory venogram) the patient should be anticoagulated using subcutaneous heparin\/LMWH according to local protocols as long as there is no contraindication. If only calf vein thrombus is detected (by screening CDU and\/or venography), the responsible clinician may anticoagulate the patient according to local protocols or alternatively arrange a follow up CDU approximately seven days later to identify any propagation into the popliteal vein. If definite popliteal or femoral vein thrombus is detected the patient should be anticoagulated unless contraindicated. If a patient develops symptoms or signs suggestive of DVT during their admission they should be investigated by either CDU and\/or venography or MRI direct thrombus imaging and treated according to local protocols if the diagnosis is confirmed. Use of heparin, LMWH and Warfarin to treat DVT and\/or PE during admission is recorded on the discharge form. Continued use of IPC in such patients is at the discretion of the responsible clinician.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"c515e13d-6182-6f7e-97e1-429b3e2eef84","text":"Low density ultrasound has been explored to influence peripheral neurons 96 or treat pain and neuropathy in clinical trials 97; however, the current concept is based on a new discovery that ultrasound can eliminate acute paclitaxel cytotoxicity by breaking the rigid microtubules. While low intensity ultrasound has been extensively used for various medical applications 83,84, and laboratory studies show that ultrasound waves impact cells and may have biological activity even on hair follicles 98, the evidence to support medical applications of ultrasound is largely anecdotal. Most medical applications of ultrasound physiotherapies were determined to lack true merit in large and rigorous clinical studies 83,84. Instead, the surprising findings 81 and unique hypothesis discussed here may be possible to introduce a rational, evidence-based use of ultrasound therapy for overcoming paclitaxel cytotoxicity into medical practice.","title":"Low Intensity Ultrasound as an Antidote to Taxane\/Paclitaxel-induced Cytotoxicity"}
{"_id":"c51695d4-821a-c696-6cf5-d67495d289b2","text":"Our system refers to a dynamic osteosynthesis because only distal locking is done after adequate reduction, to prevent the rotational malalignment and allow stability. Dynamic locking refers to the trans fixation only in the shorter fragment and allowing intermittent compression of the fracture site during early weight-bearing. The D nail provides sufficient stability by three-point fixation at either ends and also in the diaphysis by its bony contact. We believe that to achieve uneventful union with minimum morbidity, due attention should be focused on avoiding damage to the periosteum of small bone fragments in comminuted fractures.22 It has been proved19 that minimal surgical trauma and flexible fixation allow prompt healing when the blood supply to bone is maintained or can be restored early.","title":"Dynamic osteosynthesis by modified Kuntscher nail for the treatment of tibial diaphyseal fractures"}
{"_id":"c516ee5b-2e51-f139-f160-a9ff1bcb3b0b","text":"Despite the use of deep curettage ahead of PDT, we still achieved a favourable cosmetic result assessed as good or excellent in all the evaluated cases.","title":"Pre-Treatment Deep Curettage Can Significantly Reduce Tumour Thickness in Thick Basal Cell Carcinoma While Maintaining a Favourable Cosmetic Outcome When Used in Combination with Topical Photodynamic Therapy"}
{"_id":"c51c7bbb-171e-3401-fc47-b14e0c046fb5","text":"Based on our experience with etoposide phosphate in this patient, we have created a protocol for its use in the setting of hypersensitivity reactions. While an extremely rare side effect to the infusion of etoposide, hypersensitivity reactions present a therapeutic challenge with few viable alternatives. Etoposide phosphate, however, appears to be a suitable alternative and should be considered the alternative drug of choice for patients with a hypersensitivity reaction to IV etoposide.","title":"Management of a Type I Hypersensitivity Reaction to IV Etoposide in a Woman with a Yolk Sac Tumor: A Case Report"}
{"_id":"c51c8ccb-cabd-a811-5f65-3eeb5cc89068","text":"This study presents 2 LEL cases of individuals suffering from severe aeroallergen allergy which required the second line allergy treatment, omalizmab. Remarkable findings in these 2 LEL cases are marked attenuation of their problematic neuropsychiatric symptoms and subsequent improvement in the cognitive development, once respiratory allergy symptoms were under control. These 2 LEL cases revealed that respiratory allergy can manifest profound detrimental effects on neuropsychiatric symptoms and cognitive activities in LEL individuals, illustrating the importance of optimal control of respiratory allergy symptoms in LEL subjects.","title":"Marked improvement of neuropsychiatric symptoms following control of allergy symptoms with the use of humanized murine anti-IgE antibody (omalizumab) in 2 patients with severely limited expressive language"}
{"_id":"c522f52e-21aa-a250-9e4b-aacc9cd60b6d","text":"The topical drugs used in this study are relatively affordable because the basic active ingredient BA is found in plants and is relatively inexpensive to produce. Although it is advantageous that topical medications are commonly low in cost and can be easily applied by horse owners, generally the benefits of topical therapies appear to be limited to only the lesions treated and no systemic antitumor effects can be achieved. Melanomas of the lip seem unsuitable for a topical therapy because of the risk that the animal will lick off the cream or ointment and absorb it orally. By contrast, the treatment of melanomas located on the ventral tail and in the perianal region has been proven to be very feasible in this study. Future trials should evaluate the effect, safety and feasibility of the topical medication investigated when applied to melanomas located in different anatomical regions.","title":"Effects of Topically Applied Betulinic Acid and NVX-207 on Melanocytic Tumors in 18 Horses"}
{"_id":"c52a152e-1968-e50f-cf04-c02ff96e66d6","text":"The original TW80 and its macromolecular components (Components A and B) caused serious anaphylactic and anaphylactoid reactions in guinea pigs. However, there was little difference between the intensity of the anaphylactoid reaction and that of the anaphylactic reaction. Considering that serum IgE both in “anaphylactic” and anaphylactoid guinea pigs was only slightly elevated by the original TW80 and its macromolecular components, the reactions in the anaphylactic experiment are more likely to be anaphylactoid reactions although the possibility of anaphylactic reaction cannot be excluded. The anaphylactoid reactions were further proved in rabbits, and Component A caused the most severe reactions. The finding that Component C partially causes anaphylactoid reactions in both guinea pigs and rabbits indicates that macromolecules are the dangerous factor triggering anaphylactoid reactions.","title":"Macromolecules in polysorbate 80 for injection: an important cause of anaphylactoid reactions"}
{"_id":"c5337823-0702-e964-23fa-c43ec8eae9fb","text":"The testing procedure was arranged in a dental surgery and adjacent recovery area within a general hospital, which were equipped with emergency drugs and equipment. The procedures were conducted with the assistance of a trained nurse, who monitored the patient during the observation periods.","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"c5347ce3-9e5c-6f22-118e-4fdddd19cc36","text":"Ultrasound-assisted lipectomy or the newly named VAL is a technique in liposuction that is employed to emulsify fat tissue using ultrasound energy through a metal rod before aspiration. Multiple studies compared this technique to suction-assisted lipectomy to assess their risks and benefits. A few studies concluded that VAL was superior in terms of reduction in blood loss. On the other hand, multiple studies reported an equivocal outcome between both techniques in terms of complications and results.","title":"Necrotizing Soft Tissue Infection Post VASER-Assisted Liposuction and Lipofilling: A Case Report"}
{"_id":"c536a7cd-eeed-ff3b-1e0a-deaefe458666","text":"A strength of our study was that we were able to follow participants over time from diagnosis through treatment and a year following diagnosis. A limitation of this study may be that we recruited from only one out-patient clinic; patients are, however, referred to this large teaching hospital from a very wide area and are representative of the general population. Another limitation may be that we adapted the knowledge questionnaire from a melanoma knowledge questionnaire, although upmost care was taken in doing this in close consultation with clinicians.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"c539c4c4-194b-92ef-2ed1-5157c119dd13","text":"Some limitations and challenges are present in the application of fibular grafts. One of the issues is donor site mobility. The location of the fibular that is resected too distally may result in functional valgus of the ankle joints.[ Gaskill et al[ studied 946 VFGs cases between 1990 and 2006. The study demonstrated that the major complications after surgery were rare and the minor complications were controllable. More rigorous clinical studies are still required for VFG to be widely used in surgery.","title":"Application of vascularized fibular graft for reconstruction and stabilization of multilevel cervical tuberculosis A case report"}
{"_id":"c539ef12-3c66-a4bc-141f-182008ab5253","text":"Conventional radiography is the initial modality of choice to evaluate osseous changes. In the majority of cases it will be the only imaging technique used in the diagnosis and treatment of childhood osteomyelitis.","title":"Childhood osteomyelitis: imaging characteristics"}
{"_id":"c53e32ad-a5a4-6f47-8e53-14fbca7883ad","text":"We plan to investigate the relationships between the different histological types and the sites of SPCs. The histological report and the type of treatment performed may provide more information concerning the need for more extended monitoring of the FPC and the associations with an SPC. It will be useful to verify whether the onset of a second cancer will remain low in subjects with a longer duration of follow-up, at 15 or 20 years after the first diagnosis.","title":"Cancer Prevention for Survivors: Incidence of Second Primary Cancers and Sex Differences—A Population-Based Study from an Italian Cancer Registry"}
{"_id":"c53fa048-d33d-ddfa-86f8-7645ce823018","text":"The superior central excision is carried out between the pedicle and the keyhole margin.","title":"Reduction mammoplasty"}
{"_id":"c54bf48b-7d24-9aed-8b1a-74dd5ea466f6","text":"Bone marrow edema (BME) is defined as an area of altered signal on the magnetic resonance imaging (MRI) of the bone. Quantitative assessment of BME using MRI is useful in determining the stage of sacroiliac arthritis. However, there are few reports on the application value of Dixon technique in the evaluation of bone marrow edema in sacroiliac arthritis. The purpose of this study was to explore the value of magnetic resonance imaging Dixon sequence in the quantitative analysis of bone marrow edema in the diagnosis of sacroiliac arthritis in patients with ankylosis spondylitis.","title":"The evaluation of bone marrow edema in sacroiliac joint in patients with ankylosing spondylitis using magnetic resonance imaging Dixon sequence"}
{"_id":"c54efbb6-1e05-60f8-c439-41b5d76399dd","text":"Despite the fact that in our series we used this technique primarily in carcinologic cases, we are confident that it can be useful in all types of moderate tissues defects, regardless of etiology.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"c55650ce-524a-2920-f8be-e5490e607043","text":"Women who have had breast cancer have an increased risk of a second primary breast cancer for at least 20 years compared to the general population. Mammographically detected local recurrences or those detected by women themselves gave better survival than those detected by clinical examination. Follow up in alternative settings to the specialist clinic is acceptable to women but trials are underpowered for survival.","title":"Options for early breast cancer follow-up in primary and secondary care - a systematic review"}
{"_id":"c5699d85-b506-d8fa-2b3d-5f53c584faa9","text":"Historically, regional completion lymph node dissection (CLND) was performed after a positive microscopic SLNB result, and therapeutic lymph node dissection (TLND) is presently the standard recommended surgical treatment for stage III melanoma with clinically apparent\/palpable lymph nodes. However, the greatest recent paradigm change has been the de-escalation of CLND after a positive SLNB. This is supported by evidence from two prospective randomized controlled trials (the DeCOG-SLT and the Multicenter Selective Lymphadenectomy Trial 2 (MSLT-2), which showed no benefit in melanoma-specific and distant metastasis-free survivals from undergoing CLND after a micrometastatic disease found in a SLNB [40, 41]. In these studies, SLNB-positive patients were randomized to CLND vs. active surveillance of the lymph node basin with clinical exam and periodic lymph node basin US (every 4 months US for years 1–2, and every 6 months US for years 3–5), and CLND in the active surveillance group if there was nodal recurrence. At a cost of modest decrease in regional nodal recurrences, CLND did not provide survival benefit and increased the rate of lymphedema (6 vs. 24% in MSLT-2). No subgroups of patients were identified who would benefit from a CLND. The reported rate of non-sentinel lymph nodes (further positive lymph nodes present in a CLND after a positive SLNB) is ~ 20% [42]; therefore, this change of practice entails that there is further nodal melanoma involvement in 1 out of every 5 SLNB-positive patients observed. However, patients with non-sentinel lymph node involvement have a higher risk of distant recurrence [42, 43]; thus, addressing the regional nodal basin surgically with CLND will be unlikely to improve distant metastatic recurrence. An important caveat about these studies is that they took place before modern systemic immunotherapy was available, the size of the lymph node metastases in the sentinel lymph nodes was relatively small, and the published studies still have short median follow ups. A retrospective cohort study of patients in which the principles outlined in the randomized trials were utilized, however, suggests that the real-world application of the study results leads to similar results with differences noted in nodal recurrence-free survival, but no difference in disease-free survival [44].","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"c572760f-abef-740a-3ee4-642cfc596deb","text":"The use of iliac crest graft as described by Lee HG in 1957 is an inferior option as it replaces joint surface with bone instead of cartilage.","title":"Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: long-term result"}
{"_id":"c5886945-7ebc-3148-7a6d-6bdcd53c78f3","text":"Having the extra expertise in “XX” allows me to go to an underdeveloped area of the country afterward and be able to have a bit more authority in being able to present myself as a specialist in that particular topic (Fellow)","title":"Fellowship training: a qualitative study of scope and purpose across one department of medicine"}
{"_id":"c58d5b76-db61-7017-61b7-4e734afe10fa","text":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by our hospital’s Institutional Review Board. All our patients sign a written consent when they are admitted in the hospital by which they agree that their medical information can be used for scientific purposes without breaking confidentiality.","title":"Deep vein thrombosis following the treatment of lower limb pathologic bone fractures – a comparative study"}
{"_id":"c592dae1-7cc0-6958-ed87-ef53ce096cf5","text":"RNA samples that showed the 28 S and 18 S ribosomal band were considered eligible for the study (Figure 1A","title":"Prognostic significance of the sequential detection of circulating melanoma cells by RT–PCR in high-risk melanoma patients receiving adjuvant interferon"}
{"_id":"c598c4a2-693b-d710-6403-21ebbcb9fd9e","text":"This systematic review examines the current evidence on the possible effects of breastfeeding on occlusal development. The consensus is clear on the greater prevalence of posterior crossbite in both mixed and permanent dentition in the absence of any form of breastfeeding, and also on the association between a longer breastfeeding period and a lower prevalence of posterior crossbite, although one study found no association. A possible explanation for this association is that breastfeeding is based on advancing the mandible and raising and lowering the tongue, which promotes balanced muscular development, whereas the main action in bottle feeding is sucking, which contracts the buccinators and favors a narrower maxilla.","title":"Association between duration of breastfeeding and malocclusions in primary and mixed dentition: a systematic review and meta-analysis"}
{"_id":"c5ace1f7-499a-0dde-42e5-91c9c5895a8d","text":"The right latissimus dorsi musculocutaneous flap of 8 rats in this group was raised and after ischemic preconditioning as described above was applied flaps were returned to their places. Ten days after the preconditioning flaps were raised again to be subjected to ischemia reperfusion procedure and were settled in their original places. MPO and NO levels were measured in blood and tissue samples of 4 rats at the 24th hour and 4 rats on the 10th day of ischemia reperfusion. Values ​​were compared with other groups.","title":"Comparison of ischemic preconditioning and BotulinumA Toxin injection for the prevention of ischemia-reperfusion injury in musculocutaneous flaps"}
{"_id":"c5b0e672-3555-f9d1-2e4f-c268b2ccbb11","text":"Complex wounds of hands and feet have always been a challenge for reconstructive surgeon. We aim to share our experience of reconstruction of such defects using free fibula osteocutaneous flaps.","title":"Experience of Saving Limbs With Free Fibula Osteocutaneous Flaps"}
{"_id":"c5b1936b-2887-accb-8099-a3f50439c73f","text":"Given abundant data in the DCR, in combination with the fact that our focus was mortality following the most common cancers in Denmark, we decided that for each selected cancer patient with a history of cutaneous SCC, we would randomly choose 100 patients with the same index cancer but without preceding SCC of the skin.","title":"Mortality in cancer patients with a history of cutaneous squamous cell carcinoma - a nationwide population-based cohort study"}
{"_id":"c5bb2f27-6e19-426e-89d7-cf201586dea0","text":"The aim of our study was to investigate the risk factors for partial or total flap failure in a large patient cohort, operated in a university setting.","title":"A retrospective evaluation of 182 free flaps in extremity reconstruction and review of the literature Eine retrospektive Auswertung von 182 freien Lappen in Extremitätenrekonstruktion und eine Literaturübersicht"}
{"_id":"c5beb28d-f9e3-3678-0014-94a0f0208e5c","text":"All wounds were left open and dressing changes were performed 3 to 5 times a week for wound assessment and sampling. The infectious diseases specialist adapted the antimicrobial agents to the bacteriological species and susceptibility testing and administered them for 12 weeks. The second stage occurred in the second to third week, with removal of the gentamicin beads and implementation of bone grafts. Soft tissue coverage was performed by plastic surgeons using a free flap. The flap type was chosen according to defect size, arteriographical results and patients’ preferences. An internal fixation was performed in case of instability.","title":"Muscular Versus Non-Muscular Free Flaps for Soft Tissue Coverage of Chronic Tibial Osteomyelitis"}
{"_id":"c5c275a4-18a2-acc6-2135-0847199a7d55","text":"In this case we used an intermediary split thick skin graft with a thickness of 0.38 mm harvested with an electrodermatome from the anterior side of the right thigh. This skin graft contains: epidermis, papillary layer and varying portions of the underlying dermis. We chose this type of skin graft because it is well integrated on clean receiver surfaces permitting a rapid and well recovery. If the tumor recidivates, the intermediary skin graft thickness allows a quick tumoral tissue observation and gives the surgeon the opportunity to perform further excision.","title":"Giant laterocervical fibrosarcom"}
{"_id":"c5c6c81e-7e55-dada-166a-b6b3da894bd8","text":"The sentinel lymph node concept has brought about a revolution in the surgical treatment of the regional lymphatic basin while preserving the prognostic value of the regional lymph node status in breast cancer.","title":"Immunological aspects predicting metastatic sentinel lymph node in early breast cancer patients"}
{"_id":"c5c8e413-1459-88ff-91a5-d8e43d425dcf","text":"With these two overlapping standards of care, two further phase III trials were performed that directly compared the two approaches. These trials reported no significant difference in local recurrence and survival, and as a result, both approaches are supported by international guidelines. Chemoradiation is recommended as the preferred option when the patient has locoregional disease with very close margins of surgical excision.","title":"Practice-changing radiation therapy trials for the treatment of cancer: where are we 150 years after the birth of Marie Curie?"}
{"_id":"c5c96d44-11f7-6b78-3be0-6e2d9683afd6","text":"We report the results obtained from an analysis of 1720 patients affected by MM over a period of 15 years.","title":"Appearance of malignant melanoma after a non-cutaneous cancer diagnosis"}
{"_id":"c5ce4070-e92d-97e1-bc38-0f348a2ca8eb","text":"Chloramphenicol is a topical treatment that is used widely, especially in wounds around the eyes. In our practice there have been a number of cases of delayed hypersensitivity to chloramphenicol that has been mismanaged initially as an infective cellulitis. We hope to share some of our experience of this uncommon reaction to highlight the delayed reaction that can occur with topical application of this drug.","title":"Reaction or infection: topical chloramphenicol treatment"}
{"_id":"c5ded249-edf8-5c7e-e702-d434b1fb6e8d","text":"Any positive answer considered true just after excluding any probability of foreign body presence inside the nasal cavity by direct observation.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"c5e0961e-8c28-fd81-cdc1-3bcb1c24c551","text":"The anatomical basis of head and neck cancer nodal drainage has been well established and is in use on a daily basis [11]. On this basis the type as well extent of the neck dissection is determined [12]. For a long time the head and neck area has escaped the concept of sentinel neck dissection due to the conceived variability in the lymph drainage from the oropharyngeal area. In recent years this concept has made way for increasing interest in the potential benefits in patients with oropharyngeal cancer.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"c5e0fb13-688e-e357-77bf-6e404c99f5e6","text":"In order to test the conformal ability of the device on an irregular surface such as a human nose, an anthropomorphic Rando phantom was used. This phantom models the routine diagnostic computed tomography (CT) images that are routinely obtained for radiation treatment planning. A DICOM dataset of Rando phantom was constructed into an STL surface representation file using the program 3D Slicer4 open source medical imaging software platform.","title":"Novel design and development of a 3D-printed conformal superficial brachytherapy device for the treatment of non-melanoma skin cancer and keloids"}
{"_id":"c5e94ab4-f915-10b8-a3da-533d134bb2fb","text":"On the other hand, when an open procedure for a large ganglionic cyst of the knee has been decided upon, the preservation of an intact synovium should be the main consideration of the surgeon. Unfortunately, in our patient, the preservation of an intact synovium was inevitable because of the lesion's firm attachment to the capsule (Figure 5C). Our decision to carry on with an open excision of the ganglion lesion was based more on our pursuit for a complete resection of the lesion in order to diminish the recurrent rates and less on avoiding synovium invasion. The substantial defect of the synovium that was left after the complete resection of the ganglion was repaired by approximating the defect margins with interrupted sutures. The latter would be quite difficult with an arthroscopic procedure that primarily invades the synovium in order to excise such lesions.","title":"Large infrapatellar ganglionic cyst of the knee fat pad: a case report and review of the literature"}
{"_id":"c5eae195-9260-789f-fa3a-5a77d3113877","text":"Another theory is that surgery or other interventions suppress cell-mediated immunity and increase the risk for recurrence. A study from 2011 describes a significantly increased risk of recurrence after mastectomy followed by delayed reconstruction with autologous tissue compared with mastectomy only. However, two other studies were published demonstrating that delayed deep inferior epigastric perforator flap reconstruction after breast cancer surgery did not increase the risk of recurrence compared with mastectomy alone,. In the present study there was no increased risk for recurrence among those who had more than one surgery compared with those who had only one operation. In a cohort study using the Danish National Patient Register with more than 30 000 patients, there was no association between reoperation for bleeding and breast cancer recurrence also questioning the association of bleeding, inflammation and cancer recurrence.","title":"Association of postoperative infection and oncological outcome after breast cancer surgery"}
{"_id":"c5ec9cc0-dca2-c587-8787-34898fe3e2e9","text":"At our institute, the surgical strategy for parotid carcinoma shifted from total parotidectomy to partial parotidectomy in 2002. Partial parotidectomy was preferred because it preserves the facial nerve as much as possible in patients without preoperative facial palsy. In addition, the neck management for cN0 parotid carcinoma was changed from prophylactic neck dissection at cT3 and T4 cases before 2002 to no prophylactic neck dissection for cases after 2002. These changes in the surgical management and treatment policies may have improved treatment outcomes, such as postoperative facial nerve function. This study aimed to assess the changes in clinical outcomes of patients treated for parotid carcinoma at our institution due to changes in surgical strategy before\/after 2002. To the best of our knowledge, this is the first study to compare postoperative outcomes before and after implementing specific surgical management policy changes for parotid carcinoma at a single institution.","title":"Impact of Changing Surgical Strategies on Clinical Outcomes in Patients with Parotid Carcinoma: A 53-Year Single-Institution Experience"}
{"_id":"c5efe4eb-b63b-4e81-9338-6dbf488b427d","text":"Then, all patients were subjected to postoperative clinical and instrumental evaluation by a single physiatrist to correlate the CT findings with any postoperative movement impairment or pain.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"c6000aba-2b67-1bf4-73d5-387194efbfe8","text":"During each interview, the interviewees explored the ways that their development had influenced their subsequent approach to professional practice. This included practical changes, such as a fellow in a managerial position deciding to spend sessions working clinically in order to develop connections with the staff involved in practically delivering healthcare, and abstract changes in which the fellow adapted the way that they interacted with their colleagues.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"c6040754-9b57-541b-9c5f-fee7603dbd45","text":"Our data show that for most patients HbA1c was measured only within 24 h of the POME visit. If the patients with the poorest metabolic control are going to be identified in a timely manner, knowing the HbA1c sooner would be helpful, preferably through some type of prescreening before the surgical consultation date. This would allow time for appropriate scheduling for other resources that might be needed to address the DM. A recent study [10] reported on an intervention to improve identification of DM patients with HbA1c greater than 8% before surgery and showed a positive effect on glucose levels on the day of surgery. However, the authors of that study also struggled with very short intervals between the identification of the patient and the surgical date and admitted that implementing a case finding and intervention strategy similar to theirs so close to surgery would be resource and manpower intensive. The present study was intended to examine the current state of our institution's practice, rather than to conduct an intervention, and to ask whether there might be an optimal time between identification of similar cases of poor glucose control and the date of surgery. A common barrier to improving preoperative glucose levels that many centers may face, as shown by the present study and others, is the narrow window for identifying high-risk patients and implementing interventions [10].","title":"Relationship between the timing of preoperative medical visits and day-of-surgery glucose in poorly controlled diabetes Timing of preoperative visits"}
{"_id":"c6051573-a8e0-7628-6d01-ddee9141c8f7","text":"The osteocutaneous fibular harvest was dissected in a standard fashion from the left lower extremity with a planned overlying skin paddle under sterile tourniquet control. The proximal osteotomy was completed so that the fibular would be reamed to fit the radial arthroplasty system while the flap was still vascularized. The fibular length after distal osteotomy was 6 cm. The radial head arthroplasty was done after dissecting the peroneal vessels proximal to bifurcation. The construct was placed in the joint and plated to the radial diaphysis. The capsule was closed after the arthroplasty. Fluoroscopy was used to verify the placement and range of motion (ROM).","title":"Use of Osteofasciocutaneous Fibular Free Flap and Radial Head Arthroplasty in Trauma for Limb Salvage and Continued Elbow Function"}
{"_id":"c60ae561-11ff-f3bb-fd76-7088f70ec319","text":"A second major area of research in biofilm treatment is external methods of treating or removing the biofilm from the implant after the biofilm has already formed. This review largely focuses on technologies that use primarily physical means of removing biofilm and have been tested either alone or in concert with antimicrobials to produce a synergistic effect. Physical means of removing biofilms can be grouped into several subcategories: light-based methods, sound-based methods such as ultrasound or shockwaves, electromagnetic means and plasma or high energy methods of removal as summarized in Figure 2. Based on the mechanism of removal, some physical methods do require accessing the implant while others can penetrate through tissues to reach the implant non-invasively. Because of this, there are multiple factors to consider when evaluating overall effectiveness as well as improvement over current models of treating biofilms.","title":"Physical Approaches to Prevent and Treat Bacterial Biofilm"}
{"_id":"c612747b-5028-a821-86a8-726bedfda243","text":"The evaluation of the diagnostic studies of BL hypersensitivity is a field in constant evolution, which should be continuously monitored and updated to provide the most accurate diagnoses for patients. All countries should implement this monitoring due to the differences in drug use among regions. That also will contribute to classifying the patients better and using more accurate panels of STs, which also help harmonize study protocols. Better use of antibiotics ultimately results in a direct benefit to patients, thus contributing to improved use of health systems.","title":"Changes in Sensitization Patterns in the Last 25 Years in 619 Patients with Confirmed Diagnoses of Immediate Hypersensitivity Reactions to Beta-Lactams"}
{"_id":"c615a310-a608-08a4-6693-f93a237c7b89","text":"This retrospective study analyzed the electronic medical records of patients who underwent preoperative evaluation for cutaneous melanoma maximum thickness using an 18 MHz probe and histopathological examination between December 2017 and March 2021 at the Department of Dermatology in Xiangya Hospital, Central South University.","title":"The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients"}
{"_id":"c616270d-ae86-bfb4-35c2-cc6a3bf7a48e","text":"A free gingival graft was harvested from the palate to place in the exposed area to regenerate the lost periodontal tissue due to the excision.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"c61e451c-fa88-48f9-217e-797eb8163d60","text":"In this retrospective study, we compared a PVB with or without blocks targeting the pectoral region for modified radical mastectomy (MRM). We hypothesized that adding blocks targeting the pectoral region to a PVB provides more effective pain management in MRM. The primary aim of this study was to assess the intraoperative supplemental anesthetic effects of blocks targeting the pectoral region combined with a PVB. The secondary aims included determining postoperative analgesia and side effects of nerve blocks.","title":"Paravertebral Block Plus Thoracic Wall Block versus Paravertebral Block Alone for Analgesia of Modified Radical Mastectomy: A Retrospective Cohort Study"}
{"_id":"c61f7eb7-bf2c-5646-0b50-abf24addd3bf","text":"This is probably the most employed and reliable free flap in the whole body.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"c6232137-0d23-7da5-7ab6-a0876ded66ec","text":"Harvesting of the second toe is still accepted as a demanding surgical procedure. The major questions before this transfer are the location and the dominance of the arterial anatomy of the second toe. The first dorsal metatarsal artery is capable of supplying the arterial circulation of the second toe in the majority (approximately 70%) of the cases, and the relationship between this artery with the interosseous muscle and the intermetatarsal ligament is of paramount importance in the flap dissection. It is widely accepted that it is much easier to harvest the second toe via solely dorsal approach without any plantar dissection, which is possible when the first dorsal metatarsal artery is capable of supplying the arterial circulation of the second toe [4].","title":"A new method for second toe flap revascularization in plantar dominant artery pattern - dorsal metatarsal artery interpositional graft"}
{"_id":"c6233e85-5658-19ef-ce0c-88286f9016b3","text":"We present two cases, one presenting with severe ischemia and the other with stent infection after a long segment stent angioplasty of the superficial femoral artery and the popliteal artery. Hospital-stay documents and data were collected from two patients. A systematic search of the Medline database was performed with the purpose of identifying other similar cases and results.","title":"Abstracts DGG"}
{"_id":"c62a7bed-897c-5bbb-8027-25c031c2bdfa","text":"The inclusion criteria for this present study were patients aged 18 years and above with pelvic and\/or acetabulum fractures requiring operative intervention and had undergone screening with Doppler ultrasound prior to operative intervention. On the other hand, patients aged below 18year-old with open pelvic and acetabulum fractures, patients with pelvic and acetabulum fractures which were managed non-operatively, patients who did not undergo screening with Doppler ultrasound before the operative intervention, patients with associated vascular injuries of upper or lower extremities requiring emergency operative intervention, patients with complex pelvic injuries requiring immediate operative intervention, patients with the previous history of DVT and patients on anticoagulants prior to admission were excluded from this study.","title":"Study of Deep Vein Thrombosis Screening by using Ultrasound Doppler in Patients with Pelvic and Acetabulum Fractures Requiring Operative Intervention"}
{"_id":"c62d58ce-97fb-0c08-099d-30b159d64c5d","text":"Using a comprehensive prospective screening programme in a group of critically ill children with a median of three risk factors of VTE, we did not find any VTEs that were not related to a CVC. Our results indicate that non-CVC associated VTE is an uncommon event even in a selected group of severely ill small children considered to be at high risk of VTE.","title":"Incidence of venous thromboembolic events not related to vascular catheters in a prospective cohort of critically ill children"}
{"_id":"c637dc99-69a0-9c9b-872a-7a232a468997","text":"The last option in sacrum reconstruction after chordoma excision due to the drawbacks of challenging dissection of the recipient gluteal vessels for microsurgical anastomosis, the need for additional surgical time due to multiple changing positions of the patient during the operation, and the risk of free flap failure might be effective if we do not choose the latissimus dorsi free flap. Each time, more aggressive surgery and wider surgical margins for the local control of disease recurrence followed by local gluteal advancement flaps or VRAM flaps are our options. Consideration needs to be given to the anatomy of the sacrum, the neural or vascular variations, and the best reconstructive options for sacrum chordoma patients according to their general medical conditions.","title":"Anatomical Considerations and Plastic Surgery Reconstruction Options of Sacral Chordoma Resection"}
{"_id":"c63abf85-4fd2-f3a8-5f19-9f8eb978fd9f","text":"Cervical dimensions could easily be measured by ultrasound and cone dimensions measured in common practice, and could act as quality control for the surgeon. Therefore, ultrasound could improve both surgical technique and long-term outcomes. The clinician can calculate the percentage of cervix that was removed by conization based on a single 3D ultrasound of the cervix before conization and the cervical cone volume determined after excision. It is crucial that cervical excision treatments be performed under colposcopic guidance to reduce the amount of healthy tissue removed while still achieving clinical efficacy. This can be achieved by taking into consideration the type of transformation zone and desire for future pregnancies.","title":"3D ultrasound as a surgical quality control of conization in patients with severe dysplasia: a prospective study"}
{"_id":"c63bbf3d-0986-aa0c-7234-aab596a05ad0","text":"For every condition a clear increase in cytokine secretion was observed after stimulation, indicating the tissue is able to respond to inflammatory stimuli. However, the increase in IL1β secretion was not significant for the condition in which the synovium was cryopreserved in the standard medium and without CPA (p-values for all conditions are shown in S2 Table). For IL6 the increase was not significant for the Biofreeze and without protection condition and for IL8 the increase was not significantly different for the CS2 medium and without protection condition. These results indicated that except for TNF secretion, the tissue was not capable of responding to inflammatory stimuli after being cryopreserved without any protecting CPA solution. After cryopreservation with the CS10 and CryoSFM medium the tissue showed upregulation of all four cytokines studied.","title":"Functional Tissue Analysis Reveals Successful Cryopreservation of Human Osteoarthritic Synovium"}
{"_id":"c63e05ea-fd5b-58a0-9370-6196c73a3181","text":"Biopsy of skin lesions remains the cornerstone of skin cancer diagnosis. The high NPV and the relatively low PPV indicate that clinical diagnosis is more efficient in ruling out malignancies rather than diagnosing them.","title":"Clinical Diagnosis has a High Negative Predictive Value in Evaluation of Malignant Skin Lesions"}
{"_id":"c64007f4-03a0-cacb-4c2a-f7ad99f99a42","text":"Given the impact of breast cancer and the importance of the provision of quality care by health services, the following question should be asked: what do women who have undergone mastectomy think about the quality of care provided by the cancer care network?","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"c6404375-8728-66a4-6bf6-c395c1b752da","text":"In summary, there are several criteria to evaluate the success of traditional IANB, and accurately placing the needle around the nerve is not the only factor that affects anesthesia. Future studies addressing the safety of this method are needed as there are only a few studies (including basic research and clinical research) on the intraoral approach to ultrasound-guided inferior alveolar nerve blocks. It is too early to conclude that the introduction of ultrasound has any effect on the success rate of IANB in the intraoral approach. More studies are needed to explore whether ultrasound can guide this operation.","title":"Application of ultrasound guidance in the oral and maxillofacial nerve block"}
{"_id":"c640d4b2-bc88-8db9-453e-8e2ada921b28","text":"A survey was conducted to gather information on the adult XLH population across five centers in England participating in the burosumab EAP. Each specialist unit was asked to provide the number of adult XLH patients known to their service, the number receiving burosumab through the EAP, and the total catchment population served by their unit. Where the adult XLH population was unknown or uncertain, an estimate was made using the observed ratio of burosumab to total adult XLH patient numbers based on data from other centers. Data from the EAP centers were then compared with expected XLH prevalence data, using published Office for National Statistics (ONS) population figures and estimated published prevalence for adult XLH.","title":"Bone Research Society 2021 Abstracts"}
{"_id":"c641e684-ef45-93af-8d77-4b7b172cfb12","text":"Furthermore, it has been suggested that these techniques might also aid in estimating the chance of malignancy by identifying certain hallmarks of a suspicious nodule by 3D reconstruction, thereby improving preoperative planning and potentially reducing intraoperative uncertainty regarding the specific origin of a nodule, which is now often solved by either time-consuming frozen section sampling or surgical resection, which might prove redundant when postoperative histological analysis shows a benign lesion.","title":"Application of three-dimensional computed tomography imaging and reconstructive techniques in lung surgery: A mini-review"}
{"_id":"c645622e-932f-aa31-104e-e93dc8e3cf6c","text":"Hemostasis was maintained after careful observation. Tissue expander was checked fur any leakage and inserted into subcutaneous pocket. Totally, 80 mL or 100 mL kidney shaped silicon tissue expander was used based on size of the ear. Remote valve was placed underneath the skin in hair bearing area and below the incision site. Negative pressure drainage was applied and skin was closed in two layers. Suture was removed around 10 days after the surgery and first inflation with normal saline was done on the day patient comes to take the suture out. Then, for next 3 months inflation with normal saline was conducted on weekly basis. The second stage surgery was done one month after completion of the inflation.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"c64b17c6-914c-8889-1e08-0b089fa6d697","text":"Our study also demonstrated that the status of the SLN interacts with the association between tumour mutation status and subsequent disease recurrence. In our study, the presence of a BRAF or NRAS mutation had a significantly greater effect at estimating the risk of disease recurrence among patients with a negative compared to positive SLNB. Therefore, the effect of tumour mutation status on predicting disease recurrence following SLNB differed by the status of the sentinel lymph node. Of note, the non-statistically significant finding in the univariate analysis and the statistically significant multivariate result may be due to negative confounding, which underestimates the strength of the true association. Furthermore, adjuvant trials have recently shown a survival advantage for patients with stage III disease;20,21 therefore, BRAF mutation testing to guide clinical decision making will likely occur at an earlier stage and it is important to understand the prognostic implications of this test.","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"c653a001-d87c-0d07-749f-a1a811cc4260","text":"In this study of adult chronic tibial osteomyelitis cases, we demonstrated that fasciocutaneous and perforator free flaps offer a comparable efficacy to the muscle flaps for infection treatment, with a significantly higher patient satisfaction and aesthetic result.","title":"Muscular Versus Non-Muscular Free Flaps for Soft Tissue Coverage of Chronic Tibial Osteomyelitis"}
{"_id":"c65ba26d-4cea-482b-d911-af49b971489f","text":"In this case, both the patient and the orthopedic surgeons were quite lucky not to come across such a major complication.","title":"The Changed Route of Anterior Tibial Artery due to Healed Fracture"}
{"_id":"c661031e-a330-a8e2-94c9-53aefb3146a7","text":"There are also some limitations that need consideration. Data on the severity of osteomyelitis were not available, which might impact clinical outcomes and healthcare resource use. We note that the BIU population was statistically younger, and one possible explanation for this difference might be that older, frailer patients might be less inclined to travel to the BIU for consultation as compared to the younger cohort referred from other national hospitals. Nevertheless, the pre-index LOS in orthopaedic departments in the BIU cohort was higher than the other groups, which might suggest these cases were more complex to begin with. Secondly, the study design meant that the first procedure for osteomyelitis in the observation period was used as the index procedure for each centre. If this surgery fails, successful revision surgery at a second centre will not be attributed to the second centre. Multiple previous unsuccessful treatment tends to make final definitive surgery more difficult and encourages the development of multi-resistant organisms with fewer antimicrobial options. Many of the cases that are seen in the BIU have had multiple previous unsuccessful procedures to cure infection in other centres before being referred in. Therefore, these cases are not being captured as having been treated in the BIU in this analysis.","title":"A retrospective cohort study comparing clinical outcomes and healthcare resource utilisation in patients undergoing surgery for osteomyelitis in England: a case for reorganising orthopaedic infection services"}
{"_id":"c66e6f63-c261-b899-2050-16edd0a27ac6","text":"Another ultrasound scan was performed within a short period of time to further assess the nature of the new right breast lump. It was discovered from this ultrasound scan that the lump contained a significant proportion of cartilage. A review of the case with this new knowledge raised the question of whether the mass might actually represent a transformation of a small piece of costal cartilage implanted into the DIEP flap by the breast surgeon. The CT scan was reviewed to try to identify the position of the cartilage but it could not be found, and so the MDT determined that the most likely way to account for the disappearance of the cartilage and the emergence of a new calcified mass was that the cartilage must have undergone calcification over time and taken on the appearance of a radio-opaque lump.","title":"The appearance of cartilage used in deep inferior epigastric perforator breast reconstruction surgery as a calcified mass on CT scan Case report: The appearance of cartilage in breast reconstruction as a mass on CT"}
{"_id":"c67b8ee6-cdc3-f81c-79fd-bf22b7086761","text":"As practical dissection guidelines for the supratrochlear and supraorbital nerves as donor nerves with limited skin incisions, the supratrochlear nerve can be located through a tarsal incision approximately 2 cm lateral to the facial midline and 2 mm caudal to the craniomedial orbital rim. The supraorbital nerve can be dissected through a supraciliary incision approximately 1 cm medial to the mid-pupillary line.","title":"Axon numbers and landmarks of trigeminal donor nerves for corneal neurotization"}
{"_id":"c67cb016-66f9-4af5-899f-7813a5c533cc","text":"The study was approved by the Medical Ethics Committee of Tianjin Medical University General Hospital and performed according to the principles of the Declaration of Helsinki. Written informed consent was obtained from the patient whose images were used in this article, but the requirement for informed consent of the other patients was waived by the ethics committee because of the retrospective nature of this research.","title":"Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy with Hypertrophic Ligamentum Flavum: A Retrospective Study"}
{"_id":"c67d79f8-756c-32ab-9517-1a0f1e92376b","text":"The saphenous vein was harvested for the microvascular anastomosis secondary to lack of pedicle length to obtain anastomosis without undue stretch. The interposition graft was sewn end to side with the brachial artery above its bifurcation. The brachial artery was ischemic for a total of 30 minutes after which the flow was restored and confirmed by Doppler flow cytometry of the hand and through anastomosis. Couplers were used to anastomose the vein graft to the venae comitantes as well as the vein graft to the flap. The peroneal artery was sewn end to end with the saphenous graft. Both the skin and bone flaps showed appropriate blood flow. Two implantable Doppler probes were utilized distal to the arterial anastomosis beyond the bifurcation point to the skin paddle and bone. The skin flap was inserted to cover the bone and hardware. The remainder of the soft tissue defect was covered with a split thickness skin graft. The lower left leg was closed primarily, and the external fixator was reapplied.","title":"Use of Osteofasciocutaneous Fibular Free Flap and Radial Head Arthroplasty in Trauma for Limb Salvage and Continued Elbow Function"}
{"_id":"c6820c21-f69b-c7bf-419a-4cefa0a9ac25","text":"The pathophysiology of facial nerve and recurrent nerve lesion have much in common. Degenerative lesion of either nerve causes a complex damage of interactive or even antagonistic muscles. Both lesions and the consequences for non-verbal and verbal communication have a major impact on quality of life of the patients. The affected target muscles are accessible for electrical stimulation early after onset of the lesion in most patients. The major reservation against a widespread use of electrical stimulation for treatment of unilateral facial or vocal fold paralysis was the notion that it is difficult to determine or even impossible to find a combination of parameters capable to generate a selective stimulation delivered by surface electrodes. This is clearly obsolete. Applying the recent concepts of electrostimulation of denervated muscles early after onset of facial nerve or recurrent nerve lesion in combination with the correct electrostimulation devices and electrodes allow a safe and selective electrostimulation. Correctly applied, electrical stimulation does not hinder the regeneration of the facial or recurrent laryngeal nerve. It maintains muscle function in the time between onset of the lesion, and spontaneous reinnervation or surgically induced reinnervation of the target muscles. It may also reduce synkinetic reinnervation, although data are still rare to sparse to allow general conclusions. The afferent feedback is activated by the stimulation of the muscles, too. This may help to keep the cortical representation of the motor patterns intact. So by stimulation denervated muscles, the broken feedback loop controlling the high precision movements of the face and larynx could be temporary closed. This is of great importance because then early onset electrical stimulation would not only be of interest to reduce denervation atrophy and to bridge the regeneration phase mainly to maintain muscle volume. It would additionally be of interest to improve functional recovery and to reduce adjuvant rehabilitation efforts.","title":"Selective Electrical Surface Stimulation to Support Functional Recovery in the Early Phase After Unilateral Acute Facial Nerve or Vocal Fold Paralysis"}
{"_id":"c699e5ae-9895-13ed-a0e5-39c75b7a3320","text":"Identification of the adductor longus and sartorius muscles is facilitated by identifying the fascia of the respective muscles and correlating to the previously made skin markings. The medial spermatic cord is seen medially. Inadvertent dissection to the depth of the fascia lata is apparent when reddish muscular fibres are seen.","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"c6a1dd9a-ed76-cfbd-1408-6bd2b9891fea","text":"A major strength of this study lies within the large sample size of 3926 female patients and 4577 DIEP flap breast reconstructions after malignancies in 22 different breast cancer centers. Patients were divided into two groups according to timing of reconstruction. We thus compared 1136 flaps for IBR with 3441 delayed free flaps. This series allows us to draw significant conclusions with regard to outcome and complications of DIEP tissue transfers for breast reconstruction depending on timing of reconstruction, and to our knowledge no previous study analyzed a series as large in this specific patient group.","title":"Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study"}
{"_id":"c6a3afe3-9830-eb64-47b1-700de91cd2dc","text":"Comparing the donor sites, the bone availability in the cranial vault is 3 times greater than in the mandibular posterior region, and at least 2 times greater than in the mandibular symphysis.","title":"Evaluation of bone availability for grafts in different donor sites, through computed tomography"}
{"_id":"c6ae47c7-7346-43bc-72e3-4cac84a3eed6","text":"Although the detected SLNs with planar lymphoscintigraphy with conventional gamma camera in the axilla and groin regions are more than the handheld gamma camera, the difference of the total SLNs localized by both imaging system are not statistically significant.","title":"Evaluation of sentinel lymph node localization in malignant melanoma by preoperative semiconductor gamma camera and planar lymphoscintigraphy"}
{"_id":"c6b2185b-2957-927b-9f4a-d5e3ef64e4bd","text":"In conclusion, the present paper suggests that an ASP may be useful especially in medical and surgical units with the aim of reducing the use of broad-spectrum antibiotics, favoring appropriateness in antimicrobial prescription and encouraging adherence to the guidelines of antibiotic prophylaxis in the surgical field. However, in ICUs, specific programs able to limit empirical therapies and encourage the collection of microbiological samples may be useful to set up targeted therapies and to design antimicrobial protocols according to the clinical presentation of the patients and the local epidemiological situation in infections by multidrug-resistant microorganisms.","title":"Inappropriateness of Antibiotic Prescribing in Medical, Surgical and Intensive Care Units: Results of a Multicentre Observational Study"}
{"_id":"c6bf0a39-5242-3f3a-5270-7e841977fcd2","text":"Even when a single lesion is well defined on the skin surface, free surgical margins are difficult to get because of the frequent presence of adjacent other lesions that may result in confounding findings for both surgeon and pathologist.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"c6c072e4-608f-52e7-8169-443c85c5c78a","text":"All patients in this study did not receive chemoprophylaxis for VTE. We used intermittent pneumatic leg compression to enhance blood flow in the deep veins of the legs. This method is virtually free of side effects and is particularly useful in patients at high risk of bleeding, such as those undergoing plastic surgery. We also indicated early mobilization of patients as soon as possible after surgery.","title":"Venous Thromboembolism following Elective Aesthetic Plastic Surgery: A Longitudinal Prospective Study in 1254 Patients"}
{"_id":"c6c169ab-b28e-133a-43f4-390da9c8af51","text":"This is a retrospective study and may be affected by recall bias, although the small number of patients treated in each unit combined the complexity and extended nature of treatment may reduce this. In addition, patients in this series come from two continents. Whilst all patients included in this study were Caucasian, it is possible that environmental factors, such as ultraviolet exposure or genetics may influence the nature of the tumour and its response to treatment.","title":"Vismodegib for periocular basal cell carcinoma: an international multicentre case series"}
{"_id":"c6c2f604-7b26-1452-280f-2f6f4059e505","text":"In this study, Klein and colleagues investigated the impact of minimal cancer sentinel lymph node spread and of increasing numbers of disseminated cancer cells on melanoma-specific survival. The authors found that cancer cell dissemination to the sentinel node is a quantitative risk factor for melanoma death and the best predictor of outcome was a model based on combined quantitative effects of DCCD, tumor thickness, and ulceration.","title":"Quantitative Measurement of Melanoma Spread in Sentinel Lymph Nodes and Survival"}
{"_id":"c6cac6a0-eb83-54fd-e87b-4f0b312e4d1c","text":"Percutaneous image-guided core needle biopsy is a safe and useful method for the diagnosis and classification of malignant lymphomas presenting with enlarged peripheral lymph nodes and superficial masses. It can be used as the first step for tissue sampling in a patient suspicious of lymphomas., Nevertheless, its strength for the diagnosis of lymphoma is still controversial and excisional biopsy of enlarged lymph nodes is regularly recommended as the gold standard procedure.,","title":"Peripheral Lymphadenopathy: Approach and Diagnostic Tools"}
{"_id":"c6dcac64-bb84-25fa-a3e0-b49924ff7899","text":"The identification and biopsy of the sentinel lymph node has become a standard method of treatment for stage I and II breast cancer in the last decades, taking into account the fact that the management of the axilla in patients with breast cancer has evolved from the routine lymphadenectomy to a selective attitude, based on the histopathological evaluation of the sentinel lymph node, as well as on the tumor and on the patients’ characteristics.","title":"Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer"}
{"_id":"c6dcb4fe-a955-171d-a9f6-03af2194b8b8","text":"In a second step, we performed an analysis on the sites. For each patient we considered 11 theoretical drainage levels. The sites were defined as concordant when the lymph node field was both present or both absent in the Auckland software and in our lymphoscintigraphy. The sites were defined as not concordant in the remaining cases. Cohen’s Kappa was performed to evaluate the agreement on the total of the hypothetical lymph node localizations. The same analysis was performed according to the primary localization.","title":"The Lymphoscintigraphic Study of Unpredictable Head and Neck Cutaneous Melanoma Lymphatic Drainage"}
{"_id":"c6de797e-82a1-4395-ebc1-292d603b2be4","text":"Despite the limited number of treated patients, we believe that this simple-to-perform technique is a very good treatment option to correct a pinched nasal tip determined by monolateral or bilateral cartilage malformation, and it is important to reiterate that even if other authors presented it in the past, small variation can be done to improve more it. At least our functional results showed again how it is important the nasal valve in the breath physiology.","title":"Functional results in airflow improvement using a “flip-flap” alar technique: our experience Resultados funcionais na melhora do fluxo de ar utilizando uma técnica alar em flip-flap: nossa experiência"}
{"_id":"c6e24ab0-2eb2-61e9-abb3-5d12c0fd5d65","text":"A limitation of the present study is its small sample and retrospective design. We only performed exploratory analyses of the feasibility and short‐term outcomes of this procedure with respect to gastric venous congestion and bleeding by categorizing the patterns of gastric and venous resection. This topic should be investigated in a multi‐institution study with a larger sample.","title":"Gastric venous congestion and bleeding in association with total pancreatectomy"}
{"_id":"c6e5d8fc-6c99-759f-5cdb-680c75f527cd","text":"In our case report, carpal osteomyelitis in a complete SCI patient was adequately treated with one week of IV vancomycin and 12 weeks of oral doxycycline. A PET scan showed the resolution of the infection, and the patient returned to his baseline functional status. Although this case demonstrates the efficacy of prolonged antibiotic treatment in a complete paraplegic SCI patient who developed carpal osteomyelitis, it is limited being a single retrospective study. More individual reports and prospective controlled studies need to look at the functional outcomes following treatment of hand or wrist osteomyelitis with antibiotics vs. surgery in these SCI patients or other comorbidities dependent on hand function for mobility and independence. Osteomyelitis is often not the first differential for patients with a chief complaint of hand or wrist pain. However, given the importance of hand function for SCI patients, it is essential for physicians to be aware of this diagnosis and know that antimicrobial therapy without surgical intervention is a viable option for this population.","title":"A Rare Case of Carpal Osteomyelitis in a Spinal Cord Injury Patient: A Case Report"}
{"_id":"c6e5ebc1-6784-66e8-8f24-e63273ede0db","text":"Prophylactic oral or intravenous glucocorticoids are equally effective in prevention of Graves’ orbitopathy activation after radioiodine therapy but the intravenous method is safer.","title":"Abstracts and short papers from the 5th Congress of the Polish Thyroid Association, Poznan, 3-5 September, 2015"}
{"_id":"c6e72ed4-b3b3-769b-7cb7-537438a77781","text":"This study investigated the determinants of cutaneous ageing in individuals living in a temperate climate. The periorbital region is one of the first places on the face to show signs of ageing,31 not least because it is not shaded by the contour of the face or hair, and it is one of the areas most frequently considered for rejuvenation treatment.32","title":"The determinants of periorbital skin ageing in participants of a melanoma case–control study in the U.K."}
{"_id":"c6ea91a0-e812-9fbf-ff3a-1d5966f7b727","text":"Considering the high prevalence of breast cancer, this article aims to provide a comprehensive and current review of the potential role of cryotherapy in breast cancer management. It will explore existing knowledge gaps and propose necessary limitations to be addressed in future research. By doing so, this article seeks to contribute to the advancement of cryotherapy as a valuable therapeutic option for breast cancer treatment.","title":"The Evolving Role of Cryosurgery in Breast Cancer Management: A Comprehensive Review"}
{"_id":"c6f2b298-a90f-b82a-4a0a-51358bbb114a","text":"Several limitations are present in the present study. First, it focused on a limited number of patients due to the rarity of this disease, who were analyzed retrospectively. Exclusion of cases followed up for less than 12 months and with insufficient medical records reduced the number of localized cases such as those with finger or toe involvement. Because the present study focused on the factors associated with local recurrence and osteochondral destruction causing possible functional impairment, cases with relatively large joints were selected as targets for investigation. Compared with previous reports, the present eighty cases represent a relatively large cohort, and analyses for osteochondral destruction have rarely been performed. In addition, the limited number of patients particularly other than knee cases made it difficult to perform statistical analyses. It will be necessary to conduct a national or international study to facilitate better statistical analysis of joints other than the knee. The second limitation is that numerical evaluations of patients’ function after surgery, local recurrence, and osteochondral destruction were not performed, and the occurrence of osteochondral destruction is not necessarily consistent with the onset of pain. In future studies, function in addition to the presence of pain should be analyzed for not only surgically treated patients, but also those treated conservatively including watchful observation. The third limitation was the presence of slight differences in treatment strategies among the treatment periods and institutions. The final treatment modality was determined by the physicians and patients based on close counseling at each institution, and in some institutions full-time orthopedic surgeons specializing in arthroscopic surgery are not available. Indications for specific surgical procedure, arthroscopic surgery or open surgery, differ among cases. These factors may have influenced the outcome. Although the efficacy of radiotherapy for TSGCT has been reported, it has in general not been chosen in this context at our institutions, or in our country. Another limitation is that it would be necessary to evaluate by MRI instead of plain radiography or CT in order to evaluate cartilage damage more accurately.","title":"Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study"}
{"_id":"c6f8a307-550b-0ef4-a895-3f71e64a93cd","text":"We present a novel method of using three flaps: an extended medial gastrocnemius muscle flap including a part of its distal tendon (hemi-Achilles tendon) for reconstruction of the quadriceps mechanism combined with a saphenous artery fasciocutaneous flap for the additional soft tissue coverage around the proximal tibia. We also used the medial hemisoleus flap combined with these two flaps to cover the soft tissue defect extending to the middle third of the leg.","title":"Knee extensor loss and proximal tibial soft tissue defect managed successfully with simultaneous medial gastrocnemius flap, saphenous fasciocutaneous flap and medial hemisoleus flap: a case report"}
{"_id":"c7011b1c-bad0-2250-bac4-66d69d4d1c59","text":"Reconstructing a large cutaneous cheek defect post tumour excision poses a great challenge to the reconstructive surgeon. The surgical options are limited for a functional and aesthetically acceptable outcome. The microvascular free flap which is currently the gold standard is still not a common place in our practice in Nigeria. Cervicofacial flap, a single stage procedure, offers an excellent alternative as it can be done for patients who are not fit for prolonged anesthesia and can even be undertaken under local anesthesia.","title":"Versatility of cervicofacial flap in management of cutaneous cheek defects post tumour excision: a report of two cases"}
{"_id":"c7040d39-6ffd-5832-54a6-dc444e085efb","text":"By combining a bone periosteal FMC to a second skin flap for tailored defect coverage, we achieved bone union in all patients despite the lack of initial bone vascularization or chronic infection. In an era where microsurgery is widely available, combination of multiple free flaps can be used to enhance reconstructive efficacy and orthoplastic success.","title":"Combined Free Flaps for Optimal Orthoplastic Lower Limb Reconstruction: A Retrospective Series"}
{"_id":"c7081bb2-b91c-3dbd-ed49-299e937607b3","text":"Ogbureke et al reported a case of PGCG with extensive osseous metaplasia or a hybrid PGCG-POF.This case raises the question of whether non-neoplastic proliferative lesions are part of a disease spectrum or whether some of these lesions are true hybrid lesions.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"c70df918-2d01-ee82-1008-73a0a6c7fc32","text":"In this project, we applied the procedure of autologous fat transplantation compared with autologous ADSCs injection to evaluate the clinical improvement of mouth opening.","title":"Improvement of Mouth Functional Disability in Systemic Sclerosis Patients over One Year in a Trial of Fat Transplantation versus Adipose-Derived Stromal Cells"}
{"_id":"c70e20b7-b265-5b00-09a5-b2b901183f94","text":"In the presented case GKR was used as an eye preserving salvage therapy after late local recurrence of ocular melanoma. With 10 years of follow up after initial diagnosis there is no sign of systemic metastases. Despite two radiation therapies and cataract surgery, the vision in the treated eye remains 20\/20. We believe this is the first successful case of GKR for local failure after brachytherapy. GKR may be an option for select cases of local recurrence after radiation plaque brachytherapy.","title":"Gamma Knife radiosurgery for locally recurrent choroidal melanoma following plaque radiotherapy"}
{"_id":"c72c6759-0153-98f9-3b45-8da6170cd20f","text":"According to updated international guidelines, 3 invaded lymph nodes are required to perform an axillary clearing. Lastly, there is a current discussion regarding the ablation under local anesthesia of the GS at the same time as diagnostic biopsy in order to allow multidisciplinary teams to take an ad hoc decision and avoid two surgical interventions.","title":"The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management"}
{"_id":"c72eaf6e-8340-1446-1de2-d402dec172ef","text":"In contrast to previous data, the present study has shown that BSCs seam less aggressive and less likely to recur or metastasize. However, BSC tends to develop subsequent primary skin cancer more often than other types of NMSC. These data underline the need for frequent follow up with whole body surface examination for all patients diagnosed with BSC.","title":"Clinical and epidemiological analysis of basosquamous carcinoma: results of the multicenter study"}
{"_id":"c72fca08-2ab8-7b24-d750-dce3a2150beb","text":"Upper spinal site of infection was previously identified as a factor associated with paralysis.[ In our study, involvement of the thoracic spine was associated with the higher risk of SND. Thickness of the medullary canal and scarcity of artery supply at this site could explain this observation. Cauda equine syndrome was infrequent in respect to the number of patients with involvement of the lumbosacral spine.","title":"Characteristics of and risk factors for severe neurological deficit in patients with pyogenic vertebral osteomyelitis A case–control study"}
{"_id":"c731bf7f-0cfa-30cb-022e-6ce0155a1fef","text":"Several studies around the world have identified increasing acceptance of the Z0011 results and a change in clinical practice in relation to the standard treatment of axillary lymph nodes in patients with breast cancer.","title":"Survival and recurrence with or without axillary dissection in patients with invasive breast cancer and sentinel node metastasis"}
{"_id":"c736bd93-22cb-84bc-84c8-8aa48b7b5cae","text":"In order to ameliorate margin assessment different techniques have been studied.","title":"Assessment of Margins in Transoral Laser and Robotic Surgery"}
{"_id":"c73acde7-2c11-bee5-0318-e3e0b68be76e","text":"The first step was to elaborate an operational plan to provide personalized and quality care at the Radiology Service for patients undergoing interventional procedures requiring less than 24 h of hospitalization [10].","title":"Experience and results after the implementation of a radiology day unit in a reference hospital"}
{"_id":"c73bb019-6bab-206b-2d85-9a99b7aefc2d","text":"Significantly larger number of patients in group one needed 4 or more cartilage tissues for the framework fabrication compared to patients in group two. The result was further illustrated in Figure 2. There was no significant difference between two groups in term of average surgical time. For the first group, the average time required to perform stage I and stage II surgery were 1 hour and 40 minutes and 4 hour and 54 minutes, respectively. Similarly, for group two, the average surgical time required to perform stage I and stage II surgery were 1 hour and 36 minutes and 4 hours and 48 minutes, respectively. Likewise, there was not also any significant difference in terms of tissue expansion. The average amount of fluid used for expansion was 136 mL in group one and 137 mL in group two.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"c74216dd-dfa5-c30f-46c1-2c163a65ebf7","text":"Therapists approach physicians with a proposal for further therapeutic actions. The following situation has been observed in a facility with upper levels of patient success within an early morning meeting of physicians.","title":"Cooperative leadership as a condition for patient-reported rehabilitation success"}
{"_id":"c7429da0-3d62-94ff-59b2-3ec3fbee0899","text":"Tumors were also defined as being adjacent to periosteum, joint or neurovascular structure when MRI showed that lesions were in direct contact with these structures.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"c744514f-8a9c-f436-2aa0-4941e76a873c","text":"Given the disproportionate amount of residual tumour on head and neck wounds and higher recurrence rates curettage and electrocautery is not considered first line treatment for BCCs on the face.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"c746be33-4428-6f62-6009-837b9698a515","text":"All patients admitted into our centre were screened for eligibility and those who underwent surgery from September 2016 to September 2017 had a D-dimer screening after surgery, followed by an ultrasound Doppler if the former was positive. The choice of anticoagulant therapy was not influenced by this study, and observation of the use was in keeping with usual practices in our centre was done.","title":"Deep Vein Thrombosis and the Neurosurgical Patient"}
{"_id":"c748ada1-fec0-fece-ab86-2abf02778c2f","text":"COPD patients presenting with PE have an increased risk for PE recurrences and fatal PE compared with those presenting with DVT alone. More efficient therapy is needed in this subtype of patients.","title":"Pulmonary embolism and 3-month outcomes in 4036 patients with venous thromboembolism and chronic obstructive pulmonary disease: data from the RIETE registry"}
{"_id":"c74f1a48-35ec-f589-be05-e2c719497cf5","text":"A recent study has shown that rinsing of morcellized bone grafts with bisphosphonates prevents resorption and is likely to reduce the risk of mechanical failure. Though this was studied during revision total hip replacement using morcellized compacted bone allograft, the same principle may possibly be applicable to bone grafts used to fill defects after curettage.47","title":"Treatment of giant cell tumor of bone: Current concepts"}
{"_id":"c7571c92-3dae-9a2d-bf66-6e8682fa6019","text":"The treatment of choice for ankyloglossia is the frenectomy and lingual plasty associated to lingual myofunctional rehabilitation. Myofunctional rehabilitation begins one week before the surgical intervention, and the patient is explained the lingual praxis that will be carried out in the following weeks. The objective of this protocol is that the patient learns the exercises without pain. The results of our study demonstrate that the surgical technique of frenectomy with rhomboid plasty, the patient improves its lingual mobility. If this is reinforced with rehabilitation exercises and good patient collaboration, the results are excellent.","title":"Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol"}
{"_id":"c7582c6f-1224-2922-7732-9e008f3c5d80","text":"Overall importance of plastic surgery training for new and highly technical procedures is of importance and particularly there is a real need to continue actual cadaveric training due to patient variability for nerve anatomic structures.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"c7674bf2-5ac6-b694-d1e9-3193e6e63e1c","text":"Most Canadian plastic surgery fellowship program websites lacked content relevant to prospective applicants. More comprehensive fellowship program websites may be of benefit to prospective applicants and the programs.","title":"How Comprehensive Are Canadian Plastic Surgery Fellowship Websites?"}
{"_id":"c76800e8-a8d3-f62c-2e4b-81ea6e192c75","text":"It is important for the aesthetic dermatologist to understand the role of infection and biofilms as a complication of filler injections. Further studies and research are therefore essential to unfold the mystery around biofilms.","title":"Biofilms: Their Role in Dermal Fillers"}
{"_id":"c76cc7fc-668c-d659-2a42-81f0bf305a20","text":"An initial 3 mm punch biopsy of the skin at the junction of the inferior aspect of the right nipple profile and surrounding areolar skin was obtained by a dermatologist and histopathologic evaluation was reported to show subareolar sclerosing duct hyperplasia without abnormalities of the skin. Subsequently, one month later, a larger 6 mm punch biopsy was performed by a breast surgical oncologist to the same region of the right breast and histopathologic evaluation was reported to show adenosis and associated usual type ductal hyperplasia, consistent with subareolar duct papillomatosis. No atypia or malignancy was identified within either of the two sequential skin punch biopsy specimens. Repeat diagnostic digital mammography was performed on the patient during her evaluation by the breast surgical oncologist, and showed stable, benign-appearing right breast calcifications, and no suspicious mammographic findings within the right subareolar region or elsewhere within the right breast.","title":"Nipple adenoma in a female patient presenting with persistent erythema of the right nipple skin: case report, review of the literature, clinical implications, and relevancy to health care providers who evaluate and treat patients with dermatologic conditions of the breast skin"}
{"_id":"c76f3b30-7f56-3bc0-36d7-953c2d88b758","text":"Toxicity to the immune system includes many effects such as suppression or activation of the immune response. Suppression can lead to a decrease in the host’s resistance to infections or the appearance of tumor cells; activation can aggravate autoimmune diseases or induce an allergy.","title":"Evaluation of the immunotoxicity and allergenicity of a new intranasal influenza vector vaccine against tuberculosis carrying TB10.4 and HspX antigens"}
{"_id":"c785d3b7-f57d-0ecd-02ac-b54fe90a0481","text":"The overall patient satisfaction was also very high not only because the transplantation results were anesthetically pleasing but also because no potential existed for the development of flap ischemia or exposure of tissue expanders, which could have occurred with traditional surgical methods, such as scar excision, tissue expansion, and local flaps. Additionally, there was no need for general anesthesia or admission care because the procedure lasted only 1.80 hours on average and did not require any specific postoperative care. All patients were treated at an out-patient clinic with minimal recovery time. There was no need for any dressing of small grafts. Only immediate compression for less than 30 minutes was performed at the recipient and donor sites. The patients were able to wash their hair one day after the procedure and to continue with their daily lives.","title":"Treatment of Postsurgical Scalp Scar Deformity Using Follicular Unit Hair Transplantation"}
{"_id":"c78bf90c-8607-4bb3-6dab-16e3063fd77e","text":"The treatment of most scalp reconstructions must overcome the resistance of the tissue to distension, the potential involvement of neurovascular structures, and primarily the esthetic restoration of the area affected by the defect.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"c78c10b3-169e-aa90-eab0-aba2c7ce238f","text":"He underwent a left total parotidectomy and cervical lymph node dissection for metastatic malignant melanoma of the parotid gland with an unknown primary site. Three out of the twelve cervical lymph nodes taken from the neck dissection were positive for melanoma, one of which had extra-nodal extension. Gross residual disease was treated with radiation therapy. The patient declined adjuvant therapy with interferon due to the neuropsychiatric effects it may have on his Parkinson's disease. Two months later, the patient required transoral resection of the left buccal pad due to recurrence of tumor in the left buccal space, followed by radiation therapy to the area.","title":"A Rare Case of Metastatic Malignant Melanoma to the Colon from an Unknown Primary"}
{"_id":"c78c40c1-443d-f9b6-555b-ed4440004c9c","text":"In conclusion, this retrospective study shows initial results regarding SLNB guided by a radiopharmaceutical and methylene blue or NIRF imaging in scar tissue. Both mapping procedures are feasible in dogs with prior surgical excision of solid tumors. The detection rate and SLN metastases rate were comparable to those reported for simultaneous SLNB and tumor excision, especially in the case of MCT. Considering the recognized importance of SLN staging for optimal oncological management, dogs presenting with scars from previous surgery with linear reconstruction should not be excluded from SLNB. Further studies should collect data on the oncologic outcome and on the detection rate in scars from complex reconstructive skin surgery.","title":"Sentinel Lymph Node Biopsy Is Feasible in Dogs with Scars from Prior Local Excision of Solid Malignancies"}
{"_id":"c7918d3a-b225-3a42-ed32-fc785581ca28","text":"The robot is positioned on the left side of the patient and docking to the right inguinal region, as shown in Figures 1 and 2.","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"c79c6908-fffa-4169-3d97-eac95fd510ec","text":"Based on the extensive and favourable characteristics of the ALTP, we designed an L-shaped flap that was modified according to the shape of the half-tongue defect undergoing repair, making the best use of the tissue in the donor area after radical operations for tongue cancer and achieving good recovery of the function of the tongue while preserving as much of the tissue in the donor area as possible.","title":"Application of an L-shaped anterolateral thigh flap in reconstruction after hemiglossectomy"}
{"_id":"c7aa94d6-1572-512a-80fd-c6a1b3211916","text":"The application of sentinel lymph node (SLN) mapping and biopsy to the surgical staging of the axilla during breast cancer surgery has become a universally accepted standard of practice [1]. Despite widespread use of this technology, very little emphasis appears to be placed on defining the adequacy of intraoperative assessment of the axilla during breast cancer surgery. Defining the concept of an adequate intraoperative assessment of the axilla should be based upon any given principle that minimizes the risk of potentially failing to recognize a positive SLN and thereby assures accurate axillary staging during breast cancer surgery. The major determinant in this intraoperative assessment process clearly relates to be the number of SLNs harvested. In this regard, we have attempted to address this concept by retrospectively analyzing a series of 400 breast cancers from a recently published prospective randomized clinical trial [2] and determining when metastatic disease was first identified within consecutively harvested SLNs from those invasive breast cancers demonstrating a positive SLN.","title":"Re-emphasizing the concept of adequacy of intraoperative assessment of the axillary sentinel lymph nodes for identifying nodal positivity during breast cancer surgery"}
{"_id":"c7c300b5-08dd-225c-4bec-3f9aadc2407c","text":"This study examined and characterised clinical and structural correlates of BMLs identified using two different MRI sequences in asymptomatic adults. BMLs visualised using both T1- and T2-weighted sequences were the most common. When these were compared to BMLs visualised only using T2-weighted sequences, they were associated with greater medial tibial cartilage volume loss and more frequent incident knee pain over 2 years. This suggests that using information from multiple MRI sequences to characterise BMLs may provide more prognostic information than using a single sequence alone.","title":"Bone marrow lesions can be subtyped into groups with different clinical outcomes using two magnetic resonance imaging (MRI) sequences"}
{"_id":"c7c83701-d109-6f1b-af39-91f47b29e1fa","text":"Bone biopsy is frequently performed to exclude infection and malignancy but was not considered essential to confirm a diagnosis of CNO by at least 40% of physicians. Interestingly, these physicians used similar criteria to decide which cases to biopsy regardless of reported frequency of ordering bone biopsy.","title":"Physicians' Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis"}
{"_id":"c7caa11c-62a0-8e87-ace3-cdb209381398","text":"We reported five cases of ICH following the use of anticoagulation for VTE treatment and prophylaxis. This study highlights debilitating outcomes, including death, associated with the use of anticoagulation drugs in the early postoperative period. LMWH is associated with an increased risk of ICH following surgery, especially in cases of posterior fossa pathology. Therefore, we recommend the use of UFH rather than LMWH in the postoperative period and initiating the use of SCDs preoperatively, which should be continued until the patient starts ambulating. Further studies are required to more comprehensively assess the outcomes related to VTE and ICH with the use of LMWH and UFH in posterior fossa surgical procedures. Clear guidelines need to be established for the use of anticoagulants among patients who undergo posterior fossa craniotomy.","title":"Posterior Fossa Hemorrhage Following the Use of Low-Molecular-Weight Heparin: Lessons Learned and Recommendations for the Treatment and Prophylaxis of Postoperative Venous Thromboembolism"}
{"_id":"c7cdff60-0c3e-9b56-3f52-ee808ea4fe52","text":"A clinically relevant ramification of our findings is that administration of ICI agents may inadvertently shift individuals towards an adverse immunological state in which hypersensitivity reactions are favored. While it is often reasonable to blame the ICI on its own for causing an irAE, and withdraw it, this may have negative consequences on survival from the malignancy. It is therefore also important to consider the role of concomitant therapies, particularly agents known to cause hypersensitivity reactions, in the manifestation of such reactions. The long half-life of the ICI antibodies9 10 raises the possibility that their effect on the immunological perception of compounds may persist for some time after administration, which is consistent with reports of various pharmaceuticals exhibiting poor tolerability when administered in sequence with ICIs.4 5","title":"T cell mediated hypersensitivity to previously tolerated iodinated contrast media precipitated by introduction of atezolizumab"}
{"_id":"c7d3d0b9-a62e-09a5-ab78-6f883522b455","text":"Different options for upper limb reconstruction are described in literature: advancement or rotation flaps, regional flaps and free flaps are the most common. Local and regional flaps can represent the reconstructive options for small defects while large wounds require the use of free flaps or distant pedicled flaps. In case of large wound, the use of free flaps rather than distant pedicle flaps is usually preferred. To choose the best reconstructive option, it is essential for the surgeon to have a general overview about the different methods.","title":"Upper limb traumatic injuries: A concise overview of reconstructive options"}
{"_id":"c7db195b-6de5-c35a-c786-24bb34e94c3a","text":"We believe that our conclusions will help explain some of the differing reports in the literature on the sensory recovery of noninnervated flaps and will help the surgeons in their everyday practice when confronted with a total lower lip reconstruction.","title":"Sensory Recovery with Innervated and Noninnervated Flaps after Total Lower Lip Reconstruction: A Comparative Study"}
{"_id":"c7e03f91-5580-6de6-6ca0-506a82aa40cc","text":"Future research is needed to evaluate the effectiveness of diverse functionalized porphyrins with various chelated metals against microbial targets. Even if a universally applicable “silver bullet” photosensitizer cannot be found, a toolbox of functional groups may allow design of targeted porphyrins for specific applications. Targeted PDI would have applications both in therapeutics and disinfection of resistant organisms in water and on surfaces.","title":"A Comparison of Porphyrin Photosensitizers in Photodynamic Inactivation of RNA and DNA Bacteriophages"}
{"_id":"c7e2f34a-0936-99d8-a983-1da63b1bd9b4","text":"The purpose of this study was to evaluate clinical efficacy of arthroscopic knee cavity internal drainage through posteromedial portal and cystectomy through superior posteromedial portal of popliteal cyst in knee osteoarthritis patients.","title":"Arthroscopic internal drainage and cystectomy of popliteal cyst in knee osteoarthritis"}
{"_id":"c7ea0ec5-3e86-c567-eef4-ffa2acfdd6ae","text":"CMNI Winning was significantly and positively associated with verbal MBA victimization. The verbal sparring and brinkmanship so often experienced in a barroom context may provide an outlet for those with a competitive nature and or who view winning as an essential feature of the masculine with such individuals viewing it as an acceptable risk, unlike, physical violence where the consequences are more serious and the outcomes uncertain, limiting one’s confidence they will emerge a winner. Such considerations may therefore increase the risks of verbal MBA involvement but temper any associations with physical MBA, whether as perpetrators or victims.","title":"Male Barroom Aggression among Members of the Australian Construction Industry: Associations with Heavy Episodic Drinking, Trait Variables and Masculinity Factors"}
{"_id":"c7ed56e3-5323-1fd8-0046-7527b355842a","text":"In general, a large field gamma camera is used to identify the sentinel node by lymphoscintigraphy. The patient lies in a supine position, with the arm on the side of the intervention raised earlier the head to allow positioning of the gamma camera as close as possible to the axilla. Once the lymph node is visualised, the skin projection of the sentinel lymph node is marked on the axilla using a permanent marker. The added value of SPECT\/CT for the visualisation of sentinel nodes has yet to be confirmed.","title":"Development of sentinel node biopsy, ROLL and IART in early breast cancer at the European Institute of Oncology, Milan (IEO)"}
{"_id":"c7fa38c2-4821-50a8-b5bf-8fca03246b67","text":"We herein report details of two cases of the AVL technique, one in the upper limb and one in the lower limb.","title":"Efficacy of the Arteriovenous Loop for Free Flap Reconstruction in Patients with Complex Limb Trauma: Case Series and Literature Review"}
{"_id":"c80057f6-50ab-5930-ec60-3e05be345764","text":"In this study, the sensitivity of US in the detection of metastatic lymph nodes was calculated to be 91 percent, which was higher than previous similar studies. We believe that this situation may be associated with our detailed prospective anatomical examination of lymph node groups in the axillary region to find lymph node metastasis when we detected a possible malignant mass in the breast.","title":"Preoperative Evaluation of Axillary Lymph Nodes in Malignant Breast Lesions with Ultrasonography and Histopathologic Correlation"}
{"_id":"c8020404-9364-50a2-5df1-6d101c0c9102","text":"Table 1 Summary of cases of lingual leimyomatous hamartomas reported in English literature","title":"Lingual leiomyomatous hamartoma with bifid tip and ankyloglossia in a patient without oral-facial-digital syndrome: a case report and literature review"}
{"_id":"c80be7de-387d-6768-0596-511a4ed72bfb","text":"The third part of the questionnaire was then applied by the main investigator to the surgeon responsible for the surgery, preoperatively.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"c81a9f70-fbee-841b-eddc-b30680f05a44","text":"We analyzed the influence of the three different harvesting techniques on the histological and immunohistochemical characteristics of the SVGs.","title":"Influence of Three Different Surgical Techniques on Microscopic Damage of Saphenous Vein Grafts—A Randomized Study"}
{"_id":"c81ff02c-2435-4725-7520-9a5e3778d965","text":"In conclusion, prognosis of CUA in subjects with ESRF remains poor in spite of combination therapy and multimodality of wound care. Further prospective studies on a larger population are needed to characterise our findings.","title":"Calcific Uremic Arteriolopathy on Multimodal Combination Therapy: Still Unmet Goal"}
{"_id":"c82d1f89-a822-4c44-3b4c-bcf623e0e3ad","text":"With respect to managing hemiazygos vein thrombosis, literature review reveals scarce information. Work-up for a potential source of the thrombus included a negative sonography and coagulation profile. Given the small clot burden and lack of a potential source, our patient had a CECT performed following 6 weeks of anticoagulation that showed resolution of the thrombus and absence of the previously demonstrated vertebral body enhancement. No additional treatment was performed as it was felt the clot was an incidental finding and an unlikely source of the patient’s abdominal pain.","title":"Vanishing bone metastases: a pitfall in contrast-enhanced CT in patients with venous thrombosis R Preunte et al"}
{"_id":"c8315116-cc94-0b1f-9f58-3ee96ae6dfaf","text":"This study described two cases of desmoid tumors that occurred following gastric cancer surgery and were successfully treated with surgical resection. Although it was difficult to distinguish between the recurrence of gastric cancer and desmoid tumors on preoperative imaging, tumor resection with partial resection of the jejunum was performed, and no recurrence followed after a considerable follow-up period.","title":"Desmoid tumor occurrence following gastric cancer surgery: A report of two cases"}
{"_id":"c83c0c22-3b18-7fa5-c667-7bad2d07d4bc","text":"Fat embolism is a well-known complication of fractures of long bones and bone surgery. Fat droplets in small vessels may be derived from the bone marrow or from plasma by agglutination of chylomicrons or by infusion of exogenous fat. This can result in vascular occlusion and infarction. Free fatty acids have a direct toxic effect on endothelial cells and pneumocytes, resulting in capillary leakage and loss of surfactant, and the formation of hyaline membranes.","title":"Pancreatitis with an unusual fatal complication following endoscopic retrograde cholangiopancreaticography: a case report"}
{"_id":"c847e707-ab9c-9c18-54cf-77a68bf5a8d8","text":"The purpose of this study was to better understand MMS patient profiles and to determine how the histology of tumors might be related to the number of MMS stages required and the complications of the procedure.","title":"The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital"}
{"_id":"c848c885-314e-2d2c-e632-6546b6827430","text":"Our case highlights the potential role of NGS as a supplementary tool for diagnosis and risk stratification, although other factors influencing clinical outcome and the optimal therapeutic strategy remain to be established. In addition, desmoid tumors should be included in differential diagnoses when clinicians encounter a chest wall mass in a patient who has previously undergone thoracotomy.","title":"Clinical application of next-generation sequencing for the management of desmoid tumors A case report and literature review"}
{"_id":"c84d553b-0dd8-0c4c-a630-381ca8e5af3a","text":"The entire protocol of pathohistological examination is presented in Methods IV in the Supplementary Materials.","title":"Influence of Three Different Surgical Techniques on Microscopic Damage of Saphenous Vein Grafts—A Randomized Study"}
{"_id":"c8532bd6-a930-88eb-8deb-2571b41e9858","text":"The stereotype of the surgeon was not always perceived to be off-putting or negative but rather a description of attributes that might be appropriate for the role:","title":"Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study"}
{"_id":"c8550aa8-72b5-437f-b952-82abf4629bbd","text":"Patients who had systemic infectious diseases or psychiatric or neurological diseases","title":"Ultrasound-guided transversus thoracic muscle plane-pectoral nerve block for postoperative analgesia after modified radical mastectomy: a comparison with the thoracic paravertebral nerve block"}
{"_id":"c8551c64-89a5-7e70-aa86-10d22e80b59b","text":"Table 3 Comparison of the recovery rate of binocular vision function after treatment between the injection and surgery groups","title":"Comparison of Botulinum toxin type A with surgery for the treatment of intermittent exotropia in children"}
{"_id":"c8578934-0f62-f111-4bcd-c757a3c6caa8","text":"Similar to costs reported in the literature, the costs for iVR hardware included in this study ranged from 15 USD to 7100 USD. This is comparable to the costs of 3D printing, where printers can cost anywhere between 1000 to 2200 USD and each 3D printed model ranges from two to 330 USD. In the studies reviewed, iVR model production time ranged from less than two minutes to two hours. This starkly contrasts the time required to produce 3D printed models, which can range from five to 72 hours. An obstacle for the widespread implementation of iVR in preoperative planning lies in expertise and personnel requirements to produce 3D segmentations of CT and MRI images. However, as iVR and imaging technologies evolve, it is possible that the realism of iVR models will increase, while costs, production times and personnel requirements will be reduced.","title":"Immersive Virtual Reality for Patient-Specific Preoperative Planning: A Systematic Review"}
{"_id":"c85f2987-c72a-b614-7c4e-5b1b14b78de3","text":"Defects of proximal third of the leg can usually be covered with medial or lateral gastrocnemius muscle or myocutaneous flap or a combination of the two. In our series we have done this flap to cover implants used for knee reconstruction. Wound dehiscence was noted within two weeks of surgery but fortunately implant was not directly exposed to the external environment. To overcome the feared complication of infection, free latissimus dorsi flap was done to cover the defects produced after wound dehiscence. Subsequent recovery of the patient was uneventful.","title":"Complex Biological Reconstruction after Wide Excision of Osteogenic Sarcoma in Lower Extremities"}
{"_id":"c85fef82-64e6-d6d6-3499-4466a7e3ffb5","text":"The rhytidectomy has always been the gold standard in treating facial sagging and loss of facial contour, however recent years brought better understanding of the facial anatomy and facial aging processes, especially those affecting fat pads and ligaments. Understanding the fact that face is not a static structure but a 3D dynamic one allows for applying new injection techniques to achieve natural results.","title":"Practical application of the facial fat compartments and the line of ligaments concept in achieving the lifting effect in the lower face region in female patients"}
{"_id":"c864d071-5154-acf3-7490-36b551689dfd","text":"The quality of the evidence regarding the role of MRI for PJIs diagnosis was low. There is preliminary evidence that MRI has a noteworthy value of distinguishing suspected periprosthetic joint infection in patients with total knee arthroplasty or total hip arthroplasty, but the definition of specific MRI features related to PJIs diagnosis lacks consensus and standardization. Large-scale studies with robust quality were required to help make better clinical decisions in the future.","title":"Diagnostic value of magnetic resonance imaging for patients with periprosthetic joint infection: a systematic review"}
{"_id":"c86a83b5-8589-ce1d-2cdd-a1bb936dbb04","text":"The most common complication is neuropraxia of the frontal branch of the facial nerve. This usually resolves in up to 3 months. The nerve however may be more seriously injured by the sharp trochar at point A or through the placement of the superior Steinman pin. Although potentially permanent, this had not occurred in the author’s personal experience of the technique.","title":"A Modified Technique of Temporomandibular Joint Arthroscopic Operative Surgery of the Superior and Inferior Joint Spaces"}
{"_id":"c87ce645-5a38-7ae1-c8c7-1b79a05d78da","text":"Preparation for management of the child started with a complete discussion of the treatment plan with the family. All difficulties and complications were explained to parents.","title":"True bony TMJ ankylosis in children: Case report"}
{"_id":"c882235d-4464-497c-7d13-428741300ea7","text":"Measurement of venous congestion or venous abdominal insufficiency seems to be an important tool in guiding fluid management and vasoactive therapy [29]. Volume and pressure monitoring on the arterial side does not yield sufficient hemodynamic data, and right atrial pressure monitoring alone provides inadequate information about the venous side of the circulation. Monitoring abdominal venous waveforms is an easy and inexpensive noninvasive method that can help to detect fluid overload earlier.","title":"Association between Hepatic Venous Congestion and Adverse Outcomes after Cardiac Surgery †"}
{"_id":"c882d115-fba8-bfc3-4213-7c9c956f6d4b","text":"Both parties ensure the protection of the patient’s personal records. Except for documents required by law, patient names are not included in any form in tabular reports, publications or any type of research publication document. Informed consent will be formulated in strict accordance with Chinese laws and regulations. Written informed consent, including all changes made throughout the study, must be preapproved by the Internal Review Board\/Independent Ethics Committee before inclusion in the study. Medical staff at each centre will obtain a signature with written informed consent from each patient (if the patient is unable to make their own decision for various reasons, the immediate family will decide on their behalf) prior to any specific activities related to the study. Researchers at each centre will submit and keep original copies of all written informed consent forms signed by patients and provide additional copies to patients or their immediate family members for their records.","title":"Are preoperative oral antibiotics effective in reducing the incidence of anastomotic leakage after colorectal cancer surgery? Study protocol for a prospective, multicentre, randomized controlled study"}
{"_id":"c8838904-9816-4f72-2c78-ddd68aa76a24","text":"To analyze by clinical trial the use of vascular ultrasonography to map the saphenous vein in coronary artery bypass grafting to determine viability and dissection site.","title":"Use of Doppler Ultrasound for Saphenous Vein Mapping to Obtain Grafts for Coronary Artery Bypass Grafting"}
{"_id":"c89087d7-c545-e0e8-27a5-e4d7f8c06163","text":"This was a retrospective study from April 2009 to November 2012 of 74 patients selected by our department; the local ethics committee approved this study.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"c89a3314-f17a-c9b8-5681-8b4b6c275274","text":"Our results indicate that women constitute only a minority of all faculty in academic MO, RO, and SO, and they constitute an even smaller minority of program leadership positions, especially in the fields of SO and RO. Programs with a woman physician in a leadership position are associated with a higher percentage of overall women faculty in MO and RO, but not SO. These data may serve as a valuable benchmark to monitor progress as more women enter the oncology workforce.","title":"Women’s Representation in Leadership Positions in Academic Medical Oncology, Radiation Oncology, and Surgical Oncology Programs Women’s Representation in Leadership Positions in Academic Oncology Programs"}
{"_id":"c89cf43b-85f2-84bd-906d-e4a50acebd7a","text":"Plain radiography of the affected limb is needed to look for any complications from the disease. As seen with our case the patient was also having osteomyelitis of the proximal left femur which had to be treated as well. We proceeded with an ultrasound of the affected limbs for reasons of economy and easy availability. Typical findings on ultrasound would include bulky muscle with hypoechoic focal lesions and internal debris. Gordon et al demonstrated that computed tomography (CT) or magnetic resonance imaging (MRI) are the imaging of choice for early diagnosis. CT provides better delineation of muscle than plain radiographs and would be useful in differentiating between tumours, hematoma, thrombophlebitis or abscess. However, it may fail to demonstrate early inflammatory changes. MRI would be a better modality than CT as there was a case reported in which areas of signal attenuation were visible on MRI but not on CT scan. Thus, MRI is the imaging of choice as it is able to show the extent of involvement, site of collection, and help differentiate other pathological conditions from pyomyositis. Imaging studies are not pertinent to establish the diagnosis but can be used as a useful adjunct. The gold standard is still aspiration of pus from the involved muscle followed by a positive culture.","title":"An Unresolving Case of Pyomyositis: A Case Report"}
{"_id":"c8a16c11-70a1-cd15-3773-ed7f746a4b2c","text":"The result of surgery on breast pain is shown in Table 3a. Both methods had a statistically significant impact on mastalgia.","title":"Tongue-tie Repair: Z-Plasty Vs Simple Release"}
{"_id":"c8a52711-457f-c3c5-359d-18c230434728","text":"Cumulative damage to the skin and soft tissue at the site of injection increases susceptibility to infection. Tissue damage at sites distant from the injection event, including degenerative changes, areas of prior trauma and valvular endothelial damage associated with injection of particulate matter, likely increase the individuals risk of SBI. Underlying tissue damage at local and distant sites helps create an environment that is favorable for the adherence and proliferation of bacteria, ultimately leading to the development of SBI. High intensity injection drug use is likely associated with increased risk of SBI as Islam et al. demonstrated that reducing injection intensity is associated with decreased risk of invasive bacterial infections among high-frequency injection drug users [27]. Despite the known bacterial infection risk associated with intravenous drug use, few studies have attempted to link the epidemiological and physiological factors associated with SBI in PWID, our study highlights this interaction by the following:","title":"Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage"}
{"_id":"c8a8a5be-4a71-f59b-752b-10c62639ad62","text":"A longitudinal curvilinear incision is used for anterolateral approach. The common peroneal nerve is identified and saved. The fibula is sectioned slightly lower than the level of resected tibial condyle. The upper portion of the fibula is moved medially with its blood supply intact, preserving the attachments of joint capsule, lateral collateral ligament and biceps femoris tendon. The fibular graft is then jammed into tibia and the fixation supplemented by a screw. The place between the graft and the remaining bone is packed with cancellous graft from the iliac crest. The wound is closed over suction drains. The average operating time is 2 h.","title":"Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: long-term result"}
{"_id":"c8b24d95-c7c7-bdc4-779f-ffc94b4895f6","text":"Table 2 shows the AEMR for Delta major and Delta minor.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"c8b38cef-7a86-668a-c21f-47f44ff9da5a","text":"In conclusion, enthesopathy of the bicipital tuberosity of the radius can be successfully treated by surgical resection, in which intraoperative CT scan is a useful tool to assess the remaining volume of the abnormal bones.","title":"Enthesopathy of the bicipital tuberosity of the radius treated under intraoperative computed tomography"}
{"_id":"c8c084bb-8b06-1828-4ad2-7f55c5a74fc8","text":"The histopathology showed epitheloid cell granulomas composed of central area of caseous necrosis surrounded by epitheloid cells, Langhan type of giant cells and peripheral mantle of lymphocytes. A diagnosis of tuberculous osteomyelitis was thus made.","title":"Primary tuberculous osteomyelitis of the mandible mimicking a parotid fistula"}
{"_id":"c8dc20cf-56cf-d7bf-4f9f-bb05cf66e6be","text":"The other 76 patients of which allergic symptoms were not recorded in their medical record, a risk assessment could not be made nor could the need of an EAI be assessed. In the records of five of these 76 patients, it was remarked that they had been prescribed an EAI. In total eight EAIs were prescribed to patients with incomplete data.","title":"Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands"}
{"_id":"c8dc4b93-2a45-366c-c7da-ae9a4071f437","text":"The two composite resins displayed acceptable level of biocompatibility. Composite resins with higher filler content elicited significantly lower grades of inflammation on the whole, but composite resins with lower filler content elicited significantly lower inflammatory response on the 90th day of implantation.","title":"Relative biocompatibility of micro-hybrid and nano-hybrid light-activated composite resins"}
{"_id":"c8df4e58-1991-ed20-3438-efcfc34f5479","text":"The presence of fat globules in pulmonary and systemic circulation is most commonly seen after traumatic long bone fractures but has also been reported in multiple clinical conditions such as pancreatitis, fatty liver and procedures like bone marrow transplantation, liposuction and intramedullary nailing [2]. However, only few patients with fat embolism progress to the serious complication of fat embolism syndrome suggesting involvement of additional factors in development of FES. The widely accepted biochemical theory suggests that break-down of circulating fat emboli by lipoprotein lipase releases free fatty acids and other toxic metabolites into the pulmonary circulation causing endothelial damage and increased vascular permeability ultimately resulting in an ARDS like picture in these patients [2].","title":"Prone Positioning for Management of Fat Embolism Syndrome in a Patient with Spine Fracture; An Unusual Scenario and Review of Literature"}
{"_id":"c8e24264-96b6-dde4-77a6-3f03454f0113","text":"Table 4 Incidence of major and clinically relevant non-major bleeding according to subgroups","title":"Rivaroxaban for the treatment of symptomatic deep-vein thrombosis and pulmonary embolism in Chinese patients: a subgroup analysis of the EINSTEIN DVT and PE studies"}
{"_id":"c8e58971-86aa-1bb9-4bc6-14d9fd378dcd","text":"Titanium coated cage served as a template for nose inner lining. Skin and fascia were sutured around the cage and retained its shape when it was removed immediately before the 2nd stage. To further improve nasal shape, cartilage grafts could have also been used for additional alar rim support. In the future, we would also consider this modification to our technique.","title":"A Unique Method for Total Nasal Defect Reconstruction - Prefabricated Innervated Osteocutaneous Radial Forearm Free Flap"}
{"_id":"c8ed618b-6e14-5f89-5779-3e6efc0eac68","text":"An incision of 3 cm was made just below the mammary crease or in the right costal margin 1 space below and 4 cm to the right of the xiphoid process to harvest the right 7th, 8th or 9th costal cartilages. Sharp and diathermic dissection follows down to the level of the rectus muscle. The fascia overlying the muscle was harvested as a square of 6×6 cm and then muscle fibers were bluntly retracted or divided to identify the costal cartilage. Then the perichondrium was incised along its axis. Using the freer, the rib cartilage was encircled and harvested with or without its perichondrium.","title":"Autologous Diced Cartilage in Nasal Septoplasty"}
{"_id":"c8f114ae-5dd0-0b0d-e69d-3de59078ae43","text":"Orders came from the physicians directed to the staff members of the other health professions.","title":"Cooperative leadership as a condition for patient-reported rehabilitation success"}
{"_id":"c8f15d3e-2c8f-37d3-b1ea-7e71431506c6","text":"Therefore, any implementation of a tailored approach in abdominal wall surgery perhaps confirms the greater complexity that is present but does add to the more stringent demands placed on the surgeon.","title":"The reality of general surgery training and increased complexity of abdominal wall hernia surgery"}
{"_id":"c8f43330-f60d-16eb-a36f-5c950fa4212b","text":"The patient underwent a left total mastectomy as per her wish, with excision of two axillary sentinel lymph nodes and one accessory lymph node, as it was decided with the multidisciplinary tumor board of the hospital.","title":"Encapsulated Papillary Carcinoma: A Case Report and Review of the Literature"}
{"_id":"c8f5fe29-b779-f1ef-f495-02d22f0ff731","text":"Regarding the technical details, on inspection of the axilla following SLNB procedure, the integrity of the lymphatic drainage could only be confirmed via visualization of green and fluorescent nodes and lymphatics through the axilla. To have the ability to assess this integrity, all lymphatics should be clipped or sutured but not cauterized during SLNB. Otherwise, ICG leakage would cause catastrophic consequences in terms of diagnostic accuracy. The complete visualization of the axillary operative field via infrared camera system is usually difficult and even not possible due to the limited exposure through a small incision and the anatomic concavity. In the current study, a dual opto-nuclear probe was used for ICG detection in conjunction with a infrared camera, enabling to visualize the lymphatic drainage from the injection site in the upper arm up to the posterior medial part of the pectoralis minor muscle confirming the lymph flow beyond the boundaries of SLNB. The higher crossover rate in the presented study might be attributed to this technical detail which detects even the fainted fluorescence in the nodes evaluated, as well. Therefore, it is rational to presume that lymphedema is not only a function of the number of lymph nodes removed or whether ALND is performed or not, but the absence of lymphatic flow from the arm through the axilla after axillary staging intervention is completed. Moreover, the results of the presented study demonstrate that when level I-II ALND dissection is done meticulously to spare the lymphatics, radiotherapy might account for as the primary etiologic factor for lymphedema. Therefore, determining the patient subgroup who can be spared from radiotherapy for clinically and radiologically negative patients is of paramount importance that would provide a more sensitive and individualized approach to axillary lymph nodes which are only indicators in the name of staging, but do not dominate or govern distant metastases in the prognosis of the disease.","title":"Triple mapping for axillary staging after neoadjuvant therapy: Axillary reverse mapping with indocyanine green and dual agent sentinel lymph node biopsy"}
{"_id":"c8f75d59-bcb1-546b-0d1b-c079ad9cdcbd","text":"Brachytherapy is also very well suited for differential therapy. The manual implantation of radiation sources in combination with the rapid falloff in dose as the distance from the seeds gives the physician great flexibility to vary the treatment dose to different parts of the prostate gland. In addition, there are intrinsically very high doses of radiation within a few millimeters of each source. These areas, termed “hotspots,” contain radiation doses 2-3 times the prescription dose, which allows for a creation of a higher dose gradient with brachytherapy than with external beam radiotherapy. Therefore, increasing the dose directed to the tumor while decreasing dose to the remainder of the gland with brachytherapy offers a promising method of optimizing outcomes while limiting side effects and has been used in a few preliminary studies in the literature.","title":"Focal Therapy, Differential Therapy, and Radiation Treatment for Prostate Cancer"}
{"_id":"c8f93652-f5b3-01b1-5192-77426e44abf2","text":"The choice of delivery route is obstetric and there is no contraindication against artificial cervical ripening or induction of labor. The patient should continue wearing antiembolism stockings throughout the procedure, regardless of whether delivery is vaginal or caesarean.","title":"Venous thromboembolism in women: new challenges for an old disease"}
{"_id":"c8fa7904-bcfb-a29d-f99c-6ba3b804e82d","text":"Anastomosis of a free flap with a single axis is not specific to the lower limb, and it exposes the patient to risks of thrombosis. Lengthening of the arterial pedicle of the flap by venous graft or vascular loop5 might have allowed for avoidance of connection to the bypass at a distance from the lesions with a traumatic origin without increasing the risk of failure.6 Nevertheless, the saphenous vein, generally used in these indications, was already harvested, which would have justified the use of the cephalic or basilic veins.7 For the same reason, the transitional anastomosis of the flap to the contralateral leg could not be considered.8","title":"Omentum Free Flap Anastomosed to Arterial Bypass in Open Knee Dislocation: Case Report and Discussion Pauchot et al"}
{"_id":"c90418b1-ba76-7b8c-90a1-ff354f662099","text":"We have demonstrated that using both large and small auricular composite grafts has favorable long term results for reconstruction of alar rim deformities. However, use of small grafts seems more beneficial and applicability of large grafts requires further studies.","title":"Can We Add Auricular Composite Graft to Our Rhinoplasty Armamentarium?"}
{"_id":"c909655a-aaab-cfd0-5b4a-f4de1aab88a9","text":"The main problem we encountered was that the various analyzed studies did not specifically describe the exact drained axillary region.","title":"New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery"}
{"_id":"c9105e1c-6c06-a0bb-e5b9-ed151a8d2e16","text":"The overall detection rate was estimated as the proportion of patients with at least 1 SLN identified among all the patients going though PLND. When assessing sensitivity and specificity, the patients who failed in SLN mapping were excluded, and sensitivity is defined as the percentage of patients with positive SLN divided by all patients with positive lymph nodes. The specificity is defined as the percentage of patients with negative SLN divided by all patients with negative lymph nodes. Studies in which the calculation of sensitivity was based on the number of removed node packets but not on the patients were excluded during assessment.","title":"Robotic-Assisted Sentinel Lymph Node Mapping With Indocyanine Green in Pelvic Malignancies: A Systematic Review and Meta-Analysis"}
{"_id":"c9106a2f-a1ec-cacf-a70d-6d4bf8079a42","text":"The Vaccine Adverse Event Reporting System database was searched for reported allergic reactions after the administration of any of the COVID-19 vaccines from December 2020 to June 2021. After data mapping, the demographic and clinical characteristics of the reported cases were analyzed. Potential factors associated with anaphylaxis were evaluated using multivariable logistic regression models.","title":"Allergic Reactions After the Administration of COVID-19 Vaccines"}
{"_id":"c91a4111-f76c-e1c1-2f89-eff4c01c2530","text":"Clinical response was evaluated at the end of patient follow-up assisted with dermatoscopy and biopsy was performed in 63 cases. All patients were followed-up every 3 months for the first year after treatment and subsequently every 6 months up to a maximum of 6 years.","title":"Biomarkers of basal cell carcinoma resistance to methyl-aminolevulinate photodynamic therapy"}
{"_id":"c92164bd-63cc-c5c8-a680-af0b1867b87f","text":"To determine the predictors of periorbital cutaneous ageing and whether it could be used as an objective marker of sun exposure.","title":"The determinants of periorbital skin ageing in participants of a melanoma case–control study in the U.K."}
{"_id":"c92eb1bf-f3ae-1639-30ce-2ede7961ad01","text":"Based on the findings, leaders would need to sense situations that could result in departure and be humble enough to bring potential leaving plans up for discussion and to persuade physicians to stay in their current position.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"c92f713c-d796-434b-3470-97ab04d66652","text":"This study is a randomized clinical trial conducted from June 2010 to February 2013 at our institution on patients who were referred for prostate biopsy. Informed consent was obtained from all men who were enrolled in this study. Patients with evidence of urinary tract infection or tumor, urolithiasis, sexually transmitted disease, or urethral stricture were deemed ineligible. Patients who were lost to follow-up and men who did not comply with the antimicrobial regimen were excluded from data analysis. Simple random sampling was performed and using randomized block design, 450 patients who fulfilled the inclusion criteria were selected and were assigned to one of two groups of 225 each.","title":"Addition of Ceftriaxone and Amikacin to a Ciprofloxacin plus Metronidazole Regimen for Preventing Infectious Complications of Transrectal Ultrasound-Guided Prostate Biopsy: A Randomized Controlled Trial"}
{"_id":"c935d552-334a-9384-b415-bcd134be4467","text":"All samples were taken from the same location within the knee, about 1 cm from the posterior cruciate ligament attachment site on the medial condyle of the femur. From the OA patients, the medial condyle piece was rinsed and cleaned of gross contamination with blood and placed directly on dry ice and the cartilage sample was cut out with a clean scalpel. The HC and CL samples were obtained using a curette by the operating surgeon. We aimed to only remove cartilage without subchondral bone for each sample and were limited to approximately 15 mm3 in size to minimize potential risks to patients. All samples were immediately frozen on dry ice and subsequently transported from the operating theater to the laboratory for storage in a −80°C freezer within 5 minutes. There were no treatments used on the samples prior to storage.","title":"Low-Input RNA-Sequencing in Patients with Cartilage Lesions, Osteoarthritis, and Healthy Cartilage"}
{"_id":"c935f178-5af8-1fd0-c829-d3fe323d05ff","text":"In this study, we compared the ALM survival rate according to changes in BT between the initial punch biopsy and wide excision samples from an Asian population. Although punch biopsy is a useful and safe method to diagnose ALM without removing the entire tumor and although there is no definite evidence that it increases the risk of tumor seeding into the cutaneous lymphatics or blood vessels, this technique has the disadvantage of underestimating the final BT, which is the most important factor affecting the prognosis of melanoma. Nevertheless, our study revealed that changes in the initial and final BTs did not affect MSD among our patients and that the final BT and nodal metastasis were significantly associated with MSD. In other words, even if the exact BT is not estimated through punch biopsy, the survival rate of ALM patients remains unaffected.","title":"Effect of changes in Breslow thickness between the initial punch biopsy results and final pathology reports in acral lentiginous melanoma patients"}
{"_id":"c936b3ae-ac9a-efaf-ffdf-3387ff9a9a9e","text":"International collaboration among anatomy departments can lead to enhancement of student education by facilitating international experiences. This unique collaboration represented a new role for anatomy departments in GH and IoME – beyond the classic educational role of anatomy – and introduced a new purpose for international collaboration among anatomists.","title":"An International Partnership of 12 Anatomy Departments – Improving Global Health through Internationalization of Medical Education"}
{"_id":"c953aeb8-39d1-891c-bcbf-ef68077fad83","text":"This is defined as the time to recurrence of disease to a distance of 1 cm or more from previously treated metastases from the date of randomisation. It is measured by the time difference between the randomisation MRI and intracranial failure MRI identifying recurrence.","title":"Whole brain radiotherapy (WBRT) after local treatment of brain metastases in melanoma patients: Statistical Analysis Plan"}
{"_id":"c966f315-c42e-bfd2-9bbf-38c2addab5d9","text":"Both readers reviewed every examination at each reading mode independently and were blinded to any information about the patients, including age, manifestation of symptoms, and previous radiology reports. The readers were asked to read for at least 2 hours a day to simulate the typical process of batch reading in such examinations.","title":"Performance of Computer-Aided Diagnosis in Ultrasonography for Detection of Breast Lesions Less and More Than 2 cm: Prospective Comparative Study"}
{"_id":"c9686654-5608-eb88-75e6-43a291499a48","text":"Table 3 shows the pre- and intraoperatively measured mean DR of the applied radioactivity at various distances to the radiation source.","title":"10-Year experience regarding the reliability and morbidity of radio guided lymph node biopsy in penile cancer patients and the associated radiation exposure of medical staff in this procedure"}
{"_id":"c9696cf9-fa82-5a05-70d0-0cb66005fc74","text":"Patients who developed cyanotic skin changes after facial dermal filler injections were included in this study, whereas those without significant evidence of inadvertent intravascular injection after facial dermal filler injection or of skin perfusion defects on the first LDI measurement were excluded. A total of thirteen patients were included, all of whom had developed early-stage vascular complications following treatment in cosmetic clinics.","title":"Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review"}
{"_id":"c96b8694-2a77-582e-6102-315b4eb5d227","text":"The typical vertebral lesion of EG is composed of an osteolytic area causing complete or incomplete collapse and flattening of vertebrae, known as vertebra plana. The bony destruction of vertebral EG might lead to spinal instability with severe mechanical back pain and even a pathological fracture. Pediatric patients with cervical EG can present with symptoms including acute onset of neck pain with\/without history of trauma and torticollis or neck stiffness due to restricted motion [5, 6]. Vertebral collapse and impingement from extradural extension of the lesion may further result in nerve compression and subsequent neural deficit and myelopathy.","title":"The surgical strategy for eosinophilic granuloma of the pediatric cervical spine complicated with neurologic deficit and\/or spinal instability"}
{"_id":"c96cf35a-2345-cbcc-c5ec-b762ef802935","text":"Her relatives referred an intramuscular injection of ceftriaxone in the same site 8 days before for an upper respiratory tract infection. They also referred severe pain onset at the site of injection 24 hours later, which seemed out of proportion to physical findings and the appearance of a bulla after 3 days which rapidly grown up to the size of 8 × 10 centimeters. They reported that she had been sleepy and confused since 2 days before.","title":"Necrotizing Soft Tissue Fasciitis after Intramuscular Injection"}
{"_id":"c96cfa91-3867-1bf9-39c0-90a3b83cd0d1","text":"Vasculitis and Staphylococcus aureus infection occurred exclusively in patients with calcinosis.","title":"Juvenile dermatomyositis in South African children is characterised by frequent dystropic calcification: a cross sectional study"}
{"_id":"c96e172e-305b-d34e-ee07-c32bded01e93","text":"The purpose of the present study was to establish a quantitative predictor for postoperative salivary fistula development in patients undergoing parotidectomy for benign parotid tumours. Such a predictor could be used to evaluate whether a patient requires measures such as the application of a pressure dressing and administration of anticholinergics [3] for the prevention and\/or early treatment of a salivary fistula.","title":"Drain fluid amylase as a predictor of postoperative salivary fistula in cases with benign parotid tumours"}
{"_id":"c96ec8c2-357a-9514-186c-e6bd5d713282","text":"It seems that there is no one reliable and unique method to obtain a sterile, safe and viable meniscal allograft which could be useful for a very long time after transplantation. Due to many differences in the results of studies caused by the number of groups, search strategy and various methods of data analysis, further research is necessary to find new ways of graft processing, to make it safer, more durable and keep its viability.","title":"Preservation and sterilization methods of the meniscal allografts: literature review"}
{"_id":"c973319a-1ba4-edd9-3448-f31871189348","text":"The gross and histological observations are summed up in Table 1.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"c989156e-ec64-d151-7ca6-11997172f13d","text":"The free gracilis flap offers good wound healing and excellent foot contour besides being safe and effective in small to medium sized defects makes it an excellent free flap in diabetic foot reconstruction.","title":"The Gracilis Muscle Flap: A “Work Horse” Free Flap in Diabetic Foot Reconstruction"}
{"_id":"c98961ef-1ccc-6783-c2a5-31b55b376b79","text":"The principal aim of treatment is to completely remove or destroy the tumor, while preserving the function and the aesthetic appearance.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"c98e1e2b-cb40-c35a-1543-b0708fdcd0c9","text":"In this regard, all patients who underwent free flap procedure in our department between March 2018 and October 2019 were retrospectively analyzed.","title":"Seasonal Impact on Free Flap Surgery in Terms of Flap Loss and Wound Healing Disorders: A Retrospective Cohort Study of 158 Free Flaps"}
{"_id":"c98f977e-c593-2227-6aeb-bc43ed2ad217","text":"Coverage of soft-tissue defects in the lower limbs, especially open tibial fractures, is currently a frequently done procedure because of the high incidence of high-energy trauma, which affects this location. The skilled orthopedic surgeon should be able to carry out an integral treatment of these lesions, which include not only the open reduction and internal fixation of the fracture fragments but also the management of complications such as local wound problems that may arise. There is a wide variety of muscular or pedicled flaps available for reconstruction of lower limb soft-tissue defects. These techniques are not commonly used by orthopedic surgeons because of the lack of familiarity with them and the potential for flap failure and problems derived from morbidity of the donor site. We present a coverage management update for orthopedic surgeons for complications after an open tibial fracture. We choose and describe the most adequate flap depending on the region injured and the reliable surgical procedure. For proximal third of the tibia, we use gastrocnemius muscle flap. Middle third of the tibia could be covered by soleus muscle flap. Distal third of the tibia could be reconstructed by sural flaps, lateral supramalleolar skin flap, and posterior tibial perforator flap. Free flaps can be used in all regions. We describe the advantages and disadvantages, pearls, and tips of every flap. The coverage of the tibia after a major injury constitutes a reliable and versatile technique that should form part of the therapeutic arsenal of all the orthopedic surgeons, facilitating the integral treatment of complex lower limb injuries with exposed defects.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"c990c421-2621-30f7-17d7-b84628e6a562","text":"The histopathologic confirmation is mandatory especially to rule out malignant tumor such as fibrosarcoma. A diagnosis of DT can be performed on core biopsies using 14G or 16G needles at a dedicated diagnostic clinic by a specialist radiologist in conjunction with a sarcoma surgeon. Neither incisional nor excisional biopsy is recommended as the initial diagnostic modality [18].","title":"Multimodality imaging features of desmoid tumors: a head-to-toe spectrum"}
{"_id":"c99790cc-91bf-c1f8-849e-be79f6669193","text":"A total of 1315 urban and 572 rural children were studied","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"c99b9351-0ce5-535b-ed72-a22e67e25b1d","text":"The use of a 2 mm margin as the standard for an adequate margin in DCIS treated with WBRT is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcome, and decrease health care costs. Clinical judgment should be used in determining the need for further surgery in patients with negative margins < 2 mm.","title":"Society of Surgical Oncology–American Society for Radiation Oncology–American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma In Situ"}
{"_id":"c9a1d0f6-201c-d459-7a07-5e58ccdbaf94","text":"One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base.","title":"Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note Técnica endoscópica endonasal utilizando duplo retalho para reconstrução de grandes defeitos da base anterior do crânio: nota técnica"}
{"_id":"c9a317c0-29fe-5bf4-1f9b-f2c17bf65c44","text":"Food technologists and medics think that hydrolysis removes immunoreactive properties, and that food products with the addition of soy preparations may be recommended to people with allergies.","title":"Soy Preparations Are Potentially Dangerous Factors in the Course of a Food Allergy"}
{"_id":"c9a4cca3-c6df-4703-d713-2198332e05c6","text":"Data from the NHS Breast Screening Programme between 1 April 2012 and 31 March 2017 were interrogated to identify women with invasive breast carcinoma and a single sentinel lymph node (SLN) with macrometastatic disease who subsequently proceeded to completion ANC. Univariable and multivariable analyses were performed to identify patients with a single positive SLN who had no further lymph node metastasis on ANC.","title":"Residual lymph node tumour burden following removal of a single axillary sentinel lymph with macrometastatic disease in women with screen-detected invasive breast cancer"}
{"_id":"c9a4e50b-80be-ed55-fb97-e1c8e3707eda","text":"Studies were considered to be ineligible and were excluded if they met the following criteria:","title":"Ultrasound-guided transversus thoracic muscle plane-pectoral nerve block for postoperative analgesia after modified radical mastectomy: a comparison with the thoracic paravertebral nerve block"}
{"_id":"c9ab946c-2978-4ad9-df3c-c695d45ce54d","text":"In Figure 4, we depict a sample of the contouring guideline for the A071801 trial that demonstrates the additional dural margin which is intended to lower the risk of locoregional recurrence. Currently, a larger margin is recommended along the dura to decrease the risk of marginal tumor recurrence. In addition, retrospective data support that surgical bed control is improved with FSRS compared to SRS. A clinical trial is currently underway, A071801, which randomizes patients with limited BMs with one resection bed to SRS versus FSRS. The primary endpoint is to determine if the time to surgical bed failure is increased with FSRS compared to SRS in patients with resected BM.","title":"Multidisciplinary patient-centered management of brain metastases and future directions"}
{"_id":"c9b0763d-7fbb-5cf9-4e3f-5c22283e78bf","text":"Our data canvassing found that women who underwent BCS or mastectomy with reconstruction were observed to be more appeased with the contour of their breasts comparing with women who had mastectomy with no reconstructive surgery. This is in line to the study conducted by Fung and colleagues which unveiled that patients who received BCS and breast reconstruction following mastectomy were less distraught about their body appearance than those with total mastectomy alone. However, their study utilized body image (BI-7 and BI-5) score to assess satisfaction with breasts and change in their outlook apart from breast-specific Breast-Q questionnaire20. Another observational study performed in hospitals of Iran also delineated that BCS group attained the highest level of satisfaction with surgery followed by patients with mastectomy and then mastectomy with reconstructive intervention21.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"c9b2eb34-059e-b56f-8f21-d94f5e896c27","text":"A tailored approach is now employed and seen more so in hernia surgery and this fact is referred to and highlighted in the contemporaneous hernia guidelines published to date. In addition, with the increasing complexity of abdominal wall surgery, the number of procedures actually performed by trainees is no longer considered adequate to overcome any recognized learning curve. Therefore, to supplement general surgery training young surgeons should be offered a clinical fellowship to obtain an additional qualification as an abdominal wall surgeon and thus improve their clinical and operative experience under supervision in this field. Practicing general surgeons with a special interest in hernia surgery can undertake intensive further training in this area by participating in clinical work shadowing in hernia centers, workshops and congresses.","title":"The reality of general surgery training and increased complexity of abdominal wall hernia surgery"}
{"_id":"c9b3355b-9fd4-8a89-2f41-6137cc11619f","text":"Breast Reconstruction either immediate or delayed is essentially a solution for those females who would experience psychosocial and disfigurement issues after ablative surgery. This fact has been proved by the study of Wellisch et al.11 which showed that patients undergoing breast reconstruction were more stable psychologically and satisfied with their cosmetic results. A study conducted by Howes and colleagues on quality of life had revealed that women with breast reconstruction following mastectomy were living a better life and were more contented with their outlook than patients with total mastectomy and BCS. Moreover, in this study the physical well-being of BCS patients was unsatisfactory and so is the sexual well-being of mastectomy patients12. Relevantly, another study by Jagsi et al.13 also concluded that there was no difference in cosmetic satisfaction between patients with breast conservation and mastectomy with reconstructive surgery.","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"c9b39e63-fbcb-275a-59a0-af3fe7ef6362","text":"Variables were collected using a research protocol developed by the researchers.","title":"Evaluation of the diagnostic management of deep vein thrombosis in the emergency department of a tertiary hospital in Santa Catarina, Brazil: a cross-sectional study"}
{"_id":"c9b4cc4e-436d-d083-ac64-1fcd266911d9","text":"Old age was associated with a worse prognosis in previous studies in Taiwan and Western countries. Age has been proved to be a very strong and independent predictor of survival outcome after accounting for all the dominant prognostic factors. One reason that old age may be associated with a poor prognosis is that melanomas in older patients were more frequently late diagnosed, which may be related to less attention to changes on their skin, low awareness of the early signs and symptoms of melanoma, increase of seborrheic keratoses (with which melanoma can be easily confused) or development of a higher proportion of melanomas in hard-to-see anatomical sites. Another possible reason for old age being a poor prognostic factor is that melanomas in older patients were generally thicker, more likely to be ulcerated and with higher mitotic rates, which are thought to be prognostically unfavorable features. One review article in 2018 has discussed the relationship between age and sentinel lymph node status and indicated decreased sentinel lymph node positivity but increased mortality with age. This may be due to the decreased possibility of senescent melanocytes reaching sentinel nodes and the inability of local immune system to control melanocytes when they reach sentinel nodes. In this study, old age was associated with a significantly increased risk of death (P < 0.001), which was consistent with former studies.","title":"Prognostic factors and population-based analysis of melanoma with sentinel lymph node biopsy"}
{"_id":"c9ba94bc-02c3-7eee-eb97-9ba920c5c4cc","text":"Meticulous intraoperative monitoring is important to diagnose pulmonary embolism during surgery.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"c9bfd7bc-30da-c567-2b16-23e48b700bd4","text":"Patients were encouraged to perform active knee flexion and isometric quadriceps muscle strength exercises on the second day after surgery which should be performed for about 3 months postoperatively. The drain was removed 2 days after surgery. Then, the patients were allowed to take partial weight bearing with crutch for about 6 weeks. And full weight bearing was permitted 6 weeks postoperatively.","title":"Arthroscopic internal drainage and cystectomy of popliteal cyst in knee osteoarthritis"}
{"_id":"c9cc574a-1527-ad71-0e67-e6ca6b092173","text":"The majority of patients required dental care, most of which, for healthy adults, would normally be completed within a primary care setting. However, the issues surrounding the care of patients destined for HSCT indicate that there is a place for a dedicated dental service as part of the multidisciplinary team. The role of this service should be to provide a seamless interface between the medical and dental interventions necessary to establish optimal oral health prior to profound myelosuppression.","title":"Dental assessment prior to stem cell transplant: treatment need and barriers to care"}
{"_id":"c9e0d088-71bf-501d-8c59-439b43c98b34","text":"In conclusion, we demonstrated that HSI could have the potential to accurately assess mastectomy skin flap and DIEP flap viability and discriminate between patients with and without necrosis during the early postoperative period. Although the results of this pilot study should be interpreted with caution given the small sample size, we believe that the results provide useful information to improve the outcomes of reconstructive flap surgery. Although the results should be confirmed in future studies including DIEP flap necrosis specifically, these finding support the hypothesis that HSI can aid clinicians in postoperative flap monitoring, as it, based on the results of this study, enables the detection of necrosis earlier than clinical evaluation. HSI has the potential to facilitate early and accurate debridement of necrotic tissue during the in-hospital postoperative period in order to prevent long-term wound problems in the postoperative period. Ultimately, clinicians should be able to debride necrotic tissue based on HSI assessment, preferably during initial surgery and at least during the same hospital admission before clinical observation of necrosis.","title":"Perioperative Hyperspectral Imaging to Assess Mastectomy Skin Flap and DIEP Flap Perfusion in Immediate Autologous Breast Reconstruction: A Pilot Study"}
{"_id":"c9ebe409-61b7-c046-4b57-905335ff5803","text":"Whilst traditionally a team approach with breast and plastic surgeons would have always been required for these procedures, many breast surgery training programmes now incorporate oncoplastic breast surgery into their curricula, such that many contemporary breast surgeons now perform level 1 and level 2 oncoplastic procedures as well as some reconstructive procedures [13]. Alternatively, a team approach with breast and plastic surgeon is still used by some and is still usually required for autologous free flap procedures.","title":"Breast Radiotherapy after Oncoplastic Surgery—A Multidisciplinary Approach"}
{"_id":"c9f090a9-ae16-4108-7837-9fc437a315e7","text":"This is the first study employing a large dataset from a Japanese nationwide birth cohort study to analyze the impact of breastfeeding in infants on the presence of functional constipation at 3 years of age. After controlling for potential confounders, a longer breastfeeding period duration and earlier exclusive breastfeeding were identified to possibly decrease the risk of functional constipation. Such findings may constitute supportive evidence on recommending breastfeeding exclusively in early life and continued breastfeeding after weaning.","title":"Impact of breastfeeding during infancy on functional constipation at 3 years of age: the Japan Environment and Children’s Study"}
{"_id":"c9f147bc-20e2-6d74-4465-ae534e4ca276","text":"There is some difficulty in defining rare tumors and determining incidence and prevalence data, due to the small number of cases regarding some of them. Several other tumors for which there have already been reports of treatment with MMS were not included in this series, such as microcystic adnexal carcinoma and extramammary Paget's disease.","title":"Mohs micrographic surgery in rare cutaneous tumors: a retrospective study at a Brazilian tertiary university hospital"}
{"_id":"c9f251eb-1c8f-2d91-695a-ee03aa9fca39","text":"Following the detection of venous thrombosis as explanation for the abnormal bone findings, the patient was treated with anticoagulation for 6 weeks without complications.","title":"Vanishing bone metastases: a pitfall in contrast-enhanced CT in patients with venous thrombosis R Preunte et al"}
{"_id":"c9f28592-0df2-b930-3ec5-7305060cde72","text":"The goal of this paper is to investigate the combination of cryosurgery and PEF through a mathematical analysis of temperature and electric fields produced by the application of PEFs during cryosurgery. The focus of this study is to examine the effect of changes in temperature and freezing on electric fields and the subsequent implications for affecting cryosurgery treated tissue with PEF.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"c9f5c052-e814-4a3c-00f4-e9657add0101","text":"Our earlier findings [1] were described in an era of larger primary resections. Since breast cancer surgery has become progressively more conservative, we now report whether the same bimodal breast cancer recurrence patterns follow smaller operations. The availability of ten year follow up for nearly three thousand such patients treated at the Milan National Cancer Institute allows us to determine whether the dynamics of recurrence following a lesser resection has the same shape over time as mastectomy; whether it is affected by the difference between tumourectomy and the larger conservative resection of quadrantectomy; whether the dynamics of distant recurrence differ by ER status of the primary tumour in this surgical setting and whether the dynamics of post resection differ according to the organ site of that distant spread. Finally, because of the large number of patients studied we are also able to determine whether these recurrence dynamics differed when the recurrence occurred within the ipsilateral previously resected breast as compared to other distant sites.","title":"Recurrence and mortality according to Estrogen Receptor status for breast cancer patients undergoing conservative surgery. Ipsilateral breast tumour recurrence dynamics provides clues for tumour biology within the residual breast"}
{"_id":"c9f6a2d0-de6b-9a91-01ac-95d7ebf72417","text":"The increased risk of DVT in hospitalized patients has been demonstrated in many studies. Currently, there is often a knee-jerk reaction of the admitting physician to keep every hospitalized patient on DVT prophylaxis, with the majority receiving chemical prophylaxis using heparin products. Patients admitted for pancreatitis are at a critical crossroads with an increased risk of thrombotic and hemorrhagic complications related to pancreatitis, along with an established increased risk for DVT from poor mobility and inflammatory cytokine cascade itself in most of the patients. Our study showed that chemoprophylaxis for DVT in patients hospitalized for acute pancreatitis is neither harmful by causing hemorrhagic conversion of pancreatitis, peri-pancreatic hemorrhage nor beneficial by preventing splanchnic venous thrombosis. Our results indicate that chemical DVT prophylaxis is not contraindicated in patients admitted for any type of pancreatitis, including those with major complications.","title":"Chemoprophylaxis to Prevent Deep Venous Thrombosis in Patients Hospitalized for Pancreatitis: Beneficial or Harmful?"}
{"_id":"c9fcb699-68d3-a193-723c-d3aafb3f90f5","text":"Melanoma of the hand represents a complicated clinical entity. Anatomic features of the hand create challenges in successful management of melanoma not encountered elsewhere in the body. The objectives of this article are to outline current standards for managing melanoma of the hand including diagnosis, surgical, and chemotherapeutic management. Particular emphasis will be placed on currently debated topics of the role of sentinel lymph node biopsy, the role of Mohs micrographic surgery, tissue sparing management of subungual melanoma, and the consideration of melanoma of the hand as a distinct entity based on clinical and molecular studies.","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"c9fd2360-3262-f044-5b2d-e4182d2ff73e","text":"This study aimed to perfuse a flap with venous blood through the artery similar to arterialized venous flaps and explore flap survival with soft conditioning. In this study, the efferent vein was retrogradely pre-arterialized, and the flap was preconditioned with an ischemic delay procedure to ensure sufficient blood circulation of the tissue graft with venous blood after tissue transplantation.","title":"Conditioning of microvascular venous flaps in rats"}
{"_id":"c9ff9e68-1056-6c9e-7873-f92792eab2a3","text":"The differential diagnoses based on radiological features for acute and chronic osteomyelitis are summarised in Table 2.","title":"Childhood osteomyelitis: imaging characteristics"}
{"_id":"ca02453c-c5fa-2715-ca66-b426dbfc5632","text":"Mobilization of fat stores from LDs is regulated by the metabolic and energy demands of the cell. This process usually appears in the form of lipophagy or lipolysis. They are the catabolic pathways that have a fundamental role in breaking down lipids during nutrient deprivation. Both have an impact on cellular energetic balance: directly through their important role in the early steps of lipid breakdown and indirectly by regulating food intake. Defects in lipophagy and lipolysis have been linked to many metabolic disorders; among them are lipid storage and lipid metabolism diseases.","title":"Lipophagy and Lipolysis Status in Lipid Storage and Lipid Metabolism Diseases"}
{"_id":"ca0fdca3-1f5c-23ef-d729-9b59d36326ad","text":"As MMS is a treatment for skin cancers, referrals sent for Mohs surgery are typically malignant. However, Mohs surgeons should be aware of clinical and histopathologic mimickers of benign lesions and independently evaluate each patient with a CPC to avoid unnecessary surgery and ensure timely and appropriate treatment for patients.","title":"Granuloma Annulare Mimicking Squamous Cell Carcinoma"}
{"_id":"ca11a07c-9e89-ff58-7435-3c06d543c68a","text":"When not clinically evident, imaging of lesions of the nail unit can provide valuable information regarding the type of lesion or infiltration of deeper structures and can aid in surgical planning. Ultrasound and MRI are soft tissue imaging modalities most relevant to nail complex lesions and should be considered in equivocal cases to further aid diagnostic and surgical planning [27].","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"ca123462-a26c-e4f5-34ba-a1a43ecccf1f","text":"Participants will be excluded if they have any of the following conditions:","title":"Ultrasound-guided erector spinae plane block versus thoracic paravertebral block on postoperative analgesia after laparoscopic nephroureterectomy: study protocol of a randomized, double-blinded, non-inferiority design trial"}
{"_id":"ca19ef69-c036-2005-f14f-c9747f082b45","text":"Primary subungual squamous cell carcinoma (SCC) in toe is rarely reported in the literature and most of the cases are described in fingernails. Men after the fifth decade of life are statistically most affected. The tumor may manifest associated with lesions of paronychia, onychocryptosis and may lead to dischromia of the nail plate, bleeding and pain. The diagnosis of cancer of the nail bed is usually late because the lesion is confused with benign and infectious diseases. For this reason it is important to perform biopsy of all the wounds that are persistent and do not heal in the nail bed so early diagnosis, appropriate treatment and follow-up can be done, while the tumor is still confined to its primary site.","title":"Subungual squamous cell carcinoma *"}
{"_id":"ca286b57-21ac-785d-a487-dddd32a6d332","text":"There are many factors that impact final nasal morphology, and we need a proper method to assess these factors accurately. Some of the problems that may arise with final nasal morphology include cartilage shape reversion, overcorrection as a result of a surgeon's specific surgical technique, and deformation due to the skeletal growth of the infant patients. In the future, it may be necessary to use the correct evaluation method for each of these factors to evaluate relapse of the nasal wing shape.","title":"Nasal molding prevents relapse of nasal deformity after primary rhinoplasty in patients with unilateral complete cleft lip: An outcomes‐based comparative study of palatal plate alone versus nasoalveolar molding"}
{"_id":"ca2cf2c2-276e-e90b-147e-0684f0c68f8c","text":"This study is limited by the fact that the paucity of the number of cases precludes drawing any definite conclusions and that the study did not include a control group. Further comparative study with a large number of patients is required. The short follow-up period is also a shortcoming because symptoms of lymphedema usually manifest three to four years after ALND. Another limitation of this method is that this simultaneous lymphatic flap tranfser cannot be performed in cases with bilateral breast reconstruction, nor can this method be applied in cases where a large DIEP flap including the Zone 4 region is required for breast reconstruction.","title":"Simultaneous Lymphatic Superficial Circumflex Iliac Artery Perforator Flap Transfer from the Zone 4 Region in Autologous Breast Reconstruction Using the Deep Inferior Epigastric Artery Perforator Flap: A Proof-of-Concept Study"}
{"_id":"ca2ebf86-1df8-d9d2-e6f3-2552bc995ffb","text":"Endoscopic tympanoplasty is possible to be performed with 0 or 30 degree telescopes with no need to any bone drilling. Since microscope is not used during the procedure and it is possible to see the ossicular chain and the middle ear through a 30 degree telescope. This method is particular useful in cases of anterior canal overhang without need to remove the overhang.","title":"Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results Timpanoplastia bilateral transcanal por via endoscópica com cartilagem realizada simultaneamente: resultados iniciais"}
{"_id":"ca3120e9-3fd2-a245-d590-42a4e2bf8855","text":"Table 1 Clinical and paraclinical predictors for alternative findings and no alternative findings in patients evaluated with whole-leg ultrasound for suspected DVT","title":"Prevalence and predictors of alternative diagnoses on whole-leg ultrasound negative for acute deep venous thrombosis"}
{"_id":"ca36596a-a5c8-160e-cf76-208675891a64","text":"The presence of this specific transporter suggests that AA has crucial functions within skin cells. Both transporters are hydrophobic membrane proteins that co-transport sodium, driving the uptake of AA into cells and exhibit different absorption kinetics reflecting their different physiological functions.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"ca3cf63e-b84d-42b4-7103-1244eef69d3b","text":"Seven patients had been referred because they had informed their dental practitioner that they had suffered a previous allergic reaction. None of the histories supported that diagnosis and none proved to be allergic to the local anaesthetic agents.","title":"Adverse reaction to dental local anaesthetic injection — 'allergy' is not the cause"}
{"_id":"ca45ec78-7f3b-c025-b743-b723441a1cdd","text":"In our rat epigastric flap model, free flaps with pure venous blood supply can be sufficiently perfused. The timing of vascular conditioning proved to be an important step in the overall survival of these flaps. Additionally, the duration of flap conditioning appears to be a crucial factor for flap survival. Whether ischemic conditioning of the transplant or arterial retrograde vascular conditioning is responsible for the survival rate remains to be investigated.","title":"Conditioning of microvascular venous flaps in rats"}
{"_id":"ca4ac102-476b-bc13-c2b6-f565a8ab00cf","text":"Good plaque control was defined as inclusion criteria in our study since less bleeding in a healthy gingiva and the easier tissue handling would result in more predictable treatment response. [27] Liquid nitrogen is relatively cheap and the other equipments requisite for cryotherapy is uncomplicated. This method is also easier and less technique sensitive than surgical approaches. It can be regarded as a less invasive method because there is almost no concern about losing keratinized tissue in this procedure. [8] We concluded that both treatment modalities were successful in gingival depigmentation; however the decision on selecting any of these two techniques is based on the clinician preference and expertise.","title":"Comparison of Surgical Blade and Cryosurgery with Liquid Nitrogen Techniques in Treatment of Physiologic Gingival Pigmentation: Short Term Results"}
{"_id":"ca4ad248-dcfb-66ab-f102-5d62c3519e4c","text":"This study showed that CTNNB1 mutation was associated with increased absolute risk of recurrence in early stage endometrioid EC, especially after excluding patients with known molecular status other than NSMP; the association with DFS was significant only after excluding patients with known molecular status other than NSMP. To our knowledge, this is the first meta-analysis assessing the prognostic value of CTNNB1 mutations in early stage endometrioid EC.","title":"Prognostic significance of CTNNB1 mutation in early stage endometrial carcinoma: a systematic review and meta-analysis"}
{"_id":"ca5ad0de-e386-c007-3871-b86f0ab27216","text":"Despite none of the CNCs nominating themselves as clinical leaders, the CNCs in 2013 are acting in an expanded clinical leadership role which was not evident in the prior research of this group [3]. This may be demand driven or because there are more university programs in clinical leadership in this region of Sydney. Education is less evident in the enactment of roles and functions but this may be because in each of their specialities in the health district in which the CNCs work there are clinical nurse educators who fulfil this role.","title":"The role of a clinical nurse consultant in an Australian Health District: a quantitative survey"}
{"_id":"ca5da90f-3560-97c4-4f9f-11981284be1e","text":"In conclusion, CT-guided percutaneous biopsy of tumor tissue samples can be effectively used for PDTX modeling in patients who are unable to undergo surgery and patients with aggressive cancer. The established PDTX model can be used to select the best individualized treatment regimen, and thereby be used as an important reference for clinical cancer treatment.","title":"Establishment of patient-derived tumor xenograft (PDTX) models using samples from CT-guided percutaneous biopsy"}
{"_id":"ca6234e7-32cd-050b-6335-0321ece91d0e","text":"International acceptance of the SNB over routine ANC is based on several considerations. In the first instance it is a much less invasive procedure that may be performed under local anaesthesia, often on an outpatient basis. It is well documented that it is associated with a much lower risk of common morbidities which are recognized features of full ANC. The results of the ALMANAC (a large prospective randomized control trial) support the use of SNB in patients with clinically node negative beast cancer in view of the benefits regarding arm functioning and quality of life [21]. In addition, the SNB allows the pathologist to study the few SLNs in greater detail compared with the larger number of lymph nodes removed in ANC. This leads to a greater degree of accuracy.","title":"Current management of the axilla in patients with clinically node-negative breast cancer: a nationwide survey of United Kingdom breast surgeons"}
{"_id":"ca6838da-202b-5135-7bd5-f2177a012d2c","text":"Eleven years earlier, he had undergone triple bypass grafting with the left internal mammary artery used as a graft to the left anterior descending artery, the right internal mammary artery as a graft to the proximal left circumflex artery, and the RGEA as an in situ graft to the posterior interventricular branch of the left circumflex artery via the antegastric and antehepatic routes through an anterior diaphragmatic window. The patient had diabetes mellitus and hypertension, for which he had been taking medication.","title":"Long great saphenous vein grafting as temporary coronary bypass for extended left hepatectomy: report of a case"}
{"_id":"ca771277-0098-d855-58b0-81c60b677354","text":"The patient is now 22 months out from her previous aggressive operative management of her previous multiple recurrences of her fibromatosis of her left breast and she remains disease free.","title":"Management of a patient with multiple recurrences of fibromatosis (desmoid tumor) of the breast involving the chest wall musculature"}
{"_id":"ca80a259-61ea-235a-f61b-3aa11f3f9507","text":"The SIEV is an effective way to broaden the microsurgical choices in breast reconstruction using DIEP flap surgery. It provides a safe and reliable option to improve venous outflow in cases of inadequate outflow from the deep venous system and it may potentially be a good alternative for fast and reliable application as an interposition graft in case of perforator injuries.","title":"Use of the superficial inferior epigastric vein in breast reconstruction with a deep inferior epigastric artery perforator flap"}
{"_id":"ca88be94-3c9c-5ed8-bad9-95ae0260ecb9","text":"Participants reported occasional syringe sharing during instances of syringe shortages while injecting in the company of close network members where perceived HCV and HIV status was known.","title":"Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage"}
{"_id":"ca891ed8-0cc7-4b41-28f5-a06e9da8f03e","text":"Critical limb ischemia (CLI) is the most severe form of peripheral vascular disease where there is inadequate blood flow to a limb to maintain reasonable metabolic requirement of tissues at rest. The lower extremity amputation prevention (LEAP) is a comprehensive program aimed at reducing lower extremity amputations in individuals with peripheral vascular disease. The aims of LEAP are to detect and treat early chronic ischaemic lesions, offer alternatives to amputations in surgically untreatable patients, preserve the remaining limb after major amputation and reduce the global risk for cardiovascular disease. Hence, it is a multidisciplinary program with involvement at various levels from risk factor modification and patient education at the primary healthcare level, to active treatment of critical limb ischaemia at tertiary institutions.","title":"Critical limb ischaemia in a diabetic population from an Asian Centre: angiographic pattern of disease and 3-year limb salvage rate with percutaneous angioplasty as first line of treatment"}
{"_id":"ca8f0373-256a-eea7-3976-d25445eea789","text":"Involvement of the sciatic nerve was confirmed preoperatively when CT or MRI scans showed no layer of normal tissue between the tumor and the sciatic nerve. Lower limb sarcomas arising from the sciatic nerve or those extending towards the sciatic nerve were included.","title":"Limb-Salvage Surgery of Soft Tissue Sarcoma with Sciatic Nerve Involvement"}
{"_id":"ca92c190-e941-b0da-e223-caa4a08115f7","text":"Diagnoses of minor contour irregularities and the selection of the patients were established performing:","title":"Fluid Cartilage as New Autologous Biomaterial in the Treatment of Minor Nose Defects: Clinical and Microscopic Difference Amongst Diced, Crushed, and Fluid Cartilage"}
{"_id":"ca954d18-6943-c28b-dba2-3bd47093b77a","text":"Multimodal analgesia has not been described in this patient population as it has been for other surgical procedures [2, 8]. This article summarizes the underlying complexity of pain in LLA patients as well as the development and application of a multimodal analgesia protocol for postoperative pain management. This protocol specifically addresses the unique considerations of the vascular amputation patient relative to their common medical comorbidities together with surgical concerns. Although the primary goal of this review is to mobilize existing literature to enhance analgesia following LLA, it also serves to illustrate how to combine multiple analgesic modalities in a manner that considers the distinctive needs of a specific patient population.","title":"Development of a Multimodal Analgesia Protocol for Perioperative Acute Pain Management for Lower Limb Amputation"}
{"_id":"ca99e239-61d6-b378-b017-e19021d37e2a","text":"One limitation of the technique is determined by the area that can be considered to be sure of proper establishment and revascularisation of the composite graft.","title":"Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose"}
{"_id":"caa51dbc-6a8c-0e80-3016-53485ededf6b","text":"Conclusion It is important for GDPs and specialists to make patients aware of the possible morbidities following harvest of bone from the chin.","title":"An investigation of post-operative morbidity following chin graft surgery"}
{"_id":"caa57927-85ef-0694-8544-026083d12ce8","text":"It may be concluded that a large percentage of trainees intend to pursue more than one fellowship. This study is the first to investigate the main factors influencing the pursuits of more than one fellowship and compare that with those of single fellowships. The results revealed that job availability, expected income, marketability, and job opportunities in the private sector were the main influencing factors. This information may assist policymakers and the directors of training centers to analyze the economics of medical education, and ensure the training of orthopedic surgeons in all specialties and subspecialties.","title":"Trends in the pursuit of multiple orthopedic surgery fellowships among orthopedic trainees in Saudi Arabia"}
{"_id":"cab084e5-0743-6012-2e7f-ef9abc5f1403","text":"This study has several limitations, including compositional differences between cohorts and the difficulty in applying an algorithm from 1 institution to another when relevant prognostic factors were not similarly coded. This analysis constitutes a retrospective simulation demonstrating the potentially improved cost-effectiveness achievable by selecting various cutoff probabilities. However, a prospective clinical trial would be required to confirm improvements realized by adopting a chosen minimum cutoff probability to select patients for SLNB using PCM or any other appropriate prognostic methodology.","title":"Improving Selection for Sentinel Lymph Node Biopsy Among Patients With Melanoma Improving Selection for Sentinel Lymph Node Biopsy Among Patients With Melanoma"}
{"_id":"cab1ca9a-7b39-fd0f-3993-40619d7e8435","text":"The correlation between the presence of wrinkles and signs of facial aging and excessive contraction of mimicry muscles and those used for chewing and swallowing has been described by dermatologists and speech therapists(. In the present study we observed static and dynamic wrinkles on the client’s face, who, while not contracting the perioral musculature excessively while chewing, presented intense contraction of the orbicularis oris and mentalis muscles during swallowing (liquid and solid) and of the orbicularis oculi muscle when smiling and speaking. In the first session, the client was surprised when she looked at her photographs and the video recorded in the initial session. This shows that she was unaware of her oral motor habits, presenting exaggerated orofacial muscle contraction, and was also unaware of the correlation of this with the emergence of facial wrinkles. This understanding was important to increase awareness of altered orofacial movements and for proprioception of adequate orofacial motor patterns to be learnt.","title":"Utilization of electromyographic biofeedback in speech therapy to attenuate the signs of facial aging: a case report"}
{"_id":"cab46066-0fa0-4bdb-020f-fb03222c5769","text":"On ultrasound examination in the vertical position of the patient we found ptosis of platysma strands from both sides, causing deformation of the contours of neck-submandibular angle, accumulation of fat tissue over platysma was inconsiderable and did not exceed the thickness of subcutaneous fat in adjacent regions. It was found that 68% of the thickness was determined by excessive deposition of subcutaneous fat.","title":"Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques"}
{"_id":"cac380c6-5651-3b75-b9d4-a3a626c3c299","text":"Although bong graft substitute and xenograft possess function of osteoinduction as well as osteoconduction.[ Autogenic cortex and cancellous grafting remains the gold standard.[ It is necessary that both of recipient and bone grafted have close contact over a large surface area along with good blood supply for bone graft, the autogenic cortex and cancellous grafting could successfully incorporate into recipient site. As native bone grows, it will generally replace the graft material completely resulting in a fully integrated region of new bone.","title":"Wrapping grafting for congenital pseudarthrosis of the tibia A preliminary report"}
{"_id":"cac7d88c-08e6-5f6b-1da1-88068417e140","text":"The net gain of hospital beds in other facilities due to the implementation of the RDU were 752 in 2018, 1295 in 2019 and 1794 in 2020. The waiting list for renal or hepatic biopsies performed by the Abdominal Radiology section went from two months to one week, one year after the RDU was set.","title":"Experience and results after the implementation of a radiology day unit in a reference hospital"}
{"_id":"cac94d13-76b5-c43c-d3f4-904352aefbe0","text":"It is prudent to discuss insurance authorization for MRI prior to secondary mastopexy augmentation. Many patients presenting for secondary mastopexy augmentation are of an age when mammographic screening is recommended. If there is an insurance authorization obstacle, we try to convey in the peer-to-peer review process that the MRI will help detect breast cancer, evaluate implant integrity, and allow for an appropriate evaluation of the NAC blood supply. An MRI often affects the surgical plan and oncologic treatment. A mammogram and an ultrasound of the breast cannot evaluate the blood supply to the NAC and is unreliable for assessing implant integrity. Both knowing how to preserve the NAC and the condition of the implant are important to the operating surgeon. In patients with cancer, MRI is often needed in addition to a mammogram for complete screening. In addition to evaluating cancer and blood supply to the NAC, the MRI also yields information pertaining to the plane of the mammary prosthesis as well as the thickness of the skin and breast flap above the mammary prosthesis.","title":"Preoperative MRI to Improve Aesthetic Outcomes in Secondary Mastopexy Augmentation: A Step-by-Step Approach"}
{"_id":"cad43eb6-8f01-163a-faa4-9c1d96b60f33","text":"An extra-abdominal desmoid is a rare tumor. This case demonstrates a rare presentation of an unusual tumor that often manifests with nonspecific symptoms or no symptoms at all. Clinical suspicion and a tissue biopsy are required for diagnosis","title":"Extra-abdominal Desmoid Tumor Mimicking Cervical Spine Schwannoma"}
{"_id":"cad5d244-f9c9-d678-a007-b2644bb23efd","text":"Deep venous thrombosis (DVT) is a feared occurrence following body contouring surgery as it can result in pulmonary embolism. Acute presentation can range from lower extremity edema and pain to being totally asymptomatic. Surgical literature reports reveal many risk factors for developing DVT, and surgeons must risk stratify their patients to best prevent this outcome. However, there are conditions which place patients at risk that are difficult to account for when making such decisions as they can be undiagnosed and are not a part of standard screening protocols. We present a case of DVT in a 41-year-old female with undiagnosed May–Thurner syndrome following abdominoplasty and medial thigh lift for massive weight loss. The authors discuss the current literature as well as challenges faced by surgeons who strive to appropriately risk stratify their cosmetic surgery patients to avoid complications such as venous thromboembolism.","title":"Deep venous thrombosis in a 41-year-old female with May–Thurner syndrome following abdominoplasty and medial thigh lift"}
{"_id":"cada15c6-ede2-5d30-add1-e50ff0189ba4","text":"This study describes the individual lymphatic drainage pattern and SN distribution from patients with clinically T1‐T2N0 parotid tumors. The distribution of SNs was mainly detected within the parotid gland itself or in level II and V on the ipsilateral neck. The distribution of SNs within the parotid gland was detected regardless on where the tumor was situated in the gland, that is, intaparotid SN distribution was seen also in tumors located in the parotid tail.","title":"Distribution of sentinel nodes from parotid tumors–A feasibility study"}
{"_id":"cae200b4-939b-2c35-e8d9-c1c69d7edcdc","text":"Methods to achieve adequate vascular patency have been widely researched. It is understood that the success rate should be approximately 100% in an experimental model9. Some services use experimental microsurgery as a gradual step before the clinical execution of microsurgical flaps10.","title":"Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery"}
{"_id":"cae69e2e-dccc-fbb1-8156-d13c6f11a425","text":"The transverse DIEP flap design based on the perforator located below the umbilicus in zone I is recommended for small skin and soft tissue defects. We recommend the use of the oblique DIEP flap design based on the perforator lateral to the umbilicus in zone I as an extended flap to reconstruct large tissue defects.","title":"Strategies for selecting perforator vessels for transverse and oblique DIEP flap in male pediatric patients: Anatomical study and clinical applications"}
{"_id":"cae8d07d-8657-d0a6-4f85-2dbd8fefd528","text":"For these reasons, the benefit of oncoplastic surgery needs to be considered in conjunction with the clinical indications for the type of adjuvant therapy and the implications this may have oncologically but also aesthetically. Given the complexities involved, we recommend this should be done with involvement of the multidisciplinary team.","title":"Breast Radiotherapy after Oncoplastic Surgery—A Multidisciplinary Approach"}
{"_id":"cae990fc-d16d-c509-45c1-7788d41333bc","text":"The first part of the survey assessed the availability of information and the level of knowledge available to applicants prior to starting the fellowship. Current fellows and fellowship graduates were asked how well they understood their fellowship curriculum before they started and why they chose their fellowship program. The majority of fellows stated that they did not know their program's curriculum very well before starting the fellowship (Table 1).","title":"Improving Knowledge and Process for International Emergency Medicine Fellowship Applicants: A Call for a Uniform Application"}
{"_id":"caea0c91-44a1-38b3-4aff-cfdcd67ae359","text":"While the fibula flap remains the workhorse flap for bony reconstruction of the midface and maxilla, certain defects do not require a fibula flap. Under these circumstances, other bony options can be considered and included in the armamentarium of bone flaps. Defects involving only a portion of the hard palate or perhaps the orbital floor may be reconstructed with soft tissue or perhaps a titanium plate, respectively. However, there are concerns regarding the use of hardware in a contaminated field that will likely require radiation, which may lead to a high risk of infection. For these reasons, we have incorporated a variety of osteocutaneous flaps in our approach for midface reconstruction.","title":"Evolution of Medical Modeling and 3D Printing in Microvascular Midface Reconstruction: Literature Review and Experience at MD Anderson Cancer Center"}
{"_id":"caed404e-e71b-5b9e-3035-f35cf92f55f1","text":"If participants discontinue the study as a result of an SAE, the following action will be taken: an objective examination of the skin will be undertaken; if hypercalcemia or hypercalciuria is suspected in patients treated with calcipotriol, it must be confirmed by blood test as well as by objective neurological investigation in the neurological department at the nearby university hospital. If the SAE is adrenal suppression or weakening of glycemic control by diabetes mellitus is suspected in patients treated with topical corticosteroids, it must be confirmed by blood test and by an objective investigation in the endocrinology department at the nearby university hospital. If the SAE indicates a suspicion of a cataract or increased intraocular pressure arises in patients treated with topical corticosteroids, this must be confirmed by an objective ophthalmological investigation in the ophthalmology department at the nearby university hospital.","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"caf50acb-e1b3-cf74-f48e-509f3092283e","text":"Results of studies in recent years have changed the management of patients with low tumor burden in axillary lymph node involvement so that treatments have increasingly tended to be less invasive due to the early and delayed complications of axillary treatment. For example, the ZOO11 trial recommended that axillary dissection be omitted in patients who were candidates for breast conserving surgery and had less than 2 lymph nodes involved in the sentinel lymph node evaluation (Giuliano et al., 2011)","title":"Sentinel Node Biopsy in Early Breast Cancer Patients with Palpable Axillary Node"}
{"_id":"cafb7794-0e3e-dad7-883e-f4285988cb3b","text":"Sevoflurane preconditioning had a significant effect on the time course of leg muscle rSO2 during ischemia and reperfusion both during IPC and during postoperative reperfusion.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"cafd300a-db94-2eaa-2feb-972fd658ea4f","text":"This case highlights the need for clear recommendations for the duration of postoperative thromboprophylaxis in patients with CS. Clinicians should consider continuing thromboprophylaxis for at least 1 month after surgery for CS.","title":"Multiple Deep Vein Thromboses After Curative Surgery for Cushing Disease: A Case Presentation and Review"}
{"_id":"cb042491-8126-8a3b-3b29-f317623f468d","text":"This is most likely a matter of confounding by indication: larger size defects call for larger skin grafts and STSG would more often be chosen in such cases. Deeper defects can be at risk of more healing problems due to a less vascularized wound bed, and in such cases most surgeons would probably chose STSG over FTSG. The pericranium is though well vascularized, and no real contraindication for using a STSG.","title":"Full- or Split-Thickness Skin Grafting in Scalp Surgery? Retrospective Case Series"}
{"_id":"cb1660f2-f792-a023-0910-841df2ea4d56","text":"Paravertebral block in combination with sedation creates excellent conditions for breast surgery procedures. Additional temperature changes monitoring performed with infrared camera may confirm proper range of analgesia needed to perform surgery. Great cardiovascular stability and very good pulmonary function preservation make this method excellent for high risk patients. Low complication rate is additional advantage. In our opinion this method is recommendable.","title":"Thermal imaging evaluation of paravertebral block for mastectomy in high risk patient: case report"}
{"_id":"cb182c04-969b-5e6b-1baa-67035d723aad","text":"The findings of this present study in conjunction with the previously described literature suggests that patients with COVID-infection have an increased susceptibility to develop surgical site complications. They seem especially prone to impaired wound healing. This may be a result of inflammation and thrombosis in the surrounding microvasculature.","title":"COVID-associated complications after reconstructive breast surgery: a retrospective cohort study"}
{"_id":"cb279f3d-4fd1-843f-ddf8-d911b468bf23","text":"The skin incision followed the internal bicipital groove for a total length of about 15 cm. The brachial fascia was incised along the medial border of the biceps muscle, remaining anterior to the medial intermuscular septum.","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"cb2b0fb9-dacc-d582-73d9-43e869e42744","text":"The DystoniaDiary electronic patient journal for CD was developed by patientMpower Ltd and commissioned by Ipsen Pharmaceuticals Ltd. It is available for download on the iOS App Store and Google Play Store platforms. A passcode is required to access the app after download.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"cb2bb737-3afe-d326-cd55-0b996e835471","text":"Our patient was informed about surgical procedure, in particular regarding autologous fat grafting unpredictable reabsorption rate and clinical results which aimed to improve scar cosmetic appearance.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"cb368b86-02b5-dca3-818a-b356d7d9dbe8","text":"The relationship between breastfeeding and swallowing and speech disorders was also evaluated. The impact of intubation on mandibular ranges was investigated.","title":"Evaluation of Stomatognathic Problems in Children with Osteogenesis Imperfecta (Osteogenesis Imperfecta − OI) − Preliminary Study Ocena problemów stomatognatycznych u dzieci z wrodzoną łamliwością kości (Osteogenesis Imperfecta − OI) − Badania wstępne"}
{"_id":"cb399213-92c1-cf9f-8a4e-6b7c6a1b1f9f","text":"2) Thrombus more than 5 cm in length or in multiple veins","title":"A Comprehensive Literature Review on the Management of Distal Deep Vein Thrombosis"}
{"_id":"cb3dab22-2d80-d1e5-4113-aa9c867ea36d","text":"In order to select the best signals, a low pass filter of 20 Hz and a high pass filter of 500 Hz was used. The best configurations that presented the least noise and the most symmetrical and connected histogram to the signal were considered.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"cb3f4428-cdda-d4a0-4b3d-5a020478d2a7","text":"These three different surgical techniques are all immediate one-step procedures. Before surgery, all patients are diagnosed with breast cancer with pathology. Operation methods are selected by the surgeon according to the patient’s condition with comprehensive evaluation before surgery. LDF or MLDF breast reconstruction is for patients with axillary lymph node metastasis who have a high possibility of receiving postoperative radiation. Partial mastectomy with MLDF breast reconstruction is given for patients who had a large tumor with a strong desire to conserve the breast. At the same time, the breast of the patients should not be too small and the tumor is better located at the outer quadrant or upper quadrant. Patients who receive mastectomy with LDF breast reconstruction have high tumor\/breast ratios but a small breast. The goal of the autologous LDF breast reconstruction is to minimize the magnitude of donor site defect and donor site complications, while maximizing the soft tissue coverage provided by the flap. Figure 1 showed the intraoperative scene when the surgeon was separating the latissimus dorsi muscle in the LDF breast reconstruction. Nearly all patients who undergo MLDF breast reconstruction are marked with titanium clips that aim for the postoperative radiation during oncoplastic partial mastectomy.","title":"Patient-Reported Outcomes and Complications Following Breast Reconstruction: A Comparison Between Biological Matrix-Assisted Direct-to-Implant and Latissimus Dorsi Flap"}
{"_id":"cb438c5b-0ef4-201c-9c22-5cc43d14e629","text":"Secondary intention reconstruction takes a very long time and creates considerable inconvenience to the patient.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"cb4aae48-3a2c-37af-1505-05e193d8e242","text":"Therefore, controlling dental biofilms by means of proper oral hygiene and regular dental care is crucial to prevent either local or systemic disease development. When an oral disease has been established, the removal of deep biofilm by endodontic treatment or surgical intervention is necessary.","title":"The Current Knowledge on the Pathogenesis of Tissue and Medical Device-Related Biofilm Infections"}
{"_id":"cb4bc37e-808a-a59f-f7a5-b6f450ef7c28","text":"As the global burden of skin cancer rises, complex cases of locally advanced skin cancer are rising as well. Rare and aggressive dissemination mechanisms are often the cause for extensive skin cancer. Incohesive spreading patterns complicate correct diagnoses and may result in large tumors with multiple misguided treatment attempts. The aim of this study was to create awareness for cutaneous malignancies with rare, aggressive dissemination mechanisms to improve diagnostic and therapeutic strategies in such complex cases. We identified high-risk characteristics of locally advanced skin cancer warranting extended surgical treatment and a cohesive interdisciplinary approach.","title":"Resection of Skin Cancer Resulting in Free Vascularized Tissue Reconstruction: Always a Therapeutic Failure?"}
{"_id":"cb5a18ff-7978-a974-1774-8fc49c8b7402","text":"The curative treatment of basal cell carcinoma and squamous cell carcinoma with N0 status mostly includes no treatment of the lymph node regions because of insufficient evidence [47]. For patients with clinical or histological affected lymph nodes the CTV should encompass the lymph node regions listed in Table 8, but at least the affected lymph node region with one additional region. For melanomas the affected lymph node region and two additional regions should be encompassed in the lymphatic CTV. The lymph from the medial eyelid drains to the LN submandibulares and LN faciales, whereas the lymph from the lateral eyelid drains to the LN parotidei profundi and superficiales (Table 8, Figure 11) [12]. The lymph of the upper lip flows to the LN submandibulares and the lymph of the lower lip flows also to the LN submentales with possible crossing of the sides. The anterior parts of the ear drain to the preauriculares, the lower parts to the LN cervicales laterales superficiales and the posterior parts to the retroauriculares LN. The lymph vessels of the forehead and temple run to the LN parotidei superficiales and the lymph vessels of the parietal part of the scalp to the LN retroauriculares. The occipital scalp is drained by the LN occipitales. The dorsal and lateral neck regions have outflow to the LN cervicales posteriors profundi as well as to LN cervicales laterales superficiales. The lymph of the ventral parts of the neck flows to LN cervicales anteriores superficiales and forwards to the LN pre- and paratracheales. The skin of the supraclavicular region drains to LN jugulares.","title":"Guidelines for delineation of lymphatic clinical target volumes for high conformal radiotherapy: head and neck region"}
{"_id":"cb5f117c-9c61-50b9-8981-ce1c74ffa112","text":"The original search criteria focused on recurrence rates as they pertain to the initial surgical margin. As the data was abstracted and analyzed, it became apparent that the mortality data associated with initial surgical margin status required separate margin categories to be as inclusive as possible with articles that met inclusion criteria. Thus, the decision was made to publish as 2 separate articles. However, given the initial search strategy focused on recurrence rates, it is possible that there are some articles that focus on mortality rates associated with initial margins employed during MMS that could have been missed. We feel this to be very unlikely given the limited number of papers published on the topic of MMS in the setting of melanoma, especially those that include and present the initial margin taken. The authors feel confident this dataset represents a true comprehensive list of inclusion articles that have been published on the topic.","title":"Disease-specific survival of malignant melanoma after Mohs micrographic surgery is not impacted by initial margins: A systematic review and meta-analysis"}
{"_id":"cb60d881-00d4-f0bf-54e3-9d44244467e8","text":"The assumption that lymphatic drainage to cervical lymph nodes primarily originates from perivascular (glymphatic) transport receives some support from previous experimental animal research showing lymphatic drainage from cerebral perivascular circulation, even though these early studies could not define the anatomical link between the perivascular compartment and lymphatic pathways.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"cb618e39-979d-b728-8614-279104d85baa","text":"Chemo-denervation with BTA is an off-label use of the product prior to abdominal wall reconstruction to achieve temporary muscle paralysis. It allows for the reduction of the size of the hernia defect as well as thinning and lengthening of the abdominal wall musculature with partial reduction of the hernia sac contents into the abdominal cavity . These effects facilitate fascial closure and in some cases, can obviate the need for additional myofascial release . Thus, maintaining virgin planes for future repair in case of a recurrence.","title":"Preoperative botulinum A toxin as an adjunct for abdominal wall reconstruction: a single-center early experience at an Academic Center in New York Toxina botulínica A pré-operatória como adjuvante na reconstrução da parede abdominal: experiência inicial em Centro Acadêmico em Nova York"}
{"_id":"cb623e9f-eca3-e3e4-872f-2babd967332a","text":"The second part of the analysis will be to extrapolate the observed results in OVIVA beyond the clinical trial, in order to explore the potential lifetime cost-effectiveness of a switch in antibiotic administration route strategy. This extrapolation will be made in each diagnostic group, using estimates of long-term recurrence from the literature and the observed recurrence rates observed within the period of the trial. We will also use the published longer term costs associated with disability in order to reflect the consequences of treatment failure that persist beyond the end of the trial. Taking these estimates together, we will extrapolate the costs beyond the period of observation within the year of follow-up in the trial. This will necessarily involve a series of assumptions in applying estimates from the literature, and extensive sensitivity analyses will be examined in order to explore the robustness of the estimates.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"cb777228-eb1e-6a5b-d38d-2eb8884b76ea","text":"This study aimed to conduct a systematic review of the scientific literature to identify and summarise evidence on the relationships between maternal FAS during preconception and pregnancy and the risk of ankyloglossia in the offspring.","title":"Maternal folic acid supplementation and the risk of ankyloglossia (tongue-tie) in infants; a systematic review"}
{"_id":"cb7945d3-2af1-bd25-778d-e330798ea26f","text":"From December 2007 to December 2018, a total of 104 patients with jaw neoplasms that underwent reconstruction with free vascularized fibular flap were retrospectively analyzed; seven of these cases had postoperative vascular crisis during mandibular reconstruction.","title":"Jaw reconstruction with vascularized fibular flap: The 11-year experience among 104 patients"}
{"_id":"cb7f75e3-0d5d-8e55-2026-6b4fbcb68ed7","text":"To compare imprint cytology and paraffin section histology for sentinel lymph node detection in women with breast cancer treated with neoadjuvant chemotherapy.","title":"Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy"}
{"_id":"cb83f91d-cfe5-d319-2205-ba9915b0c9a5","text":"It should also be noted that the study is set in one UK medical school (due to issues of access and practicality) and it is conceded that extra student numbers would lend statistical power to the findings. We were unable to find any other UK studies which looked specifically at the career intentions of first year medical students with which to compare our results. Many of the other studies quoted were completed outside the UK and some time ago. They therefore involved very different student populations and are, consequently, difficult to compare reliably.","title":"Who wants to be a surgeon? A study of 300 first year medical students"}
{"_id":"cb86cd1d-d284-4bbf-0583-cf1f77131a1c","text":"Doppler ultrasound screening is an effective method to detect deep venous thromboses and begin early treatment, as demonstrated by the affected patient in this series. Ultrasound is a safe alternative to chemoprophylaxis and avoids unnecessary bleeding and hematomas. Sequential compression devices do not reduce the risk of deep venous thromboses in plastic surgery outpatients treated with total intravenous anesthesia. Therefore, the author has discontinued their use.","title":"Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures"}
{"_id":"cb8b9578-ab7a-bf33-9a61-03ced5e6fee9","text":"Our series demonstrated a predominance of the infections in winter. The seasonal variation in this study may be attributed to the high incidence of diseases (predisposing factors for CPCSSTIs) in winter. Previous studies indicate that an increase of outdoor air pollutants corresponds to increases in diabetes and liver morbidity, and the effects are stronger in the cool season than those in the warm season; females and the elderly were generally more vulnerable to outdoor air pollution. In addition, the high prevalence of CPCSSTIs in winter may probably due to bathing is restricted because of the extreme cold weather in winter in northeast China. Meanwhile, some of the patients were farmers; they did not come to the hospital until the harvest in autumn was over.","title":"Complicated Posterior Cervical Skin and Soft Tissue Infections at a Single Referral Center"}
{"_id":"cb9fa863-2d89-ab50-b666-7e76bb807022","text":"The lateral breast flap sling procedure is a novel technique that may serve as an option to the reconstructive surgeon to improve lateral breast contour and improve superior pole volume. The technique may be combined with other autologous breast reconstruction revision procedures to provide a more aesthetically pleasing breast in both unilateral and bilateral mastectomy patients. The use of this technique is associated with a low complication rate and does not significantly increase the total number of reconstructive procedures or duration of reconstruction. The technique may also be useful during initial free tissue transfer.","title":"The Lateral Breast Flap Sling: A Novel Technique for the Revision of Autologous Breast Reconstructions"}
{"_id":"cba1dfef-5e53-031d-2c4c-3ab375a94792","text":"To attend the JDA clinic patients are initially referred internally from different departments within CUH. Table 1 outlines the origin of both the original referral to the hospital, and the source of the internal referral to the JDA.","title":"The orthodontic-oral surgery interface. Part one: A service evaluation and overview of the diagnosis and management of common anomalies"}
{"_id":"cba46764-727d-d878-41df-35013b18d110","text":"The trabecular structure and compact bone limits were analysed according to the detail level corresponding to the one commonly used in clinical practice for the diagnosis of conventional radiography images and at the standard at which the differentiability of trabecular and compact bone structure is an important requirement to the quality of conventional X-ray images in clinical routine. It does not pretend to meet the resolution and detail level of existing technologies for the detailed evaluation of trabecular structures for the evaluation of e.g. osteoporosis by techniques like fractal analysis.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"cba6950d-7838-c0b6-89d7-f7166ab0da48","text":"Overview of own operative and clinical with vascular reconstructive possibilities in surgical approach and tactic as well as their management in complex visceral-surgical applications as well as their reflection in selected scientific references.","title":"Abstracts DGG"}
{"_id":"cbb44201-3a28-2b32-723f-507f2db9a88c","text":"The increasing demand for adult orthodontics and orthognathic surgery increases the need to understand the facial aging process.","title":"Age Changes of Jaws and Soft Tissue Profile"}
{"_id":"cbb55d8b-1bfe-8fe0-e3d5-d0fa9bc1c1dc","text":"The number of patients in Sweden with a severe injury of the lower limb is low. In this material, only 13 limb reconstructions for open tibial fracture were performed every year. Knowledge about outcome of different treatment strategies is crucial to manage these patients properly and provide them with appropriate information on prognostic aspects. To be able to ensure best treatment, these patients with severe open tibial fractures should be treated at dedicated trauma units by multidisciplinary teams with both orthopedic and plastic surgeons. This information may therefore be important to health providers to plan the appropriate and cost-effective management of patients with these severe injuries.","title":"Lower extremity soft tissue reconstruction and amputation rates in patients with open tibial fractures in Sweden during 1998–2010"}
{"_id":"cbbf527f-7638-a56c-1ef7-4edca1499cf1","text":"In this study, we evaluated the manifestation of allergic march associated with the development of PFAS in a birth cohort study of the general population in Tokyo. Sensitization to pan-allergens at 5 and 9 years of age was associated with an increased risk of PFAS at 13 years of age. Sensitization to Cry j 1 and Fel d 1, but not Der p 1, Der f 1, or Can f 1, at the ages of 5 and 9 years was associated with an increased risk of PFAS at 13 years of age. In particular, the sensitization to Bet v 1 at ages 5 and 9 years was associated with a strong risk of PFAS at the age of 13 years. Previous development of any allergic symptoms of wheezing, eczema, or rhinitis at 5 or 9 years of age was associated with a risk of PFAS at the age of 13 years. Moreover, the previous development of triple symptoms of wheezing, eczema, and rhinitis strongly affected the development of PFAS at the age of 13 years. Previous development of allergic symptoms with Bet v 1 sensitization most significantly affected the development of PFAS at the age of 13 years.","title":"Pollen Food Allergy Syndrome in Allergic March"}
{"_id":"cbda25df-5d08-0a46-19be-4bb2ba58bb64","text":"The degree of inflammation around the site of disease may be used as a reliable predictor of outcome 9,15. In one series of patients, there was a statistically significant association between visible association and histopathologic clearance 15. In our series of 22 patients, one patient failed to show any inflammatory reaction to imiquimod. It was this same patient who was the only subject to have persistent positive margins with MIS despite the treatment for 12 weeks. Our data support the observation from previous reports that a positive inflammatory reaction signals a better clinical outcome in these patients.","title":"Using topical imiquimod for the management of positive in situ margins after melanoma resection"}
{"_id":"cbe57c4a-1dce-daed-aaec-5546270c736f","text":"The main aim of the study was to analyzing the influence of three different surgical techniques on vein structural damage.","title":"Influence of Three Different Surgical Techniques on Microscopic Damage of Saphenous Vein Grafts—A Randomized Study"}
{"_id":"cbeae65b-aa42-6f4b-6f6e-7c12ecfa2f26","text":"In comparison to spheroids treated with a single PDT session, those treated with numerous PDT sessions exhibited much less development potential. These results serve to emphasize the importance of continuing research on prolonged light delivery for PDT in brain cancer.","title":"Reactive Oxygen Species Produced by 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Cancer"}
{"_id":"cbff8c86-4bdf-a3af-e448-6f695dd05bfd","text":"Therefore, we hypothesized that TPVB alone could potentially keep the patient awake to cooperate with the surgeon and also achieve analgesia in MWA of lung tumors. Based on this hypothesis, the current study aimed to compare the intra- and postoperative pain in patients under ultrasound-guided TPVB using a single injection of 40 ml of local anesthetic administered at the T4 level with that of local infiltration anesthesia. This would provide a basis for TPVB alone to be used in MWAs of lung tumors and provide an effective and convenient anesthetic modality for the surgeon and patient.","title":"Single ultrasound-guided thoracic paravertebral block with a large volume of anesthetic for microwave ablation of lung tumors"}
{"_id":"cc00d049-9d93-f39a-3613-6b597517abd9","text":"In the adult form, desmoid tumors most commonly develop in the anterior abdominal wall (arising from the rectus abdominis muscle) and in the shoulder girdle but may arise in any skeletal muscle. Retroperitoneal desmoids are common in familial Polyposis coli and Gardner syndrome and tend to be related to abdominal surgery.","title":"Congenital Desmoid Tumor of the Cheek: A Clinicopathological Case Report"}
{"_id":"cc018483-06be-d0e7-e3e5-6b66d069ec62","text":"Patients often decide to undergo implantoprosthetic treatment because it allows the missing teeth to be replaced without disturbing the neighboring ones, as was the case with traditional methods of dental prosthetics. Despite the generally large advantage this treatment modality has over other therapies, it also involves a high risk of developing periimplant inflammatory conditions. As the popularity of implant therapy grows, there are more and more patients who experience bone loss around the implants. The causes of periimplantitis may vary, but it is generally believed that the most common one is suboptimal oral hygiene. In many cases, keeping proper oral hygiene is hindered by faulty dental restoration, performed without taking account of the biological spaces of the dental prosthesis, and the insufficient amount of keratinized gingiva tissue. Because implantology is a relatively new field of dentistry, all the factors and possible causes of periimplant inflammation have not yet been fully understood. However, the main identified reason for the development of periimplantitis is believed to be microbial contamination. This is why there is a need for treatments allowing the elimination of microorganisms from the implant and its vicinity, and measures are sought that would exhibit biocidal efficacy without affecting the surrounding tissues.","title":"The Efficacy of a Diode Laser on Titanium Implants for the Reduction of Microorganisms That Cause Periimplantitis"}
{"_id":"cc01b45c-f773-9069-ad0c-a40a986070d6","text":"In conclusion, our results suggest that the presence of noncaseating granulomas on skin biopsy along with BAL lymphocytosis, a high CD4\/CD8 ratio, and an elevated serum ACE level are associated with progressive disease. Cutaneous involvement in sarcoidosis is not only useful for diagnosis but may also discriminate progressive disease. Specific lesions like lupus pernio and plaques may have a prognostic significance. Punch biopsy is a simple and accurate technique that can be easily performed for the diagnosis of sarcoidosis itself and the associated cutaneous lesions.","title":"Diagnosis of cutaneous sarcoidosis; clinical and the prognostic significance of skin lesions"}
{"_id":"cc06f550-5109-443a-133e-25e3f68a9f0b","text":"In conclusion, babies must have their first dental appointment early in life so that possible diagnoses of congenital and development alterations can be made as soon as possible. This will allow an individualized plan to prevent future problems in bone development and malocclusion.","title":"Surgery Management of Rare Hypertrophic Frenum in an Infant"}
{"_id":"cc0929c1-2a5d-02b7-885e-c058d52b4634","text":"Moreover, the continuous attempts for new molecular targets of systemic therapies in metastatic patients and the clinical trials enrolment based on the tumor molecular profile require a reliable genetic and molecular characterization, which can be obtained using different tumor biopsy techniques.","title":"Uveal Melanoma Biopsy: A Review"}
{"_id":"cc0c6d46-5048-bf1a-e7c7-69dd18d53348","text":"However, to this date, there are no studies objectively comparing the preoperative and postoperative outcomes of a frenotomy in OSA patients. Our cases have shown that a frenotomy is able to modify the tongue’s position and thus help to prevent its collapse into the airway in two of three patients. The third one showed no changes after the procedure. These findings are the opposite of what was expected, that untethering the tongue would produce glossoptosis with a worsening of the UA collapse. As far as we are aware, this is the first study to use DISE to monitor the UA pattern of collapse in patients with OSA and ankyloglossia before and after frenotomy.","title":"Does Frenotomy Modify Upper Airway Collapse in OSA Adult Patients? Case Report and Systematic Review"}
{"_id":"cc23ca96-be9d-3e5f-b542-a6f27c1e80d8","text":"The predetermined primary endpoint was the change in patients’ threshold dose of ingested peanut protein to elicit an objective clinical reaction during OFC after acalabrutinib pretreatment compared to patients’ baseline. A key secondary endpoint included the change in the severity of clinical reactions during OFC, as assessed by using a modified PRACTALL scale to score symptoms. Other secondary endpoints included size of the skin test wheal to peanut extract and the percent of basophils activated ex vivo by peanut extract while receiving acalabrutinib compared to baseline. Safety endpoints included electrocardiography and laboratory blood testing, including complete blood counts and differentials, serum chemistries, and liver function tests. Exploratory endpoints included changes in circulating quantitative immunoglobulins and serum specific IgE to peanut and peanut components.","title":"Bruton’s tyrosine kinase inhibition for the prevention of anaphylaxis: an open-label, phase 2 trial"}
{"_id":"cc2de90e-3c2c-ca0c-9004-74cc4e0c6fa6","text":"In a recent study from South Korea of 188 breast cancer survivors aged 21‐79 years with a recurrence and a surveillance mammography within 1 year before the recurrence, Yeom et al reported that among the cancers that were not detected by mammography, 43% were due to cancer being obscured by dense breast tissue and 16% were due to the cancer being obscured by postoperative scar. Although our population of breast cancer survivors is older than the Yeom et al study population, it still seems likely that some of the lower sensitivity in our group of breast cancer survivors can also be explained by cancers being obscured by postoperative or irradiation scars. As we do not have data on breast density, we do not know how much of the lower sensitivity among breast cancer survivors can be explained by higher breast density among breast cancer survivors. If higher breast density among breast cancer survivors explains part of the lower sensitivity among breast cancer survivors then tomosynthesis or ultrasound could be valuable examinations.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"cc35613e-70e6-a330-90b0-619c86fe211f","text":"Following these trends, the combination of robotic-assisted surgery in combination with artificial intelligence has the potential to change the position of the surgeon from an active operator toward a supervisor within the upcoming years.","title":"Robotic-Assisted Microsurgery and Its Future in Plastic Surgery"}
{"_id":"cc3b7676-0573-0a08-89e7-4f0f26a31eab","text":"This is best suited for very large breasts and patients who have massive weight loss with skin excess.","title":"Reduction mammoplasty"}
{"_id":"cc3cfbcd-43a9-3437-0c99-abfd96ddd7d2","text":"The HDR stent brachytherapy boost was administered as soon as the external beam radiation therapy was completed without interruption. The primary tumor had completely resolved during the external beam portion of the treatment, thus optimizing the HDR stent brachytherapy. An impression of the primary tumor was made on the outer surface of the stent which aided in treatment planning. The patient comfortably tolerated the 5 fractions of 2.0 Gy per fraction HDR brachytherapy for a minimal total dose of 70 Gy in 35 fractions over 7 weeks despite the localized mucositis from the external beam radiation therapy. Posttreatment biopsies of the buccal mucosa at 6 weeks and 4.5 months have been free of cancer. The mucositis resolved within 6 weeks of treatment completion. The patient's taste has returned to normal, and there is no xerostomia. The patient remains free of disease 10.5 months following treatment.","title":"A buccal mucosa carcinoma treated with high dose rate brachytherapy"}
{"_id":"cc412840-a042-4e6d-a897-5dc0ceb9f6e6","text":"The key element was to orient the implants at the proper angle: perpendicular to the bone, while at the same time optimal for further affixation of the prosthetic. This allowed maximum utilization of the bone surface and better mechanical stability, as well as facilitating the creation of a supporting structure for the actual prosthesis in subsequent prosthetic stages.","title":"The Latest Craniofacial Reconstructive Techniques Using Anchored Implants after Surgical Treatment of Nasal and Paranasal Sinuses Tumors"}
{"_id":"cc443269-9e16-154c-3e81-f796fcdf1b7e","text":"All cases underwent radical excision with 1 cm safety margin as proved by frozen section assessment. An infiltrated lateral margin was encountered in four cases and was treated by wider excision. In three cases there was infiltration of the deep margin that was treated by excision of part of the skull with the aid of a neurosurgical team. In all cases final paraffin section staining of margins was free of tumor. The reconstruction method was tailored for every patient according to the criteria specified earlier.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"cc459fe6-75c1-3151-036f-552181d27ed8","text":"In our study, we aimed to discuss a case about development of cystic formation in the nasal dorsum ten years after rhinoplasty.","title":"The Development of Dorsal Nasal Cyst Formation after Rhinoplasty and Its Reconstruction with Conchal Cartilage"}
{"_id":"cc4a856b-e521-754c-25a1-cb3d89d7c083","text":"Histopathologic assessment of surgical margins was complicated by the complex geometry of the resection samples and by the involvement of multiple institutions with variable approaches to margin analysis. An effort was made to standardize the analysis by obtaining the tissue to be assessed from the same 3 locations in each resection sample: at one or both intestinal transection sites and through the intestinal wall at the site of the tumor. Invasion through the wall of the tumor at the serosal surface was considered to constitute an incomplete margin. Not surprisingly, transection site margins were complete in a large majority of cats, indicating that surgeons were aggressive in removing an adequate length of intestine on either side of the tumor. However, mural margins were frequently incomplete, indicating transmural invasion by the tumor and leading to a high rate of carcinomatosis. A complicating factor during margin analyses is shrinkage of normal tissues adjacent to the tumor due to exposure to formalin during the delay between surgery and histopathologic tissue assessment. Previous studies have shown contraction of canine intestinal tissue by up to 26.3% within 24 h of formalin fixation (20), and similar findings have been reported in the human literature (21). Shrinkage of normal tissues adjacent to the tumors may have falsely increased the rate of incomplete margins in the present study.","title":"Outcome and Prognostic Factors in Cats Undergoing Resection of Intestinal Adenocarcinomas: 58 Cases (2008–2020)"}
{"_id":"cc602971-564a-c5d8-96d6-ce4167918508","text":"While the incidence of skin cancers continues to rise, there remains a disproportionate lack of introductory training on skin cancer screening and identification of modifiable behaviors in medical curricula. Trainees and students have cited low confidence in their ability to counsel patients and lack of instruction as barriers.","title":"A Brief Dermatology Curriculum in Skin Cancer Detection and Prevention to Improve Medical Student Knowledge and Confidence"}
{"_id":"cc60c4e8-c5ee-1d2b-d7b9-3a0b5c6d6efd","text":"Compared to some previous studies, one aspect that made our study unique was that we had the EM residents record videos of their ultrasounds, so that we could assess the images on which they based their interpretations. We are unaware of any previous study that has specifically analyzed EP-performed DVT ultrasounds for the purpose of finding common mistakes that might be made by novice ultrasonographers. This analysis produced several interesting findings.","title":"Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis"}
{"_id":"cc7a6a72-f8a7-abee-e96c-91e98e4bb510","text":"The aim of this study was to conduct an evidence-based review of all prospective data regarding keloid treatments published between 2010 and 2020.","title":"Keloid treatments: an evidence-based systematic review of recent advances"}
{"_id":"cc8494a9-7846-fe72-68df-e47e01e2d890","text":"CONCLUSIONS These findings show that directional jetting flow from tandem bubbles can be used to induce highly controlled mechanical stimulation on individual cells.","title":"Abstracts from the International Society for Therapeutic Ultrasound Conference 2017 Nanjing, China. 31 May - 02 June 2017"}
{"_id":"cc867c4a-c186-a057-e998-2164d7e08c79","text":"Our study demonstrates that ultrasound can be used to document quantitative changes in the skin of patients with breast cancer following BCS with radiotherapy, with statistically significant differences in skin thickness between mild and severe radiation dermatitis. The study also suggested that skin elasticity may be related to individual radiosensitivity. Ultrasound can be a useful tool for non-invasive and objective assessment of skin changes during radiotherapy.","title":"The role of ultrasound quantitative parameters in the assessment of acute radiodermatitis after breast-conserving surgery"}
{"_id":"cc8d15dd-7d47-d096-d823-73ad8e8f50ad","text":"In cases displaying bidirectional lymphatic drainage, the radioactive lymph nodes located outside the clinically involved basin were excised in the same routine manner as in an SLNB. When micrometastasis in an additional nodal basin was diagnosed, no further TLND was performed.","title":"Individualized Surgery: Gamma-Probe-Guided Lymphadenectomy in Patients with Clinically Enlarged Lymph Node Metastases from Melanomas"}
{"_id":"cc904562-0c41-355b-f6ce-9ae2afef2bf2","text":"We will use techniques common in long-term cohort studies to ensure minimum loss to follow-up such as collection of multiple contact addresses and telephone numbers, mobile telephone numbers and email addresses. Considerable efforts will be made by the trial team to keep in touch with patients throughout the trial by means of newsletters etc.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"cca3d842-b377-4156-3655-4a4c01a81b05","text":"All patient data and clinical images adopted are contained in the medical files of Far Eastern Memorial Hospital. The data supporting the conclusions of this article are included within the article and its figures and tables.","title":"Reconstruction of a secondary scalp defect using the crane principle and a split-thickness skin graft"}
{"_id":"ccadc8d5-582c-3cd7-0a0e-93606f0747c2","text":"In conclusion, the inter- and intra-rater observer agreement with regard to the detection of residual glandular tissue was not excellent, which would be desirable for a method considered reproducible enough to be used as a surveillance tool after the surgical procedure in order to ensure that there is no relevant residual glandular tissue remaining warranting further follow-up. Most importantly, further studies are warranted in order to assess the oncological risk associated with residual glandular tissue and to determine whether any kind of surveillance is motivated or not.","title":"Inter- and intra-observer agreement on evaluating the presence of residual glandular tissue with magnetic resonance tomography following prophylactic mastectomy"}
{"_id":"ccc62599-0c7b-4bdf-75f1-cfbe903d47aa","text":"Various studies were conducted to explain the etiology and management of postthoracotomy shoulder pain. Theories on the etiology involved either musculoskeletal origin or referred pain.","title":"Preoperatıve Ultrasound-Guıded Suprascapular Nerve Block for Postthoracotomy Shoulder Paın"}
{"_id":"ccd5f610-de21-7cb8-5a6a-bdb2817e32f1","text":"The present study investigated time trends in QOL up to 5 years postoperatively after breast conserving surgery versus mastectomy in an Indian population. This information can be used to tailor the treatment suitable to available expertise and resources in this low-resource setting.","title":"Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India"}
{"_id":"ccd9d09e-90af-72f4-ae63-6a841a012781","text":"The common sentinel node draining the breast and the trunk skin probably reflects the dominant lymphatic pattern of ectodermal structures and adds to the anatomical evidence to support the concept of the first draining node to a regional basin. The application of new technologies to cancer staging has to be guided by the natural history of the various cancer types. Detection of regional metastases has different prognostic implications for breast cancer and melanoma and management decisions need to be made on evidence based clinical criteria rather than any incidental findings.","title":"Breast carcinoma and malignant melanoma metastasis within a single axillary lymph node"}
{"_id":"ccdadfd2-93ef-0235-f14e-3490e256c1a5","text":"The general main surgical treatment for invasive malignant melanoma consists of wide surgical excision with clear histological margins and removal and examination of the sentinel node—the first drained lymph node to be affect by metastatic disease—to detect occult disease for staging and prognosis [4], and in selected cases complete lymph node dissection. The aim of this review is to present data for the optimal surgical management of patients with malignant melanoma.","title":"Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection for Melanoma"}
{"_id":"ccdb7dbe-54ae-326c-36cb-9649cdf1f4a1","text":"From a third to a half of the radius may be harvested for limited bony defects. Care must be taken not to detach the flexor pollicis longus muscle attachment to the radius, although a portion of the muscle is included in the flap as a muscle cuff that contains the radial artery perforators nourishing the bone. The distal limit of the bony flap is the insertion of the brachioradialis tendon and the proximal limit is the pronator teres muscle insertion. Osseointegrated implant placement in the radial bone flap has been accomplished but it is generally accepted that these are less reliable than those performed in the other bone flaps.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"ccedc16f-57e0-0793-0d05-ba66ea3050cb","text":"The present study demonstrates that low vitamin D levels are associated with a lower incidence of BCC and SCC. Vitamin D serum levels above 18 ng\/ml may increase the risk of NMSC.","title":"Vitamin D serum levels and non-melanoma skin cancer risk"}
{"_id":"ccf116ab-380c-89ad-94e0-2d2d5c210207","text":"In our study of the factors associated with DVT in neurosurgery patients and overall incidence in surgically operated cases, we found that only the Well’s score and the number of days in bed were significant predictors of the risk for developing DVT when other confounders were adjusted. Those who were in the high risk groups of the Well’s score were at a significantly higher risk of developing DVT, and with every passing day a patient remained non-ambulatory, the risk of DVT increases as well. Despite the use of mainly mechanical and single modality prophylaxis, the rate of occurrence was in fact fairly similar to other centres which used dual modality prophylaxis; suggesting that single modality can be considered for most cases, and advocating dual modality is for high risk cases only.","title":"Deep Vein Thrombosis and the Neurosurgical Patient"}
{"_id":"ccf6de81-7cc3-777f-ac12-22bc782c7edb","text":"Calcinosis cutis can significantly worsen health-related quality of life, depending on lesion location and size, increasing the risk of infection, and leading to deformities, particularly in patients with SSc [1]. While deep learning technological advancements have improved the performance of image recognition in the field of medical image analysis including the diagnosis of skin diseases [26], computer vision has not been previously applied to the problem of CC quantification. Given a lack of standardized and validated methods to assess CC disease burden, accurate and precise CC quantification represents an unmet medical need. This study evaluated the utility of applying a CNN algorithm to DECT hand images of SSc patients to differentiate CC lesions from adjacent healthy bone and to permit rapid and reproducible quantification of CC lesional area. We found that the computer vision method applied to finger images had a substantial degree of concordance and was highly accurate compared to gold standard radiologist area estimates. These data suggest that computer vision may be a useful approach for CC disease burden quantification.","title":"Computer vision applied to dual-energy computed tomography images for precise calcinosis cutis quantification in patients with systemic sclerosis"}
{"_id":"cd051bd4-dd0d-2a88-c3c1-f32c1b523f0f","text":"Totally 180 cases of microtia reconstruction using tissue expander and autologous costal cartilage over 2 years were enrolled, while two age groups were compared regarding operative time, tissue expansion, number of autologous costal cartilage harvested and complications during and after reconstruction.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"cd08bda7-660d-8d96-4205-ca80ea83ca09","text":"Herein, we present two cases of biceps brachii and brachialis paralysis due to musculocutaneous nerve injury and reconstruct elbow joint flexion using rotational transfer of the latissimus dorsi muscle with sutures to the radial and ulnar tuberosities, thereby enabling flexion by simultaneous activation of the humeroradial and humeroulnar joints.","title":"Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports"}
{"_id":"cd1622f7-c825-2e4e-7b68-ed25276b05e6","text":"The fat injection is the most common technique of penile girth enhancement. The fat harvested from the patient is implanted into the subdartoic space with the objective to symmetrically and uniformly increase the circumference of the penis.","title":"Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases"}
{"_id":"cd18d759-e292-72d8-2711-eaab20933b1a","text":"None of the 133 patients had clinical evidence of involvement of the deep lymph nodes at the time of initial staging with CT and ultrasound.","title":"Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors"}
{"_id":"cd1e7bbd-611f-477a-2884-3b412ae15278","text":"In conclusion, we have shown in our case series that free vascularized fibula transfer has gained an important place in the field of skeletal reconstruction and is a reliable method for different bone reconstructions. We used the fibula flap as a salvage procedure in our cases. Although the number of our patients was small, we achieved successful results for the forearm, foot, humerus and tibia. The objective results of more comprehensive studies on this subject and the use of clinical guidelines will contribute to determining which patients will need vascularized fibula transfer to save their limbs and which will have better results with amputation.","title":"The Use of Free Fibula Flap in Different Extremities and Our Clinical Results"}
{"_id":"cd206b6d-22e0-d531-f1e4-21d360ec96ec","text":"One final point that was difficult to explain was why DSS was associated with margin distance but RFS was not. One would assume that patients who recur are more likely to die of their disease and as such they should be tightly associated. The correlation between the margin status and DSS may be stronger than with RFS because there was other prognostic factors that had a significant influence on RFS, which “dilutes” this correlation.","title":"Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck"}
{"_id":"cd2224a6-2a37-ee7d-7cff-3be57e6643b1","text":"In this study, we presented clinical outcomes in 18 patients with massive tibial defects caused by osteomyelitis who underwent operation using induced membrane followed by trifocal bone transport and to summarize our experiences regarding these combined surgical approaches in the reconstruction of massive tibial defect.","title":"Reconstruction of massive tibial defect caused by osteomyelitis using induced membrane followed by trifocal bone transport technique: a retrospective study and our experience"}
{"_id":"cd231359-30e7-bf16-1a80-103a050061fe","text":"The results of this study show that WB-MRI plays a key role in early diagnosis of CRMO by identifying typical symmetric patterns of multifocal bone lesions. For the first time, this study introduces quantitative imaging features of bone lesions in CRMO, which can be useful for the prediction of clinical response.","title":"Early diagnosis and response assessment in chronic recurrent multifocal osteomyelitis: changes in lesion volume and signal intensity assessed by whole-body MRI Kieninger et al"}
{"_id":"cd27082e-7ea1-27c2-0433-2a30cf428d96","text":"Results of actual clinical cases are needed to evaluate the use of fibula positioning devices for facial reconstructions when soft tissues are included in the flap. In an actual surgery, the soft tissues may cause interference, so the positioning device must be designed in consideration of this. The positioning device was manufactured based on the simulation results using the patient’s actual CT data, so it is presumed there will be similar clinical outcomes as shown in the present study when only the bone segments are reconstructed using the fibula or when a fibula with little muscle fibers is used. In addition, future designs of the positioning device should be adjusted based on the soft tissue data.","title":"Precision of fibula positioning guide in mandibular reconstruction with a fibula graft"}
{"_id":"cd27218f-5d95-6953-6d36-4131e8360234","text":"Quadrant ultrasound scanning technique of the breast. The breast is divided into four quadrants as shown and then each quadrant is scanned both vertically and horizontally. Care should be taken that all scans overlap to ensure scanning of the entire breast.","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"cd2928fb-f425-1150-bf97-5a9e9ee1e701","text":"Regarding our patient, we treated him with a combination of surgical approach with intravenous application of binding agents which have led to a successful outcome. However, it should be stated that local flap techniques showed no benefit but merely buried skin grafting was finally crowned with success. Therefore an interdisciplinary approach to this disease via supporting drug therapy and surgical measures may be a promising way to treat patients suffering from Calciphylaxis. The patient was then discharged into rehabilitation centre without further wound problems in his soft tissues and until recently showed no signs of a relapse of Calciphylaxis (Figure 3 ).","title":"Calciphylaxis – a challenging & solvable task for plastic surgery? A case report"}
{"_id":"cd2e10be-46fb-92a6-2d1f-2448288dc835","text":"The training of fellows in subspecialties in sub-Saharan Africa has conventionally entailed candidates going to host institutions in the developed world for 12 to 24 months of training and subsequently returning to their home countries to practice their newly acquired skills. However, a significant limitation to this traditional model has been the lack of an enabling environment and\/or institutional capacity in the fellow's home country. Such limitations prevent the new fellow from practicing in a meaningful way the new skills he or she has learned, to the disadvantage of both the patients and the fellow. This can result in the fellow electing to license and practice elsewhere if there are no other pathways of career development in place in the fellow's home country [15].","title":"Sub-specialization in plastic surgery in Sub-saharan Africa: capacities, gaps and opportunities"}
{"_id":"cd2f21be-2c7c-8de8-d20e-1103e4eee4b1","text":"Photodynamic therapy and topical pharmacotherapy are other non-invasive interventions that may be utilized to treat superficial, low-risk non-melanoma skin cancers. Photodynamic therapy begins with topical application of a solution containing photosensitive porphyrins, such as aminolaevulinic acid and methyl-aminolaevulinic acid, to the affected tissue.8,35 After a latency period of 4−20 hours, the photosensitive porphyrins are illuminated with visible light and produce radical oxidative species that are cytotoxic to the malignancy.8,35 Most regimens include 2 or more treatments and can produce clearance rates ranging from 50% to 95%.8,40–43 This treatment is generally well-tolerated, though patients may suffer from pain, chronic open wounds, and hyperpigmentation.","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"cd392229-11cd-2fa0-0d03-64ebedd836a3","text":"These studies show that reankylosis is a common complication irrespective of surgical technique which is used treating the TMJ ankylosis.","title":"True bony TMJ ankylosis in children: Case report"}
{"_id":"cd3a623d-f45c-ae11-f531-c80b55cf5922","text":"On the basis of our results we will advocate a combination of methods as the safest way for reliable monitoring of critical and\/or buried flaps. We are aware that our good results were reduced by the O2C measurements, but clinically the application of invasive methods as ICG-videoangiography or flowmeter analysis at the anastomotic region is not always immediately possible. Implantable Cook-Schwartz Doppler probes or flow coupler devices might be therefore the regional methods of choice in daily usage and improve salvage rates. Moreover, a combination of two established methods is enough and an additional third method is not always beneficial.","title":"A comparative analysis using flowmeter, laser-Doppler |spectrophotometry, and indocyanine green-videoangiography for detection of vascular stenosis in free flaps"}
{"_id":"cd3ee647-3c21-c4c1-48eb-4f1c46068261","text":"The safety population consists of all patients receiving at least one treatment and who undergo at least one post-baseline safety assessment. The statement that a patient had no adverse events also constitutes a safety assessment.","title":"Daylight photodynamic therapy versus cryosurgery for the treatment and prophylaxis of actinic keratoses of the face − protocol of a multicenter, prospective, randomized, controlled, two-armed study"}
{"_id":"cd44c8d0-a24a-2a43-67fd-8f53dad82ccc","text":"The various approaches to the brachial plexus afford the anesthesiologist the ability to provide both excellent intraoperative anesthesia as well as postoperative analgesia with minimal complications and increased patient satisfaction following upper extremity surgery. The advantages over general anesthesia are numerous when performed in skilled hands. Ultrasound guidance with real-time needle visualization in relation to anatomic structures and target nerves makes regional anesthesia safer and more successful. With ultrasound guidance in experienced hands, brachial plexus blockade can lead to decreased block performance and onset time, increased success rate and decreased rate of complications. These advantages result in increased operating room efficiency, as well as increased patient and surgeon satisfaction.","title":"Ultrasound-Guided Regional Anesthesia for Procedures of the Upper Extremity"}
{"_id":"cd4f4983-ad1e-4af8-0bdc-5b7c3f053430","text":"Peng et al presented a case report about ultrasound-guided suprascapular nerve block and confirmed the findings with anatomic cadaveric dissection, concluding that by positioning the ultrasound probe in the coronal plane over the suprascapular fossa with a slight anterior tilt, the nerve can be visualized on the floor of the scapular spine between the scapular notch and the spinoglenoid notch. In a prospective study, Beach et al found that positive motor response to nerve stimulation did not increase the success rate of the nerve block when a satisfactory image of the suprascapular nerve was not obtained. In addition, false-negative rates proved that ultrasound-guided blocks were usually effective, even in the absence of a motor response.","title":"Preoperatıve Ultrasound-Guıded Suprascapular Nerve Block for Postthoracotomy Shoulder Paın"}
{"_id":"cd4fa9a1-9fe7-1395-995f-7a0cfa693c3b","text":"Polymethylmethacrylate has been used successfully in medical implants such as orthopaedic bone cement and craniectomy plates for more than 65 years. Compared with other biomaterials for the treatment of wrinkle lines and soft tissue loss, which degrade within a few months to years, PMMA is a non-resorbable synthetic chemical with a permanent effect.","title":"Injectable fillers: current status, physicochemical properties, function mechanism, and perspectives"}
{"_id":"cd578570-1dd2-8f93-0c7d-8bede69ae6c4","text":"Here, preclinical studies of the last five to ten years are discussed that are investigating approaches to overcome the obstacles seen in recent clinical trials.","title":"Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions"}
{"_id":"cd5ab570-7b67-504d-4c8a-c4fa332efd4b","text":"Our treatment policies provide a prophylactic use of a topical therapy to prevent skin damages. The purpose of this study was to add to the subjective evaluation of the topical therapy, an instrumental measurement for the assessment of skin damage induced by radiation therapy.","title":"Preventing the acute skin side effects in patients treated with radiotherapy for breast cancer: the use of corneometry in order to evaluate the protective effect of moisturizing creams"}
{"_id":"cd65ad75-9e70-f97c-c7ef-a09436663cbd","text":"The main limitation of our study was that we did not biopsy the wound after allograft detachment to define if sloughing was only limited to epidermis.","title":"Human Split-Thickness Skin Allograft: Skin Substitute in the Treatment of Burn"}
{"_id":"cd6e518f-1a44-93e0-11ba-2f83f6030d12","text":"The primary purpose of our study was to assess the recent diversity of academic medical leadership in terms of program directors and chairpersons for several surgical and nonsurgical specialties in comparison with the averages across all specialties. Our secondary objective was to examine changes in chairperson diversity from 2007 to 2019 using a snapshot analysis for each specialty. For continuity, the specialties chosen have been similarly analyzed in other studies. Although diversity in medicine has been previously examined in residents and faculty members, few studies have included the representation of program directors and chairpersons.","title":"Racial, Ethnic, and Sex Diversity in Academic Medical Leadership Racial, Ethnic, and Sex Diversity in Academic Medical Leadership"}
{"_id":"cd6f2033-5461-23a2-c801-a30aba9daba9","text":"Neither complete nor partial necrosis occurred in any case in this report. Necrosis usually happens when there is tension or twist on the pedicle. Some believe that keeping the humeral tendon insertion attached can minimize the occurrence of this problem. Indeed, the extended LD flap is bulkier with the additional fat and it requires less mobilization making the division of the humeral insertion unnecessary in most cases. The division should be considered only in few cases when it is necessary to obtain adequate excursion of the extended latissimus dorsi flap or in thin patients where the bulkiness in the axilla may be readily noticeable. Furthermore, the bulkiness of the axilla created by the undivided tendon will decrease with time as the muscle atrophies.[7] The latter authors have chosen to divide the nerve in their series to prevent potential postoperative involuntary muscle contraction and hence they have expected future considerable decrease of the bulkiness in the axilla.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"cd71de66-9541-c01b-7a3c-93aa8e0bb2d7","text":"The distribution of the drainage sites of the 127 SLNs are described in Table 2.","title":"The Lymphoscintigraphic Study of Unpredictable Head and Neck Cutaneous Melanoma Lymphatic Drainage"}
{"_id":"cd746d25-7cdc-2412-231f-ae1d0914b02c","text":"The aim of this study is to evaluate the efficacy of a lingual frenectomy performed through diode lasers to improve the length of frenulum and the severity of OSAS in pediatric patients.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"cd7684af-a895-8cd5-3e8c-fe77e979b377","text":"Skin incision was made along the iliac crest: from the base of the sacrum to the anterior superior iliac spine; from the midline of the sacrum and coccyx to about 2 cm superior to the anus; and from the lower end of the previous incision, along the gluteal fold, to the lateral aspect of the gluteal region. Next, a midline incision in the posterior thigh was made from the gluteal fold to 4-5 cm below the popliteal fossa and extended laterally around the leg. Skin and superficial fascia were extended from the midline to the lateral aspect of the thigh, creating two flaps of skin that can be closed following dissection. After reflecting the gluteus maximus, the heads of the hamstrings in the posterior thigh were identified at their attachment to the ischial tuberosity. There was an attempt to separate the heads of the hamstring muscles by blunt dissection, which is when the semitendinosus and LBF muscles were found fused by a common head at the origin of the ischial tuberosity.","title":"Rare Fusion of the Semitendinosus and the Long Head of the Biceps Femoris Muscles in a Human Cadaver"}
{"_id":"cd88dae0-9629-4f08-a2ed-6fabc7f5ecbd","text":"The LICAP is located at the junction of the midaxillary line and the lower border of the corresponding rib in the 3 rd to 11 th intercostal space. Because of the short pedicle length, it is possible that some breast defect reconstructions might require only the lateral quadrant. 4 The DICAP is placed up to 5 cm lateral to the midline posteriorly. Therefore, DICAP flaps were used to treat midline defects in the back. De Weerd and Weum reported using the DICAP to close cervicothoracic midline defects after spinal surgery. 12 Their study was similar to our study because ICAP flaps were used for the management of infected wounds, although it differed in the use of the medial branches of DICAP and a rotational-style flap design.","title":"Clinical Applications of the Intercostal Artery Perforator Flap for Trunk Reconstruction"}
{"_id":"cd8e4592-f831-0cea-69fb-88de481e46b4","text":"Background: One of the commonly cited reasons by parents for not giving epinephrine in the prehospital setting is the inability to recognize the symptoms of anaphylaxis. The main goal of this study is to assess parents’ ability to recognize the symptoms of anaphylaxis and to correctly make the decision to give epinephrine when appropriate.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"cd8e716b-6f86-ff9a-7c40-609d0ad93a8c","text":"When treating superficial, low-risk non-melanoma skin cancers, cryosurgery has a 5-year recurrence rate, ranging from 1% to 5%.36–38 While effective at treating superficial, low-risk malignancies, cryosurgery is more often used to treat actinic keratoses—a premalignant lesion associated with squamous cell carcinoma. Cryosurgery is highly effective for the treatment of actinic keratoses, with clearance rates reaching 99%.39","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"cd8eaf1f-9aa1-cbb4-a926-8a997ac23218","text":"Additionally, regarding the elasticity of the DG, it was appreciated early during the study that the DG had a prominent elasticity, not necessitating a meshing procedure to cover the larger recipient areas. It is a significant limitation of the present protocol that we cannot present data on the expansion rate of the DG. This is an important topic to address for the next study. However, we think that the fact that the unmeshed DG could be expanded so that it covered the recipient area of a similar size as the meshed STSG supports the idea of the potential of a favourable cosmetic outcome for the recipient site of the DG as compared to a regular STSG.","title":"A prospective dual-centre intra-individual controlled study for the treatment of burns comparing dermis graft with split-thickness skin auto-graft"}
{"_id":"cd91f14e-8e85-c661-1e02-7cc1070655d2","text":"The World Health Organization recommends exclusive breastfeeding until 6 months of age. Maternal attitudes toward infant feeding are correlated with chosen feeding method and breastfeeding duration. The Iowa Infant Feeding Attitude Scale (IIFAS) has been used to assess attitudes towards breastfeeding prenatally and is predictive of breastfeeding decisions in certain population groups.","title":"Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study"}
{"_id":"cd9aa08c-cf11-b0ad-7fe6-5d8d2fa639d0","text":"We also found that reactions occur more frequently outside of the home, particularly in public places that serve food. This trend highlights an educational gap in the food industry. The provision of epinephrine auto-injectors in public places such as food courts may be one way to address this, similar to how cardiac defibrillators have been implemented in public places to avoid cardiac deaths. Our next steps include expanding our study to include anaphylaxis deaths in other provinces across Canada, and to develop a national registry to track mortality due to anaphylaxis aimed at identifying potentially modifiable causes and to better inform patient and public education.","title":"Anaphylaxis-related deaths in Ontario: a retrospective review of cases from 1986 to 2011"}
{"_id":"cdabbaae-07f8-7011-a6f4-12b7bb24e47b","text":"Substantial variation in the hazard of secondary palate surgery exists depending on a child’s age at primary palate repair and the hospital and surgeon performing their repair. Performing primary palate repair before 9 months of age substantially increases the hazard of secondary surgery. Further research is needed to identify other factors contributing to variation in palate surgery outcomes among hospitals and surgeons.","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"cdad4984-4d58-58c6-9ed3-564cd927e237","text":"Surprisingly, this rule may also apply to breast cancer care, because even if the surgical skills required in most cases are not usually complex, the need for a comprehensive, multidisciplinary management does seem to play a difference. This has prompted a debate regarding how to guarantee women with the best care possible through a preferential access to specialized breast cancer centers.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"cdadba1b-5ed9-0192-b2e3-4e64e6b985fb","text":"Fasciocutaneous perforator flap combined with Masquelet technique provides a reliable and versatile alternative for patients with composite defects resulting from lower extremity infection.","title":"Simultaneous reconstruction of septic composite defects in lower extremities: Combination of fasciocutaneous perforator flap and Masquelet technique"}
{"_id":"cdb10a8d-ef4e-2a8d-bf7b-e7864cc927d1","text":"In addition, our study revealed significant disparities in the occurrence of surgical margin involvement among patients with cSCC, which is known to be a risk factor for local recurrence and metastasis. A substantially higher rate of initial surgical margin involvement was noted in individuals with SCC localized in regions with high sun exposure. This discrepancy may be ascribed to the intricate anatomy of facial areas, where the presence of vital functional structures frequently constrains the feasibility of extensive excisions, consequently elevating the risk of compromised margins. This higher rate of initially affected surgical margins resulted in a greater number of surgical reinterventions in the group of tumors located in highly sun-exposed areas. The final clearance of surgical margins was very similar in both groups, which does not account for the differences in local recurrence rates between the two groups. To mitigate this risk, Mohs surgery represents a viable treatment option for high-risk cSCC cases. This technique has demonstrated superior outcomes in this specific subgroup of patients [15]. The fact that all our patients were treated with conventional surgery could explain the higher rate of affected margins obtained in our study, especially in tumors located on the head and neck, compared to studies where Mohs surgery is performed for cSCC.","title":"Increased Risk of Local Recurrence in Cutaneous Squamous Cell Carcinoma Arising in Sun-Exposed Skin: A Retrospective Cohort Study"}
{"_id":"cdb8d03b-0a8e-a812-9b41-7e6541a7f220","text":"All the patients were evaluated with detailed history and a thorough physical examination and also preoperative photographs were provided. All the procedures were performed under general anaesthesia with open technique using the transcolumellar and infra-cartilageous incisions.","title":"Component Rhinoplasty"}
{"_id":"cdcf864c-92fc-f1d2-6f89-6b397974f06f","text":"The postoperative regimen starts with 6 weeks without any weight bearing in cases of internal fixation in a below-knee plaster cast and in cases of external fixation without external support. Thereafter, weight bearing in a plaster cast and removal of the external fixation depends on radiographic judgment of bone healing.","title":"Revision arthrodesis of the ankle Posterior inlay bone grafting in 11 patients"}
{"_id":"cdd64c31-925b-085a-08c2-0d84a748257b","text":"The outcomes of topical pharmacotherapy are heavily dependent on patient compliance but exhibit cure rates ranging from 85%−90%.8,44–46","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"cdd782a7-819f-5786-7f3b-ecdaa4720256","text":"Blood thinner medications (anticoagulants) are typically prescribed for the treatment of a DVT or PE. These medications increase the time it takes for blood to clot and helps to prevent new clots from forming and existing clots from growing. Anticoagulation therapy allows the body to dissolve the clot over time while preventing a new or worsening blood clot.","title":"Vascular Disease Patient Information Page: A guide for patients with newly diagnosed deep vein thrombosis or pulmonary embolism"}
{"_id":"cde88fbf-8369-b150-7fa9-9170012dc273","text":"Proton beam therapy has the potential to dramatically reduce doses to nearby critical structures, because the physical properties of the proton radiation beam are very different to photons. This is especially important, for example, near the eye and parts of the central nervous system. It also reduces the risks of ionising radiation in paediatric patients, which can have devastating effects on growth and development. Until now, proton beam therapy has mainly been introduced in privately funded centres rather than through comparative clinical trials, and thus the evidence base for some tumour types is very limited. Small-scale clinical trials and patient registries are now being established, and it is hoped that the wider introduction of proton beam therapy on a global scale will provide opportunities for larger international clinical trials to demonstrate clinical benefit and assess the cost-effectiveness of this new therapy for a broad range of tumour types.","title":"Practice-changing radiation therapy trials for the treatment of cancer: where are we 150 years after the birth of Marie Curie?"}
{"_id":"cdf9bfae-c957-82fe-c2e1-ef4183ab9d52","text":"Accurate diagnosis is often difficult and false negative rates are significant therefore it is essential that if frozen section is being considered it must be done by an expert pathologist. On some occasions pre-operative cytology and\/or histology may remain unclear and therefore the frozen section may have a role in parotid surgery. It is important not to breach the tumour capsule during parotid surgery and a partial parotidectomy specimen should be sent for the frozen section which may help determine the presence of malignancy and therefore help inform a decision regarding proceeding to radical surgery. This may be preferred rather than waiting for results of a partial parotidectomy as completion parotidectomy at a later stage carries a significant morbidity, especially with regards to facial nerve function.","title":"Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines SALIVARY GLAND TUMOURS: UK GUIDELINES"}
{"_id":"cdfb12d6-df6f-0033-63b0-d3367aa5e001","text":"There are several advantages of PDT for management of recurrent NPC. Perhaps the most important advantage is its repeatability. PDT does not have cumulative effects. In case of a partial response the same area can be illuminated again. Secondly PDT is a local treatment rather than a systemic one. The photosensitizing drug accumulates in higher concentrations within cancer cells rendering them more susceptible to the toxic effects of light, compared to normal healthy cells and the light is delivered directly onto the tumour sparing the surrounding normal mucosa. Two other advantages of PDT are normal healing of the wound and illumination is only once.","title":"Photodynamic therapy in the therapy for recurrent\/persistent nasopharyngeal cancer"}
{"_id":"ce04024f-43cb-d435-2006-6f423eac709e","text":"By 3 months from the thrombotic event a third of the thrombi had resolved and by 6 months about half of the cases had resolved on the basis of vein recanalisation using NC-MRV. On the initial MR-DTI acute thrombus was clearly depicted by hyperintense signal, while the remaining thrombi were predominantly low signal at 3 and 6 months. Some residual thrombi contained small and fragmented persisting hyperintense areas at 3 months, clearing almost completely by 6 months.","title":"Combined MR direct thrombus imaging and non-contrast magnetic resonance venography reveal the evolution of deep vein thrombosis: a feasibility study"}
{"_id":"ce08d8db-05b8-9143-94ab-3cca7c967eba","text":"The infiltrative growth pattern of DTs and their proximity to important anatomical structures make them challenging to manage. Mutilating surgery should be avoided, while active surveillance remains a valid option when growth is slow and critical structures are at a distance. Radiotherapy can be a viable adjuvant treatment.","title":"Recurring desmoid tumor of the neck: A case report"}
{"_id":"ce0bb9a9-d6fc-928d-6cfb-73f6e8924751","text":"For patients with excess skin or macromastia, the caudal dermis flap is a reliable and less expensive option for complete coverage of an implant after prophylactic mastectomy. In particular, the vascularized dermis flap can protect the implant from the consequences of skin necrosis after prophylactic mastectomy.","title":"Implant-based immediate reconstruction in prophylactic mastectomy: is the caudal dermis flap a reliable alternative to synthetic mesh or acellular dermal matrix?"}
{"_id":"ce16f97d-7958-9a1f-0b0f-aa5a153c7818","text":"Table 1 Sociodemographics of survey respondents stratified by route of prior drug use","title":"Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder"}
{"_id":"ce1ad38e-7bc9-2020-ea7f-ab38ff8868af","text":"The buccal ramus was sectioned about 10 mm distal to the main trunk of the facial nerve at its exit from stylomastoid foramen and sutured under the same conditions as for the first model, to induce isolated ipsilateral eyelid palsy.","title":"Efficacy of LED Photobiomodulation for Functional and Axonal Regeneration After Facial Nerve Section-Suture"}
{"_id":"ce1bd83e-be4c-4a92-aa24-c06ce3073a87","text":"No standardized protocol has been suggested in the treatment of postoperative osteomyelitis following fracture fixation. Our team evaluates the clinical efficacy of the modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny–Mader type.","title":"Modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny-Mader type"}
{"_id":"ce1c337a-301d-49e4-6b10-c5d773fc2d00","text":"This study examined the demographic and professional backgrounds of fellowship directors for the 31 ASES-accredited fellowships to better define the characteristics of a fellowship director in the field of shoulder and elbow surgery. Fellowship directors identified mostly as White males and demonstrated a high level of scholarly productivity, actively participated in academic societies, and tended to graduate from a select set of training programs. These results suggest that research productivity and service to the field are valued in those who reach the role of fellowship director and that these individuals are well suited to develop these qualities in aspiring shoulder and elbow surgeons. The homogeneity of fellowship directors, particularly in terms of sex and race, identifies a critical need to improve the diversity of the field's leaders going forward to benefit the specialty as a whole.","title":"Leadership Trends in Shoulder and Elbow Surgery Fellowship Directors: A Cross-sectional Study"}
{"_id":"ce1db836-4486-411e-aaf8-1fbec4b1c53b","text":"The saphenous vein can be a source of tissue engineering. Studies have shown that that cells isolated from the saphenous veins, or from veins and arteries of the umbilical cord might be feasible cell sources for tissue engineering of heart valve for the pulmonary position.126","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"ce1f9e1e-4b88-ecf7-e232-60d0576863cd","text":"In the time period between 1968 and 2007, 22 women of a mean age of 38 years, presented in our clinics with the diagnosis of cystosarcoma phylloides. Among them 19 were operated for breast tumor, which was proved by the histological examination to be a cystosarcoma phylloides. The remaining three were previously treated in other institutions and were referred to our hospital for further treatment.","title":"Phylloides tumor of the breast: a rare neoplasm, though not that innocent"}
{"_id":"ce23c09d-c1ed-d98a-7479-d87ef01900c8","text":"This study reported the morbidity rates in the largest series of non-metastatic melanoma patients in Italy and one of the largest series worldwide. The present work allowed to evaluate standardization and quality of surgical treatment of cutaneous melanoma within the frame of the Italian Melanoma Intergroup, which is the largest Italian scientific organization dedicated to the management of patients with this disease [10].","title":"The surgical treatment of non-metastatic melanoma in a Clinical National Melanoma Registry Study Group (CNMR): a retrospective cohort quality improvement study to reduce the morbidity rates"}
{"_id":"ce31edf5-d6a0-d462-be75-9b1ea812cd1d","text":"In our cadaver study, the average diameter of the deep brachial artery was 2.7 mm at its origin and 1.9 mm at its distal region. The deep brachial artery is a dispensable artery, and these results indicate that the recipient artery diameter can be adjusted depending on where you cut the deep brachial artery. In our clinical cases in which we chose the SCIP flap for coverage, the deep brachial artery was found between the long head and the lateral head of the triceps brachii muscle in all cases and was cut distally, providing us with an average diameter of 1.8 mm. This was an optimal size match for the SCIA, which has an average diameter of 1.5 mm. The use of the deep brachial artery allowed anastomosis within the defect, and thus a flap with a long pedicle was not necessary. Having a good understanding of the deep brachial artery’s anatomy significantly reduces the burden of finding suitable recipient vessels, particularly in the posterior upper arm where recipient arteries are scarce. One pitfall that should be prevented when using the deep brachial artery as the recipient artery is damaging the radial nerve. As it runs deep between the long head and the lateral head of the triceps brachii muscle, the deep brachial artery runs along the radial nerve; special caution should be taken when dissecting out the artery.","title":"The Use of the Deep Brachial Artery as the Recipient Artery for Free Perforator Flap Transfer: An Anatomic Study and Clinical Applications"}
{"_id":"ce3217c5-6fc6-441e-2f97-95b1d2bb6ae5","text":"The durations of effects have been simplified by averaging out where possible, but it is important to note that in many cases the duration was deemed to go beyond the length of the study and as such these studies are a guide that effects are ongoing, but not a measure of the actual longevity.","title":"A review of the longevity of effect of botulinum toxin in wrinkle treatments"}
{"_id":"ce368de4-cb68-6e77-e968-30002495289a","text":"Previous studies have described an association between anosognosia and behavioral changes in pAD patients, and have correlated the lack of awareness of their deficits with disease progress, and marked cognitive and functional impairment.","title":"Cognitive anosognosia and behavioral changes in probable Alzheimer's disease patients Anosognosia cognitiva e alterações comportamentais em pacientes com provável doença de Alzheimer"}
{"_id":"ce3c2c92-ff38-50e6-6e2f-430c6ad584de","text":"In this study, pharmacological thrombolysis with urokinase was considered in the case of venous thrombus or venous insufficiency even if it was not thrombosis, regardless of the presence or absence of arterial thrombus in the revision performed 24 hours after flap surgery when venous congestion signs had occurred such as purplish flap, shortened blood refill time less than three seconds, venous bleeding at pin prick or the edge of flap, or edematous flap. At that time, both arterial reliance and the congestive flap was confirmed in re-exploration more than 24 hours postoperatively. Because the decreased venous drainage and congestive clinical signs may suggest intra-flap thrombosis, it was required to aggressively initiate thrombolysis with less systemic complications through external drainage while using thrombolytic agents at high dose.","title":"Safe and effective thrombolysis in free flap salvage: Intra-arterial urokinase infusion"}
{"_id":"ce3f0edc-5a11-cc82-4455-47035c07b810","text":"This cohort study examines trends in the use of brachytherapy, external beam radiotherapy, and stereotactic body radiation therapy for disease management in patients with localized prostate cancer and compares outcomes between these therapies.","title":"Trends in Use and Comparison of Stereotactic Body Radiation Therapy, Brachytherapy, and Dose-Escalated External Beam Radiation Therapy for the Management of Localized, Intermediate-Risk Prostate Cancer Comparison of Therapies for the Management of Localized, Intermediate-Risk Prostate Cancer"}
{"_id":"ce472d2f-28bb-943e-a13d-9b74269a709f","text":"Dermatoscopy was used to delimit the lesions and mark the margins: whenever possible minimum width of 5mm and 6mm to BCC sclerodermiform. All patients had previously undergone a biopsy and received a diagnosis of NMSC.","title":"Nonmelanoma Skin Cancer at Critical Facial Sites: Results and Strategies of the Surgical Treatment of 102 Patients"}
{"_id":"ce4f5647-db91-b944-8062-bc27108b69a8","text":"Adverse immunologically mediated oral mucosal reactions to systemic medications are exaggerated immunoinflammatory responses to allergenic components of the medication occurring in genetically susceptible persons. Lichenoid tissue reaction\/interface stomatitis diseases may be idiopathic or induced by systemic medications. Antigen-bearing keratinocytes in the basal\/parabasal cell layers of the oral epithelium are thought to be the target of the immune reaction in these diseases, but the nature of the target molecules is not clear.","title":"Adverse Immunologically Mediated Oral Mucosal Reactions to Systemic Medication: Lichenoid Tissue Reaction\/Interface Dermatitis-Stomatitis, Autoimmune Vesiculobullous Disease, and IgE-Dependent and Immune Complex Reactions"}
{"_id":"ce592283-4e6b-1cfe-1f3b-375476e239c3","text":"To conclude, we present an adequate mapping of the gluteal vessels and perforators from the Ct, and a Doppler device is mandatory. They are included in the fasciocutaneous or musculocutaneous gluteal flaps which are our first option if the gluteal vessels are intact and there is no preoperative radiotherapy. If there is preoperative radiotherapy without previous abdominal surgery or a larger defect, it cannot be managed with gluteal flaps. The VRAM flap is our flap of choice.","title":"Anatomical Considerations and Plastic Surgery Reconstruction Options of Sacral Chordoma Resection"}
{"_id":"ce5a0895-3dd4-c947-bcee-f1274bffadd9","text":"We report the second case of migration and extrusion through the oral cavity of a cervical vertebral body replacement device (expandable cylinder) in a patient that had undergone cervical corpectomy due to a vertebral chordoma.","title":"Oral extrusion of a vertebral body replacement device after chordoma tumor growth and radiation: case report and review"}
{"_id":"ce648670-28ce-95c9-9a07-c9ee3c0d39be","text":"Although various methods of scrotal reconstruction after Fournier gangrene have been described, reliable coverage and protection of testicular function with an acceptable cosmetic result are seen with most reconstructive techniques. Data from the individual studies are difficult to interpret because of the variability in reported complications. We conclude that the simplest and least costly procedure is ideal for reconstructing these defects, especially since Fournier gangrene occurs predominantly in patients with significant comorbidities who may be at an increased operative risk in longer or multiple procedures. There is no conclusive evidence to support flap coverage of exposed testes rather than skin graft. An algorithm is proposed for reconstruction based on the complication rates and observations reported by the authors cited in this systematic review. Skin grafting or flap reconstruction is recommended for defects larger than 50% of the scrotum or extending beyond the scrotum, whereas scrotal advancement flap reconstruction or healing by secondary intention is best for defects confined to less than 50% of the scrotum that cannot be closed primarily without tension. Further assessment of patient satisfaction regarding testicular function, cosmesis, and mobility is warranted.","title":"Reconstruction of Defects After Fournier Gangrene: A Systematic Review Karian et al"}
{"_id":"ce656f65-631b-a6c4-d194-7abb19f305c6","text":"The delivery of regional chemotherapy to an isolated limb continues to be an important treatment for those patients with recurrent disease confined to the extremity. HILP may be associated with more side-effects and a longer recovery time for the patient, but the technique has the best chance of being able to address all micrometastatic disease in the patient with advanced Stage III melanoma.","title":"Regional Therapy for Recurrent Metastatic Melanoma Confined to the Extremity: Hyperthermic Isolated Limb Perfusion vs. Isolated Limb Infusion"}
{"_id":"ce668bc2-c73e-5bf2-0377-d43d469a1069","text":"CT with intravenous contrast is most useful for staging and response assessment of metastatic disease. It is easily accessible and cheaper than MRI or PET-CT. CT can be useful for assessing for bony involvement and detecting the presence of calcifications. The disadvantages of using CT include exposure to ionising radiation and poorer soft tissue contrast compared to MRI.","title":"Imaging features of primary sites and metastatic patterns of angiosarcoma"}
{"_id":"ce7081e1-27e4-c529-872b-ba4e03b0af42","text":"Patients should be scheduled for follow-up appointments every 2−3 months for the first 2 years following treatment.6–8 After 2 years, patients may follow-up with their provider every 6 to 12 months.6–8 At each follow-up visit, the provider should conduct a full-body skin check, treat precancerous lesions, and biopsy lesions that are suspicious for malignancy.","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"ce7bc06e-2f62-fa10-835b-c417391b379e","text":"In our retrospective study, we aimed to investigate the predictive value of mitotic rate and to analyse further clinicopathologic predictors of positive SLNB by examining the common feature of these metastasizing cases in order to prevent the majority of the T1b melanoma patients from undergoing SLNB. Cases were also reassessed according to the AJCC8th guideline and additional statistical analyses were performed to re-evaluate the prognostic value of the well-known histological parameters considering AJCC8th.","title":"Is it Necessary to Perform Sentinel Lymph Node Biopsy in Thin Melanoma? A Retrospective Single Center Analysis"}
{"_id":"ce7e0def-4766-1b20-0939-13bd2d9ad871","text":"Biofilms are established by microbial cells that attach to inert or living surfaces and gather in a polymeric matrix of their own synthesis forming sessile communities resistant to antimicrobial agents and showing a lifestyle distinct from that of planktonic cells. Biofilms provide a protected growing, allowing cell survival in a hostile environment and show emergent properties that are not foreseeable from the investigations on planktonic cells. Moreover, biofilms often are not caused by a single-species population of microbes but by mixtures of species of bacteria or fungi and develop on inert surfaces such as medical devices, on living tissues, and also on fragments of dead tissues. Conventional antifungal therapies typically contrast the symptoms of planktonic cells released from the biofilm, but fail to kill the biofilm itself; thus, after cycles of antifungal therapy, biofilm infections are typically recurring until surgically removed.","title":"Eradication of Candida albicans persister cell biofilm by the membranotropic peptide gH625"}
{"_id":"ce82e162-4e67-6234-a687-22ecf41d8487","text":"There are no clear and accurate guidelines regarding the decision to perform a neck dissection concurrent to the ablation of the primary tumor in the N0 neck. Clinical staging of the neck by manual examination is notoriously inaccurate, especially in patients with more voluminous necks. Radiological staging with either CT or MRI has improved the sensitivity for identifying nodal metastatic disease and has contributed to the upstaging of necks in a significant number of patients, resulting in a more accurate selection of patients requiring a neck dissection. With size alone as one of the more important criteria in this regard it has been shown that an important group of patients at risk for occult lymphatic metastasis may be missed [2,3].","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"ce89d170-bdf2-eceb-4d06-ed27f8d86c09","text":"In particular, the proximity of the PLDF to the neck and hypopharynx makes it an excellent option for managing pharyngocutaneous fistulas or helping prevent complications after salvage laryngectomy. An overlying cutaneous skin paddle can also be easily incorporated with the latissimus dorsi muscle while still achieving primary closure of the donor site. This allows the PLDF to be used as a patch or interposition graft. Depending on the patient body habitus, the bulk of the overlying subcutaneous tissue on the latissimus dorsi muscle may create issues with circumferential reconstruction. However, the thin and pliable nature of the latissimus dorsi muscle itself makes it a reliable option as an interposition in most cases.","title":"Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: contrasting shoulder morbidities across mysofascial flaps"}
{"_id":"ce89e835-6e72-7294-66d1-80f70d493954","text":"All patients admitted to the medical ED were following triage screened for study participation by a study investigator. Patients were included if they fulfilled one or more of the following findings:","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"ce8b1f35-7cfe-9ccd-71d5-7041166d2fef","text":"Surgical removal of tumor tissue is still the most relevant step for the prognosis in treatment of patients with malignant melanomas. In advanced stages of the disease, systemic therapies like chemotherapy are the only relevant treatment options, whereas in the adjuvant situation therapies with interferon alpha are commonly used. Chemotherapy regimens lead to small percentages of objective responses while often causing considerable side effects. Adjuvant treatment with the immunomodulating drug interferon has also significant side effects which are especially burdensome to the patient on long-term treatment regimens. Side effects ranging from myalgias and fever to depression are observed and often cause treatment interruption. Additionally, the improvement of outcome due to interferon therapy is small. In summary, these treatment regimens require the development of novel treatment strategies, especially for the treatment of patients with advanced malignant melanoma. Are we at a standstill or is treatment moving on to new possibilities?","title":"Advanced Malignant Melanoma: Immunologic and Multimodal Therapeutic Strategies"}
{"_id":"ce8f4a66-8528-0038-3546-121f16279b2e","text":"For treatment a radiotherapy regimen was performed in six patients, a combined chemo and radiotherapy treatment was performed in 19 patients, while a chemotherapy treatment alone was performed in 45 patients. For the remaining patients, treatment was not performed because it was not provided or because the patients refused any treatment.","title":"Appearance of malignant melanoma after a non-cutaneous cancer diagnosis"}
{"_id":"ce8fd550-179a-099a-0d9e-7637469c0467","text":"In this retrospective cohort study, breast cancer patients undergoing a DIEP flap breast reconstruction between 2010 and 2018 in three hospitals in the Netherlands were evaluated. Cox proportional hazards regression analyses were performed to assess the impact of different factors on breast cancer recurrence. The primary endpoint was local breast cancer recurrence. Secondary endpoints were regional and distant recurrence.","title":"The difference in local, regional and distant breast cancer recurrence between the immediate and delayed DIEP flap procedure; a retrospective cohort study"}
{"_id":"ce917b61-1524-7936-4652-59bbeb8fc2d3","text":"The mutation in this patient affected codon 1450, a site of the APC gene associated with classical polyposis and desmoid development. Based on her high risk of CRC, prophylactic proctocolectomy was recommended, and she underwent laparoscopic proctocolectomy with an ileal pouch and ileoanal anastomosis without diverting ileostomy. She has been followed with regular endoscopic examinations of the ileal pouch and oesophagogastroduodenoscopy is performed every 6 months due to duodenal adenomas.","title":"APC mosaicism in a young woman with desmoid type fibromatosis and familial adenomatous polyposis"}
{"_id":"ce972ed5-9bdd-b187-f10a-e1c399d6644a","text":"The results of tomography and angiotomography of the thorax and Doppler ultrasonography of limbs were consulted during the patients' hospitalization to collect the cases of VTE and to evaluate whether the patient received the drug therapy described in the protocol.","title":"Assessment of the adherence to and costs of the prophylaxis protocol for venous thromboembolism"}
{"_id":"ce9eece8-9fef-9e99-abf4-390cdc5fc40b","text":"During ALND, the anatomical boundaries were first defined. The lateral edge of the pectoralis major muscle was identified and retracted medially to expose the pectoralis minor muscle and allow interpectoral dissection of Rotter’s lymph nodes. The medial pectoral neurovascular bundle was preserved during the dissection. The clavipectoral fascia was entered and axillary fat pad along lateral chest wall was dissected. Long thoracic nerve along the lateral chest wall was identified and preserved. Next, the latissimus dorsi border was identified. Dissection along the latissimus dorsi border was extended inferiorly until the muscle begun to pull toward the chest wall and superiorly to the tendon of insertion.","title":"Measuring upper limb function and patient reported outcomes after major breast cancer surgery: a pilot study in an Asian cohort"}
{"_id":"cead3c7f-e785-e47d-6868-d9a40a5deefa","text":"However, this study has some limitations since it is not designed for a stratified study. There are differences in FEMA recovery after PFP with different disease courses. Stratified observation can screen out the best efficacy group with certain disease courses, giving accurate guidance of TEA timing for clinical treatment of FEMA after PFP.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"ceafe47c-e345-75f3-3a4f-87b16dcfc0a9","text":"The phase III EINSTEIN DVT and EINSTEIN PE studies demonstrated a higher degree of patient treatment satisfaction with rivaroxaban versus standard anticoagulation. 7 8 9 10 The noninterventional XALIA study of rivaroxaban versus standard anticoagulation for the treatment of DVT in routine clinical practice was conducted subsequently. One of the aims of XALIA was to determine whether improved patient experience with rivaroxaban was replicated outside the clinical trial setting; 11 this analysis presents the results of these assessments.","title":"Patient-Reported Treatment Experience with Oral Rivaroxaban: Results from the Noninterventional XALIA Study of Deep-Vein Thrombosis"}
{"_id":"ceb4e148-971d-a464-b3c6-e3450ab1e9af","text":"Ankyloglossia is commonly reported as one of the major causes of breastfeeding difficulty. There is a lack of research on infant growth and latching performance with clinical measures.","title":"Does neonatal ankyloglossia interfere in the growth of infants during the first 6 months of life? A case series nested in a cohort study"}
{"_id":"ceb97b89-b417-4644-ed1d-dc29d35af26a","text":"Certain possible issues while using this new technique are worth discussing here. The time required to complete this procedure can be variable and dependent on the operator and patient characteristics. The familiarity of the physician using nerve ultrasound would determine the time required to complete the procedure. The patient-related factors like the local anatomical variations at the site of the block can also alter the time required for the procedure. The nonavailability of the ultrasonography machine due to its higher cost could be the major limitation in performing the procedure. Nerve identification based solely on ultrasound requires expertise while the use of a nerve locator along with ultrasound can be a better alternative.","title":"Effects of Ultrasound-Guided Lower Extremity Nerve Blocks for Below-Knee Procedures in the Emergency Department of a Tertiary Care Hospital, Central Gujarat"}
{"_id":"cebc06aa-327b-2b51-aec6-1993110da4a0","text":"Traditional macro filter materials show low abrasion resistance due to the abrasion of the resin surrounding the large filler particles, loss of polymer blocks, and fractures between the cohesive filler particles and the matrix.","title":"Tests of Dental Properties of Composite Materials Containing Nanohybrid Filler"}
{"_id":"cebe8535-443c-9360-b337-e6cf033aea32","text":"In this situation, an exploratory incision on the border of the KDPF closest to the perforator vessel is made to inspect it. Depending on the quality of the perforator vessel, we orient our dissection to a either the PPF or a KDPF.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"cec2f3a6-6f74-b4b3-e7c2-dfd19c34b1d3","text":"A thorough understanding of patient concerns and expectations, as well as thoughtful consideration of risk factors, may help surgeons achieve more successful outcomes and potentially reduce the incidence of revision rhinoplasties.","title":"Prevalence of considering revision rhinoplasty in Saudi patients and its associated factors"}
{"_id":"cec6f79f-8841-a571-b99c-f54c7d4d8ce9","text":"Figure 2 shows a patient with melanoma of the temporal region; one unexpected lymph node was detected in the supraclavicular region.","title":"The Lymphoscintigraphic Study of Unpredictable Head and Neck Cutaneous Melanoma Lymphatic Drainage"}
{"_id":"cec89ab8-cf60-499a-e1ca-6dbad5bb9e39","text":"The primary endpoint of the presence of dysplasia in the resection margins will be compared using Pearson’s chi-squared test when all 300 patients have been recruited. There will be planned sub-group analysis by T stage to assess the effect of tumour size. T1 and T2 primary cancers will be compared with T3 and T4 cancers. There will be a pre-planned interim analysis when the first 164 patients have been recruited in order to assess whether the assumptions made in the power calculations hold true.","title":"LIHNCS - Lugol’s iodine in head and neck cancer surgery: a multicentre, randomised controlled trial assessing the effectiveness of Lugol’s iodine to assist excision of moderate dysplasia, severe dysplasia and carcinoma in situ at mucosal resection margins of oral and oropharyngeal squamous cell carcinoma: study protocol for a randomised controlled trial"}
{"_id":"cecb3481-0251-9014-3781-c6ebd35e853f","text":"The animal study was reviewed and approved by Institutional Animal Care and Use Committee at Dartmouth College.","title":"Paired-agent imaging as a rapid en face margin screening method in Mohs micrographic surgery"}
{"_id":"cecd74e2-76c4-7b59-4ea8-1b95e6b1cd54","text":"BTX injections under ultrasound guidance is a safe and effective treatment modality that should be employed as a first-line management in patients with belly dancer’s dyskinesia. Ultrasound guidance increases the accuracy of injections and reduces the risk of complications. Our patients tolerated the treatment very well and the abnormal movements were completely abolished. Further studies are needed to confirm the effectiveness of BTX injections on such patients.","title":"Ultrasound-guided botulinum toxin A injection in the treatment of belly dancer’s dyskinesia"}
{"_id":"ced1777c-7e62-1c5d-a8f0-2f70a14575c0","text":"We therefore believe that guidelines for the treatment of osteomyelitis should be developed that reflect the prevalence of antimicrobial resistant pathogens, the most appropriate drugs and routes of administration, and gold standards for laboratory diagnosis of each type of osteomyelitis, both in humans and in different animal species.","title":"Microbiological aspects of osteomyelitis in veterinary medicine: drawing parallels to the infection in human medicine Veterinary Quarterly"}
{"_id":"ced1e222-a9cf-d7f1-553b-024eeec0c1b8","text":"Anesthesia options for upper extremity surgery include general and regional anesthesia. Brachial plexus blockade has several advantages including decreased hemodynamic instability, avoidance of airway instrumentation, and intra-, as well as post-operative analgesia. Prior to the availability of ultrasound the risks of complications and failure of regional anesthesia made general anesthesia a more desirable option for anesthesiologists inexperienced in the practice of regional anesthesia. Ultrasonography has revolutionized the practice of regional anesthesia. By visualizing needle entry throughout the procedure, the relationship between the anatomical structures and the needle can reduce the incidence of complications. In addition, direct visualization of the spread of local anesthesia around the nerves provides instant feedback regarding the likely success of the block. This review article outlines how ultrasound has improved the safety and success of brachial plexus blocks. The advantages that ultrasound guidance provides are only as good as the experience of the anesthesiologist performing the block. For example, in experienced hands, with real time needle visualization, a supraclavicular brachial plexus block has changed from an approach with the highest risk of pneumothorax to a block with minimal risks making it the ideal choice for most upper extremity surgeries.","title":"Ultrasound-Guided Regional Anesthesia for Procedures of the Upper Extremity"}
{"_id":"ced843b9-99f9-3c48-c861-482c850a5cd2","text":"Mild improvement in her skin condition was noticed primarily in the neck region with continued topical steroid and moisturizer treatment two weeks post-RT. The forehead, perioral, and paranasal distribution of the rash remained with its concurrent irritation. Segments of the remaining rash actually worsened one month following radiation therapy with increased erythema, dryness, and irritation while applying the current treatment regimen. Notable reduction in rash presentation and symptoms were not seen until seven weeks post thermoplastic mask exposure and RT. Complete resolution of the rash and symptoms were not seen until approximately twelve weeks following RT and thermoplastic mask exposure with continued daily topical steroid and facial moisturizer regimen.","title":"Thermoplastic Mask-Induced Contact Dermatitis: A Case Report"}
{"_id":"cee1b54b-38c3-1114-aea7-dffefbc2fdf9","text":"A case of primary cutaneous adenocarcinoma was also included in this series, diagnosed after multiple paraffin sections and a broad panel of immunohistochemistry, in addition to an extensive and multidisciplinary investigation to exclude a possible primary site other than the skin. There are few reports of adenocarcinoma-like tumors treated by MMS.","title":"Mohs micrographic surgery in rare cutaneous tumors: a retrospective study at a Brazilian tertiary university hospital"}
{"_id":"cee20d45-2297-5417-66ab-23e930c702fb","text":"Deep dead space is a problem in the process of limb wound reconstruction that can be easily neglected. The chimeric perforator flap pedicled with a descending branch of lateral circumflex femoral artery can be applied to treat limb wounds complicated with residual deep dead space, which uses muscle flap to effectively obliterate the deep dead space and employs perforator flap to cover the wounds. This technique in our study yields satisfactory clinical efficacy, providing foundations for further clinical application.","title":"A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space"}
{"_id":"ceedbbc8-5100-1668-adc0-d605c47eaa2b","text":"We describe a case of 45yr old lady with closed fracture of both bones of left forearm.","title":"Vascularised fibular graft in the management of non-union of fracture shaft of radius: a less ventured entity"}
{"_id":"cef2bc3b-e87a-01c8-bea2-07ee376d51d8","text":"To ensure that the selection bias did not affect our sample we compared it with the number of scans performed between 1 October and 31 December 2019. We also compared the prevalence of DVT between 2019 cohort with a subset of asymptomatic patients (not tested for COVID disease) from 2020.","title":"Prevalence of venous thromboembolism in patients undergoing diagnostic venous ultrasound during the first SARS-CoV-2 pandemic: A personal history of VTE and a positive COVID-19 test are associated with the diagnosis of DVT"}
{"_id":"cef38190-48c9-e8b9-c11f-996756be95a8","text":"After recipient hepatectomy, the portal vein of the explanted liver was harvested on the back table. Our role in taking the portal vein graft was that the tumor should be at least 3 cm away from the hilar or first division portal vein. The extrahepatic portion and a good length of intrahepatic portal vein were carefully dissected by ligation of the connected small branches. We used mainly the main PV with the left PV, if the harvested segment of PV was short, an extra part of recanalized umbilical vein or parts of explanted liver hepatic veins were used. The segment that was harvested from the portal vein was preserved in heparinized saline until the time of anastomosis to the graft veins. The harvested segment of the portal vein was used for reconstruction of the middle hepatic vein tributaries (V5, V8), right inferior hepatic vein, or graft with 2portal veins by proline 6\/0.","title":"Successful use of venous graft from native liver with hepatocellular carcinoma during living donor liver transplantation with no impact on recurrence rate: A retrospective cohort study"}
{"_id":"cef5f63a-bc51-742d-9e4d-10e9d7b9ebe7","text":"Hip and knee arthroplasty patients are at high risk of perioperative venous thromboembolic events (VTE). VTE has been well studied in this population and it is recommended that total joint arthroplasty recipients receive chemoprophylactic anticoagulation due to risk factors inherent to the surgical intervention. There are few concise resources for the orthopedic surgeon that summarize data regarding post-operative anticoagulation in the context of currently available therapeutic options and perioperative standards of practice. The periodic reexamination of literature is essential as conclusions drawn from studies predating perioperative protocols that include early mobilization and sequential compression devices as standards of practice in total joint arthroplasty are no longer generalizable to modern-day practice. We reviewed a large number of recently published research studies related to post-operative anticoagulation in total joint arthroplasty populations that received a high Level of Evidence grade. Current literature supports the use of oral aspirin regimens in place of more aggressive anticoagulants, particularly among low risk patients. Oral aspirin regimens appear to have the additional benefit of lower rates of bleeding and wound complications. Less consensus exists among high risk patients and more potent anticoagulants may be indicated. However, available evidence does not demonstrate clear superiority among current options, all of which may place patients at a higher risk of bleeding and wound complications. In this situation, chemoprophylactic selection should reflect specific patient needs and characteristics.","title":"Review of Therapeutic Options for the Prevention of VTE in Total Joint Arthroplasty"}
{"_id":"cef69f28-64bf-dba1-d8df-aba7ed89dd9a","text":"A total of 285 cutaneous melanoma patients whose primary melanoma was located in the lower limb or trunk with no clinically detected metastases at the time of the diagnosis and who underwent inguinal and\/or iliac SNB at Helsinki University Hospital between 1 January 2009 and 31 December 2013 were included. The criteria for SNB included primary melanoma tumour Breslow classification greater than or equal to 1 mm and\/or ulceration or mitotic level greater than or equal to 1\/mm2.","title":"Pelvic sentinel lymph nodes have minimal impact on survival in melanoma patients"}
{"_id":"cefe072f-eda2-74d8-e1ff-f6dfe1ddca9d","text":"Purpose: To describe the use of the cephalic vein as a recipient vessel for venous outflow in head and neck reconstruction. The cephalic vein is used as a vessel in cases where there is a paucity of veins in the neck. This may be due to previous surgery, previous radiation therapy, or advanced cancer. The cephalic vein may also be used to salvage a failing free flap. Methods: It is a retrospective review of 230 free flaps that had been used in head and neck reconstruction performed from July 2014 to July 2018 by a single surgeon. Results: There were 6 patients in whom the cephalic vein was used as a recipient vessel. The cephalic vein was used in 2 cases where a tumor was involved with the internal jugular vein, in 1 case where a previous neck dissection had been done, in 1 case where internal jugular vein had iatrogenic damage, and in 2 cases a salvage procedure was done. In all cases, the cephalic vein was rotated above the clavicle. The cephalic vein easily reached the free flap vein and had a good caliber. There were no failures in any of the patients. Conclusion: The cephalic vein is a good option for venous anastomoses in patients in whom there is a paucity of recipient vessels in the neck.","title":"Use of Cephalic Vein for Venous Anastomosis in Head and Neck Reconstruction: A Case Series Rahman et al"}
{"_id":"cf044e35-36a1-fad5-6c45-0f92776475c6","text":"The radial forearm fasciocutaneous (RFF) free flap is useful for moderate to large floor of mouth defects since it is thin and pliable thus preventing compromised speech or swallowing due to excess bulk or tethering of the tongue. The RFF is based on the radial artery and is rapidly harvested with a long pedicle thereby facilitating head and neck reconstruction. Drawbacks of the RFF flap are decreased circulation to the hand, risk for tendon exposure due to incomplete skin graft take and a relatively unfavorable donor site appearance.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"cf05eceb-87d8-03a8-f7a9-f253a6a2d597","text":"Antibiotic therapy was based on the results of organisms cultures and antibiotic susceptibility tests. The patients were treated with intravenous antibiotics selected by an infectious disease specialist for at least 3 weeks or until the infective process had resolved on the basis of clinical manifestations and laboratory indicators.","title":"Treatment of diaphyseal forearm defects caused by infection using Ilizarov segmental bone transport technique"}
{"_id":"cf14a18a-b098-2a1c-e821-35515d782cb6","text":"To conclude, we have now shown that the bone vasculature and cortical bone microstructure in mice can be assessed simultaneously with no sample preparation. We hope our study can provide new opportunities to quantitate and better evaluate the role the vasculature plays in specific skeletal sites and different animal models. Visualisation of the 3D bone vascular network is a prerequisite for improved understanding of its role in the regulation of bone health and disease. The presented approach has the potential to link vascular abnormality to the pathogenesis of various skeletal conditions.","title":"Simultaneous visualisation of calcified bone microstructure and intracortical vasculature using synchrotron X-ray phase contrast-enhanced tomography"}
{"_id":"cf18416a-8b32-866a-f12d-e096ac4e2ad7","text":"The primary goal of our study was to evaluate if excluding CMA by a DBPCFC that includes assessment of late reactions prevents unnecessary elimination diets in the long term. Our secondary goal was to determine the MEDs for CMP in children with an acute reaction to CMP (within 2 hours after ingestion), to aid in clinically relevant labeling of food products.","title":"Double-blind placebo-controlled food challenges in children with alleged cow’s milk allergy: prevention of unnecessary elimination diets and determination of eliciting doses"}
{"_id":"cf1f184b-bfd0-f2c6-b13e-ba598fa2e9aa","text":"Of more than particular interest are the requirements of ordinances twelve, thirteen and eighteen. These deal with the ethics of professional conduct between practitioners and between practitioners and their patients. In ordinance eighteen it is made clear that a patient is at liberty to choose freely who is to treat him or her and may leave a practitioner at any stage of the treatment so long as the fee is paid, and go to another:","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"cf21caa3-a29e-f4e1-4097-77b3266e7d71","text":"We proceeded to a total resection of the mass taking away the left rectus muscle and a part of the remaining muscle of the left abdomen wall with reconstruction by a pedicled flap of the left Fascia lata with the placement of a bifacial mesh with abdominal parietal drainage.(Figure 3).","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"cf2d85ed-4031-312f-02b2-812e42d7133f","text":"Mrs C is a 50 year old female who underwent a left sided mastectomy in 2014 for breast cancer, followed by radiotherapy that completed in February 2015. Her only other past medical history of note is diabetes, for which she takes metformin and gliclazide. Following discussion of the reconstructive options she opted for a delayed left DIEP flap reconstruction.","title":"Deep inferior epigastric perforator flap demonstrating the triple response of Lewis phenomenon – A case report and insights into aetiology"}
{"_id":"cf2ec5ff-666b-8396-f79b-54ffa3ce886f","text":"Communication with surgical consultants with regard to performing the ESP block before the procedure should be routine. Clear documentation in both the chart and on the patient (we commonly place the time and block type) should also be part of the workflow when incorporating ultrasound-guided nerve blocks in the ED. Surgical consultants should also be aware that peritoneal blocks may significantly reduce the pain from acute appendicitis; thus, using the abdominal examination as a marker of progression of illness may not be possible.","title":"A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block"}
{"_id":"cf36a6e9-2eb8-92d7-bfa7-6f699d17218c","text":"The source for cartilage condyle chips was the same human knee joints as used to isolate chondrocytes for spheroid production. Condyle chips are a small solid piece of knee joint tissue consisting of cartilage and bone that were prepared to simulate cartilage defects as observed in the clinic, which can be treated with the cartilage cell transplant chondrosphere.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"cf3dadc9-cdea-0ab3-0d6d-fe7bb30cd66e","text":"In a 55 year old female patient invasive breast cancer was diagnosed in her right breast. Neoadjuvant chemotherapy was recommended followed by modified radical mastectomy and radiotherapy. After an uneventful follow up period without tumor relapse during 1 year after mastectomy the patient presented for autologous breast reconstruction with abdominal tissue. A preoperative computed tomography angiography showed a strong lateral perforator from the inferior epigastric artery. Finally a so called DIEP flap (deep inferior epigastric artery perforator flap) was harvested based on the aforementioned lateral perforator on the left side of the abdomen. Because it was hypothesized that lateral located perforators do not constantly perfuse the flap tissue across the midline and often a possibly large flap volume is necessary especially in thin patients, ICG measurement is used to define the perfusion pattern.","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"cf3e8670-f96a-abcf-cb4f-1ba5620f7e16","text":"Ultrasound treatment uses mechanical vibration delivered at a frequency above the range of human hearing. Physical therapists report that covering the wound area with a hydrogel film and applying ultrasound during the inflammatory and proliferative stages stimulates the cells involved in wound healing and also warms the tissue, enhancing healing by improving circulation. Electrical Stimulation mimics the body’s own bioelectric system that influences wound healing by attracting repair cells, changing the permeability of cell membranes, and therefore affecting secretions and orienting cell structures.","title":"Management of Chronic Non-healing Wounds by Hirudotherapy"}
{"_id":"cf4799a9-bd59-4ced-fe28-0b4abc488da8","text":"Brachytherapy is particularly useful for treating well-circumscribed malignancies in facial regions where surgical excision may result in a less-favorable cosmetic outcome.49","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"cf48c3a3-e7bf-c62d-b18d-b82fda993170","text":"Our report of an infant with a desmoid tumor on her cheek represents an example of the desmoid type of infantile aggressive fibromatosis arising in an exceedingly rare location. Surgical excision resulted in a complete removal of the tumor without evidence of local recurrence in 15 months' follow-up period.","title":"Congenital Desmoid Tumor of the Cheek: A Clinicopathological Case Report"}
{"_id":"cf48c786-cb16-6a5b-a2da-cc9f2ad36f86","text":"Recovery of the pedicled TRAM flap perfusion outside of the peri-operative period demonstrates that if the flap survives the rotation and tunneling the re-vascularization of the flap from the surrounding tissues is equally as robust. While prospective in nature, this study is limited due to the small sample size. Future studies using side by side pedicled and free flaps in animal models would be required to generalize these conclusions. Until that time, this study advances our knowledge of perfusion dynamics in free and pedicled tissue transfers applicable to the indications and use of these flaps in a multitude of reconstructive applications as well as highlighting the reliability of the Spy system as a tool to analyze flap perfusion.","title":"Comparative Perfusion Analysis of Free Muscle-Sparing Versus Pedicle Transverse Rectus Abdominis Myocutaneous (TRAM) Flaps in Vivo in the Peri-Operative and Late Post-Operative Periods"}
{"_id":"cf4b8e90-26af-2591-00d9-8d3e538d7f0c","text":"Patients were initially identified by retrospectively reviewing pharmacy records for all patients prescribed BTA by a general surgeon across the Fiona Stanley\/Fremantle Hospital group between January 2015 and December 2018. The 29 identified patients’ medical records were examined, identifying 12 patients who had an emergency laparostomy and injection of BTA into their lateral abdominal wall muscles during their care. The remaining 17 patients prescribed BTA by a general surgeon underwent either UGI or anorectal procedures.","title":"Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases"}
{"_id":"cf4e2883-a580-71e5-6369-72da353c6f29","text":"We describe the case of a 13 year-old girl with overlap syndrome with features of juvenile dermatomyositis and systemic lupus erythematosus. After 22 months of extensive immunosuppressive therapy, including monthly IVIG and Rituximab, she continued to have pain and weakness of the lower extremities. A CT scan was performed which showed significant multifocal soft tissue calcifications of the pelvis. She was started on treatment with oral alendronate with the goal of improving her calcinosis and improving her symptoms. After several months of therapy, our patient reported subjective improvement of her lower extremity pain and weakness, as well as complete resolution of abnormalities previously seen on physical examination. A repeat CT scan of the pelvis was performed after 11 months of therapy and demonstrated complete resolution of the previously seen calcinosis.","title":"Resolution of calcinosis using bisphosphonates in overlap syndrome – a case report"}
{"_id":"cf56b24e-e78a-513c-25d3-0730c1a2f63d","text":"The highlights of our study include that it is the first study to investigate the feasibility of applying cavity shaving in Chinese breast cancer patients, and it further explored the associations among positive margins and highly selected PM patients in a Chinese population compared to foreign countries. Collectively, our results showed that cavity shaving should not be performed in highly selected Chinese breast cancer patients who undergo a PM.","title":"Low rate of positive margins and re-excision after partial mastectomy in highly selected breast cancer patients: A Chinese single-institution experience"}
{"_id":"cf5c1dc9-0059-27bf-8292-ef77b6ea63a3","text":"Our results suggest that, independently of the diabetes status, foot infection may silently spread along the bone and can achieve the site of major limb amputation. Additional investigations aiming to confirm this hypothesis and to evaluate a prognostic value are in progress.","title":"Section’s osseous slice biopsy during major amputation of lower extremity: preliminary results of prospective cohort study"}
{"_id":"cf5ef1db-83ea-bc10-f2f7-5a588617db16","text":"Owing to the large muscle mass and the skin flap, the aesthetic appearance is not ideal, but the skin flap can be removed at a later stage for a better aesthetic appearance.","title":"Case Report: Modified Latissimus Dorsi Muscle Transfer for Radial Palsy, Presentation of a New Technique"}
{"_id":"cf6543dd-0459-6e62-1b15-ea6f36603861","text":"Management of regional lymph nodes in patients with melanoma has changed drastically over the last years, from a procedure destined to therapeutic purposes to one in which prognostic information is nowadays of primordial importance. The role of SLNB is decisive in patients with clinical negative nodes, and complete dissection is still a standard of care in those patients with clinically positive regional disease. Advances in adjuvant treatments make prognostic information critical in order to correctly select patients who may benefit from adjuvant therapies [24].","title":"Role of sentinel lymph node biopsy for cutaneous melanoma in elderly patients: preliminary results in a Latin-American population"}
{"_id":"cf66bf0c-f5fb-b919-48f7-984d4c7aed13","text":"The outcomes from this study suggest that cryoablation is clinically safe and feasible, because no local recurrence was observed in any of the cases. Further prospective randomized studies are warranted to elucidate the optimum protocol for this technique and effectiveness for a variety of histologically different tumors.","title":"CT guided cryoablation for locally recurrent or metastatic bone and soft tissue tumor: initial experience"}
{"_id":"cf67ef80-a073-b19a-2193-29d7c777cd36","text":"The ulnar nerve at the elbow was exposed through a longitudinal incision about 7-10 cm above and 3-4 cm below the epicondyle. The deep fascia of the anterior-medial compartment of the upper arm was exposed and de-roofing of the fibro-osseous tunnel was done by cutting the over lying fibrous tissue. The fibrous arch between the two heads of the flexor carpi ulnaris was cut and the distal end of the tunnel was widened. The entire segment of the exposed nerve was cleared from the surrounding adhesions without lifting the nerve from its bed. This resulted in the complete external release of the ulnar nerve. The intraneural decompression was done by medial longitudinal epineurotomy without damaging the vascular network. In 49 cases medial epicondylectomy was also done (because the nerve was subluxating over the epicondyle and getting traumatic neuritis during the elbow movement).","title":"Decompression of peripheral nerve trunks in leprosy to prevent the development and progression of deformities"}
{"_id":"cf6c0382-aa10-daf6-7c9c-3a249e12025f","text":"The sentinel lymph node biopsy is necessary when it is impossible to acquire the tumor thickness after a superficial biopsy or after the lesion has undergone previous cryotherapy or electrodesiccation [12].","title":"The Characteristics of Sentinel Lymph Node Biopsy in Cutaneous Melanoma and the Particularities for Elderly Patients—Experience of a Single Clinic"}
{"_id":"cf6e70f4-30a1-c40c-325b-42b6bb644daa","text":"The macromolecular substances from TW80 enhanced the vascular permeability in the pulmonary perfusion experiments. Considering that blood cells, including leukocytes, were removed by perfusate, and given that large molecules are unlikely to cross the vascular wall into the interstitial space to activate mast cells where they reside, it can be deduced that the increase in vascular permeability is likely to have resulted from a direct effect on epithelia.","title":"Macromolecules in polysorbate 80 for injection: an important cause of anaphylactoid reactions"}
{"_id":"cf708bb6-0333-68dd-d02d-a98ac3a867a5","text":"American orthopaedists are increasingly seeking fellowship sub-specialization. One proposed benefit of fellowship training is decrease in complications, however, few studies have investigated the rates of medical and surgical complications for hip fracture patients between orthopedists from different fellowship backgrounds. This study aims to investigate the effect of fellowship training and case volume on medical and surgical outcomes of patient following hip fracture surgical intervention.","title":"The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database"}
{"_id":"cf70bac5-281c-4dd9-d977-9a90d7a380f2","text":"Communication will be minimized during interventions to prevent bias except where necessary.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"cf723ca6-7f52-0543-3384-12edcad0b34c","text":"Another important use of this intraoperative transformation is in cases of incorrectly oriented scars that need a wider excision. We had three cases where the initial scar was oriented transversely on the limbs rather than longitudinally. In these cases, a KDPF is still possible, but a PPF presents a more anatomical position of the scars and exerts less tension on the donor site.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"cf732d6a-40dc-ddfd-1041-d809df362145","text":"Venous thromboembolism is an entity that encompasses both deep vein thrombosis and pulmonary thromboembolism. Although protocols for the diagnosis of these diseases are well defined, there is evidence of inappropriate use of diagnostic resources.","title":"Evaluation of the diagnostic management of deep vein thrombosis in the emergency department of a tertiary hospital in Santa Catarina, Brazil: a cross-sectional study"}
{"_id":"cf7f63eb-64ba-465b-592a-5f4ff0467889","text":"The current paper presents a case of cheek desmoid tumor with poor response to chemotherapy.","title":"Huge Facial Desmoid Tumors with Neck Extension: A Case Report"}
{"_id":"cf8349f9-1b33-d104-44be-76d9ddfe8531","text":"According to the different types of FTS growing in planta, the prognosis is different. Preoperative definite type is helpful for the design of the operation plan. The deep type commonly has adhesion to the neurovascular bundle. It is difficult to excise completely, has a high recurrence after surgery as well as easy to produce complications of numbness and pain. MRI is developed in an attempt to minimize surgical damage and preserve nerves function.","title":"Fibroma of tendon sheath in planta"}
{"_id":"cf83c993-e7ab-2ad5-c3ab-b4fbb2145d37","text":"A positive SLNB has become the gateway to adjuvant immunotherapy for melanoma patients rather than to lymph node dissection.5 Because this is a major change in the reason for performing an SLNB, the authors believe their data underscore the fact that many eligible patients still are denied an SLNB, and much work remains to be done to ensure that this procedure will be performed when indicated. The authors hope their report contributes to more awareness with regard to SLNB and eventually to a better prognosis for melanoma patients.","title":"ASO Author Reflections: Sentinel Lymph Node Biopsy Trend in Melanoma: The More the Merrier"}
{"_id":"cf8585ab-bf6e-a711-97a9-62e186343565","text":"Testing of visual acuity before administration of ethambutol and regular monitoring during drug treatment are necessary for the early detection of optic neuritis. Monthly evaluation of visual acuity is recommended when doses higher than 15 mg\/kg are administrated. Decreased visual acuity usually recovers over a period of weeks to months after ethambutol discontinuation, although occasionally visual impairment and even blindness can be permanent.","title":"Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy"}
{"_id":"cf8785fe-1878-1632-3a54-ca27228416a4","text":"The RSSAF is often at risk for venous congestion, as it relies on communication between the venacomittants of the sural nerve and the lesser saphenous vein, thus circumventing the valves of the deep venous system. Impaired venous drainage is an important cause of failure in the early postoperative period.- It has been shown that flap survival was improved by various modifications to the operative technique that enhanced venous outflow and that these changes reduced the use of leech therapy.,, We presented our experience with spout pedicle which not only affected on wider base, but also on prevention of kinking of pedicle and pressure on it.","title":"How Much Can We do by Reverse Superficial Sural Artery Flap to Potentiate Its Effects: Introducing Spout Sural Flap as a New Modification"}
{"_id":"cf897a9d-2e42-651b-a56c-91023cb383a0","text":"In conclusion, we propose performing esophageal reconstruction with the new reconstructed organ covered with the pectoralis major muscle flap and split thickness skin grafts for secondary reconstruction after necrosis of the esophageal conduit and a wide skin defect of the anterior chest wall.","title":"Secondary reconstruction with a transverse colon covered with a pectoralis major muscle flap and split thickness skin grafts for an esophageal defect and wide skin defects of the anterior chest wall"}
{"_id":"cf8d69a2-f2fb-469b-6bfc-f30a7473754b","text":"All clinical investigations and procedures were conducted according to the principles expressed in the Declaration of Helsinki. The study design was reviewed and approved by the ethical committee of the medical faculty of the Technische Universität München. A written informed consent was obtained from all patients.","title":"A Standard Algorithm for Reconstruction of Scalp Defects With Simultaneous Free Flaps in an Interdisciplinary Two-Team Approach"}
{"_id":"cf9578a0-053a-5b3e-dbdb-0db7a5c42236","text":"The patient’s parents related that her care was managed primarily by her neurologist with bi-monthly appointments. The choking episodes had, without fail, resolved by the time of each visit. There had been no changes in the patient’s health and no new illnesses or diagnoses for the preceding five years. The parents mentioned that at each visit for the prior two years the patient had been receiving local botulinum toxin injections in her arms and legs to relieve her muscle spasticity. The parents relayed that the neurologist had been increasing the dosing of botulinum over the prior year in an attempt to achieve better spasm control.","title":"Bulbar Muscle Weakness in the Setting of Therapeutic Botulinum Injections"}
{"_id":"cf96d629-e08c-9bb6-0a05-568895a9b4d1","text":"Step 4: Dissect the femoral artery and vein from this point distally to knee. Ligate, staple or cauterize all side branches of the femoral artery and vein, including the profunda femoris and circumflex vessels. The femoral artery and vein need to end up as tubular conduits without tethering branches from the inguinal canal to where they divide at the popliteal fossa.","title":"Rotationplasty for Severe Congenital Femoral Deficiency"}
{"_id":"cf986b07-1b0a-d7e7-1234-e53050e45346","text":"Although the prevalence of VTEs after spinal surgery is relatively high, there are many negative opinions about administering anticoagulant therapy during the early postoperative period. Alhalbouni et al reported that there was no statistically significant difference in the risk of PE between isolated femoropopliteal and isolated infrapopliteal DVTs, and hospitalized patients with infrapopliteal DVTs should receive anticoagulation. Deitcher and Caprini reported that symptomatic calf DVT should be treated with anticoagulation. On the other hand, Rokito et al reported that anticoagulation is no more effective than mechanical prophylaxis for reducing DVT risk. Schwarz et al concluded that their data did not show superiority of a short-term regimen of LMWH and compression therapy when compared with compression therapy alone in patients with isolated calf muscle vein thrombosis in a rather low-risk population.","title":"Risk Factors for Venous Thromboembolism After Spine Surgery"}
{"_id":"cf9962ab-2859-a61f-765f-5248002ed8c1","text":"Table 2 Clinical probability of DVT at screening time in all cohort patients","title":"Incidence of proximal deep vein thrombosis in medical critical care patients"}
{"_id":"cf9a7d5b-2eb1-9bc1-231b-8d8dbaa1f856","text":"Skin grafting in the scalp area has a limited role due to suboptimal cosmesis and a lack of durability. The surgeon can select between an STSG or a full-thickness skin graft (FTSG) for the reconstruction, both grafts initially receiving nourishment by plasmatic imbibition. STSGs usually have better success rates than FTSGs due to the reduced metabolic requirements for thickness and the fact that they can generally cover a larger surface than an FTSG.","title":"Dermal Substitutes and Skin Grafts in the Reconstruction of Post-Traumatic Total Scalp Avulsion: A Case Series"}
{"_id":"cf9d2cca-4e3c-07cc-5500-d1c9584ee9de","text":"The investigators strictly followed recommendations of the Helsinki declaration and of the European Council Convention on Protection of Human Rights in Bio-Medicine.","title":"Inguinal or inguino-iliac\/obturator lymph node dissection after positive inguinal sentinel lymph node in patients with cutaneous melanoma"}
{"_id":"cfac6d64-ccb3-2ba9-e35c-b05661723f45","text":"Another option for those patients unwilling to undergo formal lymph node dissections upfront would be performing sentinel lymph node biopsy and relying on immediate frozen section results to dictate further management. A positive result would lead to immediate completion of lymphadenectomy. Patients would need to be informed about this and counseled about the probability of further treatment if there was metastatic disease identified on final pathology or immunohistochemistry.","title":"Role of Sentinel Lymph Node Biopsy in the Management of Merkel Cell Carcinoma"}
{"_id":"cfc1c0b2-9958-2c79-c3e8-651f6ca20ae0","text":"Our reference table will be updated each time we encounter cases of complications involving substances not yet seen. Given the growing awareness among referring physicians of the value of dedicated facial MRI with gadolinium injection, we expect to see rising numbers of MRIs performed on cases with and without complications after cosmetic intradermal injectable filler procedures, to evaluate for symmetry and help referring clinicians to provide their post-filler patients with the best possible health and esthetic outcomes.","title":"MRI in detecting facial cosmetic injectable fillers"}
{"_id":"cfc1c7a2-9de4-6356-60aa-5387e13f8e9e","text":"Metastasis to parotid lymph nodes should be examined in NPC patients after IMRT. Resection of the inferior parotid lymph nodes is recommended for patients with cervical metastasis, and superficial or total parotidectomy and adjuvant therapy are recommended for intraparotid lymph node metastasis.","title":"Metastasis of nasopharyngeal carcinoma to parotid lymph nodes: a retrospective study"}
{"_id":"cfc2274c-a83a-1ea8-344f-f6f7c24f29f1","text":"Mini-abstract: Surgical trainees and young academic surgeons should understand the specifics of the career they are pursing, and surgeon mentors should enhance their leadership roles and support the recruitment and retainment of academic surgeons through effective academic career support and strategic planning. Utilizing academic development planning can serve as an essential tool as both mentors & mentees navigate different career choices towards achieving a successful and sustainable academic career advancement.","title":"Twelve-step Approach for Academic Development Planning in Academic Surgery Climbing the Academic Uphill With Strong and Steady Steps"}
{"_id":"cfc74ad7-97f9-7d78-dc99-ea5c0576941b","text":"All programmes and interventions included in this review involve both HIC institutions and LMIC institutions or contexts as we have described. Acknowledging that our search strategy and eligibility criteria is likely to have favoured studies that described programmes and interventions undertaken in international partnerships, nevertheless, our review of the literature suggests that surgical training and education programmes, in both HICs and LMICs, are not commonly termed as “global surgery” programmes unless they involve both HIC institutions and LMIC institutions or contexts.","title":"Global Surgery Education and Training Programmes—a Scoping Review and Taxonomy"}
{"_id":"cfc7e4b5-941e-c697-0d72-4719c2e1e9eb","text":"The perichondrial cutaneous graft has shown in this surgical case very favorable peculiarities that make it usable even in facial plastic surgery.","title":"Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose"}
{"_id":"cfcb8773-68af-856e-c98e-63f8a36073a6","text":"In conservative surgery, bone specimens should probably be taken at both proximal and distal margins which, however, complicates the procedure, especially if both histology and culture are performed systematically. The role of molecular genetic techniques in the detection of bacteria in bone margin biopsies is not clearly established. These techniques do not provide information on the antimicrobial susceptibility profile of the bacterial strains identified. In the absence of indication regarding the pathogenic role of the organisms identified by these techniques, no recommendations have been made so far on their use in these settings. Data on the choice and duration of the antibiotic treatment to prescribe following bone margin biopsy are lacking. The first question is about the use of empirical post-biopsy antibiotic therapy while waiting for the results. Given that a bone and joint resection or even an amputation of all or part of the foot has just been performed in a context of a possible infection, it seems logical to consider an empirical antibiotic therapy started intraoperatively after the tissue samples have been taken and continued until the results of culture are available. As some of these patients are operated while receiving antibiotics a negative result should be interpreted with caution. If a bacterial documentation has been obtained prior to the surgery and histology is positive antibiotics should probably be administered and should be stopped if histology is negative. This raises the potential interest of histology examination in these settings. In the cases of negative culture and positive histology without previous documentation, antibiotics should be chosen taking account of the antibiotics which led to a negative culture. The duration is another difficult as the optimal duration of antibiotic treatment for DFO is not known. The last edition of the IWGDF recommends consider treating DFO with antibiotic therapy for no longer than 1-2 weeks if all infected bone has been surgically removed 33. No recommendations are however provided in cases of positive bone margin biopsy.","title":"Surgical techniques for Bone Biopsy in Diabetic Foot Infection, and association between results and treatment duration"}
{"_id":"cfcc463e-956b-cec5-57fd-079a609f6f1f","text":"Table 2 Clinical and pathologic characteristics of SLNB for subgroups based on clinical suspicion of lymph node metastasis","title":"Feasibility of sentinel lymph node biopsy in breast cancer patients clinically suspected of axillary lymph node metastasis on preoperative imaging"}
{"_id":"cfcc8d4d-a2fb-cc71-c50e-59782dfc0d8d","text":"Imprint smears, immunostained with the rapid protocol, showed unequivocal melanoma metastases in 1 SLN which was negative by immunohistochemical evaluation of permanent sections. This was one of the SLN from a case with two other unequivocally positive SLNs in permanent sections and rapid immunostained imprint smears. This unequivocal positivity with immunostained imprint smears alone underscored the sampling benefit with imprint cytology.","title":"Optimization of an immunostaining protocol for the rapid intraoperative evaluation of melanoma sentinel lymph node imprint smears with the 'MCW melanoma cocktail'"}
{"_id":"cfd042c0-ec93-fb7d-3a20-5edf85f2c097","text":"One DR patient had a recurrence at 1 year follow up on contralateral side resulting to bilateral DIEP reconstruction.","title":"Breast Reconstruction–Prospective Follow up on Breast Cancer Patients’ Health-Related Quality of Life"}
{"_id":"cfd325cc-c4a5-5199-4399-634aa90ac6c4","text":"Originally the typical target of IORT was the surgical margin in which tumor cells remain due to incomplete resection or microscopic infiltration. The target was therefore usually a superficial thin layer of tissue which can be covered with sufficiently homogeneous dose by low energy electrons or photons. The use of IORT in APBI and boost irradiation within breast conserving treatment of breast cancer has changed this paradigm. The pathological study of Holland et al. showed that in 43% of patients with invasive cancers which are eligible for breast conserving treatment tumor additional tumor foci were found beyond a radius of 2cm surrounding the tumor, the number decreasing to 17% at 3cm and 10% at 4cm [35]. A margin of 1-2 cm of tissue surrounding the original tumor bed is therefore usually taken as target for boost treatment [36]. This requirement defines an extended volume of several cm3 which must be prepared for irradiation and covered with the prescription dose. Treating the larger target volume can require higher electron energies or techniques with kV X-rays which both can cause more dose in tissues surrounding the target and in some cases require additional protection of risk tissues.","title":"Present state and issues in IORT Physics"}
{"_id":"cfdbe1ab-48ce-3480-ee47-a95d4700125a","text":"There is two significant nasal growth spurts The first postnatal year which starts an endochondral ossification process (in the region of the anterior skull base) and the period of puberty when the nose grows faster compared to other periods in life.","title":"Justification for Rhinoseptoplasty in Children – Our 10 Years Overview"}
{"_id":"cfded94a-844c-5749-a430-ceb1ba3e6e94","text":"Our results demonstrated a comparable ability of the composite to eradicate infection to that of PMMA, yet with superior osteogenic and resorptive capabilities. The indirect bond within the composite allows calcium phosphate to spread evenly through the sulfate matrix. Consequently, in vivo calcium sulfate is resorbed, resulting in increased material porosity and allowing for bony ingrowth. Calcium phosphate is thought to remain stable and provide compressive strength throughout the ingrowth process. MicroCT imaging demonstrated guided bone formation both within and surrounding the resorbing composite pellet. This rapid restoration of bone is integral to the clinical management of dead space in the setting of osteomyelitis. The comparable results demonstrated in the preventative arm of the study reveal the plausible application of the composite in the treatment of polytraumatic open fractures, where bone loss and a high infection risk are concurrently problematic.","title":"Vancomycin-laden calcium phosphate-calcium sulfate composite allows bone formation in a rat infection model"}
{"_id":"cfe2a526-b7a4-e0e3-31ad-5f00fa8515de","text":"There is high incidence of venous thromboembolism, comprising of deep vein thrombosis and pulmonary embolism, in hospitalized patients. The need for systemic thromboprophylaxis is essential, especially in patients with inherited or acquired patient-specific risk factors or in patients undergoing surgeries associated with high incidence of postoperative deep vein thrombosis and pulmonary embolism. These patients, on prophylactic or therapeutic doses of anticoagulants, may present for surgery. General or regional anaesthesia may be considered depending on the type and urgency of surgery and degree of anticoagulation as judged by investigations. The dilemma regarding the type of anaesthesia can be solved if the anaesthesiologist is aware of the pharmacokinetics of drugs affecting haemostasis. The anaesthesiologist must keep abreast with the latest developments of methods and drugs used in the prevention and management of venous thromboembolism and their implications in the conduct of anaesthesia.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"cfe60455-848e-7665-9f66-badf4f1beb72","text":"This study evaluated for the first time postoperative flap perfusion monitoring with attached surface probes for the O2C analysis system in terms of detecting vascular compromise in microvascular head and neck reconstruction. The study demonstrated that attached surface probes are technically feasible and represent a safe option for patients to be used with the O2C analysis system for postoperative flap perfusion monitoring. Based on distinctive cut-off values, flap perfusion monitoring with attached surface probes showed high accuracy and, more importantly, a substantial concordance with flap perfusion monitoring with unattached surface probes, supporting interchangeability between the two surface probes. Further studies are needed to confirm the cut-off values indicative of vascular compromise for attached surface probes and to validate their accuracy to maintain the clinical utility of the O2C analysis system for flap perfusion monitoring.","title":"Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity"}
{"_id":"cfeaeea4-058a-a200-3e48-2c2cfb405fb5","text":"Based on the treatment of the described clinical case, it is noted that osteomyelitis is a very complex infection and may settle after traumatic episodes involving the craniofacial region. The surgical treatment and the correct antibiotic regimen instituted by a multidisc ciplinary team proved to be essential for the stabilization of the condition.","title":"Facial trauma followed by osteomyelitis - Case report"}
{"_id":"d0076adc-76ba-d957-2594-64bb1b284e92","text":"ASES fellowship directors share similar demographic and professional characteristics with high levels of research productivity and involvement in orthopaedic societies. There is a lack of diversity in shoulder and elbow fellowship directors, highlighting a need for priority consideration of this disparity by leaders in the field.","title":"Leadership Trends in Shoulder and Elbow Surgery Fellowship Directors: A Cross-sectional Study"}
{"_id":"d0082466-ee34-5fb0-b3e8-35d6a0a893c5","text":"Should this study demonstrate that a full-scale trial is feasible, the data from this feasibility study will be included in the final analysis of the definitive trial. This is contingent on the future definitive trial being sufficiently similar to this feasibility study. Baseline and follow-up outcome data will therefore not be released to the trial team unless the lack of feasibility is determined based on observed infection rate at the end of the feasibility study, or the definitive study cannot be conducted for other reasons (eg, lack of funding). Reporting of the study outcomes will be done accordingly to enable to use of the outcome data in a future definitive trial if such a study goes ahead.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"d00f6b8e-5bbd-b5fd-a8fd-a1ca8a8c8ad2","text":"Osteomyelitis is a common complicating factor in patients with pressure sores.3 Prompt diagnosis and adequate management of osteomyelitis is important because it is associated with an increased risk of pressure sore recurrence. The standard for diagnosis of osteomyelitis in patients with pressure ulcers continues to be intraoperative bone biopsy. Preoperative magnetic resonance imaging may be useful as a noninvasive diagnostic tool and to determine the extent of involvement. However, its impact on management and outcomes is unproven.4 When a diagnosis of osteomyelitis is made, a combination of bony débridement and antibiotic therapy guided by bone cultures should be employed.5","title":"Pressure Sores"}
{"_id":"d01639e4-c732-6517-0fd0-b1296f013708","text":"Possible algic symptoms due to scarring and back pain were investigated by administering a dedicated VAS scale.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"d031e2da-8694-ce89-4f03-7c749a0656f8","text":"Loss of media transparency due to bullous keratopathy is present in several patients three to five years after surgery, with no significant loss of endothelial cells during surgery and no significant edema in the immediate postoperative period. We consider that this loss of transparency may be due to limbal insufficiency, but it is surprising that they do not have recurrent ulcers and respond well to corneal transplantation with a speed of re-epithelialization within the normal range.","title":"Clinical Outcomes after Surgical Resection Combined with Brachytherapy for Uveal Melanomas"}
{"_id":"d03b80d7-5a81-ecbd-61e8-aa9192057733","text":"When the draining lymph node basins are clinically unaffected (clinical stage I or II), sentinel lymph node biopsy (SLNB) procedure should be considered. Clinical exam and\/or radiological studies are not a substitute to SLNB, since upwards of 20% of patients who are clinically node-negative have metastatic involvement.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"d03c816c-3056-6377-27e5-2ae74b9c7d53","text":"In conclusion, the integration of an EHR VTE risk-stratification tool is associated with significant reduction in VTE events across surgical patients and remains an effective and promising intervention across all surgical and surgical subspecialty services. The tool effectively screened patients into appropriate risk categories and allowed for appropriate selection of VTE prophylaxis, providing a standardized method for decisions and dosing in the postoperative period. Even when the tool is not mandatory, it is able to effectively reduce overall VTE events. This tool, in combination with clinical decision making, aids in mitigating VTE events in the postoperative period. Ensuring full compliance with tool utilization and appropriately prescribing VTE chemoprophylaxis at discharge to high risk patients will likely further reduce VTE events.","title":"Electronic health record risk-stratification tool reduces venous thromboembolism events in surgical patients"}
{"_id":"d04d1f51-9706-4877-e648-a24944413850","text":"Our results suggest no oncological unsafety in breast cancer patients who underwent mastectomy alone and IBR after mastectomy. We further performed the comparison analysis on LRR and DMs between two groups stratified by breast cancer molecular subtypes. We did not identify molecular subtypes as a risk factor of LRR and DMs, which further confirmed the oncological safety of IBR. During the limitation of this study, additional studies will be required to further confirm the oncological safety of IBR in each subtype. Further investigations into breast cancer relapse (local recurrence and DM) biomarkers may profoundly affect the indications and the timing for performing breast reconstruction.","title":"A Single-Center Retrospective Analysis of Local and Distant Relapse of Breast Cancer Following Immediate Breast Reconstruction According to Molecular Subtypes"}
{"_id":"d0508872-a5bc-f403-0f65-5195100bb8bd","text":"We believe radiotherapy is a good treatment option for facial BCCs located at difficult sites in patients who are not able to tolerate surgery.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"d057977a-4867-d94f-8d7a-b39c0ed71c1b","text":"Table 5 The effect of removing ARM nodes during the SLNB procedure on lymphedema","title":"Using the axillary reverse mapping technique to screen breast cancer patients with a high risk of lymphedema"}
{"_id":"d05e1d8d-db0e-d7b2-daff-67ae1af71fb8","text":"Single ultrasound-guided TPVB with a large volume of anesthetic offers effective analgesia for microwave ablation of lung tumors, helping the patient cooperate with the operating surgeon to reduce injury from multiple lung punctures. Further studies are recommended to validate these findings.","title":"Single ultrasound-guided thoracic paravertebral block with a large volume of anesthetic for microwave ablation of lung tumors"}
{"_id":"d069d78a-3749-d781-6513-cf6fefb85655","text":"From Figure 3, it is shown that the accuracy of visualizing the precise tumor segment from the 3D reconstructed liver model using ENURBS is higher than that of 2D CTA images. Figure 1 shows that surgeons can more precisely visualize the tumor section from the 3D reconstructed model than from 2D images. Our findings suggest that 3D reconstruction increases clinicians' ability to create the best surgical strategy.","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"d07373be-45a1-e92d-1d6a-b09c665c9ccb","text":"The results in our series with minimal complications favor this easy and reliable option. One patient developed a superficial wound infection which was controlled with debridement with implant retention and parenteral antibiotics. Another patient developed transient peroneal nerve palsy which recovered completely in six months.","title":"Autologous Nonvascularized Fibula Graft and Locking Compression Plating for Failed Fixation of Humeral Shaft With Atrophic Gap Nonunion"}
{"_id":"d078bbb7-53dc-f3d9-40ff-92dc48501ca6","text":"Ulcerations caused by ischemia are typically located on the tips of the toes and between the digits. The lesions often appear punched out and are painful but exhibit little bleeding. Ischemic ulcers are characterized by absence of bleeding, pain, and a precipitating trauma or underlying foot deformity. They also often develop on the dorsum of the foot and over the first and fifth metatarsal heads. Ischemic ulcers are uncommon on the plantar surface as the pressure is usually less sustained, and the perfusion is better. A heel ulcer can develop from constant pressure applied while the heel is in a dependent position or during prolonged immobilization and bed rest. It should not be a surprise that a patient with relatively mild symptoms of arterial insufficiency develops limb-threatening extremity ulcers. This is due to the fact that once an ulcer is present, the blood supply necessary to heal the wound is greater than that needed to maintain intact skin. A chronic ulcer will develop unless the blood supply is improved.","title":"Contemporary Evaluation and Management of the Diabetic Foot"}
{"_id":"d078cf96-11ff-fe7a-d0a3-b4596155371e","text":"Basic strategies focus on removing impediments to movement and rotation and stabilizing the cartilages once in the desired position.9 Some techniques used to correct the nasal tip include cephalic alar trim, suture reshaping and repositioning of the cartilages, vertical transection of the medial and lateral crura, resection of the caudal septum, insertion of tip grafts and struts, and insertion of alar strut and spreader grafts.2 Previous studies have outlined algorithmic approaches to delineating techniques to alter and define the nasal tip.29 The rhinoplasty surgeon typically selects from one or a combination of these techniques to achieve an aesthetically pleasing outcome.","title":"Nasal Sculpting: Calculated and Predictable Tip Elevation With Cephalic Trim Redstone et al"}
{"_id":"d07f6246-254b-06fb-7e43-3ff52c8714f7","text":"Sentinel lymph node biopsy is indicated in the 10% to 20% of DCIS tumours in which foci of invasive carcinoma are detected after surgical excision and analysis of the entire lesion [6, 7]. Such histological upgrading has become more common now that the preoperative diagnosis of DCIS is often made on core biopsy. Most surgeons will include a SLN biopsy when performing a mastectomy for DCIS since access to the SLN lies within the operative field and also because nodal evaluation after a mastectomy often entails ALND as the SLN can seldom be successfully identified due to the disruption of lymphatic drainage to the axilla. On the other hand, with wide local excision (WLE), a separate incision in the axilla is required for SLN biopsy and even a WLE performed in the upper outer quadrant does not interfere with successful SLN identification at a later setting. Including a SLN biopsy with the initial WLE may not reduce the reoperation rate as much as with a mastectomy, since up to 20% of these women will need a second surgery because of inadequate surgical margins [8]. Nevertheless, having a SLN biopsy done together with the first surgery will undoubtedly save those women in whom a preoperative diagnosis of DCIS is upgraded to invasive carcinoma on final histology from a second surgery. Avoiding a second surgery saves time and costs, and more importantly, it reduces psychological stress and facilitates recovery. Completing all necessary surgery in a single setting is particularly important in our society where the need for a second surgery is often perceived as a failure of the initial one.","title":"Sentinel Lymph Node Biopsy Should Be Included with the Initial Surgery for High-Risk Ductal Carcinoma-In-Situ"}
{"_id":"d080d17b-8a28-49be-6df7-5fb422936cc2","text":"Objective: To compare the efficacy between combination of nebulized salbutamol and fluticasone propionate and nebulized salbutamol in children with mild and moderate asthma attack.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"d092299b-09b4-07ce-0bdd-438398510e43","text":"Various methods of breast reconstruction have been proposed for a long time. In particular, in breast reconstruction using autologous tissue, the discovery and subsequent location of a perforator capable of supplying blood can lead to the continuous discovery of new flaps and the development of surgical methods, which in turn directly affects the improvement of the patient's quality of life and high satisfaction.","title":"Deep Inferior Epigastric Perforators Topography for “Island Transverse Rectus Abdominis Musculocutaneous Flap” in Breast Reconstruction"}
{"_id":"d09d1962-d533-bd70-c9d0-40193afa99f0","text":"Bone grafting has a lower success rate when performed after canine eruption compared to before the eruption. It has also been found that the possibility for orthodontic closure of the cleft in the dental arch is smaller than in patients grafted before canine eruption. In adults oral hygiene is of major importance. The surgical procedure should include drilling of multiple small openings through the cortical layer into the cancellous layer facilitating in growth of blood vessels into the graft.","title":"Alveolar bone grafting"}
{"_id":"d0a5ffa4-54ab-c078-584c-e66c71823cc7","text":"Malignant transformation in chronic osteomyelitis is a rare but unfavorable condition. Early diagnosis on the basis of information related to both clinical signs and imaging can lead to less invasive surgical treatments. Amputation is the definitive treatment of recurrent chronic osteomyelitis even in the absence of neoplastic transformation. It should not be delayed, and the patient’s compliance is of prime importance. Surgeons should be aware of the risk of tumor degeneration in patients with osteomyelitis and chronic wounds.","title":"Squamous cell carcinoma in chronic osteomyelitis: a case report and review of the literature"}
{"_id":"d0a7b4f4-2367-04a6-5395-094e3ef6d766","text":"Application of the albumin impregnated allograft as a filler in sinus floor elevation provided long term volumetric stability of the augmented sinuses.","title":"Comparison between Micro-Computed Tomography and Cone-Beam Computed Tomography in the Assessment of Bone Quality and a Long-Term Volumetric Study of the Augmented Sinus Grafted with an Albumin Impregnated Allograft"}
{"_id":"d0a83efd-bb76-68be-b6a2-f957314137e6","text":"Some muscle flaps like the Latissimus dorsi have certain unfavourable characteristics such as: changing the patient’s position intraoperatively, while in the rectus abdominis muscle flap the chance of herniation and mesh infections are present. The use of the rectus femoris muscle flap was demonstrated for free tissue transfer with various advantages but one of the major disadvantage is the lack of the ability of the muscle to spread and increase in surface area as compared to a gracilis flap, we found that a gracilis flap can be easily spread to twice or thrice its width.","title":"The Gracilis Muscle Flap: A “Work Horse” Free Flap in Diabetic Foot Reconstruction"}
{"_id":"d0ad7046-b174-c17a-efbe-8993d2640988","text":"There is no consensus on whether patients with NS should be treated with anticoagulation or antiplatelet therapy at present. Anticoagulant therapy is the process of reducing the endogenous and exogenous coagulation pathways through the application of drugs, and the process of reducing fibrin thrombosis. Antiplatelet is the process of taking anti-platelet aggregation drugs to reduce the adhesion and aggregation function of platelets, thereby reducing the formation of platelets and thrombosis. Hypercoagulability and enhanced platelet aggregation is considered to be the most important factors leading to lower extremity arterial thrombosis. The author thinks that anticoagulation and antiplatelet therapy are equally important for NS and arterial thrombosis because combined antithrombotic therapy maybe promote recanalization of blood vessel and prevent recurrence of thrombosis.","title":"Acute lower extremity arterial thrombosis associated with nephrotic syndrome in adults: case series and literature review"}
{"_id":"d0bd2a94-e03f-d77d-5ff2-6cc18d0403e6","text":"Anatomically, the axillary space is divided into three levels by the pectoralis minor muscle. The dissection of level III ALNs, located between the costoclavicular ligament of Halsted and the medial border of pectoralis minor, is associated with a slightly longer surgical time and associated morbidity. There is no international consensus on the anatomic levels of axilla to be addressed as a part of routine axillary dissection. National Comprehensive Cancer Network guidelines recommend to clear level I and II of the axilla only. Our institutional policy is to complete the axillary dissection up to level III in all patients with proven positive axillary nodes. The objective of this study was to determine the extent of level III ALN involvement and to ascertain the merits of doing a level III ALN dissection.","title":"Merits of Level III Axillary Dissection in Node-Positive Breast Cancer: A Prospective, Single-Institution Study From India"}
{"_id":"d0d3f8a9-e70f-f494-2f3d-f08e68921baf","text":"Institutional positions were classified by the six following categories: chief or chair, vice chief or chair, PD, plastic surgery medical director (eg, director of microsurgery, director of aesthetic surgery), and other institutional positions. National leadership positions included those who held chair, president, vice chair, or vice president positions in one or more of the following organizations: American Society of Plastic Surgeons, the Plastic Surgery Foundation, the American Board of Plastic Surgery, the American Council of Educators in Plastic Surgery, the Plastic Surgery Research Council, and the American Association of Plastic Surgeons.","title":"Effect of Training Backgrounds on Plastic Surgery Leadership: A Logistic Regression Analysis"}
{"_id":"d0da9417-1040-fc54-5ee5-5d6732c762db","text":"Allergy immunotherapy use to treat allergies that was not effectively relieved by medications and recommended for all age .On the other hands, although allergy shots is usually safe but sometimes has side effects from localized swelling and erythema at the place where the shot given to anaphylaxis shock.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"d0dce54e-f333-03b1-9d8c-d0f0a0627a1a","text":"Regarding safety, despite the production of specific IgE antibodies in response to bee venom injection, no clinical symptoms of allergy were detected. The protocol we used seems safe and was consistent with the highest dose recommended by the manufacturer for immunotherapy, 100 μg in a single injection. About 45% of patients produced IgE before the third injection and the remainders after. The peak of IgE synthesis was observed after the fifth injection in half of patients and IgG4 production began subsequently to be detected in half of patients after the sixth injection. Thus, early in the immune response a critical phase may exist which may cause allergy with clinical symptoms. However, over time, a balance in the level of specific IgE and IgG4 antibodies is induced. This phenomenon explains the desensitization of allergic patients treated by immunotherapy and may also put to rest fears of using bee venom in non-allergic subjects, which is a important finding as such and paves the way for future studies.","title":"Bee Venom for the Treatment of Parkinson Disease – A Randomized Controlled Clinical Trial"}
{"_id":"d0ebd6e6-493c-11fe-679d-9b2f62d8f5af","text":"In this feasibility study, we have shown that CLI can be performed in vivo as a novel method to evaluate and document the position of ruthenium-106 plaques during brachytherapy of posterior uveal melanoma. By using an integrated EMCCD and fundus camera, we were able identify the plaque in the fundus of all the imaged patients. In most cases, it was also possible to assess the position of the plaque relative to the tumor, which appeared as a slightly darker area encircled by the Cherenkov light. By looking at the symmetry and intensity of the light distribution around the tumor, assumptions could be drawn about possible plaque dislocation, which was later confirmed by postoperative fundus photography.","title":"Cherenkov Luminescence Imaging for Assessment of Radioactive Plaque Position in Brachytherapy of Uveal Melanoma: An In Vivo Feasibility Study CLI in Brachytherapy of Uveal Melanoma"}
{"_id":"d0f2af7c-b4d9-cf66-fdfb-5afe4b2a022f","text":"Patients were started on imatinib two to seven weeks prior to initiating radiation therapy. Imatinib was initiated at 300 or 400 mg daily, and the dose was titrated down to 200 mg daily in two patients due to nausea. Imatinib was continued indefinitely or until side effects became intolerable, but all patients received at least 6 months of imatinib treatment. Three of the patients received radiation therapy at Stanford Health Care, and one patient was treated at an outside facility. External beam radiation therapy to 50–54 Gy was delivered in 1.8–2 Gy daily fractions using either a 3D conformal or intensity modulated radiation therapy technique. Care was taken to limit radiation dose to surrounding normal structures including adjacent joints when possible.","title":"Concurrent Imatinib and Radiation Therapy for Unresectable and Symptomatic Desmoid Tumors"}
{"_id":"d0f44168-f1fb-e2e0-9146-eb1c27f99ba3","text":"The ultimate goal of any breast reconstruction is to provide an aesthetically pleasing mound with appropriate symmetry and contour while minimizing scars. Decision making regarding the choice of technique depends on both the amount of skin deficiency and the amount of 3-dimensional volume losses in comparison with the contralateral breast. Patients with large breast and minimal excess abdominal soft tissue may require the use of all zones of their donor site for appropriate volume. Our use of a dual-pedicled DIEP flap to maximize vascularized tissue transfer involves 2 separate anastomoses, effectively obliterating the poorly vascularized zone II and zone IV. Stacking DIEP flaps also increases projection, whereas folding of the intact de-epithelialized dermis preserves all collateral cross-midline blood flow while enhances inferior pole contour. Retrograde internal mammary artery and vein are adequate to supply and drain the hemi-flap.","title":"CASE REPORT The Use of Both Antegrade and Retrograde Internal Mammary Vessels in a Folded, Stacked Deep Inferior Epigastric Artery Perforator Flap"}
{"_id":"d0fd32b0-c191-7a27-9f52-26200c1d2f26","text":"Cosmetic doctors should have an in-depth knowledge of the vascular anatomy of the face to avoid inadvertently injecting fat particles into the facial blood vessels.","title":"Case report and literature review: fatal cerebral fat embolism following facial autologous fat graft"}
{"_id":"d0fd85a6-74fc-3bb2-9eca-fe5a6736e9b7","text":"We recommend using a subfascial vessel as the recipient vessel for both first and second free flaps, especially if access to the major vessel is risky or challenging.","title":"Validity of the use of a subfascial vessel as the recipient vessel in a second free flap transfer A retrospective clinical review"}
{"_id":"d0ff04e5-7791-9f74-a89e-b6e413846f40","text":"Vertebral osteomyelitis often presents with varied symptoms and is therefore a diagnostic challenge for clinicians. In the present case report, we explain our clinical process for identifying the infection source and causative pathogen in the case of an older adult woman who had recurrent fevers. In addition to describing conservative treatment plans for P. mirabilis vertebral osteomyelitis, we comprehensively reviewed previous reports of similar cases and their respective diagnostic approaches.","title":"Proteus mirabilis thoracic vertebral osteomyelitis: a case report"}
{"_id":"d10067b5-9a8e-4cfa-a494-e169418e20e7","text":"For the posterior lamell a reconstruction, we agree with Hilko Weerda7 considering the chondromucosal nasal graft as the most suitable for the total lower eyelid reconstruction. Since on the contrary of the bucal mucosa graft that provide just mucosa or the ear cartilage that provides just cartilage, the chondromucosal nasal graft7 or the chondromucosal nasal flap6 provide in one step both for the reconstruction of the mucosa and the tarsal.6 We finally decided to use the chondromucosal nasal flap instead of the chondromucosal nasal graft because we considered that the flap could be safer than the graft, although this technique is more complicated.","title":"Chondromucosal Nasal Flap With the Transposition Flap of Von Langenbeck as a Good Election for the Total Lower Eyelid Defect Reconstruction in an Old Patient With an Elevated Vision Loss in the Contralateral Eye"}
{"_id":"d1013f93-bdd3-348b-c61d-908fb80b0a36","text":"In conclusion, the role of adjuvant radiation therapy for patients with mucoepidermoid carcinoma of the parotid gland is based on data from institution reviews and lacks data from randomized controlled trials. Per our review of the literature, the pathological findings of positive surgical margins and perineural invasion in two patients with low-grade MEC of the parotid gland warranted adjuvant radiation for improved local control after parotidectomy. For these reported patients with low-grade MEC, direct treatment of the neck was not performed.","title":"Postoperative Radiation Therapy for Parotid Mucoepidermoid Carcinoma"}
{"_id":"d105f7f2-4bc2-df5e-d73d-42b875a8de67","text":"Local recurrence was evaluated using MRI every 3 to 6 months postoperatively. When MRI showed a new lesion larger than 1 cm with TSGCT-like signal intensity during the postoperative course where the surgical team should have removed the macroscopic tumor completely, and the lesion did not decrease in size in the follow-up MRI image, it was considered to be a local recurrence.","title":"Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study"}
{"_id":"d1095cb9-c5a0-eb34-e04c-b5b8db0a32da","text":"Our purpose in this study was to confirm the microstructural homogeneity of the ink pigment particles used in permanent cosmetic procedures and to identify the presence or absence of hazardous foreign substances.","title":"Analysis of microstructural characteristics and components of red and yellow ink pigments used in permanent makeup"}
{"_id":"d10a3fc7-311f-a880-beaa-2cb14433ff4c","text":"While effective, external beam radiation therapy is primarily used to treat malignancies in patients over the age of 60 under special circumstances.8,35 In short, this form of radiation therapy is most often indicated in patients who are poor surgical candidates or have perineural or large nerve involvement.6,7 This is because external beam radiation therapy promotes tumorigenesis and can alter the structure of normal surrounding tissue, thereby complicating future excisions and reconstructions.8,35 T","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"d10b97f5-f48a-d481-cd49-ea6f05921235","text":"Artificial UV exposure may play a role in the development of melanoma; in fact, the amount of UV-A exposure in a typical tanning bed session is significantly higher than exposure during normal outdoor activities or even during sunbathing","title":"Epidemiology and Risk Factors of Melanoma: A Review"}
{"_id":"d11112f4-417e-49ae-5dbb-78ce38a391d9","text":"We retrospectively investigated patients with primary VO in a tertiary care hospital during a 10-year period with the aim to assess predictors of switching from intravenous to an oral antibiotic regimen and to investigate the clinical outcome dependent on different treatment durations.","title":"Is switching to an oral antibiotic regimen safe after 2 weeks of intravenous treatment for primary bacterial vertebral osteomyelitis?"}
{"_id":"d11ee514-bbd4-eaf8-6eef-7bee8de8207f","text":"Antibiotic-impregnated cement beads were applied for patients with severe infection. Meticulous hemostasis was performed before wound closure. The vacuum sealing drainage technique was used for those with soft tissue defects or those that could not be initially closed without tension. Subsequently, local tissue flap or direct suture without tension was performed to reconstruct the small soft tissue defects, whereas flap transfer or free skin grafting was used to cover the larger wound.","title":"Bone Defects in Tibia Managed by the Bifocal vs. Trifocal Bone Transport Technique: A Retrospective Comparative Study"}
{"_id":"d1275bc4-ca64-d6b3-6cc7-b540ce949770","text":"Costal Cartilage and costa are ideal donor tissues in the reparative and reconstructive surgery fields. However the qualities of costal cartilage and costa play a critical role in the treatment effects. Although many studies reported that costal cartilage increased with age, and had a relationship with sex, no reports elaborated the exact relationship between costal cartilage calcification and age or sex. Besides, almost all the studies focused on the cartilage calcification and there were no references paying attention to the costa age related changes. As is known to us, osteoporosis is proved in menopausal women, whether this process could affect costa and what is the difference between male and female in different age groups? As a result, we have measured the calcification of both costal cartilage and costa and compared the difference with age in the present study.","title":"Characteristics of Chinese Costal Cartilage and Costa Calcification Using Dual-Energy Computed Tomography Imaging"}
{"_id":"d13b855d-f1c0-a323-7683-92bae397fce6","text":"The VFG is an excellent choice for reconstruction of multilevel cervical defects due to spinal tuberculosis. The rapid and ideal fusion as well as the lower risk of tuberculosis recurrence in this case indicates that this method may offer a new treatment strategy for long segmental cervical tuberculosis.","title":"Application of vascularized fibular graft for reconstruction and stabilization of multilevel cervical tuberculosis A case report"}
{"_id":"d13e679c-d6ba-3007-463f-383e74b708b8","text":"The obtained results regarding domestic acarofauna in the examined dwellings of asthmatic subjects cannot completely account for all variables determining the severity of asthma, as those persons may also be exposed to other indoor allergens. On the other hand, they are also exposed to mite allergens in different outdoor environments; however, these environments are usually home to other mite taxa, not only for the species of the family Pyroglyphidae, known as the house-dust mites. The actual study was performed in 16 flats occupied by 16 patients suffering from bronchial asthma which have agreed to participate in the study. This limited the number of flats examined. As the occurrence and density of mites in dust samples from different places or dwellings may vary to a considerable extent and the number of actually examined flats was limited, the further and more extensive studies are highly desirable. Above all these studies are needed to better clarify the relationships between indoor environmental factors, symptoms of asthma and the species composition of domestic mites from dwellings and other public places in Poland.","title":"Abundance of domestic mites in dwellings of children and adolescents with asthma in relation to environmental factors and allergy symptoms"}
{"_id":"d143e381-1db6-afb3-7f63-0c444ada03c2","text":"Giant phyllodes tumors are very rare tumors that can reach up to 40 cm in diameter. Reconstruction of such a defect is a great challenge, and we report what we believe is the first latissimus dorsi flap to cover successfully a defect of approximately 400 mm by 350 mm.","title":"Immediate latissimus dorsi pedicle flap reconstruction following the removal of an eight kilogram giant phyllodes tumour of the breast: a case report"}
{"_id":"d152a59d-c624-957c-a8e3-1aa0ba21b878","text":"We conducted study 1 to test the hypothesis that luminance and color contrast of women faces changes with age.","title":"Aspects of Facial Contrast Decrease with Age and Are Cues for Age Perception"}
{"_id":"d16c1f01-179f-2354-d066-f13fbd4830ff","text":"When comparing mastectomy and lumpectomy, there were significant differences among cosmetic outcome and chronic pain prevalence. Patients that received lumpectomy were significantly more satisfied with their cosmetic outcomes when considering post-surgical scar but did report skin thickening as a common radiation side effect. Compared to lumpectomy, mastectomy is associated with lower rates of chronic pain including pain at the six months threshold and pain that is persistent and present up to the time of survey.","title":"Choosing Mastectomy vs. Lumpectomy-With-Radiation: Experiences of Breast Cancer Survivors"}
{"_id":"d170002e-40a5-247f-8162-74af970ed506","text":"This study confirms that there is a significantly increased relative risk of second primary cancers in individuals with SCC. The UV component of sunlight is widely believed to be the main risk factor for skin and lip cancer and this may explain the subsequent excess of malignant melanomas and SCCs of the lip.","title":"Second primary cancers in patients with squamous cell carcinoma of the skin"}
{"_id":"d172f6ef-2b6b-d506-3725-05b0259802aa","text":"This audit highlights the problem of sonographers routinely mistaking other features like the bowel as ovaries when scanning postmenopausal women. It also highlights the difficulties of providing effective Quality Control (QC) for such scans in a large scale screening programme. Specifically, it shows that undertaking the type of expert review conducted by this study for a substantial number of sonographers on a regular basis would not be feasible without creating dedicated teams specializing in normal ovary identification from TVS images of postmenopausal women. Therefore there is a need for further research to explore how independent and reliable QC metrics for TVS might be obtained by other means, for example by the automated analysis of TVS scan images both static and video. Recent advances in machine learning research, particularly in the area of deep neural networks, suggest it might soon be viable to construct a system able to determine sonographer VR from a collection of images captured during a series of TVS examinations. Indeed, the use of such deep learning techniques in the gathering of quality metrics from obstetric ultrasound images is already reporting some promise .","title":"Audit of transvaginal sonography of normal postmenopausal ovaries by sonographers from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) [version 1; referees: 2 approved"}
{"_id":"d1787360-b124-2e45-458e-55f4c8fd8460","text":"It is recognized that the link between the knowledge and practice of pharmacists in what concerns the information given to patients about dermatoses and corresponding treatment is not fully characterized. It is also recognized that the pharmacists’ contribution in counselling and in adherence promotion to topical treatment is not fully understood. Three main objectives were then considered: identification of the knowledge of pharmacists about dermatoses and their treatment; comparison of the perspective of pharmacists with that of patients regarding treatment information; future goal of establishing clear guidelines on the communication of dosage regimen instructions by healthcare professionals to dermatological patients and promote treatment adherence.","title":"Knowledge and Practices of Community Pharmacists in Topical Dermatological Treatments"}
{"_id":"d17bd13f-7b82-eb7c-2bf8-ce596bc3e647","text":"Our study proved 106Ru -brachytherapy to be an excellent treatment option with regard to tumor control and preservation of the visual acuity in well-selected patients. Our data suggested that this treatment is also suitable for tumors with a depth of more than 5 mm.","title":"106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma"}
{"_id":"d1893d0a-4d87-bbc6-b1b3-5f8b155359bd","text":"If a diagnosis is confirmed then prompt treatment with systemic anticoagulation should be initiated and continued for three months. The risk of recurrence and possible life-threatening sequelae warrant consideration for a multimodal approach to treatment if symptoms do not promptly resolve.","title":"Upper-Extremity Deep Venous Thrombosis following a Fracture of the Proximal Humerus: An Orthopaedic Case Report"}
{"_id":"d19b25f8-3a8f-d5a9-c418-9db0ada0749d","text":"Table 11 Comparison between 2 different groups of patients with allergy to common wasp according to reaction to sting after cessation of it","title":"Insect sting allergy. A study from 1980 to 2003 of patients who started treatment with venom immunotherapy between 1980 and 1998"}
{"_id":"d19cb5fc-c64c-6db1-d87a-f743db969fa7","text":"There is not high level data to definitively establish the exact number of nodes required to deem a melanoma dissection complete, nor there is a consensus on the anatomical considerations and boundaries to utilize. In the axilla, it is reasonable to remove level I and II lymph nodes within the boundaries of the chest wall\/serratus anterior muscle, the axillary vein, and the latissimus dorsi muscle, with careful identification and preservation of the thoracodorsal neurovascular bundle and the long thoracic nerve. Most practitioners include level III infraclavicular lymph nodes, especially if they are grossly involved\/palpable. Level III axillary lymphadenectomy does increase the risk of upper extremity lymphedema. It is suggested the level III involvement is highly unlikely in SLNB-positive patients, but more likely with gross bulky nodal axillary disease [45, 46].","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"d19ffaa7-1ee0-6c73-1774-c6a1f06d1510","text":"Simultaneously, specialized nurses conducted a handheld Doppler examination of the arterial and venous pulses of the flap every two hours. Postoperative monitoring was started in the intensive care unit and continued up to three postoperative days. Saturation to monitor the patient’s general condition was displayed on another monitor with a small pulse oximeter device attached to the finger.","title":"Simple and Easily Interpretable Flap Monitoring Method Using a Commercial Pulse Oximeter and a Widely Used Bedside Patient Monitor"}
{"_id":"d1a1a19d-010b-3f54-27f2-5b04c5beb77c","text":"This is the first report of a late phase reaction and immediate type hypersensitivity occurring in quick succession in the same patient. Subsequent skin tests were able to prove the presence of these two different types of allergic reactions.","title":"Immediate type hypersensitivity and late phase reaction occurred consecutively in a patient receiving ethambutol and levofloxacin"}
{"_id":"d1a9efa2-daf0-a3b7-f78a-58e75e28445b","text":"Despite bearing the ultimate responsibility, it is still acceptable for aspects of the duty of disclosure and obtaining informed consent to be delegated. Informed consent is a communication process, and whether or not the patient has been adequately informed and educated is the key issue when delegating the duty.","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"d1ac4ec7-21e3-49f2-3cb0-eabd3033efbd","text":"Hedgehog pathway inhibitors are used in the treatment of patients with BCC even if relapses are frequent upon discontinuation of the drug, which however respond in 50% of cases to a second drug administration.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"d1b43f15-a783-3d24-0c09-37c524c81e5d","text":"Most of us considered that most of the systems had sufficient categories, with the exception of the ANHMRC system. There was almost agreement that the USPSTF system has sufficient categories. We agreed that it is possible to have too many categories as well as too few, the OCEBM system being an example of having too many categories.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"d1b5fb9f-997c-f4de-01d3-e2f132858eef","text":"In the international literature, nasal valve collapse is reported as the second most common cause of postoperative nasal obstruction, second only to the presence of residual septal deviation as demonstrated by Pearlman et al.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"d1b7138d-f4c2-6f1d-a6bf-eb5d8bab2a65","text":"Table 3 Assessment of the appropriateness of antimicrobial therapy for microbiologically documented infections","title":"Strategies of initiation and streamlining of antibiotic therapy in 41 French intensive care units"}
{"_id":"d1bc3214-10fa-4f7a-7f5e-25a06c1cc374","text":"We retrospectively analyzed four patients affected by persistent edema and venous congestion after reconstruction with pedicled and free flaps. The patients were admitted for extensive wounds with bone exposure from October 2010 to December 2011. Patients affected by postoperative tissue edema which resolved spontaneously were not included in the current study.","title":"Failure by congestion of pedicled and free flaps for reconstruction of lower limbs after trauma: the role of negative-pressure wound therapy"}
{"_id":"d1c430ef-8502-5964-f9fe-8d2e16061b2c","text":"Few studies have mentioned or investigated the progression of osteochondral destruction after surgery. Multivariate analysis showed osteochondral destruction at the initial examination and local recurrence to be independent risk factors for the progression of osteochondral destruction in the present study. Local recurrence itself sometimes causes pain and limitation of range of motion, while osteochondral destruction often impairs the patient QOL. Although the local recurrence rate was higher in cases with arthroscopic surgery compared with open synovectomy, osteochondral destruction was attributable to arthroscopic surgery in only a single case, although the follow-up period was short. The results of our previous report indicated that repeated surgery for local recurrence was a significant risk factor for progression of osteochondral destruction. However, the results of the present study did not show repeated surgery to be a risk factor for osteochondral destruction. This difference between the previous and present studies is related to the transition over time of the treatment procedure for TSGCT of the anterior knee from open total synovectomy to arthroscopic surgery.","title":"Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study"}
{"_id":"d1cca1fe-e3a8-2307-04bd-52a34949f363","text":"Although differences were found in the BTAT score between examiners, this did not imply a change in the diagnosis or treatment plan for each case. The authors agree that there is no gold-standard protocol for the evaluation and a multidisciplinary oral evaluation is needed for infants so that the diagnosis and treatment of ankyloglossia can be more assertive.","title":"Comparison of the Effects of High-Power Diode Laser and Electrocautery for Lingual Frenectomy in Infants: A Blinded Randomized Controlled Clinical Trial"}
{"_id":"d1d8359f-3828-1f13-09a2-51e6bb8674d8","text":"Potential disadvantages are the lack of a pre operative visualization of potentially affected lymph nodes as with lymphoscyntography that may lead to larger incisions to gain access to the affected area, the inability to visualize the affected sentinel node in the presence of more than 5 mm of soft tissue coverage as well as a learning curve in the use of the infra red video camera and its settings. Furthermore no numerical or other quantification exists to be able to compare different areas of uptake. Green discoloration of the injected area did not have a marked influence on the resection of the primary tumor, however when unclear mucosal disease exists it is suggested to mark the mucosal resection borders before injection of the ICG is done.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"d1dde59d-618a-b0bd-9e01-5450d7b29f09","text":"The fusion time and fusion rate were observed by imaging and the Cobb angle was measured. Cobb angle calculation was performed as two vertebrae with the anatomical position were selected; a straight line along the upper edge and the lower edge was drawn and made their vertical lines, and the Angle of the intersection of two vertical lines was considered as Cobb angle (Table 2).","title":"Clinical Efficacy and Safety of Anterior Cervical Decompression versus Segmental Fusion and Posterior Expansive Canal Plasty in the Treatment of Multilevel Cervical Spondylotic Myelopathy"}
{"_id":"d1e2f526-817b-50bb-e53e-7641cce31bae","text":"Thirty cases of pituitary adenoma models were researched in detail based on the sellar tumor models.","title":"Stereoscopic virtual reality models for planning tumor resection in the sellar region"}
{"_id":"d1e46521-9bea-4edc-94f3-6ca67588adda","text":"The presented case highlights the importance of addressing venous anomalies and hepatic venous outflow in liver transplantation to ensure the viability and success of the transplanted liver. Hepatic venous congestion remains a significant concern, and the adoption of unique anesthetic management and intra-operative care can play a crucial role in mitigating potential complications. The use of intra-operative diuretics to keep CVP low, combined with the application of TEE and sonography, aided in preserving organ viability and reducing the risk of venous congestion.","title":"An Approach to Anesthetic Management of Venous Anomalies and Outflow Reconstruction in Liver Transplants"}
{"_id":"d1ed7167-58b3-d99b-7679-a8b014c27376","text":"Looking at the median survival for the patients in the palliative setting, this rate is so high compared with many cancers that justifies any symptom reducing efforts in this population. EBRT is an effective tool to relieve bone pain or local compressive symptoms.","title":"The role of external beam radiation therapy in the management of thyroid carcinomas: A retrospective study in Iran Cancer Institute"}
{"_id":"d1f4e818-20da-3261-4277-c7c713a6933e","text":"Objectives: To investigate whether the accessibility to additional information about course over time increased the number of patients diagnosed as MAS by the experts.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"d1f5daa1-54d9-72f4-e987-3d0c67d25d31","text":"In summary, the present study demonstrated that SS-LTR with an anterior costal cartilage graft is an effective method for the treatment of simple SGS ranging from Grade I to III in pediatric patients. Extubation immediately following surgery is considered to be safe and feasible.","title":"Immediate extubation after single-stage laryngotracheal reconstruction for subglottic stenosis in children"}
{"_id":"d1f63887-be25-77ce-60df-1d310651d608","text":"To observe the clinical effect of botulinum toxin type A (BTA) injection into the salivary glands of the severe neurological patients with tracheotomy","title":"Botulinum toxin in the treatment of sialorrhea in severe neurological patients with tracheotomy"}
{"_id":"d21016f1-39f5-4bee-cd6a-2beb0b1cadf5","text":"Complex palm defects with devascularized digits often require vein grafts. This may need to be followed by a free or pedicled flap to resurface the tissue lost and also cover the vein grafts and the anastomosis. However, if the anastomosis fails, or there is marginal wound necrosis, the existing flap would be redundant and a different flap would be needed for coverage.","title":"Use of Integra® as a Temporizing Measure Before Definitive Flap Surgery in Mangled Extremities Requiring Revascularization"}
{"_id":"d219e7cf-85d1-5d97-d1ef-07508ee7325f","text":"In our study we proved that the preoperative US of regional lymph nodes spares some patients from undergoing a SNB. In addition, patients with regional lymph node metastases and a negative preoperative US have a significantly lower tumour burden in comparison to those with only clinically negative regional lymph nodes. Most importantly, this is reflected in a better OS for this particular subgroup of patients.","title":"Lower tumour burden and better overall survival in melanoma patients with regional lymph node metastases and negative preoperative ultrasound"}
{"_id":"d21d06d1-6385-eda0-9137-eed03811581a","text":"The evaluation and management of axillary lymph nodes is critical in breast cancer with impact on locoregional as well as survival outcomes. ALND can be extremely morbid for patients and adversely impact quality of life. While ALND has historically been the standard approach to patients with nodal metastases, emerging data has identified patients at low risk for regional recurrence who may be spared the morbidity of this procedure in the setting of appropriate multidisciplinary care. The omission of ALND in clinically node-negative patients with nodal metastases discovered by SLND has been incorporated broadly into clinical practice, although it is unclear if the inclusion of axillary radiotherapy adds substantial benefit. The ability of SLND to accurately identify patients with a nodal pCR after NCT is still being evaluated with the recognition that technical aspects are crucial to the reliability of the test. Targeted axillary dissection, or SLND in addition to specific removal of the sampled node (containing a clip), may be a way forward in accurately restaging the axilla, thus identifying women who do not benefit from completion ALND even among patients who present with biopsy-proven nodal metastases. Moving forward, the safety and efficacy of selective omission of ALND among patients who convert from biopsy-proven node-positive breast cancer to pathologic negative disease after NCT must be systematically studied. It is anticipated that systemic agents for breast cancer will further advance and the future holds the potential for even elimination of axillary surgery in patients with node-positive breast cancer after NCT by incorporating improved imaging modalities with or without percutaneous sampling of tissues for eradication of disease.","title":"Targeting and limiting surgery for patients with node-positive breast cancer"}
{"_id":"d222452e-9e6b-ca63-a5da-0378c7c0b84b","text":"Blood cultures were negative for growth and CT-guided biopsy of the L3-L4 disc space was also negative for both gram stain and culture. It was then recommended by Infectious Disease to treat the patient with six weeks of intravenous vancomycin and ceftriaxone upon discharge. When seen back in the pain clinic days later, it was decided that given the radiological findings and high suspicion this was a true infection, explant of the SCS was necessary and would be facilitated by neurosurgery.","title":"Lumbar Spine Osteomyelitis After Permanent Spinal Cord Stimulator Implantation: A Case Report"}
{"_id":"d22352e8-796b-6b25-8051-1f2c197eee35","text":"Therefore, the aim of the study is to assess the differences in the risk of developing a subsequent skin cancer after the diagnosis of a cutaneous neoplasm, especially considering individual types of skin malignances, and to recognize potential features linked with an amplified risk of new cutaneous tumor.","title":"Risk Factors and Clinicopathological Features for Developing a Subsequent Primary Cutaneous Squamous and Basal Cell Carcinomas"}
{"_id":"d223851e-6aed-9cac-5984-f32832d23904","text":"Although surgical methods for cervical dislocation are varied, many researchers believe that treatment decisions are likely to be affected by the neurologic status of the patient, interpretation of a disc herniation, and the classification of the injury as a unilateral or bilateral injury. The training and experience of surgeons are also closely related to the choice of methods. There is an increased likelihood that a surgeon will use an anterior approach for decompression when they diagnose the presence of a preoperative disc herniation. But Abumi and Park reported the use of the posterior pedicle screw system to achieve reduction and removal of herniated disc fragments for cervical facet dislocations by a single posterior approach. This procedure achieves satisfactory reduction with no cases of neurologic deterioration. More research is needed to confirm this finding.","title":"Comparison of anterior and posterior approaches for treatment of traumatic cervical dislocation combined with spinal cord injury: Minimum 10-year follow-up"}
{"_id":"d2286d2d-7ed8-a614-fe8e-1e497a453a05","text":"It was expected that the main effect of the topical treatment would be on wart clearance, and the main effect of vaccination would be on wart recurrence. The power of the study to detect a clinically important difference in each of these secondary outcomes was therefore calculated in proposing the reduced trial size.","title":"Human papillomavirus infection: protocol for a randomised controlled trial of imiquimod cream (5%) versus podophyllotoxin cream (0.15%), in combination with quadrivalent human papillomavirus or control vaccination in the treatment and prevention of recurrence of anogenital warts (HIPvac trial)"}
{"_id":"d23398b4-94a9-026c-fd90-1b0abc829c4d","text":"Ongoing research also seeks to explore the role of advanced technologies in reducing cardiac and pulmonary exposure, as well as to identify the appropriate regional nodal basins for coverage and the best approaches for combining radiation therapy and breast reconstruction. Final results are eagerly anticipated from the Canadian NCIC MA20 study, as well as the European EORTC 22922\/10925 study, which both focus on the role of supraclavicular and internal mammary regional radiation. An ongoing Korean KROG study focuses on internal mammary radiation specifically. Studies also seek to identify more sophisticated genomic predictors of locoregional recurrence in order to improve patient selection for therapy.","title":"Postmastectomy Radiation Therapy: An Overview for the Practicing Surgeon"}
{"_id":"d233b129-5fb0-19b5-57b6-c1e8b27955a9","text":"Analysis of the population is shown in table 1. It can be seen that surgery is the single most popular career choice of first year medical students. Medicine and general practice follow, although the proportion of students who are undecided forms almost a quarter of the student body.","title":"Who wants to be a surgeon? A study of 300 first year medical students"}
{"_id":"d2379f7f-8521-b6b3-050f-180c4539506f","text":"Resulting from the literature search, the interviews with both patient boards and the expert advisory board meeting, the TTOP has been developed with the aim to firstly qualitatively and quantitatively increase the information provided to the patients regarding their condition and its available treatment and secondly to improve the patient–doctor relationship to the extent that the communication between the two parties is optimal and does not hinder the patient’s adherence.","title":"Development of an adherence-enhancing intervention in topical treatment termed the topical treatment optimization program (TTOP)"}
{"_id":"d239aacd-90a4-6e65-a761-9a581f7d9cef","text":"Reconstruction of soft-tissue defects at the level of distal leg and ankle region remains a frequent and challenging problem for reconstructive surgeon.","title":"The Versatility of Perforator-Based Propeller Flap for Reconstruction of Distal Leg and Ankle Defects"}
{"_id":"d239c82e-04de-b496-83dc-150f43437862","text":"This study aims to analyze the width of the closest surgical margins of STSs resection specimens performed in our institution from 2010 to 2020. We reviewed local and systemic disease-free survival in the most frequent histologic STS subtypes. The generated data may help answer the question of an adequate surgical margin in STS management.","title":"Surgical Margins in Soft Tissue Sarcoma Management and Corresponding Local and Systemic Recurrence Rates: A Retrospective Study Covering 11 Years and 169 Patients in a Single Institution"}
{"_id":"d23ab80f-19cc-e174-9d60-d8d99d57168c","text":"Surgeons around the globe are challenged by the rapid evolution of the environment in which they practice their profession. Changes in surgical technologies, the complexity of surgical patient care, and the regulatory and financial environment of surgical care delivery demand that surgeons be supported in their work with access to superb educational offerings and engagement to foster satisfaction and efficacy in their professional activities. The American College of Surgeons (ACS), the largest international surgical professional organization, is committed to supporting surgeons as leaders in the healthcare system to build programs to create the optimal environment for delivery of quality surgical care to our patients. A selected portfolio of the programs of the ACS is presented.","title":"Surgical leadership in changing times: the American College of Surgeons perspective"}
{"_id":"d240716d-082d-b42f-b0a3-837abdc86d64","text":"A 54 year-old male with no significant past medical history was initially diagnosed with a cutaneous melanoma involving his left forearm in September 2012. He underwent local resection and sentinel lymph node biopsy at an outside institution with pathology showing an invasive melanoma characterized by an ulcerated Clark level V lesion with a Breslow thickness of 5.5 mm and 3 mitoses\/mm2. A sentinel lymph node biopsy was positive for 1 of 1 lymph node with a 0.35 mm deposit of melanoma. A complete lymph node dissection of the left axilla was performed demonstrating no evidence of melanoma in any of 42 lymph nodes. He underwent surveillance imaging by whole body PET CT through June of 2013 with no evidence of disease recurrence.","title":"Genetic risk analysis of a patient with fulminant autoimmune type 1 diabetes mellitus secondary to combination ipilimumab and nivolumab immunotherapy"}
{"_id":"d243764d-0396-1889-d5f3-33fb03ee1b73","text":"• Artefact reduction techniques can improve image quality for early and improved detection of complications","title":"Imaging of lumbar spinal surgery complications"}
{"_id":"d24c58f4-e155-2cee-7614-fafbb5e19f4b","text":"In osteopetrosis, a precise and early diagnosis of the disease and the implementation of prophylactic treatment in the form of restorations and periodontal care is necessary to prevent the onset of infection.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"d24fdca3-65c3-cc45-8414-7e481cfc245f","text":"In our review of the literature, we sought evidence for and against the treatment of MVT as an entity along with evidence for and against treatment in orthopaedic patients.","title":"Evidence for treatment of muscular vein thrombosis in orthopaedic patients"}
{"_id":"d259d1de-e376-af27-0e78-a4a9773363a8","text":"Vascular involvement by soft tissue sarcomas are diagnosed preoperatively with MRI and MR angiogram. MRI is considered the gold standard in diagnosing vascular involvement by soft tissue sarcomas.67 Vascular infiltration by sarcomas necessitating vessel resection is suspected preoperatively if more than 50% of the circumference of the vessel is encased by the tumor. If the tumor is found abutting the neurovascular bundle excision of the tumor along with the peri-advential tissues is sufficient.","title":"Limb conservation in extremity soft tissue sarcomas with vascular involvement"}
{"_id":"d25ce5d2-d907-2978-f5e9-314becbebae5","text":"Fig 3A and 3B show the laminar distribution pattern of LCINs in relation to CST and RST terminals in segments C4 or C5 for all 6 rats. The distribution of FG-labelled LCINs within the grey matter was similar for all rats. They were distributed throughout laminae VI to VIII and within lamina X. CTb labelled CST terminals were located in the grey matter contralateral to the cortical injection site and contralateral to the cervical spinal injection. Although the majority of CST terminals were located dorsally to LCINs (in laminae IV to VI), a moderate number of terminals were present in laminae VI to VII. CTb-labelled RST terminals were distributed bilaterally and were numerous through the deep dorsal horn, intermediate grey matter and ventral horn.","title":"Corticospinal and Reticulospinal Contacts on Cervical Commissural and Long Descending Propriospinal Neurons in the Adult Rat Spinal Cord; Evidence for Powerful Reticulospinal Connections"}
{"_id":"d25f75f3-bdbe-b099-d025-06aed043a647","text":"The treatment of one FAP patient with a central superinfected desmoid tumor was discontinued at 34.2 Gy before reaching the prescribed dose due to further progression of the abscess and progression in size of the desmoid tumor.","title":"Radiotherapy in the treatment of aggressive fibromatosis: experience from a single institution"}
{"_id":"d266292b-7ceb-8ca8-8961-7f3cc2f222c8","text":"Early full weight-bearing mobilisation is routine in all cases of hip fracture. Further details of the rehabilitation will be left to the discretion of the treating team as per usual clinical practice.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"d2696be9-ffd7-6c6b-1cf7-2ee01c28e605","text":"These slides show how difficult and random it is to carry out in both cases an examination during surgery.","title":"The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management"}
{"_id":"d276e759-e3f5-498a-a0e1-9cd3ff6a447a","text":"At six monthly intervals and at the end of the study patient GP records will be reviewed for any mention of hospital admission, to ascertain any thrombotic events including fatalities, and whether they are still taking warfarin.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"d2772215-c26f-09d6-6d9d-d53c7f71057e","text":"Using the preoperative planning and measurements of the excised femoral section calculation of the length to restore is performed. The length from the centre of rotation of the femoral head to the distal femoral osteotomy site is noted and 7.5mm added to give the length of intramedullary nail used. This nail and a 100mm cephalomedullary screw are coupled and locked in position using the set screw available from our manufacturer. A line 7.5cm proximal to the tip of the nail is marked to indicate the limit of the cement. The remaining distal femoral canal is widened with sequential flexible reamers to just beyond the length of nail to be buried distally. Should there be a substantially longer distal femoral section remaining, a length greater than 7.5cm of nail may be inserted into the femur.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"d2780cb2-a4fa-ab24-07d2-b0536acbfa59","text":"Finally, the high sensitivity of MRI in detecting periapical lesions might not only lead to the detection of lesions that would have been missed on conventional methods but might also lead to the detection of lesions which can be considered temporary and might be self-resolving without any additional treatment needed. In order to avoid unnecessary treatment initiation or overtreatment, detected lesions should always be evaluated together with the results from patient anamnesis and clinical examination.","title":"Evaluation of 3D MRI for early detection of bone edema associated with apical periodontitis"}
{"_id":"d278ec6c-5232-91d4-197b-bbbd9a5159e4","text":"We discovered that olfactory ensheathing cells with nerve conduit could improve the facial nerve recovery, and the olfactory mucosa olfactory ensheathing cells are more effective for facial nerve regeneration compared with olfactory bulb olfactory ensheathing cells 8 weeks after the transplantation. These results could cast new light in the therapy of facial nerve defect, and furnish the foundation of auto-transplantation of olfactory mucosa olfactory ensheathing cells in periphery nerve injury.","title":"Olfactory ensheathing cells in facial nerve regeneration Células embainhantes olfatórias na regeneração do nervo facial"}
{"_id":"d27a54f7-d5e4-7a99-81c3-e07d1099782f","text":"In this study we demonstrated quantitative ultrasound as an objective means of assessing late skin toxicity in postmastectomy breast cancer patients after radiation therapy. Huang et al [25] has demonstrated that skin thickness measured via ultrasonic imaging proved to be a reliable quantitative and noninvasive measure to provide diagnostically useful information for an in vivo assessment of skin fibrosis. Using this as a feasible study, skin thickness was measured as a proxy for radiation induced fibrosis and edema in 32 postmastectomy breast cancer patients who received full course of radiation therapy in our department. This is one of the few studies of its kind on postmastectomy breast cancer patients follow up comparing late skin effects particularly radiation induced fibrosis with acute scoring. To the best of our knowledge, there is limited literature available about radiation induced fibrosis after postmastectomy radiotherapy in ultrasonic imaging. This study attempted to provide some basic clinical results for this purpose. Our study has shown that there is a statistically significant difference between the skin thicknesses of the irradiated chest wall and the contra-lateral non-irradiated breast and a predisposition to chronic reactions was found in patients with acute RTOG scoring of grade 1 and grade 2. These differences could assist to explain breast reconstruction complications in postmastectomy breast cancer patients after receiving a course of radiotherapy. A number of studies have demonstrated an increased rate of breast reconstruction complications after postmastectomy radiotherapy [26-29]. Tallet et al [29] reported breast reconstruction complications were significantly greater in patients who received radiotherapy than those who did not (51% vs 14%) and a study by Behranwala et al [27] suggested that the rate of capsular contracture due to radiation might be as high as 40%. As such most complications were either due to capsular contracture with or without pain, or skin fibrosis due to radiation exposure.","title":"An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy"}
{"_id":"d28350e1-cbc4-038d-a410-3ed5c12b2318","text":"The total nerve section area was divided into two sampling fields from the distal end to proximal end. One field was chosen randomly for longitudinal section for light microscopy examination, while the other was used for cross section for electron microscopy.","title":"Olfactory ensheathing cells in facial nerve regeneration Células embainhantes olfatórias na regeneração do nervo facial"}
{"_id":"d284eda8-7928-cabb-bc37-1eaae07a02e9","text":"Pollens level is difficult to be controlled in the outdoor environment, so avoidance measures are mainly focused on the allergen control in the domestic setting.","title":"Allergen Avoidance in Allergic Asthma"}
{"_id":"d28f1f0c-7852-fa5b-4ee3-15f3b591d765","text":"While surgery and radiation can both offer local control if one responsible lesion can be determined, the frequent presence of multiple or plexiform lesions often creates major difficulties in pinpointing just which one is the etiology. Even if a particular cause of pain is identified, surgery carries a significant risk of nerve damage and heavy blood loss [5-6]. Our index case reflects this scenario as surgery had already been performed on one lesion with significant residual pain and a second symptomatic lesion was felt to be not amenable to surgery because of the risk for furthering neurologic compromise.","title":"Bevacizumab for Treatment-Refractory Pain Control in Neurofibromatosis Patients"}
{"_id":"d2973ca3-e6d4-72d8-db55-822e1f584f49","text":"We performed a randomized controlled study to test the hypothesis that paravertebral block could reduce the consumption of opioids in pancreatic resection surgery.","title":"Ultrasound-guided paravertebral blockade reduced perioperative opioids requirement in pancreatic resection: A randomized controlled trial"}
{"_id":"d2974981-e243-21c8-1ace-a9277d10e9b7","text":"Figures 8 and 9 also show that there is a dip in dose immediately after the prosthesis in the distal region that is followed by a dose escalation and then the standard dose fall off is seen. These observations are due to loss of electron fluence immediately after the prosthesis as most of the electrons generated in the prosthesis stay within it, and at the same time, the nylon provides very little backscatter.","title":"Dose comparison between Gafchromic film, XiO, and Monaco treatment planning systems in a novel pelvic phantom that contains a titanium hip prosthesis"}
{"_id":"d29b3700-23cd-24cb-4385-8a3f54e6f6c5","text":"Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the corresponding author.","title":"Ateriovenous subclavia-shunt for head and neck reconstruction"}
{"_id":"d29c2f42-db76-0586-5533-9f769fffd885","text":"The pathophysiology is not completely understood. Multiple theories have been proposed on the pathophysiology and the most accepted hypothesis is that trauma to the Auriculotemporal nerve leads to aberrant regeneration of the cut parasympathetic fibers between the otic ganglion and salivary gland tissue leading to innervation of sweat glands and subcutaneous vessels, as shown in Figure 2, which results in sweating and redness of the skin of the involved area following a gustatory stimulation [7].","title":"Recurring Facial Erythema in an Infant"}
{"_id":"d2a38ca3-8cf1-93c2-d28b-697a51b8a8dc","text":"Hyaluronic acid is a dermal filler used to cure facial wrinkles but its use in the vaginal sphere is very recent and poorly documented.","title":"Novel technique of vulvo-vaginal rejuvenation by lipofilling and injection of combined platelet-rich-plasma and hyaluronic acid: a case-report"}
{"_id":"d2a91ea3-1073-b792-00a0-540e40484296","text":"Previous therapies are either ineffective or associated to unacceptable morbidity or side effects.","title":"Treatment of Primary Axillary Hyperhidrosis with Botulinum Toxin Type A: Our Experience in 50 Patients from 2007 to 2010"}
{"_id":"d2b74117-4242-21fe-7b9c-2d5cdda26e7f","text":"Not only has the ACS been at the forefront of developing programs to optimize the care of surgical patients, the College also intentionally developed programs to optimize the personal development of surgeons as leaders.","title":"Surgical leadership in changing times: the American College of Surgeons perspective"}
{"_id":"d2be41f5-e90f-d613-adf3-2c2d79747533","text":"Supplementary searches were made through Internet search engines to identify any additional articles or references to publications on chronic osteomyelitis. We also reviewed the reference list from each relevant article identified through our database search to ensure that we had captured all of the available literature within our designated time period. No other articles were identified through these channels that met our inclusion\/exclusion criteria. Three thousand eleven abstracts were screened by 3 independent reviewers and excluded according to the following a priori exclusion criteria.","title":"A systematic review of the single-stage treatment of chronic osteomyelitis"}
{"_id":"d2be73f9-2cda-641c-7a36-a5a4aa506ff6","text":"The study was reviewed and approved by the Institutional Medical Ethics Committee.","title":"Lower tumour burden and better overall survival in melanoma patients with regional lymph node metastases and negative preoperative ultrasound"}
{"_id":"d2c17b85-b51c-43a9-ddd4-ca843a8413c0","text":"The application of R1 and R2 topical skin treatment was well tolerated, with no reported side effects. Although the clear differences in CTC grading responses between the treated and control patient groups allow for direct comparison of data, formal hypothesis tests are provided later. The original data are presented in Table 2 and Figure 2.","title":"Topical R1 and R2 Prophylactic Treatment of Acute Radiation Dermatitis in Squamous Cell Carcinoma of the Head and Neck and Breast Cancer Patients Treated With Chemoradiotherapy Manas et al"}
{"_id":"d2c2ea14-3c4c-d1d9-0fa4-be78629ec086","text":"The advantage of the free flap technique is the possibility to choose the tissue to transfer in the base of the necessity of the single case, replacing the missing tissue with one analogous with the same proprieties and characteristics.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"d2d45f2b-af64-c90c-f193-ee3d658a4b65","text":"Kappa analysis of the mother’s reported infant feeding compared to the infant feeding as determined by the DTM method yielded the results as shown in Table 1.","title":"Limitations of maternal recall for measuring exclusive breastfeeding rates in South African mothers"}
{"_id":"d2d47aa8-1b9a-d973-5d5b-2163aef1f6ad","text":"Prophylactic intravenous antibiotics were routinely given for 24 h postoperatively. The incisions were kept clean and dry until they healed completely. The incision stitches were taken out 10–12 days after surgery. The elbow was trained to flex and extend passively three times every day from the third day after operation. Active muscle contraction training for the forearm and hand should be started as early as possible after surgery to promote swelling subsidence. The magnitude of functional training of the elbow gradually increased and the rehabilitative training of the shoulder also began progressively 2 weeks after surgery. At 6 weeks, active strength training was intensified until the fracture was healed.","title":"Lateral Subcutaneous Locking Compression Plate and Small Incision Reduction for Distal‐third Diaphyseal Humerus Fractures"}
{"_id":"d2e1e1a2-8b97-d5dc-596a-f52e5b9faf20","text":"The risk of deep vein thrombosis within 30 days after hip replacement surgery was also assessed. None of the patients in either group experienced postoperative deep vein thrombosis.","title":"Comparative study of suction drainage placement in cementless hip replacement among patients undergoing extended thromboprophylaxis: a prospective randomized study"}
{"_id":"d2e2140a-ec17-7998-74d6-88e8c5e37df4","text":"Both the transverse and oblique designs of the DIEP flap are feasible for repairing skin and soft tissue defects of the lower extremities in pediatric patients. Transverse design based on the perforator located below the umbilicus in zone I is recommended for small skin and soft tissue defects. The oblique design of the DIEP flap based on the perforator lateral to the umbilicus in the zone I provides an extended flap for reconstruction of large defects, without insufficient perfusion of the distal part of the flap.","title":"Strategies for selecting perforator vessels for transverse and oblique DIEP flap in male pediatric patients: Anatomical study and clinical applications"}
{"_id":"d2ea15af-dd8d-144d-8c75-8a5827683ea8","text":"The principal strategy for the treatment for primary melanoma is surgical, specifically wide local excision to remove skin and subcutaneous tissue surrounding the biopsy site of the lesion. More specifically, radial margins are planned surrounding the biopsy scar. Typically, there is no visible pigmentation or mass at the time of the primary surgical treatment, but if there is, the surgeon should use the residual pigment or mass to determine the extent of resection. The depth of resection should extend to remove all subcutaneous down to the level of the fascia, but resection of the fascia itself is not necessary [5]. With proper surgical treatment, the vast majority of patients with melanoma need no additional therapy [6].","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"d2ed3832-53ca-46d7-bbf5-25966ef860c1","text":"She had a history of avulsion injury of the scalp left temporoparietal region while working with a chaff cutter machine four days back. The patient initially managed at an outside hospital, where she was operated on for removal of depressed fracture segment left temporoparietal region and repair of Dural rent with superficial temporoparietal fascia of the avulsed scalp. Then, the avulsed scalp was sutured back to the defect site for temporary coverage. The sutured avulsed scalp gradually became necrosed. On examination, the dimension of necrosed skin was 18 cm x 10 cm. The patient was conscious and oriented and her general condition was stable at presentation.","title":"Bipedicle Frontal-Occipital Flap for Reconstruction of Post Avulsion Injury of Scalp Temporoparietal Region: A Case Report"}
{"_id":"d2f117f1-089a-b4e1-0b5d-0d44eda67bfa","text":"This study also proves that the guided SEFFI procedure can be accompanied by a low rate of complications. However, more analyses on the use of guided SEFFI combined with other cosmetic procedures is a subject for future studies to corroborate the encouraging findings obtained in the present study. The results of this work will be published soon. This was a multicentric retrospective study, and the procedures were performed in private centers. We encountered some intrinsic difficulties in collecting homogeneous data in terms of patient selection and the evaluation of results, and we are aware that this aspect will have to be improved in future studies. In particular, selecting patients who were of homogeneous age and BMI and with similar life habits was difficult. Furthermore, although the guided SEFFI technique is a standardized procedure, personal in-tissue harvesting and injecting techniques may be possible.","title":"Guided Superficial Enhanced Fluid Fat Injection (SEFFI) Procedures for Facial Rejuvenation: An Italian Multicenter Retrospective Case Report"}
{"_id":"d300115d-aefb-14c1-64b8-cf13f56e29b9","text":"Patients were followed for three years and were assessed for hospital readmissions from causes of thromboembolic disease, other diseases and the presence of clinical data that might indicate the presence of pulmonary hypertension.","title":"Should we look for silent pulmonary embolism in patients with deep venous thrombosis?"}
{"_id":"d302587f-6057-1e85-a944-27c4560110c0","text":"Hence, from our study, it is revealed that there is still lack of definitive criteria to suggest the optimal surgical procedure for single level cervical disc herniation and in each patient the surgeon has to make a decision based on his or her experiences and existing literature which itself is still not unidirectional. However, some inferences can be drawn from our study.","title":"Single level cervical disc herniation: A questionnaire based study on current surgical practices"}
{"_id":"d302f3a7-1952-17bc-3d8f-bdcfff9f46f7","text":"Currently, this is the only case report that describes an anterior tibial artery pseudoaneurysm after partial fibula osteotomy that was successfully managed with endovascular stenting. The presentation of painful swelling and ecchymosis at nearby surgical sites are alarming signs indicating vascular imaging, such as CT angiography for potential vascular injuries. Referral to interventional radiologists or vascular surgical teams should be done promptly.","title":"Anterior tibial artery pseudoaneurysm as a rare technical complication after corrective fibular osteotomy: a case report"}
{"_id":"d309d9e5-9825-6233-12ea-f854be28d827","text":"A total of 20 masses different in size located in the mouth and in pectoral and caudal fins (characterized by abundant calcium deposits and by mild to moderate granulomatous inflammation) were observed with a significant different degree of histological severity. All internal organs of the fish were negative for mycobacteria, Ziehl-Neelsen was positive in only one of the oral masses, whereas bacterial and PCR analyses detected the presence of M. chelonae for almost all the skin and oral masses. Based on these results, a calcinosis of dystrophic origin associated with a chronic granulomatous inflammation was considered as a primary diagnosis consequent to tissue injury in areas susceptible to trauma.","title":"Mycobacterium chelonae associated with tumor-like skin and oral masses in farmed Russian sturgeons (Acipenser gueldenstaedtii)"}
{"_id":"d30cb57b-e9f7-e1c6-6598-2512b62c0da5","text":"A retrospective review of a prospectively held database from a symptomatic breast cancer service in a tertiary referral academic teaching hospital was performed. All patients who were diagnosed between the years 2010 and 2020 with a local breast cancer recurrence or a second primary breast cancer were included. All patients were over the age of 18 and recurrence was defined as histologically proven disease in the same breast, ipsilateral chest wall, local skin region, or in regional lymph nodes. Early recurrence was defined as recurrence within 12 months of original diagnosis with late recurrences being defined as those occurring beyond 12 months of initial diagnosis. A second primary was defined as being distant to the original site in the ipsilateral breast or in the contralateral breast and confirmed histologically. This was considered to be equivalent to a locoregional recurrence as it was often not possible to distinguish between the two diagnoses and the presentation was similar. Patients were excluded where their data was incomplete or where they had evidence of distant metastatic disease. The study was approved by the local hospital audit committee and was performed in accordance with STROBE guidelines.","title":"Assessing Mode of Recurrence in Breast Cancer to Identify an Optimised Follow-Up Pathway: 10-Year Institutional Review"}
{"_id":"d3185340-d99e-4257-5a8b-f52d4a46a5a7","text":"Another limitation of the study is that the FNAC-negative lymph nodes were not histologically verified and were only followed up. A follow-up time of at least 22 months seemed to be appropriate to define those lymph nodes as stable and consequently negative.","title":"Fine needle aspiration cytology of lymph nodes in breast cancer follow-up is a feasible alternative to watchful waiting and to histology"}
{"_id":"d328a237-7607-c57b-00b7-0ce1986d906c","text":"The potential disadvantages possible with the hybrid fixator are wire breakage, valgus or varus collapse, pin tract sepsis, septic arthritis if the wires are places within the joint in the capsular reflection less than 10mm from the joint line and common peroneal nerve injury if the wires are passed close to the fibular head. We did not encounter any of these complications in our study. In Aggarwal et al study of 56 patients they reported union time of 20.5 weeks with excellent results in 30 patients. They had complications such as osteomyelitis in three patients and pin tract infections in five patients. In Venkatesh G et al study of 48 patients the mean union time was 13.3 weeks with 2 cases of delayed union seen. They had excellent results in 8 patients and good results in 30 patients. Savolainan et al studied 33 patients and reported a union time of 20 weeks and had complications such as pin tract infection in 7 patients and septic arthritis in 1 patient.","title":"Evaluation of Functional Outcome Following Hybrid External Fixation in The Management of Schatzkers Type V and VI Tibial Plateau Fractures - A Prospective Study of 30 Patients"}
{"_id":"d3312467-b61d-b2c5-2091-d342779db895","text":"We described the use of the technique of L-shaped corticotomy with bone flap sliding to treat chronic osteomyelitis of the tibia in eight patients and presented the preliminary results.","title":"L-shaped corticotomy with bone flap sliding in the management of chronic tibial osteomyelitis: surgical technique and clinical results"}
{"_id":"d3329a7b-4eb4-e89a-3ade-559dd71c268d","text":"Based on the radiological findings and unremarkable laboratory findings, we made the diagnosis of idiopathic calcinosis cutis of lower limbs. The patient was given subsequent follow-up to detect any new lesion or increase in size of the nodules over the limbs.","title":"Multiple Scattered and Small Lesions of Lower Limbs: Idiopathic Calcinosis Cutis: A Case Report"}
{"_id":"d335762a-0137-c688-2425-018694d84a79","text":"During a 4 month period, healthy healthcare and research workers at the New York University Medical Center were screened by tuberculin skin testing and offered enrollment in this study if they responded with ≥5 mm induration 48–72 hours after intradermal injection of 5 TU of PPD. None of the subjects were taking a regularly prescribed medication such as steroids or immunosuppressive agents; individuals with HIV infection were excluded from the present study. All of the the subjects were >18 years of age and provided written informed consent. Information on BCG vaccination status was requested but was not confirmed by independent means; IGRA testing was not routinely available at our medical center during the period of this study. Written informed consent was obtained from all subjects, and all procedures were performed in accord with a protocol approved by the New York University Medical Center Institutional Review Board.","title":"Variation of Mycobacterium tuberculosis Antigen-Specific IFN-γ and IL-17 Responses in Healthy Tuberculin Skin Test (TST)-Positive Human Subjects"}
{"_id":"d344a4f6-d78e-0211-ed67-7411b2f74c85","text":"It is critically important to appreciate the differences between a virtual procedure and an actual procedure. In the virtual procedure an osteotomy or resection can be performed repeatedly, as many times as are necessary to achieve perfection. In the actual procedure you are limited to a few attempts at most. In the virtual procedure there are no anatomical constraints, and the region of interest can be exposed completely. In the actual procedure the anatomy is a constant issue, and adequate exposure and visualization may at times be difficult to achieve. The dissection must respect pertinent anatomy and preserve local vasculature. The physiology of the host is also an important consideration, and blood loss must be limited as much as possible. Time under anaesthesia is also a factor, both with respect to controlling blood loss as well as limiting fatigue and maintaining the concentration of the surgeon.","title":"Putting 3D modelling and 3D printing into practice: virtual surgery and preoperative planning to reconstruct complex post-traumatic skeletal deformities and defects"}
{"_id":"d3454c51-baef-e940-d13f-a1208470cd85","text":"Radiation therapy is generally considered a “local” treatment modality in cancer therapy, as radiation can only directly eradicate cancer cells inside the radiation field. However, more recent data has shown that the radiation response in the tumor and surrounding normal tissue activates a number of pathways that can help the host mount an immune response against tumors, especially in conjunction with immunotherapeutic agents. Here, we briefly summarize the interplay between cancers and the host immune system, the effects of radiation treatment on the immune system both locally and systemically, and the preclinical and clinical data on the combination of radiation treatment and immunotherapy. We also explore the existing data on the optimal dose and fractionation scheme of external beam radiation to be used with immunotherapy.","title":"Immune Modulation and Stereotactic Radiation: Improving Local and Abscopal Responses"}
{"_id":"d347f0da-c34d-73fb-a1c6-c756e6bf4ea0","text":"An open reduction and internal fixation using miniplate was performed to treat the fracture using intra oral approach through upper gingivobuccal sulcus incision and subcilliary lower eyelid incision. Then, open rhinoplasty approach was performed. Cartilage graft was harvested from the 6th rib then evenly diced into small pieces and being inserted into 1 cc dysposable syringe. Fascia lata was harvested and being sutured in cylindrical form covering the syringe filled with diced cartilage, just before final sutures the diced cartilage was injected into the fascia, then final suture was performed sealing the fascia, forming a diced cartilage fascia graft with a cylindrical tube shape. Then, the diced cartilage fascia graft was inserted into the dorsal nasal skin and fixed using a non-absorbable suture in the frontonasal area. Periosteal and alar cinch suture also performed during soft tissue closure.","title":"A breakthrough in Maxillary LeFort II fracture reconstruction: Case series of rhinoplasty using diced cartilage fascia graft simultaneously with ORIF"}
{"_id":"d34d330e-b1a1-a9a4-2b38-569dba721a5f","text":"This risk of fat embolism at the time of buttock fat transfer has received much attention recently in the plastic surgery literature. This catastrophic complication is caused by a tear in one of the large gluteal veins and fat embolism to the heart and lungs.49–51 Alarmingly, cadaveric dissections show that even superficial fat injection into the gluteus maximus muscle leads to fat (or rather its surrogate, apple sauce) accumulation around the deep gluteal veins, because there is no deep muscle fascia to act as a barrier.51 Subcutaneous fat injection is recommended.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"d351437e-6706-58ba-726d-6d24e6a727ab","text":"A 39-year-old Iranian female patient who was a known case of primary cervical dystonia since 10 years ago presented to a private office for Dysport injection. The patients experienced severe dysphagia after inferior alveolar nerve block which was preceded by cervical botolinum toxin injection. A possible synergistic effect of botolinum toxin and lidocaine to produce severe dysphagia is presented in this case report.","title":"Severe Dysphagia After Inferior Alveolar Nerve Block Preceded By Cervical Botolinum Toxin Injection: A Case Report"}
{"_id":"d355146a-13d6-98f5-8d3b-0dd8e5949341","text":"A relationship was also seen between the axillary volume and the axillary VD95%. This may be due to the difficulty in delineating the inferior extent of axillary level I in this population of patients. The RTOG contouring atlas defines the inferior extent of level I as the insertion of the pectoralis major into the ribs [16]. We found this insertion point difficult to locate due to disruptions in the normal anatomy from the expanders' subpectoral location and also that an alloderm graft was often used in the inferior-lateral portion of the expander to hold it in place on the chest wall.","title":"Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction"}
{"_id":"d35cbe5b-dfe3-8ee0-9277-de10fe53c537","text":"This retrospective cohort-study, whose aim was to evaluate the effects of orthodontic treatment on lower third facial ageing in adult patients, has successfully shown that wearing clear aligners during orthodontic treatment has beneficial effects on face soft tissues when compared to the aesthetic impact of patients of an untreated group.","title":"Clear aligners’ effects on aesthetics: evaluation of facial wrinkles"}
{"_id":"d3685f6c-460e-34b3-6522-769b5a2395ec","text":"Compared to other desmoid tumors, intrapleural desmoids tend to remain asymptomatic for a long time and are larger at presentation. Unlike superficial chest wall tumors which will create a palpable mass, intrapleural tumors will not cause symptoms until they grow large enough to cause pain due to chest wall invasion or dyspnea due to compression of lung parenchyma.","title":"Intrathoracic Desmoid Tumor"}
{"_id":"d37007c3-0399-f29d-b2b1-088e42795410","text":"All patients were treated with subtotal glossectomies only and were all reconstructed with MSAP flaps. The flap size harvested was from 4 x 9 cm to 5 x 15 cm. The flaps harvested had perforator numbers ranging from 1 to 3 perforators. The average pedicle length of the MSAP flaps harvested for reconstruction of the defects was 12.1 cm. The average operating time was 6 hours and 18 minutes where simultaneous flap harvest and oncological resection was carried out (Table 2). The average flap thickness was 5.2mm in our series which makes this flap a thin and pliable flap that can be folded and contoured to fit a subtotal glossectomy defect.","title":"Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction – An outcome study"}
{"_id":"d3709f40-aa7b-eff8-7841-8ef5c779298b","text":"The present study was limited by its retrospective design and by small sample size in verifying the statistical significance about many factors associated with wound healing. Regardless, our results of SIH treatments showed that it was acceptable for the restoration of skin defects not only on the facial area but also on the non-facial area especially such as antecubital area, with more careful dressing for initial two weeks. Image analysis using the color patch was very useful for calculating changes in the wound size as time elapsed. Further controlled trials in large sample size will be necessary to make a prediction system of final scars after SIH treatments.","title":"Sequential Change of Wound Calculated by Image Analysis Using a Color Patch Method during a Secondary Intention Healing"}
{"_id":"d372b2cd-0a31-5e19-5b6e-7e4ceda9a20d","text":"Although multilevel cervical pyogenic spondylodiscitis is rare, surgeons are occasionally required to adopt a reliable medical and surgical treatment strategy under urgent situations. The anterior and posterior combined surgical procedure is often utilized for the treatment of multilevel cervical pyogenic spondylodiscitis since the anterior approach surgery alone has a high rate of surgical complications and fusion failures, especially in the treatment of multilevel regions [2,6,10]. However, the combined surgical procedure needs to clarify the clinical issues regarding the appropriate order and timing of the anterior and posterior approaches in surgery. Although disrupting the posterior elements is inevitable for the combined surgical procedure, performing salvage surgery for failures or surgical complications of the anterior approach alone tends to be difficult because of the complicated anatomy of the anterior cervical spine and the risk of laryngeal edema and hematoma, especially in the treatment of the multilevel vertebral bodies. In the present case, for the purpose of emergency decompression of the spinal cord and safe reconstruction of the anterior cervical columns, we created a three-staged surgical strategy consisting of cervical laminectomy, posterior fixation, and anterior corpectomy and fusion with an autologous long bone graft.","title":"Three-Staged Surgical Strategy as a Combined Approach for Multilevel Cervical Pyogenic Spondylodiscitis"}
{"_id":"d376ccc6-7561-cf44-4191-9c3efa5b073d","text":"Although this analyses was performed between 2003 and 2005, it could be useful to analyse the differences in the approach of melanoma patients in each surgical scenario of the disease. The surgical subgroup of the EORTC MG is developing a new version of the surgical survey questionnaire including new treatment modalities like isolated limb infusion and electrochemotherapy which were not frequently in use some years ago. Once completed, an interesting aspect will be to compare the differences developed during a ten-year period concerning the surgical management of melanoma patients.","title":"Surgical management of melanoma: an EORTC Melanoma Group survey"}
{"_id":"d3824152-a841-f7e4-2672-5a8fedc8013b","text":"The VRAM flap is used after total sacrectomies for larger defects and mainly in patients without previous abdominal surgery [14,15]. Three main disadvantages of the VRAM flap technique are the hernia risk of the abdominal donor side, the compression of the pedicle inside the tunnel which might compromise the blood flow of the flap, and the transfer of the patient from lithotomy to prone position something that increases the surgical overall time.","title":"Anatomical Considerations and Plastic Surgery Reconstruction Options of Sacral Chordoma Resection"}
{"_id":"d3843fe0-afbd-cdeb-1a66-bc0f7b8c4405","text":"Tumor sampling procedures are commonly performed not to confirm the diagnosis of UM, but to obtain a tissue sample for prognostication, which can help assess the patient-specific metastatic risk. The obtained genetic information can also influence the surveillance timing and metastatic screening type of patients. In spite of the widespread use of biopsies in general surgical practice, in ophthalmic oncology the indications and contraindications for tumor biopsy continue to be under debate.","title":"Uveal Melanoma Biopsy: A Review"}
{"_id":"d387e107-d7dc-bede-021f-82fe6551a331","text":"The mastectomy incision is opened, and the recipient internal mammary vessels are dissected after resection of the third rib cartilage or through the intercostal space in a rib-sparing fashion. The flap is then revascularized by anastomosing the artery and vein of the centrally located perforator anterograde to the internal mammary vessels. At this time, clinical signs of venous congestion with a clearly patent venous anastomosis indicate venous insufficiency and prompt the need for anastomosis of the secondary perforator vein, which is anastomosed in a retrograde fashion to the distal internal mammary vein or in an anterograde fashion if an internal mammary perforator vein is present (Fig 3).","title":"A Novel Technique for Augmenting Venous Outflow in the Superior Gluteal Artery Perforator (SGAP) Flap Carruthers et al"}
{"_id":"d3897a80-ea44-02be-7e66-0fa41d018acd","text":"Treatment of infected non-unions of Tibia with Ilizarov ring fixation is effective but for optimal results the treatment needs to be individualised by the treating surgeon with due consideration of the socio-economic factors.","title":"Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions – a prospective study"}
{"_id":"d38b363b-ec05-491a-ab16-a776bdb70712","text":"The orthotopic and heterotopic transplantation procedures were already described in our previous study (20). For heterotopic transplantation the cortical strips were gently placed in subcutaneous pockets created above the fascia in the suprapubic area and closed with a 4-0 Vicryl suture. Orthotopic transplant was performed using four-port laparoscopy. A longitudinal incision of approximately 1 cm was made on the surface of the residual ovaries and a pocket was developed in the ovarian parenchyma by blunt dissection. Cortical strips were sutured into the ovarian pocket and the same sutures were used to close the ovary, taking care not to cause tissue ischemia. Some strips were also inserted into a peritoneal pocket close to the ovary and then closed with a 4-0 Vicryl suture.","title":"Ovarian tissue cryopreservation and transplantation: 20 years experience in Bologna University"}
{"_id":"d38e7df1-ea5f-0298-fdb0-bc09a4ff5ded","text":"The excellent performance of this radiomic model indicates that lumbar spine CT images can effectively be used to identify osteoporosis and as a tool for opportunistic osteoporosis screening.","title":"Using radiomic features of lumbar spine CT images to differentiate osteoporosis from normal bone density"}
{"_id":"d38eb472-880f-011b-2f0c-74663cfa7c82","text":"Concerning SLIT, the first dose should be administered in a hospital or clinic under medical supervision. The SLIT induction phase is usually shorter than that of SCIT, ranging between 3 and 5 days. It is important to specify that drops or tablets must be kept under the tongue for 2 min and then swallowed. It is advisable that patients keep a symptom diary to record all reactions apparently related to the assumption of SLIT. A fix and simple schedule of administration would increase the compliance to the treatment.","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"d391fa21-2de4-cf18-dc71-27548998532f","text":"To compare WBMRI with WBBS in the assessment of bone lesions in patients with CRMO.","title":"Whole-Body MRI versus bone scintigraphy: which is the best diagnostic tool in patients with chronic recurrent multifocal osteomyelitis (CRMO)?"}
{"_id":"d392cb14-fed7-401a-91f1-3bfd9c2afa95","text":"• Patients who already have swelling or other signs of an existing DVT. Such patients may be recruited once a DVT has been excluded by normal D Dimers or CDU. There is a concern that if one applied IPC to patients who may already have a DVT it may displace the thrombus and increase the risk of PE. However, this potential risk has not been documented in the RCTs so far. And we have not identified any case reports where there is convincing evidence that this has occurred.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"d3988efb-1310-3dc4-1c4f-a86dedaa94d3","text":"The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery.","title":"Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data"}
{"_id":"d3991064-fdfd-ee77-13a3-885f66a56412","text":"Hence, this study aimed to compare the salvage rate and related complications between internal fixation and external fixation with bone grafting in patients who had been controlled from active infection by treating with intravenous antibiotics and multiple debridement.","title":"Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis"}
{"_id":"d3a7e52b-0f44-db4a-42c1-923f2e03ecc2","text":"Our data demonstrating 100% flap success in osteomyelitis reconstruction in the older cohort is in keeping with the finding that free flap success rates are not influenced by age alone4. Previous series' of free flap reconstructions in the elderly for a range of indications are presented in Table 6. To our knowledge this is the first reported series of elderly patients undergoing such reconstructions for treatment of chronic osteomyelitis.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"d3a9b4a0-50c3-a7f6-1ca2-60f8c5fa092c","text":"The analysis of soft tissue symmetry improvements showed similar amendments as in the hard tissue analysis. Thus, it could be shown that with the help of simultaneous orthognathic and augmentative surgery not only hard but also soft tissue symmetry is be established.","title":"Simultaneous PSI-Based Orthognathic and PEEK Bone Augmentation Surgery Leads to Improved Symmetric Facial Appearance in Craniofacial Malformations"}
{"_id":"d3afb59d-f360-37bd-fb9d-555ccfe9b188","text":"We believe that surgical excision of symptomatic lesions is a safe and effective treatment for idiopathic calcinosis cutis of the hands.","title":"Idiopathic Calcinosis Cutis of the Hand"}
{"_id":"d3c140f9-726c-3eed-fa6d-bae885a9a42a","text":"The methods described herein show the utility of a hybrid modeling approach merging surface mesh-based modeling with voxel modeling. The ability to do so has expanded the range of features and control a surgeon has in designing a model to their individual needs. Putting the power of design in the hands of the front-line staff utilizing these tools is critical to increasing confidence in their surgical approach and improving patient outcomes. The results of this increased confidence may reduce operating time and complications associated with a procedure. Computationally, this hybrid modeling approach overcomes issues related to surface mesh-based modeling in relation to boolean operations and effortlessly allows for the merging of multiple modeling elements regardless of topological complexity. The result of this technique creates the opportunity for the integration and interweaving of more complex model elements. Finally, we show the ability to simply apply kernel-based modeling operations across select elements allowing for data to be integrated within a model element without topological alterations. The use of augmented reality would be a suitable substitute for 3D printed models in this application. The ability to overlay precision measurement elements within a printed object allows for the model's utility in more procedures which require precision in biologically opaque areas such as the brain, anterolateral thigh flaps for the creation of phalloplasty’s, and genioplasties for facial reconstruction surgery for gender affirmation.","title":"Hybrid modeling techniques for 3D printed deep inferior epigastric perforator flap models"}
{"_id":"d3c14c7f-62cd-39f9-348e-3e0289947a20","text":"Both MCC and DFSP are uncommon tumour entities of elderly or immunocompromised patients. Collision tumours are extremely rare and have never been described for MCC and DFSP. In this patient the distant metastasis of the MCC is expected to be the limiting factor for survival.","title":"Merkel cell carcinoma metastasis and dermatofibrosarcoma protuberans presenting as a collision tumour: a case report and review of the literature"}
{"_id":"d3d1d334-85a3-1f77-4546-83c83ef47179","text":"The length of inpatient stay in the OW group resulted from our procedure to change the first dressing at the hospital to monitor early complications and train patients and their parents in the handling of VAC® and pain management. In the PC group, the patients were also retained in hospital for a few days to ensure that there were no early complications or problems with pain management. In addition, we considered hospitalization advisable for children and adolescents because this reduced their activity level and allowed them to spend more time in the prone or lateral position in order to protect the wound from external disruptive forces. With growing experience with PC, the inpatient stay might be shortened, with the further treatment scheduled in the outpatient clinic. Shorter LOS is regarded as a gain for patients as well as their families because staying in hospital might be cumbersome.","title":"Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children"}
{"_id":"d3d94655-2ab0-a423-67b5-d5370341160c","text":"Here, we describe two cases of penetrating trauma resulting in injury to the IVC. Lateral venorrhaphy performed at initial damage control laparotomy may result in luminal narrowing of the IVC as demonstrated in the cases described. Patch repair at abdominal re-exploration allowed for restoration of venous diameter. Postoperative low molecular weight heparin chemical prophylaxis was used to prevent VTE and is our recommendation in this high risk population.","title":"Patching of the Inferior Vena Cava Following Lateral Venorrhaphy in Penetrating Traumatic Injury"}
{"_id":"d3e4374c-72ba-8e30-a37c-38c77598eb29","text":"Details of any late complications will be sent securely to the trial coordinating centre. Complications will be captured on the CRF by the site research associate and recorded on the CRFs at 30 days\/discharge and at 4 months via telephone interview.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"d3e71aae-f0fe-a560-5d8c-115dd2af4582","text":"Water shows higher signal than fat on T2WI, but suppressing the fat signal can allow an even better evaluation of the extent of oedema.","title":"The role of magnetic resonance imaging in the evaluation of bone tumours and tumour-like lesions"}
{"_id":"d3e9f2b0-cae6-1921-b941-b7c37f44d9c1","text":"Clinical studies and animal experiments demonstrate the fact that malignant tumours lead to an altered immune status systemically, as well as locally, through changes in the microenvironment. Functional impairment of T-lymphocytes in addition to an accumulation of chronically activated myeloid suppressor cells and regulatory T-cells has been observed systemically. This may lead to a disabled tumour killing CD 8 CTL response and enhance cancer development through activation of other immune cells.","title":"Merkel cell carcinoma metastasis and dermatofibrosarcoma protuberans presenting as a collision tumour: a case report and review of the literature"}
{"_id":"d3eff15b-64c3-33b4-ca92-7e9d7f1fc50c","text":"Behaviors favorable to breastfeeding increased 7 days after the frenotomy in all the breastfeeding assessment categories, whereas the electrical activity of the masseter decreased.","title":"Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles Efeito da frenotomia lingual na amamentação e na atividade elétrica dos músculos masseter e supra-hióideos"}
{"_id":"d3f16ca9-8d9e-c410-52c2-dc89d556f703","text":"The primary outcome was assessment of BHR by methacholine challenge testing in egg and peanut‐allergic children compared to children without food allergy. Secondary outcomes included investigation of differences in BHR, lung function, and FeNO between desensitized and failed patients receiving egg or peanut OIT, as well as the effect of OIT on BHR and emergency department visits in children with asthma.","title":"Bronchial hyperresponsiveness and asthma during oral immunotherapy for egg or peanut allergy in children"}
{"_id":"d3f57f12-b4aa-03ed-6808-980616d88a33","text":"The electron beam of an IORT accelerator is collimated by a fixed conical primary collimator placed immediately behind the exit window of the accelerator guide. Final collimation is achieved with a set of cylindrical applicators of various diameters in order to produce different field sizes. The sterilized applicator is inserted by the surgeon and radiation oncologist directly into the surgical opening above the target in a position and entrance angle which directs the beam through the underlying target tissues. Alignment of the applicator with the beam is adjusted by moving the accelerator to the correct position and angle, providing an unchanged position of the applicator. This is achieved by two techniques: with hard docking the applicator is mechanically locked onto the accelerator head. This means one must move the accelerator over the end of the applicator and carefully attach the applicator end to a receptor on the head (Fig. 2a) without moving the applicator. With the soft docking technique (Fig. 2b, c) the applicator is rigidly attached to the table with a stand and clamp. The accelerator is also moved over the applicator end but not mechanically attached. Alignment is achieved at distance by a laser guidance system which indicates the correct centering, angle and distance of applicator and accelerator. The principle of soft docking systems is explained in detail in references [2, 8] and [9]. Advantages of this system are the lower risk of injury of the patient by forces from the moving accelerator or electrical contact to the machine. The applicator is fixed in its position so that no misalignment from its intended entrance angle by movement during the docking process can occur. The soft docking system uses thin-walled metallic applicators while the hard docking machines have transparent plastic applicators allowing a direct view of the target during the docking procedure. A disadvantage of the plastic applicators can be their thicker walls which require a larger surgical opening, a disadvantage of hard docking can be longer time for machine alignment.","title":"Present state and issues in IORT Physics"}
{"_id":"d3feeaed-116c-cb67-fcc4-078b01419554","text":"For continuous scar contracture deformity of multiple joints of the same limb, simultaneous surgical release and skin graft can reduce operation frequency and obtain better efficacy of surgical operation.","title":"Abstracts from the 12th Asia Pacific Burn Congress Singapore. 14-17 August 2019"}
{"_id":"d40a0b52-14d7-0d9d-7707-b02a79f646da","text":"Promoting the rapid repair of full-thickness skin defects caused by severe burns and improving wound healing quality are significant challenges in burn treatment. The results of this study show that using minced split-thickness skin grafts with Pelnac as an overlay accelerates wound healing through enhanced cell proliferation and neovascularization. This treatment also stimulated the formation of a complete basement membrane connecting the epidermal and dermal layers of skin and alleviated scarring via modulation of collagen deposition and TGF-β expression.","title":"One-step approach for full-thickness skin defect reconstruction in rats using minced split-thickness skin grafts with Pelnac overlay"}
{"_id":"d40d9836-5882-f067-7c45-03d700a60328","text":"Using cartilage grafts in primary and repetitive rhinoplasty is mandatory; because maintenance or reinforcement of the major supporting structures is fundamental for aesthetic and functional purposes. Basically, there are two main categories of cartilage grafts used in rhinoplasty including structural and filler types. Structural type grafts are solid, strong blocks of hyaline cartilage to fortify different parts of the nose. Filler type cartilage grafts are pieces of molded hyaline or elastic cartilage to fill small imperfections for camouflage. They have no internal memory or structural strength. Various methods of cartilage molding have been stated in the literature. One of the first recommended manners to mold the cartilage was crushing introduced in 1985-1986.","title":"Evidence-Based Efficacy of Autologous Grated Cartilage in Primary and Secondary Rhinoplasty"}
{"_id":"d411b6ee-eb6c-a96a-a8b6-6ee7770aef1e","text":"Over recent years, endovascular exclusion of popliteal artery aneurysms has emerged as a new weapon in the arsenal of vascular surgery procedures available to vascular surgeons.22 This treatment option has grown in importance, especially for patients who have a high surgical risk or when no saphenous vein or prosthesis is available for grafting.9 Endovascular approaches are being used with increasing frequency as techniques and materials improve and because of their lower invasivity. This procedure is limited by the position of the stent, very often crossing the knee joint, which makes fatigue and fracture of the metallic material more likely. However, development of more flexible self-expanding stents has reaped more promising results. The results of the procedure are better in cases with good anatomy and at least two patent distal arteries.23","title":"Treatment of bilateral popliteal artery aneurysms"}
{"_id":"d4135201-d303-44cb-0ac5-4f2bbce404d5","text":"We used a paramedian forehead flap as our skin cover. This flap is the premier flap in nasal reconstruction, it can be used to replace any or all of the aesthetic subunits, and it provides excellent color and thickness match as shown in our patient. It is an axial flap based on the supraorbital and supratrochlea vessels. It has been shown that sufficient collateral blood supply from the angular arteries can sustain the flap even when the supratrochlea and supraorbital vessels are transected. The critics of the forehead flap point to the obvious forehead scarring, especially when wide flaps are designed and flap length is limited due a low hair line. Although we designed a relatively wide flap, we were able to close most parts of the defect, primarily leaving only about a 2 cm wound close to the pedicle of the flap which healed satisfactorily with no obvious scarring. At his last visit to the outpatient clinic, there was no significant hair growth on the distal part of the patient's reconstructed nose. The paramedian forehead flap has stood the test of time; it is the most useful flap that can be used for the tip, the lobule as well as subtotal and total nasal reconstruction.[10]","title":"The Naso-labial and lateral forehead flaps as a single stage: A case report and review of literature"}
{"_id":"d4159c5e-eba9-ce8e-6073-035ea1fd9721","text":"Radiation of lymphatic tissue in the axilla may also lead to lymph node dysfunction and result in upper extremity lymphedema [50]. Recent studies showed equivalent overall and disease-free survival and locoregional control between patients with a positive sentinel axillary lymph node treated with complete axillary dissection versus axillary radiation [51]. The rates of upper extremity dysfunction and lymphedema may therefore be expected to increase in the future. Symptoms related to lymphedema including repeated episodes of cellulitis, skin breakdown and functional impairment can emerge both in the acute and chronic phase of RIF as progressive fibrosis and contracture of the axillary lymph node basin impairs lymphatic drainage over time.","title":"Deconstructing Fat to Reverse Radiation Induced Soft Tissue Fibrosis"}
{"_id":"d41ab970-e54b-b525-323a-a12d659e33ac","text":"Venous ultrasound imaging unveiled no relapse of the previously recorded deep vein thrombosis although the diagnosis of post-thrombotic syndrome was made on the basis of post-thrombotic popliteal valve incompetence accompanied with significant reflex at the same level. Residual thrombi were also recognized mainly in the left popliteal vein and partially recanalization of both popliteal and gastrocnemius veins was described. Residual thrombi in left popliteal vein raised the question of whether a paradoxical embolus could explain not only the CRAO event but also the past embolic event in renal artery circulatory system.","title":"Central Retinal Artery Occlusion Secondary to Patent Foramen Ovale: The Unexpected Journey of a Paradoxical Embolus"}
{"_id":"d41b164c-4290-0c9c-72a3-7beed67b805e","text":"A concern with this model is that the SIEP flap is known to be a less reliable pedicle for abdominal tissue in humans when compared to the TRAM and DIEP flaps, which are generally based on the deep systems. For this reason most reconstructive surgeons choose the deep systems for flap harvest to decrease chances of complications including fat and skin necrosis especially in the obese patient. At our institution we do approximately 120 perforator flaps a year and less than 5 of those flaps per year are based on the superficial epigastric system. The epigastric system is unreliable at times or non-existent in some human patients. We have found in the mice model that this system appears to be the dominant system. There are little to no significant deep perforating branches present on the mouse model when raising the flaps. However, we feel that the more important issue is that the anatomical structure, as well as the physiological basis of the superficial epigastric based flap in mice is highly similar to the DIEP flaps in humans. The fact that these flaps are both composed of fat and skin only, and based on an arterial and venous pedicle, it is reasonable to assume these flaps are very similar in there characteristics and behavior. Therefore this mouse model would seem reasonable to use as a model of the DIEP flap for breast reconstruction.","title":"Development of a Mouse Model of Abdominal Cutaneous Flaps for Breast Reconstruction"}
{"_id":"d42562f5-9687-d2d5-62bf-3cbd0881ce6b","text":"A vascularized fibular osteomyocutaneous flap with severe vascular crisis often results in serious consequences. This study aims to examine the clinical effect of non-vascularized fibular graft on patients with severe vascular crisis after reconstruction of the defect jaw with vascularized fibular osteomyocutaneous flap.","title":"Jaw reconstruction with vascularized fibular flap: The 11-year experience among 104 patients"}
{"_id":"d42569c9-9f7d-1821-48a0-2edf33359d66","text":"Allowing our patients to WBAT immediately post operatively does not always mean they will be fully weight bearing from day 1. It does allow the physiotherapists to set full immediate weight bearing as a goal for these patients and tailor realistic and specific rehabilitation. It maybe also be true that patients with RWB status may load the fixation more than our post operative prescription specifies. To allow for WBAT the physiotherapists can educate the patients regarding progressive activities during their early rehab. Further work into how much weight these patients are tolerating immediately post operatively would be of interest and is likely to be of broad spectrum with multiple contributing factors. Evidence to consider when RWB in patients, is the demonstration that pressure on the acetabulum during movements such as sit to stand, which are not typically restricted, far exceed those contact forces seen in normal walking [26] as well as patients permitted only touchdown weight bearing requiring four times the energy for walking compared with the average population [27]. We did not use force plates or scales to measure the amount of weight that patients were putting through their limbs. For future work this would provide useful information to know how much weight patients were able to tolerate in the unrestricted weight bearing group or how weight was restricted in the other group.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"d42fc304-2480-416f-8ffe-01124ce9316d","text":"High dose rate brachytherapy decreases the number of clinical and dermoscopic features typical for basal cell carcinoma in the early observation. The effect is more pronounced among older patients.","title":"Basal Cell Carcinoma Treated with High Dose Rate (HDR) Brachytherapy—Early Evaluation of Clinical and Dermoscopic Patterns during Irradiation"}
{"_id":"d44c3f80-e7bb-0cb9-dbb3-a82bae9dcb85","text":"Ultrasound images were obtained by two anesthesiologists trained in ultrasound and regional anesthesia. Protected health information was removed following image collection. The image reviewer selected was an expert in pain management and regional anesthesia and was not involved in obtaining images. The reviewer viewed each image and assigned it a grade. Once images were graded, the data were retrieved and decrypted by investigators.","title":"Predictors of Difficult Ultrasound-Guided Transversus Abdominis Plane Blocks"}
{"_id":"d4525745-a05e-1a50-dc68-84a57f630eb9","text":"Auto serum therapy is a Therapy in which repeated injections of autologous serum are administered subcutaneously.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"d452fc05-58a1-241b-3031-f1d123b6731d","text":"The vertebral column is structurally weak as a result of being affected by the disease process. Normal stresses and strains of daily activities lead to pathological fracture in the diseased vertebrae and it can collapse into a kyphosis.","title":"Kyphosis in spinal tuberculosis – Prevention and correction"}
{"_id":"d4544804-e150-9fdb-b469-e666a7d6bd4e","text":"Covariates were defined using information available in PHIS from the patient’s primary palate repair. Demographic data included sex, race and median household income by postcode of residence. Race was included in the final model because prior research suggests variation among racial\/ethnic groups in receipt of cleft palate surgery.23 24 Median household income by postcode of patient residence was obtained from 2010 US Census data and split into four categories based on US federal poverty guidelines for a family of four in 2010, as previously described.25","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"d458f6d8-76ef-b434-48f2-ae78714166a8","text":"In parallel with local control, the rate of late complications is a robust marker of treatment quality, reflecting organs at risk dose exposure and the use of high quality brachytherapy implants (eg, interstitial applications to improve tumor coverage while minimizing the increase in irradiated volume and dose to organs at risk).32 Long term side effects should be documented in the medical record per organ site and scored according to the current CTCAE classification. It is important to assess the level of care by quality of life data to properly reflect treatment related morbidities. A high risk of underestimation of treatment related morbidity by clinicians was shown, and patient reported outcome measures should be integrated into the clinical routine.99–102","title":"ESGO\/ESTRO quality indicators for radiation therapy of cervical cancer"}
{"_id":"d467a340-65a1-4cc5-1e04-135fd48a2c14","text":"Photodynamic therapy uses a systemically delivered hematoporphyrin drug that is activated by laser light directed at tumor tissue. Drug activation by a specific wavelength of light produces singlet oxygen species that either destroy blood vessels resulting in tumor necrosis and\/or directly cause apoptosis. Because tumors often have increased vascularity and permeability, there can be relatively more drug concentrated within tumors, leading to destruction of more neoplastic tissue than normal tissue. Cutaneous sensitivity has been reported; therefore avoiding the sunlight is required for a few days after treatment. Because depth of treatment is directly related to depth of light penetration, most studies using photodynamic therapy for rectal cancer focused on the use of this modality as an adjunct to endoscopic resection or for small rectal cancers in nonoperative candidates, with a depth up to 15 mm reported [39, 40]. Reports of its use for colorectal pathology are scarce and mainly for nonoperable patients for palliation.","title":"Ablative Therapies for Colorectal Polyps and Malignancy"}
{"_id":"d469de63-0c9d-90c5-6ee0-bbbda9dc297d","text":"We thought that patient age is closely related to postoperative oral function and sensory recovery of the flaps and we tried to demonstrate this relationship in our study.","title":"Sensory Recovery with Innervated and Noninnervated Flaps after Total Lower Lip Reconstruction: A Comparative Study"}
{"_id":"d46dccce-bd90-2ded-056b-facc1560d6ce","text":"Pedicled flap transfers are safe and useful procedures suitable for soft tissue coverage within forward surgical units. All military orthopedic surgeons should be trained to perform such basic reconstruction techniques. Except perhaps in cases of pre-existing bone infection, these techniques permit limb salvage in most open extremity soft tissue injuries encountered in the field.","title":"Soft tissue coverage using pedicled flap in combat zone: a case series"}
{"_id":"d4725f78-7fe2-acee-fab2-1c830cb44ac3","text":"To elucidate any impact of melanoma staging according to the 8th edition of American Joint Committee on Cancer staging manual, the TNM classification and stage grouping of patients with the staging based solely on harvested SSLNs, that is a situation where no PSLNs had been removed, were compared.","title":"Pelvic sentinel lymph nodes have minimal impact on survival in melanoma patients"}
{"_id":"d479e3a3-699f-80ff-1c64-9248ccb3d2cb","text":"We report a 16 year old competitive basketball athlete who underwent a combined anterior and posterior approach for resection of an osteosarcoma of the sixth cervical vertebra. Fourteen years after the index procedure, the patient eliminated spontaneously one screw through the intestinal tract via an oesophageal perforation and developed a severe dysphagia. Three operations were necessary to remove the anterior plate.","title":"Screw migration and oesophageal perforation after surgery for osteosarcoma of the cervical spine"}
{"_id":"d47db888-2746-bf02-60a7-f2d7157ab3a7","text":"Photodynamic therapy is a procedure that can provide a selective eradication of neoplastic disease if sufficient drug, light, and oxygen are available. As this description suggests, it involves the photosensitization of malignant tissues to irradiation with photons in the visible range. While not suitable for tumors at unknown loci, it can be of use for eradication of cancer at surgical margins and therapy at sites where substantial surgery might otherwise be involved. Drug development has been delayed by several factors including the reluctance of major pharmaceutical firms in the United States to invest in this technology along with some unwise approaches in the past.","title":"More Adventures in Photodynamic Therapy"}
{"_id":"d47e2e2c-31a7-68ce-c987-3e719ea40056","text":"The combination of endovascular intervention and microvascular free flap transfer has been effectively used for chronic ischemic wounds of lower limb. The aim of this study was to determine the influence of angioplasty on free flap survival in diabetic foot ulcer reconstruction.","title":"What is the impact of infrapopliteal endovascular intervention on free flap survival in diabetic foot reconstruction?"}
{"_id":"d485390f-0595-4371-3adc-a0466e038232","text":"In patients who have previously undergone neck surgery with or without radiotherapy, the TCVs are reliable and easily accessible recipient vessels for microsurgical reconstruction in the oral and maxillofacial region. If the transverse cervical vein is unavailable, the internal or external jugular vein should be dissected carefully to serve as an alternative for microvascular anastomoses.","title":"Transverse cervical vessels as recipient vessels in oral and maxillofacial microsurgical reconstruction after former operations with or without radiotherapy"}
{"_id":"d485aafd-c9d1-cd84-6e32-6f555d04f966","text":"The main characteristics of the study population and their correlation with SLN status are shown in Table 1.","title":"Prognostic Role of Non-Identification of Sentinel Lymph Node in Cutaneous Melanoma Patients: An Observational Retrospective Study"}
{"_id":"d488b430-1af0-028d-f4f5-feef850abc3a","text":"A recognition of cutaneous lesions is important because they provide a visible clue to diagnosis especially if they have a specific appearance. These lesions also are an easily accessible source of tissue for diagnosis. Punch biopsy provided sufficient tissue for histopathologic examination, was diagnostic of both sarcodosis and sarcoidosis associated cutaneous lesions in most of our patients. In the remaining patients, histopathological examination of the incisional wedge biopsy confirmed the diagnosis. We believe that punch biopsy is a simple technique to learn and it can easily be performed for cutaneous sarcoidosis with high a diagnostic yield and a low rate of complications. As the clinician becomes more experienced with the technique, the diagnostic accuracy will increase because most of the nondiagnostic punch biopsy results were the initial biopsies.","title":"Diagnosis of cutaneous sarcoidosis; clinical and the prognostic significance of skin lesions"}
{"_id":"d48f0d93-42c7-5871-c33c-80360740b39c","text":"Complications of CPCSSTIs identified in these patients during the clinical course were defined as sepsis, septic shock, or bacteremia that are all serious complications that justify the importance of this pathology requiring intensive care in addition to antibiotic administration and\/or initial surgical intervention during the initial hospitalization.","title":"Complicated Posterior Cervical Skin and Soft Tissue Infections at a Single Referral Center"}
{"_id":"d495c473-bbe3-51fc-e962-72bfdc4e4ea7","text":"The relationship between certain extracolonic manifestations and sites of the APC mutation suggests specific roles of the APC protein in different tissues. These different roles may correspond to specific sites of missense mutations in the APC gene. For example, dental manifestations of Gardner’s syndrome have been suggested to be associated with mutations at or near codon 1556. However, the influence of unknown genetic factors independent of APC in susceptibility to desmoid tumors in FAP needs to be explored.","title":"Desmoid Tumors: A Clear Perspective or a Persisting Enigma? A Case Report and Review of Literature"}
{"_id":"d4965573-9d2b-a14f-038d-d6b602b2f3b7","text":"Following ethical approval, an online survey investigating specifics of surgical informed consent was performed among members of the Dutch Scientific Association of Orthopedic Surgeons and the Dutch Society for Plastic Surgery.","title":"Challenging the knowledge base and skillset for providing surgical consent by orthopedic and plastic surgeons in the Netherlands: an identified area of improvement in patient safety"}
{"_id":"d49a8d83-336e-bdf9-0724-5d2170749ef6","text":"The likelihood of finding cancer within anastomotic rings is rare and their histopathological examination seldom changes patient management.","title":"Routine pathologic evaluation of circular stapler anastomotic rings is not useful after resection for colorectal cancer: retrospective study and systematic review with meta-analysis"}
{"_id":"d49c5633-22c8-1806-3212-7139dcddfa40","text":"VKAs have a narrow therapeutic window as well as numerous drug and dietary interactions and need frequent coagulation testing and dose adjustments. Despite their efficacy, VKAs are far from an easy means of anticoagulation.","title":"Newer Oral Anticoagulants in the Treatment of Acute Portal Vein Thrombosis in Patients with and without Cirrhosis"}
{"_id":"d4a11d12-b42b-6f42-a23b-ce8c60e45e5a","text":"It is known that mammography screening decreases breast cancer mortality in a standard population, by finding breast cancers at an earlier stage. , It therefore seems likely that mammography screening will also detect new cases and recurrences in breast cancer survivors at an earlier stage and thereby decrease breast cancer mortality.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"d4a46c82-eeb6-7197-633f-a63e96dca9dc","text":"Patients were in various stages of disease duration and severity at the time of enrollment. Those with incomplete data for the variables of physician and patient global activity assessment scores were excluded.","title":"Patient and physician discordance of global disease assessment in juvenile dermatomyositis: findings from the Childhood Arthritis & Rheumatology Research Alliance Legacy Registry"}
{"_id":"d4acfcfe-b13a-018c-6b00-618117ab0642","text":"A retrospective study of 3011 biopsies was carried out in the Service of Oral and Maxillofacial Surgery of the Dental Clinic of Barcelona University between January 1995 and March 2008.","title":"Central odontogenic fibroma: Retrospective study of 8 clinical cases"}
{"_id":"d4b42b1c-f253-92ab-3c83-68b272471f54","text":"We suggest the beneficial effects of NSAIDs on primary melanoma may indicate its use as a co-adjuvant topical agent in chemotherapy for treating melanoma but clearly more work will be needed to establish this using this or a similar model.","title":"Use of a Tissue Engineered Human Skin Model to Investigate the Effects of Wounding and of an Anti-Inflammatory on Melanoma Cell Invasion"}
{"_id":"d4ba5c16-5882-514a-d8ed-94ec1e200e53","text":"This is the first description of a significant and transient desialylation of likely all plasma proteins associated with the development of thromboembolic events. The absence of the strong electronegative residue terminating branches of N-glycans and O-glycans, may modulate protein-protein interactions of hemostatic elements. We speculate that this defect may exacerbate the prothrombotic state caused by antithrombin deficiency, contributing to the development of thrombotic events, preferably in the arterial territory, even when the patient was under anticoagulant therapy. Unfortunately in our proband, we were not able to analyze the levels of sialic acid in platelets or the platelet reactivity at the time points when she displayed obvious desialylation. A potential desialylation of platelets might associate with increased platelet reactivity, which could contribute to explain the inability of anticoagulation therapy to avoid vascular events, the development of arterial thrombosis and the reduced platelet count observed in samples with desialylation1617. Further studies are required to define the impact of the desialylation of different elements of the hemostatic system, not only platelets, and the relevance of desialylated plasma proteins in maintaining the hemostatic balance and their role in the development of thrombosis. As the main limitation of this study is the identification of a single case with transient desialylation, additional studies are required to identify new cases with similar features, which may be explored among patients with recurrent thromboembolic events despite therapeutic INR with vitamin K antagonists. This study might also have therapeutic consequences as desialylation might be a potentially treatable condition with neuraminidase inhibitors.","title":"Transient desialylation in combination with a novel antithrombin deficiency causing a severe and recurrent thrombosis despite anticoagulation therapy"}
{"_id":"d4e05c14-f40d-8c84-2f26-aa66d7d69aa0","text":"All cases of disagreement were adjudicated by the senior supervising ED consultant. Clinical records of patients with false negative outcomes were investigated further by an independent panel. Patients with clear prospective documentation recording a high pre-test probability, VTE as the most likely diagnosis, or with eventual diagnosis of chronic thrombus left untreated or superficial venous thrombosis were reported individually but excluded from the final analysis.","title":"The application of an age adjusted D-dimer threshold to rule out suspected venous thromboembolism (VTE) in an emergency department setting: a retrospective diagnostic cohort study"}
{"_id":"d4e05da2-ca3b-89d4-5b90-81bc88e3961e","text":"By IHC and ISH, markers representative of the separate DTF and SFT gene sets highlighted at least two groups of normal connective tissue “fibroblasts” or stromal cells. The cells positive for DTF markers are found in a variety of reactive tissues, ranging from inflammatory granulation tissue to scar tissue. In contrast, cells positive for SFT markers tend to be found in normal tissue. The stromal cells surrounding breast lobules and eccrine lobules of the skin were strongly reactive for SFT markers and negative for DTF genes. These findings are consistent with the gene expression data in which SFTs highly express many genes that help create basement membrane.","title":"Determination of Stromal Signatures in Breast Carcinoma"}
{"_id":"d4e2a83c-a77a-833b-2c23-ac55a52dc176","text":"Decal bone chips were effective as the local antibiotic delivery vehicle in preventing the MRSA osteomyelitis model. It eluted vancomycin significantly and the graft uptake was also excellent. Allogeneic decal grafts eliminated the need for second surgery and acted as an excellent delivery vehicle for antibiotics.","title":"Decal bone matrix as a local antibiotic delivery vehicle in a MRSA-infected bone model: An experimental study"}
{"_id":"d4e5becc-5ad9-85db-7da2-490adb45acb7","text":"In lateral decubitus position after prepare and drape, the procedure was begun by incising the skin island and dissecting through the subcutaneous tissue to the muscle. Then muscle flap was released and elevated completely from its origin, and the pedicle was isolated. After a subaxillary tunnel creating, the flap was positioned on the anterior chest by gently pushing it through the tunnel. Inseting of the transferred skin flap into its proposed position was undertaken to ensure adequate reach without compromising the vascular pedicle.","title":"Latissimus Dorsi Musculocutaneous Flap Inset Innovation in Breast Reconstruction"}
{"_id":"d4f12895-10c6-2e89-96e4-a94514f1ec94","text":"The time from surgery until the last outpatient visit at the plastic surgery department could be seen as a proxy for the healing progress. We found no difference regarding the recipient site, but a significant difference regarding the donor site with a longer time for a split skin thickness graft. There were though missing data from over 50% of the patients in each group and most donor sites got controlled by the patients general practitioner.","title":"Full- or Split-Thickness Skin Grafting in Scalp Surgery? Retrospective Case Series"}
{"_id":"d4f71250-4e78-537b-733d-5fb75a2e207c","text":"This retrospective study was approved by the institutional review board at our institution and was carried out following the tenets of the Declaration of Helsinki.","title":"Repeated injections of botulinum toxin-A for epiphora in lacrimal drainage disorders: qualitative and quantitative assessment"}
{"_id":"d4f9cc3c-81c6-b5c3-dd97-fd5e09b68735","text":"Patients were divided into five groups depending on preoperative AUS findings and postoperative histopathological findings. The presence of at least one lymph node with metastatic character was accepted as a positive finding, and the absence was accepted as a negative finding. The presence of at least one lymph node with suspicious character was considered a suspicious finding. Histopathologically, determining at least one lymph node metastasis in the axilla was considered a positive finding, and if no lymph nodes contained metastasis, this was considered a negative finding. Groups are shown in Table 2.","title":"Preoperative Evaluation of Axillary Lymph Nodes in Malignant Breast Lesions with Ultrasonography and Histopathologic Correlation"}
{"_id":"d5011c49-6bd3-67a1-c23a-3d54e0f543d2","text":"Intraoperative view of lymph node flap based on thoracodorsal artery and vein. The picture depicts the lower chest thoracic lymph nodes located at Level III axillary lymph node position. These lymph nodes did not take up technetium, thereby avoiding the extremity drainage basin.","title":"Breast and gynecologic cancer-related extremity lymphedema: a review of diagnostic modalities and management options"}
{"_id":"d50e1c0b-2fa5-c111-e4c2-0148de56200b","text":"Application of the relatively small microbiopsy device does not require local anaesthesia or sutures and therefore no set up for a minor clinical procedure is necessary. Observations from our volunteer study suggest that collecting multiple microbiopsies within in a short period is feasible. We envision that microbiopsy devices will become a routine clinical and research device in dermatology allowing the dermatologist to obtain targeted lesion data for molecular stratification.","title":"Microbiopsy engineered for minimally invasive and suture-free sub-millimetre skin sampling v2; ref status: indexed"}
{"_id":"d51ab735-2e40-d00a-a38e-d1aa2a1ff078","text":"The average elapsed time between symptom appearance and the BAT was 6 months. We performed the BAT on four patients, even though the elapsed time was longer than six months because it was within six months of a positive ST result.","title":"The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults"}
{"_id":"d5304787-e5d2-976c-eb0b-1308733c78a0","text":"Given the wide range of adverse events, it is critical that physicians counsel patients on risks of injectable therapy and educate patients to ensure accurate treatment expectations.","title":"Lower Lip Necrosis"}
{"_id":"d539f9c8-80f7-48fd-4b78-c32c6c6aa1ac","text":"Orthopedic fellowship positions continue to be increasingly competitive, with most orthopedic residency graduates pursuing fellowship after completion of residency. Shoulder and elbow fellowship training represents an increasingly competitive and relatively smaller cohort of applicants than other subspecialties; there are only 29 programs with a total of 40 offered positions. The purpose of this survey is to identify and rank factors considered most important by shoulder and elbow fellowship directors when identifying potential fellowship candidates.","title":"Factors considered in ranking orthopedic shoulder and elbow fellowship applicants: a survey of program directors"}
{"_id":"d53a1aa4-b3ce-692b-0949-f818dd0e28bb","text":"Full face images of 289 French Caucasian women with healthy skin between 20 to 69 years old (40 faces from 20 to 29 years, 60 faces from 30 to 39 years, 71 faces from 40 to 49 years, 60 faces from 50 to 59 years, and 58 faces from 60 to 69 years) were acquired using a closed photographic system that allows accurate and reproducible positioning of the subjects as well as controlled lighting conditions. Written informed consent was obtained from all subjects allowing the use of their photographs for research studies.","title":"Aspects of Facial Contrast Decrease with Age and Are Cues for Age Perception"}
{"_id":"d53c5570-9e75-2f4e-eb7c-6964f26e1927","text":"Obesity and certain medical disorders make the reconstruction of skin defects challenging. Different kind of procedure can be used for these defect, besides, skin grafting is one of the most common and simplest procedure. Fat grafting and stem cells which are located in the adipose tissue have been commonly used in plastic surgery for regeneration and rejuvenation purposes. To decrease graft failure rate we performed nanofat grafting under an autologous split-thickness skin graft in our patient who had a problematic wound.","title":"Nanofat grafting under a split-thickness skin graft for problematic wound management"}
{"_id":"d53f26c7-9692-5410-85b2-f0bcdec690a2","text":"Locally, we will submit our findings for presentation at Gallie Day at the University of Toronto. Gallie Day attracts surgeons from all fields at the University of Toronto. Surgeons who attend this event tend to have a hand in either research or hospital administration. They work at various hospitals throughout the Greater Toronto Area. And we will present our findings at the American Society of Plastic Surgery Annual Meeting. This meeting tends to draw as many Canadians as the Canadian Society of Plastic Surgery Annual Meeting, as well as American and international plastic surgeons. This is a suitable population for dissemination as most plastic surgeons perform a large quantity of elective ambulatory surgeries. We will aim for publication in Canadian Medical Association Journal or JAMA Surgery. These journals attract a breadth of readers that include plastic surgeons and other types of ambulatory surgeons.","title":"The Effect of Mobile App Home Monitoring on Number of In-Person Visits Following Ambulatory Surgery: Protocol for a Randomized Controlled Trial"}
{"_id":"d53f70a4-a4f1-276a-54c7-28874d28a920","text":"Age-related degeneration of the intervertebral disc results in loss of viscoelasticity and a loss of height with associated posterior bulging. As the disc height decreases the ligamentum flavum folds, as does the facet joint capsule, causing a decrease in the dimensions of the canal and exit foramina. Osteophytes form posteriorly around the disc, and these combined with the disc bulge and the aforementioned in folding of ligament and joint capsule cause pressure on the exiting nerve roots or the spinal cord itself.","title":"Nonoperative Modalities to Treat Symptomatic Cervical Spondylosis"}
{"_id":"d5401fbe-05d2-1993-a063-c2dbfecd5f4e","text":"Seven hundred and seventy three women with stage I\/II invasive ductal carcinoma of the breast were treated consecutively between 1988 and 1992 by the same surgeon in a single unit at the Department of Surgery, John Radcliffe Hospital, in Oxford. In all cases the tumor was the first primary cancer and all patients underwent breast conservative surgery with axillary staging followed by post operative radiotherapy using tangential fields, including an additional boost to the operative field.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"d541be62-d1f7-0170-ab5c-ef8ffb39bfc1","text":"While traditional chemotherapy has limited effectiveness in melanoma, combining chemotherapy with immunotherapy or targeted therapy in certain cases may provide added benefit.","title":"Pathology and Molecular Biology of Melanoma"}
{"_id":"d5449282-4901-3e45-60f3-9e8bad3f104e","text":"The choice of conservative surgery is also supported by the absence of evidence of malignant transformation of MFs as well as the low recurrence rate reported in some case series after conservative treatment (9).","title":"Odontogenic myxofibroma: A concise review of the literature with emphasis on the surgical approach"}
{"_id":"d546666b-05ad-ba30-1f44-5de8e93a263e","text":"The study will explore if the application of IFN combination in so difficult to treat tumor is safe and provide benefit to the patients at designed doses.","title":"Treatment of advanced, recurrent, resistant to previous treatments basal and squamous cell skin carcinomas with a synergistic formulation of interferons. Open, prospective study"}
{"_id":"d5484c29-8298-8584-128f-35692408ac8e","text":"This retrospective study aimed to report a series of belly dancer’s dyskinesia patients and delineate the effectiveness of ultrasound-guided BTX injection in the management of such patients. Four patients with belly dancer’s dyskinesia underwent the same diagnostic evaluations and received the same BTX injection procedure under ultrasound guidance as described below. The study was approved as part of the movement disorder program at King Faisal Specialist Hospital and Research Centre and Ibin Sina Hospital. Informed consent was obtained from all patients described in this study.","title":"Ultrasound-guided botulinum toxin A injection in the treatment of belly dancer’s dyskinesia"}
{"_id":"d5498820-d2ac-dc64-650c-e3406cf6936b","text":"Each patient who planned for mastectomy should obtain sufficient information regarding breast reconstruction. Sufficient time should be spent on informing patients, both by surgeons and by specialised breast cancer nurses. The latter professionals should be activated as staff members capable to guide women with breast cancer through the therapy process. Educational sessions should be more than one short meeting before surgery. Sessions may be most beneficial for patients interested in BR, but discouraged by the imagined disadvantages of surgery. Information needs to be tailored to meet the expectations of the patient. While infrastructure problems such as lack of centres that provide BR and access to qualified physicians needs to be improved, it is not the only cause of low utilisation of reconstructive surgery. There is a large group of patients not interested in this surgery due to the high level of self-acceptance who should not be pushed towards reconstructive surgery. Patients’ education impacts the quality of life—not only before surgery but also lifelong after finishing the treatment.","title":"Patient’s Education Before Mastectomy Influences the Rate of Reconstructive Surgery"}
{"_id":"d54ffa1e-d1c2-56c1-d244-6be7a2e99136","text":"Regarding relapses, a woman healing from Ewing sarcoma had a recurrence of the disease five months after OTT and she performed additional chemotherapy. At the time of analysis all transplanted women are in good health.","title":"Ovarian tissue cryopreservation and transplantation: 20 years experience in Bologna University"}
{"_id":"d55e546a-aeda-e947-0496-0fa9927678ec","text":"Two transverse planes and one sagittal plane are obtained with partial limb flexion.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"d5629370-5944-1176-45dd-63b06e68bc45","text":"Fifteen patients—thirteen at an outpatient dermatology practice in Hackensack, New Jersey and two at the Mount Sinai Medical Center dermatology clinic in New York qualified for this study. Informed consent was obtained from each patient in his or her own language to perform skin biopsies to confirm the clinical diagnosis. A media consent form was signed by each of the patients to publish any identifying material in online and print publications. After the diagnoses were confirmed by pathology, the patients were treated and followed longitudinally for their clinical course and to determine if subsequent vaccinations induced additional eruptions. The fifteen patients were divided into two groups based on whether their eruption followed the lines of Blaschko or followed a random non-Blaschkoid distribution (Figure 3).","title":"COVID-19 Vaccine-Induced Lichenoid Eruptions—Clinical and Histopathologic Spectrum in a Case Series of Fifteen Patients with Review of the Literature"}
{"_id":"d5767926-d65a-6acb-d485-bd4dbc919397","text":"Subgroup analysis will be performed to identify any subpopulations that may be associated with the effectiveness of PDT alone or combined with different therapy. Other factors such as different type of NCC (extrahepatic cholangiocarcinoma or intrahepatic cholangiocarcinoma) and different control interventions will be taken into account.","title":"Therapeutic effect of photodynamic therapy for nonresectable cholangiocarcinoma Protocol for a meta-analysis and systematic review"}
{"_id":"d57a78e7-ce63-f504-bda9-6dd47810ee75","text":"On admission he had swelling of the right knee and lower thigh with loss of sensation on the dorsolateral aspect of the right foot. Clinical examination revealed a large mass in the right popliteal fossa. The initial diagnosis was that of deep venous thrombosis and imaging was undertaken and the patient referred for a vascular opinion.","title":"Deep vein thrombosis and pulmonary embolus associated with a ruptured popliteal aneurysm – a cautionary note"}
{"_id":"d589c2a0-5f35-61ed-6f2d-f872b7892d6c","text":"Beauty tattoos were invented before the modern era and are not a trend that temporarily becomes fashionable and then disappears. Tattooing must be done by a professionally trained practitioner using advanced medically certified equipment and needle cartridges with skilled techniques (Goldstein 2007).","title":"Analysis of microstructural characteristics and components of red and yellow ink pigments used in permanent makeup"}
{"_id":"d58bfb55-546f-cce0-284f-a203c9f49e7e","text":"Finally, given that current reviews propose an increase in the total dose to 21–30 Gy with recurrence rates significantly lower than those obtained with lower doses, the results shown in this article plus a review of the literature caused a change in protocol in the oncology centre in which this study was done. A new protocol was initiated with a dose of 21 Gy in three fractions with the goal of reducing the recurrence rate of keloids managed with surgery plus adjuvant radiotherapy. The results of said series will be stored in a prospective manner with the additional application of a validated POSAS [18] scale by the observer, and the patient along with these will be reported on in the future.","title":"Postoperative radiotherapy in the management of keloids"}
{"_id":"d58e4071-86bf-5f1c-ac53-c09ff70426be","text":"Resilient Hyaluronic Acid Redensity is the most superficially implanted product in a range of RHA fillers developed to treat wrinkles and folds in different areas while accommodating facial dynamics. This range of RHA fillers that provides durable results with a low degree of crosslinking modification of the HA chains may represent a novel and useful addition to the aesthetic toolbox.","title":"Efficacy and Safety of a New Resilient Hyaluronic Acid Filler in the Correction of Moderate-to-Severe Dynamic Perioral Rhytides: A 52-Week Prospective, Multicenter, Controlled, Randomized, Evaluator-Blinded Study"}
{"_id":"d58e4cc6-b790-71f0-906c-b14d9bc4d8cf","text":"Postoperative graft infection is a lethal complication that is often extremely difficult to treat. Considering the gravity of an event such as graft infection, we believe that from the first surgery a complete cure should be prioritized over minimal invasiveness, and thus we do not recommend the endograft procedure at this time.","title":"A Case Report on the Successful Treatment of Streptococcus pneumoniae-Induced Infectious Abdominal Aortic Aneurysm Initially Presenting with Meningitis"}
{"_id":"d5964f1c-26ce-4548-a601-1075ff0a282c","text":"Heterogeneous tumor pigmentation was also a challenge when analyzing the Cherenkov luminescence images. Because melanin absorbs light at a wide range of wavelengths, variations in melanin content may lead to an emission pattern that differs from the shape of the tumor. Likewise, possible differences in tumor vascularization and the amount hemoglobin will affect the light emission owing to high absorption in the blue–green wavelength range., The exposure time was therefore adjusted based on the degree of tumor pigmentation, because weakly pigmented tumors required shorter exposures for visualization. In cases where the tumor itself could not be identified, a comparable reference image taken with the same camera setup and the same field of view in low light conditions was useful to display the tumor and judge its location in relation to the plaque. Because there is a linear relationship between the level of radioactivity and the Cherenkov radiation, the necessary exposure time was also adjusted according to plaque activity at the time of imaging.","title":"Cherenkov Luminescence Imaging for Assessment of Radioactive Plaque Position in Brachytherapy of Uveal Melanoma: An In Vivo Feasibility Study CLI in Brachytherapy of Uveal Melanoma"}
{"_id":"d598756f-88bc-1ad4-b62c-f6c11d226fb0","text":"The additional information of the overlay image, when observed simultaneously with the two basis component images did not provide any additional diagnostic value or image quality improvement. All three observers granted the combination of bone image, soft tissue image and overlay image the exact same ratings than the sole combination of the bone and the soft tissue image.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"d59bd503-3bf1-27ba-7f66-c04cd8a345dc","text":"The perforators are fixed in their locations and supply reliable skin paddles. If a surgeon detects a reliable perforator using a Doppler probe, he\/she can use it as a pedicle for flaps that cover other defects on the face. This approach is limited only by the possibility of primary closure of the donor site.","title":"Freestyle Local Perforator Flaps for Facial Reconstruction"}
{"_id":"d59d4a1a-b1f0-eaaf-33be-a08b0c5fa463","text":"There are numerous surgical solutions proposed: reconstruction by a secondary intention, grafts of dermal matrix, transposition flaps and finally an old technique that involves the perforation of the cranial theca. Dermal matrices cannot be used on bone as they still need blood support to facilitate the repair process. Local flaps could not be used as the skin was seriously photodamaged and treatment of this would further delay the repair. In our case the solutions adopted with other patients were not applicable, therefore we evaluated the literature to determine which solution could be adopted. We had experience with tissue perforation in large ulcers and position punch grafting to facilitate re-epithelialization therefore we also drew inspiration from this method.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"d59ed090-adde-be7c-2a45-62bed5ca5836","text":"From March 2018 to December 2022, a total of 200 patients underwent EEA pituitary adenoma resection by a single author in our institute. Different skull base reconstruction strategies were applied in different periods. In the early period, from March 2018 to June 2019, fat graft was used to reconstruct the skull base. In the late period, from January 2020 to December 2022, fat graft was not used. This study respectively reviewed the surgical methods and outcomes of these cases to find out if intradural fat graft packing is indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries.","title":"Intradural fat graft packing is not indispensable in preventing postoperative cerebrospinal fluid leakage in endoscopic endonasal pituitary adenoma surgeries"}
{"_id":"d59eff5f-1893-8be1-c1cb-2eacb51dad81","text":"An additional analysis of the primary outcome was performed by excluding lesions detected with imaging methods that were clearly described as palpable even without imaging. This outcome was defined as nonpalpable ipsilateral breast cancer detected only with imaging method.","title":"Yield of Surveillance Imaging After Mastectomy With or Without Reconstruction for Patients With Prior Breast Cancer A Systematic Review and Meta-analysis Surveillance Imaging After Mastectomy for Patients With Breast Cancer"}
{"_id":"d5a42937-30ab-dbff-238b-e269003ad7e6","text":"The study may be monitored, or audited in accordance with the current approved protocol, relevant regulations and standard operating procedures by the Host organisation, Sponsor or appropriate Regulatory Authorities. A Monitoring Plan will be developed according to OCTRU standard operating procedures which involves a risk assessment. The monitoring activities are based on the outcome of the risk assessment and may involve central monitoring and site monitoring.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"d5ac068c-7dd8-ca82-ad0f-487b2158871b","text":"Melanoma represents a global health problem, as it is one of the most aggressive types of tumors. The treatment of this pathology has made great progress in recent years, with new staging techniques and the appearance of targeted molecules for systemic treatments.","title":"Variability of Sentinel Lymph Node Location in Patients with Trunk Melanoma"}
{"_id":"d5b255a5-ff3f-cdac-9e10-eb23b5843886","text":"This article contains a series of position statements from a group of plastic surgeons who met to discuss how key unmet needs in reconstructive surgery can be addressed.","title":"A Position Statement on Optimizing the Role of Oncoplastic Breast Surgery"}
{"_id":"d5b56e33-936f-83d0-b936-e4d0e40b784d","text":"Comparison of antibiograms and MICs showed that Kirby bauyer technique especially for detection of VISA strains is not reliable comparison with E-test. Already VRSA strains have not detected in Iranian chronic osteomyelitis, Thus Vancomycin is the first choice for chronic osteomyelitis empirical therapy in Iran yet.","title":"Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran?"}
{"_id":"d5ba34f1-6d64-aa95-4f8a-f7848d7f6da6","text":"By far the greatest limitation to the validity of these studies (Additional file 1: Table 4) is the significant number of patients excluded by the medical staff or breast care nurses because they considered them unsuitable. Reasons for this were not always given but it is likely that reasons are related to clinical issues such as post-surgery problems or perceived risk of relapse or anxiety on the part of the patient.","title":"Options for early breast cancer follow-up in primary and secondary care - a systematic review"}
{"_id":"d5bb26e4-3ad8-23a0-ee01-dd52caa26d77","text":"The purpose of this second study was to examine a more realistic cryosurgical configuration. In Case 2 the geometry consists of a single cryoprobe in a cylindrical section of tissue 6 cm in radius. Geometric details and boundary conditions were previously mentioned in the Models section.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"d5bebd43-f164-d30e-c13a-cc8059ac952f","text":"The proposal of simulation in basic plastic surgery training on inanimate bench models is a further complementary alternative to the arsenal of training programs already established in order to better prepare medical students before their contact with living patients which remains as the cornerstone of medical education.","title":"Basic Plastic Surgery Skills Training Program on Inanimate Bench Models during Medical Graduation"}
{"_id":"d5c1b0d9-7472-bae0-afd9-0cfbd6bd99ca","text":"To investigate the value of various MRI signs in differentiating Ewing sarcoma from osteomyelitis.","title":"Diagnostic value of MRI signs in differentiating Ewing sarcoma from osteomyelitis"}
{"_id":"d5c8397d-5e13-f1fa-8340-35753bfed539","text":"It is important to note that patients recently submitted to a surgery will always have an at least moderate risk of bleeding (Chart 14) and the possibility of using systemic thrombolytic therapy for the treatment of acute PTE needs to carefully assess the risks and benefits and should be discussed with the surgeon.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"d5ca513e-045b-374d-b3e8-e358a9b34527","text":"We would like to stress the need of careful preoperative assessment of tumour spread by MRI and further by intraoperative frozen sections if doubt exists about the aggressiveness of the lesion.","title":"Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: long-term result"}
{"_id":"d5ce11c9-84f7-7e72-6c8e-aa18d0d79682","text":"Perforator flaps serve all these purposes well for both traumatic and nontraumatic defects.","title":"How to Transform a Perforator Propeller Flap into a Keystone Flap in Case of Unsatisfying Perforator Vessel Local Perforator Flap Coverage in Limbs"}
{"_id":"d5ceb96a-6816-93ba-d3d7-22f807adb25d","text":"All participant contact information data will be stored on spreadsheets within the recruiting NHS site, which will have restricted access from password protected computers. Accrual data uploaded to the UKCRN portfolio database will be anonymised and collated by the CI or delegate to the CLRN. No identifiable data will be entered on the eCRF or transferred to the KCTU.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"d5dfa349-1625-3c4f-04fa-6892cb8373d7","text":"Follow‐up was in accordance with our institutional guidelines. Clinical follow‐up was at 6 weeks for all patients. Patients with a histologically confirmed benign lesion underwent biannual sigmoidoscopy for 2 years. In cases of malignant lesions, patients were followed up with flexible sigmoidoscopy every 4–6 months for 2 years, with MRI of the rectum twice a year for 2 years and measurement of serum carcinoembryonic antigen twice a year. All patients in this study were followed up for a minimum of 12 months. Local recurrence was defined as the development of a tumour at or near to the site of TEM more than 6 months following TEM and confirmed by biopsy. If a patient died the cause of death was obtained from hospital records and defined as either related or unrelated to rectal cancer.","title":"Transanal endoscopic microsurgery for rectal lesions in a specialist regional early rectal cancer centre: the Mersey experience M. Ondhia et al."}
{"_id":"d5e612c3-c060-bddb-e1ee-ca986ea0f1d9","text":"A difference exists in postoperative anticoagulation therapy depending on pre-existing medical conditions. Some patients are in need of therapeutic anticoagulatory whereas all others will receive a low molecular weight heparin for thrombosis prophylaxis for 4 weeks postoperatively as standard of care according to current guideline recommendations. Hence, we will stratify for therapeutic or prophylactic anticoagulatory therapy.","title":"Peritoneal flap for lymphocele prophylaxis following robotic-assisted laparoscopic radical prostatectomy with pelvic lymph node dissection: study protocol and trial update for the randomized controlled PELYCAN study"}
{"_id":"d5e63f74-b6e2-82c5-64b4-19941b50b8ea","text":"The aim of this study was to verify the results of the single case study in patients with IR by evaluating subjective symptomatic relief of rhinorrhea, nasal obstruction and sneezing and to observe the development of the number of tissues used after applying BTA minimally invasively with a sponge.","title":"Minimally invasive application of botulinum toxin A in patients with idiopathic rhinitis"}
{"_id":"d5e86011-42f2-31e7-448d-9e1f9ad50e66","text":"The success of radiotherapy depends on the accurate delineation of the clinical target volume. The delineation of the lymph node regions has most impact, especially for tumors in the head and neck region. The purpose of this article was the development an atlas for the delineation of the clinical target volume for patients, who should receive radiotherapy for a tumor of the head and neck region. Literature was reviewed for localisations of the adjacent lymph node regions and their lymph drain in dependence of the tumor entity. On this basis the lymph node regions were contoured on transversal CT slices. The probability for involvement was reviewed and a recommendation for the delineation of the CTV was generated.","title":"Guidelines for delineation of lymphatic clinical target volumes for high conformal radiotherapy: head and neck region"}
{"_id":"d5ea909c-68d2-b818-29ad-5dc72c4c1125","text":"In conclusion, we found that nuclear localization of β-catenin correlated with the CTNNB1 gene mutation status in DF, and DF demonstrated different clinicopathological features based on the mutations they harbour. We newly identified a patient harbouring both T41A and S45F mutations in his tumour. We demonstrated that CTNNB1 mutation correlates with nuclear β-catenin expression in larger or excised DF tumours, therefore caution is advised in the interpretation of the immunohistochemical and mutation data when derived from biopsied samples or small tumours.","title":"Clinicopathological features of 70 desmoid-type fibromatoses confirmed by β-catenin immunohistochemical staining and CTNNB1 mutation analysis"}
{"_id":"d5ec81ff-2f23-a6c7-46ba-f28ed0f66d95","text":"Current evidence supports the use of mechanical prophylaxis of venous thromboembolism with intermittent pneumatic compression and graduated compression stockings.[ Timing and duration of mechanical prophylaxis is critical, which should be started as early as possible preoperatively and continued until discharge to ensure maximal benefits. On the other hand, the benefits of chemoprophylaxis in reducing venous thromboembolism rates should be cautiously weighed against the increased risk of major bleeding.[ The most recent systematic review concluded that chemoprophylaxis is effective and safe in patients undergoing elective cranial or spinal surgery without increasing major or minor bleeding events.[ Yet, the robustness of the conclusion for the elderly subpopulation and the optimal time of chemoprophylaxis remain unvalidated and warrant further investigation. Owing to safety concerns, patients in China are instructed and monitored to receive mechanical prophylaxis starting from admission until discharge.","title":"Neurosurgical enhanced recovery after surgery ERAS for geriatric patients undergoing elective craniotomy: A review"}
{"_id":"d5fd2d50-2f5d-e346-bdd1-b6144d36f598","text":"Each author certifies that his or her institution approved the reporting of this case report and that all investigations were conducted in conformity with ethical principles of research.","title":"Hemi-tibia allograft and free microvascularized fibula transplant reconstitute the tibia shaft with side to side healing: 7 year follow up of a 14-year-old boy with adamantinoma"}
{"_id":"d5fd3640-5466-5f11-a54d-71af2b6334a4","text":"A major difference in our report compared with the study by Weinberg and colleagues is our definition of when RBCs become 'old'. The different methods of defining old RBCs used in various studies have made comparing results problematic. Previous definitions have included mean, median, and maximum RBC storage age in addition to the number of RBCs transfused above 14 and 21 days of age [25-27,32,41]. The change from the use of non-prestorage leukocyte reduced RBCs to the transfusion of prestorage leukocyte reduced RBCs has also made it difficult to determine the optimal definition of old RBCs. Independent associations with the amount of non-prestorage leukocyte reduced RBCs more than 14 and 21 days old have been reported with sepsis [27]. The mean RBC storage age and the amount of non-prestorage leukocyte reduced RBCs of more than 14 and 21 days old have also been associated with increased MOF [26]. Optimally when comparing the effect of RBC storage age on outcomes the definition of fresh and old RBCs should not allow for mixing of RBC storage age between groups as was done in the study by Koch and colleagues [41]. In this study of more than 6000 patients, the fresh RBC group was defined as those who were only transfused RBCs of 14 days of storage or less and the old RBC group received only RBCs of greater than 14 days of storage. In smaller retrospective studies that are not large enough to have complete separation of fresh and old RBCs, it is more appropriate to use the maximum RBC age transfused than mean RBC age to define if the patient received fresh or old blood. This is because the adverse effects of RBCs have been measured with relatively small amounts transfused [10,32,41]. When mean RBC age is used to define patients who received fresh or old RBCs this method allows for the youngest RBCs to balance out or negate the contribution of storage age from the oldest unit transfused. For example a patient who receives 2 units at 40 days old and 8 units at 10 days old will have a mean of 16 days whereas for a patient who receives 10 units at 16 days of storage the mean will be 16 days. The patient transfused 2 units at 40 days would theoretically be at increased risk but using the mean RBC age to define fresh vs old RBC patient groups does not identify this difference whereas using maximum RBC age does.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"d5fe0c91-7f87-3b0e-fc49-89b00d866900","text":"Specialisation in spinal services has lead to a low threshold for referral of cervical spine injuries from district general hospitals. We aim to assess the capability of a district general hospital in providing the halo vest device and the expertise available in applying the device for unstable cervical spine injuries prior to transfer to a referral centre.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"d60207de-81ee-8fd6-0e83-1c0a1c574d21","text":"An informed consent for publication of personal and medical data was obtained from the patient.","title":"Ultrasound guided lipofilling as a suggested method for implant salvage in implant based breast reconstruction: A case report"}
{"_id":"d6065356-cb09-7407-12c9-b3f071fae062","text":"Split thickness skin grafting remains a promising option for patients with stable recalcitrant vitiligo.","title":"Split Thickness Skin Grafting in Patients with Stable Vitiligo"}
{"_id":"d607fe80-104b-6c44-b9b6-0f4b1fce6819","text":"To analyze the patterns of locoregional recurrence in breast cancer patients after mastectomy.","title":"Locoregional recurrence patterns in women with breast cancer who have not undergone post-mastectomy radiotherapy"}
{"_id":"d60aab9e-a7b2-8209-3b86-1977412923d8","text":"We would like to objectify the gaseous changes within the free flap during the dangling protocol in a select group of patients.","title":"Is dangling of the lower leg after a free flap reconstruction necessary? Study protocol for a large multicenter randomized controlled study"}
{"_id":"d61073a6-d5b7-f432-3245-cb7e05c7a6cf","text":"Iterative discussions between staff in two NHS Trusts using the BTAT since 2016 have helped to refine the cut off recommendations for frenotomy. The collective experience of these midwives, infant feeding specialists, paediatricians, ENT surgeons and breastfeeding experts using the BTAT and more recently the TABBY tool to assess over 2000 babies suggests that a score of:","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"d61180eb-27f1-b9f2-16e7-0e7ebffe7fa1","text":"Six patients had an infection of the midfoot with ulceration. Four of these patients had a metatarsal osteomyelitis. Charcot neuroarthropathy was not present in these six patients. All six patients were treated by sequestrectomy and ulcerectomy. One patient was treated with Hyalomatrix. After one year all six skin and soft tissue ulcers were healed. Two healed between one and two months after surgery and three between three and six months after surgery. In one case wound healing occurred at about 10 months. Microbiology of intraoperative samples confirmed bacterial infection in all cases. External or internal stabilization was not necessary in this patient subgroup.","title":"Multidisciplinary Approach for the Management and Treatment of Diabetic Foot Infections with a Resorbable, Gentamicin-Loaded Bone Graft Substitute"}
{"_id":"d6171a8a-ff45-6fc9-54b5-444c4e022220","text":"The purpose of this study is to determine the feasibility of conducting a future main trial, specifically whether it will be possible to recruit and randomise 200 patients undergoing IBBR and to collect the required data for the main trial.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"d6175a2c-9c64-d81d-a6a3-57c6595c83d7","text":"However, some patients experienced rare side-effects that sometimes were fatal. The early adoption of Comirnaty as frequently associated with reports of anaphylaxis type reactions and some safety concerns were raised, resulting in some recommendations for increased monitoring of patients after receiving the injection and even avoiding Comirnaty in those with a history of allergic reactions. These measures substantially reduced the rates of serious adverse events.","title":"An Update on COVID-19 Vaccine Induced Thrombotic Thrombocytopenia Syndrome and Some Management Recommendations"}
{"_id":"d61bbc46-c2af-a6d2-6b2b-9ecac3e08b78","text":"The Italian experiences exhibits the typical features and shortcoming of not controlled study but the findings reported here confirm those previously obtained by other authors.2829 The results of the studies suggest that an early instrumental diagnosis at the onset of the disorder and the immediate use of PEMFs enables better clinical results. The authors observed that the lesions in early stage respond well to treatment with PEMFs and, in the majority of cases, as far as Ficat II, are capable of preventing the progression of the disease. Ficat stage -III does not constitute a real indication for this treatment and must always be carefully assessed, the treatment eventually being advised for the younger patients. Idiopathic lesions seem more sensitive to PEMF therapy as compared with secondary forms, because the therapies responsible of the disease cannot be interrupted. The weight bearing does not influence the evolution of lesion. This observation is unexpected, but it has also been highlighted in other studies. The relief from pain accompanied by recovery of the joint function is important, as observed in the majority of the patients within 45 days from beginning of treatment. It is likely that this effect is mediated by the antiinflammatory action of the PEMFs that enables resolution of the joint edema. With regard to this, both authors concluded that in the presence of avascular necrosis of the femoral head we can distinguish two different aspects: one concerning the cartilage and one concerning the subchondral bone tissue.","title":"Biophysical stimulation in osteonecrosis of the femoral head"}
{"_id":"d61ff784-8fe7-1024-15a9-5283fde191e2","text":"There is an overall low prevalence of fellowship training and secondary board certification among EM residency leadership, with the most common being medical toxicology. However, the assistant PDs, who averaged the shortest length of time in leadership experience, had the highest percentage of additional fellowship training. This indicates a possible trend toward additional postgraduate training among residency leadership. There may be a regional variation with the Western region exhibiting the highest percentage of fellowship and secondary board certifications across all levels of residency leadership.","title":"Demographics and Fellowship Training of Residency Leadership in EM: A Descriptive Analysis"}
{"_id":"d623b885-379c-f4d4-aab4-4f8ab0718178","text":"Now that it has been shown that clinically silent perioperative VTE-L is not uncommon in CD despite pharmacological thromboprophylaxis, further large-scale compression ultrasound screening studies are needed to determine the risk of progression to symptomatic venous thromboembolic events in these patients. With the help of this important clinical information and by including further parameters such as the comprehensive coagulation status and the above-mentioned thrombosis risk score developed specifically for CS patients by Zilio et al., it may be possible in the future to better implement medical thromboprophylaxis tailored to the individual risk of the respective CD patient. However, as long as the benefit of ultrasound thrombosis screening has not been proven in prospective clinical studies, no general recommendation can be made in this regard.","title":"Prevalence of perioperative asymptomatic venous thromboses of the lower extremity in 30 consecutive patients undergoing transsphenoidal surgery for Cushing’s disease"}
{"_id":"d6260ae8-13a1-9d7e-2882-ade37a70b50d","text":"The a cellular matrix may persist as a mass even if the cells are killed. Reduction in tumor size after radiation therapy may not occur.","title":"Huge Facial Desmoid Tumors with Neck Extension: A Case Report"}
{"_id":"d62d3a77-0124-065a-2d66-9ff497cdfff0","text":"The goal of this work is to explore the utility of this artificial dermis as a successful tool for postoncological reconstruction of wide and deep facial and scalp wounds, especially in older patients, that could not tolerate complex reconstructive procedures in general anesthesia, or need adjuvant radiotherapy, analyzing the overall morbidity of the surgical technique and aesthetic outcomes.","title":"Utility of a New Artificial Dermis as a Successful Tool in Face and Scalp Reconstruction for Skin Cancer: Analysis of the Efficacy, Safety, and Aesthetic Outcomes"}
{"_id":"d6363c0a-e8b3-cdc1-396a-a5fe2b1e9dad","text":"The anesthesiologist who performed the LPBs and SNBs was strictly blinded to the patient’s group assignment before the procedure. Only when the anesthesiologist commenced with the block was a prepared sealed opaque envelope containing the patient’s group assignment opened. Then the anesthesiologist completed the block with the indicated technique. There were two investigators in the study. One investigator blinded to the technique used was present in the block area to assess the procedure-related outcomes. To ensure blindness of the patient to the method, all procedures performed behind an opaque screen and investigators were required not to say anything about the technique in use. Another investigator assessing the block quality was blinded to the group allocation and remained outside the block area until completion of the procedure. Finally, a statistician blinded to the entire process performed the statistical analysis, with group data labelled only as numbers until all analyses were completed.","title":"Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial"}
{"_id":"d63f2d0c-4e7b-d072-d5aa-9a288686bbdf","text":"In this study, we present our experience with free and pedicled flaps in the reconstruction of soft tissue and bone sarcomas over a 5-year period at a tertiary referral university hospital and sarcoma center.","title":"Flap Reconstruction Outcome Following Surgical Resection of Soft Tissue and Bone Sarcoma in the Setting of (Neo)adjuvant Therapy: A Sarcoma Center Experience"}
{"_id":"d645025c-efe0-98a7-618d-47cbe94b6a99","text":"Maternal mortality and morbidity were significantly reduced by using neuroaxial blocks in obstetric anesthesia. Spinal anesthesia is a frequently used technique since it creates a quick deep sensory and motor block through the injection of a low dose of local anesthetic to the subarachnoid space. In recent years, it has become known that the use of ultrasound in regional anesthesia increases block success and decreases complications. Ultrasound enables accurate estimation of the depth required to reach the intrathecal space.","title":"Ultrasound-guided evaluation of the lumbar subarachnoid space in lateral and sitting positions in pregnant patients to receive elective cesarean operation"}
{"_id":"d64858d5-ef25-0366-a2bc-c289254ff01b","text":"This frustration prompted Interviewee 7 to leave their current posts and seek personal development opportunities elsewhere in order to find a fulfilling role:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"d648bd69-7207-508f-6543-bca961918df5","text":"These venous factors may be crucial for the success of free flap reconstruction of traumatic lower extremity injuries. Therefore, this study aims to investigate factors contributing to microvascular complications in lower extremity Gustilo type IIIB\/IIIC injuries reconstructed by free flap with a focus on the three venous factors mentioned above.","title":"Analysis of Anastomotic Venous Factors in Traumatic Lower Extremity Injuries Reconstructed by Free Flap"}
{"_id":"d64d5435-efdc-bd40-1a10-1b2ed88c40d7","text":"Compared with standard surgical excision and EDC, cryosurgery is associated with minimal post-procedural morbidity and typically has excellent aesthetic outcomes. Although rare, patients have reported neuropathic pain, hypertrophic scarring, and depigmentation after undergoing cryosurgery.35 When treating superficial, low-risk non-melanoma skin cancers, cryosurgery has a 5-year recurrence rate, ranging from 1% to 5%.36–38 While effective at treating superficial, low-risk malignancies, cryosurgery is more often used to treat actinic keratoses—a premalignant lesion associated with squamous cell carcinoma. Cryosurgery is highly effective for the treatment of actinic keratoses, with clearance rates reaching 99%.39","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"d6507e1e-e95b-7f25-428a-f2f6c2baaef7","text":"A comprehensive search strategy will be developed in collaboration with a research librarian and will aim to capture all relevant articles relating to the review question. Both MeSH term and free-text search strategies will be developed using the keywords described in Table 1, combined using Boolean operators. The search strategy will be applied to the MEDLINE and Embase databases with the time period from database inception to 1 October 2018. In addition, a search of ClinicalTrials.gov will be performed to make sure that no relevant studies were missed.","title":"Protocol for a systematic review of venous coupler devices versus hand-sewn anastomosis for microsurgical free flap reconstruction"}
{"_id":"d65243e1-c448-d8cb-4926-5630adc3b199","text":"Physicians entering into leadership roles may also be informed by these findings. If physicians are aware of the factors that may limit or enhance how they enact their role as a leader, they may be better prepared to deal with the challenges. The basic realization that they may struggle with the acceptance of the secondary identity as a leader may alone be enough to encourage them to explore options to overcome the limitations to acceptance of that role.","title":"The affect of vision and compassion upon role factors in physician leadership"}
{"_id":"d6539b6f-4101-8859-0980-d86f1b315369","text":"All except one (105 patients) of the remaining patients who did not develop DVT were interviewed via telephone about the DVT symptom 30 days after the operation with no symptoms of DVT. One patient who could not be contacted was diagnosed with cervical cancer stage IA2 and underwent radical hysterectomy and pelvic lymphadenectomy with bilateral salpingo-oophorectomy. She was lost to follow up.","title":"Prevalence and risk factor of post-operative lower extremities deep vein thrombosis in patients undergoing gynecologic surgery: a single-institute cross-sectional study"}
{"_id":"d6545856-a300-9842-122e-b5bc06b88089","text":"Given the diffuse though well-defined heterogeneous signal abnormalities asymmetric within the tibial shaft, initial diagnostic consideration included osteomyelitis v s infiltrative or hematological malignancy vs systemic marrow process. The identification of a transcortical tract with expulsion of marrow fat to the extraosseous soft tissues, however, is considered a highly specific finding in acute osteomyelitis effectively narrowing the differential to a single diagnosis and preventing an unnecessary biopsy to exclude malignancy.","title":"Extraosseous marrow fat: an MRI sign of acute aggressive osteomyelitis"}
{"_id":"d65af24e-84b5-74c8-ccb6-99363c8d823b","text":"Very comminuted anterior injuries that require significant soft tissue dissection and potentially sub optimal fixation with open reduction and internal fixation can be treated with anterior external fixation. Some centres would advocate the usage of the in-fix system for these injuries [18, 19]. There may be a role for this technique in obese patients however we have found supra acetabular anterior ex-fixs to be durable and patients with type B pelvic fractures can still be allowed to WBAT. The use of anterior external fixation when the pelvic fracture is found in conjunction with a bladder injury also remains a reliable choice to reduce the risk of infection.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"d65dfc9c-2eab-79b1-c65d-383a754c413f","text":"Our data shows doing so would safely avoid a significant number of ALNDs.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"d660338a-65a2-e2aa-8b91-1d033c5563ee","text":"Quantification of intra-epidermal nerve fibre density is the most important advance in SFN diagnostics over the last decade,5 33 and is probably the most validated technique to diagnose SFN. A skin punch biopsy 3 mm in diameter can be taken from any location on the body, but is typically taken 10 cm proximal to the lateral malleolus for diagnostic purposes in SFN.34 An additional frequently-used biopsy site is the proximal thigh 20 cm below the iliac spine, which in combination with the distal biopsy can help differentiate between a neuropathy and a neuronopathy.35 An alternative method to the punch biopsy is to take a sample of tissue via the skin blister technique.36 A potential benefit is that no topical anaesthesia is needed, and bleeding is minimal. Although values correlate with those from punch biopsy, additional studies are needed to establish normative values and the skin blister technique's reliability in the diagnosis of SFN.37 Skin punch biopsy of the distal leg is very well tolerated with a very low complication rate12 and can be performed in almost all patients apart from those with local skin abnormalities.","title":"The clinical approach to small fibre neuropathy and painful channelopathy"}
{"_id":"d660ce02-78db-d51f-4ab5-67d8f723b5d5","text":"In both cases the RC was involved with severe pain and functional impairment that required an arthroscopic second look to ascertain the origin and the characteristics of the mass.","title":"Ossifying tendinitis of the rotator cuff after arthroscopic excision of calcium deposits: report of two cases and literature review"}
{"_id":"d6671607-e663-ae7b-3dd8-be3d4a9b98de","text":"However, the lack of established safety standards does highlight one of the drawbacks of non-pharmacological methods of biofilm treatment–therefore, testing to ensure the safety and integrity of nearby tissue and bone is paramount to ensuring the proper utilization of these various approaches. While a certain threshold of energy must be reached to cause a significant antimicrobial effect, dependent on the mechanism of action of the method, this must be balanced against preventing damage to local tissue and may require some element of safety monitoring to ensure the proper operation of the device or method. Most studies have only observed these effects in vitro, and while some have conducted in vivo observation of local toxicities, making the jump to clinical application will require further investigation to assess both short and long term safety effects.","title":"Physical Approaches to Prevent and Treat Bacterial Biofilm"}
{"_id":"d671bf7b-0eb1-44db-21bf-c084fa075caa","text":"In this small pilot study, we observed very poor reproducibility in SLN detection in patients with oesophageal cancer before and after nCRT. We conclude that nCRT may have a clinically relevant impact on lymphatic drainage in the vast majority of these patients. We suggest that this may negatively influence the accuracy of a SLNB procedure in the same way as demonstrated in other cancer forms.","title":"“Sentinel lymph node imaging with sequential SPECT\/CT lymphoscintigraphy before and after neoadjuvant chemoradiotherapy in patients with cancer of the oesophagus or gastro-oesophageal junction – a pilot study”"}
{"_id":"d671f44d-07ed-71b5-2b31-bd9eaf314666","text":"Surgical treatment is the gold standard of care for vulvar cancer and is burdened by a high risk of wound complications due to the poor healing typical of the female genital area. Moreover, this malignancy has a high risk of local relapse even after wide excision. For these reasons, secondary reconstruction of the vulvoperineal area is a relevant and challenging scenario for gynecologists and plastic surgeons. The presence of tissue already operated on and undermined, scars, incisions, the possibility of previous radiation therapy, contamination of urinary and fecal pathogens in the dehiscent wound or ulcerated tumor, and the unavailability of some flaps employed during the primary procedure are typical complexities of this surgery. Due to the rarity of this tumor, a rational approach to secondary reconstruction has never been proposed in the literature.","title":"Secondary post-oncologic vulvar reconstruction – a simplified algorithm"}
{"_id":"d678fdbf-3e3c-f65d-8d77-3afa821ed13b","text":"Clinically, patients with unexplained fever should be carefully examined and closely monitored regarding any change with lymph nodes. If no improvement is observed in a week or so after the treatment with antibiotics, medical professionals should consider the possibility of KFD by conducting a lymph node biopsy to determine pathological features. Once KFD is confirmed and malignant lymphoma or other lymphatic diseases (such as TbL or CSD) are ruled out, appropriate steps are taken to facilitate the relief of the symptoms.","title":"Kikuchi-Fujimoto disease: a case report and the evaluation of diagnostic procedures"}
{"_id":"d6806e15-1a43-f7ec-8d3d-d11a3578dbea","text":"After resection was performed with 1 cm skin margins, down and including the temporal fascia, the clear anterior skin surface of the upper pole of the ear was freed by its internal cartilaginous skeleton. The obtained fillet flap of the homolateral upper ear pole was raised and reflected posteriorly to cover the wound completely or partially. When needed, a split skin graft was added to the reconstruction.","title":"Fillet of pinna flap in scalp reconstruction"}
{"_id":"d6816607-e84c-7057-5c4e-55306e49925a","text":"The accurate diagnosis of calcinosis cutis was confirmed by postoperative histopathological examination with many local calcifications and multinucleated giant cells in subcutaneous tissue.","title":"Idiopathic calcinosis cutis of the buttocks: A case report and review of the literature"}
{"_id":"d682cc6a-dcb8-943c-c335-a88ab852acc8","text":"Lining for full-thickness alar or unilateral tip defects that had a vertical dimension (caudal to cephalic) of 1.0 cm or less can be provided using the thin skin lining the remaining nasal vestibule.3 Defects with vertical dimensions as large as 1.5 cm may sometimes be lined using this method if the remaining skin of the interior of the lower nasal vault is of sufficient size.3 Bipedicle vestibular skin advancement flaps are insufficient to line fullthickness defects of the unilateral tip or ala that measure more than 1.5 cm in vertical height. There was insufficient skin between the defect margin and the necessary intercartilaginous incision made at the junction of the upper lateral cartilage and the alar cartilage. In these circumstances, an ipsilateral septal mucoperichondrial flap hinged on the caudal border of the cartilaginous septum can provide adequate mucosa to reline the entire interior of the ala and nasal dome.3 Basing the flap on the entire vertical height of the caudal septum rather than on a narrower, 1.5-cm-wide pedicle adjacent to the nasal spine as advocated by Burget and Menick4 served to support the flap and stabilize the pedicle, thus preventing torsion that may compromise the vascular supply to the flap. However, construction of the pedicle of the flap in this manner requires that the flap spans the distance from the caudal septum to the lateral aspect of the lining defect. This means the flap will, in part or completely, obstruct the nasal passage until it is detached from the septum. Considering this flap as an option for bilateral nasal lining means that total nasal blockage for a period of up to 3 weeks, which would mean significant discomfort to the patient. A muco-perichondrium hinge flap and septal composite chondromucosal pivotal flap have also been described for nasal lining reconstruction, but for limited mucosal defects.5 The middle and inferior turbinates have been described to line limited mucosal defects of the nose. These turbinates are richly supplied by a vascular network arising from a lateral descending branch of the sphenopalatine artery.5","title":"Complex Nasal and Periorbital Reconstruction Using Locoregional Flaps: A Case Report"}
{"_id":"d686dd77-3cd5-17cc-e792-383c9d62b990","text":"Norwegian trauma-patients will be met by trauma team members that find experienced leaders as one of the key factors to successful trauma treatment. The team might still be led by a resident who seeks experience in the team around him. It seems necessary to explore the needs for training and education of team leaders. Better qualified and more confident team leaders might enhance the teams' performance. This should be confirmed by further studies.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"d68c5916-4a54-bdc9-3424-5834d3932786","text":"Musculoskeletal sarcomas with involvement of major blood vessels are not a deterrent to limb-salvage surgery, vascular reconstruction combined with oncological surgery is feasible to provide a favorable limb function and improved life quality of patients. When vascular reconstruction surgery is performed, the synthetic substitute is an alternative option with accepted outcomes in terms of postoperative complications and rate of limb salvage.","title":"Clinical outcomes after vascular reconstruction using synthetic grafts for limb salvage in patients with lower extremity sarcoma: a single-center retrospective experience"}
{"_id":"d68fec90-baf7-6ca2-9a2c-a834edb49bf5","text":"Oral lesions with aggressive growth patterns, multiple lymphadenopathies and comorbid systemic skin lesions, elevated serum LDH, and poor response to medical therapies should warn the doctors of the possibility of malignancy and the necessity of biopsy. Excisional biopsy without sacrificing organs or functions should be preserved for patients whose pathological diagnoses cannot be established through aspiration or punch biopsy.","title":"Oral and maxillofacial non-Hodgkin lymphomas Case report with review of literature"}
{"_id":"d69d5a8b-01ed-8485-9232-3c5cbc50a792","text":"When possible, the most widely used method for the treatment of desmoid tumors has been gross resection. Chemotherapy, radiotherapy, and local excision are also used in the treatment of fibromatoses when complete resection is judged infeasible.","title":"Total Resection of Pediatric Desmoid Tumor of the Left Neck with Utilization of 3D Virtual Surgical Planning"}
{"_id":"d6a98f10-55f0-c29e-a8a1-d13de35d221e","text":"A278 Immunological Changes Induced By Intramuscular Injections of Autolologous Immunoglobulin in Patients with Severe Atopic Dermatitis","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"d6b0f1c8-e9a3-c214-8881-466bd7093fd1","text":"The construction of an educational model in plastic surgery was deemed crucial to be aligned with the undergraduate curriculum. The goals were to maximise exposure and help make informed career choices for those interested in pursuing a career in plastic surgery [8].","title":"Plastic Surgery Inclusion in the Undergraduate Medical Curriculum: Perception, Challenges, and Career Choice—A Comparative Study"}
{"_id":"d6b186da-cad0-a64c-f581-06be12c8a02e","text":"The aim of this review was to analyse the concomitant use of bone and soft tissue approaches for patients diagnosed with calcaneal osteomyelitis.","title":"Surgical Treatment and Outcomes of Calcaneal Osteomyelitis in Adults: A Systematic Review"}
{"_id":"d6b83fc6-0f25-3721-55c7-6d69981a2ef5","text":"With regards to reflection, various participants described situations where they had thought back to times when they had displayed ideal or poor leadership. This reflective process allowed them to further develop themselves as leaders. Students described journaling or keeping a professional portfolio as one method for inducing reflection.","title":"Exploring medical students’ perspectives of physician leadership"}
{"_id":"d6bb6511-bc4c-ff41-bf45-ca24b2bdeebe","text":"It is unclear which imaging modality is superior for patients with superficial soft tissue infections. CT provides excellent detail of soft tissue and is available in most hospitals in the United States but requires ionizing radiation which can be more difficult to obtain and usually involves intravenous contrast [4]. US is commonly available and provides detailed imaging of superficial structures without radiation or contrast agents. US is becoming a common initial imaging test for suspected skin abscesses, but the relative merits of US compared to CT have not been explored [5]. We compared the diagnostic accuracy of CT and US in patients with skin and soft tissue infections.","title":"Comparison of computerized tomography and ultrasound for diagnosing soft tissue abscesses"}
{"_id":"d6ceeee7-3541-b839-6a53-76b463054aab","text":"How long after completing their graduate medical training do physicians develop financial relationships with the pharmaceutical and medical device industries?","title":"Trends in Industry Payments to Physicians in the First 6 Years After Graduate Medical Training Industry Payments to Physicians in the First 6 Years After Graduate Medical Training"}
{"_id":"d6d3b67c-d78e-2ca3-c976-7c33044dfd01","text":"Although early warm massage may promote vasodilation, local heating will also increase the metabolic rate of tissue, thus reducing the ischemic tolerance of tissue. Therefore, some clinical studies have adopted the method of warm massage during the first 30 min after hyaluronidase injection (the specific temperature is unknown), followed by local cooling with a gauze pad soaked with antibiotic saline solution. Hypothermia slowed the blood flow and increased the resistance of the microvasculature; however, it did not affect the blood reserve capacity and vascular endothelial function. This treatment achieved good therapeutic effects. Although the types of fillers were different, our study confirmed that a warm compress will contribute to the recovery of intravascular embolism and improve the prognosis compared with a cold compress and no compress. The cold compress seems to have effects similar to those of the warm compress in regard to the thrombus type and hematoma occurrence. The pathological results showed that although a cold compress cannot promote vascular recanalization, it can reduce the white thrombus formed by a large number of PMMA microspheres. These results can indicate whether it is possible to further promote treatment with a warm compress combined with a cold compress; however, further reseach is necessary for confirmation.","title":"Early warm compress treatment can promote recanalization of vascular embolisms and reduce tissue necrosis after polymethyl methacrylate injection"}
{"_id":"d6dbefde-7191-50cb-f289-b7e7fe18e40d","text":"The treatment method of interstitial brachytherapy is considered as an effective and safe tool by reducing the side effects of radiotherapy and increasing the radiation dose of radiotherapy.","title":"The occurrence and development of radiation-induced lung injury after interstitial brachytherapy and stereotactic radiotherapy in SD rats"}
{"_id":"d6e00bb1-267f-e19b-13ba-cb5ffdb587da","text":"Minimizing the risk of permanent dysfunction of the facial nerve is a significant clinical problem. Intraoperative nerve function monitoring and advanced neuromonitoring devices have been introduced to support surgeons during the procedure. Currently, intraoperative monitoring of the facial nerve is performed using electromyography based on the recording of the compound muscle action potential (CMAP) from facial muscles. The CMAP occurs in response to electrical stimulation of the facial nerve with a probe or (even accidental) mechanical irritation of the nerve during tumor dissection from the gland. This method is widely used by head and neck surgeons, allowing intraoperative identification of the extracranial portion of the facial nerve that runs through the parotid gland parenchyma and minimizing the risk of damage.","title":"Prospective Assessment of Intraoperative Facial Nerve Monitoring in Patients Undergoing Partial Parotidectomy"}
{"_id":"d6e74f77-4d97-389b-4a30-8fec8dac5163","text":"This paper presents a technique of using rib cartilage grafts for nose and midface augmentation in a series of patients.","title":"Nose and Midface Augmentation by Rib Cartilage Grafts: Methods and Outcome in 32 Cases"}
{"_id":"d6ec3e9e-b054-4dd9-1677-e07a4c94f158","text":"Despite the existence of clinical recommendations, we found notable across-country differences in Europe in the completeness of PR for cutaneous melanoma, as well as in the use of SLNB. The odds of receiving a complete PR or undergoing SLNB was higher for patients treated in specialized oncologic centers than in general hospitals. Multivariable analysis adjusting for potential confounders suggested that a complete pathological report and SLNB were associated with survival benefit. Narrowing down the differences between countries by adherence to guidelines is important for achieving more favorable outcomes.","title":"Association of Sentinel Node Biopsy and Pathological Report Completeness with Survival Benefit for Cutaneous Melanoma and Factors Influencing Their Different Uses in European Populations"}
{"_id":"d6f75097-6da4-edf2-36cb-1ca8b20dc9a2","text":"A wide local excision of the lesion along with selective level II lymph node dissection under general anesthesia was performed. Circumferential skin incision was made around swelling taking 1cm margin all around. Incision was extended inferiorly along neck for around 5cms (Figure 3A). Intraoperatively, swelling was centered in the area between mastoid process and posterior margin of mandible and firmly adhered to the underlying deep fascia covering sternocleidomastoid muscle and posterior part of the parotid gland. Multiple enlarged lymph nodes of size 2x2cm to 1x1cm were found over right level II region. Lesion was separated from underlying sternocleidomastoid muscle along with deep fascia. Inferior part of the tumor was adhered to the parotid tissue close to marginal mandibular nerve. Facial nerve trunk was identified and marginal mandibular branch was carefully separated from tumor and preserved. Around 2cm margin of the normal parotid tissue was resected along with the lesion, preserving the inferior branches of the facial nerve. Inferiorly the lesion was found adhered to level II enlarged nodes which were dissected and removed in continuity with the lesion. An oriented specimen is sent for HPR (Figure 3 A, B and C).","title":"Recurrent Eccrine Acrospiroma of the Parotid Region: A Case Report"}
{"_id":"d6fe7eac-1f7b-b9c9-7895-93e0c3903ed8","text":"We performed a retrospective analysis of 21 patients who underwent treatment with topical imiquimod for residual MIS after initial wide local resection of primary melanoma or MIS lesions. We hypothesized that topical imiquimod therapy alone would effectively treat MIS in this setting and clear histologic margins.","title":"Using topical imiquimod for the management of positive in situ margins after melanoma resection"}
{"_id":"d70691e3-4055-c747-35f2-c83f2a957751","text":"The referring surgeon was informed about the completion of the procedure immediately after image processing and visualization of the SLN and all related planar and SPECT-CT images were shared through personal contacts beforehand so that early preparations for the frozen section are made. A formal written report was ready 30 minutes after study completion and it was made available for patients for collection at a suitable time. Strong communication between the nuclear medicine department and specified surgical facility with an active communication medium is required to make lymphoscintigraphy mapping and conservative axillary nodal clearance successful.","title":"Sentinel Lymph Node Mapping in Breast Cancer: Initial Experience of a Multidisciplinary Team"}
{"_id":"d70e7c97-1262-bbf3-171e-1c908292526d","text":"Crucial issues when considering decisions regarding VTE prevention include the starting time and duration of pharmacological thromboprophylaxis. Understanding the timing of postoperative events is therefore necessary. Owing to limitations in the available data, prominent guidelines on thromboprophylaxis have been unable to provide consistent and actionable guidance on the timing of initiation and duration of thromboprophylaxis. The absence of clear guidance contributes to substantial practice variation within and between centres and countries.","title":"Timing of symptomatic venous thromboembolism after surgery: meta-analysis"}
{"_id":"d716a576-c284-c3bd-fb79-af4ebe9df0ce","text":"Despite antibiotic therapy, minimal improvement was observed in the patient's symptoms, and she remained unable to put notable load through her right hip. An MRI was repeated 9 days after admission and showed progression of the right acetabular osteomyelitis with two areas suggestive of necrosis near the junction of the pubis and ilium. There was an increase in the size of the joint effusion and demonstration of breach in the cortex and cartilage with intraarticular progression. The orthopaedic surgery service was then consulted urgently.","title":"Pediatric Acetabular Osteomyelitis Treated With Hip Arthroscopy"}
{"_id":"d718c3bc-e5ed-ab4a-4250-fb0a1f923a31","text":"This was followed by multivariate analysis of factors associated with DVT incidence. All variables with a p value of less than 0.1 in bivariate analysis were included in the multiple logistic regression model. Bivariate analysis was also performed to describe chemoprophylaxis use relative to postoperative bleeding complications and PROM.","title":"Short-duration chemoprophylaxis might reduce incidence of deep vein thrombosis in Asian patients undergoing total knee arthroplasty"}
{"_id":"d71fd1c7-2dd4-26c9-0b93-de773f64665e","text":"In recent times, negative pressure wound therapy (NPWT) has gained popularity as an adjunct to temporize a wound and allow repeated debridement and staged closure. A major perceived advantage is that soft tissue coverage can be delayed until the wound is no longer infected. However, the evidence suggests that delay with NPWT risks superinfection 45 and skin flora microorganisms can migrate into the wound and adhere to internal fixation material, leading to nonunion or recurrent infection. 46 Furthermore, this approach leads to multiple unnecessary operations and cost. Our experience of 76 single-stage reconstruction for lower limb OM with a flap survival rate of 96% and 1-year infection-free rate of 90% demonstrates that single-stage reconstruction can reliably eradicate infection in most patients. 47 The four cases that experienced flap failure were successfully reconstructed with a subsequent flap.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"d7226057-32a4-5d7f-c799-0c8b8d9da4ad","text":"The patient and her parents were asked about any history of trauma. They reported that the patient had suffered a fall in childhood, which could have generated ankylosis of the right upper central incisor.","title":"Orthodontic Treatment of Ankylosed Maxillary Incisor through Osteogenic Distraction and Simplified Biomechanics"}
{"_id":"d72935bb-419a-601c-d156-1c50d962d003","text":"We found that iris atrophy could be caused by autologous fat transplantation. The plastic surgeons should pay more attention to possibility of fat embolism-induced ocular complications in the procedure of fat injection.","title":"Segmental ischaemic infarction of the iris after autologous fat injection into the lower eyelid tissue: a case report"}
{"_id":"d731e1bc-1f98-f1f8-ab36-b3e8143f4df0","text":"The operator will be required to sterilize his or her hands using a sanitizer and wear sterile gloves and mask before the TEA and STEA procedures. For the acupuncture procedures, the operator will be required to sterilize his or her hands with a sanitizer before operation.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"d735f6be-27bf-520e-efa2-5aded6c5f741","text":"Facet joint can be also a source of pain if degenerative changes are present and shows increased uptake on bone scan.","title":"SPECT\/CT bone scintigraphy to evaluate low back pain in young athletes: common and uncommon etiologies"}
{"_id":"d73e3f7b-567e-2f2f-c4e5-4b0c805885e8","text":"The presented study analyzed the largest series of microsurgical DIEP breast reconstructions in Europe, with regard to the timing of reconstruction. The data show that IBR is feasible and cannot be considered a risk factor for complications or flap outcome. Our results support the current trend towards increasing numbers of IBR. Especially in times of economic pressure in health care, the decrease in hospitalization associated with IBR cannot be overemphasized.","title":"Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study"}
{"_id":"d73eeb45-0963-b99c-5c30-7db58b0130c0","text":"Table 1 Surgical operation types and pattern of antibiotic prophylactic use in the study","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"d7435f70-b381-50aa-18e1-b703edbc1438","text":"As also stated in the article by Houssami et al there can be several reasons for the lower sensitivity among breast cancer survivors compared to women without previous breast cancer diagnoses. Breast cancer survivors might have a larger risk of getting breast cancers that are less likely to be detected with mammography screening. Secondly, breast cancer survivors might be more aware and seek help promptly when experiencing breast symptoms and thirdly some interval cancers may be due to adjunct follow‐up occurring in between mammography screenings. Our study showed that breast cancer survivors have 30%‐40% less of their breast cancers detected at screening mammography compared to women without previous breast cancer diagnoses. This was similar both for women who had a diagnostic breast imaging 0‐21 months prior to mammography screening as well as among those who did not have such an examination. It therefore does not seem likely that the difference between breast cancer survivors and women without previous breast cancer diagnoses can be explained by whether or not they had adjunct follow‐up in between mammography screenings. It neither seems likely that more breast awareness can explain the difference.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"d744588d-a703-f018-9969-f5fa3bfb3550","text":"All patients were allowed to mobilize in bed immediately postoperatively with knee and ankle exercises. Postoperative weight bearing depends on the stability of the anterior and posterior pelvic ring fixation, the quality of the patient's bone and the presence of associated injuries. Generally partial weight bearing was allowed after 2 weeks till the sixth week then fracture union was assessed clinically and radiologically to shift for full weight bearing.","title":"Does minimally invasive percutaneous transilial internal fixator became an effective option for sacral fractures? A prospective study with novel implantation technique"}
{"_id":"d749c7da-459b-d74c-2e58-48ca8d970e63","text":"Typical characteristic adverse effects are phototoxic and photoallergic reactions. These are T cell responses directed to photoadducts which originate in the skin. They usually occur after 5 days of drug administration although they may appear within hours and develop progressively spreading over the skin not exposed to ultraviolet radiation. The most common tetracycline involved in these reactions has been minocycline. Death can occur specially in those patients who develop fulminant hepatitis or respiratory failure [198].","title":"Hypersensitivity reactions to non beta-lactam antimicrobial agents, a statement of the WAO special committee on drug allergy"}
{"_id":"d74bea6a-bc8c-91db-bb44-fea78e6c2658","text":"The preoperative color Duplex scan results were affirmed intraoperatively by identifying the preoperatively sonography-detected IMAPs, and then visualizing and evaluating the perfusion of the raised breast tissue flaps in real time through intravenous fluorescein injection. There were no serious complications from the use of the dye in our series except for transient nausea in some patients.","title":"Color Duplex Assessment of 4th and 5th Internal Mammary Artery Perforators: The Pedicles of the Medially Based Lower Pole Breast Flaps"}
{"_id":"d74e80c8-eaa5-0ceb-efda-e772d6166130","text":"Positive blood culture and paraspinal abscess formation were found to be the independent risk factors for recurrent infection in pyogenic spondylodiscitis. Our results suggest that the appropriate duration of parenteral antibiotic treatment in patients with pyogenic spondylodiscitis after surgical intervention should be guided by the recurrence risk. Parenteral antibiotic therapy should be given for more than 3 weeks to patients with either of the two risk factors for recurrence. For low-risk patients, a 3-week short-term parenteral antibiotic treatment may be sufficient.","title":"Appropriate duration of post-surgical intravenous antibiotic therapy for pyogenic spondylodiscitis"}
{"_id":"d753f367-1851-6ce4-a153-b7831c5d16b0","text":"Osteoid osteoma and osteoblastoma may exhibit completely the same features except for their response to nonsteroidal anti-inflammatory drugs (NSAIDs). Osteoblastoma has a peak incidence in the second decade of life and does not respond to NSAIDs. It originates mainly from the basal bone of posterior mandible and may affect teeth as they erupt but does not commonly initiate near the apical area of a posterior tooth.","title":"A Localized Sclerosing Osteomyelitis at the Periapex of a Vital Tooth: Report of a Misdiagnosis"}
{"_id":"d75431a4-ac93-b443-e17b-98f93c3096d2","text":"In agreement with the current literature, our small case series seems to confirm that surgical resection with negative margins improves overall survival.","title":"Mucosal Melanoma of the Head and Neck: A Retrospective Review and Current Opinion"}
{"_id":"d7584dd1-baf5-d3a2-ca42-da49baa57016","text":"A thorough knowledge of the local anatomy, use of safe injection techniques and timely recognition of symptoms can help minimize the risk of the most severe complications. The face and periorbita are supplied by a rich network of blood vessels that communicate through complex anastomoses. Iatrogenic perforation or cannulation of the arterial wall during filler injection can introduce emboli that may cause vaso-occlusion either up- or downstream of the site of injection[.","title":"Complications after cosmetic periocular filler: prevention and management"}
{"_id":"d76138af-f224-6717-25d2-9c55a4a49f43","text":"The clinical features and the pathological changes of desmoid tumors were studied to point out the key factors affecting the recurrence.","title":"Postoperative recurrence of desmoid tumors: clinical and pathological perspectives"}
{"_id":"d76cf80d-4d42-6bc3-1f55-cb630ce53a2e","text":"Our study shows that rhinoplasty, despite being a complex procedure, has proven benefits in terms of functional as well as aesthetic outcomes. The rhinoplasty outcome evaluation questionnaire proves to be a valid tool for estimating patient satisfaction in our population. It can be concluded from our study that rhinoplasty provides long-term satisfaction in the majority of patients. There is a need to further train and educate surgeons in this technique to improve the outcomes of the functional and aesthetic disabilities of nasal deformities in Pakistan.","title":"Satisfaction in Patients After Rhinoplasty Using the Rhinoplasty Outcome Evaluation Questionnaire"}
{"_id":"d76f071c-ee9f-cf06-aa38-15c6db78097a","text":"Staphylococcus aureus bacteraemia on presentation or within the last 1 month","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"d76f6882-e235-6619-ac06-c5224a9cdc67","text":"In this case report, we present the use of two chimeric flaps undertaken sequentially (one acutely and the second delayed) around the knee joint to allow a greater range of motion and function after a severe traumatic event. In this clinical case, the original tissue defects had meant that a free flap was used to reconstruct an open fractured bone, and split skin grafting was undertaken on the anterior aspect of the knee. The latter was then replaced after some months of recovery.","title":"The Use of a Tetraminos Chimeric Free Flap in Lower Limb Trauma"}
{"_id":"d77a74b3-e5b6-526f-d37d-0b46096932f7","text":"Sentinel node biopsy is widely accepted worldwide as an important part of the management of clinically localized cutaneous melanoma.2,21 Despite this worldwide acceptance, there is surprisingly little standardization in the technique, with a variety of different radiocolloids and vital blue dyes being used. Although isosulfan blue and Patent Blue V dyes remain the gold standard vital dyes for identifying SLNs, not all surgeons use them.4,10 Radiocolloids are almost universally used in melanoma, but there is no agreement about which colloid to use and whether to filter it before use to restrict the particle size. The inescapable conclusion is that the ideal radiopharmaceutical for melanoma lymphatic mapping has not yet been established.","title":"Combined Analysis of Phase III Trials Evaluating [99mTc]Tilmanocept and Vital Blue Dye for Identification of Sentinel Lymph Nodes in Clinically Node-Negative Cutaneous Melanoma"}
{"_id":"d77d12a6-07f8-0a5c-b1f6-d52571cc950a","text":"The AP diameter of the spinal canal at the reconstructed level was measured as the distance between the posterior surface of the vertebral body and the innermost cortical surface of the reconstructed lamina at the C4 or C6 level, based on a cross-sectional view on CT scan. Bone healing was defined as the presence of cancellous or cortical bridging bone, or the absence of any radiolucent defect on the hinge or open side, on each reconstructed lamina on CT scan.","title":"Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy with Hypertrophic Ligamentum Flavum: A Retrospective Study"}
{"_id":"d782920a-d892-315d-77c0-f449b155cd5c","text":"This tool has been used to screen patients for abdominal wall defects before liposuction or abdominoplasty.31,32 It has been used to evaluate repairs of the rectus abdominis diastasis, and for seroma management.33–37 Hand surgeons have found numerous applications, such as visualizing tendons and foreign bodies of the upper extremities and guiding injections.36","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"d78c0c64-f14f-c354-4aa4-3353bfb77e6f","text":"Variation in the origin course and branching pattern of lower limb arteries are accidently found during dissections of the foot. Precise knowledge of this is important for surgeons and radiologists who operate and do interventional procedures in this area.Retrograde pedal access is a viable revascularization technique for saving limb in patients with critical limb ischemia. Revascularization is the main therapy for restoring adequate blood supply to the wound, to promote healing in diabetic foot, thus avoiding major amputations. First dorsal metatarsal artery is the most widely arterial pedicle used in toe to hand transplants. Success of the transplant depends on the diameter of the first dorsal metatarsal artery and not the space. As variation in dorsalis pedis artery is quite common, it is essential to have a preoperative angiography for any abnormality, to prevent risks during surgical intervention.","title":"Variations in the origin, course and branching pattern of dorsalis pedis artery with clinical significance"}
{"_id":"d791bda8-196c-7de4-74a0-f10a1f06f083","text":"Surgery was performed under local anaesthesia. The first stage involved resection of the macroscopically visible tumor with clinically free margins of 1 mm. The specimen was fixed in formalin for further histopathology. Margins of 1 mm from the remaining tumor bed were then excised, and frozen sections of these tissue strips were evaluated. The results of the microscopic examination were reported to the operating theatre before completion of surgery. If margins were not free of tumor, additional tissue excision from the involved side was performed, and the frozen sections were examined again for tumor presence. Only when all margins were reported to be free of tumor residue was the surgical wound closed and the surgery completed.","title":"Histological and Clinical Features of Primary and Recurrent Periocular Basal Cell Carcinoma"}
{"_id":"d79aa6a5-3802-e665-2016-df419bb73998","text":"Lumbar hyperlordosis secondary to anterior pelvic tilt due to hip flexion contractures can be initially addressed with muscle lengthening. Fixed lordotic curves require anterior closing wedge osteotomies to increase flexibility and allow for correction through the posterior instrumented fusion. The coexistence of scoliosis and lumbar hyperlordosis makes the use of posterior instrumentation technically difficult and increases the incidence of implant fixation problems, as well as intraoperative morbidity.32 The development of significant anterior pelvic tilt can increase the risk of inner iliac table penetration and injury to the abdominal organs during placement of the pelvic legs of the Unit rod or whilst bending the rod in situ to correct the deformity in children who already have poor bone quality. The rate of reported complications involving pelvic fixation of the Unit rod is 15.1% with a preoperative lumbar lordosis of more than 60° as compared to 3.6% for a lordosis of less than 60° with associated increased intraoperative blood loss and prolonged surgical time.32 Iliac bolts are easier and safer to insert compared to the Unit rod in this group of patients and can be connected through the rods to pedicle screws in the lumbar spine which provide bony fixation and better correction of the lordosis, especially in patients who have undergone extensive laminectomies for dorsal rhizotomies.","title":"Development and treatment of spinal deformity in patients with cerebral palsy"}
{"_id":"d7b022cc-8b33-961c-4fd2-ccf7dab9c16c","text":"The aim of this study was to evaluate the distribution of pathology test results obtained from cases of nasopharynx biopsy, to determine with which methods determination most often was made, and to investigate which kinds of cases required the biopsy to be repeated.","title":"The role of nasopharyngeal examination and biopsy in the diagnosis of malignant diseases O papel do exame clínico e da biópsia de nasofaringe no diagnóstico de doenças malignas"}
{"_id":"d7b1969f-a495-aeaf-af04-4491a4d637da","text":"Furthermore, the unnatural position of the hand caused by rigor-mortis resulting in a superposition of the projections of some bony structures, as well as the ablation of the index finger is unfavourable to the image analysis. Yet the image includes enough long and short bones visible without restrictions in order to evaluate the image quality in an adequate manner. Regardless, an evaluation of a human hand sample in an adequate position should be conducted in order to extend the evaluation of the bony structures and include the small long bones of the distal phalanxes of the fingers.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"d7b5ac67-97f9-31c6-26ea-932a188586f2","text":"The use of 3D printing technology is ideal for complex clinical cases such as the one we presented, because it increases the effectiveness of interdisciplinary communication, improves the assessment of complex anatomy and allows for a specific training of the surgical team directly on the pre-operative model. We recommend the use of 3D imagery and 3D printed models for use in complex clinical cases since it can increase the effectiveness of interdisciplinary clinical communication. To make 3D printing technology more suitable for clinical practice, however, it would be necessary to develop materials with tactile characteristics closer to human soft tissues.","title":"Advanced 3D “Modeling” and “Printing” for the Surgical Planning of a Successful Case of Thoraco-Omphalopagus Conjoined Twins Separation"}
{"_id":"d7bd6416-61c9-0fcb-2aa4-73818c09b5df","text":"The adjustable double-balloon design of the MMSTC was effective at sequestering the thrombus and decreasing distal embolization in an ex vivo flow model. Previous studies have used similar thrombosis circuits to evaluate embolus volume, size, and particle counts. One study identified that particle counts resulting from distal thrombus emboli can vary in size depending on the type of thrombolyic used. Another study also demonstrated that distal embolization was a common observation with current mechanical thrombectomy devices, highlighting the need for improved next-generation technology that can minimize the risks of distal embolization.","title":"Multimodal thrombectomy device for treatment of acute deep venous thrombosis"}
{"_id":"d7c309f2-d245-84dc-6e6d-c1531aa993cf","text":"Melanoma is a highly aggressive skin tumor with an increasing incidence and poor prognosis in the metastatic stage. Although targeted therapies and immunotherapies have greatly improved the prognosis of melanoma patients, adaptive resistance and low response rates have resulted in melanoma remaining incurable. Therefore, novel treatment strategies for melanoma are still urgently needed. Drug repositioning and repurposing is an alternative strategy to discover and develop novel treatment schemes.","title":"Novel therapeutic strategy for melanoma based on albendazole and the CDK4\/6 inhibitor palbociclib"}
{"_id":"d7c417dc-be3c-4075-ed83-b604870aeb05","text":"Although there were no independent predictors of right upper paraesophageal lymph node metastasis, it can be the only site of metastasis without other compartmental metastasis. Therefore, during surgery for patients with central or lateral lymph node metastases from PTC, it may be helpful to examine the right upper paraesophageal lymph nodes.","title":"Clinical predictors of right upper paraesophageal lymph node metastasis from papillary thyroid carcinoma"}
{"_id":"d7c73894-eeec-925f-aa4b-820d4badad4e","text":"Also septal perforation repair with Medpor, can help dorsal augmentation in sever saddle nose deformity and can combine with other graft insertion in open rhinoplasty approach.","title":"Use of porous high-density polyethylene grafts in open rhinoplasty: no infectious complication seen in spreader and dorsal grafts"}
{"_id":"d7c958c1-d56d-309b-f9e8-e82077a0aa37","text":"The series of stories or short narrations below are from cancer survivors about living with body image changes following cancer treatment. The stories were contributed by each of the authors working collaboratively to produce this perspectives manuscript. The stories illustrate various types of bodily changes these individuals experienced from their cancer treatment and what it has been like to live with the changes. Some changes have been temporary, and some are permanent, some visible and some concealed. The short narrations do not include all cancer types, all ages, or attention to every type of change or characteristics which might influence reactions or coping. The short narrations cannot tell the whole story for each person, but they offer a vantage point for gaining a deeper understanding about living with changes in body image. Collectively, they offer an emergent picture of the complexity inherent in the wholeness of human response. Individuals have more than one way to be in the world and to cope with its realities.","title":"Every Story Is Different: Experiences With Body Changes Related to Cancer"}
{"_id":"d7d1dd6e-0fcb-4c9a-1f1a-fd481e2d733c","text":"This investigation confirms cavitation in the presence of GNPs and IPL in cancer treatment. This method can be employed to increase the penetration depth by using NPs with an intensive absorption peak in the near infrared region. Such results were also confirmed in other similar investigations on phantoms. One restriction in utilizing the synergy between laser and SDT-mediated GNPs is related to the low penetration depth of photons with 532 nm wavelength. This limitation may be removed by using NIR absorber of NPs along with NIR laser radiation. Future investigations are highly recommended in order to present a more conclusive answer to questions.","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"d7ddb865-934b-5b48-0a0a-96a50bc15d4e","text":"The heart was harvested within 30 min of euthanasia and flushed with slowly running tap water and each chamber was further gently flushed using a 20 mL syringe to ensure all blood was removed to facilitate optimal fixation in 10% buffered formalin. The LA samples were collected from the LA free wall. Where a formed thrombus in the LA was identified, it was carefully removed and placed into 10% buffered formalin, while an in situ thrombus in the LAA was harvested without being removed from the LAA. After gross pathological examination, sections of the left atrial free wall and cross-sections of the ventricles at the heart base, midwall, and apex were embedded in paraffin wax in a routine manner for preparation of slides for haematoxylin and eosin and Masson’s trichrome staining for histopathological examination. The LA sample blocks were used to prepare slides for immunostaining.","title":"Immunohistological Evaluation of Von Willebrand Factor in the Left Atrial Endocardium and Atrial Thrombi from Cats with Cardiomyopathy"}
{"_id":"d7de1ab2-9faa-2bcd-f954-070a65ea4d54","text":"In our experience, DIEP breast reconstruction is a significant and complex operation that is demanding of both the patient and the surgeon but can give a superb cosmetic result in shape, warmth and movement that is very difficult to reproduce using any other reconstructive technique. We have demonstrated a definite leaning curve with the acquisition of the technical aspects of the operation and the provision of peri-operative venous thromboembolic prophylaxis and analgesia, which is reflected in the decline in complications throughout our series. Ongoing audit of our outcomes and subsequent refinement of the care pathway we offer to patients has allowed us to significantly reduce morbidity associated with the procedure.","title":"Breast reconstruction with deep inferior epigastric perforator flaps"}
{"_id":"d7efa934-8bfa-193c-a75c-8b6a7bb498c1","text":"The possibility of false positive results due to the cells of capsular nevi was disproved by the negativity of all immunostained imprint smears from 5 SLNs (5 cases) with capsular nevi. The cells in capsular melanocytic nevi located in the capsule and fibrous septa of lymph node did not exfoliate and adhere to slides during preparation of imprint smears. This appears to be due to the greater cohesiveness of the cells in capsular melanocytic nevi than the cells of malignant melanoma.","title":"Optimization of an immunostaining protocol for the rapid intraoperative evaluation of melanoma sentinel lymph node imprint smears with the 'MCW melanoma cocktail'"}
{"_id":"d7f45a49-5b30-c00f-7a3d-9bc51ca741d9","text":"All these studies demonstrate that SLNB can accurately predict the axillary lymph node status. The FN results suggest that a correct inspection of the axilla and removal of any nodes that appear abnormal is an important part of the SLN procedure.","title":"Sentinel lymph node biopsy: technique validation at the Setúbal Medical Centre, Portugal"}
{"_id":"d7f4f4fa-4712-3925-aa60-842a22d6fea8","text":"We hypothesized that an electronic patient journal (app) to enable patients with CD to record the severity of their individual symptoms and their response to botulinum toxin over the period between injections would be useful and could enrich the discussion between patient and treating physician about their response to treatment at their next clinic visit.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"d7f9817f-01d9-b7df-9492-efb0bf7759cf","text":"In conclusion, in the present study, we sought histological evidence for the presence of expansions in C9ORF72 among 200 patients with pathologically confirmed AD, but did not detect any cases where relevant tissue changes were present. We conclude that expansions in C9ORF72 are a rare occurrence in AD, and in instances where these do occur, the presence of AD may be coincidental and unrelated to the expansion. Further investigations on such cases to exclude the presence of an underlying FTLD process driven by the expansion appear warranted.","title":"Pathological assessments for the presence of hexanucleotide repeat expansions in C9ORF72 in Alzheimer’s disease"}
{"_id":"d7fc09b0-957f-849f-8573-2cd57c8e6c71","text":"We used ALDH IHC as a marker for pCSC.14 We observed few changes in IHC staining for ALDH after administration of chemotherapy combined with vismodegib or chemotherapy only. Our findings support preclinical studies that described that pCSC are highly resistant to chemotherapy. However, contrary to preclinical reports, there were no changes in the IHC staining of ALDH and hence no changes in the pCSC compartment despite administration of Hh inhibition.27,30 Our findings suggest that the Hh pathway as the only molecular target for pCSC is not sufficient to deplete the stem cell compartment. We hypothesise that alternative pathways described in stem cell biology may be more clinically significant drivers of pCSC.","title":"Phase 2 study of vismodegib, a hedgehog inhibitor, combined with gemcitabine and nab-paclitaxel in patients with untreated metastatic pancreatic adenocarcinoma"}
{"_id":"d80244e3-8d18-2042-637b-f9229c2a70a5","text":"Capacity enhancement continues to be a trend in graduate medical education at teaching hospitals. After clinical residency training, anesthesiologists encounter dilemma of whether a subspecialty fellowship is necessary to strengthen her skill sets and competitiveness in the job market. Pursuing a fellowship is yet another training commitment after lengthy residency training. The debate continues if a year or even three more years of subspecialty fellowship training is necessary in today’s challenging and rapidly advancing medical careers.","title":"Value of Neuroanesthesiology Fellowship Training"}
{"_id":"d8049d9f-f504-cb1f-2fc5-c112205a0d3c","text":"The study was carried out according to the recommendations of the Declaration of Helsinki of the World Medical Association and was approved by the Ethics Committee of Centro Hospitalar e Universitário de Coimbra.","title":"Predictive factors of melanoma thickness"}
{"_id":"d804da55-edb2-f8b8-98d7-43a5a77a397a","text":"There is a need to raise awareness of the signs and symptoms of NMSC. Information on skin cancer needs to be tailored to the individual both at the start of treatment and during the follow up months, ensuring that participants’ needs and expectations are met. Targeting education at individuals in the community who regularly come into contact with skin should help in early identification of NMSC. This is important since skin cancer caught early is easily treatable and delay in presentation leads to larger and more complex lesions which impacts in terms of increased morbidity and increased health care costs.","title":"Longitudinal, mixed method study to look at the experiences and knowledge of non melanoma skin cancer from diagnosis to one year"}
{"_id":"d805adab-fccc-5de9-a610-93c7137422c4","text":"In conclusion, we present a unique case of intermittent and delayed venous congestion of a single-perforator microvascular DIEP flap. The cause of the congestion was determined to be compression at the perforator level in a previously radiated breast, exacerbated by positional changes. This case highlights the importance of performing reconstruction carefully in a radiated field and suggests the use of multiple perforators or near skeletonization of the single perforator to avoid similar complications in the future. Close monitoring and expedient exploration are useful in preventing progression to thrombosis in cases of compromised flaps.","title":"Successful Salvage of Delayed Venous Congestion After DIEP Flap Breast Reconstruction Katira et al"}
{"_id":"d8117458-e3f9-96ed-456a-67fdba9ff3e0","text":"The aim of this review was to assess the current evidence for surgical management of abdominal desmoid tumours in terms of success, recurrence and morbidity.","title":"Surgical management of abdominal desmoids: a systematic review and meta-analysis"}
{"_id":"d817a729-05bb-e31e-1b84-de051fa69263","text":"The mere fact that vaccines are followed by serious adverse effects in only a few individuals suggests that in most of these cases underlying susceptibility factors are present, which predispose or prepare the complex innate or adaptive reaction system for an excessive or biased reaction. Among these factors, it is obvious that genetically defined pre-existing conditions are at work in some groups of subjects in the population , but research in this field is in its infancy. A genetic predisposition results from specific genetic variations that are often inherited from a parent. These genetic changes contribute to the development of a disease but do not directly cause it.","title":"Causality assessment of adverse events following immunization: the problem of multifactorial pathology [version 2; peer review: 3 approved"}
{"_id":"d82a6329-2b6c-08db-b359-4b0ede3ca3bc","text":"Treatment of breast cutaneous melanoma is the same as that for any skin parts. Surgery remains the most important therapeutic modality particularly in preventing local recurrence. Mastectomy does not improve the results obtained by wide excision of the primary melanoma. SLNB, with tremendous benefits and minimal risk, is becoming widely adopted as most surgeons who treat breast cancer and melanoma incorporate this technique into their practice.","title":"Primary cutaneous melanoma of the breast: A case report"}
{"_id":"d8368c04-3101-f462-a3dd-433dc058209a","text":"Cutaneous squamous cell carcinoma of the nasal planum in cats is a common indication for antitumor treatment such as external beam radiation therapy. Curative-intent radiation therapy has been described as a valuable treatment option, resulting in long and stable tumor control in these patients. The aim of the current study was to evaluate outcome and toxicity, as well as possible prognostic factors using an accelerated hypofractionated radiation therapy protocol.","title":"Retrospective clinical study on outcome in cats with nasal planum squamous cell carcinoma treated with an accelerated radiation protocol"}
{"_id":"d836c2cc-e982-875a-50d6-e7927b416400","text":"This technique was adopted for autologous tissue breast reconstruction monitoring after our oncological breast surgeons started performing NSM and we elected to leave a “buoy” or “sentinel” skin paddle for flap monitoring. In this limited series of seven patients, 13 flaps were performed for immediate NSM and revisional reconstructions with monitoring provided by variously located external skin paddles. The results suggest that if the skin flap is carefully designed, it can blend in with the native breast contours\/shadows and circumvent the need for excision or revision surgery to the breast mounds on the account of contour deficiencies. This principle was successfully applied to both free tissue and pedicled flap reconstructions. The different skin paddle color from the native breast skin apparently did not adversely affect the aesthetics of the reconstruction as perceived by the patients.","title":"An Algorithm for Selecting Buoy Skin Paddle Design for Flap Monitoring in Total Autologous Breast Reconstruction After Nipple-Sparing Mastectomy"}
{"_id":"d83e6b30-909c-5462-b64e-cea296f6d724","text":"The aim of this study was to compare the results of cryosurgery and scalpel technique in treatment of physiologic gingival pigmentation.","title":"Comparison of Surgical Blade and Cryosurgery with Liquid Nitrogen Techniques in Treatment of Physiologic Gingival Pigmentation: Short Term Results"}
{"_id":"d846680a-2539-b180-a9ff-fa571a65acec","text":"The current study demonstrates that less than 5% of patients with breast cancer recurrence are diagnosed at routine clinical examination as part of a scheduled breast cancer clinical surveillance programme. It is likely that annual clinical examination provides little value in the diagnosis of recurrence, and surveillance programmes may benefit from reduced focus on such a modality in diagnosing recurrent breast cancer with potential benefits on surgeon workload. More focus should be placed on regular appropriate radiological assessment, as well as ensuring patients have urgent and ease of access to a breast clinic if they develop new symptoms\/signs. There may be a role for clinical surveillance in higher risk patients, but such programmes require further investigation.","title":"Assessing Mode of Recurrence in Breast Cancer to Identify an Optimised Follow-Up Pathway: 10-Year Institutional Review"}
{"_id":"d8481ffd-29fb-0174-0bd0-51f29d12c337","text":"The frenulum is assessed as hypertrophic when the degree is 4 or 5 and a normal frenulum when it is below degree 3. We consider that frenulums 4 or 5 require surgery due to the weak driving power. Lingual frenulum 3 is evaluated as requiring surgery if it related to another alteration, pathology or disorder.","title":"Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol"}
{"_id":"d85fb279-3a9b-120c-b925-3271f97ead33","text":"This is the first economic evaluation of oral versus intravenous antibiotics for treating bone and joint infections. The trial was a large inclusive, pragmatic trial with most participants following their allocated treatment and retention was high .","title":"Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial [version 4; peer review: 2 approved]"}
{"_id":"d8621133-eca8-5400-b4ae-df2d2c0e391e","text":"In this report, we describe the case of a 16-year-old girl with refractory JDM and skin ulcerations as well as extensive intramuscular calcifications that were poorly responsive to conventional therapy but were subsequently successfully treated with abatacept. The purpose of this report is to share our experience to rheumatologists regarding the use of abatacept as a potential treatment option for refractory calcinosis due to JDM.","title":"Abatacept in the Treatment of Juvenile Dermatomyositis-Associated Calcifications in a 16-Year-Old Girl"}
{"_id":"d8621166-ef4e-2b4b-8b98-b848e08eff91","text":"This kind of studies has some limitation. There is no doubt that an organization requires enough microscopes and microsurgical instruments for everyone to use in learning new techniques. However, with the help of a master microscope including video projection, exercises can be demonstrated in detail and individual questions can be answered in a detailed way. Cooperation with outside companies might be needed in order to solve equipment issues, since the equipment is an indispensable aspect of this process. Additional limitation is the short duration of the course to have enough time to repeat the microsurgical anastomoses without mistakes. Undoubtedly, the group of participants was very diverse, which was partly due to the high proportion of non-clinical staff. The self-assessment showed us that there was a high degree of knowledge in experimental practice but very little knowledge about anastomosis. It was therefore even more impressive to see how good the results were at the end of the course. While the evaluation during the course clearly demonstrates that our course is able to teach short term skills, it would have been interesting to conduct a post-course survey to evaluate the effect of the course on the participant’s professional career. It can only be assumed that the course enabled the participants to conducting complex procedures at their home institutions.","title":"Microsurgical training course for clinicians and scientists: a 10-year experience at the Münster University Hospital"}
{"_id":"d8637fe9-fc4a-2f41-d43e-d1defeb5f3fa","text":"The multiple attributed causes of nipple pain in breastfeeding mothers, possibly as a result of a cascade of events, suggests that effective early lactation management is crucial to avoid early weaning. Thorough antenatal breastfeeding education and correction of positioning and attachment in the first week after birth would assist in the prevention of nipple damage and subsequent infection. Early assessment and detection of ankyloglossia, suboptimal milk removal, strong infant suction and vasospasm would allow appropriate management to begin in a timely manner and prevent ongoing pain and psychological distress and possible compromise in milk supply in the longer term.","title":"Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments"}
{"_id":"d86d3de8-97df-0da5-6167-6f6ffc4e9518","text":"In most cases these patients have, diverse functional and aesthetic complaints that may necessitate surgery varying from simple procedures such as minor revision, to more extensive corrections that may necessitate the use of varied techniques and grafts.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"d87f6bc6-f3bc-31dd-b885-b68be7cd6310","text":"There were 12 patients who had never received a BTx injection before this study and 4 patients who had received BTx before this study. Those 4 patients were recruited at least 6 months from BTx injection. All participants continued their previously scheduled oral medication and rehabilitation.","title":"Efficiency of botulinum toxin injection into the arm on postural balance and gait after stroke"}
{"_id":"d882ea15-b883-2116-e21b-636cd4093f7c","text":"Being a cancer rarely detected, subungual SCC does not have a standardized therapeutic approach. The treatment is preferably surgical and depends on the extent of the tumor. Surgical excision with a margin of 5 mm of the total nail apparatus and posterior cover with a skin graft is a good option for subungual SCC in situ, since the partial surgical excision of the nail apparatus is associated with higher recurrence rates and greater discomfort to the patient. Often, amputation or interphalangeal disarticulation is necessary, especially when there is bone involvement. In our case despite the absence of bone involvement, the option was for dislocation of the distal phalanx and local flap. Mohs micrographic surgery is a good option and should be encouraged despite the technique difficulty due to the peculiar anatomical unit and histological characteristics of the region. Despite the Mohs surgery is the most effective treatment there are reports of 20% recurrence rate for subungual SCC compared with 3% of recurrence for other epidermoid cutaneous carcinomas. Radiation therapy is a treatment option for patients with multiple comorbidities who are not able to tolerate the surgical procedure.","title":"Subungual squamous cell carcinoma *"}
{"_id":"d8858c3a-eba7-419a-2449-aa19a116c0b8","text":"Bone invasion was preoperatively confirmed with MRI and supported by intraoperative findings.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"d889e359-8740-24bf-4afd-39c15238b879","text":"The findings of this study, however, should be interpreted with caution because it has some limitations. Firstly: although the results were statistically significant the size of the sample is quite small. Another limitation is that the judgements given by the experts were expressed looking at photographs: this could unavoidably lead to a partial perception of the whole patient’s facial expressions. In fact it is important to consider that in most cases the facial beauty and self perception is linked to a global face evaluation rather than the appraisal of the depth of wrinkles of a specific part of it. This statement finds support in the fact that in pictures taken at T1 phase patients very often showed a change of their hairstyle or make-up, even in cases where experts’ judgments had revealed a decrease in facial aesthetics, so that patients were asked to remove their make-up before taking all the photographs not to influence the aesthetic evaluations. Probably the biggest limitation of this study is the lack of a control group treated with traditional orthodontic therapy. Such a lack is justified by the fact that the second photograph records (T1) were taken at an average period of 12 months after the beginning of therapy with clear aligners. This moment does not always correspond to the end of therapy. Therefore photographing subjects wearing brackets would have inevitably caused a methodological bias as the circum-oral soft tissues around brackets could simulate a lifting effect on the wrinkles of the lower third of the face and thus invalidate the judgment of evaluators.","title":"Clear aligners’ effects on aesthetics: evaluation of facial wrinkles"}
{"_id":"d89dba7f-72ae-f515-a045-140459ce6125","text":"Low flow anesthesia may reduce emergence delirium and postoperative pain even in short-term operations like adenotonsillectomy with no increase in the incidence of adverse events, and with no change in hemodynamic and respiratory parameters in pediatric patients.","title":"Abstracts of the ICARE 2023 77th SIAARTI National Congress"}
{"_id":"d89f0a48-1f67-1983-1715-f7c29cc4aff4","text":"In recent years, efforts have been made to develop photosensitizers in which the singlet oxygen generation efficiency is suppressed in normal cells and increased only in the target tissue. Use of the nanomedicine that activates singlet oxygen generation only in the tumor site is expected to kill cancer cells while suppressing skin photosensitivity reactions. Stimuli-responsive prodrug nanomedicines have been developed for PDT.","title":"Current Limitations and Recent Progress in Nanomedicine for Clinically Available Photodynamic Therapy"}
{"_id":"d89f5f9f-422d-0363-8662-463cf48b7244","text":"With partnerships already established with the College of Medicine and Western College of Veterinary Medicine, the Edwards School of Business is presented an opportunity to offer classes that may be focused on health care administration, particularly as there is still significant interest from current pharmacists in the traditional MBA program as evidenced by our survey results and the number of pharmacists currently enrolled in the MBA program at the University of Saskatchewan. Some external stakeholders felt it was important for a combined PharmD–MBA to have healthcare-related content within the MBA program, and hence this could be seen as an opportunity for the University of Saskatchewan to differentiate itself from the other Canadian schools that either currently offer a combined program or are in the contemplation stage.","title":"An Assessment of Demand for a Combined PharmD–MBA Program at the University of Saskatchewan"}
{"_id":"d8a19b3e-2023-918b-ac8f-f8afa61f992a","text":"Our study has shown that despite the low incidence of DVT in Asian patients undergoing TKA, short-duration chemoprophylaxis might be effective in reducing the incidence of DVT. However, most DVTs observed in our study were distal and may be of limited clinical significance. Further studies are needed to investigate the impact of chemoprophylaxis use on the incidence of PE and overall mortality rates among Asian patients.","title":"Short-duration chemoprophylaxis might reduce incidence of deep vein thrombosis in Asian patients undergoing total knee arthroplasty"}
{"_id":"d8a2cd54-ad68-397b-baac-9c31983e773e","text":"Based on our findings, fellowship status of training orthopaedic surgeons showed no major difference in the overall incidence of surgeon-reported surgical complications for hip fracture patients, and likely demonstrates the fundamental competence of orthopaedic surgeons in managing hip fractures following the successful completion of orthopaedic residency training. Despite such minor differences attributed to the fellowship type, case volume of the performing surgeon proved to have a more significant association with decreased risk of surgeon-reported surgical complications. The importance of case volume showcases the importance of additional training, thus potentially identifying the importance of concentrating hip fracture call in an early surgeon’s career. Future studies should review surgeon data later in their career to analyze these impact of early training and continued case volume as it pertains to more veteran surgeons and their medical and surgical complication rates in hip fracture procedures. Additional studies may want to further investigate the role of patient factors, including comorbidities and case acuity, as these may play a role in relation to surgeon factors, affecting the complexity and technical nature of the procedure.","title":"The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database"}
{"_id":"d8ac8048-8f49-e565-97de-397dc552b7ef","text":"Surprisingly, the ADL subscores on the PDQ-39 scale improved significantly over the study period in the placebo group compared to the bee venom group. We can only speculate about the reasons for these changes given that they do not correlate with motor scores. Most likely, the local inflammatory reactions frequently observed after bee venom injections may contribute to this effect. As such, they were generally not debilitating but nonetheless anxiogenic since patients usually wished to know whether these reactions were due to bee venom or not, a question we were of course unable to answer during the study period due to blinding.","title":"Bee Venom for the Treatment of Parkinson Disease – A Randomized Controlled Clinical Trial"}
{"_id":"d8adb807-b231-ba2e-7eda-06567fe509d0","text":"After surgery for oral cavity cancer, superficial surgical defects are usually covered with a skin graft that can be harvested with different thicknesses depending on the reconstructive need. Despite its popularity and efficacy, this solution has the disadvantage of excessive harvesting times and scarring of the donor site. Other surgeons have proposed the use of bovine pericardium as a reconstructive solution. Its use in otorhinolaryngology especially after oral cavity surgery has never been reported.","title":"An alternative to skin graft for superficial surgical defect in oral cancer surgery"}
{"_id":"d8b73d95-602e-48f4-8cd9-19ec52b59958","text":"Magnetic resonance imaging (MRI) is useful for surgical planning. 22 It provides good anatomical detail and enables delineation of the extent of bone and surrounding soft tissue involvement. The fluid sequences including T2-weighted, fat-suppressed, and short-tau inversion recovery sequences display fluid as high signal and are therefore useful for detecting inflammation. However, MRI use is limited in implant-related infection due to artifact. Furthermore, it can overestimate the extent of infection as differentiation between bone infection and bone edema can be difficult.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"d8b84585-fdb6-2f83-b53a-32f5f1edb468","text":"All adult patients presenting at the trial centres within 72 h of sustaining an open fracture of the lower limb are potentially eligible to take part in the trial. Inclusion within the trial depends on the severity of the wound associated with the fracture. Gustilo and Anderson grade 2 and 3 injuries will be included.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"d8ba8134-60d2-c971-d83f-e8d98a31331b","text":"We retrospectively evaluated all WBMRI examinations performed between January 2010 and December 2014 in 18 patients with clinical, laboratory and histology findings suggestive for CRMO.WBMRI were evaluated independently by two experienced paediatric radiologists, who eventually reached consensus. All patients also underwent WBBS within four weeks; WBMRI and WBBS findings were compared. Signal hyperintensity compared with normal bone on STIR images and increased tracer activity in bone delayed scans on WBBS were considered indicative of disease involvement.","title":"Whole-Body MRI versus bone scintigraphy: which is the best diagnostic tool in patients with chronic recurrent multifocal osteomyelitis (CRMO)?"}
{"_id":"d8c0d010-217e-3ef0-7328-eb10aca8c88a","text":"This study has suggested that there is evidence to support aspirin as thromboprophylaxis for VTE following major elective lower limb orthopedic surgery, which is backed up by its inclusion in the ACCP and AAOS guidelines. NICE should revise their dated guidelines, taking into account the evidence presented in this review. The comparison of studies in this review found a rate of 0.66% of symptomatic DVTs in patients who were prescribed aspirin after arthroplasty surgery. Aspirin is not only effective but has a good safety and side effect profile, especially when compared with other oral anticoagulants.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"d8c166aa-76bc-6fe2-37f2-113a6da9bb98","text":"CEUS can guide puncture and improve diagnosis accuracy. No statistical difference can be seen in the diagnostic efficacy of CNB and FNA for metastatic lymph nodes, CNB can provide more diagnostic information, while FNA can replace CNB for metastatic lymph nodes adjacent to blood vessels and difficult to operate.","title":"Comparative study of core needle biopsy and fine needle aspiration in the treatment of metastatic lymph nodes guided by contrast-enhanced ultrasound"}
{"_id":"d8c6a059-ca9f-b69d-5eee-303c83110cfd","text":"Melanoma is the most aggressive malignant skin tumor and arises from melanocytes. The resistance of melanoma cells to various treatments results in rapid tumor growth and high mortality. As a local therapeutic modality, photodynamic therapy has been successfully applied for clinical treatment of skin diseases. Photodynamic therapy is a relatively new treatment method for various types of malignant tumors in humans and, compared to conventional treatment methods, has fewer side effects, and is more accurate and non-invasive. Although several in vivo and in vitro studies have shown encouraging results regarding the potential benefits of photodynamic therapy as an adjuvant treatment for melanoma, its clinical application remains limited owing to its relative inefficiency. This review article discusses the use of photodynamic therapy in melanoma treatment as well as the latest progress made in deciphering the mechanism of tolerance. Lastly, potential targets are identified that may improve photodynamic therapy against melanoma cells.","title":"Susceptibility and Resistance Mechanisms During Photodynamic Therapy of Melanoma"}
{"_id":"d8c72f20-024e-f92b-4128-dd79bcdd3553","text":"Therefore, it is possible to conclude that CVCES could eradicate or prevent biofilms and planktonic bacteria at either high voltage short duration courses, or at smaller magnitude voltage in combination with antibiotics. Implementation of CVCES would involve a minimally invasive procedure to attach a lead to the implant. Without the need for removal and replacement of the implant and even longer-term antibiotics, this option could potentially provide relief to patients who would otherwise need to endure treatment under current guidelines. Preventative applications of CVCES could also prove instrumental in reducing or eliminating the burden caused by biofilms.","title":"Physical Approaches to Prevent and Treat Bacterial Biofilm"}
{"_id":"d8d13a69-e1ff-50b8-56ab-827081e0576e","text":"This study demonstrated that using attached surface probes with the O2C analysis system does not compromise technical feasibility or patient safety. No probe detachment or disconnection was observed with the attached surface probes, which could be attributed to the sufficient fixation of the probe with four sutures on the cutaneous flap surface and to the additional securing of the probe connection cable with patches on the skin beyond the flap. No damage to the microvasculature of the flap, which could lead to local or general flap necrosis, was observed. A possible explanation for this is that the sutures were superficial and not too close to the intraoperatively identified perforator vessel of the ALTF or FFF; both perforator flaps that depend on only one perforator vessel or a limited number of perforator vessels. No infections or bleeding were observed upon using the attached surface probes, likely because of adherence to sterile conditions during fixation and the superficial design of the attachment sutures.","title":"Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study"}
{"_id":"d8e151c3-7140-a497-8736-9c8d23350388","text":"Our data may be subject to selection bias, since we only included patients for whom data was complete regarding whether or not SLNB was performed. Such a decision provided us with a more homogeneous population and allowed us to exclude patients that underwent a complete lymphadenectomy, likely because of clinically palpable nodal disease. Nevertheless, we may have excluded patients that would have otherwise altered our measured outcomes. Finally, SEER does not provide information on patient-level socioeconomic status such as monthly\/yearly income or surrogates of socioeconomic status like education level or insurance status. Such factors may influence access to optimal cancer care and may partially explain the relatively high percentage of patients not undergoing SLNB in our study.","title":"Sentinel Lymph Node Biopsy in Patients with Thick Primary Cutaneous Melanoma: Patterns of Use and Underuse Utilizing a Population-Based Model"}
{"_id":"d8ece118-c035-42bb-235a-4a89f5f954e5","text":"The transdermal delivery mechanism for drug administration has been generally utilized to treat disease conditions. This system has the objective of delivery to the target site through various skin layers into the bloodstream, with little or no systemic circulation, as well as to protect the drug and increase its biological half-life.","title":"Poly(N-vinylcaprolactam)–Gold Nanorods–5 Fluorouracil Hydrogels: In the Quest of a Material for Topical Therapies against Melanoma Skin Cancer"}
{"_id":"d8f43b9a-ccb9-34f9-9af3-f32ab2914203","text":"Dry eye, lagophthalmos and slow movement of the upper eyelid during downward gaze. In addition to physical defense, the eyelid also participates in the uniform distribution of glandular secretions into the tear film to protect the eye surface from dryness. Due to the large tension, the upper eyelid movement is limited, and the palpebral fissure cannot be closed completely, which easily causes dry eyes, lagophthalmos and slow movement of the upper eyelid during downward gaze. The above shortcomings can be alleviated by compensating artificial tears in daytime and applying thick eye ointment before sleep to alleviate dry eye and avoid exposure keratitis. Movement of the head should be used as much as possible to reduce eye movement during downward gaze.","title":"Comparative evaluation of conventional and modified frontalis muscle flap advancement techniques in the treatment of severe congenital ptosis: A retrospective cohort study"}
{"_id":"d8f4a1f6-61db-a6a3-5ef6-bf4ea5114198","text":"For the second cohort, the size of the margins will be recorded for VivaScope measurement as well as for slow Mohs surgery. The calculation of the surgical defect will also be recorded. The outcome measure will be the difference between the predicted margins using VivaScope and the Mohs size of the defect in the same patient. Thus, we are comparing the confocal microscope margin with the clinically predicted margin in each patient. Additional data will be collected on the time it takes to obtain test results, interobserver variability in the interpretation of VivaScope imaging, imaging failure rate, morbidity associated with biopsy or surgery, and adverse events from biopsy or surgery. The clinician administering the tests will record results on data collection forms by hand.","title":"Evaluating the Diagnostic Accuracy of Reflectance Confocal Microscopy to Diagnose Skin Cancer: Protocol for a Prospective, Multicenter Study"}
{"_id":"d90f674c-2f1d-75ed-7229-9f480ca5fbfd","text":"Sometimes local swelling and erythema occurred in place of shot in two groups of patients.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"d910e430-1aa5-fe88-494b-ae9450ce76c8","text":"Compared to other procedures in nuclear medicine, sentinel lymph node diagnostics with radioactive tracers is associated with a relatively low radiation burden for the nuclear medical staff.","title":"10-Year experience regarding the reliability and morbidity of radio guided lymph node biopsy in penile cancer patients and the associated radiation exposure of medical staff in this procedure"}
{"_id":"d92066bd-9c7f-a8ad-8487-d43250bbb962","text":"Mohs micrographic surgery is a specialized surgical procedure used to treat skin cancer. The purpose of this study was to better understand the profile of the patients who underwent the procedure and to determine how histology might be related to complications and the number of stages required for complete removal.","title":"The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital"}
{"_id":"d9332809-cecb-4e6c-b280-89d6e4325388","text":"An entry vessel is crucial for intravenous port implantation. A safe alternative entry vessel that can be easily explored is crucial for patients without feasible cephalic vein or for those who need port reimplantation because of disease relapse. In this study, we tried to analyze the safety and feasibility of catheter implantation via the deltoid branch of the thoracoacromial vein.","title":"Deltoid Branch of Thoracoacromial Vein A Safe Alternative Entry Vessel for Intravenous Port Implantation"}
{"_id":"d93a76b3-bc71-40cc-2ed1-af4e6c09c337","text":"Efficient and safe imaging in animal models and patients was achieved with several additional functionalities described in the following section. This includes means to account for the wide variations of signal observed during freehand scanning, the potential fouling of the probe with biological matter during imaging, and the limitation of tissue exposure to UV light during ms-TRFS measurements.","title":"Autofluorescence lifetime augmented reality as a means for real-time robotic surgery guidance in human patients"}
{"_id":"d93d95fa-c89a-876f-b70e-1120bcd7daea","text":"The present study offers a literature review of the foreign body granulomatous reactions to cosmetic fillers.","title":"Foreign body granulomatous reactions to cosmetic fillers"}
{"_id":"d958249a-94c8-6ef4-3340-fb39cfebb43d","text":"Collectively, it is apparent that additional in vivo studies must be performed to elucidate the specific role of S. aureus intracellular persistence in chronic osteomyelitis. A successful in vivo experiment investigating intracellular infection should be able to demonstrate that the host cells along with internalized bacterial cells, are both alive for a prolonged period of time. Further, a successful experiment should demonstrate that internalized bacterial cells have the same clonality as the initial infecting strain. Currently, most analyses of intracellular persistence are performed using TEM, and are therefore limited in their ability to define whether cells are alive or dead. Advances in in vivo imaging techniques combined with clinically relevant animal models may allow for more accurate longitudinal tracking of bacterial infections to possibly answer some outstanding questions related to intracellular persistence in osteomyelitis.","title":"Evolving concepts in bone infection: redefining “biofilm”, “acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy”"}
{"_id":"d965629c-315b-a413-b041-ddc6346d42b5","text":"Expressing breast milk or using nipple shields and bottles are aids that can either help or hinder breastfeeding. Mothers described milk expression as frustrating and difficult. However, they also reported pride in having expressed milk for their infants when they later managed to breastfeed their infants directly at the breast. Some mothers continued to express milk to provide the infant with their breast milk when the infants could not breastfeed directly at the breast.","title":"A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth"}
{"_id":"d96565a2-a472-34c3-a70a-4c96f9837915","text":"All patients admitted to the vascular surgery ward who underwent elective open lower limb revascularization surgery using autologous GSV grafts were invited to take part in the study.","title":"Correlations between ultrasound, tomographic, and intraoperative measurements of the great saphenous vein used as an arterial graft"}
{"_id":"d967c74b-ecbe-e384-572b-3fa3522d67b9","text":"A patient with recurrent breast cancer in her skin flap was discovered to have positive axillary sentinel nodes by sentinel lymph node biopsy five years after mastectomy for ductal carcinoma in situ.","title":"Axillary sentinel lymph node biopsy after mastectomy: a case report"}
{"_id":"d96c0154-6852-56fc-bfb5-c5df16eca831","text":"For floor of mouth resections that result in substantial submandibular dead space, slightly bulkier flaps, such as the ALT free flap, are useful. The ALT free flap is particularly useful in head and neck reconstruction because it can be transferred either as a fasciocutaneous flap or as a myocutaneous flap depending on the reconstructive needs. When harvested as a fasciocutaneous free flap, it is usually intermediate in thickness between the RFF flap and the RAM flap. The RAM flap is based on the deep inferior epigastric vessels and is too bulky in most patients with isolated floor of mouth defects. Although the bulk of the flap can be decreased by harvesting it as a fasciocutaneous flap based on the deep inferior epigastric perforator (DIEP) vessels, even without the rectus abdominis muscle the DIEP flap is usually thicker than the ALT free flap.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"d9703ab3-3c56-8e5b-cb59-710d9f8a779a","text":"Having found that aspects of facial contrast decrease with age, we wished to determine whether facial contrast plays a role in the perception of age. Because so many cues other than facial contrast are known to play a role in age perception (as reviewed in the Introduction), we do not expect facial contrast to perfectly predict perceived age, but nonetheless to be significantly correlated with perceived age. Study 2 tested the hypothesis that there is a relationship between facial contrast and the perceived age of the face.","title":"Aspects of Facial Contrast Decrease with Age and Are Cues for Age Perception"}
{"_id":"d9724cd9-8bf4-5a6d-102d-86a5ec1777e2","text":"MRI is the most sensitive and specific imaging method as shown in literature and offers the advantage of being relatively less invasive than retrograde studies. It allows visualisation of fluid collections and the extent of osseous involvement and inflammatory changes. It often presents with a high signal on T 2 weighted images and low signal intensity on T 1 weighted images secondary to alteration of marrow signal intensity, due to underlying oedema. Some authors have identified the fistulous tract on heavily T 2 weighted MR sequences. In our study, high T2 and STIR signal with low T1 signal was noted in all three patients on MRI. The literature suggests heavily weighted T2 sequences are most useful in these patients, however, this was not done in our centre and T2\/STIR sequences were sufficient for diagnosis.","title":"Imaging findings of urosymphyseal fistulas Patel et al"}
{"_id":"d9752299-ac8f-9979-faea-5dd8a0d8f733","text":"Results in this experiment showed that the normal cells may have similar levels of sensitivity to PDT treatment as those of cancer cells. Fortunately, in PDT, local targeting of the diseased tissue can be achieved by selective delivery of laser beams. Sensitivity to VP-16 treatment has been found to be similar in GM05757 and A549 cells. However, the combination treatment can induce a much stronger synergistic effect in A549 cells than in GM05757 cells and is more effective in killing A549 cells than GM05757 cells.","title":"Combination of Near Infrared Light-Activated Photodynamic Therapy Mediated by Indocyanine Green with Etoposide to Treat Non-Small-Cell Lung Cancer"}
{"_id":"d97818bb-2f65-8a45-3ae8-0543c172b06d","text":"Surgical resection after tumor recurrence may improve the survival rate in patients with stage III STS according to our study. Although many other factors including individual comorbidities, age, tumor location, and the presence of distant metastasis must be considered in deciding whether to perform surgical resection of recurred tumors, our finding suggests that long-term survival is possible with adequate treatment including surgical resection even in cases of recurrence. More studies with larger patient groups must be conducted in the future to verify this finding.","title":"Actual long-term survival after resection of stage III soft tissue sarcoma"}
{"_id":"d97a36a5-9379-4d24-2834-0fa46f93b139","text":"Our aim in this review was to discuss the potential risk of non-melanoma skin cancer and melanoma in patients with psoriasis and the potential underlying mechanisms for these associations between psoriasis and cutaneous malignancies.","title":"Psoriasis Therapy and Skin Cancer: A Review"}
{"_id":"d97d6650-4d3d-5e4a-c779-5377e49c9f7d","text":"Methods: A retrospective, descriptive chart review was conducted on patients seen at the Halifax Asthma and Allergy Associates between January 2014 and June 2017 with a suspected diagnosis of FPIES. FPIES was confirmed based on predetermined clinical criteria of vomiting and diarrhea within 4 h of ingestion. Demographic and clinical characteristics were collected from electronic medical records for analysis.","title":"Proceedings of the Canadian Society of Allergy and Clinical Immunology Annual Scientific Meeting 2018"}
{"_id":"d985a9c8-22b3-a27d-8f02-73002576eb2d","text":"Our preliminary results show that video endoscopic inguinal lymphadenectomy is a safe and feasible technique in patients with penile carcinoma with no palpable lymph nodes. It allows the radical removal of inguinal lymph nodes within the same limits of conventional surgical dissection and potentially reduces surgical morbidity. VEIL has the potential to become the minimally invasive procedure for low volume inguinal lymph node disease and prophylactic inguinal lymph node dissection but long term studies with a greater number of patients are needed.","title":"Video Endoscopic Inguinal Lymphadenectomy (VEIL) -a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma"}
{"_id":"d986b097-2921-4e7b-9927-aa3da9833a2b","text":"Complications were divided into major and minor. We included all adverse events, and complications were defined as major when the adverse event led to permanent sequelae or required additional surgical intervention. On the other hand, complications were considered minor when the adverse event neither deteriorated the clinical picture neither required additional surgical intervention. The time considered for evaluating the adverse event was 30 days from the date of surgery.","title":"EARLY COMPLICATIONS OF SURGICAL TREATMENT OF CERVICAL SPONDYLOTIC MYELOPATHY COMPLICAÇÕES PRECOCES DO TRATAMENTO CIRÚRGICO DE MIELOPATIA CERVICAL ESPONDILÓTICA"}
{"_id":"d986b6c7-9091-2942-c98b-6ba39a7f0e7a","text":"Ultrasound is a modality that is readily available at a low cost and does not use ionising radiation, making it ideal for evaluating patients with breast‐related complaints in an urgent or emergent setting. When evaluating the breast in these settings, the primary goal is to efficiently identify the acute cause for the patient's presenting symptoms. This is in contrast to when ultrasound is utilised during a diagnostic imaging evaluation where the rationale is to identify or exclude a malignancy as the aetiology for a patient's presentation. This article reviews the most common causes for breast‐related urgent and emergent complaints, including trauma, bleeding and infection. Emphasis is placed on salient ultrasound imaging features to make an accurate diagnosis of a benign process and aid the recognition of a possible underlying malignancy that would require additional diagnostic imaging and biopsy. This review was approved by the Institutional Review Board of our institution's Office for Human Research Protections.","title":"Urgent and emergent breast lesions – A primer for the general radiologist, on‐call resident and sonographer Bhatt, et al."}
{"_id":"d9922e77-9df7-bb1d-d88d-e7b02a0daf04","text":"Cervical spine anatomy makes the placement of pedicle screws in this location more difficult and dangerous. Various technologies have been developed to improve accuracy rates.","title":"Cervical Spine Pedicle Screw Accuracy in Fluoroscopic, Navigated and Template Guided Systems—A Systematic Review"}
{"_id":"d999bc55-a065-940c-a9a0-f21ff266328c","text":"Patients with chronic wounds and the narrowing or blockage of arteries in lower limbs are at high risk for amputation.","title":"Therapeutic Effects of Successful Angioplasty on the Aorta and Lower Limb Arteries on the Healing of Chronic Ischemic Wounds"}
{"_id":"d99e933a-8775-6007-3147-f6786eeb417e","text":"It is a relatively suitable temporary remediation technique to immediately change a vascularized fibular osteomyocutaneous flap with postoperative severe vascular crisis to a non-vascular fibula graft, which may avoid complete necrosis and the subsequent serious adverse consequences.","title":"Jaw reconstruction with vascularized fibular flap: The 11-year experience among 104 patients"}
{"_id":"d9aef73c-beba-d592-cbde-0c26102933c7","text":"Figure 5 shows that the electric field in the frozen region is higher than about 150 V\/m for a voltage of 1 V on the cryoprobe. Equation 6 suggests that a voltage of about 400 V imposed on the cryosurgical probe is sufficient to ablate the cells with PEF in the analyzed frozen region. A graph of the electric field and temperature distributions with 400 V applied after 90 seconds of freezing can be seen in Figure 7. When 400 V are applied, the temperature rises to a higher value over a shorter distance than when 1 V was applied (Figure 7a) due to the effect of Joule heating. The electric field with 400 V applied demonstrates the same trend as the case with 1 V applied, but reaches a maximum of 160,000 V\/m rather than the peak of 400 V\/m seen in the 1 V case.","title":"Cryosurgery with Pulsed Electric Fields"}
{"_id":"d9b10414-aecb-278f-6d3f-e045881d0cd9","text":"Treatment of recurrent cutaneous or subcutaneous tumors can be a challenge because of their unresectability and relative insensitivity to conventional systemic therapies. Recurrence represents a treatment concern for the physician and a source of distress and psychological burden for the patient, whose quality of life may be adversely affected by pain, ulceration, malodorous discharge and bleeding associated with lesions.","title":"Long-lasting response to electrochemotherapy in melanoma patients with cutaneous metastasis"}
{"_id":"d9b34d23-e02d-5a5b-1f73-1a41d17f343b","text":"The present study investigates differences between a biological and a synthetic mesh regarding complication frequencies during the first 12 months after surgery. It is the first study to randomize between the two breasts in the same individual. The findings indicate that there is a higher risk for complications, particularly seroma and implant loss, when a biological mesh is used.","title":"First‐year complications after immediate breast reconstruction with a biological and a synthetic mesh in the same patient: A randomized controlled study"}
{"_id":"d9b4a3c1-12d1-16b1-6f83-9f9b11aab8bf","text":"In addition, it is unknown to which degree microbiology findings from biopsies predict microbiology results from definitive revision surgery with either method of tissue sampling in this problematic subgroup of patients.","title":"Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery"}
{"_id":"d9ba4cc2-86ee-0bb8-8a68-544b7449a6ff","text":"Most of us judged that for most of the systems necessary information would not be available at least sometimes. The OCEBM system came out somewhat better than the other systems and lack of availability of necessary information was considered to be less of a problem for the USTFCPS system. However, the OCEBM and USTFCPS systems were considered by most to be missing dimensions which may, in part, explain why missing information was considered to be less of a problem. This would be the case to the extent the missing dimensions were the ones for which information would often or sometimes not be available. The dimension for which we considered that information would most often be missing was trade-offs; i.e. knowledge of the preferences or utility values of those affected. Additional problems were identified in relationship to complex interventions and counselling, particularly with the USTFCPS and USPSTF systems. It was pointed out that the USTFCPS system addressed this problem by including availability of information about the intervention as part of its assessment of the quality of evidence.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"d9bd47cf-0842-610f-6c13-34f9b3a90642","text":"This study was carried out in accordance with the recommendations of Ethics Committe of the Sacred Hearth Catholic University of Rome with written informed consent from all subjects. All subjects gave written informed consent in accordance with the Declaration of Helsinki. The protocol was approved by the Ethics Committe of the Sacred Hearth Catholic University of Rome.","title":"Rechallenge to Carboplatin in Children with Low Grade Glioma and Carboplatin Hypersensitivity Reactions"}
{"_id":"d9c41585-a7c6-d640-e6db-4614b1f9ec7d","text":"The MSAP flap has been shown to work well for subtotal glossectomy reconstructions in our series of patients where volume to be reconstructed only involves the subtotal glossectomy volume and not for coverage of the mouth floor. An acceptable outcome and restoration can be expected with the use of such flaps for subtotal glossectomy reconstruction.","title":"Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction – An outcome study"}
{"_id":"d9d496dd-5d39-dcc3-21e7-4b571abc54cb","text":"In revision rhinoplasty, sufficient cartilage in septum is not usually exists to be used for reconstructing. Lack of cartilage tissue gives rise to harvest an extra cartilage from rib or auricle. This procedure elongates the time of surgery and also has many cosmetic problems, so the use of an artificial material with limited complications is considered as a choice in this situations.","title":"Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study"}
{"_id":"d9e30260-6c3b-8f73-5f5d-2415cdc21a2f","text":"In this study, despite a programme of home visitation in addition to routine facility infant feeding counselling, breastfeeding practices were poor. Improving breastfeeding practices in South Africa will require more effort including clear and consistent messages from health workers and community based workers and greatly improved breastfeeding support especially during the antenatal and early postnatal periods to ensure appropriate feeding choices, correct lactation techniques and optimal breastfeeding duration (see Table 3).","title":"Early cessation of breastfeeding amongst women in South Africa: an area needing urgent attention to improve child health"}
{"_id":"d9e5ecd3-45c7-350e-b56a-7199640ea082","text":"Interestingly, IPC caused significant effects with respect to rSO2 in only 22 out of 40 patients. In the remaining patients, collaterals may have prevented complete cessation of blood flow to the lower limb. This points to the fact that an effective IPC may be only achieved in 50% of patients undergoing surgery and thus may render sevoflurane preconditioning an interesting alternative.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"d9f371a8-a8a7-8ff4-737b-00ebcc8465f7","text":"Pursuing fellowship training and a career in orthopedic shoulder and elbow surgery is becoming more popular among orthopedic residency graduates. Given the increasingly competitive and relatively smaller cohort of applicants than other subspecialties, applicants need to be aware of the factors considered most important by PDs when evaluating shoulder and elbow fellowship applicants.","title":"Factors considered in ranking orthopedic shoulder and elbow fellowship applicants: a survey of program directors"}
{"_id":"d9f9ae83-440c-fb46-0613-583f9c24ad81","text":"All patients in the present study presented to our clinic with recurrent BCC, and treatment with frozen section controlled excision was chosen in order to reduce the risk of possible re-recurrence. The first excision was done 1-2 mm beyond the visible tumor margin. The number of rounds of frozen section control required for the pathologist to intraoperatively confirm clean surgical margins was 1 in 11 patients, 2 in 12 patients, 3 in 8 patients and 4 in 4 patients. These excisions resulted in an excision area that was several times larger than the apparent size of the tumor preoperatively. Graft and flap eyelid reconstruction was performed in all cases. It is well known that BCC can extensively invade surrounding tissues and that excising an area much larger than the clinically visible tumor may be necessary, especially in cases of recurrence. In the present study, frozen section controlled excision both ensured that enough tissue was removed to achieve clean surgical margins and allowed the labor intensive reconstruction procedures to be conducted with confidence knowing that the surgical margins were clean.","title":"The Importance of Frozen Section-Controlled Excision in Recurrent Basal Cell Carcinoma of the Eyelids"}
{"_id":"d9fa2cea-22ed-64ed-f65e-478b75f8860c","text":"Due to exclusion criteria, 12 patients were excluded leaving 16 patients whose ultrasound images and relevant data we collected. Images were gathered and designated as preoperative and postoperative based on the time signature saved to the image. A script was then written to display images at random, as shown in Figure 1.","title":"Predictors of Difficult Ultrasound-Guided Transversus Abdominis Plane Blocks"}
{"_id":"d9fd5e39-7756-e717-a78d-bc85f303ff6c","text":"In our study of prophylactic mastectomy, we could demonstrate that the vascularized caudal dermis flap is a reliable and safe alternative to cover the lower pole of a subpectoral placed implant for patients with sufficient skin excess in case of macromasty or ptosis mammae.","title":"Implant-based immediate reconstruction in prophylactic mastectomy: is the caudal dermis flap a reliable alternative to synthetic mesh or acellular dermal matrix?"}
{"_id":"da171ec3-24f0-e3e8-7fba-ae8f8bf04dae","text":"The limitations of this study include the fact that the sample size was relatively small compared to previous mutation studies with larger numbers of cases. However, the cohort of this study is composed of prospectively treated patients with meloxicam, while no previous studies have reported the significance of CTNNB1 mutation type in conservative treatment. The results derived from this study provide meaningful information. Second, CTNNB1 mutation was analyzed only in exon 3. Other significant mutations may exist in different areas of CTNNB1. Third, due to the small number of cases, we could not analyze the relationship between mutation status and period up to onset of efficacy for meloxicam treatment. Future studies with more accumulated cases with molecular analysis will be needed to clarify the further correlation between the prognosis and mutation status.","title":"CTNNB1 S45F Mutation Predicts Poor Efficacy of Meloxicam Treatment for Desmoid Tumors: A Pilot Study"}
{"_id":"da1c0d7e-8392-0cef-1b82-799eecf082f9","text":"Our time in therapeutic range may have implications on the duration of treatment that is adequate to achieve actual resolution of symptoms and resorption of the thrombus. Further studies need to evaluate if prolonging treatment in patients with low TTR values affects DVT treatment outcomes.","title":"Challenges in achieving a target international normalized ratio for deep vein thrombosis among HIV-infected patients with tuberculosis: a case series"}
{"_id":"da2125fc-eb61-5b86-aa87-9e6f0e4b28db","text":"The results of the current study suggest that this posterior hybrid decompression, laminoplasty interrupted by laminectomy and fixed by Centerpiece plate combined with spinous process autograft, may be a safe and effective treatment for cervical myelopathy with hypertrophy or ossification of the ligamentum flavum.","title":"Laminoplasty and Laminectomy Hybrid Decompression for the Treatment of Cervical Spondylotic Myelopathy with Hypertrophic Ligamentum Flavum: A Retrospective Study"}
{"_id":"da21e389-5aae-5a91-5a5d-ba2e2ee9962d","text":"In summary, whole body MRI is a valuable tool in assessing internal tumour volume and growth of PNs in people with NF1. Patients with high total tumour volume and young age were found to have tumour growth that might lead to complications in the future. On the other hand, patients without internal tumours on their first whole body MRI appear unlikely to develop PNs and associated complications later on. Long-term natural history studies with serial longitudinal whole body MRI examinations and clinical evaluation are needed to provide the evidence necessary for improving the care of people with NF1.","title":"Growth dynamics of plexiform neurofibromas: a retrospective cohort study of 201 patients with neurofibromatosis 1"}
{"_id":"da299460-a79c-46af-33d2-98abad6a5e3a","text":"There are major advances in the prevention and treatment of BRIs based on new compounds and technologies that have been shown to be highly effective in in vitro models but require further validation in the clinical setting.","title":"The Current Knowledge on the Pathogenesis of Tissue and Medical Device-Related Biofilm Infections"}
{"_id":"da3850e4-635b-6403-0d93-70f7140912de","text":"Brachytherapy is commonly used in the treatment of early or locally advanced cervical cancer. High dose rate intracavitary brachytherapy (HDR_BT) is a precise hypofractionated radiation treatment whose efficacy is well established in the treatment of cervical cancer. The amount of external-beam radiation that can be safely delivered to a big volume is often much less than the dose that is required to kill the tumor.[1] The pattern of the radiation dosage from intracavitary applicators allows the delivery of additional radiation to the volume of interest without exposing the surrounding normal tissues to excessive radiation. The placement of applicators within the patient aids in proper localization of the target and immobilization of the surrounding normal structures. Also brachytherapy avoids much of the geometric uncertainty present in the external-beam delivery techniques.","title":"Dosimetric comparison of high dose rate brachytherapy and intensity-modulated radiation therapy for cervical carcinoma"}
{"_id":"da43c2b1-9037-0da0-1e02-55385e4a5ca2","text":"However, based on the present data and the published results from less invasive procedures, we put forward the hypothesis that OIB is likely to be dispensable and does not need to be performed any more. Potential risks may outweigh the potential benefits. At least we do not have any indication of diagnostic superiority of OIB over other procedures of tissue sampling in this patient population. Thus, justification of OIB is at least questionable.","title":"Diagnostic value of open incisional biopsies in suspected, difficult-to-diagnose periprosthetic hip joint infection prior to revision surgery"}
{"_id":"da448037-9433-6575-5da2-63a3bd74c8ca","text":"Techniques for detecting circulating tumor cells in the peripheral blood of patients with head and neck cancers may identify individuals likely to benefit from early systemic treatment.","title":"Long term survival following the detection of circulating tumour cells in head and neck squamous cell carcinoma"}
{"_id":"da4eb9e2-ce20-5a43-0f5f-d1c37b354c28","text":"IBBR typically requires multiple procedures with refinements and revisions for completion and to maintain aesthetics over time. The high rate of revision surgery becomes particularly evident in the setting of breast cancer treatment, where unilateral breast reconstructions frequently require contralateral procedures for symmetry. The increased use of postmastectomy radiotherapy also adds to the risk of revision surgery because of the risk of capsular contracture, leading to discomfort and poorer cosmetic outcomes.","title":"Effect of Immediate Implant-Based Breast Reconstruction After Mastectomy With and Without Acellular Dermal Matrix Among Women With Breast Cancer A Randomized Clinical Trial Immediate Implant-Based Breast Reconstruction After Mastectomy Using Acellular Dermal Matrix"}
{"_id":"da4f6467-235e-9032-5dbd-994679dc0ef0","text":"Anchored craniofacial implants are a good and minimally invasive solution for postnasal resection patients with a low rate of adverse reactions. In selected clinical cases, stable fixation of the prosthesis on two anchored implants is possible and their single-step implantation significantly speeds up the prosthetic process.","title":"The Latest Craniofacial Reconstructive Techniques Using Anchored Implants after Surgical Treatment of Nasal and Paranasal Sinuses Tumors"}
{"_id":"da53ffab-3d1c-96fe-6e23-bce0a0b09440","text":"The middle gluteal muscle arises from the iliac crest and most of the tuber sacrale. Some fibers also originate from the dorsal portion of the sacroiliac ligament and from the deep layer of the gluteal fascia. A large part of the muscle lies deep to the gluteal fascia and skin and is caudally covered by the superficial gluteal muscle. In the caudodistal direction, it extends over the musculus gluteus profundus and ends in the trochanter major. A narrow but thick deep belly can be defined from the caudal border of the middle gluteal muscle. This deep portion arises on the transverse processes of the last sacral and first caudal vertebrae, and the sacrotuberous ligament ends on the trochanter major with its tendon. Its action is an extension of the hip joint, medial rotation of the hip, and prevention of lateral rotation during weight-bearing. The medial gluteal muscle is innervated by the caudal gluteal nerve (28).","title":"Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis"}
{"_id":"da5bc857-6800-81f2-f6c1-865fedc78087","text":"Subjects that experienced late HSRs to the 1st dose of BNT162b2v from December 2020 to May 2021 and were referred to our center for evaluation were included in our study group. A comparison was performed with age- and gender-matched patients in a 2:1 ratio to patients who suffered an immediate HSR to this vaccine. All patients included in this study were referred and evaluated in the Institute for Clinical Immunology, Angioedema and Allergy in the Sheba Medical Center in Israel.","title":"Late Hypersensitivity Reactions to the BNT162b2 SARS-CoV-2 Vaccine Are Linked to Delayed Skin Sensitization and Prior Exposure to Hyaluronic Acid"}
{"_id":"da5cc722-f85e-0ca3-2b36-767bdf6fc217","text":"Uniquely, a three-dimensional virtual reality model combining magnetic resonance imaging and computed tomography data was used to determine the lesion’s resectability and visualize which structures would be encountered or require protection while ensuring total resection.","title":"Total Resection of Pediatric Desmoid Tumor of the Left Neck with Utilization of 3D Virtual Surgical Planning"}
{"_id":"da5d7f24-26f6-7e92-a2b2-72d006997f5f","text":"An overview of the details of the above-mentioned features is illustrated for the failed flaps group in Table 2, and a general overview of the features associated with flap revision and flap survival is summarized in Table 3.","title":"Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team’s Experience"}
{"_id":"da5fb084-604d-9c17-2d06-e3b469985e82","text":"The findings indicate that SLTs academic training is perceived to be significantly limited in the cleft palate and craniofacial fields. Thus, there is a strong need at the undergraduate level for clinical training and exposure to multidisciplinary management. At post-graduate level there is a need to establish an educational strategy to meet the needs of SLTs providing CLP and CFD care. Participants suggested that programmes for continuing professional education, degree courses and online resources be designed to provide practising clinicians with updated information and guidance in management of CLP and CFD patients.","title":"South African speech-language therapists’ opinion of their training in cleft lip and palate and craniofacial deformities"}
{"_id":"da68d2cf-1d45-7c8d-e720-f4191ab08cf3","text":"The mothers of the present cohort had GDM and were successfully managed on diet and other lifestyle interventions, making the intrauterine environment metabolically well-described. It is not known if results can be generalized to offspring exposed to more extreme intrauterine hyperglycemia or insulin treatment.","title":"Low breastfeeding rates and body mass index in Danish children of women with gestational diabetes mellitus"}
{"_id":"da6a29e6-9cad-79f7-38ce-0e2385323450","text":"This cost-minimization modeling assessed the total costs of traditional and LCUS protocols. The data available for this study was not sufficient for a more patient centered analysis such as cost per life saved or cost per correct diagnosis. An averaged patient was used in the analysis i.e. it was not based on actual individuals, which may introduce some minor inaccuracy. Furthermore, the travel time was estimated using the speed of 80 km\/h, which reflects the speed limit of the majority of the roads in the area. Although this might cause a slight underestimate of the travelling time it was considered better than overestimating it. The goal of data collection was to gather as much data as possible and we are confident that the results reflect the actual expenses in Finland fairly well. However, the study was local regarding the organization of the Finnish health care system and the results cannot be straightforward extrapolated to other countries.","title":"Cost-minimization modeling of venous thromboembolism diagnostics: performing limited compression ultrasound in primary health care reduces costs compared to referring patients to a hospital"}
{"_id":"da6a76cf-4380-5d02-3fe8-4ae77e881149","text":"Salivary gland mucosa associated lymphoid tissue lymphoma should be considered in the differential diagnosis of cystic or bilateral salivary gland lesions. Parotidectomy is recommended in order to treat the tumor and to ensure histological diagnosis for further follow-up planning. Radiotherapy and chemotherapy should be considered in association with surgery in disseminated forms or after removal.","title":"Primary parotid gland lymphoma: a case report"}
{"_id":"da6bef18-c6de-beb6-c785-b30eeb87f718","text":"The first results demonstrate that HSI can differentiate between patients with and without PAD. Furthermore, an increased tissue oxygenation after endovascular or surgical revascularization can be recognized. Cut off points for more precise prediction of the disease development are currently assessed in different angiosomes of the foot and lower limb and additional participants are recruited for the study. This might allow statistical quantification of these and other subgroups as well as establishing standard values for StO2 and NIR. Perspectively, HSI might be useful for screening of and follow-up in patients with PAD.","title":"Abstracts DGG"}
{"_id":"da6de489-522c-d110-365f-2c35274bf227","text":"A 66-year-old male without underlying disease suffered a pedestrian traffic accident that resulted in a comminuted segmental tibia fracture and segmental fibula fracture with soft tissue defects as Gustilo–Anderson type IIIB fracture on his left lower leg. Unfortunately, he also suffered open calcaneal fracture with soft tissue defects on the ipsilateral side. An emergent operation was performed in a local clinic. Wiring of the bone fragment and application of an Ilizarov external fixator were performed, but the patient was referred to our trauma unit 7 days after the injury to cover the extensive soft tissue defect.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"da75ca1c-38cc-13d5-7c6e-abeba1f0c421","text":"Dissection done in the blood less plane along with the external auditory meatus cartilage till the zygomatic arch root.","title":"True bony TMJ ankylosis in children: Case report"}
{"_id":"da7708eb-8f45-d353-980f-d038607809da","text":"Pedicled cross-extremity flaps for lower limb wound coverage have been replaced by free tissue transfer in the last two decades. However, there are certain difficult situations where the free flap cannot be employed and alternative methods are needed. We describe our experience with cross-leg flap in 18 patients for the reconstruction of difficult leg defects in which no suitable recipient vessels were available for microvascular anastomosis in the vicinity of the defect.","title":"Cross-leg flap: Its role in limb salvage"}
{"_id":"da79d760-84fd-6356-46a5-9018de556bd8","text":"Knowledge of the exact location of the sentinel node helps to focus the surgical dissection and to reduce the morbidity of sentinel lymph node biopsy procedures, in particular the risk of arm lymphedema, without compromising sensitivity.","title":"New classifications of axillary lymph nodes and their anatomical-clinical correlations in breast surgery"}
{"_id":"da7b7443-0db8-f09c-9d3d-1d8b9a9d52f8","text":"IGAP flap is thicker and has a shorter pedicle than the gluteal thigh flap. These features and the fact that the IGAP flap is closer and similar to the tissues lost to the pressure sore make it the first choice to treat ischiatic pressure sores. The gluteal thigh flap, due to the reduced thickness, longer pedicle, and wider arc of rotation, should be regarded as an option on recurrent sores or in patients presenting ulcers located in the medial parts of the perineum.","title":"Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps"}
{"_id":"da7e15cd-b47e-ee07-5c01-99141fefb231","text":"The study aims to describe the lingual laser frenotomy perioperative protocol for newborns with ankyloglossia with or without breastfeeding difficulties developed by Odontostomatology and Neonatology and Neonatal Intensive Care Units of the Aldo Moro University of Bari.","title":"Lingual laser frenotomy in newborns with ankyloglossia: a prospective cohort study"}
{"_id":"da82939a-e06c-9121-e7d4-4c92ebb771d9","text":"The application of the Fuhrman grading system in practice is complicated as there are three separate parameters within each grade, and involves the simultaneous assessment of nuclear size, nuclear shape and nucleolar prominence. There are no directions as to how these parameters should be stratified if they individually provide conflicting information. It is not surprising that this grading system has been shown to have poor to moderate inter-observer reproducibility and this is likely to be due to the subjective nature of the grading process (17). To compensate for this, many pathologists using the Fuhrman grading system have utilized nucleolar grade alone, which is not the recommendation of the Fuhrman grading system.","title":"The ISUP system of staging, grading and classification of renal cell neoplasia"}
{"_id":"da8c9310-af7e-73c4-218e-68aa0104a69c","text":"Technical success was defined as an adequate formation of the ice ball to include the entire lesion with a safety margin of at least 5 mm. Post-procedural inpatient complications were classified according to the Clavien-Dindo system. The length of hospitalization was calculated as the number of nights spent in the Urology Department after the treatment.","title":"Percutaneous CT-Guided Renal Cryoablation: Technical Aspects, Safety, and Long-Term Oncological Outcomes in a Single Center"}
{"_id":"da8dbda4-aaf1-5ac6-724f-628c85e12397","text":"Retrospective analysis of 79 cases of basal cell carcinomas submitted to punch biopsy and subsequent Mohs surgery.","title":"Comparison of basal cell carcinoma subtypes observed in preoperative biopsy and Mohs micrographic surgery"}
{"_id":"da8f9671-7859-01ca-2186-13d01168a1a5","text":"The authors had a long discussion with the patient and family in view of his advanced age and the risks of proceeding with surgery. Their primary surgical goal was to improve both his functional status and activities of daily living. Given his significant decline in functional status leaving him wheelchair-bound with high morbidity risks and poor quality of life, it was decided that the benefits of intervention outweighed the risks. The patient was medically optimized prior to surgery with full cardiac evaluation and clearance to decrease perioperative risk. His clinical presentation, physical exam findings, and pre-operative imaging were suggestive of compression of both the lower medulla and cervical spine and so we elected to complete a multi-level laminectomy.","title":"Retro-Odontoid Pseudotumor with Cervical Medullary Compression: A Case Report"}
{"_id":"da901ab9-a44f-4235-4e12-357fd6a7e2b8","text":"The purpose of the present article is to demonstrate how and why through a review of the current literature.","title":"The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management"}
{"_id":"da9b5b38-64f3-ac3a-80fc-8da9217fa9dd","text":"All the data referring to the detection of the methylene blue-lidocaine solution in the different evaluated structures are shown in Figure 5 and Table 1 and Table 2.","title":"Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers"}
{"_id":"daa8ad33-bc63-e654-4371-ea7c861f19a7","text":"All the above examples are the solutions proposed by researchers in order to achieve a strong tumor suppression effect, while protecting normal tissues from thermal damage as much as possible. Many of them obtained some good results, presenting the value of clinical translation in the future.","title":"Solutions to the Drawbacks of Photothermal and Photodynamic Cancer Therapy"}
{"_id":"daa9a313-cc67-8afe-208a-8fb010d4da38","text":"The study will compare TEA with sham TEA to explore the feasibility for TEA in improving facial expression muscles atrophy after peripheral facial paralysis.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"daa9fcca-e995-a3b8-076a-605850a181c5","text":"Hence, the correlation between thrombotic markers and DVT thrombus volume during the perioperative period in patients who underwent knee surgery was investigated in the present study.","title":"Fibrin monomer complex on postoperative day 1 is correlated with the volume of deep vein thrombosis after knee surgery"}
{"_id":"daabf02d-0f6a-5713-7564-49280e3f7ed8","text":"The feature classifications of the patient’s nose were defined according to photographs taken before the injury. After the corresponding classifications were entered into the search field of the database, the proper nasal model could be selected automatically for nasal prosthesis design. Use of the database was an efficient solution for the lack of data sources and was an indispensable step in nasal prosthesis design.","title":"Development and application of a rapid rehabilitation system for reconstruction of maxillofacial soft-tissue defects related to war and traumatic injuries"}
{"_id":"daacd381-19d3-d68e-e2ea-7212fb282182","text":"The results of the present study indicated that the effects of BTX induced muscle inhibition did not occurred only at the masticatory load bearing area. The cortical thickness and cortical bone density of RAM and COR showed significant decreases after BTX injection, especially in post-menopausal females. Previous animal models of rabbits showed similar results, with reduced cortical thickness at the masseteric ridge and the coronoid process after BTX injection in the temporalis and masseter muscles. Therefore, reduced masticatory muscle thickness after BTX injection may lead to decreased cortical bone quality not only at the masticatory load bearing area but also muscle insertion sites. Interestingly, those effects seemed not to be prominent in young females. The diminished ability to adapt to mechanical unloading and reloading in aged rats has been observed, however the influence of aged muscles at their attachment site remains obscure. Hence, we carefully suggest the possibilities that bones in post-menopausal females could have an altered adaptive response not only to mechanical unloading but also to reduced strain at the muscle insertion site.","title":"Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults"}
{"_id":"dab2569c-bfba-df65-f4fe-32db784693fa","text":"Our findings indicate that SLN metastases in pure DCIS are a very rare occurrence. SLN biopsy should not therefore be routinely performed in patients who undergo resection for DCIS. SLN mapping can be performed, as a second operation, in cases in which an invasive component is identified in the specimen. Only DCIS patients who require a mastectomy should have SLN biopsy performed at the time of breast operation, since in these cases subsequent node mapping is not feasible.","title":"Role of axillary sentinel lymph node biopsy in patients with pure ductal carcinoma in situ of the breast"}
{"_id":"dab4cc12-d2dd-5fdd-43aa-f387042a0884","text":"The tissue samples collected in sterile saline solution were homogenized with a vortex mixer for two minutes and centrifuged twice at 4000 × g for 5 min and 30 min. Two hundred microliters of the sediment was transferred to two plates with Löwenstein-Jensen culture media; one plate was incubated at 37°C and one was incubated at room temperature for up to 6 weeks before confirming a negative result.","title":"Infections in patients with adverse reactions to the use of unknown modeling substances for soft tissue enhancement in Cali, Colombia"}
{"_id":"dabc96ed-b161-2405-3fab-a8a58be865a9","text":"To achieve re-osseointegration, in addition to a surgical approach, such as guided bone regeneration, the microbes must be completely removed from the implant surface. Complete cleaning is challenging not only because of the complex macrogeometry of the implant body but also because of the rough microstructure of the implant surface, which both hampers instrument access and impedes biofilm removal. Residual microbes can reorganise into a biofilm and revive the inflammation process. This background shows that thorough debridement is important. A strategy to destabilise the biofilm matrix could improve the efficacy of mechanical implant cleaning during a flap surgery by removing microorganisms from implant areas that are difficult to access and treat. If chemical substances are used during surgery, they must not interfere with wound healing by damaging cells.","title":"Enzymatic biofilm destabilisation to support mechanical cleansing of inserted dental implant surfaces: an in-vitro pilot study"}
{"_id":"dabdf7d8-8b4d-d492-3018-4c30b572e3b1","text":"Our study provides evidence of the utility of intraoperative ultrasonography for removing plant material from iliopsoas muscles via ventral midline laparotomy. In previous reports of dogs with iliopsoas myositis, migrating plant material was often suspected or visualized by preoperative imaging, but was retrieved during surgical exploration in only some cases. The cause of this retrieval failure can only be speculated upon: it is possible that in these cases, the plant material had migrated from the abscess and exited via the fistula prior to surgical exploration, or that the plant material was not located within the abscess but elsewhere in the musculature or lumbar parenchyma during surgical exploration. In either situation, intraoperative ultrasonography would have likely guided the surgeons to the plant material or conclusively demonstrated its absence, as we have demonstrated in this study, increasing the rate of successful retrieval of plant material. When a grass awn was ultrasonographically identified, intraoperative ultrasound allowed the surgeon to grasp the tip of the grass awn after making a precise incision through the muscle, minimizing the risk of fragmentation and iatrogenic muscle damage. To the author’s knowledge, this is the first report of such a surgical strategy for removing plant material from iliopsoas muscles.","title":"Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs"}
{"_id":"dac0e032-2f4d-1b7a-4ac7-7fbd9de46b96","text":"Arterial supply to the hind limbs diverges considerably from the human equivalent. The superficial femoral artery divides into the saphenous and popliteal arteries at the mid third of the femur. The saphenous artery emits branches that supply the greater part of the musculature, including the plantar and dorsal digital arteries. The popliteal artery penetrates the interosseous membrane in the anterior direction, from where it becomes the cranial tibial artery and supplies several muscular branches.","title":"Comparative angiotomographic study of swine vascular anatomy: contributions to research and training models in vascular and endovascular surgery"}
{"_id":"dac2df3c-bc0a-4fe3-c8dc-e986aa78e69f","text":"Should we continue to do extemporaneous examinations on sentinel lymph nodes?","title":"The Sentinel Lymph Node in Breast Cancer: Problems Posed by Examination During Surgery. A Review of Current Literature and Management"}
{"_id":"dad9c46c-7548-b375-851e-a7f8950b6ead","text":"The isolation of the bacteria is more accurate when cultures are taken from biopsy material from synovial tissue and ultrasonication increases the yield. The prior history of the patient to antibiotic resistance to the delayed healing of wounds in the patient's history should be investigated.","title":"Explaining Osteomyelitis and Prosthetic Joint Infections (PJI) in terms of Biofilm – A Review"}
{"_id":"dae72fda-9294-c6b1-8cfd-935b17ed88c7","text":"Local reactions that consist of swelling of the arm, redness or tenderness at the site of injection are usually handled with simple measures such as local cold compresses or the use of medications such as antihistamines or aspirin.","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"daece5bc-49d0-b897-ea33-0f6865e4b740","text":"Several hypotheses could be proposed to explain the lack of dynamic deficit recovery.","title":"Efficacy of LED Photobiomodulation for Functional and Axonal Regeneration After Facial Nerve Section-Suture"}
{"_id":"daed7660-794e-5a3a-b9bd-30ae48efa1bc","text":"WB-MRI at an early stage of suspected CRMO plays a key role for early diagnosis. This is the first study showing that quantitative MRI features are suitable for response assessment and can be used as prognostic markers for the prediction of clinical response.","title":"Early diagnosis and response assessment in chronic recurrent multifocal osteomyelitis: changes in lesion volume and signal intensity assessed by whole-body MRI Kieninger et al"}
{"_id":"daf0b999-ad7d-2565-0425-14dede8f4076","text":"Therefore, our first hypothesis is that facial contrast of all regions of the face should decrease similarly across faces of different races or ethnicities. If there is a global decrease of facial contrast with age in female faces of different races or ethnicities, we expect facial contrast to be a relevant cue for age perception independent of the ethnic origin of the face and the cultural origin of the observer.","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"daf6b061-4a4f-4722-65c3-b9778f412f1c","text":"As the prevalence of diabetes mellitus continues to rise, innovative medical and surgical treatment options have increased dramatically to address diabetic-related foot and ankle complications. Among the most challenging clinical case scenarios is Charcot neuroarthropathy associated with soft tissue loss and\/or osteomyelitis. In this review article, the authors present a review of the most common utilizations of negative-pressure wound therapy as an adjunctive therapy or combined with plastic surgery as it relates to the surgical management of diabetic Charcot foot and ankle wounds.","title":"Negative-pressure wound therapy in the management of diabetic Charcot foot and ankle wounds"}
{"_id":"daf7fce9-4cf1-991b-b52b-761ed9e3aee7","text":"We were not able to retrieve data about the size of the sternal defects, which would have been interesting to show the maximum size of the defects that we could cover using this technique.","title":"Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap"}
{"_id":"dafe05e8-adf0-50ed-3799-5556fd8dfc8c","text":"According to an article published by the Australian Journal of Plastic Surgery, cosmetic surgery is defined as any invasive procedure where the primary intention is to achieve what the patient perceives to be a more desirable appearance and where the procedure involves changes to bodily features that have a normal appearance on presentation to the doctor. Cosmetic treatments can be surgical, such as breast augmentations and rhinoplasty, and nonsurgical such as botulinum toxin and fillers. Social media are gaining popularity worldwide as being a method used to advertise for cosmetic treatments. Social media are integrating into many aspects of daily life in Saudi Arabia, which has one of the most active populations on social media platforms. It is important to determine the role of these advertisements in influencing the patient’s decision to undergo a cosmetic procedure.","title":"Influence of Social Media on the Decision to Undergo a Cosmetic Procedure"}
{"_id":"daffee07-b391-f63b-2fb7-8fe7a5b8bf5f","text":"We used probability statements regarding the diagnosis that were actualized as data accumulate, allowing to quantify how the degree of belief could change to account for evidence from those exams.","title":"The appropriate and sequential value of standard radiograph, computed tomography and magnetic resonance imaging to characterize a bone tumor"}
{"_id":"db03e9c0-861e-a296-d515-0ddf838359d5","text":"Physical as well as emotional and psychological trauma is a major component of FGM, and a multidisciplinary approach with psychiatrists, therapists, Gynaecologists, and plastic surgeons is needed to optimize care for FGM survivors. Post reconstruction sexual rehabilitation must also be addressed to promote recovery and improved sexual function after reconstructive surgery. Even the best technical reconstruction cannot guarantee improved function and quality of life for these women if the psychological component is not properly addressed.","title":"The Role of Plastic Surgeons in Female Genital Mutilation Reconstructive Surgery"}
{"_id":"db06e21a-f2f2-8827-3569-91bf026a20a4","text":"KVP was the lead surgeon who operated on our patient and is the main author of the manuscript. IDB was the assistant surgeon and was a major contributor to writing the manuscript. RAC also contributed to writing the manuscript. All authors read and approved the final manuscript.","title":"Knee extensor loss and proximal tibial soft tissue defect managed successfully with simultaneous medial gastrocnemius flap, saphenous fasciocutaneous flap and medial hemisoleus flap: a case report"}
{"_id":"db085b8a-21d9-1e10-f047-87ed7021c202","text":"The proportion of fellows who chose their program based on the fellowship's curriculum or its area of focus was the same as the proportion of those who made their choice based on the institution's name or reputation.","title":"Improving Knowledge and Process for International Emergency Medicine Fellowship Applicants: A Call for a Uniform Application"}
{"_id":"db0c7141-73e8-e7a7-0712-6f611ce72668","text":"The second reoperation was in the RWB group where an APC fracture in a patient with sacral dysmorphism had early removal of one of the two ISS at 3 months (S2) after complaining of radicular-like pain symptoms. One S1 screw and a 6H anterior symphyseal plate remained in situ. During follow up review at 6 months the patient experienced anterior and posterior pelvic pain, symptomatic diastasis and failure of metalwork. This patient went on to have 90–90 anterior double plating with iliac crest bone grafting and further reimplantation of a second ISS and then healed uneventfully by 6 months, pain free clinically and fused on CT.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"db0cb2fd-385c-c84c-7599-efe7ff8e0f92","text":"Retrospective record review of children with JDM attending a tertiary hospital in South Africa.","title":"Juvenile dermatomyositis in South African children is characterised by frequent dystropic calcification: a cross sectional study"}
{"_id":"db177e88-7a59-b6a1-da4e-51c3763c1b67","text":"Together these results show that sensitization and intraperitoneal challenge with the venom of T. nattereri promote an allergic response characterized by mast cell-dependent acute phase of anaphylaxis followed by the influx of eosinophils to the challenge site guided by Th2 cytokines.","title":"Anaphylaxis induced by Thalassophryne nattereri venom in mice is an IgE\/IgG1-mediated, IL-4-dependent phenomenon"}
{"_id":"db17a71f-e361-b1a9-f03c-51fcb61d0c40","text":"We included all patients with breast cancer undergoing stereotactic biopsy who developed suspicious calcification at lumpectomy scar site on annual follow-up mammogram after BCS with no mass on correlative ultrasound from January 2010 to December 2021. We excluded patients undergoing stereotactic biopsy for suspicious calcifications before surgery, calcifications in contralateral breast on postsurgical mammogram, calcifications at a site other than lumpectomy scar, and distant metastasis at the time of diagnosis.","title":"Recurrence Yield of Stereotactic Biopsy of Suspicious Calcifications After Breast Conservation Therapy"}
{"_id":"db1b98ff-c973-a8c1-a2dc-74e868746bcf","text":"Tinnitus duration varied from 4 to 6 months in subacute patients and over 6 months to a few decades in chronic patients.","title":"Integrative Treatment for Tinnitus Combining Repeated Facial and Auriculotemporal Nerve Blocks With Stimulation of Auditory and Non-auditory Nerves"}
{"_id":"db1d0d0a-7a38-c26c-9289-7353838d0db8","text":"While there is universal agreement that ‘primary palatal repair should be done at the age that allows optimal speech development and facial growth’,27 there is little agreement about precisely what that age should be.13–17 27 Currently, the debate is between primary repair at 6 versus 12 months of age.41 Dorf and Curtin13 showed that children who undergo palate repair after 12 months of age exhibit more compensatory articulations, which require speech therapy to correct. This result has been confirmed by several others, yet none of these studies examined rates of secondary surgery for both speech and fistulae.15 26 Our results show the hazard of secondary surgery is initially 6.7-fold higher for children who have palate repair before 9 months of age and that this increased hazard persists for 5 years after surgery. We do not believe this increased hazard with early palate repair is due to underlying patient differences, as complicating medical or socioeconomic conditions lead to repair at older rather than younger ages in our experience. The Timing of Primary Surgery for Cleft Palate trial is an ongoing randomised control trial comparing palate repair at 6 and 12 months of age and results should be available by 2021. Until then, our study suggest that surgeons and hospitals should be cautious to recommend cleft palate repair before 9 months of age and do so only after reviewing their own results.","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"db1db36b-e4ad-10c2-9998-7eb710a8a5d3","text":"Google Inception v3 was used as a foundation architecture for computational image analysis. Using hematoxylin and eosin-stained slides, a neural network segmentation classifier was trained to identify the tumor from the surrounding microenvironment. Because the dataset included lymph node and subcutaneous tissue sections, the classifier was trained to identify lymphocyte clusters and connective tissue in addition to tumor compartments. This segmentation classifier distinguished regions of interest with high accuracy. A response classifier was then trained to identify whether patients responded to checkpoint blockade or were resistant and progressed. A logistic regression classifier that combined neural network output with clinical and demographic variables (ECOG performance status) augmented the prediction accuracy. Class activation mapping revealed that cell nuclei played an important role in the decision to classify samples as progressive disease or response, with more and larger nuclei associated with a prediction of progression. Based on these findings, machine learning on metastatic melanoma tissue histology shows potential for predicting immunotherapy response, especially if integrated with clinical data.","title":"Perspectives in Melanoma: meeting report from the Melanoma Bridge (December 3rd–5th, 2020, Italy)"}
{"_id":"db20447f-7b23-5929-2516-50df57fbdea4","text":"Changing the position of the arm in 90° abduction and 90° external rotation enhances significantly the cross section area of the vein which can make the ultrasound guided cannulation easier and safer.","title":"37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3)"}
{"_id":"db21bbdd-fe9b-4c19-9df7-d26d0eddc7e6","text":"Our analysis showed that mothers who were counseled about EBF during postnatal care were more likely to exclusively breastfeed their children until 6 months than those who did not. This finding is supported by studies performed in Halaba and Debremarkose. This could be due to Support from skilled health care providers through breastfeeding counseling allowing women to make a well-informed decision on whether to breastfeed and to feel confident in her abilities if she decides to breastfeed. The other possible justification could be that breastfeeding counseling also improves mothers’ skills and helps to solve difficulties that may arise during breastfeeding. This could be true in countries that work to ensure infant and young child feeding counseling is available in healthcare facilities and upholding a woman’s right to information and health.","title":"Exclusive breastfeeding practice and associated factors among mothers of infants age 6 to 12 months in Somali region of Ethiopia"}
{"_id":"db2a33e8-689c-75c8-c8f4-4989823e76b5","text":"Women with increased hereditary risk of breast cancer who had undergone prophylactic mastectomy at the Department of Plastic Surgery at Umeå University Hospital between 1997 and 2016 were invited to the study. The study was prospective in that all women who met the inclusion criteria were invited to undergo imaging surveillance with breast MRI to assess the presence of residual glandular tissue during 2017.","title":"Inter- and intra-observer agreement on evaluating the presence of residual glandular tissue with magnetic resonance tomography following prophylactic mastectomy"}
{"_id":"db2c4150-220a-90b4-b3db-a822d584d7fa","text":"To report a case of varicella complicated by acute osteomyelitis in order to remind of a rare and potentially serious complication of a very common pediatric disease.","title":"RIB OSTEOMYELITIS: A RARE COMPLICATION OF VARICELLA OSTEOMIELITE DE ARCO COSTAL: UMA COMPLICAÇÃO RARA DE VARICELA"}
{"_id":"db33457b-0714-78e4-95d5-0e3e2d0b33c2","text":"While there are many published studies investigating the various techniques used to close laparostomy, there are few which include the use of BTA as an adjunct in the acute setting. This review showed primary fascial closure in 83% of patients who had BTA therapy in conjunction with more traditional methods. This improves upon our previous rate of 70% primary fascial closure despite the BTA group comprising a sub selected poor prognosis group. If BTA can be injected at the first available opportunity it will likely aide timely fascial approximation due to its ability to lengthen lateral abdominal wall muscles reducing the laparostomy defect. While this review centred on primary fascial closure, resulting ventral hernia should also be a driving force in improving fascial closure rates. The use of BTA as an adjunct means the laparostomy closure will be under less lateral tension for approximately 2.5 months, this may reduce the incidence of ventral hernia through incomplete fascial closures. The ease of BTA application as an adjunct to many of the techniques already used by surgeons will likely improve primary fascial closure rates.","title":"Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases"}
{"_id":"db36d6cc-b8d2-fe56-7007-03c016a60cd4","text":"VR fellowships are of a high standard giving fellows the experience necessary to improve perceived confidence allowing progression into consultant posts.","title":"Experience gained during vitreoretinal fellowships in the United Kingdom"}
{"_id":"db382f56-2326-b56a-0c9b-944355afa24e","text":"Three stage axillary lymphatic massage improves the successful identification of a blue sentinel lymph node in breast cancer patients.","title":"Three stage axillary lymphatic massage optimizes sentinel lymph node localisation using blue dye"}
{"_id":"db3ed333-e8b6-8854-8221-41c3958b1676","text":"Musculocutaneous flaps are compound flaps, which are supplied by one or more vascular pedicles and which involve subcutaneous fat tissue of the muscle fascia and the skin. The pedicles entering between the origo and insertion of the muscle consist of the vessels supplying the muscle. So that the muscle can be used as a flap, the whole muscle or a part of it should be mobilized. The surgical procedure performed for the mobilization of the muscle should not disrupt the sanguination of the muscle. When necrosis develops in a muscle following resection of its pedicle, that pedicle must be the major or the dominant pedicle. Minor or nondominant pedicles are small vascular structures connected to muscles.","title":"The creation of new rotation arc to the rat latissimus dorsi musculo-cutaneous flap with delay procedures"}
{"_id":"db3f2568-d9cc-44fc-d1ea-c2047072b602","text":"The small number of our patients and not applying FNA for suspicious lymph nodes by considering clinician preference are the limitations of our study. Although AUS is a method with high sensitivity and specificity for the detection of lymph node metastases, it does not rule out metastasis. It may direct to SLNB cases that are considered to be negative in AUS and ALND can be avoided in the SLNB-negative cases. When metastatic character lymph nodes are observed on AUS, they may be directed to ALND without application of SLNB by providing a correlation with US-guided FNA.","title":"Preoperative Evaluation of Axillary Lymph Nodes in Malignant Breast Lesions with Ultrasonography and Histopathologic Correlation"}
{"_id":"db4e8c23-0f09-6ccd-d0ab-21f26a729282","text":"There are no interim analyses at a fixed point in the study protocol planned. Since the intervention is not suspected to have an impact on patient safety, termination of the trial is not planned.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"db569d03-7155-40a7-c4c2-ed38cbea05ad","text":"Social networks are defined as the voluntary web of relationships between people who exchange material, informational or emotional support. The most commonly examined aspect in friendship networks involving people with breast cancer has been the size of the network in terms of number of participating members as well as their potential to solve problems arising from the disease. Researchers have found that networks with greater social integration are closely associated with better survival and better quality of life after breast cancer [38].","title":"Mastectomized women’s perception of breast cancer early detection"}
{"_id":"db59a74d-2acb-7571-ce19-ecfdaabf548d","text":"The current findings showed that preoperative mechanical prophylaxis significantly reduced the incidence of symptomatic DVT following HFS in elderly patients over 70 years of age compared with this age group who was not receiving preoperative mechanical prophylaxis. Meanwhile, there were no significant differences in symptomatic and life-threatening PE and mortality between both groups.","title":"Does preoperative mechanical prophylaxis have additional effectiveness in preventing postoperative venous thromboembolism in elderly patients with hip fracture?—Retrospective case-control study"}
{"_id":"db608eae-b722-0044-41e2-e97205c3b95d","text":"Older age groups were more likely to be concerned about the ageing effects of sun exposure and less likely to think a suntan made them look more attractive. However, they were more likely to think suntan made them look healthier.","title":"SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample"}
{"_id":"db66dca8-ab98-5312-723b-620900a49b75","text":"Representative gross images of the four types of breast implant shell surfaces are shown in Figure 2.","title":"Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant"}
{"_id":"db6da4ab-40b2-5378-29f9-530b8a34cf22","text":"To our knowledge, no studies have assessed the impact of breast implants on dose distribution in a large cohort of patients after mastectomy undergoing conventional tangential radiotherapy.","title":"No difference in dose distribution in organs at risk in postmastectomy radiotherapy with or without breast implant reconstruction"}
{"_id":"db705784-5d0e-8dd4-4245-6ea1c2c25cf8","text":"Clinical data of 18 patients undergoing latissimus dorsi myocutaneous flap in combination with iliac bone flap grafting were retrospectively analyzed. Among them, 2 patients developed chronic osteomyelitis of the lower segment of the femur, 4 were diagnosed with chronic osteomyelitis of the tibial plateau, and 12 with chronic osteomyelitis of the lower segment of the tibia.","title":"Combined application of latissimus dorsi myocutaneous flap and iliac bone flap in the treatment of chronic osteomyelitis of the lower extremity"}
{"_id":"db75068e-d3d4-dd20-fa08-55c08340c642","text":"The WSES expert panel classified soft tissue infections using the classification system illustrated below.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"db76b99d-4cf2-e575-2bea-2fb492a90dca","text":"All patients presenting to the ED over 50 years of age who had a positive D-dimer result exceeding the local trust assay.","title":"The application of an age adjusted D-dimer threshold to rule out suspected venous thromboembolism (VTE) in an emergency department setting: a retrospective diagnostic cohort study"}
{"_id":"db8196b8-ddc4-eb6a-2526-524a80d19c8a","text":"Dissection proceeded superiorly till the axillary vein was identified. The thoracodorsal bundle was identified and preserved before mobilization of the axillary fat pad and dissection off the chest wall and the inferior surface of the axillary vein and off the thoracodorsal bundle posteriorly. The intercostobrachial nerve was preserved if possible but small branches running through the axilla fat pad that cannot be spared were ligated.","title":"Measuring upper limb function and patient reported outcomes after major breast cancer surgery: a pilot study in an Asian cohort"}
{"_id":"db84a0a8-412d-fc87-75a6-4d396839a7ff","text":"Based on the results of this study, the ideal candidate for an academic trauma fellowship will have research experience, have had exposure to orthopaedic traumatologists during residency, and have an interest in an academic career. They must also have excellent letters of recommendation and demonstrate the potential to be a leader during the interview. Candidates for nonacademic orthopaedic trauma fellowships do not need extensive research experience and may come from a program that does not have prominent faculty. However, they must also interview well and have excellent letters of recommendation.","title":"The Competitive Orthopaedic Trauma Fellowship Applicant: A Program Director's Perspective"}
{"_id":"db8caff0-e36f-2f21-a0d3-ba1c51f156fc","text":"A variety of techniques have been described for closure of the perineal defect following APR for rectal cancer. To date there is only one published randomised controlled trial on perineal wound closure after APR [2]. This study compared biological mesh closure with primary wound closure, and showed no improvement in primary wound healing after biological mesh closure. The absence of an effect is probably related to the properties of the mesh: a mesh adds strength to the pelvic floor, but does not fill the perineal defect. There is still a possibility of fluid accumulation in the perineal defect with the risk of secondary contamination.","title":"Perineal wound closure using gluteal turnover flap or primary closure after abdominoperineal resection for rectal cancer: study protocol of a randomised controlled multicentre trial (BIOPEX-2 study)"}
{"_id":"db8d5ec4-1439-d2de-75c0-e012a5cd8cb8","text":"Academic development for fellows is further supported with ample opportunities for research and scholarly productivity. Fellows develop a network of mentors with their federal and NGO partners tailored to suit their particular research interests.","title":"Creating climate-informed physician leaders: The evolution of a physician fellowship in climate and health science policy"}
{"_id":"db966a61-e53a-511c-31a4-1d2290d249c0","text":"Salmonella osteomyelitis clinically and radiologically indistinguishable from osteomyelitis caused by other organisms. Adequate duration of antibiotics sensitive to the microbiological assay in addition to operative intervention offer a good outcome.","title":"Salmonella Osteomyelitis in a one year old Child without Sickle Cell Disease: A Case Report"}
{"_id":"db9806a7-97b5-d04e-a547-6d18254dced1","text":"Diagnosing and examining AD in medical practices is primarily completed through visual assessment by looking at the skin lesions after the symptoms of the condition have emerged. New research has revealed that there are other biomarkers of AD in the skin of patients—such as IgE, chemokine, ceramide, and cytokine proteins—that can provide an empirical estimation of the severity of the disease and in the case of cytokine can even predict the emergence of the condition without any apparent symptoms. These biomarkers can be obtained through the means of biopsy, blood serum extraction and skin tape stripping. These empirical examinations are much better than the conventional visual ones because they rely on measured data instead of a subjective approach. Unfortunately, all these tests can only be performed in a controlled laboratory environment and require complex equipment and a qualified lab technician to correctly assess the results. Furthermore, they are all invasive and in the case of biopsy very stressful for the patients. Thus, these methods cannot fall in line with the e-health directive of providing non-invasive and remote monitoring to patients around the world, and the need for a new generation of sensing technologies for skin condition diagnosis and monitoring becomes more apparent. Table 1 summarizes the current medical tests for AD diagnosis and highlights their drawbacks.","title":"Electromagnetic Sensing Techniques for Monitoring Atopic Dermatitis—Current Practices and Possible Advancements: A Review"}
{"_id":"db9f097d-6aa0-eed0-81fa-3e21f494ca8a","text":"In a meta analysis done to evaluate the effectiveness of PRP for periodontal regeneration in the treatment of intrabony defects, it was concluded that PRP might offer some beneficial effects on clinical and radiographic outcomes for regeneration of periodontal intrabony defects [23]. The results of the present study is in accordance with the same, where there was decrease in the PPD and initiation of bone fill when the intra bony defects were treated using PRP. A systematic review and meta analysis that was conducted to evaluate the effect of platelet-rich plasma on clinical outcomes of the surgical treatment of periodontal intrabony defects suggested that PRP may be beneficial as an adjunct for the treatment of periodontal intra bony defects [24]. According to the results of our present study, although both the groups showed a significant difference in the clinical parameters but the use of bone grafts showed a better result in terms of bone formation. Hence it can be suggested that PRP when used along with bone graft might present with superior results.","title":"Effectiveness of Platelet Rich Plasma and Bone Graft in the Treatment of Intrabony Defects: A Clinico-radiographic Study"}
{"_id":"dba3d24e-e175-1224-4ecc-1b2c6f410694","text":"There was no difference in graft take between fresh and chronic wound sites. Almost complete graft take was the rule in all cases apart from mild epidermal skin peeling in four cases and small spots of graft necrosis in three cases. Primary wound healing at donor sites was the rule with scar hypertrophy in six cases necessitating scar conservative care for few months.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"dba7ee3d-222e-6cdb-9991-2bc981540f06","text":"Although the iBRA study addressed many of the feasibility issues relating to a future trial including the most appropriate comparators, it did not include a randomised study. It is therefore not clear whether surgeons will recruit patients to an RCT comparing two approaches to IBBR or whether patients will consent to be randomised and agree to receive their allocated treatment. Further feasibility work is therefore needed.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"dbb29ce0-b3d7-4ade-e7b1-cef146850e1f","text":"The main goal of treatment is an oncological cure, but one should also aim to preserve function and maximum healthy tissue in addition to a satisfactory cosmetic result.","title":"Mohs micrographic surgery in rare cutaneous tumors: a retrospective study at a Brazilian tertiary university hospital"}
{"_id":"dbb92b9f-749c-2081-67c7-f9a990565fc9","text":"For cosmetic purposes, surgical excision is the best choice of treatment. If left untreated they can eventually increase in size causing apprehension and cosmetic concern. Malignant degeneration and recurrences are extremely rare and to the best of our knowledge have not been reported.","title":"Nevus Lipomatosus Cutaneous Superficialis: A Rare Case Report"}
{"_id":"dbba7c95-7d98-73ee-4e65-85efa912b32f","text":"In the light of the above, there was an increasing usage of the RDU in our hospital during the evaluated period. The addition of tasks not directly related to an interventional procedure and performed by specialized nurses has also contributed to the rising of its usage. Some of these procedures include mild\/moderate allergic reactions monitorization, treatment and control of extravasations of iodinated contrast at the CT, information about the preparation for CT colonography, and patient control before and after intratumoral injections of drugs or virus. In the second half of 2020 there was also a slight increase in its usage due to hepatic biopsies performed by the Hepatology Service since its Day Unit was under construction. The vascular interventional section has its own recovery room with 2 beds. Since the inception of the RDU, there has been a net increase in the number of vascular interventional procedures performed at the RDU due to the availability of more beds.","title":"Experience and results after the implementation of a radiology day unit in a reference hospital"}
{"_id":"dbbc9edb-9722-1649-ec8c-114781afccaa","text":"BRT may be used to deliver high doses of radiation in a localized volume, thereby reducing the probability of radiation-related side effects that are likely to occur when children are treated with external beam irradiation. The dose required to control STS exceeds that prescribed for the more common pediatric solid tumors which makes it more imperative that measures be taken to minimize the toxicity of radiation therapy and preserve function without compromising local control or overall survival.","title":"High-dose-rate brachytherapy for soft tissue sarcoma in children: a single institution experience"}
{"_id":"dbc4ee95-bc73-352c-376c-58b05eeb1749","text":"In disaster scenarios or health crises that we are facing today in 2020, we are forced to consider, a step down on the reconstructive ladder. The basic essence of our specialty is versatility and adaptability. There is no single best solution to any problem, but the circumstances define what is best at that moment in that particular case. The rapidly ongoing research and observation from across the world should be shared to enlighten the guidelines and experiences about the novel Corona Virus management and prevent complications.","title":"Taking a step down on the reconstruction ladder for head and neck reconstruction during the COVID-19 pandemic"}
{"_id":"dbc74a1f-9b06-a52e-0a87-1d184dd8aa93","text":"Axillary recurrence was defined as the detection of metastatic disease in the axilla based on a positive SLNB. Patients with concurrent breast relapse who had developed axillary disease based on a positive SLNB were not considered as having an axillary recurrence. In these instances, the axillary recurrence could reflect insufficient local control of the primary tumor. Additionally, some articles only mentioned local or locoregional recurrence. The latter were classified as having an axillary recurrence.","title":"Axillary Recurrence After a Tumor-Positive Sentinel Lymph Node Biopsy Without Axillary Treatment: A Review of the Literature"}
{"_id":"dbd2a52d-9377-66f9-73e9-2a2242b1068d","text":"During a follow up period of 24 months; one patient showed local recurrence with evidence of fixity to skull periosteum, which was treated by surgical resection of skull bone with the aid of the neurosurgical team followed by the use of a pedicled Latissimus flap.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"dbd9aca4-1bb4-ba53-eb6e-102b7efddb00","text":"We believe that surgeons should consider the following three items to ensure the safe use of the AV-ETS strategy with the MPETS technique.","title":"A simple free flap strategy using end-to-side anastomosis to the main vessels in injured extremity"}
{"_id":"dbe55e16-2b0f-6351-6937-12e6f7826496","text":"Previous breastfeeding duration, which may be an expression of earlier breastfeeding experience, is strongly associated with the intention and self-efficacy of breastfeeding a future child. The two psychosocial factors intention and self-efficacy explain nearly half of the association between the breastfeeding durations of the first and the second child and are therefore important to consider when planning and conducting future breastfeeding support.","title":"The role of intention and self-efficacy on the association between breastfeeding of first and second child, a Danish cohort study"}
{"_id":"dbe72230-93c7-209e-f7ec-181b78871755","text":"The patients and physicians determined the treatment strategy together in cases with local recurrence or residual tumor.","title":"Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study"}
{"_id":"dbef5381-0a02-fe66-9fbd-d56764c82c3f","text":"Upon dissolution in water, HA forms highly viscous solutions. These solutions are not suitable for use in dermal fillers as they will not stay in place at the injection site and also be rapidly degraded by the enzyme hyaluronidase, resulting in a limited residence time.","title":"Evaluating hyaluronic acid dermal fillers: A critique of current characterization methods"}
{"_id":"dbf2bdd4-7e87-50e3-3b85-7cb800f95b24","text":"Deformities of the lower extremities can be congenital or acquired. Various surgical treatments have been employed for such disorders including osteotomy followed by either external fixation, internal fixation or external fixator assisted internal fixation. The aim of surgery is correction of deformity and restoration of mechanical axis and joint line. External fixator assisted internal fixation with intramedullary (IM) nail insertion is considered the gold standard, however, it is less commonly practiced as expertise required are usually not available at most centers. This study was conducted to assess the radiological and functional outcomes after fixator assisted IM nailing for correction of lower limbs deformity.","title":"Correction of lower limb deformities with fixator assisted nailing"}
{"_id":"dbf5b36f-f8fc-dc63-5ec3-ff869c204996","text":"Some reports also have recommended the use of keratolytic agents such as tazarotene as an adjunct to imiquimod 21. Treatment with keratolytic agents can be initiated 2 weeks prior to initiation of imiquimod and\/or used concurrently with imiquimod. The use of tazarotene is thought to increase the efficacy of imiquimod cream by enhancing drug penetration through the disruption of the stratum corneal barrier 21. Previous reports have suggested the optimal time for the posttreatment biopsy is between 4 and 8 weeks after the last application of imiquimod (in order to give the local inflammatory response time to dissipate). The biopsies for our patients were typically taken during this interval, except for one patient who received his biopsy 1 week following completion of treatment. Interestingly, the biopsy results of this patient showed superficial and deep perivascular and periadnexal lymphoplasmacytic infiltrate with interface changes similar to that of discoid lupus erythematosus. These changes were attributed to the use of imiquimod, and have previously been reported 22. There was no histological evidence of residual MIS on this patient's biopsy.","title":"Using topical imiquimod for the management of positive in situ margins after melanoma resection"}
{"_id":"dbfb925b-df46-0018-0674-1d329ea42475","text":"The limitation of this restorative study is that the conditions such as systemic disease and oral environment of the test and control group could not be perfectly matched. To enhance these drawback, future studies will investigate prospective research for the controlled subjects. In addition, other bone substitutes including xenograft and alloplast might be suggested to use for further research. A strength of the present study is that a large number of subjects using CBCT were involved. The design of this study differs from previous studies in that it directly observed bone changes using CBCT. PPD and CAL may be good clinical indicators. However, radiologic measurement with CBCT is also good and accurate for evaluating the effectiveness of periodontal treatment.","title":"Evaluating Change of Marginal Bone Height with Cone-Beam Computed Tomography Following Surgical Treatment with Guided Tissue Regeneration (Bone Grafting) or Access Flap Alone: A Retrospective Study"}
{"_id":"dbfb9858-ce63-2480-5207-2d45bddb8ecc","text":"Small mucoceles are treated by surgical excision which includes the servicing mucous glands with evacuation of its contents. On the other hand large lesions may be treated by cryosurgery, laser ablation, micromarsupialization and steroid injection. Baurmash has advised on completely unroofing the lesion along its entire periphery to visualize and remove all of the glands present to prevent recurrence of the lesion.","title":"A Novel Technique for the Management of Blandin-Nuhn Mucocele: A Case Report"}
{"_id":"dc069b3a-81e8-4aad-ae7a-441c2ea873a2","text":"The importance of skin manifestations in these patients was further investigated in a recent retrospective study that highlighted that some skin lesions are associated with systemic toxicity.","title":"Cutaneous side effects and types of dermatological reactions in metastatic melanoma patients treated by immunotherapies or targeted therapies: A retrospective single center study"}
{"_id":"dc110bb1-7086-5ceb-2b3b-f2b6e113d587","text":"An SVG can also function as a hood of a second graft (Figure 6). The indication for anastomosing a second vein or arterial graft onto a vein graft hood is an inadequate length of the second graft or the avoidance of proximal anastomoses on an atheromatous ascending aorta.66 John67 suggested the second surgical option for the mismatch between aortotomy and SVG size is to disconnect the vein from the aortotomy, and then to anastomose it in an end-to-side manner to another SVG that has already been joined to the aorta.","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"dc154e8f-bfe3-3bfe-c8ac-ee25e499973f","text":"This case presents a woman with unilateral leg pain and swelling who initially had a negative emergency room workup including a negative lower extremity Doppler study. Upon a repeat visit, she was found to have extensive deep venous thrombosis and was diagnosed with B-cell lymphoma. This case highlights the importance of having patients return for repeat imaging if Dopplers are negative in the initial encounter.","title":"The Role of Serial Ultrasounds in Diagnosing Suspected Deep Venous Thrombosis"}
{"_id":"dc155844-f7ba-34a8-e0d6-d052ca336a61","text":"The study revealed an 11 times greater risk of venous congestion when pedicled perforator flaps were raised in the extremities compared to the trunk. There is a learning curve associated with the identification of perforators using CDU. Furthermore, we need to adapt and individualize the flap design with regard to shape and size according to tissue availability and knowledge of perforator whereabouts and course. CDU can be used as a tool to identify perforators for pedicled perforator flap reconstruction; however, the literature related to this subject is limited.","title":"Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps—a systematic review and meta-analysis"}
{"_id":"dc1723a5-1ae5-5e25-23cf-f3e55772793b","text":"Adjusting for reverse causation by excluding children of age over 6 months or with parental allergic diseases or without parental allergic diseases did not alter these results.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"dc1a5eff-fcd0-ec44-ae7a-e674272d2b7d","text":"Beyond perineal seeding, there is one reported case in the literature of bladder recurrence of prostate cancer post-brachytherapy presenting with biochemical failure. In this case, review of the CT scan obtained for dosimetry at the time of brachytherapy demonstrated a lone catheter protruding through the bladder wall at the site of eventual recurrence.","title":"Perineal recurrence of prostate cancer post-brachytherapy Cooper et al"}
{"_id":"dc22d587-3fb5-c42f-0a48-c07e94f08eb5","text":"Episcleral brachytherapy is currently the most widely used conservative treatment for uveal melanoma. Accurate radiation dosimetry and precise placement of the radioactive plaque in relation to the tumor are the two most important factors to achieve local tumor control and to reduce the risk of radiation-induced side effects.","title":"Cherenkov Luminescence Imaging for Assessment of Radioactive Plaque Position in Brachytherapy of Uveal Melanoma: An In Vivo Feasibility Study CLI in Brachytherapy of Uveal Melanoma"}
{"_id":"dc291346-6934-dadc-47bb-234e84b4e6f9","text":"How can we more accurately predict which patients may develop pathological scars following surgery or injury?","title":"Cutaneous Scarring: A Clinical Review"}
{"_id":"dc2a0302-de1f-ca7d-8f1a-4ddb1bb0d178","text":"A 78 year old Caucasian male presented to our casualty 6 weeks following admission elsewhere with a history of swelling of the right leg and a pulmonary embolus. He had undergone VQ scanning with a proven diagnosis of pulmonary embolus and was therefore anticoagulated with heparin and warfarin.","title":"Deep vein thrombosis and pulmonary embolus associated with a ruptured popliteal aneurysm – a cautionary note"}
{"_id":"dc31fcd2-8b32-ce34-9737-066af7e3d963","text":"The clinical diagnoses are taken from the dermatologist's referrals to pathology. The clinical malignant class includes lesions where malignancy is a differential diagnosis. The clinical benign class consists of lesions that were given a benign diagnosis by the dermatologist but were referred to pathology, which indicates that malignancy could not be ruled out by the dermatologist, even if this was not explicitly stated.","title":"Computer-Aided Decision Support for Melanoma Detection Applied on Melanocytic and Nonmelanocytic Skin Lesions: A Comparison of Two Systems Based on Automatic Analysis of Dermoscopic Images"}
{"_id":"dc342d1c-ae44-03d8-bacf-5b9be6210ac9","text":"Recent advances that include the development of GnRH antagonists have significantly decreased the interval from patient presentation to gamete cryopreservation. In contrast to GnRH agonists, GnRH antagonists immediately suppress pituitary release of FSH and LH and do not require the 10–14 days of administration prior to gonadotropin initiation. GnRH antagonists are initiated at approximately day 6 of gonadotropin stimulation which begins on day 2-3 of a menstrual cycle. This approach still requires awaiting menses prior to initiating gonadotropins but decreases the interval to oocyte retrieval compared to traditional IVF stimulation protocols.","title":"Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review"}
{"_id":"dc484bfc-09b5-1f87-71cc-66fb211b6493","text":"At a regional Danish Centre 131 offspring from nulliparous women with GDM managed by life-style interventions were followed-up for 5 months. Breastfeeding rates were lower and complementary feeding introduced earlier than generally reported in Denmark. Lowest breastfeeding rates were displayed following Cesarean delivery prior to labour. In general, the length of the children was longer and the BMI lower compared with standard WHO and Danish childhood references, and breastfeeding was associated with lower BMI. New initiatives to promote breastfeeding and increase breastfeeding rates among Danish women with GDM should be considered.","title":"Low breastfeeding rates and body mass index in Danish children of women with gestational diabetes mellitus"}
{"_id":"dc502099-4684-2ddd-9137-c9f60b94232b","text":"Antituberculosis chemotherapy is still the cornerstone in the management of skeletal TB. However, the application of posterior and anterior instrumentation with autologous grafts for spinal TB has been reported to be superior to local debridement and anterior bone grafting in recent studies. Autologous iliac crest grafts have long been considered the gold standard grafts for anterior interbody fusion in the treatment of spinal TB, but donor site complications limit autograft availability and lead surgeons to choose effective graft alternatives. With the development of allograft processing and sterilization techniques guided by the American Association of Tissue Banks (AATB) standards, bone allografts have been widely used in spine surgery for several decades. Some pioneers have used fresh-frozen femoral or humeral rings to perform interbody fusion in spinal TB patients and found that allografts and anterior instrumentation are effective in supporting the anterior spinal column. Some people are concerned about the risk of M. TB persisting and recurring if devitalized bone grafts are used, so the use of bone allografts for the treatment of spinal TB remains controversial.","title":"Tricortical iliac crest allograft with anterolateral single rod screw instrumentation in the treatment of thoracic and lumbar spinal tuberculosis"}
{"_id":"dc52b04e-89c2-d3e9-7a26-55a81f779cf7","text":"There is a lack of consistent empirical evidence to guide the timing of intervention in infants with tongue-tie, with available studies evaluating different metrics at varied time points.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"dc52c3b3-abbe-3139-54c5-d3115b67b4d5","text":"Breast reconstruction based on either autologous or alloplastic techniques has evolved tremendously in recent years, offering a variety of options tailored to the specific needs of each patient. Plastic surgery in this field aims to provide an improved aesthetic outcome while minimizing postoperative complications, always within the context of oncological safety. Although there are no consensus and guidelines regarding the imaging surveillance of post-mastectomy patients that underwent reconstructive surgery, it is important to be familiar with the normal imaging appearance of different reconstructive techniques and to be able to recognize associated complications, either benign or malignant. One must always keep in mind that even though the risk of recurrent breast cancer is radically minimized after mastectomy, it is not eliminated and can be clinically occult.","title":"Imaging of the Reconstructed Breast"}
{"_id":"dc557b0c-dbcc-b69a-3e3d-c8406a020e1e","text":"Secondary thinning of a flap was necessary in one patient due to too much bulk of the skin island that did not shrink in the postoperative course and was felt to be unpleasant when sitting on the bulky mass. Surgical excision and flap thinning was performed 12 months postoperatively without complications and the further course was uneventful.","title":"Interdisciplinary Surgical Approaches in Vaginal and Perineal Reconstruction of Advanced Rectal and Anal Female Cancer Patients"}
{"_id":"dc63b306-0b51-187f-9dcd-257af43d1556","text":"At the end of personalized rehabilitation, the patient group showed improvements in their facial symmetry and their ability to perform basic facial expressions and primary facial movements. Similarity in the pattern of fuzzy entropy for facial expressions between the patient group and healthy individuals increased. Synkinesis was detected during primary facial movements in the patient group, and one patient showed synkinesis during the happiness expression. Synkinesis in the lower face region of one of the patients was eliminated for the lid tightening movement.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"dc746ac1-452e-0172-42bd-f6c12c7afb38","text":"Wide excision is appropriate for tumours confined to the gland combined with some form of neck dissection. Some argue in favour of a wider resection for adenoid cystic tumours but even with radical surgery, it is frequently difficult to obtain adequate surgical margins. The advice for radical surgery in submandibular malignancy is at variance with recommendations for the preservation of the uninvolved facial nerve in parotid disease. Clinically high-grade tumours should be treated aggressively with excision of the gland plus a 2 cm margin of apparently healthy tissue. Resection of involved nerves with microscopic negative margins is desirable. Large infiltrative tumours with bony involvement are treated with composite resection of tumour, adjacent soft tissue cuff and bony resection as appropriate.","title":"Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines SALIVARY GLAND TUMOURS: UK GUIDELINES"}
{"_id":"dc755c35-dc62-e23e-b9a6-5ad94b0185a4","text":"Another anatomical site where interstitial IRT finds considerable application as an exclusive approach is represented by the lip, where the use of HDR IRT allows us to achieve local control rates that are clinically comparable to surgery in terms of local disease control [26].","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"dc75cb14-e527-de59-8898-a7df750644d4","text":"Currently, the mainstay of therapy for melanoma has been surgical resection to render the patient clinically free of disease for both early and select advanced stage melanoma patients. For patients with AJCC stage I and II melanoma, surgical therapy would entail wide excision with or without sentinel lymph node dissection depending on the Breslow thickness of the primary lesion and presence of other significant prognostic variables. For patients with AJCC stage III melanoma patients with nodal involvement, the therapy would involve radical lymphadenectomy. For patients with resectable AJCC stage IV disease, metastasectomy for limited burden disease would be the usual treatment of choice. Until recently chemotherapeutic, biologic, and immunologic therapies have had little success in the adjuvant setting with only high dose interferon (HDI) having an FDA indication in the adjuvant setting.","title":"Neoadjuvant treatment of melanoma: case reports and review"}
{"_id":"dc7a2c39-476c-204c-5e3a-19eed947f0f0","text":"Proteus mirabilis is the second most common pathogen that causes urinary tract infections after Escherichia coli. In rare cases, it is associated with vertebral osteomyelitis. The underlying mechanism of this relationship may be related to the retrograde dissemination of bacteria through the paravertebral venous plexus.","title":"Proteus mirabilis thoracic vertebral osteomyelitis: a case report"}
{"_id":"dc85b049-2d3e-7b82-1ef7-ff7f4656f6d4","text":"Patients with EC metastasis in specimens from the SLN biopsy were considered as true positive (the presence of metastasis in specimens from systematic lymphadenectomy is unnecessary to define true positives because SLN may be the only location for EC metastasis).","title":"Sentinel Lymph Node Biopsy in Surgical Staging for High-Risk Groups of Endometrial Carcinoma Patients"}
{"_id":"dc8eaa0e-6264-92fd-0e89-25cd2e59d933","text":"The institutional ethical committee clearance was obtained for the study, which is attached as Annexure 1. Those patients who fitted the study inclusion criteria were required to provide informed consent in the prescribed format of the institution which was attached as Annexure 2. The study was a prospective study conducted on 40 consecutive patients, of which 20 were treated with sural artery flap and another 20 with perforator based propeller flap cover for soft tissue reconstruction in extremities based on predefined inclusion criteria. Demographic and clinical details about the soft tissue defect, details of the perforator propeller flap cover used and post-operative events in details were noted and clinical outcome of the flap was assessed on the basis of 3 parameters including (i) percentage of flap surface area survival, (ii) healing of the skin margins of the flap after suture removal and (iii) presence or absence of complications. Patients were followed up for a period of three months from the time of discharge.","title":"The Clinical Outcome of Perforator Based Sural Artery and Propeller Flaps in Reconstruction of Soft Tissue of Extremities"}
{"_id":"dc8fba1c-1577-8cac-ec07-8d89d110f432","text":"A total of 314 patients with cutaneous malignant melanoma were diagnosed in the aforementioned time period. One hundred and ninety-five cases were excluded due to a lack of recording of the dermoscopic variables being assessed, and the remaining 119 cases were included.","title":"Predictive factors of melanoma thickness"}
{"_id":"dca47872-4eb6-581a-f120-1c06d6b533e9","text":"Regular ultrasound monitoring is a necessary post-operative practice for patients who received local resection or had risk factors such as multinodular masses.","title":"Clinico-histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10-year retrospective study—a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma"}
{"_id":"dcadc8e8-b15b-3128-995e-7e70d0362b80","text":"A systematic approach to secondary vulvar reconstruction can provide good surgical results with a low rate of complications. The geometry of the defect and the use of both traditional and perforator flaps should guide the choice of the reconstructive technique.","title":"Secondary post-oncologic vulvar reconstruction – a simplified algorithm"}
{"_id":"dcb2929e-5e62-4f89-79c6-75b57c9029a1","text":"The gold standard to diagnose this type of neoplasm is a deep subcutaneous punch biopsy or incisional biopsy because the surface biopsy of the lesion cannot differentiate sufficiently from benign skin lesions. Re‐biopsy is recommended if our clinical suspicion was strong and unequivocal primary biopsy was performed although this is associated with a risk of tumor seeding.","title":"Patient with recurrence dermatofibrosarcoma protuberans: A case report"}
{"_id":"dcb80a1d-0aef-a90e-1205-114436783a3a","text":"Since CFRs can be performed to treat a variety of tumors from different locations and since the primary outcome of interest in this study was perioperative mortality, we opted to categorize outcomes according to the type of procedure (skull convexity or skull base) and not according to the tumor location. These comparisons are interdependent, and the procedure type is more relevant when evaluating postoperative complications and mortality.","title":"Short-term survival in extensive craniofacial resections"}
{"_id":"dcb8a05b-cfca-c797-10c1-921b45e510a9","text":"The presence of deep axillary lymphadenopathy and the number of axillary lymph nodes may be important for differentiating lymphadenopathy after COVID-19 vaccination and metastasis. This information could be valuable when deciding whether to use cytology or SLNs to confirm the presence of lymphadenopathy on preoperative MRI for breast cancer.","title":"The location of unilateral axillary lymphadenopathy after COVID-19 vaccination compared with that of metastasis from breast cancer without vaccination"}
{"_id":"dcd88447-32a6-3e39-340a-5504387ff462","text":"All recurrent tumors are treated as high-risk malignancies regardless of their pre-interventional risk classification.6–8 Recurrent tumors that remain localized without signs of invasion are treated with surgical excision or radiation therapy. Tumors with nodal or systemic metastasis necessitate consultation of a multidisciplinary tumor board for further management.7,8","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"dcd95a4b-deac-7c61-fc42-1acddebc52aa","text":"These immunoglobulin analyses indicated that continued consumption of the offending allergen reduced allergen-specific IgE as effectively as the avoidance of the allergen in this mouse model of CMA. In contrast, the elevated level of IgG1 in BLG-sensitized mice was sustained with the CTL diet while the WP diet reduced it slightly, although the difference between the two groups was not statistically significant at this time point.","title":"Asymptomatic sensitization to a cow’s milk protein induces sustained neuroinflammation and behavioral changes with chronic allergen exposure"}
{"_id":"dcdbac8c-4300-a23d-9e1f-a29a5246fae1","text":"Univariate analysis was employed to investigate whether the same clinical and non-clinical factors may affect compliance with excisional margins recommended by the international guidelines.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"dcdd5922-bcc3-87c5-769f-25d52b8a2ff9","text":"Interestingly, contrary to what we have expected and what has been described in previous studies, there was no significant difference when comparing surgical site infections or wound healing disorders at the donor site. Only BMI and female gender showed significantly enhanced prevalence of SSIs and wound healing disorders.","title":"Seasonal Impact on Free Flap Surgery in Terms of Flap Loss and Wound Healing Disorders: A Retrospective Cohort Study of 158 Free Flaps"}
{"_id":"dcdf025d-0fdc-0f28-9994-c96a52e838f2","text":"The posterior tibial vessels are least likely to have been injured during the initial trauma and are the most reliable recipient vessels in the lower limb. 66 67","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"dcf0b2b6-7011-c6ef-1874-27dcdebbbfb1","text":"This report describes the results of a surveillance strategy for patients with stage II, III, and resected stage IV cutaneous melanoma that was implemented for adjuvant immunotherapy trials conducted at the Surgery Branch, NCI, and that included the routine use of CT imaging. Although there was some variation in the timing of evaluations during the first year for each protocol, surveillance for all patients included imaging of the chest abdomen and pelvis at intervals of 6 months or less for year 1, every 6 months for year 2, and then annually through year 5 and protocol termination. We found that CT imaging identified a large number of cases of progressive melanoma that were missed by both patients and physicians. This was evident whether the site of disease progression was systemic or locoregional. This also was the case for our patients regardless of their stage at time of protocol enrollment.","title":"Routine Computer Tomography Imaging for the Detection of Recurrences in High-Risk Melanoma Patients"}
{"_id":"dcfb33c9-2fb0-fdb4-538d-4829759ca4cf","text":"The paediatric population rarely suffer malignant disease of the oral cavity requiring any form of maxillectomy, and there is little published evidence around the rehabilitation and restorative management of children undergoing such procedures. The seemingly most common approach for a limited low-level maxillary resection in a child would be to consider resection and simple prosthetic obturation as this allows relatively simple management of the tumour from a surgical point of view as well as immediate functional and aesthetic rehabilitation with a prosthesis. It also allows for full histopathological examination of the resected specimen to ensure complete resection of the tumour before committing the patient to any form of complex surgical reconstruction which could be planned at a later date should the patient wish. The delivery of a maxillary obturator improves quality of life significantly by primarily restoring aesthetic and functional modalities. It also serves as a purpose to allow correct phonation of speech, prevent nasal discharge of masticatory contents and facilitate swallowing. The aesthetic and psychological benefits of facial restoration are paramount in a child undergoing such a procedure. The use of microvascular reconstruction techniques have allowed for autogenous tissue reconstruction of maxillary defects with either soft or hard tissue. The use of a soft-tissue-only reconstruction such as a radial forearm flap in this clinical situation would prevent successful dental rehabilitation as the soft tissue flap provides no support for the dental prosthesis and, apart from the separation of the oral and nasal cavities, provides no advantage for the patient. The use of a composite-bone-containing flap such as the fibula flap has the potential to provide oro-nasal separation as well as bone to support an implant-retained prosthesis, and with the latest digital technologies, this can be provided rapidly in carefully selected cases [8], although this mode of rapid rehabilitation is not available in many centres. However, there is no published data on this mode of dental rehabilitation in a growing child currently, and this approach should probably be deferred until all mandibular growth has been completed. The use of microvascular reconstruction, in addition, carries with it significant clinical risks as well as potential donor site morbidity and flap failure as well as the potential for fibrous union and loss of individual bony segments where multiple osteotomies are required.","title":"A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient"}
{"_id":"dcfd917e-3098-3dec-45fc-abf100d2b9de","text":"The United Kingdom Training Interface Group (TIG) pioneered the first structured training programme in oncoplastic breast surgery in 2002. These fellowships at various recognised oncoplastic centres offer recognised training to breast and plastic surgical trainees interested in offering advanced oncoplastic procedures. A database of surgeons involved with the TIG has been maintained for over a decade.","title":"Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England"}
{"_id":"dcff8e5b-62bd-9e73-9c5c-a3c60daaeee9","text":"Photodynamic therapy has a role in the management of early and late thoracic malignancies. It can be used to facilitate minimally-invasive treatment of early endobronchial tumours and also to palliate obstructive and bleeding effects of advanced endobronchial tumours. Photodynamic therapy has been used as a means of downsizing tumours to allow for resection, as well as reducing the extent of resection necessary. It has also been used successfully for minimally-invasive management of local recurrences, which is especially valuable for patients who are not eligible for radiation therapy. Photodynamic therapy has also shown promising results in mesothelioma and pleural-based metastatic disease. As new generation photosensitizers are being developed and tested and methodological issues continue to be addressed, the role of photodynamic therapy in thoracic malignancies continues to evolve.","title":"Photodynamic Therapy in Non-Gastrointestinal Thoracic Malignancies"}
{"_id":"dd05eca6-8d80-af3d-9bc4-e2f1f358c4e9","text":"All patients treated with EBT for NMSC at Cancer Treatment Services - Arizona from July 2009 through March 2010 were included in this study. This retrospective study was approved by Integriew Ethical Review Board. Data were collected retrospectively on a case report form from the medical records. Pre-treatment biopsy for NMSC had been performed on all patients to confirm the diagnosis prior to treatment. A series of digital photographs of the initial lesion on each patient was obtained.","title":"The initial experience of electronic brachytherapy for the treatment of non-melanoma skin cancer"}
{"_id":"dd09c463-fc98-be15-db34-4630e5bd04a5","text":"This is a non randomized retrospective study of 32 patients with closed fractures of the distal tibia which were treated with external fixation. Inclusion criteria were age below 50 years, absence of concomitant fractures, treatment within 12 hours from admission and the use of external fixation. Polytrauma patients were excluded from the study.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"dd0eb9bc-d556-3875-ab2e-09211070f0e7","text":"We would like to acknowledge some limitations of the paper. It is an anatomical study performed in fresh cadavers, which facilitates the dissection and measures when compared with the ones done in preserved cadavers. It is possible that the dimensions of the skin islands obtained through the pinch test do not correspond to the real size observed during dissection of the flaps. Clinical application has proved both flaps to be safe and larger than observed during the dissections as previously demonstrated by many authors [19–25].","title":"Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps"}
{"_id":"dd0ed1cf-97d8-eadd-d6ec-fb9451443722","text":"Conclusions: The use of nivolumab in some patients might mean a worse option than chemotherapy. It remains a challenge to identify those patients who could have a chance to benefit from nivolumab.","title":"Melanoma and immunotherapy bridge 2015 Naples, Italy. 1–5 December 2015"}
{"_id":"dd150004-cd1e-3e2e-5184-fbf27860b273","text":"What makes you feel nervous about your position as a team leader?","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"dd16181f-b7e6-e168-5c13-4ca5a67ab293","text":"Although anaphylaxis during anaesthesia is frequently caused by NBA and antibiotics, we suggest that skin prick testing to neat TXA should be performed wherever this is used during IOA, to exclude this as a potential cause for allergic reactivity.","title":"Tranexamic Acid: An Exceedingly Rare Cause of Anaphylaxis during Anaesthesia"}
{"_id":"dd20ecc9-dd5b-a32a-e81d-e1dda1e87f78","text":"Whereas conventional biopsies allow accurate diagnosis of tissue sampled through histopathological assessment, there is a need for an alternative technology, such as the microbiopsy, to screen multiple lesions through molecular diagnosis. In this proof of concept study, we have shown that an arrangement of stacked plates to form a 3D microbiopsy device is capable of providing molecular samples from normal and diseased skin. DNA extraction from human skin is critical for stratifying lesions in terms of mutational status. This type of characterization is becoming more and more relevant as targeted signalling inhibitors are being added to the therapeutic arsenal. Recent developments in molecular inhibitors for skin cancer, e.g. Vemurafenib and Trametinib , are driving a new need for molecular diagnostic information that cannot be gathered through morphologic analysis. Molecular biomarkers have been used to detect cancer, but are now being developed to determine which molecular therapeutic will be the most effective. Melanoma clinical biology research has resulted in genomic data identifying oncogenes that can be targeted by protein kinase inhibitors e.g. BRAF and MEK . Diagnostic assays to detect BRAF and NRAS mutations are now being used to stratify skin cancer lesions . The microbiopsy device has the potential to help screen multiple lesions for specific mutations, and to be important in discovery based research.","title":"Microbiopsy engineered for minimally invasive and suture-free sub-millimetre skin sampling v2; ref status: indexed"}
{"_id":"dd24ec51-9d7b-013d-0f98-3e7f64372b88","text":"In summary, there is a detectable signal of abnormality present in mammograms with no overt signs of cancer. This signal is present in images taken years before the cancer develops. However, its use as an imaging biomarker will require further investigation to bolster the signal and develop its clinically warranted uses.","title":"Radiologists can detect the ‘gist’ of breast cancer before any overt signs of cancer appear"}
{"_id":"dd2cda56-2eab-2d37-fe8a-9b1656750b22","text":"Several clinical studies about thromboprophylaxis in outpatients receiving systemic treatment for cancer were conducted. Anti-thrombotic prophylaxis seems to be not necessary in all unselected cancer patients on active oncological therapy, whereas prophylaxis with LMWH, apixaban or rivaroxaban should be considered for cancer outpatients who receive chemotherapy and who are at high thromboembolic risk. Current guidelines also recommend preventive use of LMWH or fondaparinux in hospitalized cancer patients with an acute medical complication. Differently, routine thromboprophylaxis with LMWH in patients with venous central catheter is not indicated, but a thromboprophylaxis of at least 7–10 days should be administered after cancer surgery, to be extended up to four weeks especially in presence of additional risk factors.","title":"Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer"}
{"_id":"dd31452c-030d-efbe-7805-c073a5c0df94","text":"The most frequently encountered findings in symptomatic cases are nasal obstruction, otitis media with effusion and epistaxis; endoscopic nasopharyngoscopy is the gold standard in clinical examination. In the presence of findings such as chronic middle ear effusion, a mass on the neck or a suspicious appearance determined on endoscopic nasopharyngeal examination, investigation of malignancy with a biopsy can be necessary, even if no specific focus is seen. Although many different scanning and specific examination methods have been described in the determination of nasopharyngeal malignancies, biopsy under endoscopy guidance remains indispensable for both a definitive diagnosis and pathological classification. When the clinical examination findings and the biopsy results are not consistent, it may be necessary to repeat the biopsy without any loss of time.","title":"The role of nasopharyngeal examination and biopsy in the diagnosis of malignant diseases O papel do exame clínico e da biópsia de nasofaringe no diagnóstico de doenças malignas"}
{"_id":"dd323529-fef5-70bf-d58a-7d8307bdc44a","text":"MR venography sequences allow for an initial positive diagnosis of cerebral venous thrombosis and also for monitoring the thrombus and visualizing its partial or complete recanalization. Complete recanalization is not necessary for symptom improvement.","title":"Imaging of Cerebral Venous Thrombosis"}
{"_id":"dd331210-bcef-b297-29ad-f0e129d16095","text":"By providing data on postoperative breast volume changes, a prediction can be made of the expected postoperative course and final breast volume for each patient, allowing the surgeon to better predict the postoperative result in the future. This can be used to adjust the preoperative planning more precisely to the expectations and wishes of the patient and to prevent potential secondary correction procedures in terms of volume asymmetry. Therefore, the objective of this retrospective study was to investigate volume changes of autologous free perforator flaps used for reconstructive breast surgery utilizing 3D stereophotogrammetry and to clarify the factors that positively or negatively affect breast volume.","title":"“Three-dimensional evaluation of breast volume changes following autologous free flap breast reconstruction over six months”"}
{"_id":"dd3b749b-f460-713d-be92-0dd51643f2b7","text":"Clinicians at this medical center are not required to obtain IRB approval for case reports.","title":"Repeated acute lower limb ischemia due to complete occlusion of an artificial vessel graft: A case report"}
{"_id":"dd4125d7-d98d-3325-f295-8d46e87f31b6","text":"Pregnant women with a cesarean section in their clinical history occasionally present a tumor of the lower anterior abdominal wall. In many cases, the tumor located close to the C-section scar appears in the second or third trimester of an actual pregnancy is palpable and temporarily causes pain. An irregular, inhomogeneous focus can be found in sonographic examination with the convex scan. Mostly the clinical diagnosis is endometriosis. The tumor resection as part of the C-section is the usual treatment. In this paper we present a desmoid fibromatosis of the lower abdominal wall in a young pregnant woman and discuss the treatment options of desmoid tumors in pregnancy and the differentiation in diagnosis and treatment between endometriosis and desmoid-type tumors considering the results of a literature review. The correct pre- and intraoperative diagnosis of this rare disease is the most important factor for the respective treatment and prognosis of the destructive desmoid fibromatosis.","title":"Desmoid Tumor of the Anterior Abdominal Wall in Female Patients: Comparison with Endometriosis"}
{"_id":"dd42e352-77cd-acee-3ed0-bc5d24a698c6","text":"Given that the review is aimed at informing the update of current WHO guidelines for infants u6m with growth faltering, it is important to highlight that the identified evidence had some concerns of applicability and validity, which we present in the following section.","title":"Effectiveness of Interventions to Manage Difficulties with Breastfeeding for Mothers of Infants under Six Months with Growth Faltering: A Systematic Review Update"}
{"_id":"dd44cf9d-57b5-c475-5911-b8fdc1acc5f7","text":"There is evidence from the studies we reviewed that mammographically detected recurrences are also detected at an earlier stage and results in better survival than clinically detected ones and that local recurrence may occur many years after treatment. The finding that a regimen of surveillance mammography offers a survival benefit among women treated for primary breast cancer when compared with a surveillance regimen that does not include surveillance mammography was also reported in a recent Health Technology Assessment incorporating a systematic review [88]. However due to the limited availability of data the studies reviewed were not randomised controlled trials and no conclusions could be drawn about the optimum frequency or duration of mammography after surgery. It is also unclear as to what age mammography should be continued. A pragmatic approach is to only undertake investigations if the findings would influence clinical decisions. In women over the age of 80 many would elect not to have surgery because of the higher risks in this age group. If there is already considerable comorbidity adding preventive medication with likely side effects and drug interactions may not be advisable. There is the potential for harm due to over-surveillance in this case. In the same way a search for distant metastases in healthy women treated for early breast cancer is not advised and this is generally accepted among breast cancer specialists.","title":"Options for early breast cancer follow-up in primary and secondary care - a systematic review"}
{"_id":"dd46ad6b-d0e4-ba82-411a-9cce51ff932e","text":"Complications related to the fibula during distraction osteogenesis could cause malalignment. Most published studies have analyzed only migration of the fibula during lengthening, with few studies examining the effects of fibular complications.","title":"Fibula-related complications during bilateral tibial lengthening 60 patients followed for mean 5 years"}
{"_id":"dd4f7f7c-17c1-59f0-cb1d-09a04e69e670","text":"Here we report a rare case of EN that occurred after olaparib administration. The skin rash resolved immediately after olaparib discontinuation. Because EN may develop following therapy with a number of different agents, careful examination is required for patients receiving invasive treatment.","title":"Development of Erythema Nodosum After Olaparib Treatment in a Patient With Recurrent Breast Cancer and BRCA2 Mutation: A Case Report"}
{"_id":"dd5bfd1b-c17a-0269-dc0a-ac1e4374fb40","text":"Patients should be assessed clinically with a history and physical examination at three monthly intervals in the first year and six monthly in the second year. An annual clinical review should be performed for years three, four and five years at which point the patient is discharged back to the primary care team. The NCCN guidelines which are widely used in the US advocate a similar hospital based follow up programme. For some patients who are highly motivated, and have a willing primary care team, there may be a role of annual follow up under the care of their general practitioner after year 2 with back to the surgical or oncological team if any new issues arise. However we suspect the majority of general practitioners, surgeons or patients may prefer follow up under the surgeons who know the specifics about their operative history and therefore hospital follow up would be appropriate. Where the follow up visit is in hospital, there should be a multidisciplinary approach to avoid duplication of examinations and investigations, and inconvenience to patients [12]. Clinical investigations should only be performed if any specific new symptom develops.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"dd5c2026-9c1f-142e-132b-20bd1a88f5e0","text":"Acute arterial occlusions are a rare complication of total knee arthroplasty (TKA). However, in revision TKA, the risk of such complications is higher and these complications can lead to amputation if not adequately treated. We describe a case of acute popliteal artery occlusion 4 hours after second revision TKA in a patient with a history of several surgical procedures because of periprosthetic infection at a previous hospital. Revascularization was achieved via bypass grafting and amputation was narrowly avoided despite time lag after symptom onset to revascularization. In this case, it was possible that the arterial disease that accompanied the vascular endothelium injury such as pseudoaneurysm had existed since the previous surgery at another hospital and was destroyed by the surgical procedure, which led to the formation of thrombosis and arterial occlusion. Preoperative evaluation of the arterial condition should be considered to avoid acute arterial occlusive disease, especially in patients who had several previous surgical procedures.","title":"Acute Popliteal Artery Occlusion after Revision Total Knee Arthroplasty"}
{"_id":"dd5d23a7-51a3-d515-2231-aa354681524e","text":"Sebaceous carcinomas (SC) are rare adnexal tumors with possible aggressive behavior usually arising in the head and neck region of adults in the seventh decade of life. Treatment has traditionally been with surgical excision with 5-6 mm wide margins but Mohs micrographic surgery (MMS) has also been reported as an effective treatment modality. We present a case of a Caucasian female renal transplant patient with a rapidly enlarging nodule on the left preauricular cheek that was excised with MMS with negative margins. The tumor recurred rapidly and metastasized ultimately leading to the death of the patient. There was some disagreement amongst pathologists as to the possible nature of the diagnosis with the original biopsy being labeled as a poorly differentiated carcinoma. We aim to highlight the potential aggressive nature of SC and review the features of the neoplasm including histological features that help in making the diagnosis.","title":"Aggressive Extraocular Sebaceous Carcinoma Recurring after Mohs Micrographic Surgery"}
{"_id":"dd6a490c-5e89-014a-b37b-c65b81ea87d7","text":"While it is our practice to consider additional postoperative boost radiation therapy in patients with positive margins after preoperative radiation, the low rates of local failures make it difficult to perform more detailed analysis of related factors that may impact local control and survival. One of the local failures occurred in a patient who had a grossly positive margin and still had a local failure after postoperative radiation therapy.","title":"Myxoid Liposarcoma: Treatment Outcomes from Chemotherapy and Radiation Therapy"}
{"_id":"dd7e1fc2-b081-4750-b54e-dfd029ca6ea8","text":"Though skin tumors are rare in our population, they opt for investigations to confirm it with the increasing awareness among patients. Our study aimed at studying the prevalence of skin tumors and their types among the skin biopsies performed in the dermatology outpatient department in a tertiary care hospital of Nepal.","title":"Skin Tumors among Biopsy Samples in Patients Attending Dermatological Out Patient Department in a Tertiary Care Hospital of Nepal: A Descriptive Cross-sectional Study"}
{"_id":"dd807143-577a-5c1c-5df9-dd32f2af4b68","text":"These results provide further considerations for surgeons when deciding which flap to use for breast reconstruction and how to counsel their patients preoperatively. This finding is significant because drains remaining in situ can put patients at risk of drain site infections and is an added postoperative inconvenience for patients, potentially reducing mobility. If inpatient abdominal drainage and time until drain removal are particular concerns for a given patient, then we suggest that DIEP flaps may be preferred over SIEA flaps in such scenarios. Interestingly, the number of outpatient visits is not significantly different between the two flap types, suggesting that difficulty getting to the hospital for outpatient seroma aspirations may not be a relevant consideration for patients when deciding between the two flaps. It is also important to note that often the decision to undertake an SIEA flap over a DIEP flap is made intraoperatively rather than preoperatively leading to potential difficulties with patient counseling.","title":"Increased Production of Abdominal Donor Site Fluid Following Microsurgical Breast Reconstruction With Superficial Inferior Epigastric Artery Versus Deep Inferior Epigastric Artery Perforator Flaps"}
{"_id":"dd816bf7-db62-4f6e-b34c-067119a28c86","text":"Most of the interviewees expressed a desire to continue to develop and explore challenges that arose, with many of them actively seeking new opportunities.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"dd88e54f-7dbb-1619-8425-d3120b6e3572","text":"Desmoid tumors are a rare group of locally aggressive, non malignant tumors of fibroblastic origin that can lead to significant morbidity due to local invasion and may even result in a fatal outcome when located around vital organs. Their clinical presentation, biological behavior and natural history can be quite varied and is incompletely understood at the present time. The optimal therapeutic approach depends on various factors, and a multidisciplinary approach is necessary to achieve local control with acceptable morbidity. Despite progress in the understanding of these tumors and the treatment options, local recurrence remains a major problem.","title":"Desmoid tumors: clinical features and treatment options: a case report and a review of literature"}
{"_id":"dd8c7a4e-67c7-e5ce-7c09-4d893d8d3dae","text":"From those donor sites we can harvest skin and easily close primarily without prior tissue expansion in even graft dimensions as up to 25×20 cm from the groin and subgluteal areas, and up to 16×10 cm from inner aspect of arms and supraclavicular areas. These dimensions could sometimes be increased or decreased according to the patient body mass index and degree of skin laxity. We also extensively use the post auricular and distal forearm crease but for a smaller size defect; which was not included in this study.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"dd8f9e3b-1c09-cdd1-1d75-808aa99c7b24","text":"Table 6 Comparison of conduit patency according to the influence of preoperative coronary stenosis","title":"Patency of conduits in patients who received internal mammary artery, radial artery and saphenous vein grafts"}
{"_id":"dd90f1e5-d77e-d5c8-7f18-7442d1eb7431","text":"Although the communities of practice to which dermatologists, surgeons and primary care physicians belonged appeared to be responsible for slowing the spread of knowledge, they can also be viewed in a more constructive light. It was suggested by some of the key informants that the push to adopt SN biopsy took place in advance of sufficient evidence supporting its use, resulting in reservations and at times challenges to the veracity of the SN biopsy guideline recommendations, particularly from some dermatologists. It is possible that the differences in opinion that existed within these different communities of practice may have helped to drive the generation of new research studies that have ultimately helped to clarify what is appropriate use of SN biopsy and our understanding of which melanoma patients will derive most benefit from it.","title":"Factors influencing acceptance, adoption and adherence to sentinel node biopsy recommendations in the Australian Melanoma Management Guidelines: a qualitative study using an implementation science framework"}
{"_id":"dd90f7c9-32f2-66b4-40db-61a9bd3d53b1","text":"The CDA has a number of problems. The registration is crucial. Alignment of the patient using the markers and transparent film is the first step, but it does not allow for twisting of the patient's body. For this reason, although theoretically only three markers are needed to define co-registration, six markers are used. The two for the site of the tumour and the nipple are less reproducible but aid the interpretation of the image. The marker images are then analysed to find the pixel with the maximum count rate for each marker. A direct transform is undertaken if the marker images for the early and later image fit, otherwise an elastic transform minimising the differences between the marker images has to be undertaken. The actual breast and axillary node images are transformed in the same way as their marker images. Errors in registration may be seen as negative shadows related to blood vessels, but the movement artefacts can be deceptive. All those on or above the line of the subclavian arteries and in the neck are ignored since they are typically due to head and neck movement of the patient between images. As the patients are mainly from the Breast screening programme and have small tumours, supraclavicular nodes are most unlikely to be involved. This technique is not able to detect them because of these movement artefacts. It is focussed on the need for defining axillary node involvement in relation to axillary clearance.","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"dd96a922-ac06-b388-2aae-622aa3a6f5f5","text":"The flaps were divided into three zones: the area where thoracodorsal artery was entered the muscle was considered as the first zone, one third of the middle of the muscle as the second zone and the area where the distal perforators of the muscle entered as the third zone. Biopsy was obtained from each region and stained with hematoxylene eosine and its histological examination was made.","title":"The creation of new rotation arc to the rat latissimus dorsi musculo-cutaneous flap with delay procedures"}
{"_id":"ddae0292-2ecb-349a-1e47-5a9d1d460b29","text":"The racial features of Asian patients not only highlight the use of expanded forehead flap, but are also concerned with the donor site selection of cartilage grafts needed for structural support. In our series, 10 of 13 needed cartilage grafts for structural reconstruction, which provide reliable support to prevent the inner lining and outer envelope from collapsing especially for full-thickness defects. Donor sites include the ear and costal region. Cartilage from the remnant septum has been taken as another important source of grafts by doctors in view of its outstanding physical properties and harvesting convenience, while we recognized it as an inappropriate choice for Chinese patients. Unlike Caucasians, the septal cartilage of Asian people is weak and scarce, especially when an extensive defect affects the cartilaginous septum, which necessitates the use of the auricular and costal cartilage. In our series, auricular cartilage was mainly used for ala, nasal tip and columellar reconstruction. Costal cartilage was designed as a three-dimensional strut to support the nasal tip, columellar, ala or dorsum and reinforce the nasal septum. It was as well treasured by our Chinese counterparts because the costal cartilage was satisfying in both quantity and quality, particularly when a large cartilaginous defect occurred. The intrinsic curve and suppleness of conchal cartilage make it the first choice to design alar batten grafts or replace lateral cartilage, while the prominent stiffness and abundance of costal cartilage are ideal to play the role as a central support element or dorsal onlay graft. Sannier et al. also preferred to use ipsilateral conchal bowl cartilage and suggested the exploitation of costochondral cartilage when cartilage was in great demand.","title":"Expanded forehead flap in Asian nasal reconstruction"}
{"_id":"ddb188e8-22d8-e041-d8d6-9e4f1c00bea8","text":"BCC is more common than all other cancers, and the most frequently seen malignancy by most doctors regardless of their specialty. We have to recognize BCC and its different histologic subtypes, as well as areas in which these might occur. Several treatment options such as surgical and nonsurgical are available. Mohs micrographic surgery is the standard treatment for cases of BCC on the head and neck. Defects after surgical excision may be repaired by adequate local flaps. Radiation therapy is also used in the treatment of primary BCC or in cases where postsurgical margins are positive for cancer. Adequate treatment promises superior local disease control for BCC. Thus, doctors in all specialties need to become more aware of BCC, and accurate and early diagnoses need to be made by them.","title":"Basal Cell Carcinoma of the Head and Neck"}
{"_id":"ddb733d7-b37f-180f-76eb-94de58ce8def","text":"Following TCP expansion in hPL or FBS and Quantum® bioreactor expansion in hPL, chondrogenic pellets were established and maintained in chondrogenic media for 28 days. There were two donors in which chondrocytes were set for pellet expansion in hPL, but a chondrogenic pellet did not form; rather a cell pellet collected within the Eppendorf tube following centrifugation, but the pellet did not form a sphere over the first few days and once the pellet was dislodged after 3 days, the cells dispersed throughout the media. Furthermore, there were two donors for which there were insufficient cells harvested at the end of passage 1 to set chondrogenic pellets for analysis, once cells had been utilized for DNA and flow cytometry analysis. The conditions for which pellets were formed and maintained to 28 days are demonstrated in Figure 4B.","title":"The Upscale Manufacture of Chondrocytes for Allogeneic Cartilage Therapies UPSCALE HOLLOW-FIBER BIOREACTOR CHONDROCYTE MANUFACTURE"}
{"_id":"ddc28f87-faf4-25ee-2190-8b8626a9df6b","text":"The posterior extended latissimus dorsi flap is a modification that serves to elongate the skin island inferior and medially. Dissection to include the muscle and subcutaneous tissue is performed with careful attention to the path of the descending branch of the thoracodorsal artery. This is vital to the survival of the flap. The insertion of the latissimus dorsi to the humerus is divided to provide more freedom to the pedicle. The modifications provide the flap with greater bulk and length at the risk of increased donor site morbidity, prolonged drainage, and seroma formation.5","title":"Posterior, Extended, Pedicled Latissimus Dorsi Flap for the Reconstruction of a Large Complicated Lower Back Wound"}
{"_id":"ddc90625-281b-883a-b8f6-cf51febcd1bb","text":"Large defects in plantar surface secondary to acral melanoma excision can be difficult to repair with local flaps, and skin grafts in weight-bearing surfaces often suffer necrosis causing prolonged disability. Acellular dermal matrices represent an easy alternative to cover deep wounds or those with bone or tendon exposure. Despite their high cost and the requirement of two surgical procedures, this alternative may offer excellent functional and aesthetic results in acral defects.","title":"Dermal substitutes: an alternative for the reconstruction of large full-thickness defects in the plantar surface"}
{"_id":"ddcb4479-9ea8-f5ff-3c68-31e7526c97d2","text":"When a surgeon faces a rare surgical problem of regional nodal disease outside the common nodal stations, such as popliteal or epitrochlear chains, the knowledge of anatomy and surgical technique is crucial to guarantee preservation of the key functional structures to avoid permanent disability. Inappropriate dissection can also result in a suboptimal radical lymphadenectomy. The technique of popliteal lymph node dissection described here was successfully performed in a patient with metastatic acral MM, without any post-operative complications or morbidity.","title":"Popliteal lymph node dissection for metastases of cutaneous malignant melanoma"}
{"_id":"ddce41ce-13cf-feed-6e13-8289952f8560","text":"Transoral laser microsurgery represents the treatment of choice for early glottic cancer. Its use and effectiveness are mainly related to laryngeal exposure and deep extension of tumor. Histopathologic assessment of surgical margin presents a main issue about transoral laser microsurgery and complete oncological excision.","title":"Impact of resection margin status and revision transoral laser microsurgery in early glottic cancer: analysis of organ preservation and local disease control on a cohort of 153 patients"}
{"_id":"ddddafed-ef25-1dce-b69d-621fd74e4919","text":"Despite its limitations, the trial will be the largest study of its type addressing this question of oral versus IV antibiotic therapy in bone and joint infection, and is likely to have important implications for patients and healthcare practitioners in the field of orthopaedic infection, and for the health economy.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"dde58e86-ec60-ef23-aaaa-e66598721a9d","text":"Another limitation of this study was due to the surgical practice that a vein identified as unusable by DUS did not undergo an additional intraoperative evaluation. An intraoperative evaluation of such veins would generally not yield an assessment differing from the ultrasonographic evaluation, which renders them unsuitable for bypass surgery. Its intraoperative exploration would therefore cause unnecessary trauma to the patient.","title":"Mapping of Autogenous Saphenous Veins as an Imaging Adjunct to Peripheral MR Angiography in Patients with Peripheral Arterial Occlusive Disease and Peripheral Bypass Grafting: Prospective Comparison with Ultrasound and Intraoperative Findings"}
{"_id":"ddebca94-09a3-cc6c-e04b-a78bd9044e21","text":"Upon comparing the symptom grades and ST results to the BAT results, we found that the reaction severity and ST positivity did not correlate with BAT results in children.","title":"The utility of the basophil activation test in the diagnosis of immediate amoxicillin or amoxicillin-clavulanate hypersensitivity in children and adults"}
{"_id":"ddf2662c-c696-e86f-6fd4-7bd909bd8b40","text":"The resilient HA filler made of long chains lightly crosslinked is at least equivalent to a well‐established comparator for the correction of NLF in subjects of diverse skin phototypes.","title":"Efficacy and safety of a new resilient hyaluronic acid dermal filler, in the correction of moderate‐to‐severe nasolabial folds: A 64‐week, prospective, multicenter, controlled, randomized, double‐blind and within‐subject study"}
{"_id":"ddf4295f-03dd-705c-e1f4-ff9e75cbe9ba","text":"BOA\/BAPPRAS guidelines recommend longitudinal wound extensions for debridement along fasciotomy incisions to preserve the longitudinal running neurovascular structures and perforating arteries medially and laterally that form the basis of local flap reconstructive options in the leg. Therefore, the debridement needs to be meticulous and performed by an experienced surgeon to avoid unnecessarily damaging important structures that may jeopardize future soft tissue reconstructive procedures. The host institution is a tertiary referral centre and a major trauma centre, and as such, debridement is performed by senior orthopaedic surgeons in conjunction with plastic surgeons. Although this technique has yet to produce a complication with soft tissue coverage, it is still important to have plastic surgical support in these cases as should the technique fail, the limb will almost certainly require a free flap with its associated morbidity. Careful assessment of the radiographs, the soft tissue and the pre-existing wound are made in conjunction with a senior plastic surgeon to assess the suitability of the case for transverse debridement. If doubt exists or the anticipated soft tissue defect will be larger than the anticipated bony debridement, then a traditional longitudinal debridement is undertaken so as not to exclude the possibility of a local flap.","title":"Transverse debridement and acute shortening followed by distraction histogenesis in the treatment of open tibial fractures with bone and soft tissue loss"}
{"_id":"ddfce802-975f-3756-aae5-48a6bb85eb60","text":"Due to the delay in the presentation of symptoms, patients may not make the association of symptoms following the consuming red meat. From a clinical perspective, a red meat allergy has not been readily associated with a past tick bite. A clinician would need to be cognizant of the correlation of allergic symptoms and the prior consumption of red meat. A history of a previous inflamed tick bite may be a supportive clue. Tick bites are very common and generally cause local inflammation, so any particular tick bite may not raise suspicion.","title":"Alpha-gal Allergy in a 6-Year-Old Male: A Case Report"}
{"_id":"ddfef592-0304-d42f-7b46-beec446f473a","text":"Our study evaluated the use of topical imiquimod cream in the management of MIS existent after the surgical resection of primary melanoma or MIS lesions. We hypothesized that a treatment regimen of 12 weeks—tailored based on individual patient's tolerance to the inflammatory response created by the therapy—would be sufficient to clinically and histologically clear the surgical margins. We were able to achieve a 95% complete clinical response rate in our cohort of 22 patients. Although the current recommended management of MIS is wide local excision with a minimum of 5–10 mm margins 4, larger lesions of the head and neck, commonly of the lentigo maligna type, frequently require larger surgical margins to achieve histologic clearance. Our data provide further support for the use of topical imiquimod as a nonsurgical alternative in the treatment of MIS in patients who are either not suitable candidates for reresection or who wish to avoid further surgery for other reasons.","title":"Using topical imiquimod for the management of positive in situ margins after melanoma resection"}
{"_id":"de04b772-21a0-3f52-c7c1-7746da91824a","text":"In this study, we investigated the feasibility, accuracy, and limitations of SLN biopsy for cervical cancer in its early stages by looking at topographic localization of SLN and patterns of lymphatic dissemination to pelvic lymph nodes. We investigated the feasibility and accuracy of combined tracer method for localization of SLN in initial stages of cervical cancer and evaluated the clinical value of SLN biopsy in replacing pelvic lymph node resection.","title":"Clinical Study of Sentinel Lymph Node Detection to Evaluate Pelvic Lymph Node Metastasis to Determine the Prognosis of Patients with Early Cervical Cancer"}
{"_id":"de0d0341-b7b1-77f2-3f6e-92ba3840ebc7","text":"Most surgeons routinely send surgical specimens for microscopic examination, however there is reluctance among some surgeons to send specimens, especially from minor operations such as cysts and lipomas. This may reduce pathology workload and costs. However the histological diagnosis will remain uncertain and the surgeon will lose an element of feedback and quality control. We report two cases to illustrate that all surgical specimens should be considered for histological examination.","title":"Should all excised surgical specimens be examined microscopically? A case report"}
{"_id":"de0d64c4-0d62-42cc-9b01-c7c35944847b","text":"Our findings suggest that it is more difficult to become competent at compression ultrasound than previously thought. Emergency ultrasound educators should be aware of this and of the difficulties that novice ultrasonographers have in properly assessing the popliteal vein for DVT.","title":"Mistakes and Pitfalls Associated with Two-Point Compression Ultrasound for Deep Vein Thrombosis"}
{"_id":"de10f361-fdcc-3d90-656a-80e1759d8148","text":"Angiolipomas cannot be easily excised like lipoma because they are slim with irregular capsule. Wide local excision of angiolipoma minimizes the risk of relapse. Wide resection may require excision of a significant part of healthy tissue containing critical neurovascular structures. Excision of an important nerve or vessel is to be operated by considering high incidence of local recurrence of the tumor that was insufficiently excised with the purpose of gain wider bounds. For this reason, the surgery should be individualized [27].","title":"Lumbar Spinal Angiolipoma with Expanding Left Neural Foramen Mimicking Lumbar Schwannoma; Case Report and Review of The Literature"}
{"_id":"de13287b-8f5d-c8ce-6755-490857cd4b5a","text":"Once the free flap used in the original reconstruction is deemed to be unsalvageable, salvage reconstruction should be performed as early as possible in order to avoid a severely compromised wound bed[16]. In cases where a severely compromised wound bed has developed initial conservative management with a delay in salvage reconstruction is recommended in order to increase the chance of success. The goals of salvage reconstruction are to select the simplest reconstructive option that will have the highest chance of survival but also is able to restore form, function and cosmesis. These goals are best achieved with a second free flap or a regional flap. In cases of a failed osteocutaneous flap for mandibular reconstruction a second osteocutaneous free flap should be used to restore both form and function. Patients who have had a failed total laryngopharyngectomy free flap reconstruction, a second free flap with either a tubed fasciocutaneous flap or enteric flap is recommended. Ideally, the reconstruction should be performed in an immediate fashion in order to allow patients to return to swallowing and speech rehabilitation as early as possible. However, in cases of infected wound beds conservative management with a pharyngostoma and esophagostoma may be required initially followed by secondary reconstruction once an ideal wound bed is achieved. In cases of flap failure following reconstruction of a partial pharyngectomy defect a second free flap or regional flap (pectoralis major or latissimus dorsi muscle) may be used. Pedicled flaps are particularly useful in the vessel-depleted neck. Failed intra-oral flaps can be salvaged with either a second fasciocutaneous free flap or regional flap. A second free flap is often the ideal reconstructive choice to provide the optimal functional result. Similarly, salvage reconstruction of large cutaneous defects can be performed with a pedicled latissimus dorsi or pectoralis major flap or a second cutaneous or musculocutaneous free flap. When a second free flap is used for reconstruction the flap success rate should be the most important factor in choosing the second flap, especially after loss of the first flap[16].","title":"Salvage of failed free flaps used in head and neck reconstruction"}
{"_id":"de13dd25-bfaf-7799-d511-69d44645074c","text":"This paper focuses on how evaluation and standardization of excisional margins is a priority for a correct surgical activity.","title":"Basal Cell Carcinoma: 10 Years of Experience"}
{"_id":"de15395b-6504-357e-5367-70cfa12bdb1d","text":"From June 2012 through May 2017, 140 DIEP flaps were performed for breast reconstruction in the Department of Microsurgery in our institution. Eight of these patients were included in our study as they were previously treated with nipple-sparing mastectomy and immediate reconstruction with implant and developed partial skin necrosis and implant exposure. Two of these patients suffered bilateral implant exposure. Immediate deepithelialized DIEP flap was performed in all patients. The two patients with bilateral implant exposure underwent tertiary reconstruction with immediate bilateral DIEP flaps.","title":"Immediate implant replacement with DIEP flap: a single-stage salvage option in failed implant-based breast reconstruction"}
{"_id":"de16d1b1-7af2-552a-bff8-3802aad8547c","text":"When present, melanin absorbs most of the light and limits the depth of photoacoustics imaging under these circumstances. For clinical application this may be of limited importance, since the extent of tumor involvement per node is presently of less relevance. Also the presence of a blue dye, generally used for sentinel node detection, may alter the penetration depth of optical imaging. However, the impact on melanoma detection will be limited since the optical absorption of blue dye in the infrared region is limited and the optical absorption spectrum of the dye is clearly distinctive from both blood and melanin.","title":"Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging"}
{"_id":"de1b17cc-d31d-3ff3-72cc-6add16af25ee","text":"Photostability is a vital property of a photosensitizer and is determined by assessing photobleaching. Exposure of porphyrin derivatives to light may cause photochemical destruction of the tetrapyrrolic macrocycle, resulting in a decrease in the intensity of the Soret absorbance band at approximately 420 nm.","title":"Antimicrobial Photodynamic Therapy Combined With Antibiotic in the Treatment of Rats With Third-Degree Burns"}
{"_id":"de253b08-acbc-66d9-c4ee-18d78b5e9108","text":"The concept of a single-stage procedure for the treatment of COM has been trialled in specialist centres for the last 20 years. Many different methods have been described to provide skeletal stability and obliterate dead space following debridement. Currently, there is no universal consensus or guidelines on how chronic osteomyelitis is best managed. The aim of this systematic review was to identify the different types of single-stage procedures that have been performed and reported for COM, to evaluate their effectiveness and identify factors that influence recurrence.","title":"A systematic review of the single-stage treatment of chronic osteomyelitis"}
{"_id":"de255f0b-ac74-6c99-ae2c-e1fc9635872f","text":"Extension studies such as abdominopelvic and chest CT reported no evidence of lymph node metastasis.","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"de2bc26a-2090-890b-6ab4-ddfa7c20c37f","text":"Both the frenotomy and control group showed statistically significant drop in maternal pain scores. However, the frenotomy group showed significantly more improvement than the sham group. IBFAT scores showed statistically significant improvement in frenotomy group than the control group. All these differences persisted only for the first 2 to 3 weeks of the intervention and there was no significant difference between the groups beyond the third week. Many mothers of the sham group subsequently opted for frenotomy. Thus crossing over of groups prevented any long term assessment beyond 4 weeks. The authors conclude that frenotomy causes immediate improvement in nipple pain and breastfeeding scores, despite a placebo effect on nipple pain.","title":"Release of Tongue-Tie in Neonates"}
{"_id":"de2c36db-8414-bd69-5719-0b82b07fcd4b","text":"The present retrospective cohort study has successfully shown that malocclusion therapy conducted through the use of clear aligners in a population of adults affected by dental crowding has beneficial effects on lower third facial ageing.","title":"Clear aligners’ effects on aesthetics: evaluation of facial wrinkles"}
{"_id":"de41b3a8-9161-202a-6394-5dda1f6add85","text":"Ambulatory venous pressure monitoring, once considered the gold standard involves connecting a pressure transducer to a cannula introduced into a vein and the fall of blood pressure with 10 tip toe movements was recorded. It is no longer preferred because of its invasive nature and poor localization of incompetent perforators. Air plethysmography is a non-invasive maneuver that measures the air pressure required to milk and empty the veins of blood. It is limited by its poor ability to localize the incompetence.","title":"Clinical Tests Combined with Color Doppler Versus Color Doppler Alone in Identifying Incompetent Perforator Veins of the Lower Limb: A Prospective Analytical Study"}
{"_id":"de533510-415f-2da8-eb6f-da33ec33f4c5","text":"Our experience differed from that of Touam et al. [29] who found a greater number of complications when lateral supramalleolar flaps were chosen and testified that the distally based sural artery flap is more reliable especially regarding the venous congestion. Several authors concentrated mainly on the use of a sural flap [13,15,16]. The disadvantages are thick, hairy, and insensate and need good knowledge of anatomy and proper dissection. It causes an ugly scar on the back of the calf which is especially not acceptable to women and leads to permanent loss of sensation in the distribution of the sural nerve on the lateral border of the foot and 5th toe. The donor site usually requires skin grafting, occasionally it can be closed in case of smaller flaps and older age groups when skin is lax. The skin closure is also made easier if a flap is raised in an elliptical fashion, which decreases the chances of skin grafting. Another innovation we did in surgical technique that we identify the short saphenous vein near the pivot point and putting a silk ligature around it but do not ligate the vein; an important step. The ends of the free suture around the vein are left outside of the wound. Postoperatively, if the flap develops venous congestion due to venous drainage of the short saphenous vein, then this vein can be ligated through its free ends outside the wound. In this way, we do not have to take the patient to the operating room for exploration of the vein and subsequent ligation. The flap vascularity can be increased when both neurocutaneous and veno cutaneous vessel (sural nerve and saphenous vein) both are incorporated in the pedicle of the flap.","title":"Comparison of distally based sural artery and supramalleolar flap for coverage of dorsum of foot and ankle defects; a cross-sectional study of 53 patients"}
{"_id":"de5983ce-0b41-8f56-0631-0172483d0576","text":"In general, the study demonstrated that flap perfusion monitoring with attached surface probes for the O2C analysis system was comparable to flap perfusion monitoring with unattached surface probes in terms of technical feasibility and patient safety, as no event of probe detachment or disconnection and no infections or bleeding due to the attachment structures were observed as potential disadvantages of the attached surface probes [26].","title":"Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity"}
{"_id":"de5c2a0b-e8db-87c4-7ecd-edafe048b552","text":"In this case we demonstrate the feasibility of serial microvascular transplantations with removal of the primary flap while preserving the vessels to connect a secondary free flap in complex reconstructions of the scalp. The radial artery and concommitant vein were available as relatively large vessels, matching the thoracodorsal vessels. This approach might therefore be taken into account when planning complex microsurgical reconstructions, especially when discard of the first flap is mandatory like in the presented case.","title":"Unusual explosive growth of a squamous cell carcinoma of the scalp after electrical burn injury and subsequent coverage by sequential free flap vascular connection – a case report"}
{"_id":"de61f022-4acc-fa08-f347-b89f654d662d","text":"HIV infected patients starting treatment for TB were identified and followed up two weekly. Cases of DVT were diagnosed with Doppler ultrasound and patients were initiated on oral anticoagulation with warfarin and followed up with repeated INR measurements and warfarin dose adjustment.","title":"Challenges in achieving a target international normalized ratio for deep vein thrombosis among HIV-infected patients with tuberculosis: a case series"}
{"_id":"de6df5c6-9cdf-16cc-54d6-e4fb39de03f5","text":"Breast cancer is the most common cancer in the female population. Adjuvant radiotherapy has become increasingly important as conservative treatment. Muticatheter interstitial brachytherapy is a type of radiation technique wherein the radioactive sources are directly implanted into or close to the target tissue and may be considered an extremely precise, versatile, and variable radiation technique. Literature data support muticatheter interstitial brachytherapy as the only method with strong scientific evidence to perform partial breast irradiation and reirradiation after previous conservative surgery and external beam radiotherapy. The aim of our work is to provide a comprehensive view of the use of interstitial brachytherapy, with particular focus on the implant description, limits, and advantages of the technique.","title":"The Role of Interstitial Brachytherapy for Breast Cancer Treatment: An Overview of Indications, Applications, and Technical Notes"}
{"_id":"de6f895f-44e9-b5ec-0958-9b2cc5003ac2","text":"Sabapathy et al5 proposed the usage of lower abdominal pedicled flap and primary bone grafts for reconstruction of finger injuries with dorsal bone and soft-tissue defect, thus requiring syndactylization, immobilization of the upper extremity, and another procedure after 3 to 4 weeks. Although local pedicled flaps produce exposed donor site scars, they are our first choice for dorsal finger injuries because physiotherapy can commence within a few days. When repairing the extensor apparatus, gliding surfaces should be restored10 and early and sustained mobilization should be performed to lessen scar adhesion between the reconstructed bone and the extensor tendon.11 This is best achieved by definitive and functionally stable osteosynthesis.","title":"Immediate Reconstruction of Complex Hand Trauma With Iliac Crest Bone Graft and 2 Pedicled Fasciocutaneous Skin Flaps: A Case Report"}
{"_id":"de739376-9523-675f-cc71-b60c75eaca04","text":"Single ultrasound-guided TPVB with a large volume of anesthetic can provide effective analgesia for most MWAs of lung tumors, and patients can better cooperate with the surgeon to reduce injury from multiple lung punctures. Multicenter clinical studies with larger sample sizes are required in the future to validate the findings of the current study.","title":"Single ultrasound-guided thoracic paravertebral block with a large volume of anesthetic for microwave ablation of lung tumors"}
{"_id":"de758a3a-20af-7351-2d51-7b48530b96fb","text":"This study involved human subjects and was reviewed and approved by the University Hospitals Institutional Review Board.","title":"Permanent Interstitial Cesium-131 Brachytherapy in Treating High-Risk Recurrent Head and Neck Cancer: A Prospective Pilot Study"}
{"_id":"de766b60-2855-d85c-3a9b-93280b7b1db8","text":"This is also one of the significant finding in our study. We believe that standard protocol should be developed regarding the timing of the surgery for microtia patients taking into consideration the age, weight, psychological issue and pre–operative radiological analysis of the costal cartilage development of the patient. We suggest further research should be done comparing the number of costal cartilage harvested and chest deformity among the patients.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"de7a1b24-bb23-bac0-ecc8-74042f4f2641","text":"In conclusion, percutaneous cryoablation is shown to be a safe and effective treatment for extra-abdominal DT with efficacy similar to those treated with traditional strategies in the short to medium term.","title":"Cryotherapy in extra-abdominal desmoid tumors: A systematic review and meta-analysis"}
{"_id":"de7a7362-a4bf-c144-c84b-65c868bf7600","text":"Even if MRI was proven to be a reproducible method for the detection of residual glandular tissue, there is still no clear correlation between an increased amount of residual glandular tissue and an increased cancer risk. Thus, the decision to implement routine surveillance has to be weighed against the potential anxiety provoked by surveillance itself.","title":"Inter- and intra-observer agreement on evaluating the presence of residual glandular tissue with magnetic resonance tomography following prophylactic mastectomy"}
{"_id":"de7b4aba-1ac8-8ae4-d8db-7fc2724eca53","text":"Continued research in the field of cryoablation for the treatment of small breast cancers and the role cryoablation plays in the immune system is essential for continued development of effective breast cancer treatment regimens. Cryoablation is known to not only destroy target cells, but can also lead to the circulation of intact tumor specific antigens for the immune system to recognize and react to. With our current understanding of checkpoint inhibition and the effects of blocking PD-1\/PD-L1 and CTLA-4, the potential for these agents to have a synergistic effect with cryoablation must be studied. Clinical trials examining this relationship are currently underway and their results will help evolve our understanding of how to treat not only localized small breast cancers but also nodal and distant metastatic disease.","title":"An update on the use of cryoablation and immunotherapy for breast cancer"}
{"_id":"de816b5c-c7e0-c12a-5980-5adcb1a66723","text":"The subsequent thawing is achieved through the instillation of helium gas. Cryosurgery has demonstrated its effectiveness as a less invasive alternative with lower morbidity rates compared with other surgical resection techniques for treating serious health conditions like cancer. Figure 2 provides a schematic representation of the underlying pathophysiological mechanisms involved in the destructive effects of cryosurgery on biological tissues and the resulting tissue damage.","title":"The Evolving Role of Cryosurgery in Breast Cancer Management: A Comprehensive Review"}
{"_id":"de8e32a1-7b93-12d5-bf4b-0a9215ecc4f8","text":"The prolonged submental perforator flap has a moderate thickness, simple operation, reliable blood supply, flexible rotation, is close to typical head and neck defect sites, and can be removed in the same surgical procedure as the tumour. The donor site scarring can easily be hidden behind the mandible with good aesthetic effect and speech and swallowing function repair to the throat is satisfactory. Based on previous surgical experience, we attempted to create an extended submental perforator flap distal to the connecting line between the mastoid and the sternoclavicular joint to repair postoperative defects in the upper airway in the nasal cavity, soft palate and contralateral larynx and pharynx, as well as other relatively distant areas with less trauma and straightforward surgery.","title":"Application of prolonged submental perforator flap to repair the postoperative defect of upper airway malignancy"}
{"_id":"de9a52d9-7463-74f2-0f8f-fb34d93d7ba9","text":"The proportion of patients with breast cancer receiving mastectomy and BCS over time was calculated, as was the proportion needing a further operation over time.","title":"Breast cancer recurrence after reoperation for surgical bleeding"}
{"_id":"de9a6575-0bfd-1cb8-1df6-3924375791aa","text":"The benefits of intraoperative guidance using Hyper Accuracy 3D in a patient with multiple myomas and infertility are demonstrated.","title":"Incorporating 3D reconstruction in preoperative surgical planning of Multiple Myomectomy"}
{"_id":"dea5a72e-43a7-b3df-e735-384cfbfb19f1","text":"It is important to understand the different surgical techniques for breast reconstruction in order to be familiarized with the normal postoperative imaging appearance of the reconstructed breast and also to recognize common benign complications associated with each reconstruction method. The identification of breast cancer recurrence and malignant disease associated with breast implants is another issue that is discussed in this review.","title":"Imaging of the Reconstructed Breast"}
{"_id":"deb42435-a254-6f98-194a-fde6d50f7888","text":"8 phakic eyes underwent Hydrus Microstent implantation with OMNI Surgical System ab interno canaloplasty. 2 patients underwent concurrent Kahook Dual Blade goniotomy and 1 patient underwent a concurrent micropulse transscleral cyclophotocoagulation. 6 out of 8 eyes achieved successful intraocular pressure reduction. Only 1 achieved success without the need for additional medical therapy. 1 required Neodymium-doped yttrium aluminum garnet laser to clear iris obstruction of the Hydrus inlet and 1 required selective laser trabeculoplasty for additional intraocular pressure lowering. 2 out of 8 eyes required subsequent incisional glaucoma surgery for unacceptable intraocular pressure levels despite maximum tolerable medical therapy.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"debb8a74-c9ec-a850-4b5a-1f874ad41e19","text":"Development of the PD role must be done in parallel with the organization prioritizing educational activities at a more general level.","title":"Factors related to the role of programme directors in association with quality in postgraduate medical education – a cross-sectional study"}
{"_id":"dec749f0-68e6-4af7-c43b-1aa7437888cd","text":"Four patients in this study had concomitant soft tissue defects, two of which were treated with latissimus dorsi flap transfer in the first stage. The other two patients had small wounds that healed during bone transport. We believe that the early application of the flap for larger wounds can reduce the chance of reinfection and decrease the number of dressing changes. Reducing the pain and financial burden of the patient. For smaller wounds, the skin and soft tissues can be transported simultaneously during bone transport, covering the wound for a shorter period of time, without flap transfer. Ilizarov bone transport technique based on distraction osteogenesis have been applied in treatment of bone defect, especially in cases associated with soft tissue loss given its naturally advantages of simultaneous histogenesis result in expected treatment outcomes. The main drawback of this technique is the long duration of the external fixation, which causes many life and psychological obstacles to the patient.","title":"Reconstruction of massive tibial defect caused by osteomyelitis using induced membrane followed by trifocal bone transport technique: a retrospective study and our experience"}
{"_id":"ded3b5f0-0234-4ae8-9e23-4309e3589ca6","text":"Keloids are a pathologic scarring response to dermal injury that progress to involve normal tissue outside the original injury and have a significant impact on quality of life. With multiple treatment modalities available, first-line therapy is silicone gel or sheeting with corticosteroid injections for more tumoral lesions or tape for flatter keloids. Providers can consider adjuvant intralesional 5-FU, bleomycin, or verapamil depending on patient preference and side effect profile. Laser therapy can be considered in combination with intralesional injection of corticosteroids or topical steroids with occlusion. For keloids that inadequately respond, excision with RT of 16–20 Gy over a maximum of 5 days started within 24 h can be considered. Additional treatment with silicone sheeting and pressure therapy is reasonable with possible oral colchicine to prevent recurrence. As the field continues to progress in the understanding of keloid etiology, the promise of new therapeutic targets and more specialized treatment regimens emerges.","title":"Keloid treatments: an evidence-based systematic review of recent advances"}
{"_id":"dedb69cd-f662-a9fd-895f-0106f88c5574","text":"In this study, the molecular mechanisms of imiquimod‐induced cell death of melanoma cells are elucidated. These findings support the development of adjuvant therapeutic strategies using IKK inhibitors or IAP antagonists to enhance the effectiveness of imiquimod in the treatment of malignant melanoma.","title":"Imiquimod‐induced apoptosis of melanoma cells is mediated by ER stress‐dependent Noxa induction and enhanced by NF ‐κB inhibition"}
{"_id":"dedc2e1b-d613-8606-dec2-50dcd026ee87","text":"Because of variations in techniques and time of assessing morbidity, direct comparisons between studies are difficult. Nevertheless at a minimum, a clear trend is present: having the LS images and skin markings to assist during SLNB appears to yield more favorable morbidity outcomes for the patients compared to performing SLNB with only the probe or performing SLNB with dye alone. These results are extremely pertinent, as the main reason for performing SLNB itself in the first place is to achieve reduced morbidity.","title":"Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature"}
{"_id":"dee0c057-04c1-a748-edf2-494e66050245","text":"This protocol will allow us to test our hypothesis that low dose intradermal immunotherapy with grass pollen allergen is an effective treatment in seasonal allergic rhinitis caused by grass pollen. The first participant was randomised in February 2013 and the last participant is expected to complete the trial protocol in August 2014.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"dee4e457-ab3f-4195-5f37-f917777c111c","text":"An example of a nasal vestibule implant with relative treatment plan and final clinical outcome is reported in Figure 3.","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"deeb0391-b914-42ff-9b49-f73cbdcfcd57","text":"This retrospective study reviewed 12 cases where BTA was used as an adjunct to close laparostomy. It compared primary fascial closure rates to historical controls at the same institution.","title":"Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases"}
{"_id":"def17a9c-2f37-9987-d6f7-4976b71d7a2a","text":"Currently an estimated 1200 persons die of metastatic squamous cell carcinoma each year and now the freedom that physicians have to eradicate these lesions early in their evolution affords the opportunity to reduce that figure significantly.[5] Albinos need protection against their major enemies - the neglect of an uninformed society and the hostility of the tropical sun. Registering all albinos early in life, educating the society on the educability of most albinos with correctable ocular defects and offering them encouragement and guidance through school and employment will help to restore them in society. The damaging effect of the sun can be minimized by using protective clothing, sun screening agents and indoor occupation.[5]","title":"MALIGNANT TRANSFORMATION OF ACTINIC KERATOSES TO SQUAMOUS CELL CARCINOMA IN AN ALBINO"}
{"_id":"def89c6e-53df-9f45-d048-9e8a9d3b2414","text":"Recreation of the helical rim curvature is challenging. Distinct techniques may be employed, including basting sutures, jelly roll flap and secondary intention healing. Basting sutures are more successful during the first stage to recreate the helical sulcus since wound healing and flap contraction at the second stage may distort the sulcus. The jelly roll technique consists of doubling up the skin flap into a roll to simulate the soft tissue that overlies the cartilage. Horizontal mattress sutures behind the flap leading edge place the helical skin under compression and create redundancy. Secondary intention healing of the anterior portion of the defect (if limited in size) naturally helps to recreate the sulcus, as in the present case. Regardless of the technique implemented, flaps should not be placed under tension since this will attenuate and flatten the sulcus.","title":"Staged retroauricular flap for helical reconstruction after Mohs micrographic surgery *"}
{"_id":"def8ec3c-a0f7-939b-91f1-31aa5ea10b26","text":"The morbidity of the HILP was confined to the treated extremity and consisted of erythema to the HILP level and worsening lymphedema in most patients. The lymphedema has to be taken in the context that most of these patients will also have previous primary site surgery, SLN surgery and complete lymph node dissection surgery (both first and second station nodes) along with the HILP. It is unclear what is the contribution to the lymphedema from just the HILP. One patient did require a below knee amputation due to an unrecognized clotting disorder prior to surgery. Another patient did develop leukopenia that required growth factor administration presumably due to leak of the melphalan into the systemic circulation.","title":"Regional Therapy for Recurrent Metastatic Melanoma Confined to the Extremity: Hyperthermic Isolated Limb Perfusion vs. Isolated Limb Infusion"}
{"_id":"defbe10e-d382-016b-4f9b-3882d4f4c6a1","text":"The model consistently avoided the physeal lines and vessels. Signal in the medial part of the femoral metaphysis was missed by the model in one peripheral slice. The general impression was that most inaccuracies were found in the peripheral slices.","title":"Automated segmentation of magnetic resonance bone marrow signal: a feasibility study"}
{"_id":"deffaf44-c3cf-3a5e-d033-9cc4c072b6b7","text":"An excessive amount of dermal fillers can cause vascular compression resulting into a reduction in skin perfusion. Delayed injection necrosis through vascular compression from hyaluronic acid has been described previously. Minimizing this risk of aspiration prior to injection is recommended. Also it has been suggested that use of small amounts of filler and a suitable injection technique may reduce the risk of the complications. Early diagnosis of vascular compromise and even vascular necrosis after filler injection may improve the outcome of wound healing.","title":"Nasal Alar Necrosis Following Hyaluronic Acid Injection into Nasolabial Folds: A Case Report"}
{"_id":"df00a1e7-9fba-d2f6-19f9-da4bc5e1f2e8","text":"In patients undergoing breast reconstruction with DIEP flaps, these reconstructive procedures can be combined by including inguinal lymph nodes into the DIEP flap for a reconstruction of the axillary drainage.","title":"Plastic Surgery for the Oncological Patient"}
{"_id":"df076177-47dd-4d0f-f81b-dc368d79b6b2","text":"We describe secondary esophageal reconstruction using a transverse colon that was covered with a pectoralis major muscle flap and split thickness skin grafts in a patient with an esophageal defect and wide skin defect; this procedure was performed to treat necrosis of the esophageal conduit after esophageal reconstruction with the terminal ileum and ascending colon.","title":"Secondary reconstruction with a transverse colon covered with a pectoralis major muscle flap and split thickness skin grafts for an esophageal defect and wide skin defects of the anterior chest wall"}
{"_id":"df08cf0e-89f4-b874-e60f-74364bf5b845","text":"Any technique to mold and shape cartilage grafts in rhinoplasty, has advantages and disadvantages. Filler type cartilage grafts first known as crushed cartilage, were used to camouflage slight tip and dorsum irregularities since 1985 and increasingly popularized till 1995 and its use dramatically ceased recently. The use of diced cartilage grafts in reconstructive surgery was first described in 1943, though it was not for rhinoplasty. A number of studies describing diced cartilage have followed since then, but the technique had never achieved widespread use.","title":"Evidence-Based Efficacy of Autologous Grated Cartilage in Primary and Secondary Rhinoplasty"}
{"_id":"df0d3d00-76fa-e19d-1e40-38b284d2f468","text":"Our study was approved by the Human Research Committee at the Brigham and Women's Hospital with written informed consent from all participants.","title":"Risk of a Second Primary Cancer after Non-melanoma Skin Cancer in White Men and Women: A Prospective Cohort Study"}
{"_id":"df142c21-3413-4e3a-5c65-784eb4883ce8","text":"The initial symptoms are probably caused by mechanical occlusion of multiple blood vessels with fat globules that are too large to pass through the capillaries. Unlike other embolic events, the vascular occlusion in fat embolism is often temporary or incomplete since the fat globules do not completely obstruct capillary blood flow because of their fluidity and deformability. The late presentation is thought to be a result of hydrolysis of the fat into the more irritating free fatty acids, which then migrate to other organs via the systemic circulation. It has also been suggested that paradoxical embolism occurs due to shunting.[10]","title":"Emergency management of fat embolism syndrome"}
{"_id":"df21a082-7965-cc1a-a9a1-f81a286139aa","text":"Those with a negative reply will not be contacted. Those patients who do not return their postcard will be given a second postcard a month after the first one was given out. If a patient wishes to take part in the study but their GP is unwilling, alternative arrangements will be made at a hospital clinic.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"df2a2408-63a2-fd3d-89d1-d88f4bcb610d","text":"Any disagreements in grading will be reviewed by a third adjudicator. A summary and graphic representation of the QUADAS-2 gradings for all studies will be presented in the final review. A sensitivity analysis will be conducted by removing studies with a high risk of bias.","title":"Protocol for a systematic review and meta-analysis of the diagnostic accuracy of artificial intelligence for grading of ophthalmology imaging modalities"}
{"_id":"df305281-4c86-427c-b07d-0817fb3bb3ae","text":"However, it should be noted that surgical exposure will always be limited by a craniotomy performed at one specific time in a live patient, whereas a cadaveric specimen can be freely explored through many craniotomies and approaches at different time points. Furthermore, when using a cadaveric specimen, more aggressive retraction and dissection can be performed to reach distant anatomical targets that are deemed not safe in a real patient or are being tested for feasibility. Virtual models can support learning by allowing numerous rehearsals, with skills then confirmed by actual dissections in a laboratory. Eventually, with optimization of our pipeline and future advances in 3D virtual technology, we believe that accurate and realistic 3D virtual models can be effectively applied to both cadaveric and real-life specimens. Our technology is developed and exists to augment neurosurgical training; we have no doubt that considerable practice dissecting the cranium and brain is mandatory to achieve technical excellence for the progressing neurosurgeon.","title":"Development and Validation of a Novel Methodological Pipeline to Integrate Neuroimaging and Photogrammetry for Immersive 3D Cadaveric Neurosurgical Simulation"}
{"_id":"df30ac63-0dc0-c275-ab30-8bf109bfa807","text":"Largely related to the processes of chondrogenic and osteogenic differentiation, LIUS stimulation can induce the expression of extracellular matrix proteins not only in stem cells, but also in other cell types such as chondrocytes.","title":"Ultrasound Therapy: Experiences and Perspectives for Regenerative Medicine"}
{"_id":"df39a8db-f191-9d5f-18d7-17e31eae69cb","text":"The presence of mutations in the exon 3 of CTNNB1 appears as a significant predictor of recurrence in early stage endometroid EC, in particular in the NSMP EC. This finding strengthens the idea that CTNNB1 status might be used to substratify early stage, low-grade EC with NSMP, aiding to identify cases that need adjuvant treatment. Further studies are encouraged to confirm these findings and define their clinical significance in cohorts of patients stratified by TCGA classification.","title":"Prognostic significance of CTNNB1 mutation in early stage endometrial carcinoma: a systematic review and meta-analysis"}
{"_id":"df3ca40c-d0f6-03ff-61a3-5be9e8c3fc8c","text":"surgical excision remains the best tool for management of skin tumors affecting nasal skin, however many surgical techniques have been used for reconstruction of the nasal defects caused by excisional surgery. The aim of this work is the evaluation of the feasibility and outcome of levator anguli oris muscle based flaps.","title":"Levator anguli oris muscle based flaps for nasal reconstruction following resection of nasal skin tumours"}
{"_id":"df46947d-8f8a-fc92-4313-dacff1616396","text":"Again, a careful preoperative evaluation with a multidisciplinary tumor board discussion is revealed as essential for selecting the eligible patients and appropriate treatment.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"df477063-3b66-c372-5d2c-c832c886a7a1","text":"A persistent and strong personal desire to be one of change catalysts for the advancement of reconstructive surgery in Ethiopia is the main motivational factor which serve as a drive for embarking on this journey of fellowship. The current practice of plastic and reconstructive surgery in Ethiopia is characterized by usage of old-fashioned methods of reconstruction, where skin graft, local flap, and pedicled regional and distant flaps are used as the main reconstruction armamentariums. Reconstructive microsurgery is one of the missed tools in our current practice of reconstructive surgery.","title":"Fellowship Away from Home: A Journey toward Advancing the Current Practice of Reconstructive Surgery in Ethiopia"}
{"_id":"df506274-3cea-6013-3c8a-0d864a60983a","text":"To the best our knowledge, there is no report on effective nonoperative treatment for calcaneal malunion. For all patients, nonoperative treatment for calcaneal malunion with customized insole use for at least 6 months failed. The morphological changes of the calcaneal malunion do not improve with nonoperative treatment including orthotics and insoles.","title":"Mid-term follow-up results of calcaneal reconstruction for calcaneal malunion"}
{"_id":"df53e5ae-cc7b-5d5b-bb77-97c86e67e9f5","text":"The anterolateral thigh flap ensures an acceptable post-operatory result, both from the functional and aesthetic point of view, in case of its use in covering the complex postablational defects of the tongue. The use of free flaps in the immediate reconstruction of the tongue after tumor resection should aim at the maintenance of the mobility of the residual tongue and restoration of tongue bulk in order to optimize the recovery of speech and swallowing function. The volume, shape and size of the flap can be adjusted depending on the defect. It has the same range of success as the classical free.","title":"Ablation of advanced tongue cancer and mobile tongue reconstruction by using a sensitive anterolateral thigh and vastus lateralis muscle free flap"}
{"_id":"df57c1c7-2cbb-66b7-20a8-a9eb83acb2b2","text":"Patients diagnosed with cutaneous melanoma between 2000 and 2018 were studied.","title":"The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)"}
{"_id":"df591b2c-5276-8609-9774-7d919697840d","text":"The examiners had no time limit, and were allowed to change their decisions and confidence levels once they had made it within each block. The examiners spent 20 to 40 min to complete this test, and were not informed of their own results until every test was completed.","title":"Medical Professional Enhancement Using Explainable Artificial Intelligence in Fetal Cardiac Ultrasound Screening"}
{"_id":"df5deedf-f6ce-6113-5eaa-6b79799bddad","text":"Although the lack of a requirement to routinely monitor anticoagulation with DOACs may be advantageous in some situations, it may actually increase the likelihood of patients stopping their anticoagulant treatment earlier than recommended. Adherence may be particularly problematic where health literacy is relatively low, such as in some Latin American regions, and thorough education is needed to ensure that patients adhere to their treatment regimens as prescribed.","title":"Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care"}
{"_id":"df642477-bbb0-529b-e318-a9cb230d232e","text":"The CARRA systemic JIA CTP pilot study was completed successfully. The patients were reasonably balanced at baseline between CTP groups, and the primary determinants of CTP choice appeared to be site and physician preference rather than patient characteristics. Those initially treated with biologics had a greater likelihood of achieving clinical inactive disease off GC at 9 months. Having demonstrated feasibility of the CTPs, additional patients will be enrolled as part of a larger comparative effectiveness study to determine the most appropriate treatment strategy for new onset systemic JIA.","title":"Proceedings of the 2016 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting Toronto, Canada. 14-17 April 2016"}
{"_id":"df647611-9ad1-a850-1dde-436b7186e91b","text":"Cases of facial cleft should be operated under naso-endotracheal intubation. This gives way for more critical assessment of new point of commissures not only preopera-tively but immediate postoperatively also. This also avoids reconstruction of orbicularis oris under tension which is possible when nasoendotracheal intubation is done. This repair is significant to achieve normal sphincter like function which is necessary for articulation and mastication.","title":"Bilateral Transverse Facial Cleft as an Isolated and Asyndromic Deformity"}
{"_id":"df7bda5d-2864-e950-7f0c-8a0771c19134","text":"We aim to perform a cohort study to evaluate if revascularization of lower limb is sufficient for wound healing in patients with impaired cardiac function.","title":"Does impaired cardiac function affect peripheral arterial angioplasty outcomes?"}
{"_id":"df7ef6a2-9b25-29fe-4ca2-332a4cf169fd","text":"On one side of the debate, proponents like Granick et al advocate for routine histological examination of all excised mastectomy scars, citing four cases intended for late reconstructive surgery. In one of these, a pathological examination has identified adenocarcinoma in the absence of abnormal clinical findings. This perspective highlights the potential for histological analysis to uncover otherwise undetectable recurrences, suggesting that thorough examination is crucial for patient safety.","title":"Histologic Examination of Mastectomy Scars during Breast Reconstruction: A Systematic Review"}
{"_id":"df81aa94-e608-b24b-73cb-ad830ca99a10","text":"Fine needle aspiration or bone biopsies have been used for sampling in paediatric osteomyelitis and in vertebral osteomyelitis. Confirmation of Mycobacterium tuberculosis osteomyelitis requires acid-alcohol resistance staining of the biopsy or specific culture techniques.","title":"Microbiological aspects of osteomyelitis in veterinary medicine: drawing parallels to the infection in human medicine Veterinary Quarterly"}
{"_id":"df8224b8-23f5-658a-b947-78357e7f4e6c","text":"Surgical excision of tumoral calcinosis is indicated if there is significant skin breakdown or joint involvement. Early excision should be undertaken while the masses are small to avoid operative difficulties and ulceration of the overlying skin with secondary infection that occur with very large masses.6 Excision may be difficult if no true capsule is present as the mass may invade adjacent muscle tissue. Recurrence in idiopathic tumoral calcinosis is uncommon. Spontaneous regression of the mass of tumoral calcinosis has never been reported. The prognosis is good particularly in the absence of secondary infection.","title":"Idiopathic Tumoral Calcinosis in Hand: A Case Report Xu et al"}
{"_id":"df83f73b-35f8-ab36-8d19-21418fb04794","text":"Biofilms are ubiquitous with an estimated 99% of the world’s bacteria living enclosed in a biofilm. The problems that biofilm cause in industry have been well documented and methods to reduce their impact have been explored since before the middle of the last century. However, the extent to which biofilms play a significant detrimental role in chronic disease and implantable medical device failure has only been acknowledged over the past few decades whilst the role they play in surface and surgical instrument decontamination failure has only recently been highlighted.","title":"Special Issue: Microbial Biofilms in Healthcare: Formation, Prevention and Treatment"}
{"_id":"df882db6-9ffa-7016-a9c8-9bd54f55c777","text":"Access to the general dental service in Lothian and across the UK is extremely variable. Forty percent of our patients reported seeking dental care occasionally or only when in pain, suggesting irregular attendance and the possibility of lapsed registration. It is unlikely that a course of treatment, especially for unregistered patients, would be completed within two weeks. Patients who are regular attenders may feel more comfortable attending the dentist with whom they are familiar13 but this simply may not be practical.14 Referral to a dental clinic within the hospital is convenient for the patient and reduces administrative delays; appointments can be arranged to coincide with visits to the oncology unit and in co-ordination with blood tests and transfusion of blood products.","title":"Dental assessment prior to stem cell transplant: treatment need and barriers to care"}
{"_id":"df89987e-277b-69d0-37c3-f32baefee119","text":"Hospital Episode Statistics (HES) data were obtained for all patients undergoing varicose vein treatment between April 2006 and April 2007 to identify those reattending with either deep vein thrombosis or pulmonary embolism within 12 months.","title":"The incidence of post operative venous thromboembolism in patients undergoing varicose vein surgery recorded in Hospital Episode Statistics"}
{"_id":"df8b6392-a6c9-1ea5-41d7-c4aec1bf3300","text":"Introduction: Leadership amongst professional organizations is a key opportunity for scholarly activity which is essential for academic advancement. Our objective was to examine the differences between men and women in leadership within surgical organizations.","title":"Leadership Amongst Regional and National Surgical Organizations: The Tides Are Changing"}
{"_id":"df8e2fa2-a9de-d39e-1128-4d5b657cba82","text":"Despite the recognition that regular postoperative follow up plays a key role in ongoing care of cancer patients, there is little consensus on the nature of the process.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"df8e4a31-433f-75ac-9d6c-2ad5937ddb38","text":"The averaged results of the measurements of the mandibular movements in general and in the age groups are presented in table III. The mean range of dehydration in the study group was similar in boys and girls. The range of movements in temporomandibular joints does not differ from functional norms, although there is a tendency for hypermobility in temporomandibular joints, also dehydration, protuberance and translation.","title":"Evaluation of Stomatognathic Problems in Children with Osteogenesis Imperfecta (Osteogenesis Imperfecta − OI) − Preliminary Study Ocena problemów stomatognatycznych u dzieci z wrodzoną łamliwością kości (Osteogenesis Imperfecta − OI) − Badania wstępne"}
{"_id":"df90b768-5f69-cae4-a344-0bfcb2df4195","text":"Knowing the source of the filler is important as it helps the dermatologist to take decisions about the need for preskin testing and to know the patient’s preference. Many patients may not wish to use animal products for religious or personal reasons.","title":"Dermal Fillers: Tips to Achieve Successful Outcomes"}
{"_id":"df90f42b-5d1e-d7d1-49a4-fba7a362c39e","text":"The loss of projection observed in patients undergoing nipple reconstruction with local flaps is not well understood. Possible explanations include the absence of underlying connective tissue support for the local flaps and presence of wound contractile forces at the base of the reconstructed nipple. The injection of filler material to the dermis of the nipple directly augments the nipple and minimizes the counteracting effects of the above-listed factors. While hyaluronic acid filler is generally not considered a permanent solution for restoring volume, especially for its more common use in the face, we did not observe any loss of nipple projection among our cohort during the study period. We postulate that perhaps degradation of the filler is slower in the nipple compared to the comparatively more well-vascularized face. Although repeat filler injections in the future are expected, the patients have been satisfied with their results and have not required a repeat injection after 6–9 months.","title":"Use of hyaluronic acid filler for enhancement of nipple projection following breast reconstruction: An easy and effective technique"}
{"_id":"df928eb9-c1a1-0855-3892-3b49004fc9be","text":"Ultimately, there has not yet been agreement on protocol for treating Charcot osteoarthropathy of the lower extremity with or without osteomyelitis. The most current literature for treatment of Charcot osteoarthropathy and osteomyelitis highlights the lack of consensus, although does show some commonality between approaches.","title":"Charcot foot and ankle with osteomyelitis"}
{"_id":"df96018a-67ec-7cb3-f8b4-68c18467c926","text":"Large animal models represent the human skeleton with higher fidelity than smaller animals, making them more relevant for the study of spinal infections. Dogs and sheep have been investigated for vertebral osteomyelitis, owing to their close anatomical dimensions with the human spine. These models allow for the use of approved clinical instrumentation to determine risks of postoperative infection without the need for implant scaling. Larger animals better tolerate multiple procedures than small animals and allow for easy IV access for antibiotic administration. Of course, considerations around ethics, cost per animal and housing over long time courses make large animal models more challenging to investigate. A canine model offers a unique opportunity to design and investigate antimicrobial treatments in randomized control trials through recruitment of canine patients presenting to veterinary clinics with ongoing infection. A large retrospective study of discospondylitis reported 513 dogs with an active infection that were treated with administration of antimicrobial drugs. Therefore, veterinary clinics offer an abundant population of patients, presenting with the natural disease that is suitable for randomized trials. This cohort of patients should be investigated as an intermediary step between a controlled, artificially induced preclinical model and a human clinical trial for promising interventional therapies targeting spinal infections.","title":"Preclinical models of vertebral osteomyelitis and associated infections: Current models and recommendations for study design"}
{"_id":"df98f552-e0d9-3abf-2e8a-de4e1d48542f","text":"On the other hand, de novo supra osseous bone formation using guided bone regeneration (GBR) is a unique clinical technique for bone augmentation in which a barrier membrane is placed under periosteum providing a space over bone surface resulting in new bone formation in this space. It is clear that in GBR, migration of soft tissue including periosteum into the space under the barrier membrane is eliminated providing a favorable space for bone regeneration. However, creating a sizeable GBR space is not commonly feasible clinically. The technique requires excellent soft tissue management to avoid the major complication of premature membrane exposure and the subsequent bacterial contamination. This is generally due to insufficient soft tissue coverage leading to excessive tension of tissues during flab closure.","title":"A novel osteogenesis technique: The expansible guided bone regeneration"}
{"_id":"dfa40556-ce1f-fa29-f1c0-3426569d94c3","text":"This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prosthesis following low-level maxillectomy for malignant disease.","title":"The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy"}
{"_id":"dfaa9488-8c40-c3f0-b854-4b25e6a1661b","text":"This study aimed to characterize the observations of The Aesthetic Society members regarding the potential impact of repetitive panfacial fillers on the outcomes of subsequent facelift surgery.","title":"Potential Effects of Repetitive Panfacial Filler Injections on Facelift Surgery and Surgical Outcomes: Survey Results of the Members of The Aesthetic Society"}
{"_id":"dfb73efe-b523-9dac-2c65-39240562dd74","text":"A multidisciplinary approach in the investigation and management of these women is vital.","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"dfb84f2b-011f-10fc-fe39-4316de6a2db5","text":"Report: Herein we present a 56-years-old male Caucasian patient who developed skin lesions on the back of the hand 3 months after initiation of therapy with canakinumab as a part of a clinical trail for treatment of coronary artery disease. Upon admission the skin changes involved the dorsum of the hand and were presented by annular papules and plaques, the largest 3 cm in diameter with depressed center and elevated and infiltrated borders. The patient had no other relevant history of present or past disease beyond the coronary artery diseases and elevated serum cholesterol levels. He took no other medication prior or during the disease onset.","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"dfd37808-35a1-e827-dc85-e7f0d3ae2601","text":"The use of a soft tissue rather than composite reconstruction may also facilitate a shorter hospital stay and allow adjuvant radiotherapy to be delivered in a more rapid timescale with possible impact on overall cure rates of this very debilitating tumour. The initial experiences with this procedure in over ten cases have been extremely positive with excellent appreciation by patients who value being provided with a fixed dental prosthesis so quickly after major surgery.","title":"The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy"}
{"_id":"dfd4379b-0971-e757-a459-08d70ce589e5","text":"Infectious complications in the patients who underwent emergent surgery developed several months after the surgery with proper primary healing of the soft tissues and bones. In our view, prophylactically instituted both general and local antibiotic therapy could cause chronic inflammatory process without the acute phase. Fibak18 in 1994 pointed to an increased number of infected nonunions after intramedullary stabilization of open fractures treated within 24 h after the injury. This led to delay in operation in cases of open fractures from 10 to 15 days. Gopal et al.1 state that multifragmentary compound fractures of the tibial type IIIB and IIIC according to Gustilo–Anderson classification should be treated surgically in the firm and aggressive way. It should be done by teams comprising orthopedists and plastic surgeons with the use of an intramedullary nail or external fixator and immediate covering of the skin loss with pedicled free or rotational muscle flaps. In the opinion of these authors, the use of external stabilization makes plastic surgery difficult and increases the rate of delayed union or nonunion. For this reason, as they state, fractures of this type should be treated only in specialist centers.","title":"Management of open fractures of the tibial shaft in multiple trauma"}
{"_id":"dfe8102a-1ebb-f772-dfac-c136338bd330","text":"A 3 case series of such infections leading to extensive loss of the proximal femur is presented. We specifically describe our technique of debriding the infected segments as well as utilization of a trochanteric slide osteotomy to resect the femur.We also demonstrate preparation of the “pseudoacetabulum” and femoral component with an antibiotic spacer.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"dfed24d4-f362-348c-87a7-4a985632ad23","text":"We report a case of tumoral calcinosis of unusual localization in a hemodialysis patient.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"dff25686-5419-4d38-e159-0a2f57b4b853","text":"A mapping was created by reviewing the photographic record of the recorded position of the perforator, and the most frequent section between each perforator was identified.","title":"Deep Inferior Epigastric Perforators Topography for “Island Transverse Rectus Abdominis Musculocutaneous Flap” in Breast Reconstruction"}
{"_id":"dff2bbd4-ef24-f726-c2af-c29467101b07","text":"Access to decrypted data and safekeeping of the decryption key will be limited to the principal investigator and the study nurse. Participating spine surgeons only have access to their own site data and cannot see the data of the other recruiting centers. The use of encrypted data sets and the RedCap software management program will protect confidentiality. Anonymized data can be provided upon request.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"dff2f4eb-99c9-a801-9a29-5b6dd0730284","text":"A confident surgeon can easily get transformed into an insecure team leader. An urologist placed in the position as a team leader; in worst case scenario he has no competence in trauma care.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"dff7742b-838a-ba7d-85ab-91c206f31a6f","text":"Using LCUS in diagnosing DVT in primary health care instead of referring these patients to the hospital is shown to save a significant amount of public and private resources.","title":"Cost-minimization modeling of venous thromboembolism diagnostics: performing limited compression ultrasound in primary health care reduces costs compared to referring patients to a hospital"}
{"_id":"dffb7ebf-1426-1f07-ea8c-1b31e9dc74c0","text":"We believe that venous super-drainage could dramatically reduce the incidence of venous congestion by augmenting the venous output, thereby increasing flap reliability and allowing for larger flap sizes with lower rates of complications related to venous congestion. We advise the routine usage of this technique in flaps larger than 10 × 5 cm, especially if the flap shows signs of initial venous congestion, which puts it at an increased risk of necrosis.","title":"Super-Drained Distally Based Neurofasciocutaneous Sural Flap: A Case Series and Review of Literature El-Diwany et al"}
{"_id":"dfff91bc-da34-49bc-66a2-188bcb0348bc","text":"In addition to the mechanisms of osteomyelitis persistence described above, many groups have questioned the contribution of intracellular colonization of bone cells as a possible mechanism for quiescent osteomyelitis. The role of intracellular persistence in chronic osteomyelitis disease pathology remains a subject of intense debate because of a lack of compelling in vivo evidence.","title":"Evolving concepts in bone infection: redefining “biofilm”, “acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy”"}
{"_id":"e00417e0-0d83-6fb7-3982-5e025d6d47a7","text":"The required length of fibula bone was finally measured with calibrated paper scale and retrieved after making multiple osteotomy cuts with the help of an oscillating saw for recontouring of the bone to give it the mandibular shape according to the prefabricated template and pre-plated reconstruction plates, before dividing the pedicle. The fibula transplant was plated with pre-plated recon-plate in the pre-marked screw holes and transferred and divided later into the mandibular defect once the recipient’s vessels were prepared for anastomosis. The pedicle was placed along the inner side of the flap and the lingual side of the mandible. The micro-vascular anastomosis of the flap was then performed in the recipient bed following standard techniques with facial and superior thyroid arteries, and external and internal jugular veins. After closure at the donor site, a plaster splint was fabricated for the donor limb and applied to the posterior aspects of the leg.","title":"Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study"}
{"_id":"e00450bc-20eb-e64e-fe59-7d10950b67e0","text":"In conclusion, free flaps are a viable option even in resource constrained environment. Good surgical outcomes could be realized by the use of basic surgical equipment such as loupes. The best approach is through a multidisciplinary approach with teams encompassing various related disciplines. The team must ensure adequate training in microsurgery before starting on the surgeries through fellowship programs or by inviting faculties from centres where these surgeries are done frequently. For starters, flaps that are relatively easy to raise and with good calibre vessels may be the best to start with, followed by more complex procedures. Meticulous surgical technique and careful observation of the flaps on the table and soon after surgery is paramount in ensuring good surgical outcome. The saying that “flaps are lost on the table” is probably truer in such an environment than anywhere else. The team must also learn to support each other in the event of flap failure and regroup again to try again, for that is the only sure way of being perfect with free flaps.","title":"Free Flaps in a Resource Constrained Environment: A Five-Year Experience—Outcomes and Lessons Learned"}
{"_id":"e0080264-95da-c623-e3e9-520077028d8d","text":"Therefore, this study aims to evaluate the risk of developing a subsequent skin neoplasm after having a first diagnosis of skin cancer, as well as to identify potential factors associated with an increased risk of new neoplasms.","title":"Risk factors for development of new skin neoplasms in patients with past history of skin cancer: A survival analysis"}
{"_id":"e00ff5ff-7012-10d3-4328-1cea70ba94f1","text":"According to these studies we decided to evaluate sensory alteration in nasal tip and adjacent upper columella (territory of external nasal nerve), so we randomly selected two groups each containing 25 patients with thick nasal skin; sensory testing was done preoperatively in all patients; in group one we removed subdermal soft tissue, but in group two we did not remove any soft tissue and we compared the sensory recovery in 3 weeks and 6 months postoperatively between these groups with a set of sensory testing monofilaments.","title":"Comparing the Alteration of Nasal Tip Sensibility and Sensory Recovery Time following Open Rhinoplasty with and without Soft Tissue Removal"}
{"_id":"e010fc94-8ef1-3a7a-153d-8a6b43038163","text":"To the best of our knowledge, the present study is the first to assess the use of LDI in the evaluation and treatment of vascular complications caused by dermal filler injections. We hypothesized that LDI could reliably identify skin perfusion defects without interference from other factors. Toward this end, we compiled a cohort of thirteen patients with vascular complications for whom LDI was used to identify skin perfusion defects and guide treatment.","title":"Laser Doppler Imaging for Treating Vascular Complications from Procedures Involving Dermal Fillers: Case Series and Literature Review"}
{"_id":"e012eac4-b404-8286-9b5f-9d069247e76c","text":"The GRADE Working Group has continued to grow as an informal collaboration that meets one or two times per year. The group maintains web pages and a discussion list.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"e014eb7a-6e53-d13c-79d6-0d8a001ab5b3","text":"Rhinoplasty, a surgery that reshapes the nose to increase facial beauty or to restore the nasal function after a physical defect, is the most popular plastic surgery worldwide and second most common in Saudi Arabia. Regardless of how common this procedure is done in Saudi Arabia, there is a huge lack of studies on how medical students feels and acts towards it. Thus, this study aimed to assess the perception and attitude of cosmetic rhinoplasty among Fakeeh college students in Jeddah, Saudi Arabia.","title":"Perception and Attitude of College Students toward Cosmetic Rhinoplasty"}
{"_id":"e01e9e62-38fc-1170-0efe-72afca0f6841","text":"What is the mechanism that these nodal metastases may exist after the initial treatment of the primary melanoma. Even to this day, some patients are not having their nodal basins addressed at the time of the radical resection of the primary melanoma. Depending on tumor thickness, a percentage of these patients will have microscopic nodal disease left behind that will become apparent with the appearance of intransit metastases and a nodal dissection with the HILP. Some patients will not undergo a CLND after a positive SLN biopsy despite the fact that approximately 15% of these patients will have microscopic disease beyond the SLN. Nodal metastases will then be found with any subsequent nodal dissection and HILP. In patients with a negative SLN biopsy with the initial cancer operation, about 5% will have a false negative result. These patients will have nodal metastases at the time of HILP. In addition, the local recurrence metastases or intransit metastases that give the patient the indication for a HILP may metastasize to the regional nodal basin in a different distribution than metastases from the primary melanoma. Certainly this different pattern of metastases from metastatic lesions is well documented in the lymphatic mapping literature and allows for lymphatic mapping from the metastatic focus despite the patient having a previous mapping from the primary site. Finally, even if a patient has an initial positive SLN followed by CLND of the involved basin, second station metastases may occur either from direct drainage from the primary site or from the intransit metastases. Thus, nodal disease may occur in a variety of mechanisms in this scenario.","title":"Regional Therapy for Recurrent Metastatic Melanoma Confined to the Extremity: Hyperthermic Isolated Limb Perfusion vs. Isolated Limb Infusion"}
{"_id":"e01ea189-b1ca-afdb-420e-232b4fb3036d","text":"The concepts of repair and of reconstruction may greatly differ in relation to the final outcome, because promoting the wound healing not necessary means for the patient a return to the preop physical and mental state.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"e0273459-eff2-1c33-8d0a-2e8ff6dfe733","text":"Overall, clinical trials of Iranian osteomyelitis are needed in future to evaluate exact results of E-test by clinical response to antibiotics. Although our study supported Vancomycin empirical therapy, detection of a reliable method for finding a right narrow spectrum antibiotic can induce lower empirical therapy and consequently keep VISA in a low level and prevent construction of VRSA strains in Iranian chronic osteomyelitis.","title":"Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran?"}
{"_id":"e02854a0-1885-f76f-69ec-d6ecb0636c41","text":"At histopathological analysis, margins larger than 2mm were considered as free, and margins equal to or less than 1mm were considered as coincident and as compromised in cases where there was a lack of margins.","title":"Nonmelanoma Skin Cancer at Critical Facial Sites: Results and Strategies of the Surgical Treatment of 102 Patients"}
{"_id":"e03276d1-989b-bed1-fba3-7be29bdeb4a9","text":"The data analyzed were the pressure exerted to stop the bleeding and if the hemorrhage was controlled or not. By doing this, the simulator could be validated taking into account both, the design and the implementation. With respect to the control of the hemorrhages, in all the simulated scenarios the hemorrhage was controlled. With respect to the pressure exerted, in the hemorrhagic trauma scenario in which the external saphenous vein is compromised, Scenario 2 according to Table 3, the medical students apply a much higher pressure than the doctors. The median of the pressure exerted by the students is of 275 mmHg whereas the median of the pressure applied by the doctors is of 156 mmHg. Figure 4a shows the wide range of values obtained depending on the doctor or on student that performed the pressure to stop the bleeding.","title":"Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study"}
{"_id":"e0329b95-0e0f-296d-d321-bf5223cd77c1","text":"TOB-incorporated into CPB for local bone administration was proven to be more successful in increasing the efficacy of TOB in this rabbit osteomyelitis model and hence could represent a good alternative to other formulations used in the treatment of osteomyelitis.","title":"In vivo efficacy of tobramycin-loaded synthetic calcium phosphate beads in a rabbit model of staphylococcal osteomyelitis"}
{"_id":"e032d10b-435b-0645-ecda-3f339624bf43","text":"Informed consent was obtained from all individual participants included in the study. The participant has consented to the submission of the data to the journal.","title":"Versatility of unilateral propeller groin flap for coverage of large scrotal defects and its impact on testicular function"}
{"_id":"e03d4b5f-649f-4781-6360-752ac69862da","text":"Table 7 shows the differences between the mean scores in patient satisfaction scales and the qualitative variables studied, and Table 8 shows the results after correlating the mean score on both scales with the quantitative variables of the study.","title":"Long-Term Quality of Life (BREAST-Q) in Patients with Mastectomy and Breast Reconstruction"}
{"_id":"e042a647-8b7a-6b73-cb8c-5b084c7884f4","text":"Resolution of ovarian vein thrombosis has been documented after only 7 to 14 days of therapy [9]. Others have shown that ovarian vein thrombosis may not resolve with short anticoagulation therapy, and 3 to 6 months of anticoagulation is indicated until there is radiologically confirmed resolution of the thrombus. An association of puerperal ovarian vein thrombosis with inherited hypercoagulability disorders has been noted, which may predispose these patients to ovarian vein thrombosis.","title":"Ovarian vein thrombosis"}
{"_id":"e045fc9b-dfad-c925-aa30-2e50dd165c93","text":"Undergoing SLNB was associated with a better prognosis. The poor prognosis of old age and low SES may be due to decreased percentages of patients undergoing SLNB. Therefore, we recommend that SLNB should be performed on patients, especially in old age or low SES, who are candidates for SLNB according to current guidelines to achieve maximal survival. Further studies are needed to provide better evidential support for the survival benefit of SLNB.","title":"Prognostic factors and population-based analysis of melanoma with sentinel lymph node biopsy"}
{"_id":"e0476f99-69e3-0f05-ed36-73dcead19c1f","text":"This analysis provides data that the new AJCC 8 criteria may lead to improved concordance and reproducibility among pathologists in the classification of invasive melanoma, although the size of this effect is modest. One explanation of the improvement in concordance of pathological staging of T1a and T1b melanoma in AJCC 8 is the change in stage T1 subgroups and criteria from AJCC 7. In AJCC 7, the criteria for T1b were presence of dermal mitotic activity, Breslow thickness, or epidermal ulceration, whereas in AJCC 8, the primary determinants for T1a vs T1b were Breslow thickness and ulceration, with the elimination of mitotic activity.","title":"Concordance and Reproducibility of Melanoma Staging According to the 7th vs 8th Edition of the AJCC Cancer Staging Manual Concordance and Reproducibility of Melanoma Staging by AJCC 7th vs 8th Edition Definitions"}
{"_id":"e04dc805-171d-b4fd-6966-8c7f1012fd21","text":"The primary tumor was located in the mandibular or maxillary gingiva in 7 patients, the lateral margin of the tongue or glosso-mandibular sulcus in 5, the floor of the mouth in 3 and the mandibular symphysis in a single patient. The largest defects required a bilateral nasolabial","title":"Versatility of nasolabial flaps in oral cavity reconstructions"}
{"_id":"e04eb0fc-047d-b00c-0055-4b2d155527ef","text":"Patients with a first idiopathic venous thromboembolism will be recruited through anticoagulation clinics and randomly allocated to either continuing or discontinuing warfarin treatment for a further 2 years and followed up on a six monthly basis. At each visit D-dimer levels will be measured using a Roche Cobas h 232 POC device. In addition a venous sample will be taken for laboratory D-dimer analysis at the end of the study. Patients will be examined for signs and symptoms of PTS using the Villalta scale and complete VEINES and EQ5D quality of life questionnaires.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"e05a8440-62f4-bede-5cb1-6eee1f21fbc1","text":"Therefore, an early diagnosis and treatment of the condition of ankyloglossia associated with myofunctional therapy should be indicated in pediatric subjects with sleep apnea problems.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"e060262d-1fe5-6c11-05f6-c8740251c500","text":"In this prospective cohort study, lesion excision and subsequent surgical reconstruction strategies in 102 consecutive patients with facial BCC and SCC were analyzed, along with the initial histopathological and cosmetic results and possible complications.","title":"Nonmelanoma Skin Cancer at Critical Facial Sites: Results and Strategies of the Surgical Treatment of 102 Patients"}
{"_id":"e0707e89-ee74-59fe-fa3a-0868d2bc0144","text":"We applied the PEDro scale to evaluate the risks of bias and the GRADE system to evaluate the quality of evidence. The GRADE system is currently the most widely accepted approach for grading the quality of evidence in systematic reviews and clinical practice guidelines, and for grading the strength of recommendations in clinical practice guidelines. A major strength of this study was that online and offline stimulations were assessed separately, resulting in a relatively high quality of evidence. However, given the small number of included studies, further studies are required to establish a strong evidence base.","title":"Effects of Combining Online Anodal Transcranial Direct Current Stimulation and Gait Training in Stroke Patients: A Systematic Review and Meta-Analysis"}
{"_id":"e072dd4a-a733-4fea-b1a7-8e1106501c0a","text":"The patients had not undergone any other preliminary selection. Only patients who met with all the conditions listed above were enrolled in the study.","title":"The long-term results and prognostic significance of cutaneous melanoma surgery using sentinel node biopsy with triple technique"}
{"_id":"e083c558-9c26-388f-fa7e-49de3543972c","text":"One of the key trends in the STF Decisions and the CMPA STF Data is the role of thorough and detailed documentation of informed consent discussions in patient records when a Court or regulatory body assesses if informed consent has been obtained (Figure 2).","title":"Soft Tissue Filler Therapy and Informed Consent: A Canadian Review"}
{"_id":"e09a19d7-35c9-c3df-e6cd-cdd61aa5d5ed","text":"Table 6 Result of multivariate logistic regression analysis of breastfeeding initiation, breastfeeding at 6 months, exclusive breastfeeding at 6 months and breastfeeding at 1 year","title":"Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study"}
{"_id":"e09bca1c-33b2-82a6-f41a-987c73e1190e","text":"The ability to reconstruct even total scalp defects via free tissue transfer enables the radical surgical resection of malignancies.","title":"Microsurgical Reconstruction of Extensive Oncological Scalp Defects"}
{"_id":"e09c1cf9-4418-37ae-d304-1fdd770df962","text":"We have demonstrated that the concept of an “orderly progression” of melanoma nodal metastases maintains its validity for the majority of patients with clinically enlarged nodal metastases.11 Metastasis to lymph nodes outside a clinically involved basin can be detected by lymphoscintigraphy and gamma-probe-guided lymph node dissection. This is an observation that has not been mentioned in any previous studies. Another observation especially worthy of note is that the radioactive lymph nodes within a clinically involved nodal basin carried a significantly higher risk of being involved with metastases.","title":"Individualized Surgery: Gamma-Probe-Guided Lymphadenectomy in Patients with Clinically Enlarged Lymph Node Metastases from Melanomas"}
{"_id":"e09cec03-2d65-db52-291a-8c8b41868678","text":"The implementation of MTMS proved to be straightforward. The preparation of the “muffin” is simple and only takes 2–5 min of extra time. Apart from the tissue dyes, there is no additional procedural cost compared to simple excisions. Preparation of the pathology slides and their interpretation was uncomplicated and unambiguous. We believe that the directions provided in this paper alongside Supplementary Video 1 demonstrating tissue preparation will be sufficient for any dermatological surgeon to readily adopt this technique into everyday clinical practice. However, it should be noted that previous experience with MMS is advantageous and encouraged as it would aid the surgeon in determining the appropriate margins for primary tumor excision and increase confidence in tissue orientation and tumor mapping.","title":"Muffin Technique Micrographic Surgery for Non-melanoma Skin Cancer"}
{"_id":"e0a085b6-7bca-e1c0-4151-b7ee3a585432","text":"MIRPE does not require resection of the cartilage. Firstly the heart and mediastinum are slowly and carefully pushed down by the specific introducer, and the prepared convex steel bar is inserted under the sternum and across the bilateral thoracic incisions. The bar is turned, and the deformed sternum and costal cartilages are then brought into the correct position. The bar is left in place for at least two to three years, depending on the patient and the severity of the deformity.","title":"Clinical experience of repair of pectus excavatum and carinatum deformities"}
{"_id":"e0adf1d9-a3b7-d363-62e9-df754ff55c9e","text":"Further randomized trials are necessary to better define tumor independent factors that impact on overall survival and to compare different multimodal treatment strategies.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"e0af3e19-8bc1-219f-e105-3ad5631f11a1","text":"The surgical procedure is carried out under local anesthesia with intravenous sedation. The midface suture suspension procedure is performed through a temporal incision. A marking is made 1 cm lateral to the nasal flare of the nostril on the nasolabial fold and a further marking 1 cm inferior to the previous, following the contour of the nasolabial fold. Two lines are drawn from the nasolabial fold markings to the temporal hair line. The first line passes 1 cm lateral to the lateral canthus and the second line runs parallel to the first, passing 1 cm lateral to it. These lines are extended to the temporal incision site which is marked 1 cm above the hairline (Figure 1).","title":"Suture midface suspension"}
{"_id":"e0b393be-0a45-48b7-1ecd-81e0715048e5","text":"The most important find is highlighted by Pearson correlation test that showed an atypical not linear relation [Table 6]. In fact we observed a linear correlation between satisfaction score and implant volume up to 475 cc then a trend inversion was recorded. We went to study this phenomenon looking for patients who received wider implant and reported lower score. We discover that they had BMI higher the 31. This finding is well known in literature where is highly reported obesity have to be consider as exclusion criteria to implant based breast reconstruction.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"e0b45e38-0aed-1fe8-9d4b-81e05ddad01b","text":"The perforasome theory was initially described by Saint-Cyr et al, who demonstrated the ability of a single arterial perforator to adequately vascularize large volumes of skin for soft tissue reconstruction. Since the implementation of the propeller flap, it has become increasingly popular as a soft tissue coverage option, particularly for the medial aspect of the lower third of the leg, where free tissue has traditionally been the mainstay for substantial defects.","title":"Peroneal Artery–based Propeller Flap to Cover the Medial Distal Tibia in the Absence of the Posterior Tibial Artery"}
{"_id":"e0b8802f-d595-50ab-9963-6cb7347e8dd3","text":"Flap reconstruction seems to be a preferred method of reconstruction in variety of surgeries, and primary closure might be associated with some complications such as infection or dehiscence.","title":"Inferior Part of Rectus Abdominis Muscle Flap Outcomes after Abdominoperineal Resection: A Case Series Pilot Study"}
{"_id":"e0bf0b8d-1bfe-d98a-67d6-1fc5fa4dbf84","text":"In addition, these findings are of clinical relevance and can help guide PSA monitoring for patients as they live longer after treatment. Because we found patients to be at increased risk of biochemical recurrence at later time points, clinicians should be discouraged from “graduating” patients who achieve a good performance status and long anticipated survival even at later time points, especially given the variety of salvage treatment options available. Patients should instead be counseled on the risks of long-term recurrence to discuss potential benefits and risks of PSA surveillance even years after treatment completion.","title":"Conditional Risks of Biochemical Failure and Prostate Cancer–Specific Death in Patients Undergoing External Beam Radiotherapy A Secondary Analysis of 2 Randomized Clinical Trials Biochemical Failure and Prostate Cancer–Specific Death in Patients Undergoing External Beam Radiotherapy"}
{"_id":"e0c24458-6049-7214-66a0-ee603161167e","text":"A survey was conducted at 70 UK district general hospitals with designated acute trauma admission status. Eligible centres were identified randomly using an electronic NHS directory.","title":"Specialisation of spinal services: consequences for cervical trauma management in the district hospital"}
{"_id":"e0d1b924-3a76-ecde-1d2c-0dd6e47f0441","text":"The effect of all sources on a point of the affected area Ω may be described as follows:","title":"Optimal Placement of Irradiation Sources in the Planning of Radiotherapy: Mathematical Models and Methods of Solving"}
{"_id":"e0db3436-79eb-2a0b-ca51-f078a296898f","text":"The best technique for inguinal dissection in penile cancer should include all the nodes situated in the inguinal region. Studies focused on anatomical landmarks for penile cancer are rare. The aim of this study is to provide a better understanding of node distribution, by describing and quantifying the superficial and deeper inguinal nodes, to help prevent the complications of unnecessary and extended dissections.","title":"Anatomic Aspects of Inguinal Lymph Nodes Applied to Lymphadenectomy in Penile Cancer"}
{"_id":"e0ea027e-c0aa-1eed-3c05-6edcb57e0f98","text":"Our results show the safety of this new protocol to start oral desensitization to milk. None reacted to the first dilution administered even if none was pre or cotreated with anti-allergic drugs.","title":"Oral desensitization to milk: how to choose the starting dose!"}
{"_id":"e0ec19bb-f127-e712-fc81-5ea1074de277","text":"The author flew with his wife to Haiti in 2010 immediately after the earthquake to assist local general surgeons in caring for the mutilated victims. In the following missions, the INTERPLAST teams could already prepare for operations in simple tents as the earthquake had also destroyed all the hospitals in the region.","title":"INTERPLAST-Germany—adapting to global plastic surgery"}
{"_id":"e0eda506-fff2-67fb-849e-eb9ac7660c4b","text":"Clinical fellowships for surgical trainees are common worldwide and can offer targeted opportunities for additional training and personal development. Typically lasting 6 months to 1 year, these optional posts are frequently undertaken toward the end of training at centers offering supervised subspecialty clinical experience.","title":"Clinical Fellowships in Surgical Training: Analysis of a National Pan-specialty Workforce Survey"}
{"_id":"e10338ac-b5dd-f02b-2e91-c9916e8234b2","text":"Our case highlights the need for MTS to be kept as a differential diagnosis in a young female patient who primarily presents with lower limb DVT because the uncorrected anatomical defects of MTS can lead to recurrent DVT, pulmonary embolism, or iliac vein rupture. Our case also highlights the successful usage of iliofemoral venous stenting after a failed attempt at in-line pharmacokinetic and IR-guided mechanical thrombolysis alone. Systemic anticoagulation alone is insufficient for managing MTS cases, but it is generally recommended as routine treatment for DVT. The exact duration of systemic anticoagulation is debatable, but it is highly recommended that anticoagulation is administered for a six-month period to maintain the patency of the vein.","title":"Clot Mayhem: A Case of May-Thurner Syndrome"}
{"_id":"e1044d4d-1c44-d5f1-8c87-571e3eb0899c","text":"Some limitations of our study should be considered when interpreting the results. First, not all physicians recognize the existence of BII. As a result, registration of BII in DBIR is subject to the plastic surgeon’s individual knowledge of and beliefs in the disease. This may have led to an underestimation or overestimation of women who underwent revision because of BII. In addition, because of the generally poorer health of patients with breast cancer, plastic surgeons might be less likely to link health problems directly to the implants in reconstructive cases compared with women with a cosmetic indication. This could possibly explain why BII was more often registered in women with cosmetic implants vs women with reconstructive implants.","title":"Prevalence of Local Postoperative Complications and Breast Implant Illness in Women With Breast Implants Local Postoperative Complications and Breast Implant Illness in Women With Breast Implants"}
{"_id":"e1047dc5-5b1e-0dbc-66e7-55c8d85cf0c4","text":"Ratio of allergic reactions of different types of vaccines was compared.","title":"Allergic Reactions After the Administration of COVID-19 Vaccines"}
{"_id":"e113fc40-f106-8b8d-ef37-d945c58c20f5","text":"With the stage migration of prostate cancer witnessed in the late 1990’s and early 2000’s along with the persistent morbidities associated with prostatectomy and radiation therapy, the concept of focal prostate cancer treatment remains quite attractive. Herein we evaluate the tolerability and non-oncologic outcomes of a highly select cohort of men that underwent focal cryoablation of the prostate for the treatment of localized prostate cancer.","title":"Focal cryosurgical ablation of the prostate: a single institute’s perspective"}
{"_id":"e11a7323-aca5-cfd3-ad2b-90a1f71a86da","text":"DSA is also used to guide exceptional therapeutic procedures such as endovascular mechanical thrombectomy used alone or combined with other techniques such as direct aspiration or pharmacological thrombolysis.","title":"Imaging of Cerebral Venous Thrombosis"}
{"_id":"e11c0aaa-4222-bdae-e600-640465a35a6c","text":"Nasal deformity after cleft lip repair is currently regarded as the result of both tissue displacement and hypoplasia. Patients in our study were found not only to have the distortion of alar cartilage, but also the collapse and deflection deformity. Therefore, the perfect fitting of graft material to nasal bone is the key to the success of the operation.","title":"3D Printing Technique Assisted Autologous Costal Cartilage Augmentation Rhinoplasty for Patients with Radix Augmentation Needs and Nasal Deformity after Cleft Lip Repair"}
{"_id":"e11e75cc-ade0-7cd7-e5dc-b3a18fce2198","text":"Phases 1 and 2 will be undertaken in an iterative and cyclical manner, continuing throughout the recruitment period with close monitoring of changes in screening log data and recruiter practice to optimise recruitment and informed consent, all in close collaboration with the CI and wider study team.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"e11e7e54-7467-dba3-7624-325e37ca399e","text":"When occurred, the radial nerve lesions may be associated with significant functional and socioeconomic consequences and should be managed by experienced specialists.","title":"Etiological and epidemiological characteristics of surgically treated radial nerve lesions: A 20-year single-center experience"}
{"_id":"e1210872-19dc-6e3c-6c52-6619589690c7","text":"Surgery is the mainstay of treatment of idiopathic scrotal calcinosis with an overall good cosmetic outcome. Preserving the median raphe with its uninvolved skin improved the aesthetics after surgery. The residual scrotal skin regained its laxity with the scrotum assuming its normal configuration at follow-up. There is the risk of recurrence of the calcific nodules, but these may be small in relation to the regained configuration of the scrotum and thus could be amenable to excision with further preservation of the native scrotal skin.","title":"Idiopathic Scrotal Calcinosis: A Case Report and Review of Postoperative Outcomes"}
{"_id":"e12919e7-0190-c751-e4d0-b9e9e1390f3c","text":"The problem of the initialization of the initial contour is another issue to be solved to reach the desired success rates. ACWE and SPF can be operated with high success rates for segmentation of round cross-sectional objects with predetermination of the location of the initial contour automatically with circular Hough transform.","title":"Segmentation of Bone with Region Based Active Contour Model in PD Weighted MR Images of Shoulder"}
{"_id":"e12de5b0-f13d-42fb-24c5-c2c0aab8bacd","text":"The sample size was calculated based on a series of estimates considering the latest data recorded on the number of patients diagnosed with breast cancer and undergoing mastectomy in the province of Almeria during the year 2020, whose figure was 111 patients.","title":"Long-Term Quality of Life (BREAST-Q) in Patients with Mastectomy and Breast Reconstruction"}
{"_id":"e13a65d1-a283-a8b0-1a86-326d474bab76","text":"The primary focus of this review is to describe the most important elements to consider when performing virtual surgery as a planning procedure to design patient-specific 3D printed implants, highlighting certain aspects that may be unique to specific conditions. This discussion will address virtual surgical planning and implant design considerations, indicating how this process could be successfully introduced into clinical practice.","title":"Putting 3D modelling and 3D printing into practice: virtual surgery and preoperative planning to reconstruct complex post-traumatic skeletal deformities and defects"}
{"_id":"e13e89f4-4fee-2dd1-5fdc-076f957ef5a2","text":"In AJCC 8, T1b is now defined by Breslow thickness 0.8 mm or greater or ulceration in melanomas smaller than 0.8 mm. Because recognition of mitoses in thin melanomas is considered potentially unreliable and the recording of Breslow thickness more reliable, one would expect to find greater reliability of both T1a and T1b classification in the AJCC 8 staging. In fact, our results correspond exactly to this presupposed increase in reliability of classification of T1a and T1b in AJCC 8. A retrospective restaging of the Netherlands Cancer Registry database also reported a modest improvement in stratification of pT1 melanoma associated with the implementation of AJCC 8 criteria.","title":"Concordance and Reproducibility of Melanoma Staging According to the 7th vs 8th Edition of the AJCC Cancer Staging Manual Concordance and Reproducibility of Melanoma Staging by AJCC 7th vs 8th Edition Definitions"}
{"_id":"e14f0310-bdfc-5fff-99a1-b52a88e88cd6","text":"To assess the proportion of patients with thick primary melanomas undergoing SLNB over time, we tabulated the number of SLNB procedures performed relative to the total number of cases of thick primary cutaneous melanoma per year.","title":"Sentinel Lymph Node Biopsy in Patients with Thick Primary Cutaneous Melanoma: Patterns of Use and Underuse Utilizing a Population-Based Model"}
{"_id":"e153a3c9-b52b-645b-9cef-8a48e08eb7db","text":"A 32 year old man presented to us with a 12 month history of infection around his lower right tibia and ankle. There was no history of fracture; rather, the infection was attributed to a soft tissue injury sustained after impact with a concrete bollard whilst running. Before presentation to us he had undergone incision and drainage of a large volume of pus as well as windowing of the tibia and two bony debridement procedures, the last 6 months previously. A wound swab taken at the time of injury had grown a fully sensitive Group A haemolytic streptococcus, and a single intraoperative sample from the right distal tibia taken at the time of the last debridement had grown Staphylococcus aureus (resistant to erythromycin). Blood cultures had remained negative throughout. He had completed a short course of oral clindamycin 300mg QDS (5 days) and oral flucloxacillin 500mg QDS prescribed by his GP at the time of initial presentation, as well as a second short course of oral flucloxacillin and two short courses of oral amoxicillin immediately after each of his surgical procedures. He was a smoker, but had no other significant medical co-morbidities.","title":"Clostridium cadaveris Osteomyelitis: an Unusual Pathogen which Highlights the Importance of Deep Tissue Sampling in Chronic Osteomyelitis"}
{"_id":"e1593445-325e-4cb2-8101-bf574df1f44f","text":"These two cases demonstrate the importance of using the triple technique to maximize the identification of SLN and improve the sensitivity and specificity of SLNB and fallacies of preoperative lymphoscintigraphy. This also raises a question that should preoperative scintigraphy should be carried out in all the cases?","title":"Fallacies of preoperative lymphoscintigraphy in detecting sentinel node in breast cancer"}
{"_id":"e15a6b17-1e27-99b4-f7ae-308b4031b770","text":"The second challenge is that the gist signal is quite small, especially in the interesting case where the visible cancer will not develop for several years. An important direction for future research would be to develop ways to increase the size of that signal. This could involve training an artificial intelligence tool to detect the signal and\/or to train radiologists to detect the signal more reliably. Such work may tell us that some images are making a disproportionate contribution to gist. Knowing this would help us to isolate the critical components within images that give rise to gist impressions. This information will enable us to identify evidence-driven strategies to best identify the women for whom the gist is useful.","title":"Radiologists can detect the ‘gist’ of breast cancer before any overt signs of cancer appear"}
{"_id":"e15c9de7-9c32-bc95-26db-df7719ee8ba1","text":"The clinical data and specimens of 56 patients who underwent desmoid tumor resection from 2003 to 2008 were reviewed. Possible clinical factors related to the postoperative recurrence were analyzed statistically. The specimens round the lesions were studied histopathologically.","title":"Postoperative recurrence of desmoid tumors: clinical and pathological perspectives"}
{"_id":"e15d1f65-c834-bff2-bc62-f5bd0ae35a0d","text":"Reconstruction of the anterior neck skin often requires a second flap, either another free flap or a pedicled flap. The PMMC flap or pectoralis major muscle flap covered by a skin graft is frequently used to reconstruct the anterior neck skin (Figure 12). An elegant solution is to use a single flap to reconstruct both the pharynx and the anterior neck skin. The ALT free flap can often be designed with 2 skin paddles based on independent cutaneous perforating blood vessels that join together proximally within the main vascular pedicle, thus requiring only a single set of arterial and venous anastomoses to complete the reconstruction [101]. When more than one perforator is not available, the vastus lateralis muscle can be included with the ALT free flap and skin grafted to reconstruct the neck skin defect. Alternatively, the ALT free flap or other fasciocutaneous free flaps can be partially deepithelialized and a portion of the skin paddle can be used to reconstruct the neck skin defect.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"e15eb59d-09fd-f9f4-d70f-01ad8c694f05","text":"Linear cutaneous depression after BTX A injection was demonstrated in 1 previous report, in which the patient was biopsied for concern of coup de sabre, but this biopsy showed no abnormalities. We would like to reassure injectors that a biopsy for linear depressions after BTX A injections may be deferred until 3 to 6 months after injection, during the time when the BTX A effect should resolve. Additionally, serial normal saline injections may temporarily improve the appearance. Further studies and reports are encouraged to confirm our findings.","title":"Two cases of linear cutaneous depressions after botulinum toxin A"}
{"_id":"e15f267c-31a6-3e3b-94ec-afccca8c98da","text":"Bacterial meningitis can cause critical complications, and it should be regarded as a systemic infectious disease. To avoid delays in diagnosing complications, we should consider vertebral osteomyelitis as a potential complication of meningitis when nuchal stiffness persists despite an improvement in meningitis signs, and urgent surgical treatment should be performed when necessary.","title":"Vertebral osteomyelitis as a hidden cause of persistent meningeal irritation in a patient with pneumococcal meningitis A case report"}
{"_id":"e1606584-64ef-8a14-a7fa-8a40a296a7d7","text":"A summary of the experiments described here can be found in Table 2.","title":"Radiation dose rate effects: what is new and what is needed?"}
{"_id":"e168bbde-136e-8c40-e59c-008fca420dd3","text":"Future research endeavors should aim to address these limitations by utilizing larger and more diverse cohorts to identify and analyze key prognostic factors. An enhanced understanding of the intricate relationship between cSCC in regions with low solar exposure and its prognostic implications will significantly contribute to the enhancement of its clinical management and the formulation of preventive strategies for this particular subset of patients.","title":"Increased Risk of Local Recurrence in Cutaneous Squamous Cell Carcinoma Arising in Sun-Exposed Skin: A Retrospective Cohort Study"}
{"_id":"e16e0f6f-c86a-76b3-3f52-80db55b487d5","text":"A 71 year old male patient suffered from an extensive tissue defect at the dorsum of the left hand as a result of a bicycle incident. After multiple debridement and wound conditioning using negative pressure wound therapy the defect had to be reconstructed by a large free anterior lateral thigh flap from the left thigh. During flap harvesting two distant main perforators were detected, located very lateral within the flap. Following complete flap dissection the first ICG measurement was performed with the flap left in place at the thigh. Thus, the special perforator constellation and the borders of the adjacent perforasomes could be determined. Figure 1 clearly displays the perforasome border nourished by the proximal perforator in the flap which was not to judge sufficiently by clinical signs. After a few seconds the distal perforasome was also perfused shown by an uptake of the ICG dye. Due to this analysis both perforators were then included in the flap.","title":"Enhancing Safety in Reconstructive Microsurgery Using Intraoperative Indocyanine Green Angiography"}
{"_id":"e16f2c8f-f693-dd5c-2d4d-a8d4744c226a","text":"To evaluate typical patterns of bone involvement on MRI in paediatric patients with CRMO.","title":"Chronic recurrent multifocal osteomyelitis (CRMO): typical patterns of bone involvement on MRI with particular emphasis on Whole Body MRI (WBMRI)"}
{"_id":"e16f7fa5-dd7a-0b55-252f-cb1d933d8b52","text":"Overall PDT using PpIX precursors like ALA, BF-200 ALA or MAL to treat specific NMSC skin cancers results in good clinical and excellent cosmetic outcome and represents an attractive alternative to surgery.","title":"Oncologic Photodynamic Therapy: Basic Principles, Current Clinical Status and Future Directions"}
{"_id":"e17045dc-2bbd-e0c3-52cd-62d2ad303a40","text":"In one of the rabbits, the patella of the control side got dislocated and there was fibrous tissue found macroscopically as well as microscopically on the shaved patellar surface. Another rabbit showed fibrocartilage formation on the control side.","title":"Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study"}
{"_id":"e17f7dad-5022-1901-c745-c2268481daf2","text":"The work done by the UKCTOCS group on the QC of TVS scanning seeks to improve understanding of challenges associated with performing screening for ovarian cancer on a large scale and at multiple centres. All previous studies of ultrasound screening of postmenopausal ovaries for the early detection of cancer (excepting the recent QC study by our group) have accepted the self-reporting of ovarian visualisation rates as accurate. This is the first published audit of self-reporting of ovarian visualization rates and the results cause us to question the reliability of this metric, particularly for QC purposes.","title":"Audit of transvaginal sonography of normal postmenopausal ovaries by sonographers from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) [version 1; referees: 2 approved"}
{"_id":"e1838f80-7a7c-6883-b644-d04210c0ad2d","text":"On postoperative day 1, he returned to the operating room for planned re-exploration. Direct examination of the site of the IVC injury and repair indicated that there was clot within the IVC. Intraoperative ultrasound confirmed the clot in the IVC and documented that it extended down into the common iliac veins bilaterally. Control of the IVC both proximal and distal to the prior repair was completed with ligation of multiple posterior lumbar branches between silk ties or clips. Vessel loops were placed around the proximal IVC and common iliac veins bilaterally. Additionally, we obtained proximal and distal controls of the aorta and iliac arteries. With adequate proximal and distal venous controls, the patient was given an intravenous heparin bolus, and time allowed for adequate circulation. A clamp was placed on the proximal IVC just below the renal vein takeoff. The prior repair was opened, and fresh appearing thrombus was encountered. The origin of the clot was at the suture line repair with a tongue of fresh clot extending upward toward the renal veins that was clearly anchored distally but freely mobile more proximally. This was removed, and a #6 Fogarty was run down each iliac vein sequentially with removal of a significant amount of acute thrombus and restoration of brisk venous bleeding. A cryopreserved piece of femoral vein was thawed and prepared according to the protocol. A segment of this was opened longitudinally to serve as an on-lay patch. The prior posterior IVC wall repair was inspected and appeared intact. The cryopreserved femoral vein patch was then sewn to the anterior wall defect with 4-0 running Prolene suture. The repair was irrigated with heparinized saline and then vented prior to completion of the closure to ensure no air or additional thrombus was present. The clamps were then removed, and the repair appeared hemostatic. There was no longer narrowing of the vena cava (Figure 1). Intraoperative duplex confirmed a patent compressible lumen with no evidence of residual iliac vein thrombus.","title":"Patching of the Inferior Vena Cava Following Lateral Venorrhaphy in Penetrating Traumatic Injury"}
{"_id":"e18769bd-d08b-ec98-1a7e-1444b84eefba","text":"Pediatric fibromatoses are often locally aggressive and invade into adjacent tissue walls and bone, making them difficult to fully expunge. Still, some studies advocate for a “wait-and-see” approach that favors surveillance and conservative intervention dependent on tumor location, size, and growth rate. Fibromatoses exhibit a tendency toward recurrence, with reports suggesting higher rates in patients who do not undergo complete excision, or for those for whom negative margins are impossible. Pediatric anatomy, endocrine development, and continued growth present special surgical and therapeutic challenges.","title":"Total Resection of Pediatric Desmoid Tumor of the Left Neck with Utilization of 3D Virtual Surgical Planning"}
{"_id":"e19a3f1a-96be-5b9a-5f79-2d6e12a86276","text":"Once an awareness and understanding of FGM has been realized in the plastic surgery arena, then technical innovations in clitoral and vulvovaginal reconstruction can be developed and employed. However, this does not mean to depart from the techniques already reported in the gynecologic and urological literature, but rather, expand upon these techniques and work with Gynaecologists and urologists who have historically cared for these patients. Plastic surgeons are accustomed to collaborative environments and need not stand alone but join with the others who have been working to help FGM survivors regain the rights to their body, sexuality, and lives.","title":"The Role of Plastic Surgeons in Female Genital Mutilation Reconstructive Surgery"}
{"_id":"e1a0eb14-6fc1-ac74-edd6-a4b12b6fc3d6","text":"The objectives of this study were to evaluate and report upon the management of abdominal desmoid tumours at our centre and compare it with the national and international standards.","title":"Evaluation of outcomes in the management of primary sporadic desmoid-type fibromatosis at a specialist soft tissue sarcoma unit"}
{"_id":"e1a39b8e-9ca6-c602-8e79-8f13b5db5154","text":"The combination of the two Masquelet techniques is reliable and feasible for the reconstruction of septic composite defects in the lower extremities and has a low incidence of complications. This technique is effective for avoiding recurrence of infections and maintaining limb length, although staged procedures are required. Clarity on the details of the technique itself and the mechanism behind it should be further investigated.","title":"Simultaneous reconstruction of septic composite defects in lower extremities: Combination of fasciocutaneous perforator flap and Masquelet technique"}
{"_id":"e1a7e268-96c3-a8d8-0aaf-3bca6f2c29bb","text":"To determine the efficacy of Photodynamic therapy of patients with recurrent Nasopharyngeal Carcinoma we reviewed all available literature.","title":"Photodynamic therapy in the therapy for recurrent\/persistent nasopharyngeal cancer"}
{"_id":"e1b1d29a-4202-c501-27f9-91c59ae32104","text":"This randomized clinical trial of 199 adults found that compared with tonsillectomy, functional recovery was quicker after laser tonsillotomy although resolution of the chief concern leading to surgery was lower.","title":"Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults A Randomized Clinical Trial Laser Tonsillotomy vs Conventional Tonsillectomy in Adults"}
{"_id":"e1b2c77c-bae3-9d9d-897d-f666a97136d4","text":"The aim of this report is to present our protocol for the early treatment of vascular complications after facial rejuvenation with dermal fillers in order to avoid skin necrosis. We present two cases of vessel damage and skin suffering of the face after dermal infiltration of hyaluronic acid (HA), which occurred in 2017 and was treated successfully with our protocol.","title":"Early hyaluronidase use in preventing skin necrosis after treatment with dermal fillers: Report of two cases [version 2; peer review: 2 approved"}
{"_id":"e1b3a2da-c229-717e-de96-43a43caa5029","text":"The patient underwent tumor resection with lymphadenectomy of level I axillary nodes. No metastasis in the lymph nodes was observed in the postoperative pathological examination. The patient did not accept chemotherapy or radiotherapy.","title":"Follicular dendritic cell sarcoma in the right chest wall A case report"}
{"_id":"e1b44786-be90-cc5f-4b7b-aa84d572adf8","text":"Similarly, a legal entity should be written in the advertising and media related to plastic surgery and legal act with physicians that exaggerate the results of their plastic surgery with Photoshop. At the same time, reform of public opinion in relation to cosmetic surgery is necessary to explain the real value of humanity. The human real value is not limited to the changes in the appearance. Attitudes in the society and medicine also have a significant role in the tendency of people. Consultation may be required before any plastic surgery including cosmetic surgery, in this context, to assess the mental and physical condition of the patient prior to any procedures.","title":"Medical Ethics in Plastic Surgery: A Mini Review"}
{"_id":"e1b63aee-d9e4-f3bc-58eb-f450655ba20c","text":"Table 5 Sub-group analysis of CTCs count in patients with high metastatic volume","title":"Circulating tumor cells in patients undergoing androgen deprivation therapy with versus without cryosurgery for metastatic prostate cancer: a retrospective analysis"}
{"_id":"e1bb10f0-91ce-9693-418c-8aa5c0a6b88b","text":"At present, adjuvant cryotherapy is described as one of the stages in excision of CM, as previously mentioned. The freezing process in cryotherapy ultrastructurally mimics the damage of a thermal burn, which causes shedding of the superficial epithelium from the substantia propria with the superficial atypical melanocytes, in addition to direct damage to tumor cells due to ice crystals, which cause cell lysis. It is advised to target the very superficial melanocytes or the small number of melanocytes potentially left behind in the deeper layers of conjunctiva after excision, and not to treat the nodular portion with cryotherapy only. The use of cryotherapy aids in reduced exenteration rates in unifocal CM, but multinodular CM has metastatic rates as high as 45% when surgery is combined with cryotherapy. It is also advisable not to perform cryotherapy on bare sclera but to prefer alcohol application to avoid potential scleral melt. To overcome inadvertent tissue damage and enhance the effectiveness of cryotherapy, Finger introduced “finger-tip” cryotherapy probes which formed more homogenous burns over larger areas and covered flat target areas more effectively with less chance of missing the tumor.","title":"Current Management of Conjunctival Melanoma Part 2: Treatment and Future Directions"}
{"_id":"e1be769c-1bb3-3e42-e196-bc73bd947483","text":"Based on our experience of incisional NPWT use, we cut the foam dressing into a U shape and applied it along the suture line after fasciocutaneous flap reconstruction. This left an open area over the pedicle axis, which can prevent compression and allow for monitoring of the flap’s condition and temperature. There are available stripped foam dressings for NPWT designed for incision wounds, which can also be used directly around the flap edge. In our patient cohort, there were two cases of venous congestion that occurred on the first postoperative day. However, we believe that comorbidities were responsible for the development of complication as one patient was a heavy smoker and the other had a history of poorly controlled diabetes mellitus. These two flaps eventually survived after removing part of the incision sutures to allow for decompression and applying anticoagulant agents.","title":"Immediate application of negative pressure wound therapy following lower extremity flap reconstruction in sixteen patients"}
{"_id":"e1c04a88-e872-3a98-224e-6864b6611aa6","text":"Understanding the test characteristics of bedside ultrasound protocols helps to improve patient care and decrease rates of morbidity and mortality.","title":"Two-point Compression Ultrasound Technique Risks Missing Isolated Femoral Vein DVTs"}
{"_id":"e1c12046-01d0-71bb-a44e-a5e78d9b4d45","text":"Ultrasound can demonstrate excellent views of the implant [13]. It is important for the radiologist to fully understand the surgical techniques involved in cases of breast reconstruction and to bear in mind suture position when reporting the images. It is incumbent on surgeons to give the radiologists adequate information as to the previous surgical procedures and highlight any differential diagnoses to them in the radiology request.","title":"Diagnosis and management of breast implant capsule recurrence following mastectomy and subpectoral implant – innovative use of ADM for reconstruction"}
{"_id":"e1c49b54-f34d-8772-b654-71bb7edb7fa0","text":"Photodynamic therapy of tumors requires the topical, systemic or oral administration of a photosensitizing compound, illumination of the tumor area by light of a specific wavelength and the presence of oxygen. Light activation of the photosensitizer transfers energy to molecular oxygen creating singlet oxygen, a highly reactive and toxic species that rapidly reacts with cellular components causing oxidative damage, ultimately leading to cell death. Tumor destruction caused by photodynamic therapy is not only a result of direct tumor cell toxicity via the generation of reactive oxygen species but there is also an immunological and vascular component involved. The immune response to photodynamic therapy has been demonstrated to significantly enhance its efficacy. Depending on a number of factors, including type of photosensitizer, light dose and dose rate, photodynamic therapy has been shown to induce cell death via apoptosis, necrosis, autophagy and in particular immunogenic cell death. It is the purpose of this review to focus mainly on the role photodynamic therapy could play in the generation of specific anti-tumor immunity and vaccines for the treatment of brain tumors.","title":"Photodynamic therapy mediated immune therapy of brain tumors"}
{"_id":"e1c8e18b-db0a-4410-e19d-93926aeaceec","text":"Infection occurs within 30 days after the operation and infection involves only skin or subcutaneous tissue of the incision and at least one of the following:","title":"A double blind randomized controlled trial comparing primary suture closure with mesh augmented closure to reduce incisional hernia incidence"}
{"_id":"e1cdbc52-3e65-2f38-454d-0308f31227f5","text":"Time to revascularization is defined as the period from the approximate time of injury to the time at which the patency of the injured vessel is restored at surgery. Arterial reconstruction was considered successful when the pulse distal to the reconstruction was present or if the continuity of the vessel was documented by angiography. Limb salvage is defined as the presence of a viable limb at one month after injury, regardless of functional outcome.","title":"A decade of civilian vascular trauma in Kosovo"}
{"_id":"e1d4a3f4-1bdf-206d-4b3c-9d6e77ff8436","text":"Patients underwent lymphadenectomy in accordance with both the IOA results and clinical criteria as determined by gynecologic oncologists, such as enlarged lymph nodes with abnormal consistency or conglomerated retroperitoneal lymph node masses. Pelvic lymphadenectomy consisted of the bilateral dissection of all lymph nodes between the circumflex vein as the inferior margin, 2 cm above the bifurcation of the external iliac artery as the superior margin, the genitocrural nerve as the lateral margin, the superior vesical artery as the medial margin, and the obturator nerve as the dissection floor. Paraaortic lymphadenectomy had ureters as the lateral margins, the infrarenal vein as the superior margin, and 2 cm above the external iliac artery bifurcation as the inferior margin.","title":"Diagnostic performance of intraoperative assessment in grade 2 endometrioid endometrial carcinoma"}
{"_id":"e1da62f9-19b4-4be1-6e7e-8cca8e7995d5","text":"In summary, the standard of care for local treatment of high-risk BCC includes several options such as surgical excision, MMS or radiotherapy. When BCC progresses to an advanced state, in some cases lesions are no longer suitable for surgery, while in other cases surgery would result in substantial morbidity or deformity and systemic treatment is scarce. The inhibition of the Hedgehog pathway is a new strategy that challenges the actual and future options of treatment for metastatic BCC and locally advanced BCC patients.","title":"Management of high-risk and advanced basal cell carcinoma"}
{"_id":"e1df7f24-8d94-0eea-7d36-deaffd76d999","text":"CT should be employed for suspected osseous lesions or occult fractures.","title":"Diagnostic imaging for spinal disorders in the elderly: a narrative review"}
{"_id":"e1e6019e-add9-c605-50d6-63c717208f0a","text":"Seven years prior to her current presentation, she presented to an outside community hospital with a palpable left breast mass in the inferior lateral aspect of her left breast. She underwent a left breast biopsy at that time that was reported as showing dense fibrous stroma with fibrocystic changes.","title":"Management of a patient with multiple recurrences of fibromatosis (desmoid tumor) of the breast involving the chest wall musculature"}
{"_id":"e1e9518f-c5aa-4d53-9b3c-35176222ebf9","text":"Mohs micrographic surgery is a surgical technique for the treatment of nonmelanoma skin cancer. Surgery begins by removing the visible tumor before excision of the tissue specimens for evaluation of the tumor margins.","title":"Horizontal histological sections in the preliminary evaluation of basal cell carcinoma submitted to Mohs micrographic surgery"}
{"_id":"e1e99478-04c6-4d38-a38f-997edee59942","text":"One such de-escalation strategy is to provide BCS for patients previously deemed unresectable or unsuitable for BCS. In an era of targeted therapy, increased rates of pCR in the breast have been observed. However advances in response to systemic therapy have not been matched with increased rates of BCS. It would be expected that those who achieve a complete response would be more likely to undergo BCS. However meta-analysis of RCT assessing eligibility for BCS following neoadjuvant chemotherapy found no association between rates of BCS and pCR (97). The inability to accurately detect viable tumour following neoadjuvant chemotherapy may contribute to the decision of the surgeon to perform a less radical procedure.","title":"Evolving Trends in Surgical Management of Breast Cancer: An Analysis of 30 Years of Practice Changing Papers"}
{"_id":"e1eeb4e1-eb9e-aab7-b2e4-e7a5dca20d96","text":"Surgery is the primary means of treatment for squamous cell carcinoma of the skin.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"e1f1eee3-9e17-2570-208a-ccb31c46cc97","text":"This review offers a user friendly resource for clinicians and researchers regarding osteomyelitis of the spine and will serve as a catalyst for further discovery.","title":"Osteomyelitis of the spine: treatments and future directions"}
{"_id":"e1fc4b55-3740-fe47-e9a8-2f5714517da8","text":"The expected number of deaths was calculated by applying the US mortality rates to the appropriate person-time accrued by XP survivors in the cohort.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"e2054afd-c03a-c0b2-a93b-e316ba72efd6","text":"A total of 558 patients with histopathologically confirmed cSCC treated at the HURS in Córdoba were included in the study. The demographic and clinical data of the patients are shown in Table 1 and their cSCC features are collected in Table 2.","title":"Increased Risk of Local Recurrence in Cutaneous Squamous Cell Carcinoma Arising in Sun-Exposed Skin: A Retrospective Cohort Study"}
{"_id":"e20dd82c-bae5-6552-59a2-5452ba004b7b","text":"The multi-items for each of the constructs are summarized in Appendix A and the relationships of the model represented in Figure 3.","title":"The affect of vision and compassion upon role factors in physician leadership"}
{"_id":"e20fd81b-c5bf-bdd1-6cf7-0ad26fc2ce80","text":"Facial reconstruction has always been challenging to the reconstructive surgeon. When the reconstruction of the face involves two or more units of the face with trauma to the adjacent tissue, the reconstruction becomes even more difficult and challenging.1 Our patient had a composite defect involving the nose and periorbital region. Goals of reconstruction included restoration of a functional nasal airway and redefinition of the contours of the nose as well as its relationship to the cheek and lip; restoration of an aesthetic eyebrow and functioning ocular unit with the least amount of morbidity to the patient. This article details a multistage approach to repairing such a defect using an prefabricated forehead flap for nasal reconstruction and temporoparietal fascial flap for eyebrow reconstruction.","title":"Complex Nasal and Periorbital Reconstruction Using Locoregional Flaps: A Case Report"}
{"_id":"e21417df-476d-7208-ad1f-b4fff7268d2b","text":"Following dissection and mobilisation of the sigmoid and descending colon, the inferior mesenteric artery and vein were ligated and divided high (in primary resections and recurrent operations if not done previously). The small bowel was reflected and protected to allow exposure of the pelvis to enable the initiation of the lateral dissection. The retroperitoneum was dissected at the level of the bifurcation of the aorta exposing the origin of the common iliac arteries. The lateral lymph node dissection was performed the same way as it was previously described in 1989 by Moriya [10]. The bifurcation of the common iliac artery was identified and the internal iliac artery was traced down towards the lower pelvis. The lateral pelvic lymphadenectomy was performed either en bloc with the internal iliac vessels or by preserving them, depending on the proximity of tumour to the internal iliac artery. This decision was often guided by preoperative assessment at the local colorectal multidisciplinary team meeting.","title":"Extended lymphadenectomy for locally advanced and recurrent rectal cancer"}
{"_id":"e215eb87-d42c-9fd6-50a8-de046cdd0738","text":"Our study findings are clinically relevant. Damage to other fat pads, such as those of the knee and heel, is considered as a contributing factor to joint pain; moreover, Kaya showed that pathological changes in the fat pad on the AIIS were common in patients with anterior hip pain. The present study showed that the fat pad on the AIIS extended distally deep to the gluteus minimus tendon and to the superficial portion of the vastus lateralis, and posterolaterally to the anterior portion of the gluteus maximus tendon. If the pathological adhesion between the joint capsule and pericapsular muscles, as previously reported, is caused by fat pad fibrosis, such pathological adhesion might occur in accordance with the spatial distribution of the fat pad as presented in this study. Although there was no evidence to indicate that fibrosis caused pain, increased levels of connective tissue and pain might occur in tandem. It is therefore important to know the baseline values of the fat pad stiffness, like the shear wave velocity in the present study. This speculative association can be investigated further in a future study with a large sample size. Moreover, understanding the pathological change of the fat pad and its extent should be further studied to understand the development of anterior hip pain.","title":"Spatial distribution of loose connective tissues on the anterior hip joint capsule: a combination of cadaveric and in-vivo study"}
{"_id":"e21796f2-ee3d-9e84-3408-e1376bb25ecb","text":"Polynucleotides are widely distributed in the human body and exist physiologically in the extracellular environment. They readily bind to water molecules and act as free radical scavengers. The nutritional effects of PN have been shown in multiple in vitro studies using human fibroblasts in primary cultures. The ability of PN to stimulate the secretion of collagen proteins and other proteins in the extracellular matrix has also been demonstrated.","title":"Comparative Evaluation of the Effectiveness of Novel Hyaluronic Acid-Polynucleotide Complex Dermal Filler"}
{"_id":"e2183e8d-0612-7080-0554-f6664b8af9ee","text":"Stratification of patients by risk category is considered the most appropriate tool for taking decisions on the prophylactic measures to be employed. Each patient’s potential risk of VTE should therefore be calculated at the time of hospital admission and thromboprophylaxis should be initiated as soon as possible. 7 , 18 The Padua and Caprini scores proved to be useful for this purpose and easy to use, since they attribute scores for different risk factors and help to illustrate how patients with the same number of risk factors may nevertheless be allocated to different VTE risk strata. They also demonstrate the importance of restricted mobility among high-risk clinical patients, the scale of surgery among patients in the 41-60 years age group, and obesity and confinement to bed among moderate and high-risk surgical patients.","title":"Evaluation of deep vein thrombosis prophylaxis in a general hospital"}
{"_id":"e21af91e-255b-91f4-ded0-4f99afe797bf","text":"Therefore, studies in real world practice with longer monitoring periods are required to obtain a more valuable understanding of the effects of these biologic therapies on skin cancer development.","title":"Psoriasis Therapy and Skin Cancer: A Review"}
{"_id":"e21c58d5-ef50-fc83-e6e7-65579a7eb7a2","text":"Injected filler agents are used to treat skin wrinkles and for soft tissue augmentation for cosmetic reasons. However, fillers may induce adverse inflammatory reactions that may require biopsy for adequate characterization. Slowly biodegradable or non-resorbable fillers may cause severe reactions that may appear years after the injection, when the patient does not remember which product was injected. Histopathology is the gold standard technique to identify the responsible filler [1]. However, fillers are thought to remain locally at the site of injection and unexperienced pathologists may have trouble identifying the images as aesthetic fillers when found in an internal organ. This adds to the complexity of providing an accurate diagnosis as illustrated by this case of glomerulonephritis following infection of subcutaneous filler material.","title":"Small vessel microembolization and acute glomerulonephritis following infection of aesthetic filler implants"}
{"_id":"e21e07b7-754b-79be-40cf-db8a0a3a8f01","text":"One of the etiologic theories to explain autologous fat grafting effect is based on the nerve pathways intraoperative damage and nerves entrapment in scar fibrosis, which represents a continuous trigger for nerve excitation.","title":"Autologous Fat Grafting Improves Facial Nerve Function"}
{"_id":"e2211a8a-9fc2-98ee-8a0b-7b3087f21e5f","text":"Our audit suggests that sonographer’s self-reported visualization rates of postmenopausal ovaries they judged to have normal morphology is unreliable. Our study was facilitated by the unique TMS and URA systems employed in UKCTOCS which permitted a retrospective review of the images and measurements recorded by the sonographer. It could be argued that the static images used for this audit represent a snapshot of a continuous pelvis examination so might not truly represent what was seen by the sonographer. Nevertheless, these static images were used to measure the ovaries, so the structure marked by the callipers was definitely considered to be an ovary by the sonographer.","title":"Audit of transvaginal sonography of normal postmenopausal ovaries by sonographers from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) [version 1; referees: 2 approved"}
{"_id":"e22139da-7d2c-df07-0819-06b13328a18a","text":"It is important to underline that the success of the photodynamic protocols is linked the presence of sufficient oxygen. Thus, a low amount of oxygen present in the root canal system and in the dentinal tubules could represent a limit of the photodynamic performance in endodontics. To overcome this limitative aspect is fundamental to add an adequate diffusion of the photosensitizing agent molecules within this micro-anatomy","title":"5-Aminolevulinic Acid and Red Led in Endodontics: A Narrative Review and Case Report"}
{"_id":"e22493a2-79a8-9399-9dbf-7cbb5def6ce3","text":"The caries experience of people with mouth cancer who have been treated with radiotherapy with or without chemotherapy is increased.33 The pathological process of radiation-induced caries remains controversial. Impaired saliva secretion and the loss of its protective effects undoubtedly has an impact on caries. However, it may also be influenced by the direct effect of the radiotherapy beam on tooth structure. Laboratory studies have indicated that changes in both the microhardness and micromorphology of tooth structure may result from interaction with the radiotherapy beam.34 This may further tip the balance of dysbiosis in favour of pathology. While radiation caries follows the same aetiopathogeneis as conventional caries,33 the clinical pattern differs with cervical margins, incisal edges and cusp tips being affected.35 While radiotherapy-induced changes to collagen within the mineralised portion of the tooth have not been demonstrated, pulpal collagen does appear to be affected,36 although the significance of this is yet to be determined.","title":"The dental management of a mouth cancer patient"}
{"_id":"e22ae17c-934a-1c45-11fb-5b4a58362d49","text":"Nonsurgical rhinoplasty using hyaluronic acid fillers is a commonly performed procedure in current practice and, in many cases, is considered an efficient alternative to surgery because of the minimal downtime. Non-satisfied patients with surgical rhinoplasties often prefer to go for a nonsurgical option for a touch-up in order to prevent longer surgical revision rhinoplasties and all the associated aesthetic and safety issues.","title":"Ethnicity and Nonsurgical Rhinoplasty"}
{"_id":"e22e6430-bee6-a090-909e-4d2260fc40e9","text":"The histological analysis of the visible tumor of each patient performed by horizontal incisions allowed identification of the tumor site in 13 cases, and the relation between tumor and margin showed that in 11 cases, the lateral margin was compromised. Eight cases needed only one surgical phase, six patients had to undergo a second phase, and one patient required four phases for total BCC excision.","title":"Horizontal histological sections in the preliminary evaluation of basal cell carcinoma submitted to Mohs micrographic surgery"}
{"_id":"e2327194-2901-fd61-e2a2-7c162cef32e9","text":"The main objective of this study was to report our preliminary experience in adult OSA patients before and after ankyloglossia treatment using DISE to evaluate the UA modifications resulting after treatment, and to present a systematic review of the impact of ankyloglossia and its treatment on OSA adults.","title":"Does Frenotomy Modify Upper Airway Collapse in OSA Adult Patients? Case Report and Systematic Review"}
{"_id":"e2357038-685e-3ea0-fec6-667d946ec707","text":"The aim of this study is to assess the efficacy and safety of TEA compared to sham TEA in alleviating FEMA after PFP.","title":"Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial"}
{"_id":"e23ff1c5-3e12-ecc9-1058-5a8f905d8d2a","text":"MTC requires a different management compared to that of the BCC, particularly if it has been incompletely excised. However, these differential diagnoses can occasionally pose difficult morphological problems. The stated distinctions are clinically important because the risk of progressive disease is significantly higher with squamous carcinoma of the skin and MTC than of the BCC.","title":"Metatypical basal cell carcinoma: a clinical review"}
{"_id":"e242d083-0ef2-3994-4da5-d01aee96a43b","text":"Phototherapy is a non-toxic, and vulnerable technique to abolish cancer cells when light waves of a certain wavelength are used with suitable triggering agents. It is mostly restricted by its quality to diseases that are deeply located in the skin. It helps in the diagnosis and treatment of numerous kinds of cancers. Some free radicals released by chemotherapy induce the death of tumor cells and release the hypoxic illness in the tumor micro-environment that is posing main obstacles in photodynamics and radiotherapy. The mixture of nanomedical agents and phototherapy shows better results than separate treatments. We are focusing in detail on different categories of phototherapy techniques to treat cancer.","title":"Nanoparticles and Nanomaterials-Based Recent Approaches in Upgraded Targeting and Management of Cancer: A Review"}
{"_id":"e2433f4c-e4ea-3206-33c3-022c5b40f01a","text":"We experienced consecutive 266 patients who underwent elective surgery for CRC during the study period. Finally, the medical records of 218 patients with CRC administrated fondaparinux or enoxaparin following surgery were retrospectively reviewed to evaluate symptomatic VTE until 28 days and postoperative bleeding comparing perioperative D-dimer levels.","title":"The impact of pharmacological thromboprophylaxis and disease-stage on postoperative bleeding following colorectal cancer surgery"}
{"_id":"e248b534-0bb0-f4f2-1b71-ed2ccba0133c","text":"This project was classified as exempt research by the Committee for Protection of Human Subjects of Dartmouth College on 11 September 2019.","title":"Complications and misdiagnoses associated with infant frenotomy: results of a healthcare professional survey"}
{"_id":"e24c3181-95c5-8094-924d-f3de14c8a1c4","text":"All of these patients were included as conchal\/auricolar or septal cartilage graft was not indicated nor enough to cover their tissue deficiency.","title":"Minimally Invasive Harvesting Technique for Costal Cartilage Graft: Donor Site, Morbidity and Aesthetic Outcomes"}
{"_id":"e24c370e-6cfb-1ff1-9726-dcaafed5eb31","text":"The limitations of this study are as follows: First, given that the number of cases was small and this was a retrospective study based on medical records and radiological data, more studies based on a larger number of cases are needed to confirm that the reverse sural artery flap is indeed an effective treatment for patients who underwent internal fixation through the MIPO procedure. The fact that this study did not mention a correlation with the patient’s underlying disease, such as the presence of vascular diseases that may affect the survival rate of the flap, should also be supplemented in future studies.","title":"Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap"}
{"_id":"e25106fc-b148-0b71-fd8e-7ad02e11d01a","text":"Time spent in developing countries emphasizes the importance of community health and increases cultural and linguistic competence. Experience working with the underserved during an IM has been shown to increase interest in volunteerism, humanitarian efforts, and work with underserved populations both in the US and abroad. IMs also afford physicians the opportunity to learn about the delivery of health care abroad and are associated with an increase in primary care specialty choice.","title":"Loss of international medical experiences: knowledge, attitudes and skills at risk"}
{"_id":"e25d9495-e42b-5ca1-a435-97151681a019","text":"We think that the use of omental flap is a useful flap and should be considered in the scalp and head and neck reconstruction.","title":"The use of an omental flap for the reconstruction of a burn injury to the scalp: A case report"}
{"_id":"e260417d-3de3-b6c1-7db2-ae23038b2988","text":"Data were obtained from the patients’ clinical records. Surgery duration was defined as the time from the first incision to the last suture, and flap ischemia duration was defined as the time from the interruption of flap perfusion at the donor site to the onset of flap perfusion at the recipient site after anastomosis.","title":"Attached compared with unattached surface probes for monitoring flap perfusion in microvascular head and neck reconstruction: a feasibility study"}
{"_id":"e2609a5d-21bd-6418-1e58-d04a3f4bbff3","text":"A particularly challenging situation arises when a patient is diagnosed with an isolated distal DVT. Due to its low risk of embolization, the use of anticoagulation in this scenario is not clear. The purpose of this review is to highlight the current literature available to help guide physicians about the management of an isolated distal DVT.","title":"A Comprehensive Literature Review on the Management of Distal Deep Vein Thrombosis"}
{"_id":"e262e1d3-2060-6b55-15b9-1f21cd10a2eb","text":"The objective of this systematic review was to assess and identify studies that examined model-based economic evaluation of external beam radiation therapy for the treatment of localized prostate cancer.","title":"Model-based cost-effectiveness analysis of external beam radiation therapy for the treatment of localized prostate cancer: a systematic review"}
{"_id":"e26f9c7c-42a8-449a-8b5a-6473de2e3ba0","text":"A 35 year-old civil servant who was involved in a road traffic accident about two years ago. He sustained multiple injuries with an extensive facial injury which was managed in a private hospital with three operative procedures to repair the facial injury. He was discharged after ten weeks post injury. He presented to us with complete loss of nasal cover and lining as shown in Figure 1. The nasal bone and upper lateral cartilages were however intact. He had a transverse scar on the upper lip as well as a complete distortion of the normal anatomy of the upper lip. The lower lip appeared normal; he had multiple scars on the face. The patient was concerned with the loss of nasal structure and became socially withdrawn. He went out when it was absolutely necessary and covered the mid-portion of his face with a mask. He was referred to our hospital for nasal reconstruction. The patient was examined to ascertain the missing structures of the nose and besides good preoperative preparation, the mode of reconstruction and possible outcome were discussed with the patient. He was reconstructed with superiorly based, bilateral, nasolabial flaps to line the floor and the nasal septum and a paramedian forehead flap for skin cover as shown in Figure 2. The patient did well postoperatively: the stitches on the donor site of the forehead flap were removed by the 5th postoperative day, and patient was discharged home on the 7th postoperative day. He was seen at the follow-up clinic after four weeks and although he was satisfied with the outcome of the procedure, he did not seem to like the convexity at the root of the nose where the forehead flap was transposed. Hence, 12 weeks after the first operation, he had a refashioning of the site done under local anesthesia by a wedge excision and a linear wound closure7\/1\/2009 as shown in Figure 3 and was seen six months postoperatively.","title":"The Naso-labial and lateral forehead flaps as a single stage: A case report and review of literature"}
{"_id":"e276b046-d771-7a8e-6d64-6c90b4085e03","text":"There is no accepted national surveillance policy for the ipsilateral chest wall or reconstructed breast following mastectomy for DCIS. The use of screening mammography when following up patients who have had an SSM with a transverse rectus abdominis muscle flap reconstruction has been shown to detect recurrences earlier while the disease is still in situ.26 However, few data are available to assess the effectiveness of mammography in patients undergoing SSM and immediate reconstruction.","title":"Comparison of Local Recurrence After Simple and Skin-Sparing Mastectomy Performed in Patients with Ductal Carcinoma In Situ"}
{"_id":"e28636a3-5ad0-fd30-6e31-7c11cd853288","text":"Orthodontists and maxillofacial surgeons have always been interested to quantify the influence of orthodontic and\/or orthognathic surgery treatment on craniofacial morphology.","title":"3D image superimpositions for orthodontic diagnostics and therapy"}
{"_id":"e28893b9-95ae-f011-c285-a044d9df9559","text":"CONSORT flow diagram for participants in trial up to 6 months follow-up","title":"Wound Healing In Surgery for Trauma (WHIST): statistical analysis plan for a randomised controlled trial comparing standard wound management with negative pressure wound therapy"}
{"_id":"e296ff37-6cd3-f17c-671f-a80192a6f3bd","text":"The implementation of VivaScope in clinical practice has the potential to improve the accuracy of the diagnostic process. VivaScope is noninvasive and would reduce the number of surgical interventions. It would also lead to a better patient experience, particularly lessening patient anxiety due to uncertainty while waiting for a diagnosis. In the margin delineation cohort, VivaScope could minimize the amount of normal tissue excised unnecessarily and reduce the duration and number of stages of the Mohs surgery.","title":"Evaluating the Diagnostic Accuracy of Reflectance Confocal Microscopy to Diagnose Skin Cancer: Protocol for a Prospective, Multicenter Study"}
{"_id":"e29a9cf9-395b-588f-d01f-d5ba379390fa","text":"Unfortunately, physical removal of biofilm from implant hardware via irrigation or sonication has been met with limited success. Therefore, complete hardware exchange and extensive debridement remains the gold standard to reduce the risk of reinfection due to bacterial persistence in biofilms.","title":"Evolving concepts in bone infection: redefining “biofilm”, “acute vs. chronic osteomyelitis”, “the immune proteome” and “local antibiotic therapy”"}
{"_id":"e29dba47-36d1-c870-926a-00931ceab90f","text":"We found no statistically significant association between the mean score on the three quality of life scales and the timing or type of breast reconstruction performed.","title":"Long-Term Quality of Life (BREAST-Q) in Patients with Mastectomy and Breast Reconstruction"}
{"_id":"e2a23383-650d-18a5-5b4c-dd3521971174","text":"This was a single-group retrospective study carried out in the spine department at a single tertiary center. All patients signed informed consent forms prior to the study, which was approved by the Institutional Review Committee of our hospital and performed in accordance with the relevant regulations and guidelines.","title":"Vacuum-assisted closure combined with a closed suction irrigation system for treating postoperative wound infections following posterior spinal internal fixation"}
{"_id":"e2a79e83-2850-6f25-09e2-2db225bcd66d","text":"The aim of the study was to investigate whether a systematic US screening might improve the management of the antithrombotic therapy in critically ill patients or it may rather lead to a harmful overdiagnosis.","title":"Ultrasound screening for asymptomatic deep vein thrombosis in critically ill patients: a pilot trial"}
{"_id":"e2b01af7-50a1-bd6e-83b9-d9d36bfa47d9","text":"MRI gave a clear indication of where the MSCs were located and was unable to detect MSCs in regions beyond the fat pad or synovial fluid allowing us to confirm that MSCs were not in other regions. This is clinically useful as it is not feasible to perform histological measurements that involve tissue sectioning and disruptive surgery. We conclude that if the MSCs do hone to the osteochondral defect, they may do so at a much earlier time point than a week after surgical creation of the defect. In a natural in vivio situation while differentiation and honing to the defect is possible after seven days, this would be tracking of descendent cells, due limited lifespan of MSCs.","title":"Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model"}
{"_id":"e2b09572-729f-a10d-26de-f2fd7de71d55","text":"There was no influence of serum levels of calcium, phosphorus or the PTH on the occurrence of myringosclerosis in the study group.","title":"Myringosclerosis in patients with chronic renal failure: comparative analysis with a control group"}
{"_id":"e2b3c10d-e178-e146-d2b3-17b1f8293867","text":"Bone graft treatment changes the characteristics: lyophilization results in more open space due to elimination of blood and fat. A lyophilized bone graft can be conserved long-term at room temperature and is less antigenic.67 No significant difference was found in elution profile of gentamycin and vancomycin between impregnated morselized bone and freeze-dried bone powder.31 This is in contrast to the claim that bone marrow removal and freeze drying dramatically increases antibiotic uptake capability.28","title":"Current Insights in the Application of Bone Grafts for Local Antibiotic Delivery in Bone Reconstruction Surgery"}
{"_id":"e2b7c0b9-f907-1616-5095-4c8cd9f19215","text":"While the TME has been studied across many types of cancer, this review aims to examine the role of the TME in non-melanoma skin cancer as well as potential therapeutic considerations. A better understanding of the intricate components of the TME in skin cancer will allow for the development of novel therapies to treat advanced skin cancers.","title":"Review of the Tumor Microenvironment in Basal and Squamous Cell Carcinoma"}
{"_id":"e2b87f36-b440-f27d-935d-d3c6d099111b","text":"This constraint is however more a subjective limitation than an objective one, since there are no rules that can indicate it to us. What is considered to be important is that the graft should have the maximum possible contact with the vascularised tissue, which can be considered to be the bed upon which the graft is placed; postoperative gentle scarification of the graft, in combination with a constantly applied heparin solution decongests venous stasis normally seen in such grafts helps to establish a stable and early blood supply enhancing graft take [1,9]. Important is then to have the consciousness that creating a well-vascularized recipient bed with an optimization of the raw contact surface give the chance of good result.","title":"Clinical case-study describing the use of skin-perichondrium-cartilage graft from the auricular concha to cover large defects of the nose"}
{"_id":"e2cb1f84-8c4f-96bd-9562-26c8c5969228","text":"Remote preconditioning could also have been applied at sites different from the site of surgery by intermittently inflating a cuff around an extremity. However, preconditioning performed by inflating a cuff around an extremity above systolic blood pressure involves risks like embolism or tissue damage by compression that are probably more predominant in patients with vascular disease. Since in most patients vascular disease is not confined to the extremity at which surgery is performed, the same risks may occur at the other extremities. Hence, we prefered to investigate IPC by clamping the femoral artery with the same clamping technique as applied for definite clamping for surgery [3].","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"e2d9b717-4c6b-6d48-ba2d-b6077001a61d","text":"At this point the proximal end of the peroneal artery and two venae comitantes were ligated and the fibula osteocutaneous flap was harvested (Figure 8). The time required for the flap harvesting was recorded. The maximum length of the vascular pedicle was measured from the proximal end to the first skin perforator branching site. The diameter of the proximal end of the proneal artery and vein was also measured using a digital caliper. The flap was restored to its place after completion of measurements. Information about the distance of each perforator from the fibula head, the fibula bone length (the distance between the fibula head and the lateral epicondyle of the ankle), age and gender of the subjects were also recorded.","title":"Evaluation of Anatomic Variations of Fibula Free Flap in Human Fresh Cadavers"}
{"_id":"e2dcd682-1d23-29b9-6037-2d273dfa41ab","text":"This is the first study to observe the application effect of CNP combined with MB and ICG combined with MB tracers in SLNB of breast cancer patients. No significant difference was observed among the patients in SLN identification and lymphatic vessel display. Omitting the step of searching for lymphatic vessels in SLNB surgery does not reduce the surgical effect, but the reduced operating steps can reduce the surgical time and theoretically reduce postoperative complications.","title":"Comparative observation of common tracers in sentinel lymph node biopsy of breast cancer and a study on simplifying its surgical procedure"}
{"_id":"e2de2b83-a866-8deb-8f97-ea6f348e5928","text":"Prospective academic surgeons should pursue their careers with strong understandings of the nature of potential jobs. Often times, a lack of understanding of career options and the professional requirements within academia can demotivate individuals and limit the recruitment and retention of future generations of professionals within this field. Understanding of these professional requirements and their challenging nature should not be a deterrent but rather a prompt for preemptive preparation to tackle these demands.","title":"Twelve-step Approach for Academic Development Planning in Academic Surgery Climbing the Academic Uphill With Strong and Steady Steps"}
{"_id":"e2e10739-c5d4-a0b7-0fe6-5ebb62bd6df4","text":"Detailed results for the incidences of postoperative fistula, dehiscence and cutaneous perforation formation within the subgroups with regard to all analysed possible confounding factors are shown in the Supplementary Tables S1–3.","title":"Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study"}
{"_id":"e2e36ad4-3118-7abf-80f5-8d194190d76c","text":"Conservative treatment was applied to the 2 patients with partial NAC necrosis. Local wound care: daily changing dressings and debridements along with topical heparin and loose dressings to prevent additional ischemia by compression.","title":"Assessment of Mastectomy Skin Flaps for Immediate Implant-Based Breast Reconstruction"}
{"_id":"e2e5b39d-ed34-a423-119b-e0af2c3ea667","text":"The theory behind the procedure was that by resecting the tight split skin graft and freeing up the myofascial planes with a flexible and dynamic soft tissue coverage would allow greater flexibility in the joint, while additionally providing greater protection to the underlying joint. The chimeric free flap used has demonstrated good effect and improvement in this case; however, a greater number of case reports are needed before any recommendations can be provided. This presents a new, viable option for patients who require improved functionality with a dependable flap over the crucial joints of the lower limb.","title":"The Use of a Tetraminos Chimeric Free Flap in Lower Limb Trauma"}
{"_id":"e2eda804-b72e-93d8-7b0f-ee6f4a4e6f3d","text":"The presented study proves that guided SEFFI alone or in combination with other facial rejuvenation techniques performed in medical facilities is a minimally invasive procedure with a shallow rate of complications. In light of this evidence, guided SEFFI is proven to be a promising medical antiaging treatment that combines effectiveness, safety, and simplicity.","title":"Guided Superficial Enhanced Fluid Fat Injection (SEFFI) Procedures for Facial Rejuvenation: An Italian Multicenter Retrospective Case Report"}
{"_id":"e2ef665f-55f5-0afe-1448-bc7ae39d5865","text":"It is therefore necessary to intervene on the removal of known risk factors such as avoiding sunburn, avoiding the use of tanning lamps, and exposing to the sun without using sunscreen.","title":"Epidemiology and Risk Factors of Melanoma: A Review"}
{"_id":"e2f5b5e2-e890-29f9-49c6-38d8d486b5f0","text":"Symptoms of PE and PC are recognised infrequently during early childhood, apart from a child not wanting to go without a shirt while swimming or participating in other athletic or social activities.5 Pectus patients commonly try harder to keep up with their peers, using wider diaphragmatic excursions to compensate for diminished chest wall excursions caused by the PE or PC deformity; however, almost all patients experience a worsening of their symptoms with time.","title":"Clinical experience of repair of pectus excavatum and carinatum deformities"}
{"_id":"e2f71c21-998f-d095-6e4c-3c482d4b5aff","text":"A total of 33 patients were recruited for the study from November 2008 to April 2013. The baseline characteristics are summarized in Table 1.","title":"Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa"}
{"_id":"e2ff825a-61d4-ea48-a731-cafaefaf36a9","text":"The aim of this review article was to ascertain the duration of action of botulinum toxin type A in the treatment of glabellar frown lines1 in order to provide evidence-based advice to patients by ascertaining the average length of time a patient perceives their aesthetic botulinum toxin treatment lasts, and compare that to the published values.","title":"A review of the longevity of effect of botulinum toxin in wrinkle treatments"}
{"_id":"e3011384-9227-3c09-7416-a7d3a5893adf","text":"Ongoing venom IT is very effective when adequately performed and the majority of patients feel substantially safer. Most of them found the effort very worthwhile. We should endeavour to get more of the patients to complete five years of IT as the results both while ongoing and after IT is much better for the adequately than for the inadequately treated patients. Still after cessation of adequate IT 22% of the wasp sting incidents resulted in a SAR. Fortunately the majority of patients keep epinephrine at hand and were able to use it when needed. Maintenance IT of 0.1 mg of single venom may be taken over by the general physician. Only the following parameter, the reaction to IT during incremental dosing was statistically significant for predicting the reaction to a future sting after cessation of adequate IT. This may help in deciding whether a patient should continue IT after five years or not.","title":"Insect sting allergy. A study from 1980 to 2003 of patients who started treatment with venom immunotherapy between 1980 and 1998"}
{"_id":"e30298d6-599d-5e62-aa92-39b6c5f5d758","text":"The goal of this study was to better determine the incidence of occult breast cancer found during preoperative workup or the pathology assessment of the reduction specimens using a large retrospective cohort of women who underwent surgery within an 11-year period (2000–2010). Such information may allow for the development new screening recommendations. Although the majority of our resected breast tissue specimens were benign, our findings indicate that there is a continued need for histopathological examination. In addition to this, the goal of our study was to outline the importance of developing more feasible screening methods that become commonplace due to this unaddressed risk of cancer development in female patients.","title":"Occult Pathologic Findings in Reduction Mammaplasty in 5781 Patients—An International Multicenter Study"}
{"_id":"e303f446-1b8e-6e84-489e-1cc61be84ee1","text":"In this study we propose that the spread of melanoma can be prevented by early diagnosis of a primary cutaneous melanoma and topical treatment post-surgery with a local application of a NSAID such as ibuprofen. The justification for giving the latter is to reduce the inflammatory wound bed conditions post-surgery which we suggest are conducive to melanoma metastasis.","title":"Use of a Tissue Engineered Human Skin Model to Investigate the Effects of Wounding and of an Anti-Inflammatory on Melanoma Cell Invasion"}
{"_id":"e310bcb3-c761-c357-8b72-9663eb992870","text":"Possible future studies can feature both retrospective and prospective reviews. In terms of the retrospective studies, infection rates after surgical procedures can be compared to the timing of antibiotic administration. Additionally, data can be collected to observe the compared peak time of pediatric and adult patients without normal renal function. A statistical power ratio can be conducted to determine the necessity of administering preoperative antibiotics at ideal timing, maximizing their therapeutic output. As for prospective studies, it may be beneficial to explore the significance of preoperative antibiotic administration based on the ideal timing defined in our study. Additionally, a larger sample size would be necessary in order to implement a power ratio on the data for a more nuanced picture.","title":"The Ideal Time to Administer Pre-operative Antibiotics: Current and Future Practices"}
{"_id":"e3131e22-5ec9-ad7c-50e1-52162e477075","text":"Blinding is not possible, since we consider that giving prolonged intravenous placebo would pose an unnecessary risk to participants and therefore would be unethical. Because an open label study is at risk of bias, we have appointed an endpoint review committee to review the clinical notes relating to any patient who fulfils the criteria for a potential treatment failure. All notes reviewed are redacted for personal identifiable data and for any information that might indicate the choice and route of antibiotic therapy. The endpoint review committee is therefore blind to treatment allocation. The notes are examined against objective criteria for meeting the primary endpoint.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"e316165c-ca6e-ead8-26b2-00960f9b4a12","text":"Dermoscopy shows subsurface structures of the skin with the use of handheld devices that extend optical light ray penetration beyond the skin surface and minimize surface reflection. In contrast, naked eye examination limits visualization of certain skin structures because the stratum corneum has reflective properties. Dermoscopy plays an important role in the diagnosis of skin cancer. It has higher discriminating power than a clinical analysis. The report made by Marie-Lise Bafounta, Alain Beauchet, Philippe Aegerter, on the diagnosis of melanoma skin cancer shown that sensitivity and the specificity obtained by dermoscopy techniques were comparatively higher than clinical analysis. Skin lesion on the face was usually diagnosed by comparing the dermoscopic features of lentigo senilis and lentigo malinga based on logistic regression method. Dermoscopy plays a crucial role in distinguishing the melanoma cells from benign cells with the help of various diagnostic tools such as pattern analysis, ABCD rule, Menzies method, and 7-point checklist. The dermoscopic studies were made on 20 pigmented skin lesions based on the pattern analysis and the results were found to be more accurate. Dermoscopy techniques are used to analyze the vascular structure of melanocytic and non-melanocytic tumors based on their morphological behaviour of the skin. Dermoscopy extends its application in early diagnosis of malignant melanoma and differential diagnosis of pigmented lesions of the skin by in vivo methods. The study was made on 2522 skin cancer subjects based upon the accuracy rate, dermoscopy techniques showed better results than conventional technique, but the main drawback of this technique is that it requires a high-resolution camera to capture the images of skin lesions.","title":"Skin cancer detection using non-invasive techniques"}
{"_id":"e31ba05e-7a6e-30a5-a12a-9e943a8dff57","text":"Nevertheless, HSI is an approach with high potential and could lead to lower total flap failure and higher salvage rates leading to better overall survival. It combines the advantages of non-invasive and invasive monitoring methods and has so far only shown advantages compared to the other techniques.","title":"Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study"}
{"_id":"e31eac53-f5be-46be-b529-20591ca8412b","text":"In summary, our study shows that children with ASD were breastfed for a shorter period of time, had complementary foods introduced later, and had poor acceptance of complementary foods compared to TD children. Breastfeeding and the introduction of complementary foods may be associated with core symptoms and neurodevelopment in children with ASD in later life. This study also suggests that breastfeeding for 12 months and beyond may be beneficial to the neurodevelopment of children with ASD. Children who are breastfed for shorter periods and have difficulty introducing complementary foods should be carefully assessed for neurodevelopmental disorders. And we need to further investigate the interrelationship between early feeding and ASD.","title":"Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: a national multicentre survey"}
{"_id":"e32eabe4-0353-e027-3601-e5e9803e3825","text":"In the present study, a cross‐sectional analysis was performed to take measurements of tongue mobility using TIP as well as LPS among subjects in the general population. This study validates TIP measurements as an effective assessment of anterior tongue mobility and LPS measurements as an effective assessment of posterior tongue mobility. The advantage of the LPS measurement is that it best describes one of the main functional outcome goals of myofunctional therapy: achieving tongue body to palate contact requisite for establishing ideal resting oral posture and swallow mechanics. LPS measurements have been used to track progress with tongue strengthening and rehabilitation in myofunctional, speech and swallow therapy protocols. Measurements for this study were taken at 10 sites internationally for maximal external validity, but it should be noted that the recruitment of friends and family of the researchers may have introduced selection bias that can affect generalisability.","title":"Assessment of posterior tongue mobility using lingual‐palatal suction: Progress towards a functional definition of ankyloglossia"}
{"_id":"e332d770-411e-38b1-d5cb-08ef46e6ac5a","text":"The present study only sought to determine whether the fibula bone segment can be accurately positioned, according to the surgical simulation results, in cases of mandibular reconstruction using a fibula. The scope of the study is limited to the reconstruction of this hard tissue and the findings are not supported by actual clinical outcomes. If soft tissue is included with the fibula for the mandibular and facial reconstructions, there may be interference when positioning the cutting guide and positioning device on the fibula. Moreover, there may be difficulties in positioning the surgical device on the flap when thick muscle fibers are attached to the lateral surface of the fibula. A cutting guide can assist with accurate angles and positions, even with a small gap in between. However, a positioning device may incur greater error if soft tissues or thick muscles are attached to the fibula because the device is designed based the position of each fibula bone segment. Fixation plates, such as the miniplate or reconstruction plate, and screws limit the region of its placement. The usefulness of a positioning device may be different for each patient, as the fibula flap varies. Thus, CAD\/CAM reconstruction plates may be a great alternative because they also guide the fibula bone segment to the accurate position and angle determined by surgical simulation.","title":"Precision of fibula positioning guide in mandibular reconstruction with a fibula graft"}
{"_id":"e33ab9a3-3893-07e3-297b-358a31f4532e","text":"Our small series suggests that HDRB is efficacious for primary or recurrent vaginal cancer. Patients treated with primary disease and those with recurrent disease without prior irradiation have the greatest benefit from HDRB in this setting. The salvage rate for patients with prior radiation therapy is lower with a higher risk of significant complications. Additional patients and follow-up are ongoing to determine the long-term efficacy of this approach.","title":"High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina"}
{"_id":"e3573c0a-c044-f207-19b3-9244fc6b846a","text":"A recent study from a Scotland tertiary center found long-term ventilation as the main indication for tracheostomy in their series of 111 children and cited some articles from United Kingdom hospitals with similar findings. However, a study in New Zealand included 122 patients undergoing tracheostomies between 1987 and 2003 and found that the obstruction of upper airway was the indication in 70% of the patients. More recently, an American study published in March, 2013, which reviewed data from 158 patients, raised the hypothesis that indications of tracheotomy would be changing again, with a reduction of indications for prolonged endotracheal intubation and an increase in the group of craniofacial anomalies and upper airway obstruction.","title":"Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil Traqueostomia em crianças: uma experiência de dez anos em um centro terciário do sul do Brasil"}
{"_id":"e3617407-c7ab-bfc4-3fc8-f7447e188df6","text":"Aesthetic evaluation of the face must first consider the goals of the patient: does the patient want to restore the old original look or does the patient want a new and different look? The assessment of the area to be treated should be done with the patient in an upright position. Gravitational force alters the defects or grooves. It is also important to identify any asymmetry and make the patient aware of it before starting the procedure. Proper judgement can be done by taking a photograph and studying it. As described above, check for the exact Part of face to be treated.","title":"Dermal Fillers: Do's and Dont's"}
{"_id":"e3636bd2-e5be-286b-b36b-0ceabe577a8b","text":"Bipedicled free flaps can sometimes be necessary in patients undergoing abdominal flap breast reconstruction and can be successfully undertaken in large microvascular surgery centers. They are a reliable and safe option for unilateral autologous breast reconstruction when the volume of tissue required to make a breast mound is larger than that can be transferred on a single flap pedicle. They can greatly benefit the correct patient.","title":"Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification"}
{"_id":"e36520b9-a401-9c27-48c3-d19ae3bcbb8d","text":"Intraoperative Doppler US: a routine surveillance intraoperative US study entails grayscale assessment of the liver parenchyma and biliary tree and Doppler evaluation of the vasculature.","title":"Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein"}
{"_id":"e3672bbb-f2db-0d80-f2a7-62d4f9ac6447","text":"For the cases investigated in this study, the removal of a cage was indicated if the impression of a cage infection was indicated preoperatively or intraoperatively. Both anterior and posterior approaches for cage removal, followed by interbody debridement and fusion with bone grafts, were found to be feasible methods that offered promising results. A posterior-alone approach can be considered first when the elapsed time to the diagnosis of cage infection is less than 6 weeks and posterior cage migration has occurred. An endoscope-assisted technique was found to have facilitated cage removal and offered enhanced safety during posterior procedures. An anterior approach is suggested when the elapsed time to the diagnosis of cage infection is more than 12 weeks, anterior cage migration has occurred, there is prominent infected involvement around the anterior body and paraspinal region, or a titanium cage was used (due to the high coefficient of friction). In this series, however, an anterior approach for cage removal usually had to be combined with a posterior approach for extension of the instrumented level due to the high incidence of concurrent pedicle screw loosening.","title":"The comparison between anterior and posterior approaches for removal of infected lumbar interbody cages and a proposal regarding the use of endoscope-assisted technique"}
{"_id":"e369f0d9-a4d3-f8dc-9946-33b7ec5d1d6b","text":"In patients suffering from the after effects of a mastectomy it is feasible to carry out reconstruction at a later date, once supporting treatment is complete and the patient has recovered from any illnesses. There is currently no fixed waiting time between the end of treatment and the time of reconstruction.","title":"Oncoplastic surgery in the treatment of breast cancer"}
{"_id":"e36c2151-ba6b-3290-a87b-2e07a8bb332f","text":"The flap design and marking were performed according to the bone defect length. The pulsation site of femoral artery was regarded as the starting point and the anterior superior iliac spine was considered as the end point. A connecting line was drawn between two points. During the cutting of iliac bone flaps, the iliac blood vessel branches were properly protected and the separation between vessel pedicle and iliac bone was averted as possible. The iliac bone was treated smooth and sealed with bone wax. The donor site was subject to direct suturing. The vessels distant from the lesions were chosen for vascular anastomosis. Two patients presented with chronic osteomyelitis of the lower segment of the femur, 4 with chronic osteomyelitis of the tibial plateau and 12 with chronic osteomyelitis of the middle and lower segments of the tibia.","title":"Combined application of latissimus dorsi myocutaneous flap and iliac bone flap in the treatment of chronic osteomyelitis of the lower extremity"}
{"_id":"e376c817-46de-1ece-a3aa-a99a647d04c9","text":"Our experience using 3D printing in conjoined twins surgery is limited to a single clinical case, but we can confirm that the use of 3D printing in the pre-operative phase solves a number of clinical, technical and logistical problems. The 3D models used in this clinical case were extremely useful for the set-up of the operating room, allowing us to organize the spaces appropriately. Thanks to the placement of the 3D printed models on the operating bed just a few days before surgery, it was possible to check that all the organized spaces were adequate according to the spatial orientation of the patients on the operating bed.","title":"Advanced 3D “Modeling” and “Printing” for the Surgical Planning of a Successful Case of Thoraco-Omphalopagus Conjoined Twins Separation"}
{"_id":"e37722c6-7106-392d-f949-c92a29470bcf","text":"Lymphatic mapping and SLNB are preferably performed before wide excision of the primary lesion. Occasionally, the primary lesion might be too close to the draining basin and wide excision can be undertaken first so that the signal does not interfere with SLNB. Prior wide excision does not preclude SLNB and lymphatic mapping\/SLNB can still be performed with good accuracy [38].","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"e377458b-12da-5faa-6032-afe1ab8e18a2","text":"Our study suggests that high-frequency 18 MHz ultrasonography is an effective tool for the preoperative evaluation of AM thickness. The HFUS measurements correlated well with the histopathological thickness measurements, making it a valuable and reliable method for clinicians to assess the thickness of melanoma lesions preoperatively.","title":"The utility of high-frequency 18 MHz ultrasonography for preoperative evaluation of acral melanoma thickness in Chinese patients"}
{"_id":"e37a6cc6-143f-22d8-ccc6-0c55abc79528","text":"However, the implementation of an aggressive anticoagulation protocol, driven by the clinical evidence of this increased thrombotic risk based on early reports, may account for the lower incidence of thrombotic events compared with that reported from China at the beginning of the pandemic period.","title":"Role of Complete Duplex Ultrasound to Diagnose Deep Vein Thrombosis in COVID-19 Critical Patients"}
{"_id":"e37bc06d-8790-7822-e615-57c953eca057","text":"Poor splint compliance was a major issue especially in children coming from low socio-economic strata and where the parents education level was poor. Out of 14 relapses, in 9 patients Denis-Browne splint was used infrequently and it was never used in 5 patients. We feel that although the foot morphology improves with rigid adherence to the casting technique it is the post-correction phase which needs careful attention and close follow up to ensure a successful outcome. We tried to nullify poor splint fitting by providing D-B splint of correct size from a single manufacturer directly under our observation. We now advocate tenotomy in every case to achieve at least 15 degrees of ankle dorsiflexion. This is a critical step as frequently equinus is the first sing of recurrence.","title":"Mid-term results of ponseti method for the treatment of congenital idiopathic clubfoot - (A study of 67 clubfeet with mean five year follow-up)"}
{"_id":"e381ddf8-ca3a-04cd-60ab-45e944f84758","text":"Method: Potential participants were recruited whilst attending their retinopathy screening appointments 1 day a week over an 8 week period. Those consenting had a lower limb arterial assessment using an automated device measuring ABI and pulse volume negating the need to rest the patient, and plantar light touch sensation checked, during the waiting time required for pupil dilation to occur prior to retinal screening.","title":"Abstracts from The College of Podiatry Annual Conference 2017 Liverpool, United Kingdom. 16-18 November 2017"}
{"_id":"e386d22d-8ade-b80d-b85e-78d09f9d69f7","text":"The regression analyses used to impute missing data included the same explanatory variables used in the missing data imputation in the clinical analysis .","title":"Cost-effectiveness of oral versus intravenous antibiotics (OVIVA) in patients with bone and joint infection: evidence from a non-inferiority trial [version 4; peer review: 2 approved]"}
{"_id":"e3875800-6445-9cea-9f56-f7a06a57dbab","text":"According to some authors, the negative reactions of permanent fillers are produced by a low-grade bacterial infection surrounding foreign substances. The development of related fibrosis is determined by the implant’s physical attributes and inherent traits.4","title":"Facial Contouring after Permanent Filler Removal with Combined Facelift and Fat Grafting: A Case Series"}
{"_id":"e3922f6c-b5cf-0ca1-3762-d6d304825bb5","text":"An anterior approach to the knee joint was utilized. The hardware and cement were excised. The tissues and the femoral and tibial canals were debrided of devitalized tissue and retained cement. The tibial and femoral surfaces were recut to be flat and opposing. The femur and tibia were then stabilized with metallic fixation devices. The bone surfaces were apposed to minimize medial or lateral gapping.","title":"Arthrodesis Using Pedicled Fibular Flap After Failed Infected Knee Arthroplasty"}
{"_id":"e3a149a7-90a4-94ce-4ebf-443992582828","text":"It remains unclear which patients would benefit most from an upfront surgical approach rather than from initial non-operative management involving either medical treatment, locally ablative therapies, or active surveillance. Here, we retrospectively analyzed both adult and pediatric patients with desmoid tumors treated at a tertiary academic cancer center over a period of 30 years. We compared outcomes between patients treated with a primary surgical modality and patients managed with either active surveillance or with a non-surgical approach including medical therapy or local treatments. At the same time, we correlated patient and tumor characteristics with outcomes to identify features with prognostic value.","title":"Management of Patients with Newly Diagnosed Desmoid Tumors in a First-Line Setting"}
{"_id":"e3a25509-d935-df54-06b1-6976e71ae4f9","text":"The promotion of sun safety is not likely to inhibit physical activity. Skin cancer prevention programs should continue to promote midday sun avoidance and sun protection during outdoor activities.","title":"Parents’ Perceptions of Skin Cancer Threat and Children’s Physical Activity"}
{"_id":"e3a2ba66-6888-91ee-c593-ee64924623f2","text":"Improved resolution and access to diagnostic imaging has led to a higher than ever incidence of VTE. Yet not all venous thrombotic events are created equally. For example, as illustrated by our cases, what to do with isolated distal DVT and subsegmental PEs remains a muddy situation with arguments both for and against anticoagulation. A better understanding of the diagnostic factors that predict which patients with distal VTE remain at risk for recurrence is a research priority. Clinical prediction rules and algorithms that specifically address these groups are highly anticipated. Two approaches that are currently undergoing study include withholding anticoagulation in patients with subsegmental PE and negative lower-extremity ultrasounds (NCT01455818) and completing screening CTPA in patients with IDDVT and elevated D-dimer values.","title":"Current Challenges in Diagnosis of Venous Thromboembolism"}
{"_id":"e3a7016b-b620-284c-56b7-56744f877a03","text":"Women who had mastectomy with reconstruction had a better psychosocial outcome comparing to mastectomy without reconstruction. Dean et al.22 in his study had also witnessed a decrease in postoperative depression in women who had early reconstruction postmastectomy. Albornoz et al.23 in another study also published similar results where quality of life measures such as satisfaction with breast, psychosocial and sexual well-being were remarkably improved between preoperative and operative phase in women who underwent mastectomy with reconstruction. Another important finding highlighted in our study is that there was no significant difference in physical wellness of chest in all three groups of women who went through BCS and total mastectomy with or without reconstruction although a previously cited study contraindicated our result as they found worst physical well-being of chest in women that underwent (BCS which they concluded that it could be due to adjuvant radiotherapies12. A study conducted by Kim et al.24 in a Korean Hospital employing the questionnaire of EORTC QLQ-C30 and the BR23 module disclosed that patients in the BCS and total mastectomy with immediate reconstruction groups were more physically better in contrast to the total mastectomy group (P < 0.05 each).","title":"Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study"}
{"_id":"e3aafd5c-a405-b365-6b06-da507dfcd305","text":"VAS abdomen measures the intensity of pain related to the bisiliac sovrapubic scar after closure of the abdominal donor site, and VAS lower back measures the pain due to postoperative stiffness.","title":"A New CT Analysis of Abdominal Wall after DIEP Flap Harvesting"}
{"_id":"e3b4fc2d-5c42-f477-2d47-eaeee92dca70","text":"Injury to the ring apophysis caused by disc material protruding through the growth plate of ring apophysis can result in limbus vertebra. This is seen as a small corticated bony fragment matching osseous defect at the superior margin usually in anterosuperior location and on imaging that needs to be differentiated from an acute vertebral fracture, a Schmorl nodule, or calcified disc herniation. Limbus vertebra is usually asymptomatic unless it has a posterior location when it can potentially cause a neurologic symptom [18].","title":"SPECT\/CT bone scintigraphy to evaluate low back pain in young athletes: common and uncommon etiologies"}
{"_id":"e3bd1b1b-9617-ce7c-9050-9a420c47d5e8","text":"With the increasing popularity of facial filler injections, the numbers of reported complications are growing. Our patient had vision changes and keratitis secondary to HA facial filler injections and completely recovered following HBOT. To our knowledge, this report is the first case of successful HBOT for ocular ischemia and keratitis following cosmetic facial HA injection.","title":"Hyperbaric Oxygen Treatment of Keratitis Following Facial Hyaluronic Acid Injection Keratitis Treatment After Hyaluronic Acid Injection"}
{"_id":"e3c44292-7e50-c2cb-ba7c-10db452ab034","text":"Female representation in orthopaedics remains low compared with other specialties. Recently, several studies have examined the membership composition and leadership roles of women in orthopaedic societies. However, there is a paucity of information on the possible connection between the number of women within state and regional orthopaedic societies and women who serve in leadership roles within these societies.","title":"Women in Leadership in State and Regional Orthopaedic Societies"}
{"_id":"e3c76f40-e264-d7a2-a70c-a1291005eeb6","text":"Evidence will be searched without date restrictions and publication types will include letters, editorials and reviews. Only documents in English will be included in this review due to limited translation resources. We will contact our stakeholder group to request additional documents which they believe may be relevant for the development of an initial programme theory or programme theories.","title":"In which context and for whom can interventions improve leadership of surgical trainees, surgeons and surgical teams and why: a realist review protocol [version 1; peer review: 3 approved, 1 approved with reservations]"}
{"_id":"e3ce5ca5-412c-eb38-5d05-d6f617859ac5","text":"Conclusions: Both the young and old can enjoy satisfactory outcomes from surgical resection of chronic osteomyelitis with simultaneous orthoplastic reconstruction including free tissue transfer. Age alone should not be a barrier to potentially curative surgical treatment.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"e3d443ad-e998-a3a6-9e2a-ebc59f3be367","text":"Randomisation will be performed within the computerised clinical case report form (CRF) produced in Primary Care Clinical Sciences, University of Birmingham. When a patient is identified as being eligible for the study and has given written consent to take part, the research nurse will enter details into the computerised CRF and will be issued immediately with a dedicated randomisation code allocating the patient to either continuing warfarin therapy or stopping warfarin therapy.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"e3d5cdeb-3b6d-c334-8b80-ccf43b10de6b","text":"The women participating in this study stated that educating people to stay away from known risk factors, and encouraging them to healthy habits are among the first steps towards the prevention and control. And breast cancer screening is the best strategy for reducing cancer mortality. Similar findings emerge from the breast cancer screening literature which suggests that attenders for screening have more faith in the health care system than non- attenders, perceiving positive, rather than negative, consequences as the likely outcome of screening.","title":"Women’s Perspective of Breast Self-examination"}
{"_id":"e3d6cff5-5224-ce40-a16e-9f413247ca29","text":"MRI also offers a good option to show local bone edema related to a pathological fracture that may occur on a bone weakened by metastases. However, discriminating small fractures from local progression of the lesion can be difficult using MRI. The detection of subtle impaction of the trabecular bone or subtle cortical fracture is easier on T1 weighted images or on high-resolution sequences, and often benefits from the combination of a CT scanner assessment to better depict the structural changes of the bone.","title":"Fracture Risk Evaluation of Bone Metastases: A Burning Issue"}
{"_id":"e3d99632-61cf-ea09-518c-8cb9949c1e1d","text":"This study obtained information directly from you and other data during the surgical operation.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"e3ea447a-0c2a-f39f-551b-41a161571443","text":"A compromise to the blood supply of the skin flaps may result in skin necrosis, poor tissue healing, infection and can even lead to Implant extrusion\/failure. As such, appropriate assessment of the skin flap vascularity is imperative to the success of the operation and can be conducted through either a systematic clinical assessment or by using special devices to look for adequate flap vascularity intraoperatively. A clinical approach has been described by the senior author elsewhere.","title":"Implant-based Prepectoral Breast Reconstruction: The Importance of Oncoplastic Plane, its Blood Supply and Assessment Methods"}
{"_id":"e3f71ad3-0f6f-c85c-50e4-7d0cd52b0fc1","text":"We recommend the free LDF for the coverage of large wound defects in irradiated areas after the failure of VRAM flap. If an AV loop is necessary within the flap transfer, we recommend conducting two procedures to guarantee the perfusion of the AV loop.","title":"AV loop free flap: an interdisciplinary approach for perineal and sacral defect reconstruction after radical oncological exenteration and radiation in a colorectal cancer patient"}
{"_id":"e3fa9219-3df9-6506-d655-86f2c349d81e","text":"The literature reports rates between 13 and 39 per cent of pathological neck node metastases in parotid cancer. Neck dissection should be performed in patients with clinical or radiological evidence of nodal disease.","title":"Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines SALIVARY GLAND TUMOURS: UK GUIDELINES"}
{"_id":"e3fbcec8-63ac-bd03-c827-c29105b5c5ef","text":"A complete disease evaluation is performed before immunotherapy is initiated, and although a repeat disease evaluation was not mandatory on COG ANBL0032, it is strongly recommended. The toxicity associated with this therapy is nontrivial, and if a patient has had disease progression on therapy, it is important to move on to other therapeutic options rather than continuing to deliver treatment known to have significant side effects.","title":"Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications"}
{"_id":"e3fdad09-b2e1-f83c-12f6-27591e114e39","text":"A secondary healing strategy may be an option for the treatment of vulvar cancer in situations of non-extensive surgical wounds when primary closure of the wound is not possible.","title":"Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control study"}
{"_id":"e405fb97-bd5b-f077-4f40-616f28639923","text":"There was poor agreement among the 12 assessors who independently assessed the six systems. A summary of the assessments of the sensibility of the six approaches to rating levels of evidence and strength of recommendation is shown in Table 1.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"e4063931-8036-bd76-fce5-1e6fe45972e0","text":"Antibiotic therapy in cervical infection is advocated in the early stage of the disease and for patients without complications, while both medical and surgical treatment methods are adopted in the late stage of the disease and for patients with complications. Several surgical techniques are used in the treatment of cervical spine infections including the anterior approach, posterior approach, and combined anteroposterior approach.","title":"The pre-surgical role of halo-traction in patients with cervical infection associated with refractory kyphosis: a retrospective study"}
{"_id":"e40a874f-4a4b-66a1-3d25-f799c8dda535","text":"The concept that using LS further reduces morbidity over that of using the probe without LS or using dye alone is intriguing to say the least. The analysis we performed suggests that a strong trend exists for additional morbidity reduction in the groups using LS.","title":"Using the intraoperative hand held probe without lymphoscintigraphy or using only dye correlates with higher sensory morbidity following sentinel lymph node biopsy in breast cancer: A review of the literature"}
{"_id":"e40b2279-9a4d-e127-6939-190b23dd844e","text":"It is important to correctly differentiate between venous and arterial vessels, which become increasingly more difficult within deeper tissues. Venous vessels are easily compressible compared to arterial vessels when pressure is applied with the ultrasound probe. Color Doppler also serves as a useful tool to utilize in differentiating between venous and arterial vessels. Arterial vessels will demonstrate a pulsatile flow on color Doppler while the venous vessels will demonstrate a continuous flow on color Doppler [27]. Both Trendelenburg positioning and Valsalva maneuver will increase the diameter of jugular veins with minimal changes in the size of the carotid arteries, aiding the anesthesiologist in correctly identifying the internal jugular vein for central line placement.","title":"Perioperative Point-of-Care Ultrasound Use by Anesthesiologists"}
{"_id":"e413107b-89cd-a3dd-a764-d3699671c1fd","text":"The indications for allograft skin use in wound management are the covering of the extensive wounds where autologous tissue is not available and the covering of widely meshed skin autografts.","title":"Surgical management of extensive burns treatment using allografts"}
{"_id":"e4135d05-e2fe-af52-e4c1-a91d2902c84a","text":"Crushed autologous cartilage dorsal onlay grafts are a relatively new technique associated with improved dorsal irregularities and contour and high patient satisfaction. Septal cartilage is often used in crushed cartilage grafts due to its ease of harvesting during rhinoplasty. When mixed with prepared fat as performed by the senior author, the adipose tissue may serve as a scaffold for cartilage placement as well as further smoothen minor defects in dorsal contour. A limitation of this technique is related to patients with a paucity of septal cartilage, as in the case of revision rhinoplasty patients.","title":"Aesthetic Rhinoplasty: Technique, 3-Dimensional Simulation, and Outcome Assessment"}
{"_id":"e416d61d-a081-e804-8813-049350da98c6","text":"Optimal management of patients with osteomyelitis is a challenge for clinicians particularly since cure requires prolonged courses of antibiotics.[ Although bone biopsy remains a gold standard for non-vertebral osteomyelitis, clinicians frequently rely on clinical information and radiologic studies to establish the diagnosis and biopsies are more commonly performed to guide antibiotic choices.[ In this large retrospective study conducted in an academic hospital we looked at the impact of IGBs on management of clinically suspected non-vertebral osteomyelitis, focusing on its diagnostic yield and its clinical utility by reviewing the impact on the antimicrobial therapy.","title":"Impact of diagnostic bone biopsies on the management of non-vertebral osteomyelitis A retrospective cohort study"}
{"_id":"e41905ee-5cd3-c375-f048-069a2e00536d","text":"Time to event data for VTE is shown in Figure 2. The median time from admission to VTE diagnosis was 10 days. Venous thromboembolism was detected in 58 of the 65 patients at first CT examination and in 7 patients at the second or third exam. Of the 34 patients in whom VTE was not identified by CT image, 24 were examined by CT once and 10 were examined twice.","title":"Venous thromboembolism in major trauma patients: a single‐center retrospective cohort study of the epidemiology and utility of D‐dimer for screening"}
{"_id":"e41a80c9-bd18-7974-c53f-9a51b60ec583","text":"A summary of the results is presented in Table 5. An overview of the key findings according to GRADE methods can be found in Additional file 4.","title":"Negative pressure wound therapy in patients with wounds healing by secondary intention: a systematic review and meta-analysis of randomised controlled trials"}
{"_id":"e41c883b-54b0-bb03-93bf-477546193c36","text":"P26 Galsulfase hypersensitivity and desensitization of a mucopolysaccharidosis VI patient","title":"7th drug hypersensitivity meeting: part one"}
{"_id":"e41ff39d-6701-ac74-a2ae-f1979c247828","text":"There are numerous and disparate approaches to prevent, treat, and eradicate biofilms in clinical practice, but ultimately there is a lack of comprehensive and uniform understanding of the overall physio-pathological process of biofilm-induced inflammation, resulting in a dearth of effective treatments and alternative strategies for serious bacterial infections and chronic refractory biofilm inflammation that occur after surgical operations. The necessity to reasonably tailor the treatment by understanding the characteristics of the biofilm itself. The therapeutic approaches we present above are based on three major components. Firstly, we aim to preempt to thwart the ability of planktonic bacteria to form further biofilms during the migration and initial surface adhesion phase. Secondly, we design to destroy the developing seeds through a combination of therapeutic approaches between initial adhesion and biofilm maturation stages. Thirdly, we plan to stop the spread of planktonic bacteria at the time of biofilm dispersal to contain the development of biofilms.","title":"Strategies to prevent, curb and eliminate biofilm formation based on the characteristics of various periods in one biofilm life cycle"}
{"_id":"e4232a44-f43a-46f5-5420-a53fb33ce553","text":"Dutch guidelines on registration of neoplasms have changed over the years. The introduction of the third edition of the WHO Classification for Soft Tissue and Bone Tumours stimulated improvement of coding, enabling a better pathology registration.25 Due to the benign nature, this neoplasm is not registered among soft tissue tumors in the national cancer registries precluding verification of our data. The overall incidence of sarcomas has remained stable over the years at approximately 30–35 patients per million people, with a slight increase to around 40 patients per million people over the past 5 years.26","title":"Time Trends in the Incidence and Treatment of Extra-Abdominal and Abdominal Aggressive Fibromatosis: A Population-Based Study"}
{"_id":"e4256501-e5cf-b1f1-cd32-1b5b249f7ac2","text":"Materials and methods: 824 ultrasound exams were performed in a period between June and November of 2016 in which it was evaluated its use in the care of the polytraumatized patient","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"e426c044-0a94-da46-dae2-ced503723a59","text":"The participants were informed that if at any time they did not feel comfortable with answering a question, they were not obligated to do so. They were also informed that each participant would be given a pseudonym to protect her identity.","title":"Women’s Perspective of Breast Self-examination"}
{"_id":"e432ce53-5130-409a-fbfc-df9731975d35","text":"Brachytherapy is a form of radiation therapy where high doses of radiation are directly applied to the malignancy.35,49 The direct application of radiation maximizes the therapeutic effects of radiotherapy while minimizing the exposure of surrounding tissue to radiation.35,49 Brachytherapy is particularly useful for treating well-circumscribed malignancies in facial regions where surgical excision may result in a less-favorable cosmetic outcome.49 The reported 5-year recurrence rates of non-melanoma skin cancers following brachytherapy range from 1% to 13%.49 It should be noted, however, that there are limited data describing the long-term effects of brachytherapy for the treatment of non-melanoma skin cancer. Lastly, forms of brachytherapy specifically designed for the treatment of non-melanoma skin cancers are not as readily available as external beam radiation and standard surgical excision in many geographic regions.","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"e4365d17-8bcb-7eba-f283-d25af204b55a","text":"Two patterns of lympathic drainage pathways from the breast to the axillary basin were found. (1) One pattern was a subcutaneous lymphatic vessel from the subareolar area running through the anterior surface of the breast into the lymph node in the midaxilla near the intercostals brachial nerve. Patterns of subcutaneous lymphatic drainage pathway from the areola into the axilla: From one to two streams was drained.","title":"Sentinel lymph node biopsy for breast cancer patients using fluorescence navigation with indocyanine green"}
{"_id":"e439fdda-69a1-b081-cbe3-ad9722b7d3ef","text":"The present study is a comparison of dose distribution to the target and neighboring critical structures with IMRT and HDR_BT. In practice, the effective total dose to be delivered to target with IMRT needs to be computed by accounting the equivalent biological effective doses (BEDs) for HDR_BT and IMRT. Also the early and late effects on normal structures need to be considered in determining the total dose to be delivered with IMRT.","title":"Dosimetric comparison of high dose rate brachytherapy and intensity-modulated radiation therapy for cervical carcinoma"}
{"_id":"e447a14b-f662-5555-bf37-66453d500e74","text":"The limitation of our study is the smaller sample size hence needs further studies with larger samples or multicentric studies. Another limitation is that our study is not a randomized controlled trial; hence it is suggested to conduct further evaluation through randomized controlled study to augment and strengthen the level of evidence.","title":"Immediate Versus Late Flap Coverage for Traumatic Soft Tissue Defects of Lower Extremity: A Comparative Observational Study"}
{"_id":"e44ce3fb-2e23-836f-d041-cfa7e615bc56","text":"Aminolaevulinic acid (ALA) is the first committed step in haem synthesis. In the presence of excess ALA the natural regulatory feedback system is disrupted allowing accumulation of protoporphyrin IX (PP IX) the last intermediate product before haem, and an effective sensitiser. This method of endogenous photosensitisation of cells has been exploited for photodynamic therapy (PDT). We have studied the fluorescence distribution and biological effect of induced PP IX in normal and tumour tissue in the rat colon. Fluorescence in normal colonic tissue was at a peak of 4 h with a rapid fall off by 6 h. The fluorescence had returned to background levels by 24 h. All normal tissue layers followed the same fluorescence profile but the mucosa showed fluorescent levels six times higher than the submucosa, with muscle barely above background values. At 6 h the ratio of fluorescence levels between normal mucosa and viable tumour was approximately 1:6. At this time laser treatment showed necrosis of normal mucosa and tumour with sparing of normal muscle. There was good correlation between the fluorescence distribution and the biological effect of ALA-induced photosensitisation on exposure to red light. ALA may be superior to conventional sensitisers for tumours that produce haem as the PP IX is synthesised in malignant cells while the other sensitisers mainly localise to the vascular stroma of tumours. There is also a greater concentration difference between the PP IX levels in tumours and in normal mucosa and normal muscle than with the other photosensitisers raising the possibility of more selective necrosis in tumours.","title":"Fluorescence distribution and photodynamic effect of ALA-induced PP IX in the DMH rat colonic tumour model."}
{"_id":"e44d4a7e-8c97-1d37-38c0-21a3be8bc66e","text":"We used three different protocols of irradiation in the distal BM SS:","title":"Efficacy of LED Photobiomodulation for Functional and Axonal Regeneration After Facial Nerve Section-Suture"}
{"_id":"e450835b-7512-ead5-a742-e1d1ab3e8c47","text":"All the patients reported minimal pain at the donor site, which was treated with oral medication. This allowed the authors to promptly and safely discharge the patients on the same day of the procedure.","title":"Minimally Invasive Harvesting Technique for Costal Cartilage Graft: Donor Site, Morbidity and Aesthetic Outcomes"}
{"_id":"e455631f-63c8-0ffa-340d-3b9b3be776f0","text":"Nowadays, the growing use of permanent dermal fillers for soft tissue augmentation of the aging face presents the urgent need to educate patients about their increasing complications. They are classically classified into early, late, and delayed, and they include bruising, swelling, edema, infections, foreign body reaction, skin discoloration, and biofilm formation, in addition to vascular compromise.12","title":"Facial Contouring after Permanent Filler Removal with Combined Facelift and Fat Grafting: A Case Series"}
{"_id":"e45a8fc3-d83a-56dc-7d10-5d5a314f6055","text":"The case demonstrates to general practitioners and other clinicians that a prolonged administration of antibiotics can be prevented by means of a comprehensive diagnostic procedure for possible bacterial osteomyelitis.","title":"Chronic recurrent multifocal osteomyelitis manifested as painful clavicular swelling: a case report"}
{"_id":"e45beaa4-00e1-6187-945e-f7d56fbde175","text":"Routine blood counts and CRP were obtained on days 2 and 7. The patients were followed up after discharge at the office at 1, 2 and 6 weeks and then after 6 months or if further surgery was planned.","title":"Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol"}
{"_id":"e45e142a-1680-608e-55f5-75e551d6629f","text":"Reports of severe allergic reactions from the literature raised concern that the new mRNA vaccines involve a higher risk of anaphylaxis in comparison with the adenoviral-vector vaccines, thus explaining the hesitancy of some people to take this type of vaccine.","title":"Role of Allergist Advice in Determining Personal Decisions for COVID-19 Vaccination of People With a History of Allergies"}
{"_id":"e460008e-518a-f210-fa3f-3e4ca93aeb32","text":"Preoperative lymphoscintigraphy is a valuable tool in radioguided detection of sentinel lymph nodes. We believe that further clinical studies should be conducted in order to evaluate the role of lymphoscintigraphy for detection of extra-axillary sentinel lymph nodes in patients with clinically node positive breast cancer in whom axillary lymph node dissection is already planned.","title":"Sentinel Lymph Node Detection in Contralateral Axilla at Initial Presentation of a Breast Cancer Patient: Case Report Meme Karsinomlu Olguda Preoperatif Lenfosintigrafi ile Kontralateral Aksiller Drenajın Gösterilmesi: Olgu Sunumu"}
{"_id":"e463ea6a-07e6-cdc6-aca9-979b2015eb9d","text":"Studies have suggested that AA could be used as a treatment for BCC and SCC of the skin. The use of a topical formulation of AA, in a context of increasing incidence of these diseases, could be part of current therapeutic strategies. In conclusion, further studies are needed to understand the potential role of this treatment. Although the cases discussed here are preliminary clinical studies, it is important to consider them as a first step in the development of new topical therapies for skin cancers diseases.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"e46598a7-7583-f3b6-407d-945bed01b180","text":"The recovery of emotional expressions after personalized rehabilitation was satisfactory to the patients. The assessment with complexity analysis of sEMG data can be used for developing new neurorehabilitation techniques and detecting synkinesis after full-face transplantation.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"e46ac11a-cc5b-fcff-14cb-3bd939db24d6","text":"A large trial in Rotterdam aimed to assess whether a traditional CFR approach was superior to surgical debulking followed by the application of topical chemotherapy. Survival rates were measured over a 23 year period using the Kaplan-Meier method and a significant increase in survival was found in patients treated with debulking and topical chemotherapy. It suggests that this method becomes the mainstay of treatment for sinonasal malignancy [9].","title":"Endoscopic Resection and Topical 5-Fluorouracil as an Alternative Treatment to Craniofacial Resection for the Management of Primary Intestinal-Type Sinonasal Adenocarcinoma"}
{"_id":"e471c8b7-7dbd-4d50-0e6f-c83686a974e6","text":"Benign plexiform neurofibromas may grow rapidly in children and adolescents (Figure 3). Children and young adults with rapidly growing tumours or large total body tumour burden may be at especially high risk for developing an MPNST in the future, but longitudinal whole body MRI studies with longer follow up are needed to determine whether this is so. We note with some concern that whole body tumour burdens greater than 1000 mL are distinctly unusual in the patients we studied over 40 years of age.","title":"Growth dynamics of plexiform neurofibromas: a retrospective cohort study of 201 patients with neurofibromatosis 1"}
{"_id":"e47ba47e-6509-c2a1-e2e0-4d24e442a9b8","text":"We conducted a randomized clinical trial to compare CO2 laser tonsillotomy performed under local anesthesia to tonsillectomy performed under general anesthesia for tonsil-related concerns in adults. We hypothesized that tonsillotomy would have a shorter functional recovery period. Secondary outcomes included relief 6 months after surgery of the primary concern that led to tonsil removal and tonsil symptom severity.","title":"Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults A Randomized Clinical Trial Laser Tonsillotomy vs Conventional Tonsillectomy in Adults"}
{"_id":"e4967b5a-2da6-f199-8945-c6f0ba20c76b","text":"A retrospective study of the Scottish Melanoma Group showed without any doubt that local recurrence and distant disease free survival, as well as the overall survival were significantly higher in those patients who had a surgical reintervention after diagnosis of CM [37].","title":"Controversies in the diagnosis and treatment of early cutaneous melanoma"}
{"_id":"e4985a9f-d213-299b-7a9b-61caa30a6669","text":"Gender and location of implantation have no significant influence on patient satisfaction. Younger patients especially women are less satisfied than older patients. Phobic patients are totally satisfied with implant rehabilitation under general anaesthesia which means that this treatment can be considered as a treatment of choice giving these patients the same opportunity like others to improve their oral health and well-being.","title":"Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study"}
{"_id":"e4a4fa4a-98b2-82df-5834-da57578141a3","text":"Our findings should encourage clinicians and nurses to concentrate on infants born with a low birth weight or who develop BDP and\/or medical complications requiring surgery when assessing oral feeding readiness. Further studies are required to develop evidence-based interventions to promote the achievement of feeding independence and direct breastfeeding, which can reduce the duration of hospitalisation and the costs of healthcare.","title":"Effect of co-morbidities on the development of oral feeding ability in pre-term infants: a retrospective study"}
{"_id":"e4b1cf8c-99f6-0070-b678-19f223e32505","text":"The management of the inguinal region in patients with squamous penile cancer is very controversial. The main predictor of survival is lymph node involvement.","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"e4b2c56a-5f81-647c-0f29-32ffa880333c","text":"A plethora of options exist in the treatment of MCC, yet, the optimal option for this aggressive disease has yet to be found. Currently, a multimodality approach is advocated and includes in general a wide and deep local excision with regional lymph node dissection and adjuvant radiotherapy. Radiotherapy as a primary modality has been advocated in cases of inoperable disease. Sentinel lymph node biopsy can help to identify the presence of occult metastatic disease which can have prognostic implications.","title":"Role of Sentinel Lymph Node Biopsy in the Management of Merkel Cell Carcinoma"}
{"_id":"e4b67e6a-7b3c-0ec5-8b08-82d9f95b1eb4","text":"A 45 year old man was diagnosed Maxillary Le Fort II fracture due to a fall from motorcycle. There was a comminuted nasal fracture without complaint about difficulty of breathing.","title":"A breakthrough in Maxillary LeFort II fracture reconstruction: Case series of rhinoplasty using diced cartilage fascia graft simultaneously with ORIF"}
{"_id":"e4b7c3b7-6289-1d02-62fe-250daaf861a2","text":"Sedation with pethidine and promethazine was administered half an hour prior to the procedure in order to reduce procedure-related pain and discomfort. The procedure was performed in the supine position. Using USG guidance, the omentum was assessed to identify the site of maximum thickening. The needle path was also assessed using color Doppler to ensure that there were no blood vessels in the expected needle path. The presence of ascites in these patients was not considered a contraindication. Ascitic fluid was not routinely tapped unless asked for by the referring doctor.","title":"Ultrasound-guided omental biopsy: Review of 173 patients"}
{"_id":"e4bbea2f-7989-5085-0788-8644445ecde3","text":"Following surgery, patients are permitted to partially weight bear and to commence 6 weeks of tailored intravenous antibiotic therapy as an outpatient.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"e4bdbc9e-af08-6363-1195-8c818289fe75","text":"Melanoma is an increasingly prevalent disease that has a predilection for the young and productive members of our society with an immeasurable social, economic, and emotional cost. The disappointing historical results of melanoma systemic therapy are rapidly replaced with promising effective therapeutics targeting multiple pathways in tumor growth and immune suppression. While the initial studies of novel agents were tested as single agent in the metastatic settings as proof of principle, the most effective way to treat metastatic melanoma may encompass targeting tumor growth, reversing tumor immune suppression, and cytoreduction of clinical tumor bulk. Neoadjuvant approach is historically under-utilized in the treatment of metastatic melanoma in comparison to other tumor types mainly due to the ineffectiveness of systemic therapy. The promising results of biochemotherapy neoadjuvant trials and the emergence of active agents in melanoma suggested that this approach would shed light on the rational selection of optimal treatment for metastatic melanoma patients.","title":"Neoadjuvant treatment of melanoma: case reports and review"}
{"_id":"e4bea97b-31d6-bbbd-5da1-0ba98986f620","text":"While primary radiotherapy is occasionally used for unresectable lentigo maligna or invasive melanoma, it is more commonly used as adjuvant radiotherapy for cutaneous melanoma likely to recur locally. Radiotherapy is not advised for local control of inadequately excised tumors—instead every effort should be made to achieve good margins.","title":"Malignant Melanoma"}
{"_id":"e4c5432d-1f0a-67e9-c5b0-ba6603af8586","text":"Idiopathic scrotal calcinosis is a rare and benign condition with an unclear pathogenesis. In some cases, the disease is extensive requiring scrotal skin excision. We report a similar case with extensive idiopathic scrotal calcinosis which was excised through multiple stabs. Although the depth of the excision is limited to the dermis, complete excision of even the smallest of lesions is required to minimize recurrences.","title":"Idiopathic Scrotal Calcinosis: A Case Report of a Rare Entity"}
{"_id":"e4d02f2d-69ca-ef3e-fe02-8805826b76e2","text":"The turbidimetric test with spectrophotometric reading at 340 nm was used.","title":"Immunological aspects predicting metastatic sentinel lymph node in early breast cancer patients"}
{"_id":"e4d1867b-3dd0-d422-eda5-ab03d941b501","text":"Thus, the ability of the surgeon to get a decent result involves augmentation and repair of the mucogingival defect and complete excision of the lesion. All of these can be performed during one surgical procedure with proper planning.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"e4de9c25-d109-d771-4591-520bc3419527","text":"The next step is to release the superficial aspect of the soleus distal to gastrocnemius with the finger and then release the soleus from the Achilles tendon. It is useful to retain a thin layer of aponeurosis. The final step is the release of the muscle from its lateral attachments. The lateral border must be released as proximally as possible to allow the rotation of the flap. The flap will cover the defects of the middle third tibia of the leg.16–19","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"e4dfcb5a-a16b-5db7-ac1e-1a1b08d013de","text":"Clinical data of patients with palmar hyperhidrosis, axillary hyperhidrosis and plantar hyperhidrosis admitted to the Department of Thoracic Surgery of Gansu Provincial People’s Hospital who performed ETS treatment from April 2014 to August 2021 were collected.","title":"Comparison of the efficacy of ETS with different segments for palmar, axillary and plantar hyperhidrosis"}
{"_id":"e4efbbf1-63ab-0067-5c95-57a2007b788d","text":"The Society of Skeletal Radiology (SSR) Practice Guidelines and Technical Standards Committee identified musculoskeletal infection as a White Paper topic, and selected a Committee, tasked with developing a consensus on nomenclature for MRI of musculoskeletal infection outside the spine. The objective of the White Paper was to critically assess the literature and propose standardized terminology for imaging findings of infection on MRI, in order to improve both communication with clinical colleagues and patient care.","title":"MRI nomenclature for musculoskeletal infection"}
{"_id":"e4f363bd-a8a6-7c86-39bd-b21cad563df3","text":"The great saphenous vein is widely used as a graft in coronary artery bypass grafting surgery. Complications due to saphenous vein harvesting can be minimized when using ultrasonography mapping and marking.","title":"Use of Doppler Ultrasound for Saphenous Vein Mapping to Obtain Grafts for Coronary Artery Bypass Grafting"}
{"_id":"e4fd1685-2ad1-df3d-f51d-c81a9679b7eb","text":"71\/F presented with left sided headaches and neck pain with nuchal rigidity progressively worsening over 3 weeks with no other neurologic symptoms. Odontoid osteomyelitis with epidural abscess was discovered on further workup with neuroimaging. Concurrent jugular vein and transverse sinus venous thrombosis was also found and suspected to be secondary to the pyogenic odontoid osteomyelitis. Patient was treated with intravenous antibiotics for the osteomyelitis as well as intravenous heparin for the venous thrombosis. To our knowledge, this is the first case reported in literature of transverse sinus venous thrombosis secondary to odontoid osteomyelitis.","title":"Pyogenic Odontoid Osteomyelitis with Sinus Thrombosis"}
{"_id":"e503f9f9-739d-8b6d-9e60-39a78756c569","text":"Our criteria of surgical intervention takes into account the maturation processes.","title":"Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol"}
{"_id":"e5095af9-4f82-75b6-fb87-ab55776a618d","text":"Microbiological diagnosis is difficult in some cases and not easy to obtain without soft tissue biopsy from the affected organ, which might delay the initiation of specific antibiotics. Nocardia can produce serious complications, but early diagnosis and early treatment initiation can lead to successful results, especially in cancer patients. Reasonable control of this condition will help resume specific cancer treatment once the infection is well controlled. This early diagnosis and early specific antibiotics initiation need to be thought about in cancer patients, especially with characteristic clinical and radiological features in immunocompromised patients.","title":"Disseminated Nocardiosis in a Breast Cancer Patient Caused by Nocardia otitidiscaviarum: A Case Report of Tertiary Centre in Saudi Arabia"}
{"_id":"e5151fe4-29ba-24cb-058c-10da5a1e33a4","text":"After determining the tumor border and local anesthetics, the BCCs were excised with a 4 to 6 mm surgical margin based on the number of risk factors for BCCs. The excised tumoral tissue was marked with suture or a different ink color in the superior and inferior directions.","title":"Outcome of staged excision with pathologic margin control in high-risk basal cell carcinoma of the head region"}
{"_id":"e5163a51-e92a-71f1-fb0d-b1d5a483126e","text":"The results of the macro- and microscopic studies of the PDT zone on the 21st day after exposure to murine B16 melanoma indicate that the use of chlorin e6 conjugated with a PSMA-ligand as a photosensitizer in the PDT schemes used here had high antitumor activity.","title":"On the Pathomorphological Pattern of the Efficiency of Photodynamic Therapy of Murine Melanoma B16 Using a New Photosensitizer Based on Chlorin e6 Conjugate with a Prostate-Specific Membrane Antigen"}
{"_id":"e5168edd-ca9c-4e9b-73ad-705bf285e54c","text":"Osteomyelitis is an infection of the bone and bone marrow that can be caused by an exogenous source or by hematogenous spread. The hematogenous spread of bacteria usually results in bacteremia with subsequent infection of the bone. The most commonly associated pathogen with this type of infection is Staphylococcus aureus, with other gram-negative organisms, such as Pseudomonas aeruginosa, also frequently encountered. The microorganism Serratia marcescens is a rare and infrequently encountered cause of this condition known to cause nosocomial infections. This organism can be notoriously difficult to treat, with resistance to many commonly used antibiotics. The case presented is one of vertebral osteomyelitis in an intravenous drug user caused by Serratia marcescens with subsequent treatment and management of the condition. This case allows for investigation into the continued management of intravenous drug user infections, with the isolation and treatment of less commonly encountered pathogens.","title":"A Complicated Case of Vertebral Osteomyelitis by Serratia Marcescens"}
{"_id":"e51f88d4-f8f0-1883-1fee-bbad2d4e37e6","text":"There were no soft tissue or wound healing complications in this series, and all the split skin grafts were performed by the orthopaedic surgeon. All the trauma surgeons involved in performing this technique in this series have had plastic surgical training or been trained to perform split skin grafting.","title":"Transverse debridement and acute shortening followed by distraction histogenesis in the treatment of open tibial fractures with bone and soft tissue loss"}
{"_id":"e5218a8b-14cd-13d3-898f-0e91b5ff4013","text":"There are reported cases in which patients were treated by open surgery with a venous bypass with successful results, but it is not a widely used treatment option because of the limited experience with the technique and the lack of long-term results. Angioplasty and stenting are also described, with varied results.","title":"A rare cause of deep vein thrombosis: inferior vena cava agenesis Agenesia da veia cava inferior: uma causa rara de trombose venosa profunda"}
{"_id":"e52d9cf7-662a-e520-cdc9-8c71e6c590ed","text":"This fact suggests that the search for a surgeon with greater skill and knowledge of improved techniques is the main reason why patients seek other professionals when they need a surgical revision.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"e533943d-ea30-6a11-00a7-d63289d09a65","text":"Suprastructure maxillectomies result in defects that do not involve the palate. Suprastructure defects that do not violate the bony orbit do not necessarily need reconstruction. An exception is when facial soft tissues are included in the resection and soft tissue cheek reconstruction is needed. Another exception may be when intracranial contents at the skull base have been exposed. In the latter case, a bulky soft tissue free flap that obliterates the maxillary sinus is recommended to isolate the intracranial cavity from the nasal cavity by creating a watertight seal against the dura or brain, thereby preventing cerebrospinal fluid leaks and meningitis, although small defects can sometimes be sealed with local or pedicled flaps, such as the temporoparietal fascia flap.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"e534d150-1b84-1073-02ef-fc8982774297","text":"During free tissue transfer for breast reconstruction, the internal mammary vessels are often used as recipient vessels for the flap. Pneumothorax is more of a risk given the close proximity to the pleura, prompting a greater awareness of the potential diagnosis. However, if a spontaneous pneumothorax were to occur, then flap congestion could potentially be seen due to increased intrathoracic pressure impeding venous return in a similar manner to that already described.","title":"Diagnosing Intraoperative Pneumothorax in Patients Undergoing Autologous Breast Reconstruction: A Useful Clinical Sign"}
{"_id":"e536030e-43d6-abaf-ef04-e97665759459","text":"In the presented case involving GCT excision, success was measured on functionality of the joint, viability of the graft, and the absence of tumor recurrence and pain. The techniques and methods described provide a roadmap for successful excision of a GCT in the distal radius with a PRC and arthroplasty using a vascularized fibula free flap autograft. Based on the outcome of the case, the use of a vascularized fibula free flap following PRC can be utilized in the management of a GCT with a similar presentation.","title":"Wrist Joint Reconstruction With a Vascularized Fibula Free Flap Following Giant Cell Tumor Excision in the Distal Radius"}
{"_id":"e5399586-ea38-4134-594e-f7da10c03e1a","text":"The state, being reformed under Henry VII with a civil service shaped by Cardinal Wolsey and his successor Sir Thomas More, was prepared to take a firm hand in the control of the administration of guild behaviour, as seen in the Act of 1503 For making of statutes by bodies incorporate.7 It is as a direct consequence of the requirements of this Act that under Henry VIII the Ordinances for the Barber-Surgeons were prepared in 1530.","title":"The ethics of dental practice in London in the sixteenth century. 2. Sir Thomas More's 'Ordinances' for the Barber-Surgeons, 1530"}
{"_id":"e53d6bcd-f5b8-1064-c2e3-54f764e73125","text":"The scope of this case report is to raise awareness of the following aspects: Hoffman disease has an extremely low occurrence rate, a difficult differential diagnosis and no standard therapeutical strategy. It also highlights the effectiveness of scalpectomy and free latissimus dorsi flap covered by meshed split-thickness skin graft in treating a very advanced stage of the disease together with providing a natural contouring of the scalp. Ultimately, it discusses the other treatment alternatives.","title":"Surgical management of dissecting cellulitis of the scalp using free latissimus dorsi flap and meshed split–thickness skin graft A case report"}
{"_id":"e53dba5f-136a-ec55-1b89-41ee23cc0373","text":"The study was approved by the Research Ethics Board of the Privolzhsky Research Medical University. Informed consent was obtained from all participants and\/or their legal guardians enrolled in the study. All methods were performed in accordance with the relevant guidelines and regulations.","title":"In vivo multimodal optical imaging of dermoscopic equivocal melanocytic skin lesions"}
{"_id":"e54720a7-7898-d0e9-cea9-98421cabc2d5","text":"The aim of this study was to evaluate the attitude of dermatologists towards the different therapeutic options available for NMSC. For this purpose, clinicians were asked to indicate which treatments they prescribe in their daily routine clinical practice.","title":"Attitudes among dermatologists regarding non-melanoma skin cancer treatment options"}
{"_id":"e54ef695-3c5b-b4e6-7fd2-4b8830c5a888","text":"The primary objective of this trial is to quantify and draw inferences on differences in the rate of deep infection of the lower limb in the 30 days after major trauma between participants receiving standard dressings and those receiving NPWT. Secondary objectives include assessing differences between the same groups in disability, wound healing, quality of life, neuropathic pain, and the number and nature of complications experienced at 3 and 6 months post-randomisation.","title":"Wound Healing In Surgery for Trauma (WHIST): statistical analysis plan for a randomised controlled trial comparing standard wound management with negative pressure wound therapy"}
{"_id":"e55069a3-437f-0af4-966e-8e0a1fe0a6cc","text":"The keystone flap has been a major step forward in the treatment of lower extremity defects during the preceding decade. Since the keystone flap has a higher success rate and lower complexity than free flaps or pedicled propeller flaps, if applicable, the keystone flap procedure should be the preferred approach for lower extremity reconstruction.","title":"A systematic review of the keystone design perforator island flap in lower extremity defects"}
{"_id":"e556dbd6-8a4d-4342-9352-4047add871e0","text":"A small amount of excess tissue that matches the nose in color and texture lies near the melolabial fold, and its underlying fat has a strong tendency to contract. The melolabial fold can supply enough skin to resurface the ala, and the contractility of the nasolabial flap can be used to simulate the round, expected bulge of the normal ala [20]. The donor site scar from the melolabial transposition flap is relatively easy to camouflage in the natural expression lines of the face.","title":"Reconstruction of Nasal Skin Cancer Defects with Local Flaps"}
{"_id":"e55f074d-fdf2-8b10-617c-6901ee231912","text":"GAN can provide an effective graft source for reconstruction of the facial nerve and yields good functional results after radical parotidectomy.","title":"Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy"}
{"_id":"e561871f-2b55-40b4-1049-58f12ce60684","text":"The absence of effect of fellowship training on hip fracture surgeon-reported complications when compared to procedures such as joint arthroplasty may be attributable to the common practice of hip fracture call regardless of surgical subspecialty, which likely is a fundamental skill acquired during orthopaedic surgery residency training. While elective procedures like THA may largely be concentrated to adult reconstruction fellowship-trained surgeons in early practice, general orthopaedic or hip fracture call is broadly dispersed thus enabling surgeons from any subspecialty to gain considerable caseloads. This would not be true in reverse, thus muddling conclusions about value of fellowship training for hip fracture complications. Additionally, this current study uses data from ABOS candidates who are in their initial stages of their career and this finding may differ after years of being an attending physician.","title":"The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database"}
{"_id":"e568c117-b806-bf86-47df-b1b3f5c7b03e","text":"We therefore support the use of posterior fixation for treatment of this disease process, particularly in older patients. Further investigations of the pathophysiology of this disease process are warranted to help create a more unified treatment approach. Whichever surgical intervention is decided, early recognition and treatment of spinal cord compression can help improve neurologic outcomes.","title":"Retro-Odontoid Pseudotumor with Cervical Medullary Compression: A Case Report"}
{"_id":"e56b381d-5352-df44-e4af-e525903a58eb","text":"In sum, we determined that patients with T1DM are at a high risk of VTE, especially between the ages of 29 and 40 years. We suggest that clinicians should be aware that T1DM is a potential risk factor for VTE. Future studies investigating the relationship of T1DM and VTE in other ethnic groups and exploring the underlying pathophysiology are advised to confirm our findings.","title":"Type 1 diabetes is associated with an increased risk of venous thromboembolism: A retrospective population-based cohort study"}
{"_id":"e56bcd2c-762a-3bf5-edab-8e5ba64580b7","text":"The present results also showed a rapid increase in the characterization of resorptions for the apical third, which is a region that typically imposes the greatest difficulties to the diagnosis of resorptions due to the peculiar features as narrowing of the root and reduced area. The axial plane was the least precise in affording resorption identification, followed by the coronal and the sagittal planes. As demonstrate elsewhere , clinicians must know the best protocol to resort for an accurate diagnosis when requesting CT scans.","title":"Comparison between two tomographic sections in the diagnosis of external root resorption"}
{"_id":"e5774e67-9dae-7f98-43e2-232a027afec8","text":"The cases described in this study show that newborns diagnosed with ankyloglossia in the immediate postpartum period can overcome the initial breastfeeding difficulties and attain normal development. This finding suggest that nonsurgical management could improve breastfeeding outcomes and reduce the number of unnecessary procedures.","title":"Does neonatal ankyloglossia interfere in the growth of infants during the first 6 months of life? A case series nested in a cohort study"}
{"_id":"e57cd44a-97b1-f4f2-5ce2-e25c41fb50cd","text":"FNAB is a valuable tool in clinical medical practice in stratifying palpable soft tissue lesions into benign and malignant categories and it can be used in the initial evaluation of all palpable soft tissue lesions especially in primary soft tissue neoplasms and clinically suspected metastatic carcinomas.","title":"Fine needle Aspiration Biopsy (FNAB) in the initial evaluation and diagnosis of palpable soft tissue lesions and with histologic correlation"}
{"_id":"e57da24a-0ce5-01bf-b5cd-229da513ef80","text":"Herein, the fact that 3D planning predicted a greater number of cryoprobes than 2D planning and that there was a higher success rate in the 3D cohort suggests that 3D planning allows for a more comprehensive assessment of the coverage area needed for successful tumor ablation. Future studies with more patients will assess how this method of procedure simulation compares to traditional 2D planning with mpMRI and how it impacts long-term treatment efficacy. In addition, the impact of providing real time guidance immediately on the same screen that provides ultrasound guidance will be assessed and a multi-center study will be performed to determine the actual impact of 3D planning on cPGA.","title":"MRI guided procedure planning and 3D simulation for partial gland cryoablation of the prostate: a pilot study"}
{"_id":"e58a572c-b5f3-40ba-21bf-9ccd8e865b68","text":"A retrospective review was performed on charts of 128 consecutive cases that underwent open or closed septorhinoplasty using injectable cartilage shaving, from May 2008 to January 2014. The study complied with declaration of Helsinki and was approved by the Ethics Committee of the Iran University of Medical Sciences. All patients were provided with written informed consent.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"e58a95bf-0203-cd06-a1c8-a95ca90a8479","text":"Our treatment of the FN palsy relied on tapered CS therapy reinforced with facial rehabilitation for acute FN palsy. The recently published study by Lee et al. [12] about FN injury after blunt craniofacial injury showed steroid therapy onset within 24 hours, and steroid therapeutic duration for longer than 14 days possessed a significantly better recovery rate. There was no conclusion about which doses of CS therapy should be administered and how should the doses be tapered. Our treatment was initialized in the fires 24 hours and lasted for 14 days which just reached the recommended cutoff.","title":"Unusual Mechanism of Facial Nerve Palsy Caused by Penetrating Neck Trauma"}
{"_id":"e58c0463-1e69-5316-1061-41ebe4a9e30b","text":"Destruction of the adjacent bone may be the result of erosion due to repeated microtrauma to the bone caused by the large size of the mass and its periarticular location.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"e58fdd96-5b30-2a08-c791-9339e4352e06","text":"This study was performed on 102 patients with breast cancer who visited Imam Khomeini Hospital in Sari, Iran, from 2016 to 2018. The study was approved by and registered in the Cancer Research Center of Mazandaran University of Medical Sciences. Patients with a pathology report of invasive breast cancer and tumor size of less than 5 cm whose axillary lymph nodes seemed non-pathologic in clinical examination and ultrasound were selected for sentinel lymph node biopsy. Patients’ demographic information and their pathologic reports before and after breast surgery as well as their axillary pathology reports were collected and analyzed.","title":"Sentinel Node Biopsy in Early Breast Cancer Patients with Palpable Axillary Node"}
{"_id":"e5923691-bcee-d1b7-8e80-0c8c438a25fa","text":"The tumor size is subdivided and emphasized in the new 8th AJCC STS staging system. Grade 2 or 3 sarcomas larger than 5 cm are classified as stage III and those larger than 10 cm are subclassified as stage IIIB. Likewise, in the present study, tumors larger than 10 cm were associated with poor long-term survival. Contrary to the new AJCC staging system in which grade 2 or 3 does not alter the tumor stage, grade 3 was significantly associated with poor survival in this study.","title":"Actual long-term survival after resection of stage III soft tissue sarcoma"}
{"_id":"e593f2c7-dd33-619a-4aba-203017cbd692","text":"The IR was defined as the number of patients with a successfully identified SLN divided by the total number of patients in whom an SLNB was attempted. The FNR was defined as the proportion of patients with a negative SLNB but at least one positive non-sentinel lymph node, divided by all patients with an identified SLNB and at least one positive lymph node after NAST. Accuracy was defined as the proportion of patients with a true-positive or true-negative SLNB out of all patients with successfully identified SLNs.","title":"Swedish prospective multicenter trial evaluating sentinel lymph node biopsy after neoadjuvant systemic therapy in clinically node-positive breast cancer"}
{"_id":"e59792db-bf41-e7bc-4460-a9befab80223","text":"The ABOS Research Committee approved the current study and the study was classified as exempt by our institutional review board.","title":"The case for decreased surgeon-reported complications due to surgical volume and fellowship status in the treatment of geriatric hip fracture: An analysis of the ABOS database"}
{"_id":"e59c90d2-37a3-c307-b1aa-300e6d482918","text":"One of the most important factors in choosing an appropriate flap for a particular defect is the donor site outcome.","title":"Lateral Arm Flap: Its Usage as Pedicle and Free Flap"}
{"_id":"e5a5077b-9a4f-1b88-3f00-4a6dee511ad8","text":"In this study, cutaneous adverse events of new immunotherapies and targeted therapies are presented in a retrospective cohort of 146 patients with stage III\/IV melanoma who received treatment either in adjuvant or metastatic setting. The aim was to review the incidence of skin toxicity in the two cohort of therapy (immunotherapy and target therapy), to categorize from a dermatological point of view the different manifestations of cutaneous adverse events and to assess of potential association of skin toxicities. Of course, the sample size of our sample may restrict the generalization of our findings.","title":"Cutaneous side effects and types of dermatological reactions in metastatic melanoma patients treated by immunotherapies or targeted therapies: A retrospective single center study"}
{"_id":"e5ba7516-cc0d-2505-4ade-3b084971adc3","text":"Limitations of this study include the relatively small number of patients included and the retrospective nature of the investigation. The next logical step in validating the utility of barbed sutures in autologous breast reconstruction would be a randomized study directly comparing standard and barbed suture closures. Longer follow-up and an assessment of patient satisfaction would also be beneficial.","title":"Early Experience With Barbed Sutures for Abdominal Closure in Deep Inferior Epigastric Perforator Flap Breast Reconstruction"}
{"_id":"e5ccd4a0-dc1f-3499-6b72-a8c237d96ed5","text":"Concerning medical schooling, all studies we have reviewed discussed resident education and improved understanding of the intricate structure and potential exercise on that structure before the real surgical procedure. This may be a useful tool in the upcoming time that requires questioning and researching, addressing the rare cases, complicated cases, and stimulate training on these 3D models prior to the surgery. Although surgeons have started using implants, a further study is needed before it develops into a common procedure or practice. A detailed follow-up is required to assess these cases and complications that might rise on the long term. Although it seems as a promising field in the upcoming years, ethical issues should be paid attention to while running the trials to guarantee no harm is caused to the patients.1","title":"Three-Dimensional Printing Surgical Applications AlAli et al"}
{"_id":"e5d3c180-abc4-bea9-ae60-3d3d134feed8","text":"The reconstruction operation took approximately two hours. The deepithelized skin and both muscle flaps showed bright red bleeding after the suture, indicating a healthy state. Primary closure of the skin envelope was possible owing to the previous free flap. The wound healing was uneventful and was well maintained two months after surgery.","title":"Reconstruction of complex knee wounds with a distally based gracilis flap and gastrocnemius myocutaneous flap: A case report"}
{"_id":"e5daf38d-5d94-d8df-0986-9a90a913e088","text":"We would like to emphasize again that it is very important when creating the flaps to perform a very careful subcutaneous dissection to preserve the integrity of the vascular network. Indeed, we prefer to perform the mastectomy using a blunt scissors to avoid thermal injury to the skin flap caused by electrical devices. We have found that careful dissection aids in maintaining the integrity of the dermal and subcutaneous vessels, thereby increasing the survival rate of dermal flaps.","title":"Skin-reducing mastectomy and immediate breast reconstruction in patients with macromastia"}
{"_id":"e5e078eb-39d3-64bd-2e07-c07a3a3d7562","text":"In addition, this study was the first in this field to create a most accurate deep learning prediction model, which was analyzed and validated by using imbalanced data, corrected through sMOTE oversampling, and utilizing three representative packages among neural network machine learning algorithms. Due to the nature of machine learning prediction models, the results may vary depending on the quality and quantity of the data, but by defining the method and package settings used to obtain the most efficient and high AUC when using a prediction model with limited and imbalanced data like in the reconstructive surgical field, these models can be used and replicated effectively for risk assessment of patient outcomes in free flap operation as well as other reconstructive surgical procedures.","title":"Validating machine learning approaches for prediction of donor related complication in microsurgical breast reconstruction: a retrospective cohort study"}
{"_id":"e5e82738-f83c-e309-1c2e-fae93ec6fb0d","text":"After a period of 10 days, the wounds were ready for skin grafting. NPWT was applied as the dressing, this time with a layer of Telfa between the skin graft and the gauze to prevent accidental removal of the skin graft at dressing changes.","title":"Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective"}
{"_id":"e5ee803a-1c0e-a81f-d514-b65d06976c95","text":"Parotidectomy is uncommon in the pediatric age group. Children with a solid parotid tumor have a higher risk of parotid malignancy when compared to adults. A parotid mass presenting in the second decade of life is more likely to be malignant than benign.","title":"Indications and Outcomes of Parotidectomy in Saudi Children: Experience From Two Tertiary Centers"}
{"_id":"e60bd497-48cb-8306-c32c-8c4543058b7a","text":"Full-thickness skin graft can also be used to reconstruct the penile urethra in one or staged procedures with satisfactory results. Tissue expansion can be also practiced to augment the amount of skin harvest at the donor site with the advantage of primary closure preserved. Full-thickness skin graft consists of the epidermis and the entire thickness of the dermis containing almost all of the skin appendages which will not only serve as a cover for raw areas, but it will also preserve multitude of the specialized skin functions.","title":"Extended Use of Full-Thickness Skin Grafts, Employing Variable Donor Sites"}
{"_id":"e613fc17-d47b-d6bb-e657-bdf57c71231b","text":"With second-look ultrasound to prove the histology of additional foci found on MRI, this study provides supporting evidence for the targeted use of preoperative breast MRI in patients with ILC to optimise definitive surgical management by significantly correlating the size with final histology results and demonstrating low false positive rates.","title":"British Society of Breast Radiology Bristol, UK. 3-5 November 2019"}
{"_id":"e61a1e48-10d4-15ac-4b8c-2900dbfaff10","text":"The limitation of this study is the lack of control group of operation alone without rehabilitation, although postoperative rehabilitation is preferable.","title":"Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol"}
{"_id":"e6343df5-e03e-998d-eb09-d4b12b9a085b","text":"Surgery excision is considered the gold standard in BCC therapy. Surgical techniques like Mohs micrographic surgery and frozen section can be used to minimize postoperative recurrence. Postoperative recurrence of primary BCC has been reported at rates of 1.7% in the frozen section group and 1.6% in a Mohs micrographic surgery group. Although both of these techniques result in similar recurrence rates, Mohs micrographic surgery is more difficult and costly to perform.16 The aim of the present study was to report the surgical outcomes of patients who presented to our clinic with recurrent periocular BCC after primary excision and underwent frozen section controlled excision to prevent further recurrence.","title":"The Importance of Frozen Section-Controlled Excision in Recurrent Basal Cell Carcinoma of the Eyelids"}
{"_id":"e64259dc-3ff1-efb5-614a-f18b91937dbc","text":"The present study was conducted on selected patients presenting an enlarged cervical lymphadenopathy. This study was limited to the selected cases that had undergone a FNNAC from the cervical lymphadenopathy and followed by a subsequent excisional biopsy of the same lymphadenopathy or a biopsy of the suspected primary site for a definitive histopathological diagnosis. Patients with missing FNNAC reports or those cases who could not undergo biopsy were excluded.","title":"Fine needle non-aspiration cytology for the diagnosis of cervical lymph node tuberculosis: a single center experience Punção não aspirativa com agulha fina para o diagnóstico de tuberculose linfonodal cervical: experiência de centro único"}
{"_id":"e642a48f-b5e9-f9ba-c63d-557c0277a291","text":"Trends in breast cancer care continue to progress towards less invasive surgical treatment. Recent data from the ACOSOG Z11 trial suggests that axillary dissection may not be of benefit in node positive patients who receive maximal systemic therapy and radiation. As systemic therapy improves, and individualized and targeted approaches evolve, it is unclear what role surgery will play in achieving local control. Primary ablative therapies may make questions of margins obsolete, in that if a tumor is ablated and resolves on imaging, then surgical excision may not be necessary.","title":"Optimizing Surgical Margins in Breast Conservation"}
{"_id":"e642ac59-5b98-6cee-b571-d0d3e98659aa","text":"Randomized trials indicate that adjuvant radiotherapy plus tamoxifen decrease the five-year risk of recurrence among ductal carcinoma in situ patients treated with breast-conserving surgery from about 20% to 8%. The aims of this study were to examine the use and impact of these therapies on risk of recurrence among ductal carcinoma in situ patients diagnosed and treated in the community setting.","title":"Declining recurrence among ductal carcinoma in situ patients treated with breast-conserving surgery in the community setting"}
{"_id":"e643994e-afdb-08a9-3f3f-342683f35565","text":"All the patients reported a reaction near the injection site after the complete resolution of the other local and systemic symptoms associated with vaccination.","title":"Erythema Migrans-like COVID Vaccine Arm: A Literature Review"}
{"_id":"e64599b4-a282-6406-d7ed-bcbdf3b058b7","text":"Gingival tissues are exposed to constant irritation of bacterial plaque and biofilm. Reactive lesions generally arise from the periodontal ligament and connective tissue; therefore, the gingiva is the most common reactive lesions site. Also, gingival tissues in the anterior mandible and maxilla are the most affected areas that might cause esthetic problems. Complete removal of the lesion and the elimination of irritating factors and their etiology are necessary for reducing the recurrence rate.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"e6463906-ccfa-fad7-7ccc-75fe9f9d58a8","text":"Similar opinion is presented by Naique,24 who evaluated the patients taken directly to specialist trauma centers and local hospitals and found that the majority of union complications, failure in the use of pedicle muscle flaps, and infectious complications occurred in patients treated in local hospitals.","title":"Management of open fractures of the tibial shaft in multiple trauma"}
{"_id":"e651888f-dcdb-6629-27ef-be3e5e7fef5d","text":"The patient agreed to the study and signed the informed written consent form. The study was approved by the Research Ethics Committee of the First Affiliated Hospital, University of South China.","title":"Application of vascularized fibular graft for reconstruction and stabilization of multilevel cervical tuberculosis A case report"}
{"_id":"e659951e-d5a5-2996-53f2-6807a67e4fc3","text":"To assess the accuracy of coronal and sagittal CT sections to detect cavities simulating root resorption.","title":"Comparison between two tomographic sections in the diagnosis of external root resorption"}
{"_id":"e65a19bc-5ba3-d298-c915-87b9be96e007","text":"In small cases of tissue loss, aggressive and focused wound care protocols can expedite debridement and wound closure without the need for revisional surgery. Larger wounds require debridement for removal of the non-viable soft tissue, wound care and either local tissue advancement or rearrangement for satisfactory closure. When the area of necrosis is very large, such as in our patient, this may initially require operative debridement and placement of a skin graft in anticipation of future procedures. Skin grafts are often useful in patients with a history of poor wound healing.","title":"Anatomic reconstruction for major tissue loss following abdominoplasty: A case report"}
{"_id":"e65b0437-63dc-5f50-ebb3-d7a8a120036c","text":"This study is the first to observe the application effect of CNP combined with MB and ICG combined with MB in SLNB of breast cancer. No significant difference was observed between them in SLN identification and lymphatic vessel display. In SLNB operation, ignoring lymphatic vessels and directly looking for stained lymph nodes have the same effect as standard operation in SLN identification. However, reducing operation steps can reduce operation time and theoretically reduce postoperative complications.","title":"Comparative observation of common tracers in sentinel lymph node biopsy of breast cancer and a study on simplifying its surgical procedure"}
{"_id":"e6613674-14aa-d1e3-07cb-3d5b1e82786e","text":"Autologous bone grafts are the current gold standard of care. In the case of mandibular reconstruction, nonvascularized grafts are traditionally harvested from the rib or iliac crest, whereas vascularized free flaps are primarily harvested from the fibula. Due to the necessity of the vasculature for graft survival, nonvascularized bone grafts are only used to treat small defects where a robust vascularized tissue bed is already present. A flap is required in cases of soft tissue injury. Although autologous bone grafts have had significant clinical success, they require a second surgical site and are accompanied by notable costs including donor site morbidity and limited supply.11, 18 Bone allografts have been developed as an alternative graft material and are readily available; however, they have significantly reduced bioactivity and a high rate of clinical failure due to poor osteointegration and osteonecrosis of the graft. As an avascular tissue, cartilage is not only capable of surviving without a vascular supply but is also responsible for recruiting blood vessel invasion for the newly formed bone during endochondral ossification.2, 3 Thus, cartilage is not only better suited than bone to survive within poorly vascularized areas of tissue injury but its use also parallels the natural healing process of endochondral repair.","title":"Chondrocyte‐to‐osteoblast transformation in mandibular fracture repair"}
{"_id":"e668e8f9-846d-bfcc-604c-66407b8c53d0","text":"Pedicled flaps are limited in the rotation by the length of the nourishing artery and concomitant vein, if the defect lies too distally from the blood supply another solution must be identified.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"e66e5b73-f3d8-06bc-5347-270bcaf3ea72","text":"Fourthly, not only systemic therapy but also adjuvant radiotherapy can be regarded as a treatment modality for any remaining axillary lymph node metastases. Radiotherapy to the breast as part of BCT includes the lowest portion of the axilla. In several studies it has been objectified that the clip marking the SLN fell within the standard tangential fields of the whole breast radiotherapy in 78–94 % of the patients.57,58 Veronesi et al.59 described that radiotherapy to the breast is one of the possible explanations for the lower than expected numbers of axillary metastases in the no axillary radiotherapy arm of their randomized trial to assess the role of axillary radiotherapy. A recently published systematic review demonstrated that patients with a node negative SLN who underwent radiotherapy had a significantly lower rate of axillary recurrences as compared to patients who had not been not treated with postoperative radiotherapy of the breast.60","title":"Axillary Recurrence After a Tumor-Positive Sentinel Lymph Node Biopsy Without Axillary Treatment: A Review of the Literature"}
{"_id":"e67199ff-8855-64b7-2cdb-b1d83b4f2b59","text":"Prasad et al recommended that PG and POF might be different stages of the same pathology. Sridhar et al also reported a case of PG in the mandibular anterior segment, which was surgically excised but recurred after a year as a POF in the same segment. The authors concluded that regular follow-up is very important to avoid recurrence. Singhal et al reported the recurrence of a POF as a PG within one week. This case emphasizes complete excision to prevent a recurrence.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"e6727a83-1bb3-3735-444f-c1645e792d24","text":"The IGH programme exposed the fellows to other cultures, challenges and health professionals that the interviewees did not believe they would have experienced in their roles within the NHS. It was noted by the interviewees that were not working face-to-face with patients in the NHS that there was great value in working on projects relating to the practical delivery of healthcare. This allowed them to develop an understanding and appreciation of the challenges and demands from a different perspective:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"e6780d51-b626-216a-997c-c051af0843da","text":"Bar graph comparing frequency of codon mutations in both the published cases of desmoid tumors and the reference population of FAP","title":"Desmoid tumors complicating Familial Adenomatous Polyposis: a meta-analysis mutation spectrum of affected individuals"}
{"_id":"e681935f-3bd1-ecf5-1a5a-54cc56c1ebd9","text":"I have now gravitated towards doing medial pedicle technique with a vertical resection or Inverted T resection for majority of the cases that I do and use the inferior pedicle technique with Inverted T resection for the larger breasts.","title":"Reduction mammoplasty"}
{"_id":"e6948130-eb0e-c64e-19b8-56ad6a3c610d","text":"It is very well known that cancer is one of the leading cause of death worldwide. The earlier cancer can be detected, the better the chance of a cure. On the other hand, the success of resection surgery, the oldest cancer treatment, highly depends on the ability to determine as accurately as possible the tumor margins to infer the lowest harm to the organ where the tumor originated but without leaving residual tumor. Patients undergoing repeat surgical procedures have significantly lower survival rates. Commonly, boundaries of the surgical cavity have been inspected visually by a surgeon using a surgical microscope, but small projections and filaments of the tumor may escape detection. Further, removed tissue may be sectioned and inspected by a pathologist to ensure that a rim of normal tissue has been removed along with the diseased tissue. This may be done intraoperatively using frozen sections and followed up with a microscopic evaluation of stained sections for tumor-specific features—but stained sections are typically not available until days after the surgery.","title":"Sensing Using Light: A Key Area of Sensors"}
{"_id":"e695056e-4afe-22d3-c434-c0c4fc0c49db","text":"Septal and costal cartilages were considered more appropriate in comparison to conchal cartilage which was more pliable and fragile. The material was then soaked in solution of gentamycine in sterile saline and introduced to one or more 1 ml Luer-lock syringes. The effort to find the best location for injection was done using visual and tactile evaluation of the surface and if performed as a part of open rhinoplasty, it was postponed until the skin flap was returned back and sutured at the end of the operation.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"e6955118-04e0-5c02-ed40-e074ba2f4e52","text":"The use of zygomatic implants to supplement the stability and retention of the maxillary obturator in this case has improved the function of the prosthesis and provided for a very high-quality rehabilitation for the patient reported with no evidence of disruption to facial growth in the 22 months following surgery.","title":"A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient"}
{"_id":"e6957ae4-5ad3-d893-7b55-00a5e39116bf","text":"Hyaluronic acid plays a principal role in the preservation of hydration and elasticity of the skin. Sericin gel also has moisturizing effect when applied on the skin. This may be attributed to the hydration of epidermal cell and an increase in hydroxyproline level. This aids in skin care and anti-aging effect of sericin.","title":"Anti-aging and Sunscreens: Paradigm Shift in Cosmetics"}
{"_id":"e69d9dfa-4e8a-8fe2-1248-8e468e303f47","text":"The aims of the present study are to describe the workflow and methodology for the creation of customized molds and planning via CT, and to describe the efficacy and toxicity outcomes at 10 years from the implementation of the treatment technique.","title":"High-dose-rate plesiotherapy with customized molds in non-melanoma skin cancer: efficacy and safety at 10 years—single institution experience"}
{"_id":"e69ffe88-a4d6-631d-ad34-91a603e1036c","text":"Collision tumors are neoplasms composed of two or more distinct cellular lineages coexisting at the same anatomic site. Incomplete biopsy, partial pathological slide examination or failure to include this diagnosis into the clinical differential may complicate and delay appropriate therapy. Although collision tumors are well documented, basal cell carcinoma (BCC) occurring with sebaceous carcinoma (SC) has only been reported in a single case report. The aim of the authors is to present a case of collision BCC and SC to highlight a rare clinicopathological case. We also present this case to advise caution to detect mimickers of BCC that warrant greater clinical workup and use this case to emphasize the importance of Mohs micrographic surgery for the treatment of SC.","title":"Collision of Basal Cell Carcinoma and Sebaceous Carcinoma Extirpated With Mohs Micrographic Surgery"}
{"_id":"e6a35c1c-94be-e683-d950-0e87b793cacf","text":"We previously reported the histopathology after an EIM in which the intima of the venule was compressed and injured adjacent to the lacerated vein.4 The venule wall is composed of three layers like the arteriole wall, but the middle layer of the venule is thinner because of fewer elastic fibers, unlike the arterioles, while the coronary veins on the surface of the epicardium are surrounded by rich fat. Namely, the venule might be more porous and easily lacerated but could be protected against continuous bleeding by the fat around it. Several patients experienced manifest leakage of the contrast medium into the pericardial space with capillary rupture but the majority of the pericardial effusions resolved by the next day, suggesting that the epicardial fat around the coronary vein could have provided hemostasis and might have absorbed the leaked contrast medium and bleeding if the damage to the venule leading to the leakage during the initial injection was trivial. On the contrary, in physically small lean women with a poor compliant heart as we experienced, their venules and the epicardial fat around them might be too fragile to restore their serious conditions such as requiring pericardial centesis regardless of the features of the VOM.","title":"Potential complications in patients undergoing an ethanol injection into the vein of Marshall"}
{"_id":"e6a8d7a7-b5f0-a51a-1d33-a299991819d4","text":"Lack of guidelines explains the low adherence to appropriate surgical antibiotic prophylaxis in Palestine, with high rate of broad spectrum antibiotic use, long duration and inappropriate time of first dose .We recommend adopting guidelines for prophylaxis and training all health care providers accordingly.","title":"Adherence to guidelines of antibiotic prophylactic use in surgery: a prospective cohort study in North West Bank, Palestine"}
{"_id":"e6a94e8e-bcf4-1296-ac04-05523f0efa79","text":"We reviewed the charts of 35 patients who underwent suture facelift surgery and at least 2 years of follow up after the operation. In this series, the procedure was performed either as primary surgery or as an adjunct to other oculoplastic procedures such as upper and lower blepharoplasty, endoscopic brow lift and neck liposuction.","title":"Suture midface suspension"}
{"_id":"e6b8d103-d0d5-d735-d716-e261536280af","text":"Thanks to the posterior half of the tibia left during debridement, another great advantage of this technique in comparison to the conventional technique may be the ability of the patients to bear weight and to be ambulatory better and earlier during treatment, and thus, some related complications such as refracture of the regenerated bone, angulation at the docking site, and deformity, which are complications usually resulted from excessive functional exercise or overload of weight bearing, may be avoided. Also, discrepancy is unlikely to occur with our method because the length of tibia will remain the same during the whole course of treatment.","title":"L-shaped corticotomy with bone flap sliding in the management of chronic tibial osteomyelitis: surgical technique and clinical results"}
{"_id":"e6baf3d3-329c-d7b7-781f-84834df907dc","text":"We hope that the findings of this initial evaluation of the TABBY will be reproducible in other tongue-tie assessment settings, and that the new picture tool will be useful in research studies. Our recommendations for the use of TABBY are built on experience with the BTAT and supported by Dixon et al. in New Zealand [7] who have integrated the BTAT into their clinical care pathway for assessing breastfeeding problems and shown that this has led to more appropriate referrals for frenotomy being made. We plan to evaluate the use of the TABBY tool in other languages and in different settings.","title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)"}
{"_id":"e6be1103-5678-a765-72ac-3a00c242d427","text":"Adjuvant treatment involved chemotherapy with CMF for premenopausal patients and Tamoxifen for postmenopausal patients, according to the protocol adopted at that time.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"e6c0659f-9253-1fb6-3cd9-43e4abcc086a","text":"Our results provide information on shared environmental and genetic risk factors for first and later cancers and may help to identify individuals at high risk for subsequent cancers, which will be important as skin cancer incidence continues to rise.","title":"New malignancies after squamous cell carcinoma and melanomas: a population-based study from Norway"}
{"_id":"e6c2d328-2f0e-9b13-e6a4-aab7b7c67be0","text":"The free flap can be effectively and safely salvaged, even in delayed salvage cases more than 24 hours after primary surgery, using high-dose intra-arterial urokinase infusion within a short period of time without systemic circulation resulting in the avoidance of systemic hemorrhagic complications and results in successful salvage and total flap survival.","title":"Safe and effective thrombolysis in free flap salvage: Intra-arterial urokinase infusion"}
{"_id":"e6ccc75b-c3b7-5561-1e0b-1c6c59f7b880","text":"Patients were instructed to apply the cream to the pigmented area and to a minimum 1 cm margin around the pigmented area once a day, five days per week for a minimum of 6 weeks. Patients were told to expect a brisk inflammatory reaction to occur at the treated sites and to continue imiquimod despite this. At the end of the 6-week period they were reviewed.","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"e6d12dee-7d69-0cec-f9c5-9749df866c31","text":"Another important point to consider is that the classic TNM staging system does not always account for the therapeutic challenges that may arise in the face due to potentially disfiguring surgical procedures.","title":"ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer"}
{"_id":"e6d65198-5b7d-5540-8b35-12760483a734","text":"In this retrospective cohort study, the archives of the radiation oncology ward were accessed for case finding. We looked for patients with pathologically confirmed thyroid cancer treated by EBRT between 2008 and 2016 in cancer institute, which is affiliated to Tehran University of Medical Sciences. We excluded patients with thyroid pathologies other than carcinoma. Patients who did not come back or answer their phones for follow up after completion of radiation therapy were excluded as well. The design of our study was reviewed and approved by the institutional review board and ethics committee. Written informed consent is obtained routinely from all admitted patients allowing use of their medical information for research purposes.","title":"The role of external beam radiation therapy in the management of thyroid carcinomas: A retrospective study in Iran Cancer Institute"}
{"_id":"e6de6c4b-f35d-5d37-b70d-3ba2cbad3255","text":"All procedures described herein were performed in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","title":"Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant"}
{"_id":"e6e8e8d5-79ab-ca04-10eb-d116d3cd6cd8","text":"The prevalence of DVT is high in hospitalized patients with direct ARDS caused by bacterial pneumonia and may be associated with adverse outcomes. The current thromboprophylaxis strategies may need to be further optimized.","title":"Deep vein thrombosis in acute respiratory distress syndrome caused by bacterial pneumonia"}
{"_id":"e6f3d3aa-98cb-6aeb-b19b-5095b0e59ef3","text":"With the aid of intraoperative nerve monitoring and surgical magnification, the anatomical continuity of the facial nerve could be preserved, even with rerouting of the facial nerve during surgery for tumors located in both the superficial and deep lobes. Although temporary facial weakness might be caused by excessive manipulation of the facial nerve, rates of permanent facial weakness seemed not to be high due to preservation of the nerve continuity and recovery of the facial nerve conduction.","title":"Incidence of postoperative facial weakness in parotid tumor surgery: a tumor subsite analysis of 794 parotidectomies"}
{"_id":"e6f53f9e-8fa3-ce66-e20b-a51659c6e531","text":"The study populations in the four manuscripts included in this review consisted of dogs with MCT (< 6 cm) of PG I and II. Only one study included 2 PG III tumors and no studies included tumors larger than 6 cm diameter. Increased PG and increased tumor size are both factors that have been previously reported to be associated with more biologically aggressive disease. Large tumors and those with PG III typically have more extensive microscopic disease, which in turn makes them more difficult to completely excise and it is therefore expected they will have higher local recurrence rates [7, 20, 21]. The lack of study populations that included dogs with large tumors or those graded III on the Patnaik grading system prevent any conclusions being made in regards to surgical margins for those populations using the existing data. Thus, the recommendation for surgical margins determined from this systematic review cannot be extrapolated to larger tumors or those that are categorized as PG III. It is possible given the influence of size and histologic grade on completeness of histologic excision and local recurrence rates, and the differences in dog size that a single metric measurement may not be the most appropriate for surgical margin recommendations for MCT removal. Additionally, only one of the four included studies within this systematic review evaluated MCT using the Kiupel grading system, so conclusions cannot be directly made from this review regarding margin recommendations for tumors graded using this system. Further research is required to establish margin recommendations for more diverse patient populations with MCT.","title":"A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs"}
{"_id":"e6fb2f83-d69c-915a-73fa-6eec5af1ca1b","text":"This prospective study was performed in order to present the VTE outcome of a defined protocol for thromboprophylaxis and update the epidemiological data on VTE complications and mortality following a wide range of different orthopaedic procedures in large cohort of consecutive patients. The results represent all symptomatic events of VTE diagnosed within 6 weeks of surgery. Diagnostic investigations where performed only when the clinical suspicion of VTE was high.","title":"Symptomatic venous thromboembolism and mortality in orthopaedic surgery – an observational study of 45 968 consecutive procedures"}
{"_id":"e6ff63de-cc01-8a8b-4173-2acff67f27e8","text":"Here, we characterized the structure and contents of the CVOCA and provided in vitro and in vivo evidence supporting our hypothesis, demonstrating how the CVOCA works to augment marrow stimulation to improve articular cartilage repair. Histological staining revealed that the structure of the native hyaline cartilage is preserved and a thin layer of subchondral bone is present within the CVOCA. The CVOCA retains and secretes ECM proteins and growth factors that are typically found in hyaline cartilage. The CVOCA was non-immunogenic and contained viable chondrocytes that stained positive for aggrecan and type II collagen. Functionally, the CVOCA induces MSC migration and triggers MSC chondrogenesis. The highest level of chondrogenesis in vitro was seen when the MSCs were cultured within the pores of the CVOCA. These results support the hypothesis that the CVOCA can induce chondrogenesis of MSCs recruited from the bone marrow and trapped within the CVOCA pores following marrow stimulation, producing type II collagen and restoring damaged cartilage.","title":"A novel, cryopreserved, viable osteochondral allograft designed to augment marrow stimulation for articular cartilage repair"}
{"_id":"e70155d1-bd00-e114-16c6-de0774540f09","text":"This case report focuses on a 17-year-old polytrauma patient who suffered a septic wound infection after an open reduction and internal fixation (ORIF) and soft tissue reconstruction with a pedicled flap, which led to a substantial bone and soft tissue defect of the lower leg. After thorough antibiotic treatment and after ensuring a non-septic wound, the defect was reconstructed using a contralateral free fibula flap designed as a flow through flap in a double loop manner to accommodate two fibular fragments and an ipsilateral ALT flap. Early weight bearing was initiated 11 days after the free flap transfer under external fixation, with full weight bearing achieved in 36 days with external fixation. After the removal of external fixation, full weight bearing was able to be reinitiated after 13 days, leading to the patient’s return to normal activity 6 months after the bony reconstruction. This case presents an innovative approach to treating a complex defect, with the final decision on using two separate free flaps instead of a single osteofasciocutaneous free flap resulting in a good bony reconstruction and soft tissue coverage, and with the use of external fixation enabling early rehabilitation.","title":"Simultaneous Free Fibula and Anterolateral Thigh Flap in Lower Extremity Reconstruction Following Osteomyelitis in a Trauma Patient: A Case Report"}
{"_id":"e7075192-d68a-8e60-6e91-bcdec9810b0e","text":"The authors of this article have obtained all required consent forms from the patient. Her consent has been given for the images and other clinical information to be reported in this article excluding her name.","title":"Malignant melanoma of parotid glands from a neglected lesion: A case report"}
{"_id":"e70b9994-3735-09a9-67f9-2a944c09b111","text":"By continuous TEE we observed hyperechogenic material consistent with ongoing fluid infusion in the pulmonary artery following intraosseous flush and infusion. Infusion fluid or emboli were not detected in the LVOT, except in the one animal with patent foramen ovale which was excluded.","title":"Intraosseous fluid resuscitation causes systemic fat emboli in a porcine hemorrhagic shock model"}
{"_id":"e70be094-1ef5-f703-0e71-3ed04b354474","text":"Baseline screening was conducted before PDT. The lesions were measured and the exact location of AKs was documented with digital photography. Two weeks after the single session of PDT, patients started to apply imiquimod 5% cream to the treatment area once daily, three days per week. Imiquimod was left on the skin for at least eight hours before being washed off. Treatment continued for four weeks (course 1) followed by a clinical evaluation and decision about the further procedure. Patients without clinically visible AK lesions in the treatment area were considered to be completely clear and their treatment ended. Patients who had not cleared all of their AK lesions in the treatment area at the end of course 1 participated in a second four-week course of treatment. Patients were clinically evaluated at least six months after the end of the treatment—one patient withdrew from further treatment because of a lack of response to the treatment. All patients gave written informed consent to participate in this investigation.","title":"Effective Combination of Photodynamic Therapy and Imiquimod 5% Cream in the Treatment of Actinic Keratoses: Three Cases"}
{"_id":"e712d0b7-a129-975a-90dd-c94b7eff2a3a","text":"In the craniofacial region, the difference in the quantified ARDA of each instance is not obvious, while the quantified ARDA of the eye socket and maxilla bone is slightly greater than that of other instances. The ARDA map of the craniofacial region in Fig. 4 shows that the growth of the average ageing salience is flat, and there are two most obvious ageing regions in the temporal bone. In addition, the two regions that always show ARDA are the frontal bone and the eye socket.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"e714a097-e8fe-55f0-2065-7562ab749a20","text":"This case is being reported to emphasize the role of adjuvant radiation in cases of cutaneous squamous cell carcinomas developing from longstanding, nonhealing, itchy cutaneous lichen planus lesion in the lower limbs. Therefore, such lesions should be subjected to regular histopathological examinations for early detection of skin cancers. Adjuvant radiation is indicated when reexcision of the tumor is not possible, when the residual disease is very close to major neurovascular structures. Adjuvant radiation therapy either with electrons or photons has been shown to reduce the local and distant failure rates in such cases. Posttreatment followup is essential to detect any recurrences or even a second squamous cell carcinoma arising from a different lichen planus lesion.","title":"Squamous Cell Carcinoma Developing in a Cutaneous Lichen Planus Lesion: A Rare Case"}
{"_id":"e716f693-7897-6a77-cbbc-a82b06b36952","text":"Tan et al suggested that suprascapular nerve block was ineffective in the management of postthoracotomy shoulder pain. They postulated that pain from distraction of the shoulder capsule was unlikely to be a major component of shoulder pain, and based on Mackenzie’s convergence theory, the somatic afferent suprascapular nerve to spinal cord is amplified by visceral pain coming from the diaphragm via the phrenic nerve. They concluded that the phrenic nerve is a major target for postthoracotomy shoulder pain. In contrast to our ultrasound-guided nerve block at the supraspinous fossa, Tan et al applied a suprascapular nerve block by using a nerve stimulator in the form of a needle 1 cm above the midpoint of the scapular spine. Similar to this study, Martinez-Barenys et al reported that ipsilateral periphrenic fat pad infiltration was superior to a block of the ipsilateral suprascapular nerve in reducing the incidence and severity of postthoracotomy shoulder pain. However, they determined that a limitation of their study was a possible lack of precision of the block, which resulted from performing the suprascapular nerve block without using electromyography or ultrasound guidance, which are more effective than blind injection into the suprascapular fossa.","title":"Preoperatıve Ultrasound-Guıded Suprascapular Nerve Block for Postthoracotomy Shoulder Paın"}
{"_id":"e717187f-d92d-ecc6-2197-d237ff53cb49","text":"The antibiotic cement spacer and Kirschner wire were removed subsequently after the resolution of active infection. The small wound was managed by local tissue flap or direct suture without tension, while the larger soft tissue defects were resolved by flap transfer or free skin grafting. The standard radiographs were used to plan the placement of the monolateral external fixator.","title":"Treatment of diaphyseal forearm defects caused by infection using Ilizarov segmental bone transport technique"}
{"_id":"e721d0ba-bda7-f0ad-2808-fe01dd85e68d","text":"Effective photodynamic therapy involves the using of photosensitizer, molecular oxygen and visible light. PDT is an alternative clinical protocol against localized malignant tumors and other diseases. Traditional strategies for developing PS platforms are based on molecular design, which requires specific modifications to each PS prior to PDT. Thus, PDT has been combined with immunotherapy as a promising treatment option for metastatic cancer. From this point of view, it is desirable to create a common tumor sensitive PDT platform with minimal loss of ROS due to an endogenous antioxidant, usually glutathione. On the other hand, the most important problem of PDT is activated phototoxicity for selective destruction of cancer cells with a low level of damage outside the target and at the same time predicting its effect.","title":"Development of Novel Tetrapyrrole Structure Photosensitizers for Cancer Photodynamic Therapy"}
{"_id":"e728d51c-cdff-183b-c9fb-74008ba6920d","text":"Taking into account that the pressure to apply is different depending on the type of blood vessel and its location on the body [38,39], different pressures need to be applied to control hemorrhages. The arteries support a pressure of approximately 100 mmHg whereas the veins support a pressure of approximately 15 mmHg. This shows the difference in pressure that is needed to stop a hemorrhage depending on the type of blood vessel. Therefore, the simulator developed allows to distinguish the type of bleeding visually, providing realism to the scenario and facilitating the identification of the type of blood vessel affected that will lead to the decision on how much pressure to apply.","title":"Design and Development of a Hemorrhagic Trauma Simulator for Lower Limbs: A Pilot Study"}
{"_id":"e72af290-ffb7-cbfc-8d10-c44e138ed7c5","text":"This study aimed to clarify the clinical outcomes of AS for patients with DF and identify the leading risk factors of AT after AS at our institution. Additionally, AT methods and their outcomes after AS modality is also investigated.","title":"Clinical results of active surveillance for extra‐abdominal desmoid‐type fibromatosis"}
{"_id":"e730aca1-f2c8-1f19-5237-1ce033af3d21","text":"Firstly, Masters level qualifications in China are primarily research-based and offered on a fulltime basis, except for the small number of MBA and EMBA programs. Managers working in the CHC may find participation in these programs a challenge as it is highly likely they would be required to take leave of absence from their positions due to the fulltime demands of study, and the geographical location of the Universities that offer postgraduate study being different from the workplace. Unlike hospitals, CHCs are not specifically affiliated with universities in China and therefore, lack the opportunity to collaborate with research projects supporting enrolment in a Masters by research degree. This compares with managers at Level III public hospitals affiliated with a medical university where there are opportunities for managers to pursue their study while working full or part time. Future research exploring the perceptions of CHC managers to undertake postgraduate qualifications using qualitative research methods is recommended to develop an understanding of the barriers and facilitators for completion of postgraduate learning in China.","title":"Managers in the publicly funded health services in China - characteristics and responsibilities"}
{"_id":"e7326e8c-b917-6789-160a-091ffd2fcb34","text":"We screened 353 consecutive adult patients with documented symptomatic VTE aged from 22 to 71 years, referred to outpatient clinics between January 2012 and January 2016. The diagnosis of DVT was established on the basis of positive findings on color duplex ultrasound, whereas the diagnosis of PE was performed by positive result of high resolution computed tomography. Patients with a history of portal vein thrombosis or cerebral sinus vein thrombosis confirmed by imaging were also eligible. Following documented VTE episodes, all patients were treated with unfractionated or low molecular weight heparins followed by VKA or rivaroxaban, for at least six months in patients with VTE provoked by transient risk factor, or longer in patients with unprovoked VTE. The decision as to whether VKA or rivaroxaban would be continued was left at the discretion of the treating physician based on the patient preferences. A VTE episode was defined as provoked if the patient had a history of surgery requiring general anesthesia, major trauma, pregnancy or delivery, hospitalization within the prior three months, hormone replacement therapy or oral contraception. A proximal DVT was defined as the presence of thrombus in the popliteal, femoral or iliac veins.","title":"Delayed Thrombin Generation Is Associated with Minor Bleedings in Venous Thromboembolism Patients on Rivaroxaban: Usefulness of Calibrated Automated Thrombography"}
{"_id":"e732b80c-3176-a4a0-09ea-4bea56d510cb","text":"Duration of wound healing in the OW group encompassed the timespan between excision and completed wound healing. In the PC group, time to wound healing was the period until suture removal if no wound healing problems had occurred. If wound healing was not completed at this time point, it was handled in the same way as in the OW group.","title":"Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children"}
{"_id":"e737e42b-4204-c9c4-a646-9360265a0277","text":"Thighplasty is becoming more popular as patients lose large amounts of weight from dieting and after bariatric surgery. This surgery may also be indicated in patients who have developed skin laxity from aging.","title":"Near-circumferential Lower Body Lift: A Review of 40 Outpatient Procedures"}
{"_id":"e7455a49-0af3-ea02-fb23-62d246742420","text":"We report the two cases: the first case is a child with severe ankyloglossia treated by diode laser frenotomy, highlighting the clinical advantages of this modality. The second case is a young woman with ankyloglossia suffering from dental phobia treated by diode laser frenotomy along with light conscious sedation.","title":"Clinical Outcomes of Diode Laser Treatment of Ankyloglossia in Children and Young Adults: A Report of Two Cases"}
{"_id":"e7489887-c33a-f2f2-8996-87caba12e6b4","text":"The strongest predictor of a positive SLNB is its tumor Breslow thickness.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"e74ecef7-d9c9-2a5f-c818-f80144d790bb","text":"Okay so the training exposed me to these topics that I wasn’t aware of before and it showed me the importance of having the leadership aspect, the management aspect in my work and based on the… like what we learned in the diploma was the basics, I decided to go further into that and proceed with an MBA.","title":"Evaluating an e-learning program to strengthen the capacity of humanitarian workers in the MENA region: the Humanitarian Leadership Diploma"}
{"_id":"e75301ae-5380-e2a8-080c-7cb1b6c5781f","text":"A 57-year-old ethnic Danish woman was admitted to the Department of Plastic Surgery at Aarhus University Hospital for delayed reconstruction of her right breast. Two years earlier the patient had had a mastectomy of the right breast due to ductal carcinoma in situ (DCIS) and Morbus Paget of the breast. The patient had undergone adjuvant therapy with chemotherapy and Trastuzumab and received treatment with letrozole at the time of the first operation. At no time had the patient received radiation treatment of the breast. In addition to letrozole, the patient used Acrivastine and Pseudoephedrine for rhinitis, as well as Simvastatin for hypercholesterolemia and multivitamins. There was no medical history of allergic reactions or dermatological disease, although a rash had previously been noted in conjunction with the use of micropore scar tape. Upon proper information the patient opted for delayed breast reconstruction with autologous fat transfer and the Brava system.","title":"Delayed Total Breast Reconstruction with Brava"}
{"_id":"e75542fa-9409-a303-436f-b4070c8a7e04","text":"Salviz et al.43 report that adding ultrasound-guided thoracic paravertebral blocks to general anesthesia reduces analgesic consumption in breast reduction patients. Ultrasound guidance helps to select needle insertion sites, provide depth information, improve the accuracy of the block, and minimize the risk of pleural puncture.43","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"e76bbc2f-396c-6e84-c433-91fe92fad432","text":"Until recently, feasibility and accuracy of SLN biopsy in these patients were considered limited due to the possible alteration of lymphatic patterns after chemotherapy, but several studies have reached different conclusions.","title":"Recent advances in the surgical care of breast cancer patients"}
{"_id":"e7775da7-c6a1-feeb-06ba-88bc423f165b","text":"The individual described in the case report cannot be identified by any of the images or through any part of the text.","title":"Papillary thyroid cancer with extrathyroidal extension of desmoid-type fibromatosis. A case report of an aggressive presentation of an uncommon pathologic entity"}
{"_id":"e7793e1f-7b3c-5634-428f-72ac52c2bd77","text":"The popliteal LNs are divided into superficial and deep popliteal LNs by the deep fascia. While these popliteal LNs are generally regarded as minor players in the context of lower limb LNM, they should be taken into consideration during tumor staging. Popliteal LN involvement can be observed for lower limb tumors of the distal extremities. In some patients with primary melanoma tumors situated below the knee, popliteal LN drainage may occur such that assessing the popliteal nodes can predict recurrence and overall survival, although popliteal LND does not confer any survival benefits to these patients. An estimated 67% of N1 patients diagnosed with rhabdomyosarcoma of lower extremities exhibit popliteal LN positivity, underscoring the importance of performing popliteal LN biopsy procedures for tumors of the lower extremities, particularly for tumors of the distal extremities.","title":"Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions"}
{"_id":"e77ff5fe-ba4c-e7f9-980c-026a84accd92","text":"Following locally advanced melanoma excision, reconstruction is historically a multistage or delayed procedure when the wound is left open until the final pathological examination has confirmed negative margins. As neither frozen section analysis nor MMS is the standard of care in treating invasive melanomas, the decision to perform immediate reconstruction is based on the likelihood of obtaining a negative margin coupled with the patient’s wishes and wound care concerns until permanent pathological results are finalized.","title":"Challenges in the Complex Management of Neglected Cutaneous Melanomas in the Head and Neck Area: A Single Center Experience"}
{"_id":"e789282a-01cd-1e26-d4e8-840a63393588","text":"Although based on only one case we have demonstrated that emollients and other skincare products may act as a barrier preventing imiquimod absorption or cause its degradation. It may be useful top warn patients not to use any other skin care product during the treatment phase.","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"e7909188-f36e-c8a0-52e9-a38fa0859473","text":"Any AE related to the clipping of the most suspicious axillary lymph node and","title":"Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (TAXIS): study protocol for a multicenter, randomized phase-III trial"}
{"_id":"e790e35f-4aeb-7b1e-657e-54046c802efc","text":"To our knowledge, this is the first study to provide information on changing risk of recurrence among DCIS patients treated with BCS in the community setting. Our findings suggest that DCIS patients diagnosed in the late 1990s had approximately half the risk of a recurrence at five years compared to patients diagnosed in the early 1990s. Furthermore, this was observed for recurrences that included both DCIS and invasive disease and when recurrences were restricted to invasive disease. The decline appeared to be only partially due to an increase in use of adjuvant radiotherapy and tamoxifen. Changes in pathologic practice during this period particularly with regard to margin evaluation also likely contributed to this decline.","title":"Declining recurrence among ductal carcinoma in situ patients treated with breast-conserving surgery in the community setting"}
{"_id":"e794bc9e-78c0-40b8-8b1a-3b827d95fd65","text":"The need to introduce a new checklist stemmed from the inadequacies inherent to the local trust checklist. The initial process of signing in the patient was often carried out in the ward rather than in the operating theatre and often by a junior doctor rather than the operating surgeon or the team present in theatre. This inherently natured the risk for error and miscommunication. Moreover, recent observations reveal that the pre- and postsurgical checks of the patient were also often missed or carried out in the anaesthetic room, and on many occasions, the members of the team including the scrub nurses were thus not involved in this process.","title":"WHO Surgical Checklist and Its Practical Application in Plastic Surgery"}
{"_id":"e794e54d-1ced-beac-6c40-2c32b9f7c9e5","text":"After NPWT removal wound bed was medicated with alginate and silver sulfadiazine for the following 14 days twice a week in order to prepare it for the final reconstructive step.","title":"Matching Biological Mesh and Negative Pressure Wound Therapy in Reconstructing an Open Abdomen Defect"}
{"_id":"e79568e0-1ccd-43a6-d2c1-0e83e2c89bb2","text":"In conclusion, based on our findings and literature review, total surgical excision alone or in conjunction with preoperative embolization and total surgical excision with preoperative embolization, are the main treatment modalities for TMPs and TJPs, respectively. However radiotherapy and observation modalities are also considered in case of large tumors, recurrent cases, advanced age and patient preference. In addition subtotal resection must be considered rather than sacrificing major neurovascular structures in case of preoperative functioning cranial nerves and large tumors. Besides tinnitus and hearing loss, otorrhea may also be either a presenting symptom or a postoperative finding pointing to tumor recurrence or a complication like cholesteatoma for TBPs. Additionally to our knowledge we have reported the first case who has received cochlear implantation for simultaneous occurrence of VS and TMP in the opposite locations.","title":"Temporal bone paragangliomas: 15 years experience Paraganglioma do osso temporal: 15 anos de experiência"}
{"_id":"e7982c20-ec45-2a0b-c800-807f6ea859c2","text":"A dermal matrix Type 1 heterologous equine collagen and hyaluronic acid in sterile sponge plates 10 × 10 cm adaptable to the site, thickness about 2 mm is placed on bone tissue with bleeding breccias.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"e79f04d7-ea78-134e-2666-a180ea8a382f","text":"The aim of this study is to evaluate the sensitivity and specificity of TIC in a consecutive series of breast cancer patients undergoing SLNB, with a special focus on how the sensitivity varies between tumor size and histological subtype.","title":"Evaluation of intraoperative touch imprint cytology on axillary sentinel lymph nodes in invasive breast carcinomas, a retrospective study of 1227 patients comparing sensitivity in the different tumor subtypes"}
{"_id":"e79fdf27-bd53-3682-6fc7-e9b5303f92c2","text":"The primary outcome is incident proximal lower extremity DVT detected after the third calendar day of enrollment. Certified ultrasonographers will perform routine twice weekly bilateral proximal lower extremity venous ultrasound, and if DVT is clinically suspected. The first ultrasound is performed within 48 h of enrollment. Prevalent DVT is defined as DVT documented within the first three calendar days of enrollment, and is considered to reflect a baseline characteristic and less likely be related to the study intervention. Patients with prevalent DVT will be included in the main analysis but a prevalent thrombosis is not considered a primary outcome.","title":"Thromboprophylaxis using combined intermittent pneumatic compression and pharmacologic prophylaxis versus pharmacologic prophylaxis alone in critically ill patients: study protocol for a randomized controlled trial"}
{"_id":"e7a0c2f8-6f51-f921-a857-c50d246bf1fa","text":"The interview transcripts underwent open coding that was refined into a final coding framework as seen in Table 1. Each transcript was coded independently by two researchers; in the event of conflict, a third researcher coded the response to resolve the disagreement. The transcripts were analysed within this framework and grouped together by theme. All transcripts and quotations were anonymised prior to analysis to ensure confidentiality.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"e7aa477f-1855-23d2-30e7-5ada363bdc32","text":"The management of chest-wall tumors is not always easy and still represents one of the most important and difficult challenges for surgeons and oncologists.","title":"Chest-Wall Tumors and Surgical Techniques: State-of-the-Art and Our Institutional Experience"}
{"_id":"e7b01018-ad7c-a72d-d8d1-24d093deadae","text":"A variety of free flaps are available for this task, most prominently the latissimus dorsi and the ALT flap. In very large defects, the latissimus dorsi and a parascapular flap can be elevated on their common vascular tree and used as a chimeric flap. Although the reconstruction itself as well as the perioperative management can be challenging, the overall outcomes with regards to the reconstruction is good.","title":"Microsurgical Reconstruction of Extensive Oncological Scalp Defects"}
{"_id":"e7b11a8e-542b-19af-5ff2-2da347c79096","text":"A 76 year old British seaman presented in April 2010 with an unevenly pigmented brown macule on the left side of his neck, measuring 31 × 26 mm. This was at the site of a previous lentigo maligna that had been excised with a 5 mm margin.","title":"Lentigo maligna mimicking invasive melanoma in Mohs surgery: a case report v1; ref status: indexed"}
{"_id":"e7b928dc-e1de-4da7-5fa0-81cf69f16b76","text":"This study was approved by the Institutional Review Board and the Research Ethics Committee of King Abdulaziz University in Jeddah.","title":"Perception of Plastic Surgery and the Role of Media Among Medical Students: Cross-Sectional Study"}
{"_id":"e7bb4f9c-9bc1-09ca-3099-491bbf9b319a","text":"None of the patients showed obvious or spontaneously reported significant side effects or harm after injection of BTX. The treatment led to a complete relaxation of the muscles of the glabellar region. On the other hand, innervation of the muscles of the perioral region was only partially inhibited to prevent an impairment of adequate lip closure.","title":"Botulinum Toxin Therapy for Psychiatric Disorders in Clinical Practice: A Retrospective Case Study"}
{"_id":"e7c6b2a1-18c8-43ea-4c31-726133f58d1d","text":"Sentinel node biopsy is increasingly being used to provide accurate staging in early stage head and neck malignancies, such as melanoma and oral squamous cell carcinoma. Lymphatic mapping in the head and neck area can be complicated because of the complex anatomy and variable drainage patterns in this area and easy obscuration of sentinel node by the primary injection site. The need for accurate imaging extends beyond planar lymphoscintigraphy.","title":"Sentinel Node Detection in Head and Neck Malignancies: Innovations in Radioguided Surgery"}
{"_id":"e7c7119c-c298-6c01-4f8a-5438b4362f94","text":"The pathological lingual frenulum, in the most complex cases, can lead to problems that can be solved only and exclusively with the collaboration of various professional figures including a pediatric dentist, orthodontist, otolaryngologist and speech therapist. The last two figures should intervene alongside the dentist in the medical team in case of prolonged respiratory problems such as OSAS or in case of bad habits or dyslalias.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"e7cd875b-be22-e810-ee86-c416fc3a4ae4","text":"Patients with thromboembolism may be treated with anticoagulation, and evaluation for the risk of bleeding and thrombosis is really necessary during treatment. There have been case reports of the successful use of apixaban in patients. Testing for antiphospholipid antibodies is also recommended to assist in the selection of vitamin K antagonists or oral anticoagulants. 18 45 Warfarin was previously reported to be more effective in patients with antiphospholipid syndrome. 74 In addition, multiple factors contribute to thrombosis, and it is conceivable that the use of immunosuppressive and immunomodulatory agents to modulate endothelial cell function and reduce the inflammatory milieu, combined with anticoagulation, could be a measure to avoid the recurrence of thrombotic events. Further studies are needed to clarify the mechanisms of thrombosis and to evaluate the efficacy of anticoagulation in patients with VEXAS. 45 Consideration of prophylactic anticoagulation in patients with VEXAS is still up in the air.","title":"VEXAS Syndrome—Review"}
{"_id":"e7d06f1d-8c78-4a25-037b-f251a9789073","text":"Outsourcing of EWSL procedures has routinely been used in Denmark where a static system was unavailable. Lithotripsy services were performed by dedicated technicians who visited hospitals periodically and provided treatments using a mobile lithotripsy system. However, such outsourcing of medical procedures may lack clinical ownership and inconsistencies, thus potentially risking inferior clinical results [7]. There are only a very limited number of studies that explores the efficacy of mobile lithotripter services being performed by commercial companies. And as health care services continuously are being outsourced to private operators it seems reasonable to investigate the efficacy of such treatment.","title":"Efficacy of commercialised extracorporeal shock wave lithotripsy service: a review of 589 renal stones"}
{"_id":"e7d0ad49-7190-5971-bfe5-a5bd6809eb25","text":"The women who did not practise EBF for their last child were more likely to discontinue EBF at one month and three months after a caesarean delivery. Our findings are in agreement with a study in Hong Kong which showed that the participants who did not breastfeed exclusively or who practised EBF for up to only two months were more likely to stop EBF earlier than those who breastfed exclusively for more than two months [25]. A systematic review on breastfeeding experiences concluded that previous breastfeeding experience consistently correlates with subsequent breastfeeding initiation and duration. Previous short breastfeeding duration and unsatisfactory experience can negatively affect subsequent breastfeeding practices [26]. A qualitative study in the United States found that women who had successfully breastfed in the past were intrinsically motivated from their own emotional attachment to the practice. Besides, they were also extrinsically motivated from their family who encouraged them to breastfeed [27]. Therefore, it is recommended for midwives and lactation consultants to provide individualised interventions to the mothers based on their previous breastfeeding experience to improve breastfeeding initiation and duration [26].","title":"Determinants of non-exclusive breastfeeding practice during the first 6 months after an elective caesarean birth: a prospective cohort study"}
{"_id":"e7d342eb-01f4-d2ab-9a4b-3cda8313cf98","text":"The patient-rated level of discomfort during POCUS of the heart, lungs and deep veins is very low and the vast majority of patients would accept being assessed by the use of POCUS if the patients once again had to be examined for possible disease.","title":"Does point-of-care ultrasonography cause discomfort in patients admitted with respiratory symptoms?"}
{"_id":"e7d8d066-c113-37b0-f8dc-a310a61f6d4e","text":"A circle with a radius equivalent to the CTA‐assessed depth of the perforator successfully predicted the location of the perforator in almost all cases. Depth of the perforator measured by CTA combined with Doppler‐identified location can help safely locate the perforator during ALTF harvesting.","title":"Preoperative perforator localization in anterolateral thigh free flap using acoustic doppler and computed tomography angiography"}
{"_id":"e7e5df23-9981-ac5f-86ad-35083a13c5fc","text":"Finally, a media campaign was supported by KIBS to promote breastfeeding messages using radio and video messages and public service announcements.","title":"Are we doing enough? Improved breastfeeding practices at 14 weeks but challenges of non-initiation and early cessation of breastfeeding remain: findings of two consecutive cross-sectional surveys in KwaZulu-Natal, South Africa"}
{"_id":"e7ecab75-5804-ea13-8fe1-74d36b612f4d","text":"This article was previously accepted as a meeting abstract at the RACS Annual Scientific Congress on the 12th of May 2020 and published as an abstract in the ANZ Journal of Surgery on the 4th of June 2020.","title":"Closing Difficult Laparostomies With the Aid of Botulinum Toxin A: An Audit of 12 Cases"}
{"_id":"e7f4ef95-89ab-9f67-0ea1-bf433404642f","text":"There are numerous techniques for the microsurgical constructs of bipedicled flaps and surgeons intending to perform this surgery should be familiar with them. Our series shows that double-pedicled abdominal free flaps can be safely undertaken with total rib-preservation technique of internal mammary vessel exposure. The algorithm that we have derived from our experience can assist surgeons embarking on this complex microsurgery if they adopt the discussed principles.","title":"Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification"}
{"_id":"e7f513d2-84c8-8f8d-c64b-0000dc0e932a","text":"The authors thank all the medical staff and patients who contribute to this study.","title":"Study protocol for comparing the efficacy of left-open single-flap technique versus double-flap technique after proximal gastrectomy: A multicenter randomized controlled trial"}
{"_id":"e7f56cfa-0bea-8638-7f20-a632e3402846","text":"The timing of breast reconstruction postmastectomy averaged 19.9 months, without statistically significant association between reconstruction timing and recurrence rates. Postreconstruction follow-up periods ranged from 60 to 87 months. The postreconstruction adverse outcomes ratio was 2.21%.","title":"Histologic Examination of Mastectomy Scars during Breast Reconstruction: A Systematic Review"}
{"_id":"e7fdb9e0-f974-fe13-85f5-06e15c0ff26d","text":"A group of 61 patients with PAD who required PTA were enrolled in the study. It was a small group but reflected a usual profile of patients with a high burden of cardiovascular risk. General patient characteristics are given in Table 2.","title":"Percutaneous Transluminal Angioplasty in Patients with Peripheral Arterial Disease Does Not Affect Circulating Monocyte Subpopulations"}
{"_id":"e8057744-a683-41d2-3a0f-ee6a4412d12a","text":"Several treatment strategies have been designed to treat the never-ending rate of skin carcinoma. A void in the therapy regimen should be filled to facilitate cellular inhibition and apoptosis. The section below discusses the scope of the dermal therapeutic approach against skin cancer.","title":"Skin cancer: understanding the journey of transformation from conventional to advanced treatment approaches"}
{"_id":"e8088c25-4abf-e81a-9cbf-6611e0fc29a3","text":"As the literature continues to demonstrate that older RBCs are potentially harmful in critically ill patients, and there is biologic plausibility, consistency, and size effect, well-designed prospective controlled trials to test this hypothesis must be performed. The clinical effects of the storage lesion and the precise mechanisms of how they potentially cause adverse effects need further study. Blood banks do not routinely record the storage age of RBCs transfused. This needs to become standard to facilitate the study of age of RBC on outcomes. Blood banking methods or alternative storage solutions also need to be studied to determine if these potential adverse effects can be mitigated. Furthermore, the criteria for licensing current and future storage solutions should also include the monitoring or testing of the many potential adverse effects of the storage lesion. Finally, study is needed in human subjects to determine if stored RBCs are able to perfuse the microvasculature tissue and increase oxygen delivery and consumption for critically ill patients with shock.","title":"Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries"}
{"_id":"e80f181d-cc7d-4ec1-41f3-9bd6efa9a4d3","text":"The fibular free flap is most frequently used for reconstructing the mandible owing to the adequate length of the bone with a reliable blood supply. It has a long vascular pedicle with adequate vessel diameter for anastomosis and also a good amount of skin paddle for coverage. However, the reports of post-operative complications at the donor site among pediatric patients are scarce in the literature. We present a pediatric case of ankle valgus deformity following vascularized fibular harvest.","title":"Post-operative Complication at the Donor Site of Fibular Free Flap in a Pediatric Patient"}
{"_id":"e81ec035-b33b-10f6-c712-708042850217","text":"The posterior edge of the femur is the key anatomical landmark for managing popliteal injuries.","title":"WSES position paper on vascular emergency surgery"}
{"_id":"e81fd07d-4dbc-b7d5-720b-2c52a0ca3038","text":"After initial systemic treatment, multiple systemic treatments were given to 10 patients in different regimens. Seven patients received 2 treatment regimens and three patients received a total of 4 treatment regimens.","title":"Outcome of Nonsurgical Management of Extra-Abdominal, Trunk, and Abdominal Wall Desmoid-Type Fibromatosis: A Population-Based Study in the Netherlands"}
{"_id":"e82bfbf1-34a7-75c8-ca1f-817296976139","text":"A correlation has been established between exposure to sun and the incidence of the above cutaneous problems in oculocutaneous albinism.[1] Albinos are at an increased risk of developing skin malignancies and, hence, a regular examination for early detection and treatment of the malignancies would increase their life expectancy to a great extent. We report here a case of oculocutaneous albinism with multiple actinic keratoses transforming into squamous cell carcinoma and cutaneous horns.","title":"MALIGNANT TRANSFORMATION OF ACTINIC KERATOSES TO SQUAMOUS CELL CARCINOMA IN AN ALBINO"}
{"_id":"e833a453-2964-e343-ecc6-2346ffd537a5","text":"The present study is an observational retrospective study on patients affected by primary cutaneous melanoma who underwent SLNB.","title":"Prognostic Role of Non-Identification of Sentinel Lymph Node in Cutaneous Melanoma Patients: An Observational Retrospective Study"}
{"_id":"e84d120c-f297-a8d9-8b6e-9aabed2565ae","text":"The informants routinely included collegiality as an element of good physician leadership. Collegiality was perceived to manifest as general appreciation towards colleagues and respect for another’s work, but also as a certain kind of balance that manifested in the form of equality between colleagues.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"e84da55c-981f-4fa8-48f9-4e4c626efbc3","text":"Identification of the SLN takes some getting used to as the node has to be exposed to some extent before the light reaction can be visualized through the infra red video camera. All cases where identification was attempted through the skin were unsuccessful. Thereafter the skin incision and exposure of the neck in a sub-platysma muscle level and exposure of the levels IA and IB with an attempt to identify the first station of lymph drainage followed. (Figure 4) In the next step the Sternocleidomastoid muscle was retracted and the Jugulodigastric lymph nodes were evaluated by the Infra red video image for possible sentinel nodes. (Figure 5) There was enough time (more than two hours) to complete the neck dissection and identify the SLN of the contralateral side in one case. It was clear that the longer the lag time from injection to visualization the more lymph nodes were identified. A subjective ideal time was later set at 5 minutes after injection.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"e855d255-8b2c-84d1-ecd4-7198d7d0e928","text":"Table 2 and Table 3 provide an overview of types of free flaps used for reconstruction after full-thickness resection and corresponding success-rates and Table 4 provides a set of considerations regarding the ALT flap as technique of choice for full-thickness defects of the head and neck area.","title":"Full-Thickness Tumor Resection of Oral Cancer Involving the Facial Skin—Microsurgical Reconstruction of Extensive Defects after Radical Treatment of Advanced Squamous Cell Carcinoma"}
{"_id":"e857b7e4-a4f1-41b4-3c08-5366dcde1b58","text":"Biopsy site infection in the setting of osteosarcoma is a potentially devastating complication. We present the case of a 16-year-old adolescent girl with a distal femur osteosarcoma who developed an open biopsy site ulceration and infection after initiation of neoadjuvant chemotherapy. This was treated with careful local excision of the ulcerated biopsy site and systemic antibiotic therapy throughout the duration of her chemotherapy course. She subsequently underwent wide resection of the tumor en bloc with a generous ellipse around the biopsy scar and reconstruction with cemented knee megaprosthesis. No recurrence of either infection or malignancy was observed. This case represents the successful treatment of a biopsy site ulceration and infection in a patient with osteosarcoma and may merit adoption in future instances of this complication.","title":"The Management of an Open Biopsy Tract Site Infection and Ulceration in the Setting of Osteosarcoma"}
{"_id":"e8590ec4-284a-74f6-1334-e8a942c938b3","text":"The aim of this study was to evaluate the satisfaction of patients who underwent rhinoplasty in a tertiary centre using the ROE questionnaire pre-operatively and post-operatively and determine the relation with patient characteristics and surgery details.","title":"Evaluation of aesthetic and functional outcomes in rhinoplasty surgery: a prospective study Avaliação dos desfechos estéticos e funcionais em cirurgia de rinoplastia: um estudo prospectivo"}
{"_id":"e85b02ed-f010-bc08-30e6-3adf15a84282","text":"We report a successful surgical extirpation of desmoid tumor arising from buttock in a child, and briefly discuss management of this rare tumor in context of the particular anatomic site.","title":"Desmoid Tumor of the Buttock in a Preadolescent Child"}
{"_id":"e85ceaca-07d5-8273-97f8-50de0f2352c2","text":"A common treatment modality for prostate cancer is external beam radiation therapy. It is aimed at delivering a lethal radiation dose to malignant tissues so as to provide a high probability of tumor control while sparing or inducing minimal damage to adjacent normal tissues. Therefore, radiotherapy is directed toward keeping normal tissue complications within acceptable limits while attaining a high therapeutic ratio. However, an increasing number of patients requiring megavoltage photon beam radiotherapy for malignancies in the pelvic or hip region have metal implants or prostheses which could shadow the target and influence the dose distribution leading to a dramatic difference in clinical outcome.1, 2, 3, 4","title":"Dose comparison between Gafchromic film, XiO, and Monaco treatment planning systems in a novel pelvic phantom that contains a titanium hip prosthesis"}
{"_id":"e85f441b-8ae4-82fa-2d23-16b293621b44","text":"The VR setup consisted of an HTC Vive Pro and a computer with an Intel i7 processor and an Nvidia 2080 TI graphics card. Room-scaled tracking was used with an approximate area of 3 × 3 m. The application was controlled with one Vive controller, which was held in the dominant hand of the participant. All interactions could be performed with the index finger by pressing the trigger button on the controller. The application was designed around this one-button-style interaction and the concept of flat menus in order to keep it as simple as possible and make it easy to learn in a short time.","title":"Virtual Reality for Surgical Planning – Evaluation Based on Two Liver Tumor Resections"}
{"_id":"e8619e1c-e47f-dbc8-033f-56f452910bb2","text":"In light of new adjuvant treatment options and new indications for checkpoint inhibitors where studies are designed to treat patients with regional or local advanced disease, we can expect open surgery to decrease.","title":"Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection for Melanoma"}
{"_id":"e86d8afc-7b55-1b39-a656-808334517a84","text":"Here we tested the hypothesis that facial contrast is a cross-culturally valid cue for age perception. This general question contains two parts: does the decrease of facial contrast observed with age generalize to women of different races or ethnicities, and do people from different cultures use facial contrast as a cue for perceiving the age of the face?","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"e87a0bc8-8bd8-f255-f4a4-92d69577ef90","text":"There are currently no guidelines regarding anticoagulation treatment of pulmonary artery thrombosis after cardiovascular surgery in children, or antithrombotic prophylaxis after PAS repair. As our patient responded well to unfractionated heparin and was monitored closely in the intensive care unit, we decided to discontinue the anticoagulation therapy after 2.5 weeks of treatment and demonstration of a complete resolution of the pulmonary artery thromboses. The patient did not present recurrent pulmonary artery thrombosis or any other thrombotic event. Therefore, we did not perform thrombophilia workup.","title":"Complicated Postoperative Course after Pulmonary Artery Sling Repair and Slide Tracheoplasty"}
{"_id":"e8839f21-44db-94fa-b473-f61f021952a4","text":"In the second patient, SWE demonstrated that the size and echogenicity of a nerve segment do not necessarily reflect the hardness of the surrounding tissues. Whole segments of the nerve may be swollen in severe cases, which makes identification of the precise location of injury with conventional US techniques difficult. However, identifying these hardened areas is critical for successful perineural hydrodissection. Using SWE to guide perineural hydrodissection can avoid unnecessary treatment of nerve segments which appear abnormal on US due to prior surgery, but which are not surrounded by scar tissue and do not contribute to symptoms.","title":"Shear Wave Elastography to Guide Perineural Hydrodissection: Two Case Reports"}
{"_id":"e88ec344-e202-b0ae-9b43-982120117387","text":"All patients were treated according to the procedure for diagnosis and treatment of patients with breast cancer at the University Hospital Osijek.","title":"Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients"}
{"_id":"e8926027-1be6-eaf6-6e84-083683b13abc","text":"The important point of this step is to avoid the principal vascular axes of the vaginal to prevent haematomas and emboli. The safest area to inject is the posterior wall of the vagina. The injection of the fat graft has to be homogenous.","title":"Novel technique of vulvo-vaginal rejuvenation by lipofilling and injection of combined platelet-rich-plasma and hyaluronic acid: a case-report"}
{"_id":"e8995680-4fad-06aa-85a6-616b2fe49183","text":"Our findings of the increased use and higher frequency of screening mammography post reduction mammography could be explained by the difficulty interpreting radiographic postsurgical changes in the breast. The rearrangement of glandular breast tissue and subsequent scar formation may be interpreted as suspicious lesions requiring further investigation in the form of repeat imaging or tissue sampling. Similarly, our findings of increased mastectomy rate after breast reduction among patients who developed breast cancer may relate to additional ipsilateral abnormal breast imaging findings, prompting patients and providers to seek out the removal of all abnormal appearing tissue with mastectomy. Although our noted mastectomy rate of 41.6% is higher than the Canadian national average, high mastectomy rates in Alberta have been previously documented, and further investigation into potential variation in practice patterns may be warranted.","title":"Breast Cancer After Reduction Mammoplasty: A Population-Based Analysis of Incidence, Treatment and Screening Patterns"}
{"_id":"e89c0620-f7c7-6dd8-6699-63dc1eda58ce","text":"Melatonin circulating in the blood has limited access to the skin due to significant first-pass degradation in the liver, a problem that can be circumvented by its topical administration. Unlike oral administration, topically applied melatonin is considered as effective protection against the harmful effects of UV radiation. It is also recommended for the treatment of alopecia and atopic dermatitis and to ameliorate skin tonicity, leading to a significant reduction in skin roughness and wrinkles. Important studies have recently been carried out on new skin protection techniques and time-dependent aspects of skin barrier functions as well as skin chronopharmacology. Finally, the use of topically applied melatonin is a very promising area of preventive skin medicine.","title":"Protective Effects of Melatonin on the Skin: Future Perspectives"}
{"_id":"e89fdbd0-386b-14ba-a744-3070de21143c","text":"The data we obtained underline how cutaneous melanoma presents an extremely heterogenous lymphatic drainage at the level of the axillary cavity. A previous study by Cirocchi et al. [28] had shown how the lymphatic drainage of cutaneous melanoma is extremely heterogenous: it is more various if compared to the topographic localization of the lymph nodes at the level of the axillary cavity.","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"e8a623a6-6ca5-dad6-40ac-c19c230bdd71","text":"Comparison of symptoms in patients with primary versus metastatic melanoma of colon.","title":"Pathogenesis, diagnosis and management of primary melanoma of the colon"}
{"_id":"e8a8e255-c015-59af-62d6-4baecfb72390","text":"The prevalence of adverse reactions to subcutaneous immunotherapy observed in our study is similar to the reported worldwide. The most reactions are local, small and self limited. The low prevalence of systemic reactions and the absence of fatalities makes subcutaneous immunotherapy a safe therapy.","title":"Poster 2021: The incidence of adverse reactions induced by subcutaneous immunotherapy in an allergy center in Monterrey, México: a retrospective chart review"}
{"_id":"e8a92f72-2b30-91d6-abc8-67227790c661","text":"Patient 1 cleared the LM from the tip of the nose but developed pigmentation on the upper lip at a site where imiquimod had not been applied. Initially she had applied the cream very sparingly to a small area on the tip of the nose. There had been a minimal inflammatory response. She was happy with the outcome and declined a second course of treatment. Patient 2, despite apparent correct application over 2 courses, did not develop any inflammatory response. It was thought likely that she had not used sufficient cream because of her concerns about the described inflammatory reaction. The pigmented area reduced but did not resolve. Biopsy confirmed the presence of lentigo maligna. Patient 8 applied imiquimod for 6 weeks but there was no inflammatory reaction and no change in the appearance of the LM. It was subsequently discovered that he had been using a sunscreen and skin moisturiser when he had used the imiquimod. He stopped using the skin care products and reapplied the imiquimod, once a day, 5 days per week for 6 weeks; there was a very brisk response and the pigment resolved.","title":"Observational Study of Topical Imiquimod Immunotherapy in the Treatment of Difficult Lentigo Maligna"}
{"_id":"e8a963df-f19f-ca08-861b-35f7edf30e6c","text":"This study did not receive any funding from governmental or private organizations.","title":"Recurrent cutaneous basal cell carcinoma after surgical excision: A retrospective clinicopathological study"}
{"_id":"e8aab8e8-7e64-f395-d003-b6ec4c082b51","text":"What education for the role as a leader have you received?","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"e8b1c9dc-a769-9c25-252c-7e035300fba5","text":"Recently, a case of anaphylaxis caused by intravenous administration of chlorpheniramine confirmed by IDT and basophil activation test was reported in Korea.[ Similarly, we identified chlorpheniramine as the confirmative cause of anaphylaxis in the 2 patients in this report according to an increase in serum tryptase level and positive responses in IDTs for chlorpheniramine. Although the precise mechanisms of chlorpheniramine allergy are unknown, based on the results of IDT and basophil activation tests and of elevated tryptase levels, an IgE-mediated reaction or direct basophil or mast cell activation may be involved.","title":"Chlorpheniramine-induced anaphylaxis Two case reports and a retrospective review of pharmacovigilance database"}
{"_id":"e8b39f04-98e4-209e-17af-2e9b1cf8ba04","text":"It includes a small sample size .Further studies are needed to compare the diagnostic efficacy of CNB and FNA in other rare diseases to confirm our observations.","title":"Comparative study of core needle biopsy and fine needle aspiration in the treatment of metastatic lymph nodes guided by contrast-enhanced ultrasound"}
{"_id":"e8bdb179-50fd-bf20-da86-0fb77d06b5ad","text":"Characteristics of the AK patients and AK lesions are presented in Table 2.","title":"Topical Photodynamic Therapy with Different Forms of 5-Aminolevulinic Acid in the Treatment of Actinic Keratosis"}
{"_id":"e8cd4f59-b398-996b-0e7a-bce8bf017d6a","text":"The glabellar area may be particularly high risk because of its vascular anatomy and proximity to the retinal arterial circulation. Minimizing injection volume and the use of cannulas vs needles may decrease the inadvertent retrograde injection of dermal fillers in this facial region.","title":"Hyperbaric Oxygen Treatment of Keratitis Following Facial Hyaluronic Acid Injection Keratitis Treatment After Hyaluronic Acid Injection"}
{"_id":"e8cf7f27-991f-41aa-6f14-aabce3383cd5","text":"HSI can detect changes in perfusion at the calves after EVT in patients with Rutherford class 2–6. Peri-procedural deoxyhemoglobin changes at the calves and feet are significantly different between limbs with and without clinical improvement. Decrease in deoxyhemoglobin directly after EVT may identify limbs that show clinical improvement 6 weeks after EVT.","title":"Detecting Changes in Tissue Perfusion With Hyperspectral Imaging and Thermal Imaging Following Endovascular Treatment for Peripheral Arterial Disease"}
{"_id":"e8d1174d-48ff-5672-89ff-d2b4295fb2ef","text":"Clinically relevant complications assessed at 3 months and 12 months include:","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"e8d4332c-fb04-0efd-c34e-2c68f363b6cf","text":"This study demonstrated that SIEA harvest is a significant predictor of increased abdominal drain output postoperatively. This accounted for longer periods before drain removal and more patients discharged with an abdominal drain in situ and should be an important consideration for reconstructive surgeons. There was no demonstrable difference in the number or volume of seroma aspirations after drain removal for either group.","title":"Increased Production of Abdominal Donor Site Fluid Following Microsurgical Breast Reconstruction With Superficial Inferior Epigastric Artery Versus Deep Inferior Epigastric Artery Perforator Flaps"}
{"_id":"e8d63a82-983a-ede1-67f5-e3037900e078","text":"Table 4 summarized our recommendations for follow-up. Although performing a routine imaging is controversial we recommended to do it at least every 6 months. It is important to review any new symptom reported by the patient and to perform a physical examination in each visit.","title":"SEOM clinical guideline in ovarian cancer (2020)"}
{"_id":"e8dc57ad-6826-33a4-3ef0-f6bce2e552dc","text":"Conclusion The large majority of IDDVT patients received anticoagulation for more than 3 months. Most bleeding and thrombotic complications occurred after the first 90 days of anticoagulation therapy. These results indicate that an extended anticoagulation beyond 90 days in IDDVT patients is associated with increased risk of complications. Whether an extended treatment may lower recurrences after anticoagulation withdrawal should be assessed by specifically designed studies.","title":"Management and Outcomes of Isolated Distal Deep Vein Thromboses: A Questionable Trend toward Long-Lasting Anticoagulation Treatment. Results from the START-Register"}
{"_id":"e8e25ff7-dd33-3029-8176-60562c69fe68","text":"The purpose of this work is to describe a novel technique used at our institution for brachytherapy of lip cancer and to illustrate its dosimetric advantage over the “classical” interstitial technique and the functional and cosmetic results.","title":"Novel high dose rate lip brachytherapy technique to improve dose homogeneity and reduce toxicity by customized mold"}
{"_id":"e8e95c41-8038-e118-63b8-d9bb407da6f8","text":"A total of 29 articles were included in the review. Table 1 shows the characteristics and the main findings of the included studies.","title":"Multiple Papillomas of the Breast: A Review of Current Evidence and Challenges"}
{"_id":"e8f4bf64-4f92-69ba-096c-b44c01e27130","text":"The overall patient satisfaction in this study was very good. Nine patients were deeply satisfied and four were satisfied. The only poorly satisfied patient in this study suffered distal necrosis of the dorsal flaps with consequent wound breakdown, which necessitated surgical intervention. Also, she had a suboptimal aesthetic result because of the asymmetry between both breasts due to underestimation of the contralateral breast ptosis in addition to the postoperative irradiation effect on the flap. The asymmetry could have been improved by contralateral breast surgery but the patient refused.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"e8f735b7-452e-5335-303f-622f8790df8c","text":"The history of painless abdominal mass, the age and sex of the patient, the location of the mass within the anterior abdominal wall, and the imaging features make desmoid tumor a strong primary diagnostic consideration even if it is a rare entity. Aggressive, wide surgical resection with negative margin is the best surgical option. Complete surgical excision of desmoid tumors is the most effective method of cure, sometimes necessitating removal of most of an involved anterior abdominal wall in a giant desmoid tumor. However, the radicality of resection should be tempered so that significant compromise of function is avoided. Close follow-up may be acceptable in lieu of radiation therapy if it is estimated that salvage treatment in the event of recurrence will not compromise functional and cosmetic outcome.","title":"Desmoid Tumors: A Clear Perspective or a Persisting Enigma? A Case Report and Review of Literature"}
{"_id":"e8f75c11-9654-ce35-bd46-a7dfeb0f884a","text":"The modified horn flap based on the superior alar artery as well as the nasalis muscle is the preferred option for the authors.","title":"The modified horn flap for nasal tip reconstruction"}
{"_id":"e8fbc44f-3186-c1dd-43f3-2cd9744b6431","text":"This method offers high aesthetic effects depending mainly on the quality of the prosthesis and it supports a comfortable rehabilitation process [24]. A prosthesis mounted on craniofacial implants allows it to be fixed in place without the risk of displacement, and it can be put on and removed efficiently and easily.","title":"The Latest Craniofacial Reconstructive Techniques Using Anchored Implants after Surgical Treatment of Nasal and Paranasal Sinuses Tumors"}
{"_id":"e8fc28fb-b91a-96c0-ad46-67673284c038","text":"It is clear that palpation-guided surgery cannot improve objectivity and measurability of the resection procedure. If we desire progress in objectivity and optimization of breast cancer excision, we need to make the tumor and the surround tissue visible and measurable during the course of the operation in real time. IOUS seems to be the optimal solution to this complex requirement.","title":"Intraoperative ultrasound in breast cancer surgery—from localization of non-palpable tumors to objectively measurable excision"}
{"_id":"e8ffe231-aa52-305c-9537-2ec74e605083","text":"A technique for reconstructing facial units with matching colour, similar texture and sufficient contour is ideal for patients with various facial defects. The current report aimed to present the experience of the authors in facial reconstruction using pre-expanded scalp flaps combined with laser hair removal.","title":"Reconstruction of facial defects using a pre-expanded scalp flap: A description of the method used and outcomes of 43 patients"}
{"_id":"e9112bd4-58e5-092e-74d9-1d59bde58c1d","text":"We present a case of a patient with a femoral neck fracture that shows neurological impairment and respiratory distress 1 day after trauma, caused by the Fat Embolism Syndrome with the presence of Cerebral Fat Embolisms.","title":"Fat embolism syndrome in a patient that sustained a femoral neck fracture: A case report"}
{"_id":"e917cce6-2d42-3350-49e6-1565d024be64","text":"Early cessation of breastfeeding is common amongst both HIV-negative and positive women in South Africa. There is an urgent need to improve antenatal breastfeeding counselling taking into account the challenges faced by working women as well as early postnatal lactation support to prevent breast health problems.","title":"Early cessation of breastfeeding amongst women in South Africa: an area needing urgent attention to improve child health"}
{"_id":"e91d8dc7-a663-acf4-1174-a6e7f622e8ee","text":"My knowledge increased, and this helped me evolve in my work, because I started as a PSS officer and then became the senior, and the thing that helped me most was the fact that I learned at Global Health Institute how things should go, so I paved my way with the help of this program.","title":"Evaluating an e-learning program to strengthen the capacity of humanitarian workers in the MENA region: the Humanitarian Leadership Diploma"}
{"_id":"e921175c-037c-c2d7-3491-30c323041dc2","text":"In opposition to the old belief that patients presenting mild myelopathy should be treated conservatively, there has progressively been amount of evidence indicating that the clinical course of this disease is progressive deterioration and that early surgical intervention improves long-term functional recovery.","title":"Cervical Spondylotic Myelopathy: Pathophysiology, Diagnosis, and Surgical Techniques"}
{"_id":"e924d8d3-e63b-2602-4921-97bada0bf761","text":"The exclusion criteria included patients previously submitted to rhinoplasty that had undergone only functional corrections and those who did not agree to participate in the study.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"e92a5920-3c7a-227a-0124-ce5b1f003ff8","text":"All mammography screenings performed between 2007 and 2017 in the Danish national mammography screening programme were included. Screenings in women with a breast cancer diagnosis prior to invitation were included in the “breast cancer survivors” group, while remaining screenings were included in the “no previous breast cancer” group. We compared the proportion of false positive screenings and the proportion of breast cancers detected at screening among breast cancer survivors and women without previous breast cancer. The analyses were further stratified according to whether the women had a diagnostic breast imaging in the 21 months prior to the screening.","title":"Breast cancer survivors' risk of interval cancers and false positive results in organized mammography screening"}
{"_id":"e92f0da5-356c-c650-1602-9dc463c127e9","text":"Previous studies have examined the lymphoscintigraphy results in relation to BCRL in breast cancer patients who underwent surgery that included ALND.[ Lymphedema can also occur in patients who undergo SLND; to our knowledge, there have been no studies on lymphoscintigraphy in patients who underwent only SLND with or without RTx on an axillary site. In this study, we aimed to investigate the pattern of lymphoscintigraphy according to whether RTx was performed on an axillary site in BCRL patients who underwent SLND for breast cancer.","title":"Lymphoscintigraphy in patients with breast cancer-related lymphedema after sentinel lymph node dissection and axillary radiation therapy"}
{"_id":"e93bb470-6aca-ffda-63f7-85163de55f3b","text":"Complete removal of an ICD system carries considerable risk. In patients with a history of hematological disease, it is crucial to exclude cutaneous manifestations of the disease prior to device removal.","title":"Chronic lymphocytic leukemia skin infiltration mimicking an ICD pocket infection: a case report"}
{"_id":"e93fd8ea-4f5f-b360-ef47-49a753c9d15c","text":"Women were more likely to worry that sun exposure would cause their skin to age or lead to skin cancer than men, but there were no gender differences in positive attitudes. Both concern about the ageing effects of the skin and beliefs that a suntan made them look more attractive were higher among those with educational qualifications.","title":"SunSmart? Skin cancer knowledge and preventive behaviour in a British population representative sample"}
{"_id":"e9422638-26d8-ccab-a576-51207e317884","text":"The first follow-up visit was one month later with the receiving of the questionnaire and the repetition of the HDSS and the minor test for evaluating the effect and treating eventual residual areas of hyperhidrosis.","title":"Treatment of Primary Axillary Hyperhidrosis with Botulinum Toxin Type A: Our Experience in 50 Patients from 2007 to 2010"}
{"_id":"e94513d8-2686-d41e-4a09-871f695d46d4","text":"Peripheral nerves do have the potential to regenerate after injury. Current strategies to repair injured peripheral nerve system focus on developing bridging scaffolds that could guide axonal regeneration across the lesion site. With the development of tissue engineering, it is possible to use nerve conduits, grafts filling material, and appropriate seed cells to bridge the injured peripheral nerve and to promote nerve regeneration. Previous studies showed that the outcome of peripheral nerve regeneration using tissue engineering is similar to that of autogenous nerve transplantation.","title":"Olfactory ensheathing cells in facial nerve regeneration Células embainhantes olfatórias na regeneração do nervo facial"}
{"_id":"e946256f-a4a7-024c-1779-c45ab342f70b","text":"This analysis indicated that OPRS PDs in the United States were principally males with extensive scholarly productivity. As women remain underrepresented in OPRS, increased gender parity at this leadership position should be encouraged in order to expand the recruitment of women into the field.","title":"An Analysis of Ophthalmic Plastic and Reconstructive Surgery Fellowship Program Directors in the United States"}
{"_id":"e94eed42-5bd5-04fc-5e73-e8395207a877","text":"Skin disorders were grouped according to the symptomatology and type of lesion, and a generic TPP was proposed for each illustrative disorder. All of the disorders had a general inflammatory character associated with some skin lesions and symptoms that differentiated them.","title":"Patient-Centric Design of Topical Dermatological Medicines"}
{"_id":"e956eb41-31e8-13ca-6ff8-eb88db2e5690","text":"All patients underwent aggressive surgical resection. This included parotidectomy for cases in which parotid involvement was suspected on preoperative imaging or clinical exam. Parotidectomy ranged from superficial to radical parotidectomy with sacrifice of the facial nerve. The majority of patients required neck dissection and postoperative radiation. Selective, modified, or radical neck dissection was performed at the time of resection or in a staged procedure. Neck dissection was indicated when nodal metastasis was suspected on preoperative imaging or when the patient presented with an advanced T classification of their lesion. Postoperative radiation was recommended for patients with large cutaneous malignancies when more than one positive node was identified on neck dissection, when negative surgical margins could not be obtained, or in the presence of perineural or lymphovascular invasion. Histological margins were defined as negative if the advancing tumor edge was ≥4 mm from the line of surgical excision and positive if less than 4 mm. All cutaneous defects were repaired either by primary closure, split thickness skin graft, local or regional flap coverage, or free tissue transfer.","title":"Outcomes of Recurrent Head and Neck Cutaneous Squamous Cell Carcinoma"}
{"_id":"e95ce3da-9872-e8d8-7ef2-4410a5ad7e94","text":"In conclusion, SLN biopsy should likely be offered if the primary tumor has LVI, as LVI was the second strongest predictor for SLN positivity after tumor thickness. MS is an adverse prognostic factor for RFS, but its influence on outcome is modest. Ulceration width predicts RFS but may lose its independent prognostic significance for MSS when adjusting for other contemporary clinicopathologic factors. As mitotic rate was the second strongest predictor for MSS after the positive SLN status, we recommend continuing reporting the mitotic rate for primary cutaneous invasive melanomas across all T categories.","title":"Clinical impact of ulceration width, lymphovascular invasion, microscopic satellitosis, perineural invasion, and mitotic rate in patients undergoing sentinel lymph node biopsy for cutaneous melanoma: a retrospective observational study at a comprehensive cancer center"}
{"_id":"e9619072-0001-a00c-907d-911507468ef0","text":"The questionnaire contains six modules, of which the first two are related to cosmetic surgery and the rest to breast cancer surgery:","title":"Long-Term Quality of Life (BREAST-Q) in Patients with Mastectomy and Breast Reconstruction"}
{"_id":"e961d980-0821-2bed-354e-d0972f73f611","text":"In hospital settings, specialties had their distinct features affecting physicians and their work which could not be ignored in physician leadership.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"e96b06c2-653d-e875-1163-3aa87b517825","text":"In the last decade and a half, there has been increasing interest (particularly by a group led by Miguel Blanca in Malaga, Spain) in LAR, a term applied to patients whose allergy skin and blood testing is negative but who have a history suggestive of allergic sensitization and local evidence of atopy diagnosed by sIgE in nasal secretions or by positive nasal allergen challenge or both.","title":"Recent advances in allergic rhinitis [version 1; referees: 2 approved]"}
{"_id":"e96c81f8-4580-8cc2-8f8f-9872281ec9f7","text":"Our small series of cases seems to confirm that surgical resection with negative margins improves overall survival.","title":"Mucosal Melanoma of the Head and Neck: A Retrospective Review and Current Opinion"}
{"_id":"e9712514-e5f3-157d-22c1-0986bdfbdfed","text":"For the evaluation in each experiment, the ground truths were those of a CT bone model and the error between the CT bone model and the model generated in each experiment was evaluated using the average symmetric surface distance (ASD) expressed bywhere d was the Euclidean distance between the two points and and were the point cloud models of ground truth and reconstruction results. The point cloud model was generated from the volume by the Marching cubes method.","title":"2D–3D reconstruction of distal forearm bone from actual X-ray images of the wrist using convolutional neural networks"}
{"_id":"e97584da-9579-d846-1ad8-c29de80d2490","text":"Granulation tissue is a highly vascularised tissue that begins growing into the wound site approximately 3–4 days following wounding.91 This tissue is composed of fibroblasts, macrophages, and neovasculature that move into the wound site in a coordinated fashion, and is coordinated by chemical as well as mechanical signals that are transmitted either by direct cell to cell contact or through the extracellular matrix (ECM). As discussed above, platelets release many of the signals necessary to orchestrate the onset of wound healing within 10 minutes of their activation.35 Studies have shown that while there is a delay of approximately 4 days between wounding and granulation tissue invasion, re-wounding followed by de novo fibrin matrix formation does not affect the rate of wound healing once the surrounding tissue has been activated.92 This suggests that the activation of the surrounding tissue by growth factors released from platelets is one of the rate-limiting steps in promoting the formation of granulation tissue.92","title":"Using biomaterials to rewire the process of wound repair"}
{"_id":"e9765300-923f-44e7-dfed-76224fcb9d02","text":"The treatment of basal cell carcinoma with osteoma cutis involves the removal of the primary neoplasm. Excision should be performed down to the level of the fat with the removal of osteoma cutis in the surgical specimen, especially for tumors located on the face. Indeed, surgical removal via standard excision or Mohs micrographic surgery (as in our patient) may be preferred over local destruction to prevent wounding or scarring that may lead to further calcification or ossification, especially since there is an increased prevalence of osteoma cutis in sites of prior electrodessication and curettage.","title":"Basal Cell Carcinoma with Osteoma Cutis"}
{"_id":"e97f6e79-5a2a-baf8-7197-823543f4c7f5","text":"The management of high-energy proximal tibial plateau fracture requires the surgeon to take good care of the soft tissue envelope as the proximal tibia surface is covered only with skin and subcutaneous tissue. Various modalities of complex proximal tibial plateau fracture management have been considered, ranging from simple external fixators in impending compartment syndrome to periarticular proximal tibia plates and inter-locking nails with poller screws. Here we discuss the clinical outcomes of proximal tibial plateau fractures after surgical management and fixation with plate.","title":"Evaluation of Radiological and Functional Outcome of Intra-articular Proximal Tibia Plateau Fracture Treated with Plating"}
{"_id":"e98042a2-c8a3-501b-29b7-4cda211c39e8","text":"Postfiller complicated infection is not common. However, secondary RPF is a serious medical condition which carries fatal consequences and poor quality of life. Though this condition is very rare, it is important for the practitioners as well as the candidates to be vigilant for such adverse outcomes and avoid injecting permanent or unlicensed materials. The knowledge gap of the underlying pathophysiology and management approach necessitates further prospective work.","title":"Retroperitoneal Fibrosis after Chronic Abscesses of Silicone Fluid Fillers in a Case of Gluteal Augmentation"}
{"_id":"e982b038-b174-71b3-123d-e441673b8070","text":"A prospective cohort study will be carried out from January 2012 to June 2014. A total of 250 patients with a physician-confirmed diagnosis of food allergy will be included and followed during one year. Outcome measures are frequency, severity and causes of unexpected reactions. Participants complete an online questionnaire after every assumed accidental exposures and send in the product with food label they reacted on. The product will be analyzed to detect if the suspected allergens are present.","title":"Unexpected allergic reactions to food, a prospective study"}
{"_id":"e989c469-7c9c-8364-4c97-ed7d66d1e386","text":"Injectables that behave similarly to native tissue and preserve facial expressiveness represent a new frontier in aesthetic medicine. A range of fillers made of high molecular weight hyaluronic acid (HA) chains with low crosslinking have been specifically developed to complement facial dynamics.","title":"Efficacy and safety of a new resilient hyaluronic acid dermal filler, in the correction of moderate‐to‐severe nasolabial folds: A 64‐week, prospective, multicenter, controlled, randomized, double‐blind and within‐subject study"}
{"_id":"e98c5332-bc2b-a34b-987d-2e4e1f9b5054","text":"The risk of developing recurrent melanoma peaked at one year, and the site of first recurrence had a significant impact on survival. Defining the timing and expected patterns of recurrence will be important in creating an optimized surveillance strategy for this patient population.","title":"Hazard-Rate Analysis and Patterns of Recurrence in Early Stage Melanoma: Moving towards a Rationally Designed Surveillance Strategy"}
{"_id":"e99a47df-8df0-8acf-9aec-7b94c5438598","text":"Recommendation Surgical resection is weakly recommended for cases with small number of metastases with no other incurable factor.","title":"Japanese gastric cancer treatment guidelines 2018 (5th edition)"}
{"_id":"e9a4ebd3-8004-0155-dba6-3d3c22d2146c","text":"A steady volume reduction was observed in most melanomas treated with BA. Despite the small number of cases, this resulted in a significant positive treatment effect in the time:group interaction compared to the placebo group towards the end of the treatment period. Although these first results after topical BA application on small equine melanocytic lesions are promising, the observations must be confirmed in larger studies with a longer treatment period and with a more diverse horse population in order to be able to draw sound conclusions regarding the effectiveness of the substance in melanoma-affected horses. Modifications in the test formulation, such as increasing the concentration of the active ingredient or incorporating permeation enhancers that transport large amounts of the compound through the fibrous tumor capsule of equine melanomas to the tumor cells, could also have a positive effect on tumor volume regression and may reduce the treatment period.","title":"Effects of Topically Applied Betulinic Acid and NVX-207 on Melanocytic Tumors in 18 Horses"}
{"_id":"e9aeb4fc-7ef5-9751-fa63-e618b8484672","text":"Dorsal surgical approaches for the management of cervical spondylosis are well established and in recent years have undergone a host of modifications in order to make the surgeries minimally invasive. The rationale behind these advances is to cause less tissue injury on exposure, thereby decreasing postoperative pain, but most importantly the aim is to decompress the neural structures with minimal disruption of dorsal structures, thereby preserving motion and decreasing adjacent level disease and the incidence of postdecompression kyphosis.","title":"Operative Techniques for Cervical Radiculopathy and Myelopathy"}
{"_id":"e9b62a83-865d-f7f9-b6e2-5cf6c8f873c2","text":"The current career\/specialisation stage and the underlying life experience of the physicians being led were important aspects to consider because physicians at different stages of their career need different kind of leadership. In the early stages of physicians’ careers, difficult situations were more frequently experienced in patient encounters, which was why young physicians needed mental support from their supervisor in addition to the physical presence of a leader.","title":"Elements of perceived good physician leadership and their relation to leadership theory"}
{"_id":"e9b9c17c-e8fd-4167-0f82-58ff7a86d806","text":"Our patient suffered Gustilo–Anderson type IIIB open fractures at two sites, including the proximal tibia and calcaneal region. There was a high probability that this severe injury would require amputation, so we hesitated to use the opposite leg as a donor because of concern that the patient might end up with difficulty to use both legs. In addition, reconstruction of the injury required both a bony component and extensive soft tissue coverage. The contralateral vascularized fibula osteocutaneous flap was unsuitable because of its limited flap dimensions.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"e9bb469b-cbfd-0509-dbcc-7597687ffecb","text":"Table 1 Clinicopathological characteristics of patients who had a positive and a negative sentinel lymph node biopsy","title":"Tumour mutation status and melanoma recurrence following a negative sentinel lymph node biopsy"}
{"_id":"e9c1ad20-3cca-08b6-6e90-f0a6a6dca0c3","text":"When only the cutting guide was used, the mean vertical errors in the posterior mandible area were greater than 6 mm. When both the fibula cutting guide and the positioning guide were used, the mean vertical errors for the same region ranged from 2 to 5 mm. This pattern was similar to that observed in the 3D distance errors, and it indicates that the potential for error increased in the posterior direction. Consequently, in actual clinical cases, we can expect a greater potential for error in positioning segments in the posterior mandible.","title":"Precision of fibula positioning guide in mandibular reconstruction with a fibula graft"}
{"_id":"e9c38152-8175-5706-50d9-db7b047d885c","text":"This study revealed that the free flap reconstruction had higher failure rate in the recurrent group than the primary group, but such a difference may be mostly attributed by the different patient characteristics. In addition, the reconstructive option determined by the surgeons seemed to vary in handling recurrent and primary cancers.","title":"Comparison of the surgical outcomes of free flap reconstruction for primary and recurrent head and neck cancers: a case-controlled propensity score-matched study of 1,791 free flap reconstructions"}
{"_id":"e9cb13ad-4e0b-7467-60a1-c80ad9182344","text":"This patient most likely has a hypercoagulable state which predisposed him to DVT. Emboli from the venous system caused subacute PE and subsequent pulmonary hypertension which caused the right to left shunt through his PFO, leading to the formation of paradoxical embolism.","title":"Paradoxical embolism, deep vein thrombosis, pulmonary embolism in a patient with patent foramen ovale: a case report"}
{"_id":"e9cd4b19-e4cc-d3d7-1f3c-afc9b1c427f5","text":"The present study illustrates the clinical potential of light fractionated PDT using BF-200 ALA for enhancing PDT efficacy in (pre-) malignant skin conditions such as basal cell carcinoma and vulval intraepithelial neoplasia and its application in other lesion such as cervical intraepithelial neoplasia and oral squamous cell carcinoma where current approaches have limited efficacy.","title":"Light Fractionation Significantly Increases the Efficacy of Photodynamic Therapy Using BF-200 ALA in Normal Mouse Skin"}
{"_id":"e9cf841b-24a1-b339-7dc7-4734304ca617","text":"The pectoralis major flap is one of the most commonly used pedicled flaps for head and neck reconstruction because of its robust blood supply. Moreover, this flap can be used to reconstruct the defects even at the level of infratemporal fossa because of its long pedicle. Thus, the pectoralis major flap is an alternative for head and neck surgeons when 1 flap alone cannot entirely cover the defect. In combination with gastric pull-up to restore intestinal continuity, the pectoralis major flap can ensure a tension-free anastomosis and provide sufficient blood supply for the anastomosis to reduce the likelihood of anastomotic leakage, which is a severe postoperative complication that could lead to necrosis of the gastric flap. When a pectoralis major flap is used to cover the neck to protect the pharyngogastric anastomosis and the exposed great vessels after gastric pull-up alone is used to restore intestinal continuity, the pectoralis major flap can also provide additional tissue that was not irradiated preoperatively to protect patient from fistulas resulting from postoperative radiotherapy.","title":"Combined use of gastric pull-up and pectoralis major flaps for massive defects after total laryngopharyngoesophagectomy in patients with advanced hypopharyngeal carcinoma"}
{"_id":"e9dceb47-4d9b-f923-d1c0-0a198dea60b7","text":"The correct use of the plastic surgeon’s tools encompassed in the reconstructive ladder may be the key to better functional recovery and satisfactory result.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"e9de6c94-4729-92ba-1761-69a9cd900455","text":"Surgeons must maintain a high index of clinical suspicion for a chloramphenicol allergy, particularly in those patients who have developed perioperative site erythema and swelling within the first 24–72 hours of chloramphenicol application and do not respond to antibiotics. A delayed type hypersensitivity reaction must remain a prominent differential diagnosis even if symptoms occur outside these parameters or indeed if chloramphenicol has been used previously without adverse reactions. On consideration of these cases, we have adjusted our practice and now cease topical ointments prior to initiating systemic therapy for suspected infection.","title":"Reaction or infection: topical chloramphenicol treatment"}
{"_id":"e9de9ef3-68eb-540c-8034-8143d360b6b8","text":"One of the purposes of this study was to analyze whether trend changes in prescribed BLs have influenced the diagnosis of immediate hypersensitivity reactions. In this sense, we have observed that changes in the drugs involved in immediate reactions to BLs have influenced the sensitivity of skin tests. The role in diagnosis played by major and minor determinants of BP has decreased, while that of amoxicillin and, more recently, clavulanic acid and cephalosporins has progressively increased.","title":"Changes in Sensitization Patterns in the Last 25 Years in 619 Patients with Confirmed Diagnoses of Immediate Hypersensitivity Reactions to Beta-Lactams"}
{"_id":"e9e15236-a553-63ae-ebbb-4975fa247b97","text":"Firstly, our study was based on only one sample of an ex-vivo human hand. Further samples of the same and other bony structures of the human body should be examined for revalidation of the obtained results and for the evaluation of the transferability of these results to other anatomical structures such as a leg or an arm, where the amount of soft tissue is considerably higher compared to the hand.","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"e9ec2557-033c-efa3-5207-0f6322a970a6","text":"Practical exercises are divided into 10 Steps. A good simulation is characterized by a high degree of authenticity, low cost and a good supply","title":"Microsurgical training course for clinicians and scientists: a 10-year experience at the Münster University Hospital"}
{"_id":"e9ed7650-b666-0908-88bf-f6d7d8ac4350","text":"Patients were included if they were at least 18 years of age, had a diagnosis of cancer and concurrent radiological diagnosis of DVT and\/or PE, and were prescribed treatment with either rivaroxaban or enoxaparin during the study period. Patients were excluded if the length of anticoagulation therapy was less than 30 days, if therapy with enoxaparin or rivaroxaban was initiated more than 6 months after DVT or PE diagnosis, or if they did not receive therapeutic doses of the therapy. Patients with DVT of upper extremity were also excluded.","title":"Comparative analysis of enoxaparin versus rivaroxaban in the treatment of cancer associated venous thromboembolism: experience from a tertiary care cancer centre"}
{"_id":"e9fa9f7e-9762-9988-8804-a8ef64ecaf4e","text":"Squamous cell carcinoma is the most common malignancy of the oral cavity. Primary treatment involves surgical resection of the tumour with a surrounding margin. Historically, the most commonly accepted margin clearance is 5 mm. This distance is controversial, with recent publications suggesting closer margins do not impact local recurrence and survival. The objective of this study is to determine the closest surgical margin that does not impact local recurrence and overall survival.","title":"Surgical margins of the oral cavity: is 5 mm really necessary?"}
{"_id":"ea07883c-cd89-d9d5-875d-145603a7f110","text":"In this cohort study of 5016 patients with metastatic melanoma between 2005 and 2016, the overall risk of second primary cancers increased after the introduction of immune checkpoint inhibitors. Risks for cancer of the small intestine and myeloma were higher than before the era of immune checkpoint inhibitors.","title":"Assessment of Trends in Second Primary Cancers in Patients With Metastatic Melanoma From 2005 to 2016 Trends in Second Primary Cancers in Patients With Metastatic Melanoma, 2005-2016"}
{"_id":"ea08ba62-1798-b7de-49f7-ca7b48bdefe0","text":"Considering the aforementioned arguments, the aim of this study was to identify the risk factors that lead to proximal DVT more frequently than to distal DVT.","title":"Systemic and Local Factors’ Influence on the Topological Differences in Deep Vein Thrombosis"}
{"_id":"ea16bd03-f851-8bd3-e514-ef38036a6f6e","text":"I got talked into doing it by a supervisor who made the case that it would help to open doors career wise (Fellow)","title":"Fellowship training: a qualitative study of scope and purpose across one department of medicine"}
{"_id":"ea1ada1e-6c15-5dd5-cb6e-8da98ea86b27","text":"Some of the interviewees explained that the skills and attitudes that they had developed through the programme would be increasingly important as they progressed through their careers, discussing their roles as consultants, GP partners and members of the CCG. One of the interviewees explained that it was too soon to understand the true impact of the programme on their career, the majority expressed that it had been very helpful:","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"ea1fd157-4abe-5e15-d218-e640a7a5c1ea","text":"The prognosis of MM is continually improving due to medical advances. The treatment of myeloma with chemo- immunotherapeutic agents and autologous stem cell transplantation renders the patient immunocompromised for periods of time, exposing them to infection. Spinal fixation has been employed traditionally to treat myeloma patients when decompression and stabilisation were deemed to be essential. However, it is well established that in situ instrumentation is at risk of getting infected when the patients are in an immunocompromised state. If the metalwork gets infected, then the consequences can be catastrophic. Cement augmentation is a very effective way of stabilising the anterior and middle spinal columns without the need for metalwork fixation. It is an excellent way to relieve the pain from a VCF. The myeloma spine treated with bisphosphonates appears to produce an external scaffold of bone that stabilises even the most moth-eaten spinal elements once the disease process is under control. An external orthosis can be very effective when trying to achieve pain relief from a fracture. It also helps to maintain the correct sagittal balance in patients with multiple fractures while they heal or before they are treated with cement augmentation. The development of radiofrequency ablation in combination with cement augmentation procedures is currently under investigation with encouraging results.","title":"The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG)"}
{"_id":"ea251691-0124-3cb4-8227-de78dcb59161","text":"Our present study demonstrates that both bifocal and trifocal bone transport using unilateral rail system led to satisfactory bone and functional results in the treatment of large tibial defects caused by infection. All patients in our series reached bony union with or without bone grafting at the end of the treatment. However, trifocal bone transport led to better functional results but not bony result than bifocal bone transport; this can be explained due to the external fixator not being able to be removed sooner in trifocal group, as well as patients being willing to exercise frequently without fixation placement, which could potentially prevent muscle contraction and joint stiffness. There are many factors that can impact successful distraction osteogenesis based on our experience, such as comprehensive understanding of application of external fixator, prudent patient selection, radial excision of infected bone, timely follow‐up during and after distraction period, early detection of predicted complications and proper surgical or non‐surgical intervention and psychological counseling with in‐charge surgeon during entire treatment course.","title":"Bifocal or Trifocal (Double‐Level) Bone Transport Using Unilateral Rail System in the Treatment of Large Tibial Defects Caused by Infection: A Retrospective Study"}
{"_id":"ea2687bc-891b-557b-f227-30437d72bc65","text":"The case presented demonstrates the critical importance of early diagnosis of acute osteomyelitis and the appropriate treatment of a closed fracture, as well as the importance of preventive treatment of skin and soft tissue wounds, which present a potential risk for local and systemic bacterial infection. This is especially important in patients with chronic diseases or otherwise immunocompromised patients, who are at greater risk of developing these complications. The patient in the case presented was diagnosed with advanced osteomyelitis, as a closed clavicle fracture had previously been overlooked, resulting in no standard therapy and follow-up. A chronic deep skin wound also had not been previously aetiologically diagnosed or treated, which could have presented an important preventative measure against later complications. Furthermore, this case demonstrates that osteomyelitis, although a very uncommon complication, should be considered a possible cause of a deteriorating clinical condition in patients with a history of recent trauma. All of these factors are crucial in contributing to an adequate treatment outcome.","title":"Complicated acute haematogenous osteomyelitis with fatal outcome following a closed clavicle fracture—a case report and literature review"}
{"_id":"ea2d595c-6ad6-2301-0e8b-963daf51ddda","text":"• Anticoagulation prophylaxis is proven to decrease the risk of venous thromboembolism in other patient groups, but may increase the risk of progression of intracranial hemorrhage","title":"Prophylactic anticoagulation to prevent venous thromboembolism in traumatic intracranial hemorrhage: a decision analysis"}
{"_id":"ea3c0fed-dafa-f6b3-7354-7576eba6ee94","text":"Opioids including fentanyl and its derivatives and morphine are considered as the pillar stone of pain management in the surgical process. However, opioid usage has been reported to be correlated with certain adverse outcomes after the pancreatic section. Thus, reduction of opioids, a common goal in surgical analgesia strategy, may be of great importance in pancreatic resections of cancer patients. Our study found that paravertebral block reduced the opioid requirement during the perioperative period, which may be through the effect of an inflammatory mediator such as IL-10. Given the fact that the majority of anesthesiologists still have a preference for epidural blockade or other alternative analgesic regimens and limited clinical studies have been conducted with paravertebral block, especially in pancreatic cancer surgery, our study can provide further evidence for the benefits of the application of this technique.","title":"Ultrasound-guided paravertebral blockade reduced perioperative opioids requirement in pancreatic resection: A randomized controlled trial"}
{"_id":"ea40efe3-1104-4da9-f84c-3e15bec21ca9","text":"Table 5 Maternal sociodemographic characteristics of participants who were breastfeeding at 1 year postpartum versus those who were not breastfeeding at 1 year postpartum","title":"Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study"}
{"_id":"ea41c677-3ef4-484b-8409-860e74d27505","text":"In both cases, correction was commenced late so as to ensure complete wound healing. We believe that it is not necessary to wait for 6 weeks provided the soft tissues are adequately healed. In a subsequent successful case, we were able to commence correction at 3 weeks. In delaying correction, we used distraction osteogenesis with manipulation of immature fracture callus at the fracture sites. The advantages of delaying the correction from 3 to 6 weeks may result in faster fracture union.","title":"Conversion of open tibial IIIb to IIIa fractures using intentional temporary deformation and the Taylor Spatial Frame"}
{"_id":"ea44a954-33b9-5cbb-c87c-e9fbe7c64843","text":"Patients are routinely consulted regarding dislike of their upper and middle back contour and associated back rolls that stick out of their bras. Although patients only associate this fullness with excess fat, on examination it becomes evident that back rolls are due to a combination of excess fat as well as skin redundancy. To date, treatment of both excess skin and fat in back rolls has required consideration of excisional surgery such as an upper body lift.","title":"Successful Back Contouring With Elimination of Back Rolls Using Ultrasound-Assisted Liposuction and Helium-Activated Radiofrequency"}
{"_id":"ea469d66-0b22-dae0-b0f9-a7911ff0521d","text":"Finally, skin cancers are preventable and treatable pathologies with sun protection and early diagnosis. The present study gives the informations about a small population’s NMSC statistics. We think that we need to have better knowledge about the distribution of skin cancers in our country by the necessary notifications about the NMSC and multicentric studies.","title":"Non-metastatic Non-melanoma Skin Cancers: Our 3 Years of Clinical Experiences"}
{"_id":"ea47d7c9-0556-ef6e-5396-c1ad2e739170","text":"Autologous costal cartilage is a commonly employed graft for septorhinoplasty. It is particularly favored as an abundant source of cartilage in cases of revision rhinoplasty in which more local sources (septum and concha) are depleted. Gibson and Davis emphasized the importance of reducing of warping by balanced costal cartilage cross sections, achieved by concentric carving as demonstrated in a retrospective study on 46 patients. Warping is related to distortion of graft material, which was shown later with structural deformity. Many different techniques have been utilized to minimize warping. The most frequently applied techniques were to delay grafting or immersing the graft in solution before shaping or insertion.","title":"Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty"}
{"_id":"ea47da34-a0a1-4d19-cf8d-347addfb41b0","text":"In contrast with the cartilage, the calcium volume in costal cancellous bone showed a sharp decline since the 50 years old in female patients, which leaded to decrease in CT measurement. However the costal cortical bone almost shared a similar calcium volume and CT measurements in different age groups. This suggested that female underwent a significant bone loss around the 50 years old and the major change occurred in the costal cancellous bone. There are many life events contributing to the bone loss and one of the most important event is menopause in the female patients. Although bone loss in menopausal women has been conformed in many studies, there were no reports discussing the costa bone calcium in this special population. So our study is the first time to provide information on the costa calcium loss as age increased in female patients.","title":"Characteristics of Chinese Costal Cartilage and Costa Calcification Using Dual-Energy Computed Tomography Imaging"}
{"_id":"ea4a649c-daf5-114a-f81b-9f73bb2e0e86","text":"The authors confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.","title":"Native tricuspid valve infective endocarditis with Staphylococcus lugdunesis: An unusual complication post spinal epidural injection – Case report and literature review"}
{"_id":"ea4f65f3-0ff2-a657-3529-75d0fbc43148","text":"The purpose of our study was to evaluate functional outcomes and patient well-being after the debridement and simultaneous reconstruction of the sternal defect using a pedicled latissimus dorsi flap.","title":"Deep sternal wound infection – latissimus dorsi flap is a reliable option for reconstruction of the thoracic wall"}
{"_id":"ea53b254-cbfd-5f6c-8d8e-d7e89a12f87d","text":"Postoperative deep infection occurring in patients who have undergone instrumented spinal fusion surgeries can cause mortality or disastrous complications resulting from long-term antibiotic use and immobilization. These infections can also necessitate further surgeries including removal of a previously inserted instrument to control the infection or additional instrumentation for stabilization [4]. Therefore, when spine surgeons plan instrumented spinal fusion surgery for patients with degenerative spinal disease, identifying those at high risk of postoperative deep infection is a prerequisite to avoiding postoperative complications.","title":"Risk Factors for Postoperative Deep Infection after Instrumented Spinal Fusion Surgeries for Degenerative Spinal Disease: A Nationwide Cohort Study of 194,036 Patients"}
{"_id":"ea54b912-4232-bc1e-fd24-d519fe98b2ab","text":"Plastic surgery is overlapped by many other specialties unlike other surgical disciplines which have more clearly defines areas and restrict themselves to certain anatomical boundaries. Because of the breadth of plastic surgery and the diversity of the procedures, much information needs to be spread in the society. According to American Society for Aesthetic Plastic Surgery, nearly 8.3 million cosmetic procedures were performed in 2003.8 This represents an increase of 299% since 1997. The marketing of cosmetic surgery and related services to the patients is becoming a major objective. As a result, the public is becoming more aware of the role of the plastic surgery. The specialty of plastic surgery in not a very new one. The development of plastic surgery as a specialty has resulted in a significant positive impact on health care.","title":"Views of College Students on Plastic Surgery"}
{"_id":"ea56e536-d6f7-6b4e-9ad1-baaf2ab08421","text":"Flap reconstruction is an effective way to cover the perineal wound reducing both perineal complication rate and wound healing delay. The ORAM is particularly interesting for female whose tumors require resection and subsequent reconstruction of the posterior wall of the vagina.","title":"PERINEAL REPAIR AFTER ABDOMINOPERINEAL EXCISION WITH RECTUS ABDOMINIS MYOCUTANEOUS FLAP RECONSTRUÇÃO DO PERÍNEO APÓS AMPUTAÇÃO ABDOMINOPERINEAL COM RETALHO PEDICULADO DO MÚSCULO RETO ABDOMINAL"}
{"_id":"ea572214-9017-aafa-63b2-330389df3042","text":"Cancer survivors have an increased risk of developing a subsequent cancer compared to the general population and individuals with multiple primaries now account for a substantial fraction of the newly diagnosed cancers [15]. While these results have been established in more common cancers, the risk of a second primary for patients with rare cancers has not been addressed until now. We found that participants with at least one rare cancer had a 23% increased risk of a subsequent cancer diagnosis compared with individuals with no prior cancer diagnosis, and those with at least two rare cancers had a 47% increased risk of a subsequent cancer diagnosis compared to those with fewer than two prior rare cancers.","title":"Are rare cancer survivors at elevated risk of subsequent new cancers?"}
{"_id":"ea5db662-f0ba-2989-71a1-407803f0950e","text":"The anteromedial arthrotomy of the knee extends distally to the proximal tibia and the pes anserinus and medial soft tissues are elevated off the tibial metaphysis. The tibia can be externally rotated and the patella everted. The distal femoral oncologic component is disengaged from the proximal tibial component and the areas of reactive scar tissue are excised. The distal femoral component condyles and body components should be disarticulated to facilitate exposure to the popliteal fossa and posterior aspects of the knee and proximal tibia. Soft tissue adhesions to the distal posterior femur at the implant “collar” are released with a release of the posterior margin of vastus lateralis and vastus medialis. In a standard arthroplasty setting, the origins of the gastrocnemius muscles are elevated. There may be several superior geniculate vessels that need to be ligated at this step.","title":"Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty"}
{"_id":"ea6087ab-d609-30f4-cf1a-14b6a7cca67b","text":"The adequate prophylaxis for venous thromboembolism in the perioperative evaluation involves detailed knowledge of the risk factors of each patient together with the risks inherent to the surgical procedure.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"ea61d04c-745e-6a79-fa4b-2fbcbbad3a03","text":"To the best of our knowledge this is the first time the number of removed lymph nodes in pN+ patients has been investigated in non-luminal A breast cancer in such detail, number of cases and the effect it has on survival.","title":"Does the number of removed axillary lymphnodes in high risk breast cancer patients influence the survival?"}
{"_id":"ea61d0d1-4e2c-3b63-9e15-99ed8e7e81da","text":"LDLT was done through a bilateral subcostal incision with an upward midline extension. Intraoperative cholangiography via cystic duct was required to study the anatomy of the bile duct. Right hilar dissection was then performed to isolate the right hepatic artery, right portal vein, and right hepatic duct. Then the right lobe of the liver was rotated toward the left side for division of the ligaments on the right side of the liver and the minute hepatic venous branches. The liver was transected at a plane just to the right of the middle hepatic vein using an ultrasonic dissector. The transection plane was determined by intraoperative US and temporary occlusion of the right portal vein and right hepatic artery. When the transection approached the liver hilum, the right hepatic duct together with the surrounding Glission sheath was encircled. Then, the right hepatic duct was divided near the confluence of the hepatic ducts by scissors.","title":"Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein"}
{"_id":"ea650ce0-0d9e-0b05-e4f4-1609644d3e40","text":"Analysis of anastomotic errors (Figure 6) showed that the total number of errors cumulatively increased amongst all subjects from 91 errors per anastomosis at baseline to 137 errors per anastomosis with the introduction of cognitive distraction and external stress. The comparison of pre and post intervention frequency of errors is illustrated in Figure 6. The overall frequency of each error with intervention is illustrated in Figure 7.","title":"Determining the Effect of External Stressors and Cognitive Distraction on Microsurgical Skills and Performance"}
{"_id":"ea66112a-5e71-6b86-e4e8-96484a93817a","text":"Data were obtained from clinical records and O2C analysis system measurement records. Surgery duration and flap ischemia duration were calculated as the time interval between the first incision and the last suture or between the separation of the flap pedicle vessel at the donor site and the release of the vascular clamp to initiate flap perfusion at the recipient side after anastomosis. Flap revision was defined in terms of flaps whose anastomosis was surgically revised with a return to the operating room, and flap failure was defined in terms of flaps that were completely lost due to tissue necrosis and subsequently removed.","title":"Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity"}
{"_id":"ea6a67d7-deed-1d6f-5325-cecd466ab436","text":"Midface and scalp advanced oncologic reconstruction using cervical or superficial temporal recipient vessels did not differ in terms of success and complication rates. Therefore, the use of superficial temporal recipient vessels may be a reasonable option, especially in a secondary reconstruction setting.","title":"Recipient vessels for free flaps in advanced facial oncologic defects"}
{"_id":"ea6c65c4-4242-801c-4111-cf4081686f51","text":"The use of an SVG for a bypass or reconstructive purpose was a preferable treatment of choice in neurosurgery for the management of extracranial atherosclerotic disease, extra- and intracranial aneurysms, and tumors involving the carotid artery at the skull base or cervical regions.13 Cerebral revascularization was established in three ways: a superficial temporal artery to middle cerebral artery bypass; a long interposition SVG between the carotid artery in the neck and the branches of the middle cerebral artery, or a short SVG from the intrapetrous to the supraclinoid carotid.13","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"ea6c69f3-ee60-9898-f6ba-8275301176b6","text":"Thin grafts are only a temporary solution and in any case it is necessary to create a blood supply condition.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"ea6cc2cd-9660-98c1-10de-a1e8a6207c85","text":"In this study ice slurry injection was a safe and effective method to produce cryolipoysis for selective reduction of VAT, leading to weight loss. This is the first report of successful use of ice slurry for targeting VAT and inducing weight loss. Furthermore, ice slurry treatment induced visceral adipocyte cell death as early as day 1 post treatment, associated with increased expression of pro-inflammatory markers in adipose tissue, followed by significant upregulation of genes involved in neocollagenesis and angiogenesis at later time points. Since VAT is strongly associated with obesity and metabolic syndrome, the results of this study offer the possibility of injecting slurry into abdominal VAT for targeted reduction thus improving not only weight but possibly also metabolic disease. Many more safety and feasibility trials will be required in large animals to demonstrate that injection of slurry into abdominal VAT will not pose a risk to surrounding organs or vessels. Adding image guidance such as ultrasound can help reduce the challenges associated with precise needle placement into abdominal VAT. Given that slurry is selective to targeting only adipose tissue makes this a potentially viable treatment.","title":"Selective reduction of visceral adipose tissue with injectable ice slurry"}
{"_id":"ea72eeb0-efd2-7a17-0d8a-16cae4a0a956","text":"We report the results of the first national survey of oncoplastic breast surgeons involved with the TIG and assess their practices of TM. In particular, we ascertained what selection criteria surgeons used when considering TM, which of the various described techniques were used or preferred, and how involved surgical margins were managed.","title":"Current Practice of Therapeutic Mammaplasty: A Survey of Oncoplastic Breast Surgeons in England"}
{"_id":"ea860f3b-7483-8e0f-694c-f4b0287491bd","text":"Attached surface probes for the O2C analysis system are a feasible option for intraoral flap perfusion monitoring.","title":"Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity"}
{"_id":"ea8743b0-cfdb-d905-a60a-8b3b1852f63f","text":"To simulate possible changes in systematic review results if rapid review methods were used.","title":"Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study"}
{"_id":"ea896d88-32b4-1993-6842-0076f4026295","text":"Blue dye technique was performed for SLN biopsy procedure. It was injected periareolarly in an intradermal plane for localisation and identification of SLN. Intraoperatively, SLNs were identified by their blue colour in addition to those found suspicious on palpation and those with afferent lymphatic vessels stained blue. ALND was performed if no SLN could be identified.","title":"Frozen section evaluation of sentinel lymph nodes in breast carcinoma: a retrospective analysis"}
{"_id":"ea8bdd66-a6d5-5cfa-3c13-61022f44e395","text":"These elements have to be considered in the generalization of results.","title":"The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours"}
{"_id":"ea8d39e7-44f4-2fd6-8dcd-7d7c7cba0dad","text":"The discovery of bone formation in the skin should alert the clinician to consider the possibility of an adjacent neoplastic or inflammatory entity. However, the prognosis of basal cell carcinoma is not altered by the concurrent presence of osteoma cutis. Therefore, treatment in patients who have the disease should be appropriate for the associated skin cancer.","title":"Basal Cell Carcinoma with Osteoma Cutis"}
{"_id":"ea8e0761-9184-988a-3cba-17ab45f46f1f","text":"The readers assessed the images by rating the following quality criteria:","title":"Photon-counting spectral basis component material decomposition for musculoskeletal radiographs"}
{"_id":"ea910b18-2993-8409-0b58-dff67b9a3088","text":"A low lying labial frenum can usually be seen on clinical examination. If there is blanching of the interdental papilla in the midline when the upper lip is everted, the frenum may be contributing to a midline diastema. However, commonly it may not be possible to ascertain whether a low lying labial frenum is causing a midline diastema or if it is a consequence of a midline diastema. In either case the management of the low lying labial frenum will be the same.","title":"The orthodontic-oral surgery interface. Part one: A service evaluation and overview of the diagnosis and management of common anomalies"}
{"_id":"ea93586d-9425-ad5f-812a-eecff87f160a","text":"Proximally, this flap cannot be delineated further than the junction of the heads of the gastrocnemius, as at this level the sural nerve and the artery are subfascial until they reach the popliteal fossa.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"ea9c3a90-13a9-2012-ad7d-f928c886a00b","text":"The most common pathway to DOM in this study cohort was prior service as Department Chair. This suggests that diversification among Department Chair positions or expansion of search criteria to seek leaders from pools other than Department Chairs may facilitate increased diversity, equity, and inclusion among DOM overall.","title":"Common pathways to Dean of Medicine at U.S. medical schools"}
{"_id":"ea9d94c3-878e-ef82-c2b9-1d1fb2048342","text":"This paper, starting from an extensive review of the literature related to the topic, describes the main treatment options currently available for the management of BCC, with particular attention to recent results on the use of PDT in this disease and on its potential benefits and possible limitations.","title":"Usefulness of Photodynamic Therapy as a Possible Therapeutic Alternative in the Treatment of Basal Cell Carcinoma"}
{"_id":"ea9dede9-0974-497a-08a0-1bae9e19bcf7","text":"Bilateral endoscopic transcanal cartilage tympanoplasty can be considered as a safe minimally invasive procedure that can be performed in a same-day surgery. It reduces the costs and operation time and is practical with a low rate of postoperative complications.","title":"Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results Timpanoplastia bilateral transcanal por via endoscópica com cartilagem realizada simultaneamente: resultados iniciais"}
{"_id":"ea9e5411-cb38-1f77-ba59-d6e7d9642056","text":"Deep vein thrombosis is a well-known complication of fracture occurrence, lower limb surgery and periods of prolonged immobilisation. Its incidence can be increased even more in specific cases with metastatic bone disease and adjuvant treatment. There is a small amount of literature that addresses the incidence of DVT by comparing osteosynthesis and arthroplasty as surgical treatments. Current recommended anticoagulation protocols might be inadequate for specific groups of cancer patients undergoing osteosynthesis or arthroplasty.","title":"Deep vein thrombosis following the treatment of lower limb pathologic bone fractures – a comparative study"}
{"_id":"ea9ef5db-294d-021a-90a0-7682dea2040c","text":"A 49-year-old Hispanic female with a past medical history of type II diabetes mellitus and hypertension presented with a complaint of a pruritic rash over her eyebrows which occurred a month after she had done microblading to both brows in Mexico 16 months prior. She stated she had two intralesional steroid injections administered over two months by the same doctor in Mexico who performed the initial microblading and had noticed some temporary improvement. She also tried Quadriderm cream, sulfur cream, and mupirocin ointment with no resolution of her symptoms. She mentioned having a red lip liner tattoo in the past with no local reactions or complications.","title":"Chronic Granulomatous Reaction to Semi-permanent Eyebrow Tint"}
{"_id":"eaae0a84-cda7-d8d9-0fd9-d98b8a0d3e29","text":"We consider that open surgical excision should be reserved for cases of large ganglionic cysts because it can provide a complete resection of the lesion and minimize the risk of recurrence. On the other hand, arthroscopic treatment is more suitable for small lesions that lay strictly within the synovium.","title":"Large infrapatellar ganglionic cyst of the knee fat pad: a case report and review of the literature"}
{"_id":"eab86063-5845-6071-b235-f8397e6a3f20","text":"Insufficient leadership was also pointed out as the reason for trauma management that failed.","title":"Leadership is the essential non-technical skill in the trauma team - results of a qualitative study"}
{"_id":"eabb0444-c49a-e135-defa-f143ed657681","text":"Adequate surgical excision leads to complete cure of this benign lesion, but recurrences are common following incomplete excision. Therefore awareness among clinicians of this rare entity is vital in offering the best possible care to the patients.","title":"Unusual case of recurrent thigh lump in a girl: a case report"}
{"_id":"eabc3cd1-ccb1-88f8-40f0-45a2d4f0533a","text":"Surgical treatment was essential for stabilization of the condition. Due to the complexity of this type of infection in the craniofacial region, planning and execution must be carried out through a multidisciplinary team.","title":"Facial trauma followed by osteomyelitis - Case report"}
{"_id":"eabe0dbf-f917-5b21-c8a6-9847fc777ace","text":"Whistling deformity often occurs after cleft lip primary repair, marked by deficiency of vermilion tubercle. The purpose of the surgery includes improving the appearance and function of the lip. Adequate amount of vermillion tubercle is necessary to fully cover the front teeth, produce lip seal while speaking consonant sound and balance the projection of face.","title":"Reconstruction of whistling deformity using V-Y advancement flap after primary cleft lip repair"}
{"_id":"eac4d711-4717-ecab-eb09-f675312e29f4","text":"This is an area requiring further study, but it is clear that there is an improvement in breastfeeding following division; therefore, ankyloglossia should be addressed as early as possible in affected infants.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"eac88051-00ee-e7c2-634d-5d4a9817a46c","text":"Patients were asked about not being aware of any nasal discharges until it gets out of the nostrils.","title":"Frequency of Minor Skin and Soft Tissue Complications in Facial and Periorbital Area after Septorhinoplasty"}
{"_id":"eacddc72-55ba-7064-81d4-829a048bb79c","text":"The main limitation of our study is related to the laboratory origin of the database and therefore the lack of clinical or radiological data, yet useful for the diagnosis of osteomyelitis, especially when potential contaminant like coagulase-negative Staphylococcus are isolated. However we limited this by analyzing only cultures from bone specimens, and not including deep soft tissue samples. Our risk factor analysis should be interpreted with caution given the number of missing values, but the association between number of previous surgeries and infection with MDR has been already reported [23]. Patients with missing data were more frequently from Iraq and we found that the time since injury was significantly longer in patients from Iraq. This could result in selection bias and an overestimation of the association between FLAR infection and shorter time since injury.","title":"Post-traumatic osteomyelitis in Middle East war-wounded civilians: resistance to first-line antibiotics in selected bacteria over the decade 2006–2016"}
{"_id":"eacf3124-0691-18cb-ffec-54a1e8600300","text":"Different perforator locations are associated with a harder or easier dissection, and sometimes lead to extensive splitting of the muscle; compared to lateral vessels, medial perforators offer better flap perfusion but a harder dissection due to a long intramuscular course. Perforator dissection is carried out along the deep inferior epigastric pedicle up to its origin from the external iliac artery. The DIEP flap should be adapted and shaped to the single patient and type of breast reconstruction, with an optimized anatomical preoperative study that allows the identification of personal anatomical characteristics in order to accelerate dissection and flap harvesting, as well as to avoid vascularization deficiencies. An accurate preoperative planning with evaluation of single anatomical variants allows a decrease in decrease operating time and theatre utilization, with a consequent benefit in terms of surgical waiting lists and staff optimization.","title":"Conventional CT versus Dedicated CT Angiography in DIEP Flap Planning: A Feasibility Study"}
{"_id":"ead13070-1802-2a88-5c46-245c6cfc8786","text":"In conclusion, this study supports the notion that harvesting vein through multiple incisions using the Mayo vein stripper is quicker, results in better wound healing and has no deleterious effect on endothelial function compared to the open technique.","title":"Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest"}
{"_id":"ead34df0-3222-4aff-0882-556fa68ac2cf","text":"An example of procedure with wide large soft tissue excision and outer calvarian resection followed by two step reconstruction with skin substitute (template) and a skin graft is reported in Figure 3 .","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"ead5e606-b26b-d423-ebe4-091fb77471df","text":"We would like to highlight the advantages of using skin allograft in different scenarios outside the scope of burn injury in three illustrated cases of reconstruction following oncological resections and a traumatic case using free tissue transfers.","title":"The versatility of a glycerol-preserved skin allograft as an adjunctive treatment to free flap reconstruction"}
{"_id":"eada91bc-2387-580a-79a6-187156d35290","text":"This study reveal that TFE3 has a potential to serve as a diagnostic marker capable of assisting in the differential diagnosis of DTF and other spindle cell lesions.","title":"Nuclear TFE3 expression is a diagnostic marker for Desmoid-type fibromatosis"}
{"_id":"eadfbfe8-3619-e08b-c385-d7f25d87db72","text":"We report the case of a woman who presented with breast cancer metastases to the femur causing pathologic fracture of the femoral neck requiring surgery. She received adjuvant radiotherapy to the femur at that time that did not include the surgical scar tract. Almost four years after her surgery she presented with biopsy proven skin recurrence of breast cancer on the skin overlying her incision from her femoral surgery.","title":"Surgical Scar Recurrence of Bone Metastases to the Femur: A Case Report"}
{"_id":"eaeaf3a0-15d8-756a-ba95-d1d1cb8a9105","text":"In this study, the median number of harvested SLNs was five and the median number of harvested PSLNs was two per patient in the overall study group. SLNs were removed until no focal radioactivity remained rather than strictly following the widely used 10 per cent rule, that is harvesting SLNs with radioactivity of 10 per cent or more of that of the most radioactive node. The high numbers suggest that there may be more second-tier nodes removed than in other studies. For the interests of this study, however, it was essential to remove all potential sentinel nodes in an attempt to identify any clinical impact. Despite the great number of harvested pelvic lymph nodes, they appear minimally important in the treatment and prognosis of melanoma patients.","title":"Pelvic sentinel lymph nodes have minimal impact on survival in melanoma patients"}
{"_id":"eaebbc64-c355-fc8a-8da0-87df199bc33b","text":"The two remaining patients with grade II anaphylactic reactions after build-up phase were readmitted after 3 and 4 weeks respectively and subsequently underwent an adapted build-up phase. Over three days the bee venom dose was increased to 60 µg in an inpatient setting. Three to five days later, we repeated the dose of 60 µg once in an outpatient setting and then further increased the bee venom dose to 80 µg and 100 µg at one-week intervals. One week after this modified build-up phase, the maintenance dose of 100 µg of bee venom was repeated once. We did not observe any anaphylactic reactions during this specifically tailored build-up phase. All three patients reached the standard maintenance dose of 100 µg of bee venom and subsequently entered the maintenance phase involving monthly injections. No further anaphylactic reactions were reported during the first two years of maintenance therapy.","title":"Anaphylactic reactions in the build-up phase of rush immunotherapy for bee venom allergy in pediatric patients: a single-center experience"}
{"_id":"eb00af16-d70c-8373-94df-7ceb74b0fae3","text":"The results of this study suggest that a frenotomy in OSA patients with ankyloglossia could reduce tongue collapse, probably by allowing the tongue to take its optimal position in the oral cavity.","title":"Does Frenotomy Modify Upper Airway Collapse in OSA Adult Patients? Case Report and Systematic Review"}
{"_id":"eb035046-f919-9f31-f490-daa73bc57dd8","text":"The literature seems unanimous on estimating the MCS superior to standard wide excision in preventing false negative margins and thus local recurrence but this may partially due to a patients selection bias.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"eb069bd8-cfeb-af25-3e8f-29b0a4d17caf","text":"The purpose of this study is to compare both strategies—double flap transfer and pure intraoral resection with temporal microvascular anastomoses for intraoral reconstructions—regarding feasibility, operation time, and complication rates in these clinically challenging reconstructive cases as the choice of recipient vessels and options available to the reconstructive surgeon in case of retreatment with a free flap is limited.","title":"Superficial Temporal Artery and Vein as Alternative Recipient Vessels for Intraoral Reconstruction With Free Flaps to Avoid the Cervical Approach With the Resulting Need for Double Flap Transfer in Previously Treated Necks"}
{"_id":"eb089abb-bd66-9c03-94bf-c6263f096579","text":"The main goal of therapy is to eliminate the risk factors of an upper airway collapse thus reducing the risk of persisting OSAS.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"eb132d1c-c4b0-1c68-2598-fecb14e81f4d","text":"The patient denied a personal and family history of related diseases.","title":"CTNNB1 p.D32A (c.95A > C) somatic mutation in stage I grade 1 endometrioid endometrial carcinoma with lung metastasis: a case report"}
{"_id":"eb2168fb-530c-183c-9c4d-2657bb50ba6e","text":"The aim of the present study was to analyze the factors that influence the surgical choices of breast cancer patients in China who were eligible for BCS. Our hospital has a specialized surgical team for breast cancer treatment and the technologies needed for postoperative radiotherapy, and intraoperative pathological examinations for BCS are routinely performed. Because these potential medical biases did not need to be considered, this study focused mainly on demographic and socioeconomic factors that influenced the surgical choices. We address this problem by examining the decision-making process prospectively and allowing the patients to make their own decisions.","title":"Non-doctoral factors influencing the surgical choice of Chinese patients with breast cancer who were eligible for breast-conserving surgery"}
{"_id":"eb22626a-239d-354f-a124-d6e50bb57028","text":"Further evidence of disease modification by AIT comes from the results of a phase IV study with the Timothy grass SLIT tablet that examined the effect of three years of treatment of children ages 5 to 12 years who had documented grass-induced AR but no evidence of pre-existing asthma on careful screening . In the 812 children, three years of treatment produced persisting improvement in clinical AR during two years of follow-up. More importantly, the development of both summertime and wintertime asthma was significantly reduced in the group that had received the Timothy SLIT tablets when compared with those who had received placebo treatment ( Table 2). This suggests, for the first time, that immunotherapy may protect against the development of asthma caused by factors beyond the allergen used in treatment.","title":"Recent advances in allergic rhinitis [version 1; referees: 2 approved]"}
{"_id":"eb32c6c8-f0d5-2166-e863-a85c8ea40e3d","text":"Any amendments to the protocol will be reported to the appropriate regulatory bodies, with a full copy of the current protocol available for download from the study website. There are no amendments to date.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"eb346546-ddd9-a220-71d1-219375604a95","text":"The present study lays the groundwork for further research into postoperative breast volume changes following autologous reconstruction. Further prospective research should be undertaken on flap volume changes and the identification of factors that have an influence on this, to ideally create a prediction model for plastic surgeons to facilitate predictable surgical outcomes. Nevertheless, the findings of this study are the first to show that breasts undergo volume changes, which is something to be aware of in daily practice.","title":"“Three-dimensional evaluation of breast volume changes following autologous free flap breast reconstruction over six months”"}
{"_id":"eb4349bd-4d63-5edb-941d-014898eda3f5","text":"The vessel density and the total length both of small and large caliber vessels were calculated. The small caliber vessels visible on the OCA images were ≤ 15 μm in diameter. Vessels ≥ 50 μm in diameter were classified as large caliber. The vessel density was calculated as the product of the multiplication of total number of skeletonized pixels by area of the one pixel in square micrometers. Density and vessel lengths were calculated in the entire volume acquired in the dermis, over the entire visualization depth of ~ 1 mm.","title":"In vivo multimodal optical imaging of dermoscopic equivocal melanocytic skin lesions"}
{"_id":"eb4585e1-94db-d1da-efa7-e9ae1b5cd776","text":"Through this needle, we could perform the repeated nerve blocks more effectively by opening up the hubcap for repeated nerve stimulations in the same targeted site at each intervention.","title":"Integrative Treatment for Tinnitus Combining Repeated Facial and Auriculotemporal Nerve Blocks With Stimulation of Auditory and Non-auditory Nerves"}
{"_id":"eb4a47ae-163a-7018-15c9-f00752db74be","text":"The loss of tissue needs reconstruction which can be done immediately after adequate debridement or later. Studies report acute reconstruction using nasolabial or melolabial flap and paramedian forehead flap for nasal defects following human bite injuries. 13 14 15 16 17 However, only few number of cases were reported in such studies. We performed delayed reconstruction of nasal defects to allow the infection to heal and scars to become supple. Though it increases the time the patient has to tolerate the cosmetic deformity, it decreases the chances of infection especially when cartilage graft is to be used. There is abundance of studies reporting the success of forehead flap for nasal reconstruction. However, most of these studies are performed for postmalignancy excision defects and in Caucasian population. This article documents the success and acceptable color match seen after forehead flap cover for post-human bite nasal defects in Indian population.","title":"Human Bites Over Nose: Management and Reconstruction"}
{"_id":"eb4adc5d-4923-8060-6fa8-071f1c57f13f","text":"This study was the first case series to prospectively apply 3D printing to treatment of pediatric tumor patients. Preoperative planning using 3D printed models increased the operator's satisfaction and adverse events during surgery occurred only in very few cases. Its use in educating students and residents was found to be highly effective, and the satisfaction of treatment was improved by better understanding when acquiring pre-operational consent for guardians.","title":"Application of 3D printing technology for pre-operative evaluation, education and informed consent in pediatric retroperitoneal tumors"}
{"_id":"eb4c1934-8551-9faf-1aed-8664252b9e4a","text":"Experiencing problems with breastfeeding was also an important factor influencing breastfeeding duration. Women who experienced problems with breastfeeding had a shorter duration of breastfeeding compared to women who did not experience problems. Women who reported that their infants experienced excessive weight loss also had a shorter mean duration of breastfeeding, as did women who reported that their newborn required supplementation in hospital.","title":"Breastfeeding challenges and support in a high initiation population"}
{"_id":"eb4f7387-0e18-55bf-82e6-f9ff288da834","text":"Our experience with this case indicates that amputation is the most appropriate treatment for squamous carcinoma occurring in patients with chronic osteomyelitis. To avoid risks of lymphonodular and organ metastasization, this radical surgical procedure should not be delayed. Early diagnosis and timely therapy can prevent amputation only in selected cases. Surgeons who treat osteomyelitis and chronic wounds should be aware of the risk of tumor degeneration. Squamous cell carcinoma associated with chronic osteomyelitis has a low-grade malignancy, but implications of lymphonodular involvement and organ metastasis should not be excluded.","title":"Squamous cell carcinoma in chronic osteomyelitis: a case report and review of the literature"}
{"_id":"eb531815-6922-1ca6-3d76-4e2ee6d25100","text":"One study subject in the rivaroxaban group who withdrew from the study eventually died before 90 days of observation is completed. There were 11 study subjects who died in the rivaroxaban group. The majority of death in the atorvastatin group occurred in less than 30 days of observation. This showed that death is not due to the study drug, because the duration of study drug consumption remains minimal. The main cause of death in both the atorvastatin and rivaroxaban groups was cancer progression. In the atorvastatin group, there was 1 patient who died of severe COVID-19 infection in the COVID-19 isolation ICU.","title":"The effectiveness of atorvastatin for the prevention of deep vein thrombosis in cancer patients undergoing chemotherapy"}
{"_id":"eb576cce-d714-4d78-91a1-f06d6b1bb536","text":"Additional bilateral compression Doppler ultrasounds will be performed on suspicion of DVT or pulmonary embolism. The treating clinician may therefore take additional measures to reduce the risk of complications from any identified thrombosis. We anticipate that this algorithm will mitigate any additional risk that could be posed by the use of EPO in this cohort.","title":"Erythropoietin in traumatic brain injury: study protocol for a randomised controlled trial"}
{"_id":"eb59af04-4a66-c979-3dad-95b7af19879c","text":"Once you have an understanding of your answers to these questions, develop annual goals for the next 5 years and give special consideration to how these goals fit with previously stated values in step 2. As you proceed through your career, keep in mind that regular reassessment of career goals is encouraged and may allow you to focus on your priorities and redirect your efforts toward new or revised goals.","title":"Twelve-step Approach for Academic Development Planning in Academic Surgery Climbing the Academic Uphill With Strong and Steady Steps"}
{"_id":"eb5a9ba5-2689-aa58-193d-ed8c7860da6e","text":"Local and regional flaps have been used for closure of such defects but when there is quite a loss of soft tissue these flaps are of no use9, 5.","title":"Cancer patients with large defects. Reconstructional options: A case study"}
{"_id":"eb6188aa-5845-c23a-35b5-ea4db216d94b","text":"There are no specific clinical or radiographic findings. Histologic findings include spindle cells with rare mitoses and an abundant collagenous stroma with infiltration of the surrounding tissues.","title":"Huge Facial Desmoid Tumors with Neck Extension: A Case Report"}
{"_id":"eb667987-c4fc-72f7-2954-50f645504b95","text":"High-energy fractures have soft tissue compromise and a potentially reduced viability of bone ends which can alter the normal healing process with considerable delay in union expected. The method chosen for treatment of these fractures has a substantial effect on the local mechanical and biological environment. The treatment strategy for these fractures focuses on fixation stability while respecting the biological reserve.","title":"Bone transport for the management of severely comminuted fractures without bone loss"}
{"_id":"eb7815aa-4af0-563f-c269-7459e9a9d1e8","text":"The goals of patient follow up are to treat benign complications which have arisen from surgery such as anastomotic strictures and delayed gastric emptying requiring endoscopic dilatation which tend to present within the first year following surgery [51]. All patients should undergo nutritional assessment before and after surgery and a dietician must be involved in each patient's care. Weight loss is a concerning symptom but immediately following surgery this may be simply due to inadequate caloric intake and adaptation of eating habits. A further goal of follow up is to offer and maintain psychosocial support. Some patients will need more support than others and the clinical nurse specialist plays an invaluable role in this area. Follow up plays a role in identifying disease recurrence as early as possible to ensure patients receive the appropriate palliation or further treatment if indicated. Finally it is imperative that physicians record their morbidity, recurrence and survival rates so we can continually endeavour to audit and improve the management of these patients.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"eb7b9126-5dff-540e-8ec1-5ef095e319d2","text":"We describe six review areas outside the breast where incidental finding should be sought.","title":"Meeting Abstracts from the British Society of Breast Radiology Annual Scientific Meeting 2022"}
{"_id":"eb7d2656-bf5d-ef7a-cf9c-b9dc24c5ff7b","text":"To our knowledge, we are the first group to use DECT to analyze calcinosis in a cohort of scleroderma patients. Our limitations include the small population of patients, five of whom also had overlap disease. However, their calcinosis did not appear any different or any more extensive than in those without overlap disease, and further studies are needed to determine the differences in pathophysiology between those with and without overlap disease.","title":"Use of dual-energy computed tomography for the evaluation of calcinosis in patients with systemic sclerosis"}
{"_id":"eb8e60de-dbc1-2930-c48c-cf917e513338","text":"The compensator shape was calculated using the dose distribution around the brachytherapy sources as a pattern according to which the open photon beam was modulated in order to achieve the desired total dose distribution.4","title":"Dosimetric verification of compensated beams using radiographic film"}
{"_id":"eb8e6e3c-5d57-3feb-fda9-5c612264bef7","text":"Three weeks after completing radiotherapy, the patient presented again as an emergency case to the Neurosurgical Department with severe neurologic symptoms for a significant cerebral edema with thrombosis in the sagittal sinus and continuation in the evolution of the cerebral disease through secondary leptomeningeal determinations. The patient ended his struggle with the disease on Christmas day, after 2 months of “best supportive care”.","title":"The Benefits and Challenges of the Multimodal Treatment in Advanced\/Metastatic Malignant Melanoma"}
{"_id":"eb93c633-9b1d-2ca4-1d22-2a6c50f373c1","text":"In the groin, it is reasonable to remove the inguino-femoral nodal bundle contained within the femoral triangle, bound by the medial border of the sartorius, the lateral border of the adductor longus, and the inguinal ligament, to also include the lymphovascular tissue 4–5 cm cephalad to the inguinal ligament anterior to the external oblique aponeurosis, which commonly bears additional lymphoid tissue. The neurovascular structures of the femoral triangle need to be protected and the greater saphenous vein can be spared if not involved by tumor. Controversy exists about the routine need of deep pelvic ilio-inguinal dissection to include the external iliac and obturator nodes. However, deep dissection is still standard for clinically involved ilio-inguinal\/obturator lymphadenopathy on PET-CT or pelvic CT, or in certain cases with melanoma involvement of the Cloquet’s node on intraoperative frozen examination (the last inguino-femoral lymph node present in the femoral canal, posterior to the inguinal ligament). Other practitioners routinely perform a deep pelvic dissection for grossly and apparently involved superficial groin disease. With the advent of modern systemic treatments, the routine need for clinically uninvolved deep ilio-inguinal dissections has been questioned.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"eb977c61-4aa6-cf3d-2b84-89d29b7e5aa8","text":"Factors known to influence local recurrence include the surgical margin, the site of the tumor and the response to chemotherapy17. Control of the surgical margin is particularly important. Unplanned surgery may result in inadequate surgical margins, inappropriate skin incision and inappropriate drainage locations. These factors may lead to a higher local recurrence rate and earlier local recurrence. However, due to the small sample size, it was not possible to assess the association between individual surgical methods and local recurrence rate in our study. Regardless of the surgical method used, destruction of the surgical margin likely led to local recurrence. The time from surgery to local recurrence may have been shorter in the unplanned treatment group because of the extensive surgery that these patients received and substantial contamination by the tumor during the initial unplanned surgery. Thus, incisional biopsy for histological diagnosis should be performed carefully, and core needle biopsy should be the preferred method1819.","title":"Effect of Unplanned Therapy on the Prognosis of Patients with Extremity Osteosarcoma"}
{"_id":"eb9ad74a-01c3-ad9b-8b83-5d22010e2f2c","text":"Regarding in vivo investigations, certain limitations related to GNPs administration have been applied in order to arrange their distribution in tumors selectively.","title":"An overview of therapeutic applications of ultrasound based on synergetic effects with gold nanoparticles and laser excitation"}
{"_id":"eb9b5d62-2da0-f002-c8a2-7fafb1aa26e2","text":"The practice of routinely doing FS in SCC of the oral cavity and the lips is questionable. It does not seem to significantly influence the outcome of final surgical margin status and in some situations it may even mislead the surgeon. The necessity of taking FS should be evaluated case by case. The specific situations in which FS are necessary and what is the most useful sampling protocol may be the subject of further studies.","title":"The impact of frozen sections on final surgical margins in squamous cell carcinoma of the oral cavity and lips: a retrospective analysis over an 11 years period"}
{"_id":"ebb15fd4-98d1-f91b-5e05-8f0fc5fb8ae0","text":"Cases of persistent positive blood cultures require appropriate diagnostic techniques to find the source of the infection to guide treatment. Different ways of imaging that have been used include MRI and CT, which can detect structural changes including increased areas of edema and local tissue inconsistencies in contrast enhancements. Radiolabeled imaging techniques, including FDG PET scans, can detect infections more specific and often earlier than conventional MRI or CTs as molecular and cellular changes occur before edema and local organ damage can be visualized [9]. When inflammation is caused by an infection, it is paramount to have source of infection control to provide appropriate treatment.","title":"F-18-Fluorodeoxyglucose Positron Emission Tomography\/CT Effectively Identifying Source of Infection in a Patient With Multiple Dialysis Arteriovenous Fistula Access Points"}
{"_id":"ebb6df6b-5993-daa7-a79e-e788db2104ee","text":"Due to a massive and immediate venous congestion, she had to undergo 12 hours later a second operation and the flap had to be moved back to the initial position. Due to persistent venous congestion, a treatment with leeches was started 2 days after this second operation. Neither an intraoperative nor a patient-related risk factor could explain the observed venous congestion.","title":"Infections following the application of leeches: two case reports and review of the literature"}
{"_id":"ebbc84b5-f245-836b-f14e-0803f586439d","text":"One of the main problems in middle eastern rhinoplasty is the poor contractile nature of thick, sebaceous skin in the supratip region. poor contractile ability of this tissue and presence of skin excess at completion of the rhinoplasry can lead to disappointing long term result and is perhaps the most difficult component to control. Supratip deformity can result from over-reduction of dorsum and radix and loss of tip support. A logical treatment of these pathological findings is dorsal nasal augmentation and improving tip support.","title":"Fibrinolysinoma after Direct Injection of Fibrinolysin for Treatment of Nasal Tip Swelling: A Case Report"}
{"_id":"ebc1a45e-244f-913d-d5b3-9192c4ae4728","text":"Interestingly, many of the interviewees stated that it allowed them to practice skills that would not have been possible for them in the UK.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"ebcb211f-d457-73b4-8064-5dfd65b76cab","text":"Conclusions: MTMS is a superior alternative to simple excision of skin cancer by providing full margin control and residual tumor mapping.","title":"Muffin Technique Micrographic Surgery for Non-melanoma Skin Cancer"}
{"_id":"ebd62d24-f6f2-5fb0-1029-67a8f8740d3e","text":"Case 4 a Middle aged male with biopsy proven well differentiated squamous cell carcinoma of the left maxilla. b CT scan with contrast showing enhancement in the left maxilla sinus, left sided palate with destruction of the left maxillary arch. c Picture showing a moderate volume with large surface area defect after wide local excision of the tumor (subtotal maxillectomy) including resection of maxillary arch, palate and anterior and lateral walls with preservation of the orbital floor. d Four weeks follow up picture showing good mucosalisation of the temporal muscle flap. e Follow up CT scan of the patient showing temporalis muscle flap filling the defect. f Late follow up picture, patient has good facial contours with mild temporal hollowing","title":"Taking a step down on the reconstruction ladder for head and neck reconstruction during the COVID-19 pandemic"}
{"_id":"ebd70029-4303-948a-9f6a-7de9433e046a","text":"The limitation of this study was that there were fewer studies about safety margin in large tumors with aggressive features. Another limitation of this study is that only a few studies include long term follow up and recurrence rate of the patients. Since most studies regarding the surgical margins have included small tumors, the proper approach for high-risk groups and recurrence needs further research. Although micrographic control is the best option, some authors still recommend greater than 4 mm margins for high-risk groups and 6 mm margins for recurrent BCCs as adequate. Hence, more evaluation should be done for excision margin in large and recurrent tumors regarding the feasibility of surgical margins.","title":"Surgical Margin of Excision in Basal Cell Carcinoma: A Systematic Review of Literature"}
{"_id":"ebdea180-a7ca-7fd2-51dd-82b1a628622a","text":"In our study, we used cadavers, which of course have different elasticity in comparison to the viable skin of the living body. Therefore, our findings might be different when applied on living patients. We believe that our proposed method has demonstrated reproducible and satisfactory results with possible favorable outcomes when applied on real patients. Thus, we recommend further studies to be performed on alive patients in order to develop a new approach that can be added to the reconstructive ladder in reconstructive surgeries involving the scalp.","title":"The 1-2-3 cm Advancement Flap Rule in Scalp Reconstruction"}
{"_id":"ebdf368e-a1bc-274a-07f4-7b83153e6286","text":"Before the operation, Doppler ultrasound, computed tomography or a smartphone-compatible thermal imaging camera was used to identify the locations of the blood vessels in the donor area and to locate the surface of the perforating branches in all patients to reduce the operation time and prevent unnecessary injury during the operation (Table 1). During the operation, it was found that the position of the perforating branches was basically consistent with the findings from before the operation, and the design of the flap did not change during the operation for any of the patients. In the traditional group, 5 patients were examined by Doppler ultrasound; 2 patients underwent computed tomographic examinations of the blood vessels of the leg (Table 1), in which most of the positions of the perforating branches during the operation were basically the same as those before the operation; and the donor area of the anterolateral femoral flap was transposed from the left leg to the right leg in only one patient.","title":"Application of an L-shaped anterolateral thigh flap in reconstruction after hemiglossectomy"}
{"_id":"ebe9626b-dcf9-7c0d-46c8-ae64bdc235e3","text":"Patients in the BCT group exhibited approximately a 2.5-fold increased risk of LR compared with those in the mastectomy alone group. The incidence of LR increases continuously in the BCT group in contrast to the mastectomy alone group. Furthermore, one-third of patients with an isolated LR after BCT experienced distant metastasis despite of aggressive salvage mastectomy followed by systemic treatments. Although BCT had equivalent OS to total mastectomy alone and it can be recognized as the first local treatment option for young women with breast cancer, countermeasures are required to improve quality of life in patients treated with BCT through preservation of breast cosmetic outcomes. To reduce the risk of distant metastasis and to improve prognosis in patients with isolated LR after BCT, more effective systemic treatments should be investigated. Ultimately, it is more important to reduce the incidence of LR by developing novel treatments for improved prognosis, as well as preserving cosmetic outcomes in young women undergoing BCT.","title":"Local Recurrence in Young Women with Breast Cancer: Breast Conserving Therapy vs. Mastectomy Alone"}
{"_id":"ebf11392-299f-c490-1a1f-6073acfb7053","text":"While complete surgical excision with extirpation of the nidus is considered as the gold standard treatment, aesthetic hair bearing scalp restoration is also of paramount importance for the patient. This is done by using scalp tissue expansion after proper selection of the expander.","title":"Excision of Large Scalp Arteriovenous Malformations with Aesthetic Scalp Reconstruction"}
{"_id":"ebf36c3d-3cb0-4166-d838-7471a85d57b2","text":"Lymphadenectomy is the treatment of choice for patients with inguinal lymph node metastases; it is considered as a standard management for palpable lymphadenopathy secondary to penile cancer and is recommended in the management of patients with clinically negative nodes at high risk of micrometastases [1].","title":"Robotic bilateral inguinal lymphadenectomy in penile cancer, development of a technique without robot repositioning: a case report"}
{"_id":"ebfaed34-66e3-d31c-ad40-a165c8d79006","text":"Margins of excision were assessed using cavity shaves, if these demonstrated no evidence of either in-situ or invasive disease excision was assumed to be complete. Positive margins were defined by the presence of either in situ or invasive disease within one or more of the four separate margin specimens. Involved margins were not routinely re-excised, according to the policy adopted in Oxford before 1992, which was based on the belief that radiotherapy would have negated the effect of eventual residual disease. This policy allowed us to evaluate the outcome of this group of non-reexcised positive margins and to compare it with the group in which complete excision was achieved.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"ec04ece5-6246-8c5d-178b-9534ab9b4c9d","text":"Although things seem pretty clear at a superficial glance, there are some controversies in detail with regard to when in the very early stage of anaphylaxis adrenaline should be given. There seems to be a divergence between pediatric allergists and allergists dealing more and mostly with adult patients because adrenaline has well-known pharmacological effects that can be detrimental to people with severe cardiac disease, especially arrhythmia. Furthermore, problems arise in prophylactic use, which means giving anti-anaphylactic treatment before development of symptoms after exposure to a known allergen. The situation is simple when it is a child who has inadvertently eaten peanuts and a history of severe peanut anaphylaxis.","title":"Anaphylaxis: Educational Programs Are Needed"}
{"_id":"ec0b1868-800c-dd4f-b825-0137268a2271","text":"Further characterization of serum sickness and type IV hypersensitivity reactions face similar challenges, with the added difficulty of greater diagnostic uncertainty as there is a lack of consensus definition for serum sickness reaction (9). There are no diagnostic tools available to determine the risk of reintroducing an agent to which a patient experienced a suspected SSR or SSLR. A few patients who developed SSLRs while participating in omalizumab clinical trials were able to continue therapy without interruption. Challenge could be considered for patients who develop SSLRs to omalizumab after shared decision making, though data is limited to a handful of patients (16).","title":"Hypersensitivity reactions to biologics used in the treatment of allergic diseases: clinical features, diagnosis and management"}
{"_id":"ec0b9a90-6edc-3166-5a18-ecf461963be8","text":"A tourniquet was applied to the leg while harvesting the fibula. Whenever possible, the graft was harvested by incorporating the superficial skin flap to provide soft tissue coverage and to allow postoperative monitoring of the microvascular flap. However, skin paddles wider than 8 cm usually required skin grafting of the donor site. An elliptical skin paddle, with its central axis along the posterior border of the fibular head and beginning 10 cm below the fibular head, was incised and harvested subfascially up to the septum between the soleus and peroneus muscles. The skin perforators were identified. All skin perforators were dissected up to their origin and all muscle branches were clipped or ligated. The plane of dissection was between the peroneus longus and soleus and 2 – 3 mm of muscle sleeve around the fibula was included to incorporate the peroneal vascular pedicle. The interosseus membrane was divided and proximal and distal osteotomies were performed. The vascular pedicle was finally separated from the posterior tibial muscle and dissected up to the level of the posterior tibial artery. After these procedures were completed, the blood supply of the flap was solely from its vascular pedicle. The tourniquet was then released and the pedicle was ligated and separated when the recipient site was ready. Bony fixation was then achieved according to the situation of the recipient bones by impelling the end of the fibula into the medullary cavity of the recipient bone, if possible additional screw fixation were performed following microsurgical vessel anastomosis. Postoperative monitoring was easily performed by inspecting the microcirculation of the skin paddle.","title":"The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection"}
{"_id":"ec1dbe80-26d8-02f3-0fb9-bf620449654e","text":"In direct proportion to the increasing rate of nasopharynx examinations applied, the early diagnosis and treatment of lesions in this region is possible. At times the clinical findings and the biopsy results are not consistent, so biopsies may have to be repeated.","title":"The role of nasopharyngeal examination and biopsy in the diagnosis of malignant diseases O papel do exame clínico e da biópsia de nasofaringe no diagnóstico de doenças malignas"}
{"_id":"ec1e878f-2bec-de4c-c5b7-fa2d836131b8","text":"To reduce the frequency of this postoperative condition, prophylactic anticoagulation (ie, chemoprophylaxis) has been recommended for patients deemed to be at high risk.56–59","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery\n\n"}
{"_id":"ec320009-fae9-edf6-57d0-baa19d494d9b","text":"In summary, our findings provide preliminary data that US is more sensitive than CT for diagnosing skin and soft tissue infections but CT is more specific. Ultrasound provides more detailed information concerning the abscess cavity without ionizing radiation but the clinical importance of this is unknown. Further research is needed to determine how to best use both US and CT in patients with skin and soft tissue infections.","title":"Comparison of computerized tomography and ultrasound for diagnosing soft tissue abscesses"}
{"_id":"ec3aec8f-d9d8-2695-4df8-9b37ebeca2d3","text":"Surgical treatment of fractures of the distal third of the humeral shaft, without previous radial nerve injuries, with the MIPO technique associated to exploration of the radial nerve had a high rate of fracture healing and good evolution of motion and function of the elbow. Despite the transient neuropraxia, the modification of the technique allowed excluding the interposition of this structure on the fracture focus and\/or plate.","title":"Fracture of distal humerus: MIPO technique with visualization of the radial nerve"}
{"_id":"ec3cd820-8e6d-1d35-635a-12ac5fa84250","text":"Our consensus criteria for the switch to oral antibiotics for musculoskeletal infections identified patients who went on to have excellent outcomes at one year and two years, suggesting that these criteria can effectively identify patients at low risk for treatment failure. Collaboration between ID specialists and orthopedic surgeons to select antimicrobial regimens can avoid significant burdens, costs, and complications associated with prolonged IV therapy.","title":"Excellent Outcomes With the Selective Use of Oral Antibiotic Therapy for Bone and Joint Infections: A Single-Center Experience"}
{"_id":"ec3f48f2-a8d4-17ad-d0a6-370f396b93a5","text":"Fellowship microsurgical training for the plastic surgeon is essential to be able to perform this technique. Surgical oncologic training is an asset for the resecting surgeon. Cross training in terms of electives in plastics or surgical oncology can be helpful at the fellowship level if available. A local simulation lab, such as the Advanced Technical Skills Simulation Laboratory (ATSSL) in Calgary [34], provides invaluable opportunities to practice the intraoperative set up and the switching up of the main operators, and for microsurgeons to practice supermicrosurgical anastomoses as well as for the surgical oncologist to become facile using the microscope and microinstruments in order to be the first assist for the lymphatic reconstruction when necessary.","title":"Mitigating Breast-Cancer-Related Lymphedema—A Calgary Program for Immediate Lymphatic Reconstruction (ILR)"}
{"_id":"ec478696-335c-6347-e7bc-d97561a447ca","text":"Our study showed that the patients with desmoid tumor with vessel and nerve involvement had a comparatively high recurrence rate. One reason could be the vessels and nerves were preserved with their benign feature to avoid severe limb disturbance, which might leave the residual lesions in the vessel-nerve bundle surroundings or even inside causing local recurrence. Therefore, partial vessels and nerves need to be removed if necessary followed by local reconstruction to achieve the negative surgical margins.","title":"Postoperative recurrence of desmoid tumors: clinical and pathological perspectives"}
{"_id":"ec4c2542-77e8-9dfd-9302-6c13764c6449","text":"Due to the unpredictable behavior of DTs, such as long extended periods of stable disease and even rapid progression, treatment must be individualized to improve the efficiency of local tumor control and protect the quality of life. Consequently, the application of a multidisciplinary assessment along with multimodality treatment shapes the foundation of care for the related patients.","title":"The Management of Desmoid Tumors: A Retrospective Study of 30 Cases"}
{"_id":"ec5a0607-c2a6-052f-5606-8529986cddf6","text":"Pow and Vale 20 could not support aspirin outright as a thromboprophylactic agent due to the suboptimal prophylactic regime investigated in their study (a quarter of patients were not prescribed thromboprophylaxis after discharge). This is despite there being no significant difference in the incidence of VTEs in those receiving aspirin and those receiving anticoagulants. The regime was unfortunately something they could not control, an issue with a retrospective study.","title":"A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years"}
{"_id":"ec5b324b-50af-9029-b886-4fabd55c6a46","text":"The identification of those patients with higher risk for ADA development and HSR onset represents an important clinical issue. Risk assessment for biologicals-related HSR requires accurate evaluation of risk factors associated with immunogenicity.","title":"How to Prevent and Mitigate Hypersensitivity Reactions to Biologicals Induced by Anti-Drug Antibodies?"}
{"_id":"ec682528-77b1-242e-9e10-a8ccbbee898b","text":"The primary hypothesis of our study was that an abnormal cerebral venous drainage ipsilateral to the side of malignant MCA infarction in patients who underwent decompressive surgery would result in reduced venous drainage and consecutive venous congestion, more severe edema progression, and worse functional outcome compared to patients with normal ipsilateral venous drainage. However, in our study evaluating the CVD pattern in 88 patients with malignant MCA infarction who underwent hemicraniectomy, ipsilaterally abnormal venous drainage was not significantly associated with long-term functional outcome. Moreover, also contralaterally abnormal or any abnormal CVD were not predictive for poor functional outcome in this cohort.","title":"Cerebral Venous Drainage in Patients With Space-Occupying Middle Cerebral Artery Infarction: Effects on Functional Outcome After Hemicraniectomy"}
{"_id":"ec6b068a-5136-555a-73e8-a19bf99a742a","text":"All the included patients had stopped taking antibiotics for at least two weeks before surgery commenced. Intraoperative intravenous cephalosporins or clindamycin were administered only after the specimens were collected for culture and histology purposes. The same experienced surgeon collected the samples for both BSC and TSC.","title":"Devascularized Bone Surface Culture: A Novel Strategy for Identifying Osteomyelitis-Related Pathogens"}
{"_id":"ec74012b-022d-3b41-6a91-a8803d796e49","text":"There was 1 re operation for failure of fixation in each group.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"ec75697d-3206-d6e6-a710-4857a2a0796e","text":"Sentinel lymph node biopsy (SLNB) permits lymph node staging and is considered the gold standard method for the evaluation of axillary lymph node status for patients without clinical suspicion of lymph node involvement. SLNB has been used in clinical practice for over a decade and has considerably reduced the morbidity associated with axillary surgery and resulted in axillary lymph node dissection. Now, SLNB is restricted to specific situations 5.","title":"Intraoperative imprint cytology versus histological diagnosis for the detection of sentinel lymph nodes in breast cancer treated with neoadjuvant chemotherapy"}
{"_id":"ec75ad70-9b8c-7043-7776-fc17d88ef9fe","text":"Skin cancers of the face not only hold significant potential to call attention to themselves, but also have the problem that once treatment is completed, the residual effects of that treatment may continue to pose cosmetic concerns [1]. It is almost certain that any surgical treatment to the face is likely to leave at least some degree of cosmetic change visible to the patient and others. Thus, efforts that seek to reduce the possibility of large resections may carry with it the potential for reduced cosmetic morbidities. In this circumstance, it is not unreasonable to assume that larger lesions will carry the explicit potential for increased posttreatment cosmetic changes that pose personal and social restrictions. Consequently, treatment approaches that create a realistic opportunity to limit the extent of surgical resection offer a considerable attraction in the management of skin cancers of the face. For these reasons, our group has worked toward the goal of evaluating combined methods for the treatment of facial lesions, thereby not only optimizing surgical treatment by reducing the anticipated area of resection, but also doing so with reduced tissue morbidity.","title":"Neoadjuvant Use of Photodynamic Therapy in Basal Cell and Squamous Cell Carcinomas of the Face"}
{"_id":"ec7a1b91-b0f6-55de-72ce-e1c7c4d316aa","text":"Repeated missions at the same hospitals with training of local surgeons have increased significantly compared to earlier “parachute missions.” Microsurgical procedures for free flaps with magnifying glasses are now possible for the experienced even in hospitals in developing countries. The most efficient medical aid in the future will be the expansion and establishment of departments or hospitals in developing countries supported or maintained by partner hospitals in our home country.","title":"INTERPLAST-Germany—adapting to global plastic surgery"}
{"_id":"ec7c9c3e-4408-144d-5997-e92c31cc1621","text":"When soft tissue is used, the flap must be adequately bulky to prevent substantial deviation of the mandible toward the resected side. Anticipating soft tissue atrophy, especially when postoperative radiation is administered, some volume overcorrection is desirable. A pectoralis major myocutaneous pedicled flap may also give satisfactory results in posterior mandibular reconstruction. However, the pectoralis major myocutaneous pedicled flap can be limited in reach and arc of rotation for very high or posterior defects. Because late contraction of the pedicle may also cause a descent of the bulk of the flap toward the neck or result in limited neck mobility, the author considers pectoralis major myocutaneous flaps a second choice to a bulky soft tissue free flap. Whether bony or soft tissue reconstruction is utilized, there will be risk for malocclusion due to loss of the condyle and temporomandibular joint disruption. Nonedentulous patients tend to experience fewer problems with malocclusion since they can use their remaining teeth to guide their jaws into the proper occlusal relationship.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"ec7d4800-3cf4-e562-4dd8-4173b4ace24a","text":"Currently detection of the malignancy of skin lesions, is doing by dermatologists based on their professional experience using the pathologic results from the skin biopsy of the suspicious area; and in some cases, meanwhile the skin biopsy of the suspected area, they also recommend the sonography imaging in order to inspect the skin tissue better and in more details.1 Sonography is a noninvasive method by which radiologists try to capture unusual symptoms in the skin sonograms.2 Due to the complication of sonograms in appearance, the diagnosis of malignant skin depends on the self‐experience of the dermatologist. This means that in most cases, the early symptoms of malignant lesions seems to be normal, and ignored.2 This causes the many false detection. Since these errors are always hazardous, there is significant interest in developing intelligent methods for detecting these abnormalities as a useful tool for dermatologists to accelerate the detection and prevention of unnecessary skin biopsy.3","title":"Early diagnosis of skin cancer by ultrasound frequency analysis"}
{"_id":"ec88a6df-2da9-75f0-c7ed-d106b85a51cb","text":"Phototherapy such as photothermal therapy and photodynamic therapy in cancer treatment has been developed quickly over the past few years for its noninvasive nature and high efficiency. However, there are still many drawbacks in phototherapy that prevent it from clinical applications. Thus, scientists have designed different systems to overcome the issues associated with phototherapy, including enhancing the targeting ability of phototherapy, low‐temperature photothermal therapy, replacing near‐infrared light with other excitation sources, and so on. This article discusses the problems and shortcomings encountered in the development of phototherapy and highlights possible solutions to address them so that phototherapy may become a useful cancer treatment approach in clinical practice. This article aims to give a brief summary about current research advancements in phototherapy research and provides a quick guideline toward future developments in the field.","title":"Solutions to the Drawbacks of Photothermal and Photodynamic Cancer Therapy"}
{"_id":"ec8b2908-f43d-52ea-48b4-f1f033993c43","text":"The fact that the opening of the contralateral leg did not occur in Group 1 indicates a good accuracy of the method in identifying and evaluating the graft quality.","title":"Use of Doppler Ultrasound for Saphenous Vein Mapping to Obtain Grafts for Coronary Artery Bypass Grafting"}
{"_id":"ec8e4de6-b825-4cbb-0c02-206ce413fe91","text":"In cases where tumor involvement necessitates the resection of a large amount of soft tissue, the resulting bone exposure poses additional difficulties in achieving successful wound healing. After removing the periosteum, exposed bone cannot form a layer of healthy granulation tissue where skin graft can be applied directly and integrated. Additionally, it is important to consider early coverage of exposed bone to avoid bone infection and accelerate wound healing, especially in the case of sarcoma patients when adjuvant therapy is needed. Traditional reconstruction methods, such as skin grafts or local flaps, may be limited in their ability to provide durable coverage.","title":"Integra® Dermal Regeneration Matrix: A Versatile Solution for Complex Soft Tissue Sarcoma Reconstruction in the Hand"}
{"_id":"ec95d6d1-0378-f68e-1a01-19cec4551b4e","text":"The above-mentioned studies have attempted to understand or characterize the ageing of humans from different perspectives or to explore the factors that cause and delay ageing.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"ec9bfb47-237d-7b16-e11f-959013f39d71","text":"The objective of oral cavity reconstruction after tumor resection is to restore the mucosal lining and cover the exposed bone, if any, to obtain both a functional and aesthetic result. Depending on the location and width and thickness of the defect, free and locoregional flaps or skin grafts may be used.","title":"An alternative to skin graft for superficial surgical defect in oral cancer surgery"}
{"_id":"ec9efcec-19aa-c84e-985b-72c46ebae488","text":"Unlike melanoma, NMSC often requires reconstruction techniques because the more aggressive local behavior leads the surgeon to wider resections to obtain free margins and low recurrence rates.","title":"Xeroderma Pigmentosum: A Genetic Condition Skin Cancer Correlated—A Systematic Review"}
{"_id":"ec9f364f-b3f6-583b-00dc-5fe73cd6fad7","text":"Table 2 The major genuine sensitizers from the relevant allergenic sources","title":"Clinical practice recommendations for allergen-specific immunotherapy in children: the Italian consensus report"}
{"_id":"eca8cc4e-7456-897b-488b-f859f3254fa7","text":"Microsurgical osteoseptocutaneous fibula transplantation was performed. To ensure the safety of the free flap, rehabilitation of the affected limb and donor leg was only allowed from the seventh day after surgery. X-rays were taken before surgery and every 2 weeks after surgery. The Ilizarov device was kept in position until bone union was confirmed by both surgeons and the radiologist. The principles outlined in the Declaration of Helsinki have been followed.","title":"Combining the External Fixation and Microsurgical Osteoseptocutaneous Flap Transplantation Methods for Limb Salvage"}
{"_id":"eca8f1a5-594c-7a7a-31b7-5889490135f2","text":"There are no good randomized clinical trials of treatment for desmoid tumors and most studies are based on small case series. The effects of treatment are further compounded by the variable natural history of the disease with some tumors apparently regressing or remaining stable even without treatment [6].","title":"Desmoid Tumors: A Clear Perspective or a Persisting Enigma? A Case Report and Review of Literature"}
{"_id":"eca99fc8-d903-61fc-0469-825509a94b60","text":"Nipple shields were described as either a saving solution or a hindrance. The nipple shield was experienced by some mothers as an aid that helped the infants to get a good latch. However, it was a relief when the infants started to breastfeed without the nipple shield. On the other hand, the nipple shield was also experienced by some mothers as bothersome, a failure and\/or difficult to handle. The mothers who still used a nipple shield because the infants did not latch without it wished for the infant to manage breastfeeding without the nipple shield in order to be free and not bound by the shield.","title":"A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth"}
{"_id":"ecaa4445-5016-f4f4-3541-2780bdbe7f23","text":"Statistical significance between different surgical procedures could not be evaluated because of the wide variety of techniques used for different types of defects, and each group has a small number of cases.","title":"Reconstruction of Scalp and Forehead Defects: Options and Strategies"}
{"_id":"ecb594e9-ff58-2605-a109-bb88004c176c","text":"We present here a method of detection of DT specific CTNNB1 mutations using a targeted strategy ddPCR on cfDNA extracted from blood samples and the correlation of total plasmatic cfDNA concentration with evolution of the tumor.","title":"Proof of concept: prognostic value of the plasmatic concentration of circulating cell free DNA in desmoid tumors using ddPCR"}
{"_id":"ecb9c818-efdb-3e02-0efe-9b17e545686c","text":"The data reported in this analysis are based on a subset of questions from a larger study whose purpose was to evaluate adherence to newborn discharge instructions [17]. The goal of this subset of questions was to assess whether women received professional breastfeeding support, and to measure their level of interaction with the health care system. Additional aims were to analyze associations between the support received by women and their breastfeeding success in the early post-natal period, and to identify risk factors of early discontinuation of breastfeeding in our study sample. This community-based study aims to provide information for planning effective interventions to improve the sustainability of breastfeeding during the postpartum period.","title":"Breastfeeding challenges and support in a high initiation population"}
{"_id":"ecbd2d25-b5b6-0447-7642-150209b9fc45","text":"Mean and maximum times required for the acquisition of all sonographic parameters were 18 and a half minutes and 25 minutes for the handheld sonographic machine, and 9 and a half minutes and 15 minutes for the high-end sonographic machine. Of note, the time spent to perform the examination with the handheld machine also included that required for the wireless connection; this could vary from day to day depending both on the speed and stability of the company network. Finally, the rechargeable batteries allowed a non-continuous use of a few hours.","title":"Accuracy and performance of a new handheld ultrasound machine with wireless system"}
{"_id":"ecbe13f1-67b5-8ca1-bb7b-6287132b97d7","text":"Auditing trial conduct will be performed by the independent observer, and an interim analysis will be made when 100 participants are included.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"ecbe5bec-40e2-8b35-6ebe-eec90b877220","text":"The variables we studied suggest that CRF does have a significant influence on the onset of tympanosclerosis. The mechanism whereby renal disease generates tympanic sclerosis, however, is not clear from the data in this study, as the metabolic changes we studied and the duration of hemodialysis appeared to have no influence on the frequency of myringosclerosis. The literature states that the effects of altered calcium, phosphorus and PTH levels on pathological calcification may take place without any serum elevation of these factors being detected. It has been well defined that ultra-structural changes in tympanosclerosis are similar to those found in vascular and visceral calcification in CRF patients. Furthermore, as the serum metabolic changes in these patients are present systemically, it is logical to infer that their effect on the calcification process takes place similarly in the lamina propria of the middle ear mucosa. This is even more evident in the group of patients that presented myringosclerosis without an otological history of inflammation, where the only clear cause was renal disease, notwithstanding the aforementioned memory bias that might have affected these results to some uncertain degree.","title":"Myringosclerosis in patients with chronic renal failure: comparative analysis with a control group"}
{"_id":"ecc5f54f-8c50-ca0d-58b8-0ed4ea8426bf","text":"Before participation in the trial patients are informed that in the two scheduled interventions they will receive at least once a verum injection with BT-A.","title":"Botulinum neurotoxin type A in the treatment of classical Trigeminal Neuralgia (BoTN): study protocol for a randomized controlled trial"}
{"_id":"ecd26b17-fe42-285f-d6af-211cbc696e0a","text":"Although there have been important developments in microsurgery in recent years, there is no current and comprehensive bibliometric study in the literature. In this study, we aimed to present a summary of the articles published on microsurgery between 1980 and 2019 with bibliometric analysis.","title":"Global Scientific Outputs of Microsurgery Publications: A Bibliometric Approach About Yesterday, Today, and Tomorrow"}
{"_id":"ecd64967-8778-2022-934c-a3e55c244e06","text":"The technique for both permanent and temporal implant followed the local treatment policy of each centre. The characteristics of the patients are shown in Table 1.","title":"Salvage brachytherapy in prostate local recurrence after radiation therapy: predicting factors for control and toxicity"}
{"_id":"ecde7f29-f9a4-094a-1977-d16c13055633","text":"This study had a few limitations, including those related to its retrospective nature. This was a single center study and patient satisfaction was rated subjectively and not with a validated questionnaire. Another limitation was the inability to measure and calculate the survival of the grafted fat. The underlying disease process of patients with SSc might affect graft survival due to enhanced fibrosis and lack of stromal tissue to provide vascular support for the grafts. Accordingly, during injections, it is important not to over-stretch the skin, to prevent the risk of tissue necrosis. The number of ASCs varies between patients and donor sites and this might lead to varying results between procedures in the same patient and among different patients.","title":"Total Facial Autologous Fat Grafting for Treating Skin Manifestations in Scleroderma"}
{"_id":"ece98ba9-5006-40c9-9057-eb5766f82b79","text":"Familiarity with all the possible causes of adverse events after injections with hyaluronic acid gel fillers accelerates the treated and healing of the patient with complications. Reporting this case should raise awareness about possible teeth‐related complications.","title":"Unilateral facial edema after filler injection of the lower eyelid"}
{"_id":"ecea79b7-7f68-b0f1-e9e8-f8ba6b776537","text":"Second, in our study the difference between both procedures in detecting positive lymph nodes was not significant. It might be that the sample size in our study was too small to detect small but clinically relevant differences.","title":"Is the sentinel lymph node biopsy more sensitive for the identification of positive lymph nodes in breast cancer than the axillary lymph node dissection?"}
{"_id":"ecedff8b-2520-caaa-53ca-25466bf63a09","text":"5 – 10 μM sanguinarine effectively inhibits MCF-7 proliferation after a single application of drug. This growth inhibition is accompanied by a striking relocalization of cyclin D1 and topoisomerase II from the nucleus to the cytoplasm, and this effect persists for at least three days after drug addition. DNA synthesis is transiently inhibited by sanguinarine, but cells recover their ability to synthesize DNA within 24 hours. Taking advantage of the fluorescence characteristics of sanguinarine to follow its uptake and distribution suggests that these effects arise from a window of activity of a few hours immediately after drug addition, when sanguinarine is concentrated in the nucleus. These effects occur in morphologically healthy-looking cells, and thus do not simply represent part of an apoptotic response.","title":"Disruption of nucleocytoplasmic trafficking of cyclin D1 and topoisomerase II by sanguinarine"}
{"_id":"ecfe8f81-f07e-2277-91f6-622b89cf82e5","text":"The specific objectives for the feasibility phase of this study are:","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"ed014a9b-7c0d-0d78-3a06-03d89c6c0bf3","text":"For the majority of patients, the decision not to have nonreconstruction was reportedly a personal choice. The major reason was refusal of further surgery. Clearly it is legitimate for patients to be reluctant to have surgery that is not necessarily perceived to be an integral part of treatment of the disease as such. Patients’ concerns about the number of surgeries and the duration of recovery may outweigh the potential benefits in terms of cosmesis and quality of life.","title":"Reasons of not having breast reconstruction: a historical cohort of 1937 breast cancer patients undergoing mastectomy"}
{"_id":"ed1118d4-41ce-0892-f79f-6098a2f375bd","text":"In conclusion this straight posterior incision with the forearm rested on a board across the chest allowed easy and relatively safe exposure of fractures of the mid shafts of both the radius and ulna.","title":"Exposure of both the radius and ulna through a single posterior incision: a technical note"}
{"_id":"ed1b222f-1134-104b-c198-d2b841afd86e","text":"Ultrasonographic images were retrospectively reviewed by a breast surgeon with 13 years of experience in performing breast implant ultrasonographies.","title":"Use of High-Resolution Ultrasound in Characterizing the Surface Topography of a Breast Implant"}
{"_id":"ed2354dd-6c58-166f-fdcf-af138c682480","text":"Further studies investigating the electrical activity of the suprahyoid muscles through surface electromyography after surgery to release the lingual frenulum may contribute to a better understanding of the impact of ankyloglossia on tongue movement during breastfeeding.","title":"Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding"}
{"_id":"ed23f3dc-5eb8-5ca6-fbd9-fd82e6f29635","text":"The findings of this meta-analysis highlight the need to provide thorough patient education on the risks of skin cancer development, especially in patients treated with MTX. Although skin cancer prevention is an important discussion for all patients, educating those with psoriasis about the increased risk of skin cancer in the setting of MTX can potentially affect tumor burden and patient comorbidity from NMSC. Risk modification can include increased screening for skin cancer with regular full-body skin examinations, more thorough counseling on appropriate skin protection, and increased education about signs of NMSC.","title":"Psoriasis Patients Treated With Methotrexate Have an Increased Risk of Nonmelanoma Skin Cancer: A Systematic Review and Meta-Analysis"}
{"_id":"ed267236-b579-69bd-9826-d2b069db0e1d","text":"Biological agents can provide precise inhibition of specific targets and are widely used in clinical practice. Most biologics have been approved by state authorities and have been included in medical insurance, and patients are willing to undergo biologic agent therapy. As biologics have become one of the mainstream treatment modalities for psoriasis vulgaris, it is important to have scientific evidence to guide medical staff in areas that need to be monitored and focus on before, during, and after patient treatment. Evidence 30 to 34 describe aspects of biologic therapy that are relevant. Minimizing the side effects associated with biologics administration and relieving patient physical and psychological stress are also necessary to reduce the patient treatment burden.[ Since patients receive biologic injections mostly on a regular basis in outpatient clinics and are not hospitalized, medical staff should teach patients to actively experience changes in their condition after a medication has been administered and regular review, which is also a part of treatment burden management.[","title":"Self-management of psoriasis vulgaris treatment burden: A Review"}
{"_id":"ed4b9088-e7bc-cb84-4bc2-06de1d3ca8a0","text":"Aseptic procedure and aspirating a needle are always critical while injecting botulinum toxin. Recognizing the location and shape of vessels passing through the muscles are important as well.","title":"Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain"}
{"_id":"ed4d3eca-308e-a49d-3094-9767aacc3902","text":"This study aimed to support the role of dentists by providing an osteomyelitis diagnosis key through a quantitative approach performed in a relatively simple manner. In particular, the objective of this study was to allow early diagnosis of osteomyelitis on digital panoramic radiographs using basic functions provided by the picture archiving communication system (PACS) program showing radiographic images.","title":"Early diagnosis of jaw osteomyelitis by easy digitalized panoramic analysis"}
{"_id":"ed52e873-a632-6bef-f054-87e571c342a4","text":"Since recurrence from breast cancer can occur 20 years or more after treatment for the primary cancer and women who have had breast cancer are also at increased risk of developing a new cancer in the other breast, it is likely that routine surveillance mammography will be of benefit in detecting asymptomatic cancers and improving survival for an indefinite period of time. The weight of evidence supports surveillance mammography as an effective means of detecting curable recurrences and new cancers and that it improves survival. All of these observational studies of routine clinical practice showed that some cancers were still detected by clinical examination. Routine clinical examination still serves as a “safety net” for women who have not attended for mammography, do not wish to self examine, or have, for other reasons, failed to report symptoms. It is also possible that clinicians are more likely to detect recurrence in the axilla than patients who self examine. For this type of information comparison of retrospective reports of survival based on method of detection can be misleading since the method of detection will depend on the services available, the type of cancer and adequate recording of data. Slow growing cancers are more likely to be detected in the preclinical, asymptomatic stage than fast growing ones and in addition to this there is the problem of lead time bias. The studies reviewed in this section measured survival from diagnosis thus avoiding lead time bias but earlier stage detection of slow growing cancers is a source of bias that is more difficult to avoid. In future more precise characterisation of the tumour by genetic tests and surveillance with MRI may enable earlier detection than routine mammography. In a study among women at high risk of breast cancer MRI was found to be more sensitive than mammography [27]. To date MRI scanning has not been used for primary population screening because the specificity is too low but it can be effective in detecting recurrence when mammograms are difficult to read particularly after radiotherapy.","title":"Options for early breast cancer follow-up in primary and secondary care - a systematic review"}
{"_id":"ed590870-0940-18e1-ef0d-4b5ab8a205e2","text":"Research sites are responsible for reporting serious adverse events for their trial participants during the course of the trial on the electronic CRFs. The following adverse events are expected after surgery in this patient population:","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"ed6eabbb-b415-abc8-21f0-69a643301dcd","text":"Conclusions: Through the current study, we have demonstrated that the betalactam hypersensitivity reactions are mostly delayed and non severe. The diagnosis was confirmed using skin tests which were useful not only in identifying the culprit drug but also in assessing cross reactivity. These findings have to be improved by the drug provocation test which is still not performed in our centre.","title":"7th Drug hypersensitivity meeting: part two"}
{"_id":"ed7540dc-d00b-a0d3-0797-36422389ed99","text":"This trial will clarify the role of NPWT and its potential for reduction in SSI in groin incisions for lower limb revascularization. The major limitation of this trial is the inability to blind the surgical team and the patient. We will randomize the incisions once the incision is primary closed to reduce the bias that could occur from the surgical team.","title":"Negative pressure wound therapy for high-risk wounds in lower extremity revascularization: study protocol for a randomized controlled trial"}
{"_id":"ed7aff49-6e51-8192-ebae-42a0336191e5","text":"Large ganglionic cystic formations arising from the infrapatellar fat pad are quite uncommon and only a few are mentioned in the literature. An open excision in these cases is mandatory.","title":"Large infrapatellar ganglionic cyst of the knee fat pad: a case report and review of the literature"}
{"_id":"ed7e3c75-3868-47b6-802d-44c41aa3b822","text":"One important finding from this study is that the differences in lifetime compensation between many of the subspecialties, when compared with each other, are markedly greater than the differences between many subspecialties and general pediatrics. Another important finding is the notable variation in the differences in lifetime compensation between general pediatrics and the various subspecialties depending on the data source used.","title":"Comparison of Calculations of the Financial Impact of Fellowship Training by Data Source Calculations of the Financial Impact of Fellowship Training Differ by Source"}
{"_id":"ed842ef9-c75f-33ba-dc48-fe5ba4d4c00b","text":"Knee rotationplasty is a suitable reconstructive and limb salvage procedure for infected femur and knee prostheses. It involves external rotation of the lower limb with an intact neurovascular bundle to function as a knee joint. Functionally, it has better outcomes when compared to alternate options like above knee amputation. It results in better cortical reorganization and superior stance mechanics, enabling a more efficient gait and better quality of life. Here we report a 57-yr-old male who underwent modified rotationplasty for an infected knee endoprosthesis as a composite lower leg free flap.","title":"Modified Rotationplasty as a Composite Free Flap for Femur and Thigh Reconstruction"}
{"_id":"ed86f2ca-c3fe-b30e-bf00-15730b86314d","text":"The water-fat ratio of magnetic resonance Dixon sequence can be used as a reference index to evaluate the degree of bone marrow edema in active stage of sacroiliac arthritis.","title":"The evaluation of bone marrow edema in sacroiliac joint in patients with ankylosing spondylitis using magnetic resonance imaging Dixon sequence"}
{"_id":"ed8a2db5-0775-ca96-330d-5f7079460aed","text":"Many medical students returning from IMEs have expressed concern about doing procedures beyond their scope of training.7 Thus, if Canadian medical schools are to continue supporting IMEs, a minimum level of competence in certain basic skills should be required. Without this we are shifting the burden of training to those whose resources are limited. Furthermore, language barriers may impede effective teaching of potentially dangerous procedures. Departing students are often cautioned that participation in procedures should match their current level of training. This is often not the reality and students may feel pressured to perform procedures above their level. Indeed many students return from electives wondering if their participation had been harmful to patients.6","title":"Procedural skills training for Canadian medical students participating in international electives"}
{"_id":"ed9326a5-7166-8d74-3bf5-b618df252475","text":"We cannot estimate the recurrence rate of NMSC or subsequent cancer risk among people with multiple NMSC because we only recorded the first report of each type of skin cancer in both cohorts. We do not have data for non-whites in this study, and our results cannot be generalized to non-whites owing to the dramatic difference in skin cancer incidence among different races. In summary, we observed a modestly increased risk of other cancers among individuals with a history of NMSC. Because our study was observational, these results should be interpreted cautiously and are insufficient evidence to alter current clinical recommendations. Nevertheless, these data support a need for continued investigation of the potential mechanisms underlying this relationship.","title":"Risk of a Second Primary Cancer after Non-melanoma Skin Cancer in White Men and Women: A Prospective Cohort Study"}
{"_id":"ed981d9a-ca72-803a-7023-d47229c09a30","text":"Hospital Episode Statistics data linked to mortality records from 1 April 1998 to 31 March 2017 were used to identify all BTOA injections undertaken in adults in the National Health Service secondary care in England. Patients were followed up longitudinally until death or 31 March 2017. A multivariable regression with a Fine and Gray model adjusting for the competing risk of mortality in addition to age, sex and socioeconomic deprivation was used to identify factors associated with progression to further procedure. Secondary outcomes included serious complications after injection and subsequent surgical site infection.","title":"Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis"}
{"_id":"ed9ec480-9c73-bd45-f04c-20302750ebce","text":"Wells Score was obtained from radiology request forms and presenting symptoms recorded in the clinical documentation.","title":"Prevalence of venous thromboembolism in patients undergoing diagnostic venous ultrasound during the first SARS-CoV-2 pandemic: A personal history of VTE and a positive COVID-19 test are associated with the diagnosis of DVT"}
{"_id":"eda403e6-4f83-d02d-5c0d-c4f1f6e4b735","text":"Treatment of a complicated case of filler pulmonary embolization and pneumonitis is based on limited experience as there is no published consensus. Patients with severe respiratory symptoms might be admitted to ICU and treated with massive IV steroids and antibiotics. The role of anticoagulants or thrombolytic therapy is controversial. Sedation and prone position, non-invasive or even invasive mechanical ventilation might be needed. ECMO might be considered in patients complicated by hemodynamic shock or severe ARDS and acute respiratory failure.","title":"Fatal pulmonary embolism following injectable gluteal filler usage: a case report"}
{"_id":"eda64e88-70e6-1e3b-ca1e-4b8077a7ec22","text":"A particular role may involve simultaneous injections of vaccines, because it is obvious that the type of nonspecific reactions are enhanced, if they are due to additional pathogenic factors . This is even more evident when you consider that vaccination is generally not recommended in children who have a febrile condition, whatever the cause.","title":"Causality assessment of adverse events following immunization: the problem of multifactorial pathology [version 2; peer review: 3 approved"}
{"_id":"edaa0ae4-65ba-f04d-778e-86f563a5604e","text":"A total of 38 patients who underwent double-tower folding ear cartilage tip plasty at Hangzhou Yixing Medical Cosmetic Hospital from May 2018 to June 2019 were included in this report. There were 3 male patients and 35 female patients aged 18–35 years old. We eliminated heavy saddle noses, severe short noses and contracture in patients, totaling 22 cases of primary surgery and 16 cases of secondary surgery. A second surgery was mainly required for a simple prosthetic nose job or when nasal tissue damage was not serious, after which the comprehensive edges, ear cartilage and nasal septum cartilages remained relatively intact in all 38 cases.","title":"A new technique for Asian nasal tip shaping: \"twin tower\" folding ear cartilage transplantation"}
{"_id":"edaebba8-b31e-2377-3384-5a71b1b31cea","text":"We conducted a retrospective chart review of patients receiving subcutaneous immunotherapy in our allergy practice between November 2012 to June 2013 looking at the incidence of local and systemic allergic reactions.","title":"Poster 2021: The incidence of adverse reactions induced by subcutaneous immunotherapy in an allergy center in Monterrey, México: a retrospective chart review"}
{"_id":"edb526de-1d68-0881-64f4-e25111a13a97","text":"This case underscores the potential of bilateral DVT as an early manifestation of aggressive lung adenocarcinoma, particularly in patients without common risk factors for thrombosis. While DVT is a recognized complication of malignancy, bilateral presentation as a preliminary indicator is relatively rare. Our findings emphasize the importance of keeping a broad differential in cases of DVT and recommend further investigations when there is an unexplained clinical presentation. Given the association between malignancy and thrombosis, early diagnosis and intervention are crucial to improve prognosis and overall survival rates. Collaborative medical efforts and specialized care can greatly enhance patient outcomes, as demonstrated in this case.","title":"Bilateral Deep Vein Thrombosis (DVT) as a Harbinger of Lung Adenocarcinoma: A Rare Presentation"}
{"_id":"edb5a2ce-a882-16bc-8a66-995a6c7394d5","text":"With more than 100 common melanocytic nevi and more than 50 cherry angiomas, red and blonde hair was associated with an increased risk of developing subsequent melanoma in a study conducted by Pastor-Tomas et al[ While light hair color and the presence of multiple melanocytic nevi are well known risk factors for developing melanoma[ the association between multiple cherry angiomas and the increased risk of developing subsequent melanoma was an unexpected finding.","title":"Multiple primary melanomas: A literature review"}
{"_id":"edbb7d70-9576-2c7c-2bb1-bea356a3fe28","text":"The outcome variable was time from primary palate repair until the patient underwent secondary palate surgery. Patients not undergoing secondary surgery during the observation period were censored on 30 December 2013, the last date for which outcome status was available.","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"edbc5731-d1a7-4ee5-0117-f304fea8e414","text":"Basic themes, organizing themes and the global theme that illustrate the findings and the analytic process. The tracks are intertwined with each other and can be understood as tracks on a map where the goal is to find one’s own unique way in breastfeeding","title":"A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth"}
{"_id":"edc59c72-3f85-2b74-8aed-e522a649a512","text":"Breast cancer is the most common type of cancer in women, with an estimated 2.3 million new cases and 685 000 deaths globally in 2020. In the UK, there are around 55 200 new cases of breast cancer each year. Around one in seven UK women will develop breast cancer in their lifetime, and the incidence is projected to rise by 2 per cent in the UK between 2014 and 2035. Breast cancer survival is increasing; almost 80 per cent of the 55 000 women diagnosed with breast cancer each year in the UK survive at least 10 years after their diagnosis and 67 per cent survive 20 years or more. Despite advances in breast cancer treatment and care, up to 40 per cent of women in the UK require a mastectomy. The loss of a breast can adversely affect women’s quality of life and impact personal, sexual, and social relationships.","title":"Secondary healthcare costs after mastectomy and immediate breast reconstruction for women with breast cancer in England: population-based cohort study"}
{"_id":"edcf66d2-7e3e-c86c-3d57-7320537ab9d4","text":"A total of 79 students could be evaluated based on questionnaire responses and simulator performance. 115 students began training with session 1 but 36 out of 115 did not complete both questionnaires and therefore were deemed lost to follow-up. Of the 79 students that completed both questionnaires and simulator training, 62 attended both sessions and 17 attended only one session. Some students were unable to attend both sessions due to scheduling conflicts with other curriculum requirements.","title":"Implementation of microsurgery simulation in an ophthalmology clerkship in Germany: a prospective, exploratory study"}
{"_id":"edd071f1-004a-6864-33e0-c3ee3545a4c5","text":"There was also an increase in sensitivity of the method over time, which might be explained by the learning curve of the method. By comparing the false negative and true positive TIC results we did find that the patients who had false negative test results had fewer macrometastasis. The downside of the method is that the SLN is split down the middle, the metastasis would have to be located in that area of the node to be detected, higher detection rate of macrometastasis is expected for that reason.","title":"Evaluation of intraoperative touch imprint cytology on axillary sentinel lymph nodes in invasive breast carcinomas, a retrospective study of 1227 patients comparing sensitivity in the different tumor subtypes"}
{"_id":"edda02c4-0570-782f-5b31-d50b6fd3e810","text":"Our overall results are summarised in Table 5. We directly compare outcomes in the young and the old cohorts and identify any statistically significant differences.","title":"The Effect of Age on Outcome in Excision of Chronic Osteomyelitis with Free Muscle Flap Reconstruction"}
{"_id":"eddc7d2e-81a8-0adf-fe5c-ddff0d387eff","text":"One interesting observation was the relationship between BTLA expression on mature B cells prior to vaccination, and increases in H1N1 specific IgG antibody titers with concomitant decreases in IgM titers. This seems to indicate that high BTLA expression on mature B cells might play a role in augmenting IgG production, specifically in shifting the response from IgM to IgG. The fact that we only saw this for the H1N1 virus, and not the H3N2 virus needs to be noted. It may reflect that H1N1 underwent a dramatic change in 2009 and is thus a fairly recent virus while variants of H3N2 have been circulating since 1968.","title":"BTLA expression declines on B cells of the aged and is associated with low responsiveness to the trivalent influenza vaccine"}
{"_id":"eddfaaa4-2616-6af0-ee53-ed59ee684377","text":"A systematic search of articles in PubMed, EMBASE and The Cochrane Library databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for the period from January 2000 to November 2020.","title":"Surgical management of abdominal desmoids: a systematic review and meta-analysis"}
{"_id":"ede6fd4e-684d-b28a-6352-b027769309c6","text":"DFS is a rare yet recurrent skin tumor. Wide excision with free margins remains the cornerstone of treatment. We report a case of a giant DFS treated with wide excision and reconstructive surgery to cover the defect.","title":"Giant Darier–Ferrand dermatofibrosarcoma protuberans of the abdomen and pelvis: a case report"}
{"_id":"ede872df-2be1-9fff-f58e-ef587659dd25","text":"This study showed that free flaps could be safely used for the treatment of osteomyelitis in patients with comorbidities and those who had osteomyelitis developing from diabetic foot ulcers. However, care should be taken in patients diagnosed with end-stage renal disease.","title":"Factors affecting the outcome of lower extremity osteomyelitis treated with microvascular free flaps: an analysis of 65 patients"}
{"_id":"edeb0027-2ace-dc20-51e1-ce595a7de972","text":"Patients with tumoral calcinosis usually present with periarticular masses associated with pain and limitation of joint motion usually affecting the hip, elbow and shoulder.","title":"Tumoral calcinosis of unusual location in a chronic hemodialysis patient Sakhy et al"}
{"_id":"edf0a1e2-204c-eafc-f10d-0f65ac9d6c36","text":"The results of the PDUS clearly confirmed that CA4P treatment of spontaneous solid tumours in dogs resulted in an acute tumour vascular response within 10 min after start of the infusion. The statistically significant correlation between intratumoural VI and the gold standard MVD at 72 h supports the hypothesis that PDUS offers an objective and reliable assessment of the tumour vascularity at the time of US scanning in an in vivo and in situ manner. Standardized power Doppler settings and image-processing protocols enable a precise and objective evaluation of the VI and make PDUS a convenient and immediately applicable way to determine the efficacy of anti-vascular agents in a therapeutic setting.","title":"Power Doppler ultrasound and contrast-enhanced ultrasound demonstrate non-invasive tumour vascular response to anti-vascular therapy in canine cancer patients"}
{"_id":"edf2d33d-b959-7726-ff8c-d54ad2c5d9aa","text":"Management of ocular metastases is palliative since treatment is limited to the primary tumor.","title":"Photodynamic Therapy in Ocular Oncology"}
{"_id":"edf33077-4f76-8998-0fd5-8344725d9a02","text":"Participants underwent a structured evaluation for VTE consistent with local usual care protocols. We considered patients to have a PE if their CTPA demonstrated a filling defect in a pulmonary artery or if a VQ scan was read as high probability for PE. If a patient was low or intermediate pretest probability for VTE but did not have imaging performed but had a negative D-dimer performed by the hospital's clinical laboratory, we considered them to have ruled out for VTE. We considered patients to have a DVT if a thrombus in a deep venous leg vein proximal to, or at the level of, the calf was found by either venous ultrasound or contrast venography. Patients with possibility of recurrent VTE were included in the study. For those patients, they were considered to be PE or DVT positive if imaging demonstrated clot in a new location or extension of a previously documented DVT. All radiologic studies were interpreted by board-certified radiologists.","title":"Highly Elevated Quantitative D-Dimer Assay Values Increase the Likelihood of Venous Thromboembolism"}
{"_id":"edf569a1-09d3-0228-de59-37da26c4e59d","text":"We also confirm correlation between involved margins and risk of local recurrence. In addition we have shown a relation between margin positivity and worsening prognosis for node negative patients and a similar, but non significant, trend in women with positive nodal disease. Interestingly, our local recurrence rate of 12% with a 10 years follow-up was identical in both node negative and node positive patients who had negative margins. There were fewer recurrences in margin positive patients who were node positive as compared to those with negative nodes – reflecting the greater early mortality in this group and thus not allowing long enough follow-up for full potential of local recurrence to be realized.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"edfa9f1a-b266-6ed2-7e59-22eb44eb6ef7","text":"In a recent case series of 5 patients, 3 patients with locally advanced CM who refused orbital exenteration and 2 with metastatic disease received multiple cycles of an anti-PD1 agent together with ipilimumab or nivolumab. All cases showed improvement in local and metastatic CM and complete response was seen in 2 patients, 1 of whom initially had systemic disease.","title":"Current Management of Conjunctival Melanoma Part 2: Treatment and Future Directions"}
{"_id":"ee01d7f4-7c04-3c89-2554-77846babbecc","text":"To our knowledge, the present study represents one of the largest assessments of patients who underwent delayed surgical decompression for severe BP refractory to medical treatment. While no significant differences were noted between the two main comparison groups, the subgroup analysis suggests that patients with severe BP may benefit from decompression surgery up to 90 days after the onset of symptoms in the absence of an opportunity to proceed earlier to surgery.","title":"Delayed facial nerve decompression for severe refractory cases of Bell’s palsy: a 25-year experience"}
{"_id":"ee051067-54cb-a2ed-a03f-e03e85f0af1b","text":"Sural flap coverage is classically done for defects around mid or distal tibia but in our series it was done for three cases of proximal tibia osteosarcoma (Figure 1). With slight modification in the technique and selection of donor site more proximally in the calf it is possible to extend the pedicle for proximal tibia defect coverage without additional flap related morbidities [9]. Bony reconstruction was done with the help of autograft nonvascularized fibula with corticocancellous graft. In one case vascularized fibula was done in addition to sural artery flap.","title":"Complex Biological Reconstruction after Wide Excision of Osteogenic Sarcoma in Lower Extremities"}
{"_id":"ee0ee905-95ec-ebc6-ac67-784207148fb5","text":"SLN biopsy is the most accurate and the only reliable method for nodal staging which can diagnose microscopic tumour spread to the regional lymph nodes. Minimal invasive SLN biopsy can replace lymphadenectomy for staging. Planar lymphoscintigraphic imaging is an important element in lymphatic mapping but interpretation of planar lymphoscintigrams is hindered by the absence of anatomical landmarks in the scintigraphy image (10).","title":"Detection of Sentinel Lymph Nodes in Gynecologic Tumours by Planar Scintigraphy and SPECT\/CT"}
{"_id":"ee0fec7e-36c3-fdc1-0652-b59616881eec","text":"Autologous cartilage grafts can be used as crushed, diced or grated material to camouflage the surface irregularities with or without fascia, but placement of these grafts must be done through classic incisions and as a part of a septorhinoplasty procedure. We have designed injectable cartilage shaving which is prepared from septal, costal or less frequently conchal cartilage and can be injected via 14 to 18 gauge needles or blunted tip cannulas of lipofilling with 1.3 to 1.7 mm diameter. It can be introduced from skin or mucosal surface directly to the desired location without the need for any incision or elevation of skin flap; therefore, the injection can be performed as an outpatient procedure.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"ee16cf28-66a4-6aab-fa64-feb494edbeb4","text":"Capital costs were incurred for hospital buildings (operating theatre and the ward) and for equipment used for the surgical procedures and on the ward. For this study, the value of the hospital buildings was estimated based on the income if the area occupied by the buildings had been used for land lease. The capital cost of the operation theatre and the ward was estimated by multiplying the capital cost of each building by the proportion of the total surface area allocated to each of these units. To calculate the capital cost per surgery, the capital cost of the operating theatre was divided by the annual number of surgeries. The capital cost per day spent at the hospital was calculated by dividing the capital cost of the ward by the total number of patient days on the ward. Major equipment, such as the operating table and autoclave, was depreciated over 10 years. NPWT pumps were depreciated over three years.","title":"Cost analysis of negative-pressure wound therapy versus standard treatment of acute conflict-related extremity wounds within a randomized controlled trial"}
{"_id":"ee18145e-d4b0-4850-af4d-e3089bbf7ada","text":"Quantitation of inoculum is a basic requirement for reproducibility in microbiology, and the nature of that inoculum is clinically relevant. As few as 100 CFUs of biofilm bacteria can initiate a PJI, validating the rejection of the 105 rule of thumb for infection by Zimmerli et al. and reinforcing the idea that biofilm inoculation is the likely cause of dSSIs. Researchers using pure culture to inoculate animal models of infection must apply more planktonic CFUs to initiate a chronic condition. This results in unnatural amplification of the innate immune response and may require other modifications such as balancing mortality against morbidity to accurately represent the chronic disease. The convenience of using planktonic inoculation is associated with notable and important confounding effects. Bacteria living in biofilms have different gene expression and metabolic indicators in addition to their association with extracellular polymeric substances, all of which persist after inoculation, affecting the disease progression, response, and outcomes.","title":"Improve Integration of In Vitro Biofilm Body of Knowledge to Support Clinical Breakthroughs in Surgical Site Infection"}
{"_id":"ee1a819b-76aa-e164-d4ac-3294b0967258","text":"A360 Experimental Mouse Model of Asthma Induced By Dust Mite Dermatophagoides Pteronyssinus allergenic Extract","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"ee2dfa38-5a70-5f62-1651-6bc8ac873095","text":"The purpose of this study is to evaluate endoresection as a primary treatment for choroidal melanoma.","title":"Outcomes of primary endoresection for choroidal melanoma"}
{"_id":"ee37b994-2c55-911f-35e3-d4251f4d2138","text":"Patients are grateful to know that their surgeon emphasizes safety and is willing to provide an important additional safety measure at no extra cost. Open discussions with patients regarding the risk of VTE and methods to reduce risk are helpful. Consulting physicians are often impressed with this heightened level of concern. Such safety measures are likely to reduce our shared medicolegal liability.","title":"The Expanding Role of Diagnostic Ultrasound in Plastic Surgery"}
{"_id":"ee39cb16-4575-c66d-3d3a-3267565bba65","text":"Patient data were recorded in an Excel database for analysis. Continuous variables were reported as measures of central tendency, and count data were reported as absolute frequencies and presented as percentages. Pathogenic microorganisms were considered only when they were present in two or more tissue samples identified by culture or 16S rRNA PCR. Contamination was considered possible when a microorganism was isolated in only one sample. Polymicrobial infection was defined as the isolation of more than one other microorganism, excluding contamination.","title":"Infections in patients with adverse reactions to the use of unknown modeling substances for soft tissue enhancement in Cali, Colombia"}
{"_id":"ee3c816e-db6f-b0b4-fafd-b2fcc678c737","text":"The present guidelines are intended to support optimization of therapeutic management of cutaneous side-effects and to improve the quality of life of oncology patients.","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"ee3cb11e-255c-fe35-6161-95da2891f659","text":"Studies of imiquimod action in DFTD also provide valuable insights into the response of human tumor cells to direct imiquimod treatment. While previous studies have elucidated a role for imiquimod in the activation of stress responses in human cancer cell lines [16, 17], our analyses have used DFTD as a tumor model to highlight the key molecules and pathways regulated at a global scale. In human cancer therapy, combinatorial immunotherapies have demonstrated promise for their ability to target multiple pathways and overcome immune resistance [67]. Through an improved understanding of pathways regulated by imiquimod, the approach used in our analysis will allow for mechanistic identification of potential therapeutic targets and drug combinations involving imiquimod treatment. Our analysis also provides evidence that imiquimod exerts suppressive effects against pathways involved in the normal functioning of tumor cells, including those involved in invasion, cell migration and immune evasion. These suppressive effects could improve the ability of the immune system to target tumor cells, perhaps aiding tumor rejection in vivo. This study provides a basis for further exploration of imiquimod as a therapy in cancer.","title":"Transcriptome and proteome profiling reveals stress-induced expression signatures of imiquimod-treated Tasmanian devil facial tumor disease (DFTD) cells"}
{"_id":"ee41b6ed-c33d-289b-63a9-286bf8668a35","text":"Immune response correlation depending on tumour dimension and axillary lymph nodes status","title":"Immunological aspects predicting metastatic sentinel lymph node in early breast cancer patients"}
{"_id":"ee47b6b3-e750-56b5-81b9-f120468dc279","text":"There are various methods of treatment for local recurrence after radical prostatectomy for prostate cancer. We hereby report the case of a patient who underwent low dose rate brachytherapy for castration-resistant and external beam radiotherapy-resistant local recurrence of prostate cancer after prostatectomy.","title":"Salvage Brachytherapy for Castration-Resistant and External Beam Radiotherapy-Resistant Local Recurrence 17 Years after Radical Prostatectomy"}
{"_id":"ee4f455c-e79c-2d18-2eed-51ed265ac81a","text":"Cartilages of the septum, ear concha and rib are the most frequent sources of autologous grafts while covering fascia of the temporalis or rectus abdominis muscle, fascia lata, and calvarial or iliac bone are other examples. Most of the grafts are used alone or in combination, to rebuild or augment a specific structure of the nose and some advanced techniques in manipulation of the tip and other subunits of the nose have been proposed to adjust the structures as precise as possible, but sometimes the grafts are used for the purpose of camouflage and improvement of surface aesthetic properties.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"ee54e0f0-68ac-7eae-d885-7b7ba36bed91","text":"The present study provides more contemporary information regarding the modified NPWT technique in managing infected metalwork. The modified NPWT with copious saline irrigation is safe and reliable with over 96% success rate in metalwork retainment and resolution of acute infection in extremity cases. This improved technique is a valuable adjunct to conventional antibiotic therapy in orthopaedic patients with retained infected metalwork.","title":"Modified negative pressure wound therapy as an adjunct to antibiotics in the treatment of orthopaedic infected metalwork"}
{"_id":"ee5c0deb-3dbd-f72e-4605-340f7d9798d9","text":"Aggressive treatment of the underlying organ dysfunction is an essential component of improving patient outcome. Physiologic support including close invasive monitoring in an intensive care unit setting and aggressive resuscitation are often necessary in necrotizing infections.","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"ee62579a-ac43-889c-7cc7-4451ea5526fe","text":"The likelihood of local recurrence is therefore a competitive effect between those factors leading to local recurrence and those predicting systemic relapse. In our study we therefore analyzed the effect of positive margins on ipsilateral breast recurrence and how this may relate to nodal status on long-term follow-up. We were able to analyze a cohort of patients operated between 1987 and1992 who did not necessarily undergo re -excision of positive margins because of the belief at the time that radiotherapy wouls sterilize any positive margins left in-situ and local recurrence could be successfully treated by salvage mastectomy without survival disadvantage.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"ee629213-a4c3-89b0-52a3-fb187b62bbb7","text":"This report illustrates the safe treatment of recalcitrant achalasia with LES injection of botulinum toxin A. The effect was not long lasting, as is typical for this type of treatment, and our patient required surgical cardiomyotomy eight months after delivery. Botulinum toxin A injection of the LES proved to be a safe temporary alternative to surgery and the requisite anesthesia during pregnancy. In this case, the dysphagia was well palliated and the patient gained weight and delivered a healthy baby at term.","title":"Achalasia in Pregnancy: Botulinum Toxin A Injection of Lower Esophageal Sphincter"}
{"_id":"ee62ab9a-3583-fac7-370a-3cfb97b4b5e8","text":"A preliminary study showed that in the mice showing uncomplete eradication of tumors even after mPDT for 8 h\/day over a period of 5 days, residual tumors in the surrounding margin away from the position of LED began to regrow. This finding suggested that the light emitted from the LED no longer reached the limbic regrowing tumor, and we therefore decided on a protocol of 8 h\/day for 5 days.","title":"Metronomic photodynamic therapy using an implantable LED device and orally administered 5-aminolevulinic acid"}
{"_id":"ee62d121-34a4-6ce3-5388-2e22b0fbe9ee","text":"The main muscles involved in GMC are the gluteus maximus and gluteus medius, although in severe cases, the deep-lying gluteus minimus and piriformis may be involved. The gluteus maximus is the largest muscle in the gluteal region, and it extends from the outside of the iliac wing to the gluteal crest of the femur. The gluteus medius originates on the exterior of the iliac bone between the anterior and posterior gluteal lines and ends on the lateral side of the femoral greater trochanter.","title":"CT-based morphological study of the pelvis in patients with gluteal muscle contracture"}
{"_id":"ee633394-dbd1-9e54-ed21-ffcab38b9ecc","text":"The database, to which all of the CRF is transferred to, will only contain a unique number for each patient and no personal data. The unique number is logged in a separate database with personal data of each patient to facilitate follow-up, this database is only available to selected members of the study group. The paper forms of the CRF will be stored in a locked closet in a locked room, to which only the study group has access. The database containing the CRF will be stored locally and only be accessible to members of the research team as well.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"ee635d5b-cbb4-5d14-3f68-7562e2ee36ba","text":"Conclusion: The incorporation of anatomical and ultrasonographic knowledge favors the quality of care of physicians who perform in extreme situations. The correct use of ultrasonography as a diagnostic tool allows to improve the response times and decision making of surgical procedures.","title":"Abstracts from the 13th WINFOCUS World Congress on Ultrasound in Emergency & Critical Care"}
{"_id":"ee6aa6c2-5746-235e-44a5-7687ba6a199a","text":"Development of a discharging wound after an orthopaedic procedure where prosthetic material has been implanted","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"ee6bc2c8-ec5c-4585-b8f5-be83b7fad1e5","text":"n is the total number of patients with failed or successful blocks, and","title":"Minimum Effective Volume of 0.75% Ropivacaine for Ultrasound-Guided Axillary Brachial Plexus Block"}
{"_id":"ee797911-56d1-9ba5-b3fa-4f79b7497511","text":"This evaluation aimed to consider the impact, if any, of participation in the CPhOGH Fellowship, particularly in relation to leadership skills. It also deliberates whether this programme offers a development opportunity to provide demonstrable benefits to pharmacists as individuals and the wider NHS. The overall impression from the responses provided in the questionnaires indicates that all CPhOGH Fellows underwent a great deal of personal and professional development over the one-year Global Health Fellowship.","title":"Assessing the Impact of a Global Health Fellowship on Pharmacists’ Leadership Skills and Consideration of Benefits to the National Health Service (NHS) in the United Kingdom"}
{"_id":"ee808851-cbde-8f04-4ee3-a1ef6cd9afbc","text":"Patients with chronic inflammation and exudative wounds are catabolic and may be nutritionally deplete. Efforts to optimize the patient to promote wound healing and reduce the risks of wound-related complications should include smoking cessation, 27 nutritional support and decolonization of carriers of methicillin-sensitive S. aureus . 28","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"ee914bad-9c07-ca00-21be-a08ad59eeb31","text":"Our method utilized a Large Surgical Pin Cutter to remove a titanium reconstruction while leaving the unexposed parts of the plate intact without disrupting the adjacent soft tissue. Minimal damage to the surrounding skin and soft-tissue was of the utmost importance in this case due to the poor likelihood that a large wound would heal reliably in a previously irradiated field. Bony union at the bridging point between the fibular graft and mandible was confirmed via CT scan; thereby ensuring that the plate would be able to be safely removed without sacrificing stability of the mandible. After removal, the splice points of the plates were smooth with no evidence of kinking, which can occur if too much leverage is placed on the plate or if a poor initial cut is made.","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"ee9b907f-d843-2df1-145c-6f70d4c2497f","text":"The use of tissue expansion is an option to increase the possibility of primary closure but unfortunately this option was not suitable for most of our patients for many reasons: most of the defects were too large for this technique; many patients had a lack of skin pliability and some had recurrent tumors or received radiotherapy; in addition this technique is neither free of complications nor suitable for immediate coverage [6, 14].","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"eea8503b-f43a-5509-206b-6f42c5c72b0c","text":"Data of the OHIP-14 questionnaire and the set of special questions were collected through follow-up visits at least 3 years after prosthetic treatment. The patients filled the patient consent and the questionnaires at the recall examination under supervision of one of the authors who is not involved in the treatment to avoid bias and any effects of interpersonal reactions. The individuals expressed satisfaction answering questions. The answers have score 0 to 5 where the scoring is distributed as following:","title":"Satisfaction level in dental-phobic patients with implant-supported rehabilitation performed under general anaesthesia: a prospective study"}
{"_id":"eea8a16c-02d9-d562-00ee-5b80c079b9c2","text":"This feasibility study is embedded within the World Hip Trauma Evaluation cohort.21 It will be run in five different centres across England including Major Trauma Centres and Trauma Units. All patients being surgically treated for hip fracture will be considered for enrolment.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"eeb3fe27-22a5-d6f2-2460-6ce25daaf3fd","text":"This systematic review will summarise the best available evidence and definitively establish the incidence of incomplete surgical excision in non-melanoma skin cancer. It will determine if there is variation observed amongst different operating groups and provide some evidence for potential other factors causing this difference. This knowledge will provide a standard for future audits and will contribute to improving the treatment of non-melanoma skin cancer treatment.","title":"Global incidence of incomplete surgical excision in adult patients with non-melanoma skin cancer: study protocol for a systematic review and meta-analysis of observational studies"}
{"_id":"eeb7e9a9-720f-f7c0-4ee1-55ef437ed622","text":"A limitation of this review is the fact that all but one of the reviewed studies were retrospectively analyzed. It is therefore difficult to control for treatment bias and selection bias. In some studies patients were more likely to be older and have more favorable tumors characteristics such as smaller size, low tumor grade and less lymphovascular infiltration than in the general breast cancer population. This is shown in Table 4 by the trend for smaller tumor size, more BCT and micrometastases in patients who has been treated with only SLNB. Unfortunately, details on the type of surgery or adjuvant radiotherapy for those patients who developed an axillary recurrence was not presented in the majority of the different studies. Axillary recurrences were reported in 6 patients after BCT and 2 after mastectomy, whereas in 28 patients it was not described in detail. Also, the results extracted from the two American database studies dominated the results of this review because of the greater number of patients in comparison with the other 28 studies. In those database studies the selection bias is substantial because patients were selected to undergo only SLNB if they were more likely to have a favorable prognosis. Also, these cancer registries may underreport axillary recurrences because the definition “ipsilateral regional events” is used instead of “axillary recurrence.” Although the other studies do use the exact definition, underreporting might still occur in all studies because of their retrospective nature.","title":"Axillary Recurrence After a Tumor-Positive Sentinel Lymph Node Biopsy Without Axillary Treatment: A Review of the Literature"}
{"_id":"eebb8ace-2cc9-23fc-7cc5-96d3362e12ae","text":"The author prefers to use a locking titanium reconstruction plate to secure the osteotomized fibula to the remaining native mandibular segments. Some surgeons have had success with using smaller, very low profile miniplates. Such plates have the advantage of permitting fine adjustments to the final shape of the reconstructed mandible while locking reconstruction plates are considered to possess superior stability and are able to tolerate higher loads.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"eed9bf96-de8b-0c40-072f-8aee05377f36","text":"Multivariate regression analysis demonstrated no influence of basic characteristics variable on IHC outcome.","title":"Immunohistochemistry comparing endoscopic vein harvesting vs. open vein harvesting on saphenous vein endothelium"}
{"_id":"eedd45c8-efe9-270c-f060-5486fc10dc8b","text":"The dependent and external positions of the reconstructed scrotum may have similar thermoregulatory effects on the testes as that of normal scrotum, which is proven by the results of the semen analysis before surgery compared to the results 6 months and 1 year after surgery, which showed nonsignificant changes in all parameters.","title":"Versatility of unilateral propeller groin flap for coverage of large scrotal defects and its impact on testicular function"}
{"_id":"eee20a23-a8f3-5465-0939-94dc79c2adea","text":"We suggest avoiding ALND in cases of micrometastatic SLN and in all remaining positive SLNs.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"eef12c41-2fa9-1386-362c-5f3111d04b80","text":"As the histopathology report from the wide local excision is most often negative and given to patients at the follow-up visits several weeks after all surgery is completed; we did not analyze lead time to patients were informed on the final histopathology results.","title":"Differences in cutaneous melanoma treatment and patient satisfaction"}
{"_id":"eef1fe4f-d883-5c46-1ced-fe60e0fe209b","text":"In conclusion, pediatric orthopedic surgeons double their pediatric case volume after fellowship training. Prospective trainees and faculty are provided a benchmark to improve operative training in pediatric orthopedic surgery during residency and fellowship training. More research is needed to understand the impact of case volume on clinical outcomes in pediatric orthopedic surgery, including the potential establishment of case minimums in an evidence-based manner.","title":"Case Volume Benchmarks During Residency and Fellowship Training for Pediatric Orthopedic Surgeons"}
{"_id":"eef32672-e514-4a35-de12-e2981d195003","text":"The harvested rectus flap is rotated 180° in a clockwise manner on its DIEA pedicle to reach the pelvis (Figure 2A). Care must be taken not to kink or place tension on the vascular pedicle. The flap is rotated and led precautiously to the perineal defect in order that the lateral end of the flap covers the anterior side of the defect (Figure 2B). Closure of the perineal defect is performed by interrupted vertical mattress suture using resorbable polyglactine stitches. In case of posterior vaginal defect, is recommended to start the perineal closure by putting some stitches between the skin flap and the remaining walls of the vagina in order to create an adequate neovagina.","title":"PERINEAL REPAIR AFTER ABDOMINOPERINEAL EXCISION WITH RECTUS ABDOMINIS MYOCUTANEOUS FLAP RECONSTRUÇÃO DO PERÍNEO APÓS AMPUTAÇÃO ABDOMINOPERINEAL COM RETALHO PEDICULADO DO MÚSCULO RETO ABDOMINAL"}
{"_id":"eef50d08-52f4-e189-90c2-d3c4f0e0c609","text":"The ALT free flap proved to be effective for covering large temporal skull base defects resulting from the radical removal of temporal bone malignancies. The surgical procedures are safe and their results are acceptable. The complications at the recipient and the donor sites are rare and manageable.","title":"Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection"}
{"_id":"eefb3f3a-5c06-575d-cafa-bd4a3ff604d1","text":"Interestingly, during the last years several well conducted epidemiological surveys have demonstrated the high prevalence of allergic diseases in tropical underdeveloped countries. In addition, the hygiene hypothesis has failed to resolve important contradictions with empirical data and finally, the immunostimulatory effects of helminthiases have been evaluated at the population level. Based on the limited historic information available, it is very difficult to define if there is an allergy epidemic in the Tropics or how long these diseases were present. However, since tropical centers started to be involved in the Study of Asthma and Allergies in Childhood (ISAAC), it was evident that asthma and rhinitis were very frequent in some cities. We do not know if this trend came from long or even if the natural exposure to mite allergy induced underdiagnosed allergy symptoms. In the following five sections we will review the prevalence and relevant clinical aspects of some allergic conditions. Asthma and rhinitis as well as atopic dermatitis will be analyzed by including both ISAAC and regional studies from the Tropics.","title":"Particularities of allergy in the Tropics"}
{"_id":"eefc3ab8-a2de-5db5-d179-113c5680a633","text":"Each of the study subjects completed the first PDT procedure, and because of extensive AK lesions, 16 of them qualified for a second PDT session. One patient refused to continue the treatment because of severe pain experienced during the first PDT procedure.","title":"Topical Photodynamic Therapy with Different Forms of 5-Aminolevulinic Acid in the Treatment of Actinic Keratosis"}
{"_id":"ef0003d1-4860-4c25-550f-b2cf601cf536","text":"Ultrasound imaging has been used extensively to detect abnormalities of the non-lactating breast. In contrast, the use of ultrasound for the investigation of pathology of the lactating breast is limited. Recent studies have re-examined the anatomy of the lactating breast highlighting features unique to this phase of breast development. These features should be taken into consideration along with knowledge of common lactation pathologies in order to make an accurate diagnosis when examining the lactating breast. Scanning techniques and ultrasound appearances of the normal lactating breast will be contrasted to those of the non-lactating breast. In addition ultrasound characteristics of common pathologies encountered during lactation will be described.","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"ef07fe12-965c-84ee-75d3-3fd03d5bb0ba","text":"The patient provided consent to treatment and the publication of this case report. She received two treatments of autologous fat grafting both of which were done using a Coleman type approach [10]. The area to be treated was marked with the patient standing. For the harvest of fat, 20 mL of 1% lidocaine with adrenaline was injected into the periumbilical area followed by initiation of sterile technique. Using a Coleman liposuction harvesting cannulae, a total of 15 mL of fat was harvested in an atraumatic fashion through a small periumbilical stab incision. The fat was not centrifuged, but was simply transferred directly into 1 mL leur lock syringes for injection, discarding any fluid that accompanied the fat. An infraorbital nerve block was performed with local anesthetic injection into the depressed area. The face was prepped and draped in a sterile fashion and a small stab incision was performed in the mid cheek subunit at the intersection of a vertical line drawn down from the lateral canthus and a horizontal line drawn from the ipsilateral alae. A total of 8 mL of fat was injected into the soft tissues of the cheek and various levels ranging from the supraperiosteum to the subcutaneous plane. Both umbilical and facial stab incisions were closed with a single fast absorbing gut suture. This procedure was repeated 1 year later as a second stage of treatment to improve the correction of the facial deformity. The patient reported no adverse effects from treatment and was satisfied with the results (Fig. 1). She continues to be followed annually though future treatments are not anticipated.","title":"Idiopathic facial lipoatrophy in a healthy middle-aged woman: a case report"}
{"_id":"ef09c9b4-e8a3-f987-b088-4f7b6e9d43a7","text":"We present a clinical case of spondylodiscitis that developed in a young man with rheumatoid arthritis and a history of post-traumatic chronic osteomyelitis in the lower limb.","title":"Spontaneous Cervical Spondylodiscitis With Retropharyngeal Abscess and Bacteremia: A Case Report"}
{"_id":"ef1b9ce8-31f9-b216-ec14-bcc1528f4f3a","text":"At the beginning of the study 26 patients had a self-reported adverse reaction after eating some food but in 24 of these patients the clinical history was not clear and had a negative prick test. Only 2 patients had a clinical history suggestive of food allergy and a positive prick test with the suspected food (egg and shrimp) but both patients had a negative oral food challenge.","title":"Clinical and Immunological Changes of Immunotherapy in Patients with Atopic Dermatitis: Randomized Controlled Trial"}
{"_id":"ef27a1b5-cf1f-274e-096c-55d845edf922","text":"The artificial dermis has become more popular in recent years for reconstruction because of its simplicity and the predictability of the reconstructive results. The biodegradable dermal replacement layer serves as a matrix for the macrophages, fibroblasts, and endothelial cells from the host tissue. It causes a new dermis to grow, thereby creating a functional tissue instead of the excised one. The only donor site that is needed is a very thin split skin graft for final closure after the dermal graft has taken. The main drawback of this reconstructive modality is its price which is very expensive.","title":"Post-burn breast reconstruction using an artificial dermis—a long-term follow-up"}
{"_id":"ef3a2be3-ee6d-c1c4-80be-2cb4953436af","text":"Randomization was performed by means of a computer-generated list of consecutive random numbers. The information regarding the group to which each patient had been allocated was given to the surgeon minutes prior to the start of the surgical procedure.","title":"Complete axillary dissection without drainage for the surgical treatment of breast cancer: a randomized clinical trial"}
{"_id":"ef3c4d31-6c72-ebcd-df03-f2ccca49c50a","text":"The results from this descriptive study have the potential to inform the decisions of trainees considering subspecialty training at FPRS fellowship programs that perform microvascular surgery, especially in light of their variable levels of microvascular exposure during residency [3]. They may also be of interest to those overseeing their fellowship training in guiding decisions about the volume and variety of procedures fellows may expect. For those currently in practice, this report provides a benchmark for comparison in the evolving field of otolaryngologic reconstructive microvascular surgery.","title":"Fellowship training in microvascular surgery and post-fellowship practice patterns: a cross sectional survey of microvascular surgeons from facial plastic and reconstructive surgery programs"}
{"_id":"ef3c788a-20b4-5be9-e8db-d5847278b7d7","text":"Mortality and dependency rates of CVT remain high with an estimated 15% of cases resulting in death or significant disability [9]. Complications occur in the form of venous infarcts and early detection leads to more favorable outcomes with early initiation of anticoagulation to prevent progression of thrombosis with resultant venous infarcts. Treatment for osteomyelitis requires long term intravenous antibiotics and possible surgical excision of epidural abscesses or empyema if present. Osteomyelitis affecting the odontoid process is rare and special consideration should be made when treating these infections since it is well situated to cause cerebral venous thrombosis due to continuity between of the internal jugular vein with cerebral venous sinuses. Since these two entities require very different treatment approaches, CVT as a potential cause for neurologic complication should be assessed in any patient with high cervical infections.","title":"Pyogenic Odontoid Osteomyelitis with Sinus Thrombosis"}
{"_id":"ef3f4782-4670-92ac-5591-b009fe87aa5e","text":"These in vitro results support the hypothesis that the local addition of an anti-inflammatory drug such as ibuprofen can attenuate melanoma invasion and may promote healing post surgical excision of primary tumours but further work will be required with other cell lines to establish how widespread or otherwise this effect of ibuprofen may be.","title":"Use of a Tissue Engineered Human Skin Model to Investigate the Effects of Wounding and of an Anti-Inflammatory on Melanoma Cell Invasion"}
{"_id":"ef412d47-34ad-5fb5-bfc7-2c1807a65be3","text":"We assessed the recovery of 2 face transplantation patients with measures of complexity during neuromuscular rehabilitation. Cognitive rehabilitation methods and functional electrical stimulation were used to improve facial emotional expressions of full-face transplantation patients for 5 months. Rehabilitation and analyses were conducted at approximately 3 years after full facial transplantation in the patient group. We report complexity analysis of surface electromyography signals of these two patients in comparison to the results of 10 healthy individuals.","title":"Recovery of facial expressions using functional electrical stimulation after full-face transplantation"}
{"_id":"ef454238-2674-f4ac-b7f8-6a15f356c15d","text":"A single photograph of a benign naevus is sometimes used to document and support the clinical decision not to biopsy that benign naevus. However, serial mole photography should not be used to diagnose benign melanocytic naevi. In other words, if the physician cannot 100% exclude a diagnosis of melanoma on visual inspection the appropriate diagnostic test is a biopsy and not serial photography.","title":"Malignant Melanoma"}
{"_id":"ef4b491b-a18d-eb62-c73c-f707f33f6b80","text":"This cohort study found that the financial relationship and potential conflicts of interest between newly independent physicians and industry began to form and continued to expand in the early years of independent physician practice. Surgical specialty and male sex of the newly independent physicians were significantly associated with acceptance of higher general payments in the early years of independent practice. Further studies are needed to evaluate whether modifiable factors, such as the ACGME’s Milestone ratings in professionalism and systems-based practice during GME training, can indicate the future outcome of acceptance of general payments during independent physician practice.","title":"Trends in Industry Payments to Physicians in the First 6 Years After Graduate Medical Training Industry Payments to Physicians in the First 6 Years After Graduate Medical Training"}
{"_id":"ef4f2ea5-dea3-1e53-0887-6c5bb6be6251","text":"Through their reflections most of the fellows were able to consider the ways in which they could influence their effectiveness as leaders and develop their own style.","title":"The Improving Global Health fellowship: a qualitative analysis of innovative leadership development for NHS healthcare professionals"}
{"_id":"ef4f9be1-29ef-c50c-672d-4b95ae6621da","text":"As our experience in immediate WBAT has grown we have increased the number of patients that are permitted this post operative prescription, particularly in the APC group, this is illustrated in Table 3.","title":"Is unrestricted weight bearing immediately after fixation of rotationally unstable pelvic fractures safe?"}
{"_id":"ef508937-50b9-e2a3-948a-d53ff20942e1","text":"We have hypothesized that contrast agents do enter the loose parts of thrombi, serving as a measure of relative hardness, and this has implications for thrombolysis.To confirm our premise, we initially examined an in vitro model of thrombosis, observing the changes and extent of thrombi formation over time and determining whether or not there is contrast agent entering fresh thrombi. We then assessed 28 patients with cardiac thrombi to further evaluate the clinical stability of such thrombosis, based on CEUS findings.","title":"Cardiac thrombotic stability determined by contrast-enhanced echocardiography: investigative protocol and preliminary results"}
{"_id":"ef5557c1-6221-b150-f866-edd69fb36fcf","text":"Only 4 studies in this systematic review provided assessment of testicular function outcomes after scrotal reconstruction, the majority of which were subjective. Three studies reported overall patient satisfaction with the functional outcome after scrotal reconstruction with flap reconstruction but did not explain how this was assessed.11,14,15 Only 1 study reported objective outcomes based on testicular biopsy before and after implantation of the testes in the medial thigh, with normal sperm counts and normal histology reported before and 6 months after implantation in the thigh.6","title":"Reconstruction of Defects After Fournier Gangrene: A Systematic Review Karian et al"}
{"_id":"ef557747-d83f-5d97-c30f-7241fa946b83","text":"The role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture treatment. We hypothesized that open cerclage wiring can be applied in patients with severe comminuted femoral shaft fractures without affecting bone healing.","title":"Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails"}
{"_id":"ef6b8b97-9669-e7ac-7416-b2f41db350e1","text":"When ESPB is administered at the T5-6 level in thoracic surgeries and the T7-9 level in abdominal surgeries, anesthesia and analgesia can be provided in the area to be treated. It was reported that the local anesthetic agent injected after ESPB moves in the cephalo-caudal direction with the thoracolumbar fascia and also blocks the sympathetic fibers by spreading to the paravertebral area. Erector spinae plane block can prevent visceral pain in addition to somatic pain. Tulgar et al reported that bilateral sensory block was achieved after unilateral ESPB was applied at the T9 level. In this case, when this study was planned, it was revealed that ESPB could provide effective analgesia when performed unilaterally. Moreover, before starting the ablation process after ESPB, when the sensory blocks of the patients were evaluated with the pinprick test, the block was accepted to be sufficient according to whether they felt the needle slightly or not.","title":"Clinical efficacy of ultrasound guided erector spinae plane block in patients undergoing microwave ablation"}
{"_id":"ef6d9e64-c66b-4c73-955c-02e2847e872a","text":"Whether a participant had any number of children prior to this pregnancy was added into the multivariate models to control for the relationship between having children and previous breastfeeding. Having other children was defined as having given birth to another child, regardless of if the child still lived at home with the study participant. Children living in the participant’s home but who were not biological children of the study participant were not included in this variable. Years in the country and birth country were not included together with primary language in the multivariate models owing to the correlation among these variables; only the variable primary language was included as a predictor. Only participants with complete data on the selected variables were included in the multivariate models. Data were entered in Excel and subsequent analyses were conducted using SPSS version 19 statistical software (IBM Corporation, Armonk, NY).","title":"Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breastfeeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study"}
{"_id":"ef714304-ab4a-fbed-5d52-7a6fde65c0d5","text":"Head traumas are important in children and may require clinical followup and imaging. The inside of the potential cavity that occurs in the lacerations located on the scalp should be thoroughly washed with saline and after the bleeding is controlled, it should be sutured after making sure that there is no foreign body inside. Otherwise, they may cause complications requiring surgery to avoid potential fatal complications involving the circulatory and respiratory system.","title":"A rare foreign body migration: from head to neck"}
{"_id":"ef76444b-7890-b8ea-c86d-def5556ef775","text":"Answering the study questions should help to further improve patient selection and the surgical procedure itself and reduce donor site morbidity in the future.","title":"Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life"}
{"_id":"ef784c22-8698-6604-5e7b-20fe73a4a6fa","text":"To determine our rates of LRR and compare the effect of the type of mastectomy performed, we undertook a retrospective review of all patients who underwent a mastectomy for pure DCIS at our institution between 2000 and 2010.","title":"Comparison of Local Recurrence After Simple and Skin-Sparing Mastectomy Performed in Patients with Ductal Carcinoma In Situ"}
{"_id":"ef7c61b7-2bb2-499a-e86b-dd7902e80d59","text":"In adulthood the presentation is atypical and so many other inflammatory, infectious and neoplastic disease begin at the same age and can be an aid to diagnosis or a false diagnosis. Other consideration is that some patients haven’t been recognized for years and are nowadays with a different phenotype what makes the diagnosis more difficult.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"ef841337-6962-8f7d-ce69-1cd66edd0332","text":"The first purpose of our clinical study was to compare micromorphometric data obtained by CBCT and micro-CT analysis of the augmented sinus and to determine whether CBCT as a modality was an adequate tool for the microarchitectural assessment of augmented bone. The second purpose of our study was to carry out a volumetric assessment of the re-pneumatization of the augmented sinuses to determine the long-term stability of the bone gain achieved by using the albumin impregnated allograft.","title":"Comparison between Micro-Computed Tomography and Cone-Beam Computed Tomography in the Assessment of Bone Quality and a Long-Term Volumetric Study of the Augmented Sinus Grafted with an Albumin Impregnated Allograft"}
{"_id":"ef857aef-a20d-3316-2b64-e156c82e7a13","text":"Basal cell carcinoma (BCC) is one of the most common malignancies worldwide. Some patients may develop locally advanced BCC with significant morbidity and with reduction in life quality. The employment of a Hedgehog inhibitor known as Vismodegib has already proven itself helpful in the management of laBCCs. Sonidegib is the most recently available drug approved for treatment of laBCCs that acts by inhibiting the Hedgehog pathway. Real-life data seem to show that efficacy and safety are similar to those already demonstrated in trials. Herein we report our experience with retrospectively collected data from laBCC patients treated with Sonidegib.","title":"Sonidegib in Locally Advanced Basal Cell Carcinoma: A Monocentric Retrospective Experience and a Review of Published Real-Life Data"}
{"_id":"ef8ce055-329d-0133-f4b1-dc46a2fdb937","text":"Table 2 outlines the core curriculum content pertinent to hand and wrist conditions that residents should know by the completion residency. The top and middle cluster of items consisted of both bony and soft-tissue procedures. The least important items appeared to involve more complex procedures of the hand and wrist that may require sub-specialized fellowship training prior to becoming proficient in performing these procedures.","title":"What orthopaedic surgery residents need to know about the hand and wrist?"}
{"_id":"ef8d2e94-6922-d02e-d2d0-751367e75d73","text":"Preoperative image findings on the extent of osteosarcoma invasion in the tibia of a patient. a The tumor was located at the proximal tibia according to plain radiography. b and c Sagittal and coronal MRI views show that the margin of the tumor was just 2 cm below the joint surface of the knee. d The MRI cross-sectional view indicated that the posterior tibial vessels could be preserved. e HE staining of the tumor tissues","title":"Plastic lengthening amputation with vascularized bone grafts in children with bone sarcoma: a preliminary report"}
{"_id":"ef8d419c-41c1-7d3f-b978-b92e28938074","text":"Anterior decompression and fusion is advocated in all such cases. Here internal salient is removed either by transthoracic transpleural anterior approach or by the extrapleural anterolateral approach. The internal kyphectomy allows spinal cord to transpose anteriorly. The response to anterior decompression is faster, better and safe in patients with active disease. While in patients with healed disease the anterior decompression is technically more difficult and the recovery less satisfactory.30 Complications such as neural deterioration (transient or permanent) and CSF fistula have been reported31 and patient should be warned before the surgery about the possibility of neural deterioration.","title":"Kyphosis in spinal tuberculosis – Prevention and correction"}
{"_id":"ef929d91-92ab-2e19-8b2c-2f9000e106a6","text":"The temporomandibular joint (TMJ) is a diarthrodial atypical synovial joint that is capable of both rotational and translatory movements. The TMJ is formed by the mandibular condyle and the glenoid fossa of the squamous part of the temporal bone and is separated into upper and lower cavities by a fibrocartilagenous articular disc.","title":"Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis"}
{"_id":"ef9345d0-698c-fee2-51ca-6487f2b3ef3e","text":"Patients requiring autologous tissue reconstruction based on their need for adjuvant radiotherapy or refusal to accept implant-based reconstructions were considered for abdominal tissue reconstruction. The decision to perform a bipedicled flap rather than a standard unipedicled flap was based on clinical assessment of the donor abdomen by the senior author (CMM). This was based on an estimate that three quarters of the lower abdominal tissue (which can be reliably perfused by one set of deep inferior epigastric vessels) would not be sufficient to reconstruct the required breast size. This took into account increasing the abdominal tissue available by schamfering the harvest while enabling safe closure of the donor site. An underlying assumption was (the nearly universally held view) that DIEP flaps are preferable to free TRAM flaps in view of the donor site morbidity. No intraoperative tests, such as clamping of the one set of perforators, were undertaken to determine the horizontal extent of the flap perfusion.","title":"Decision Making in Double-Pedicled DIEP and SIEA Abdominal Free Flap Breast Reconstructions: An Algorithmic Approach and Comprehensive Classification"}
{"_id":"ef96c8d8-d39a-7725-fc76-1a88c8aebfab","text":"Of the 4 patients whose mass was located in the upper eyelid\/medial canthal region, lacrimal system involvement was discovered intraoperatively in 1 patient and the excision area was expanded to include the lacrimal sac and canaliculi. During reconstruction for these 4 patients, the posterior lamella was formed using ipsilateral tarsal rotational flap and the anterior lamella of the upper eyelid and canthal region was created with a glabellar rotation flap.","title":"The Importance of Frozen Section-Controlled Excision in Recurrent Basal Cell Carcinoma of the Eyelids"}
{"_id":"ef99db3b-0781-1cef-e0a3-ce0ca612326a","text":"This research analyzed indicators of breastfeeding in babies with ankyloglossia according to the severity of the alteration. Results showed that those with severe ankyloglossia did not show changes in breastfeeding assessments and pain score despite an aspect of breastfeeding, sucking, which has been shown to be associated with severe ankyloglossia. The data collected in this study may indicate that the changes in breastfeeding caused by tongue-tie may resemble other changes in the beginning of breastfeeding and can be overcome with clinical control measures.","title":"Ankyloglossia severity in infants: maternal pain, self-efficacy, and functional aspects of breastfeeding Gravidade da anquiloglossia em bebês: dor materna, autoeficácia e aspectos funcionais do aleitamento materno"}
{"_id":"ef9cea6f-895c-8ea4-8b11-b189286166d7","text":"The improvement in diagnostic confidence is not only associated with a greater number of lesions but in the confidence related to a negative scan for assessing potential metastatic disease, sacroiliitis, enthesitis, and bone stress lesions. In all joint abnormalities, the pattern of uptake is more defined and was found to more closely correlate with the MRI findings in the cases where follow-up was available. In the thoracic spine xSPECT uptake was frequently identified in the small joints of the spine and these are infrequently identified as abnormal on SPECT\/CT imaging. These joints can be a significant cause of symptoms and in 6 cases lesions identified only on xSPECT\/CT were treated with CT guided injections that led to relief of symptoms. xSPECT\/CT appears to be an improved method of assessing difficult thoracic and chest pain.","title":"The clinical value of xSPECT\/CT Bone versus SPECT\/CT. A prospective comparison of 200 scans"}
{"_id":"efa3cb02-c747-3db9-380a-a54157929d5e","text":"A multidisciplinary approach with involvement of infectious disease specialists to bone and joint infections is a long-standing concept. Recently it has even been stated that orthopedic infectious disease can be considered as subspecialty of its own. Therefore clinical practice guidelines recommend a multidisciplinary approach to spondylodiscitis care that brings together all relevant disciplines to discuss optimal disease management. However, multidisciplinary case conferences have not been introduced or examined in the context of spondylodiscitis so far while being an essential component of cancer care in many countries. Recently, this standardized multidisciplinary approach was introduced in the context of prosthetic joint infections as well. The implementation of these conferences could improve the treatment plan and might even be associated with better clinical outcome and survival. In this study, we retrospectively analyzed patient records to test the hypothesis that the implementation of a multidisciplinary infections conference is an effective approach to significantly improve management of spondylodiscitis.","title":"Implementation of a multidisciplinary infections conference improves the treatment of spondylodiscitis"}
{"_id":"efaa449b-495b-4807-d5bc-c7fb1a918c7e","text":"Small defects of the floor of mouth with bone exposure can be repaired with a facial artery musculomucosal (FAMM) flap (Figure 8). The FAMM flap is based on the facial artery and includes a portion of the buccinator muscle in addition to the buccal mucosa and is usually useful for small defects up to about 2 cm in width that enable primary closure of the donor site [59–61]. The blood supply to the FAMM flap is the facial artery. When elevating a FAMM flap, a small amount of buccinator muscle is included in the flap, along with the buccal mucosa and the facial artery. Venous drainage depends mainly on the buccal venous plexus. The FAMM flap can be superiorly based on the angular artery to repair palatal defects but needs to be inferiorly based on the main facial artery in order to be rotated to the floor of the mouth. Prior to elevation, a handheld Doppler ultrasound is used to trace the course of the facial artery. The width of the flap is limited by the amount of laxity in the buccal mucosa that allows primary closure of the donor site, usually around 2 cm.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"efb7a0dc-a93d-5ee5-a938-08791a17f457","text":"The diagnosis of brain tumors relies on the rigorous histopathological assessment of the surgically excised tissue. This is conducted, in the majority of cases, at the time of tumor removal. When this is not possible because of the location of the tumor or because the patient is not amenable to an invasive surgical procedure, a biopsy becomes paramount to characterize the tumor and to offer the proper guidance for subsequent treatments.","title":"Reassessing the Role of Brain Tumor Biopsy in the Era of Advanced Surgical, Molecular, and Imaging Techniques—A Single-Center Experience with Long-Term Follow-Up"}
{"_id":"efb90465-22b6-52db-1c91-a225a8ddd495","text":"Cranioplasty refers to the surgical procedure where a bone defect or deformity in the skull is repaired, which can be achieved through the use of cranial implants. The reconstruction of such defects is mostly performed to re-establish the structure and function of the missing cranial bone. A faultless cranial bone is crucial to assure biomechanical protection of the underlying soft tissues of the brain, as well as to normalize intracranial pressure and restore normal cerebrospinal fluid flow dynamics. In addition, in children patients, an intact cranial vault is crucial for the normal growth and development of the brain.","title":"Synthetic skull bone defects for automatic patient-specific craniofacial implant design"}
{"_id":"efbfba00-36f5-8f58-abfd-fcbe9bccf04c","text":"It is very difficult to diagnose traumatic neuromas occurring in mastectomy scars because they can mimic recurrent lymph nodes or local tumor recurrence. In order to manage patients' treatment, the most critical problem is to distinguish it from recurrent breast carcinoma. Although some assistant examination methods are valuable to a certain extent, the final diagnosis can only be confirmed on pathologic examination.","title":"Traumatic neuroma in a patient with breast cancer after mastectomy: a case report and review of the literature"}
{"_id":"efc9832f-6a95-2953-98a5-863e278a5ac4","text":"We report a long-term clinical and quantitative eye movement study of the efficacy of retrobulbar botulinum toxin A injection to treat dysconjugate nystagmus in a 68-year-old patient who was status post left suboccipital craniotomy for treatment of pontomedullary junction cavernous malformation and failed conservative treatment. One retrobulbar botulinum toxin A injection improved oscillopsia, visual acuity, and nystagmus amplitude for months in both eyes, with sustained effects longer than six months in the left eye and less than six months in the right eye. One injection to the left eye was efficacious for two years until another injection was needed, while the right eye required five injections in the same two-year period.","title":"Treatment of Nystagmus in Brainstem Cavernous Malformation with Botulinum Toxin"}
{"_id":"efcfcde6-c2ae-9940-4ec9-3d4166eb2f79","text":"The basic principle that viable active tumoral tissue shows a higher degree of enhancement than nontumoral\/necrotic areas can also be applied to directing biopsies to viable cellular areas and noninvasive assessment of response to therapies such as radiotherapy and chemotherapy. The most reliable indication of necrosis in MRI is probably still simple: a visible lack of enhancement after the administration of gadolinium-based contrast medium.","title":"The role of magnetic resonance imaging in the evaluation of bone tumours and tumour-like lesions"}
{"_id":"efd552c7-d5d5-35fb-e2d0-5bcda9d753d3","text":"Innovation: This evaluation is believed to comprise the largest cohort of patients treated with NPWT published to date and is one of the few studies that have attempted to provide a direct comparison of the performance of alternative NPWT systems.","title":"A Retrospective Comparison of the Performance of Two Negative Pressure Wound Therapy Systems in the Management of Wounds of Mixed Etiology"}
{"_id":"efd7604a-149c-e4b2-f530-c55f6961cf18","text":"We are going to explain our arguments to rule out the mentioned techniques and why we preferred one procedure to another in this case report.","title":"Chondromucosal Nasal Flap With the Transposition Flap of Von Langenbeck as a Good Election for the Total Lower Eyelid Defect Reconstruction in an Old Patient With an Elevated Vision Loss in the Contralateral Eye"}
{"_id":"efe093b8-126a-4a19-f29d-8bb14cadaf27","text":"A questionnaire was also given to the patients to evaluate the degree of their satisfaction from the general result of rhinoplasty at least one year after their operation. They were not asked to identify themselves and the questionnaire was collected in a specific folder in the office that contained same questionnaire sheets from other patients. Patients voluntarily chose one of the three choices (very satisfied, satisfied or unhappy with the result) in the questionnaire. Standard photography for rhinoplasty was performed in frontal, lateral, oblique and basal views before operation and at the follow up sessions of 6 months, one year and then each year after operation. Only patients who attended at a minimum of one year follow up were included.","title":"Injectable Cartilage Shaving: An Autologous and Long Lasting Filler Material for Correction of Minor Contour Deformities in Rhinoplasty"}
{"_id":"efef6598-90a7-a9cc-b610-4f7883b65502","text":"Two models of regenerative templates are available, the first is expected to be immediately skin grafted, the second is covered by a temporary silicone patch and requires about 15 days before be grafting.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"f003f9bd-17fc-6784-6632-9e5058ca080d","text":"Nonvascularized conventional bone autografts or bulk allografts constitute a different approach for the reconstruction of distal humerus bone defects.12 Their application is quite straightforward, and it does not necessitate a technical expertise or experience. At the same time, a soft tissue procedure such as the transposition lateral arm flap can be performed for the management of soft tissue damage. This flap provides coverage that is thin and supple and promotes the free gliding of the underlying structures.12 However, avascular grafts are more susceptible to infection or nonunion as they are probably never replaced by completely healthy bone tissue, and exist as a mixture of necrotic and viable bone with reduced strength.11,13","title":"Reconstruction of a Severe Open Distal Humerus Fracture With Complete Loss of Medial Column by Using a Free Fibular Osteocutaneous Graft"}
{"_id":"f013f5c6-21c5-a383-ef70-534e7360f5c3","text":"If a bone block arthrodesis were to be attempted in the setting of a prior septic first MTPJ, a multidisciplinary approach should be taken including consideration for a two-stage approach with first a cement spacer placement, followed by antibiotic treatment under the supervision of an infectious disease specialist. Kirschner wires or an external fixator may be used to stabilize the cement spacer if necessary. Only when the infection is cleared, should implantation of a bone graft and internal fixation be performed.","title":"Orthopaedic Management of Gout"}
{"_id":"f014c2ec-fed0-cf62-2509-5d76bbc388b1","text":"We would suggest the following as a possible follow up strategy, as illustrated in Table 1, for clinically well patients undergoing curative oesophagogastric resection based on current practice, guidelines and typical peaks of recurrence. This is by no means wholly evidence based, but a pragmatic approach must be adopted in order to provide patients with the reassurance and support they require, while being able to investigate and manage symptoms as they present in order to ensure the best quality of life for patients. Any symptomatic patient needs directed investigations, most units starting with either gastroscopy or CT neck, chest and abdomen.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"f0174b81-597a-f698-85f6-f3fc2d679fb2","text":"Studies looking at the rates of progression of isolated MVT have shown conflicting results. There is also a lack of consensus between studies that compare progression amongst groups with or without anticoagulant treatment. The majority of the studies do not distinguish between medical, surgical or orthopaedic patients.","title":"Evidence for treatment of muscular vein thrombosis in orthopaedic patients"}
{"_id":"f01ac1d3-3ee8-5ec0-c749-54aac5063d88","text":"A subset of patients who have undergone breast conservation therapy with lumpectomy followed by radiation desire either mastopexy or reduction to improve their postoperative appearance as well as improve the symmetry between their treated and untreated breast. The current recommendations are to limit offering these surgeries to carefully selected patients as long after radiation as possible. The use of fat grafting to “prime” the skin envelope as a separate procedure prior to attempting a reduction or a lift is an alternative strategy that has been successfully utilized in our practice (nonpublished) with reproducible and reliable results.","title":"Lipotransfer Strategies and Techniques to Achieve Successful Breast Reconstruction in the Radiated Breast"}
{"_id":"f01bec98-9c7c-b7f7-06d0-edab85bb962a","text":"The findings of the present study suggest that combined inguinal and pelvic lymph node dissection should be considered for patients with clinical evidence of groin nodal disease, as this approach achieved survival of 5 years for about one-third of patients in the presence of deep disease. Patients with a positive sentinel node might be spared ilio-obturator dissection owing to the low risk of nodal involvement in this area.","title":"Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors"}
{"_id":"f01ed5e7-8a95-6862-141b-6e4ebd6ca869","text":"Good local control can often be achieved with surgical excision of the tumour with en-bloc resection of the vessels combined with radiotherapy. Our experience also leads us to believe that reconstruction of the vein is not necessary in those cases where a major vein such as the long saphenous vein in the lower limb can be preserved. This together with collateral venous circulation is often enough for venous drainage. Other authors have reported a high thrombosis rate in those who undergo venous reconstruction [16].","title":"Leiomyosarcomas of Vascular Origin in the Extremity"}
{"_id":"f01f677c-6593-f5ed-a96b-1f1fdfb26773","text":"Participants may decline to continue to take part in the trial at any time without prejudice. A decision to decline consent or withdraw will not affect the standard of care the patient receives.","title":"Randomised controlled feasibility trial of standard wound management versus negative-pressure wound therapy in the treatment of adult patients having surgical incisions for hip fractures"}
{"_id":"f01fad86-c3a8-fefc-111e-605ef7d5391c","text":"OEM is an infection occurring in elderly and diabetic patients. Imaging allows to confirm the diagnosis and to carry out the assessment of extension; but also has a great interest in the follow-up of these immunocompromised patients who are subject to complications with insidious evolution","title":"Malignant external otitis complicated by spinal cord compression: Case report"}
{"_id":"f028fdc8-04b0-88f7-7bf1-65136a8bb55b","text":"This may be due to the impracticability of combined procedures in outpatient settings requiring a tertiary hospital facility.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"f038391c-ac62-2ec2-faf5-8243efcc5438","text":"The extent of newly formed tissue in the human subchondral cartilage defects was assessed as area of repair tissue (RT) present within the defects after 12 weeks of co-cultivation. Histomorphometrical analyses on histological sections with interactive measurements using the software Zen 2012 SP2 from Zeiss enabled quantification of the newly formed tissue. These measurements excluded the areas occupied by the implanted spheroids and thus only reflected the new tissue formed. Additionally, the total defect area was measured to calculate the percentage area of newly formed tissue that filled the total defect area for each donor sample. Histomorphometrical analyses were performed in duplicate for each condyle chip. The newly formed tissue as percentage of total defect area was used as read-out parameter for the potency of the implanted spheroids.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"f03b76f8-703d-468a-cb6c-a357426ff890","text":"The repair of a long bile duct defect in a left hepatectomy for hepatocellular carcinoma may resort to a saphenous vein patch.45 Successful repair of iatrogenic common bile duct injuries has been achieved by SVGs in two patients with cystic duct avulsion, in one patient whose duct was split by a balloon catheter, and in one patient where a segment of the duct was resected. The grafts remained patent at a 5-year follow-up.46","title":"A Reappraisal of Saphenous Vein Grafting"}
{"_id":"f03df195-2ff4-f101-b7fa-abefba8a2c08","text":"The most significant advantage of this flap was the ability to bury the pedicle, obviate the second stage, preservation of inter brows distance and limited scar length in the forehead donor site. The patient can use eyeglass earlier and cost of operation was less than multiple stage operation. This variation of forehead flap was a good choice for nasal skin defects, especially for those patients that had problems with cost or multistage reconstruction of nasal defects.","title":"Subcutaneous Forehead Island Flap for Nasal Reconstruction"}
{"_id":"f041d1c9-afc9-0f88-f54e-4f7682d2dce8","text":"The main points from the guidelines demonstrate a lack of defined or standardised follow up protocols. All the guidelines admit that routine follow up does not impact on patient survival outcomes but should be used to concentrate on palliating symptoms from benign complications of treatment, nutritional status and psychosocial support. Studies have shown that cancer patients prefer regular follow up for ongoing support and reassurance and as a point of contact should new symptoms or concerns arise [14, 17, 18]. It is important to differentiate between those patients who are essentially asymptomatic or have minor chronic symptoms in whom a routine follow up approach is appropriate, and those patients developing new or suspicious symptoms in whom more urgent assessment and investigation is required.","title":"Proposed follow up programme after curative resection for lower third oesophageal cancer"}
{"_id":"f0502d0a-fee8-6d7f-60b5-e494abe6e8d6","text":"Anticonvulsive drug hypersensitivity syndromes can present with a wide spectrum of unspecific symptoms, which the prescribing clinician should be aware of.","title":"Diarrhea, negative t-waves, fever and skin rash, rare manifestation of carbamazepine hypersensitivity: a case report"}
{"_id":"f0516d1f-1e2c-0ceb-1045-c3133c34e156","text":"Our multi-institutional joint study revealed that advanced N stage independently affects both OS and DFS. Given the high incidence of distant failure, an effective systemic therapy is essential for improving DFS of SDC. Partial parotidectomy with facial nerve preservation may constitute a less invasive standard surgical procedure for parotid gland SDC in the early T stage without facial nerve palsy.","title":"Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients"}
{"_id":"f055dec9-5b09-128a-e902-2dbe630e234d","text":"Prior interventional BPH therapy did not affect the oncologic outcomes nor did it increase the risk of rectourethral fistula or ED in sexually performing patients prior to cryosurgery. Prior interventional BPH therapy was associated with increased risk of urinary retention and incontinence after primary whole-gland prostate cryoablation for prostate cancer.","title":"Does prior surgical interventional therapy for BPH affect the oncological or functional outcomes after primary whole-gland prostate cryoablation for localized prostate cancer?"}
{"_id":"f05884b2-784b-45a8-5d9e-42f59758c9d8","text":"The results obtained were subjected to statistical analysis on the basis of which conclusions were drawn concerning disorders in the stomatognathic system which tend to occur in children with OI. The renunciation of breastfeeding significantly contributes to sucking and swallowing disorders, rumen disorders, as well as biomechanical disorders in the temporomandibular joint. A significant dependence between breastfeeding and swallowing problems was found, whereas there was no such dependence with respect to speech impediments.","title":"Evaluation of Stomatognathic Problems in Children with Osteogenesis Imperfecta (Osteogenesis Imperfecta − OI) − Preliminary Study Ocena problemów stomatognatycznych u dzieci z wrodzoną łamliwością kości (Osteogenesis Imperfecta − OI) − Badania wstępne"}
{"_id":"f05b728a-ea08-87f3-c12a-a8d7932dda9e","text":"This study aims at reporting clinical and microbiological results as well as treatment details regarding the use of linezolid for the treatment of PJI in a large cohort of patients treated with a standardized surgical approach and analyzes risk factors for treatment failure.","title":"Two-Stage Revision Arthroplasty for Resistant Gram-Positive Periprosthetic Joint Infections Using an Oral Linezolid-Based Antibiotic Regime"}
{"_id":"f0700652-7f7a-e2c2-9735-ba32f0713224","text":"Xenografts are skin substitutes harvested from the animals for use as temporary graft in human. The earliest reported xenograft application for wound coverage was as early as 1500 BC with the use of frog skin. Porcine skin allograft is the most commonly used xenograft in modern practice of burn care.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"f076660f-fa3e-453e-9be2-b87b69d5b246","text":"We performed a retrospective records review of the clinic registers of the cervical cancer clinic for a period of four years from January 2017 to December 2020. We purposely selected all patients who had undergone treatment for any cervical lesion and gave appointment dates for the week 6 and one-year follow-up visits.","title":"High Rate of Loss to Follow-Up Among Patients Undergoing Treatment for Premalignant Cervical Lesions at Mbarara Regional Referral Hospital, Southwestern Uganda: A Retrospective Cohort Study"}
{"_id":"f078ef4c-2cb5-4ae4-54be-2d029e0c92d7","text":"In this study, we examined scalp reconstructions using the free LD flap in a single center over a period of twelve years. The presented data further solidifies the LD flap as an ideal choice for complex soft tissue defects of the scalp that require microsurgical tissue transfer. Furthermore, our results confirm the fact that extensive and complex defects are best treated by free tissue transfer.","title":"Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience"}
{"_id":"f0792d0b-ce4c-53d2-126d-a2e2b5403242","text":"For CM type IV lesions with segmental involvement or with infected nonunions, an assessment of the bone stability is undertaken after excision. 32 In stiff nonunions, we initially compress the bone with an external fixator and then distract at 1 mm per day for 10 days, or until full length is achieved. For mobile nonunions, we excise the nonunion and stabilize with an Ilizarov fixator. If possible, we acutely shorten the bone to allow bone contact at the defect and relengthen through a separate remote corticotomy (bifocal compression\/distraction). If the defect is larger or the soft tissues prevent acute compression, a bone transport technique can be undertaken. If a muscle flap is needed for soft tissue cover, this can be transferred simultaneously with the frame application. The muscle will partly fill the segmental defect but will be “pushed out” during bone transport. When using a frame with a free flap, careful planning is required between the orthopaedic and plastic teams about pedicle position to allow immediate flap coverage through the frame. Fine wires can be safely placed though the flap as long as they are away from the pedicle 33 ( Figs. 3 ​44 ).","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"f081249e-5700-1400-e87f-9a81104f77a5","text":"This review aimed to identify and assess interventions that could potentially improve the tolerability of LA intradetrusor BTA injections. BTA injections typically need to be repeated every 6 months for patients with neurogenic lower urinary tract dysfunction and every 9 months for patients with idiopathic refractory OAB. It is hence paramount to ensure that LA intradetrusor BTA injections are tolerable under LA to avoid the risks and financial implications of repeated general or spinal anesthetic.","title":"Interventions to improve tolerability of local anesthetic intradetrusor Botulinum toxin injections: A systematic review"}
{"_id":"f08d641c-ae2d-5425-0d80-093ad805d9fc","text":"Our results were based on a retrospective analysis of lymph node samples of a sizeable group of melanoma patients, however, evaluating sentinel-positive and negative cases separately according to disease progression or survival yielded more limited case numbers. To obtain a more complete view on the immune characteristics of these lymph nodes and on the prognostic value of these immune markers, prospective studies on larger patient cohorts are warranted.","title":"Immune cell profile of sentinel lymph nodes in patients with malignant melanoma – FOXP3+ cell density in cases with positive sentinel node status is associated with unfavorable clinical outcome"}
{"_id":"f0961d6f-c146-365d-dae9-5c89f3c8e0f7","text":"All patients treated with primary radiotherapy with curative intent for newly diagnosed and biopsy-proven cervical cancer treated at our center between October 2006 to April 2019 were included. Patients had to have received at least EBRT at our center in order to collect sufficient data on EBRT and follow-up. Patients scheduled for curative radiotherapy who were unable to complete radiotherapy for any reason and therefore did not receive a curative dose were excluded. Patients who were lost to follow-up during or in the first 2 weeks after treatment were also excluded from the analysis. In general, patients treated with primary radiotherapy at our center were followed up every three months for the first two years after treatment and, thereafter, every 6 months for up to 5 years after treatment.","title":"The Effect of Contemporary Brachytherapy Practices on Prognosis in Women with Locally Advanced Cervical Cancer"}
{"_id":"f09b7dd8-bf81-eb49-2547-35330b796b5a","text":"Table 2 Topical antipsoriatic drugs that can be prescribed in the study","title":"Long-term improvement of psoriasis patients’ adherence to topical drugs: testing a patient-supporting intervention delivered by healthcare professionals"}
{"_id":"f09efaae-079e-1856-6079-2eb6e8270e83","text":"Reconstruction of lower limbs after trauma is a challenging problem for the reconstructive surgeon, in terms of both surgical treatment and postoperative healing.","title":"Failure by congestion of pedicled and free flaps for reconstruction of lower limbs after trauma: the role of negative-pressure wound therapy"}
{"_id":"f0a10ffd-1d3c-ef4e-8c99-5677f5973f97","text":"Table 3 shows the results of the comparative analysis between two consecutive control checkpoints. Statistically significant differences in the reduction in pain intensity and MIO were found in the measurements between days 0 and 28 in both of the study groups. The values remained stable until day 90.","title":"Botulinum Toxin and Percutaneous Needle Electrolysis for the Treatment of Chronic Masticatory Myalgia"}
{"_id":"f0a87e40-b957-01dc-c9e0-43b2862f89ae","text":"Cloaca should be distinguished from pathologic fracture. While cloaca always result in discharge of infected soft tissue through a rent in the overlying cortex, the same is not always true of pathologic fracture. The term pathologic fracture should be used when there is a delineated fracture cleft resulting from weakened bone undergoing normal or minimal stresses. Cloaca should also be distinguished from an erosion, which should only be used to describe focal intra-articular defects of the subchondral bone plate.","title":"MRI nomenclature for musculoskeletal infection"}
{"_id":"f0ab6698-4b65-9bc5-f079-8f59c7ff262c","text":"Intraoperative venous congestion was identified on the left side. A contributing factor was an unresolvable size discrepancy between the deep inferior epigastric and the internal mammary venae comitantes. A saphenous vein graft can be used to drain the donor inferior epigastric vein to the contralateral internal mammary venae comitantes.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"f0bf9b9f-e5e3-17fe-67db-5ba3332788cc","text":"A fibula graft is one of the most common orthopedic procedures for reconstruction of a bone defect, and some complications related to persistent defects of the fibula have been reported previously. We believe that regeneration of the fibula may be critical for postoperative function and prevention of complications. This report describes a 9-year-old female with Ewing sarcoma of the pelvis who was treated with the double-barrel fibula grafts for pelvic bone defect following tumor resection. The defect after fibular resection was filled with unidirectional porous hydroxyapatite (UDPHAp) implants. A plain radiograph revealed new bone formation and a callus-like structure at one month after surgery and bony union between each UDPHAp implant 5 months after surgery. Resorption of implanted UDPHAp was identified, and partial remodeling of the bone marrow cavity could be seen 1 year 2 months after surgery. A radiograph at final follow-up (5 years 10 months after surgery) demonstrated almost complete absorption of the implanted UDPHAp and clear formation of the cortex and bone marrow in the resected part of the fibula. The patient is able to walk well without any walking supports and to take part in sports activities.","title":"Regeneration of the Fibula with Unidirectional Porous Hydroxyapatite"}
{"_id":"f0c0377a-1c40-f4c7-cb68-2de676d905bf","text":"HA fillers exhibit both elastic and viscous behavior and viscoelasticity is their main characteristic. To better understand the concept of viscoelasticity, we may describe a rubber band as a purely elastic matter that deforms up to a certain point under shear stress and recovers its original shape when the force causing deformation is removed. The rubber band is an example of an elastic material, which stores energy that it will use to restore its strain. Honey is a purely viscous matter that is not able to recover its shape when the force causing deformation is removed. Honey is an example of viscous material with the ability to lose the energy that should enable it to recover strain. A purely elastic matter cannot be injected into the soft tissue because it is too hard and a purely viscous matter is not able to restore the soft tissue volume because it is too liquid. The balance between these two characteristics in the HA filler determines its rheological features and makes it ideal for specific indications.","title":"The Rheology and Physicochemical Characteristics of Hyaluronic Acid Fillers: Their Clinical Implications"}
{"_id":"f0cb9561-3bcb-7dc4-e391-51627e30270e","text":"We fixed the acellular dermal matrix to the wound bed with nonabsorbable sutures and compressed the wound with gauze. Four patients were admitted for surgery and further surveys for metastasis, and the others were discharged on the day or the next day of surgery.","title":"Single-stage acellular dermal matrix reconstruction of defects in the nose and ears with exposed cartilage: a prospective case series"}
{"_id":"f0cbd930-10a9-586d-346f-98a4c4e37a80","text":"The participants also offered various innovative methods to directly engage medical students in leadership development. Some suggestions included providing medical students with a teaching role in clinical skills sessions; structuring research projects to give medical students a more prominent and independent role; as well as having medical students be involved in extracurricular activities such as clubs. Another student explained how actively practicing leadership would help medical students to demonstrate this skill in high pressure scenarios:","title":"Exploring medical students’ perspectives of physician leadership"}
{"_id":"f0d09d70-35bc-cc93-db08-b808f7e554dd","text":"The rate of and risk factors for DVT in patients with CSM before or after spinal surgery have remained relatively unknown. The current study focused on the prevalence of preoperative DVT in patients with CSM who were scheduled to undergo spinal surgery. We also assessed risk factors for preoperative DVT in patients with CSM to identify patients who should undergo vascular evaluation to exclude the presence of asymptomatic DVT.","title":"Preoperative deep vein thrombosis in patients with cervical spondylotic myelopathy scheduled for spinal surgery"}
{"_id":"f0d7651f-ce0c-6bc2-6e21-48306247a927","text":"Even in large institutions, it is difficult to accumulate sufficient cases to document the natural history for such a tumor and draw conclusions about treatment results because of rarity of the tumor. When diagnosed or suspected preoperatively, radical orchiectomy with wide local excision is the recommended treatment. Adequate local resection provides the best chance of eradicating this disease. Adjuvant radiation should be considered in tumors of intermediate or high grade and in recurrent liposarcoma after previous wide excision. The role of chemotherapy is not well defined. Regardless of initial therapy, the risk of local recurrence and subsequent increase in grade always necessitates long-term followup.","title":"Paratesticular Liposarcoma: A Case Report and Review of the Literature"}
{"_id":"f0e29a5b-ff9a-a1ac-c8db-af82909bd050","text":"In this study, the whole group showed a significant decrease in the CMAP amplitude from the orbicularis oris and the orbicularis oculi muscles (ENoG), and a statistically significant prolongation of R1 and R2 latencies was found 1 month postoperatively (blink reflex test). This shows that the blink reflex test and ENoG are sensitive methods for the objective assessment of facial nerve function in patients after parotid surgery. They could provide valuable support in ENT practice. Our study further demonstrated the safety of the intraoperative facial nerve monitoring device and its efficacy in reducing the prevalence of transient palsy of the facial nerve after surgery for benign parotid tumors. It does not affect surgery or its duration. The use of monitoring largely reduced the negative influence of local factors and significantly reduced the prevalence of transient facial nerve palsy. Therefore, the routine use of intraoperative facial nerve monitoring can be strongly recommended in all parotid surgical procedures.","title":"Prospective Assessment of Intraoperative Facial Nerve Monitoring in Patients Undergoing Partial Parotidectomy"}
{"_id":"f0e6d97a-3a3b-2b24-76bc-f8148429a692","text":"Endovascular treatment of PAA using stentgrafts is safe in selected cases. However, it is reasonable to avoid endovascular treatment due to an increased risk for thrombosis in patients with a low number of patent distal arteries or impaired distal flow.","title":"Popliteal artery aneurysms treatments: early midterm results of the use of endovascular stent grafts"}
{"_id":"f0ec67e3-2527-e108-3b8e-fb6c39b20d35","text":"The systemic effects of intramedullary nailing were first described by Kuntscher. Increased IM pressure has been shown to cause increased fat embolisation in vitro. Richards found that reamed intramedullary nails were a risk factor for cognitive impairment one year post-operatively. Applying a vacuum or venting during reaming has been shown to lessen intra-medullary pressure and therefore reduce fat embolisation. Volgas monitored intracardiac fatty emboli with intraoperative transoesophageal echocardiography, comparing standard sequential reaming technique with a Reamer Irrigator-Aspirator system. He showed significantly lower levels of fatty emboli in the RIA group. Unfortunately, the significant cost and bulkiness of the RIA system could hinder its widespread adoption. Baig describes the use of a technique which could be used with conventional reaming equipment where the suction tubing for intramedullary reaming is advanced to the end of IM bone and suction is applied for two to three minutes once access to the medullary canal is gained, the procedure is then carried out and suction repeated in a similar manner afterward. Medullary cavity irrigation has also been shown to lead to reduced emboli size on transoesophageal echocardiography during TKA.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"f0edbad7-6dd7-3edc-4bd0-0503bc38f9b0","text":"This study concludes that Sickle Cell Disease is a risk factor for developing Deep Venous Thrombosis in patients undergoing spinal surgery. The study also concludes the effectiveness of mechanical prophylaxis in preventing Deep Venous Thrombosis and recommends pharmacological prophylaxis after assessing the risk profile or positive D-dimer test.","title":"Incidence of Deep Venous Thrombosis and Sickle Cell Disease in Patients Undergoing Spinal Surgery in South Gujarat, India: A Prospective Observational Study"}
{"_id":"f0ee5f34-8253-7905-811e-7af019958867","text":"From the results obtained in this study, the pediatric dentist could be considered a sentinel in the early diagnosis of OSAS during a historical and physical examination by investigating not only malocclusions associated with OSAS but also by recording qualitative and quantitative measures of the lingual function.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"f0efab11-2a2c-d3d2-a1bd-b3d747b3e8df","text":"An optimal solution for the above mentioned problems would be to locally deliver an antibiotic through a biodegradable substance with a suitable elution profile. This would raise local antibiotic levels, making it possible to eradicate biofilms without systemic adverse effects and perhaps to treat bone implant related infection in a one-stage procedure.15 A technique that could meet these criteria is bone grafting. While bone grafting is already widespread in reconstructive orthopedic surgery, the use in bone deficiency after infection has been seen as a contraindication since the avascular grafts are prone to re-infection.16 It has been suggested that antibiotic-loaded bone grafts have the appropriate characteristics for prophylactic purposes as an adjunct to systemic profylaxis.17","title":"Current Insights in the Application of Bone Grafts for Local Antibiotic Delivery in Bone Reconstruction Surgery"}
{"_id":"f0f4f85c-8003-b49a-cf1e-40d62417dc7c","text":"The sample size was determined using the theoretical saturation point, at which additional interviews stopped providing new insights into the questions being explored. We utilized a purposeful sampling technique that enabled the researcher to interview the most valuable participants to address the aim of the study.","title":"Developing Leadership Among Dental Residents: An Exploratory Study"}
{"_id":"f1034cb5-156c-e6e4-3432-c1d3e0cf9323","text":"The dissected body clearly has the potential to teach many lessons both to the undergraduate and the graduate medical doctors. Therefore, development of precise skills for dissection of cadaver models provides a valuable opportunity to exercise technique in a stress-free environment. However, detailed anatomical dissection is very time-consuming and revised undergraduate and graduate teaching have decreased hours in the use of cadavers by associating with other computer simulation. Unfortunately, some medical schools in Australia and the United Kingdom have even eliminated use of cadaver models altogether, even though studies have shown that it would be better to balance the use of digital technologies with cadaver dissection.[ In a study in Michigan State University, it was clearly shown that practical dissection of cadaver enhanced identifying body parts and also how they functioned when compared with groups of students who learned with multimedia and then were tested on cadaver models.[","title":"Return of the cadaver Key role of anatomic dissection for plastic surgery resident training"}
{"_id":"f105cdda-e562-a13c-dc16-a006b49c6741","text":"The number of products available to dermatologists for soft tissue augmentation has grown significantly over the past several years in the US. This manuscript will review the various hyaluronic acid fillers and other Food and Drug Administration -approved products we are utilizing for our patients in the rejuvenation process. It is hoped that through this article clinicians will feel more comfortable using these products in their everyday practice of dermatology.","title":"Soft Tissue Augmentation in Dermatology – 2009 Update"}
{"_id":"f10e8805-6731-40d4-5c9d-2b5c76d3b02a","text":"The most frequently used ultrasound parameters to improve the properties of cells and the regenerative capacity of tissues are shown in Table 2.","title":"Ultrasound Therapy: Experiences and Perspectives for Regenerative Medicine"}
{"_id":"f116d90a-8830-a947-63be-b2f82c717f21","text":"The variables evaluated and compared between the three reconstructive techniques are shown in Table 3 and Table 4:","title":"Clinical and Surgical Outcomes in Extensive Scalp Reconstruction after Oncologic Resection: A Comparison of Anterolateral Thigh, Latissimus Dorsi and Omental Free Flaps"}
{"_id":"f1195f3c-4cdd-7e1a-beed-49701ef74bfe","text":"Clear visualization is possible if 5 mm or less of tissue covers the lymph node. Lymph pathways may be visualized that may lead to deeper lying draining lymph nodes. Uptake of ICG by other tissues like the submandibular gland was noted, but easily distinguished as non lymphatic tissue. An assistant can hold the infrared video camera and an area can be explored in real time.","title":"Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience"}
{"_id":"f11f8d56-7bdf-c10e-b410-55d8917cf7ee","text":"The occurrence of complications was described by treatment group using absolute and relative frequencies. Hypothesis testing of differences between subgroups was performed by χ2 or Fisher’s exact test as necessary. Continuous variables were summarized by reconstruction type with mean and standard deviation and compared between groups using the Mann-Whitney U test.","title":"Retrospective analysis of complications in 190 mandibular resections and simultaneous reconstructions with free fibula flap, iliac crest flap or reconstruction plate: a comparative single centre study"}
{"_id":"f1226757-f7b7-2f0a-61cd-dd0b6d1c8d90","text":"The aim of this feasibility study was to solidify a workflow and schedule for additive manufacturing titanium implants for surgery that can be applied to various procedures involving cranial surgery. To the author’s knowledge, this is the first report in the scientific literature regarding the workflow for metallic additive manufacturing for cranioplasty in veterinary medicine.","title":"Schedule feasibility and workflow for additive manufacturing of titanium plates for ranioplasty in canine skull tumors"}
{"_id":"f12c38ca-2167-cbc2-e48b-afc098b72502","text":"Irrespective of the mechanism of action of MSC, there is a significant body of research that demonstrates the efficacy of MSC in treating such joint pathology as meniscal regeneration and osteoarthritis. These results indicate that intra-articular MSC injections could represent a genuine therapeutic strategy for joint disease. However, the successful launch of MSC therapy as a therapeutic treatment is complicated by a lack of understanding of cellular behaviour within the joint. The lack of sensitive functional tools that can be used to measure cells after injection impedes in vivo cell fate tracking, especially within deep tissues.","title":"Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model"}
{"_id":"f1309334-a06c-0fbd-bf18-1b38a9689dc9","text":"Rationale: Patients who have both food allergies and asthma are at increased risk for anaphylactic reactions and life-threatening asthmatic reaction. The aim of this study is to determine the asthma impact of on characteristics of children with food induced anaphylaxis adrenaline autoinjectors were prescribed.","title":"XXIV World Allergy Congress 2015 Seoul, Korea. 14-17 October 2015"}
{"_id":"f133dba9-de43-2419-0ada-8699d08292b6","text":"Existing software for surgical planning is almost always based on the 2D MRI\/CT images displayed on a standard monitor. Planning the spatial process of the operation based on 2D images leads to the software only supporting limited functions such as measuring distances on a 2D plane or drawing circles on individual images to indicate important or critical structures. In addition, these tools often have unintuitive or complex controls and surgeons lack the time to put additional effort into learning these tools.","title":"Virtual Reality for Surgical Planning – Evaluation Based on Two Liver Tumor Resections"}
{"_id":"f1343170-d3ba-203d-89f7-340acf37ea2e","text":"Skin grafting was used for the first time by Reverdin who performed the first skin transplant in 1870. Skin grafts are used to provide coverage over a broad spectrum of open soft tissue defects. Those are transferred from a donor region to a receptor one of the same subject or to a different person.","title":"Giant laterocervical fibrosarcom"}
{"_id":"f13d93a8-cee8-0cad-e6a7-5d94ed7337aa","text":"The European Wound Management Association has published a compendium on the use of NPWT in visible osteosynthesis postoperatively. The recommendations include that NPWT can be used when covering the exposed metalwork is otherwise not possible. In addition, they state that NPWT should be used as a last attempt to prevent amputation. These recommendations rely on two studies: one on NPWT with exposed bone and one on an experimental model with porcine wounds. Thus, they do not rely on research on fractures with exposed metalwork. This amplifies the need for further studies on the use of NPWT following FRI with exposed internal osteosynthesis.","title":"The use of negative pressure wound therapy for fracture-related infections following internal osteosynthesis of the extremity: A systematic review"}
{"_id":"f1441549-36fd-23c8-85ab-cb133f78c667","text":"Drug hypersensitivity was divided into four major pathophysiologic types: type-I hypersensitivity, which is mediated by IgE and mast cells and usually occurs soon after administration; type-II hypersensitivity, which is mediated by IgG or IgM and immune cells; type-III hypersensitivity, which is mediated by antigen-antibody immune complexes; and type-IV hypersensitivity, which is mediated by T cells. We speculate that the BTA injection might infiltrate into the facial capillary, then enter the superficial facial veins and then the anterior jugular vein, ultimately redistributing to the anterior chest wall through vascular and invoke type-I hypersensitive reaction.","title":"Mild Allergic Reactions after Botulinum Toxin Injection: A Case Series and Literature Review"}
{"_id":"f153f407-9a01-b45f-5bbb-f559c3da043c","text":"This study included 131 patients who were diagnosed with lymphoma with a nodal biopsy which was acquired via surgical excisional biopsy or core needle biopsy between 2014 and 2020 in our center. Around 68 patients underwent surgical excisional biopsy and the remaining 63 underwent core needle biopsy. Samples that allowed to the identification of the exact tumor type and\/or subtype were accepted as fully diagnostic. Sufficient amount of tissue that the pathologist could have any suspicious findings considering malignant lymphoma was classified as partial diagnostic group. Inadequate samples were the ones who were not enough to report any final diagnosis.","title":"Should Core Needle Lymph Node Biopsy be a Relevant Alternative to Surgical Excisional Biopsy in Diagnostic Work Up of Lymphomas?"}
{"_id":"f155016c-0030-f207-97f2-5591823b4b94","text":"The arterial anatomy of the digits was studied in detail by Strauch et al. They identified three palmar arches in the digits arising from the proper digital arteries: the proximal and middle arches at the level of the C1 and C3 cruciate pulleys (lying deep to the flexor tendons) and the distal arch just distal to the profundus tendon insertion as a convergence of the terminal digital arteries. The dorsal branches were arranged in a repetitive pattern of condylar, metaphyseal and dorsal skin vessels in the proximal, middle and distal phalanges.","title":"Homodigital Pedicled Digital Artery Perforator flaps for fingertip reconstruction - a review of flap options"}
{"_id":"f156aadf-9ca8-b161-27bd-624e66ff9917","text":"Arterial and venous thrombosis can develop through different cellular and plasma pathways, so that it is not surprising that drugs with different targets can achieve different results in preventing thrombosis in different vessel districts. The prevention of arterial recurrences mediated by HU may be due to myelosuppressive activity but also to the direct antithrombotic action on polymorphonuclear leukocytes function and their interaction with platelets. The importance of leukocytes in the pathophysiology of arterial thrombosis is well established in non-MPN individuals. Accordingly, leukocytosis has been reported as a potential determinant for myocardial infarction both in PV and in ET but not for VTE.","title":"Hydroxyurea prevents arterial and late venous thrombotic recurrences in patients with myeloproliferative neoplasms but fails in the splanchnic venous district. Pooled analysis of 1500 cases"}
{"_id":"f15a6740-9c46-4f4c-1752-ee6c48faa02a","text":"Photodynamic therapy (PDT) involves activation of a photosensitizer by means of light of an appropriate wavelength to produce focal damage to tissue. The treatment typically involves systemic administration of a photosensitizer and its subsequent activation by light of an appropriate wavelength to create a photochemical reaction that causes photodamage. PDT has become an accepted treatment for certain types of malignant tumors and is showing great promise for treating and managing a variety of nonmalignant diseases.5","title":"Does hypericin boost the efficacy of high-power laser? A preliminary experimental study on rats A hipericina aumenta a eficácia do laser de alta potência? Um estudo preliminar e experimental em ratos"}
{"_id":"f15d2ffb-37b9-25b3-3717-9dd794ab9f39","text":"To report the efficacy of split thickness skin grafting in a series of 50 patients with stable vitiligo.","title":"Split Thickness Skin Grafting in Patients with Stable Vitiligo"}
{"_id":"f16339e7-a52a-5624-a099-e2c41279a68b","text":"We propose a complete alar cartilage section and removal, in opposition to other proposed techniques, even if this is contrary to more common suggested, because we believe (following our results) that the technique is less aggressive than appears. Removal of the cartilages carefully dissected is not aggressive in expert hands, it is widely showed that an aggressive surgery modality even if made in closed technique is able to determine worse functional and esthetic outcomes that open\/reconstruction technique. Sometimes an hard manipulation trying to reach the result using a conservative technique give worse results that a soft manipulation using technique that can appear more aggressive.","title":"Functional results in airflow improvement using a “flip-flap” alar technique: our experience Resultados funcionais na melhora do fluxo de ar utilizando uma técnica alar em flip-flap: nossa experiência"}
{"_id":"f16e789c-3feb-905a-6ce2-16c82d7239b8","text":"A musculocutaneous anterior thigh flap comprising quadriceps and parts of the adductor compartment was then elevated based superficially. Along the medial thigh incision, the superficial femoral artery and vein were identified at the level of the adductor canal underneath the sartorius muscle and the vessels were skeletonized distally into the popliteal fossa keeping the blood supply to both heads of the gastrocnemius intact to for the basis of a filleted musculoskeletal calf flap. The tibial nerve and the common peroneal nerve were divided at this level. The knee joint was then disarticulated and the patella resected. The musculocutaneous thigh flap is further developed by elevating the quadriceps muscles and adductor muscles from the femur. The muscular flap, which is in continuity with the calf (superficial femoral and popliteal vessels and saphenous nerve intact), is then retracted anteriorly to allow adequate access to the hip and pelvis. The adductors are detached from the pubis and the symphysis is divided.","title":"Reconstruction after external hemipelvectomy using tibia-hindfoot rotationplasty with calcaneo-sacral fixation"}
{"_id":"f16e9ba2-8c62-0d15-1535-5b1558e2e0e0","text":"This retrospective observational study has shown that age is one of the most important factors determining the need for general anesthesia for PBT in children. While the safety of PBT under general anesthesia was sufficiently maintained in children under 15 years, in order to perform PBT with general anesthesia\/sedation without securing the airway it will be necessary to collect data across institutions and to develop a consensus guideline for the indication of general anesthesia\/sedation.","title":"Age as a decisive factor in general anaesthesia use in paediatric proton beam therapy"}
{"_id":"f1760cca-b0d6-a6f3-f880-72b76d4946ac","text":"Evidence indicates that integrins are candidates for sensing mechanical stimulation derived from the extracellular matrix. As a result, mechanical stimuli transmit local energy into the environment, supporting signal pathways for tissue and wound healing, which are a way to improve the efficiency and outcome of stem cell transplants. There are a number of issues indicating that ultrasound can trigger several biochemical events at the cell surface and increase the secretion of growth factors and many anti-inflammatory molecules, reported by in vitro and in vivo studies.","title":"Low-intensity ultrasound combined with allogenic adipose-derived mesenchymal stem cells (AdMSCs) in radiation-induced skin injury treatment"}
{"_id":"f17a46c8-5b43-7ea7-364f-4672463bff13","text":"The results of this study are similar to those performed by Altomare et al., who analyzed the effects of US on the process of wound healing by ischemia in Wistar rats, verifying greater and better wound contraction on days 7 and 14 in the treated group when compared to the control group. In this present study, the US used in the animals of the treated group was also effective in the tissue repair, since the temperature remained constant throughout the development, indicating an ideal healing process.","title":"Use of thermography in skin grafts after the application of therapeutic ultrasound in Wistar rats"}
{"_id":"f17ba2e6-3a0f-58f1-cb26-fd13973e6d6f","text":"The axillary lymph nodes, the number of which varies from 15 to 36, establish a common crossroads where the lymphatics of the upper limb and those of part of the thoracic and abdominal walls converge.","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"f180d735-db1b-9c05-c5ac-0039e8062a6b","text":"If signs and symptoms of severe sepsis are not present","title":"World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections"}
{"_id":"f18135c0-41b6-3bec-b6f9-a43a3ae4058d","text":"A retrospective chart review was performed in all patients who underwent rhinoplasty using CCSA by a single surgeon in Canada. Written consent was provided, by which the patients agreed to the use and analysis of their data. This study was approved by the WCG IRB Connexus, and the ethical standards of the Declaration of Helsinki were adhered to.","title":"A Canadian Experience With Off-the-Shelf, Aseptically Processed, Costal Cartilage Segment Allografts in Complex Rhinoplasty"}
{"_id":"f1837c4f-e9a7-11af-eaf7-638c22ba7fd5","text":"The main limitation of the study was the subtotal glossectomy nature of the patients where one could arguably state that functional deficit was not as large compared to a total glossectomy. However, the MSAP flap is only suitable for small sized defects in which subtotal glossectomies fit its use. MSAP flaps are not clinically indicated in total glossectomies and hence we were not able to assess the function of this group of patients in this study. The observational and retrospective nature of the study limited the level of evidence assessed but instead provides a cross-sectional study of the characteristics of the patients suitable for MSAP flap reconstruction and their associated outcomes.","title":"Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction – An outcome study"}
{"_id":"f187bdea-6c17-d14c-9357-c15eb0a5fbf0","text":"Clinically, the CVOCA has been used both as an adjunct to marrow stimulation and as a primary repair without deep marrow stimulation, more similar to a traditional osteochondral allograft. In the latter case, debridement of the cartilage and subchondral bone is performed until a bleeding bed is created within the lesion. The bleeding bed results in the formation of a blood clot that may help with integration of the implanted CVOCA. It is hypothesized that cartilage repair with the CVOCA will be mediated by the same mechanisms known for fresh stored osteochondral allografts. The CVOCA has a thin layer of bone which assists in integration with the patient’s own subchondral bone. However, the bone portion in the CVOCA was further reduced compared to fresh stored OCAs to enable the CVOCA to be flexible and to minimize damage to a patient’s healthy subchondral bone. Additional benefits to the CVOCA compared to fresh stored osteochondral allografts include a longer shelf life and no requirement for donor matching.","title":"A novel, cryopreserved, viable osteochondral allograft designed to augment marrow stimulation for articular cartilage repair"}
{"_id":"f1890bf6-ed68-60a8-810d-b06c00813618","text":"Anticoagulant prophylaxis did not reduce the incidence of VTE and the incidence of major bleeding was comparable between the two groups. Usefulness of perioperative anticoagulation was not demonstrated in this study. Pharmacological prophylaxis must be restricted in Japanese patients with higher risk of VTE.","title":"Efficacy and safety of anticoagulant prophylaxis for prevention of postoperative venous thromboembolism in Japanese patients undergoing laparoscopic colorectal cancer surgery"}
{"_id":"f18f04fc-4f5b-5a40-e2cd-ceaed2d4114c","text":"Table 4 shows the distribution of intact and ruptured implants by the number of signs of an intact and a ruptured implant on US examination.","title":"The Value of Ultrasound in the Evaluation of the Integrity of Silicone Breast Implants"}
{"_id":"f18f1e67-b42f-bb27-8efe-c5356c0b102a","text":"We retrieved the medical records of patients who underwent surgery for PSD at our institution between 1 January 2006 and 31 December 2016. During the study interval, we changed our surgical technique to manage primary PSD from total excision of PSD followed by open wound care to elliptical excision of PSD and primary transverse wound closure. In the first 5-year period, all patients underwent total excision and open wound care with or without negative pressure treatment. Thereafter, the surgeons in charge offered transverse elliptic excision and primary transverse closure of the wound to all patients in whom primary closure of the wound seemed feasible.","title":"Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children"}
{"_id":"f193475f-19df-2867-aa98-b035b8a37412","text":"The patient chronic condition of recurrent open wounds for many years because of multiple sharp and irregular surface of the skull caused by multiple drill holes in the outer surface of the skull was treated.","title":"The use of an omental flap for the reconstruction of a burn injury to the scalp: A case report"}
{"_id":"f19949d5-f0e3-e0c3-4812-02ef676a282d","text":"All patients had improvement in disease activity and frequency of admission especially due to complications of calcinosis. One patient had complete clearance of calcinosis for the last 5 years, others had significant improvement in calcinosis with no new lesions,decreased sites and density and decreased calcinosis related contractures. There was no serious side effects to rituximab.","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"f19a306f-a087-a3a5-c09f-d555ef52536f","text":"Scalp reconstruction is often further complicated by previous operative attempts at closure of the defect. Four of our free flap reconstruction patients had previously undergone an operation to close the scalp defect, either with skin grafting or non–free flap reconstruction, including our 2 free flap patients who required reoperations. In addition, traumatized and vascularly compromised tissue from radiation or infection increases the risk of local flap failure.6 Free tissue flaps have superior functional and esthetic outcome when compared with local tissue advancement flaps. Free flaps are often a better option for larger defects and for patients who have undergone previous reconstruction attempts or those requiring radiation therapy.7","title":"Evaluation of Options for Large Scalp Defect Reconstruction: A 12-Year Experience Eck et al"}
{"_id":"f19c0309-c3df-77dc-dc32-29c7e99ec5aa","text":"Thermally significant blood flows into locally cooled diseased tissues and warm them during cryosurgery so that the iceball is often hard to cover the whole diseased volume. This paper is aimed at investigating the effects of large arterial bifurcation on the temperature distribution during cryosurgery through simulation method.","title":"Computational study of the effects of arterial bifurcation on the temperature distribution during cryosurgery"}
{"_id":"f19fedbe-dbcd-01b9-a66f-d9b82d3623c1","text":"The major flaws of microvascular grafts are generally associated with their blood supply. Intraoperative adaptation of the shape and the desired size of the flap that fit the donor site frequently leads to injury of the supplying blood vessels, which causes flap ischemia and necrosis.","title":"Protocol and Evaluation of 3D-Planned Microsurgical and Dental Implant Reconstruction of Maxillary Cleft Critical Size Defects in Adolescents and Young Adults"}
{"_id":"f1a61262-fd45-b3d9-16ab-1e8d9e0c6ee9","text":"After 3 days of antibiotic coverage, an intermittent vacuum therapy at 80 mm hg is placed for one week to clean all the external skull table and stimulating granulation tissue at the periphery of the surgical wound.","title":"Case report: Reconstruction exposed bone following excision of malignant scalp tumors, multidisciplinary approach of an old method with new materials"}
{"_id":"f1b41c1f-1cd2-9d1b-fe29-78e524d30040","text":"In the CCA group, the aseptically processed, nonterminally sterilized, fresh frozen cartilage (Profile, MTF, N.J.) was provided by MTF and available in 14 sizes and two shapes (cartilage sheets and segments). The allografts were harvested from the seventh to ninth ribs of the donors with debridement of all soft-tissue attachments. A surfactant was applied to remove noncartilaginous materials. The cartilage was then soaked in antibiotic solution for decontamination and packed in sterile conditions after rinsing. Before distribution, negative cultures from the final product were confirmed. The frozen condition (−40℃ to −80℃) was maintained during shipment and storage. Before surgery, a pre-cut allograft was thawed in normal saline. During surgery, it was fashioned into rhinoplasty grafts of needed sizes and shapes using no. 10 blades depending on the procedure (Fig. 2). Later, these grafts were secured by 5-0 polydioxanone sutures. The graft types are documented in Table 2.","title":"Prospective Clinical Trial Evaluating the Outcomes Associated with the Use of Fresh Frozen Allograft Cartilage in Rhinoplasty"}
{"_id":"f1b92ae9-487d-24b7-5d55-12c18a0ff64d","text":"It is important to recognize a patient who has realistic expectations at the time of consultation. For the case of cosmetic purposes, consulting the patient before the procedure is of utmost important because it could eliminate factors capable of causing problems after the procedure.","title":"Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain"}
{"_id":"f1ba001f-357f-32e7-c929-5bdc38eb24c4","text":"Topical PDT combined with deep curettage may be considered as a treatment option of selected thick BCCs in cases where surgery or other invasive treatment methods are regarded as suboptimal.","title":"Pre-Treatment Deep Curettage Can Significantly Reduce Tumour Thickness in Thick Basal Cell Carcinoma While Maintaining a Favourable Cosmetic Outcome When Used in Combination with Topical Photodynamic Therapy"}
{"_id":"f1c12598-9ea9-8820-647d-114d02b52c5a","text":"Ueshima and Otake [25] observed a larger spread of the solution when it was injected in the fourth intercostal space compared to when it was administered in the fifth. These authors suggest that the structure of the TT muscle may lead to differences in the spread of the solution.","title":"Description of an Ultrasound-Guided Transverse Approach to the Transversus Thoracis Plane Block and Evaluation of Injectate Spread in Canine Cadavers"}
{"_id":"f1c6774a-9339-bc62-0f4f-20804ce4cf80","text":"We present our experience on the integration of plastic surgery into the UEA undergraduate medical curriculum. The fully integrated teaching approach at the UEA provides an example of how plastic surgery can be taught throughout the undergraduate degree. The benefits of plastic surgery to medical students include, gaining insight into the various diseases, workload and patient care involving plastic surgery, acquiring the skills to diagnosis and manage common plastic surgery-related injuries and enabling students with an interest in plastic surgery to make an informed career decision at an early stage. Subsequently, students can plan to further their experiences of the specialty through plastic surgical placements at electives, foundation training, basic surgical training, courses and research projects.We hope this will enlighten medical faculties in other medical schools worldwide with a fully integrated medical course to consider encompassing Plastic and Reconstructive surgery into their curriculum similar to that of University of East Anglia.","title":"Integration of plastic surgery into the undergraduate medical curriculum: the Norwich model and experience"}
{"_id":"f1c78217-d91b-7309-c935-9f178f1df74b","text":"No procedure for unblinding will be needed as all data analyses are performed after the trial is closed.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"f1c7fead-7e86-0d63-0392-3079c00799e3","text":"Phyllodes tumors account for less than 1% of breast tumors in women, and giant phyllodes tumors are those that are larger than 10 cm in diameter. Removal of such large tumors places a huge burden on the surgeon to reconstruct a breast that is aesthetically acceptable by the patient. We report what may be the largest giant phyllodes tumor and, most likely, the first latissimus dorsi flap used to cover such a large defect caused by the resection.","title":"Immediate latissimus dorsi pedicle flap reconstruction following the removal of an eight kilogram giant phyllodes tumour of the breast: a case report"}
{"_id":"f1cd54e4-d1a4-7269-2c39-03c5475bd61b","text":"The early detection of subsequent KC is crucial since it usually is associated with a smaller tumor size, which is connected with a reduced scar and the improvement of the cosmetic result, as well as a decrease in the cost of therapy linked with repeat surgery. Additionally, for BSC, and especially for SCC, reducing the possibility of metastasis disease development and even avoiding mortality makes the early detection of this cancer an even better advantage.","title":"Risk Factors and Clinicopathological Features for Developing a Subsequent Primary Cutaneous Squamous and Basal Cell Carcinomas"}
{"_id":"f1d1f310-c9c9-a7ae-f5af-3321c08c6586","text":"Patients that present with no intraspinal soft tissue mass, but overt bony destruction and dubious spinal stability are another important group of patients. A posterior vertebral wall defect or pedicle\/facet fracture may lead one to question the spinal stability in this patient group. Often all that is needed is a spinal brace to keep them out of pain while the spine confers itself stability by producing bridging bony osteophytes58,59. This appearance is similar to diffuse idiopathic skeletal hyperostosis60. It is a phenomenon that may be accelerated by or the result of treatment with bisphosphonates. This is a very interesting finding and warrants further research to see whether patients with myeloma present a completely different clinical problem than patients with osteolytic metastases due to solid tumours.","title":"The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG)"}
{"_id":"f1daab2a-5ee5-b40b-80ac-9d18d66bc8a9","text":"The inferior portion of the parotid gland was elevated. The digastric muscle and styloid process muscle were then detached to identify the hypoglossal nerve and expose the parapharyngeal space. The carotid sheath was exposed, and dissection was performed along the surface of the carotid sheath to the cranial side. The blood vessels and important nerves at the base of the skull were dissected and protected, and the lymphoid tissues in the parapharyngeal space were dissected.","title":"Reconstruction of nasopharyngeal defect with submental flap during surgery for nasopharyngeal malignant tumors"}
{"_id":"f1df9822-6026-c5ed-c6e6-170dab9ae530","text":"A prospective analysis was performed on all patients above the age of 18 who underwent dedicated face MRI after injection of intradermal fillers at our institution between 2013 and 2015. These patients were referred to our imaging department from the plastic surgery department and outpatient clinics as well as from private esthetic clinics after complaining of asymmetry, facial pain, or both.","title":"MRI in detecting facial cosmetic injectable fillers"}
{"_id":"f1e3f083-7276-a515-e33c-6900629b01d3","text":"Non-melanoma skin cancer is the commonest cancer worldwide of which surgical excision is the mainstay of treatment. This systematic review will aim to summarise the best available evidence and definitively establish the incidence of incomplete excision. This knowledge will establish a global standard of which future studies in this area can be compared to in order to improve skin cancer treatment worldwide. It may also elude to risk factors that influence the incidence, namely the operating practitioner, the location of lesions, the complexity of reconstructions undertaken and the presence of high-risk histological components. The knowledge derived from this review will provide a global standard for future audits and studies in this area. This standard will be based on recent clinical evidence, and crucially not an extrapolation from Mohs micrographic data which forms the basis of some national guidelines. Up-to-date epidemiological evidence about levels and trends in skin cancer care is essential information for effective national health policy and guidelines.","title":"Global incidence of incomplete surgical excision in adult patients with non-melanoma skin cancer: study protocol for a systematic review and meta-analysis of observational studies"}
{"_id":"f1ef746c-2b72-df51-23c8-609a8380f572","text":"This study includes 174 breast cancer patients who were diagnosed using CNB or VAB and who underwent skin- or nipple-sparing mastectomy with immediate breast reconstruction at our hospital between August 2018 and April 2020.","title":"The significance of biopsy scar excision at the time of skin- or nipple-sparing mastectomy with immediate breast reconstruction"}
{"_id":"f1ef7766-31a1-badc-1f7d-5c443ff29029","text":"Tuberculous osteomyelitis of the mandible is a rare entity; however the resurgence in the incidence of tuberculosis due to coinfection with HIV has brought back the focus on this age old disease. Oral tuberculosis is usually secondary to pulmonary involvement however the systemic manifestations may be absent and oral lesion may be the presenting finding.","title":"Primary tuberculous osteomyelitis of the mandible mimicking a parotid fistula"}
{"_id":"f1f062f2-bc13-b765-6da6-f3815c139d13","text":"Standard radiation therapy for cervical cancer consists of external beam radiation therapy followed by an intracavitary brachytherapy boost. When brachytherapy cannot be performed due to unfavorable anatomy or coexisting medical conditions, stereotactic body radiotherapy with the CyberKnife is another treatment option which is less invasive and can be performed in a shorter treatment time. We performed non-invasive therapy using the CyberKnife for five cases of urogenital cancer located in the cervix. The local tumor control was excellent with minimal toxicity. Non-invasive treatment was demonstrated as feasible with the CyberKnife for contraindication of surgery or brachytherapy.","title":"CyberKnife Stereotactic Radiosurgery for Primary and Metastatic Cancer in the Cervix"}
{"_id":"f1f0ac5f-c994-5418-9a75-564c9dc2e9d4","text":"Incisional and excisional release and skin grafting are the mainstays of post burn reconstruction. However using skin grafts in burn reconstruction has its own sets of problems. They are prone to contraction and recurrences that are common after contracture release and grafting. So there is a prolonged need of splintage and physiotherapy in the post-operative period.","title":"Use of Local Perforator Flaps for Post Burn Reconstruction"}
{"_id":"f1fba869-1f50-1e5b-bb71-cbbcc8083eee","text":"CEA avoids the mesh aspect of split skin autografts and discomfort of donor site after skin harvesting. It is however limited by the fragility and difficulty of handling, unpredictable take rate and high cost.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"f1fd7755-6c61-f1ce-3716-28c6d90b4003","text":"Negative margins halve the risk of IBTR compared with positive margins defined as ink on DCIS. A 2 mm margin minimizes the risk of IBTR compared with smaller negative margins. More widely clear margins do not significantly decrease IBTR compared with 2 mm margins. Negative margins less than 2 mm alone are not an indication for mastectomy, and factors known to impact rates of IBTR should be considered in determining the need for re-excision.","title":"Society of Surgical Oncology–American Society for Radiation Oncology–American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma In Situ"}
{"_id":"f204a0cb-a54d-69f6-4f58-3a9e69de2d07","text":"Rhinoplasty is a common and complex plastic surgery procedure. The evaluation of surgical success in rhinoplasty is primarily based on patient satisfaction. The purpose of the study is to assess the characteristics of patients who underwent rhinoplasty and their satisfaction using the FACE-Q questionnaire.","title":"Ethnic Rhinoplasty: A Middle East-Centered Patient Satisfaction Survey Using the FACE-Q Questionnaire"}
{"_id":"f20b203e-c967-77e3-dc7a-29c5a768c3db","text":"The skull defect was easily accessible with an ultrasound probe and the defect was clearly detectable after surgery and over the further course. The obtained data roughly match those from the postmortal μCT. The authors conclude that ultrasonography can be used as a method to track tissue formation within large calvarial bone defects. Because ultrasound is not associated with radiation it is of potential clinical use. However, the method has several limitations. The given setup could not distinguish between new bone and new firm connective tissue formation because the ultrasonic waves were reflected in a similar manner by both tissues. Furthermore, for skull defects, this method can only be used for implants with a very low ultrasound reflecting matrix like PCL.","title":"ECM Inspired Coating of Embroidered 3D Scaffolds Enhances Calvaria Bone Regeneration"}
{"_id":"f20dd508-c9fb-274d-c950-34f9d9389c39","text":"Careful with the popliteal vein and saphenous nerve is advised when dissecting the popliteal artery.","title":"WSES position paper on vascular emergency surgery"}
{"_id":"f20f6037-de30-9383-e40b-90108c05d70d","text":"Cavitary voids left in the bone following excision must be managed to prevent hematoma or seroma collection, which may become infected from the small numbers of planktonic organisms inevitably present at the end of debridement. Therefore, obliteration of the dead space is essential. 24 This can be achieved by importing vascularized tissue as a flap, particularly following cortical OM excision. Muscle flaps have the advantage of being able to conform to complex three-dimensional defects. However, for cavitatory defects, synthetic bone graft substitutes that elute antibiotics are beneficial. They serve as osteoconductive carriers that promote bone healing while the carrier dissolves gradually and releases very high concentrations of antibiotic into the local region. 14 The levels achieved are many orders of magnitude higher than the concentrations achieved by parenteral antibiotics but without the risk of systemic toxicity. 35 36 37","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"f2146e0e-2ce1-ce9f-f6fe-0b257992666a","text":"The first measurement performed before surgery and the second measurement performed 3 months after surgery. Each measurement repeated 3 times and average value was recorded.","title":"Does Cosmetic Rhinoplasty Affect Nose Function?"}
{"_id":"f21696e6-e1db-e64f-d9b0-827ff35e3d13","text":"In cases where the VTE is suspected, the management depends on the degree of clinical suspicion and the stage of pregnancy. The management will also change if certain anticoagulants are contraindicated and whether DVT, PE, or both are suspected. In cases where there is a strong suspicion of an acute episode of pulmonary embolism, it is advisable to start anticoagulant therapy even before the diagnostic evaluation. It may be discontinued if the diagnostic evaluation refutes the diagnosis. In cases of low to moderate degree of suspicion of PE, it is better to evaluate the patient clinically and diagnostically before the anticoagulant therapy is instituted.","title":"Strategies for Diagnosis and Prevention of Venous Thromboembolism during Pregnancy"}
{"_id":"f2453baa-d85c-2d77-86b2-702fe4c15fdd","text":"In this cohort study, we found a changing incidence of second primary cancers after metastatic melanoma that shifted in the era of systemic therapy from hematological cancers to a mix of cancer of the small intestine and myeloma. As ICIs continue to gain approval as part of the standard-of-care treatment for multiple cancers, our findings highlight the importance of tailored monitoring approaches for patients treated with immunotherapy and further identifying potential risk factors associated with subsequent cancer development. Vigilant individualized monitoring and screening for these cancers are warranted.","title":"Assessment of Trends in Second Primary Cancers in Patients With Metastatic Melanoma From 2005 to 2016 Trends in Second Primary Cancers in Patients With Metastatic Melanoma, 2005-2016"}
{"_id":"f24a571a-bcc0-52cc-bb47-b6c241e2256e","text":"Primary closure, re-approximation of wound edges with suture, is the most desirable form of reconstruction. This is often possible on the trunk or proximal extremities but not feasible in the hand or fingers. If a wound is unable to be closed then the surgeon can consider healing by secondary intent. This is often employed in the fingertip where moist dressing changes will allow contraction of the wound periphery bringing in sensate, glabrous skin for potentially stable reconstruction. This method requires a viable wound bed without bone or tendon exposure in order to be a viable option. The disadvantage is that the wounds can take weeks to heal and may be uncomfortable in the interim.","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"f24ea539-e1b1-d937-3947-88f24adb73a5","text":"All the most significant studies discussed here are summarized in Table 2.","title":"Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: The Current and Future Role of Radiation Therapy in the Era of Immunotherapy"}
{"_id":"f2506995-9f12-f67a-288c-4805d946a76c","text":"The Gustilo IIIB tibiofibular fractures often result in long bone loss and extensive soft tissue defects. Reconstruction of these complex wounds is very challenging, especially when it includes long bone grafts, because the donor site is limited. We describe our experience using a set of chimeric ipsilateral vascularized fibula grafts with a thoracodorsal artery perforator free flap to reconstruct the traumatic tibia defects. A 66-year-old male suffered a severe comminuted tibia fracture and segmented fibula fracture with large soft tissue defects as a result of a traffic accident. He also had an open calcaneal fracture with soft tissue defects on the ipsilateral side. All the main vessels of the lower extremity were intact, and the cortical bone defect of the tibia was almost as large as the fractured fibula segment. We used an ipsilateral vascularized fibula graft to reconstruct the tibia and a thoracodorsal artery perforator flap to resurface the soft tissue, using the distal ends of peroneal vessels as named into sequential chimeric flaps. After 3 weeks, the calcaneal defect was reconstructed with second thoracodorsal artery perforator free flap. Reconstruction was successful and allowed rapid rehabilitation because of reduced donor site morbidity.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"f2535794-cf92-8da9-f889-036913bfe790","text":"Although exact statistics on the prevalence of cosmetic surgery in Iran are not available, reports indicate that Iran is one of the top countries in the world in terms of popularity of cosmetic surgery the demand for these surgeries is increasing and these changes have provided a suitable market for plastic surgeons. , According to unofficial sources, Iran ranks first in the rate of rhinoplasty worldwide. A study conducted in Iran in 2011 reported a 15% prevalence of cosmetic surgery among women.","title":"Prevalence of elective cosmetic surgery and its relationship with socioeconomic and mental health: A cross‐sectional study in west of Iran"}
{"_id":"f25d4e69-c9e1-4ed4-0963-3ab7d3e00746","text":"The exposure of necrotic cartilage to the articular cavity is likely to increase the chances of infection recurring. The exposure of the bone graft to the articular cavity easily permits the bacteria remaining in the bone tissue to enter the articular cavity, or the inflammatory joint fluid to infiltrate the bone graft, both of which are counter to infection control. In addition, grafted bone extensively exposed to the articular cavity is not easily vascularized, requires a long time to be able to resist infection, may easily become a new source of infection and is likely to accelerate joint wear and degeneration.","title":"Combined debridement, bone graft and articular cavity sealing using synovium in treating metaphyseal osteomyelitis involving knee joints"}
{"_id":"f2608fab-e177-60fe-2f56-af5aad92dddd","text":"Currently, numerous patients who receive targeted chemotherapy for cancer suffer from disabling skin reactions due to cutaneous toxicity, which is a significant problem for an increasing number of patients and their treating physicians. In addition, using inappropriate personal hygiene products often worsens these otherwise manageable side-effects. Cosmetic products for personal hygiene and lesion camouflage are part of a patients’ well-being and an increasing number of physicians feel that they do not have adequate information to provide effective advice on concomitant cosmetic therapy. Although ample information is available in the literature on pharmaceutical treatment for cutaneous side-effects of chemotherapy, little is available for the concomitant use of dermatological skin-care products with medical treatments. The objective of this consensus study is to provide an algorithm for the appropriate use of dermatological cosmetics in the management of cutaneous toxicities associated with targeted chemotherapy such as epidermal growth factor receptor inhibitors and other monoclonal antibodies. These guidelines were developed by a French and German expert group of dermatologists and an oncologist for oncologists and primary care physicians who manage oncology patients. The information in this report is based on published data and the expert group’s opinion. Due to the current lack of clinical evidence, only a review of published recommendations including suggestions for concomitant cosmetic use was conducted.","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"f26cbc28-cc98-a3b4-bd6d-04f06a22f00f","text":"Recently introduced systemic therapies for locally advanced and metastatic non-melanoma skin cancers (NMSCs) are paving the way for neoadjuvant approach. Although none of the therapeutic options has currently gained indication in this setting, neoadjuvant approach for NMSCs is an open field and we are likely to see huge developments in the near future. Targeted therapy with sonic hedgehog pathway inhibitors is very effective in locally advanced or multiple basal cell carcinomas while immunotherapy with immune checkpoint inhibitors appears to be promising for advanced cutaneous squamous cell carcinoma and Merkel cell carcinoma. To date, targeted therapy and immunotherapy represent the frontiers in NMSC therapeutic management and, according to recent studies, good results can be achieved.","title":"Neoadjuvant Therapy for Non-melanoma Skin Cancer: Updated Therapeutic Approaches for Basal, Squamous, and Merkel Cell Carcinoma"}
{"_id":"f277c844-097a-d0ce-b25e-4630f63ccd78","text":"In spite of benign and indolent characteristic of a epidermoid cyst, complete excision is still the goal we pursue for the symptomatic lesions while asymptomatic lesions can be kept on conservative observation.[ But the goal is really hard to achieve because of the intimate adherence between the capsule and spinal cord, so subtotal excision is more often to be adopted and leaves the possibility of recurrence which may occur and quickly become symptomatic shortly after surgery.[ Metastatic lesions of the epidermoid cyst were never reported, while malignant transformation was very rare but there were still few intracranial cases with malignant transformation reported.[ The recurrent lesion of our case was the result of 3-time subtotal excisions and had some notable changes such as soluble osseous destruction, invasive growth, and solid changes of the cyst content. These changes suggest the possibility of malignant transformation, although it was not supported by the final pathological examination. But mild to moderate atypical hyperplasia let us confirm the necessity of adequate treatment and also reminded us the close follow-up of the patient.","title":"Repeated recurrent epidermoid cyst with atypical hyperplasia A case report and literature review"}
{"_id":"f27ae72f-a447-1baf-7b08-a9c57443d530","text":"COVID-19 is predominantly a pulmonary disease with underlying systemic involvement associated with widespread vascular thrombosis and thromboembolic events. We present a classic case of VTE in a patient on therapeutic enoxaparin for venous thrombosis developing refractory hypoxia with a clot in transit detected in the right ventricle using POCUS. The patient was subsequently treated with a systemic thrombolysis, resulting in a good outcome. Although COVID-19 pneumonia patients are being maintained on therapeutic anticoagulants if coexisting thrombosis or elevated d-dimer levels are detected, recognizing the events of VTE in the critically ill that can cause rapid deterioration and refractory hypoxia and commencement of systemic thrombolysis can result in the reduction of mortality.","title":"Thrombus in Transit on Point-of-Care Ultrasound in COVID-19 Pneumonia: A Cause of Refractory Hypoxia Requiring Systemic Thrombolysis"}
{"_id":"f27de898-4e10-ff00-538c-dac199c61271","text":"This case demonstrate the feasibility of minimal invasive procedure of harvest an omental flap laparoscopically, and the use of large omental flap to cover the entire scalp after a burn injury of a child skull the probably even latissimus dorsi flap may not provide similar coverage and pliability.","title":"The use of an omental flap for the reconstruction of a burn injury to the scalp: A case report"}
{"_id":"f2822ac8-0c4b-06cd-72b9-579e2292c592","text":"The ePLND surgical template includes removal of fatty lymphoid tissue overlying the common and external iliac vessels and within the obturator fossa [3]. The medial border of the surgical template of ePLND concerns the ureter, the caudal border the obturator nerve and the cranial border the genitofemoral nerve continued to the inner aspect of the pubic bone. All four template sections were individually collected and presented for histopathologic analysis.","title":"Pelvic lymph-node staging with 18F-DCFPyL PET\/CT prior to extended pelvic lymph-node dissection in primary prostate cancer - the SALT trial -"}
{"_id":"f2853ed2-6593-3f5e-73fd-35afbb03ff36","text":"In brain tumor surgery, an appropriate and careful surgical planning process is crucial for surgeons and can determine the success or failure of the surgery. A deep comprehension of spatial relationships between tumor borders and surrounding healthy tissues enables accurate surgical planning that leads to the identification of the optimal and patient-specific surgical strategy. A physical replica of the region of interest is a valuable aid for preoperative planning and simulation, allowing the physician to directly handle the patient’s anatomy and easily study the volumes involved in the surgery. In the literature, different anatomical models, produced with 3D technologies, are reported and several methodologies were proposed. Many of them share the idea that the employment of 3D printing technologies to produce anatomical models can be introduced into standard clinical practice since 3D printing is now considered to be a mature technology. Therefore, the main aim of the paper is to take into account the literature best practices and to describe the current workflow and methodology used to standardize the pre-operative virtual and physical simulation in neurosurgery. The main aim is also to introduce these practices and standards to neurosurgeons and clinical engineers interested in learning and implementing cost-effective in-house preoperative surgical planning processes. To assess the validity of the proposed scheme, four clinical cases of preoperative planning of brain cancer surgery are reported and discussed. Our preliminary results showed that the proposed methodology can be applied effectively in the neurosurgical clinical practice both in terms of affordability and in terms of simulation realism and efficacy.","title":"Current Practice in Preoperative Virtual and Physical Simulation in Neurosurgery"}
{"_id":"f286ad70-7874-63b8-888b-2700cee409fe","text":"In patients with allergic asthma triggered by the exposure to particular allergens, the avoidance is the first measure to prevent the appearance or the worsening of bronchial symptoms.","title":"Allergen Avoidance in Allergic Asthma"}
{"_id":"f28a64d1-ca88-5f62-fa27-922f2fe1a39c","text":"Four out of eleven patients needed one or more surgical revisions.","title":"Bilateral Fibular Graft: Biological Reconstruction after Resection of Primary Malignant Bone Tumors of the Lower Limb"}
{"_id":"f2956bde-db0b-2252-0c29-7d7d4a35642e","text":"This study was approved by the Medical Ethics Committee of the Rasool Akram Medical Complex.","title":"First reported case of delayed‐type hypersensitivity reaction to non‐hyaluronic acid Polycaprolactone dermal filler following COVID‐19 vaccination: A case report and a review of the literature"}
{"_id":"f295f30c-d52e-d073-7112-53e5aec684fb","text":"Venography was performed and a large amount of thrombus lining from left femoral vein to left iliac vein was noted with total occluded left common iliac vein. After catheter-directed thrombolysis and balloon dilatation, better flow was regained and her symptoms improved completely after procedure.","title":"Postpartum deep vein thrombosis resolved by catheter-directed thrombolysis A case report"}
{"_id":"f2985782-9dc4-63bf-2688-a7ae5f547d80","text":"Considering the very high prevalence of BCCs, the relatively high number of HRBCCs, and the lack of access to MMS at most dermatosurgery centers worldwide, the present study evaluated the results of SEPMC in HRBCCs in the head region over seven years.","title":"Outcome of staged excision with pathologic margin control in high-risk basal cell carcinoma of the head region"}
{"_id":"f29ca662-d998-0f8a-e99e-633ca033ca66","text":"Patients with a history of VTE who undergo surgery may have a high recurrence risk, a finding that challenges the current thromboprophylactic strategy for these patients.","title":"Risk and Risk Factors Associated With Recurrent Venous Thromboembolism Following Surgery in Patients With History of Venous Thromboembolism Recurrent Venous Thromboembolism After Surgery in Patients With History of Venous Thromboembolism"}
{"_id":"f2a343bc-89c3-fc31-0bb3-e9ba40fff11c","text":"We aimed to investigate whether the pattern of lymphatic basin drainage influences the risk of nodal disease in patients with melanoma of the trunk and negative SLNB. As a secondary goal, we aimed to assess the false-negative rate of SLBN in trunk melanomas.","title":"Does the pattern of lymphatic drainage influence the risk of nodal recurrence in trunk melanoma patients with negative sentinel lymph node biopsy?"}
{"_id":"f2a6aac8-62eb-b059-5b87-3bac98850934","text":"Inadequate robotics exposure and training is likely to lead to longer operative learning curves as an independent surgeon. This may result in poorer patient outcomes during phase 1 of the learning curve as well as reduced theatre efficiency, and a more hesitant adoption of this technique potentially resulting in large health inequalities between countries.","title":"The Atlantic divide: contrasting surgical robotics training in the USA, UK and Ireland"}
{"_id":"f2ab3af9-16b8-c6de-4ae1-12ad21c1b43c","text":"There is no gold standard for elderly patients with cancer thus the ability to establish a diagnosis of frailty and to provide effective intervention to prevent progression to disability remains the major challenges in managing the patient’s complexity [12]. Probably, Sarcopenia condition that has been widely associated to frailty and it has been proposed as the underlyng condition of frailty itself becouse strictly related to negative outcomes as toxicities and mortality could become the keystone in the assessment of the elderly cancer patient [19].","title":"Management of The Elderly Cancer Patients Complexity: The Radiation Oncology Potential"}
{"_id":"f2ab72a4-1493-10ea-3f7a-993034a268f7","text":"SAE data will be collected on paper SAE report forms and faxed to the KHPCTO. Summary details of SAEs will be transcribed to adverse event section of the eCRF. For all other data collected, source data worksheets will be prepared for each patient and data will be entered onto the eCRF database. Source data worksheets will be reconciled at the end of the trial with the patients NHS medical notes in the recruiting center. During the trial, critical clinical information will be written in the medical notes to ensure informed medical decisions can be made in the absence of the study team. Trial related clinical letters will be copied to the medical notes during the trial. The Chief Investigator will provide an electronic signature for each patient Case Record Form once all queries are resolved and immediately prior to database lock.","title":"Protocol for a double-blind randomised controlled trial of low dose intradermal grass pollen immunotherapy versus a histamine control on symptoms and medication use in adults with seasonal allergic rhinitis (PollenLITE)"}
{"_id":"f2afb165-d3f8-b967-b6f2-b7a4a2074936","text":"During the follow-up period, one patient exhibited a superficial posterior wound infection and recovered after 2 weeks of antibiotics treatment. There were no cases of pseudarthrosis or hardware loosening. All patients exhibited favorable union according to CT scans that were performed 6 months postoperatively, and there was no recurrence of spinal cord compression caused by closure of the opened laminae, according to the MRI study that was conducted 12 months postoperatively.","title":"Laminoplasty instead of laminectomy as a decompression method in posterior instrumented fusion for degenerative cervical kyphosis with stenosis"}
{"_id":"f2b56ef1-444a-b435-741f-2685da9e532e","text":"Osteomyelitis (OM) is a destructive inflammatory process of bone caused by an infecting microorganism. It commonly occurs in the lower limb where it is often a result of direct bacterial invasion from surrounding tissues or implants. This is known as contiguous focus OM (cOM) and is a recognized complication of diabetic foot infections, open fractures, and implant-related surgery. Plastic surgeons most commonly encounter cOM as the surrounding soft tissues may be severely compromised and require reconstruction as a result of the underlying chronic inflammation with extensive fibrosis and discharging sinuses.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"f2b652cb-ba82-242c-8916-e585aff96d97","text":"We report three cases of successful DIEP flap transfer for immediate breast reconstruction despite injections of therapeutic doses of enoxaparin into their abdominal fat 24–32 hours before microsurgical transfer. All three patients were treated by primary chemotherapy for breast cancer and were prescribed subcutaneous heparin for line-related thrombotic complications. They were referred for reconstructive consultations towards the end of their chemotherapy and had already been receiving subcutaneous injections into the abdominal fat when a decision regarding DIEP flap reconstruction was taken.","title":"Successful Deep Inferior Epigastric Perforator Flap Harvest despite Preoperative Therapeutic Subcutaneous Heparin Administration into the Abdominal Pannus"}
{"_id":"f2b69f25-19ae-64d7-a5c4-de4bf1ea2fa6","text":"Cutometric measurements performed in the combination therapy group were significantly higher compared to filler monotherapy and IR monotherapy:","title":"HA PEGylated Filler in Association with an Infrared Energy Device for the Treatment of Facial Skin Aging: 150 Day Follow-Up Data Report"}
{"_id":"f2ca6f38-fc5a-396a-c32f-5ebbb7330819","text":"For the present study, we excluded patients who underwent limb revascularization procedures prior to the date of study entry or did not undergo noninvasive arterial evaluation during the study period. We included patients with PAD who underwent noninvasive arterial evaluation of the lower extremities at the Mayo Vascular Center. The final study cohort comprised 1413 community residents with clinically diagnosed PAD confirmed by noninvasive arterial evaluation.","title":"Association of Ankle-Brachial Indices With Limb Revascularization or Amputation in Patients With Peripheral Artery Disease Association of Ankle-Brachial Indices With Limb Revascularization or Amputation"}
{"_id":"f2daca7c-e863-5503-20e8-6a0aca4e85c8","text":"To compare the outcome of NMSC patients with excision performed with and without IFS.","title":"Use of Intraoperative Frozen Section in the Surgical Management of Patients with Nonmelanoma Skin Cancer"}
{"_id":"f2dd2724-fb42-bb60-3c1a-1b6a4b05daca","text":"Our third case expands on many diagnostic issues discussed in the prior cases and applies them to a medically complex and elderly patient. This includes the use of pretest probability, safety of lung imaging, and the potential for overdiagnosis in patients with advanced age and medical comorbidity.","title":"Current Challenges in Diagnosis of Venous Thromboembolism"}
{"_id":"f2e662c2-2672-2a8d-2950-d8164c328ac7","text":"Therefore, treatment protocols that favor tumor cell death by both apoptosis and necrosis, as the protocols shown in this work, have a great potential to induce antitumor immunological response: necrotic cells would provoke the necessary inflammatory response to attract defense cells, and apoptotic cells being phagocytized by professional antigen presenting cells would trigger the development of specific antitumor immunological response. Nevertheless, more studies are required to determine if the type of cell death observed for the PDT treatments of this work would be the key for the establishment of a lasting and effective antitumor immunity.","title":"Photodynamic therapy combined to cisplatin potentiates cell death responses of cervical cancer cells"}
{"_id":"f2e7064e-c1bf-1b74-6734-d8a50f8481ef","text":"This quasi experimental study was done at Department of Surgery of Dow University Hospital Karachi during January 2013 to September 2015 after the approval of Hospital Ethical Committee. A total number of 85 patients with biopsy proven carcinoma were included in the study.1% methylene blue dye was infiltrated in the peri tumoural area of the diseased breast. The blue stained node called sentinel lymph node (SLN) was recognized and carefully dissected out. SLN and mastectomy with axillary clearance specimen was sent for histopathology in two separate bottles and the report of the histopathology was compared.","title":"Sentinel lymph node identification by blue dye in patients with breast carcinoma"}
{"_id":"f2fbfdb0-6eab-f3cf-01f9-b86673e6b913","text":"In some cases, the wound is not in a regular site. The graft should be pliable to be simply placed on surfaces that can be uneven such as fingers or elbows. Skin substitutes have to be manageable and adaptable but not fragile for avoiding scarring.","title":"From Grafts to Human Bioengineered Vascularized Skin Substitutes"}
{"_id":"f307e600-b242-38fc-5ebf-7c32eebb387f","text":"Patients were seen by a radiation oncologist at least weekly during the RT. Follow-up visits were arranged 2–4 weeks after completion of IMRT and every 3 to 6 months for the first 2 years and annually thereafter with a digital rectal examination and a serum PSA level obtained at each visit. Patients alternated follow-up visits between their urologist and radiation oncologist. A minority of patients who did not attend these visits were contacted and data were successfully retrieved.","title":"Acute and late toxicity in prostate cancer patients treated by dose escalated intensity modulated radiation therapy and organ tracking"}
{"_id":"f310b2fe-38e4-7df6-4040-98d321e60b02","text":"Multilevel cervical reconstruction and fusion after cervical tuberculosis has always been a challenge. The current implantation materials for cervical fusion, including titanium mesh, cage, and plate are limited by its inferior biological mechanical characteristics and the properties of the metallic material. This has led to the increased risk of recurrent infection after surgery. In addition, the unique nature of tuberculosis infection results in the low rate of cervical fusion and high risk of recurrence. This case report presents 1 patient who suffered from long segmental cervical tuberculosis and had reconstruction surgery using a vascularized fibula graft. The patient had successful graft incorporation 3 months postsurgery and was followed-up for 30 months. In this review, we detail the advantages of using vascularized fibular grafts and compare it with other types of grafts.","title":"Application of vascularized fibular graft for reconstruction and stabilization of multilevel cervical tuberculosis A case report"}
{"_id":"f31103b9-6c5d-d6ed-e37d-c7bfd291ea91","text":"Figure 6 shows the scanning electron microscopy images of the nevus tissues in the untreated, fresh, and cryopreserved groups. The epidermis had detached from the dermis or disappeared in the fresh and cryopreserved groups. Densely packed collagen fibers constituted the dermis layer with no vesiculation or laceration, and the density of the collagen fibers appeared to be almost the same in all groups. Fine collagen fibrils had gathered together to form large fibers, and no fragmentation or swelling of fibrils was observed.","title":"Inactivated Nevus Tissue with High Hydrostatic Pressure Treatment Used as a Dermal Substitute after a 28-Day Cryopreservation Period"}
{"_id":"f31727ba-ec8b-4c34-9fb0-237a22c8469d","text":"Total of 1312 women with 2026 surveillance breast MRI after BCT between January 2014 and September 2018 were studied. Early recurrence was defined as newly diagnosed breast cancer and\/or axillary metastasis within 12 months of surgery. Late recurrence was defined as recurrence after 12months of surgery. We assessed the detectability of recurrent lesions in each postoperative imaging modality and evaluated characteristics of recurrent lesions on postoperative MRI by comparing early and late recurrence groups.","title":"Usefulness of postoperative surveillance MR for women after breast-conservation therapy: Focusing on MR features of early and late recurrent breast cancer"}
{"_id":"f31b8d54-c559-0067-7f97-2dc4cf1feb4f","text":"Patients with resectable recurrent HNC who were deemed to have a high risk of second recurrence were eligible. Immediately after tumor extirpation, seeds were implanted in the surgical bed based on the preoperative treatment plan with intraoperative adjustment. The surgical bed and the seeds were covered with a regional flap or microvascular free flap. A CT of the neck was obtained on postoperative day 1 for evaluation of the postoperative dose distribution. Patients were followed 1 and 3 months after surgery, then every 3 months in the first 2 years.","title":"Permanent Interstitial Cesium-131 Brachytherapy in Treating High-Risk Recurrent Head and Neck Cancer: A Prospective Pilot Study"}
{"_id":"f33095ec-b759-0048-d3c4-0787d39ff83f","text":"Thus, it can be concluded that the indicators of EI in the persons enrolled in the HLF program are associated with strong leadership qualities and a high level of psychological stability, which in turn confirm the high efficiency of the developed program of elite training: the persons who have been trained under this program have characteristics such as higher professional knowledge and skills than have those who did not undergo such training, as well as a greater degree of leadership qualities.","title":"Leadership and Emotional Intelligence: Current Trends in Public Health Professionals Training"}
{"_id":"f3349c37-cbdd-b23a-1470-02ac2ecb245c","text":"In conclusion, distal gastrectomy may be a safe method with which to prevent gastric venous congestion and bleeding when combined with TP. To preserve the subtotal or whole stomach, one of the gastric drainage veins should undergo preservation or reconstruction. Anastomosis between the RGEV and left ovarian vein is a new operative procedure to reduce gastric venous congestion.","title":"Gastric venous congestion and bleeding in association with total pancreatectomy"}
{"_id":"f342b64a-0a54-2935-b983-55476d7045c7","text":"The patient was discussed on the tumor board and was planned for palliative chemotherapy for a cutaneous recurrence of infiltrating ductal carcinoma of the breast. The patient was followed up for the next six months, and there was a decrease in the size of the cutaneous metastasis, and the patient was doing well.","title":"A Rare Occurrence of Cutaneous Recurrence in a Patient of Post Modified Radical Mastectomy"}
{"_id":"f3444729-b384-763c-fda3-a734fc67a21e","text":"Due to the tumor characteristics and the surgeon's personal preferences, the constructed models in this study were applied in surgical planning for other approaches such as the expanded transnasal approach and supraorbital keyhole approach.","title":"Stereoscopic virtual reality models for planning tumor resection in the sellar region"}
{"_id":"f344e80a-151a-6dc5-e502-ca20c70a71d3","text":"All cases were operated using standard field 4.5x magnification loupes under tourniquet control. Tumors localized at the dorsal surface were removed using dorsal incisions. Midlateral incisions were used for laterally localized tumors. Tumors localized at the volar surface were approached with either lateral or volar incisions. Utmost care was given to remove the tumor in one piece with the capsule intact whenever possible and to protect digital nerves, arteries and tendons. En bloc excision were also performed for the tumors which invaded medullary space. Before the closure of the incision closure, the operation field was inspected for any satellite lesions. Standard postoperative management involved active finger motion at the end of the first week, suture removal at the end of second week and physiotherapist supervised rehabilitation until a full active range of motion was reached.","title":"Giant cell tumor of tendon sheath in the hand: analysis of risk factors for recurrence in 50 cases"}
{"_id":"f3468dbd-71eb-849b-e13a-8423e2f40c0f","text":"This detailed analysis showed that OA synovial tissue explants can be cryopreserved while maintaining the morphology, viability and phenotypical response after thawing.","title":"Functional Tissue Analysis Reveals Successful Cryopreservation of Human Osteoarthritic Synovium"}
{"_id":"f3474225-400a-6250-dd22-359fc2012d47","text":"The leg, foot, and ankle receive arterial blood from the popliteal artery and its associated branches. A complete understanding of normal anatomy is crucial to the treatment of vascular disease. In the posterior region of the proximal tibiofibular joint, the popliteal artery gives off the anterior tibial artery and continues as the tibioperoneal trunk [1]. The anterior tibial artery pierces the interosseous membrane in the region of the inferior border of the popliteus muscle to enter the anterior compartment of the leg. The anterior tibial artery is situated anterior to the interosseous membrane and is bordered medially by the tibialis anterior muscle and laterally by the extensor hallucis longus muscle.","title":"Unilateral Anomalous Origin of Dorsalis Pedis Artery From Peroneal Artery in a Cadaver"}
{"_id":"f3582c05-0c19-5ae5-7fdb-e733eb64f598","text":"Multiple analyses confirmed that superficial BCC was a risk factor for complications and that there was no correlation between complications and other histological diagnoses or age. The histological diagnoses that do not appear in Table 5 were not used due to the low number of cases or because the patients did not present any post-operative complications.","title":"The importance of superficial basal cell carcinoma in a retrospective study of 139 patients who underwent Mohs micrographic surgery in a Brazilian university hospital"}
{"_id":"f35ec3ca-6bd4-a3c8-c37a-01b33bbf15c9","text":"A careful clinical examination as well as palpation for the detection of suspicious regional or distant lymphadenopathies along with a visual inspection for detection of occult mass must be carried out in such patients.","title":"Current Trends in Mucosal Melanomas: An Overview"}
{"_id":"f35ed354-b274-10c5-a0ae-818a365cbf59","text":"The therapeutic management of osteomyelitis is still object of controversy. This study reports the first Italian consensus on the management of uncomplicated AHOM in children of pediatric osteomyelitis, based on expert opinions and a vast literature review.","title":"Italian consensus on the therapeutic management of uncomplicated acute hematogenous osteomyelitis in children"}
{"_id":"f362fac5-28f4-9c1d-ecb6-6f8617e4a9e0","text":"Patients were diagnosed with primary breast cancer by clinical mammography and biopsy. They were examined by a breast surgeon. If conventional breast-conserving surgery was predicted to result in an unfavourable cosmetic outcome, or if mastectomy was the primary recommendation based on tumour size and location rather than for oncological reasons, then the patient was informed of the alternative of oncoplastic breast surgery. Potential candidates for oncoplastic breast surgery were hence referred to a plastic and reconstructive surgeon for additional consultation to assess possible reconstruction methods. If oncoplastic breast surgery was deemed suitable, planning for immediate partial reconstruction and optional contralateral surgery to ensure symmetry ensued.","title":"Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery"}
{"_id":"f3697f71-d2b8-37ac-5177-41a63812abbe","text":"We summarize and modified the conventional treatment algorithm according to Cierny–Mader type for the treatment of PPO following fracture fixation with the clinical experiments. This procedure is simple and shows promising results; however, more clinical evidence is needed to confirm the existing findings and optimize the treatment of PPO following fracture fixation.","title":"Modified algorithm for managing postoperative osteomyelitis following fracture fixation with Cierny-Mader type"}
{"_id":"f36cc4ee-3eb7-292f-dd23-0347e839bd7f","text":"A 54-item online survey to collect quantitative data was conducted by telephone and email using a randomised sample of SLTs in different areas of South Africa.","title":"South African speech-language therapists’ opinion of their training in cleft lip and palate and craniofacial deformities"}
{"_id":"f3745972-56a5-6d2e-30d3-bff69a88be05","text":"The real-time data accrued by the DystoniaDiary app could lead to the development of a complete and comprehensive scale that could both classify the condition and accurately rate response to treatment.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"f374fbde-3ed2-f277-b5e1-0241a304eacf","text":"This study followed the tenets of the Declaration of Helsinki for research involving human subjects, informed consent was obtained from all participants, and the study was critically reviewed and approved by the institutional review board of Shanghai Jiao Tong University School of Medicine.","title":"Characteristics of Chinese Costal Cartilage and Costa Calcification Using Dual-Energy Computed Tomography Imaging"}
{"_id":"f37b2f41-b026-52e0-0d35-a3bf4b6b2c54","text":"The timely restoration of skin protective functions is the key to the successful treatment of burn victims with various severity of damaged skin. Conventionally, autologous split or full-thickness skin graft have been recognised as the best definitive burn wound coverage, but it is constrained by the limited available sources, especially in major burns. Donor site morbidities in term of additional wounds and scarring are also of concern of the autograft application.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"f389389d-395e-c747-db07-cc71dba99152","text":"Three measurements were made on scanned plaster models cast from the impressions:","title":"A Comparative Analysis of Post-Retraction Changes in Gingival Height after Conventional and Surgical Gingival Displacement: Rotary Curettage, Diode and Er:YAG Laser Troughing"}
{"_id":"f3923477-6d65-7cf5-1cbc-2ff7aa9c142e","text":"The SLN or SLNs are defined as the first lymph node or first lymph nodes to which cancer cells are most likely to drain from the site of the primary tumor. A SLN mapping and biopsy procedure is performed with the use of an agent which is injected into the tissues with the area of the primary tumor and which passively travels through the lymphatic channel draining from the area of the primary tumor and ultimately is taken up by the SLN or SLNs [19]. Resultantly, the SLN mapping and biopsy procedure will allow for the accurate identification, removal, and examination of the lymph nodes which are most likely to contain cancer cell which have lymphatically metastasized from the primary tumor site. If no lymph node metastases are found, patients can avoid unnecessary radical surgical removal of the contents of entire regional lymph node basins, and avoid the subsequent development of adverse long-term side effects, such as chronic pain and lymphedema.","title":"A Wearable Goggle Navigation System for Dual-Mode Optical and Ultrasound Localization of Suspicious Lesions: Validation Studies Using Tissue-Simulating Phantoms and an Ex Vivo Human Breast Tissue Model"}
{"_id":"f39c7470-bd0d-8831-3da8-19b053586373","text":"Eligible patients will be recruited at undisturbed consultations and patients will not be contacted about the study prior to this appointment. Patients are recruited either during their follow-up course after skin melanoma treatment where a metastasis to the groin area can be identified clinically, by ultrasonography or PET-CT scan and a subsequent biopsy will confirm the diagnosis. The patient may also present with metastatic disease in the groin at initial consultation. ILND will only be offered, if there is no evidence of disease elsewhere and all such patients will be discussed at a multi-disciplinary team meeting according to national guidelines. Completion lymph node dissection for micrometastatic disease diagnosed with sentinel node biopsy is by 2018 no longer performed routinely in Denmark [16].","title":"Prevention of seroma following inguinal lymph node dissection with prophylactic, incisional, negative-pressure wound therapy (SEROMA trial): study protocol for a randomized controlled trial"}
{"_id":"f3a36433-a3f6-b132-6d03-210e51185773","text":"In general, lateral chest wall flaps have a number of distinct advantages including preservation of the underlying latissimus muscle which can still be used if needed in the future, a relatively well concealed scar, the avoidance of a contralateral balancing procedure, the ability to perform the resection and reconstruction in the same position. In the case of mastectomy reconstruction, free flaps and standard alloplastic techniques are effective but severely resource or material intensive. The ability to use a local flap when appropriate can alleviate some of these resource pressures.","title":"The Versatility of Lateral Chest Wall Perforator Flaps in Immediate and Delayed Breast Reconstruction: Retrospective Study of Clinical Experience with 26 Patients La polyvalence des lambeaux latéraux perforants de la paroi thoracique dans la reconstruction immédiate et différée du sein : étude rétrospective d’une expérience clinique avec 26 patientes"}
{"_id":"f3afbfc7-5311-a902-785b-d7d80db6ecb5","text":"Surgical excisional biopsy is accepted as the standard of care approach in the diagnosis of lymphomas. Financial issues related to the increased cost and the invasive nature of the procedure forced physicians to use some alternative diagnostic methods. Percutaneous core needle biopsy, which gained a reputation for the diagnosis of lymphomas with the advent of improved pathological, immunohistochemical, and molecular analysis, made it possible to have an accurate diagnosis with limited tissue samples. In this retrospective study, we aimed to compare the diagnostic yield of surgical excisional biopsy and core needle biopsy.","title":"Should Core Needle Lymph Node Biopsy be a Relevant Alternative to Surgical Excisional Biopsy in Diagnostic Work Up of Lymphomas?"}
{"_id":"f3b205a1-685c-64b0-087a-8bf278c03d9b","text":"Clitoral reconstruction for women with FGM was first described by Thabet and Thabet in 2003. This technique involves release of local tissue adhesions to the clitoris, then cutting the suspensory ligament and pulling the remaining clitoris forward. The suspensory ligament is then reattached in a more posterior position. This procedure essentially exposes the remaining clitoral body.","title":"The Role of Plastic Surgeons in Female Genital Mutilation Reconstructive Surgery"}
{"_id":"f3b5e881-6af8-118b-46cb-0c330497f388","text":"A total of 4 patients were excluded from the second analysis in the SLN metastasis group, including one with missing information and three without further cALND. Based on whether nSLN metastases were detected, 20 of all eligible patients were divided into the metastatic group and the remaining 77 patients were divided into the non-metastatic group.","title":"Axillary management for early invasive breast cancer patients: Who will truly benefit?"}
{"_id":"f3bc6774-aa2b-e43c-3b5d-8d98773cb401","text":"Currently little is known about the financial burden which osteomyelitis places on the NHS or the healthcare utilisation associated with its management. Whilst determining accurate cost data is difficult and outside the scope of this paper, this study aimed to determine whether a specialist centre can deliver improved clinical outcomes and reduced healthcare utilisation for patients treated surgically for osteomyelitis, as assessed using hard endpoint measures.","title":"A retrospective cohort study comparing clinical outcomes and healthcare resource utilisation in patients undergoing surgery for osteomyelitis in England: a case for reorganising orthopaedic infection services"}
{"_id":"f3bf6e13-ff2c-4f5e-e588-67f04e77077a","text":"Nevertheless, 1 to 2 years after surgery, none of our patients showed clinical signs of arterial or venous graft failure following the endoscopic or open harvesting. It seems that endothelial damage caused by a single short-term manipulation does not necessarily have a severe impact on the development of atherosclerosis. It is known that atherosclerosis does not always occur at the endarterectomy site, where the entire intima and media are removed. Our results showed that the loss of endothelial cells during any surgical procedure is not necessarily relevant for the outcome of the graft.","title":"Endothelial loss during the surgical procedure in saphenous veins harvested by open and endoscopic techniques in coronary artery bypass surgery"}
{"_id":"f3ccdb42-1b26-a224-8f60-e560315e1c29","text":"Tumoral calcinosis is an uncommon and benign condition characterized by the presence of large calcific soft tissue deposits occurring predominantly in a periarticular location. It generally occurs as a complication of renal dialysis or trauma, and is rarely seen in familial and sporadic cases. Bone scintigraphy is a sensitive method for diagnosing tumoral calcinosis. A 28-year-old female patient with a history of operation due to tumoral calcinosis located bilateral hips, referred to our department. She had a tender palpable mass in the right knee and a fistulized incisional scar overlying the bilateral hip joints. A sporadic case of tumoral calcinosis with relapses was presented.","title":"Tc-MDP bone scintigraphy in a case with sporodical tumoral calcinosis"}
{"_id":"f3d27b06-bc78-acde-a3c5-4c5eee0d1515","text":"The difference between injectable fillers of the polylactide class and others is that, in addition to directly stimulating collagen production, it also takes some time to slowly come to mind, most appropriate for those who feel that a sudden change will be too noticeable and hope for gradual improvement and that the cosmetic filling effect can be maintained for more than two years. In this study, the 13 weeks listed foreign body reaction of control samples was more vigorous than the test samples, the 52-week one was more vigorous, and the listed foreign body reaction of control samples was smooth. This indicates that the new injectable filler has a longer degradation time and a slower appearance of a vigorous foreign body response, stimulating collagen production slightly later. With the progress of tissue repairing, the matrix metalloproteinase 9 positive expression gradually increased, and the increased positive expression of test samples in the 52-week was evident. In contrast, the change in positive expression in the marketed control samples was not significant, which also illustrated the problem of the extended maintenance time of the cosmetic filling effect.","title":"Mechanism of remodeling and local effects in vivo of a new injectable cosmetic filler"}
{"_id":"f3d57026-ec89-aab2-6e75-9c4ff181a2f7","text":"After ethical approval from ethical committee of hospital this quasi experimental study was planned from 01 Jan 2017 to 31 Dec 2017. All the patients suffering from diabetic foot ulcer for more than 02 weeks and having MRSA positive strain were included. Patients suffering from sepsis, osteomyelitis, allergic to vancomycin and those who did not gave written informed consent were excluded from the study. The data was collected by non-probability convenient sampling technique. The patients were treated at first with saline dressings and debridement twice weekly for first three weeks then the same wound was treated with vancomycin impregnated dressing for next three weeks.11,12 Thus patients served as their own controls. Vancomycin dressing was made by mixing 500mg of injection in 5 ml Saline and spraying it on dry gauze placed in wound. The patients were not given any parenteral or oral antibiotics.","title":"Effects of topical Vancomycin Dressing on Methicillin-Resistant Staphylococcus Aureus (MRSA) positive diabetic foot ulcers"}
{"_id":"f3d69c14-3af6-b16e-145d-59c9b153fd67","text":"Our present and previous results published from this trial do not support an advantage of using an acellular dermal matrix in IBBR. Immediate IBBR with ADM did not yield fewer reoperations compared with conventional IBBR without ADM, nor was IBBR with ADM superior in terms of HRQoL or patient-reported cosmetic outcomes. Patients treated for breast cancer contemplating ADM-supported IBBR should be informed about the lack of evidence validating ADM’s suggested benefits.","title":"Effect of Immediate Implant-Based Breast Reconstruction After Mastectomy With and Without Acellular Dermal Matrix Among Women With Breast Cancer A Randomized Clinical Trial Immediate Implant-Based Breast Reconstruction After Mastectomy Using Acellular Dermal Matrix"}
{"_id":"f3d85daf-0cf3-34c2-9d85-6e627ebfbb90","text":"Margins of at least 2 mm are associated with a reduced risk of IBTR relative to narrower negative margin widths in patients receiving WBRT. The routine practice of obtaining negative margin widths wider than 2 mm is not supported by the evidence.","title":"Society of Surgical Oncology–American Society for Radiation Oncology–American Society of Clinical Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Ductal Carcinoma In Situ"}
{"_id":"f3e4ae73-11a3-7c0e-a8e6-0fe276b82499","text":"A weakness of this study is that immunohistochemistry was not used for collagen typing, predominantly because of the expense of doing this form of testing. We refer to research that suggests MTC and PSR stains are sufficient for qualitative testing of collagen content and typing [15] but acknowledge that immunohistochemistry would be required to make any quantitative assessment of collagen fibre typing. As there was significant variability in proportions of collagen types and elastin fibers across the floor of mouth in every individual, it was felt that any attempt to quantify could also be confounded by a potential sampling error. As our study was of small numbers and the tissue was attained from cadavers over 50 years of age, we were insufficiently powered to determine the presence of any gender or age-related changes occurring in fascial thickness that have been suggested in other studies [16].","title":"Understanding the Lingual Frenulum: Histological Structure, Tissue Composition, and Implications for Tongue Tie Surgery"}
{"_id":"f3e6e9a6-8778-50ee-9504-73f1764472bb","text":"Even though the variety of dosages of the antibiotics used gives a broader insight into the effectiveness of the treatment, using concentrations multiple times higher than can be expected to be achieved in the bone could render findings less meaningful. The different antibiotic concentrations used can be related to the experimental approach employed, with some studies based on the actual measured MIC in vitro, while others chose the concentrations based on the maximum plasma\/serum or bone concentrations observed in vivo. Ideally, both factors need to be considered. Using a concentration of antibiotic that cannot be achieved in the bone does not lead to results relevant for treating osteomyelitis, and using concentrations that are lower than the MIC are unlikely to establish an effective treatment and are more likely to induce adverse effects, for example, phenotypic adaptation, antibiotic resistance, autophagy or an adverse immune response. It is postulated that a concentration 4-fold higher than the MIC should be reached in infected tissue to maximize the chance of an effective treatment and minimize the risk of unintended antibiotic effects. Consequently, we advocate using antibiotic concentrations in a model that are at least 4-fold the MIC and lower than the maximal bone concentration.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"f3ea0c9a-121d-507d-9758-239f64dc5d32","text":"In addition, other potential prognostic factor as mitotic rate could not be incorporated in our analysis due to lack of complete data.","title":"The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)"}
{"_id":"f3ecbd35-d7a0-ee15-6370-fc516699678a","text":"In conclusion, there is no clearly agreed upon definition of ankyloglossia and none of the published scoring systems have been rigorously validated. The traditional thinking that the lingual frenulum is a cord of connective tissue tethering the tongue to the floor of the mouth appears to be incorrect; the frenulum is a fold of fascia in continuity from the floor of the mouth to the bottom of the tongue and it contains motor and sensory branches of the lingual nerve and as a result there is no clear anatomic basis for a “posterior” tongue tie, a view shared by some members of the American Society of Pediatric Otolaryngology (41).","title":"What is tongue-tie and does it interfere with breast-feeding? – a brief review"}
{"_id":"f3ed42f6-781d-fcc6-45d9-8c0fc966629d","text":"The aim of this study was to examine the clinical characteristics of RA patients who underwent cervical spine surgery using a multicenter observational database. Our hypothesis is that RA patients requiring cervical spine surgery have a higher disease activity than those who do not undergo surgical treatment.","title":"Clinical characteristics of rheumatoid arthritis patients undergoing cervical spine surgery: an analysis of National Database of Rheumatic Diseases in Japan"}
{"_id":"f3fa538b-e958-f4aa-d461-d77817ebb78d","text":"A monocentric retrospective study was conducted over a period of 19 years between February 2000 and November 2019 at the oncology department of Salah Azaïz Institute. Our study concerns 30 patients with desmoid tumor. All data regarding patients were obtained from the medical record.","title":"The Management of Desmoid Tumors: A Retrospective Study of 30 Cases"}
{"_id":"f40d1132-fc27-a262-4eff-133f5a490091","text":"In the present study, the MRI contrast agent gadobutrol was utilized as CSF tracer and detected in cervical lymph nodes in 19 patients. It should be noted that a relative MRI signal increase in tissue at interest, even though when induced by presence of contrast agent cannot be used to quantify contrast agent concentrations at this stage. We estimated contrast enhancement in the largest, deep cervical lymph node available for measurement and with a length diameter of at least 15 mm. A threshold of 15 mm was selected to avoid partial volume effects and provide robust measurements. We aimed at exploring contrast enrichment in cervical lymph nodes on a phenomenological basis, since smaller lymph nodes are more susceptible to measurement error.","title":"Magnetic resonance imaging provides evidence of glymphatic drainage from human brain to cervical lymph nodes"}
{"_id":"f411d28a-ba24-94a9-2774-33e48a54e7e6","text":"In summary, this case highlights the need for multiple deep tissue samples with appropriate culture to identify unusual causative organisms in chronic deep tissue infections. This is the first case of C. cadaveris osteomyelitis in the literature, identified only after suitable culture technique was employed. Identification of the causative pathogen enabled targeted antibiotic therapy which contributed to the overall successful outcome.","title":"Clostridium cadaveris Osteomyelitis: an Unusual Pathogen which Highlights the Importance of Deep Tissue Sampling in Chronic Osteomyelitis"}
{"_id":"f4154689-6623-39e4-faea-e6bbd43e6800","text":"Desmoid tumors are benign but locally aggressive tumors of mesenchymal origin which are poorly circumscribed, infiltrate the surrounding tissue, lack a true capsule and are composed of abundant collagen. History of trauma to the site of tumor origin is elicited in up to 1 in 4 cases and they most commonly develop in the anterior abdominal wall and shoulder girdle but they can arise in any skeletal muscle. The clinical behavior and natural history of desmoid tumors are unpredictable and management is difficult with many issues remaining controversial, mainly regarding early detection, the role, type and timing of surgery and the value of non-operative therapies.","title":"A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report"}
{"_id":"f419fb55-4645-4978-6c65-b56595a7c500","text":"The case described illustrates the importance of the hybrid approach in a scenario in which endovascular techniques were unfeasible and open surgery had resulted in complications. The combination of several endovascular techniques with open surgery enabled resolution of a complex case and a favorable patient outcome.","title":"Hybrid treatment for lower limb revascularization in a patient with vascular graft infection: a case report"}
{"_id":"f41bb9a9-8e54-635e-fb8d-c3a9f0ebe556","text":"The aim of this paper is to describe our experience of the use of myocutaneous flaps and combination of them with reconstructive plates for covering large defects.","title":"Cancer patients with large defects. Reconstructional options: A case study"}
{"_id":"f430bace-58de-4ada-ade4-33df5bf2eb60","text":"All sites discussed in this article are excellent options for the removal of autogenous bone grafts for the reconstruction of defects and for the bone resorption of the jaws. The choice of the site will depend on the type of defect.","title":"Evaluation of bone availability for grafts in different donor sites, through computed tomography"}
{"_id":"f4313598-d80f-ec3a-a3ba-640be9f9a9bb","text":"A high serum concentration of infliximab is expected to be maintained for a short period after infliximab administration, and it may be safer in terms of preventing uveitis in patients with BD. In the present event, our patient had received botulinum toxin injections more than 7 weeks after the last systemic infusion of infliximab. On the previous occasion, he fortunately received botulinum toxin injections just 2 weeks after infliximab administration, and thus we speculate he did not experience botulinum toxin-induced uveitis.","title":"Botulinum toxin-induced acute anterior uveitis in a patient with Behçet’s disease under infliximab treatment: a case report"}
{"_id":"f43914d7-bba9-5477-b86f-3d93a0ae9505","text":"In accordance with this study, further randomized studies with greater samples are essential to understand the efficacy of a lingual frenectomy in pediatric OSAS.","title":"The Efficacy of Lingual Laser Frenectomy in Pediatric OSAS: A Randomized Double-Blinded and Controlled Clinical Study"}
{"_id":"f44518f9-731c-0a04-fa7c-a5c6159bddbf","text":"Time from the emergency department to the initial operative encounter","title":"Circumferential Negative Pressure Wound Therapy with Instillation and Dwell Prior to Delayed Flap Coverage for a Type IIIB Open Tibia Fracture"}
{"_id":"f445e526-e1c1-a8b0-f667-7868d2d3d4a5","text":"Ethical approval was obtained from the relevant ethics review board prior to commencement, and the study was performed in accordance with the pertinent ethical guidelines.","title":"Bone transport through an induced membrane in the management of tibial bone defects resulting from chronic osteomyelitis"}
{"_id":"f446c4ff-1a8b-d890-5c97-0db6f18160f3","text":"Lymphatic stasis caused by venous hypertension leads to inflammation of the vein wall by inducing degeneration of adipocytes at that site. This inflammation causes proliferation of medial smooth muscle cells and excessive production of fibrous matter, leading to hyperplasia, which in turn reduces the elastic compliance of the venous wall. Therefore, structural deterioration of the microlymphatic network might contribute to venous insufficiency. Furthermore, it has been suggested that sustained inflammation could lead to apoptosis of the lymphatic vasculature. The functions of the venous and lymphatic systems are closely related, so it is thought that many vascular disorders are not simply diseases of the venous system or lymph ducts and that if the function of one declines, then the other will also be affected. Consequently, a vicious cycle develops between lymphatic stasis and venous insufficiency. The dynamics of the venous and lymphatic systems may interact as an inseparable and mutually dependent dual outflow system in the tissues; the mechanism is complex and homeostasis can be maintained between the two systems. Venous treatment modalities including surgery, such as stripping, may be useful for breaking the vicious cycle between lymphatic stasis and venous insufficiency.","title":"Lymphatic flow restoration after stripping surgery for varicose veins: A case report"}
{"_id":"f4508ff8-0222-d5f8-8f78-ffc5e30f0727","text":"Placing antibiotics directly into the site of infection carries several advantages over systemic administration. It can provide significantly higher concentrations to infected tissue with reduced systemic exposure. This may lower rates of antibiotic-associated adverse events and decrease antimicrobial resistance through preservation of the gastrointestinal microbiome.","title":"Local Antibiotic Delivery Options in Prosthetic Joint Infection"}
{"_id":"f4510c63-6890-407c-bdfb-ec0732230dc7","text":"The next step is the reduction of the posterior wall. The principle is the same as that in the associated posterior column and posterior wall fractures. Traction through the femoral head assures that all of the debris is out of the joint. Marginally impacted fragments are realigned to the intact femoral head by releasing the traction and using osteotomes and bone graft. Lag screws may help maintain the reduction. A 3.5 mm reconstruction plate is then placed on the medial border of the posterior column, from the sciatic buttress to the ischium, and is fixed with 3.5 mm screws. A spring plate (Figure 2) may be applied in fractures with multiple fragments and small fragments that locate close to the acetabular rim. It is very important to contour the posterior plate precisely to avoid both the anterior gapping of the column and the lack of a buttress of the posterior wall when applying the posterior plate. To avoid avascular necrosis, the posterior wall fragments must not be detached from the capsule. Intraoperative fluoroscopy in multiple views should be used to ensure that all screws are safely placed. An additional lag screw can be placed from the superior aspect of the plate across the transverse fracture line for additional fixation (Figure 9).","title":"Safe surgical technique for associated acetabular fractures"}
{"_id":"f4570c2a-914a-29b7-58e7-5b30d7b71a53","text":"The aim of this study is to evaluate the rate of local recurrence of extra-abdominal desmoid tumor and compare the outcomes of surgical treatment with those of conservative treatment.","title":"EXTRA-ABDOMINAL DESMOID TUMOR: LOCAL RECURRENCE AND TREATMENT OPTIONS"}
{"_id":"f45887c7-9c70-3c6b-0611-63766133f35b","text":"Patients with axillae with no lymph node metastasis of breast cancer and with lymphadenopathy on imaging in the axilla on the side administered with COVID-19 vaccine were assigned to the vaccine group. The metastasis group included patients with axillae with lymph node metastasis of breast cancer and with lymphadenopathy on imaging in the axilla on the side that was not administered with COVID-19 vaccine.","title":"The location of unilateral axillary lymphadenopathy after COVID-19 vaccination compared with that of metastasis from breast cancer without vaccination"}
{"_id":"f458db91-0fab-f161-f780-0e2d9b4c8627","text":"Contextualizing these most recent data on shortening the duration of DAPT in the perioperative period, Holcomb et al. demonstrated that the risk of complications following noncardiac surgeries is significantly reduced from the 6th month of PCI with DES. The authors analyzed more than 20,000 cases of noncardiac surgeries after coronary PCI, with approximately half of them with DES. Notably, they also introduced another important concept of interventional treatment of acute coronary disease in the perioperative period. When PCI was performed in the context of MI even after one year, the risk of thrombotic complications is still greater than in cases where PCI was performed electively.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"f459ee43-e8b4-c14e-39c2-ee37d0e160a9","text":"Table 1 Patient characteristics for all patients and for patients diagnosed with VTE and those with no VTE during the ICU stay","title":"Point of care ultrasound screening for deep vein thrombosis in critically ill COVID-19 patients, an observational study"}
{"_id":"f45ba2d0-78d3-2ffd-f130-36e5a9f63996","text":"Some participants mentioned that comparing their situation to others who may be worse off helped them to accept as said by this participant:","title":"Beyond the scars: a qualitative study on the experiences of mastectomy among young women with breast cancer in a country with crisis"}
{"_id":"f4612ae0-c67c-9460-4ef5-8f9a1c4d82e1","text":"Desmoid tumors are rare, benign fibroblastic tumors that are locally infiltrative and can cause extensive morbidity by destruction of adjacent vital structures. Due to the rarity of these tumors, evidence regarding optimal treatment protocols is drawn from case reports and single-arm series with small patient numbers. We report a case of a patient with a desmoid tumor of the left supraclavicular region that was diagnosed and treated in our department and a review of the current literature.","title":"Desmoid tumor of the supraclavicular region: a case report"}
{"_id":"f4675f97-3cef-49fb-8a3c-e11e651fde5c","text":"In conclusion, intraosseous infusion is an effective alternative if IV access is not readily attainable for adults requiring urgent parenteral access for initial resuscitation. We reported here a potentially limb threatening acute tibial contiguous-focus osteomyelitis three months after intraosseous catheter insertion. One has to keep in mind that adverse events with low incidence rate can be easily underestimated. Thus, we believe that it is important to continue to report long-term infectious complications of this unusual infusion procedure as they are difficult to capture by conventional clinical trials.","title":"Acute Tibial osteomyelitis caused by intraosseous access during initial resuscitation: a case report and literature review"}
{"_id":"f4726cab-f5d3-a332-130b-ba06c5394f2b","text":"Many knee reconstructions are possible through the gastrocnemius muscle flap alone, but its role is limited in patients with insufficient volume. In this case, a free flap can be a better option, but there are cases where it is impossible. The author reconstructed the defect in a short time using the gastrocnemius muscle and skin island separately and using a supplementary flap in a patient who could not perform the free flap. The method shown in this case could be considered a way to reconstruct the knee in limited circumstances.","title":"Reconstruction of complex knee wounds with a distally based gracilis flap and gastrocnemius myocutaneous flap: A case report"}
{"_id":"f4811db3-9ef4-c006-89fa-648710ed8df6","text":"QOL scores in Indian women did not differ significantly between MRM and BCT in the long term. Both options are acceptable in the study setting.","title":"Is quality of life after mastectomy comparable to that after breast conservation surgery? A 5-year follow up study from Mumbai, India"}
{"_id":"f481e174-6edd-d470-9ef4-b72b0cd0d2e3","text":"Children with symptoms of allergic diseases are usually managed by primary care pediatricians and general practitioners, although the available data are reported only by a limited number of studies. Our findings on prevalence, levels and patterns of sensitization will be discussed in the light of the epidemiological data available so far.","title":"Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation"}
{"_id":"f494629f-2735-6266-f17a-5c14b4438f41","text":"Details of other MRI signs of PJIs are shown in Tables 2 and 3.","title":"Diagnostic value of magnetic resonance imaging for patients with periprosthetic joint infection: a systematic review"}
{"_id":"f49757e3-a33c-97ee-9994-a91bf07f6e0c","text":"This survey captures the current experience of British Ophthalmologists and Oculoplastic Surgeons in the management of visual vascular complication with dermal fillers. This may relate to the rarity of this complication. Although there is an awareness of visual loss as a complication from aesthetic dermal fillers, there appears to be a lack of knowledge of current management guidelines across Eye Specialists in UK. It is important for practitioners to be able to recognise and manage vascular compromise and further study recommendations are made.","title":"Awareness of management of hyaluronic acid induced visual loss: A British National Survey"}
{"_id":"f49e840a-806a-cd3d-5924-77a733c9eff0","text":"This study identified a potential association with repetitive panfacial filler injections and outcomes following facelift surgery, although the exact effect on postoperative outcomes remains unclear. Large prospectively designed studies are needed to capture objective data comparing facelift patients with a history of repetitive panfacial fillers with those facelift patients who have never had injectables. Given the results of The Aesthetic Society members’ survey, the authors encourage careful history-taking to elicit an accurate filler injection record including complications after filler injections, as well as engaging patients in a thorough preoperative discussion regarding the potential of panfacial fillers on the facelift procedure and postoperative outcomes.","title":"Potential Effects of Repetitive Panfacial Filler Injections on Facelift Surgery and Surgical Outcomes: Survey Results of the Members of The Aesthetic Society"}
{"_id":"f4a9ffc9-7503-ef56-e48b-54bab47f59ed","text":"Composite tissue defects with deep infection continue to be one of the most intractable challenges for orthopedic and plastic surgeons. The reconstruction procedures should not only provide reliable soft tissue coverage and bone length maintenance but should also potentially prevent recurrent infections.","title":"Simultaneous reconstruction of septic composite defects in lower extremities: Combination of fasciocutaneous perforator flap and Masquelet technique"}
{"_id":"f4aaaf82-db89-810f-c50e-d4e050c1c3e3","text":"Two transverse planes are imaged of the femoral TRs and condyles.","title":"Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings"}
{"_id":"f4b104c8-7da5-c5a9-4bef-45bc0c7fba24","text":"The ACS also embraced active participation and engagement of the future leaders in American surgery by actively recruiting and empowering the resident members and young surgeons in the College. Separate governance structures and committees allow these young surgeons to craft programming pertinent to their interests, to bring their new ideas and concepts forward to the ACS’ governing bodies, and to provide dynamic outreach to medical students and the young surgeon community [6].","title":"Surgical leadership in changing times: the American College of Surgeons perspective"}
{"_id":"f4b333aa-068e-235a-accb-de8d87f642d9","text":"The data of patients were saved in Excel Software program. The results were organized in an appropriate table and figures in numbers and percentages and reviewed by statistician.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"f4b6c23e-6079-ee2b-3f94-136a91e8a4ba","text":"The old Freestyle was excised, and the old saphenous vein interposition graft to the left coronary was detached from it. The annulus was then rimmed with mattress sutures which were passed through the base of a Valsalva graft then a magna pericardial valve. The valve and graft were lowered, and the sutures tied in and cut. The old vein graft to the left coronary could not be directly implanted, so a segment of autologous saphenous vein was interposed. The distal end of the Valsalva graft was grafted to the ascending aorta, and the right coronary artery was anastomosed to the Valsalva.","title":"Loeys-Dietz Syndrome Complicated by Right Coronary Artery Pseudoaneurysm"}
{"_id":"f4c1097a-26b3-fabb-984b-fe89e83cc7e7","text":"Relevant animal models are valuable tools for obtaining knowledge on the interplay between host and pathogen. Accordingly, animal models have enabled detailed descriptions of disposing factors, infectious agents and host response to infection. There are obvious limitations when comparing murine to humane wound healing and regeneration. Mice heal with predominantly contraction in a looser attached skin with higher hair density and thinner dermis versus the humane granulation healing. There are also significant differences in the immune response, with more neutrophils in the humane circulating blood versus a higher number of lymphocytes in mouse blood in addition to substantial differences with regards to the antimicrobial peptides. Despite this, mice represent a generally accepted experimental animal of choice.","title":"Immune Responses to Pseudomonas aeruginosa Biofilm Infections"}
{"_id":"f4c3cb44-67f7-b23f-ff0e-948bb361f8d6","text":"The appearance of bilateral peripheral corneal infiltrates after SMILE is an uncommon benign complication, with Type I hypersensitivity being the probable cause. Patients prone to hypersensitivities are at a higher risk of developing these corneal infiltrates. When patients with a history of allergy who aim to perform corneal refractive surgery, surgeons must consider possible hypersensitivity reactions after treatment. More studies are needed to clarify the relationship between contact glass used in femtosecond laser corneal refractive surgery and IgE mediated hypersensitivity reactions.","title":"Hypersensitivity reactions after femtosecond laser small incision lenticule extraction: a case report of corneal infiltrates"}
{"_id":"f4c41517-7636-0728-786e-2e45223f8bfb","text":"Authors have propounded that since soft tissue and intraosseous lesions are histologically indistinguishable and since in the maxilla and mandible, origin in bone or soft tissue is uncertain, the term desmoplastic should not be used in the area of head and neck but all the lesions should be termed desmoid fibromatosis.[6]","title":"Aggressive fibromatosis of anterior maxilla"}
{"_id":"f4c54758-845a-6ade-5478-a34aaa2b9185","text":"The second risk was the potential for the development of pressure ulcers on the tibial stump because of lost muscle coverage. The management of stumps has been improved with recent silicon liners. The sleeve-like structure lined with silicone inside can reduce friction between skin and socket while maintaining an excellent suspension action.4 In this case, deep pressure ulcers were prevented by maintaining the skin perception around the stump. We first considered covering the tibia with sufficient soft tissue such as a free latissimus dorsi flap or a reverse anterolateral thigh flap.5,6 However, these flaps would have resulted in the loss of skin perception of stump and the development of deep ulcers.","title":"The Functional Benefits of Preserving the Proximal Lower Leg Even in Total Necrosis of the Lower-Leg Muscles"}
{"_id":"f4c5b6e9-ed71-0429-8d25-7744bcc2c3f6","text":"Patients were transferred to radiotherapy ward, 30 to 90 minutes after operation and the catheter was connected to the machine to receive radiation in less than 30 min. Total dose was 12 Gy that was delivered in 3 divided fractions on days 0, 1 and 2 after surgery and then the catheter was removed.","title":"Outcomes of Surgical Excision and Brachytherapy in Intractable Keloids"}
{"_id":"f4c884e5-b7f5-278a-918f-b5abb6101843","text":"It is clear that the LETBs reflect the Government’s ambition that they are very much service provider led. Education providers, the local universities and medical schools are also entitled to serve on the board [14] although this does not appear to be the case in all LETBs. It is the healthcare service providers who are therefore chiefly responsible for educating and training doctors, dentists, nurses and all other allied healthcare professionals at a local level in England and now take the lead in the planning and development of the local workforce.","title":"Health Education England, Local Education and Training Boards (LETBs) and reform of healthcare education: implications for surgical training"}
{"_id":"f4cf23b7-3718-0267-c57e-b45545a2133e","text":"A 2 cm longitudinal incision was made above the medial malleolus. The long saphenous vein was identified and cleared of all adventitial and connective tissue using sharp dissection. The distal end of vein was tied. The proximal part was also tied and about 6–8 cms of thread was left with that end. The vein was then divided between the two tied ends. The end with a thread was passed through the ring in the Mayo vein stripper and forward pressure was applied to the vein stripper in the direction of usual vein anatomy while applying traction on the vein through the length of thread. Whenever resistance was felt on the vein stripper, a small incision (2 to 3 cm) at the area where resistance was felt was made. With a combination of sharp and blunt dissection any branch of the saphenous vein at that site was isolated and ligated using a 4\/0 ethibond ligature on the vein side and a metal clip on the patient side. The same process was repeated with multiple short incisions until the required length of vein was obtained. The skin incisions were closed with skin staples and full-length pressure dressing applied.","title":"Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest"}
{"_id":"f4d0cc94-20ca-80f3-4702-061fd5c80de6","text":"Administer in a setting where the appropriate medications and equipment are available to respond to an episode of anaphylaxis;","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"f4d6b78d-8711-c252-826d-98a709e7ffd2","text":"Subjects that withdraw after the 6 week study visit will not be replaced with new subjects.","title":"Dietary supplementation with Bifidobacterium longum subsp. infantis (B. infantis) in healthy breastfed infants: study protocol for a randomised controlled trial"}
{"_id":"f4da5f91-4336-a6ad-f1e7-0f261d30113d","text":"The feasibility phase of the study will specifically inform and test the recruitment rate for the main trial as well as assess the acceptability of the process of consent. Recruitment will take place in five trial centres over a period of 6 months for the feasibility phase. The expected rate of recruitment is based on recent audit data from two of the centres (Oxford and Coventry). In these centres, an average of four eligible patients are admitted with an open fracture to the lower limb every month. All centres involved in the trial will be Major Trauma Centres or Trauma Units with similar catchment areas as the five initial sites. During the main phase of the trial, trial site recruitment of the remaining sites will occur over a period of 8 months. Recruitment in these sites will take place over a period of 27 months to reach the target of a minimum of 460 patients.","title":"Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb: UK Wound management of Open Lower Limb Fractures (UK WOLFF)"}
{"_id":"f4e53b44-2bdc-ec21-c6a8-83b5e9cf8bd9","text":"A potential weakness of our study is that the analyses were carried out in three different melanoma cohorts from the United Kingdom and Spain. The fact that the three centers had slightly different inclusion criteria for entry into the respective melanoma cohort with only the United Kingdom study being population‐based, whereas Valencia and Barcelona were retrospective studies from large melanoma secondary and tertiary referral centers were addressed at least, in part, by adjusting for all melanoma prognostic factors. The distribution of these prognostic factors proved to be very similar between the three centers with slightly thicker tumors in Spain, owing to the inclusion criteria, as patients being offered only SLN biopsy were included in the Spanish melanoma cohorts. The differences regarding the recommendations for SLN biopsy in the three different centers were also a weakness with United Kingdom having a very low rate of SLN biopsy. However, we adjusted for the source of the cohort. Furthermore, as there is no evidence that having SLN biopsy affects survival, the differences in SLNB practices between UK and Spain are unlikely to have been an issue for the survival analyses.30 There is no reason to speculate that nevus counts may be altering the decision of a clinician to offer sentinel node biopsy or the patient to accept the procedure apart from age.","title":"High nevus counts confer a favorable prognosis in melanoma patients Ribero et al."}
{"_id":"f4e6dc55-849a-a4dc-8e69-f6263709b304","text":"Björk and Palling [8] found that during the earlier teenage years, growth of the mandible exceeds that of the maxilla resulting in straightening of the profile and retroclination of the lower incisors which may be one of the reasons for the increase in lower arch crowding at that time.","title":"Age Changes of Jaws and Soft Tissue Profile"}
{"_id":"f4f54d6a-930e-ee21-8e3a-34ba91bc7e78","text":"Vertebral osteomyelitis is an uncommon complication of infective endocarditis with the organism Streptococcus viridans being a rare cause of the condition. This case highlights an unusual presentation of Streptococcus viridans associated with infective endocarditis and pyogenic osteomyelitis in a patient following a dental procedure.","title":"Streptococcus viridans osteomyelitis and endocarditis following dental treatment: a case report"}
{"_id":"f4f6b172-be0d-9977-4232-5040b7eb53ae","text":"Major reconstructive surgery for oncological resection and traumatic injury can sometimes be prolonged and may be associated with tissue swelling and edema. This can prevent tension-free wound closure and may require split thickness skin graft to cover the raw areas. The use of GPA as illustrated in our cases provides a means of wound cover until the swelling has settled and the wound edges can be secondarily sutured or can be partially closed with a skin graft. Several advantages are gained by using GPA in this setting; it can ensure a complete take of a skin graft with better wound bed preparation, it minimizes the use of skin grafts, and it gives better aesthetic outcome. These were well illustrated in all of our cases.","title":"The versatility of a glycerol-preserved skin allograft as an adjunctive treatment to free flap reconstruction"}
{"_id":"f50350b1-9f0b-c4f1-3370-ee364a0ee9e7","text":"The average time to union following RIA bone grafting was six months in our series. While the success rate was considerable, the duration of treatment and time within the frame should be communicated to the patients and their families in order to mitigate expectations. Furthermore, despite the growing evidence in favor of RIA ABG, patients should be counseled on the associated complications unique to this technique including fracture through the long-bone harvest site.","title":"Bone grafting via reamer-irrigator-aspirator for nonunion of open Gustilo-Anderson type III tibial fractures treated with multiplanar external fixator"}
{"_id":"f508d408-47c0-feb1-3e9c-2ada6927a87a","text":"In recent years, NPWT has become an accepted option for managing and treating trauma cases.1 It is also beginning to be appreciated more widely both in open fractures of the lower extremity and in both high- and low-energy trauma wounds because of its ability to handle high volumes of exudate and provide a closed wound environment.","title":"Advanced Wound Therapies in the Management of Severe Military Lower Limb Trauma: A New Perspective"}
{"_id":"f50be34d-5057-2111-6980-0ffa02a62cbe","text":"The data acquired during the trial will be kept strictly confidential and only be accessible by members of the research group. Personal information of patients will not be released and their personal privacy will be protected.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"f51b6403-be26-a972-71fa-63d8dfcd6db0","text":"First purpose of this trial was to investigate, if repetitive clamping of the femoral artery results in repetitive decrease of leg tissue rSO2. Repetitive decrease of leg tissue rSO2 was regarded as a prerequisite of effective ischemic preconditioning of the lower limb in patients with occlusive arterial disease. Hence, we used NIRS to investigate the primary hypothesis that repetitive clamping of the femoral artery results in effective ischemic preconditioning of the lower limb in patients with occlusive arterial disease. Effective ischemic preconditioning was defined as two cycles of a statistically and clinically significant decrease and increase of tissue oxygen saturation measured by NIRS.","title":"Effect of ischemic and pharmacological preconditioning of lower limb muscle tissue on tissue oxygenation measured by near-infrared spectroscopy – a pilot study"}
{"_id":"f51d0d6d-b345-ac76-6244-b3781f2a1343","text":"The most common complications of the surgical treatment of open fractures of the tibial shaft in multitrauma patients with locked intramedullary nail were union disturbances and infections.","title":"Management of open fractures of the tibial shaft in multiple trauma"}
{"_id":"f525d16c-ab22-f9ec-71ba-2c94f7836b89","text":"Implications for D&I Research: Further understanding of how facilitation enables practice improvement in different settings and the multilevel organizational factors driving PF adaptations will enhance the design and evaluation of strategies for improving adoption of evidence-based practices in the wide range of primary care practice settings in the US.","title":"Proceedings from the 10th Annual Conference on the Science of Dissemination and Implementation"}
{"_id":"f526429c-3b14-fab2-8af5-55c705989068","text":"A survey was disseminated to members of the Survey of Key Informants’ Patients Program from 2021 to 2022 and distributed to patients 18 years or older newly entering one of 68 substance use disorder treatment programs across the USA with a primary diagnosis of an opioid use disorder. Participants were surveyed about practices when preparing and using drugs, along with self-reported infections and drug use complications.","title":"Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder"}
{"_id":"f528f1fb-8ff9-1ec6-bd19-5e437041484e","text":"A 49-year-old Caucasian female shop assistant visited a dental technician to have her teeth cleaned and polished. One week after her visit to the dentist she began to develop severe pain in her lower back. The patient initially saw her general practitioner who initially thought the back pain was mechanical in nature and referred her to an osteopath. However, over the next two months after seeing the dentist the back discomfort worsened and the patient also began to develop paraesthesia over her right thigh. As a result she was admitted to Accident and Emergency department for further assessment of her symptoms.","title":"Streptococcus viridans osteomyelitis and endocarditis following dental treatment: a case report"}
{"_id":"f52d819c-1a28-b076-aa3c-6256ec7c2549","text":"Deep dead space may be thought as an independent risk factor of the poor infection control after flap reconstruction in complex limb wounds. But it can be easily neglected. The conventional skin flap and musculocutaneous flap are difficult to obliterate the deep dead space in irregular shape effectively. It was investigated that the clinical application of chimeric anterolateral thigh perforator flap in the treatment of complex wounds complicated with deep dead space of the extremities in the paper.","title":"A neglected problem in the utilization of free anterolateral thigh flap toward reconstructing complicated wounds of extremities: the obliteration of deep dead space"}
{"_id":"f537b950-210d-69a1-1720-521487f6d40c","text":"In summary, we have shown that the apoptosis mechanism is impaired in the β-catenin S45F mutated cells. We have also shown that RUNX3 plays a role in the inhibition of apoptosis found in these β-catenin S45F mutants and that restoration of RUNX3 overcomes this inhibition in the S45F mutants via the caspase pathway. Although the regulatory effect of RUNX3 on β-catenin is already known, our results suggest that there may be a previously not described regulatory feedback loop between CTNNB1 S45F mutation and downregulated expression of RUNX3. Further investigation are needed to better understand the mechanisms underlying this possible feedback loop.","title":"β-catenin S45F mutation results in apoptotic resistance"}
{"_id":"f53e6651-471f-73b3-7f47-24a328a54d0c","text":"to correlate the tumor burden in the SLN with the mortality of patients undergoing SLN biopsy.","title":"Evaluation of tumor load in sentinel lymph node in patients with cutaneous melanoma Avaliação da carga do tumor em linfonodo sentinela nos doentes portadores de melanoma cutâneo"}
{"_id":"f5409c2e-30f8-22a1-6f4b-f174b64cf1d8","text":"In conclusion, transconjunctival injection of BTA in the lacrimal gland showed favourable outcomes for epiphora without permanent complications. It is a simple and minimally invasive technique performed in the office. Repeated injections had consistent efficacy and duration of effect. BTA injections can be repeated for symptomatic epiphora as an alternative to complex surgery such as CDCR, especially in older patients whose lacrimal gland can be easily exposed.","title":"Repeated injections of botulinum toxin-A for epiphora in lacrimal drainage disorders: qualitative and quantitative assessment"}
{"_id":"f540fda5-916b-ac79-6557-cdde9981be75","text":"All patients are assessed at a preoperative anaesthetic assessment clinic approximately one month before surgery. They are admitted one day before surgery and seen by the senior author. A handheld Doppler probe is used to map potential perforators. We do not employ the routine use of CT-angiography. Preoperative low molecular weight heparin is not given and tamoxifen is not stopped prior to surgery.","title":"Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients"}
{"_id":"f5424f82-a307-ab99-96bb-2119c82df8da","text":"There was a statistically significant difference between the CRF patient group and the control group in the frequency of myringosclerosis.","title":"Myringosclerosis in patients with chronic renal failure: comparative analysis with a control group"}
{"_id":"f543d17d-1fbd-8811-48f9-51a31a9a20a5","text":"The treatment began through undertaking breastfeeding sessions, in order to correct nursing posture and improve latching on to breast. At the same time, work with a specialist in orofacial rehabilitation was done involving the stimulation of sucking and rooting reflexes and the carrying out of intraoral and extraoral exercises.","title":"Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn: Breastfeeding Sessions, Myofunctional Therapy, and Frenotomy"}
{"_id":"f544fe6d-8abe-764a-4b00-d0ba2df50645","text":"Another critical site that easily colonized by bacteria and difficult to reach for decontamination is the fixture-abutment interface, in this regard do Nascimento et al 11 demonstrated how the application of iodoform paste in the fixture-abutment connection has a decisive role in preventing bacterial colonization.","title":"Electrolytic Cleaning and Regenerative Therapy of Peri-implantitis in the Esthetic Area: A Case Report"}
{"_id":"f54daf42-8952-5a5f-d440-39f83c033b57","text":"Since there are only two studies that have reported the efficacy of fosfomycin against intracellular S. aureus, further studies are required to establish its utility as a treatment option for osteomyelitis.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"f55bcd1d-a02e-edd1-4cab-55d74858b02f","text":"for scalp defects wider than100 cm2, the best tool of reconstruction is free flaps. Pedicled distant flaps are reserved if free flaps are not feasible or failed. Split thickness skin grafts are cosmetically inferior and not suitable for recurrent and irradiated tumours and better reserved for patients who cannot tolerate major operations.","title":"Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?"}
{"_id":"f55c4d82-58fe-75e0-8d18-11e8c7525d7a","text":"Prostate and colorectal cancers are often treated with pelvic radiation therapy and while many measures are taken to spare normal tissue from radiation exposure there is often some exposure to surrounding tissues that can lead to radiation-induced chronic side-effects. Currently there is no cure for radiation-induced fibrosis. It is still largely unknown why certain individuals develop radiation-induced fibrosis while others have almost no complications. We and others have shown that radiation can induce fibroblasts to differentiate into myofibroblasts, an activated form with highly contractile properties and that produce and deposit collagen into the extracellular matrix. When these cells remain activated and unchecked the excess collagen accumulates over time which, eventually results in fibrosis and organ dysfunction. However, there are other cell types besides fibroblasts that are exposed to irradiation during external beam therapy for pelvic cancers that could be involved in fibrosis as well.","title":"Adipocytes protect fibroblasts from radiation-induced damage by adiponectin secretion"}
{"_id":"f5623661-11ad-2fd6-f456-fb262a73c9f6","text":"Here we describe the novel application of immediate postoperative NIPPV of a patient with ALS without vascular compromise of midface fibula free flap reconstruction. Key factors to success of the reconstruction included a medial tunnel of the vascular pedicle along the inner aspect of the mandible, as well as use of a full face NIPPV mask with a soft sealing layer which did not place direct pressure on the midface reconstruction.","title":"Immediate postoperative non‐invasive positive pressure ventilation following midface microvascular free flap reconstruction"}
{"_id":"f569d03c-1109-7585-693b-3c22d8d10d39","text":"Our findings revealed that RA patients requiring cervical spine surgery tend to have a higher disease activity than control subjects. Our results also indicate that conducting a meticulous evaluation of cervical lesions is therefore required, particularly in patients with a high disease activity in spite of the intensive use of biologics.","title":"Clinical characteristics of rheumatoid arthritis patients undergoing cervical spine surgery: an analysis of National Database of Rheumatic Diseases in Japan"}
{"_id":"f56af4c0-9c08-27f8-06dd-b751ddbcdcd3","text":"Chondrocyte spheroids were generated from 14 donors, and implanted into a subchondral cartilage defect that was manually generated in human articular cartilage tissue. Implanted spheroids and cartilage tissue were co-cultured ex vivo for 12 weeks to allow regeneration processes to form new tissue within the cartilage defect. Before implantation, spheroid characteristics like glycosaminoglycan production and gene and protein expression of chondrogenic markers were assessed for each donor sample and compared to determine donor-dependent variation.","title":"An ex vivo human cartilage repair model to evaluate the potency of a cartilage cell transplant"}
{"_id":"f56fc642-5656-589b-f30d-f5364fbb5b26","text":"The repair of defect after severe trauma with extended soft tissue loss over anterior aspect of upper and middle third of leg is challenging because of the paucity of available local options for large defect. Available options like cross leg flap cover and free flap, are both poles apart, with cross leg flap being an age-old method while free flap still lacks available expertise. Despite severe trauma over anterior aspect of leg, the posterior region of leg is usually spared and thus, gastrocnemius myocutaneous flap is an excellent and versatile option available for a large defect because of its reliable anatomy and vigorous blood supply.,","title":"Gastrocnemius Myocutaneous Flap: A Versatile Option to Cover the Defect of Upper and Middle Third Leg"}
{"_id":"f570633d-b9a2-f9cb-d1f1-f644bc973858","text":"The remaining 13 patients who underwent secondary surgery required relatively simple procedures; surgery was at the resection site in nine cases and the donor site in four. Resection site procedures included closure of wound dehiscences, skin edge debridements, and open drainage of collections. Donor site complications were typically mild. Three patients had simple wound dehiscences that were debrided and resutured and one patient had a hematoma that was evacuated and closed over a surgical drain.","title":"Preoperative Radiotherapy and Wide Resection for Soft Tissue Sarcomas: Achieving a Low Rate of Major Wound Complications with the Use of Flaps. Results of a Single Surgical Team"}
{"_id":"f5707727-e6bf-1ecb-6521-d4cbcd1de970","text":"Full weight bearing was allowed 2 weeks after healing of the fistula.","title":"Distally based sural fasciomusculocutaneous flap for treatment of wounds of the distal third of the leg and ankle with exposed internal hardware"}
{"_id":"f5709c79-b840-ee1b-733f-702afeedda31","text":"Ultrasound guidance reduces the dosage of local anesthetic drugs to be used and provides surgical anesthesia without any complications or adverse effects.","title":"Minimum Effective Volume of 0.75% Ropivacaine for Ultrasound-Guided Axillary Brachial Plexus Block"}
{"_id":"f573e8ac-0b54-8ee3-700b-08dbb9c1cba1","text":"This research set out to establish the prevalence of DVT among patients who underwent major abdominal surgery at a tertiary hospital in sub-Saharan Africa.","title":"Deep venous thrombosis after major abdominal surgery in a Ugandan hospital: a prospective study"}
{"_id":"f57406ff-6c6c-4d01-80cc-12b938a9b111","text":"This preliminary case series report shows that autologous hair can serve as a thread for repairing skin wounds. We described our meticulous approach to using this delicate tissue for epidermal suturing. The aesthetic outcomes of using autologous hair as a suturing thread for facial wounds were excellent, and most of the patients expressed satisfaction. Hair-based thread is also low cost, meaning that it is suitable in settings characterized by facility and equipment limitations due to economic circumstances. It may also be useful for the battlefield or exceptional periods as in mass casualty.","title":"Dermatologic Microsutures Using Human Hair: A Useful Technique in Cutaneous Stitching Al azrak and Ogawa"}
{"_id":"f5778061-b601-9c4a-e4c1-5b68a4134eff","text":"We describe our case of successful treatment of a substantial osseus and soft tissue defect of the forearm caused by septic nonunion. We used bone transportation and lengthening techniques and after 13.5 months we managed to restore the defect and achieve union. After ensuring the eradication of the infection, we used tendon transfer principles to restore the function of the hand.","title":"Combined Bone Transportation and Lengthening Techniques for the Treatment of Septic Nonunion of the Forearm Followed by Tendon Transfer"}
{"_id":"f57eae6c-8623-23e8-e72e-024b023fd87f","text":"Figure 7 demonstrates the clear increase in bone definition in the pelvis with xSPECT\/CT compared with SPECT. In the fused image the posterior sacroiliac joints are noted to be abnormal in configuration with secondary degenerative changes on the CT and demonstrate abnormal tracer uptake on xSPECT\/CT but only equivocal changes on SPECT.","title":"The clinical value of xSPECT\/CT Bone versus SPECT\/CT. A prospective comparison of 200 scans"}
{"_id":"f57f6fb5-3212-6af1-8e63-cca2ed1c172c","text":"Metal plate exposure treatments that occur after distal tibial fractures that have been treated with the MIPO procedure can be successfully treated with a retrograde superficial sural artery flap, and it is believed that more successful flap survival can be achieved by applying several surgical techniques during the flap.","title":"Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap"}
{"_id":"f589c731-41b7-89bc-598e-55311941a900","text":"During the abdominal phase the posterior and lateral resection margins are identified and dissected as distal as possible to join with the perineal dissection later on in the procedure. Subsequently, the pubic symphysis and superior pubic rami are exposed to the level of transection depending on whether a partial or complete pubic bone excision is planned. In a complete bone excision, the anterior abdominal wall is elevated from the pubic symphysis and superior pubic rami and the iliac and femoral vessels and nerve are mobilized away from the line of the bony transection. In case no pubic bone excision is required, the anterior dissection plane through the space of Retzius is proceeded posterior to the pubic symphysis but stops above the inferior aspect of the pubic symphysis.","title":"Understanding the Philosophy, Anatomy, and Surgery of the Extra-TME Plane of Locally Advanced and Locally Recurrent Rectal Cancer; Single Institution Experience with International Benchmarking"}
{"_id":"f58add5a-b2cb-d33f-6cac-5db1d346e7d2","text":"Within the limits of the present study, it is possible to conclude that the duration of surgery and not the flap design might influence the acute postoperative symptoms and signs after lower third molar extraction.","title":"Effect of flap design and duration of surgery on acute postoperative symptoms and signs after extraction of lower third molars: A randomized prospective study"}
{"_id":"f58e7b4a-e92e-3c2b-2466-60ec0cf2acdd","text":"These skin substitutes which act temporarily like skin, have the advantages of being relatively abundant in supply and not expensive. While the synthetic skin substitutes can be synthesised on demand and can be modulated for specific purposes with increased control over scaffold composition, the biological skin substitutes have a more intact and native ECM structure which may allow the construction of a more natural new dermis. They also allow excellent re-epithelialisation characteristics due to the presence of a basement membrane. However, natural constructs can exhibit problems with slow vascularisation of the material. The most widely used biological substitute worldwide are cadaveric skin allograft, porcine skin xenograft and amnion.","title":"Biologic and synthetic skin substitutes: An overview"}
{"_id":"f599a4a2-4ac8-130b-17db-6d0ae151e334","text":"Our results suggest that brachytherapy is a viable option for certain cases of head and neck cancers in previously irradiated areas. Specifically, our data indicate that brachytherapy may be better suited for mucosal disease than neck disease, particularly in patients with known ENE who have especially poor outcomes. Future directions for research include prospective data collection on dosing, toxicities, and outcomes associated with brachytherapy for head and neck cancers in previously radiated areas.","title":"Permanent Interstitial Brachytherapy for Previously Irradiated Head and Neck Cancer"}
{"_id":"f59a3cd6-b5db-48c4-7bc8-8c5ee8dc3ff6","text":"For genitourinary tumors, a consensus meeting of the Association of Urological Oncology of the German Cancer Society acknowledged the lack of firm data, and recommended follow‐up scans every 8 weeks in treatment of metastatic renal cell carcinoma, after every cycle of therapy for patients with urothelial cancers receiving potentially toxic chemotherapy, every 12 weeks for prostate cancer, and after two cycle of chemotherapy and again after completion of chemotherapy for nonseminoma testicular cancer.6","title":"Optimal frequency of scans for patients on cancer therapies: A population kinetics assessment"}
{"_id":"f5a00328-d89c-2858-b1b0-7908f8b6aaa2","text":"Another finding of this study was that the occurrence rate of acute allergic reactions did not differ after the first and second doses of vaccination. In addition, the occurrence of acute allergic reactions did not show age dependency, whereas it was significantly higher in women than in men. Women have been known to suffer from higher rates of adverse drug responses, including allergic reactions, than men, which has been mainly explained from the aspect of pharmacokinetics or pharmacodynamics. The present study demonstrated that intramuscular injection of an mRNA vaccine also causes higher rates of acute allergic reactions in women than in men. This fact may suggest that females are predisposed to dysregulated immune response upon the first-time administration of drugs, as suggested by the higher prevalence of autoimmunity in women than in men. To be noted, the reported rate of acute allergic reaction was significantly lower than that of approximately 2% as previously reported in the United States. This discrepancy between the countries implies that the rate of acute allergic reactions with mRNA vaccines may differ with countries and ethnicities.","title":"Reports of acute adverse events in mRNA COVID-19 vaccine recipients after the first and second doses in Japan"}
{"_id":"f5a0559a-3f82-c929-1b47-15c7e1e0c3c5","text":"Barbed sutures are one of a number of technologies that have been adopted by plastic surgeons to improve the efficiency of incision closure. As the use of such devices increases, it is important that their efficacy and safety be evaluated for each procedure and application. In this study, we have demonstrated excellent outcomes with absorbable unidirectional barbed sutures for repair of abdominal fascial defects in DIEP flap breast reconstruction.","title":"Early Experience With Barbed Sutures for Abdominal Closure in Deep Inferior Epigastric Perforator Flap Breast Reconstruction"}
{"_id":"f5ab8a3f-60d7-ba39-2d39-96145eb9a5c2","text":"Surgical management used to be radical, which resulted in a high incidence of postoperative complications. The current study uses a dual dye technique that uses methylene blue dye for identifying sentinel nodes and fluorescent dye to trace lymphatics draining the arm.","title":"Evaluation of Axilla With Sentinel Lymph Node Biopsy (Using Methylene-Blue) and Reverse Axillary Mapping (Using Fluorescein) to Validate Optimum and Safe Axillary Dissection in Breast Cancer"}
{"_id":"f5af9206-e24a-f3c2-17d5-2dba186fcc98","text":"Skin plays a vital role in defending the body against external stimulus of various nature, considering also the fact that skin is the largest and most accessible organ of the integumentary system, it appears to be a promising field for research on stem cells and their role in the maintenance of compartments homeostasis and regeneration [6].","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"f5b5bc4f-6326-32b0-86e5-3d1facc37ae6","text":"There is still some controversy concerning the performance of routine contralateral inguinofemoral lymphadenectomy in patients with lateral vulvar cancers and positive ipsilateral inguinal nodes. Isolated reports have indicated that contralateral inguinal lymph node metastases can occur in these patients. However, the frequency of contralateral spread in these patients is extremely low, and the risk of contralateral inguinal lymphadenectomy may outweigh its benefits, particularly if only a small number of ipsilateral nodes are positive.","title":"Selective Inguinal Lymphadenectomy in the Treatment of Invasive Squamous Cell Carcinoma of the Vulva"}
{"_id":"f5b9a4d8-8ed3-6adb-1c76-4ba258206eab","text":"Those physicians with more clinical experience in diagnosing and managing CNO were more confident in their abilities caring for these patients than those with less clinical experience caring for patients with CNO. However, the years of practice did not affect the confidence level.","title":"Physicians' Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis"}
{"_id":"f5c71bbc-5667-08db-56fb-dcb33a550cb8","text":"Data on the optimal antibiotic therapy to administer after bone resection of foot amputation in these patients are lacking. Current guidelines recommend treating with antibiotics for up to 6 weeks if the culture demonstrates pathogen(s) or if the histology demonstrates osteomyelitis 1.","title":"Surgical techniques for Bone Biopsy in Diabetic Foot Infection, and association between results and treatment duration"}
{"_id":"f5ca4ae4-6961-6aa5-70d0-91925b68425c","text":"The initiation of appropriate therapy with anticoagulants is as important as prompt and accurate diagnosis to decrease the incidence of potentially fatal complications.","title":"Deep vein thrombosis and pulmonary embolism – Prevention, management, and anaesthetic considerations"}
{"_id":"f5cce05c-a005-2a09-5f9d-c15ca70be917","text":"To assess the benefit of MSP in high-risk patients before a melanoma diagnosis, this study will compare Breslow thickness of the primary melanoma at trial entry and biopsy rates prior to diagnosis between participants who were under at least annual surveillance:","title":"Study protocol for a randomised controlled trial to evaluate the use of melanoma surveillance photography to the Improve early detection of MelanomA in ultra-hiGh and high-risk patiEnts (the IMAGE trial)"}
{"_id":"f5ceb7d7-7033-c456-2dac-daeca7085c6b","text":"Formal ethical approval was unnecessary because the analysis employed routinely collected non-patient identifiable data. The use of these data for research purposes has been approved by the Privacy Advisory Committee to the Board of NHS National Services Scotland.","title":"Second primary cancer risk - the impact of applying different definitions of multiple primaries: results from a retrospective population-based cancer registry study"}
{"_id":"f5d46278-9975-ac12-0da8-23be1f577074","text":"In our department we have considerable experience with the unilateral pectoralis major muscle advancement flap, which has been used to cover most of the sternal defects that have presented to our reconstructive surgical team. To the best of our knowledge, there are relatively few reports that focus solely on this surgical approach.","title":"Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap"}
{"_id":"f5d4a765-07dc-5ad2-bcc5-99a26f242d0a","text":"Chemotherapy and radiation therapy before surgery are associated with the risk of postoperative complications. There is a lack of data on patient satisfaction and the results of the aesthetic appearance of reconstructive breasts, which are results of special interest to plastic surgeons and patients.","title":"Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients"}
{"_id":"f5dfba3e-fa2a-2949-a72d-c41a63bb33c9","text":"The lactating breast produces milk of a complex composition that is tailored for the optimal growth and development of the term infant [1], yet the knowledge regarding pathology and treatment of the lactating breast is limited compared to that of the non-lactating breast. Ultrasound imaging provides a non-invasive method of investigating the breast during lactation and this paper will review ultrasound techniques used during lactation along with normal and abnormal appearances of the lactating breast.","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"f5f8e375-f48c-421d-903d-058a7a88e79a","text":"She was subsequently transferred to the intensive care unit and was commenced on heparin infusion. She had a second cardiac arrest in the intensive care unit with pulseless electrical activity and was resuscitated successfully and continued with heparin, as she was unstable for surgical intervention at the time.","title":"Missed Massive Pulmonary Embolism and the Hidden Threat of a Distal Deep Vein Thrombosis"}
{"_id":"f5fdd1a1-138a-4606-606a-25d57974288d","text":"3D virtual and printing models played a crucial role in our case, as the surgical team used these models for 1 year during pre-operative meetings to obtain important information on anatomical details and to discuss different interventional strategies. Both 3D printing and Virtual 3D Modeling had an important role in the understanding of complex anatomy and in the joint surgical discussion of the clinical case. The 3D printed rib cage model was very useful to all members of the surgical team for a better understanding of the CT radiological images. Above all, the 3D reconstructed bone model was able to highlight the geometry of the fused sternal arc, which is uncommon to see in routine clinical practice. This information was certainly visible in the conventional radiological images, but the reciprocal position of the patients’ rib cages was better represented with the use of 3D printed models.","title":"Advanced 3D “Modeling” and “Printing” for the Surgical Planning of a Successful Case of Thoraco-Omphalopagus Conjoined Twins Separation"}
{"_id":"f600e495-9e5c-69f6-8846-bd499644a116","text":"AA is able to passively distribute itself across membranes [18,19] and therefore its transcutaneous absorption is directly influenced by the pH of the environment and the pKa of the molecule. It is known that the ionization of a molecule influences its diffusion, because cell membranes have a greater permeability towards its non-ionized form than the less fat-soluble ionized one. Generally, an acid vehicle improves the absorption of molecules with acid characteristics in the undissociated state and the concentration gradients determined by ion trapping can theoretically be very large if the difference in pH between the compartments considered is large. The difference in pH between the compartments plays a role in the absorption of drugs and in the case of acid topical formulations, the difference with the pH of the skin could determine a further contribution for its passage through the stratum corneum.","title":"Topical L-Ascorbic Acid Formulation for a Better Management of Non-Melanoma Skin Cancer: Perspective for Treatment Strategies"}
{"_id":"f600fbdc-96ca-f8ca-233f-834b8855ecd3","text":"It has been saliently noted that clinical studies of fillers differ in a number of respects from everyday dermatological practice. This reflects the limitations of clinical trials whose efficacy end points must be selected to show effects of a single product. In everyday clinical practice, sustained perioral correction may be more volume-efficient because dermal fillers can be combined with botulinum toxin treatment.","title":"Efficacy and Safety of a New Resilient Hyaluronic Acid Filler in the Correction of Moderate-to-Severe Dynamic Perioral Rhytides: A 52-Week Prospective, Multicenter, Controlled, Randomized, Evaluator-Blinded Study"}
{"_id":"f602d824-f718-8ba9-5a60-f33e71a084fa","text":"Rather than taking the negative of this value as was done by Łuksza et al., we have left this value as a positive and will refer to it as the fitness cost. The greater the fitness cost, the more immune recognition and immune-mediated destruction we predict for the tumor. We have chosen to look at both the average and the maximum fitness cost for the neoantigens in each tumor to avoid presupposing that the single strongest neoantigen is of sole importance in the tumor recognizability.","title":"Neoantigen Fitness Model Predicts Lower Immune Recognition of Cutaneous Squamous Cell Carcinomas Than Actinic Keratoses"}
{"_id":"f608cfd5-8d4a-4eb9-20ce-eb11dec4f599","text":"In summary, ultrasound is a versatile tool for manipulating biological systems and continues to find novel applications in the fabrication of biomaterials for regenerative medicine applications. Ultrasound has the capacity to induce several distinct effects within biological systems, including heating, fluid streaming, and microbubble cavitation. Numerous ultrasound-based techniques that have the capacity to manipulate biomaterials have emerged in recent years. These include the use of ultrasound to modify the conformation and organization of fibrillar ECM proteins either directly or indirectly, as well as innovative strategies to use ultrasound to enhance cellular activities within engineered scaffolds. The convergence of these developments with an evolving understanding of the role of ECM during tissue repair represents a significant opportunity to harness ultrasound as a non-invasive methodology for fabricating ECM-based scaffolds with enhanced complexity and regenerative capacity.","title":"Using Acoustic Fields to Fabricate ECM-Based Biomaterials for Regenerative Medicine Applications"}
{"_id":"f60ad998-40bf-f359-bb62-268c0bb4501d","text":"Immediate breast reconstruction after mastectomy can improve the quality of life for women with breast cancer and rates are increasing. Long-term inpatient costs of care were estimated to understand the impact of different immediate breast reconstruction procedures on healthcare expenditure.","title":"Secondary healthcare costs after mastectomy and immediate breast reconstruction for women with breast cancer in England: population-based cohort study"}
{"_id":"f60f1afd-5e6a-2e39-9c7d-74b19066c23e","text":"Our purpose was to examine the rate and risk factors for pseudarthrosis in the pediatric cervical spine. We hypothesized that uninstrumented fusions and fusions involving the occiput would have a significantly higher rate of pseudarthrosis.","title":"Rate and risk factors for pediatric cervical spine fusion pseudarthrosis: opportunity for improvement"}
{"_id":"f6134676-1868-7c1a-10e4-84e564c72ca4","text":"While effective at treating superficial, low-risk malignancies, cryosurgery is more often used to treat actinic keratoses—a premalignant lesion associated with squamous cell carcinoma.","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"f616090c-81e7-41eb-59a1-cb6d75b3407c","text":"One patient with milk sensitization did not display clinical signs of milk allergy and became skin prick test negative after one year. This behavior is typical of the natural history of milk and egg allergy in children [30, 31]. We observed early local reactions after injection of immunotherapy in some patients, but they occurred only during the first applications and none of our patients withdrew from the study or required hospitalization because severe adverse reactions with immunotherapy.","title":"Clinical and Immunological Changes of Immunotherapy in Patients with Atopic Dermatitis: Randomized Controlled Trial"}
{"_id":"f617c0a8-5d04-ac65-fa7f-3cc8234d29a6","text":"Should any unfavorable outcome be encountered as regards the viability of the transplanted skin, it is to be replaced by autologous split thickness graft which is the eventual end point for these patients if left untreated until development of malignancy.","title":"Living related hemi-face skin transplant using radial forearm free flap for a xeroderma pigmentosa patient: early outcome"}
{"_id":"f61c0aaa-1ee8-4d89-4244-667a017fbaf7","text":"There was generally poor agreement between the individual assessors about the scoring of the six approaches using the 12 criteria. However, there was general agreement that none of these six prominent approaches to grading the levels of evidence and strength of recommendations adequately addressed all of the important concepts and dimensions that we thought should be considered. Although we limited our appraisal to six systems all of the additional approaches to grading levels of evidence and strength of recommendations that we identified were, in essence, variations of the six approaches that we had critically appraised. Therefore we are confident that we did not miss any important grading systems available at the time when these assessments were undertaken.","title":"Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches The GRADE Working Group"}
{"_id":"f61e5b7e-30f4-9100-2381-18ddb41ac492","text":"Olfactory ensheathing cell is a unique kind of glia cells, which can promote axon growth. Little is known about the differences between olfactory mucosa olfactory ensheathing cells and olfactory bulb olfactory ensheathing cells in the capability to promote nerve regeneration.","title":"Olfactory ensheathing cells in facial nerve regeneration Células embainhantes olfatórias na regeneração do nervo facial"}
{"_id":"f620746f-ed2a-2e22-8096-9facd58db6d8","text":"The compilation of the pros and cons of each of the meniscal allograft preservation methods is shown in Table 1.","title":"Preservation and sterilization methods of the meniscal allografts: literature review"}
{"_id":"f6295330-cde0-c3c1-a7b5-0c089223c89a","text":"Thus, the primary aim was to study the agreement of the SLNB result before NAST with the ALND result after NAST in cN0 breast cancer patients, irrespective of the result of the SLNB upfront. The secondary aim was to evaluate the feasibility and false negative rate of repeat SLNB.","title":"Swedish prospective multicenter trial on the accuracy and clinical relevance of sentinel lymph node biopsy before neoadjuvant systemic therapy in breast cancer"}
{"_id":"f62b39de-6a22-1fb1-5062-f6bd051ad58e","text":"As mentioned previously, an optimized response to light fractionated PDT is dependent on the damage induced by the first light fraction, which is influenced by the choice of irradiance, light dose and the PpIX concentration [25]. This means that any combination with other optimization methods for increasing the response to therapy may have a different optimal treatment scheme. For example, the haem cycle can be modulated to result in more PpIX accumulation. Illumination with the same illumination scheme may than result in too much damage in the first light fraction leading to a different subcellular response that stops the cells to become more vulnerable to a second light fraction.","title":"Light Fractionation Significantly Increases the Efficacy of Photodynamic Therapy Using BF-200 ALA in Normal Mouse Skin"}
{"_id":"f62f74af-5026-be26-3c11-3a5a3010e98f","text":"The study is designed as an exploratory prospective randomized trial with even allocation into all four study groups.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"f63a8eae-10f7-533a-29fe-56406f3a6250","text":"In treatment of lichen planus, surgical management including cryosurgery and carbon dioxide laser has been suggested. Despite this, surgical excision is not recommended as the first choice of treatment due to the inflammatory condition which may recur. The use of topical corticosteroids with other types of desquamative gingival conditions such as erosive lichen planus or cicatricial pemphigoid is common.","title":"Treatment of Desquamative Gingivitis with Free Gingival Graft: A Case Report"}
{"_id":"f63f12ba-dccc-3d28-bfb8-93b9fdfc4839","text":"There are very few reports to date on the proper management of exposed plating systems. Several technical issues with plating systems have been addressed in the literature, mostly in the setting of trauma and orthopedics.3,7 While the complications with plating systems used in orthopedics typically are not due to wound healing in irradiated tissue, the complications incurred with these plating systems can undoubtedly occur in mandibular reconstruction as well. Notably, jammed screws, stripped screw heads and difficultly removing the plate itself are more common than they are reported. These complications lead to significant delays in operating time and damage to surround tissues upon their removal if not carefully executed.6 Therefore, it is necessary to explore all possible options than can be employed for effectively removing plating systems when the first line mechanisms fail or are not available.","title":"CASE REPORT Removal of Exposed Titanium Reconstruction Plate After Mandibular Reconstruction With a Free Fibula Osteocutaneous Flap With Large Surgical Pin Cutters: A Case Report and Literature Review"}
{"_id":"f646091e-7fcf-75da-04de-a9ad84808b74","text":"The results suggested that patients with breast cancer are most concerned about the body image in the immediate postoperative period and problems with the body image decrease after about two years [53,54]. The specificity of the course phases of mourning and the time needed to experience psychological changes associated with the loss of time requires the adaptation (as reported in the literature of at least one to two years) to the new reality after a mastectomy.","title":"Psychological Resilience as a Protective Factor for the Body Image in Post-Mastectomy Women with Breast Cancer"}
{"_id":"f64f7739-78ea-85a7-acd4-401b0c6d37a2","text":"Accurate repair of orbicularis oris is mandatory since this is the muscle which sets the tone to provide a good shape and contour to the commissure. A small triangular skin flap is raised from lower lip and inserted into the commissure, improves the overlapping of the upper and lower lips. Some authors have reported good results from a vermilion square flap commissuroplasty and triangular flaps. Yushimura et al compared 5 children with Z-plasty and 7 with simple line repair. They found less pleasing appearance with Z-plasty. Mahtar et al have supported that reconstruction of the integrity of the oral sphincter associated with W-plasty usually gives the best results.","title":"Bilateral Transverse Facial Cleft as an Isolated and Asyndromic Deformity"}
{"_id":"f6503e18-e0d7-03de-dd1e-a56c3f819f40","text":"This 36-year follow-up in a patient who had major scalp reconstruction using free latissimus dorsi muscle and skin grafting followed by scalp and forehead expansion shows that this method provides an excellent and reliable long-term coverage for such an injury.","title":"36-year Follow-up on Scalp Reconstruction Using Free Latissimus Dorsi Muscle Flap, Skin Grafting, and Scalp Expansion"}
{"_id":"f665f70c-4dd3-e04d-6f59-b557f60b0031","text":"Fat grafting is commonly utilized at the time of the secondary procedure. Fat graft is used to disguise surface contour irregularities, which commonly occur along the perimeter of the flap. In the case of a significant breast asymmetry fat graft is placed diffusely into the breast flap to increase its volume. The abdominal donor site frequently benefits by obtaining the fat graft from areas of excessive fullness.","title":"Optimizing aesthetic outcomes for breast reconstruction in patients with significant macromastia or ptosis"}
{"_id":"f666f695-8e07-11df-c904-eb0f3a0c38b7","text":"The Gleason grading system is the standard staging system and the following rules should be applied:","title":"Summary of the Standards, Options and Recommendations for the management of patients with nonmetastatic prostate cancer (2001)"}
{"_id":"f66911da-86bf-1c14-f89a-5f346be0ffd3","text":"Parents indicated that the information they received from health professionals, health facilities and provided on the radio had moved away from older infant feeding practices, particularly those that encouraged discarding colostrum and introducing additional foods and liquids at an early age. However, the parents taking part in the focus groups were able to identify the three recommended infant feeding practices: putting the infant to the breast within 1 hour of birth; EBF for the first 6 months; and continued breastfeeding with the addition of foods until the age of 2 to 3 years.","title":"Exploring the challenges and opportunities towards optimal breastfeeding in Ethiopia: a formative qualitative study"}
{"_id":"f6737707-0e35-f5a0-13c5-ee839d72b562","text":"In contrast, Mark and Brodsky mentioned shoulder position and mechanical traction of the thoracic muscular and skeletal structures for shoulder pain mechanism. In a 2006 review, Gottschalk et al stated that chronic pain after thoracic surgery could be localized or radicular in nature, and that the pain could be exacerbated by movement of the ipsilateral shoulder. Considering these theories, suprascapular nerve block seems to have a partial role in pain conduction from the shoulder.","title":"Preoperatıve Ultrasound-Guıded Suprascapular Nerve Block for Postthoracotomy Shoulder Paın"}
{"_id":"f674e1fd-ccd1-5cf1-6ea4-104c3b7172aa","text":"The study has several strengths that support the validity of findings and suggest potential for future analyses. First, while there have been surveys of graduating residents [8], to our knowledge data regarding demographics that lead to change in behavior pattern including career plans has not been studied. Second, the survey was structured so that most responses were obtained in the last month of academic cycle 2013 giving junior residents an opportunity to gain experience in plastic surgery prior to responding to the survey. Third, scope of our study including representation from all types and years of training as well as from programs all across US offers a comprehensive national picture of plastic surgery residency training.","title":"A survey of current state of training of plastic surgery residents"}
{"_id":"f6765d83-0bb1-d7b1-db73-defba7d55081","text":"In conclusion, incorporating HA3D imaging technology for the management of patients with gynaecologic surgical pathology is feasible. The adoption of HA3D imaging technology guide the surgeon to better plan the surgery. Difficult to locate uterine myomas may be missed during surgery, in these cases HA3D technology can be a valuable tool for the surgeon. Shorter operating times could result from the application of the HA3D technology. Further studies are needed to evaluate the clinical impact of this promising novel technology.","title":"Incorporating 3D reconstruction in preoperative surgical planning of Multiple Myomectomy"}
{"_id":"f6824883-a533-a54f-77c0-0f40ee2c16c1","text":"This study highlights the high cost burden of CPCSSTI patients. Those patients with predisposing factors or complications tended to have a longer hospital stay.","title":"Complicated Posterior Cervical Skin and Soft Tissue Infections at a Single Referral Center"}
{"_id":"f68891dc-d6a6-28fe-4e7b-1012206f85b8","text":"Therefore, the SCC guidelines should include the assessment of growth in depth as well as the diameter of the tumor during the preoperative assessment.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"f68cf993-0de8-33ff-efa3-c603aeb356de","text":"The inflammatory bone loss associated with osteomyelitis can result from the direct destruction of bone tissue by bacteria and their products. Furthermore, significant bone loss is likely to result from the recruitment and activation of infiltrating leukocytes such as neutrophils and macrophages. The direct activation of these cells by bacteria via an array of cell surface and cytosolic pattern recognition receptors, and the presence of an inflammatory milieu at the site of infection, results in the production of degradative enzymes and cytotoxic molecules. Consistent with host-pathogen interactions at other anatomical sites, the microbes responsible for bone infections can manipulate leukocyte survival pathways in a bacterium specific manner with some organisms inducing apoptosis and\/or pyroptotic cell death, while other organisms appear to promote the survival of innate immune cells, particularly neutrophils. While lengthening the life span of these cells might represent an attempt by the host to clear the infection, the unintended consequence of such a vigorous response can be extensive inflammatory bone destruction.","title":"Apoptosis-associated uncoupling of bone formation and resorption in osteomyelitis"}
{"_id":"f68f7246-4b55-837a-4ef2-24daba6b87ca","text":"The purpose of our study was to investigate the prevalence and risk factors for cervical lesions in patients with RA under current pharmacologic treatment after the approval of biological agents, and to investigate the relationship between osteoporosis and VS development.","title":"Risk factors associated with cervical spine lesions in patients with rheumatoid arthritis: an observational study"}
{"_id":"f697570b-5d0d-ebde-7e82-123cd2bc41fb","text":"Skin cancer is a common type of cancer that emerges from the skin. It is extended due to the development of abnormal growth of cells. These cells can invade other parts of the body. More than 90% of cases occur due to the exposure of UV radiation. The UV radiation wavelength ranges from 100 nm to 400 nm. Cancer occurs due to unrepaired DNA damage to skin cells which is caused mostly due to UV radiation. In melanoma, cancer cells arise from moles on the skin which causes inflammation around the epidermal layer which in turn increases the temperature around it.","title":"Skin cancer detection using non-invasive techniques"}
{"_id":"f699c0e4-e729-9f8c-bd2a-954f19b350b7","text":"The removal of more than 10 LN did not result in a significant survival benefit even in high risk pN + breast cancer patients.","title":"Does the number of removed axillary lymphnodes in high risk breast cancer patients influence the survival?"}
{"_id":"f69d2da0-bbde-6d2e-239c-ac773751c5b6","text":"Figure 3 shows the most important elements of the surgical technique.","title":"Squamous Cell Carcinoma of the Heel Invading the Calcaneus Treated by Radical Excision and Reverse Sural Flap"}
{"_id":"f6a51f82-d6d3-58e4-50a2-7e6816d555e9","text":"A lymphatic SCIP flap procured from the Zone 4 region in DIEP flap breast reconstruction can contribute to the improvement or prevention of lymphedema with no additional donor site.","title":"Simultaneous Lymphatic Superficial Circumflex Iliac Artery Perforator Flap Transfer from the Zone 4 Region in Autologous Breast Reconstruction Using the Deep Inferior Epigastric Artery Perforator Flap: A Proof-of-Concept Study"}
{"_id":"f6aba034-83a8-62b6-740d-235bb71e7014","text":"During the last decades, many groups have tried to analyze successful predictive factors that allow us to establish imaging protocols and surgical indications in the different scenarios lithiasis may be found.","title":"Extracorporeal Shock Wave Lithotripsy and Combined Therapy in Children: Efficacy and Long-Term Results"}
{"_id":"f6b133b0-a575-c0a2-c30b-d7b1ee2b64c5","text":"This case report describes a rare case of desmoid tumor of the anterolateral abdominal wall presented with a large mass of the left flank and iliac fossa. The diagnostic was suspected radiologically following an abdominopelvic computed tomography (CT) and magnetic resonance imaging (MRI). An exploratory laparotomy found a large mass infiltrating the left rectus abdominis muscle, a part of the flat left abdominal muscles, and the left iliac crest. The patient underwent a total resection of the mass involving the left rectus muscle with autoplasty by a pedicled flap of the left LATA fascia with the placement of a bifacial mesh.","title":"Desmoid tumor of the anterolateral abdominal wall: A rare case report"}
{"_id":"f6bdd112-842b-70d0-2a76-bb057bc0eb09","text":"Combined grafting for problematic wounds seems to be a useful technique for cases requiring reconstruction. The potential existence of stem cells may be responsible for the successful result in our patient.","title":"Nanofat grafting under a split-thickness skin graft for problematic wound management"}
{"_id":"f6c76a40-407b-054b-0432-f0f2b27a80cb","text":"Although resurfacing of the penile shaft is most frequently performed using local skin flaps, those patients who have undergone multiple repairs may have a deficiency of local skin for such use. In instances where penile skin is deficient, both split thickness and full thickness skin grafts have been applied for skin coverage.[5051] Principles of skin transfer must be adhered to in order to ensure adequate take of the graft. Scar tissue must be excised and a vascular bed prepared for the graft.","title":"The role of flaps and grafts in modern hypospadiology"}
{"_id":"f6ca9e76-5bfc-1300-7243-f6f0b8d9b8e2","text":"In clinical practice, physicians often prescribe oral Gemifloxacin to patients suffering from lower respiratory tract infections and ask them to return five to seven days later for a checkup after completing treatment. However, the delayed onset of the skin rash means that the physicians may not have been aware of the skin eruption, as it would not yet have occurred at the checkup. The delay onset skin eruption is unique.","title":"Female Asthmatic Patients Have Higher Risk to Develop Gemifloxacin-Associated Skin Rash, Highlighting Unique Delayed Onset Characteristics"}
{"_id":"f6dece5d-1ce0-a9c2-aa72-c83f7d60e5f0","text":"Table 3 Proportion of cases found in each histological grade in the three classification systems studied","title":"Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis"}
{"_id":"f6e74123-c721-e1dc-b914-991f6383a39a","text":"All patients were discharged home on the same day of surgery with prophylactic oral antibiotic and without steroid nasal spray. The first follow up visit was scheduled at 1 week after surgery. At the 3-month visit the DCR tube was removed at the outpatient clinic. For cases who had a recurrence of NLD obstruction, revision surgery was scheduled and the NLD tube was kept in place for at least 6 months postoperatively.","title":"Endoscopic dacryocystorhinostomy: A comparison of double-flap and single-flap techniques"}
{"_id":"f6ec46df-5d29-c5e7-f6ab-1953afa001b2","text":"A large body of literature exists related to PVCS as a cause of CPP and that the initial treatment of choice is OVE. The overwhelming consensus from the systematic reviews that have been undertaken is the need for robust multicentre randomized controlled trails (RCTs).","title":"Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options"}
{"_id":"f6f6cf75-a01c-0b7d-2724-66d4f97368aa","text":"This case series illustrates three patients who developed nodular eruptions shortly after administration of onabotulinum neurotoxin type A (ONA) injections. We have described the clinical presentation and management of this rare side effect, in addition to reviewing the existing literature for reported cases of this rare condition to allow comparison of similarities and differences.","title":"Nodular Eruptions as a Rare Complication of Botulinum Neurotoxin Type-A: Case Series and Review of Literature"}
{"_id":"f70068c2-ccb9-39ea-c071-61565ae66db7","text":"Reports of extraocular extension following treatment with plaque brachytherapy are few and have been attributed to treatment failure with recurrence of the intraocular tumour.","title":"Extrascleral extension of choroidal melanoma after iodine-125 brachytherapy treatment: a case series"}
{"_id":"f702649d-2fbe-8278-6db7-222755e129c6","text":"In the eFTR specimen, the pathologist will assess the presence of reactive changes compatible with scar tissue in the specimen. Definite histopathological confirmation of complete scar resection is known to be difficult and might not always be possible. In case the pathologist is not able to histologically confirm complete scar resection, further treatment will be based on the macroscopic completeness of scar excision and patients will be followed according to protocol.","title":"Long-term oncological outcomes of endoscopic full-thickness resection after previous incomplete resection of low-risk T1 CRC (LOCAL-study): study protocol of a national prospective cohort study"}
{"_id":"f707b820-d787-f0bd-830d-badecc426e7b","text":"The definition of working-practice standards is important in ensuring that institutions are working in a manner that optimizes patient care. The group identified a range of standards that should be applied to OPBS. These standards were defined at both institutional level and at the level of the individual surgeon:","title":"A Position Statement on Optimizing the Role of Oncoplastic Breast Surgery"}
{"_id":"f708b36a-79fe-32dc-a82c-ee585f0df54e","text":"Generally, urologic surgeons prioritize the preservation of as much of the neurovascular bundle as possible to prevent urinary incontinence and erectile dysfunction, thus precluding the execution of a wide surgical excision of periprostatic tissue and risking the occurrence of PSM. Prostate cancer patients of advanced age were less likely to have PSM, indicating that most elderly patients likely underwent radical prostatectomy without nerve sparing, perhaps due to poorer pretreatment sexual function.","title":"Positive Surgical Margins in the 10 Most Common Solid Cancers"}
{"_id":"f70a0d1f-5820-86a9-e724-96212611a03c","text":"For epitrochlear TLND, the lymph node tissue in between the biceps muscle (anterior), triceps muscles (posterior), the intermuscular groove (superior), and brachioradialis\/pronator teres muscles (inferior) is removed. The brachial artery, median nerve, and sensory cutaneous nerves are protected.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"f714d3f4-c7f3-a861-0aaf-f47aced6450d","text":"Unlike in previous studies in which thrombolytic agents were infused into systemic circulation, in the present study, urokinase was injected only into the flap circulation, minimizing the amount absorbed into the body to reduce systemic complications caused by the thrombolytic agent. Furthermore, urokinase injection is an effective method with a relatively high success rate of revision more than 24 hours after free flap surgery.","title":"Safe and effective thrombolysis in free flap salvage: Intra-arterial urokinase infusion"}
{"_id":"f717cd48-41f4-7476-f9b9-1364d1bc79cc","text":"It remains unclear, whether smoking affects microvascular free flap perfusion in the RFFF and ALTF used in head and neck reconstruction, and whether similar flap survival rates in smokers and nonsmokers reconstructed with microvascular free flaps in the head and neck region could be due to unimpaired flap perfusion in smokers.","title":"Smoking and microvascular free flap perfusion in head and neck reconstruction: radial free forearm flaps and anterolateral thigh flaps"}
{"_id":"f71bf44f-44ad-ec63-0e5f-5817fb4e3309","text":"A strict protocol for mobilization of the patients following surgery was observed and all the patients except one patient who had fixation of acetabular fracture were mobilized 48h after surgery. All the patients underwent duplex ultrasonographic assessment of both the lower limbs between the seventh and 14th postoperative day. The Doppler assessment included examination of bilateral common femoral, superficial femoral, popliteal, anterior tibial and posterior tibial veins. They were assessed for flow, visualized thrombus, compressibility and augmentation. A diagnosis of DVT was made where there was visualization of thrombosis, absence of flow, lack of compressibility or lack of augmentation. The thrombus was classified as distal if it involved the calf veins only and as proximal if it involved the popliteal or a more proximal vein. Patients who had both a proximal and a distal thrombus were classified as having proximal thrombosis.","title":"Routine chemoprophylaxis for deep venous thrombosis in Indian patients: Is it really justified?"}
{"_id":"f71c109f-83de-a7fd-0550-3833d8199d9c","text":"Axillary nodal status was assessed by either clearance or sampling; those patients with node involvement had axillary irradiation if block dissection was not performed.","title":"The importance of margins status after breast conservative surgery and radiotherapy in node positive patients: a follow-up of 10–15 years"}
{"_id":"f71f74c0-a362-6954-f821-8615a5a9a67e","text":"Pus swab specimens were obtained deep from discharging sinuses or collected intraoperatively and placed into the Stuart Transport Medium and immediately transported to the laboratory. Care was taken to avoid the skin contamination. The specimens were Gram-stained and cultured on blood Agar Media and MacConkey Agar Media.","title":"Chronic Osteomyelitis - Bacterial Flora, Antibiotic Sensitivity and Treatment Challenges"}
{"_id":"f72255ba-b782-c133-048b-5f46d0c22424","text":"Navigating smoothly through one’s breastfeeding journey means that breastfeeding was experienced in a positive way without any major problems or difficulties. In this theme, breastfeeding was a way to become close with the infant and thus strengthen the relationship between the mother and infant. The mothers experienced a feeling of togetherness with their infants. They described this feeling of togetherness as a mutual interaction and an intimate relationship with the infant. Such mutuality and intimacy was reported to provide a unique closeness and strong bond with the infant.","title":"A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth"}
{"_id":"f7248e92-dcc6-b3d2-5b44-0939756f2569","text":"Methods An archival search of the pathology database was performed to retrieve cases reported as being consistent with cosmetic fillers.","title":"Beauty is only mucosa deep: a retrospective analysis of oral lumps and bumps caused by cosmetic fillers"}
{"_id":"f729d476-02a2-e249-4a80-e58cdccae039","text":"The authors present a case report where a large soft tissue defect of the forearm with exposure of the vital structures was reconstructed by a microsurgical latissimus dorsi flap, followed by hyperbaric oxygen therapy.","title":"Salvage of Upper Limb following a Severe Crushing Trauma: Immediate Reconstruction with a Free Flap and Subsequent Hyperbaric Oxygen Therapy"}
{"_id":"f734b792-813f-f6c1-0679-f707f078a88d","text":"We did not perform MRI examination after arthroscopic knee articular cavity internal drainage of popliteal cyst and cystectomy cyst wall debridement. The main reason is that the arthroscopic knee cavity internal drainage of popliteal cyst is just to enlarge the communication between knee cavity and popliteal cyst. There is still some remnant fluid in the popliteal cyst. But the pressure inside the popliteal cyst will decrease and the symptoms will disappear. Through cystectomy cyst wall debridement, popliteal cyst cavity will disappear gradually through adhesion of medial gastrocnemius tendon and semimembranosus tendon. So there is no need to perform MRI examination postoperatively.","title":"Arthroscopic internal drainage and cystectomy of popliteal cyst in knee osteoarthritis"}
{"_id":"f7366f9d-64b3-96dd-c1a1-6b172cf5183a","text":"The mainstay of treatment for cervical dystonia (CD) is regular botulinum toxin injections every 3-4 months. Clinical evaluation of response is dependent on the patient’s recall of how well symptoms responded to the previous injection. A mobile health app could assist both patients and health care professionals to monitor treatment benefits and side effects to assist with the selection of muscle and toxin dose to be injected at the next visit. The DystoniaDiary is a bespoke electronic health journal for monitoring symptoms of CD and response to treatment.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"f736b6ec-fa62-73c7-e066-7064e2badbc3","text":"This analysis did not show a statistically significant difference in the duration of surgery between the study groups. However, the time of surgery was significantly longer in patients with tumors located in the deep lobe of the parotid gland or a portion of the lobes. A longer time of surgery was not a factor increasing the risk of facial nerve palsy. It is an additional parameter in the most difficult surgical procedures associated with a higher risk of facial nerve injury. Placing and securing electrodes and preparing the device for monitoring do not prolong the procedure duration. It is performed during surgical draping and takes approximately 5 minutes when performed by an experienced team.","title":"Prospective Assessment of Intraoperative Facial Nerve Monitoring in Patients Undergoing Partial Parotidectomy"}
{"_id":"f74708b2-aabf-ce0d-bf8d-49aafdf2b219","text":"We report the favorable outcome of rituximab on severe calcinosis in 4 JDM patients and present their clinical data","title":"Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two Genoa, Italy. 28 September – 01 October 2016"}
{"_id":"f7477851-7365-e3b1-0ac6-d722ba17a02c","text":"In conclusion, this study has extended the translational potential of the these uniquely multifunctional nanoparticles by adding photodynamic therapy as a potential modality without requiring targeting or other modification of the nanoparticle structure or composition. In addition, it is likely that skin photosensitivity reactions that are a complicating factor in clinical PDT practice may be significantly lower with porphysomes than with Photofrin and this is under active investigation.","title":"Porphyrin-lipid nanovesicles (Porphysomes) are effective photosensitizers for photodynamic therapy"}
{"_id":"f748e8da-fcef-fbc1-bc1a-820d9dfc3d73","text":"However, we believe it is necessary to continue the current line of investigation, since it could lead to a radical change in the prevention and prognosis of this type of cancer.","title":"Vitamin D serum levels and non-melanoma skin cancer risk"}
{"_id":"f74a5ea7-6fb8-dec8-1126-c3760a204ac3","text":"In this study, a model of the arterial system was established and the saphenous vein graft was exposed to internal pressure. Perivascular administration of cyanoacrylate onto the saphenous vein graft to prevent vascular injury due to extreme stress in group 1 proved to be protective in vitro.","title":"Administration of perivascular cyanoacrylate for the prevention of cellular damage in saphenous vein grafts: an experimental model"}
{"_id":"f75af318-c0ff-dfe9-8f50-d7774447190f","text":"Identifying the potential for utilisation of D-dimer POC testing will make feasible the identification of those high risk patients within a primary care setting negating the necessity for costly and inconvenient referral elsewhere. Thus people with a first unprovoked proximal DVT or PE could be managed differently to current management with the potential for significant improvements in health outcomes and patient well being.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"f760711a-4e66-c052-290b-60d568d73fdc","text":"An evolution in treatment strategies over this timeframe, from cryotherapy to laser ablation to adjunctive anti-VEGF therapy, may be a key determinant of this improvement in patient outcomes. Our study supports the advantages of using laser therapy over cryotherapy as a primary treatment modality, as the latter was associated with a need for secondary interventions, which might be explained by its destructive action on retinal tissues and its potential to induce proliferative vitreoretinopathy.","title":"Clinical features and prognostic factors in 71 eyes over 20 years from patients with Coats’ disease in Korea"}
{"_id":"f76a1751-720d-e7dd-0311-3f57763b4766","text":"While complication rates in free tissue transfers have continuously decreased over time due to improved techniques, the intraoperative use of vasopressors and their negative effects on flap microcirculation and patency of the anastomoses remains controversial. To further elucidate this matter, this retrospective study examines the effect of intraoperative vasopressors on free gracilis muscle and free fasciocutaneous anterolateral thigh (ALT) flaps for lower extremity reconstruction.","title":"Abstracts DGMKG"}
{"_id":"f775c62c-8063-d1a4-3d96-59626415a6ff","text":"Incorporation of PTT and PDT as a dual technology for cancer and bacterial infections ensures selectivity and improved efficacy to the system. Previous attempts have been made using and varying different porphyrin or derivatives for photodynamic therapy or using different noble metals or carbon nanotubes for photothermal therapy or incorporating the two therapies but no ideal photosensitizer or an ideal specific drug which damages only the cancer cells has been discovered. This review is aimed at giving and overviewing of the studies made on the application of photothermal and photodynamic therapy by encapsulating gold nanorods with porphyrin for better cancer and bacterial therapy. A thorough research and further experimentation will be made on both so as to find a more specific and less invasive technology.","title":"Encapsulation of Gold Nanorods with Porphyrins for the Potential Treatment of Cancer and Bacterial Diseases: A Critical Review"}
{"_id":"f7773bec-e59a-d779-266d-ba185f9fa5cb","text":"The main limitation to our study is the inability to blind patients, their caregivers and the ultrasonographer\/technician performing ultrasound with regard to allocation due to the nature of the intervention. We gave careful consideration to applying sham IPC in the control group. After discussion and deliberation, we decided not to include a sham IPC in the control group due to the potential harm of placing a cuff on the legs without inflation.","title":"Thromboprophylaxis using combined intermittent pneumatic compression and pharmacologic prophylaxis versus pharmacologic prophylaxis alone in critically ill patients: study protocol for a randomized controlled trial"}
{"_id":"f77d7903-a2dd-59ba-51d0-8d92de5d26f2","text":"A skin incision was made following the ventral border of the right zygomatic arch and extended caudally to region dorsal to the temporomandibular joint. The incision was continued through the subcutaneous tissue as well as the platysma muscle. The periosteum was incised to facilitate ventral elevation of the masseter muscle at the point of insertion on the zygomatic arch. This exposed the fractured segment of the zygomatic arch and the temporal bone. The segmental fracture of the zygomatic arch was manually reduced followed by application of the pre-contoured titanium miniplate. The implant was secured to the rostral and caudal segments and the comminuted segment was secured to the implant. The most caudal screw hole on the temporal bone was not accessible and was left empty. The surgical wound was closed in three layers followed by post-operative CT imaging to verify acceptable reduction (Figure 11A).","title":"Virtual surgical planning and 3D printing: Methodology and applications in veterinary oromaxillofacial surgery"}
{"_id":"f77e15f9-92ea-11db-74fa-a345077b11f5","text":"The trial is a first clinical test of resection planning in liver surgery in VR using a head-mounted display. Novel technologies usually raise interest at first but implementation in daily clinical use is a lengthy process, which is hardly predictable. Thus a lasting employment of VR using a head-mounted display for liver resection planning cannot be assumed. If implementation of this technology into daily practice is sustainably achieved and well accepted by users, expansion into different fields of operation planning is possible and desirable.","title":"Patient-individualized resection planning in liver surgery using 3D print and virtual reality (i-LiVR)—a study protocol for a prospective randomized controlled trial"}
{"_id":"f7829d4e-1f47-c0e4-df95-40ad66a20312","text":"The main limitations of the present study include the retrospective nature of the analysis and the small number of patients who have had positive SLN metastasis at two or fewer nodes. We believe, however, that these limitations did not greatly affect the results of the study as the differences between non-SLN positive and negative were too marked to have resulted from bias. Our results thus provide useful information on the risk factors for renmant non-SLN metastasis under the condition of SLN metastasis at two or fewer nodes.","title":"Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer"}
{"_id":"f78fe074-4afa-82eb-8cc7-39334222541b","text":"You have the right to not participate in this study and this will not affect the quality of the surgical operation.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"f79851ae-499c-ac97-5eee-a2dc597668c1","text":"Blurring of the bony details is the first sign and later a radiolucent area can also be seen on CT due to decalcification. The diagnosis is difficult in children because in its primary form it is paucibacillary and bacteriological correlation is always lacking. Absence of AFB in smears showing an otherwise characteristic cytological picture should not weigh against the diagnosis of TB. Considering the overall prevalence of TB in India, the presence of epitheloid cell granuloma is indicative of TB unless proven otherwise.","title":"Primary tuberculous osteomyelitis of the mandible mimicking a parotid fistula"}
{"_id":"f79b51c0-21e9-3e81-f8b4-dcb2bdd1c341","text":"Such training patterns may also relate to trends in clinical practice because orthopaedic surgeons repair nearly 10 times as many fractures and dislocations of the carpus and forearm than their plastic surgery colleagues. Only approximately half of plastic surgery residents decide to pursue fellowship training, whereas at least 90% of orthopaedic residents enter fellowship. Our data show that residents completing plastic surgery programs complete on average more than 400 hand cases and 28 nerve repairs compared with orthopaedic residents who complete approximately 240 hand cases and 3 nerve repairs. This discrepancy in volume may explain why plastic surgery residents tend to enter practice directly after residency rather than undertaking a dedicated year of hand surgery training, as is more often the case with the orthopaedic resident.","title":"Variability in Hand Surgery Training Among Plastic and Orthopaedic Surgery Residents"}
{"_id":"f7a35fa7-105d-2858-3c78-71165c6137be","text":"The dominant mammary branch of the IMA can be located by positioning the transducer in a transverse plane alongside the sternum and making a sweep scan from the second to the sixth intercostal space. Colour Doppler imaging is essential to locate the IMA, which appears as a circular hypoechoic area between the rib spaces deep to the pectoral muscle. The probe is then rotated until the long axis of the branch of the IMA is imaged passing through the rib spaces towards the mammary gland (Figure 11) [34, 35]. Doppler flow measurements are advised to be taken near the origin of the branch both distal to the pectoral muscle and removed from the parenchyma of the mammary gland. The mammary branch of the LTA can be located laterally and superiorly to the breast near the axilla. Generally settings for Colour Doppler are those typically used for low flow vessels, for example the velocity range can be as low as 4.5 cm\/s. Steering of the Colour beam will facilitate detection and interrogation of vessels that are oriented almost parallel to the beam.","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"f7a50942-ed2b-750f-8051-d4bf170aaaf7","text":"Many residency programs in Lebanon have guidelines and curricula in place that address and promote residents’ wellbeing. These entail a policy about resident impairment which permits the diagnosis of burnout and depression, provides opportunity for treatment as well as the possibility of returning back to work. The goals of this policy are to protect patients against any potential risks of suboptimal care provided by impaired resident as well as compassionately helping the impaired resident recover and return back to duty. In addition, residency program curricula incorporate mental health lecture series as well as workshops that aim to provide residents with techniques to shift their attention to effective ways of coping with uncertainties and heavy job demands.","title":"The mediating role of residents’ wellbeing between program leadership and quality of care: A cross-sectional study"}
{"_id":"f7aabc35-7d28-72e7-d673-ff73f0be3929","text":"The dorsalis pedis flap was first described by McGraw et al1 in 1975 as a local pedicled flap. The flap has a role in local reconstruction of the foot and ankle, or it may be employed as a free tissue transfer where thin, pliable skin is required. It can be used to reconstruct areas such as the hands, where tendons may also be transferred. Advocates cite its reliable vascularity and relatively thin skin, while the depth of the dermis in this flap ensures it is an excellent option for local reconstruction of the foot and ankle.2","title":"A Previously Discounted Flap Now Reconsidered: MatriDerm and Split-Thickness Skin Grafting for Tendon Cover Following Dorsalis Pedis Fasciocutaneous Flap in Lower Limb Trauma Dunne et al"}
{"_id":"f7b6e241-3d12-ed96-784c-91475f16f469","text":"Rarely, patients present with pure desmoplastic melanomas which have been suggested to have lower rates of SLNB positivity compared to mixed desmoplastic of other melanoma subtypes. However, the data is mixed, and pathological interpretation and reporting of desmoplastic melanoma are heterogeneous. Therefore, recommending forgoing SLNB for pure desmoplastic melanoma is controversial [32,33,34]. Another special circumstance may be patients with microsatellites in the biopsy or isolated, resectable satellites and\/or in-transit disease (stage III disease) with clinically negative locoregional lymph node. SLNB could be offered to these patients for better stage determination, since a negative SLNB will remain at N1c disease [35].","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"f7bd9720-12cc-54f3-10be-b335848b9e83","text":"Anal melanoma is a rare malignancy with a dismal prognosis and a natural history quite different from that of anal squamous cell carcinoma . Lesions may be pigmented and often present with bleeding. Metastatic disease is often present at diagnosis and is the major source of morbidity and mortality . Surgical resection is the treatment of choice for anal melanoma; however, the extent of resection is debated . Local excision should be attempted if an R0 resection is possible, particularly for symptomatic patients. There is emerging evidence that targeted therapies such as imatinib may be useful in select patients, although further research is needed .","title":"Recent advances in the management of anal cancer [version 1; referees: 2 approved]"}
{"_id":"f7c11d2d-1366-d7f5-eb61-02d2b67449c7","text":"In contrast to the attention given to the potentially devastating donor site morbidity related to inadequate ulnar inflow, little has been published on the impact of radial artery occlusive disease in the setting of attempted RFFF harvest. The very nature of the arterial arcades within the hand may mask pre-existing radial artery damage as ulnar collateral circulation through the palmar arches can produce a palpable pulse on the radial side of the wrist crease in spite of radial artery occlusion more proximally. This may predispose to intra-operative flap failure. Performing the Allen’s test in the reverse direction can ensure the adequacy of flow through the radial artery and prevent this potential complication.","title":"The Allen’s test: revisiting the importance of bidirectional testing to determine candidacy and design of radial forearm free flap harvest in the era of trans radial endovascular access procedures"}
{"_id":"f7cf658f-31fb-9a5e-7d25-fae53c166bc8","text":"The sample evaluated included 16 patients with lesions located on the face. Comparing the histopathological examinations of incisional biopsy in vertical sections and debulking in horizontal sections, there was agreement in seven cases. The histological analysis performed in horizontal sections allowed identification of the tumor site in 13 cases, and the relation between tumor and margin showed that in 11 cases, the lateral margin was compromised.","title":"Horizontal histological sections in the preliminary evaluation of basal cell carcinoma submitted to Mohs micrographic surgery"}
{"_id":"f7d40360-ed97-d0aa-d87f-4d13762252dd","text":"Patients randomised into group W will continue with their warfarin management as before. INR data will be collected from the anticoagulation database at six monthly intervals throughout the study to assess overall control.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"f7d5a9e7-f836-6ebd-6575-6e8e8a71db9c","text":"The standard surgical treatment for the permanent closure of large full-thickness skin wounds that can occur following acute trauma or surgical intervention consists in replacing tissue loss with skin autografts harvested from an uninjured donor site on the patient. However, when the skin loss exceeds 50% of the total body surface area of the patient, donor site availability for harvesting autografts becomes limited. Progress in tissue engineering has led to the development of technologies, allowing the production of skin substitutes. These substitutes can be either epidermal or dermal substitutes or bilayered skin substitutes.","title":"Improved Methods to Produce Tissue-Engineered Skin Substitutes Suitable for the Permanent Closure of Full-Thickness Skin Injuries"}
{"_id":"f7e3472a-f41f-d8c1-e4ab-bd0e6e1e7c70","text":"It has been hypothesized that all these variables may affect the outcome of reconstructive surgery, in addition to having an impact on oncology therapy.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"f7e57127-cd43-7a62-e7fc-836ac4008932","text":"Table 1 summarizes epidemiological and clinical features of calcinosis cutis associated with autoimmune diseases.","title":"Calcinosis Cutis and Calciphylaxis in Autoimmune Connective Tissue Diseases"}
{"_id":"f7e91f6b-7154-2369-ea02-088959c93d0f","text":"In the evaluated records, the most common location of tumors was the neck region, and the majority of head and neck tumors were benign. The most common benign and malignant tumors were found to be lymphangioma and non-Hodgkin lymphoma, respectively. Although benign tumors in the head and neck region was more prevalent than malignant tumors, a low rate of benign tumors in males indicate that more attention should be paid to the diagnosis as early as possible for proper management of the condition.","title":"Prevalence of Head and Neck Tumors in Children under 12 Years of Age Referred to the Pathology Department of Children’s Hospital in Tabriz during a 10-year Period"}
{"_id":"f7f02f9b-5b9e-c81d-2659-1689c5ced5e1","text":"This study is an attempt to establish the knowledge of the medical community on the specialty of plastic surgery and the spectrum of patients they cater to.","title":"Awareness and Perception of Plastic Surgery among Healthcare Professionals in Pune, India: Do They Really Know What We Do?"}
{"_id":"f7f91f51-5c2d-b410-03bc-5b50fe6f80ab","text":"Absolute satisfaction was documented in all patients in case group from donor site while no patient in control group expressed absolute satisfaction, four patients were relatively satisfied and 16 patients were dissatisfied. Lower pain level, absence of daily activity impairment and acceptable scar color were the reasons for satisfaction in patients in case group. We had one patient with folliculitis due to bacterial contamination in donor site resolved by local irrigation and oral antibiotic therapy.","title":"Outcome of Comparison between Partial Thickness Skin Graft Harvesting from Scalp and Lower Limb for Scalp Defect: A Clinical Trial Study"}
{"_id":"f80747c5-85ea-76ce-5c29-2c2956e6120c","text":"In this study, we have established a feasible method for the prediction of the anaphylactoid reactions to injectable drugs and differentiate them from allergic or inflammatory reactions by screening an animal model, optimizing the mode of drug administration and optimal selection of physiologic indexes. Two well-known herbal injections and two Western medicine injections which were reported to be allergenic were tested to verify this method. Diammonium glycyrrhizinate injection was also used as the negative control. The result showed that this method could distinguish between the anaphylactoid, allergic and inflammatory reactions of injectable drugs.","title":"A Reliable Method for the Evaluation of the Anaphylactoid Reaction Caused by Injectable Drugs"}
{"_id":"f807ae16-6a77-ec12-a682-33983d29c026","text":"Training of additional workforce for surgical treatment of cancer patients is another critical need. While there is diversity in the training pathways for SWTC around the world, work has been done to suggest core elements of knowledge and skill to be included in curricula for these surgeons. The International Federation of Head and Neck Oncologic Surgeons (IFHNOS) has established a successful Global On-Line Fellowship (GOLF) for training of surgeons around the world in the treatment of head and neck cancers. This program creates opportunities to reach a greater number of trainees while offering them supportive learning structures to enhance their skills and knowledge within a diversity of practice settings in countries around the world; the leaders of this program offer it up as a model to replicate in other disease sites in order to meet global needs. There is an opportunity for surgeons to support and participate in the concept that training should be the ‘right size’: the optimal content and duration of training for candidates from, in, and for the populations and practice settings where they are needed, and to participate in increasing the capacity across all settings for training SWTC to meet future global workforce needs.","title":"A Review of the Current State of Global Surgical Oncology and the Role of Surgeons Who Treat Cancer: Our Profession’s Imperative to Act Upon a Worldwide Crisis in Evolution"}
{"_id":"f80930ad-3aa3-e2e4-1133-7367b8eed894","text":"Cryosurgery should not be first line in the management of facial BCCs due to the high risk or recurrence and potentially poorer cosmetic outcome.","title":"Treatment of Facial Basal Cell Carcinoma: A Review"}
{"_id":"f80a280e-b099-9074-2395-a38558a4fe5c","text":"Our study demonstrated an earlier switch to oral treatment of pediatric bone and joint infections in our hospital in the second period.","title":"Impact of a pediatric infectious disease consultation service on timely step-down to oral antibiotic treatment for bone and joint infections"}
{"_id":"f80ad33e-8804-12e4-9c8f-0ea652c61d7b","text":"One major limitation of this study is its small sample size. Larger sample randomized controlled clinical trials are needed to verify the results of this study. To the best of our knowledge, our study is the first to report the efficacy of the nanomicroneedle therapy delivered with BoNTA in treating crow's feet and compare it with conventional injections. We conclude that BoNTA delivered through nanomicroneedle and intradermal microdroplets injection can effectively treat crow's feet. Its exact mechanism of action and how to optimize its clinical effects are still worth further researches.","title":"A Comparative In Vivo Study on Three Treatment Approaches to Applying Topical Botulinum Toxin A for Crow's Feet"}
{"_id":"f811d808-9b0b-8f67-50f4-b7075c75f2b6","text":"Vertebral osteomyelitis with CVT is uncommon likely due to anatomic factors since most infections are detected before extension into nonadjacent vertebral bodies or skull base. Neurologic complications from osteomyelitis often arise from epidural abscess formation and since the dura is tightly adherent to the foramen magnum separating intracranial dural space from the spinal thecal sac, epidural abscesses typically do not cross from thecal sac intracranially. Infection can spread through hematogenous means since both arterial and venous systems span both intracranial and spinal segments. Vertebral osteomyelitis in high cervical segments such as the odontoid process can spread to adjacent soft tissue resulting in adherence of fibrin, blood, and platelets producing thrombosis which can extend intracranially into the sigmoid and transverse sinus as in our patient.","title":"Pyogenic Odontoid Osteomyelitis with Sinus Thrombosis"}
{"_id":"f8123973-fd00-1f3e-e016-a37277b2093d","text":"Desmoid tumors are cytologically benign fibrous neoplasm originating from the musculoaponeurotic structures throughout the body.","title":"Giant Desmoid Tumor of the Anterior Abdominal Wall in a Young Female: A Case Report"}
{"_id":"f818a70c-6357-da98-e583-6b3b929922bf","text":"The study received approval and was monitored by the institutional review board of the University Clinic of Navarra.","title":"Enhancing Lower Extremity Defect Coverage: High Viability Ultra-Thin Split-Thickness Skin Grafts Obtained from the Scalp"}
{"_id":"f81ad7be-e350-0b7a-f03e-005cdfe4e8bb","text":"An important implication of our findings for therapeutic research in NF1 is that it may be best to design clinical trials for treatment of PNs to target pediatric patients, in whom either reduction of growth rate or regression of the tumour can be taken as outcome measures. For trials targeting adult patients, only tumour regression can be taken as an outcome measure because substantial growth of PNs is uncommon.","title":"Growth dynamics of plexiform neurofibromas: a retrospective cohort study of 201 patients with neurofibromatosis 1"}
{"_id":"f81d387a-9680-2536-333c-ff88f98d8865","text":"These patients received the preexpanded bipedicled scalp visor flap procedure for upper and lower lip reconstruction [5, 19]. A 500 ml to 800 ml tissue expander was implanted under the scalp and expanded to 2.5 to 3 times volume during a 6-month expansion period. The bipedicled visor flap was elevated by the same senior surgeon in a standard method as previously described in the literature. After the flap was transferred to resurface the defects on the upper and lower lips, the bilateral pedicles were exposed and covered with Vaseline gauze instead of skin grafting. This was performed to avoid secondary damage considering that the donor site for the necessary skin grafting was relatively rare and precious for burn patients. The disadvantage of this procedure was the exudation from the pedicle tissue requiring the gauze to be replaced regularly. The brief surgical procedure is shown in Figure 1.","title":"The Use of Infrared Thermography in Determining Timing for Early Pedicle Division of the Preexpanded Bipedicled Visor Flap after Ischemic Preconditioning"}
{"_id":"f81f2212-5934-cd31-9c42-ff22c311b2de","text":"Intravenous chemotherapy may be used for SCC in patients with distant metastasis, when surgery and radiotherapy failed or when these treatment are contraindicated.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"f8226e41-a865-da70-951a-566f677a313d","text":"The graft is based specifically on the vascularization that runs along with the sural nerve. Flap irrigation is accomplished by a distal reverse flow of the superficial sural artery dependent on perforators of the peroneal arterial system.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"f8229787-b0cc-917a-cafc-6d3223dea401","text":"In both cases of venous compromise in this patient, positional changes preceded the onset of venous compromise and release of the mastectomy skin from the flap resulted in improvement in the flap circulation. The relative inelasticity of her radiated mastectomy skin, as compared with the contralateral side, clearly contributed to this phenomenon. After a critical period of postoperative edema or with position changes after skin closure, venous occlusion occurred around the abdominal fascial cuff around the perforator, a process that may have been exacerbated by positional change.","title":"Successful Salvage of Delayed Venous Congestion After DIEP Flap Breast Reconstruction Katira et al"}
{"_id":"f8254910-6501-3e87-f60d-d05449a10e19","text":"Cushing syndrome (CS) is a prothrombotic state associated with an increased risk of postoperative venous thrombosis. We aim to present the case of a patient with Cushing disease who underwent pituitary surgery and subsequently developed acute lower extremity deep venous thromboses after anticoagulation was stopped.","title":"Multiple Deep Vein Thromboses After Curative Surgery for Cushing Disease: A Case Presentation and Review"}
{"_id":"f82a40fe-2657-0bb0-a1cc-6f4fe37499ee","text":"Introduction: Plating in distal tibia fractures are associated with higher rate of soft tissue complications. As adequate soft tissue cover is available over anterolateral surface of the tibia, use of anterolateral plate fixation in distal tibia fractures has increased. The purpose of our research is to evaluate the outcomes of anterolateral locking plate fixation in distal tibia fractures using ORIF.","title":"Minimally Invasive Osteosynthesis of Distal Tibia Fractures using Anterolateral Locking Plate"}
{"_id":"f82da80b-7508-aec5-c4de-f7ed5fd32813","text":"Margins were considered positive when the tumour involved the inked margin of the specimen in cases of invasive cancer or was within 1 mm of the inked margin for ductal carcinoma in situ.","title":"Low rate of positive margins and re-excision after partial mastectomy in highly selected breast cancer patients: A Chinese single-institution experience"}
{"_id":"f82f84d6-fa15-b51e-3bd9-e33f48f03ea0","text":"The knowledge of community pharmacists about the characteristics of chronic dermatoses and their therapeutic regimens is unknown, which may hinder their role as players in plans to promote adherence to dermatological therapy. The transmission of health information is most effective when its contents are specifically targeted at a person or population group and when the message is well delimited, highlighting the benefits and costs associated with behaviours and decision making [15].","title":"Knowledge and Practices of Community Pharmacists in Topical Dermatological Treatments"}
{"_id":"f83732ff-695e-19c4-1e2b-2a8a0dc2653e","text":"The presented case is a rare case of juvenile musculoaponeurotic fibromatosis in a 12-year-old boy. The case highlights the typical presentation of such tumors. The option of a free flap was excluded due to the available local options and the increased risks associated with such a major reconstruction if the more complex microvascular route was selected.","title":"Complex reconstruction after wide excision of juvenile aponeurotic fibromatoses of upper one-third of leg"}
{"_id":"f83f6241-3789-4913-b861-3cb763eb6212","text":"We performed a retrospective study of patients who underwent surgical, hormonal or chemotherapy treatment for abdominal wall desmoid tumors between 1982 to 2014 at two institutions affiliated with the University of São Paulo, Brazil.","title":"Sporadic Abdominal Wall Desmoid type Fibromatosis: treatment paradigm after thirty two years"}
{"_id":"f8451b97-6780-9fb1-a606-255e7916b88c","text":"To report a series of 8 phakic eyes of 8 patients with open angle glaucoma with uncontrolled intraocular pressure on maximum tolerable medical therapy receiving Hydrus Microstent implants combined with concomitant OMNI Surgical System ab interno canaloplasty.","title":"Hydrus Microstent implantation with OMNI Surgical System Ab interno canaloplasty for the management of open-angle glaucoma in phakic patients refractory to medical therapy"}
{"_id":"f847864c-15d6-0a0e-48c4-b978d543607b","text":"Endoscopic tympanoplasty is time saving and anatomy of the middle ear will be preserved. This procedure does not require surgical exposure such as canal drilling and skin incision, and avoids the substantial risk of unnecessary injury to the chorda tympani, in contrast to conventional methods.","title":"Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results Timpanoplastia bilateral transcanal por via endoscópica com cartilagem realizada simultaneamente: resultados iniciais"}
{"_id":"f851d813-427a-3f94-7843-022f56437580","text":"Our results show that Danish outdoor workers use sun protection significantly more at leisure and on sun holiday than they do at work and between outdoor and indoor workers, the only significant difference in UV exposure and use of sun protection outside working hours was for the use of sunscreen at leisure.","title":"Skin cancer risk perception and sun protection behavior at work, at leisure, and on sun holidays: a survey for Danish outdoor and indoor workers"}
{"_id":"f8577f46-242d-468c-ffe7-3749a33c22e1","text":"Little is known about populations of unselected patients with VTE. In Europe there is only minimal data describing individual patient characteristics, management patterns, factors influencing health care resource utilization and the corresponding costs. For completeness these data need to be derived from confirmed cases within hospitals, out of hospitals, in primary care or in specialized centers. The critical period for recurrences and bleeding is the time between first diagnosis and the following 12 months. Including unselected patients with both first time and recurrent VTE allows the burden of disease to be quantified.","title":"The management of acute venous thromboembolism in clinical practice – study rationale and protocol of the European PREFER in VTE Registry"}
{"_id":"f868e615-92c3-bd5b-9e88-4b40ae12773f","text":"Histologically, periarticular calcification is an obligatory finding for tumoral calcinosis.7 Other diagnostic criteria for this condition are the amorphous granular nature of the calcific material and the absence of crystal deposits. An unusual finding in our case was the presence of a moderate neutrophilic inflammatory infiltrate within the calcific debris, raising the possibility of superimposed infection. However, other case reports describe a mild neutrophilic component found on histology, without evidence of an infective component.1 This acute inflammatory response in our case may simply relate to traumatization of the lesion although there remains the possibility of sepsis, particularly in view of the preoperative needle aspiration procedure. Cartilage and synovium are not normally found in the lesion itself in cases of tumoral calcinosis.","title":"Idiopathic Tumoral Calcinosis in Hand: A Case Report Xu et al"}
{"_id":"f86bc807-c414-29d8-4a23-e09e4b3d13cc","text":"Routine preoperative peripheral arterial screening by sonography is a feasible and effective strategy to avoid unnecessary post CABG complications.","title":"Assessment of carotid artery stenosis and lower limb peripheral ischemia before coronary artery bypass grafting operations: a non-randomized clinical trial"}
{"_id":"f86bf680-1b4d-4df3-f3de-7fc95b8b15a5","text":"The findings relating to repeat US scanning are subject to even greater limitations. Only a relatively small number of studies were identified and none compared repeat US to a venography in all cases. The potential benefit of repeat US is therefore very uncertain.","title":"Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis"}
{"_id":"f8737a2c-e3f0-53b8-71d6-7f577a84c4dd","text":"The aim of this review article is to focus on the most effective interventions for reducing exposure to the most common airborne allergens in patients with allergic asthma. Primary prevention of allergic sensitization and allergic asthma, which includes also percutaneous sensitization and sensitization of oral and the gastrointestinal tract falls outside the purpose of this review.","title":"Allergen Avoidance in Allergic Asthma"}
{"_id":"f87c3231-aaf7-65cb-da90-04524c29cd28","text":"Three patients from Group OT were excluded from analysis because they died within the first year after index surgery for reasons other than infection. All these cases were infection-free when they died. There were a further four deaths in Group OT after the first year and a total of four deaths in Group CG (all occurring after the first year of treatment). None of these deaths were related to infection recurrence.","title":"A comparison of clinical and radiological outcomes between two different biodegradable local antibiotic carriers used in the single-stage surgical management of long bone osteomyelitis"}
{"_id":"f88753f8-3ce5-4d81-c5f2-5137cf05c33f","text":"The muscle was divided as usual from its attachments into the iliac crest and the thoracolumbar fascia. Its anterior border was then separated carefully from the underlying Serratus anterior muscle. The insertion of the muscle into the intertubercle groove on the humerus was subtotally divided to keep the pedicle protected by some fibers of the muscle and at the same time, minimize the axillary bulk which would be caused if whole insertion were to be left. This technique also allows for more reach of the muscle. The thoracodorsal nerve was preserved to minimize future atrophy of the muscle. The muscle with the overlying fat was now separated from all its attachments except at the intertubercle groove insertion and then mobilized to the chest wall through a subcutaneous tunnel, wide enough to introduce four fingers to reach to the site of reconstruction. Care was also taken not to disturb the inframammary fold in case immediate reconstruction was to be done.","title":"The extended latissimus dorsi flap option in autologous breast reconstruction: A report of 14 cases and review of the literature"}
{"_id":"f88fa4e7-85b4-c1e1-7686-8cb996ee4f39","text":"It is significant to mention though the proper donor site vein selection. The vein comitante of the radial artery is not always of reliable size and it is important to plan the flap in order to include large subcutaneous veins or even cephalic vein. This was the cause of failure in our case.","title":"Dorsalis Pedis Free Flap: The Salvage Option following Failure of the Radial Forearm Flap in Total Lower Lip Reconstruction"}
{"_id":"f89027d0-6ed6-50c1-33ea-5bb363bbf5e4","text":"In order to achieve full advantages and success of the procedure, the expansion process must also aim to minimize complication. The major complication in this procedure is expander extrusion which was fortunately not seen in any of our patients. We believed that the main reason for expander extrusion is inappropriate surgical technique. Prevention from implant exposure requires careful planning and certain modifications in surgical technique. We managed to prevent extrusion of our expanders by placing expanders in an adequate pocket and by placing incision far away from the area needed to be expanded.16 By this distant placed incision, we were able to achieve the extra advantage of early start of expansion procedure. It also seems to reduce the rate of complications that would occur later due to dehiscence of scar later extrusion of expander since the migration or recruitment of tissue during expansion causes the tissue to move toward expander. Furthermore as already mentioned in methods that our incision of insertion of expander was always radial which means they lied in the line drawn from the approximately the midpoint of the implant.17 In this way the incisions are not prone to being forced open when the expansion is started. By using these maneuvers our implant extrusion rate was zero. To lower the infection rate in tissue expansion, we ensured the proper aseptic environment with per-operative I\/V cefezolin at the time of induction of anesthesia. We continued post-op same antibiotic till the removal of drain. Moreover, before placement of expander we irrigated the pocket with gentacin solution as it is abroad spectrum antibiotic which has good coverage against gram positive and important gram negative organisms responsible for expander infection. Our policy of placing close suction drain prevented further formation of seroma that leads to infection. We also concentrated on prevention of late infection by inflation of expander under sterile condition by using povidine-iodine solution for preparation of inflation site. Hence, tissue expanders provide beneficial effects for the reconstruction of post burn alopecia. Despite the disadvantage of being (at least) a two-stage procedure, the expander technique provides tissue of the same texture and color with minimal donor site morbidity.","title":"Reconstruction of post burn scalp alopecia by using expanded hair-bearing scalp flaps"}
{"_id":"f896e72d-a0aa-8dfc-aacb-147f986d4563","text":"With the COVID-19 pandemic fresh in the mind of most physicians, recency bias played a role early in the clinical course of this patient, leading to increased costs and a delay in optimized treatment. Therefore, it is of the utmost importance for clinicians to obtain a thorough history when attempting to diagnose the cause of a patient’s respiratory failure so that the proper treatment measures can be initiated as soon as possible.","title":"COVID-19 Infection Or Buttock Injections? the Dangers of Aesthetics and Socializing During a Pandemic"}
{"_id":"f89a1774-b9ae-d13a-36e1-a1b9ec399c44","text":"Anterior cervical hybrid construction appears to be an acceptable option in the management of multilevel cervical degenerative disc diseases and spondylotic spinal stenosis.","title":"Anterior hybrid construction of multilevel cervical disc disease and spondylotic spinal stenosis: surgical results and factors affecting adjacent segment problems"}
{"_id":"f8a24de3-e081-8c85-39b8-2fc51de51248","text":"Forty patients met the inclusion criteria, of whom 23 started or switched to oral antibiotics while 17 patients remained on IV antibiotics throughout their treatment. Table 1 displays the demographics and comorbidities of the cohort. Patients treated with oral antibiotics were younger and less likely to have chronic kidney disease; other characteristics were similar between groups.","title":"Excellent Outcomes With the Selective Use of Oral Antibiotic Therapy for Bone and Joint Infections: A Single-Center Experience"}
{"_id":"f8a75a7e-d479-e971-2958-862883cf577e","text":"Second, simple frenotomy with or without local anesthesia appears well tolerated until approximately 3 months of life, after which correction under general anesthesia better controls pain.","title":"How to Treat a Tongue-tie: An Evidence-based Algorithm of Care"}
{"_id":"f8aa3760-eba0-3ad5-30c3-abb8ec7bd702","text":"Though uncommon, iatrogenic botulism should be kept on the differential for patients who present with muscle weakness and a history of botulinum toxin injections.","title":"Bulbar Muscle Weakness in the Setting of Therapeutic Botulinum Injections"}
{"_id":"f8aae216-92c4-542f-cdab-4bd0bf86bd9d","text":"Vaccines are a major contribution to public health on modern age and act as a powerful stimulus to the immune system which, theoretically, has the potential to induce or exacerbate immune processes shown as serologic findings or clinical autoimmune diseases.","title":"Dermatomyositis post vaccine against SARS-COV2"}
{"_id":"f8b61746-8af7-8de7-43f0-4f792ee11d51","text":"The addition of US to the clinical work-up of patients with cN0 OSCC increases the detection of metastases, thus US potentially reduces the number of patients requiring a secondary neck surgery after sentinel node biopsy.","title":"Staging of Cervical Lymph Nodes in Oral Squamous Cell Carcinoma: Adding Ultrasound in Clinically Lymph Node Negative Patients May Improve Diagnostic Work-Up"}
{"_id":"f8b888a9-ea82-71a3-7d97-75b1e7d4401d","text":"⑤ From the level of aortic arch to cervical area, all lymph nodes and tissues were removed along the left RLN with an ultrasonic harmonic scalpel.","title":"A novel technique for lymphadenectomy along the left recurrent laryngeal nerve during minimally invasive esophagectomy: a retrospective cohort study"}
{"_id":"f8bd3643-f203-3321-5b7f-038d07af97bb","text":"The patient lay in supine position, with the limb in external rotation and the knee slightly flexed. The incision starts at midcalf, 2 cm behind the posteromedial border of the tibia and curves proximally to reach the popliteal fossa. It is important to avoid injury to the saphenous vein and nerve. The deep fascia is incised and retracted posteriorly as far as the plane between the two heads of gastrocnemius. A plane is developed between soleus and the medial head after the incision of the thin aponeurosis, and often the plantaris tendon is found in this space.","title":"Pearls and tips in coverage of the tibia after a high energy trauma"}
{"_id":"f8bf0426-dc09-339d-9324-7524a4a2156e","text":"To our knowledge, there are no commercial products available for external fixation of rat bony defects. This has led many investigators to develop their own systems of external fixation. For practical reasons, the external fixator must be lightweight, inexpensive, relatively easy to apply, and stable through the duration of the experiment. An assortment of external fixation frames and techniques has been developed for this purpose. While bone cement is convenient to apply and provides initial solid fixation to the pins, it has been found that there is often loosening in late stage of the fixation. The external fixator used in this study was designed for convenient assembly without the use of highly specialized tools or skills. The parts for this external fixator can be purchased from any hardware stores. The external fixator provided sufficient strength of bone fixation using a lightweight material (aluminum alloy) that the animals were able to tolerate without difficulty. The ability to bear weight early is important for bone regeneration in long bone defects as it provides mechanical stimulation. In this study, all animals had the ability to bear weight immediately postoperatively and walked without difficulty. The external fixator used in the current study is also adjustable, and the M4 fasteners can be tightened as needed to prevent loosening of the frame.","title":"External fixation of femoral defects in athymic rats: Applications for human stem cell implantation and bone regeneration"}
{"_id":"f8d56fdb-6b29-69f4-8500-781862d23ee3","text":"A preoperative angiogram was carried out to assess the anatomical variation of the vessels at the donor and recipient site. The recipient vessels may be displaced by previous surgery and scar formation and must be preserved during radical resection of the tumor. The scar tissue was debrided and vessels dissected free.","title":"The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection"}
{"_id":"f8d5b99d-e691-cd93-4925-7c7aed01bf6f","text":"We demonstrated HIV patients’ persistence of anti-spike IgG, with high serum levels being demonstrated in most patients, six months after the third dose of the BNT162b2 mRNA vaccine and the predictive role of the humoral response after the second dose in patients with LLV and OV. Our results may help to formulate more stringent recommendations and motivate patients to accept further vaccine doses. Immunological controls are needed to check the persistence of responses and could help in designing vaccination strategies for selected patients, who could be better identified by multiple plasma HIV viremia tests. Further studies evaluating the IgG time course after the fourth dose or in the case of breakthrough COVID-19 may help elucidate the influence of HIV viremia detectability.","title":"Humoral Response after Two Doses of BNT162b2 mRNA Vaccine Has a Role in Predicting Response after Three Doses That Is Related to Plasma HIV Viremia and Nadir CD4+ Cell Count in HIV-Positive Patients"}
{"_id":"f8d71e21-fc66-274f-f6ad-4ad1ad601f5e","text":"In our experience, 14 to 16 cm of bone length is typically needed to reconstruct a bilateral maxillectomy defect [19]. The lateral surface of the fibula bone is used to restore the vertical maxillary height, measured from the orbital rim to the occlusal plane of the hard palate, by orienting it such that it faces anteriorly on the face. The peroneal vessels, therefore, assume a posterior position facing the maxillary sinus. Some flexor hallucis longus muscle is usually included with the flap in order to obliterate the maxillary sinus cavity and provide adequate soft tissue around the vascular pedicle to prevent its desiccation. The skin paddle of the flap is used to reconstruct the palatal defect and the nasal surface of the flap is left to mucosalize spontaneously in most cases.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"f8d9e0f5-4cc0-c8df-7e22-4604e406d743","text":"The central compartment of the neck includes the region between the common carotid arteries and is bounded superiorly by the hyoid bone. The inferior border has been variably defined as the sternal notch or the innominate artery. The paratracheal nodes may be anterior and posterior to the recurrent laryngeal nerves. These nodes may be found posterior to the common carotid artery on the right because of the anatomic variation of the sides. In this study, dissection of the right upper paraesophageal lymph nodes included the area posterior to the right recurrent laryngeal nerve. The field was inspected for macroscopic disease before dissection. Figure1 shows the boundaries of the upper paraesophageal area that was dissected.","title":"Clinical predictors of right upper paraesophageal lymph node metastasis from papillary thyroid carcinoma"}
{"_id":"f8de51a2-61ca-9d64-9e84-d8895a259167","text":"Although rare in the United States and Western Europe, non-pyrogenic causes of spondylodiscitis are fairly common in the rest of the world. At this time, there is little data specifically regarding the cervical spine, but one can presume from the data on pyrogenic spondylodiscitis that involvement of the cervical spine also likely leads to significant associated morbidity and mortality and special attention should be paid to these infections organisms in the cervical spine.","title":"Cervical spine spondylodiscitis: Review of literature on current treatment strategies"}
{"_id":"f8e92c46-caab-b204-c5b1-d62c50f1c637","text":"Various donor sites have been used for harvesting bone grafts. Autogenous cancellous bone from anterior iliac crest is used in many centres. Cancellous bone can also be harvested from tibia and to a smaller extent from the mandible. Cranial bone and rib have also been used but tooth eruption through these grafts has not been demonstrated as successfully as with iliac and tibial bone. Also bone-inducing techniques have been demonstrated using pedicled periosteum or free tibial periosteal grafts with moderate results.","title":"Alveolar bone grafting"}
{"_id":"f8ea21e0-0a8a-7559-e04e-ba4c2aff6cbc","text":"None of the assistants associated with the randomization process are directly involved in this study to avoid bias.","title":"Study protocol for comparing the efficacy of left-open single-flap technique versus double-flap technique after proximal gastrectomy: A multicenter randomized controlled trial"}
{"_id":"f8f5e1f7-0ac7-16da-3fb6-9ce0d8cd449c","text":"Current research tends to estimate the age based on ageing changes in the bones. But there are few studies on ageing itself and its salience as well as regional dynamic changes with age. The feasibility of our method in representing the development and ageing of the craniofacial and cervical spine provides a new perspective and ageing metrics for ageing research.","title":"Ageing and degeneration analysis using ageing-related dynamic attention on lateral cephalometric radiographs"}
{"_id":"f8f6cb29-986f-de30-eb8e-80c511204faf","text":"Certain precautions and modification of techniques can optimize results at sites that are difficult to treat.","title":"TISSUE GRAFTS IN VITILIGO SURGERY – PAST, PRESENT, AND FUTURE"}
{"_id":"f8f7d7f5-e664-526e-21ca-79c62e28d2ea","text":"Lymphatic staging of breast cancer was initially established by axillary lymph node dissection followed by sentinel lymph node biopsy1. There may be more than one sentinel node, depending on the location of the tumour and the network of surrounding lymph vessels2. For patients with early breast cancer and clinical and radiological absence of axillary lymph node metastases, sentinel lymph node biopsy is currently considered the standard of care3.","title":"Network meta‐analysis of novel and conventional sentinel lymph node biopsy techniques in breast cancer C. W. Mok, S.‐M. Tan, Q. Zheng and L. Shi"}
{"_id":"f8fef8cd-fdb8-336d-b892-b5560761b5b9","text":"This study has shown that using 3D cones for tracking SPIO-labelled MSC generates MR images of high anatomical detail, evidenced by a similar image features between the MRIs and the histological evaluation of ovine joints. The superior structure detection of this method over standard Cartesian MRI acquisitions is a unique strength of UTE MRI provided by 3D cones, which we would like to use for future longitudinal monitoring of both clinical and experimental joint surface defect healing. UTE methods will enable us to further validate biological healing of small osteochondral defects, which are difficult to image due to their small size and the fast MRI signal decay rates of bones and SPIOs. Confirmation of the correlation between MRI and histology will help future studies monitor not only MSC locations, but also monitor the effects of mesenchymal stem\/stromal cell healing of damaged tissues.","title":"Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model"}
{"_id":"f90a4633-0cc6-cf54-f3c5-1ef9367d3561","text":"In conclusion, evidence suggests a benefit of 3D reconstruction in pulmonary surgery by reducing operating times, intraoperative blood loss and lowering the rate of surgical conversion. It enables adequate surgical planning surgical, assessment of resection margins in oncological surgery and might be of added value in both residency training and patient education. By visualizing the complex spatial relationship between surgically relevant bronchovascular structures, it enables surgeons to perform minimally invasive and complex anatomical resections safely and adequately. Future research should focus on confirming these results in prospective clinical trials.","title":"Application of three-dimensional computed tomography imaging and reconstructive techniques in lung surgery: A mini-review"}
{"_id":"f90e8d4c-8553-bdea-2c4e-a94cbbfdbfe2","text":"Spinal cord injury guidelines recommend pregabalin as the first choice of first-line medications for the reduction of NP intensity among people with spinal cord injury. Cervical myelopathy is the most common form of spinal cord injury in adults in North America, with an incidence of 76 per million. The present definition of cervical myelopathy is both the presence of long-tract signs and high signal changes on T2 MRI in the cervical spinal cord. There is also little information on the effect of pregabalin in patients with NP in cervical myelopathy under routine clinical practice.","title":"Comparison of the use of opioids only and pregabalin add-on for the treatment of neuropathic pain in cervical myelopathy patients: a pilot trial"}
{"_id":"f90f5551-389b-5a5f-4849-d0463d20ca98","text":"This was done after meticulous debridement and treatment of the cause (which was done by the authors), optimising the patient’s general condition, blood sugar control in diabetics and strict instructions on smoking cessation. An informed consent was obtained from all patients included in the study. As medical grade honey preparations are not available, patients brought original honey from local beekeepers without irradiation and kept it in dark containers at room temperature. The dressings were handled by the patient or one of the relatives at home after teaching them the steps of dressing during their initial hospitalisation where it was done by the resident. The dressing started by thorough wound washing with saline and using gauze to remove any superficial debris. No antiseptic was used in the study. After drying the wound, a ribbon of gauze soaked with honey was applied and folded into at least three layers. We used gauze to function as a mesh keeping honey to prolong its contact with the wound. The gauze length and amount of honey varied according to the wound size for covering the whole wound, filling its depth and hanging over its edges. A dressing was applied over the gauze and a crepe bandage was applied lightly. The frequency of dressing was variable according to the soaking of the dressing with exudates. This was done twice daily or once daily. With improvement of the wound condition, dressings were changed every other day. According to the culture results in infected cases, systemic antibiotics were given for four weeks.","title":"Honey dressing: a missed way for orthopaedic wound care"}
{"_id":"f914a30f-767d-349b-cc80-ae7bbfdc6014","text":"Local erythema at 9 days after the first dose of the mRNA-1273 vaccination","title":"Delayed skin reaction after mRNA-1273 vaccine against SARS-CoV-2: a rare clinical reaction"}
{"_id":"f918f3dd-58f1-be6f-d696-94439b86e64a","text":"The development of staged treatment protocols, modifications of surgical approaches and modern implants have reduced the overall complication rate in the treatment of pilon fractures. However, in part due to the amount of the initial bone and extent of soft tissue injury as well as the experience of the surgeon, severe complications such as non- and malunion, bone infection and deep soft tissue infection are still associated frequently. Among these complications, chronic osteomyelitis (COM) and septic nonunion of the distal tibia are the most devastating. An accompanying ankle joint infection particularly aggravates this already complex situation, since it leads to a combined bone defect of the distal tibia with associated ankle joint loss after resection of the nonunion and ankle joint in order to treat the present infection. Large soft tissue defects may further complicate these conditions with unpredictable outcomes. Despite complex limb salvaging techniques and many surgical revisions high rates of complications and treatment failure still occur, thus at the end amputation is often required. Therefore, orthopedic surgeons are faced with the question of whether an attempt to preserve the extremity in these situations is still sensible and worthwhile.","title":"Analysis of bone transport for ankle arthrodesis as a limb salvage procedure for the treatment of septic pilon fracture nonunion"}
{"_id":"f919ad8b-7dae-798f-e231-93d1d0c19055","text":"Our retrospective study implied that immediate CLND did not bring further RFS benefit after an observation for Chinese melanoma with SN micrometastasis in real clinical practice, even for patients with the acral subtype or more tumor burden such as thick Breslow invasion and ulceration. Further prospective studies are still needed to investigate biomarkers that can efficiently predict NSN status and survival outcomes for SN-positive patients in the Chinese population.","title":"Survival impact of immediate complete lymph node dissection for Chinese acral and cutaneous melanoma with micrometastasis in sentinel nodes: a retrospective study"}
{"_id":"f91dd895-70c2-5ceb-1092-a59603337076","text":"Hypopigmentation is the main side effect of cryosurgery due to melanocytes destruction during freezing.","title":"A Review of the Literature of Surgical and Nonsurgical Treatments of Invasive Squamous Cells Carcinoma"}
{"_id":"f922b937-42d3-632a-f560-93a194bdab71","text":"An implantable venous Doppler was placed to monitor flap viability in the postoperative period. The patient’s immediate postoperative course was uncomplicated, with reassuring flap skin paddle appearance and Doppler signals bilaterally.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"f92b3435-2ece-7fd6-3bda-171f97c13dbc","text":"AVF is a useful procedure for single-stage reconstruction of a soft tissue or combined defect of a finger. We consider that this procedure could be applied to finger, despite an avascular or hypovascular recipient bed if vascularity of the periphery of recipient bed is good and if the recipient beds are free from infection.","title":"The clinical result of arterialized venous free flaps for the treatment of soft tissue defect of the fingers"}
{"_id":"f93d1f34-fc5e-72cf-9e2f-2a8f1d02a7fa","text":"Biopsy is a medical procedure in which a small sample of human tissue is sourced from a patient to be further examined to determine the presence of a specific disease. Obtaining a skin biopsy is a commonly used method in the diagnosis of skin cancer, as it provides the most insight into the extent of the condition [26]. Varying levels of specific molecules and compounds found within the biopsy may serve as evidence toward the presence of AD.","title":"Electromagnetic Sensing Techniques for Monitoring Atopic Dermatitis—Current Practices and Possible Advancements: A Review"}
{"_id":"f93e8069-c3c9-91a3-84f3-e7fdd8fbd072","text":"The use of allografts or bioengineered materials should be avoided because they are frequently rejected as foreign bodies.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"f9423996-df38-1995-9a91-9c162661928e","text":"Surgical management of these tumours is either by wide local excision or mastectomy depending on the size of the tumour and remaining breast tissue. It is important to achieve a complete resection with negative resection margins, as margin status is a major factor for local disease recurrence. Axillary clearance is not necessary as these tumours do not spread via the lymphatic route. Adjuvant radiotherapy to the chest wall may reduced the risk of local recurrence [10]. Although adjuvant chemotherapy with either doxorubicin, cisplatin or ifosfamide based regimes has increased the survival of primary bone sarcomas, there are no proven benefits to the use of these regimes in primary osteosarcoma of the breast.","title":"Primary osteogenic sarcoma of the breast: A case report"}
{"_id":"f94382d2-c22b-2fec-e9e3-a5633778b587","text":"All injectors performing the BT therapy are experienced in BT therapy and specialised in movement disorders. They were trained to perform ultrasound guided intramuscular injections and used them for at least 6 months prior to the study.","title":"Dysphagia in cervical dystonia patients receiving optimised botulinum toxin therapy: a single-center retrospective cohort study"}
{"_id":"f945fe5b-d5da-2d93-b01f-4df5c0303252","text":"Procedure volume counts included all cleft palate repairs in patients younger than 4 years of age, regardless of cleft type or additional medical conditions, as all palate repairs were predicted to increase the surgical team’s experience with the procedure. For surgeons or hospitals who had reported in PHIS for fewer than 365 days at the time of a patient’s palate repair, procedure volume was calculated as the number of cleft palate repairs performed during their first 365 days of reporting. Procedure volume was categorised into tertiles.","title":"Variation among cleft centres in the use of secondary surgery for children with cleft palate: a retrospective cohort study"}
{"_id":"f9476401-f390-fac4-eb38-8015b1f6da8b","text":"The fact that complication rates in free tissue transfer for head and neck defects is reported higher may be attributed to the nature of reconstruction of head and neck defects, commonly involving sterile and non-sterile anatomical areas. Free flap surgery in the head and neck area is commonly utilized after ablative procedures adjacent to the oral cavity and\/or the upper respiratory tract. In such non-sterile areas, it is imperative for flap surgery to reconstruct anatomical barriers that are airtight and watertight while the flap and its sutured wound margins are constantly put under stress such as saliva, respiratory air pressure and mucosal secretions since the very beginning, from the flap inset. At a later timepoint, further stress to the reconstruction result might occur through oral fluid and food intake. Such factors can put constant strain on the flap and its margins to autochthonous tissues and invoke wound dehiscence or infections spreading from non-sterile to otherwise sterile tissue planes. These factors may in fact be unavoidable in reconstructions in the head and neck area and explain differences in complication rates compared to free tissue transfers on the lower extremity. Even though free flaps transferred on the lower extremity have to sustain other types of stress factors, this is generally not the case from the very beginning of the flap-healing phase. Immediate weight bearing, extremity movement and shearing forces are generally avoided during the early postoperative course by means of extremity fixation, meticulous wound dressings and careful ambulation. These measures aim to provide sufficient time for the flap and surgical wounds to heal adequately by protecting the newly transferred flap from possible stress that could jeopardize its function.","title":"Free Tissue Transfer in Head and Neck Reconstruction: A Multidisciplinary 15-Year Experience"}
{"_id":"f947bbdb-57c1-5212-791d-4b402593a9b5","text":"Program directors were asked to provide their opinions on the preparedness of their residents at the end of the residency training program, the degree of support from radiation oncology colleagues in allowing medical physics residents to engage in BT procedures, and the level of independence achieved by residents for different BT tasks. Additionally, directors were asked if a BT fellowship would be beneficial to their residents, what the greatest hurdles are in providing BT training, and what resources would be needed to overcome these hurdles. Finally, programs were asked what percentage of their residents practice BT in their first postresidency position.","title":"AAPM BTSC Report 377: Physicist Brachytherapy Training in 2021—A survey of therapeutic medical physics residency program directors"}
{"_id":"f949bad8-fbd8-9d4a-8700-22bdecc1cffe","text":"Since this is a cross- sectional study that only investigated conduct on the first day of new admissions, its results cannot be extrapolated to adequacy of thromboprophylaxis throughout the entire period of these patients’ time in hospital. However, they nevertheless indicate a need for effective programs that are designed to ensure patient safety in relation to VTE in the first hours after admission.","title":"Evaluation of deep vein thrombosis prophylaxis in a general hospital"}
{"_id":"f94a4e84-b619-b752-37b7-4adee0e3da03","text":"A strength of this study is the variety of descriptions during a long follow-up and the relatively representative sample of breastfeeding mothers of preterm infants in a Swedish context. One limitation may be that the comments provided by the mothers are, to some extent, short; however, these comments provide a rich variation in the descriptions of lived experiences of breastfeeding during the first year as a mother of a preterm infant. To gain an even deeper understanding of the possible changes and their influences during the breastfeeding journey, regular individual interviews during the breastfeeding period are warranted. The breastfeeding support given in the RCT in the first 2 weeks after discharge may have influenced the mothers’ experiences of breastfeeding. However, the support was provided for only a short period and not all mothers took advantage of the support offered. Hence, we do not believe it to have affected the experiences of breastfeeding over the 12 m period to any great extent. Another limitation of the study is that it only included mothers who were breastfeeding at discharge and did not include experiences of mothers who ceased breastfeeding while in the neonatal unit potentially impacting generalizability.","title":"A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth"}
{"_id":"f94babab-a0f9-e9ac-cade-0d9c1736d58a","text":"Since February 2014, 195 participants were recruited to the study. The study closed to recruitment in January 2016 and the first participants completed 2 years of follow up in February 2016. Data collection will continue until January 2018 with results expected to be published in late 2018.","title":"Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol"}
{"_id":"f953d307-316f-542c-5b70-e2a909aba892","text":"Clinical and pathologic characteristics of the patients are described in Table 3.","title":"The role of miRNA-133b and its target gene SIRT1 in FAP-derived desmoid tumor"}
{"_id":"f957f3f9-0636-e730-2679-9eab74126eb8","text":"When positive margins do occur unexpectedly, the impact due to the need for further treatment and ultimately increased risk of recurrence can be significant. Results can be compared to those for unplanned excisions. Therefore, surgeons should be aware of the different circumstances in which positive margins occur to help guide treatment planning and managing patient expectations.","title":"Positive Margins Following Excision of Primary Bone & Soft Tissue Tumours in a Tertiary Centre and the Impact on Patient Outcomes"}
{"_id":"f95c8784-8e31-a560-b8f6-c61909bb471a","text":"Based on the radiological findings, a radiological diagnosis of juvenile ossifying fibroma in relation to the maxillary right posterior region was given. Fibrous dysplasia was considered as radiological differential diagnosis, but the margin of the swelling was well-defined and well demarcated from the surrounding areas which was very much unlike FD whose margin is ill-defined and merges with the surrounding areas.","title":"Fibrous Dysplasia versus Juvenile Ossifying Fibroma: A Dilemma"}
{"_id":"f9631b27-a9a3-84d7-a5e0-bf0633074313","text":"Distant fasciocutaneous flap transfers to the upper limb. a Groin flap for a missile injury of the right hand: a flap repositioning was required after limited distal necrosis. b Multiple abdominal flaps for a burn injury of both hands: note the flap loss on the right 5th finger","title":"Soft tissue coverage using pedicled flap in combat zone: a case series"}
{"_id":"f963de47-ba82-c8cb-83df-d259df73055c","text":"Since Masquelet and colleagues described it in 1986, the induced membrane technique has become popular for treating traumatic long bone defects. 2 3 4 5 We have often used it to treat chronic osteomyelitis or long bone defects. Its simplicity is a powerful advantage and the higher union rate with less donor morbidity makes it attractive compared with other techniques. In this case, a one-stage vascularized fibula graft was attempted using the induced membrane technique, but unfortunately, docking site nonunion was found. While saving the membrane, we changed the plates and screws and inserted a cancellous iliac bone graft at the proximal and distal docking sites between the transferred fibula and tibia. Reelevating thoracodorsal artery perforator flap while saving the membrane was easy because of the skin flap characteristics. Skin flaps or fasciocutaneous flaps are much more suitable for secondary procedures than muscle flaps for treating Gustilo–Anderson type IIIB open tibia fractures. 15 16 Bone union proceeded well and the transferred fibula had hypertrophied by 3 months later.","title":"Reconstruction of a Severe Open Tibiofibular Fracture using an Ipsilateral Vascularized Fractured Fibula with a Thoracodorsal Artery Perforator Free Flap"}
{"_id":"f971e268-6821-b075-18a6-bab1bf793961","text":"In conclusion, Zuckerkandl's tubercle which is defined as posterior extension of lateral lobes of the thyroid gland, is a common anatomical structure found in the majority of cases. Excision of the tubercle requires fine and meticulous dissection with great care because of close relationship between ZT and RLN. The RLN is uncommonly located on anterior surface of the tubercle. This unusual lateral course may increase the risk of injury. Based on the occurrence of unusual variations, we propose to identify the RLN before attempting dissection of adjacent structures. Excision of ZT is mandatory for completeness of thyroidectomy. Fine and delicate dissection with care around the ZT is also mandatory after identification and isolation of the RLN for preventing nerve injury.","title":"Incidence and Surgical Importance of Zuckerkandl's Tubercle of the Thyroid and Its Relations with Recurrent Laryngeal Nerve"}
{"_id":"f97e4879-7ba9-a8dc-a432-401ec1ff886b","text":"The speech function of the reconstructed tongue was evaluated by the speech comprehension score system [12] developed by the MD Anderson Cancer Center. Grades were selected on the basis of the number of pronunciation errors and whether the speech could be understood: 1 represents major errors in pronunciation and an incomprehensible statement; 2 represents multiple errors and a statement that is comprehensible only when the listener understands the topic; 3 represents some errors and a statement that is comprehensible when the listener does not understand the topic; 4 represents few errors and a statment that is comprehensible when the listener does not understand the topic; 5 represents no errors and a fully comprehensible statement.","title":"Application of an L-shaped anterolateral thigh flap in reconstruction after hemiglossectomy"}
{"_id":"f985189d-5fe2-49f3-8a90-119b6f17b999","text":"Ethical approval for the study was not required as this was a retrospective study without any patient intervention. Signed informed consent was obtained from patients prior to the procedure as well as for using their information without patient identifying data. All sensitive data were anonymised with patient-identifying elements removed.","title":"Modified negative pressure wound therapy as an adjunct to antibiotics in the treatment of orthopaedic infected metalwork"}
{"_id":"f98b2943-127d-bdf4-570e-9eb2465ac2a4","text":"Perioperative opioid use for pain control has been found to be associated with side effects and adverse prognosis. In this study, we hypothesized that paravertebral block could reduce the consumption of opioids during pancreatic resection surgery.","title":"Ultrasound-guided paravertebral blockade reduced perioperative opioids requirement in pancreatic resection: A randomized controlled trial"}
{"_id":"f99169c0-1820-1e2d-897e-2f6e42b35030","text":"Four weeks later, the patient was returned to the operating room for removal and modification of the obturator. The cavity was healing well, and both implants were firm with no evidence of infection. The initial obturator was modified with the application of a soft lining material and the patient subsequently discharged with instructions on the insertion and removal of the obturator.","title":"A novel report on the use of an oncology zygomatic implant-retained maxillary obturator in a paediatric patient"}
{"_id":"f9972115-500e-2c42-3230-09b9390c6d19","text":"A time interval of 4 to 6 weeks following RT prior to surgery is then indicated to be preferable.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"f99afde0-bb61-e610-4da2-b8e419b2d2bd","text":"Nose surgical wounds can be challenging even for most experienced dermatological surgeons and it is noteworthy that tumor location can influence the closure type choice In this study surgical wounds located on the nose showed a 39% chance of being submitted to other closure types rather than to linear repairs when evaluated with Poisson regression model similar to Alam et al. that also found more flaps than primary closures in nose defects. Transposition flaps can redirect surgical wound tensions and are very useful for defects near free margins such as the nose, eyelids e lip. In our study this surgical approach, despite demanding high complexity in execution and planning, was the second most used flap option among the 975 cases studied demonstrating surgeon’s experiences in reconstructing complex cancer cases and was oftenly used for nose and scalp defects.","title":"Keep it simple. A ten-year experience in reconstructions after Mohs micrographic surgery"}
{"_id":"f9a1c041-18d1-cccc-c726-31c3ba2f9340","text":"In this study, we analyzed the effect of BTA injection on the improvement of severe dry eye symptoms based on the subjective symptoms of patients and the numerical effects of various imaging devices and instruments that have been newly introduced to assess the tear condition.","title":"Botulinum Toxin A Injection for the Treatment of Intractable Dry Eye Disease"}
{"_id":"f9a37097-5aa6-70b7-51da-adf332ea118a","text":"Here we reviewed approaches evaluating novel immunomodulatory agents and recent insights into genetic and phenotypic characterization of specimens from patients with melanoma to develop robust biomarkers to guide clinical decision-making.","title":"Perspectives in Melanoma: meeting report from the Melanoma Bridge (December 3rd–5th, 2020, Italy)"}
{"_id":"f9a519d6-510f-4d3d-6b48-3ebddc474f90","text":"Table 6 outlines the available literature on these procedures alongside some of the available data.","title":"Natural Orifice Translumenal Endoscopic Surgery: Review of Its Applications in Bariatric Procedures"}
{"_id":"f9a58afb-9004-52f5-613e-b3eb86e96a46","text":"This is a retrospective analysis of all thirteen patients who underwent deformity correction of the lower limb with fixator assisted intramedullary nailing from January to 2010 till June 2017 in our tertiary care hospital. Approval was taken from hospital's ethical review committee. All those patients who underwent fixator assisted intramedullary nailing of tibia or femurs for deformity correction were included. Patients who lost to follow up and those with missing records were excluded from the study. All surgeries were performed by a senior surgeon in orthopedics with experience in deformity correction surgeries. The work has been reported in line with the PROCESS criteria [5].","title":"Correction of lower limb deformities with fixator assisted nailing"}
{"_id":"f9a5baf4-1c05-e4d0-f2b5-4a4a65150874","text":"Furthermore, the causality between therapeutic ineffectiveness and justified non-adherence to the protocol was considered improbable despite a reasonable temporal relationship between the prophylaxis administration and the diagnosis of PTE, since the thrombotic event could be explained by other clinical factors 19.","title":"Assessment of the adherence to and costs of the prophylaxis protocol for venous thromboembolism"}
{"_id":"f9adbc0d-d1ff-e43c-1cc7-e1a4632fa7b7","text":"We presume that a steep learning curve occurred during the switch from OW to PC in the course of the study period. Therefore, the performance might have been suboptimal in the first few PC operations conducted.","title":"Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children"}
{"_id":"f9b55bad-abb8-b573-ae38-93900a04872c","text":"In summary, scarring on the chest wall or in the LIMA dissection bed is not uncommon in patients with a history of chest radiation who require a coronary bypass operation. However, as this case demonstrates, recurrent cancer cannot be ruled out based on gross appearance alone and we recommend surgeons have a low threshold for sending specimens of what may appear to be radiation scar for formal histologic evaluation.","title":"Case report: recurrent metastatic breast cancer in internal mammary dissection bed discovered at the time of coronary bypass"}
{"_id":"f9c67907-8553-9f4e-9579-5cc55606cd6e","text":"The segmentation time reduction was largest for the head and neck lymph nodes. This is most likely due to the complexity and individual variation for these structures. The pelvic lymph nodes are closely linked to the neighbouring bone structures. This facilitates both manual segmentation and editing, leading to a smaller reduction of segmentation times than for the head and neck nodes. However, even if the magnitude of time saved per patient for the pelvic lymph nodes is modest, for a large throughput of patients the gain can still be of importance.","title":"Clinical evaluation of multi-atlas based segmentation of lymph node regions in head and neck and prostate cancer patients"}
{"_id":"f9c81f5d-8311-d993-6cf2-9593ec133a09","text":"The major findings in our study were the high local control rate with 106Ru brachytherapy even in tumors with a depth of more than 5 mm and the overall low acute and long-term toxicities. Despite the limited number of patients, these results prove 106Ru brachytherapy to be an excellent treatment option in clinical practice for uveal melanoma and should be promoted in well-selected patients. The treatment is also suitable for tumors with a depth of more than 5 mm.","title":"106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma"}
{"_id":"f9cee9ee-a81e-d81e-b467-b5490ee60e34","text":"This report describes the use of a vena saphena magna interposition ateriovenous subclavia-shunt for the reconstruction of complex defect in the head and neck region.","title":"Ateriovenous subclavia-shunt for head and neck reconstruction"}
{"_id":"f9d48dce-648a-d962-15db-733fba8bc862","text":"Additionally, missing from previous analyses has been an assessment of the magnitude of differences in potential lifetime compensation among the subspecialties themselves. If financial return is believed to be a motivating force in the decision process of whether to pursue fellowship training, it follows that the choice of a specific subspecialty may also be affected in a similar fashion. If so, such information is an important part of workforce analysis and planning.","title":"Comparison of Calculations of the Financial Impact of Fellowship Training by Data Source Calculations of the Financial Impact of Fellowship Training Differ by Source"}
{"_id":"f9d60103-dd68-7634-2dc3-f47284c3e482","text":"The results from Study 2 gave clear evidence that aspects of facial contrast are used as cues for perceiving the age of female faces in both French and Chinese participants. When we tested these groups with faces from the four racial groups and from a large range of age, female faces with increased facial contrast were judged younger than those with decreased facial contrast. The effect was robust and largely above chance regardless of the ethnic origin of the face or the cultural origin of the participant; with French participants selecting high contrast faces slightly more often than Chinese participants. Collectively, these findings are consistent with the idea that the aspects of facial contrast that decrease with age in the majority of female faces are cross-culturally valid cues to the perception of women's age.","title":"Facial Contrast Is a Cross-Cultural Cue for Perceiving Age"}
{"_id":"f9d9068b-9847-8508-e440-2fbd720778a5","text":"The success of the operation depends on its details and what the procedure entails. As many arteries and veins as can be identified should be anastomosed. One artery and two veins were anastomosed in this case because the blood supply in the amputated tissue was found to be adequate immediately after surgery. Effective fixation is also essential to ensure success. When anastomosing the lateral calcaneal artery and nerve, the medial margin and distal end of the amputated tissue should be fixed on the wound. To prevent vascular and nerve avulsion caused by pulling during vein anastomosis, the medial side of the anastomosed lateral calcaneal artery and nerve should also be fixed. The cause of distal necrosis in this case was a severe tissue contusion and insufficient arterial blood supply, but these occurrences had no significant effect on the overall appearance and function during long-term follow-up.","title":"Case report: Microsurgical replantation of heel skin and subcutaneous tissue"}
{"_id":"f9dbb927-a120-f2af-7b7b-b042ad91fc31","text":"Our results suggest that in early breast cancer patients with micrometastasis, complete ALND does not seem to be required and that SLNB suffices to control locoregional and distant disease, with no significant adverse effects on survival compared to complete ALND.","title":"The prognostic significance of further axillary dissection for sentinel lymph node micrometastases in female breast cancer: A competing risk analysis using the SEER database"}
{"_id":"f9e93842-6c22-b325-874d-cb1203fded8e","text":"The literature analysed consistently supports the use of emollients and mild soaps, and a controlled study demonstrated significantly improved skin physiology and appearance with combined use of mild soap and emollients.21","title":"Algorithm for dermocosmetic use in the management of cutaneous side-effects associated with targeted therapy in oncology"}
{"_id":"f9ea0b34-0e9d-39eb-869a-765c25c10931","text":"The liposomes are prepared vesicles structured as lipid bilayers enveloping an aqueous core that are frequently used as vehicles for delivery of substances in a controlled manner to particular areas of skin or its layers. According to their special structure, liposomes can carry hydrophilic agents in their internal aqueous partition and lipophilic molecules via the nonpolar tails of the bilayer section. Liposomes, with their small size and resemblance to the skin structure considering their lipid composition, provide consistent facilitation to the penetration inside the horny layer that is more pronounced if compared to conventional dosage forms. In the last years, particulates such as liposomes have drawn great attention as a result of their effectiveness to improve penetration into the hair follicle structures. In order to consent to particles to penetrate deep into the hair follicles, they must have a size between 400 and 700 nm to be considered optimal. On the contrary, particles larger than those indicated above will remain on the surface of the skin, while those of smaller dimensions will reach a significantly greater depth [46,57,61].","title":"Stem Cells as a Target for the Delivery of Active Molecules to Skin by Topical Administration"}
{"_id":"f9f5029e-3c13-236c-4e2d-e6466e955eaf","text":"Figure 8 shows a case of a treatment of oral ulcer by botulinum toxin in our hospital. A patient suffered from oral ulcer persisting even though the patient visited and received treatment from the Department of Oral Medicine and the Department of Periodontology. On biopsy, the ulcerative lesion was found to be erosive lichen planus, and when we injected 0.5 unit of BTXA into the mucosa surrounding the lesion and at the center of the lesion, it relieved the pain and significantly reduced the size of the ulcer.","title":"Application of botulinum toxin in maxillofacial field: Part II. Wrinkle, intraoral ulcer, and cranio-maxillofacial pain"}
{"_id":"f9f70713-b667-76d6-6990-8c02e7dfb4e3","text":"Reactive lesions are common on the gingiva and tend to be not painful, without neoplastic growths, but often interfere with plaque control and cause patient discomfort. Most of these lesions are discovered between the fifth and sixth decades of life with a predilection for females.","title":"Complete excision and soft tissue augmentation after recurrence of a peripheral ossifying fibroma as a pyogenic granuloma: A case report"}
{"_id":"f9f942d8-94aa-b4fc-65cf-9ec040106443","text":"In this randomized clinical trial that included 136 patients with cervical radiculopathy, there were similar and significant improvements in Neck Disability Index scores for both treatment groups at the 5-year follow-up. There was no statistically significant difference in change of Neck Disability Index score at 5 years between patients who underwent arthroplasty and fusion.","title":"Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy A Randomized Clinical Trial Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy"}
{"_id":"f9feb304-ccdf-0565-91b0-de7055f28451","text":"From May 2002 to May 2003, 80 patients scheduled for elective first time coronary artery bypass grafting were recruited into the study. Study participants had isolated coronary artery disease that required at least part of their revascularization to be done using the LSV. Exclusion criteria included patients undergoing emergency coronary artery bypass grafting and those with severe varicose veins. The study was approved by the Local Research and Ethics Board at Glasgow Royal Infirmary. Before enrollment and randomization each participant provided written informed consent.","title":"Decreased morbidity following long saphenous vein harvesting using a minimally invasive technique: a randomised controlled trial comparing two techniques for long saphenous vein harvest"}
{"_id":"fa1cb659-617a-419a-c0e9-6bf149b75bbc","text":"To avoid unnecessary and prolonged antibiotic therapy or a failure to treat osteomyelitis, it is important that clinicians should be aware of the limitations of clinical and radiological diagnostic modalities. Microbiological examination is also unreliable unless it is undertaken appropriately using bone biopsies. Further research is necessary to identify improved strategies for the accurate diagnosis of osteomyelitis in patients with pelvic pressure ulcers.","title":"Diagnosing pelvic osteomyelitis in patients with pressure ulcers: a systematic review comparing bone histology with alternative diagnostic modalities"}
{"_id":"fa1fee28-d7ce-0897-8f15-38228d422faf","text":"In 73% of the cases of the chronic osteomyelitis was caused by inadequate treatment of open fractures. Children less than 16 years old constitute 63% of the whole group. Antibiotic treatment prior to the admission could be one of the factors contributing to a relatively low white cells count for the participants.","title":"Chronic Osteomyelitis - Bacterial Flora, Antibiotic Sensitivity and Treatment Challenges"}
{"_id":"fa266b89-33ee-2fa9-191a-ef9e69eb4675","text":"Data mining is an emerging discipline that has emerged in recent years. It makes comprehensive use of various learning methods and approaches such as statistics, rough sets, and fuzzy mathematics to extract abstract knowledge from massive amounts of data, thereby revealing the intrinsic relationships and essential laws of the objective world hidden in the data, thus enabling the automatic extraction of knowledge.","title":"Meta-Analysis and Data Mining-Based Study on the Expression Characteristics of Inflammatory Factors and Causes of Recurrence in Spinal Tuberculosis"}
{"_id":"fa2b4344-5438-5861-20e5-feb1aadb7f5d","text":"The aim of this study was to assess the opinions of local plastic surgeons on the challenges faced practising microsurgery in the ECSA region and how to improve the service.","title":"Challenges in global reconstructive microsurgery: The sub-Saharan african surgeons’ perspective"}
{"_id":"fa329abb-66aa-09fd-cee5-751e235b2292","text":"The monocentric observational cohort study was carried out after the approval of the Regional Hospital Ethics Committee for Multicentric Clinical Trials. The data processed were obtained from the prospective database of preventive multimodal nosocomial infection control protocol. The database is maintained since 2001 and contains prospective data related to all parameters collected with respect to monitored nosocomial infections in our NICU as well as other parameters related to patients’ health status.","title":"Incidence of surgical site infections after cervical spine surgery: results of a single-center cohort study adhering to multimodal preventive wound control protocol"}
{"_id":"fa361da0-7e33-2331-2081-0997f3b519e8","text":"The new drugs used under anesthesia allow sedation or general anesthesia with rapid recovery and without side effects;","title":"Oral surgical procedures under local anaesthesia in day surgery"}
{"_id":"fa3ba738-c2b1-ff37-0f91-cca8e284ce5b","text":"Our main emphasis was to identify differences in B cell subsets at baseline and upon immunization between aged and younger individuals and to assess if and how the differences may explain low responsiveness of the aged. Confirming previous results, numbers of circulating naïve B cells were lower in the aged [25] while numbers of some of the other subsets only showed a trend towards an age-related decline. Our main finding was that on all B cell subsets expression of BTLA prior to vaccination was significantly lower in the aged.","title":"BTLA expression declines on B cells of the aged and is associated with low responsiveness to the trivalent influenza vaccine"}
{"_id":"fa41db90-2155-7413-064f-7f19466bebc8","text":"The use of soft tissue flaps to close a typical hemi-maxillectomy defect is an effective way of dealing with the oro-nasal communication, but in isolation, this technique works against dental rehabilitation as the bulk of the flap provides a very poor moveable foundation for a subsequent removable prosthesis. The move towards the use of composite reconstruction (especially the fibula flap) has been facilitated by the use of digital planning in which dental implants can be inserted into the fibula flap at the time of harvest and inset facilitated by the use of stereolithographic guides. However, this procedure is not widely applicable for all patients due to financial, technological and medical restrictions and is not currently able to provide patients with an early loaded fixed dental prosthesis especially when post-operative radiotherapy is being utilised. Many older patients presenting with maxillary malignant tumours also have significant peripheral vascular disease and other significant medical co-morbidities which may prevent the harvest of a vascularised composite flap.","title":"The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy"}
{"_id":"fa44b0d1-78c1-bfbc-49bc-3a858d377086","text":"The study questionnaire was distributed electronically via SurveyMonkey TM to the 600 trainees currently registered in the SMSB surgical training programme. A survey reminder was sent to potential participants every two weeks for a total of four attempts before closing the survey after 8 weeks. By the end of recruitment period only 130 trainees of the 600 contacted accessed and opened he questionnaire through SurveyMonkey TM.","title":"Needs assessment study of postgraduate surgical education in Sudan: Trainees perspective"}
{"_id":"fa50faf0-2f4f-30e6-3555-faee48778f53","text":"Many authors in their works note the importance of accurate assessment of causes of neck contour disorders. Nevertheless, they often neglect to use diagnostic methods. Only lately publications in the world literature appeared about role of instrumental examinations in planning surgical correction of facial and neck tissue atrophy.","title":"Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques"}
{"_id":"fa50fc23-e1af-6d85-6a0e-9ea3d3a3aed7","text":"In this article, we report a rare case of an association of three cutaneous reactions after a vaccination with the AZD1222 vaccine.","title":"Site Injection Reaction, Maculopapular Rash, and Rosacea Exacerbation after COVID-19 Vaccination"}
{"_id":"fa60f202-913d-5e2c-3be6-c68b37ae12bb","text":"Other salvage options such as cryotherapy or radical prostatectomy were discussed as well but were refused by the patients. Written informed consent was obtained from the patients for participation in this retrospective review, which was approved by the Institutional Review Boards of the participating institutions.","title":"Salvage brachytherapy in prostate local recurrence after radiation therapy: predicting factors for control and toxicity"}
{"_id":"fa61bda6-a543-3d08-c131-9fbbf612f9c8","text":"Drain fluid amylase concentration may be a valuable predictor of postoperative salivary fistula in cases with benign parotid tumours.","title":"Drain fluid amylase as a predictor of postoperative salivary fistula in cases with benign parotid tumours"}
{"_id":"fa64c09d-4acf-6a8e-3113-dd4b13dd7377","text":"Providing adequate training in plastic and reconstructive surgery is fraught with several challenges and this survey was performed to investigate the various shortcomings in training perceived by the trainees.","title":"A survey of current state of training of plastic surgery residents"}
{"_id":"fa7daf34-165a-7e1e-39e7-d944d75389bd","text":"It is intuitive that the longer spinal cord compressed, the worse neurological deficit and prognosis would be [2]. It is well established that surgical decompression of the cervical spinal cord is an effective treatment option, not only to stop the progression of symptoms and promote meaningful functional recovery but also to reestablish spinal stability. Surgical decompression can be performed via either an anterior surgical approach or a posterior surgical approach. Anterior surgery typically takes the form of either an anterior cervical discectomy and fusion or corpectomy, and posterior surgery typically involves a laminoplasty or laminectomy and fusion.","title":"Clinical and Radiological Outcomes of Anterior Approach Microscopic Surgery for the Pincer Mechanism in Cervical Spondylotic Myelopathy"}
{"_id":"fa80825a-8631-3240-6038-eebce2144649","text":"The primary endpoint is definite failure of infection treatment, where definite failure is indicated by one or more of the following:","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"fa826d94-da54-f987-1613-015cffc26c7b","text":"The main objective of this 3-month prospective clinical trial was to evaluate the efficacy and safety of BTA in the treatment of refractory and localized MM compared to another minimally invasive treatment modality, such as PNE. In our study, these procedures were performed with the help of EMG prior to therapeutic administration. The results obtained showed a significant reduction in pain and an improvement in masticatory function. Our study revealed that it is possible to achieve satisfactory mouth opening and free and painless mandibular movement using both BTA and PNE in the treatment of chronic masticatory pain, with little or no adverse effects. The optimal use of BTA and PNE in patients with localized myalgias in the masticatory muscles could contribute to improving the efficiency of care in healthcare systems. Therefore, the use of BTA and PNE could be considered a valid and safe therapeutic alternative among the available options to treat refractory and localized MM when a better therapeutic response is expected, as both demonstrate high efficacy.","title":"Botulinum Toxin and Percutaneous Needle Electrolysis for the Treatment of Chronic Masticatory Myalgia"}
{"_id":"fa88c825-fbe1-ea92-0f07-91ee818abb98","text":"This recommendation remained controversial for more than a century, as a consequence of the possible and unnecessary comorbidities to which the patients could be exposed.","title":"Preliminary Study of Axillary Lymphatic Drainage in Cutaneous Melanoma Patients: A Cross-Sectional Study"}
{"_id":"fa88cd24-d926-363a-7058-ea28df9e4499","text":"Catabolism of LDs into free FAs is a crucial cellular pathway that is required to generate energy in the form of ATP. Their catabolism is strictly under the control of hormone and enzyme activation. Moreover, it is required to provide building blocks for biological membranes and precursors in hormone synthesis. Degradation of LDs is strictly regulated by the protein composition on the surface of the vesicle and generally occurs by two mechanisms: lipolysis or lipophagy.","title":"Lipophagy and Lipolysis Status in Lipid Storage and Lipid Metabolism Diseases"}
{"_id":"fa8dbf0f-9b9d-5e12-c0c8-a6f228479b88","text":"For each anatomic site among all included cases in OncoPanel, the prevalence of primary tumors with at least one CDH1 mutation was calculated as the number of primary tumors with at least one positive CDH1 mutation divided by the number of primary tumors evaluated. The prevalence of tumors with at least one CTNNB1 mutation for each tumor site was calculated analogously for OncoMap and OncoPanel patients combined. After combining CTNNB1 OncoMap and OncoPanel data for lung cancer patients, we excluded OncoMap data for the single included patient who was evaluated using both platforms to avoid double-counting.","title":"Somatic mutations in CDH1 and CTNNB1 in primary carcinomas at 13 anatomic sites"}
{"_id":"fa8ea3d0-42b5-eebd-8f8b-f6cb8dd42f6e","text":"To test this hypothesis, we have repeated previous studies using these 3 data sources independently. We believe this approach may provide a clearer picture of the range of differences in potential compensation for general pediatrics and the subspecialties and shed light on the implications for using seemingly valid but different data sources for the same analyses.","title":"Comparison of Calculations of the Financial Impact of Fellowship Training by Data Source Calculations of the Financial Impact of Fellowship Training Differ by Source"}
{"_id":"fa9bb410-91ab-2fc1-550b-bacf2a373afc","text":"MR images can be categorized into two classes: high resolution with high SNR and high resolution with low SNR. High resolution with high SNR is a consequence of increased acquisition time of MRI which is not feasible due to the patient comfort. Noise reduction in PD weighted MR images has an important effect on segmentation success as much as correction of intensity inhomogeneity. Owing to the fact that the distribution of the noise in PD images is not Gaussian, noise problem cannot be solved sufficiently by traditional noise reduction methods such as Gaussian filter and median filter [8].","title":"Segmentation of Bone with Region Based Active Contour Model in PD Weighted MR Images of Shoulder"}
{"_id":"fa9ed58c-13fc-f283-43d6-fa5bf5f71622","text":"Patient and injury selection for this technique is critical. Such decisions must be made by a surgeon proficient in the techniques of adult tibial deformity correction and be made in conjunction with the patient. In addition, backup options of a free flap and secondary reconstruction or amputation should be discussed with the patient in case the wound does not heal.","title":"Conversion of open tibial IIIb to IIIa fractures using intentional temporary deformation and the Taylor Spatial Frame"}
{"_id":"faad30a7-195f-4c12-435f-211d33af5834","text":"In stroke patients, and those with other acute medical conditions, IPC can only be applied after the patient has become immobile. Immobility may then persist for weeks or even be permanent in such patients. DVTs may develop rapidly and cannot then be so effectively prevented by a treatment starting sometime after the initial period of paralysis and immobility. Clearly, we cannot test the effectiveness of IPC applied before stroke onset but it is a challenge to recruit patients into a RCT, with the need to collect informed consent, as early after the stroke as IPC might be applied if it was being used in routine clinical practice. For this reason we are trying to maximise the proportion of patients recruited on Day 0 or 1.","title":"Does intermittent pneumatic compression reduce the risk of post stroke deep vein thrombosis? The CLOTS 3 trial: study protocol for a randomized controlled trial"}
{"_id":"fab114c8-0c77-90ab-4f5e-92279262edd4","text":"This systematic review revealed that the literature describing color Doppler ultrasonography used to identify perforators for pedicled perforator flap reconstruction of local defects is limited and the findings have some apparent limitations: first of all, the low level of evidence of the included studies. There was just one prospective study and 11 retrospective chart reviews. Secondly, several of the included studies were small case studies. On the other hand, the diversity of flaps and rate of successful reconstructions reported in this review seems to indicate that pedicled perforator flaps are a reliable alternative to other reconstructive options. Correct use of CDU enables the surgeon to target the perforator and plan a pedicled perforator flap for local reconstruction using the available tissue adjacent to the defect with the shortest possible arc of rotation or transposition to minimize the risk complications.","title":"Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps—a systematic review and meta-analysis"}
{"_id":"fabb554e-33d6-17be-38ef-142d78e0630a","text":"The ERC is only required to review definite or potential treatment failures. All other endpoints are determined directly by the local study clinicians.","title":"Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): study protocol for a randomised controlled trial"}
{"_id":"fac27946-5ed8-15f2-692d-7b521a5ac7af","text":"There were no serious complications or side effects of BTX injection. There were four episodes of chest pain that lasted for up to 4 h after injection, which resolved spontaneously and did not require medical treatment. No other side effects were observed.","title":"Treatment of achalasia: the short-term response to botulinum toxin injection seems to be independent of any kind of pretreatment"}
{"_id":"fac99548-7a3b-12d1-bf77-6d7b8de18fa7","text":"All organizations have in common that physicians represent the only professional group whose complete participation in team meetings goes without saying. Other professional groups might only be represented by means of delegates, often the leading person of the respective group. This is the case in two of the three institutions with a lower level of patient success but in none of those with an upper level of patient success. Team members who are not able to take part in the team sessions regularly criticize this type of delegation. For example, a physiotherapist from a facility with a lower level of patient success reports in a group discussion:","title":"Cooperative leadership as a condition for patient-reported rehabilitation success"}
{"_id":"fadb8f62-8d38-17c3-ffd6-f1f7157c449f","text":"The school invested in ongoing surveys to enhance its understanding of what was going on which resulted in the development of the following questions:","title":"Students' perceptions of online learning in higher education during COVID-19: an empirical study of MBA and DBA students in Egypt"}
{"_id":"fae3d274-6942-cc7d-9071-b1b9013e095c","text":"This survey represents the views of the first year medical students in their first term at medical school; it is the study's express intention to look at the career intentions of this group before exposure to the system, and it is accepted that their opinions may change. Although it would certainly be interesting to follow up the sample as a cohort in the years to come as an additional project, it falls beyond the aim of the project at this time.","title":"Who wants to be a surgeon? A study of 300 first year medical students"}
{"_id":"fae5d49b-66f0-52f7-cbde-246f05adb418","text":"In this context, the optimization of the surgical management of NMSC is of great importance in order to ensure the highest quality of surgical treatments and a subsequent optimal outcome for all patients.","title":"Identifying the factors that influence surgeon's compliance with excisional margins of non-melanoma skin cancer"}
{"_id":"fae9324d-62a1-be0f-d2e5-a2fb8a65cdea","text":"Musculoskeletal involvement in the course of sarcoidosis is increasingly recognized due to implementation of modern imaging techniques. The most troublesome situations concern the patients with focal bone disease, recognized in patients without the signs of pulmonary sarcoidosis. Tissue biopsy is often required to differentiate between bone sarcoidosis and metastatic neoplastic disease because MR images of bone lesions are nonspecific, mandating differentiation between sarcoidosis foci and metastatic lesions or multiple myeloma. Modern imaging techniques facilitate tissue sampling and enable monitoring of the disease course. Although the spontaneous regression of bone sarcoidosis is possible, some patients require immunosuppressive therapy to achieve the remission of the disease.","title":"Imaging Plays a Key Role in the Diagnosis and Control of the Treatment of Bone Sarcoidosis"}
{"_id":"faefd9e1-1e48-d26c-f3c8-787165af3bee","text":"Our patient refused the surgical excision of the nasal lesion, and so treatment consisted of radiation therapy; 30 Gy external beam radiation was delivered in 10 fractions with 3 Gy per fraction over two weeks, followed by 30 Gy delivered by brachytherapy.","title":"Triple malignancy in a single patient including a cervical carcinoma, a basal cell carcinoma of the skin and a neuroendocrine carcinoma from an unknown primary site: A case report and review of the literature"}
{"_id":"faf73df3-bc90-816e-3379-30001c7a4301","text":"Data was extracted from the ACS NSQIP procedure-targeted database from the time period of January 2005 to December 2019. Patients who underwent a hysterectomy for a known malignancy were included within the extracted dataset. The ACS NSQIP database is a national surgical registry used to track risk-adjusted outcomes after surgical procedures from any medical specialty. Prospective variables are obtained and audited by trained clinical reviewers. The American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.","title":"Machine learning methods to predict presence of residual cancer following hysterectomy"}
{"_id":"fafa95b3-d87d-80b9-7f8d-595d0d963bfa","text":"The main findings of the present study were that the incidence of free flap failure in 625 patients undergoing free flap reconstruction of the upper and lower extremities was 6.1%, and that a low PNI and female sex were independent predictors associated with free flap failure in this patient cohort. In addition, the duration of hospital stay was significantly longer in the free flap failure than in the free flap survival group. To our knowledge, this study is the first to show that the PNI is significantly associated with free flap failure in extremity reconstruction.","title":"Prognostic Nutritional Index is a Predictor of Free Flap Failure in Extremity Reconstruction"}
{"_id":"fb0309dd-a7e7-6ff4-9017-5997de70a8de","text":"Decorative cosmetics remotion in rosacea patients should be conducted using skin cleansers that are low-foaming and free of lipids and volatile solvents, which are responsible for worsening facial redness due to their harmful effect on intercellular lipids. Another possible alternative is cleansing creams, which can be particularly useful in patients with dry rosacea who need complete removal of decorative cosmetics, as these creams provide both cosmetic removal and gentle cleansing of the skin.","title":"Rosacea Topical Treatment and Care: From Traditional to New Drug Delivery Systems"}
{"_id":"fb04ed40-fb7e-1de0-0138-2d87c915298e","text":"To critically examine the existing Brazilian and International scientific literature regarding the influence of short lingual frenulum over growth and development of the stomatognathic system, as well as how it impacts the achievement of the shape-function balance.","title":"ANKYLOGLOSSIA AND ITS INFLUENCE ON GROWTH AND DEVELOPMENT OF THE STOMATOGNATHIC SYSTEM A INFLUÊNCIA DA ANQUILOGLOSSIA NO CRESCIMENTO E DESENVOLVIMENTO DO SISTEMA ESTOMATOGNÁTICO"}
{"_id":"fb134597-53b1-189c-bcb8-cc5fb8bc41b4","text":"In summary, we have demonstrated that imiquimod selectively induces apoptosis in DFT1 and DFT2 cell lines. Our results have highlighted the importance of continuous imiquimod treatment for activation of these pathways, which may have implications for its therapeutic use in both DFTD and human cancers. As a DFTD immunotherapy, imiquimod has potential to activate TLR7 mediated immune responses, while deregulating tumour growth and survival in a direct and targeted manner. Together this suggests that imiquimod is suitable for DFTD therapy, warranting further investigation into strategies for its use in the Tasmanian devil.","title":"The Immunomodulatory Small Molecule Imiquimod Induces Apoptosis in Devil Facial Tumour Cell Lines"}
{"_id":"fb1f288c-b1ee-d139-5c9c-d639b3f3c76f","text":"Aggressive surgical management of fibromatosis of the breast with suspected chest wall involvement is appropriate to attempt to obtain a long-term durable cure.","title":"Management of a patient with multiple recurrences of fibromatosis (desmoid tumor) of the breast involving the chest wall musculature"}
{"_id":"fb2ad7b5-e597-c119-b7fe-1d69502e2147","text":"We present a case where a perforating flap was used to repair a significant soft tissue wound due to a fragmentation injury, and is presented with consent of the patient.","title":"Telemedicine support aids lower limb reconstruction after combat injury in Ukraine"}
{"_id":"fb2d5cc5-ffe5-0e29-1187-43464711b20a","text":"Overall, we found a growth in the number of general surgeons, but this growth was primarily concentrated in large practices of 6 or more surgeons. Our estimates of the number of surgeons using the new MD-PPAS data set is consistent with general surgery workforce estimates from the existing literature using data from the Association of Academic Medical Centers, the American Medical Association Masterfile, or the US Census Current Population Survey. Our results show that changes in the consolidation of general surgery practices match similar changes in physician practice consolidation across other medical specialties. Surgeons running small practices may find it difficult to compete with larger practices affiliated with health systems. Furthermore, when a hospital is purchased by a larger health system, surgeons in small practices based within that hospital may be forced to join a larger physician organization within the health system or relocate their practice to remain independent. More so than in many specialties, surgery has specific infrastructure, technological, and equipment requirements, and the choice to relocate a practice may be especially burdensome. Therefore, health care systems hold considerable leverage in consolidating surgical practices as they expand their hospital networks.","title":"Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US Comparison of General Surgical Practice Size and Setting in 2017 vs 2013 in the US"}
{"_id":"fb3e7a7e-48fb-ba42-1534-87e1ea3ec9c9","text":"Following debridement of the wound, the diameter of this defect increased to approximately 3 cm. A variety of reconstructive options were available for this defect of 7 cm2. Although located at the vertex of the scalp, the amount of thinning hair demonstrated no whorl pattern. Conservative management with daily normal saline dressing changes would be expected to produce not only granulation tissue but also some wound contracture. This contracture could potentially cover or nearly cover the calvaria. If the wound failed to reduce to cover the calvaria, burring of the outer table to obtain granulation tissue would be necessary. All open tissue would need skin grafting. This process could be expected to take several weeks or longer. The ideal skin graft would be a full thickness skin graft, most likely harvested from the inguinal crease.","title":"Dufourmentel Flap for Scalp Reconstruction"}
{"_id":"fb426138-2c54-aff5-e7c5-a0dbf82ab99e","text":"Subjects with ankyloglossia had reduced maxillary and mandibular intercanine widths and reduced maxillary intermolar width. The mandibular plane angle and overbite were altered with severity of ankyloglossia.","title":"Skeletal and dental characteristics in subjects with ankyloglossia"}
{"_id":"fb47a493-c79f-9613-3e70-3200997c5c99","text":"However, evidence on injection site reactions specifically in biologic treatments is limited and reported incidence rates of injection site reactions are highly variable between different biologics. According to a narrative review conducted in 2019, incidence of injection site reactions vary greatly - between 0.5 to 40% depending on the biologic. The underlying mechanisms of injection site reactions were found to be either irritative reactions caused by the proinflammatory actions of the drugs or allergic reactions to the drug itself. Despite the mandatory collection and reporting of adverse events in randomized controlled trials, the methodological and reporting quality surrounding adverse events in contemporary clinical trials have been found to be inconsistent.","title":"A Systematic Review and Meta-Analysis of Injection Site Reactions in Randomized-Controlled Trials of Biologic Injections"}
{"_id":"fb49ae6f-e0d8-1dce-946a-8d5b8cef6a27","text":"After 3 weeks postoperatively, the free flap pedicle was occluded with noncrushing clamps at the bedside and the flap vascularity status was assessed clinically using a needle prick test. If there is bright red blood bleeding in the distal part of the flap and no signs of insufficient flap circulation noted, we then conduct the second stage of flap separation and divide it from the recipient extremity. If flap circulation seems insufficient, we wait further 4 or 5 days and repeat that. After the removal of the external fixator and separation of the two legs, physiotherapy is started immediately to prevent joint stiffness.","title":"Reliability and Safety of Cross-Leg Free Latissmus Dorsi Muscle Flap in Reconstruction of Mutilating Leg Injuries Using End-to-Side Anastomosis"}
{"_id":"fb4d9e3c-17dc-738d-7590-caef3458e9ed","text":"The color Doppler technique requires a higher skill level. In the present study we consider the total or partial absence of blood flow in the color Doppler examination as an indicative of vein thrombosis and we used it as the gold standard for the confirmation of the diagnosis (Additional file 5: Video S5).","title":"Ultrasonographic evaluation of deep vein thrombosis related to the central catheter in hemodialytic patients"}
{"_id":"fb542d39-388a-3027-889f-03e7ecf8cca9","text":"All authors have no relevant or other potential conflicts of interest.","title":"Repeated acute lower limb ischemia due to complete occlusion of an artificial vessel graft: A case report"}
{"_id":"fb564023-4660-aabe-9eb7-5cdd594d30a4","text":"A 60-year-old male with a chronic pretibial wound with underlying osteomyelitis of the right leg presented himself at the emergency department and was admitted to the surgical ward of the Haaglanden Medical Centre in October 2018. His medical history included the following:","title":"Complications in the Treatment of Delayed Union and Underlying Chronic Osteomyelitis After Right Crural Fracture Treated With Anterolateral Thigh Flap and Double-Barrelled Vascularized Fibula Graft"}
{"_id":"fb59fa36-a12c-a536-09a3-24cf7f28e434","text":"Multicollinearity was assessed by creating a heatmap correlation matrix to omit variables with high variance inflation factors (VIFs) to preserve the integrity of the statistical significance of the input variables for the model. Any variables with a VIF greater than 3 were dropped from the model. Variables were dropped one by one, starting with the variables with the highest VIF, after which the list of VIFs for all features included in the model were reevaluated to see if they were all under or over 3. If all the variables included in the model did not have a VIF under 3, then the next variable with the highest VIF was dropped from the model.","title":"Machine learning methods to predict presence of residual cancer following hysterectomy"}
{"_id":"fb681877-59b1-2b12-3f42-f99b9a308fa5","text":"Table 3 Clinical and pathologic characteristics of patients clinically suspected of lymph node metastasis for subgroups based on type of axillary operation","title":"Feasibility of sentinel lymph node biopsy in breast cancer patients clinically suspected of axillary lymph node metastasis on preoperative imaging"}
{"_id":"fb692f0b-ae04-c0b8-3ef2-19e91c67a554","text":"In conclusion, the findings of the present study demonstrated that BTA is a safe and effective therapy for the management of AGA and BTA combined with FNS presents excellent results. These data provide a novel theoretical basis and therapeutic strategy for the treatment of AGA.","title":"Effectiveness and Safety of Botulinum Toxin Type A in the Treatment of Androgenetic Alopecia"}
{"_id":"fb6d5e0e-ae58-b90b-cb2c-88656953fe80","text":"PHDRB exemplifies the true interdisciplinary management of cancers by integrating brachytherapy with surgery. The ‘tumor bed effect’ theory explains the rationale of delivering a high dose of radiation in the immediate perioperative period. It alters the interaction of the microscopic residual disease cells within the tumor bed with the normal host tissues and prevents their reimplantation and subsequent local recurrences. Improved local control in turn lead to decreased local and distant failures and improved overall survival. Reducing the treatment-related toxicity is another argument for the practice of brachytherapy, as it confines the radiation dose to a small area with a rapid dose fall off in surrounding structures. Concurrent chemoradiation is considered the standard of care in management of locally advanced head and neck cancers. Significant Grade 3 toxicity ranging from 21 to 38% has been reported with the use of concurrent chemoradiotherapy protocols in head and neck cancers. Grade 3 toxicity upto 39% has been reported with reirradiation using external beam techniques. One of the ways to reduce this treatment associated toxicity is to reduce the volume of irradiation by integrating brachytherapy into the treatment protocols.The isodose distribution of PHDRB implants Figure 4 show the high degree of conformity achieved within the treatment area with minimal dose to the surrounding critical organs. Gaztanaga et al have shown perioperative high dose rate brachytherapy to have equivalent treatment outcomes when compared to wide field radiotherapy with 5 year locoregional control rates from 60.9 to 79.4%.","title":"Perioperative high dose rate brachytherapy in head and neck cancers: case report and review of clinical application Bahl et al"}
{"_id":"fb71d277-978d-ebc4-510a-e2d6f709d548","text":"This retrospective study was approved by the Ethics Committee of the Sacred Heart Catholic University.","title":"Rechallenge to Carboplatin in Children with Low Grade Glioma and Carboplatin Hypersensitivity Reactions"}
{"_id":"fb770e0d-440f-7175-a5bc-0c1e084e2c40","text":"SLNB for clinically node-negative breast cancer has become a standard procedure worldwide and it is important to determine pathologically whether the node is negative before surgery. Although ALND has been the standard procedure if patients are positive for SLN metastasis, recent clinical trials suggest that ALND is unnecessary if positive SLN metastasis is detected in one or two nodes. The ACOSOG Z0011 study [6] showed that SLNB alone without ALND results in extremely low locoregional recurrence and excellent overall survival comparable to that in patients undergoing ALND if SLN metastasis is present in two or fewer nodes. In the present study, we investigated patients with SLN metastasis in two or fewer nodes to elucidate predictive clinicopathological factors in the case of SLN metastasis in two or fewer nodes. The results revealed a > 30% risk for non-SLN metastasis even if SLN metastasis occurred in one or two nodes only. Breast surgeons must understand the risk of renmant non-SLN metastasis if they do not perform additional ALND for patients with SLN metastasis in two or fewer nodes. Thus, predictions of non-SLN metastasis in the case of positive SLN metastasis in two or fewer nodes are necessary when making decisions regarding additional ALND.","title":"Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer"}
{"_id":"fb84d52d-1ecc-2ecc-29ee-564be6ab889f","text":"The LD flap is unique in that it is a distant pedicled flap for arm and elbow defects that does not require staged reconstruction. Such distant pedicled flaps requiring division at a second stage include the thoracoepigastric flap, lateral thoracic flap, external oblique fasciocutaneous flap, pectoralis major flap, and rectus abdominis flap. In addition, the LD flap is of significant size compared with alternative locoregional pedicled options such as the anconeus and radial forearm flap.17 The limitation of the LD flap is that reconstruction of defects distal to the olecranon may have higher rates of complication secondary to necrosis of the distal LD flap.18","title":"Functional Latissimus Dorsi Transfer for Upper-Extremity Reconstruction: A Case Report and Review of the Literature Sood et al"}
{"_id":"fb9175bc-6ec0-5d53-5786-b32d1a775f3f","text":"Following this line of thought, it is understandable that chronic inflammation present in psoriasis could have some kind of role in the pathogenesis of skin cancer.","title":"Psoriasis Therapy and Skin Cancer: A Review"}
{"_id":"fb91f3b6-dc65-bf70-e702-b406e316d436","text":"The results of the present trial suggest that active screening for DVT with complete US examination of the lower limbs is associated with an increased diagnosis of DVT, without a corresponding overtreatment. The screening could be associated with a reduced incidence of proximal DVT and could improve the management of the patients with increased bleeding risk.","title":"Ultrasound screening for asymptomatic deep vein thrombosis in critically ill patients: a pilot trial"}
{"_id":"fb98cb1b-1bc8-f94e-6a78-c0b56389b96a","text":"This involves taking a part of the tissue for confirming the diagnosis and is commonly employed when inflammatory dermatosis is suspected. The incision may extend into the surrounding normal skin. In porokeratosis, incision extends from the centre of the annular plaque through the raised margin into the surrounding normal skin so as to visualize all the three zones.","title":"Techniques of Skin Biopsy and Practical Considerations"}
{"_id":"fb994023-e1cd-3df1-8d00-03d26d96b179","text":"The results from the present study demonstrated that the cortical bone qualities of the TMJ condyles, masticatory load bearing areas and COR and RAM, the masticatory muscle insertion sites seemed to be influenced by BTX injection in the temporalis and masseter muscle. Those effects were more prominent in the post-menopausal females compared to young females. The interactions between bone and muscle have become a topic of interest for both basic researchers and clinicians. The mechanical forces applied to the bone that originate from associated muscles are crucial to maintain skeletal health and bony integrity. Animal studies which attempted to reveal the interactions between BTX-induced hindlimb muscle paralysis and atrophy may provide information about the effects of muscle contraction and unloading on maintaining bone structures. This phenomenon also could be applied to the craniofacial area where reduced masticatory force after BTX injection may cause deterioration of the cortical and trabecular bony integrity of the condylar and alveolar bones. Generally 0.2–1.0 U BTX injection in per masseter muscles in rodents and 10 U BTX injection in per masseter muscles in rabbits could elicit mandibular bone loss. Some human studies ever tried to investigate the effects of masticatory muscle paralysis induced by BTX injection on the mandibular bone quality. One study revealed that 30 U BTX injection in per masseter muscles and 20 U per temporalis muscles could cause reduced cortical bone thickness of the mandibular condyles and mandibular bone texture. However specific protocols for dose and injection intervals of BTX injection which could elicit mandibular bony changes have not been established yet.","title":"Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults"}
{"_id":"fba3d2b6-4378-4677-4a72-823c2c35f77b","text":"A study done in Malaysia among 45 peripheral vascular injuries patients shows a salvage rate of 88.9%, only six patients underwent delayed revascularization after 24 hours of injury. This study suggested that early revascularization of peripheral vascular injuries is crucial but delayed revascularization with a bypass graft of injured vessel can also have favorable salvage outcomes considering it reduces muscle ischemia and improves limb perfusion. Likewise, in a study done in India among 61 patients, the salvage rate was 90.1% even though the meantime from injury to treatment was 21 hours. Aim of surgical intervention for such trauma is continuity of distal blood flow unless there is a significant risk of reperfusion injury or if there are other pathways of blood flow.","title":"Peripheral Vascular Trauma among Vascular Surgery Cases Operated in a Tertiary Care Hospital: A Descriptive Cross-sectional Study"}
{"_id":"fba91edd-8b7d-df46-e868-c1ee3b0a0f8f","text":"The explanations for factors associated with low BPI score in our study were it is possible that when mothers live with their husband, they get support from their husbands which decreases their workload and give them more time to breastfeed properly. Also, a mother who had poor knowledge and negative attitude about breastfeeding did not follow breastfeeding protocols like the introduction of food before six moth and early weaning breastfeeding and discontinuation of breastfeeding after six months. The possible reasons for factors associated with higher BPI score might be that housewives have more time to care for their infant and infants are not dependent on caregivers throughout the day and when mothers adhere to antenatal and postnatal care, they will get breastfeeding advice increasing their breastfeeding knowledge and motivating them to use good breastfeeding practices.","title":"Four in every ten infants in Northwest Ethiopia exposed to sub-optimal breastfeeding practice"}
{"_id":"fba99fb1-f41d-b436-e5c5-2f012db12b8b","text":"We reviewed our four cases who had undergone rotationplasty with vascular reconstruction for revision of tumor prosthetic knee joints after long-term infections. Despite the small number of patients, the results of our cases are of interest because rotationplasty is rarely indicated for revision of infected prosthetic joints. Although there is little discussion regarding the most appropriate method of vascular management during rotationplasty for this indication, we consider that vascular transection and reanastomosis is better than vascular preservation.","title":"Rotationplasty with Vascular Reconstruction for Prosthetic Knee Joint Infection"}
{"_id":"fbb57ab5-eaed-edeb-f12a-a2fe98c2effe","text":"This study highlights the use of a submental perforator flap distal to the connecting line between the mastoid and the sternoclavicular joint to repair postoperative defects for upper airway malignancy as an innovative surgical approach that provides more tissue and good arteriovenous blood supply to adjacent sites. This method has high clinical value and provides an effective option for repairing postoperative defects of upper airway malignancy.","title":"Application of prolonged submental perforator flap to repair the postoperative defect of upper airway malignancy"}
{"_id":"fbb718f3-f8fa-4343-4939-0c46bdae407b","text":"A total of 163 physician view logs were registered throughout the study. Multiple logs from the same physician on the same day for the same patient and logs by author GAT as principal investigator were filtered out leaving 40 physician view logs from a total of 24 different physicians participating at any given time during the course of the study. None of the other authors of this paper had log views to filter out and none of the authors had access to log-data while the study was being conducted.","title":"Electronic reporting of patient-reported outcomes in a fragile and comorbid population during cancer therapy – a feasibility study"}
{"_id":"fbb93243-f611-6240-7a2a-d7ea14b5d96a","text":"This study investigated the feasibility of using a dedicated imaging protocol for the assessment of all filler-related procedures and related complications, independent of expert clinical input. We show that by the addition of a high resolution face MRI using T1 T2 Dixon with a fat and water suppression technique, radiologists can identify fillers in unexpected locations, and differentiate different kinds of facial fillers.","title":"MRI in detecting facial cosmetic injectable fillers"}
{"_id":"fbbba02e-55ce-8773-21e4-6a5961b9e6d8","text":"A retrospective study was performed to analyze medical records of patients who had been treated at the Istanbul University Department of Maxillofacial and Oral Surgery during the period from January 2010 to July 2013. The aim of this study was to gain insight into the types and frequencies of diagnoses and ambulatory surgical treatments at the Department of Oral Surgery in Istanbul University. We also explored whether there was a significant difference in procedures according to sex, age, and operation side. By learning all these parameters, it is our main goal to find answers to questions such as what we can do in hospital conditions, what we can win, and what operations we can treat.","title":"Oral surgical procedures under local anaesthesia in day surgery"}
{"_id":"fbbc5766-b183-f136-9143-1d2b6847b87c","text":"Specific substances may play a role in accelerating tissue damage. Additional substances may be needed to prepare drugs for intravenous administration, which is an acid in the setting of intravenous crack use. The use of acidic substances will further damage the veins.","title":"Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage"}
{"_id":"fbc4b883-5086-e1f3-0ab6-7ce9116b54dc","text":"Scalp is a specialized area of skin which covers the skull. Post-burn alopecia is a common condition requiring treatment of large areas of defects in skin and soft tissue which poses a real challenge to the reconstructive surgeon.1 The psychological impact of such an extensive defect is often quite traumatic for the patient. Hence, the reconstruction process is a difficult task for the surgical team in terms of both outcome of surgery and patient satisfaction. The conventional methods of rotational scalp flaps, serial excision, micro-vascular flap transfer and follicular unit transplantation have many drawbacks including lengthy hospital stays, flap necrosis and inability to cover major scalp defects.2 Moreover, Use of skin grafts or flaps from remote parts of the body may be cosmetically unacceptable because of bald spots on the scalp or mismatch of the colour.3","title":"Reconstruction of post burn scalp alopecia by using expanded hair-bearing scalp flaps"}
{"_id":"fbc51dd1-5a3d-38e7-7eb9-5de9ce66612a","text":"In both our second and third patients, the deformity was multiplanar and much distal to the knee joint. The use of internal fixation would have resulted in a period of immobilisation due to lack of weight bearing stability along with awkward incisional planes and risk of devitalisation of soft tissue and bony architecture jeopardising the final outcome of our total knee arthroplasty. The stability obtained with a TSF allowed early weight bearing and provided an ideal environment for new-bone formation and soft tissue healing following corrective osteotomies.","title":"Extra-articular deformity correction using Taylor spatial frame prior to total knee arthroplasty"}
{"_id":"fbca6478-5ff8-5ad9-9d0e-a58ff255d482","text":"The latissimus muscle with one or two ribs revascualrized by reverse flow from perforators is harvested; the ribs are bisected after harvest yielding four to six struts of vascularized bone to fill the huge upper tibia defect. Internal fixation is very important and we favor LCP plates for long bone fixation and the rib struts are fixed in place by small titanium screws to maintain the “picket fence” design. The muscle is then wrapped around the ribs and the defect is completely reconstructed.","title":"Combined Rib-Latissimus Flap; the “Picket Fence” Concept for Reconstruction of Upper Tibia Defects"}
{"_id":"fbd44f91-3510-c8d4-8c33-b02c3118c7c2","text":"The results support the hypothesis that combining bone substitutes with antibiotics may decrease the risk of EIs and could be a viable option to improve spinal surgery outcomes. However, a larger sample size would be needed to confirm the benefit of rifampicin-combined Mg-enriched hydroxyapatite substitutes over autologous bone for surgical site infection prevention.","title":"The benefit of antibiotic-combined Mg-hydroxyapatite bone graft substitute over autologous bone for surgical site infection prevention in posterolateral spinal fusion: a retrospective cohort study"}
{"_id":"fbd6c225-759d-1978-9dc3-d9bacb79e3b4","text":"Breast reconstruction can be offered immediately at the time of initial surgery in the case of neoadjuvant therapy, or as a delayed procedure following any required adjuvant therapy and necessary planning. The timing of reconstruction is highly dependant on such therapy, with a delayed autologous tissue flap more indicative if postmastectomy radiation is required due to an increased risk of capsular contracture or flap failure if performed as an immediate procedure prior to radiation.26 Patients undergoing a mastectomy plus breast reconstruction have a significantly decreased incidence of anxiety and depression when compared with mastectomy alone.6 Breast reconstruction provides an aesthetic benefit and the current standard of practice is either an autologous tissue flap or implant based (silicon or saline) procedure. However both can impose further morbidity that should not be unheeded and require an in-depth discussion between clinician and patient evaluating the risks and benefits of each. The sequalae of an autologous tissue flap includes the short-term complication of flap failure and long-term complications of fat necrosis and donor site morbidity17 while the silicone\/saline implant based procedure incurs short-term risk of infection and long-term risks of capsular contracture and implant rupture.15 Textured implants are at present under review due to a possible association with anaplastic large cell lymphoma.3 These risks emphasise the need for a new technique of breast reconstruction.","title":"Breast Reconstruction with a Tissue Engineering and Regenerative Medicine Approach (Systematic Review)"}
{"_id":"fbd8e810-d575-86ce-bf30-47c49b182081","text":"This study describes how the lack of evidence-based guidelines for education and use of ultrasonography by GPs makes ultrasonography in general practice any individual’s game. GPs are left to navigate themselves through choosing equipment, selecting the right training, making sure to maintain skills and selecting which examinations to perform on patients. Some of the GPs described how ultrasonography increased the consultation time and this might increase GP workload and affect accessibility for patients. These findings may extend beyond general practice and apply to other clinicians and implementation of other new technologies.","title":"Danish general practitioners have found their own way of using point-of-care ultrasonography in primary care: a qualitative study"}
{"_id":"fbdcf23b-7f79-1e04-3775-1ba3c91ef044","text":"The two major graft sources traditionally used for extra temporal facial nerve reconstruction after radical parotidectomy include the great auricular and sural nerves. The great auricular nerve is a superficial branch of the cervical plexus, contributed to by fibres from the C2 and C3 spinal nerves. The GAN leaves the cervical plexus at the posterior border of the sternocleidomastoid muscle and courses anteriorly over the lateral surface of this muscle. It then courses superiorly, dividing into anterior and posterior branches.[15] The GAN is traced proximally until additional branches coming off the cervical nerve roots are isolated. Dissection should be done to include as much length of the graft as is possible with several branches.","title":"Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy"}
{"_id":"fbe4102a-4dba-a919-68db-09aee034b425","text":"Table 4 Comparison of the reported complications with the reported location of the frenotomy N = 196","title":"Complications and misdiagnoses associated with infant frenotomy: results of a healthcare professional survey"}
{"_id":"fbeb9897-9f7a-7881-c68d-ad95f6229ee1","text":"The quest of plastic surgeons for the ideal flap coverage to be used in soft tissue defect reconstruction has led to a steady evolution of reconstructive surgery. Soft tissue reconstruction is used to define the various surgical techniques devised to cover raw area from a post traumatic event, defect formed from excision of scar\/oncological disease, post-burn contracture excision defects or from incision wounds. Soft tissue reconstruction can be a simple process or it can be an extensive and complicated surgical procedure, depending on the location and the type of reconstructive technique being used. This study was undertaken to assess the outcome of a modified version of the sural artery flap with that of propeller perforator flaps for the reconstruction of lower extremities, particularly the heel defects.","title":"The Clinical Outcome of Perforator Based Sural Artery and Propeller Flaps in Reconstruction of Soft Tissue of Extremities"}
{"_id":"fbf95bb0-b229-ec22-6564-93fec1d333bd","text":"Our results showed a low rate of patients undergoing retreatment due to tumor recurrence 3 years after brachytherapy.","title":"Long-Term Outcomes in Uveal Melanoma After Ruthenium-106 Brachytherapy"}
{"_id":"fc045be3-26e6-4a3a-a763-75c522cd7fa9","text":"The first outcome measure was the frequency that patients reported an association between physical exercise, alcohol consumption or use of analgesics with increased severity of allergic symptoms to food.","title":"Cofactors in allergic reactions to food: physical exercise and alcohol are the most important Versluis et al."}
{"_id":"fc12bafa-e145-4789-8220-855679ffeba6","text":"Although there was a high incidence of complications, FFLF can restore active knee ROM and function, with most patients ambulating without gait aids following reconstruction of large oncologic defects in the thigh.","title":"Free Functional Latissimus Dorsi Reconstruction of the Quadriceps and Hamstrings following Oncologic Resection of Soft Tissue Sarcomas of the Thigh"}
{"_id":"fc192955-4e85-da51-24f1-275697aea3c1","text":"All patients presented with parotid mass were evaluated with ultrasound and ultrasound guided fine needle aspiration cytology. Patients were informed that definitive diagnosis could not be achieved accurately with clinical features and cytology for parotid mass; surgery was necessary for persistent or enlarging mass for both definitive histological diagnosis and treatment. Patients were advised that partial parotidectomy would be performed and the surgical specimen would be sent to pathologist for intraoperative frozen sections. Frozen section might not be able to confirm the definitive pathology; however, it could indicate accurately whether the lesion was benign or malignant in nature. If the frozen section pathology was suggestive of benign in nature, partial parotidectomy was adequate. If the frozen section pathology was suggestive of malignant tumor, total parotidectomy would be performed immediately after frozen section. Of all patients who were considered potentially feasible by the author for small access postaural parotidectomy, they were given the options of Blair incision, facelift incision, postaural incision with extension incisions and small access postaural incision. All patients in this study opted for attempt of small access postaural parotidectomy with consent to proceed for extension incisions, flap reconstruction and nerve graft to be decided necessary intraoperatively.","title":"Small access postaural parotidectomy: an analysis of techniques, feasibility and safety"}
{"_id":"fc1b1416-db66-1dbb-1f66-a75a850e3ffc","text":"Calcification in primary lung cancers has been proposed to have different mechanisms ranging from engulfment of a calcific scar tissue, degenerated bronchial cartilage and granulomatous process engulfing the tumor to dystrophic calcification in areas of tumor necrosis. Calcification may also develop as sequelae to chemotherapy or in association with hypercalcemia. Calcium deposition may also occur as a result of a secretary function of the carcinoma.[3144647]","title":"The calcified lung nodule: What does it mean?"}
{"_id":"fc1bb433-1791-abf3-e6f9-22ac1a3a8436","text":"Patients should continue to take other asthma medications unless the regimen is changed by the managing physician.","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"fc20c3a0-a6f1-345d-d308-4a123157a67a","text":"This study was approved by our Institutional Review Board and was in accordance with the Helsinki Declaration of 1975, revised in 2000. The medical records of all patients treated with brachytherapy for head and neck cancers to a previously radiated area during the era of rigorous electronic medical records were retrospectively analyzed. Sixty-nine patients met each of the following criteria and were included:","title":"Permanent Interstitial Brachytherapy for Previously Irradiated Head and Neck Cancer"}
{"_id":"fc233b8d-948a-98b5-5189-beadfcab9fcd","text":"Coupled end-to-end anastomoses were performed between the flap vein and vein graft (3-mm coupler), and between the vein graft and the right lateral IMV (2.5-mm coupler; Fig. 2). (See figure, Supplemental Digital Content 1, which displays insetting of the DIEP flaps following saphenous vein graft anastomoses. https:\/\/links.lww.com\/PRSGO\/D216.) There was no immediate or delayed venous congestion noted, and both flaps demonstrated adequate perfusion and drainage (Fig. 3). An implantable venous Doppler was placed to monitor flap viability in the postoperative period. The patient’s immediate postoperative course was uncomplicated, with reassuring flap skin paddle appearance and Doppler signals bilaterally.","title":"Successful Intraoperative Salvage of a Venous Congested Deep Inferior Epigastric Perforator Flap Using a Cross-thoracic Saphenous Vein Graft"}
{"_id":"fc2efb1e-7efe-ee2d-0407-a7512d87c22d","text":"Thus SFT and DTF show significant differences in clinical behavior. Although the histologic growth patterns are distinct, with DTF showing a more aggressive infiltrative growth than SFT, the individual cells that comprise these tumors are histologically very similar and hard to distinguish. As such, these two tumors form a good model system to use for discovery of novel connective tissue markers.","title":"Determination of Stromal Signatures in Breast Carcinoma"}
{"_id":"fc314319-f26b-3466-3984-dad3e1f1d58d","text":"We describe how these methods would potentially reduce workload in Box 1.","title":"Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study"}
{"_id":"fc37da45-b78e-1922-2983-d63f9d10732a","text":"We will select studies according to the eligibility criteria informed in Table 1.","title":"Therapeutic effect of photodynamic therapy for nonresectable cholangiocarcinoma Protocol for a meta-analysis and systematic review"}
{"_id":"fc3c2e67-8ab4-6992-9c00-54c01cfb222a","text":"The present study used surface EMG to conduct a comparison of EMG ratios between the VMO and VL before and after BTA injection to thoroughly investigate the effects of BTA in treating PLS-related AKP.","title":"Improvement of Pain and Function by Using Botulinum Toxin Type A Injection in Patients with an Osteoarthritic Knee with Patellar Malalignment: An Electromyographic Study"}
{"_id":"fc3fdd19-33a2-d523-aaf0-cca12b935958","text":"In addition to decompression, anterior reconstruction with a tricortical iliac crest graft and fixed with locking cervical plate is a useful method for the prevention and correction of the deformity in the lesions involving the odontoid process. The tricortical iliac crest graft provides a good, viable option for reconstruction of odontoid. A satisfactory segmental stability and fusion are achieved.","title":"Reconstruction of the Odontoid Process by a Tricortical Iliac Crest Graft in a Case of Tuberculosis of C1, C2, and C3 Vertebrae"}
{"_id":"fc44802d-9965-de79-aae8-b211f87e0691","text":"Internal instrumentation can only provide temporary fixation, and the differences in segmental stability and kyphotic deformity correction loss have been linked to the type of bone graft material used. There are several options available for reconstructing structural voids in the spinal column after spinal debridement and decompression. Autograft bone, the gold standard bone graft material, show optimum skeletal integration, but the presence of host morbidity and donor site complications limit their availability. With the development of allograft processing and sterilization techniques guided by AATB standards, bone allografts have been widely used in spine surgery for several decades. Experimental studies have confirmed an immune response to bone allografts, but their clinical significance in humans remains unclear. Some pioneers have used fresh-frozen bone allografts to perform interbody fusion in spinal TB patients and found that allografts and anterior instrumentation are effective in supporting the anterior spinal column, and although fusion occurred late, the grafts remained stable.","title":"Tricortical iliac crest allograft with anterolateral single rod screw instrumentation in the treatment of thoracic and lumbar spinal tuberculosis"}
{"_id":"fc4adacb-9ec0-76f5-f271-0af78e392f92","text":"Clinically involved parotid gland lymph node requires superficial parotidectomy with preservation of the facial nerve and modified radical neck dissection of the ipsilateral lymph nodes. Total parotidectomy is associated with a higher risk of facial nerve injury.","title":"Surgical Management of Melanoma: Advances and Updates"}
{"_id":"fc4d802b-4a46-1590-0112-0466a4e00ad4","text":"Evidence is scarce with regard to the use of catheter-directed thrombolysis for the treatment of proximal DVT of the lower limb, causing substantial uncertainty that the benefits outweigh the risks associated with the procedure.","title":"3rd Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology"}
{"_id":"fc517e2e-a7b7-ebc1-3222-9678beb97933","text":"AO principles were followed in fractures which were treated with unilateral external fixators including fixation of the fibula, anatomic reduction of the articular surface, internal fixation of the fracture, occasionally use of bone grafts and finally stabilization with a unilateral external fixator. The proximal part of the devise was stabilized with the use of 3 half-pins into the tibial shaft and the distal part with 2 half-pins into the calcaneus and talus respectively, enabling at the same time motion of the ankle joint through a hinge which initially was locked.","title":"Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia"}
{"_id":"fc52a604-8a23-1077-9b43-1d74634c9459","text":"Adenoid cystic carcinoma of the parotid gland is a rare and slowly growing, but highly malignant tumor. Surgical resection of a malignant parotid tumor should include resection of the facial nerve when the nerve is involved in the tumor. Facial nerve reconstruction is required after nerve resection. A 14 year-old female presented with complaints of painless enlargement of the right parotid gland and facial asymmetry. Physical examination revealed a firm mass in the region of the parotid gland as well as right facial paralysis. Biopsy obtained from the mass showed an adenoid cystic carcinoma of the parotid gland. A radical parotidectomy with a modified radical neck dissection was carried out. Grafting material for the facial reconstruction was harvested from the great auricular nerve. The proximal main trunk and each distal branch of the facial nerve were coapted with the greater auricular nerve. The patient received radiotherapy after surgery and was seen to achieve grade IV facial function one year after surgery. Thus, the great auricular nerve is appropriate grafting material for coaptation of each distal branch of the facial nerve.","title":"Adenoid cystic carcinoma of the parotid gland: Anastamosis of the facial nerve with the great auricular nerve after radical parotidectomy"}
{"_id":"fc5bd1a9-1333-c0b2-742e-4c6048dd0675","text":"The aims of this study were to assess the number of all venous scans performed in the first months of pandemic in a large teaching Hospital Trust, to evaluate the incidence of DVT, and assess the predictive value of the clinical information available on the electronic patient record in prioritising the scans.","title":"Prevalence of venous thromboembolism in patients undergoing diagnostic venous ultrasound during the first SARS-CoV-2 pandemic: A personal history of VTE and a positive COVID-19 test are associated with the diagnosis of DVT"}
{"_id":"fc635773-b466-4e0b-3077-973b7882daea","text":"In our study, it was found that dissecting the surgical specimen before formaldehyde exposure provided more accurate staging since the dissected number of N1 lymph nodes and multiple N1 positivity was higher in the surgical group than in the pathology group. Lymph node involvement is one of the most critical factors determining the prognosis of NSCLC. NSCLC cases with mediastinal lymph node involvement have a poor prognosis. Therefore, intraoperative mediastinal lymph node sampling\/dissection is important for staging and deciding the course of the treatment. The T factor was revised in the last TNM stage, since one of the reasons for the differences in survival was the size of the mass. While it is planned to provide more accurate predictions with the changes in the T factor in the 8th staging, the debates on the detection of N1 lymph node involvement and prognosis continue. Variable results in patient survival suggest that different prognostic factors exist; studying these variables is imperative to provide the ideal treatment modality to the patient for better prognosis.","title":"N1 lymph node detection in lymph node harvesting in non-small cell lung cancer: Formaldehyde exposure is a drawback?"}
{"_id":"fc6a62a8-faf9-d0b2-2e48-009334b6a529","text":"One of the main concerns in selecting skin substitutes is the risk for transmission of diseases [3]. Because of the strict serological and microbial screening in our skin retrieval and processing protocols and use of gamma radiation for sterilization, the processed skin samples have low levels risk for transmission of diseases.","title":"Human Split-Thickness Skin Allograft: Skin Substitute in the Treatment of Burn"}
{"_id":"fc6bddb7-068a-364d-dcd4-2b98a017daba","text":"Among all of the image acquisition methods, sonography is one of the appropriate methods. With the ability of feature extraction of skin tissues, it can not only separate the lesions from the healthy parts but also specification detection of the lesion is noticeable.2","title":"Early diagnosis of skin cancer by ultrasound frequency analysis"}
{"_id":"fc6feb8c-6fbc-95cd-80c0-0076a7bf3aa3","text":"Others found greater success in the academic areas in which they had previously been working:","title":"Training tomorrow’s leaders in global health: impact of the Afya Bora Consortium Fellowship on the careers of its alumni"}
{"_id":"fc717641-d3ea-7419-edf1-e9699168f176","text":"Case 4 chronic osteomyelitis and non union in Ewing's sarcoma A Preoperative conventional bone X-ray showing the inserted allograft with pseudarthrosis at the proximal and distal end 2 years after resection of the Ewing's sarcoma. B Preoperative X-ray showing the inserted allograft with pseudarthrosis. C Harvesting of the free fibular graft. D Placement of the fibular bone graft and fixation of the femur fragments with a plate E Postoperative bone X-ray 4 weeks after grafting the free fibula between the femur fragments","title":"The versatility of the free osteocutaneous fibula flap in the reconstruction of extremities after sarcoma resection"}
{"_id":"fc75299c-581c-9976-1587-f852f0bcaa30","text":"Type II hypersensitivity occurs when autoantibodies secondary to the viral infection cause tissue damage. Type IV Hypersensitivity reactions occur when T cells primed to fight the viral infection induce inflammation or directly kill target cells of the host. These reactions can occur even if the virus has little or no cytopathic effect.","title":"COVID-19: Infection or Autoimmunity"}
{"_id":"fc7707ec-74af-b10c-6ef4-c93465011941","text":"The results of the present proteomic study of inhalant wheat allergens suggest the importance to use the wheat flour to which allergic bakers are exposed and the need to identify all the wheat allergens to which bakers are sensitized in order to evaluate their role, by follow-up studies, in bakers suffering from occupational wheat-related allergic comorbidities.","title":"Glucose\/Ribitol Dehydrogenase and 16.9 kDa Class I Heat Shock Protein 1 as Novel Wheat Allergens in Baker’s Respiratory Allergy"}
{"_id":"fc79f913-65e3-66c8-f2ff-57b9eae35044","text":"We had a case with 3 limitations for applying the advancement tarsoconjunctival flap: the old age of the patient, the elevated vision loss in the contralateral eye, and the high size of the resection. The patient was advanced in years with a severe vision loss in the contralateral eye, so the occlusion of the right eye and the risk of a second step operation would not be the best options. The defect would be too big for applying this technique. Reviewing the bibliography, we thought this patient could be a good candidate for the total lower eyelid reconstruction with the nasal chondromucosal flap, because it does not need eye occlusion and the reconstruction is achieved with one-step operation.6","title":"Chondromucosal Nasal Flap With the Transposition Flap of Von Langenbeck as a Good Election for the Total Lower Eyelid Defect Reconstruction in an Old Patient With an Elevated Vision Loss in the Contralateral Eye"}
{"_id":"fc7a509b-8052-6de5-5cf8-807e0a8f61b7","text":"The etiology underlying the sparing of the previously irradiated skin maybe due to either decrease in the population of EGFR expressing cells or decrease in the EGFR expression.","title":"Lack of Cetuximab induced skin toxicity in a previously irradiated field: case report and review of the literature"}
{"_id":"fc7aa6e8-79c5-c9ef-8da1-cf7fd9a53efb","text":"Diffuse type is known to have a high recurrence rate after surgery and occasionally causes osteochondral destruction. Clinical concerns of diffuse type after treatment include local recurrence after surgery and progression of osteochondral destruction. Local recurrence is frequently observed in this disease, particularly in patients with knee involvement. On the other hand, patients with hip and ankle involvement are prone to the development and\/or progression of osteochondral destruction. Simple en bloc resection has been performed for the localized type, with thorough excision of synovial tumorous tissues having long been the standard therapy for the diffuse type. Arthroplasty, arthrodesis, and artificial joint replacement have been performed in patients with severe joint destruction, particularly in the diffuse type. The multiple institutions participating in the present study performed an identical surgical treatment until recently as described above. However, in the past decade, the present authors have employed open total excision for posterior tumors and arthroscopic excision for anterior tumors in knee cases with both anterior and posterior tumor involvement to reduce the operative stress and obtain a favorable range of motion of the knee.","title":"Tumor location and type affect local recurrence and joint damage in tenosynovial giant cell tumor: a multi-center study"}
{"_id":"fc7fa4b5-e6d6-cde1-344f-a52a06d55d45","text":"Table 1 Identification rate of a non-palpable breast lesion by IOUS and WGL","title":"Intraoperative ultrasound in breast cancer surgery—from localization of non-palpable tumors to objectively measurable excision"}
{"_id":"fc86583a-1bca-24ab-0c62-12d4cdc6cd94","text":"Written informed consent was obtained from the patient's parent for the publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","title":"Successful management of scalp avulsion with full‐thickness graft"}
{"_id":"fc8fcb9c-fe9c-6aa4-c338-f262e947cf7d","text":"Proactive treatment to prevent radiation dermatitis is directed at reducing the drying effect of radiation on the skin and involves instructing patients to avoid irritating the irradiated region. Dryness due to RT leads to desquamation and loss of the superficial protective layers of the skin including lipid barriers. Simple moisturizers are applied in an effort to hydrate the skin and form a barrier to transcutaneous water loss and topical steroids are applied to reduce pruritus.","title":"A phase III trial comparing an anionic phospholipid-based cream and aloe vera-based gel in the prevention of radiation dermatitis in pediatric patients"}
{"_id":"fcac636d-23c3-afa8-d38f-4500303c2a01","text":"We report the second case of collision of BCC and SC and use this case to emphasize the importance of verifying biopsy pathology during Mohs surgery when frozen section evaluation reveals disparate findings to the originally biopsied tumor. Follow-up with permanent sections and immunohistochemistry may be necessary. We advise caution to detect mimickers of BCC that warrant greater clinical workup. Given the frequent periocular location of SC and the superior cure rate, we recommend Mohs micrographic surgery for SC.","title":"Collision of Basal Cell Carcinoma and Sebaceous Carcinoma Extirpated With Mohs Micrographic Surgery"}
{"_id":"fcafb127-1ac4-690f-a2f5-484e5d644342","text":"The study population was described using the appropriate summary statistics used for different variables.","title":"Immunogenicity and efficacy of fourth BNT162b2 and mRNA1273 COVID-19 vaccine doses; three months follow-up"}
{"_id":"fcb14970-951b-c451-5b51-3d5bdfc36e79","text":"The intranasal evaluation of patients who reported obstructive nasal symptoms are shown in Table 8.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"fcb4862d-b6c6-b07e-6f95-b2d5f4496514","text":"Infections of proximal femora with prosthetic implants in situ have long been a major concern in orthopedic surgery. The gold standard in the management of infected proximal femurs in the presence of prosthetic implants has traditionally been a two-stage revision. However, this is challenging in the setting of extensive bone loss.","title":"A Novel Antibiotic Spacer for Significant Proximal Femoral Loss - Surgical Technique"}
{"_id":"fcbeb9f7-c3fd-0e09-8f83-a060d4a687c5","text":"Table 1 Comparison of the severity of nipple and areola cracks in mothers using peppermint water and expressed breast milk","title":"Effect of peppermint water on prevention of nipple cracks in lactating primiparous women: a randomized controlled trial"}
{"_id":"fcbfc83e-3b74-adfa-42da-9b9adbd816ec","text":"In conclusion, secondary surgical skin closure following initial NPWT is largely successful and results in a very low rate of recurrent surgical site infection. Due to the retrospective nature of this study, we were unable to assess quality of life and the actual reduction in health care costs which will be evaluated in ongoing analyses. Furthermore, as a secondary skin closure was attempted when the patient and wound condition appeared suitable for it, a comparison to patients who did not receive a secondary skin closure is not possible due to prohibiting factors for a secondary skin closure. However, we feel that the advantages of a successful secondary skin closure in terms of quality of life and cost reduction appear self-evident. Thus, secondary skin closure is a valid alternative to the standard open wound treatment with the advantage of completed skin closure at the time of hospital discharge, and therefore reduced requirement for outpatient wound management.","title":"Successful surgical closure of infected abdominal wounds following preconditioning with negative pressure wound therapy"}
{"_id":"fccae2e1-3eba-2bd7-7142-c77b64c10623","text":"In this review, we seek to identify and understand the different types of clinical leadership which have been characterised in previous surgical research. We bring together the concepts of leadership and evidence-based practice to understand how mechanisms and contexts of healthcare organisations influence surgical leadership, and the organisational processes which can support and advance leadership in surgery.","title":"In which context and for whom can interventions improve leadership of surgical trainees, surgeons and surgical teams and why: a realist review protocol [version 1; peer review: 3 approved, 1 approved with reservations]"}
{"_id":"fccb9d0a-5b42-e0c2-2260-df0bd0a067e0","text":"Postoperative complications in our patient group included delayed soft tissue healing in 2 patients, which required 3 to 4 weeks to close. Two patients complained of pain around their incision and anterolateral femoral skin numbness and paresthesias. These later resolved in 1 patient 5 months after surgery. One patient was diagnosed with a deep vein thrombosis of the left leg, and was maintained in stable condition with anticoagulation. Cystic lesions were found on the hips and thighs on the operative side of 1 patient, which did not recur following local excision. These lesions were confirmed on pathology as soft tissue cysts with histologic evidence of chronic inflammation and surrounding fibrosis. No sciatic nerve stretch injuries were observed, and no vascular or nerve damage was reported postoperatively.","title":"Transiliac Osteotomy in Surgical Management of Pelvic Post-Traumatic Malunions A Retrospective Study"}
{"_id":"fcd4767e-e6eb-a3c7-b8ed-2eb0e72211f2","text":"Myocutaneous flaps provide bulky and healthy tissues which are well vascularized to fill the empty space of perineum, thus improving better wound healing and decreased infection rates. It can also provide better access for immune system agents to the area and increase oxygenation.","title":"Inferior Part of Rectus Abdominis Muscle Flap Outcomes after Abdominoperineal Resection: A Case Series Pilot Study"}
{"_id":"fcda0c06-19a6-9245-f1c4-b37a7c1ff8fe","text":"The consultant spine surgeon informs the patient who is eligible for inclusion of the study and hands out the written participant information. The research personnel follows up with the consent form a few days later. In this way, the patient may take some time to deliberate and subtle coercion will be minimized.","title":"Comparison of posterior muscle-preserving selective laminectomy and laminectomy with fusion for treating cervical spondylotic myelopathy: study protocol for a randomized controlled trial"}
{"_id":"fcda5855-faa6-8182-70cb-5054c9d068b2","text":"Effect of osteotomy on patency of nose in cases with septoplasty is shown in Table 5; it is more prominent at the level of MCA1.","title":"Does Cosmetic Rhinoplasty Affect Nose Function?"}
{"_id":"fcdaf954-d558-1084-b541-6d889b470f81","text":"When asked which type of students they felt would benefit from a combined degree, the majority indicated them to be those looking at ownership or any senior management position. It was mentioned by 2 respondents that higher level positions within large companies and large healthcare institutions now often require an MBA, and that senior level positions would no longer be attainable without one. Respondents also expressed that those entering academia, advocacy organizations, the pharmaceutical industry or doing policy analysis would benefit from a combined degree as well. One respondent felt that any pharmacist would benefit, as there are skills learned in the MBA program that will help make people successful regardless of their position.","title":"An Assessment of Demand for a Combined PharmD–MBA Program at the University of Saskatchewan"}
{"_id":"fcdcfd98-17b1-18a7-dbc1-0f0386b5325b","text":"The mRNA expression was evaluated by RT-qPCR described above and the list of the primers used are shown in Table 2.","title":"Human microRNA expression in sporadic and FAP-associated desmoid tumors and correlation with beta-catenin mutations"}
{"_id":"fce651c3-a69c-d8ef-74f0-c933b0afed9c","text":"The rate of wound healing in our patients is higher than that in a study by Aust et al. in Germany (2008) on patients with lower limb chronic wounds and arterial occlusion. The authors drew upon open thrombectomy or bypass surgery in addition to angioplasty along with stenting and reported successful wound healing in 21% of their patients with the absence of pulse and evidence of arterial occlusion.","title":"Therapeutic Effects of Successful Angioplasty on the Aorta and Lower Limb Arteries on the Healing of Chronic Ischemic Wounds"}
{"_id":"fce659e7-b26f-88bc-4370-e00cdbe7e32e","text":"The residency program’s exposure to patients from 77 different nationalities with varying cultural backgrounds provided a unique and enriching experience. Dealing with patients from diverse backgrounds increased the volume of cases and challenged the residents to develop their communication skills as they interacted with patients who spoke different languages and had varying cultural beliefs. This exposure allowed the residents to better understand the complexities of providing patient-centred care and improved their ability to work in a culturally diverse environment. Furthermore, the residents could sharpen their surgical skills through the increased volume of cases and the diverse range of conditions they were exposed to. This experience will undoubtedly serve as a valuable asset in their future careers as practising orthopaedic surgeons.","title":"Trauma and orthopaedic surgery response at the world’s largest sporting event: an analysis of the FIFA World Cup Qatar 2022"}
{"_id":"fcece0cd-f86e-60ac-3bca-ee29320fb122","text":"The treatment of COF is conservative surgery through the enucleation of the lesion and the use of a curette to heal the remaining cavity. Recurrences of COF are not common. In our study, no case of recurrence has been reported in 5 years of tracking. Dunlap and Barker (14) presented 2 cases of COF in the upper jaw treated with the enucleation of the lesion and the use of a curette to heal the remaining cavity with a consequent 9 year tracking period without evidence of COF recurrence. In their revision of 68 cases of COF, Ramer et al (10) reported 5 cases of recurrence and suggested that the cases of recurrence are not related to the histological type but due to an incomplete surgical removal of the lesion. In 2004, Alawi et al (15) published a recurring case of COF in the form of an ameloblastoma in a 65-year old male which presented a mixed image in the right posterior part of the mandible. The lesion reappeared 4 years later in the right part of the mandible. The researchers suggested that the recurrence was due to an incomplete removal of the initial tumour since it was not encapsulated and presented a close connection to the interior dental nerve which made its correct excision more difficult. Despite the low recurrence rate, a post-operation tracking should be carried out on the patient up to at least 5 years after surgical intervention.","title":"Central odontogenic fibroma: Retrospective study of 8 clinical cases"}
{"_id":"fced4787-5eba-fbf1-6a30-c15a82b578a1","text":"All patients underwent lymph node dissection. During the cervical lymph node dissection the available recipient vessels were carefully identified and preserved. Resection of the hypopharyngeal tumor with an adequate margin was carried out in three dimensions: the length of the resection margin was more than 25 mm and the depth of the margin reached the prevertebral fascia. Tumor-free margins were confirmed by intraoperative frozen sections.","title":"Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma"}
{"_id":"fcf36005-011c-e440-882d-6792df561070","text":"Salivary gland diseases are rare in childhood and adolescence. Their pattern of incidence differs very much from that of adults. Acute and chronic sialadenitis not responding to conservative treatment requires an appropriate surgical approach. The rareness of salivary gland tumors is particularly true for the malignant parotid tumors which are more frequent in juvenile patients, a fact that has to be considered in diagnosis and therapy.","title":"Diseases of the salivary glands in infants and adolescents"}
{"_id":"fd07a968-f3a5-ba1e-420f-58ec6d709bc0","text":"This study aimed to determine the factors and motives influencing trainees to pursue multiple fellowships. To the best of the author’s knowledge, this is the first study to elucidate the motives behind the trend of trainees pursuing multiple fellowship subspecialties in the field of orthopedic surgery.","title":"Trends in the pursuit of multiple orthopedic surgery fellowships among orthopedic trainees in Saudi Arabia"}
{"_id":"fd0e9a2b-70b3-b303-1b06-1d70c69cbd06","text":"Ultrasound‐guided BTA injection into salivary glands can effectively relieve the symptom of drooling. The time of changing cannula was shortened obviously and the incidence of recurrent pneumonia infection was reduced in our study. BTA injection of salivary glands to cure drooling could advance to the clinical therapy in severe neurological patients after tracheotomy and might be an effective method in these people.","title":"Botulinum toxin in the treatment of sialorrhea in severe neurological patients with tracheotomy"}
{"_id":"fd15e53a-701e-1562-1450-4f32764d0622","text":"In conclusion, both the VBG and MT are good and reliable options for the reconstruction of Gustilo type III open tibial fractures. The union time was comparable between the MT and VBG in patients with bone defects less than 60 mm; moreover, the efficacy of the vascularized bone flap reconstruction does not decrease even with a large bone defect reaching 200 mm. Considering the complicated and unpredictable nature of the injuries during trauma, adaptable and flexible treatment strategies or even the combination of two methods for the reconstruction of Gustilo type III open tibial fractures can probably achieve better outcomes.","title":"Comparison of the clinical outcomes between vascularized bone graft and the Masquelet technique for the reconstruction of Gustilo type III open tibial fractures"}
{"_id":"fd1c3c8f-6b59-92a4-5182-07b07d56cf29","text":"The purpose of this study was to survey current orthopaedic department chairs at ACGME-accredited orthopaedic surgery programs in the United States to determine whether department chairs valued the importance of formal leadership training and, if so, to understand the leadership development opportunities available along with the benefits of these program for their orthopaedic faculty.","title":"Leadership in Orthopaedic Surgery: A Survey of the Value of Leadership Development for Orthopaedic Surgery Faculty"}
{"_id":"fd1d02ab-b29f-cf9f-2e1e-db731a4c8db6","text":"This study also revealed that working years and working years in the current institute were important factors associated with these outcomes. Longer working years often indicate a higher level of experience and expertise, which can contribute to greater job satisfaction and commitment to the organization. As primary care providers gain more experience, they may feel more confident in their ability to provide quality care and may also enjoy greater autonomy in their work. In addition, primary care providers who have worked at the same institute for a longer period of time may have developed strong relationships with colleagues and patients, which could increase their sense of belonging and commitment to the organization.","title":"Factors Associated with Primary Care Provider’s Job Satisfaction and Organizational Commitment in China: A Machine Learning-Based Random Forest Analysis"}
{"_id":"fd1f02fb-d12c-fe64-1763-61f0d9015178","text":"A similar mechanism could also be envisaged as regards the onset of pruritus after administration of immune checkpoint inhibitors, able to cause an increase of immune cytokines that may cause skin toxicities.","title":"The Impact of Immunological Checkpoint Inhibitors and Targeted Therapy on Chronic Pruritus in Cancer Patients"}
{"_id":"fd318fe3-bdbf-7505-1312-7a4608679828","text":"In female patients presenting a tumor of the lower abdominal wall especially after cesarian section, an endometriotic tumor as well as an aggressive desmoid tumor should be considered. Symptoms in correlation with the monthly period can facilitate the presurgical differentiation between endometriosis and fibromatosis. Ultrasound reveals the typical location of both tumors and its remarkable sonographic appearance. In the clinical practice, the desmoid fibromatosis of the lower abdominal wall is a very rare disease. We present a case of a 25-year-old pregnant and discuss diagnostic and therapeutic options by a PubMed literature review. With the knowledge of the prognosis of the desmoid fibromatosis and the respective treatment options including wait and see, complete surgical resection with macroscopically free margins and adjuvant approaches is essential to avoid further interventions and progression of the locally destructive tumor.","title":"Desmoid Tumor of the Anterior Abdominal Wall in Female Patients: Comparison with Endometriosis"}
{"_id":"fd353e9d-04c5-3cc1-2186-9ac2ab0801b4","text":"All images were acquired by students pursuing a degree in medical imaging and radiotherapy with the supervision and guidance of an experienced professional in the field of breast ultrasound.","title":"Ultrasound as a Method for Early Diagnosis of Breast Pathology"}
{"_id":"fd39b762-0345-4617-f6fa-5d13fbf1c5d2","text":"Multiple technical considerations may improve outcomes for free flap scalp reconstruction. To improve flap survival, one must perform wide undermining of the galea around the pedicle tunnel if there is one and assure diligent postoperative patient positioning to prevent compression of flap pedicle. Using superficial temporal recipient vessels when possible and performing intramuscular pedicle dissection can increase pedicle length and eliminate the need for vein grafts. Covering the calvarial or cranioplasty sites with the proximal portion of the muscle flap and positioning the least reliable flap areas to minimize morbidity if partial flap loss were to occur can further improve recipient site outcomes.22","title":"Evaluation of Options for Large Scalp Defect Reconstruction: A 12-Year Experience Eck et al"}
{"_id":"fd4283e9-b24f-fb14-f81a-d0a47b88ab50","text":"Reconstruction of microtia is one of the most challenging surgical procedure for the reconstructive surgeons because of its complex structure and need to construct near normal external ear. Over the past, various reconstructive methods have been used for the microtia reconstruction. Till date, surgical technique developed by Brent and Nagata are still most widely performed procedure for the reconstruction of microtia., The use of tissue expander is still controversial, but we have been using this method of reconstruction for more than 10 years with well acceptable results.","title":"Microtia Ear Reconstruction Using Tissue Expander and Autologous Costal Cartilage: Our Experience and Comparing Two Age Groups"}
{"_id":"fd46ff19-1800-c391-9eb1-c4bfac53ab36","text":"Intelligentized simulation design of maxillofacial prosthesis is the most crucial step in the whole process and has a direct correlation with the definitive prosthetic treatment outcome. Nasal, auricular, and orbital prostheses are the most commonly observed prosthesis types in the clinic, and the design methods differ from each other due to their diverse features. Our system has developed a design process for every type of prosthesis, and auricular prostheses will be used as an example in this study.","title":"Development and application of a rapid rehabilitation system for reconstruction of maxillofacial soft-tissue defects related to war and traumatic injuries"}
{"_id":"fd4960f6-5f96-2192-b9dc-9eac9d21e8db","text":"We assessed recipient site complications and functional outcomes as main endpoints of the study within the first 6 to 12 months after surgery and free flap reconstruction. Recipient site complications were further classified either as minor complications including wound dehiscence and local infection or major complications including salivary fistula and free flap failure. Presence of ectropion, oral incompetence and trismus were used as functional endpoints. All outcomes were rated by treating head and neck surgeons.","title":"Outcome in Patients with Partial and Full-Thickness Cheek Defects following Free Flap Reconstruction—A Multicentric Analysis of 47 Cases"}
{"_id":"fd4f818f-949e-c5e0-19e3-7345b92c3a44","text":"CEUS can guide puncture and improve diagnosis accuracy. As indicated in the results of this study, no significant difference can be seen in the diagnosis of metastatic lymph nodes between FNA and CNB. CNB can provide more adequate diagnostic information and tissue immune information for pathological diagnosis, avoid open biopsy surgery and reduce the possibility of cancer spread. FNA can replace CNB by virtue of its easy operation, less pain to patients, and obvious advantages for small lymph nodes adjacent to great vessels. No obvious difference can be seen in the diagnostic efficacy of CNB and FNA for metastatic lymph nodes. CNB is recommended for most biopsy in clinical practice, but FNA is preferred for small lymph nodes adjacent to great vessels.","title":"Comparative study of core needle biopsy and fine needle aspiration in the treatment of metastatic lymph nodes guided by contrast-enhanced ultrasound"}
{"_id":"fd503fe0-9980-ea99-e34f-ab95766401e2","text":"Conclusions: Understanding the scope of ultrasound practice, the training undertaken and the requirements for mentorship will underpin the development of competencies and recommendations defined by the College of Podiatry to support professional development and ensure safe practice.","title":"Abstracts from The College of Podiatry Annual Conference 2017 Liverpool, United Kingdom. 16-18 November 2017"}
{"_id":"fd516260-0475-721b-e64f-f282efcd4f2a","text":"Pelvic venous congestion is a common cause of CPP and one of the most underdiagnosed. Valuing symptoms during history-taking and a careful physical examination can lead to clinical suspicion, which should be followed by appropriate investigation including imaging exams for good treatment planning. Although currently available studies offer weak evidence because of poor design, the data and results reported appear to confirm the endovascular approach as treatment of choice in this scenario, since it enables potential points of venous reflux to be eliminated and varicose veins obliterated in a single intervention, resolving or considerably reducing patients’ complaints. It is also of great importance to conduct a careful examination of the pelvic venous anatomy, since this is a potential factor in morbidity and mortality during surgical interventions in this anatomic region.","title":"Endovascular treatment of pelvic venous congestion syndrome in a patient with duplication of the inferior vena cava and unusual pelvic venous anatomy: literature review"}
{"_id":"fd58071f-9749-6720-4ac8-6fbfb96ca691","text":"All patients gave their informed consent prior to being included in the study.","title":"Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection"}
{"_id":"fd5b354f-6413-d5d3-c321-1805116ba94c","text":"Methods A Mohs surgery service with a combined dermatological and oculoplastic approach was set up in Manchester in 1994. We reviewed 60 of our patients who underwent Mohs surgery and compared the size of defect produced as well as the type of reconstruction required with the results we would have predicted for standard excisional surgery with a 3 mm margin.","title":"Oculoplastic reconstruction following Mohs surgery"}
{"_id":"fd60342b-dd8e-8f81-a917-fb0b9a09bc3d","text":"Surgical and nonoperative facial rejuvenation remains one of the most common cosmetic procedures performed in the United States despite recent decreases in overall procedures performed by plastic surgeons. This decline is likely multifactorial but may also be attributed to the larger number of otolaryngologic surgeons now performing these procedures. The public perception of unnatural outcomes as well as potentially morbid complications such as DVT and facial nerve injury may have also had an influence on the individual decision to undergo rhytidectomy.","title":"Evaluating Facelift Complications and the Effectiveness of the SMASectomy Technique: A Single Center’s 15-Year Experience"}
{"_id":"fd6c5f10-34b9-3d47-ed9f-fcebfb901d93","text":"SLNB for axillary staging has saved many breast cancer patients from ALND and resultant complication, when the SLN was found to be negative for metastatic disease. Knowing when to limit ALND is the objective of our discussion.","title":"Axillary Dissection in Breast Cancer Patients with Metastatic Sentinel Node: To Do or Not to Do? Suggestions from Our Series"}
{"_id":"fd6dcac2-8e65-9586-36f2-41ff3ac691e7","text":"Using new instruments in facial reconstruction should be associated with enough attention to future cosmetic aspects especially asymmetry and irregular feature of the reconstructed tissue because reoperation of prosthesis cannot be usually provided following the fibrosis and tissue adherence. This precision makes new methods to be avoided by some rookie surgeons. In our study, the high prevalence of eye movement disorders among patients with orbital rim fracture, limited the number of our cases. Also some patients disagreed to be entered the study because they could not follow the follow up schedules. Also some patients needed emergent surgeries while the expert man was not the on time resident surgeon to evaluate the patient for entering to the study.","title":"Porous high-density polyethylene in facial reconstruction and revision rhinoplasty: a prospective cohort study"}
{"_id":"fd7f393e-e2df-554c-a8e7-ddb291b8d78c","text":"The histopathological results obtained by biopsy or surgical specimens within 2 weeks after CEM examination are regarded as the reference standard for the classification of breast lesions in this study. None of the patients had undergone any form of treatment for the suspected lesions before the specimens were obtained. Lesions containing any invasive component or ductal carcinoma in situ are considered malignant; otherwise, the lesions are considered benign.","title":"Radiomic Analysis of Contrast-Enhanced Mammography With Different Image Types: Classification of Breast Lesions"}
{"_id":"fd81c919-6341-4e23-70d9-abcbe7ba6c2d","text":"The objectives of this study were to evaluate the adequacy of surgical margins and the re-excision rates in patients with primary BCC who underwent standard surgical treatment using our proposed algorithm and to define the risk factors in patients with recurrent BCC.","title":"Adequacy of surgical margins, re-excision, and evaluation of factors associated with recurrence: a retrospective study of 769 basal cell carcinomas"}
{"_id":"fd891d03-97b1-a9fe-4de8-59751e3139cb","text":"The pathophysiological mechanism of the disease is not clear. Researchers need to compare different types of calcification to more comprehensively understand the pathogenesis of calcinosis cutis and the differences between calcification patterns. To treat calcinosis cutis, patients with etiology should actively treat the primary disease to expect the improvement of local symptoms. There is insufficient evidence to support the effectiveness of these treatments. New assessment tools and outcome measures need to be developed, and studies involving randomized controlled trials to develop evidence-based therapies for this disease. At the same time, a better understanding of the pathogenesis of calcinosis is also helpful to the choice of treatment.","title":"Idiopathic calcinosis cutis of the buttocks: A case report and review of the literature"}
{"_id":"fd977e0f-102a-8ab3-343c-5d5a6b914a40","text":"Leukemia cutis is the infiltration of neoplastic leukocytes or their precursors into the epidermis, the dermis, or the subcutis, resulting in clinically identifiable cutaneous lesions. We describe a case of CML who presented with extensive cutaneous manifestations at the time of second blast crisis with multiple subcutaneous skin nodules over the face and trunk with extensive violaceous papules and plaques over all four limbs and the trunk, with scalp showing extensive crusting and scaling with foul smelling discharge.","title":"EXTENSIVE CUTANEOUS MANIFESTATIONS: PRESENTING FEATURE OF CHRONIC MYELOCYTIC LEUKEMIA IN SECOND BLAST CRISIS"}
{"_id":"fd990806-3a86-14b4-d6c4-a73015337ba4","text":"In summary, we report on the fate of retained cement spacers in the management of osteomyelitis. Although retention of temporary spacers is not the standard management and would not be appropriate in all cases of osteomyelitis, our study suggests that some of these retained spacers may have good clinical outcomes due to satisfactory infection control and limb function. A further prospective study is required to identify the factors that contribute to the successful application of this technique.","title":"Antibiotic-impregnated cement spacer as definitive management for osteomyelitis"}
{"_id":"fd9bf732-aaa1-5949-cefa-f71dcd5fc1ea","text":"The fracture sites were the proximal third of the lower extremity in 2 cases, the middle third of the lower extremity in 7, and the distal third of the lower extremity in 9. The transferred free flaps were an anterolateral thigh flap in 13 cases and a latissimus dorsi musculocutaneous flap in 5. The anastomosed recipient arteries were the anterior tibial artery in 10 cases, the posterior tibial artery in 6, the popliteal artery in 1, and the superior medial genicular artery in 1.","title":"Free Flap Transfer to Preserve Main Arterial Flow in Early Reconstruction of Open Fracture in the Lower Extremity"}
{"_id":"fda660f2-8691-0129-c5ec-f836276a0e65","text":"A study of 41 cases with mammary neoplasms assessed the lymphatic drainage using indirect lymphography. The authors found that the first and second neoplastic mammary glands drain to the axillary ipsilateral lymph node and infrequently to the ipsilateral and sternal axillary simultaneously. The third mammary gland drains to the ipsilateral axillary lymph node and superficial inguinal simultaneously, but sometimes only cranially to the ipsilateral axillary lymph node. It rarely drains only caudally to the ipsilateral superficial inguinal and medial iliac lymph nodes. The fourth mammary gland drains only caudally to the ipsilateral superficial inguinal lymph node and rarely to the axillary and superficial inguinal lymph nodes simultaneously. The fifth mammary gland drains to the superficial inguinal lymph node and rarely to the ipsilateral popliteal lymph node and the lymphatic plexus medially (Table 5) [143].","title":"Canine Mammary Cancer: State of the Art and Future Perspectives"}
{"_id":"fdab7ff5-0733-b9af-26ee-ffc6444b35c8","text":"Histopathological examination showed the absence of tumor elements within the 2 mm from the superficial incision on the tumor side in 21 of the 29 evaluated margins, and their presence in eight margins. RCM examination did not discover tumor elements in the 2 mm between the superficial incision and the tumor in 25 of the 29 evaluated margins (Figure 3). These observations have been summarized in Table 3.","title":"Preoperative Evaluation through Dermoscopy and Reflectance Confocal Microscopy of the Lateral Excision Margins for Primary Basal Cell Carcinoma"}
{"_id":"fdacc41e-5204-d7ce-808f-85112a406e33","text":"A first VTE was defined as a first time diagnosis of a VTE within 1 week before start of warfarin treatment. Recurrent venous thrombosis was defined as presence of a previous VTE diagnosis 90 days or more before start of warfarin treatment due to the recurrent VTE. During the study period, almost all patients with VTE were treated with warfarin in Sweden, new oral anticoagulants were not available for this indication by then.","title":"Venous thromboembolism and cancer risk"}
{"_id":"fdb01b07-24bb-4562-36a2-5c6871b22c63","text":"Unfortunately, even after two rounds of treatment our patient did not show significant signs of improvement from topical application of imiquimod 5% cream. He had to interrupt the second round of treatment because the side effects involving irritation and burning were too debilitating. Failure with imiquimod treatment was reported in very few cases, and the contributing factors to unsuccessful treatment was not fully understood [7]. It was postulated that failure could have been attributed to the presence of invasive disease missed on initial or subsequent biopsy and complicated by lesion thickness variability. Our patient reported having difficulty treating the left hemiscrotum because the imiquimod cream did not apply well to his moist skin. Failure of proper adherence to the lesion could have attributed to inadequate penetration of the topical cream.","title":"Management of Extramammary Paget's Disease: A Case Report and Review of the Literature"}
{"_id":"fdc2373a-5956-5762-9785-2b28cd8c5288","text":"These are firstly the assumption of a linear relationship between the counts in the two images being processed. This assumption may be violated by variations in gamma camera response between data acquisitions taken 24 h apart. Secondly and more serious is that large areas of very positive change, for example the liver in immunoscintigraphy, will dominate in calculating the regression line thus swamping the contributions from small areas of positive change with far fewer pixels.","title":"Axillary node status in breast cancer patients prior to surgery by imaging with Tc-99m humanised anti-PEM monoclonal antibody, hHMFG1"}
{"_id":"fdc462f2-36af-fa19-dd4e-851381c0fc54","text":"Contemporary literature findings concerning CS surgery do not provide explicit evidence regarding the type of surgical approach and intraoperative damage to the vertebral artery. Preoperative preparation and visualization of the vascular anatomy of the area are of cardinal significance. Surgeons tend to choose the approach with which they are most familiarized and more appropriately trained. However, in case of complications, expeditious diagnosis and treatment are imperative concerning major vascular injuries with pernicious consequences for the patient. The purpose of the present study was to investigate whether there is a substantial difference regarding the incidence of vertebral artery injury in cervical spine operations depending on the type of surgical approach, posterior or anterior.","title":"Incidence of vertebral artery injury in patients undergoing cervical spine trauma surgery in correlation with surgical approach: A review"}
{"_id":"fdc6d7e6-a5c3-a2d3-8908-8979381f3c41","text":"The limitations of these studies are apparent. Many are retrospective and small cohorts so care should be taken in applying their interpretation into clinical practice. Patients should be counseled thoroughly before embarking on any conservative melanoma resections.","title":"Melanoma of the Hand: Current Practice and New Frontiers"}
{"_id":"fdd7a2b5-b370-1bd5-6a0f-184ad9e7dc00","text":"Trained and certified sonographers performed lower limb venous Doppler ultrasound on patients before and 3 to 5 days after surgery for screening of DVT using a standardized method.","title":"Risk factors for venous thromboembolism in patients with diabetes undergoing joint arthroplasty"}
{"_id":"fde222cf-5d24-67a0-ad6f-ba31153fb50e","text":"All mammograms were presented to participants in a randomized order and were independently rated by each participant. The sequence for presenting the images was randomly generated for each reader. Each participant viewed each image and rated whether or not they would recall the patient on a scale of 0–100, with 0 indicating complete confidence that cases were normal and 100 indicating confident abnormality. No feedback was provided to the participants.","title":"Radiologists can detect the ‘gist’ of breast cancer before any overt signs of cancer appear"}
{"_id":"fde4a991-3178-4142-b1ef-aa54fe8688b8","text":"It has to be noted that there is inherent uncertainty in all imaging techniques and their interpretation on which the model is based, which was also mentioned by the participants, refer to category Inherent Uncertainty of Imaging. Therefore, by using a VR planning tool like the one presented here, the users always have to be aware that there could be a mismatch between the model and the real situation. The frame function of the application makes the users aware of this possible interpretation mismatch as they can overlay the model and the MRI or CT images.","title":"Virtual Reality for Surgical Planning – Evaluation Based on Two Liver Tumor Resections"}
{"_id":"fde529cc-3fab-afed-7854-7dd06fe905ce","text":"Subgroup analysis will be conducted for the primary outcome to assess how the effect of treatment may vary in clinically relevant subgroups. We anticipate clinical heterogeneity and thus the following a-priori clinically relevant subgroups have been identified for consideration:","title":"Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol"}
{"_id":"fdea4f25-7908-29f2-63a7-6ec3df6d3d13","text":"Work-related distress among physicians has also increased in association with these challenges and has implications for both physicians and patients. Most physicians now practice in organized groups, where effective leadership is important to address the continuously evolving challenges in the medical practice environment. Evidence indicates that the leadership behaviors of physician supervisors are strongly associated with professional fulfillment and burnout among the physicians they lead. This and similar findings on the importance of leadership to employee health indicate that greater attention to leader selection, development, evaluation, and feedback are an important component of organization-level efforts to reduce occupational distress among physicians and other health care professionals.","title":"Association of Burnout, Professional Fulfillment, and Self-care Practices of Physician Leaders With Their Independently Rated Leadership Effectiveness Physician Burnout, Professional Fulfillment, and Self-care Associated With Leadership Effectiveness"}
{"_id":"fdec8833-56ca-1604-c55e-df7499e7f39b","text":"We used a purposive sampling procedure. We invited a total of 136 residents from seven surgical programs to participate voluntarily in the quantitative phase. We chose the five programs that were either accredited or in the process of obtaining high-quality accreditation. We included two others that had the longest standing tradition in the country. We explained verbally and in writing to the participants the purposes of the research, as well as the procedures to assure the confidentiality and anonymity of data, at individual and program levels, as well as the further management of information. The Commission for Medical Education of the Universidad de la Sabana granted ethical approval.","title":"Supervisors’ transformational leadership style and residents’ job crafting in surgical training: the residents’ views"}
{"_id":"fded0fc2-d9bd-7220-5451-f3292a30aa0f","text":"Nonetheless, this is the first study comparing the rate of SSIs in patients undergoing posterolateral spinal fusion with Mg-hydroxyapatite bone combined with rifampicin versus autologous bone without antibiotics. Although not statistically significant, these results support the hypothesis that the combination of bone graft substitutes with antibiotics prevents SSIs and could be a viable option to improve spine surgery outcomes.","title":"The benefit of antibiotic-combined Mg-hydroxyapatite bone graft substitute over autologous bone for surgical site infection prevention in posterolateral spinal fusion: a retrospective cohort study"}
{"_id":"fdfad1bd-eb71-90d5-3006-a05a1ae40555","text":"Therefore we encourage the collaboration of multiple centers and the use of clinical data interoperability, artificial intelligence, and big data processing to aid the data collection process for similar future studies.","title":"Medical Imaging of Inflammations and Infections of Breast Implants"}
{"_id":"fe027f35-2e9c-f0e8-ee71-e0965f4dcf41","text":"As mentioned earlier, journal clubs can be a venue to teach critical appraisal skills to residents, either as formal sessions or through discussion of the chosen papers. Supplemental formal lectures on this topic could also be provided in the core curriculum of training programs. This has been an important stated goal of orthopedic program directors.4 Residents can also be evaluated in journal club sessions regarding national college training requirements, such as the core competencies from The Royal College of Physicians and Surgeons of Canada Canmeds program or The American Council for Graduate Medical Education. If this is an important goal for program directors, establishing formal objectives and evaluation of the journal club would aid in an external review of the training program by their respective national college.","title":"Planning and executing orthopedic journal clubs"}
{"_id":"fe0a1df7-4c0c-5462-da43-840f9bbe09a2","text":"The aim of the ultrasound examination of the breast is to survey the entire breast for abnormalities. When an abnormality is detected targeted ultrasound is employed.","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"fe0a582e-7606-d21d-a0b6-41ff33999675","text":"The survey was written in English and sent to ICOPLAST Directors with an invitation to facilitate translation into their respective regional languages. Most Directors agreed that English was the dominant professional language for plastic surgeons internationally; therefore, the final survey was distributed in English. The survey was initially sent via e-mail in August 2016. Three reminder e-mails were sent before the survey closing in January 2017. Although the authors were mindful of the principles outlined in the Declaration of Helsinki, formal Human Research and Ethics approval was not required as the project did not involve patient care or utilize clinical data, and the risk to participants was deemed to be negligible in accordance with the National Health and Medical Research Council National Statement on Ethical Conduct in Human Research.","title":"Establishing Priorities for the International Confederation of Plastic Surgery Societies"}
{"_id":"fe0b3953-06ee-437f-03e4-25e2ffb1550c","text":"In 2001, Lefourn et al., Al. Qattan and Mueller et al.21 described a fasciomuscular sural artery flap in which a sleeve of gastocnemius muscle was included at the sural artery which passed deep between the two heads of gastrocnemius flap for better vascularity. Later, the cross-leg flaps and then the local fasciocutaneous flaps came into use. The coverage of the heel defects with sural artery flap underwent some modifications over a period of time which revolutionized the management of heel defects. The present studies have modified the flap with the inclusion of the posterior perforators and its fasciocutaneous territory and including a sleeve of gastrocnemius muscle only where, the median sural artery is crossing between the two heads of the gastrocnemius muscle.","title":"The Clinical Outcome of Perforator Based Sural Artery and Propeller Flaps in Reconstruction of Soft Tissue of Extremities"}
{"_id":"fe1210b8-d376-90b8-7ea9-aabea923f90a","text":"Among the three adiposity indicators, WC had a better casual association with facial aging, which indicated that subcutaneous fat may present a major contribution in facial aging compared with visceral fat.","title":"Association between adiposity and facial aging: results from a Mendelian randomization study"}
{"_id":"fe1f3345-43f8-4b54-4006-6201c9f1e007","text":"The patient has been followed for osteopetrosis since childhood with a history of two fractures of the right and left femur following a minor trauma that was treated orthopedically.","title":"Surgical management of chronic osteomyelitis with benign osteopetrosis: A case report"}
{"_id":"fe21f7e3-8b89-bcaf-ed20-779f70b7ce3f","text":"As old and historic as anaphylaxis may sound and as clear as pathophysiology and treatment may look in the textbooks, it remains a challenge for the patients and the practicing physician.","title":"Anaphylaxis: Educational Programs Are Needed"}
{"_id":"fe247a03-a393-a699-f0d2-2adb86c0affb","text":"Fat embolism can be explained by 2 pathophysiologic mechanisms: the mechanical and biochemical theories.[ The mechanical theory suggests that obstruction of the pulmonary capillary beds occurs because of fat droplets released from the bone marrow into the venous system. The fat droplets travel through capillaries or arteriovenous shunts to the systemic vasculature. The mechanism is triggered by elevated intramedullary pressure following trauma. Occasionally, orthopedic procedures such as intramedullary nailing can increase the pressure and cause a second hit of FES. Alternatively, the biochemical theory proposes that trauma elevates inflammatory mediators and releases free fatty acids from the bone marrow into the venous system. Free fatty acids damage the endothelial cells of each organ and subsequently cause vasogenic edema and hemorrhage. This condition further promotes proinflammatory cytokine release and exacerbates inflammation.","title":"Use of venovenous extracorporeal membrane oxygenation for perioperative management of acute respiratory distress syndrome caused by fat embolism syndrome A case report and literature review"}
{"_id":"fe31c25c-49db-3f6d-a468-f8a928d2f871","text":"May et al reported their 13-year experience of 97 microvascular free tissue transfers in 96 patients with chronic traumatic bone wounds. 39 Ninety percent of these were in the lower limb and 83% flaps were muscle-based. The overall free tissue transfer success rate was 97.9%. At a mean of follow-up of 13 years, 95.8% of patients had complete wound closure without drainage, 89.6% ambulatory without assistance, and 5.2% subsequently underwent amputation. In our series of 76 single-stage reconstruction in the lower limbs of 73 patients, flap survival rate was 96%. 47 Eleven of 76 cases required emergency return to operation theater for flap salvage and one patient required secondary amputation due to failure of reconstruction. Sabino et al reviewed 395 flap procedures in traumatic war-related extremity reconstruction, including pedicled and free options. 57 They reported flap failures of 14 and 8% in the pedicled muscle and fasciocutaneous groups, respectively, and 12 and 3% for the free muscle and fasciocutaneous groups, respectively. However, flap choice was not randomized and hence outcome from these groups are not directly comparable.","title":"Management of Post-Traumatic Osteomyelitis in the Lower Limb: Current State of the Art"}
{"_id":"fe322bb1-a147-33a0-02c1-3a9d3904a95f","text":"A rapid intraoperative evaluation of sentinel lymph nodes (SLNs) for melanoma metastases during the interval between the SLN biopsy and the wide excision of the melanoma biopsy site may eliminate the need of an additional surgery for completion of regional lymphadenectomy.","title":"Optimization of an immunostaining protocol for the rapid intraoperative evaluation of melanoma sentinel lymph node imprint smears with the 'MCW melanoma cocktail'"}
{"_id":"fe3230cc-0990-5d23-7140-0f4efb6c5c3a","text":"A formal sample size calculation is not required for this external pilot study. At 12–18 months, the number of sites recruiting; proportion of eligible women that are approached and randomised; the number of women recruited per site per month will be reviewed and adherence to trial allocation will be reviewed. There are no plans to assess the feasibility of recruitment and randomisation in any specific patient subgroups. If the study has opened and is successfully recruiting at an acceptable number of sites with high adherence to treatment allocation and follow-up rates, a main trial will be considered feasible and parameters for the full study determined.","title":"Best-BRA (Is subpectoral or prepectoral implant placement best in immediate breast reconstruction?): a protocol for a pilot randomised controlled trial of subpectoral versus prepectoral immediate implant-based breast reconstruction in women following mastectomy"}
{"_id":"fe36a7fc-c331-44d7-82db-4eb99369fc0a","text":"Gastro esophageal reflux and a poorly coordinated swallowing mechanism can be suspected from the history of coughing episodes during feeding, as well as the development of recurrent aspiration pneumonias, which may lead to progressive lung damage and fibrosis.28 Preoperative chest radiographs may show evidence of pulmonary fibrosis and lung function tests would detect respiratory compromise; however, these are often impossible to perform due to poor patients' cooperation. Episodes of prolonged and recurrent oxygen desaturations during sleep indicate poor respiratory reserve. The reduction in the anteroposterior diameter of the chest secondary to thoracic lordosis can cause bronchial obstruction, which in conjunction with the decrease in lung volume due to the scoliosis will further impair gas exchange. Prolonged postoperative care in the intensive care unit (ICU) may be anticipated in selective patients even though prolonged ventilation post-surgery is rarely required. Placement of a tracheostomy postoperatively may be necessary in rare occasions to assist weaning the patient off the ventilator and aggressive pulmonary toilet can prevent the risk for chest infection. Preoperative tracheostomy is only indicated in children with complex upper airway abnormalities.","title":"Development and treatment of spinal deformity in patients with cerebral palsy"}
{"_id":"fe39b70e-e70e-857f-a2cc-920d8e182d5d","text":"Since the introduction of a microsurgical free flap for the reconstruction of a head and neck defect in 1976 a wide variety of free flaps have been described for the reconstruction of the head and neck region [8]. As since then many different free flaps have been shown to provide excellent reconstructive results free microvascular tissue transfer has become a popular method for repair of large head and neck defects [4,9]. Due to the robust blood supply free flaps improve outcomes of healing even under impaired soft and hard tissue conditions although free flap survival rate in secondary reconstruction is significantly lower than that in immediate reconstruction because of the limitation of available recipient vessels, significant scar formation and delayed wound healing due to irradiation [10].","title":"Ateriovenous subclavia-shunt for head and neck reconstruction"}
{"_id":"fe3f3b43-a371-f9c2-b4c3-b31a9a160880","text":"The success of the SHSFM observed here is likely due to the design of the matrix, which encourages cellular infiltration and neovascularization by replicating human extracellular matrix. Prior studies utilizing the SHSFM in post-Mohs defects have demonstrated minimal scarring and excellent aesthetic results. The SHSFM could be a viable alternative to flaps and grafts in elderly patients and may limit the risk of poor cosmetic outcomes and prolonged heal times seen with secondary intent alone.","title":"Utility of synthetic hybrid-scale fiber matrix in dermatologic wounds"}
{"_id":"fe4d5297-1b1a-4aa8-712d-c577a63dde83","text":"We hypothesize that sodium thiosulfate may have a role in stabilizing or improving calcinosis, and in diminishing pain and promoting revascularization of cutaneous ulcerations. A controlled study in order to determinate the safety and efficacy of this treatment in JDM is currently planned.","title":"PReS-FINAL-2013: Sodium thiosulfate for the treatment of Juvenile Dermatomyositis complicated by calcinosis"}
{"_id":"fe534f86-105c-3a5c-5dec-ac168aa007e2","text":"In conclusion, a profound variations had been observed among Iraqis in the pattern of facial nerve branching that have not been previously reported. It can be clearly seen that the results differ in different studies. The topography of the facial nerve during parotidectomy has always been a problem for surgeons due to unknown and unexpected differences in the patterns of the facial nerve branches. The main recommendation of present study was the familiarity with these common differences in facial anatomy provides the surgeon with useful information about accurate dissections, facial nerve preservation, and complete removal of the parotid gland neoplasm.","title":"New classification of branching pattern of facial nerve during parotidectomy: A cross sectional study"}
{"_id":"fe53bd28-b972-ebfb-f4e5-fc40bd8b47ce","text":"This observational study demonstrated that the DystoniaDiary app was perceived as useful and acceptable for a large proportion of this sample of patients with CD attending a botulinum toxin clinic. Patients with CD appear to be willing to regularly record symptom severity for at least the duration of a botulinum injection treatment cycle (12-16 weeks). This app may be useful in monitoring and optimizing individual patient responses to botulinum toxin injection.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"fe56d69b-498a-3e91-2e65-14a126b37b9d","text":"Seventy-nine German medical students in their 10th semester of education completed up to two days of training on the simulator during their ophthalmology clerkship. They received an objective numeric score based on simulator performance and completed pre and post training subjective questionnaires.","title":"Implementation of microsurgery simulation in an ophthalmology clerkship in Germany: a prospective, exploratory study"}
{"_id":"fe5e17ea-2e02-2d21-c59b-452990309f96","text":"The trunk is a less common site of loaSCC development, and the conventional repair with direct tissue approximation after extensive subcutaneous undermining is straightforward most of the time.","title":"Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review"}
{"_id":"fe6550a7-6633-4697-6053-18b73c6ac5af","text":"In practice, managing patients with severe dermatological disease following a diagnosis of malignancy is challenging. Available evidence to guide dermatologists in the management of these patients is significantly lacking. The British Association of Dermatology guidelines recommend oncology involvement in assisting with these decisions, as well as patient education on potential treatment risks, and the need for compliance with national cancer screening programmes.","title":"A retrospective review of the management of patients following a malignancy diagnosis on biologic therapies for the treatment of dermatological disorders"}
{"_id":"fe68cc44-edf4-769f-b63e-88ace52fb92c","text":"The duration and frequency of use of the app was variable. All patients recorded ratings of symptom control at least once. The median interval between first and last data input was 140 days and the median number of occasions where symptom score data were entered was 13. The median number of occasions where symptom score data were entered per week for each patient was 0.81 per week which was less than planned (2 per week). The duration and frequency of input of symptom control score data is illustrated in Figure 5 and summarized in Table 2. Some patients entered data very frequently throughout the observation period.","title":"A Bespoke Electronic Health Journal for Monitoring Response to Botulinum Toxin in Treatment of Cervical Dystonia: Open-Label Observational Study of User Experience"}
{"_id":"fe7a7c29-7cab-8970-840a-c4de42395ddd","text":"The accuracy of SLNB has been questioned following neoadjuvant chemotherapy. Chemotherapy may lead to fibrosis of the lymphatic duct leading to the sentinel lymph node and thus the blue dye or technetium molecule is directed to travel to other lymph nodes that are not the true sentinel nodes. In addition, the order of response of the nodes in the axilla is not known; the sentinel node may respond to treatment and become free of tumor, regardless of whether or not the other axillary nodes still harbor disease. This is of particular concern in patients with clinically node-positive disease who undergo chemotherapy before surgery. However, the sentinel node carries the highest tumor burden and one would argue that if there is no residual disease in the sentinel node then most likely disease has also been cleared from nodes with less tumor burden.","title":"Controversial Indications for Sentinel Lymph Node Biopsy in Breast Cancer Patients"}
{"_id":"fe7bc272-00f2-1ccf-d052-aa4454c046f4","text":"Even though fixation of long bone fractures is the most common cause of FES, prompt and adequate immobilisation of fractures may be very important in preventing the release of further adipose cells into the circulation. Tanton proposed that proper immobilisation of a fracture may help reduce the rates of FES as far back as 1914. A large Finnish trauma centre noticed a trend in decreased rates of FES following a change in policy to fix long bone fractures in the first days after injury. A prospective American study showed that long bone fracture fixation within 24 hours reduced rates of FES, as well as ARDS and pneumonia in patients fit enough for surgery. In fact, delayed fracture fixation has been shown to lead to longer ICU admissions. Pape’s 10-year retrospective study reported that early fracture fixation of a patient with co-existing chest injury led to increased incidence of FES, therefore he proposed that patients with chest injuries should undergo un-reamed intramedullary nailing. This contradicts Brundage’s findings, who concluded that delay of fixation surgery in patients with polytrauma was shown to lead to increased rates of FES as well as other complications and concluded that polytrauma is not a contraindication to early fixation, Pinney et al also shared similar findings.","title":"Fat Embolism Syndrome – A Qualitative Review of its Incidence, Presentation, Pathogenesis and Management"}
{"_id":"fe7c989c-6825-c056-a355-596175d73197","text":"Botulinum toxin injection at the EGJ has been used for achalasia treatment since 1994.27 The main effect of botulinum toxin is to block the release of acetylcholine which ultimately causes the temporary loss of muscle contraction. The main limitation of this treatment is its temporary efficacy, with a drop in symptom relief from 78% at one month to less than 40% after one year.28 Hence, botulinum toxin injection use is also limited to specific clinical situations such as a bridge therapy before an invasive procedure or for frail patients not candidates for more definitive therapies.29","title":"Achalasia: Insights into Diagnostic and Therapeutic Advances for an Ancient Disease"}
{"_id":"fe84a7c5-0a45-3367-a962-acc14c2e5209","text":"The initial MMS histopathology of the recurrent cases was reviewed and no errors or difficulty were noted with the processing or interpretation of the slides.","title":"Clinical Characteristics of Non-Melanoma Skin Cancers Recurring within 5 years after Mohs Micrographic Surgery: Single Institution Retrospective Chart Review"}
{"_id":"fe8e45fe-23d4-2510-3ef2-7628d27ed70f","text":"The choices of local flaps available for the distal third of the leg include the dorsalis pedis island,4 the extensor digitorum brevis muscle flap,5 the peroneal fascial flap,6 fasciocutaneous flaps based on the lateral calcaneal branch of peroneal artery7 or anterior perforating branch of peroneal artery,8 bipedal fasciocutaneous flap, distal flaps based on septocutaneous perforators of the posterior tibial9 or peroneal artery,10 and random fasciocutaneous flap.11 Propeller perforator flaps are a recent new option for small defects of the lower leg. However, they are associated with complications of total or partial flap loss from 5.5% to 11.6%.12 The choice and success of each of the aforementioned procedures depends on the anatomical and physiological variability of the individual patient. The degree of associated surrounding scarring and fibrosis often precludes safe use of some of the other local flap options, which occurred in this case and prompted the development of the split hemitibialis turndown muscle flap as an alternative flap. It also permitted us to avoid trying to develop a cutaneous or perforator flap surgery in a fibrotic and scarred region of the extremity resulting from the original traumatic crush injury. The flap described offers another alternative in selected cases.","title":"Split Hemianterior Tibialis Turndown Muscle Flap for Coverage of Distal Leg Wounds With Preservation of Function Gundlapalli et al"}
{"_id":"fe91090d-7bf9-6211-d065-1847a68b5d96","text":"The patient in the discussion had a significant infection following intramedullary nailing of the femur with collection of profuse necrotic materials. The surrounding muscle tissue was not healthy looking. There was no remarkable improvement with routine dressing even after repeated debridement. With the use of NPWT, the necrotic tissue load decreased significantly, and there was formation of granulation tissue and decrease in the size of the wound. Muscles turned red within five days of NWPT. The wound healed nicely with secondary sutures and without any further need of muscle or skin flap. It can be presumed that regular dressing might not have reduced the wound size and that would have warranted need of flap cover. NPWT has delivered appreciable results in terms of wound healing in this grossly contaminated and infected wound.","title":"Negative Pressure Wound Therapy Assisted Closure: An Effective Mode of Management for Infected and Contaminated Wound With Non-Union Fracture Femur"}
{"_id":"fe918d69-2164-0922-fa42-ddebbd225fea","text":"The DA surgeons were fellowship trained at one institution and extensively used a DA approach for primary THA. The DA surgeons in this study perform the surgery without a specialized table or intraoperative fluoroscopy. The PL surgeons were also fellowship trained at one institution and extensively used a PL approach for primary THA. Inclusion criteria included the first 100 patients of each fellowship-trained arthroplasty surgeon during their first year in practice undergoing primary THA. The surgeons exclusively used the respective approach emphasized in their fellowship for their first 100 cases. No crossover of approach to PL was found for complex primary THA among the DA group. All nonprimary THA, including conversion THA, was excluded from the study.","title":"Total Hip Arthroplasty Learning Curves Based on Approach for New Fellowship-trained Surgeons"}
{"_id":"fe920da7-971b-ef97-3d1c-9deb97b3503a","text":"The study does not have a placebo topical treatment arm to be able to detect an effect of vaccine on clearance in the absence of any topical treatment. While of scientific interest, this would have increased the size of the study, and make it harder to recruit given the current standard of care.","title":"Human papillomavirus infection: protocol for a randomised controlled trial of imiquimod cream (5%) versus podophyllotoxin cream (0.15%), in combination with quadrivalent human papillomavirus or control vaccination in the treatment and prevention of recurrence of anogenital warts (HIPvac trial)"}
{"_id":"fe94c4e3-074b-278f-d21a-97d24866b75e","text":"EBRT has also been recommended in patients with MTC or poorly differentiated thyroid cancer who are not suitable for RAI due to none or low avidity to 131I. Therefore, the role of EBRT in patients with DTC and MTC remains elusive.","title":"The role of external beam radiation therapy in the management of thyroid carcinomas: A retrospective study in Iran Cancer Institute"}
{"_id":"fe97c944-5dd0-00bd-419a-e7e54c119aeb","text":"Motor denervation with botulinum toxin in patients suffering of movement disorders or other pathologies, and in whom it was injected neurotoxin for cosmetic purposes, may still present proprioception and physiological alterations several months after the motor effects of the toxin have disappeared. Clinicians should keep in mind that the effects of botulinum toxin are sustainable and it induces alterations that are still present even after a complete motor recovery.","title":"Long-Term Effects of Botulinum Toxin Complex Type A Injection on Mechano- and Metabo-Sensitive Afferent Fibers Originating from Gastrocnemius Muscle"}
{"_id":"fea4eda3-4e5e-83ad-d2b8-c29bff9a9120","text":"In all patients the treatment was well tolerated, there were no adverse events matching the criteria of CTCAE. The lack of serious side effects may be caused by the interval between doses and the use of a protective infusion of amino acids before and after each treatment.","title":"Abstracts and short papers from the 5th Congress of the Polish Thyroid Association, Poznan, 3-5 September, 2015"}
{"_id":"febe401d-b965-cbaa-e138-70e65550743d","text":"The most common symptom attributed to ankyloglossia is difficulty breast feeding due to poor latch, inefficient milk extraction and\/or maternal nipple pain. During the past two decades, despite a declining birth rate, there has been a dramatic increase in the number of infants diagnosed with and treated for ankyloglossia in the United States, Canada and Australia. Despite a dramatic increase in the diagnosis and treatment of ankyloglossia in these countries, there remains no universally agreed upon definition of ankyloglossia and none of the published scoring systems have been rigorously validated. However ankyloglossia is defined, the majority of infants with ankyloglossia are asymptomatic. Perhaps, infants with ankyloglossia have a greater incidence of difficulty breast feeding. Lingual frenulotomy may decrease maternal pain and at least transiently improve the quality of breast feeding in some infants however no published studies take into account the fact that sucking and feeding are soothing to infants and the observed improvements immediately following frenulotomy may be a response to the pain associated with the procedure rather than a result of the procedure itself. While there are almost certainly some infants in whom tongue-tie interferes with breast-feeding, there is currently no good evidence lingual frenulotomy leads to longer duration of breast-feeding. Frenulotomy appears to be a generally safe procedure however there are reports of serious complications. Finally, there are no studies of long-term outcomes following frenulotomy during infancy and given traditional thinking that the lingual frenulum is a cord of connective tissue tethering the tongue to the floor of the mouth may be incorrect and the frenulum contains motor and sensory branches of the lingual nerve, the procedure may be less benign than previously thought.","title":"What is tongue-tie and does it interfere with breast-feeding? – a brief review"}
{"_id":"febf89e1-372d-5ea1-796f-c4847b22d613","text":"The strategy for reconstruction following near total and total glossectomy is different than for hemiglossectomy [78–81]. A bulkier flap is required to reconstruct the greater volume of resection and flaps such as the RAM or ALT are commonly used. Swallowing and speech outcomes are better when the flap can be made convex into the oral cavity. To do so, it is helpful to design the flap to be somewhat wider than the oral defect, at least 8 to 9 cm in most cases, anticipating some atrophy of the flap with time, particularly if postoperative radiation will be administered. Additionally, many surgeons believe that laryngeal suspension using permanent sutures between the hyoid bone and mandible helps to prevent prolapse of the flap and also improves functional results by elevating the larynx. Laryngeal suspension from the mandible is performed with permanent circumhyoid sutures placed through drill holes on both sides of the mentum.","title":"Reconstructive Surgery for Head and Neck Cancer Patients"}
{"_id":"fec2dc0f-d895-8a42-ffa5-fdcd3ace3847","text":"Ultrasound can be targeted to the area of a palpable abnormality in both the non-lactating and lactating breast. Location of the abnormality and simultaneous scanning should elucidate any distortion of the normal structures of the breast. When no abnormality is detected comparison to the opposite breast may be useful. Further investigation should be considered in the absence of ultrasound changes.","title":"Ultrasound imaging of the lactating breast: methodology and application"}
{"_id":"fec55e84-9b89-a97d-d53b-da2132dd1beb","text":"Table 2 Descriptive Variables for Groups by Experiencing Problems or Not","title":"Breastfeeding challenges and support in a high initiation population"}
{"_id":"fec696bf-26ba-fb87-6360-b5a5233a82a0","text":"The lack of data related to some variables and the absence of an optimal correlation between the dermoscopic and the anatomopathological examination constituted study limitations.","title":"Predictive factors of melanoma thickness"}
{"_id":"fecdc70a-0b40-9e03-88dd-b47a2d8a27e7","text":"1Mohammed Bin Rashid University for Medicine and Health Sciences, 2Mediclinic Welcare Hospital and 3Mediclinic City Hospital","title":"Sixth Annual Mediclinic Middle East Research Conference"}
{"_id":"fed1cbf1-4744-7bc8-ffce-f9ecf2a1910c","text":"To draw the profile of the main aesthetic-functional complaints reported by patients to be submitted to revision rhinoplasty and to correlate them with the internal and external objective nasal evaluation performed by the surgeon.","title":"Revision rhinoplasty: physician–patient aesthetic and functional evaluation Rinoplastia revisional - avaliação estética e funcional médico-paciente"}
{"_id":"fed7f8e0-8407-57aa-5393-05e953f341c3","text":"The Society of Skeletal Radiology (SSR) Practice Guidelines and Technical Standards Committee identified musculoskeletal infection as a topic for study and selected an ad hoc White Paper Committee; twelve SSR member musculoskeletal radiologists and one podiatric surgeon with expertise in diabetic foot infection, tasked with developing a consensus on nomenclature for musculoskeletal infection. Musculoskeletal radiologists on the panel were selected by the SSR Practice Guidelines and Technical Standards Committee based on prior musculoskeletal infection research or clinical experience and expertise in MRI for musculoskeletal infection. A musculoskeletal radiologist with longstanding expertise and an author of many of the original publications on MRI of musculoskeletal infection was selected as the senior author and committee chair. We limited our study to MR imaging, and limited scope to infection outside of the spine (but including the sacroiliac joints). A literature search and conference call determined the range of terms used; the committee was divided into six subgroups. Subgroup categories and assigned terms are outlined in Table 1.","title":"MRI nomenclature for musculoskeletal infection"}
{"_id":"fed8378f-2b9d-76cc-fd14-5e9ee83203a1","text":"When cryptococcosis manifested in the form of a soft tissue mass, it was mainly accompanied by invasion of the surrounding bone. Although the temporal relationship cannot be accurately determined, it is presumed that osteomyelitis preceded and extended to the surrounding soft tissue with or without pathological fractures to produce a soft tissue mass in the form of a cryptococcal abscess[; however, the presented Case 1 is an extremely rare case as the manifestation only occurred as intermuscular mass without invasion from a surrounding bone.","title":"Cryptococcal infection presenting as soft tissue abscess and arthritis Case report"}
{"_id":"feda664b-42fb-61dc-2f93-a565ec1c61e8","text":"The face of the American surgical workforce is changing rapidly. The value of having a workforce that reflects the diversity of the community served was well documented to be of benefit to the people of that community. Cultural competency improves the ability of the healthcare workforce, including surgeons, to meaningfully and empathically provide care to the patients they serve.","title":"Surgical leadership in changing times: the American College of Surgeons perspective"}
{"_id":"fedbe9d6-02f8-6857-6455-3280bddcae1e","text":"We have encountered several side effects during IT. The percentage of patients with a systemic reaction during incremental dosing is comparable to the EAACI multicenter study [19] although we did not pretreat our patients with antihistamines. The percentage of patients experiencing a SAR during incremental dosing is higher. One reason for this may due to the higher percentage of females in this study as the reaction rate to IT in females was higher than in males in this and the other study [19]. Our rush regime leads to a high accumulated dose on the fourth or fifth day. This was in another study [20] found to be a cause for serious reactions. We therefore planned to modify our IT schedule on day four and five to reduce the number of reactions. However, venoms are presently only available in depot extracts in Norway. The very few reactions during normal adequate venom maintenance dosing allows us to continue our practice of having the patients' local physicians continue the IT if they take the necessary precautions.","title":"Insect sting allergy. A study from 1980 to 2003 of patients who started treatment with venom immunotherapy between 1980 and 1998"}
{"_id":"fee2881c-ecae-8f3f-d935-b4581761b65f","text":"Discrepancies were found between what pharmacists claim to report to patients and what patients claim to have been reported by pharmacists, which is in accordance with our previous study, since most patients announced that they did not receive the reinforcement of the dosing instructions when they fill the prescriptions at the pharmacy [45].","title":"Knowledge and Practices of Community Pharmacists in Topical Dermatological Treatments"}
{"_id":"fee6741c-034e-0e2b-799f-4f0e77e982e0","text":"All patients of the Internal Medicine Department with a presumptive diagnosis of lymphoma on the basis of clinical presentation and imaging findings were referred to the Imaging Department for image-guided CNB. Before the CNB procedure, a review of all imaging and medical records was carried out with the medical staff to choose the most appropriate biopsy target. No patient with suspected lymphoma had fine-needle aspiration cytology before CNB. Informed consent for the procedure was obtained from each patient.","title":"Diagnostic precision of image-guided multisampling core needle biopsy of suspected lymphomas in a primary care hospital"}
{"_id":"fef0f1d7-4944-048e-0227-612edacbf415","text":"Should an adequate vascular bed not exist, acellular dermal matrices may be used to develop one before graft placement.8","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"fef1251b-b85f-d05d-7961-de41963f2dea","text":"Rotationplasty is a limb sparing surgical technique allowing the ankle to function as a knee joint. It is essentially an intercalary amputation of the knee joint with a 180° axial rotation of the distal limb and attachment to the proximal femur, .","title":"Modified Rotationplasty as a Composite Free Flap for Femur and Thigh Reconstruction"}
{"_id":"fef70804-e42c-f27a-c033-36535b6804f1","text":"These results confirm that the exposure of the skin of mice sensitized with T. nattereri venom triggers dermatitis with edema and subcutaneous infiltration of CD4 Th2 lymphocytes that drive leukocytes influx.","title":"Anaphylaxis induced by Thalassophryne nattereri venom in mice is an IgE\/IgG1-mediated, IL-4-dependent phenomenon"}
{"_id":"fef8ca91-a316-edc7-bb73-0f9dcde0798e","text":"Functional and cosmetic defects in the maxillofacial region are caused by various ailments and these defects are addressed according to their need. Simplicity of procedure, intact facial function and esthetic outcome with the least possible donor site morbidity are the minimum requirements of a good reconstruction. Oro-mandibular reconstruction, although a challenge for the head and neck reconstructive surgeon, is now reliable and highly successful with excellent long-term functional and aesthetic outcomes with the use of autogenous bone grafts. Reconstruction of trauma- or mandibular oncologic defects with bony free flaps is considered the gold standard. However the the optimal reconstruction of mandibular defects is still controversial in regards to reconstructive options which include the donor site selection and the timing of surgery. The purpose of this study was to determine the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstructions.","title":"Reconstruction of mandibular defects - clinical retrospective research over a 10-year period -"}
{"_id":"fefb5743-5c9e-91f3-c6bc-34875244f497","text":"Since the possibility exists that a Xolair injection may cause a generalized allergic reaction, we require that Xolair be administered at a facility equipped to treat you if you experience such a reaction. You will be observed up to two hours after each injection for the first three injections. The period of observation will be determined based on your physician's instructions. A doctor who can treat severe reactions to the drug will be available in the clinic during the time that you are present.","title":"Omalizumab: Practical considerations regarding the risk of anaphylaxis"}
{"_id":"feffcf10-1ee6-2181-ec08-ce609d6f0981","text":"To assess the risk profile for VTE in recently hospitalized clinical and surgical patients and evaluate the thromboprophylactic measures implemented in the first 24 hours of hospitalization.","title":"Evaluation of deep vein thrombosis prophylaxis in a general hospital"}
{"_id":"ff09306a-fcd6-538c-b9e3-eb53ad8fe48c","text":"Of our three recurrences, two were reported histologically as completely excised (supporting the practice of following up patients even if histological clearance has been confirmed), and both had undergone excision and direct closure on the same day. Had we waited for histological confirmation before reconstruction these two patients would not have had more tissue removed (due to the histology report) but would have had a second theatre visit for reconstruction. The third patient in the group declined further surgery in spite of a histology report showing that the tumour was incompletely excised. It was therefore likely that they would have a recurrence.","title":"Small margin (up to 2 mm) excision of periocular basal cell carcinomas in the setting of a one-stop clinic — long-term outcomes at a minimum of 11 years’ follow-up"}
{"_id":"ff21fdcf-24f4-f47c-d77c-4c7c5b60eec8","text":"This electron arc technique could be useful for treating skin cancer patients who have received prior radiotherapy in whom it is particularly important to minimize the radiation exposure of normal tissues of the irradiated arms and legs.","title":"Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi’s sarcoma in the distal extremities"}
{"_id":"ff27b503-7cc6-d471-570f-50a329e132cd","text":"While the current CFMS guidelines comprehensively focus on ethical and cultural dilemmas, guidelines for training in procedural or surgical skills are absent. While on an IME, students may be asked to perform procedures independently or with little supervision.4 This practice engenders greater risk of violating ethical principles.5 The amount of training required to ensure competence in a specific skill may vary amongst trainees. However, the practical and theoretical knowledge required to perform procedures at the home institution should not differ when a trainee goes abroad. Competence is defined broadly as the ability to safely care for patients in a knowledgeable manner whilst maintaining acceptable standards of professional behavior.10","title":"Procedural skills training for Canadian medical students participating in international electives"}
{"_id":"ff283079-c182-792c-ff21-0cbb8ff1dde7","text":"Chances of developing a PE or PDVT in patients with DDVT","title":"A Comprehensive Literature Review on the Management of Distal Deep Vein Thrombosis"}
{"_id":"ff2b4775-f04c-11ea-4237-597b37b8b6b8","text":"Severe spondylosis at more than 1 segment was an exclusion criterion in our study. This was not based on systematic radiographic analysis prior to inclusion. Therefore, it is possible that some patients not meeting the criteria for arthroplasty may have been included in the study. This may favor the fusion group. Future studies should allow inclusion of patients with signs of degeneration in more than 1 cervical spine segment.","title":"Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy A Randomized Clinical Trial Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy"}
{"_id":"ff2bba32-59f0-c9bf-dcde-30571afdfa7e","text":"In the last years, a lot of different methods and materials were used to find a proper alternative to autologous bone to treat osseous defects. The use of autologous bone is the preferred augmentation method and is therefore furthermore the gold standard.","title":"Eggshells as natural calcium carbonate source in combination with hyaluronan as beneficial additives for bone graft materials, an in vitro study"}
{"_id":"ff2bee8f-c8e7-b088-5085-462cfe11026e","text":"To date, breast conserving therapy has equivalent local control to mastectomy alone. However, it is not clear whether this finding is equally applied to young women because of the lack of large scale prospective randomized studies. In this study, we compared the local control between breast conserving therapy and mastectomy alone for young women with breast cancer. We found that young women who underwent breast conserving therapy had an approximately 2.5-fold increased risk of local recurrence compared with those receiving mastectomy alone. The prognosis of young women who had local recurrence after breast conserving therapy were poor despite the aggressive salvage treatments. Therefore, the development of more effective novel systemic treatments is required to improve treatment outcomes in young women with breast cancer receiving breast conserving therapy.","title":"Local Recurrence in Young Women with Breast Cancer: Breast Conserving Therapy vs. Mastectomy Alone"}
{"_id":"ff2c537a-2d96-7e11-ea1e-79f93d06a56b","text":"TFS was partitioned further into states with and without toxicity by introducing another end point: time to cessation of both ICI protocol therapy and toxicity. The end point was calculated as the sum of the time to ICI protocol therapy cessation plus the number of days after cessation with an event-defining toxicity. We used three alternative event definitions for toxicity: days with a grade 3 or higher TRAE that either was persisting from the ICI protocol therapy or was newly reported after ICI discontinuation but before subsequent therapy initiation; days with a grade 2 or higher TRAE; and days when systemic or topical immunomodulatory medication was used for a TRAE of any grade after the ICI protocol therapy had been discontinued, with the exclusion of immunomodulatory or thyroxine-like medication use as hormone replacement for pituitary and adrenal insufficiency.","title":"Treatment-Free Survival: A Novel Outcome Measure of the Effects of Immune Checkpoint Inhibition—A Pooled Analysis of Patients With Advanced Melanoma"}
{"_id":"ff39101f-b041-04e1-13b4-28a79ccca1ad","text":"Punch biopsy techniques are the gold standard for diagnosing non-melanoma skin cancers, though negative pathology reports do not necessarily rule out malignancy. This is because punch biopsy techniques are associated with false-negative rates, ranging from 6% to 19%.9–11 To minimize the risk of a false negative result, providers should ensure that the biopsy is 3 mm in width and deep enough to include the reticular dermis.6,7,9,12","title":"Treatment of Non-melanoma Skin Cancers in the Absence of Mohs Micrographic Surgery"}
{"_id":"ff41aced-73c4-1dd0-da1b-e89b0beb1b24","text":"Small pedicle flaps and even free strip grafts of donor scalp had been employed for decades for scar correction on the scalp and eyebrows and had a resurgence after 1975 largely due to the work of J. Juri in Buenos Aries.[6] His long scalp flaps eliminated the curious tufted appearance of a punch graft hairline, but they were still not always popular with patients. This was because of their higher failure rate and even when successful, the frontal hair growth was frequently unnatural in density and direction. In the current practice, the routine use of scalp flaps remains restricted to the hands of a select few individuals such as the Juri brothers in Argentina, Patrick Frechet in France and Mayer and Fleming in the USA.","title":"A Review of Modern Surgical Hair Restoration Techniques"}
{"_id":"ff42a8c5-1ec5-b5d2-def9-5447a5794c4c","text":"Despite the number of surgical advances and innovations in techniques over time, radical vulvectomy frequently results in substantial loss of tissue that cannot be primarily closed without tension, the mobilization of surrounding tissues or even the rotation of myocutaneous flaps 4. In fact, a large wound size, tension on the suture line, surgery close to contaminated areas and comorbidities, such as diabetes and obesity, may contribute to wound breakdown 5. All of these factors must be cautiously balanced before the primary closure of the wound. The utility of leaving the operative wound deliberately open for secondary healing is not well established. This is the reason for our pilot study. This procedure does not delay oncological treatment because our patients always receive chemotherapy and radiotherapy at the site of the vulva and lymph nodes at least 40 days after lymphadenectomy, when the healing of the lymphadenectomy is complete.","title":"Secondary healing strategy for difficult wound closure in invasive vulvar cancer: a pilot case-control study"}
{"_id":"ff457b5d-50cb-81e6-ccbc-c645e5eeabaf","text":"Specimens and slides were submitted to a specialized cutaneous pathologist. The pathology demonstrated atypical mononuclear and multinuclear cell proliferation with multifocal emperipolesis most consistent with RDD with extensive areas of expansive aggregates of histiocytes positive for S100 and CD68 consistent with RDD with sarcomatous features.","title":"Recurrent Cutaneous Rosai-Dorfman Disease"}
{"_id":"ff486f81-c964-b710-2845-0f2ef5011390","text":"Plain X-ray imaging of the hands was sufficient to confirm and assess the size and distribution of calcinosis in most of our cohort, although in five subjects the DECT showed better details due to significant flexion deformities or osteopenia in the presence of large and extensive calcinosis nearby. Figures 1, 2, and 3 compare representative DECT images with their plain radiographs of three subjects with significant hand deformities. Figures 1 and 2 were taken from two subjects with diffuse cutaneous scleroderma, both presented with increasingly painful flexion contractures of the hands. Their extensive calcinosis was confirmed incidentally by imaging. Figure 3 was a subject with limited cutaneous scleroderma and erosive arthritis, whose extensive joint destruction and bulky calcinosis were better demonstrated on DECT.","title":"Use of dual-energy computed tomography for the evaluation of calcinosis in patients with systemic sclerosis"}
{"_id":"ff4efc8e-3d1e-7817-5b93-9110305df47f","text":"Treatment efficacy was defined as a lack of enhancement of the treated lesion at one-month follow-up. Any tumor that showed residual vital tissue within this time point was considered to be a persistence. Primary treatment efficacy was calculated based on the number of persistent lesions after cryoablation. Secondary treatment efficacy was calculated after retreatment of these lesions. A recurrence was defined as an enhancing or enlarging soft tissue nodule in or around the ablation zone on cross-sectional imaging following a previously documented successful ablation.","title":"Percutaneous CT-Guided Renal Cryoablation: Technical Aspects, Safety, and Long-Term Oncological Outcomes in a Single Center"}
{"_id":"ff595ed2-8d54-9af8-76f1-89a50b391d1e","text":"This study provides the largest evaluation to date of common rapid review methods for study identification on a large corpus of systematic reviews, covering a wide range of clinical areas. We have been able to examine effects not only on the number of studies found but also on whether these change the results of the associated meta-analyses.","title":"Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study"}
{"_id":"ff5f8174-83a2-49e4-efe3-7376851ee663","text":"Topical medicines have been associated with poor adherence despite being considered the mainstay of dermatological treatments.","title":"Patient-Centric Design of Topical Dermatological Medicines"}
{"_id":"ff6e002f-b643-3fdd-7b9f-67c53d77da4a","text":"It is stated that ruptured popliteal artery aneurysms are best treated by ligation and continuity established preferably by autologous saphenous vein graft or by synthetic grafts when the patients have unsuitable veins. More recently this condition has been managed by percutaneous endovascular treatment in medically unfit patients [7].","title":"Deep vein thrombosis and pulmonary embolus associated with a ruptured popliteal aneurysm – a cautionary note"}
{"_id":"ff6f18da-d4f3-90ec-1a3d-66ea2bfca130","text":"MMS and WLE are both viable surgical options for managing DFSP of the breast. MMS could potentially minimize reconstructive needs due to smaller average defect size and result in fewer complications but may also result in asymmetry. Immediate flap reconstruction, especially in larger defects, can achieve excellent aesthetic outcomes for patients with DFSP of the breast without compromising detection of disease recurrence.","title":"Wide local excision, Mohs micrographic surgery, and reconstructive options for treatment of dermatofibrosarcoma protuberans of the breast: A retrospective case series from Mayo Clinic"}
{"_id":"ff700ee6-29ec-acd0-ac3c-e8a58a290bee","text":"In lateral pelvic exenteration adequate knowledge of the anatomy of the lumbosacral triangle, or triangle of Marcille, is eminent as it is the gateway for surgical exploration of the lateral compartment [53]. All important neurovascular structures as well as the ureter are located within the triangle or Marcille. The first step is to open the uretero-hypogastric fascia and mobilize the ureters, followed by dissection with or without ligation of the internal iliac vessels. The distal branches will need to be ligated individually and if possible the first dorsal branch at the internal iliac origin should be preserved to maximize wound healing in the buttock region. Incision of the piriformis fascia will expose the lumbosacral trunk and sacral nerve roots with piriformis muscle deeper to nerves. As mentioned, the sciatic nerve can be sacrificed to obtain R0 resection if involved.","title":"Understanding the Philosophy, Anatomy, and Surgery of the Extra-TME Plane of Locally Advanced and Locally Recurrent Rectal Cancer; Single Institution Experience with International Benchmarking"}
{"_id":"ff7270f1-a01f-49f3-f1b6-8e257bd8ff9a","text":"In this research, we proposed a new enhanced three-dimensional visual reconstruction technology-enhanced nonuniform rational basis spline (ENURBS) combined with virtual surgical planning of CTA images on precise resection of liver cancer in hepatobiliary surgery. The first focus of this work is to reconstruct the 2D CTA images of liver cancer into 3D reconstructed model using the ENURBS algorithm for efficient visualization and diagnosis of liver cancer. The second goal is to plan the surgical methods using VSP based on the 3D reconstructed liver model for precise liver resection. The performance of this approach is compared with that of 2D images.","title":"Influence of Three-Dimensional Visual Reconstruction Technology Combined with Virtual Surgical Planning of CTA Images on Precise Resection of Liver Cancer in Hepatobiliary Surgery"}
{"_id":"ff73b85e-d514-47f5-c543-f9a3100ecb69","text":"The learning points from our case are presented in Table 1.","title":"Primary osteogenic sarcoma of the breast: A case report"}
{"_id":"ff750663-157c-5dad-99e9-4a52658abad3","text":"The above results were utilized to build a nomogram in order to ease the practical implementation of our prognostic model, which might improve treatment personalization.","title":"The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)"}
{"_id":"ff8546b1-76dc-35aa-6bc9-cc64aaea91be","text":"In the sequential treatment of chronic osteomyelitis of the lower extremity with soft tissue defects, the use of NPWT to cover flap closed-incisions after the implantation of 3D-printed prostheses can effectively reduce the occurrence of related major complications and improve patient satisfaction. This approach promotes the recovery of lower limb function and daily activity, ultimately improving the overall success rate of sequential treatment for chronic osteomyelitis with soft tissue defects.","title":"Negative pressure wound therapy for flap closed-incisions after 3D-printed prosthesis implantation in patients with chronic osteomyelitis with soft tissue defects"}
{"_id":"ff92a5ed-df57-1d00-c5d9-14c22fe7dd7b","text":"No early or late complications were observed in either patient with no local recurrence after 18 months of follow-up. The donor area could be closed primarily in both cases and the flaps survived completely.","title":"Half forehead reconstruction with a single rotational scalp flap for dermatofibrosarcoma protuberans treatment"}
{"_id":"ff976977-8b17-f7f9-2422-da53d74082bb","text":"WBC appears to be a useful method of atherosclerosis prevention in AS patients.","title":"Whole-Body Cryotherapy Decreases the Levels of Inflammatory, Oxidative Stress, and Atherosclerosis Plaque Markers in Male Patients with Active-Phase Ankylosing Spondylitis in the Absence of Classical Cardiovascular Risk Factors"}
{"_id":"ff98aeda-f89f-91fb-5fd1-468ed09841cf","text":"A summary of the data relating to antibiotics with bacterial cell wall disruption as a mode of action is shown in Table 3.","title":"Can intracellular Staphylococcus aureus in osteomyelitis be treated using current antibiotics? A systematic review and narrative synthesis"}
{"_id":"ff99323a-a354-d104-3820-29ef6389107b","text":"Reconstructing the defect after curettage can be quite challenging. In case the gap left behind after the curettage is small and does not jeopardize the structural integrity of the bone it can be left alone and the cavities fill up with blood clot which then gets ossified to form bone.15 For larger defects the traditional methods of reconstruction have been cementation or use of bone graft with each method having its advantages and disadvantages.","title":"Treatment of giant cell tumor of bone: Current concepts"}
{"_id":"ffa9683f-bfbc-b49b-a5b6-f2b254a695de","text":"Only case series and cases reports were discovered during the literature search. We reviewed the selected cases and included those that fulfilled at least one of the following criteria:","title":"Pulmonary Fat Embolism Following Liposuction and Fat Grafting: A Review of Published Cases"}
{"_id":"ffb32c49-afce-2f50-583e-3b2bf552ab20","text":"Specific detection of melanin can be useful in intraoperative photoacoustic imaging of an excised sentinel node. This would permit an immediate node dissection if metastatic foci are demonstrated and would obviate the need for a second operation. Perhaps the sentinel node could even be analyzed in vivo. A penetration depth of 2 cm in the absence of melanin deposits enables the analysis of the entire nodal volume. This is in contrast with the conventional pathology evaluation that samples less than 0.1% of a node.","title":"Detection of Melanoma Metastases in Resected Human Lymph Nodes by Noninvasive Multispectral Photoacoustic Imaging"}
{"_id":"ffb52ead-8927-c779-5675-a52ed380b7cf","text":"Primary flap reconstruction after sarcoma surgery satisfies oncologic goals. Large tumors in difficult areas can be removed and complete tumor resection achieved. Our findings indicate a high survival rate after sarcoma surgery utilizing flap reconstruction and a low recurrence rate.","title":"Primary flap reconstruction of tissue defects after sarcoma surgery enables curative treatment with acceptable functional results: a 7-year review"}
{"_id":"ffbf816f-ec6a-777e-ed72-681b43f456e3","text":"In our study the use of DBS in Mohs surgery is extended to varying sizes of head tumors over a period of 18 months and a total of 170 cases treated. DBS is found to be highly effective in harvesting uniform strips of tissue in all cases. DBS's ease of use allows less experienced surgeons to thoroughly excise the peripheral tissue strips needed for the histological evaluation, minimizing the operation error. In the hands of a more experienced surgeon, DBS is timesaving, a value mostly appreciated in hospitals with long lists for Mohs surgery.","title":"Double-Bladed Scalpel in Mohs Micrographic Surgery"}
{"_id":"ffcec57f-d88e-ed02-1759-97c4625ead85","text":"Benign adverse events were reported to occur commonly in adults and children. Predictive factors for risk are unclear, but for neck pain patients might include higher levels of neck disability or cervical manipulation. In neck pain patients benign adverse events may result in poorer short term, but not long term outcomes.","title":"What are the risks of manual treatment of the spine? A scoping review for clinicians"}
{"_id":"ffd5bf3d-1aa9-ef1c-a606-5c11e078cf6f","text":"Three veins required shifting of the heel position of the flap vein to avoid kinking. Trimming of venous cusps was performed in six veins because of the presence of venous valves at the anastomotic site. Four anastomoses needed additional stitches to control blood leakage at the anastomotic site, but all leakage was easily controlled by tightening the suture around the bleeding site and tying the loosened suture with additional stitches.","title":"Efficacy of the microscopic parachute end-to-side technique for creating large-to-small venous anastomoses in free flaps in the extremities"}
{"_id":"ffdab1ba-f386-2b30-2f72-8d3b8e8ccc36","text":"The introduction of a VTE risk-stratification tool within the EHR resulted in a significant decrease in VTE events across all surgical patients and among the general surgery patient subgroup in the 5-year period after implementation. This study demonstrates applicable benefit of the VTE stratification tool across all surgical and surgical subspecialty departments by standardizing individual patient risk assessment and VTE prophylaxis prescription on admission.","title":"Electronic health record risk-stratification tool reduces venous thromboembolism events in surgical patients"}
{"_id":"ffddfb41-88d3-6b2c-9683-1655f4d64651","text":"The apparent lack of a significant change from baseline in measures of popliteal vein blood flow or vein diameter with the GCS intervention does not necessarily indicate a lack of physiological effect, as blood flow progressively decreases and vein diameter increases over time with sitting [20]. It is probable that the GCS prevented these physiological changes that would have occurred in the model of venous stasis secondary to prolonged seated immobility. The GCS did prevent the increase in calf circumference which occurred with prolonged sitting with the MMC.","title":"Efficacy of Micromobile Foot Compression Device in Increasing Lower Limb Venous Blood Flow"}
{"_id":"ffe094be-af68-21e9-eb1d-eb78558c8373","text":"There is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons.","title":"How do specialist surgeons treat the atrophic tooth gap? A vignette-based study among maxillofacial and oral surgeons"}
{"_id":"ffe34cbf-bf20-e813-abce-8d9a866cbde8","text":"Both platysma and submental flap techniques can be used for the reconstruction of complex facial defects with the acceptable functional outcomes. The platysma flap can be harvested to medium size defects up to 70cm2. The submental flap is simpler, faster with a wide arc rotation can be used in different ranges of head and neck defects with better functional outcomes. However, it should be used cautiously in patients with advanced nodal diseases.","title":"Submental versus platysma flap for the reconstruction of complex facial defects following resection of head and neck tumors"}
{"_id":"ffe99e9c-cd9a-53b7-bbb9-02360a06c23e","text":"A review of the literature regarding these applications in oculoplastic reconstruction.","title":"The use of the paramedian forehead flap alone or in combination with other techniques in the reconstruction of periocular defects and orbital exenterations"}
{"_id":"fff4587a-06cc-a65b-1cec-c88dfb22d193","text":"Immunotherapy outcomes from small studies have provided supporting data for increasing survival rates at yearly intervals in mucosal melanomas of the head and neck.","title":"Immunotherapy as a treatment modality for mucosal melanoma of the head and neck: A systematic review"}
{"_id":"fff47928-de84-5b68-c07d-9ed8a41e8fc4","text":"This study describes two successful cases where a patient specific reconstruction plate and lower jaw surgical guides were designed based on 3D MRI models. A prospective clinical trial must be performed to support the added value of the current 3D planning workflow in terms of improved resection margin planning, since evaluation of free bone margins is not included in this study. Besides evaluation of free bone margins, the prospective clinical trial can include cost comparison.","title":"Optimisation of three-dimensional lower jaw resection margin planning using a novel Black Bone magnetic resonance imaging protocol"}
{"_id":"fff6745f-72dc-3ace-0f0c-798ca54a6005","text":"It would be very useful to have an accurate predictor of recurrence of VTE to decide which patients with a first episode of unprovoked proximal DVT or PE would be most likely to benefit from long term oral anticoagulation, and also which patients should only receive short term therapy.","title":"Trial Protocol: A randomised controlled trial of extended anticoagulation treatment versus routine anticoagulation treatment for the prevention of recurrent VTE and post thrombotic syndrome in patients being treated for a first episode of unprovoked VTE (The ExACT Study)"}
{"_id":"fffa473e-f73d-686d-15e1-f3e161f50df3","text":"Subgroup analyses of patients with iliac LND will be conducted as removal of these more proximal and deeper lymph nodes require extensive surgery beyond the inguinal boundary. Patients requiring this additional surgery may be at an increased risk of additional morbidity such as lymphedema, and recurrence.","title":"Prevention of seroma following inguinal lymph node dissection with prophylactic, incisional, negative-pressure wound therapy (SEROMA trial): study protocol for a randomized controlled trial"}